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Back in the saddle: Teen doesn’t let T1D stop her from competing

There’s a graceful irony to the sport Alivia Garwood has chosen to pursue.

The 13-year-old from just outside of Des Moines, Iowa, is an accomplished equestrian in the discipline of equitation — the art of horsemanship.

Garwood competes in Saddle Seat Equitation where horse and rider are evaluated on, in so many words, their manners and behavior. It’s an elegant display of control and poise.

“You’re thinking about performance, body position, and you have to go in patterns,” says Alivia. “It takes a lot of concentration and discipline. You can’t think ahead. You have to stay in the moment.”

Of course, the irony is that living with type 1 diabetes doesn’t always afford the option for staying in the moment.

Alivia was diagnosed when she was six. Her mother, Antoinette, vividly remembers Alivia’s rapid weight loss, the drive to the children’s hospital, and the look on the medical team’s faces as they delivered the news.

Alivia has scattered memories of that late summer day — her parents crying, the gray sweatshirt with the pink heart she was wearing, the kindness of the nurses.

Antoinette recalls how her initial shock eventually turned to resolve.

“As a mom, I can’t fix this,” Antoinette recalled. “I can’t do anything. Lots of tears and lots of fear. I had a lot of those really dark emotions that I can’t make this better for her. I’m going to fail her. I’m terrified.

“A week later, we said we’re going to kick this thing’s butt. No feeling sorry. We’re going to take this and make the best of it. That’s been our goal for the last seven years.”

Alivia was always athletic. But after her diagnosis, the gymnastics club she attended kept her on the bench. She instead turned to dance and developed a passion for ballet.

“It was slow and calming, I loved it so much,” Alivia said. “In ballet you have to have certain forms and techniques. You’re using parts of your body you don’t normally use in everyday life. I think that helped me so much with equitation.”

Saddle Seat Equitation is very much a dance. Alivia leads, and her quadruped teammate follows. Her less visible partner in the background is her t:slim X2™ insulin pump with Control-IQ® technology. Because of the intense focus needed for competitions, Alivia has to do her best to avoid experiencing highs or lows.

“While I’m showing, I have to be in range or I won’t be able to concentrate,” Alivia said. “Control-IQ technology has really helped with that.”

The Garwoods had tried other insulin pumps with little success. It wasn’t until they got the t:slim X2 pump with Control-IQ technology that everything came together for Alivia.

“It was a game-changer,” Alivia said.

But beyond competition, Control-IQ technology has helped strengthen the bond between mother and daughter. Antoinette recalls being fixated on Alivia’s CGM (continuous glucose monitoring) readings. That led to non-stop worry, sleepless nights, and a relationship that seemed to only revolve around diabetes.

“I think Control-IQ technology has given both of us more independence,” Alivia said. “I can go to the barn for a day and only have to look at my pump a couple of times.”

Added Antoinette: “I think there’s more peace and less worry. She gets to have more control over her diabetes, and we get to spend more time on our relationship. Now we can talk about TV shows and vampires. We’ve opened up a whole dialogue that’s not about diabetes.”

To illustrate Alivia’s determination, Antoinette pointed to a recent competition where Alivia was hospitalized for a non-diabetes related illness. Alivia still wanted to compete, and the doctors gave their blessing — but mom still felt shaky.

“We got back from the hospital at 2 AM and she said, ‘Mom, I can do this,’” Antoinette said. “The next morning she was out there competing. We’re in awe of her.

“We have a saying in our home: ‘I never lose, I either win or I learn.’ She just has to feel good. She just wants to be on her horse and do her thing. That’s the kind of person she is. This kid just plows through.”


Thank you, Alivia and Antoinette, for sharing your story about how Control-IQ technology changed your lives. We can’t wait to keep following your riding career.

Photo Credit: Terry Young Photography

From time to time, we may pass along suggestions, tips, or information about other Tandem insulin pump user experiences or approaches to the management of diabetes. Please note, however, individual symptoms, situations, circumstances, and results may vary. Please consult your physician or qualified healthcare provider regarding your condition and appropriate medical treatment. Please read the Important Safety Information before using a Tandem Diabetes Care product.

Responsible Use Control-IQ Technology

Control-IQ technology does not prevent all high and low blood glucose events, and is not a substitute for meal boluses and active self-management of your diabetes. Control-IQ technology will not be able to predict sensor glucose values and adjust insulin dosing if your CGM is not working properly or is unable to communicate with your pump. Always pay attention to your symptoms and blood glucose levels and treat accordingly. Please visit tandemdiabetes.com/tslimX2-use for more information.

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