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For young sufferers, staying vigilant is key to diabetes


At least eight times a day, 15-year-old Megan Davis pricks her finger to check her blood sugar level.
Each meal or even a snack becomes a math exercise as she scrutinizes the amount of carbohydrates she consumes, especially in light of school, sports, piano and other daily activities.

Almost 24 hours a day, the Ferris High School sophomore is attached to a small pump that infuses insulin – the hormone that converts sugar, starches and other foods into energy and ensures Davis’ survival.

Six years ago, she was diagnosed with Type 1 diabetes, an autoimmune disease that attacks and destroys insulin-producing cells in the pancreas.

Unlike the more commonly known Type 2 diabetes, Type 1 cannot be prevented by diet or exercise. Although it can strike anyone at any age, Type 1 is generally diagnosed in children, teens or young adults, which is why the disease is also known as juvenile diabetes.

As someone living with this disease, Davis has to play the roles of mathematician, dietician and scientist each day just to stay alive.
“It’s definitely a balancing act,” she said, describing the routines of keeping track of her food intake, counting carbohydrates, monitoring her blood glucose levels, changing the infusion site to her pump and other duties in order to avoid seizures and other life-threatening reactions.

Nearly 24 million children and adults in the United States have diabetes, according to 2007 statistics from the American Diabetes Association. Another 57 million have pre-diabetes, which means they are at risk of getting Type 2 diabetes.

Every year, 1.6 million new cases are diagnosed in people ages 20 and older. The total national cost of diagnosed diabetes in the United States is $174 billion.

In Spokane County, about 7.6 percent of adults – roughly 25,000 people – are living with the disease, according to statistics from the Spokane Regional Health District.
The local statistics do not distinguish between Type 1 and Type 2 diabetes. According to the ADA, about 5 to 10 percent of people with diabetes have the Type 1 form.

“It’s the more severe form of the disease,” said Kay C. England, manager of the Inland Northwest branch of the Juvenile Diabetes Research Foundation. “Type 1 is happening to kids as young as two months old in Spokane.”

Davis was 9 years old when she started displaying symptoms of the disease.

She was getting up in the middle of the night multiple times to go to the bathroom, recalled her mother, Illa Davis. She also had become lethargic and had lost about seven pounds in a short time period.
It didn’t make sense since Megan, the youngest of three kids, had always been an active and healthy child.

When the doctor told them it was Type 1 diabetes, her parents were shocked. Neither one had a family history of the disease. At the time, they also knew very little about this illness that would take over their family’s life.

When Megan was first diagnosed, Illa Davis would drive to Moran Prairie Elementary School to give her a shot of insulin at lunchtime. After some time, a school nurse would help administer the shot, but the nurse couldn’t always be available since she had duties at other schools throughout the district.

During Megan’s soccer games and many of her practices, Illa Davis or her husband, Kevin Davis, had to be there in case she suffered from extremely low or high blood sugar levels.

Megan’s diagnosis also changed her family’s lifestyle. Although the Davises had always been relative healthy eaters, they made a point to abstain from processed fare, limit visits to fast-food joints and stick to a diet of whole grains, fresh fruits and vegetables and mostly whole foods.
“It takes away from spontaneity,” said Illa Davis. “You can’t just pick up and go. You can’t leave the house and be caught without the (blood glucose) meter, snacks and insulin. That would have devastating consequences.”

Once, Megan couldn’t play the second half of a soccer game because she couldn’t get her blood sugar level to go down. As a child, there were many times when she had to get an extra shot of insulin just to attend a birthday party and eat a slice of cake, her mom recalled.

“It’s frustrating for children,” Illa Davis said. “It cheats them out of their childhood a little bit.”

After a few months, Megan was able to give herself the shot. She also switched to using an insulin pump within a year of being diagnosed.

Now that she’s a teen, Megan is able to manage the disease 99 percent of the time. She and her family have also reached out to other area youth and children who have Type 1 diabetes through the Juvenile Diabetes Research Foundation.

Four years ago, Megan traveled to Washington, D.C., on behalf of the foundation to lobby for more funding to find a cure. She also has regularly attended Camp STIX, an independent, community-based summer camp in northeastern Washington for youth with diabetes.
“They look like normal, healthy kids – and they are,” said Illa Davis. “Megan is the epitome of health. However, if she is not vigilant 24 hours a day, she can get sick really fast …

“But Megan has taken on the responsibility of taking care of herself and taking charge of her diabetes. She owns it and does not let it own her.”

