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Question:

From Kenya:

I am in serious need of your assistance to help me out or send me information on how to cure or treat Juvenile Diabetes. My sister is 14 years old and has a medical history of pancreatitis, for which she was treated in Canada and a pseudocyst she had developed was drained out in the University of Alberta hospital about 5 years ago. Since then she used to get some pains which were due to her pancreatitis or some inflammation of her pancreas or so.

For a few days, she has been quite thirsty and frequently urinating, so we suspected it to be symptoms of diabetes. As my father is also a diabetic for the last 22 years, we thought it might be due to genetic heredity.

My mum checked her glucose levels and they were 19 mmol on the first day we suspected, 18 mmol on the second day and 14 mmol on the third day and again on the fifth day they were 18 mmol. These were all fasting sugar levels. She has been on very strict diet control and exercise for the past five days and she is not so far on any drug or insulin.

We took her to the doctor and he suggested that it is Juvenile Diabetes. My sister has become very depressed after hearing that she has diabetes. She is a very timid child and is even fearful of needle pricks. She literally cries when my mum checks her sugar levels. We are afraid that she might have to go on insulin and as she is afraid of needles she has been depressed more and is even crying by thinking that she might have to come on insulin and inject for lifetime. Is there a way that her diabetes can come in control without injections of insulin? Aren't there any drugs, nasal sprays or painless injecting equipment for a child of this kind?

The doctor suggests that she might be having this diabetes due to change of hormones which happen at this age in girls, she even hasn't got her monthly periods yet. We are taking her for a blood test tomorrow and then we'll exactly know what is she having.

We would be very obliged if you can send us some information on the treatment of Juvenile diabetes in such cases and ways of treating this without insulin injections and, if not so, please send us the names and description on the type of equipments used for painless methods of injecting children. We even do not have good medical aid here in Kenya that's why we look on for a suggestion from you.

Answer:

Your sister's condition sounds very complicated. You have not said why she had pancreatitis. It is possible that diabetes is occurring due to damage of the part of the pancreas which makes insulin from the previous pancreatitis. I do not know if she has any other disorder such as cystic fibrosis which can predispose to both pancreatitis and diabetes. There may also be a hereditary component if your father has diabetes. In any event it sounds like your sister will need insulin.

It is understandable that after all the pain your sister has gone through that she would be upset about receiving the diagnosis of another illness for which there is no cure and which requires injections.

I suggest that you try to reassure her that the pain of the insulin injections and blood sugar monitoring is very little compared to the pain that she has already gone through. (I also suggest that you sympathize with her that she has had so many illnesses.)

There are needle-less injectors, but they are expensive and need special handling. The new short 30 gauge needles which are available in the US really hurt very little and are much easier to use. At the present time there is no way to test the blood sugar without a needle stick, but again the new lancets and lancing devices really hurt very little.

I really don't know much about the medical care of children with diabetes in Kenya. You can start with the information on Children with Diabetes as a good source of information. Your sister can even get an international pen pal with diabetes to correspond to.

There is a very good manual available on-line through the Barbara Davis Center for Childhood Diabetes called Understanding Insulin-Dependent Diabetes and you can get more information from the American Diabetes Association website, including articles from their magazine Diabetes Forecast and from the Juvenile Diabetes Research Foundation website.

Finally, it sounds like you really need the advice of a physician who can coordinate all your sister's medical problems. If there is no one in Kenya, perhaps her doctors from Canada can help advise you or recommend a doctor closer to you. You can also find the names of diabetes organizations around the world at Global Diabetes Organizations.

TGL

Original posting 5 Oct 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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