James Talarico, the newest US senator from Texas, did not wake for 36 hours after a medical emergency that began on the campaign trail. He was diagnosed with Type 1 diabetes, a chronic condition with no cure.

'I was lucky to be alive. The nurses and the doctors in Williamson County saved my life,' Talarico said at a town hall. He described himself as perfectly healthy before the crisis.

A Walk That Turned Dangerous

In 2018, during his first run for the Texas House of Representatives, Talarico decided to walk the entire length of his legislative district. He covered the 25-mile route on foot in one day, in the Texas heat.

He was not worried about his ability to complete the walk because he hiked in Big Bend National Park every year and the route was comparatively flat. Halfway through, he felt fatigued and nauseous and threw up a couple of times.

He finished the walk, went home and assumed he was dehydrated and needed a good night's sleep. Instead, he did not wake for a full 36 hours, and his family took him to the emergency room, where nurses tested his blood sugar.

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A Blood Sugar Reading of 900

A normal fasting blood glucose level is generally below 100 mg/dL. Talarico said his reading was 900 mg/dL. The CDC advises people with diabetes to seek emergency care if their blood sugar remains at 300 mg/dL or above.

'I was in a state of diabetic ketoacidosis, which leads to coma and death without insulin.' The Type 1 diabetes diagnosis came on the spot.

Diabetic ketoacidosis, or DKA, can be life-threatening. Without enough insulin, the body burns fat instead of glucose, flooding the system with acidic chemicals called ketones.

Too many ketones make the blood acidic, causing vomiting and abdominal pain. If acidity keeps rising, DKA can cause falling blood pressure, coma and death. It usually develops slowly, but it can all happen in a few hours.

Signs of DKA include nausea, vomiting, headache, muscle aches, being very tired, fruity-smelling breath and fast, deep breathing. Talarico's fatigue, nausea and vomiting on the walk match several of them.

What Causes Type 1 Diabetes

Diabetes is a disease in which the body does not make enough insulin or cannot use it properly. In Type 1, Mayo Clinic says, the pancreas makes little or no insulin.

Type 1 typically starts in childhood, but it can develop in adults. Cases peak in children aged four to seven and again between 10 and 14. The exact cause is unknown, though the immune system usually destroys the insulin-producing islet cells in the pancreas.

Genetics and exposure to viruses are other possible causes. Having a parent or sibling with Type 1 diabetes slightly raises the risk. There is no known way to prevent the disease, though researchers are working on it.

Type 1 symptoms can appear suddenly, including increased thirst, frequent urination, hunger, weight loss, irritability, fatigue and blurry vision. DKA is sometimes the first noticeable sign in people not yet diagnosed.

Treatment and Daily Management

In hospital, people with DKA receive IV fluids for dehydration and insulin to lower blood sugar. Treatment is also likely to include replacing electrolytes and treating any underlying illness.

People with Type 1 diabetes need insulin therapy to stay healthy because it replaces the insulin the body does not make. It can be given by shots, pens, a pump or, for some people, an inhaler.

Type 1 diabetes has no cure, despite extensive research. Still, it is considered a chronic, manageable condition, and people with it track their blood sugar and use medication, insulin therapy, diet and exercise to regulate it.

For Talarico, the road to managing the disease began in an emergency room. DKA was the first sign anything was wrong.

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Frequently Asked Questions

  • What is Type 1 diabetes?
    Type 1 diabetes is a chronic condition where the pancreas produces little or no insulin.
  • What causes diabetic ketoacidosis?
    Diabetic ketoacidosis occurs when the body produces high levels of blood acids called ketones due to insufficient insulin.
  • How is Type 1 diabetes managed?
    Type 1 diabetes is managed through insulin therapy, regular blood sugar monitoring, diet, and exercise.
  • Can Type 1 diabetes be cured?
    Currently, there is no cure for Type 1 diabetes, but it can be managed effectively with proper treatment.