Trista Miller

While Trista Miller is on her own path to conquering the obstacle she’s recently facing, the brave twelve-year old is already looking forward to helping other people meeting the same challenge. She has been learning how to live with the Type 1 diabetes she was diagnosed with in early June.

Trista’s parents, Michelle and Chad, started to notice changes in their daughter a few months prior to her diagnosis, first noticing that Trista was beginning to lose weight. The weight loss on the already thin girl was worryingly obvious on her small body.

“It started to become extremely noticeable weight loss,” Michelle explains. You could see all her ribs and her collarbone was sticking out.” Suddenly her clothes were too big and hung on her undersized frame. The swimsuit from the prior year that should have been getting smaller on her was instead too big, and they found themselves buying her a new swimming suit that was two sizes smaller.

They first attributed the weight loss to the braces recently put on Trista’s teeth, believing her difficulty eating was due to the new apparatus in her mouth. As she continued to lose more weight, the thought of a possible eating disorder even crossed their minds. Chad explained how he noticed how thirsty she had become, and Michelle explained that they suddenly started going through a gallon of milk every day, an amount suited for a much larger family than their family of four. Suddenly a large Powerade that previously lasted Trista two days she now gulped down in only 20 minutes.

One Saturday in June while Trista was eating applesauce, she commented on how much it hurt her mouth. Her mom was alarmed when she peered into Trista’s mouth and discovered her tongue was white. Suspecting thrush, a yeast infection, Michelle took her to Convenient Care at the Yankton Medical Clinic and younger daughter Tori came with. They were fortunate that Trista’s regular doctor was working the shift that day. The doctor examined Trista and found her to be underweight for her age, weighing 61 pounds instead of being in the 80-pound range.

Dr. Dawn Larson conducted some tests with Trista and had her get blood drawn for lab work. On a whim, she also included a hemoglobin check in the lab request. The Miller’s left the clinic knowing that they would have to patiently wait for the lab to run the tests before they could get the results. “When we were walking out of the clinic that day, from the clinic to the parking lot up front just up by the little hill to my car, she just sat down and put her head down on the center console,” Michelle explained. Trista added that she just felt very winded and tired with that short walk. Michelle began to wonder if they needed to turn around and go back in to the doctor.

After the appointment, Michelle headed to the park, so Tori could play while she sat with Trista to rest. They stopped at a gas station on the way to buy something to drink. Michelle’s cell phone rang; Dr. Larsen was calling to tell her she needed to get her daughter to the

Emergency Room, so Trista could be transported to a Sioux Falls hospital, not yet giving her the details. Michelle and the girls picked up Chad to find out that Dr. Larson had already called him with some details upon his request. Dr. Larson believed Trista was Type 1 diabetic. Her blood sugar level which should be between 80-110 was reading a dangerously high level of 589.


Trista remembers the incident clearly and listening to her parents retell the story to me brought forth an emotional reaction from her and sister Tori. Michelle explained that when the family arrived at the Emergency Room, they were told that Trista would be flown to Sanford Children’s Hospital, the hospital her parents chose. Chad would ride with Trista during the flight while Michelle dropped Tori off with family and packed an overnight bag from home. Because of strong winds, the medical helicopter couldn’t fly that day, so Trista was taken to Sanford in a twin-engine plane. Chad praises the amazing service of the medics during the rough flight.

Michelle had already arrived at Sanford and met the others as their flight landed. Trista was immediately started on saline drip and an insulin drip, receiving the fluids very slowly due to her young age. The young girl was so dehydrated that her veins had collapsed.

Chad explained Trista’s situation as it was explained to him: the insulin in the body acts as a key for the cells to open and let the sugars in, which is where your energy comes from. With no insulin in Trista’s body, those sugars in her system had no place to go, forcing her to drink more fluids to flush the sugars through her system. With blood sugars as high as hers were, her body started to consume itself in a desperate search for energy. Her body first looked to fat, then to muscle for this energy source, explaining her rapid weight loss.

