Inspired to care

OUR 2020 JOHN MCLAREN AWARD WINNERS

In 2020, Diabetes NZ broke with tradition and awarded two John McLaren Awards in the Academic category. Both winners, Madeleine Lord and Matt Slemint, were outstanding – and both had set their sights on studying to become healthcare professionals.

Matt Slemint

Matt Slemint: Studying nursing at Otago Polytechnic

Matt has been playing guitar for 10 years. He says, ‘There are just a few things I hold very dearly because I did them before I was diagnosed with type 1. That’s why I love playing the guitar so much – I started before I was diagnosed. It’s like a remembrance back to before.’

He was diagnosed six years ago, at 12. ‘A lot of the time before then I don’t quite remember, but what I do remember is playing guitar and going skiing. So I love skiing as well. They’re my two things that take me back.’

Living in Ōamaru, he was lucky to be able to go on the youth skiing camps that the Otago branch of Diabetes NZ organises each year. But guitar was all year round.

‘Guitar, for me, has become an outlet. When things turn to custard, I turn to the guitar. It’s got me through a lot of stuff. I just hop on my guitar and let it out. It really helps.’

He thought briefly about pursuing a career in music. ‘I wish I could sing. If I could, I’d throw everything else down the drain and be off busking. But unfortunately, I can’t quite sing!’

DECIDING ON NURSING

‘From a young age, I’ve always been interested in health,’ says Matt. He jumped from one career idea to another. ‘I had a fascination with animals, and I thought I might end up being a vet one day, then I got a dog and realised I’m too much of a sook to ... you know.’

He considered emergency medicine and med school, before settling on nursing as a pathway. He’d realised how much he appreciated the nurses involved in his own diabetes care. ‘They put in so much work and they care deeply.’ He admits that sometimes he’s felt specialists don’t take his own knowledge about his body seriously. ‘Then you talk to the nurses, and they’re the ones that actually listen, sometimes.

‘Also, I think the hardest part of diabetes is the mental side of it. The anxiety around it flares up really fast, and nurses understand.’ It was no hardship at school to study the subjects he needed to get into nursing school – chemistry and biology. ‘I always loved my sciences, and that was fuelled by the teachers I had. I went to Waitaki Boys, and their science department is second to none. The teachers are phenomenal. Science isn’t for everyone, but I had a soft spot for it and the teachers were great.’

His final year at school – 2020 – was tough for him, and not only because of Covid-19. ‘You get to your last year, and you realise you’re just over it. You’ve worked stupidly hard the whole time throughout school, and you’re at the end. You feel like you’ve finally done it all, you get your prefectureship and all your awards at the end of year 12, and then you get into year 13, and you’re like – I just want to leave. You just want to get out there and get into the real world.’

NURSING SCHOOL LIFE

Moving to Dunedin has been the fresh start Matt was desperate for: ‘New people, new friends, new everything. I’ve met some really amazing people – doing midwifery, occupational therapy, architecture, engineering.’

He lives in a hall of residence. ‘What’s good about it is you meet tons of people. The hall I’m in, there are a couple of options. You can have the traditional dorm style, with the long hallway and the rooms at the side, and then there’s the apartments. Each one’s like a little four-bedroom complex with a lounge. It’s kind of like a flat.’

Matt chose the apartment option. ‘I thought, well, the best way to meet people is to force yourself to, by living with them. And I’m very, very lucky with who I got put with. They’re really cool people.’

His nursing degree is three years long, and, at the moment, he’s still unsure what area of nursing he’d like to move into. ‘The lecturers say everyone arrives wanting to do ED or Paediatrics. I really want to try theatre or mental health maybe.’

DIABETES MANAGEMENT AWAY FROM HOME

Thinking about how you’ll organise your meals when you move away from home is a bigger deal for young people with diabetes than for their non-diabetic peers. Matt says, ‘To make it easier for myself as I settled in, I bought the catering package the hall offers.’

He had to weigh up the pros and cons first though. He knew if he cooked for himself he’d be able to control what he was eating and would always know how many carbs he was consuming. But he was worried that, if he got too busy, he wouldn’t cook, ‘and then I’d start eating crap.’

Buying the catering package means a little less control, but he always knows there is decent food waiting for him. ‘I have to try and figure out the carbs for all the different meals that I get. There’s a lot of chicken and rice, which is amazing. But there’s also lots of pasta which is always hard for me. I get delayed highs with pasta. But I think you can’t keep avoiding it. It’s good to force yourself to figure it out.’

He’s surprised himself by how easily he’s taken fuller responsibility for his own diabetes management. ‘Moving away from home and not having your mum looking after you or there to talk to, it forces me to really think about what I’m doing.

‘I thought I’d struggle a lot with getting in good routines and being healthy, but I’ve found all that pretty good. I think I’ve grown up enough to understand that I’ve got to take ownership of this now, as I always have tried to. I know you’ve got to look after yourself.’

The diabetes clinic he goes to now is close to the hall he lives in. ‘I don’t play clinic by ear. I prep beforehand, unload my pump, check all my levels, and come up with an idea of what I’d like to change before going in. It’s just taking agency.

‘I’m in a transition clinic. They do that for the students because, moving away from home, that’s quite big. They don’t want to chuck you straight into adult care. Going into a transition clinic, you get a bit more support.’

That said, ‘The nurse and the doctor thought I was quite on to it and they wanted to put me into the adult clinic straight away. I was like, hold on! We’re not doing that yet! At the end of the day, I’m still a student, still young. And I’m going to go and do the things everyone else does.’

