The Bears open their season at Soldier Field today, and though I’m not much of a football fan, I’ll be cheering on Chicago quarterback Jay Cutler. He was 25 and quarterbacking for the Denver Broncos when he was diagnosed with Type I diabetes, joining a team of 2 million other Americans like me who live with the chronic disease every day.
Diabetes is a difficult disease to understand, in large part because of the two different types. Type I is the one that was formerly known as juvenile diabetes, Type II used to be called adult onset diabetes, and both diseases have to do with insulin, which helps move sugar from the blood into cells for energy.
A person who has Type II still has a pancreas that produces insulin, but in some cases because the person has a poor diet and/or is overweight, their pancreas just can’t keep up. In others, people develop a kind of insulin resistance which limits the effectiveness of insulin. Many of the people diagnosed with Type II diabetes can improve the condition (even reduce or eliminate the need for insulin injections altogether) by watching their diet and exercising.
A person diagnosed with Type I diabetes has a pancreas that doesn’t work at all — it doesn’t produce any insulin. No matter what we do (exercise, diet, whatever) our bodies will not make insulin. We either have to take multiple injections of insulin throughout the day, or wear an insulin pump.
There is no behavior that causes Type I–it’s an autoimmune disease — some trigger wrongly tells the body to attack the cells that produce insulin. It usually occurs in childhood. I was diagnosed when I was seven years old, long before short-acting insulin, home blood glucose monitors or insulin pumps came on the scene. In recent years it has become increasingly common for people Cutler’s age or older to be diagnosed with Type I, and thanks to advances in care of Type I, we can test our blood sugar levels regularly at home and give ourselves insulin throughout the day to match our food intake and exercise levels. The more we test our sugar levels, the easier it is to walk the tightrope between high and low blood sugars.
It’s never a walk in the park, though, and I cannot imagine what it must be like for someone to walk that tightrope with millions of people watching TV as he fends off 300+-pound gorillas rushing to knock him down. In an interview in Diabetes Forecast magazine, Cutler was asked how he uses a blood glucose monitor to check his blood sugar level on game days. His answer:
I check my blood sugar about four or five times before the game—try to stay around 150 to 160 [mg/dl] before kickoff. Most of the time, I prick my finger every time we come off the field, especially in the first half.
When asked if he worried whether his teammates, the media, or fans might blame his Type I diabetes as a reason for poor performance, Cutler said he didn’t want sympathy, he just wanted to be judged like every other quarterback. “But living with diabetes in the public eye does make it harder,” he said, conceding that if he goes out and has a bad game, some people might assume it’s because of his blood sugar numbers. “I just try not to worry about it and go out and play my game.”
A short YouTube video shows Cutler visiting with kids in a hospital who have just been diagnosed with Type I. He figures if kids meet him and then see him on TV playing football, they’ll realize that Type I doesn’t have to stop them from doing what they want to do. They’ll just have to learn to manage the disease, and be good with numbers. Like #6
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Dear Beth,
Have you considered a pancreas transplant?
My cousin’s daughter was diagnosed with type A when she was 2-years old.
In her 20s, she stupidly smoked. They would not do a transplant with someone who smoked cigarettes and she would not quit.
She came near to death several times. One time two Doctors almost got into a fight while the grandmother, my aunt was standing there by the bed. One Dr said let her go she has been through too much and it was time to let her go.
The other Dr. wouldn’t. He said she was too young.
Well, eventually when she was about 38, she had a stroke. After the stroke she never remembered that she used to smoke. They did a pancreas and maybe kidney transplant and she is no longer a diabetic.
But, because of the stroke, her brain is somewhat impaired. She can function, but has trouble speaking and has other affects.
If she had only quit smoking at an earlier age she could have had that transplant.
Anyway, I am curious as to whether you have considered a transplant.
I have type 2. It is the one brought on by age and lack of exercise and weight. Always fighting my weight.
In 2007 my wife gave me a kidney. Before that I had been on Dialysis for 9-months. That was no fun at all.
