Standing in her evening gown as finalist in the 1999 Miss America pageant, Miss Virginia was awaiting the judges' decision when one motioned to her.Andy Starnes, Post-Gazette
Nicole Johnson Baker shows her Dexcom continuous glucose sensor to her 9-month-old daughter, Ava. The wireless sensor allows Ms. Johnson Baker, who has Type I diabetes, to continuously monitor her glucose levels.
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"Are you wearing it?" he asked. "If so, where is it?"
The judge was curious. Where had Nicole Johnson stashed her insulin pump? She quietly told him she'd strapped it inside her leg to keep it hidden under the form-fitting gown.
Nicole Johnson Baker, Miss America 1999, is a Type I diabetic, diagnosed at 19. During the pageant she talked much about her diabetes. But overcoming its challenges to emerge as Miss America is the story behind her accomplishment.
"Never to my knowledge was a Miss America contestant wearing an external medical device, other than a hearing aid," she said. "Young diabetic patients love hearing that story."
Diabetes requires discipline and continual maintenance. But, as Ms. Johnson Baker proves, it's no obstacle to success.
The 32-year-old Kilbuck resident is a national diabetes consultant for Animas Corp., a Johnson & Johnson Co. that produces the insulin pump she uses.
She also exemplifies the importance of technology in improving control as a way to improve one's health.
She is host of the CNBC television show, "dLife," which airs 7 p.m. Sundays and "is dedicated to empowering millions of Americans living with diabetes." The show features diabetes experts, medical info, inspirational stories about diabetics and recipes to help them control their sugar levels.
Ms. Johnson Baker has done public service announcements and televised specials including "The Tonight Show" and "Live with Regis and Kathie Lee." She's written articles, three cookbooks and her autobiography. Other accomplishments include promoting passage of diabetes legislation and helping to raise $16 million for research.
In addition to her insulin pump, Ms. Johnson Baker often uses a glucose sensor attached to her stomach to get continuous blood-sugar readings. She downloads test results into a laptop computer to show trends. Rather than a chore, it gives her the confidence of being in control and living a healthy lifestyle, she said.
After diagnosis, she said, her physician, among others, told her the pageant would be too stressful for a diabetic. It made her determined to win. When she married Scott Baker, former WTAE-TV news anchor, she was told she never should get pregnant. Another challenge, another success.
Maintaining strict control during pregnancy, she gave birth to a healthy daughter, Ava, in January, without adverse impact on her condition.
"One's greatest challenge can be one's greatest blessing, physically and psychologically," she said. "I wanted to try to get people with diabetes to figure out what a blessing it has been for me with business relationships, professional relationships and with my child."
People with Type I diabetes do not produce enough insulin to keep their blood glucose at normal levels. They are required to take insulin via injections, pumps or inhalation to reduce blood-sugar levels.
People with Type II diabetes, so-called adult-onset, undergo problems in producing enough insulin or efficiently using the insulin they produce, leading to elevated blood-sugar levels. Type II diabetics take insulin or medications that help their bodies use their own insulin efficiently.
Key to maintaining both types of diabetes is balancing insulin levels and caloric intake to keep blood-sugar levels in or close to the normal range of 80 to 110 milligrams per deciliter, or mg/dL.
Levels too high lead to long-term health problems including circulatory, heart and kidney disease and blindness. When one's blood sugar drops too low without sugar intake, it causes weakness, sweating and eventually unconsciousness.
Because balance is key, technology looms important.
Since 1997, Ms. Johnson Baker has worn an insulin pump, which allows her to introduce insulin into her body at a steady rate or with the touch of a button. Thus the judge's inquiry while on stage in her gown.
Nowadays, she often wears a glucose sensor to provide continuous readings of glucose levels without the need to prick a finger for blood.
Injections of Symlin, a hormone that makes the body use insulin more efficiently, have improved her control.
She's now awaiting delivery of a cell phone that automatically transfers information to her healthcare team as another tool in her diabetic arsenal.
"I make most of the decisions myself, but I can't make all the decisions," she said.
Audrey Finkelstein, Johnson & Johnson executive vice president of clinical and government affairs, described Ms. Johnson Baker as unbelievable, inspirational and more beautiful inside than out.
"She's a role model and an inspiration, especially for parents of children with diabetes," she said. "She is proof that you can do everything. Anything is possible, and for diabetics, the world is their oyster."
Ms. Finkelstein said Ms. Johnson Baker eats right, exercises and keeps herself under control, with help from technology. She's working to change perceptions that diabetics cannot take on challenges and succeed.
"She works nonstop," Ms. Finkelstein said. "Nothing slows her down."
Too many promises are made to diabetics about cures, treatments and technological advances that are not as imminent as people would hope, she said.
But available technology can provide people enough information to understand their blood-sugar readings and take action to keep them in the normal range.
"Nicole is one of the finest people I know, and she's working hard every day, not only for herself but everyone else," Ms. Finkelstein said. "She's tireless. She's special."
During her run for Miss America, Ms. Johnson Baker said, she used her experience to advise others about living with "killer diabetes." That's why she sang "That's Life," by Frank Sinatra, in the talent segment. "I'm not letting life get me down," she said.
So here she comes, Miss America, on television, meeting with healthcare and government officials, and working to help people with diabetes be physically, socially and psychologically sound.
"Diabetes is very life changing," she said. "But what you think will steal life away has given me life. It has taught me more than ever about determination and discipline and other things I've never been exposed to."
Technology has helped her understand diabetes and overcome its obstacles.
"It's opened a window to the mystery inside my body," she said.
David Templeton can be reached at email@example.com or 412-263-1578.