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Your Health
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Juggling Diabetes, Childhood All Part of the Day — and Night — for Family of Young Patient

Technology, treatment techniques and support system improve, but those dealing with chronic disease must remain vigilant

While managing her Type 1 diabetes, 9-year-old Darianna Leon of Arroyo Grande dances six hours a week and pursues other activities a typical fourth-grader likes. She was diagnosed with the disease three years ago. Click to view larger
While managing her Type 1 diabetes, 9-year-old Darianna Leon of Arroyo Grande dances six hours a week and pursues other activities a typical fourth-grader likes. She was diagnosed with the disease three years ago. (Janene Scully / Noozhawk photo)

[Noozhawk’s note: This article is the first in a series on diabetes in Santa Barbara County.]

Darianna Leon’s parents expected to hear a simple diagnosis three years ago — not the life-changing pronouncement that their daughter has Type 1 diabetes.

“It was very surprising,” said Darianna’s mother, Mayra Leon of Arroyo Grande. “I was very shocked.”

The Leons noted their now-9-year-old daughter’s increased thirstiness, frequent urination and unexplained weight loss in a very short time.

Her pediatrician delivered the diagnosis of Type 1 diabetes on Aug. 23, 2012.

“Besides my heart sinking,” Leon told Noozhawk, “the first thing I asked the pediatrician was what we had done as parents to cause it, thinking it was something like Type 2 diabetes, which is what mostly people are familiar with.”

The pediatrician’s answer: The Leons had done nothing wrong.

Many people know about Type 2 diabetes, which typically affects older adults and is related to diet, exercise and lifestyle.

“Type 1 diabetes has nothing to do with that,” Leon said. “It’s just an autoimmune disease that most people are not familiar with.”

That’s not surprising since only 5 percent of people with diabetes have Type 1, according to the American Diabetes Association.

Before her daughter’s diagnosis, Leon said she wasn’t familiar with Type 1 diabetes.

“It’s just the body attacking itself,” she said. “It attacks the pancreas. It doesn’t produce insulin so you have to resort to injections to replace the insulin that the body no longer produces.”

Today, Leon is part of a community of Type 1 parents working to create awareness about juvenile diabetes, and the fact it’s different from Type 2.

According to the Centers for Disease Control and Prevention, approximately 30 million people in the United States — 9 percent of the population — have diagnosed and undiagnosed diabetes.

In all, there are four types of diabetes linked by troublesome blood sugar issues, but they’re all very different.

After Darianna Leon was diagnosed with Type 1 diabetes, her family was referred to the Pediatric Endocrine and Diabetes Clinic at Cottage Children’s Medical Center. There, they were paired with a nutritionist, endocrinologist, nurses and others to help maneuver through the management of the disease. Click to view larger
After Darianna Leon was diagnosed with Type 1 diabetes, her family was referred to the Pediatric Endocrine and Diabetes Clinic at Cottage Children’s Medical Center. There, they were paired with a nutritionist, endocrinologist, nurses and others to help maneuver through the management of the disease. (Janene Scully / Noozhawk photo)

No matter the diabetes type, they are linked by one common factor: Having too much glucose, or sugar, in the blood because the pancreas stops making insulin, can’t make enough insulin or the body’s tissues can’t use insulin properly, according to the Cottage Health Diabetes Education Center.

Insulin is a hormone that helps the body’s cells use sugar for energy, and also assists the body in storing extra sugar in muscle, fat and liver cells, according to Cottage Health. Without insulin, the sugar can’t get into the cells to do its work, and instead remains in blood, causing high-blood sugar levels.

Type 2, the most common form of diabetes, once was known as primarily an adult disease. These days, it is being seen more and more in younger patients due to a rise in childhood obesity.

Some people with Type 2 diabetes can manage their condition with healthy eating, exercise and weight loss, if needed. Others may need oral medications or even insulin to help meet target blood glucose levels.

More recently, medical professionals have found weight loss surgery can help Type 2 and pre-diabetes patients.

Another form is called pre-diabetes, referring to those at risk for getting Type 2 diabetes. In patients with pre-diabetes, the blood sugar is higher than normal. Many people who develop Type 2 diabetes have pre-diabetes first.

However, lifestyle changes can help get blood sugar back to normal and delay, or even avoid, diabetes.

People of Hispanic and Latino origin are at high risk for getting diabetes, but their chances vary based upon ethnic groups and other factors, including the length of time they have been living in the United States, according to two studies published in the August 2015 issue of Diabetes Care.

The Hispanic Community Health Study/Study of Latinos (HCHS/SOL), conducted by the National Heart, Lung & Blood Institute, discovered a diversity among Hispanic/Latino groups when it came to the prevalence of diabetes, as well as a low rate of diabetes awareness and diabetes control.

