Wednesday, April 05, 2006

Sad Diabetes Story

I read this story today- its about this 24 year old girl who contracted diabetes. Once active and intelligent- now she has problems pouring a glass of orange juice to save her own life.

It is before dawn and there is movement in the kitchen. There is the soft tread of feet, the fridge door opens and there is the clinking of glass.

I find Jessica, my daughter, who rarely rises early, standing immobile as if contemplating something deep and puzzling. The light from the open fridge spills across her face. She has placed a bottle of orange juice next to the sink, but it is clear she does not know quite what to do next. Jessica is trying to save her life. Normally brilliant and sparkling, she is trying to make her brain solve the riddle of how to find a glass and how to pour the juice. But her brain is dulled, deprived of the energy that makes the neurons spark in correct order.

Diabetes Type I is an auto-immune disease, but despite immense research efforts, the precise cause remains unknown. It is increasing in frequency – about 3% a year in Australia – though at nowhere near the rate of Type 2. Apart from genetic factors, environmental triggers are suspected, and studies are looking at wide ranges of possible causal links, including recently the age at which children begin drinking cows’ milk. It is vastly less common than Type 2 – about 140,000 Australians are diagnosed as suffering Type 1.

Whatever the cause, Jessica’s immune system had made a massive mistake: instead of protecting her, perhaps against a virus, it had turned upon itself, destroying the beta cells within her pancreas. Her own protective system had ruined her body’s ability to produce insulin.

I should have known. Jessica had spent the previous weekend with me. We drove around town and at every service station she asked me to stop. Each time, she would fly to the toilet and buy a bottle of water before we left. She guzzled the water before the next stop. I assumed it was some kind of diet, and it was all that water that was forcing all those pit stops.

In my happiness to be spending a weekend with my child, I had ignored the classical symptoms of the onset of diabetes. Her body was no longer processing sugars and it was demanding the impossible – to be flushed.

Within a day, she was desperately ill. Glucose had built up in her bloodstream to the point she could feel pressure behind her eyes. Her heart was having difficulty pushing the increasingly gooey stickiness of her blood through her arteries. Potassium, the electrolyte element required to keep the heart beating regularly, had been stripped from her system by excess urination. Her blood sugar content was so high she was entering a state known as ketoacidosis (DKA) – a complex, major life-threatening state.

Fortunately, workmates became alarmed by her obviously deteriorating circumstance. Nearing unconsciousness, she was taken to a doctor who sent her directly to hospital. Short analysis of her symptoms and blood glucose content confirmed her condition.

She would, she learned within hours, be required to inject insulin four or five times a day for the rest of her life. In effect, she would have to save her own life every few hours, every day. (An increasing number of young diabetics are able to control their insulin requirements through a marvellous invention known as a “pump”, which is attached to the body and administers the hormone more automatically. The pump requires a story of its own, but the principle remains the same: insulin has to be injected either by syringe or the pump because stomach acids would destroy it if administered orally.)

Jessica had been catapulted from the carelessness of youth to the ranks of those from the Options Generation who could no longer afford options.

Her life now would be a balancing act: figure out how many portions of carbohydrates – starchy food from plants which are basically lumps of glucose – that would be in each meal and then inject the corresponding dose of insulin to deal with it.

Too much insulin and she would risk a hypoglycaemic episode – the dreaded “hypo”, when the glucose level of the blood, required to provide the energy to sustain life, plummets. Too little insulin and the result is a hyperglycaemic state, when sugars build to dangerous levels. Both are potentially fatal.

Read the full story here

No comments: