Fighting to Survive Type 1 Diabetes: Ali’s Journey to a Pancreas Transplant

‍Ali’s Decade of Denial

Ali Dugger was diagnosed with type 1 diabetes (T1D) just days after her 18th birthday. Her brother had lived with T1D since childhood, and her mother had since become a rockstar diabetes educator. Ali had all the support she could’ve needed at home.

Instead, she was plagued with intense denial. For the first decade of her life with T1D, Ali barely took her insulin.

“I can count on one hand how many times I probably took rapid-acting insulin in my early 20s,” says Ali with honesty and courage. She doesn’t hesitate to take ownership of those years. “I only took my long-acting insulin, and that was it.”

Yes, Ali’s blood sugar levels were consistently in the 300s or higher. She felt miserable. But the denial was deep. And her body had grown accustomed to high blood sugar levels, which meant blood glucose levels in the 100s felt like hypoglycemia. 

By her 30s, this decade of denial led Ali to develop nearly every diabetes complication in the book, including a rare complication that left her in a wheelchair for almost two years.

Retinopathy (Eye Disease)

Retinopathy is a condition that occurs when persistently high blood sugars damage the tiny nerves and blood vessels in the back of your eye. Over time, this damage can lead to bleeding blood vessels, abnormal cell growth, and scar tissue formation. The earliest stages of diabetic retinopathy often have no symptoms and can only be detected through your annual diabetes eye exam. If left untreated, it can progress to vision loss or blindness.

Nephropathy (Kidney Disease)

High blood sugar levels damage the small blood vessels and nerves in your kidneys, impairing their ability to filter waste and excess fluid from your blood effectively. This damage can cause protein to leak into your urine (proteinuria), leading to swelling, high blood pressure, and, eventually, kidney failure. Managing blood sugar and blood pressure levels is crucial in preventing or delaying nephropathy.

Neuropathy (Nerve Damage)

Elevated blood sugars over time can damage nerves throughout your body, particularly in your feet, toes, and hands. This nerve damage often results in numbness, tingling, or burning sensations. Additionally, poor blood flow and oxygen delivery to these areas increase the risk of infections, ulcers, and, in severe cases, amputations. Neuropathy can also affect other organs, leading to issues like digestive problems and heart complications.

Gastroparesis

This condition develops when high blood sugar levels damage the nerves controlling your stomach muscles, impairing their ability to move food through your digestive tract. As a result, digestion becomes delayed, irregular, painful, and unpredictable. Symptoms may include nausea, vomiting, bloating, and poor blood sugar control due to inconsistent digestion.

Charcot Foot

This complication is considered rare. Charcot foot is a serious complication involving weakening of the bones in the foot, which can occur because of nerve damage from neuropathy. If your feet are numb due to neuropathy, you no longer feel minor injuries or pain. Over time, this can lead to seemingly sudden fractures and joint dislocations. 

Watch Ginger’s video with Ali here. 

The Worst Low Blood Sugar Ever — Before the Transplant

It was just after 6 a.m., and Ali’s mother was preparing for her day when she heard a strange, distant howl. She thought it might be coyotes in the woods behind their home, but she quickly realized it was coming from inside the house. She rushed to Ali’s bedroom.

Ali was thrashing uncontrollably on the hardwood floor. Her body was rigid and convulsing. All around her were glucose tabs and gummy worms that she had tried to feed herself because she was losing consciousness due to a severe low blood sugar. Ali’s parents gave her repeated doses of emergency glucagon, but it wasn’t enough — likely because Ali had been low for hours and her liver’s glucose storage was depleted.

Her parents were hesitant to call 911 because any diabetes-related hospital admissions could get her kicked off the transplant waiting list. But the glucagon wasn’t working. 

By the time the paramedics arrived, Ali’s body temperature had dropped to 77°F — severe hypothermia. Her left eye was swollen, her body was covered with bruises, and even scratches from her alert dog, Dixie, trying desperately to wake her up before her mother arrived.

It took six responders to restrain Ali during her seizure. They administered drugs to halt the seizure, intravenous glucose, and transported her to the hospital.

In the emergency room, her condition was dire. She was intubated, placed on a ventilator, wrapped in a C-spine collar, and fitted with a heat suit to stabilize her body temperature. Over twelve hours, emergency clinicians worked to bring her back from this near-death crisis. 

Her body was no longer functioning on its own; her lungs had stopped working, and she was in a coma.

Will She Make It?

Ali’s family was told to prepare for the worst. Doctors didn’t know if or when she would wake up, if there would be brain damage, paralysis, or loss of speech. They were told to prepare to say goodbye.

Three days later, Ali opened her eyes. Ali was immobilized, restrained, and struggling to breathe through the tube in her throat. Her first thought was haunting: “I recognized the position I was in from my father’s death, I was immobile and on a ventilator.”

Then she noticed everyone else in the room. Her family was overwhelmed with joy at seeing her awake.

And she made a full recovery. From the moment she woke up, she was functioning perfectly — no brain damage, no mobility issues, and no speech impediments. She was discharged from the hospital within a week. She was still on the transplant list — waiting.

Waiting for a Pancreas/Kidney Transplant

For nearly four years, she endured dialysis — an arduous process for kidney failure during which machines filter your blood for you because your kidneys cannot. This also involves sitting in the hospital for hours at a time every week. 

But Ali’s resilience and spirit remained steady. She wanted a transplant, and she was now doing everything she could to be the best transplant candidate, including managing her blood sugars as tightly as possible. 

Her experience reinforced a profound lesson: the will to survive is essential. Her near-death experience and survival made her appreciate every breath and every moment. With a new appreciation for her body’s strength, Ali waited for that critical phone call.

It was nearly midnight on Valentine’s Day when my phone rang—  Loma Linda Hospital with a donor match for her pancreas and kidneys. 

Her family was away, and Ali was alone at home in California. The journey to the hospital in Loma Linda came with a variety of logistical challenges: the flight was delayed, her luggage was lost, and she battled significant nausea during the flight. But she made it.

Arriving at the hospital, Ali faced a long wait — over fourteen hours—before surgery. When the moment finally arrived, the medical team approached her with a mix of reassurance and hope. 

This wasn’t the first time Ali had received a call about organs. Last time, while waiting at the hospital, she was told the organs had been damaged and were no longer viable. It had been devastating news after feeling so close.

Hopefully, this time was different.

The head surgeon, who had previously delivered difficult news, now took Ali’s hand and told her that this transplant was specially meant for her. The organs were an even better match than the ones before. 

Transplant Successful — So Far

The transplant was successful. Ali’s body accepted the pancreas and kidney, freeing her from the threat of low blood sugars and kidney failure. Her initial recovery went smoothly, and within weeks, she was back home, adjusting to life on immunosuppression medications — grateful for the second chance she’d been given.

Of course, that’s just the beginning. 

As of May 6, 2025, Ali is nearly three months post-transplant. She’s had several trips to the hospital when her bloodwork showed signs of rejection, but with immediate treatment (ie, large doses of the steroid prednisone), Ali’s journey to recovery continues.

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