Trista was put in the Intensive Care Unit where she spent the next 24 hours. She was then transported to a hospital room while still on a slow saline drip to hydrate her and drop her blood sugar. During the next three days in the hospital, the family met with diabetic specialists, nutritionists and dieticians. They had to learn about counting calories, carbohydrates (carbs), what and when to eat, what “free foods” were and how much insulin Trista needed to take. They had to learn how to test Trista’s blood sugar and how to give her insulin shots.

She is on two types of insulin per day, Lantus and NovoLog. Lantus lasts through the night, but she is still required to check her blood sugar levels at 2:00 AM every day. NovoLog is a fast-acting insulin that she takes with every meal, helping the cells to open and take in the energy. The family is currently trying to get Trista’s blood sugar in a consistent and stable range.

Chad explains that Trista’s pancreas quit working during this process, a result from the diabetes. She is currently in the “honeymoon phase,” where the pancreas could still produce a bit of insulin but not enough for her to go off insulin. She will need to stay on insulin throughout her life as her pancreas will no longer fully function. Chad explains that her diagnosis, previously known as juvenile diabetes, is now recognized as an auto-immune disease; the condition ran in his family with his father’s mom and grandma both Type 1 diabetics.

He explains his first reaction to the diabetes diagnosis. “What scared me right away is I remember seeing my friends or seeing my family members taking insulin and I’m thinking there’s this great big syringe and vial.” He quickly found out how advanced the treatment had become and showed me her insulin pen, which appears to be very efficient, with a built-in insulin dial and small needle.

Trista confidently explained where her insulin shots need to be given, either on the backside of the upper arm, the upper thigh or the waist, rotating injection sites. “Before, I had Mom or Dad give me the shots because I didn’t know to do it. Then I had Dad teach me and thought, ‘that doesn’t look so bad after all!’” She started by giving herself the shots in her leg and then her arm and easily demonstrated the process for me.

Her dad smiled, “We are about 7 weeks into this and she’s doing everything on her own. She figures her own carbs, her own serving sizes, it’s amazing.” Being very good in math has greatly helped her in this routine.

During the learning phase of this new process, Chad and Michelle credit the staff at the Sanford Children’s Hospital for being remarkably helpful. They started off by calling the hospital with Trista’s blood sugar levels every morning at 2:00 and at each meal. The staff would help them calculate how much insulin to give her. In the beginning, Trista would take one unit of insulin for 15 grams of carbs. She is progressively feeling better, has gained most of her weight back and can now consume more carbs before taking insulin. She quickly rattled off her insulin schedule: one unit of insulin for 25 grams of carbs in the morning, one unit of insulin per 23 grams of carbs for lunch and supper is the same routine as breakfast. Her dosage in Lantus, the 24-hour slow-release insulin, has also been reduced.

She easily gives me a short lesson of the amount of carbs in various foods and several options for “free” foods, including fruits, meat, eggs, diet pop, cheese and non-starchy vegetables such as green beans, cauliflower and broccoli. The “free” foods, containing carbohydrates of 15 grams or less, allow her a snack without having to take insulin.

Michelle explains that, while Trista is normally a picky eater, she has ventured out of her comfort zone to try new foods. Trista remembers something her doctor said that sticks in her mind, “You can’t say you don’t like it if you don’t try it.”

She still visits the Sanford hospital regularly for check-ups, though not nearly as often as before. When they venture through the facility for the appointment, they look up at the ceiling tiles, which are painted by children during their stay, and they find Trista’s painted tile. They speak highly of the staff and doctors at the facility, crediting them for easing the family’s stay and patiently helping them learn so much about the condition in such a short time.

I comment to Trista that I am amazed at how the young girl already knows so much about her condition. She showed me a Pink Panther book about diabetes that helped her understand everything at her level. Chad is thankful for amazing support that he’s found in online support groups. The extremely compassionate pre-teen is already looking to help other children facing this challenge and grins as she gives advice for others diagnosed with it. “I know you might feel like it’s changed your life, but you’re still the same person, just with an autoimmune disease.”