“The secret is to know how to manage the disease and not the other way around”
I am a total of 8.5 years old. What child wants to be hospitalized and start straight with regular injections and stabs to the body? But already in the first hospitalization despite all the difficulty, I decided that I would deal with the injections and tests independently. It was an important decision that helped me cope.
Diabetes accompanies me. Luckily for me the whole family enlisted, my parents, brother and two sisters, were involved in the care and follow-up, monitoring, measuring sugar and giving insulin injections when needed. For 25 years I have been walking around with a glucose meter, measured by a finger prick and in recent years with a continuous glucose meter glued to my hand, plus an insulin syringe and a glucagon syringe (for cases of too low sugar), always in a bag that accompanies me everywhere, at any given moment.
Throughout the years, I always made sure my whole environment knew I was sick. As a child my friends knew there would be times I would join in “snatching” a chocolate bar, I explained to everyone ahead of time the processes I must go through every day, and over the years I just refreshed my environment through simple explanations, what it means to be sick and what is required of me. For example measure sugar before and after each meal, go out in the middle of a lesson to measure sugar or eat something that will balance the sugar. Familiarity with my environment with the situation, facilitating day-to-day coping.
Family support is essential to coping
I completed medical studies at Ben Gurion University of the Negev (in Be’er Sheva). During my studies I worked at Soroka Hospital in the pediatric ward as an assistant doctor, even then I chose to help children with new diabetes, I saw my occupation as a mission and took care to encourage them. After graduation I returned to Rambam Medical Center to specialize in the ward where I was hospitalized. I finished an internship and today I am caring for children who are hospitalized due to unbalanced sugar values.
Up to this moment I can define the relationship of with the disease as good. Diabetes is part of who I am. I owe the credit for this to my parents and the rest of my family, and this is the best recommendation I can give to new patients. Family support is essential for coping – mobilization to support glucose measurement, avoiding snacks and sweets at home. It is important that the whole family knows the behavior of the disease, takes responsibility and helps the patient to detect it.
The treatment of me as a child with diabetes has always been – you are a healthy, normal child but, you are “sweet” – literally! It is the inheritance of this consciousness that has made me as balanced as possible. The very fact that I made sure to measure sugars as much as possible, to give insulin before meals, with the encouragement of my parents and family, is what inherited the interest that diabetes is part of the routine and not a burden.
How will you recognize diabetes? Type 1 diabetes is most often manifested first by hyperglycemia (high sugar or in diabetic language – hyper) – the initial manifestation will usually be accompanied by multiple urination, and in children can be recurrence of nocturnal urination, excessive drinking of water in a very unusual way, weight loss, fatigue and exhaustion. Then if the disease is not diagnosed in time, it can deteriorate to the point of weight loss in an abnormal and very drastic way, vomiting and abdominal pain are accompanied by rapid breathing.
Another condition of imbalance is hypoglycemia (low sugar, or in the language of sugars – hypo) – the patient feels dizzy, confused, trembling, rapid pulse, sweating, extreme hunger and marked weakness. If left untreated in time, the condition can progress to seizures.
Complications that may occur: Visual disturbances and impaired vision to blindness, and in children cognitive impairment; Impaired renal and renal function and protein excretion in the urine, to the point of renal failure; Vascular damage including peripheral hearts (legs and arms), cardiac events and strokes (heart attack and stroke); Impaired fertility, peripheral nerve damage (i.e. in the paws and fingers and toes for example), eating disorders in adolescence and increased blood pressure.
How to deal properly with juvenile diabetes?
- As I mentioned above the mobilization of the whole family is necessary, to be aware, to inform the members of the school, the teaching staff, and to explain to them the situations in which you may come.
- Parents and Family – Remember that there is no way to prevent the disease, and no way to anticipate it, so if parents show guilt or helplessness it is important to put them aside and understand that the best way to cope is to accept the new reality and embrace it.
- One of the big challenges is resisting the temptations of carbs and sugars. More challenging for children, it’s a little hard to stop a small child from eating a birthday cake at a classmate’s, or not eating snacks when everyone does. It is important to simply teach the child how and how to inject insulin if necessary.
- Many diabetics incidentally avoid consuming carbohydrates in general whenever possible.
- It is necessary to exercise carefully. It will greatly contribute to the balance of glucose values, and will keep glucose values closer to the norm. In addition it leads to a reduction in insulin doses.
- It is important to keep meals organized 3 times a day and skip accordingly.
- Another challenge is always adolescence – many times you also see a kind of “rebellion” in boys and girls.
- All patients should be regularly monitored both at home or in settings on a daily basis and it is always advisable to be in contact with the diabetes doctor, with the diabetes nurse, dietitian, and even psychologist, in order to help deal with these difficulties and guide them.
Dr. Wasim Said Physician in the Department of Pediatrics, Rambam Medical Center