Ester Basanta led a typical life until her late adolescence when her body began sending alarming signals. She experienced intense trembling, excessive sweating, extreme fatigue, and even occasional fainting.
“I used to faint in elevators, at home, or anywhere. I just passed out completely where you could move me from one spot to the other, and I wouldn't recall getting there,” said Basanta. “Miraculously, I didn't die, but it was scary.”
Concerned, she sought medical attention, and blood tests revealed a startling truth: she had been suffering from severe hypoglycemia, with her blood sugar plummeting to dangerously low levels – sometimes as low as 20 milligrams, where normal levels are between 70 and 100 milligrams. These extreme drops in glucose were behind her fainting spells, signaling the early signs of a life-altering disease.
(Courtesy Ester Basanta)
Ester Basanta and her husband Julio Basanta.
Now 60 years old, Basanta recalls her blood tests at that time didn’t reveal any significant abnormalities. Doctors misdiagnosed her with irritable bowel syndrome and other gastrointestinal issues but encouraged her to come back for more tests. Believing her health problems were minor, she didn’t return for further testing, even though she frequently experienced symptoms of low blood sugar, such as fainting after meals. Eating starchy foods like pasta or bread temporarily stabilized her blood sugar, making her think everything was fine. Over time, she began to gain weight.
At age 30, after a series of blood tests, Basanta was diagnosed with Type 2 diabetes. As her condition progressed, her diabetes worsened, leading her to regularly monitor her blood sugar and inject insulin multiple times a day.
In 2020, her blood sugar skyrocketed to over 700 milligrams, resulting in a critical hospitalization. Basanta was told she had Type 1 diabetes, not Type 2 as she had previously been told. She had also developed chronic pancreatitis, a condition that exacerbated her ability to produce insulin and manage her blood glucose levels that swung drastically between extreme highs and lows, relying on insulin injections to avoid life-threatening complications. This diagnosis marked a turning point, highlighting the seriousness of her condition and the need for serious lifestyle changes.
(Courtesy Nicklaus Children's Hospital)
Dr. Adriana Carrillo, a pediatric endocrinologist and medical director of the Diabetes Program at Nicklaus Children’s Hospital.
Basanta admits to having ignored clear signs of pre-diabetes in fluctuating glucose levels during an early two-hour test and low blood sugar during pregnancy at age 23.
“I knew something was wrong when they did that two-hour glucose test because your glucose is not supposed to be at 40 and then rise so quickly to 195,” she said. “They told me they were going to have to do more tests. And I just neglected it because I didn't want to think about it.”
She believes that underestimating her condition and not following up with additional blood tests led to multiple misdiagnoses when, in fact, she had been suffering from pancreatitis and Type 1 diabetes all along.
Basanta is not alone. According to the CDC, 38.4 million people in the U.S. have diabetes, with 8.7 million of them undiagnosed. November is Diabetes Awareness month, a time dedicated to spreading information about the disease.
(Courtesy Ester Basanta)
Ester Basanta (last-right) with her three daughters.
Dr. Adriana Carrillo, a pediatric endocrinologist and medical director of the Diabetes Program at Nicklaus Children’s Hospital says many people can be misdiagnosed with Type 2 diabetes when they have Type 1 due to rising rates of obesity, which can occur in both types.
Carrillo explains that Type 1 diabetes, which is common among younger individuals, is an autoimmune condition in which the body mistakenly attacks its own insulin-producing cells in the pancreas. She said this leads to diabetic ketoacidosis (DKA), life-threatening diabetes symptoms produced when the body doesn’t have enough insulin to allow blood sugar into cells for energy.
She adds how children are rarely misdiagnosed compared to adults because doctors routinely check for pancreatic antibodies in children to rule out Type 1 diabetes, especially with obesity being so common nowadays.
“In adults, one goal of universal screening is to prevent misdiagnosing Type 1 as Type 2, since the treatments are different,” said Carrillo. “There are also research opportunities for medications that can alter the course of Type 1 diabetes.”
Her division is collaborating on a research project called TrialNet with Breakthrough T1D, a nonprofit organization dedicated to funding diabetes research to better understand the progression of Type 1 diabetes and explore potential prevention methods. Currently, there is no cure for the disease developed out of genetic predispositions and impacted by environmental factors.
(Courtesy Baptist Health)
Dr. Michelle Adibe, a primary care physician at Baptist Health.
Basanta believes she was genetically predisposed to have Type 1 diabetes due to the recurring trend in her family.
EARLY DETECTION
Carrillo highlights the importance of screening individuals and detecting the disease early on.
