Details the final Capstone project for MDS 495. Purpose of the project was to start a support group for military members who are Type 1 Diabetics (late onset)

Robarge, David C.

English

Boise State University - ScholarWorks

Boise State University ScholarWorks MDS/BAS 495 Undergraduate Capstone Projects Student Research Fall 2021 Stronger Together: Type 1 Diabetes & Military Personnel David C. Robarge Boise State University 1 Stronger Together: Type 1 Diabetes & Military Personnel   Final Capstone Submission Professional Action Paper       David C Robarge Multidisciplinary Studies, Boise State University MDS 495: Capstone Project Instructors: Margaret Sass, Johnny Rowing and Christy Bowman 28 November  2021                      2    As my college undergraduate work begins to wind down with the completion of my degree in Multidisciplinary Studies, I felt compelled to select a powerful capstone project to finish off with. There were numerous ideas I generated that provided possibilities, but only one that I truly felt impassioned about. Since returning to college in 2019, I had always tried to minimize the amount I talked or shared with others about my then recent diagnosis of type 1 diabetes. I didn’t want that to be my sole defining feature similar to how I tried to withhold my military background. With this being the final semester, I decided that it would absolutely be appropriate and timely to create a final project that incorporated not only my diagnosis, but all of the knowledge that I have been able to gain as a result of the help of so many. The next step became narrowing down the timeframe, audience and determining what I hoped to accomplish.   For those unfamiliar with Type 1 Diabetes, Bullard (2018) describes it as a result of “...the autoimmune destruction of the pancreas’s beta cells, which produce insulin. Persons with type 1 diabetes require insulin for survival; insulin may be given as a daily shot or continuously with an insulin pump.” To simplify that further, a type 1 diabetic (or T1D), cannot regulate the amount of sugars in their body which can lead to highs or lows ultimately resulting in severe medical conditions and/or death. The only means to prevent this is strict adherence to management of the condition including administering insulin into the body. Since being diagnosed, I had aggressively and rapidly found successful ways to manage the condition. With the help of dozens of personnel inside my organization, medical experts, and legal counsel I was granted a full return to duty (which is still believed to be unprecedented across my entire branch of service for someone in my profession). Throughout my own struggles and challenges I faced during the process, there was one thing I craved and wished I could’ve had - support from 3 another military member who had gone through the same process. With my capstone project, I sought out to change this for others.   Knowing first hand the experiences that service members would be going through, I decided on planning an event coordinated through our local installation’s diabetes educator. My plan was to first seek approval and endorsement from the medical specialist we all worked with, Mr. Jon Cucura, and brainstorm ideas with him about the best way to hold such a function. He was immediately receptive to the idea and allowed me to share the scope of what I hoped to accomplish: to bring military members together to support one another through the process of living as a type 1 diabetic. I began by sharing different approaches to bringing people together such as gathering for lunch, coffee before work, or a trail run. What I finally decided on was holding an initial face to face luncheon at a local restaurant that would hopefully allow for people to get to know one another in a non-intimidating environment.   Some of the things I wanted to share and talk about was the reality we all live - constantly being cognizant of our bodies blood glucose levels for one - and provide insights into what we’ve found works for each of us. In Could Age, Sex, and Physical Fitness Affect Blood Glucose Response to Exercise in Type 1 Diabetics? (2018), it mentions how blood glucose levels can remain out of range up to several hours after physical activity has ended (Yardley). While data such as this may leave the common reader scratching their head, this is vital to someone who needs to keep their glucose levels in an optimum range. If I was to ask a fellow well managed diabetic how they handle their levels after a workout, they’d immediately have an answer of what’s worked, what hasn’t, and instances when they’ve done everything right...and it still hasn’t worked and what they did to correct it. These were the sort of conversations I wanted to generate amongst my professional peers who I had yet to meet or exchange with.  4  After my initial planning was conducted for the event, I immediately thought about what I wanted to accomplish; did I just want to complete a capstone project or did I want to create a continuing community that would long endure a simple college semester? I knew I wanted something more than a passing grade and my diploma. Having been the byproduct of dozens of people who fought for me to stay in the United States Air Force, supported me relentlessly, wrote letters on my behalf, and educated me on ways to manage the condition, I felt obligated to do more. I can remember a teammate of mine who I asked to train up for a competition that was mere weeks away consisting of the top 20 teams in the Air Force battling to be crowned the best of the career field in a week-long event. Without hesitation, he agreed and dove into physically grueling preparation all to help me in my fight to remain in the military with T1D’s and continue the job I was so impassioned about. That’s one of countless examples and I knew I wanted to try and be the conduit for someone else. It was my turn to give back.  