According to a 2012 study in the journal Diabetes, life expectancy at birth for a child given a diagnosis of the disease between 1965 and 1980 was 68.8 years. That was before widespread blood glucose testing and other advances in care. Today, a Type 1 child can expect a life span about as long as anyone’s, according to Richard Insel, JDRF’s chief scientific officer. Good blood glucose control also has extended the time many diabetics live without complications. At the same time, though, the number of Type 1 diabetics in the United States is on the rise, for reasons no one really understands, Insel said.
Fitness and diet are key
My daughter’s Type 1 diabetes cannot be controlled by diet and exercise alone; the cells that produce insulin are dead, killed in an autoimmune attack. But working out and eating right are critical to managing the disease. A diabetic must eat enough sugar to meet her needs, but not too much, which would require more insulin. It’s a constant juggling act for each person, an art, not a science.
Exercise, of course, burns sugar, but it presents the same dilemma as sugar intake. Some exercise is good. Too much can cause low blood glucose emergencies, some as long as six hours later, as my daughter learned when she recently went back to working out regularly.
Type 1’s evil twin, Type 2 diabetes, which results when insulin-producing cells are overwhelmed but still functioning, can be prevented and reversed by staying fit and eating healthfully. Type 2 diabetes, an adult disease that afflicts more than 20 million Americans, now is showing up in about 3,600 children a year, mostly kids who are obese, get little exercise and have poor diets.
This has always struck me particularly hard: the idea of 10- and 12-year-olds sticking their fingers and receiving insulin, as my daughter does, when for them the disease is usually preventable.
It takes a village . . .
A small one, at least, to raise a kid with a chronic disease. When my daughter was very young, we planted stuffed animals and other trinkets at neighbors’ homes for them to give her on Halloween, instead of sugary treats. As she got older, we initiated a buy-back program for the ridiculous amount of candy children collect on that holiday, before she finally reached an age where we could trust her not to binge on her haul.
Every year, we gave her teachers emergency supplies for low blood sugar, such as apple juice and cake icing, as well as short presentations on the warning signs. At birthday parties, we supplied no-sugar treats for her. At sleepovers, her friends learned to keep an eye on her. A physician friend took our calls at any hour.
How did we know about all this? Early on, other families with diabetic children came by to advise us and show us that life would be different, but fine. Later it was the JDRF, doctors, nurses and other health practitioners. Some of it we figured out on our own. Much of it, my daughter has determined by trial and error.
“I don’t ever get to forget about having diabetes,” she told me. “Sure, I have carefree days, but it’s always there in the back of my mind. I have to think about my pump when I swim, make sure I have my testing supplies and emergency juice whenever I leave the house. It really helps to have a good support system — roommates, family — who help me notice signs of low blood sugar when I stop paying attention.”