Childhood Diabetes ~ 1 of 4

Resting in God’s Sovereignty ~ Childhood Diabetes by Mary Silverberg

I have a wonderful husband and six precious children, three girls and three boys.  My oldest son is married to a lovely young woman, and they have a beautiful baby.  Many blessings have come to our home over the years, but we’ve had our burdens too. When our oldest son was just two years old, he was diagnosed with Type I or Childhood Diabetes.
The diagnosis was actually a relief, because we thought he might be dying of some rare disease.  I knew diabetes was bad, but I also knew it was treatable.  It wasn’t always easy giving a two year old daily injections, and poking his finger for blood sugar tests at least four times a day.  Because of his young age and my inexperience with the illness, he suffered many violent insulin reactions, but the Lord was very gracious and we made the adjustment “easily” considering the circumstances.

One of my worst fears became a reality when my youngest son was only four.  The sad fact became apparent that he too would suffer with the disease.  It seemed impossible that a third child would be afflicted, yet it was undeniable, when at the age of ten, he diagnosed himself!  This time it wasn’t as difficult for me, however, it hit my husband very hard.  Three was just too much!  But, God in His mercy did not abandon us. He has sustained and comforted us through it all.

During the many years that diabetes has touched, or maybe I should say gripped our family, it’s been a real learning experience.  So much of that knowledge came from trial and error in caring for my boys.  As my personal experience is three times that of the “typical” mother of a child with diabetes, I felt a strong desire to share with those who also carry this burden.  My book, “Reflections on Childhood Diabetes” is the fulfillment of that dream, and the chapters following “Childhood Diabetes” are excerpts from it.  I picked these chapters to include in “Special Needs / Special Love,” because I thought they would be helpful to any family who has a child with special needs.

Our family is growing up quickly.  Rachel, Anna Marie, and Abigail are lovely young ladies.  Jason and Zach are fine young adults, and Nathan is an outstanding teenager who has taken over control of his diabetes.  I rarely do anything for his diabetes now other than drive him to a doctor’s appointment or pick up prescriptions for him.  Oh, and of course there’s the COST of diabetes.  Let’s not forget that, as if I could!  But, there was a time when caring for my boys’ diabetes was on my mind day and night.  It is my prayer that sharing some of those thoughts with you will bless your family as you seek to give them your best.

“Diabetes mellitus, often simply referred to as diabetes—is a condition in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger).”

“Symptoms may develop rapidly (weeks or months) in type 1 diabetes while in type 2 diabetes they usually develop much more slowly and may be subtle or absent.”

“There are three main types of diabetes:

Type 1 diabetes: results from the body’s failure to produce insulin, and presently requires the person to inject insulin.

Type 2 diabetes: results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency.

Gestational diabetes: is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy. It may precede development of type 2 DM.”

“As of 2000 at least 171 million people worldwide suffer from diabetes, or 2.8% of the population.  Type 2 diabetes is by far the most common, affecting 90 to 95% of the U.S. diabetes poplution.”  ~Wikipedia~

There seems to be a big misunderstanding among the general public as to the difference between Type I (Childhood or Juvenile Diabetes) and Type II (Adult Diabetes).  Most likely this is due to the fact that the overwhelming population of diabetics are Type II.  Although, the Juvenile Diabetes Research Foundation reports that, “As many as three million Americans may have type I diabetes.” & “Each year, more than 15,000 children – 40 per day – are diagnosed with type I diabetes in the U.S.”

With Type II or Adult Diabetes the body may still produce some insulin, it just is not enough.  In some cases if the adult will follow a proper diet and exercise regularly they may be able to control their diabetes simply by following a healthier lifestyle.  Also, there are oral medications available that may help the body to increase the amount of insulin it produces.  However, many adult diabetics do become insulin dependent.

With Type I (Childhood Diabetes) the body’s own immune system attacks the pancreas and kills the cells that produce insulin.  Children who get Type I cannot control their diabetes with diet and exercise alone and are all insulin dependent.  There is no cure and no known way to prevent it.  They will not “grow out of it.”  Oral medications are not effective with childhood diabetes, because the body must produce some insulin in order for the oral medications to work.  (Insulin cannot be taken orally, because the acids in the stomach will render it ineffective.)