“We screen to prevent severe complications, like DKA, which can have both immediate and long-term effects on health, including cognitive function,” said Carrillo. “Early detection helps manage diabetes better and reduces the risk of serious health issues.”
Type 2 diabetes, Carrillo explains, is often linked to obesity and excess body fat, leading to insulin resistance where, over time, the insulin-producing cells can also get damaged. She said these are the two main diabetes diagnoses, each with its own challenges and risk factors.
Basanta feels like her condition is worse than her husband’s, who has Type 2 diabetes, but doesn’t deal with the same dangerous lows as her.
“If you see his monitor and graphs, mine looks like a rollercoaster ride while his is more stable,” she said. “Sometimes my blood sugar levels are so low and I need to eat something sugary immediately, but my husband doesn’t have extreme lows. He just gets sleepy.”
Approximately 107,700 adults in Florida are newly diagnosed with diabetes each year, according to the American Diabetes Association. Type 2 diabetes, often linked to obesity, is especially common in Hispanic and Black communities, which make up a significant part of the Miami-Dade County population, making them more vulnerable to rising diabetes rates.
Dr. Michelle Adibe, a primary care physician at Baptist Health, said diabetes disproportionately affects Hispanic and Black communities because of their inability to access quality healthcare and the prevalence of food deserts, where healthy food options are limited or unaffordable.
Adibe screens patients 18 and older for diabetes by checking for common symptoms like frequent urination and thirst, blurry vision, and signs of numbness in their upper and lower extremities or tingling in the arms and legs, which indicate neuropathy, nerve damage caused by high blood sugar.
Carrillo warns about the prevalence of misdiagnosing children and adults, where heightened thirst, constant urination, and abrupt weight loss, common symptoms of Type 1 diabetes, can seem normal in Miami’s extreme heat.
“In our hospital, we emphasize awareness of Type 1 diabetes among patients and staff,” said Carrillo. “New innovations like a medication called Tzield, can help delay the clinical onset of diabetes in children over eight by up to two years. This is a significant advancement, as it's the first approved medication for Type 1 diabetes and opens doors for further research.”
A diabetes screening starts with a blood test, usually ordered by a primary care doctor or performed at a health center. Based on the results, the doctor will assess whether the patient should consider diabetes treatment.
ACCEPTANCE AND RESILIENCY
Both Carrillo and Adibe often witness patients' shock and fear following a diabetes diagnosis. They focus on building positive relationships with their patients to help them adjust by recommending the right medications and lifestyle changes, empowering them to manage their condition and live a healthy life.
“They think their life is over in a sense because of what they hear about diabetes,” said Adibe. “Nowadays, because of the type of medications that we have, we can get diabetes well under control, and patients can have a long happy life as long as they are cognizant of what they eat and take their medication responsibly.”
She adds that patients who receive care at Baptist are supported by a multidisciplinary team of dieticians, primary care doctors, endocrinologists, and pharmacists.
Carrillo shared how some of her patients go into denial, especially if they are diagnosed later in life.
“Families experience a mix of denial and resilience as they learn to navigate life with diabetes together,” she said. “It’s a team effort. That’s why we also have psychologists and maintain open communication with families.”
Carrillo highlights her team's collaboration with Breakthrough T1 to raise awareness and support families affected by diabetes.
A SUSTAINABLE LIFESTYLE
After decades of scary encounters with diabetic symptoms, Basanta has transformed her life, adopting a health-conscious lifestyle. She is now deeply attuned to the internal and external factors that influence her glucose levels, taking proactive steps to manage her condition and stay in control.
She mentions how stress and excitement adversely affect blood glucose levels.
“Too much excitement and stress could raise your blood sugar, and it's horrible because you can be really stressed out, and your blood sugar will spike up even if you barely ate anything,” she said. Indicative symptoms of stress, such as feeling unexplainably warm in the upper body, urge her to be more mindful of her mental health.
Basanta now has a FreeStyle glucose monitor, a system that is attached to her skin and measures her blood glucose levels to provide real-time readings. She occasionally pricks her finger to measure her glucose levels for more accuracy.
She recommends maintaining a proactive lifestyle with regular workout routines and eating mindfully to achieve overall health.
“Working out is crucial,” said Basanta. “A 15-minute workout such as a fast-paced walk after you eat, or exercising at home to bring up your heart rate helps control glucose levels.” She doesn’t inject herself with insulin before the gym since working out lowers her blood sugar naturally. The combination of both could cause her blood sugar to drop too low, leading to hypoglycemia.
Basanta has some advice to help people avoid a diabetes diagnosis.
“Take care of your body, eat healthy, meditate, relax, and don't take life so hard,” said Basanta. “I wish I would have started that earlier in my life.”