Diabetes developing in teen years. How does it affect a 16 YO?

I taught a boy who had type II. He was in a 'special school', not just because of the diabetes. He gave himself his own shots and he also had to fill in repeat prescriptions when he needed to re-stock. His parents wanted nothing to do with 'the stuff' he needed, I think they were in denial. He was very matter of fact about the whole thing. I can remember him injecting himself by just stabbing the syringe into his leg. gulp He was often tired and listless, but he always put that down to the fact that he was still growing. He was also very cheerful and a lot of the younger kids looked up to him as a role model. Given that some of the kids had terminal illnesses/conditions that was quite something to achieve. I think, but am not sure, that he had a satchel/bag that went everywhere with him and that had all sorts of 'stuff' that he needed.

Do you mean Type I? Type II is generally related to obesity (which I'm only questioning since you say the character is a cheerleader), while Type I is an autoimmune disease that often does start in childhood (and yes, 16 would be a typical age)

Type I onset often includes a few months of a 'honeymoon' period where the beta cells haven't entirely been destroyed, but once that's over, yes, she'd absolutely need insulin to survive. As far as her cheerleading goes, it'd be advisable for her to test before and after and make sure she keeps a bit of quick sugar on hand (sugar tabs, OJ, etc), but many, many kids who are type I are able to keep up with their sports after they're diagnosed. (Then again, teens being what they are, they tend to do stupid things. Some teens like the headrush of low sugar. Some abuse insulin for dietary purposes. It's the kind of thing you can play with a bit.)

Does that help? There are others around here who are MDs (I'm not, am a diabetes researcher), but if you're more specific on what you're looking for, will try to help.

It'd be a tough sell that no one else knows - if she's sixteen, her parents would be involved with a doctor, etc. And the schools are pretty strict about kids with diabetes, in terms of where medications and needles are kept, etc. The collapses themselves are plausible, it's the idea she could be diagnosed without anyone else knowing about it. eta: Just saw that you said her parents and doctor - she wouldn't have to tell her friends if she didn't want to, but the school and her coach would have to know, I'd say.)

The mechanism is basically that once your blood sugar gets too low, the brain has a tough time functioning. So essentially, once you get somewhere in the neighborhood of 20-30 mg/dl (normal is 80-120), you pass out. There are all sorts of diabetes online communities out there - might want to lurk a bit, see what it's really like for these teens. Some places to start are JDRF, Joslin diabetes...

My wife is a type I diabetic who has had it since she's been six years old.

Distinguishing between Type I and Type II is pretty important.

Type I: the pancreas produces absolutely no insulin and the diabetic is completely reliant on insulin injections and blood-sugar monitoring several times a day. There are long term insulin shots, one taken in the morning and one taken in the evening that form the foundation, then short-term doses of insulin done as required to bring blood-sugar levels down to acceptable levels when they rise because of meals and snacks or otherwise. If they get low, there are glucose tablets, though my wife typically drinks a juice box (the sugar is already in a dissolved state, so it's even quicker to digest). Normally, however, they can feel the sugar-low come on and wouldn't pass out of the blue (unless they're not aware they have Type I of course, but they'd still feel weird before it happened).

Type II: the pancreas produces some insulin. Mild cases can be treated by simple changes in diet and shots may not be needed. The worse it gets, the more like Type I it is. I wouldn't expect somebody to develop severe Type II very quickly, however. There's some genetics behind it, but also alot of behavioral and dietary influences as well (exercise and diet of course). The mother's side to my family is prone to Type II and I'm watching my weight and eating careful.

Could she hide it? Certainly: using her blood-sugar meter and doing her injections in the bathroom. That's where my wife does hers because she doesn't really like to be seen doing it in public.

Finally, I think the idea of a diabetic cheerleader is a great idea. Even if your pancreas is producing no insulin, you can lead a very active lifestyle. For example, Jay Cutler (Chicago Bears QB) has Type I diabetes. My wife is very active and is an incredible downhill skier (she skied off of a ten foot drop yesterday and made it look graceful), amongst other things.

One of the seniors I photographed last year has diabetes, discovered it in Jr High. There were not alot of people outside of family and close friends that knew about it. They (girl and her mom) mentioned it briefly while we were talking during one of their appointments and I want to say hers was so bad she had an insulin pump and a younger sister was having to undergo the same type of treatment.

I know recently on facebook she posted something to the effect of "Dear Nosy People in Town, I am not pregnant, anorexic nor have I attempted suicide. My recent stay in the hospital was because of 'DKA' brought on by my diabetes which I've battled for ??? years now. Google it!"

