T1Dto100: So, tell us what happened:

Jim: Three months into retirement, I was commuting on my bike to the adult retreat of T1D United, the T1D community that I belong to in the Pacific Northwest, on April 20th, 2024, when the accident happened. I was about half a mile from the retreat location when I was hit by a pickup truck. I was knocked out briefly and suffered nine rib fractures, four pelvic fractures, and a broken left collarbone.

I was lucky that the woman who hit me stayed at the scene, which helped once the ambulance arrived. I was entirely in the right as a cyclist on the road riding in the very wide shoulder, and she just hit me from behind.

Ironically, the first words out of my mouth were, “Oh no, I’ve got to cancel my hotel reservation!”

I was transported to the hospital by ambulance. I didn’t really think about my T1D that much. Of course, I told the paramedic on the scene that I had type 1 diabetes and was wearing a pump. My phone was smashed; it had fallen on the road and cars had driven over it. So, Loop was no longer working.

At the time, none of my injuries were going to require surgery, which was great news, but I had no idea what I was going to do about my diabetes.

I don’t remember much about the ER; they were giving me pain meds. And they were doing finger sticks to check my sugar. Without my phone, there was no immediate way to read the CGM that was still on my body.

Later that day I was transferred to a Trauma Center in Seattle. That’s where I finally saw my family.

I was luckily awake and doing okay while waiting for a room, and it was there that my children brought me my Dexcom receiver and Omnipod PDM. Like many of us, my children have never been much involved in my T1D other than knowing to ask what my number was if I was acting weird!

With a smashed phone, I had no way to run the DIY Loop algorithm. I couldn’t really use my left arm because of the broken clavicle. But the family brought some supplies. So right there in the ER, they learned how to put a pump on me. And I was able to connect the CGM to the receiver.

T1Dto100.com: That sounds like a terrifying experience! How long were you hospitalized? What happened with your diabetes care during your stay there?

Jim: I was there for six nights. After that initial time, I was mostly able to manage my diabetes myself. However, this experience made me want to follow the instructions on the T1Dto100.com website and write up a set of instructions so that I can get support if I am unconscious.

Once I got into a room, I was missing my Loop system but was able to manage with the pump and the CGM in manual mode. I was fortunate that my hospital care team was open to me doing all I could for myself, and to me continuing to use my devices.

From day one, the hospital was willing to let me manage my diabetes, but they insisted on finger sticks before meals. And so, the nurse would come in before a meal and do a fingerstick, then give me that number and ask how much insulin I was going to give myself. I’d tell her, and she would leave, and all was good. And then I would watch my sugar.

Later, if I needed more insulin, I would simply adjust it myself. It worked well. But it was hard to control being back in a manual situation, and my diet was kind of strange.

In fact, I was on their “diabetic diet.” These days, ordering a meal at the hospital is all electronic. But at one meal, I remember, I was going to order my wife a little something, too, since she was visiting at mealtime. When I placed that order, the system said I had reached my carb limit for that meal. I didn’t even know I had a carb limit, and they would not let me order anything else!

It was a very slow recovery. I just needed to start learning how to walk again and get up and start moving.

T1Dto100.com: What happened when you got home?

Jim: My family had ordered a hospital bed, so I lived in the living room and slept in that bed for three months. I was able to immediately get back on Loop as I had an old iPhone SE that was still working. My computer, which had also been damaged in the accident, was working enough so that I could build Loop onto that old phone.

Getting back on Loop that quickly was a godsend! I think the hardest thing about my T1D during my recovery was not so much blood sugar control, because, once Loop was running, I could see what was going on. And it wasn’t the drugs I was taking – I was mainly on Extra Strength Tylenol. It was the device changes!

I only had one working arm, and so I heavily relied on my thighs for my pumps. And I used the right arm for my CGMs. It was a challenge!

