What does 15-year-old Erin D. from Littleton, Colo., have in common with Supreme Court Justice Sonia Sotomayor, pop star Nick Jonas, and Chicago Bears quarterback Jay Cutler? Like them, she has type 1 diabetes. And like them, she doesn't let diabetes stop her from being active and ambitious.
"I was diagnosed when I was 8 years old, and at first I thought I would have to stop doing stuff I loved to do, like Irish step dancing and going to sleepovers," says Erin. That's because controlling her diabetes involves checking her blood sugar levels frequently and giving herself insulin shots daily. She also needs to keep track of the carbohydrates in the foods she eats because of the way her body processes them. It all seemed overwhelming at first.
With the help of her family, doctors, nurses, and dietitians, Erin learned how to manage her diabetes. Today, she plays tennis for her school, performs in local theater productions, and competes in ballroom dance contests. Life-threatening swings in her blood sugar levels rarely happen. But if they do, she knows the warning signs and how to handle them.
Erin is just one of approximately 186,000 U.S. kids and teens with type 1 or type 2 diabetes. Diabetes is a chronic illness -- that means it doesn't go away. Type 1 is the most common form among kids. In type 1, the pancreas, a small organ located behind the stomach, stops producing a hormone called insulin. In type 2, the body doesn't make enough insulin or is unable to use insulin properly.
Insulin is very important. "Insulin is what moves the energy, or glucose [a type of sugar], in food from your blood into your cells," says Theresa Garnero. She's a diabetes nurse and author of Your First Year With Diabetes. "Your cells run on glucose -- it's fuel for the body." Without it, you would be very, very tired.
But too much glucose is also a problem. Over time, it can lead to blindness, heart disease, nerve damage, and kidney problems. Keeping blood glucose levels in a target range is an ongoing concern for diabetics.
"Diabetes is something that has gone wrong with your body, but it's something you can live with," says Dr. William Clarke. He specializes in treating kids with diabetes at the University of Virginia Children's Hospital. "It's just that diabetes isn't something that can be put on the back burner," he adds. "It's a disease that has to be managed every day."
The classic signs of high blood glucose are frequent urination and extreme thirst. In fact, having those symptoms is how many kids learn they are diabetic. John P., a type 2 diabetic from Winchester, Va., was 11 years old and on a family vacation when he had those symptoms.
"I didn't understand how I could be drinking tons of water and still be thirsty all the time," says John, who is now 15. "Since type 2 diabetes runs in my family, my mom knew the symptoms and took me to the doctor as soon as we got home."
Just as high blood glucose is a problem, very low blood glucose is too. A quick remedy is eating or drinking something rich in glucose, such as juice, raisins, a piece of candy, or glucose tablets. Warning signs of low blood glucose include shaking, weakness, irritability, and confusion. "Many patients have told me stories about friends who saved their lives because they knew the warning signs of low blood sugar and got their friend a juice box or bite-size hard candy," says Clarke.
Managing diabetes is a balancing act. For type 1 diabetics, the keys are monitoring their blood glucose and taking insulin. It's also important to eat at regular times and choose healthy foods.
Erin typically gives herself three or four insulin shots each day. She uses a syringe to draw insulin from a prescription bottle and then injects it into fleshy tissue on her abdomen. Some kids inject insulin into the thigh or buttocks.
Instead of shots, Madi D., 15, a type 1 diabetic from Milford, Del., relies on a small insulin pump attached to her body. The pump releases small amounts of insulin throughout the day. When she needs to adjust her insulin amount, all she has to do is press a button. "I didn't like using syringes and having to tell people why I needed a shot," says Madi, who switched to the pump when she was 7 years old.
For kids and teens with type 2 diabetes, the keys to controlling symptoms are losing weight and adopting a more active lifestyle. Many people with type 2 diabetes are overweight, explains Shannon Lyles, a diabetes nurse educator at the University of Florida's Diabetes Center for Excellence. Some people who have gotten more active and lost enough weight can control their type 2 diabetes without medicine, she adds.
That was the case for John. At first, he needed seven to 10 insulin shots a day. Now that he's slimmed down, rides his bike regularly, lifts weights, and spends a lot of time outdoors, he has put away the insulin bottles and syringes. He still takes pills twice a day to help his body use its own insulin more effectively.
"I had a difficult time at the beginning but eventually went from really bad control to very good control," says John. "It was hard work, but the complications of diabetes just aren't worth it. There are too many things I want to do." One of those things is sharing his diabetes experiences with others. This fall, as part of an Eagle Scout project, he will run a diabetes awareness program for kids coping with the disease.
Helping other kids be more comfortable talking about diabetes is a good thing. That's something Erin can appreciate. "At first I didn't want to tell anyone I had diabetes or deal with it," says Erin. "But ignoring it doesn't do any good."
Today, Erin accepts diabetes as part of her life. It doesn't hold her back. When she spoke to Current Health, she was looking forward to a mountain climbing trip with a group of diabetics who also do triathlons. You can't get much more active and ambitious than that!
Syringe a special tube to inject fluids into the body
No one knows for sure what triggers type 1 diabetes. Doctors consider it an autoimmune disease Those are diseases in which, for some reason, the body's immune system attacks its own body cells. In diabetes, the immune system attack cells that make insulin. Nobody knows yet how to prevent type 1, and it does not have a curve. Type 1 diabetes tends to hit suddenly.
* Increased thirst, urination, and hunger
* Unexplained weight loss
* blurred vision, irritability, and flu-like symptoms such as fatigue and weakness
Type 2 diabetes tends to come on gradually. Being overweight or obese are risk factors for type 2 diabetes. So is having a family history of diabetes. People who are African American, Latino, or Native American, as well as some Asian American and Pacific Islanders, are at a higher risk. Losing weight and exercising can help too. Those lifestyle changes can also delay or prevent the need for insulin and other medications.
Symptoms* Type 2 diabetics may experience the symptoms of Type 1, or no symptoms at all.
Neither form of diabetes is contagious.
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