By Alexi Melvin

Netflix’s “Say I Do” is a reality show about surprise dream weddings, but its first episode showcased something we don’t often see in reality TV – type 1 diabetes (T1D). In the episode, Marcus LaCour was given the chance to surprise his wife Tiffany with a magnificent wedding do-over.

Alongside planning and logistics, Marcus also spoke candidly about his life with type 1 diabetes, spurred by a conversation around how wedding catering decisions needed to take into account the food choices he makes to help manage his blood sugar levels. We caught up with Marcus to chat about his experience on the show, how he handled presenting his type 1 diabetes to the world, and where he and his family are now.

Did you ever imagine that you’d be on a TV show on Netflix?

I definitely didn’t expect it. It’s one of those things where you’re like, you know what? If it happens great, if it doesn’t, it’s great too. I don’t think it dawned on me really until we started shooting. Once we started filming, I was like, “Oh, this is it. This is legit.”

When you were talking about your T1D on the show, it came across so well. Is that something you discussed beforehand with the producers? Did you preface anything or was it organic?

It was organic. We literally were just sitting and talking about it. The subject of food came up and early on I told them, “Hey, I’m a type 1 diabetic.” We were just having a conversation of, “Hey, how’s this, how’s that? How did that happen? How were you diagnosed?” Literally, just conversation flowed from there. In my honest opinion, it was one of the most genuine conversations I’ve had with anyone about my condition, just because it was in a room and in the area where there was an open space where I could tell them everything I needed to tell them about the condition.

You touched on how much your wife did for you when you had a situation where you lost your healthcare – the rationing of food and things like that. Did that also include rationing of insulin? Were you having issues with getting supplies?

I was. I was getting samples from my doctor’s office at one point. You know when you’re trying to ration insulin or trying to pick the insulin you can afford, it’s not as effective as what you’re used to. I was getting the regular 70/30 mix insulin pens. I kept bottoming out throughout random times of the day. I was used to taking NovoLog but [at one point, my doctor] didn’t have any NovoLog samples. So I was literally just getting whatever he had.

When [my doctor] did get the NovoLog pens, I was using those thinking, okay, he should have some more samples. Well, there was a time where he didn’t, and that time for about a month maybe, we’ll say three weeks, I was rationing my insulin, because I’m trying to make sure that if I do go high, I have enough to cover the high. If I go low, just [having food] to eat, but more importantly, what you need on a daily basis [to keep your levels stable].

One day, the doc called and said they didn’t have any samples. I was down in my last 10 units. So for about an extra two and a half, almost three weeks, I was rationing 10 units of insulin.

When did that situation start getting better for you?

I ended up getting a loan from my boss because at the time I started a new position and he was like, “I don’t want to see you suffer.” At the time, NovoLog Flex Pens were $250 for the pack. So he gave me a check for $250 and said, “Hey, go get your meds.” So that was how I got through that. Then somehow, by some sort of miracle, after that pack ended, my doctor, all of a sudden, got samples again.

What is your management routine like now?

It’s the Omnipod right now. I’ve got better insurance that covers the pods altogether. It’s still an adjustment for me though, because I’m used to not having a PDM. Before, [when] I was on the injections, it was, wake up, take your long term, and then just carry the Humalog pen on me at all times. Then with the pump, [if] we’re going to work out, I forget to suspend my insulin flow. Or if the site doesn’t take, having to double check and make sure blood sugars aren’t really high. So it’s a couple of different things, but it’s not bad. It’s still an adjustment though.

Do you feel you prefer the MDI or do you feel the pump ultimately is going to be better?

I’m already seeing changes in my numbers, just from average standpoint. On the shots, the lowest my A1C was, or I could get it, with 6.9, 6.8, but now I’m seeing, that even though there are days where I may be high because the pod didn’t take, or I may run low, those days are few and far between, so I’m running normal on a lot more of a regular basis.

Do you use a Continuous Glucose Monitor (CGM)?

I don’t. It looks we have to go four months without a CGM and track those numbers before insurance will approve it.