From this point on, my recovery is not really a T1D story. It’s just about having trauma and getting through massive amounts of PT and getting better. And I was fortunate that I didn’t have more permanent injuries.

T1D 10 100: Tell us a little bit of your general T1D background:

Jim: I was diagnosed as an adult at the age of 39 in October 1995.

I was doing my annual physical to keep my North Carolina nursing license up to date. And a physician assistant asked, “Do you have diabetes?” He said that I had glucose in my urine. And so, they did a blood draw, and my sugar was about 300. I was pretty much in denial because I thought I was really quite healthy, and there’s no way I would ever get diabetes. Looking back, though, I did have the classic elevated glucose symptoms for several months and just did not connect the dots. I was treated as a type 2 for about a year until I was down to about 150 pounds with continued elevated sugars.

My endo finally said, “We think you’re a type 1 and let’s start you on insulin.” So, I started on regular insulin and NPH, which made me feel immediately better. I had no T1D in any part of my family that I knew of.

About a year after I started taking insulin, we moved to Seattle. There, I got connected with the Joslin Clinic, and I began to take managing my diabetes much more seriously.

I do have a clinical background – I’m a former critical care nurse. So, doing finger sticks and giving myself shots was never really a big problem for me. I feel fortunate about that.

But it’s funny, despite that background, I never really dug into researching how best to manage my T1D. I don’t know why I didn’t do that. I just had type 1 diabetes, and I kind of dealt with it. I think probably a lot of us were like that at that time.

I remained on Multiple Daily Injections (MDI) until 2017.

T1Dto100.com: When and how did you find a T1D Community to share your experiences with?

Up until 2016, I wasn’t part of any kind of community.

My endocrinologist had a diabetes group conference call. However, it was primarily focused on Type 2. There were hardly any type 1s on it. I remember the classes and the exchange diet.

There was a local community called ConnecT1D, which had their first adult retreat in 2016. And that’s where I realized there was a community of people like me out there.

It’s a local Pacific Northwest community that has since transformed into T1 United. It’s a great organization that also supports diabetes camps for children and families. Their adult retreats include two days with knowledgeable speakers, informative breakout sessions, and fun. I was headed to one of those retreats when I had my accident!

The most valuable part of these gatherings was just being able to connect, sit at a table, and talk with others who share what I was experiencing. That was an eye-opening experience, sitting in a room full of people with Dexcom alarms going off. Having never been on a CGM, I said, “Well, I’ve got to get one of those.”

T1Dto100.com: How did your diabetes care evolve after that?

Jim: At the time, I was under the care of a rather old-school, yet knowledgeable, endocrinologist who never talked to me about various technology options. So, I called the Dexcom rep and let them do the heavy lifting. I let another year pass before switching to the Omnipod Eros, after being connected with a wonderful Certified Diabetes Educator and a new endocrinologist who both encouraged me to do so.

My time on the Omnipod Eros was short-lived when I stumbled upon the Medtronic G670 trial at the University of Washington in 2018. I have always enjoyed participating in clinical trials – especially device trials – so I did that for about 14 months.

After picking up serious road cycling in 2015, I rode in a couple of JDRF (Breakthrough T1D) rides. In 2016, I did the Tucson Century. And then in 2018, I did the Death Valley ride wearing that Medtronic G670, and it did a pretty good job. But I’m not a tube pump kind of guy. As soon as the study ended, I went back on the Omnipod while learning about a device called Loop and the community that supports it.

At the 2019 TCOYD One Conference, I saw Katie DeSimone in a breakout group discussing the DIY (Do-It-Yourself) Loop community. I was sold! So, in 2019, I started Looping.

Not long after that, I became part of the Omnipod Horizon clinical trial – the system that later evolved into the Omnipod 5. I was on that for much longer than I had anticipated because of the pandemic. It took a lot of work, but I had pretty good results with the Omnipod 5. And then, finally, I went back on Loop and have never looked back. I so love and appreciate the volunteer DIY community.

