Letters to the Editor
You're Not Alone
I was especially drawn to a letter written by Staci Perkins in the April issue. She isn't alone in her frustration with people who don't or won't accept diabetes as a serious disease with life-threatening complications.
I'm 43 and have brittle type I diabetes. My husband, children and grandchildren have all been "exposed" to my insulin shocks - convulsions and seizures at times so severe that I have temporarily stopped breathing. My reactions come on with little to no warning, usually at a BG level of 40 or below. My family is forced to live with the guilt that they should have been there to help me during my strongest reactions. I assure them I appreciate their concern, but I will not allow it to control my entire life.
Often I feel guilt as well. Every time I'm sick in the hospital, or have intense highs or lows, I can see the worry in my family.
The harsh realities of diabetes need to be exposed to the rest of the world. Contrary to public opinion, it's not just "Take your pill or shot" and "Don't eat candy or sweets and you'll be fine."
I'm not ashamed of my diabetes. I eat healthier and I live healthier. My family shares a closeness of a different kind now because of it. Yes, we still have our differences and disagreements, but I find myself handling them in a calmer, more patient way. Life is just in a different light now. It is not ideal, but all in all it's not that bad.
"Don't Worry, He'll Grow Out of It."
The letter from Staci Perkins in your April issue really hits home. My son, now five-and-a-half years old, was diagnosed with diabetes at 18 months. Ms. Perkins' and my situations are somewhat unique, having to handle babies and small children with diabetes. But the real challenges are yet to come, what with school and a growing child's needs.
What is especially distressing is the apparent void of public knowledge concerning diabetes. Our schools and many friends and relatives are still living in the dark ages as far as diabetes awareness goes. Many times I have heard (from supposedly intelligent people), "Don't worry - he'll grow out of it."
Our support group at St. Vincent's Medical Center in Staten Island has picked up the silver ribbon campaign for diabetes awareness started in California by Wilma Reiber (Diabetes Health, March 1997 issue). If we can make more people aware of diabetes maybe then the pressure would be on to find a cure.
Staten Island, N.Y.
The Naked Truth
If one looks at your Question & Answer section in the March 1997 issue, one would assume that you are only interested in plugging products and not really interested in the health and well being of people with diabetes. How else can you explain the photo of the two skaters not wearing protective headgear, knee pads or wrist protectors? I would say that you were simply looking for some T & A to catch the (male) reader's eye.
C. T. Chase
The JDF Shows Us the Money
I'm writing to comment on some of the perspectives presented by Mike Barton in his article "Show Me the Money" in the April issue.
First and foremost, as the parent of two children with diabetes and a long standing member of the board of the Juvenile Diabetes Foundation (JDF), I am appalled that the JDF was never mentioned in this article. Over 30 million dollars of JDF money will go into diabetes research this year - more than any non-governmental agency in the world. Our goal is to cure diabetes by raising money for research, and we are the leader both in raising these funds and in advocacy with the federal government to enlarge its contribution to research. No article of this type is complete without mention of the JDF and its role in research funding.
I am also perplexed by Mr. Barton's characterization of a "poll driven tight-fisted Congress." As a member of the national Government Relations Committee of the JDF, I am one of many volunteers from across the country that write, phone, fax and visit their congressmen regularly to ensure funding for research. Over the past six years, I have seen a genuine, tangible and growing commitment to research by Congress. Even in the last couple of very lean years, when spending cutbacks have been the norm and holding to the past year's level of spending has been considered a victory in other camps, biomedical research funding has grown (6.9 percent last year). It never grows as much as we would like, but it has grown in distinctly greater percentages than in other programs.
While the presidential campaign produced promises of increases in medical research, the President's budget only includes a 2.6 percent increase - less than the rate of medical inflation. Conversely, men and women in Congress have stood firm in their conviction that biomedical research "promotes the general welfare." This movement has been led by courageous people: Representative John Porter of Ill., Speaker Newt Gingrich of Ga., Senators Phil Gramm and Kay Bailey Hutchinson of Texas and Connie Mack of Fla., to name just a few.
As the parent of two teenagers who must live with this capricious, confusing and contradictory disease, I am the first to say that progress is never fast enough; I want a cure for diabetes yesterday.
We at JDF will continue to work tirelessly to raise private funds for research and continue to pressure relentlessly for more public moneys for research. But let's look honestly at who our friends are in this important battle. Congress has responded, not just to the polls, but to the will of the people. We must continue, in even greater numbers, to thank them for past support and to remind them that the victory is still ahead.
National Government Relations Committee
Texas State Leader, JDF
Tight Control in the U.K.
The April issue gave a substantial amount of coverage on the worrying topic of hypoglycemic events in young children.
However, there seemed to be a slight misinterpretation of what the DCCT advised with regard to trying to achieve tight control in young children with diabetes. In the U.K. there has been some misinterpretation, which has meant that some parents and doctors are trying to achieve near normal glycemia in children despite the poor child having recurrent and sometimes severe hypoglycemic attacks.
