IT WAS 33 YEARS AGO. I was 9½ years old and excited to be going to fourth grade.
We started the day at my pediatrician’s office for my annual well child visit — and, of course, to have the school form completed! After the appointment, we spent the day shopping for school clothes and supplies. It was early evening when my mother, sister, and I finally returned home. And we learned that my pediatrician had been trying to reach us all day. (Thirty-three years ago there were no cell phones or answering machines; you just called until someone answered! Imagine that!)
My pediatrician had been trying to reach us because there were abnormalities in my urine, and he wanted us to go to a lab first thing in the morning to have fasting blood work — which allows physicians to see your blood-sugar level before you eat anything — done. He was concerned I may be diabetic.
Early the next morning, we went to the lab to have the blood drawn — something I was not too happy about! But I was much less happy later that same day, when I was admitted to Children’s Hospital of Pittsburgh with a diagnosis of diabetes. So many thoughts raced through my head.
How was this happening? I had no symptoms! I have to stay here overnight?! For a week?! And what do you mean I can’t have a candy bar? There’s nothing wrong with me!
I happen to have been one of the lucky ones. I was not in what is called diabetic ketoacidosis, because my pancreas was still producing some insulin — just not enough. I was determined to be an uncommon presentation, and was able to be controlled on oral medications for almost 2 years, until my pancreas gave out and we finally had to use the daily injection.
DIABETES WAS NOT FOREIGN TO MY FAMILY. There’s a strong history of adults with the disease on my mother’s side, but I was the first child with the diagnosis. I can still remember my Mom looking as if she were hit by a truck. I remember sitting in the classes as the dietician explained how I needed to eat now. No more sleeping in or skipping meals. More strict regiments about when and what I ate. And the importance of keeping control. If I didn’t keep control of the blood sugars over time, I could develop kidney or eye problems, to name just a few.
How did this happen? A few days ago I was shopping for school clothes, and now I’m learning to prick my fingers and check blood sugars multiple times a day?! Why me?!
What I didn’t know at the time was that I had lots of company.
Diabetes affects more than 23.6 million people in the United States. (That’s about 7.5% of the population.) On average, 80 people per day are diagnosed with Type 1 Diabetes.
Diabetes is a metabolic disorder that prevents the body from breaking down food, especially carbohydrates.In kids, diabetes is usually caused by inadequate production of insulin by the pancreas. Insulin is needed to help process and break down the foods we eat (like proteins, fats, and carbohydrates.) These foods are broken down to glucose that the body uses for energy. When insulin is not present, the glucose cannot be used by the body and instead is excreted in the urine, or it remains in the blood cells, causing high blood sugars.
Diabetes can occur at any age, but there seem to be peaks at ages 5-6 and again in puberty. It’s believed that a virus or some other agent damages the pancreatic cells which produce the insulin. This auto immune response may start years before the first symptoms develop. In most cases, diabetes presents with symptoms of weight loss despite an increase in appetite, extreme thirst, and excessive urination. This occurs because the cells are in a sense starving for sugar that the body is not providing. This does not, however, happen in all cases. (It didn’t in mine.)
Unfortunately, there is still no cure for diabetes, and no way to prevent Type 1 Diabetes. There is a genetic pre-disposition; approximately 30% of Type 1 diabetics have a family member with the disease. That’s good to know, but of course, there’s nothing we can do about our genes! Damage to the heart, blood vessels kidneys, eyes and nervous system can occur with uncontrolled diabetes.
THE GOOD NEWS is that Diabetes is one of the few diseases that, if taken care of properly, both kids and adults can minimize the damages that could be caused by uncontrolled sugars and lead a completely normal life. I’m proud to say I’m proof of that!
Diabetes is managed by diet, exercise and insulin. Diabetics are encouraged to follow the same healthy diet as those without Diabetes, including complex carbohydrates, unprocessed foods, and fresh fruits and veggies, while also avoiding the simple sugars. Most Type 1 Diabetics are treated with either daily insulin injections or the use of an insulin pump to provide the needed exogenous insulin to break down the foods. These regimens are monitored closely and adjusted based on activity and sugar levels.
Another important aspect for Diabetics is to test the sugars regularly to help determine the amount of food and insulin they need. This is a regimen that not only the patient but also the family, school staff, and athletic coaches need to be involved with, to help avoid significant lows or highs.
I managed to survive 4th grade with a lot of help from my family, doctors, nursing staff, and school. I made it through high school, college, and even medical school with minimal complications. There are days I still wonder why. But then I look at what I have accomplished even with my disease, and I realize it doesn’t matter, because I have succeeded. I fulfilled my dream of becoming a pediatrician and caring for children. I’m married, and the proud mother of 2 beautiful girls who are healthy and thriving. Yes, the pregnancies were a bit tougher than average, but it was all so worth it!
TO ALL THE CHILDREN OUT THERE: if I can learn to control diabetes and thrive, you can too. Yes, you have to make adjustments to your schedule and monitor your sugars, especially if you’re very active. But you can live a full and wonderful life just like all of your friends!
To all the parents out there: help your children to be independent, and teach them why the choices they make are important. Even when they’re young, they need to participate in their management. If you need it or want it, support is available for both parents and children affected by this disease.
Together, parents and children can learn to manage the challenges of diabetes. And know that, even with a chronic disease, children can still lead a normal, healthy, wonderfully fulfilling life.
Dr. Hartung, a shareholder in the practice, has been a Kids Plus Doc since 2001.