Sometimes, to escape from life's daily grind, Kevin Hoffman will hop on his mountain bike and ascend the nearest hill in Auburn.

Or the 33-year-old businessman from Loomis will travel to the Maldives islands with a few buddies to surf the Indian Ocean.

Or he'll head to Jackson Hole, Wyo., for some backcountry skiing. Or …

You get the idea. Hoffman's an active, outdoors type. But here's what might surprise: He's also a Type 1 diabetic who must rigorously monitor his blood glucose level at all times, lest it result in serious health problems.

Nearly 21 million Americans have diabetes, according to the Juvenile Diabetes Research Foundation. And 10 percent of those have Type 1, often referred to as juvenile onset diabetes. (Type 2 diabetes often is a result of poor diet and obesity, and can be controlled with diet and exercise.)

Hoffman was 13 and a nationally ranked junior swimmer when it was diagnosed that his pancreas was no longer producing insulin, the hormone that helps transport glucose from the bloodstream to cells for energy. Rather than give up swimming, he monitored himself and eventually earned a swimming scholarship to UC Santa Barbara.

That was 15 years ago. Now, Hoffman and his father head an information technology company in Roseville – a stressful job, he says. He went through a period in his late 20s when his weight rose to 250 pounds (he's 6-foot-1) and diabetes "issues" developed.

In recent years, he has better watched his diet, increased his exercise and dealt with the stress. He's now 208 pounds, and his physique is chiseled as in his competitive swimming days.

"Exercise is highly recommended," says Dr. Sobha Kollipara, a Sacramento endocrinologist. "The more active you are, the better the insulin works. But if you have an active lifestyle, you need to test more frequently."

Hoffman says his "normal" life still takes diligence to monitor his carbohydrate intake. He says he tests himself 10 times a day, but that can rise to an extra five to 10 measurements during, say, a snowboarding session.

"You become astute how your body reacts to various situations," he says. "Insulin counteracts carbs, so you've got to keep track of your carb ratio. And it can shift depending on time of day, if I'm sick, or stressed. I can tell. If I'm frustrated about work or something, my sugar goes way higher."

In recent years, Hoffman has used an insulin pump to determine and regulate his blood sugar levels. It helps him know when to eat and when to increase or decrease the level of exercise.

Before wearing the pump – and especially when he was swimming 7,000 yards a day in college – Hoffman says he had some scary diabetes-related health issues when his blood sugar fell too low. In the worst case, it can lead to seizures, loss of consciousness, coma and death.

Hoffman says he experienced the first two conditions numerous times. "I'd (pass out) and slam my head into the ground and split my head open and patch myself up because I didn't want to go to the hospital," he says.

One problem for teenagers with Type 1, he says, is the social stigma, which is lessening but still persists.

"You're a 13-year-old kid trying to fit in, and you have to take shots and blood tests," he says. "You're different. And if you get too much blood sugar, you get dizzy, sweaty, confused and scared. It's tough on a kid. But they can be active. I was."

Call The Bee's Sam McManis, (916) 321-1145.