Praising the (insulin) pump
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By Deirdre Cox Baker | Saturday, March 15, 2008 |
One man with juvenile-onset diabetes is now 20 and has been dealing with the life-changing disease for 12 years. A second, now 58, was diagnosed with juvenile diabetes “out of the blue” in the 1980s.
Jared Dye, 20, of Moline, knew something was wrong when he was just a youngster. “I’d be out at SouthPark Mall for two hours and I’d have to use the restroom like 10 times.” He was always thirsty, and his parents took him to a doctor who administered a blood test and immediately admitted him to the hospital to start learning how to manage the chronic disease.
Dave Schebler was 35 years old when he fell ill with blurry vision, an inexplicable weight loss and the need to urinate frequently. He reported to the doctor and, like Dye, was quickly admitted to the hospital after a diabetes diagnosis.
Both Dye and Schebler began to manage the disease with syringe injections of insulin, the substance normally produced in the pancreas to stimulate the production of glucose and other metabolic substances. However, 21 million people in the United States have diagnosed and undiagnosed diabetes and must use various means to get the necessary insulin.
Some take pills, others deliver insulin with a pen-type instrument. Many use syringes filled with the substance and give themselves shots.
Schebler, though, has been using an insulin pump for 15 years, and Dye, who has been injecting himself with syringes since childhood, soon will get his own pump.
Pumps become popular
Close to 50 percent of diabetics with Type 1, the most serious form of the disease, are on insulin pumps, according to Dr. Catherine Weideman, an endocrinologist with Genesis Health Group in Bettendorf.
“They are even going into patients as young as 1 year old,” she said. The devices are much improved since they were introduced in 1976.
Insulin pump therapy resembles the body’s own release of insulin and improves blood sugar control, according to the American Diabetes Association at its Web site, diabetes.org. The computerized devices are the size of a cell phone or a pager and can be hooked to a belt. They contain a reservoir of insulin and a plunger.
The pump is attached to a patient’s abdomen by a tiny needle with a cannula, or flexible tube, made of Teflon. That, Schebler says, is much more comfortable than the first “bent needle” pump attachments he began using in 1993. Patients keep track of when and how much insulin is needed, and they push a button to automatically inject it.
“Diabetes is a complicated disease, but the pumps are getting more and more sophisticated,” says Schebler, a certified public accountant in Bettendorf. “I don’t know if I could survive the tax season without the pump.”
The device is expensive, priced at about $6,000, with about $1,500 needed annually for supplies, Weideman estimates. Both Dye and Schebler rely on health insurance to help cover the costs.
The number of diabetics who discontinue using the pump is less than 5 percent, the doctor says, but one reason for people dropping it is patients losing health insurance coverage.
Required classes
Dye has taken part in the extensive preparation required by Weideman’s medical practice before he can acquire the pump. He’s gone to daylong classes and sharpened his skills at reading food labels and measuring the amount of carbohydrates in food products.
“After 12 years, I’m a pretty good estimator of how much insulin I need,” he says. A lifelong athlete, Dye works out regularly at the Two Rivers YMCA in Moline and eats a healthy diet, even though he doesn’t like milk or many types of vegetables.
Schebler has run for his exercise for 25 years and has not let the disease sidetrack that passion. The changes in diet and new rules about his nutritional needs were overwhelming at first, but he dived headlong into learning about the disease.
He became active with the diabetes association at the state level and has volunteered for University of Iowa diabetic research studies. “I really wanted to get a pump, so I figured these activities might help me to get one,” he says.
The most successful patients on pumps are those who fully want better control of their diabetes, Weideman says, adding, “That can happen at various ages. But you have to want to have a pump in the first place.”
Most of Weideman’s pump users are 20 to 40 years of age, but she has two patients who are more than 75 years old.
The pump’s great usefulness is that it almost completely ends hypoglycemia-induced problems. The sharp drop in blood sugar means some diabetics get confused or disoriented, and they can lapse into a coma. That has never happened to either Dye or Schebler.
Improved insulin
Dye credits improved insulin as a big influence in how he manages his disease. “I’ve played sports all my life and it’s been pretty normal. It — my diabetes — was never an issue in school.”
Schebler calls diabetes an “odd disease” that many patients can handle pretty well for a long time. “A certain complacency happens,” he says, “but things can turn around quickly.”
The most serious complications are fewer these days, Weideman says. “It’s much less common to see, for example, amputations, but they do happen.” (Diabetes can damage both the circulation and nervous systems, affecting blood flow and feeling in the limbs.)
When Dye first discovered he had diabetes, his mother gave him the insulin shots. His father later allowed him to practice by injecting him with water.
Dye had to do three or four shots each day at first, but that number has decreased with the improved insulin. He wants the pump for its convenience. “Doctors, all those who have used it, everyone thinks it’s easier,” he says.
Schebler agrees. “There is no reason I can’t live pretty much a normal life and move forward,” he says. “Diabetes is a manageable disease.”
Deirdre Cox Baker can be contacted at (563) 383-2492 or dbaker@qctimes.com. Comment on this story at qctimes.com.
March 25: Diabetes Alert Day
“Diabetes Alert Day” on March 25 is designed to encourage people to learn whether or not they are at risk for the disease. About one-third of the nearly 21 million Americans with diabetes are unaware that they have it, organizers say.
To learn more about diabetes, check these Web sites: diabetes.org, which is run by the American Diabetes Association, and YourDiabetesinfo.org, which is sponsored by the federal government and operated by the National Diabetes Education Program.
— Deirdre Cox Baker
Register now for local juvenile diabetes walk
Registration is open now for the Juvenile Diabetes Research Foundation Walk to Cure Diabetes, planned for May 3 at Niabi Zoo in Coal Valley, Ill.
This is the first time a juvenile diabetes awareness and fundraising walk has been held in the Quad-City area, organizers say.
The Team Captain Kickoff will be 5:30 p.m. Tuesday, March 18, in the Mississippi Room of the Davenport RiverCenter.
To sign up to either captain or walk on a team, check the Web site, walk.jdrf.org, and click on the “register now” section. Choose the Niabi Zoo location when registering.
The goal is to welcome more than 1,000 walkers and raise $75,000, organizers say.
The two-mile course will follow the path around the zoo. Refreshments and snacks will be provided, as well as entertainment, special attractions and children’s activities. Race-day registration will be at the ticket booth outside the zoo entrance.
The walk attracted more than 500,000 participants at 200 locations in more than a dozen countries last year.
For more information, contact Meredith Stach of the Juvenile Diabetes Research Foundation at (319) 393-3850 or e-mail her at mstach@jdrf.org.
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