A healthy lifestyle is very important for childhood diabetics, but I think the main challenge is trying to match up insulin intake with carbohydrate intake.  What makes this difficult is that activity levels also affect the equation and are very hard to measure.  In addition, stress, even good stress like a birthday, can make one’s blood sugar rise or fall.  When my son went to buy an engagement ring, he was so happy and excited that his blood sugar dropped!  He was able to correct it with some juice, but he had to wait before he was able to drive.  He commented that he didn’t think that would have happened if he hadn’t bought the ring.

Sometimes people “freak out” when they see one of my sons enjoying a treat.  What they don’t realize is that 1. Sugar in moderation along side a healthy lifestyle is acceptable, and he has counted carbohydrates and given the proper amount of insulin for the treat.  Also, when my children were growing (not trying to lose weight) they often needed more carbohydrates than an adult.  Or 2. my son’s activity level for the hour is extra high, and he needs the extra sugar in order to prevent an insulin reaction.

Often I’m asked the question, “Which kind of diabetes (Type I or II) is worse?  That’s not easy to answer.  Type I and the Type II diabetics that are insulin dependent have much in common, and when it’s not kept in good control the results can be devastating.  According to the American Diabetes Association, “Diabetes was the seventh leading cause of death listed on U.S. death certificates in 2006.”  Some of the complications include:  heart disease & stroke, high blood pressure, blindness, kidney disease, nervous system disease, and amputation.  Although, Type I diabetics don’t commonly see these symptoms until they are of adult age.  If I had to pick one type as worse, I would pick Type I (Childhood Diabetes), because it cannot be controlled with diet and exercise alone, and its victims are always insulin dependent.  As I said earlier, in some cases, especially if it’s detected early, Type II (Adult Diabetes) can be controlled with diet and exercise alone.

What confuses people even more is the growing obesity rate among children.   Overweight children can be afflicted by Type II (Adult Diabetes).  It use to be adults over forty and overweight were the common targets of Type II (Adult Diabetes).  Now with so many obese children, it’s affecting the young too.  People often get the impression that Type I (Childhood Diabetes) is caused from a poor diet and little exercise, but that’s not the case.  It was something that went haywire with their immune system.

One of the most hurtful things ever suggested to me was that I had caused my own children to develop diabetes, because I didn’t feed them salad.  It is true that I am the only one in my family who eats salad, but we do eat fruits and vegetables.  We are very physically active and all of us are in good shape.  I have to say that I was “down” for about three weeks after that comment.  I even began to wonder if it was possible.  I asked my doctor if I had given my children more fresh fruits and fresh vegetables would their immune system have been in a stronger state to combat whatever it was that triggered the attack.  “ABSOLUTELY NOT!” was his reply.

I don’t hold any bitterness to the woman who made that statement. She made the comment out of ignorance (lack of knowledge).  She is a kind, dear friend, and I believe she was simply trying to help.  I only write this to keep you from making the same mistake.

Many, many dear friends and family have been so helpful and supportive to us in this affliction, and you don’t have to do something big, outrageous, or expensive to be an encouragement.  Cards to the children when they were diagnosed, or recovering from an injury were very encouraging.  So were visits to the hospital.  Do you realize how boring it can be in the hospital?  Especially when you’re there for an extended stay!  And, it’s not the expense of the gift, but the thought that counts, really.  One dear friend gave my son a card with a couple packs of gum taped to it.  He was so happy to receive it.  Anything to let the child and parent know you’re thinking and praying for them is appreciated.  If you can afford a larger gift, go for it.  My mother gave me a subscription to “Diabetes Forecast” when my first son was diagnosed.  My mother-in-law gave me an envelope of $5 bills to be used every time I took my son to a hotel swimming pool for physical therapy when he was recovering from a serious injury.  It’s true, you can’t buy happiness, but a card with a bill in it sure does put a smile on a kid’s face.

