LAS VEGAS -- Super fans of the world's biggest pop star will track every movement of a certain Kansas City Chiefs tight end during Super Bowl LVIII. Another K.C. TE will be tracked in a much different way.
Tucked beneath the beltline on Noah Gray's back, snuggled inside compression shorts under his game pants, will sit a Dexcom continuous glucose monitoring system tracking the tight end's blood sugar throughout the game.
Constant monitoring has been the way of life for Gray since being diagnosed with Type 1 diabetes at 18 years old.
As a freshman at Duke, Gray began losing weight, was pockmarked by extreme acne, and eventually lost his vision. A sky-high 930 blood sugar level sent him to the hospital for four days.
"The doctors were like, 'We don't know how you didn't walk in here in a coma,'" Gray told NFL.com this week as he prepares to play in Super Bowl LVIII. "I think they said that because I was working out so much, it was helping out a little bit, but, you know, I'm drinking Gatorade and all these sugary drinks because I'm so dehydrated that it was throwing me through the roof. And eventually, my body was just like eating itself."
Rarer than Type 2, about 5 to 10 percent of people with diabetes have Type 1, per the CDC. Believed to be caused by an autoimmune disorder, the body attacks itself by mistake, destroying the cells in the pancreas that make insulin. As a result, little to no insulin is produced, leading to high blood sugar levels. Currently, there is no known cure or preventative measure for Type 1 diabetes.
Previously referred to as juvenile diabetes, the disorder can develop at any age. Gray's diagnosis at 18 was considered later in life compared to most.
From there, it's been a game of managing the disease as he pursued his NFL dream.
Like all who have with Type 1 diabetes, Gray learned how to live alongside the disorder, constantly monitoring his blood sugar with finger pricks and using insulin injections before meals to regulate his blood sugar. It's an exhaustive process, but Gray said it jumpstarted his maturity in college.
"It's helped me mature. When I was a freshman, I was eating pizza every night," he said. "I was eating terribly like I did my whole life because that is just naturally how I ate, but then when I got (Type 1), I realized I feel so much better when I'm eating cleaner foods. So, I think it helped me mature in my eating habits. What I'm putting in my body as an athlete, I think that helped me out a lot."
Early after the diagnosis, he experienced some difficulties in regulating his blood sugar levels, especially during workouts, when levels can dip to dangerous lows.
"I did have some low episodes in the weight room in college and stuff like that, which is pretty difficult to deal with," he said. "It's helped me out a lot in the NFL getting the (insulin) pump and the Dexcom to help manage that and decrease the likelihood that I would go low or high."
Extreme lows can lead to hypoglycemia and even death, while prolonged highs can lead to Diabetic ketoacidosis and other issues.
Gray noted for the first four or five years after his diagnosis, he used manual injections and finger pricks to dose and monitor his condition. Thanks to technological developments, he now wears a Dexcom device that constantly monitors his blood sugar level and a pump that administers his insulin. The combination has helped make life easier to manage, particularly as a professional athlete.
"My blood sugar has been 10 times better since I got (the pump)," he said. "It's like a constant drip and constantly corrects if my blood sugar is going high or low, so that's been really helpful."
During games, Gray unhooks the pump, which is situated in the belly region, but can play with the Dexcom to constantly monitor his blood sugar levels without fear of it breaking. The monitor sends a signal to a device (not his phone, as that's prohibited to use during games) if he needs to check.
The 24-year-old said at this point, he usually can feel when he gets too high or too low.
"For me, I can feel when I go low, and I also feel really lethargic when I go high, so when I come to the locker room, I'll check myself," he said. "Sometimes I don't check it at all because I just kind of have that feeling. If I do start to really feel it, that's when I'll check it and make sure I go eat, or I'll connect my Tandem pump again and give myself insulin. I kind of do it off of feel, but some diabetics can't even feel when they're going low until it's too late. They don't realize they're going high. It affects everyone differently, which is unique to diabetes, especially Type 1. But that's how I manage it through games."
Gray said he's fortunate never to have had an incident during a game and credits his pregame routine with helping keep him regulated, which includes eating three and a half hours before a game.
"I try to keep the meals I eat at the exact time before games and eat pretty much the same meal," he said. "Like I'll eat steak and rice before games usually. Or if it's a really early game, I'm just eating breakfast food, so I love fruit, and I'll eat eggs. And I love toast, too, so I'll have a slice or two of toast. But I try to keep it exactly the same every game just because it makes it more predictable."
With a 3:30 p.m. local time kickoff for the Super Bowl, Gray can expect to eat his pregame meal at noon on Sunday.
The third-year pro said being an athlete has helped manage his disease.
"Yes, a lot, because when I'm not working out, my blood sugar is a lot harder to control," he said. "When you're more fit and more active, it's really beneficial to maintaining your blood sugar. So when I take my month off after the season's over, I have to take pretty much double the insulin that I would take while I'm in-season because I'm not working out and getting that exercise."
It should be abundantly clear at this point that Type 1 diabetes isn't like an ankle or knee injury that an athlete can rehab and get over. It's something Gray and others play through their entire lives. It's constantly top of mind.
"I think that's one thing that I can't stress enough: You have to put in as much time managing it as you do in your job," Gray said. "It's very much life or death. Me being able to play football at a high level is really dependent on me making sure that my body feels good blood sugar-wise to go out there. Working hard at managing it and taking that seriously is very, very important."
Gray isn't the first to battle through Type 1 in the NFL.
Baltimore Ravens tight end Mark Andrews is perhaps the most famous Type 1 diabetic currently in the league. Gray said while he's never met Andrews, he's in group chats with Miami Dolphins long snapper Blake Ferguson and Jaguars linebacker Chad Muma, both Type 1 diabetics. He noted that sharing ideas and experiences helps him manage it during games and practices.
Gray also tries to help others, particularly those much younger who will have to deal with the disease their entire lives.
"I usually work with young kids who get diagnosed," he said. "I wasn't a young kid when I was diagnosed with it, but as an 18-year-old, it was tough. I'm a grown dude, and it was hard on me. I can't imagine what it's like for a 5-year-old who gets diagnosed. They're going to school and having to give themselves injections or check their blood sugar. ... It's really important to me to try to help other people with (Type 1), especially the younger generations, because I see how hard it is on me. I can't imagine how it is for them."
Sunday during Super Bowl LVIII, Gray will inspire all those youngsters living with Type 1 that no matter the literal highs and lows, they can pursue their dreams to any height -- even the Lombardi-lifting kind.