“The study found that the prevalence of total diabetes (both diagnosed and undiagnosed) among all Hispanic/Latino groups was roughly 16.9 percent for both men and women, compared to 10.2 percent for non-Hispanic whites,” the American Diabetes Association reported.

Click to view larger

Individually, rates varied from a high of 18.3 percent for those of Mexican descent to a low of 10.2 percent for people of South American descent, the study found.

The fourth type of diabetes, gestational diabetes, involves pregnant women who typically are diagnosed around the 24th week, according to the American Diabetes Association. The diagnosis of gestational diabetes doesn’t mean the woman had diabetes before conception or that she will have diabetes after giving birth.

Following doctors’ advice regarding blood glucose levels is vital to keep both mom and baby healthy, experts say.

Without proper management, high blood sugar can take a toll on a patient’s body and can lead to problems with the eyes, heart, blood vessels, nerves and kidneys. Additionally, a diabetic patient is more likely to get a serious illness or infections.

Common symptoms of diabetes are urinating often, feeling very thirsty, feeling very hungry even though you are eating, extreme fatigue, blurry vision and cuts/bruises that are slow to heal.

People with Type 2 diabetes also may experience tingling, pain or numbness in their hands and feet, known as neuropathy.

To help patients diagnosed with all types of the disease, Cottage Health offers education encompassing diabetes management and lifestyle modifications. Topics covered include facts about the disease, personalized nutrition, carbohydrate counting, self-glucose testing, medication information, insulin resistance, weight management, complication prevention and community resources.

Free classes are held at all three Cottage Health hospitals in Santa Barbara, the Goleta Valley and the Santa Ynez Valley.

Managing the chronic disease is a vital public health concern as one in four people over the age of 65 have diabetes. The California Department of Public Health recently released a report, Economic Burden of Chronic Disease in California, which estimated the health-care costs of managing six chronic diseases, including diabetes, in 2010.

For Santa Barbara County, the study found that diabetes added up to $143 million in costs. In Ventura County, the cost was pegged at $288 million while San Luis Obispo County totaled $92 million.

Technological developments and medical advancements are promising for patients beyond the creation of insulin pumps and continuous glucose monitors.

A powdered insulin that is inhaled now is available under the name Afrezza. Santa Barbara’s William Sansum Diabetes Center was among dozens of locations across the country to participate in trial tests.

An insulin pill being developed by researchers at UC Santa Barbara may provide a different blood sugar management option for diabetes patients.

And grant-funded research is underway on an artificial pancreas. UCSB chemical engineers Frank Doyle and Eyal Dassau and Dr. Stuart Weinzimer of Yale School of Medicine, plus their teams, are undertaking the development of an artificial pancreas for children. The goal is to stop overnight hypoglycemia created by the long time between dinner and breakfast.

After receiving Darianna’s diagnosis, the Leon family was referred to the Pediatric Endocrine and Diabetes Clinic at Cottage Children’s Medical Center.

“Your life just changes completely, especially during those few months or even year that you are first dealing with it,” Leon said. “Just having the support you need to guide you through the process has been very helpful.”

At Cottage Health, the Leon family linked up with a nutritionist, endocrinologist, nurses and others to help maneuver through the management of the disease.

“It’s just nice to have the support to help you out because you’ve already got enough to deal with on a daily basis, and they’re there to support even more,” Leon said.

Darianna’s mom appreciates the convenience of having the facility so close to home, eliminating lengthier travel for what now are quarterly appointments.

“They also have a complete team to help you through and assist you every step of the way at the beginning when you’re first diagnosed,” Leon said, adding that her daughter’s doctor helps obtain the latest technology.

Darianna’s diabetes is managed through an insulin pump and continuous glucose monitor so she doesn’t have to give herself a shot every time she needs insulin.

Despite the technology, the family still counts Darianna's carbohydrate intake and monitors blood glucose levels.

“We have to watch what she eats — not in the sense of a Type 2 diabetic, but mostly watching for spikes in blood sugar,” Leon said.

“Right after she eats, you might have different foods that have different effects on the body. Like pizza will take a long time to digest, so if you give the insulin right away she’s going to have a low blood glucose level afterward.”

Hormones, exercise and growth also need to be taken into account when assessing blood sugar readings. Sickness can affect blood-sugar levels.

“Managing diabetes, it’s like having another full-time job,” Leon said. “I think one of the biggest challenges Type 1 parents face is having to wake up multiple times in the night to check on our kids. It’s like having a newborn baby except it’s not going to outgrow the stage.”

 Leon explains that the commitment is all part of the family’s routine now.

“Diabetes is a huge part of our life,” she said. “It’s not something that precludes us from enjoying our life, but it is there and it takes a lot of time to manage it.”

More than three years after the diagnosis, Darianna is a healthy and happy fourth-grader who takes dance classes for six hours a week.

"She can do anything she wants,” her mom said.

Noozhawk North County editor Janene Scully can be reached at .(JavaScript must be enabled to view this email address). Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.

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