DKA = Diabetes Ketoacidosis

So...could she hide it, yes. But remember if she is collapsing at public events, etc and has not provided a medical reason for it...get the small-minded big-mouthed people in town to discuss the possibilities!!!

An insulin pump is not related to the severity of Type 1 diabetes--it's just a different option for management of blood sugar

Intristing fact: There is a diabetes eating disorder that is really really dangerous--basically you eat food and don't take insulin for it so it can't make you fat. But of course your blood sugar goes really high and that's quite bad for you over time (like, you can go blind and have many horrible diseases). Google "diabulimia". It's scarily common for teenage girls w Type 1 diabetes which is why i mention it. http://www.jdrf.org/index.cfm?fuseaction=home.viewPage&page_id=FDF69313-1279-CFD5-A79B429F10056B6F

underthecity said:

In my current story, I'm tinkering with the idea that the MC (16yo girl) develops diabetes at 16. This does happen, doesn't it? That is, until now, she never knew she had it. But there are the symptoms: blurred vision, fatigue, increasing thirst, weight loss, dizziness, and maybe she passes out at some point. (She's a cheerleader.)

And since she's a cheerleader, how would having diabetes affect cheerleading? For the purposes of the story, I'm leaning toward Type II and her needing regular insulin shots.

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Hi

First, Type II would be very uncommon for a teenage girl that was of normal weight. More and more Type II is being seen on obese kids--not healthy kids.

I was diagnosed with diabetes at 16. It was Type II--but I come from a long line of people with diabetes. Although type 2 is possible--type 1 is more likely.

Thirst and frequent urination and sudden weight loss are the things that one would see. At diagnosis--I've seen kids with bloodsugar levels in the 500's.

Insulin shots are USUALLY but not always only for Type I diabetics--those that produce NO insulin at all. Type II diabetics usually don't produce 'enough' insulin.

The most common treatment these days for Type I is an insulin pump.

Being active, she'd have to check her bloodsugar often. It would not require her to quit cheering. Passing out from insulin shots is pretty common in kids when they are just learning about their disease--and when they do take the shots. We take our shot--don't eat--and pass out.

Could she hide it? Certainly: using her blood-sugar meter and doing her injections in the bathroom. That's where my wife does hers because she doesn't really like to be seen doing it in public.

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She could hide it for a while, but eventually she's going to be in a situation where she either can't hide to test or she has a very public sugar crash (especially being new to the disease).

But the struggle to hide her diabetes is good for the story--self discovery, emotional growth, yada, yada, yada.

Having several family members with Type I diabetes, (which is the type I think you mean), the onset definitely can be sudden. There are theories that it's triggered if your body is stressed (i.e. sick, not getting enough sleep, working too hard, etc.), and then the actual onset might not be overnight, but close. In one case I know about, the person was incredibly thirsty, and so was drinking soda obsessively (even freezing it to try to quench their thirst), and, of course, the soda was sending their blood sugar threw the roof, so it was a vicious cycle. That lasted for a week or two until a friend finally convinced the person to check into the hospital and they diagnosed it as type I diabetes.

So symptoms when one has high blood sugar: head aches, groggy, tired (because your blood vessels are getting squeezed by the high amount of sugar in your blood)

Symptoms when one has low blood sugar: seems drunk, slurred speech, inability to make good decisions, and of course that can lead to passing out.

It be great to have more characters in literature that have Type I diabetes. Kids who have it can easily feel different from their peers, and it's always nice to know you're not alone.

Good luck!

underthecity said:

And since she's a cheerleader, how would having diabetes affect cheerleading? For the purposes of the story, I'm leaning toward Type II and her needing regular insulin shots.

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All I have to add is that teenagers tend to have high noncompliance rate with their treatments. I guess it's from dread of standing out from their peers and disbelief that anything bad can really happen to them anyway. Good luck with it.

I'd Recommend you to try this book it's a very good read.

And since she's a cheerleader, how would having diabetes affect cheerleading?

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Depending on how discipline she is. A well managed diabetes could pretty much do anything typical teen do. Though, as a cheerleader I foresee denial, I could see her perfect world crumble before her eye. I don't think any teen could handle that well.

Most of what I was going to say has been covered pretty well already. I was diagnosed with Type 1 Diabetes when I was 14. My honeymoon period (that period of time when I was still producing some insulin, but not enough and not consistently) lasted for a very long time. My symptoms started 1 year before the diagnosis and my honeymoon period lasted until 4 months after it.