Because I enjoy bright shiny objects, I recently changed to TRIO, another DIY algorithm, and I’m impressed. Though my TIR (Time in Range) is very similar to Loop, I am seeing fewer lows.

T1Dto100.com: When did you first start thinking about the issues of aging with T1D?

Jim: I’ve consistently attended these local adult retreat events. At the 2021 event, there was a session called “Diabetes After Dark,” where folks could talk about just about anything related to T1D, including special needs and concerns. As one of the oldest T1Ds at the retreat, I mentioned how T1D seniors have special needs that are often overlooked. From that comment and the lively discussion and interest that followed, I committed to starting a senior group where we can discuss topics that don’t arise in a group with younger adults.

That led to a monthly Zoom call that I lead up in the Pacific Northwest, with some folks from other places, where we talk about aging with type one diabetes. It’s informal – we just meet and chat.

That’s been going on since late 2021. We have folks living with T1D ranging from over 60 years to those in their 70s who were recently diagnosed.

T1Dto100: So now that you have recovered from your accident, you are back to biking?

Jim: I am. I will say one thing about aging and getting hurt like that: we heal more slowly. I was quite active before the accident – biking, walking, and going to the gym. Remaining active has always been an essential part of my approach to aging gracefully, not to mention maintaining those stubborn highs. I remember lying in the emergency room, thinking about the Breakthrough T1D ride I had signed up for later that year in October. Doing the math, I actually thought I would be healed enough to do that ride. NOT! However, as soon as I could after the accident, I started walking while at the same time doing tons of PT. Now I am gratefully back to biking, though my pace has slowed. My hope is to ride through the winter and then join back in to some group rides in the spring.

T1Dto100.com: Finally, what are some things you would tell people about preparedness for emergencies as a T1D having gone through this experience with your accident?

Jim: I always heard it said in the Loop community, “Have a backup phone with you.” That would have made life MUCH easier! So that immediately comes to mind.

Also, put together a Go Bag. When I was hit, I had a couple of back-up pods with me and a spare CGM sensor as well as some syringes and insulin. But I had no backup devices with me for reading my CGM and running my pump. I didn’t even have those in a ready-to-go location at home that my family could easily find. They had to dig through my supply closet to find the Omnipod PDM and the Dexcom receiver. Just having had that receiver with me would have been a huge help.

Joanne Milo always talks about having a diabetes advocate – someone who knows your treatment regimen and the equipment you use. Someone who really understands what you are doing and can talk to the medical team with your family. I agree!

Luckily, I was conscious, but having to teach people how to put things on you while you’re in pain and quite freaked out is a challenge. My family was stellar and so supportive of me. My daughter’s a hospice social worker. So, she played a key role in hospital discharge planning.

I know that having written instructions for my devices and therapy available would have helped my family better advocate for me. Though I haven’t done this, as we age, we need to begin involving our spouses and/or others close to us in what we are doing daily to manage living with T1D.

Just as important from an emotional perspective, you’ve got to be patient and let time do its healing. As a patient in the hospital, please understand that the staff will have protocols that may differ from what you are accustomed to. Definitely stand your ground in what you need, but also try to meet them where they are. After all, they are just trying to do their jobs.

Ultimately, I believe that in both challenging and easy times, it is essential to cultivate gratitude. Being the most traumatic thing that had ever happened to me, it was easy to get discouraged during the acute phase of my recovery. I had some days when I would throw myself huge pity parties. That’s certainly to be expected. But I also realized how much worse it could have been, including having permanent disabilities. Luckily, I was recovering while many people with similar accidents don’t. I learned to be grateful for what I could do each day and for what I would be able to do again in the future.

So, lean into gratitude – a little each day – for wherever you are in life!

For more about the many ways you can be prepared as a T1D, see the Are You Prepared section of this website.

Interview with Jim Cheairs by Barb Giammona, T1Dto100.com