Now that my motivation was thriving, I locked in the location for the event. After some analysis of the best time to conduct the luncheon, I decided on holding the event following the lunch rush that the establishment has daily. I also selected a restaurant that offers a relatively low carb menu variety, barbecue, as it’s much easier for people with T1D to manage. The last thing I wanted was to cause undue stress for strangers coming together for the first time as they tried to determine how much insulin to give/take as a result of a tricky menu to navigate! While I attempted to get the event catered, it was difficult to project how many people I would have attending due to unpredictable work schedules. Ultimately, I decided that I would set aside the appropriate amount to cover a smaller group. On the day of the event, I was excited, nervous, and extremely anxious to see if those who RSVP’d would all be in attendance. My personal goal was to get 25% participation from the Fort Bragg T1D community there. 5 Arriving early at the restaurant, I got a table to accommodate our party and started to think about what I’d say. Having rehearsed numerous ideas in my mind, as I waited I kept thinking about how awesome this actually happening was and a testament for just how far I’d been able to come in the past 2 years since being admitted into the hospital with dangerously high glucose levels. As the showtime came, people began to show and introduce themselves. There were 5 of us total - the largest group I had ever seen with T1D - along with our diabetes educator Mr. Cucura. After brief introductions, we all began to relax and start to share our own stories with one another. The similarities were astounding: the symptoms before being diagnosed, the initial hospital visit, the shotgun blast of information, the life altering changes...each story similar yet unique and personal. I felt like I was with friends, not strangers that I’d just met.  Over the course of the next 2 and half hours, we all continued to talk amongst one another and laugh. All of us were from different backgrounds, yet unified by our military service and diagnoses. Conversation turned towards what sort of management techniques we each were using to help with our physical fitness goals. As noted by Brazeau (2008) “...found that individuals with greater perceived barriers to physical activity had poorer glycemic control as measured by A1C”. As you can imagine, one of the best practices for diabetes management is a healthy diet and physical activity. Each one of us in attendance had our own working formula and it was fascinating to hear what was working. At one point, we each pulled out our emergency sugar of choice to show the group. All of us were able to tell what we’d used with good results, or offer up the challenges we were currently dealing with. One of the individuals was training for an upcoming half marathon, another a physical fitness test. Yet another was a cycling enthusiast and the final member was a huge soccer player. Each of us walked the rest of 6 the group through our own discoveries and provided recommendations or helpful tips. This was exactly what I had hoped for - and more!  Before we came to a close, I asked each of them to provide their contact information if they’d like to conduct future get-togethers. All of them were eager to provide this and even provided recommendations on meeting locations. As we started to depart, I felt a wave of gratitude for the opportunity that the capstone project had allotted me. While the desire to do something similar had been long running, I’d never taken the time to actually start a community. The required push came in the form of the assignment which was very appreciated. I have already started to create ideas for future events bringing the T1D community together in the local area and across the Department of Defense. The difficulty remains finding the time to do so while being a husband and father, military member, and student trying to pursue his graduate education. However, what this taught me was that the benefit of making something such as this happen far outweighs the workload if it helps others. Navigating the constant struggles, accomplishments and frustrations, breakthroughs and hardship is best when undertaken with others. For those of us inside the military umbrella, we are already predisposed to working with our teammates. Capitalizing on that may be the greatest accomplishment I personally make during my career and I intend to continue to schedule meetings, provide support to others, and help share with the men and women who I proudly serve alongside.        7 Works Cited  Brazeau, A., Lhoret, R., Strychar, I., and Mircescu, H. (2008). Barriers to Physical Activity   Among Patients With Type 1 Diabetes. Diabetes Journal.   https://care.diabetesjournals.org/content/diacare/31/11/2108.full.pdf   Bullard, K. M., et al.. (2018). Prevalence of Diagnosed Diabetes in Adults by Diabetes Type -   United States, 2016. MMWR. Morbidity and mortality weekly report, 67(12),  359–361. https://doi.org/10.15585/mmwr.mm6712a2.   Yardley JE, Brockman NK and Bracken RM (2018) Could Age, Sex and Physical Fitness Affect   Blood Glucose Responses to Exercise in Type 1 Diabetes? Front. Endocrinol. 9:674. doi: 10.3389/fendo.2018.00674.  

Stronger Together: Type 1 Diabetes & Military Personnel

https://scholarworks.boisestate.edu/cgi/viewcontent.cgi?article=1000&context=mds495_proj

Stronger Together: Type 1 Diabetes & Military Personnel

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