Alissa's Fitness Blog

Alissa's Diabetes and Fitness Blog


Discussion of Diet and Fitness as a tool to manage Diabetes

Miss New Hampshire 2016 and T1D, Caroline Carter

You can keep up with Caroline by visiting her official Facebook page, Miss New Hampshire Caroline Carter

Alissa:   When were you diagnosed with diabetes?

Caroline:  I was diagnosed on November 17th, 2008. I was just about 10 years old. Before I was diagnosed with diabetes, I had been dealing with Mononucleosis.  Then something changed. I lost 13 pounds in one week despite the fact that I was eating a lot. I was urinating frequently, and losing muscle alarmingly fast. Ironically, the day I finally went to the doctor I had eaten a bag of nacho chips and a pint of ice cream to keep my weight up. My blood sugar was 545.

Alissa:   Does diabetes run in your family?

Caroline:  No, an environmental factor eventually led to my diagnosis of diabetes. No one else in my family has diabetes before me, or after.

Alissa:   Being diagnosed as a child must have been challenging. How did you learn to cope with your new norm?

Caroline:  When I was diagnosed my mom told me that “Everyone has something.” She explained that this was my something and I had to learn to deal with it. I continued to live my life as a happy-go-lucky 10-year-old girl. I was the only student at my school diagnosed with diabetes. I became the teacher to my teachers, explaining diabetes and the ways to assure that I was safe. I was also incredibly lucky because my basketball coach was a diabetic educator at the hospital near me. In fact, my entire team was very supportive – it was like having 15 sisters. They made a game out of testing my blood sugar during practice. Everyone had to try to guess what my sugar level was and whoever was closest was excused from running during the next drill.

Alissa:   You have recently been newly crowned Miss New Hampshire. Can you share with me your journey? 

Caroline:  My sister was the first to compete in pageants. I wasn’t really interested as my time was divided between basketball and the drama club.  However, when I learned the Miss America Organization held components based off of talent, community service, and awarded scholarship dollars, how could I refuse? At the age of 14 I opted to try the pageant circuit, and I have never regretted that decision. I have had such a great time through my years. I've sang the national anthems more than 350 times, and I have networked and created relationships with so many people. The Miss America Organization  lead me into my involvement with the Juvenile Diabetes Research Foundation.

I’ve integrated my diabetes into every part of competition. Many people are concerned with their weight, always working out and watching what they eat. I have learned a very important lesson: While the number on the scale is important, the number on my blood sugar monitor matters more in regards to my health. This past year, I took part in the swim suit competition. I chose to wear a one piece, and was the only one at Miss America to do so. The suit I wore was blue in support of the diabetes community.

Alissa:   How can others get involved in competing within their state?

Caroline:  Go to their state website! For myself, it was  In other states the website will start with Miss followed by the state Anyone can sign up to compete in a local pageant. All you need is a resume, which is pretty easy to write up, and a Personal Platform. The Miss American Organization promotes these ‘platforms’; community service projects you advocate for. Mine is called “1, 2, We: Diabetes Advocacy.”

In the teen competition, participants have to participate in a fitness number, which involves all the girls going on stage to do jumping jacks or pushups. There is also a talent portion. Participants can sing, dance, play a musical instrument, or perform a monologue.  I have seen a wide variety of talents even outside of these. The Miss contestants will participate in a 10-minute interview with the judges where they will be questioned on politics, their platforms, and their resumes. The Teen contestants have an 8 minute interview, where they are asked about their platforms and resumes.

Alissa:   Why do you think the judges selected you to be Miss New Hampshire?

Caroline:  I believe I was chosen because of my confidence.  Any judge wants to see that you believe in yourself. From the judges’ feedback, I know they valued how passionate I am about the diabetic community and I am committed to making a difference.

Alissa:   What did it feel like when they announced you as Miss New Hampshire?

Caroline:  It was amazing! Something that made it extra special was that my first runner-up was one of my best friends. She was Miss New Hampshire's Outstanding Teen before I was, and she has given me so much support throughout my years. The competition could have gone either way. In that moment, it was just surreal. We both knew that one of our lives was about to change, and I'm very happy I was able to share it with a friend.

Alissa:   How do you manage your blood sugars during the Miss America competition?

Caroline:  I learned a lot about myself during those two weeks. I rely on my glucose monitor which is on my phone to check my blood sugar. During the competition for security reasons I wasn’t allowed to have a phone on me.  I knew I would have to return to checking my blood sugar on a meter 8 times a day, and that was what I did.  I was also given Elovate packets, a sugar packet for diabetics. It is only 62 calories and has 15.5 grams of carbs – this will bring your blood sugar up from a low within 15 minutes. This was a lifesaver, especially during the swim suit competition. The packets helped keep my sugar in check, especially at night.

Alissa:   What did it feel like when you weren’t called to join the top 15 in the Miss America Pageant? Do you thing it had anything to do with you being diabetic?

