Children with diabetes can lead normal lives

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At 11 and 8, they do all of the usual kid things - homework, softball practice and keeping their rooms tidy. In between, they check their blood sugar levels, monitor their insulin and watch what they eat and how much exercise they get.

Because both girls have Type 1, or juvenile, diabetes, this is their reality.

"I wish I didn't have it," Katelin said. "But I'm getting used to it, I guess."

Estimates from the K-12 school systems in Colbert, Franklin and Lauderdale counties reveal there are as many as 100 children like Ashlyn and Katelin who suffer from the disease.

As a means of reaching out to those children and their parents, Southeastern Diabetes Education Services, or SDES, has helped form a support group.

The goal is to encourage families to network with others, according to Terry Ackley, SDES executive director. The organization is based in Hoover.

"We want families to know they're not alone," he said. "With good diabetes education, it is possible to live well and be healthy and do what a person needs to do."

Having the support and knowing there are other parents whose children have Type 1 diabetes is what the girls' mother, Gena Tsukashima, is seeking.

"There are times I feel overwhelmed," she said.

"I've had to quit my job; we take frequent trips to Nashville. I've wished I had someone to tell me what I was doing was right or what was happening with the girls was OK. We do need support, and we need to be reminded that there is life after this diagnosis."

Tsukashima, pronounced sook-a-sheema, has been dealing with Type 1 diabetes since Katelin was diagnosed two years ago at the age of 6.

Both Katelin and her mom remember those early days as frightening and filled with confusion. It was only with the help of diabetes educators at Vanderbilt that Tsukashima said life slowly began to return to normal.

It was a new normal, however.

Katelin had to learn how to test her blood at school, change her diet to add better foods for her body and give herself insulin shots.

Two years later, older daughter Ashlyn began presenting with strange symptoms. Originally diagnosed with strep throat, Tsukashima said she knew something was wrong when Ashlyn wasn't responding to the antibiotics to treat the virus.

"She was in bad shape," Tsukashima said. "Her blood sugar had spiked to 916, and she had to be MedFlighted to Vanderbilt. She was so sick."

With both girls as diabetics, Tsukashima said the whole family has made changes in diet and exercise. Both girls have learned how to manage their symptoms at school. Ashlyn and Katelin go to a private school and there is no nurse on staff to help in case of an emergency.

Kelly Stanhope, lead nurse for Lauderdale County schools, said 35 students have Type 1 diabetes in the system. She said students become less dependent on the nurses as they learn how to manage their condition. It's a different story when they're first diagnosed.

"The student and parents are faced with a lot of information in a short period of time, and this can be overwhelming," Stanhope said. "The school nurse can be a resource for the parent as well as a comfort because they will assist the student as needed during the school day."

Across the river in Colbert County, Lori Blackburn, Stanhope's counterpart in Tuscumbia, said advances in technology have made it easier for students.

"Insulin pumps have made all the difference because it gives students so much more independence," she said. "But this is a life-changing condition, and it has an effect on what they do at home, at school and in the rest of their lives."

Blackburn said there are seven children in her district with juvenile diabetes.

"One thing I've found is critical is for families to continue to educate themselves," she said. "When you've had a child with this for a couple of years or more, you forget how quickly things can change. I always recommend a refresher course, especially as students get older."

People such as Jana Pilkington, a registered nurse and certified diabetes educator at Children's Health Systems in Birmingham, often step in at this point.

Too often, she said, parents feel overwhelmed when they learn of the diagnosis.

"There are a minimum of four blood sugar checks a day; some children have to do more, and they can feel overwhelmed with having to fit this into their schedule, but somehow they do," Pilkington said.

Once they learn how to manage the disease, they feel more empowered, she said.

"Diabetes education is the key to making sure you have good self-management, and self-management is the key to preventing complications when you're an adult because you already know how to control your diet or how to check your blood sugar or give yourself insulin," Pilkington said.

Often, she said children who were diagnosed at age 6 or 7 will come back as teens to educate themselves because it was their parents who had managed the disease for them.

One thing doctors and researchers still don't know about Type 1 diabetes is the cause.

There is speculation that it's passed genetically to a child through DNA. A virus in childhood is thought to cause the body's white blood cells to release a toxin that kills the body's insulin. The pancreas produces insulin.

"It's called juvenile diabetes because it usually presents during childhood," said Dr. Duane Carter, a pediatrician at Shoals Pediatric Group in Florence. He said he diagnoses about two new cases of the disease each year.

"There's never any good way to deliver this kind of bad news," he said. "But the biggest thing I see is that children come in, and they're drinking water all the time or they're losing lots of weight. I hear that and I almost know what the lab work will say. What's important, though, is the parents help get it under control, and the child will have as normal a life a possible."

Even with the ups and downs that come with having Type 1 diabetes, Tsukashima and her daughters say they are able to manage day by day.

"As the kids grow and change, we're constantly monitoring their insulin levels," she said. "We're looking forward to camp this summer where the girls can go and be with other kids with diabetes."

Ashlyn is still getting used to the idea that she has to check her blood-sugar levels.

"It's not been too bad," she said. "Yeah. I wish I didn't have it, but I think I'll manage. I'm going to be OK."[/i]