The blood-glucose monitor on the dash of his race car is just another dial that driver Charlie Kimball needs to keep an eye on as he speeds around a track.
"It's like watching the lap time and the speed and the water temperature," said Kimball, who will race Saturday at the Kentucky Speedway in Sparta in the Indy Lights series.
That matter-of-fact attitude has come after years of learning to manage his diabetes. For a short time in 2007, Kimball thought his career was over. Instead, he is the only racer in Indy car history to race with diabetes.
His medical journey began when Kimball, who decided on racing instead of going to Stanford University out of high school, went to the doctor for a skin rash.
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"He asked if I had any other health concerns, and I said I had been a little thirsty lately," Kimball said in a recent phone interview. What did he mean by a little thirsty? Kimball told the doctor he was drinking four or five bottles of water a night.
A quick test showed that his blood sugar was extremely elevated. When he stepped on the scale, he found that he'd lost 25 pounds in a week. "As an athlete, I didn't have 25 pounds to lose," he said.
After the examination, the doctor told him he had diabetes.
"There are moments in your life when it's like someone has just hit 'pause,'" Kimball said. This was one of them. He was afraid his career was over.
"Racing was everything I knew," said Kimball, who started driving go-karts as a 9-year-old in California. "I grew up watching motor sports because my dad is a mechanical engineer."
In fact, Gordon Kimball was a world-renowned Formula One design engineer and Indy 500-winning car designer during the 1980s.
"I thought I was going to lose the chance to do what I loved," Charlie Kimball said.
He didn't spend much time pondering the "why" of it all.
"It didn't kind of matter." What did matter was "how to deal with it and how to get back in the race car," he said.
Kimball, 25, soon teamed up with Dr. Anne L. Peters, a professor of medicine and director of the University of Southern California Clinical Diabetes Programs.
Peters had helped swimmer Gary Hall, who won 11 medals in the 1996, 2000 and 2004 Olympics, after Hall was diagnosed with diabetes in 1999.
Peters said she was struck immediately by Kimball's attitude. Although he began racing professionally at 16, he wasn't simply obsessed with getting back on the track.
As passionate as he was about racing, he wasn't adamant that he would drive again. He wanted to race only if he could be sure he could do it safely.
"I really appreciated that about him," she said. "To deal with diabetes and race cars, you have to be very responsible."
The stresses of racing did present a challenge, she said.
"It's something that uses a lot of both mental and muscular strength," she said. Glucose is necessary for the muscles and the brain to work. Too much glucose and you are sluggish. Too little and you could lose consciousness.
"You have to keep that fine line," said Peters, who had a team, including a nurse practitioner and a dietician, working with Kimball.
Peters, who rode on the race track to better understand what Kimball dealt with, said there were some unexpected findings as they explored how the disease affected him as a driver.
His blood sugar levels were vastly different when he drove on a track than when he competed in road races. Different kinds of concentration affected blood sugars differently.
Kimball's race car was fitted with a continuous glucose monitor that uses special sensors in his racing suit. His mechanical engineer dad helped work out the technology glitches.
Kimball uses the same kind of hydrating helmet used by other drivers, but instead of water, Kimball keeps his filled with orange juice in case he needs a little blood sugar boost.
These considerations are in addition to improved diet and constant blood-sugar monitoring. Plus, he takes medicine.
Although he was back in the driver's seat six months after his diagnosis, he checks his blood sugar four to six times a day.
"Sometimes I feel like diabetes is a moving target," he said. "There will be times when my blood sugars will be really good, and then they will not be. It's not a cut and dry sort of treatment. You are constantly fine-tuning."
Fortunately, Peters said, Kimball is doing well at managing the disease.
"It's really hard for Charlie," she said, "and he does it impressively."
In fact, Kimball said, he has never had even a sip of juice while racing.
Off the track, Kimball has created a mission of talking to people about his disease. Even his car makes a statement: It is sponsored by Novo Nordisk, the company that makes the Levemir FlexPen, which he uses to give himself insulin, and the two forms of insulin he takes to control his blood glucose levels.
Kimball is eager to create a lasting legacy.
The Indy Lights series that he competes in is the race car equivalent of the minor leagues in baseball. Kimball has set a goal: to be the first driver with diabetes to win the Indy 500.
"I didn't want to be just the kid with diabetes," he said.