TUSCALOOSA, Ala. — They give you an orange to practice on, that part they get right on television. Not just to the child, but especially the parents, because they’re the ones who usually end up giving the injections for the first few years.
Keith Holcombe didn’t, though.
He was 9 when told he had diabetes. It was a Friday, April 15, tax day, when his blood sugar was so off that he should have been convulsing. The doctor who finally figured out what was wrong told his parents to go straight to the hospital, don’t even stop at home to get anything, because they could get him there faster than a dispatched ambulance.
That’s a lot for someone that age to take in.
Yet when it came time for his first non-administered insulin shot three days later, which his mother was going to do after practicing with the orange all weekend, Holcombe looked up at the nurse and asked “Can I do it?”
“I had to grow up really fast,” he said.
“I put a lot of the responsibility on myself because all the dreams and aspirations that I had for playing sports at the college level, and maybe going on to the professional level. At first I thought it was over.”
Instead, Holcombe went home from the hospital on Monday. On Tuesday night he was back playing baseball.
Now he’s a two-sport standout for the University of Alabama, a linebacker for the national championship football team, and an outfielder who’s off to a blistering start in baseball this spring, all while wearing an insulin pump during practices and games. It’s under a hip pad for the former, and attached to his back for the latter so he can slide either legs first or headfirst.
“It’s just something that I’ve pushed myself to better myself,” he said. “Just keep on driving through that.”
Holcombe’s mom cried when the diagnosis happened, and he sort of “freaked out,” not quite knowing what it all meant. But her tears were more relief than anything because she feared it could be something worse like leukemia.
Keith had lost a lot of weight, his ribs stuck out and he had really started to bruise. Despite being super active, his eyes were sunken and he was always tired. Plus, he was constantly asking to go to the restroom in school. His teachers wouldn’t let him go at times because they thought he was faking or just trying to get out of class.
“I mean he was sick,” Kendra Holcombe said. “I am not a hypochondriac. There has to be a bone sticking out before I take one of my boys to the doctor. I had an older son, they all play sports. We just didn’t go to the doctor, it was, you know, put some mud on it. He’ll be fine. Put some dirt on it, run on it.”
It took six trips to three different doctors before one finally pinpointed the problem.
Type 1 is a chronic condition in which the pancreas produces little or no insulin. When the body breaks down sugars and starches into glucose, which is used for energy, insulin is the hormone that delivers it from the bloodstream to the cells.
The condition can develop at any age and there’s no known way to prevent it. Type 1 diabetes accounts for approximately 5 percent of all diagnosed cases.
Far more common is type 2, when the body can’t use insulin properly. Most cases can be prevented and are brought on by being overweight and physically inactive. The person afflicted is usually 45 and older and with a family history.
According to the Centers for Disease Control and Prevention, just under 10 percent of the U.S. population has some form of diabetes, with 23.1 million people diagnosed and an estimated 7.2 million undiagnosed.
Another 84.1 million adults (33.9 percent) have prediabetes, which means the blood sugar level is higher than normal but not at a level to be considered type 2 diabetes. Barring lifestyle changes, most people with prediabetes will eventually see it progress.
Type 1 can be managed, but a person has to calculate everything that he or she consumes, food and drink, the grams of carbs that have been ingested and how much insulin is needed to compensate.
If the blood sugar gets too high, the person can go into convulsions, but too low could result in a coma.
“Diabetes can really be a struggle if you let it,” Keith Holcombe said. “There was for sure a few days of ‘Oh man, I’m tired of doing this. I’m tired of dealing with this. I just want to be a kid and not deal with anything. I want to be able to wake up and go through an entire day as a normal kid.’
“That responsibility can get really tiring for a young kid or a teenager.”
It could be tricky for anyone, never mind a multisport athlete who is on very different diets when playing football and baseball. Holcombe’s endocrinologist suggested he give up sports, especially football, and maybe try something that didn’t require the body take such a pounding, like tennis.
But sports were his passion, especially team sports. The idea of giving them up sort of washed over him, like the time his mother said that when he went to college that maybe he should have a service dog trained to alert him of physical changes (which probably wouldn’t have gone over very well during practices).
So the family decided to meet both aspects — of Keith having diabetes, and dealing with it while playing sports — head on. Whereas some parents don’t want anyone to know if something might not be right with their children, they went the opposite direction. They wanted everyone to know, so if something did go wrong they would be quick to react.
“His father and I sat down, it was never secret to the kids or anything, or was anything to be ashamed of, it just was what it was,” Kendra Holcombe said. “These are the facts. … because that’s what he was worried about, ‘That I’m not going to be able to play sports anymore.’ And we were like ‘No. you can do anything you want to do. Anything that you want to do, you tell us and we will figure out a way for you to do it.’”
There was a lot of trial and error. In seventh grade, Keith tried to get though practices and games without taking insulin, seeing if he could get through it, only to feel awful most of the time. He definitely wasn’t playing his best, so they tried something else.