There was a time when my son was recovering from a very bad injury.  Feeling and movement were slowly coming back to his legs and feet, but the process was slow and laborious.  When he graduated from a wheel chair to special crutches and leg bracing his Karate instructor took me aside privately with an idea.  He wanted to know if I would approve of Jason suiting up in his black belt uniform and helping to teach class.  He thought this would include Jason in Tae Kwon Do in an active way.  Would I EVER approve!  What an excellent, thoughtful idea!  It was obvious he had my son’s best interest at heart.  He didn’t need Jason to help teach class, but wanted to support and encourage him in his recovery, and it was indeed a tremendous boost to his morale.  Give it some thought.  What can you do to edify someone?  What unique position are you in to help?

Grandparents … You gotta love em.  When Jason was recovering from the above referenced accident he was attending physical therapy sessions three days a week, but the closest place that offered therapy for nerve damage was an hour’s drive.  This was a small price to pay, and we were happy to do it, but still it took up a large chunk of my time:  two hours driving, the hour P.T. session, plus the extra time needed to get him out of the house and into the van, out of the van and into the rehab center, etc.  Keep in mind that he out weighed me by 40 lbs!  It easily took up most of my afternoon.  Grandma to the rescue!  She and her husband gladly offered to take Jason to P.T. every Friday, and afterwards they took him out to dinner.  They faithfully persevered for five months until he “graduated.”  What a blessing to our family.  It freed up my Friday afternoons to do my regular chores, and developed a nice bond between the three of them.  Not everyone is in a position to do something like this, but maybe you are.  Think about it.

Okay, one last story.  Simply paying attention or looking for a way to help will often reveal a need.  My friend Sarah was “listening” one day when I expressed to her my struggle finding a diabetic bracelet small enough for my four year old.  There were some expensive ones available, but the cheap ones were all adult size and too uncomfortable, even when I took out some of the links.  A couple of weeks later she presented me with a small gift.  It was a child’s ID bracelet that had the word “DIABETIC” engraved on it.  It was perfect: functional, comfortable, and nice looking too.  I can’t tell you how that warmed my heart.  It was a very caring and thoughtful gift, and that’s just what it said, “I care about you.”   My son really liked it, but I think it ministered more to my heart than to his wrist.  Look for a way to bless someone, and I believe the Lord will answer that prayer.  After all, we are commanded to bear one another’s burdens.  And remember, a simple card goes a long way in saying you care.

I would be remiss if I failed to mention the dreaded insulin reactions.  Sometimes it’s obvious when to watch for them.  Days with extra levels of activity (especially swimming) are a big target, but sometimes they “hit” without warning.

Be aware of the symptoms and you may be able to help intervene or prevent a mild or moderate insulin reaction from going extreme.  According to the American Diabetes Association:

Symptoms of hypoglycemia (low blood glucose) include the following:
Pale skin color
Sudden moodiness or behavior changes, such as crying for no apparent
Clumsy or jerky movements
Difficulty paying attention, or confusion
Tingling sensations around the mouth”

Also from the American Diabetes Association:

How do I treat hypoglycemia?

The quickest way to raise your blood glucose and treat hypoglycemia is with some form of sugar.  Many people with diabetes like to carry glucose tablets.  You can get glucose tablets at any drugstore and at many other stores as well.

Other sources of sugar or simple carbohydrates also work well to treat hypoglycemia, such as fruit juice, hard candies, or pretzels or crackers.  The important thing is to get at least 15-20 grams of sugars or carbohydrates.  A food’s nutrition label can tell you how much you need to eat of that food to get enough to treat an episode of hypoglycemia.  To treat hypoglycemia you should stick with something that is mostly sugar or carbohydrates.  Foods that have a lot of fat as well as sugars and carbohydrates, such as chocolate or cookies, do not work as quickly to raise blood glucose levels.

Foods with 15 grams carbohydrates:

4 oz (1/2 cup) of juice or regular soda
2 tablespoons of raisins
4 or 5 saltine crackers
4 teaspoons of sugar
1 tablespoon of honey or corn syrup

According to Mary Silverberg (me), the best way to treat a severe low blood sugar or insulin reaction is with juice, especially grape juice (NOT grapefruit juice) or sweet soda (NOT Diet).  Don’t even try hard candy or crackers.  This is serious and you need something easy to swallow.  You may have to assist in getting the patient to drink.  They may not be able to hold the cup or get it to their mouth.  Encouraging words like, “It’s okay, You’re doing fine, You’re going to get better, Keep sipping, You’re getting it,  That’s it,  Keep drinking” are very helpful and should be repeated over and over until the patient has drunk the juice or soda.  And be careful, they may recover for a short while only to “drop” again.

