Thursday, April 26, 2001
The University Daily Kansan
Section A·Page 7
Teel wears the pager-like insulin pump all day except when she shows. Though the pump makes regulating blood sugar easier, it makes wearing dresses and swimsuits cumbersome, if not impossible.
Lagan Fleming draws 30 units of regular insulin into a syringe before injecting himself lunchtime. Fleming takes insulin at every meal to balance his body's inability to process carbohydrates and sugars.
their disease. To the passing stranger, the group of young people looks like any group of KU students gathering for a good time. But each one lives his or her life focused on a hidden, potentially deadly disease. Interested students can contact Fleming at 838-301 or e-mail Catherine Teal at cteel@newyork.com.
In the midst of these students, Ken and Ruth Stoner sit and share stories about their lives, their son and his disease.
The Stoners have become parental figures to KU diabetics, offering them kind words and a shoulder when they need it. They help organize events and provide a family for those away from home, while hoping that someone is doing the same thing for their son at K-State.
"We wanted encouragement by interacting with college students who had successfully controlled their diabetes," said Ruth, who has been attending for the last year. "We are parents of a college-aged student with diabetes. If we could help students or their parents, we wanted to be there."
The Pump
While the Stoners offer support and guidance, new technology is offering diabetics an alternative to daily insulin injections. The pump, which is worn on the belt and is about the size of a pager, connects to a small tube with a tiny syringe at the end of it. The needle remains inserted into the stomach where it regularly injects insulin into the body. The pump gives diabetics greater control of the diabetes and more flexibility in their diet. For example, it can quickly adjust the dosage to counteract carbohydrate-heavy foods.
During a KU Diabetes Organization meeting at Mr. Gatti's, Catherine Teel, Alexandria, Va., senior, quickly estimated the number of carbs, reached to her gray pump and, with her index finger, increased the amount of insulin she would receive that night.
The pump takes guesswork out of how much insulin diabetics inject before a meal. They no longer have to worry about eating just the right amount of sugar to mix with the hormone. While the pump neither measures the blood sugar nor automatically adjusts insulin injections, it provides diabetics with a continuous rate of insulin that mimics the body's own gradual release of the hormone.
Teel, who stopped shots two years ago, said the pump was convenient. While she still experiences the highs and lows of diabetes, the pump gives her a better way to regulate them, she said. Though technology allows her sharper control of her insulin, she still has not taken the Jolly Ranchers and Starbursts out of her bag quite yet.
Teel must wear the pump almost 24 hours a day. It is attached to her hip almost like a working pancreas, and she does everything from sleep to exercise with it. The only break she gets is when she shows, which must take less than 30 minutes.
The pump also creates wardrobe problems as she can no longer wear dresses without a bit of creativity. With summer approaching, Teel has made the decision to go off the pump and return to the shots. She longs to wear a bathing suit again and see what life is like without the pump, she said. She will decide next fall whether to return to the pump or to stay on the shots, a decision that may be dictated by finances rather than convenience.
The pump costs about $4,500 Because Teel's father is in the military, the family has excellent medical insurance, which covers most of the pump and the $700 cost for supplies every two to three months.
"I'm worried about when I graduate and lose that insurance." Teel said. "I'm not sure what I'm going to do."
While cost can put the pump out of reach for some students, others may be skittish about its side effects. The American Diabetes Association warns that 30 percent of users may develop an infection at the injection site. Also, with a shot, diabetes know instantly that the insulin was injected into their bodies. A pump, on the other hand, may develop an obstruction in the tubing unbeknownst to the diabetic. Ketoacidosis, or extremely high blood sugars, could then produce vomiting, trouble breathing, dry and itchy skin, and even a coma.
Brown, St. Louis freshman, switched to the pump before coming to the University, hoping greater precision and hourly injections of insulin would help her during her college years. Brown frowned on the idea of carrying syringes, insulin and a variety of equipment with her to each class. While the pump has worked so far, Brown said it had its down sides.
"It can be annoying when it runs out of insulin at three in the morning," Brown said. "I have gotten into a little bit of trouble with it. The pump has stopped working before because the needle hit a muscle and could not give me enough insulin."
The pump also gets in the way of Brown's aerobic classes. She works out with friends to try to stay in shape for her health and to burn some of the calories she consumes eating at Mrs.
Searching for a Cure
E's cafeteria.
Brown said she was irked by the notion that she might have to live the rest of her life with the pump. She is not optimistic that a permanent remedy can be found for diabetes.
"I don't want to get my hopes up," she said. "I don't think we will ever have a cure."
Scientists continue to make advances toward a cure for diabetes, including islet transplants into the pancreas. Islets are clusters of beta cells in the pancreas that make insulin.Type I diabetes destroys these islet cells. The experimental procedure is less expensive and safer than transplanting an entire pancreas.
Scientists are hoping to learn how to protect islet cells from attacks by the immune system. Scientists are also hopeful they can develop instruments to continually check blood sugar and insulin amounts. Future machines could even automatically regulate blood sugars.
Research on diabetes does not come easy because the disease is low on the funding list. For every dollar the government spends trying to cure diabetes, it spends $7 trying to cure AIDS and breast cancer, according to the ADA.
