The ABCs of Diabetes

My daughter Yael, 15, is a fierce competitor. Soccer, cross country, basketball or flag football –  doesn’t matter, my girl’s got game!

It’s no wonder that she’s a disciplined student athlete. For three years and counting, Yael has worked 24/7 with an unrelenting personal trainer called Type 1 diabetes.  It’s an auto-immune disorder in which the pancreas stops producing insulin, a life-sustaining hormone we all need to convert food into energy.

Type 1 diabetes, which is most commonly diagnosed in children, teens and young adults, used to be called juvenile diabetes.

But trust me, there is nothing juvenile about diabetes — Type 1 or Type 2 (which I’ll write about later this month).

Just ask Yael, who faces a daily regimen that includes insulin shots and blood tests. Or ask Miami HEAT sharpshooter, Ray Allen, who has shared the heart-breaking moment when his toddler son was first diagnosed with Type 1 diabetes.

I am telling you all this because it’s November — National Diabetes Awareness Month.  And on behalf of Yael, the Allen family and all those touched by Type 1 diabetes, I want to share one of the scariest parts of the disease. The onset of Type 1 diabetes can be a near-fatal, stealth attack, dangerously hiding behind the familiar symptoms of a generic flu or a stomach bug.

In Yael’s case, the absence of a fever and her growing listlessness puzzled me. What kind of flu arrives with no fever? That bugged me. Alarmed, I took her to the pediatrician, who took a quick blood test and sent us to the emergency room.

 In the ER, Yael was diagnosed with Type 1 diabetes and diabetic ketoacidosis  (DKA), a life-threatening illness that can lead to a coma or death, according to the American Diabetes Association (ADA).

Mild to extremely dangerous stages of DKA typically accompany the onset of Type 1 diabetes. 

Here are a few other facts:

What causes Type 1 diabetes?

With Type 1 diabetes, cells within the body harm the pancreas’ ability to produce insulin. “Without insulin, the body cannot convert sugar from food into nutrients for cells. Excess sugar builds up in the bloodstream and may eventually cause severe damage to organs and premature death,” according to JDRF, a leading diabetes research organization.

Medical researchers don’t know what sets off the attack and believe that genetic, environmental or viral factors may be factors. Nationally, one in every 400 to 600 children and teens has Type 1 diabetes, according to ADA.  

Why is insulin so important?

At the time of diagnosis, Yael’s blood sugar levels were four times the normal range, but her muscles were starved for sugar. To compensate, the body burns fat to create energy, and that process generates toxic acids that could lead to a coma, organ failure or death. 

To avoid that toxic chain reaction, Yael gives herself daily shots of insulin and carefully watches her blood sugar levels.  Too much or too little sugar in the bloodstream can have serious consequences.

What are the warning signs?

Watch out for sudden or extreme loss of weight, fatigue, frequent urination and extreme thirst. “The symptoms— including those that resemble the flu—are often easy to miss. The only families typically able to catch the symptoms and avoid hospitalization are those with a history of diabetes in the family,” says Lois Exelbert, R.N., manager of the Diabetes Care Center  at Baptist Hospital of Miami.

Other symptoms, according to the JDRF include:  

• Lethargy
• Sudden vision changes
• A fruity, sweet or wine-like odor on a person’s breath
• Heavy, labored breathing
• Confusion or unconsciousness

Are there any early-screening tests?

Diabetes is diagnosed with a blood test. High blood sugar levels are a red flag. Unfortunately, routine diabetes screenings are not included in most childhood physicals. Diabetes educators, however, are pushing for change.  Ms. Exelbert is passionate about screening. Her advice: If you suspect your child has a flu or virus, it’s important to request a blood sugar test to rule out diabetes, which often masquerades as other illnesses before detected.

Let me tell you, it was a scary time when Yael was diagnosed. She spent almost a week in the hospital, including a few days in the intensive care unit (ICU). During that time, our entire family received a crash course on diabetes management. 

Thankfully, Yael has managed her diabetes well, so it hasn’t slowed the active high school sophomore down.  And like others her age who don various jewelry pieces they call their “bling,” Yael has quite a collection. Her signature piece is a silver bracelet with a medical alert about diabetes. She covers all bases.