‘Walking a Tightrope’; Those With Disease Must Constantly Monitor Blood, Diet, Activity and More
By Copyright 2007 Albuquerque Journal BY OLIVIER UYTTEBROUCK Journal Staff Writer
Shellie Jablonowski’s days and nights have revolved around her 8- year-old son’s blood tests and insulin injections since the boy’s immune system betrayed him seven years ago.
Type 1 diabetes destroyed Anthony’s ability to manufacture life- sustaining insulin when he was 13 months old.
"It’s just this whirlwind of variables that you deal with," Jablonowski said of her son’s diabetes.
An estimated 15,000 children and adolescents are diagnosed with type 1 diabetes each year in the United States, according to a study published in June in the Journal of the American Medical Association.
The New Mexico Department of Health estimates that 130,000 New Mexicans have diabetes, of whom 5 percent to 10 percent have type 1.
Jablonowski said she gets up at 2 a.m. every morning to check her son’s blood-sugar level — a test the family performs at least seven times a day. She also tests ketone levels in his urine every three hours.
Results of those tests help her determine insulin dosage for Anthony, who receives at least four injections each day.
Anthony’s blood-sugar level could plunge in an instant, causing seizure, coma and brain damage. But high glucose levels pose tragic long-term consequences, including blindness, heart disease, limb amputations and kidney failure. Other factors that affect Anthony’s blood-sugar include his diet, activity level and overall health.
"It’s like walking a tightrope," Jablonowski said.
Type 1 used to be called "juvenile" diabetes. But some, like Albuquerque endocrinologist Dr. Jeremy Gleeson, say the term is misleading. "Juvenile diabetes makes it sound like a kids’ problem," Gleeson said. That’s wrong on several counts. Though typically diagnosed in children, type I diabetes can strike at any age, he said. Also, people must deal with the disease all their lives. An example is Gleeson’s longtime patient, Jack Hoover, 66, who has battled type 1 diabetes since age 5. A retired teacher, father of two, and now a Wal-Mart employee, Hoover has avoided many of the pitfalls of diabetes with rigorous self-testing and insulin treatments. "You either learn to live with it or you learn not to live with it — and you don’t do very well," he said. Only recently has he developed some neuropathy — or nerve damage — in his toes. He began using an insulin pump about 15 years ago, replacing multiple insulin injections each day. Hoover describes the pump as an invaluable tool for managing the disease. "I would advise any diabetic to use an insulin pump because it will change your life," he said. "You get used to it and you don’t even know it’s there." Hoover meets quarterly with Gleeson, most recently on Wednesday. An Aug. 31 event was on top of Hoover’s agenda. That day, he experienced convulsions for the first time ever when his blood- sugar
dipped to dangerously low levels. His fiancee noticed that Hoover was absentmindedly chopping onion after onion. "She asked me why I was chopping so many onions," Hoover told Gleeson. By that point, his mind wasn’t functioning, he said. "I just kept chopping onions." Hoover used an oral glucose gel to quickly boost his blood-sugar level.
Gleeson said the episode poses no major concern so long as Hoover maintains his rigorous testing regime. Hoover tests his bloodsugar at least 10 times a day because his diabetes is "brittle" and his blood-sugar changes dramatically. "It varies so much I just have to check it more."
Hoover records each test in a spiral notebook that contains hundreds of entries each month. He and Gleeson pored over the data Wednesday. Overall, Gleeson told his patient, Hoover’s blood-sugar levels have remained at healthy levels despite the Aug. 31 convulsions.
"This is the challenge of diabetes," Gleeson said. "You’re between the rock and the hard place with low blood-sugars and high bloodsugars." Diabetes facts
Diabetes is emerging as a major health crisis of the 21st century.
An estimated 20.8 million Americans — 7 percent of the U.S. population — have diabetes, according to the Centers for Disease Control. That’s up from 18 million in 2003.
If the current rate continues, one in three Americans born in 2000 will develop diabetes, according to the Journal of the American Medical Association.
Diabetes occurs in two forms: type 1 and type 2.
Both types share many symptoms and dangers. In the long term, both forms can damage nerves and blood vessels and lead to heart disease, stroke, blindness, loss of limbs and kidney failure.
Type 1 diabetes accounts for 5 percent to 10 percent of the nation’s diabetic population.
But type 1 and type 2 diabetes differ in fundamental ways. develops when the body’s own immune system destroys beta cells in the pancreas, which produce the hormone insulin that regulates blood glucose. People with type 1 diabetes need insulin injections to live. Causes of type 1 diabetes remain unproven but genetics might play a role combined with a trigger such as an infection or toxin. Type 1 strikes an estimated 15,000 children each year in the United States. occurs when the body fails to produce enough insulin or develops "insulin resistance" and fails to respond to insulin produced. Aging, obesity and inactivity are the top contributing causes.
TYPE 1 DIABETES
TYPE 2 DIABETES
9 a.m. Saturday at Balloon Fiesta Park
9 a.m. Saturday at Balloon Fiesta Park
www.jdrf.Walk to Cure Diabetes The Juvenile Diabetes Research Foundation International, a nonprofit group dedicated to finding a cure for diabetes, holds an annual fundraising walk at 200 sites nationwide. The Albuquerque event attracted some 3,000 walkers in 2006 and raised $346,000 for diabetes research. Organizers are shooting for 4,000 walkers this year. The foundation provided about $122 million for diabetes research last year. For more information or to register online, visit the group’s Web site at org/ newmexicoor call (888) 533-9255.
(c) 2007 Albuquerque Journal. Provided by ProQuest Information and Learning. All rights Reserved.