Living Well With Diabetes

A week ago or so there was a story in the Salt Lake Tribune about a study done at the University of Utah which found that teenagers with type 1 diabetes do better in managing their diabetes when their parents are more involved.

From the story:

A University of Utah study found when parents become less involved in their teens’ care of type 1 diabetes and when their relationship quality drops, teens are less likely to manage the disease. … When the relationship improves and when parents, say, monitor their children’s insulin levels, the teens do a better job of watching their diet, exercising and testing their blood-sugar levels.

The study authors suggest parents continue to be involved in their child’s diabetes management even as the child reaches an age when he or she is increasingly independent. By the age of 13, children can physically do the work of managing diabetes, but “They’re still making gains in cognitive development until late adolescence, ” says the study’s author. They need parental guidance while they fully develop problem-solving and reasoning skills.

The story appeared in the Salt Lake Tribune here:

Diabetic teens do listen

You can also find stories about this study in these places:

• Parents keep diabetic teens on track
• Parents Keep Diabetic Teens on Track
• Parents key managing diabetes in teens

This story really made me think back to my own teenage years. I was diagnosed with type 1 at the age of 13 and I struggled with it throughout my teens and not really fully accepting that I had diabetes until I was in my twenties. I wonder what this study would say about the teenager who wants nothing more than for the whole diabetes thing to just go away?

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I read in the Wall Street Journal this morning about Kris Freeman’s experience last Saturday in the 30-kilometer cross country ski race at the 2010 Winter Olympics.

Kris was trailing the race leader by just six seconds. He was in a very good position be the first American since 1976 (five years before Kris was born, I might add) to medal in an Olympic cross-country skiing event. This achievement is made all the more impressive when you know that Kris has to manage type 1 diabetes right alongside his rigorous training schedule.

As the Wall Street Journal story describes it, Kris was suddenly down in the snow calling for help. His blood sugar had gotten low. He needed some sugar and he needed it fast.

In a bike race or just out for a ride, I have felt those symptoms of low blood sugar — the shakes, the cold sweat, the confusion, the weakness — and it’s not a good feeling so boy, I can relate to what Kris was going through. Of course, I’ve never had as much on the line as he had in this race.

No, wait, that’s not true. I’ve had just as much on the line as Kris did. Hypoglycemia is a dangerous condition that, if not treated, can very quickly leave a person incapacitated or unconscious or in a coma or even worse. So, Kris and I and all other athletes out there with type 1 diabetes — and there are a lot of us — put our lives at risk every time we go out to exercise, no matter what the activity is. It’s only through careful monitoring of our condition and knowing very well how our bodies react to exercise that we know that we have minimized that risk.

If a person objects to that risk, well, the alternative is to do what the doctors used to tell newly diagnosed diabetic patients back in the 1970′s when I was first diagnosed: take it easy, don’t try to do too much, don’t think about strenuous activities because the risk of severe swings in blood sugars was too great. Well, you know what I say to that? To hell with that, is what I say.

There are endless ways that people can receive a wake up call that life is way too short and must therefore be lived to its fullest. Diabetes, for me, was that wake up call. It took probably 15 years for that wake up call to register inside my thick skull and sometimes I wonder if it still hasn’t fully registered, but I think the diagnosis of diabetes is probably one of the more gentle wake up calls to receive. I mean, think about it. The other classic “hey, stupid, life is short. Enjoy the gift while you can” wake up calls are things like cancer, a serious car accident, the death of a close friend or family member, etc, etc. I could go on, but you get the point. Getting diabetes is really pretty tame compared to those things.

So, I will continue cycling for the rest of my life. With any luck, on the day I die, I will finish my daily bike ride, dismount, and fall over dead. And until that day, I will do any and all other things that look like fun to me whether it’s bicycling to all 50 states (only Hawaii is left), learning to sail, reading all of the Modern Library’s 100 Best Novels of the Twentieth Century, climbing Mt. Kilimanjaro, visiting New Zealand, bungee jumping from the Royal Gorge Bridge in Colorado, or simply taking a long nap on a rainy summer Saturday afternoon.

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This is the tag line of Zip The Cure, an online fund-raising campaign of Pittsburgh teenager Monica Oxenreiter. The idea is to raise $100 in donations to the Juvenile Diabetes Research Foundation (JDRF) from each and every one of the 42,000 zip codes in the United States. One hundred dollars doesn’t sound like much from an area as large as a zip code, but as the saying goes “a hundred dollars here and a hundred dollars there, and pretty soon we’re talking about real money.” When all of the zip codes are represented by $100, $4.2 million will have been donated to the JDRF. That’s a lot of money for a great cause!

The campaign started in November 2009 and so far they have 147 zip codes sponsored. Well, actually, 148 now since I made a donation this morning. Check out their web site at www.ZipTheCure.com. They have a map of the United States so you can see what zip codes are already sponsored.

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A study funded by the JDRF has shown that a first generation artificial pancreas system helps reduce the risk of dangerously low blood sugar levels in children and teenagers while they sleep.

As defined by this study, a first generation artificial pancreas is composed of commercially available continuous glucose sensors and insulin pumps and a sophisticated computer program which is used calculate adjustments in insulin delivery rates. In this study, the adjustments are then entered into the insulin pump manually by a nurse while the study participant slept.

Results of the study were published on February 5, 2010 in The Lancet. There’s also a summary at the JDRF:

Early Artificial Pancreas Trials Show Benefits for Kids, Teenagers with Diabetes While Sleeping Overnight

Almost as an afterthought, the study showed that the system improved blood sugar control. But, preventing overnight hypoglycemic (very low blood sugar) situations is a major concern for every person with diabetes because it can go unnoticed while asleep and can cause seizures, coma, and even be fatal.

For myself, there’s nothing more disruptive to my sleep than waking up in the middle of the night and feeling those all to familiar symptoms of a low blood sugar. I’ll take 30, 45, even 60 minutes to treat it, make sure I’ve treated it adequtely, and then finally get back to sleep.

So while improved blood sugar control is a nice benefit, preventing those nighttime hypoglycemic events will help everybody, especially parents I imagine, sleep better.

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Google thinks so. Google has an application called Google Trends that allows you to view the long-term trends for search terms used on the Google search engine. According to Google Trends, over the past five years, the number of searches for the term “diabetes” has been slowly declining.

What does this say about diabetes? You’d think that if diabetes is on the rise worldwide (and I think there’s general agreement that it is) that Google would have an increase in the number of searches for that term.

Well, if you take a look at Google Trends for some other general health-related search terms, they show similar trends. For example,

• cancer
• obesity
• heart disease
• asthma

All of these show a similar long-term downward trend. Even non-health-related search terms show a downward trend:

• bicycling
• running
• automobile

Interestingly, automobile is dropping dramatically and running is very close but not quite level.

My theory about these downward trends, and about the diabetes search term in particular, is that it says very little about the popularity of the activity or object or the incidence of the disease. Instead, it’s all about the evolving nature of life online. People are getting more sophisticated in their online activities. They’re less likely to find satisfaction in searching for a generic term like “diabetes” or “cancer” or “running.” I mean, it isn’t helpful when Google returns over 65 million results when you search for “diabetes.” Plus, five years ago we didn’t have the concept of social networking sites like Flickr, Twitter, facebook, myspace, etc. so people are finding places other than Google to go to for information. That’s my theory. Anybody have other ideas? I’d love to hear them.

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