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Diabetes Awareness Month
November 9, 2016
November is Diabetes Awareness Month, with November 14th internationally recognized as World Diabetes Day, an official United Nations Day. November 14th was the birth date of Sir Frederick Banting, who alongside colleague Dr. Charles Best, discovered insulin in 1922. Banting later received the Noble Prize in Medicine, and split his earnings with Best.
Trinity School for Children and I would like to acknowledge the students and families managing the challenges of type one diabetes by raising awareness and education on this difficult disease. Only 5% of the tens of millions suffering from diabetes have type one, most diagnosed as children and teens.
Type one diabetes (T1D) is an autoimmune disease where the pancreas stops producing insulin, a hormone that converts sugar (glucose) from food into energy. Cells use glucose as fuel. A type one diabetic’s immune system confuses the insulin-producing cells (beta cells) in the pancreas as foreign, and destroys them. Without insulin to normalize blood sugar, cells throughout the body build up with glucose and starve. And if left untreated, begin to damage the kidneys, nerves, eyes and heart and cause swelling in the brain, leading to coma and/or death.
This autoimmune attack is NOT a result of consuming too much sugar or being sedentary. Although the onset of T1D isn’t entirely understood, scientists believe that gene variations and environmental triggers such as viruses are at play. While a genetic predisposition to developing T1D seems obvious, the inheritance pattern isn’t always clear. All too often type one diabetes manifests inside little people and young adults with zero known family history. T1D has to start somewhere, but many questions remain as to why or when it might.
Since the body cannot function without insulin, an individual with type one diabetes has no choice but to introduce multiple insulin injections or insulin pump therapy into their day-to-day routine. And it’s often challenging to accurately determine how much insulin to take, considering this amount is based on so many variables, including carbohydrate nutrition, physical activity/exercise, illness, stress and hormones. T1D management is a constant balancing act – some days there is no rhyme or reason for fluctuating glucose levels. Some days controlling diabetes can feel like you’re walking a tightrope in a hurricane.
T1Ds typically measure their blood glucose levels by pricking their fingers 6 or more times every day. This number helps decide how much insulin is needed to cover a snack or a meal, or to correct a high blood sugar. Taking too much insulin causes the body to burn too much glucose, which pulls blood sugar down, sometimes dangerously low. This is called hypoglycemia. Symptoms include shakiness, dizziness, nervousness, nausea, hunger, confusion, irritability, blurred vision, coordination loss, fatigue, seizures and unconsciousness.
Taking too little insulin will starve the body’s cells of the energy they need to operate, which spikes blood sugar, sometimes dangerously high. This is called hyperglycemia. High blood sugar and diabetic ketoacidosis (DKA) symptoms also appear at onset of the disease and include thirst, frequent urination, bedwetting in children, stomach pain, nausea, vomiting, hunger, sudden weight loss, mood swings, muscle weakness and lethargy.
It is important to note that the symptoms for T1D mirror the symptoms for the stomach flu and other viral infections that may or may not be present at onset. Remember type one diabetes is autoimmune and possibly triggered by the presence of a common illness. So a misdiagnosis by medical professional unfortunately occurs frequently. And if you don’t have the family history or familiarity to recognize the signs, a proper diagnosis of Type One Diabetic may go unnoticed until it’s too late.
If you suspect your child may exhibit the symptoms of T1D, please make an appointment immediately with your pediatrician. A quick, non-invasive finger stick will measure their blood glucose level to see if it falls within the normal range. Listen to your instincts and be firm in this request. Peace of mind is well worth the copay.
Type one diabetes is a dispiriting, often overwhelming disease. Thankfully modern day science and technology have made incredible advancements to lessen its burden. I remember my own mother having to inject pig insulin and carry around a roaring blood sugar meter the size of a VHS tape. We now have insulin pumps that fit right inside your pocket, a Dexcom Continuous Glucose Monitor that allows T1Ds to track and share glucose levels from anywhere in the world right on their smartphones, and finally, FDA approval on the very first Medtronic Artificial Pancreas, a hybrid closed loop system featuring a SmartGuard HCL algorithm tailored to the needs of each and every individual. Math and science, kids!
Although there is no biological cure for type one diabetes, really smart people at the Diabetes Research Institute, the Juvenile Diabetes Research Foundation, ViaCyte, Inc. and various stem cell research programs around the world are working incessantly to find one. And they just might be onto something. Beta Cell Encapsulation is currently in the earliest phases of clinical trials – a subcutaneous outpatient implant of human embryotic stem cells that mature into pancreatic insulin-producing beta cells, virtually turning type one into type none. No more life-saving devices, no more needles, no more pain. And when this day comes, we’re throwing the biggest party EVER.
Sometimes superheroes reside in the hearts of small children fighting big battles.