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Endocrinology

Lauren controls Type 1 diabetes

Lauren controls Type 1 diabetes

Lauren shares a light-hearted moment with Donald Zimmerman, MD, head of the Division of Endocrinology.

Jim and Karen will always remember their vacation to Portland, Oregon three years ago, but not for the tourist attractions and family visits. It was during this trip that their 20-month old daughter Lauren was diagnosed with Type 1 diabetes.

“She was dehydrated, listless and didn’t want to eat,” Karen recalls. “The doctor said, ‘She has a virus.’ We wanted to believe it was just a virus.” When the virus didn’t get better, the Hustons took Lauren to the emergency room, where the triage nurse immediately suspected diabetes.

Type 1 diabetes is the most common type of diabetes in the pediatric population, affecting 1 in 500 children and adolescents. An auto-immune disease, Type 1 diabetes is the body’s inability to produce or use the hormone insulin. Produced in the pancreas, insulin regulates the amount of sugar in the bloodstream essential to brain and body function. Consistent amounts of excess blood sugar cause circulation problems and a build-up of acid in the bloodstream, which strains the liver, kidneys, heart, lungs and central nervous system and is responsible for the complications associated with the disease such as blindness, nerve damage, stroke, and limb amputation.

“The day-to-day management of diabetes is with the family, but our diabetes team is their co-pilot,” says Shirley Goodman, RN, certified diabetes educator and coordinator of Children’s Memorial’s diabetes education program.

By the time Lauren was taken to the ER, she had ketoacidosis, a build up of ketones (acids) in the blood caused by lack of insulin which can poison the body. Ketoacidosis is a warning sign that diabetes is out of control.

Lauren was admitted to the hospital and her parents underwent the mandatory education to learn how to monitor blood sugar levels and administer insulin. To survive, people with type 1 diabetes need the hormone insulin to help the body's cells make energy from the food they eat. Insulin transports the blood sugar from food into the cells of the body where energy is made. Insulin can only be delivered through injection. People with diabetes may take one to four or more injections of insulin every day or use an insulin pump to deliver the insulin constantly throughout the day.

Food increases glucose levels while exercise and insulin make glucose levels fall. Controlling diabetes involves balancing food, exercise and insulin. Through finger pricks, patients or parents monitor blood sugar levels several times a day to help evaluate the effectiveness of the insulin given and helps determine the proper doses of insulin.

Because Lauren was so young when she was diagnosed, the Hustons missed some of the most common, and less threatening, early symptoms of Type 1 diabetes in their daughter — frequent urination, increased thirst and hunger. A toddler still in diapers and unable to clearly articulate her needs meant the symptoms were difficult to recognize.

A diagnosis of type 1 diabetes is just the beginning for this lifelong disease. Lauren is now a patient in the diabetes program run by the Division of Endocrinology at Children’s Memorial. The diabetes program serves more than 500 children and adolescents annually and includes a multi-disciplinary team of physicians, nurse practitioners, diabetes educators, a social worker, a clinical dietitian and a psychologist.

“The day-to-day management of diabetes is with the family, but our diabetes team is their co-pilot,” says Shirley Goodman, RN, certified diabetes educator and coordinator of Children’s Memorial’s diabetes education program. “The family becomes the expert about their child’s diabetes, but I have the knowledge from 90 other kids, and I can give them advice.”

A comprehensive, individualized educational program was developed with the family. Managing diabetes is a continuous learning process. Quarterly clinic visits, outpatient education sessions, phone and e-mail contact and a parent-support group are available to help patients. The family has actively participated in all of these activities. “Our friends can never know what it’s like to parent a child with diabetes,” says Karen. “The parents in the support group know what it’s like.” The support group has been great for information and preparing for issues that lie ahead as Lauren gets older, as well as helping other families. “It gives us a chance to give back,” says Jim.

“We have a lot of folks on our team who are in frequent contact with patients,” says Donald Zimmerman, MD , head of the Division of Endocrinology. “We give patients and families the knowledge and the support so that we can confidently manage diabetes on their own.”

Lauren can now tell her parents when she’s hungry or tired, signs her blood sugar may be low and an indication that even at a young age, she’s starting to play a role in her diabetes management. “When it’s time to check her blood, she just sticks out her finger,” Karen says.

Lauren is also enjoying the life’s pleasures of little girls her age, including ballet. Some activities, like pre-school, summer camp and sleep-overs, will require planning by her parents to make sure teachers, counselors and parents are aware of Lauren’s diabetes and know how to handle any emergencies or issues that arise. “We have to do some extra work to make those activities possible,” says Karen. “As difficult as it can be at times, Lauren can still participate like all of her friends.”

Children's Memorial Hospital seeks philanthropic funding to enhance its programs and services. As a proud partner of the Children's Miracle Network (CMN), all funds raised in the Chicago area through CMN also benefit Children's Memorial. To find out how your support can help the hospital better serve children and families, please contact the Children's Memorial Foundation at 773.880.4237 or Foundation@childrensmemorial.org. Or visit our Web site at www.childrensmemorial.org.



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