MILWAUKEE -- Placed smack-center on Charlie Kimball's steering wheel, a blood-glucose monitor stares into the cockpit of the race car like a digital Cyclops surrounded by all the usual gauges and buttons.
For the 26-year-old rookie driver, this device is no monster but a life-saver.
One of 27 drivers competing in the Milwaukee 225 this weekend, Kimball is the first competitor in the IndyCar series to be racing with Type 1 diabetes, a life-long autoimmune disease that destroys insulin-producing cells of the pancreas.
Kimball finished 13th last month in the Indianapolis 500. Although the race this weekend is less than half as long as the Indy 500, the Milwaukee Mile racecourse provides plenty of challenges. One such difficulty lies in the design of the course.
Without long straightaways like ones at the Indianapolis Motor Speedway, this compact oval course relentlessly forces drivers to be turning during almost the entire race.
"When they're turning the corner against those G forces, it's a fight for them .?.?. especially upper body strength," Michael Olinger, director of medical services for IndyCar, said. "On the road courses, they need to have strong lower extremities to brake as hard as they need to be."
Race car drivers need to possess not only the physical strength required to control their cars, but also incredible athletic fitness. Researchers at the University of Miami found that drivers actually experience physical demands comparable to elite athletes participating in traditional team sports.
"Even though you're strapped into the car, you still have to brace yourself against all the forces on top of having to be aware of everything around you," Graham Rahal, a teammate of Kimball with Chip Ganassi Racing, said.
For Type 1 diabetics, intense physical activity can prove to be dangerous. Exercise lowers blood-glucose levels, and if levels drop too low, it may cause numbness, seizures and coma.
Athletes with Type 1 diabetes face an additional problem during competitions when the stress hormone epinephrine (commonly known as adrenaline) is released into their bodies.
"We know that epinephrine is a counter-regulatory hormone (so) it increases the body's resistance to insulin," said Irene O'Shaughnessy, interim division chief of endocrinology at the Medical College of Wisconsin. "The challenge for athletes is to respond to the physical activity they're doing and monitor their blood sugar."
To overcome the obstacles of being diabetic in the professional sporting arena, Kimball follows a regimen of insulin and dietary management along with a few additions to his car such as the installation of a blood-glucose gauge on the dash.
"When Charlie applied to be a driver with IndyCar Lights (in 2009), he demonstrated to me the technology to monitor his glucose levels in real time through a sensor stuck under his skin," Olinger said.
Every few laps, Kimball glances at his monitor when he checks the car's vitals and periodically calls in his sideline medical team with his readings.
Although he keeps two options to stay hydrated, water and sugar water (or orange juice) in case his blood sugar drops too low, he says he has yet to use the glucose supplement during a race.
Kimball attributes his daily diabetes management and insulin regiment with allowing him to completely focus on driving rather than worry about his diabetes. Novo Nordisk, the manufacturer of the insulin he uses, also sponsors his car.
Kimball celebrates two anniversaries each year. On Feb. 20, like legendary driver Bobby Unser, Kimball celebrates the date of his birth. On Oct. 16, he has "D-versary" to commemorate the day of his diabetes diagnosis and celebrate "another year of good health and success," he said.
This year, his fourth D-versary falls on the day of the last IndyCar race of the season in Las Vegas.
After he was diagnosed in 2007, Kimball left racing for six months.
"People are often shocked by the diagnosis," O'Shaughnessy said. "It takes some time for them to really understand that it is a life-changing and life-long diagnosis."
"I realized pretty quickly that I had to face it head-on if I wanted to get back in a race car," Kimball said.
During his leave, he consulted with Los Angeles-based Dr. Anne Peters to develop a diabetes management plan that would allow him to continue racing.
"For many athletes, it's trial and error to really figuring out what and when to eat, how much insulin they need before the physical activity and what their typical glucose response is after the physical activity," O'Shaughnessy said.
Rahal admires how Kimball is able to overcome obstacles set by this medical condition. "I feel like he's surrounded himself with really good people to help him through it all. His family is also very supportive of him."
Kimball's father, Gordon, is a race car engineer and taught his son competitive karting at age 9. Gordon will also be at the Milwaukee race over Father's Day weekend.
Though Charlie Kimball does not believe diabetes has negatively affected his racing, he has come to accept the social responsibilities.
"For so much of my racing career, I was very self-centric," he said. "Now, I'm focused on doing this responsibly."
As part of his partnership with Novo Nordisk, Kimball participates in outreach to share his story and raise awareness of the disease.
"I get a sense of fulfillment when I meet with kids with diabetes and see their faces light up when they realize that a race car driver has diabetes," he said. "Diabetes doesn't have to slow you down."
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