Stoner said he was hopeful a cure could be found for his son, J.C., but said the government would have to
provide more money to fund research. With no cure in sight, diabetics need to focus on their daily maintenance regimen. But they still need the security of other people.
Brown's dependence on people extends past her playful, outgoing personality. She needs them because she has become immune to feeling when she has low or high blood sugar.
Her life depends on friends to tell her when she is exhibiting signs of sagging blood sugar such as absent-mindedness, fatigue, or extreme thirst or hunger because she has become immunized to these warning signs.
Near the door in her dorm room is an emergency kit filled with syringes, insulin, finger-pricking supplies and other necessities. Passersby sometimes trip on the bag, a constant reminder of her condition and its effects.
Brown's biggest problem may be that she is currently without a roommate. She fears what might happen if she has another seizure while alone. When her blood sugar drops to that level, she begins convulsing and yelling in her sleep. She doesn't always wake up and sometimes has to rely on someone else to bring her out of it.
"I always have to depend on someone to be there," she said. "It is really scary not to have anyone there."
—Edited by Melinda Weaver
Technology could provide convenient alternative
Special to the Kansan
By Courtney Craigmile
As a Type 1 diabetic, Brian Harries is tired of carrying Lifesaves, test strips, a meter to read his sugar levels, insulin and syringes with him everywhere he goes.
With the help of George Wilson, Higuchi professor of chemistry and pharmaceutical chemistry, Harries, Vasser junior, may not have this inconvenience much longer.
Wilson works with a team of 15 doctors and researchers at the University of Kansas to improve the lives of diabetics. During the last 15 years, the team has developed a continuous glucose monitoring system to replace the current finger-stick method Harries and other diabetics use.
With the new system, diabetics don't have to draw blood. They simply place a wire-like sensor just under the skin in the abdomen to test levels.
The sensor uses polymers and enzymes to detect glucose in the body. It connects to a module about the size of a matchbook. Wilson said the module received measurements taken by the sensor and transmitted the reading to a separate unit. This unit, about the size of a pocket calculator, tells diabetics what their blood sugar level is.
Wilson's device provides convenience because it alerts diabetics when their blood sugar levels are too high or too low.
Harries said he looked forward to the simplicity of the new system.
"It would reduce the need for test strips and just everything you carry
with you," Harries said. "You wouldn't have to prick your finger for one thing."
But it may be a few more years before Harries and other diabetics can use the continuous glucose monitoring system.
Before this unit hits the streets, it must receive approval from the Food and Drug Administration.
"We have to demonstrate that this device is safe and effective," Wilson said. "What we will then need is to carry out some clinical trials showing that the system works."
The clinical trials require that the tested sensors undergo the same manufacturing process that the retail sensors will use.
"This has been a problem for us because we make these things by hand," Wilson said.
To combat the problem, Wilson and his team need to automate the production process. When they complete this stage, the team will work to meet the FDA quality control standards and hopefully gain the green light for production.
Once the system receives FDA approval, interested diabetics, such as Harries, can obtain the display unit and module at no charge. The sensor is the only cost associated with the new system.
Wilson said the test strips used with the finger-stick method cost at least 50 cents each. His goal is to reduce this high cost for diabetics.
Although the actual price of the sensors has yet to be determined, he said it would definitely be cheaper than the current method.
—Edited by Melinda Weyerver
dependent diabetes, the immune system makes a mistake, and cells that should protect you from germs instead attack your beta cells.
The beta cells die.
Without beta cells, the body can't make insulin.
Glucose builds up in the blood,
creating diabetes.
Symptoms:
Symptoms:
■ Lose weight without trying
■ Frequent urination
■ Extreme hunger
■ Extreme thirst
■ Trouble with vision
■ Fatigue
■ Coma
Managing diabetes:
Insulin shots
Healthy diet
- Consistency — eat about the same number of calories each day and plan meals and snacks for the same times each day
- Never skip meals
Never sk
Exercise
Treatment:
Treatment
Numerous shots given a day in stomach, thighs and upper arms, given at regular times.
Regular checking of blood sugar levels gives information about how well the diabetes care plan is working. Checking is done by taking a drop of blood, usually from a finger using a fingerstick. The blood is placed on a special test strip in a glucose meter.
Blood sugar levels are measured in milligrams per deciliter of blood (mg/dl). A normal blood sugar level is between 70 and 120 mg/dl.
The pump, a new device that eliminates the insulin shot, delivers a continuous flow of insulin to the body with a shot that injects a needle into the stomach and sends a continuous flow of insulin into the body, much like a functioning pancreas.
Fast Facts about Diabetes:
Type 1 diabetes is one of the most common chronic diseases in children. Nearly one child out of every 600 develops it.
There are an estimated 500,000 to 1 million people with Type 1 diabetes in the United States today.
Diabetes can run in families, but researchers are still studying how and why it happens.
Peak incidence occurs during puberty, around 10 to 12 years of age in girls and 12 to 14 years of age in boys.
The symptoms for Type 1 diabetes can mimic the flu in children.
There is a higher incidence of Type 1 diabetes in whites than in other races.
American Diabetes Association
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