Matt enjoys participating in clinical trials, and, as well as finding them fascinating, it’s enabled him to access various new diabetes technologies. Currently, he’s using a Dexcom CGM. He says, ‘Going back to finger-picking ... almost anything’s better than that once you’ve been on a sensor.’

This is despite the fact that he has difficulties with sensors shutting off sooner than they should and has to think hard about where he puts them. ‘I have a problem trying to gain weight. With the sensor, if there’s not enough fat where it’s placed, then the filament goes in and sort of bends on the muscle, and it doesn’t last as long. Most of them will cut off before eight days. This one that’s on at the moment, I think’s it’s on its ninth day, so I’m pretty rapt with that. I’ve had a few where they’ve only lasted two days.’

He finds his blood sugar control is better when he’s using a sensor, and he’s noticed that it’s easier for him to keep his levels steady than for other students with type 1 who aren’t using CGMs.

RECEIVING THE JOHN MCLAREN AWARD

Matt remembers, ‘I was really struggling last year. Things had got on top of me. And when I got this award, it was awesome.’

He says, ‘Obviously I applied for it because of the financial support – that's no secret.’ He also thought it would be a validation of his academic achievements. But as soon as he heard he’d received it, he realised it meant a lot more to him than that. It was a concrete acknowledgment of the extra challenges he faces as a young person striving to live with diabetes, and of his perseverance.

‘You can be as smart, talented, and gifted as you like, but all of that means nothing when your mental health is suffering. I like to think I’ve achieved well academically, and some believe I have a talent with my guitar, but I’ve had dark times, and I know all these so called “important things” go out the window. Nothing’s more important than being positive, happy, and proud.

‘When I got the award, I was like, oh hell, this is actually pretty bloody cool. I was rapt.’

Madeleine Lord: Studying Health Science at University of Otago

Madeleine Lord

Madeleine has shifted all the way from Auckland to Otago to study this year. ‘My parents both went away for uni, so they were really supportive of me doing that, too.’

She’s loving her first year. ‘Studying health science means that, at the end of this year, I can decide which path I want to go on to.’ One of the options – for those who get the very highest grades – is med school.

Madeleine says, ‘If I got offered a place, I definitely wouldn’t turn it down. That’s the goal. But if not, I’ll probably end up doing a biomedical science degree and maybe applying for medical school again at the end of that. A lot of people do it postgrad, and the entry requirement isn’t quite as high.’ She says that, in a way, it can be better to do med school that way, as you have more life experience when you go into it.

COMING THROUGH COVID

Madeleine attended Carmel College in Auckland’s Milford. She loved it. ‘I did sciences all the way through to year 13. But I also did drama and English on the side.’

She was made an academic prefect in 2020 – an interesting year for it, thanks to Covid-19. The prefects started innovating. ‘The whole leadership team and prefect team did a lot of things to help all the students to keep going throughout lockdown. Me and the other academic prefects, we compiled a list of lots of our best study techniques for staying motivated while you’re at home.

‘We did a website where we compiled links and study resources that we ourselves had found useful over the years. And then, when we weren’t in lockdown, we organised tutoring programmes and things like that.’

As for her own school work, ‘Covid was a change in lifestyle. At first, I found it quite nice to take a step back and have more of a simple life with not so much going on all the time. But it quickly grew a bit old.’

On the positive side, ‘There was a lot more self-directed learning. I found it good working to my own schedule, but I know a lot of girls struggled with that because it was so different.’

LIVING WITH TYPE 1

Madeleine was diagnosed with type 1 diabetes in 2010, when she was six. ‘I can’t remember that much from beforehand, which I’m quite grateful for.’

She thinks her diabetes influenced her interest in health and medicine. ‘Just being in hospitals a bit more than the average child and seeing a bit more of that side of things made me interested. Also, I was always interested in the science behind diabetes. I’ve always liked the science side of things.’

When it comes to work and socialising, settling into university hasn’t been too hard for Madeleine, but ‘the diabetes side has definitely been harder. It’s the first time I’ve fully been away from my parents, and, in the halls of residence, carb counting is really hard. The food is delicious, but it can be quite fatty and high carb, and there’s the odd meal where I just have to accept it’s going to be tricky to manage my levels.’

Amazingly, she found that in her dorm she was only three doors away from another student with type 1. ‘We talk to each other about things and complain about random lows and highs. It’s nice to have someone to talk to here.’

Like Matt, Madeleine is currently using a Dexcom CGM. When she’s between CGMs, she finds the patchy information that the finger-prick tests offer her to be frustrating. For example, ‘When I wake up, I want to know what happened with my levels overnight.’

She considered using the Otago Student Health Service for her diabetes appointments, which would have allowed her to stay with the same DHB she had growing up. ‘They have some diabetes nurse specialists at Student Health, but I ended up deciding to transfer completely from Waitematā DHB to Southern DHB. It means I have an endocrinologist as well.’

She says Southern DHB seems to offer a really good service, ‘and the wait times here are a lot shorter.’

THE JOHN MCLAREN AWARD

Madeleine applied for the John McLaren Award mostly to help cover her accommodation fees. ‘I was so happy when I got the award – I immediately texted my whole family group chat. Everyone was celebrating. It was really nice.’

Who will be the 2021 John McLaren Award winners?

Diabetes NZ congratulates all our 2020 John McLaren Youth Award winners: Matt Slemint, Madeleine Lord, and Yogya Mehra who received the Award in the Sports category.

If you or a young person you know has diabetes and is pursuing academic, cultural, or sporting excellence, we encourage you/them to apply.

For more information, see page 12 of this issue of Diabetes Wellness.