While there is a lot of controversy in the diabetic community over this (frequent Type 1 Type 2 showdowns happen on this topic online all the time), Type 2 is associated with obesity, but not necessarily caused by it. It is also much more common in adults (though that trend has been changing in recent years due to the growing waistlines of children). So either way Type 2 would be more unlikely than Type 1 for a 16 year old Cheerleader. Lastly, Type 1 is also known as Juvenile Diabetes (though adults can be diagnosed with it well into adulthood and in that case the name changes to Adult Onset Juvenile Diabetes).

Some other things that I thought you might need to know for your character.

There are 2 daily difficulties with Type 1 diabetes that are constant: High Blood sugar and Low blood sugar. Low B.S. is a more immediate threat because it can lead to Diabetic comma, seizures, and death in the short run and in the long run it can affect brain function (specifically memory loss) if extreme cases are very frequent. I'm actually struggling with this right now because I spontaneously developed something called the Dawn Phenomenon (where your Blood Sugar drops drastically for no apparent reason close to dawn). For a period of about a month I was going so low in my sleep that I was having seizures and not even knowing about it). Whereas my memory used to be extremely good, now I'm constantly forgetting what I was about to say . . . case and point is this post which so far as resulted in me going on an irrelevant tangent twice already instead of staying on point . . . sorry.

High blood sugar can lead to DKA (as mentioned earlier in another post), and that can lead to death (the only grand short term adverse reaction). In the long run it leads to all those complications people associate with Diabetes (blindness, loss of kidney function, amputation, heart attacks, strokes, and so on).

I only bring this up because if your character is out of her honeymoon period and is experiencing all the symptoms of High Blood sugar, then passing out would be a catastrophic event. You don't pass out from High Blood sugar unless you have been at record high numbers for a very long time. She would also have gone through so many other issues before the passing out stage that it would be impossible for her to function in school or elsewhere in any capacity. Trust me, I've been there and for 24 hours I looked, felt and acted like a zombie from a cheesy horror movie. The sequence would go as such: Increased thirstiness to the point of madness (I'm talking about chugging water nearly nonstop), increased urination, extreme fatigue, drastic changing in mood/behavior/personality, gradual darkening and sinking of the eyes, vomiting, and eventually collapse (though she would have been bedridden long before the actual collapse).

Low Blood sugar is different. I won't list all the symptoms as they are readily available online, but one main difference is that it can be extremely sudden and it can lead to passing out fairly easily and quickly.

As a cheerleader she would have issues with keeping her Blood sugar under control (mainly keeping it up) since physical activity lowers blood sugar. Another issue is weight gain. Insulin (an absolute necessity for Type 1 diabetics) is also a growth hormone (so it can lead to mild weight gain even under normal use). On the other hand, keeping your Blood Sugar high (but not too high) all the time leads to rapid weight loss. These are issues constantly discussed on Diabetic Forums online. There are actually several eating disorders specific to diabetics (teens specifically), but I'm not as educated on them as I never struggled with any of those.

For extra punishment and torture you can make you character a Brittle Diabetic (a term and condition that is still debated in the medical community). Brittle diabetics as in constant diabetic hell because their pancreas (which produces insulin) sometimes works normally, sometimes not at all, and sometimes goes into overdrive (producing far too much insulin for no reason at all). While many will say it doesn't exist and tend to blame the diabetic for practicing poor control, I have actually seen it in action and attended the funeral of such a person who died from it. It's quite spectacular (in a morbid kind of way) to see a woman eat 10 times the amount of glucose tablets (the best treatment for low blood sugar) need to treat a low blood sugar episode, wash them down with a whole jug of juice (also very good for treating a low), and finish it off with a few spoonfuls of honey (fantastic for treating a low) and 30 minutes later test her sugar and see it in the 30s (with normal being between 80 and 120) even though she has no insulin in her system. I've also seen her take absurd amounts of insulin for something as little as a piece of bread and still test off the charts High.

Anyway, now that I've probable bored you with a whole lot of information you probably don't care about I'll leave you with this: one of the best online forums for diabetics is called tudiabetes.org. The people there are very friendly and will be more than happy to help you with any info you need. And with more than 15,000 members you are sure to find an answer to your questions.

Sorry for the long post, but this was a good way for me to warm up my fingers for the writing I'm about to do as I start working on my WIP again.

Just came upon this thread and, as a Type 1 diabetic myself, am impressed with the quality of advice given here. The author has received a good education in the ins and outs of managing diabetes - and it's complications in adolescence. Look forward to seeing the completed book!