The DCCT said quite clearly that children are different from adults with regard to the benefits and risks of trying to achieve tight control. In adults, the benefits are clear. But with certain adult patients the risk of an at least threefold increase in hypoglycemic events may not be worth the benefits that should follow later in life.
In children, the DCCT advised that there was no firm evidence that the benefits of tight diabetic control outweighed the risks, so they did not advise it.
This is because looser diabetic control in children does not seem to put them at an increased risk of diabetic complications in later life. Secondly, as Mr. Carney indicated in his letter in the April issue of Diabetes Health, the IQ of youngsters can be reduced if they are exposed to recurrent severe hypoglycemic events.
When I started as a doctor (some twenty years ago!), seizures in children with diabetes due to hypoglycemia were fairly unheard of. It worries me now that such events are not uncommon, and sometimes may not be given the attention they deserve.
Dr. Matthew Kiln, MB, BS, DRCOG, FRSH.
Paxton Green Health Center
Thank you for your comments. We hope that they help to clear up some of the confusion about this issue.
"A Bitter Pill," Hard to Swallow
I am writing in response to "A Bitter Pill," in the May issue ( regarding 13-year-old Eric Carr's suspension for passing out glucose tablets to his friends). I can't believe the ignorance! I had diabetes when I was thirteen and I know how hard it was at that age. With all the shots, blood tests, reactions, and fears, Superintendent Lee Brittenham should be ashamed for putting this child through even more trauma. At age 13, we all just want to be like everyone else and having diabetes makes it a lot harder. Situations like this can only make someone feel worse about their condition. We all make mistakes and Brittenham should learn to admit his.
I was recently at a fund raising cycling event for diabetes and we gave out glucose tablets. I guess we should all be arrested, right? Glucose is not a drug, maybe the administration at Hollenbeck Middle School is on drugs.
Lets all donate money so the Armistead family can take those empty-headed fools to court.
Jennifer C. Savarese
The ADA Clears Up "Fair Play"
I am writing to clarify some details about "Assembly Bill 221 Offers Fair Play," printed in the April 1997 issue of Diabetes Health.
First, please note the correct spelling of Jesi Stuthard's last name. The American Diabetes Association's National Center and the Ohio affiliate joined the Disability Rights Education and Defense Fund (DREDF) as plaintiffs in Jesi's fight against KinderCare Inc. The settlement agreement was negotiated by the plaintiffs, defendants and the U.S. Justice Department and was announced by Attorney General Janet Reno, who stated, "Children with diabetes shouldn't be left out on the sidelines. We hope that other child care facilities will do the right thing and follow KinderCare's lead."
Additionally, the American Diabetes Association's National Center is also a plaintiff with Calvin Davis in his case against La Petite Academy, the second largest day-care provider in the country. Again, working with the DREDF, the Association is close to settling this dispute.
Belinda Childs, ADA president, Health Care and Education, testified before the California Assembly's Subcommittee on Health, regarding AB 221, thus signaling national support of the bill. This is the important legislation that would allow a day-care provider to administer a "finger-prick" test. She was joined by Dr. Francine Kaufman, president of the American Diabetes Association, California Affiliate. The bill was passed unanimously by the subcommittee and will face the full Assembly soon.
These activities are part of the ADA's wide-ranging advocacy efforts to improve the lives of the 16 million Americans with diabetes. The Association's recent activity has resulted in the overturning of a 39-year-old blanket ban by the Federal Aviation Association (FAA) against insulin-dependent pilots, the victory against KinderCare, the passage of diabetes insurance reform legislation in 12 states, wide ranging support on Capitol Hill for diabetes Medicare reforms, and increased federal funding for diabetes medical research and Center for Disease Control (CDC) activities.
Michael L. Mawby
Vice President, Government Relations
American Diabetes Association
Glucagon - Don't Leave Home Without It
The Research Report in the April 1997 issue entitled "C-Peptide Test Sheds Light on Diabetes Diagnosis" referred to Glucagon. The definition for glucagon was given as "the body's principle carbohydrate reserve. In people without diabetes, it is easily turned into glucose." However, glucagon is a hormone produced in the pancreas. It stimulates the changing of glycogen to glucose in the liver. Secretion of glucagon is brought on by low blood sugar.
Every patient taking insulin should have a Glucagon Emergency Kit, and family members and/or friends should be instructed in its use.
Keep up the good work. Your information is invaluable to people with diabetes as well as to people caring for people with diabetes. I am a diabetes educator and have had type I diabetes for 32 years, so I am familiar with both sides of the story.
Ann A. Borsello, CLP
Thank you for the correction. We apologize for the error.
A Witty Ditty
Thinking of young diabetics, and how foolish they can sometimes be, I was moved to write the following verse:
To A Young Diabetic
Take your pills or insulin
Whatever funky mood you're in
If you find you're diabetic
You can't be apathetic
To test your blood do not delay
And do it more than once a day
Sometimes youthful compromises
Cause premature demises