Caroline:  It just wasn’t my year. When one door closes, another one opens, and I'm very grateful for my experience in Miss America.  I admit it was a little hard not hearing my name called; I spent a lot of time working for this title. In the end, it was a great experience and I made a lot of great friends. I know there is this perception that pageants bring out the cattiness between competitors, but people need to realize this isn't Toddlers in Tiaras. We are smart and driven young women who want to make a difference, and we were all there for the same reason. I strongly believe that the right women made it to the top 15.  I have made my impact with diabetes, and I have helped people, particularly younger children, accept their diagnosis and wear their equipment with pride. Everyone saw my Dexcom CGM and my Medtronic pump, and in turn I have received so much positive feedback as well as stories from those like me.

Alissa:   Did they tell you where you placed or is it just top 15?

Caroline:  I won a non-finalist talent award, but after top 15 they do not place you.

Alissa:   Tell me a little bit about your talent. How did you get into singing?

Caroline:  It all began in 7th grade drama club. I remember the director mentioning a musical that was similar to Disney’s Little Mermaid. This was the beginning of my singing addiction. My first singing instructor was the leader of the Gospel Divas of Soul, Bebe. She really helped me find my voice. It was exciting for me to incorporate my love of singing into the pageant. My first talent song was “I Defining Gravity” about 5 years ago, and I ended with “I Dreamed a Dream” at the Miss America pageant. 

Alissa:   What is the biggest challenge a pageant competitor with diabetes faces?

Caroline:  Initially, I thought it was obvious; the swim suit competition. In reality, it was preparing myself for the possible reality that I could be crowned Miss America, which would require a great deal of travel that would be out of my control. The Miss America winner is a national spokesperson, not only for the organization but for the platform she represents. I would have been traveling 320 days out of this year. I know that I would not be able to control the meals I would eat nor would I always have the right foods on hand when meal planning. It would have been interesting trying to manage my diabetes, but one of my role models, Nicole Johnson, had done it.  At least I know I would have had someone who had gone through the same circumstance to rely on.

Road trips are not so simple for a diabetic. We must proactively prepare: How much insulin do I use in a day? How much insulin do I need to bring with me? What about test strips? What would I do if I run out?  It would have been a life lesson on always being prepared.

Alissa:   Do you think the Miss America pageant perpetuates obsessive behavior in regards to fitness or eating disorder traps?

Caroline:  I don't believe in dieting. A person must be active in ‘healthy living’ in all components- physically, mentally, and emotionally. I have always been a size 4/6. I was one of the “biggest” girls competing at the Miss America pageant, and that was okay!  You can't hate your body, because it's one of the only constant things about you in your life.  A happy mind equals a happy body.

Alissa:   So do you think that pageants can lead to eating disorders?

Caroline:  Yes it can, but only if you let it. When it comes down to it, it's your choice whether you are happy with your body or not. Unfortunately, there are some who will always think that they are not as skinny as others, and they will then go to unreasonable lengths to get their ‘dream’ body. Have I seen it happen to people? Absolutely. Has it happened to me? Absolutely not. During Miss America I was eating a special diet of six meals a day, and of that, I was eating 125 grams of protein a day with cardio and strength training. We need to emphasize that what we do to look on stage is not alright for typical everyday life. It is short time people who compete call “Peak Week”. It is important to know how to transition from competition eating habits to a regular diet.

Alissa:   How do you maintain your diet when you are not competing?

Caroline:  Before and during Miss America, I ate more proteins did a lot of cardio. Now, I do more strength training, and I don’t necessarily eat six meals per day.  Honestly, when you come back from a competition the first thing you are going to do is indulge in something unhealthy like fried ice cream, i.e. me. Then you get back into a routine of eating around five meals per day. During competition, I would have the equivalent of five eggs for breakfast in egg whites and some toast with a healthy fat, like coconut oil in my coffee. Typically, I will now have oatmeal and two eggs.

Alissa:   What you are doing now to advocate for National Diabetes Awareness month? 

Caroline:  I wear my Dexcom CGM (Continuous Glucose Monitoring) and my Medtronic pump in the visible range. I get the most positive response when people can see the equipment, and that includes testing my blood sugar in public or dialing some insulin with my pump. 

I've also travel to various schools so I can educate the kids about diabetes. I teach them not only about diabetes, but the importance of diet and exercise.  Obesity in America is skyrocketing, and so is Type 2 Diabetes! I have also received requests regarding travels to speak at JDRF galas around the country. 

Alissa:   What are you college plans and career goals?

Caroline:  Thanks to the amazing scholarships I received through Miss America Organization, I will attend the University of New Hampshire this coming fall. I am one of the 24 students accepted into the Kinesiology Department, majoring in exercise sciences with a minor in biology. I have also earned a full scholarship for graduate school, studying for my doctorate in chiropractic.

Alissa:   Are you going to continue in the pageant world?

Caroline:  For now, I am all done.  I have so many doors opening for me; I don't think I could fit any more onto my schedule.  I am excited to let someone else enjoy the spotlight and job as I have. 

Alissa:  Who is your role model?

Caroline:  I look up to both my mother and my sister. They are the strongest female figures in my life.  My mother raised my sister and I to be strong, independent adults.  She has always encouraged us to aim for our full potential and has never let anything hold us back.

My sister taught me to be fearless. She traveled to India for yoga school, she's lived on a tropical island, opening up Hospice centers, and now she's in Seattle working as a palliative care nurse, engaged to be married!  We are both extremely happy and grateful to be where we are today.


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