In terms of your diet, on the show, you talked about how you’re conscious of what foods are going to spike your blood sugar. Is there a specific diet you to stick to? Are there certain foods you prefer or are you getting more flexible with it because of the pump?

I am still a very conscious eater. I prefer to eat clean. Everything has to have a balance. Now I know with the pump, you have that freedom to literally eat whatever you want. But for me, when I was diagnosed, I didn’t have that option. So, it was literally sticking to that diet, sticking to that regimen. Everything has to have a fresh fruit or fresh vegetable, [there] has to be a starch. There has to be a grain and there has to be a protein. That’s the only way that I know.

I came across a comment online that said, “Well, diabetics can eat whatever they want.” It’s very true. But for me, I don’t want to run that risk. I think I’ve always done something whenever I got a new insulin, when I got my Humalog, I wanted to make sure it worked. So I got a peanut butter Twix, took it to cover it, just to see what it would do. When I got my pump, I had a chocolate chip cookie just to make sure it was working. It would work, but overall, my diet is consistent. I prefer to eat clean. It’s just because I know these things aren’t going to have a whole lot of impact on my blood sugar.

I saw on Instagram that your daughter’s been learning more about your T1D management. How’s that going?

It’s going well honestly. Before, when I was taking my shot, it was just, “Hey, Daddy’s got to take his insulin,” or, “Daddy’s got to check his blood sugar.” So she’d always been curious about it. Then one day I had to change my pod. “Are you changing your pod, Daddy?” “Yeah, Daddy’s changing his pod. you want to watch?” “Yeah, I want to watch.” So she came in and got hands on. I always want to make her aware just in case something happens. If my blood sugar goes low and I’m unresponsive, or if I’m too low and I can’t get up to get anything, I want to make sure she’s aware to say, “Oh, Daddy’s not feeling well. Daddy he needs something to eat.” Or, “Something’s going on. Let me tell Mommy.” I always want to make sure she’s aware of what my condition is, not to scare her, but to the point where she can be reactive.

Who did you have as a support system when you were first diagnosed?

My mom was my biggest supporter. I didn’t keep it from my friends, but I felt they wouldn’t be able to understand. They were used to me just being able to get up and do whatever. If we wanted to play football, it was get up and do it without having to worry about anything. They knew I had type 1 diabetes, but they didn’t know the entire scope of what it meant to take care of that condition. So it was my mom. Then over time, my friends started to get a little bit more of an understanding of it. So my friends would ask, “Hey, what’s your blood sugar like? Are you OK?” Or if I was going to the gym to work out with some of my buddies, “Hey, don’t forget your meter.” Or I’d always bring my meter with me and I’d have to check in the middle of work out, see either I’m high or low, or just to figure out where I was at. They would always ask, so they held me accountable in that regard.

Have you been getting a lot of people in the type 1 community reaching out on Instagram or social media?

I’ve gotten that. It’s always refreshing because [they’re] like, “Thank you for representing and letting the world know about your condition.” Well, it’s a part of me. I’d be foolish to hide it, like, “I don’t have a condition.”

Had you been involved in the type 1 community at all before appearing on Say I Do?

Not necessarily. I’ve always wanted to though. I’ve been at this for almost 20 years, it’ll be 20 years in November. When I first got diagnosed, there weren’t a lot of support groups. There weren’t very many places for me to go where I could vent or even if I had high blood sugars or even lows, how to combat that and deal with those. But now times have changed. I would love to be able to get out and talk to people about what our condition is and how to manage it effectively.

What’s next for you and your family?

Honestly, I am not sure. I work for a Children’s Hospital down here, so I recruit for them and it’s just more or less just going with everything at this point, just laying back and enjoying the ride while we have it.

Do you think you’re going to seek out more TV opportunities?

To be honest, I don’t know. This is all new. It’s all new to both of us. If more opportunities come, then yeah. Absolutely. But it really just depends on what comes down the pipes. I think the ultimate goal would be just for us to just enjoy this and see where it takes us.

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Read more about A1c, continuous glucose monitor (CGM), Humalog, inspiration, insulin, Intensive management, interview, NovoLog, Omnipod.