A police officer friend of mine once told me a story about an arrest.  The suspect was very belligerent and uncooperative, and naturally the officers were having to use force to subdue him.  My policeman friend’s father was diabetic and he recognized the man’s actions for what they really were, a very low blood sugar.  My police officer friend was able to intervene on his behalf and get him sugar, and the other officers to stand down a notch.  So, look over the symptoms of hypoglycemia again, and maybe you can help a neighbor in need of sugar.

When we first moved close to my husband’s family they were not familiar with insulin reactions.  The first one they experienced was at a family outing on the river.  My husband’s brothers had brought their boats and we were taking turns riding and water skiing or tubing.  Jeff (my husband) was gone for a ride with some of our children, and I was left on the beach with a couple of our kids and Jeff’s brother, a couple of sister-in-laws and their kids.  Jason was very young, maybe four or five, and he suddenly had a very low blood sugar.  I was struggling with him, trying to hold him and get something sweet down his throat.  I’m sure it was a frightening sight, especially if you’ve never seen someone have a seizure before.  I could sense everyone was scared and wanted to help, but didn’t know what to do, and really there was nothing they could do.  Even though I was stressed, I had it “together” and was focused on helping Jason.  I didn’t know the family that well, because, until recently, we had lived far away.  I guess you could say we hadn’t “bonded” yet.  So there I was, the new comer, in crisis, with my husband gone tubing.  And ladies, isn’t that the way it usually happens!  Well, I’ll never forget my sister-in law Ann, and how she helped me that day.  She came and sat down beside me.  I don’t remember what she said, just sitting with us and rubbing Jason’s sweet little head or my back.  Her presence was a comfort to me, and I was so thankful that she was able to overcome the awkwardness of the moment and be there for me.

Another time I was at Wal-Mart with all six children when Nathan, who was about five, all of a sudden had an extreme headache, followed by other symptoms of a low blood sugar.  There was no time to leave the store.  He was quickly getting worse.  I moved the cart out of the main isle, instructed the older children to watch the younger ones, and sat on the floor with Nathan in my arms and coaxed him to drink some juice.  All this in the middle of Wally-World!  Nathan was in extreme pain and had lost some control over his arms and legs.  I was trying my best to hold him still, get him to drink some juice, and reassure him he was going to feel better soon.  He was upset and softly crying because of the pain, and he had spilled, spit out, or dribbled the juice.  “It’s okay.  It’s not your fault.  It’s because your blood sugar is low.  You’re going to get better soon.  It’ll be over soon.  Just keep trying to swallow the juice.”  I consoled him.  I was aware of the strangers’ stares, but did my best to ignore them and focus on helping Nathan.  It wasn’t long before a Wal-Mart employee came and kneeled next to me and asked if there was anything she could do.  There wasn’t really.  I had it under control, but it was so nice to have her ask, and stay with me until Nathan recovered enough for us to leave the store.  Maybe she was an angel in disguise (Ha!  An angel incognito as a Wal-Mart employee), or maybe just a caring soul.  I don’t know, but I was thankful for her presence.  So, the moral of the story is, you don’t always have to know what to do to help, just be there.

Our family is growing up quickly.  Where does the time go?  When the boys were little the burden of this disease was heavy for me, and it seemed like it would never be lifted.  It is much lighter now as they all regulate their diabetes on their own, but I feel for these young gentlemen, starting out fresh with the financial and physical burden of diabetes.  I still wish I could take it for them or make it go away, but that is not God’s will at this time.  I take comfort knowing that His ways are higher than mine, and I rest in His sovereignty.

I hope the following posts on diabetes will be a blessing to all families with extra needs.  I enjoyed writing them and it is my pleasure and honor to share them with you.

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