Health & Fitness

They’re learning to live with diabetes as a child or teen

Danilza Velez, RN, a pediatric nurse with the Baptist Children’s Hospital inpatient unit, reviews diabetes resources with Haley, a patient.
Danilza Velez, RN, a pediatric nurse with the Baptist Children’s Hospital inpatient unit, reviews diabetes resources with Haley, a patient.

Haley Gassenheimer was practicing her clarinet during marching band practice at Coral Reef High School in August when she suddenly couldn’t breathe.

“I was gasping for air,” recalled Haley, 15.

Haley had to be carried out of the band room. She was rushed to Baptist Children’s Hospital, where doctors discovered she was suffering from diabetic ketoacidosis, a serious complication of diabetes that occurs when the body produces high levels of blood acids called ketones.

Haley was diagnosed with type 1 diabetes, a condition in which the pancreas produces little or no insulin. Insulin is a hormone that feeds the cells to produce energy.

Type 1 diabetes usually begins during childhood or adolescence but can develop in adults.

Symptoms include excessive thirst, eating a lot and weight loss, said Dr. Arcenio Chacon of Baptist Children’s Hospital. Haley had experienced these symptoms.

When blood sugar levels are high, it becomes difficult for the kidneys to process, so the sugar spills into the urine. That leads to frequent urination and dehydration. Weight loss results because the body is not absorbing the sugar, which has the calories.

“A family can have difficulty diagnosing because the symptoms start gradually,” Chacon said.

“I didn’t realize she had symptoms because everyone was struggling with the heat during band camp practice,” said Haley’s mom, Patty Gassenheimer. “I thought she was dehydrated.”

Approximately 1.25 million American children and adults have type 1 diabetes, or about 5 percent of all diabetes cases, according to the American Diabetes Association. About 193,000 Americans under age 20 are estimated to have diabetes, nearly 25 percent of that population.

The risk factors for type 1 diabetes include family history, genetics and age.

Haley’s older brother, Zachary, was diagnosed with type 1 diabetes when he was 16.

“I had a really hard time at first [with the diagnosis],” Haley said. “But knowing that my brother has a good normal life, I knew it was going to be OK. He was a good role model. He made me feel confident in my life and that it will be easier.”

Haley had to adjust to carbohydrate counting, which involves counting the number of carbohydrate grams in a meal and matching that to a dose of insulin.

Monica Grimaldi, registered dietitian and certified diabetes educator at Nicklaus Children’s Hospital, said it’s important to eat whole grains like whole wheat bread, quinoa, couscous and brown rice, which are lower in carbs and higher in fiber than such foods as white rice and pasta. Fiber helps control blood sugar levels.

Meals should also include veggies and legumes like beans, lentils and peas. Eat lean meats and fish such as salmon and tuna, which have less saturated fat, over red meat.

And eat fruits rather than drinking fruit juices and other sugary drinks. Sugar-sweetened beverages like soda, juices, iced teas and energy drinks can cause your blood sugar levels to spike.

“Sugar-free drinks are fine, but read the nutrition label to check for carbs,” Grimaldi said. “If there are carbs, they have to be counted.”

Regular exercise that incorporates aerobic and resistance-training activities can help diabetics improve insulin sensitivity, cardiovascular fitness and muscle strength.

The ADA recommends one hour of physical activity every day and less than two hours of screen time. Physical activity can include riding a bike, playing, dancing or joining a sport, Grimaldi said. “It should be some activity they enjoy doing and not something they consider more of a chore.”

Adolescents should check glucose levels regularly and not assume they are doing well because they are feeling well, said Dr. Mauricio Flores, pediatric endocrinologist at Joe DiMaggio Children’s Hospital at Memorial Healthcare System. Pay close attention to glucose levels, especially before driving, participating in water sports or climbing.

“For older teens going to college, we recommend avoiding alcohol as much as possible and be open to their close friends about diabetes,” Flores said.

Consuming alcohol can cause blood glucose to drop because alcohol blocks the liver’s ability to produce glucose.

Haley hasn’t let her diagnosis slow her down. Even though she was hospitalized shortly before the new school year began, she was back in the marching band and made it to the first day of school.

After graduation, she plans to pursue a career in the healthcare industry.

“I’ve always wanted to be a nurse since I was 10 years old,” Haley said. “I want to make a difference, whether it is in the diabetic field or healthcare in general.”

Camps for children

Although a diagnosis can be a big change in a child’s lifestyle, two summer camps can help children become educated about the disease while having fun.

Camp Coral Kids, a medically supervised summer camp for children with type 1 diabetes with Broward Health, runs for two weeks every summer in Coral Springs.

The day camp teaches children how to check blood sugar and bond with other children undergoing the same thing, said Kathy Byrne, RN, director of Camp Coral Kids. “They realize they aren’t the only kids with type 1 diabetes. That being different makes them special and they build friendships with other campers. At school, the kids have to be pulled out of class to check blood sugar. At camp, everyone is doing this too.”

Joe DiMaggio Children’s Hospital at Memorial Healthcare System runs Camp Gene, a medically supervised summer camp for children with diabetes, sponsored by the American Diabetes Association.

At Camp Gene, children get to meet other children with diabetes while developing social skills, self-respect and lifelong friendships. They also learn more about living a healthy lifestyle and the importance of nutrition, exercise, emotional well-being and glucose control.

Contact the camps

For information about Camp Coral Kids, visit browardhealth.org/camp or 954-344-3344.

For information about Camp Gene, contact Michelle Foster at mfoster@diabetes.org or 407-660-1926 ext. 4643.

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