A comparison of several popular Insulin Pumps Links 800#'s Animas (877) 937-7867 Deltec (800) 826-9703 Disetronic (800) 280-7801 MiniMed (800) 933-3322 Insulet (781) 457-5000 Sooil USA (866) 747-6645 Model Ping Cozmo® Spirit® Paradigm 522/722 OmniPod DiabecareIIS Dim. [mm] 51 x 77 x 18 80 x 47 x 24 80 x 47 x 24 522: 51 x 79 x 20 722: 51 x 91 x 20 pod: 41x61x18 pda: 66x110x26 46 x 77 x 19 Volume 5.525 ci 90.54 cc 5.06 ci 83 cc   522: 4.9 ci 722: 5.6 ci 92 cc Pod: 2.7 ci PDA: 11.5 ci 4.3 ci 67 cc Weight [oz] 3.9 2.7 2.8, 4.8 with batt full cartridge inf set 3.5 oz 3.8 oz OP: 1.2 oz (full res.) PDM: 4.0 oz (w/ batteries) 1.9 oz Reservoir Size 200u plastic 300u plastic 315u 176 or 300u pl 200u 300u plastic Connection Luer lock Luer lock Luer lock Proprietary Built-in Proprietary Screen Size 992 sq mm 870 sq mm   774 sq mm 1,848 sq mm on PDA controller 595 sq mm Colors blue, silver, black, pink, green blue, black, atomic purple Blue, with 30 pump skins in colors and styles clear, smoke, blue, purple white Black, Gray, Pink, Green, White Basal Increment 0.025u 0.05u 0.1u from 0.1 to 25.0 u/hr 0.05 u 0.05 u u/hr, up to 30 u/hr 0.1 u/hr or 0.01 u/hr Total Basals 12/day 48/day 24/day 48/day 48/day 24/day Basal Profiles 4 4 5 3 7 1 Basal Interval 30 min 30 min 60 min 30 min 3 min 60 min Basal Delivery varies, 0.2 u/hr every 3 min every 3 min every 3 min varies, 0.6 u/hr = every 10 min   Every 4 min Temp Basal -90% to +200% in increments of 10% for 0.5 to 24 hours (30 min increments) in 0.05 u increments, or -10% to +150% in increments of 5% for 0.5 to 72 hours (30 min increments) in 10% increments from 0% to 200%, and 15 min to 24 hr +/- 0.1 u increment as single basal rate for 0.5 to 24 hrs or as % of current basal % or u/hr (1-12 hrs, in 30 min increments) 10% increments from 0% to 200% and up to 12 hours Bolus Increments 0.05 visual or audio, 0.1, 1.0, 5.0 audio 0.05, 0.1 visual, 0.05, 0.1, 0.5, 1.0 visual or audio 0.1, 0.2, 0.5, 1.0, 2.0 0.1 visual, 0.5 or 1.0 visual or audio, remote extra 0.05, 0.1, 0.5, 1.0u 0.1, .05, 1.0u Carb and Correction Factors yes, carb and bg values can be entered into the pump or meter-remote yes, manual carb, BG from attached CoZmonitor meter or manual entry yes, manual carb, BG from Accu-Chek BG monitor yes, manual carb, BG direct from BD meter or manual entry yes Yes, manual carb Bolus Type units or carbs: standard, extended, combination units or carbs: standard, extended, combination quick, scroll, extended, multiwave units or carbs: standard, extended, combination Meal, correction, meal & correction; normal, extended, combination Normal, extended, combination 1 u Bolus Duration 1 or 3 sec adjustable, 1-5 5 sec 30 sec. 40 sec. 12 sec Battery AA lithium or alkaline x 1 AAA x 1 AA x 1 Alkaline or Rechargeable AAA for pump, A23 for remote AAA x 2 (PDA) 1/2 AA 3.6v lithium Battery Life 4-6 with lithium, 2-4 with alkaline 3 weeks 4 week 3 weeks 4 weeks 8-10 weeks Motor DC DC DC DC stepper DC Memory non-volatile: 500 boluses, 270 basals, 120 daily totals, 60 alarms, 60 primes, 900 bg levels non-volatile: 90 days (2000 events) of basals, carb boluses, correction boluses, alarms non-volatile: 90 days (4,500 events); history recall of last 30 boluses, alerts, daily insulin totals, and temporary basal rate increases 4000 events, volatile (basal & history loss can occur): 24 boluses, 7 day totals 90 days of data (up to 5400 records) Last 500 boluses, primes and daily totals. Last 100 alrams (all time and date stamped) Software Download ezManager Max, downloads in 3 minutes with dongle and software that are available at Animas CoZmanager: IR port, program pump and download last 4,000 events at Deltec Pocket Compass with Bolus Calculator , insulin pump configuration software, IR Communication Port Medtronic CareLink® Therapy Management System and ParadigmPAL™ 3.0 Software at Medtronic none none Water? 12 ft for 24 hrs watertight IPX 8, 60 minutes at 2.5 meters splash resistant watertight Watertight Extra Features Meter-remote offers wireless bolus calculation and delivery within 10 ft. ezCarb software stores up to 500 food items from CalorieKing database on the meter-remote. Calculator features for carbohydrates, blood glucose corrections and insulin; reminders for time of day and when to perform blood glucose checks. Pump and meter-remote are available in Spanish. PC and Mac downloads are available with ezManager Max software integrated Freestyle meter, personalized carb and correction factors, tracks residual bolus insulin, many reminders including missed bolus, daily correction bolus total, detailed history in pump choice of standard, advanced or custom selectable user menus, icon- and menu-driven programming, backlit display, reversible display screen, 12 languages, audible or vibrating bolus confirmation and alerts.   remote, vibration, colors, backlight, extended bolus, auto off backlight, reminders & alerts, child lock, integrated Freestyle meter, 1000 common foods in PDA, Tubeless Carb Counting Program, Auto Dose capability, Bolus frequency restrictions, preset meal and default bolus. PIN# programming and access to functions including daily maximums and mode settings for healthcare professions / caregivers. Backlight, icon menu. Auto display of remaining insulin and remaining battery life. Lock-out feature with PIN unlock. Twelve languages

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