On October 22 she is going to have a knee replacement. Since she gave me a kidney, now she wants me to give her a knee. (smile)
Best, –Bob Ringwald
Oh, Bob, had no idea you’d had a kidney transplant. My brother-in-law has Type II and had a kidney transplant last year, so I know a little bit about how that goes. About getting a pancreas transplant myself: When I was training at the Seeing Eye with Whitney, another blind woman who was there to train with a new dog told me she “used to have Type I.” As you know, diabetes is a leading cause of kidney failure –Tracey had been diagnosed with Type I when she was eight years old, and she was on dialysis for a year and a half in her thirties before receiving a kidney and pancreas transplant. Like Tracey, I was diagnosed with juvenile diabetes when I was a kid, and over the years, friends have asked if I might consider a pancreas transplant. It’s true a pancreas transplant might offer a “cure” for type 1 diabetes, but many physicians are reluctant to transplant a pancreas alone for diabetes without renal failure. The reason? Side effects of the immunosuppressant drugs required after transplantation can be more detrimental than the complications of diabetes.
When someone like Tracey (who had severe kidney damage due to type 1 diabetes) is experiencing renal failure, doctors reason they may as well combine a pancreas transplant with
a kidney transplant. That way you end up with a healthy kidney, plus a pancreas that won’t damage it anymore.
Being a transplant recipient is great, Tracey would tell me. “No more diabetes or kidney problems!” At the same time, she readily acknowledged that she’d exchanged one set of challenges with another. I’d hear her alarm go off twice a day to remind her to take her anti-rejection medication, and she still has regular doctor visits and blood tests and a compromised immune system to deal with.
So while I envied the way she could eat desserts at dinner without worrying how much extra insulin to inject to “cover” the extra carbs, or how she’d scurry out to the Seeing Eye shuttle bus without pricking her finger to check her blood sugar level first, or never had to pat her pockets to confirm she had a glucose tablet along, you know, in case of a low blood sugar en route, I am hopeful my kidneys stay healthy and I never need a transplant.
More about this in a post I wrote encouraging people to sign up to have their organs donated once life ends: http://bethfinke.wordpress.com/2012/01/27/nine-lives/ Go Bears!
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If anyone wants to know more about diabetes–I and II- you can read my YA book Diabetes (Lerner). Definitely a difficult, complicated disease.
Marlene Targ Brill
Marlene, it’s high time I learn more about your work. I knew about your recent book about speech disorders, but had *no idea* you’d written a book for teens about diabetes. What I would have given to have a book like that when I was in high school
Nice educational promo.
Thanks, bro!
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Great post and great follow-up comments. I’m going to try this commenting thing myself, Beth. I have a cousin who is a pancreas / kidney transplant doctor. We are not around each other that often, and seem to mostly communicate via our moms. I have never asked him if he chose his speciality because of the Type I diabetes in the family tree, but I know he has looked into the history of what happened to our aunt, who died in childbirth due to complications of her diabetes. She was also one of the first diabetics in Arkansas to be put on insulin some time in the early-1930s. He has also told me that when he was doing his residency, he had a young thirty-something father and Type 1 diabetic as a patient. He needed a transplant. The hospital in that state at that time would not approve the kidney transplant for a Type 1 diabetic. Why? Because the Type 1 diabetes would continue and it would then afflict a perfectly good kidney. That young father died. My cousin was the one who got word to me through the family grapevine to make sure I went on an ACE Inhibitor–a medication shown to assist in protecting the kidneys from long-term effects of diabetes. When I was last in the same room with cousin Bob–a couple of years ago just after the memorial services for my Dad, so I wasn’t on the ball about a follow-up question–my cousin indicated that he felt like his speciality might disappear not long after his retirement. He more or less said that transplant therapies have simply not provided the benefits needed. Pretty much confirming what Beth said about trading one set of challenging issues for another. It is life-saving, life-giving, for those who have no other choice, but he continued to assure me that I should hang on to my kidneys for as long as possible. I, too, sometimes long for a cure. So life could be easier…but also because, even when I try my hardest, there are too many times when I guess wrong, the blood sugar comes in higher than is healthy, and the drip, drip, dripping of the wear and tear on the body from elevated blood sugars goes on. Special “thank yous” to Bob’s wife and Tracy’s donor, and to Beth for telling us about Jay. Duh Bears!
You think maybe your cousin meant his specialty might disappear soon because he’s sure there will finally, finally , finally be a *CURE* for diabetes and people won’t need a double-transplant anymore? I’m going to think that’s what he meant. Let’s hope.
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