By eighth grade he was playing with the use of a pump, which continued through his years at Hillcrest High School in Tuscaloosa, in the Crimson Tide’s backyard.
Nowadays it’s about the size of a small iPhone, with a sensor, insulin and tubing that is connected to the body at what’s called the port site. Holcombe used to always have two port sites on his body, just in case.
“Sometimes it’ll get ripped out and then they have to re-insert it,” Kendra Holcombe said. “You have to change the port site about every three days because the injection site, your body reads it as a wound so it immediately starts to try and heal itself.
“It’s a double-edged sword. The healthier you are the harder it is to wear the port site because you start healing around it faster than someone who is not healthy. Same with the leaner you are the worse it is with the port site because it needs to go in fatty tissue. Well, he hardly has any fat on him.”
Keith’s been through a more than a few pumps over the years (they cost roughly $6,000 minus insurance, plus insulin is roughly $600 a month), including one he landed on, giving him a bone bruise in the process. The broken screen was blank, but because he knew all the buttons and settings he could still operate it for the next couple of days until a replacement arrived.
Nowadays, Alabama’s medical staff always has a backup pump on hand, just in case, and there’s a whole team of people helping look out for him. From team trainer Jeff Allen to nutritionist Amy Bragg, the Holcombe family raves about the Crimson Tide’s support system that has helped keep an eye on things even when Keith can’t.
For example, he’ll go through football practices and not even give insulin level a second thought while focusing on all the things that go into being linebacker. He’ll sometimes find out after practice that they checked him every 15 minutes. Sometimes he’ll have a trainer come up to him and say, “Hey, you need this,” and hand him a Gatorade or saltines.
Moreover, one can tell when something isn’t right by watching the 6-foot-4, 236-pound athlete move, especially if they’re familiar with him and know what to look for.
“When my blood sugar is getting really high, very quickly, you feel like you’re sick 24/7,” Keith Holcombe said. “You get that lethargic. You pick up the remote and go ‘Oh, I’m so weak.’ The remote feels like a 100-pound dumbbell. It’s just one of those things. Like your legs feel like they’re full of concrete.
“One the other hand, being low is like you’re very jittery. Your vision goes in and out, like kind of blurry, because it’s really hard to focus. I don’t know if my mom said this, but very short temper. There’s been a number of times she probably wanted to slap me on the side of my head because I was being a brat on top of being a brat because you’re a teenager.”
Instead, Keith Holcombe is now known for making 38 tackles last season, including 11 on special teams, and was one of the players to step up and make key contributions when the linebacker corps was decimated by injuries. Against Colorado State, he had a career-high 9 tackles, and against Florida State made the fumble recovery that helped turn the season opener into a rout.
In baseball, he’s batting .361 through Sunday, with 5 extra base hits and 2 stolen bases. He’s second on the team in batting average and fourth in slugging percentage.
In February, his .679 on-base percentage topped the SEC, as did his .625 batting average. He had a nine-game hitting streak from February 17-March 3, and he’s reached base in every game he’s played in this season but one.
That would be impressive for any player, never mind one trying to play two sports.
“It’s unbelievable how low-maintenance and independent Keith is, you wouldn’t know it as a coach,” said baseball coach Brad Bohannon, whose mother had diabetes but he’s never had a player try and play with it.
“He’s such an impressive young man. He’s smart, he’s mature. You’re talking about a guy who’s an SEC-level football player and an SEC-level baseball player, and a college graduate, he’s diabetic and no one would know about it if we didn’t read about it. It’s an ultimate compliment to his maturity.”
Holcombe isn’t Alabama’s first athlete with diabetes, far from it. Recently, softball catcher Molly Fichtner played with type 1 diabetes in 2013-14, and another scholarship football player was diagnosed with it in high school only to see his career quietly fizzle out. There’s also a walk-on football player with it, but Holcombe knows he’s more in the spotlight.
Not only does he play for Nick Saban, but his father Danny was on Paul “Bear” Bryant’s last Alabama team as an offensive lineman and long-snapper.
#Alabama coach Nick Saban’s first pitch tonight at Sewell Thomas Stadium
Dirt ball. Good block by LB/OF Keith Holcombe pic.twitter.com/uv8Y2lDckT
— Chandler Rome (@Chandler_Rome) March 7, 2018
Consequently, the son wants to use his platform to help others with diabetes, especially kids. Most of that will come after he leaves Alabama, but he regularly goes out of his way to talk to those who are dealing with it and reaches out to those who are dealing with something similar. Former Gonzaga basketball standout Adam Morrison was one who did that for him, and it made an impression.
“It’s very important [to me],” Keith Holcombe said. “You’d be surprised how many athletes are type 1 diabetic as a professional or in college and dealing with it.
“The main thing that I want to do is I don’t want kids to be defined by being a diabetic. I want the kids to be ‘Yes, I’m a type-1 diabetic, and you know what I’m not going to let that slow me down at all.”
It certainly hasn’t with him.