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Joe DiMaggio Children's Hospital Helps a Young Girl Fight Diabetes with Life-Saving Insulin Treatment

Diabetes doesn't slow down 4-1/2-year old Caitlin, thanks to the convenience of an insulin pump.

November 2004 — Managing diabetes is as much a part of Caitlin's day-to-day routine as dolls, dancing and dress-up. Caitlin was diagnosed with diabetes at just 10 months of age. For the rest of her life, keeping track of blood sugar levels and administering insulin will be vitally important. However, thanks to an insulin pump prescribed by a physician at Joe DiMaggio Children's Hospital, this is a responsibility that doesn't slow her down.

Early Warning Signs

The first signs of Caitlin's illness appeared in December 1999. For three weeks, she had been sick with flu-like symptoms, vomiting frequently and acting irritable. Her mom, Kelly, took Caitlin to her pediatrician three times. On the third visit, the little girl was diagnosed with a sinus infection and prescribed antibiotics. But she didn't improve. She was still vomiting, and now she was soaking her diapers constantly. "I was changing Caitlin's bed sheets up to three times a night," says Kelly. Early in the afternoon on December 31, Kelly went into Caitlin's room to check on her sleeping daughter. She was not prepared for what she saw. Caitlin's breathing was very labored and her hands and feet were cold and blue. She was rushed to an emergency department, where doctors struggled to insert an IV into veins that had collapsed as a result of severe dehydration. "Caitlin looked like a rag doll - she was lethargic and out of it," says Kelly.

Five uncertain hours later, Caitlin's emergency room physician consulted with the family. Tests had confirmed his suspicion: diabetes. "We were just so relieved," says Kelly. "Our daughter had been in such a critical state, we feared she might die."

Understanding Diabetes

Diabetes is a chronic metabolic disorder in which the pancreas produces little or no insulin, a hormone that is needed to convert sugar, starches and other food into energy. Every day, approximately 35 children are diagnosed with juvenile, type 1 diabetes, according to the Juvenile Diabetes Research Foundation International. There is no cure for juvenile diabetes, and someone with this disease requires daily doses of insulin to live.

Initially, Caitlin received insulin via injections. Caitlin's family - including her parents, older sister Meghan and both grandmothers - were trained to count carbohydrates, test blood sugar and administer insulin. "We experienced a lot of unsteadiness and mood swings with this," says Kelly. "We were administering injections three to six times a day, and I never slept before 3am. When Caitlin's counts were high, she'd scream and pull at her hair."

A whole new world opened up for Caitlin and her family when they were referred to Robin Nemery, MD, pediatric endocrinologist on the medical staff at Joe DiMaggio Children's Hospital. The Division of Endocrinology is a recognized provider by the American Diabetes Association. Dr. Nemery spent hours talking to Caitlin's parents about juvenile diabetes and suggested that they come back with a detailed, two-week record of all of Caitlin's activities, meals and behaviors. "Dr. Nemery was appalled at how erratic Caitlin's condition was and promptly prescribed a new type of insulin," says Kelly.

Approximately four months later, Dr. Nemery consulted the family about an insulin pump. She felt that Caitlin and the family members who cared for her were ideal candidates for this convenient, timesaving mechanical device. With the training and support of Dr. Nemery and Christina Ring, ARNP, a diabetes educator and nurse practitioner at
Joe DiMaggio Children's Hospital, the family learned a whole new way of managing Caitlin's diabetes.

Caitlin received a special pump the size of a pager that releases specific amounts of fast-acting insulin to regulate her blood sugar around the clock. The pump can be programmed to deliver two insulin doses: the basal dose and the bolus dose. The basal dose is a continuous stream of insulin, while the bolus dose is an extra shot of insulin released before a meal. "With injections, we had to follow such a rigid schedule, with Caitlin eating to match her insulin," says Kelly. "With the pump, it's the other way around - we match the insulin with what she eats, so she can enjoy a more normal schedule."

Living with Diabetes

While still too young to fully comprehend the causes of diabetes, Caitlin understands that the insulin pump helps her feel better. And the insulin pump not only delivers life-saving insulin for her, but also peace of mind for her family. "In learning to live with Caitlin's diabetes, we have been blessed with love and support from family and friends, as well as an amazing doctor and staff at Joe DiMaggio Children's Hospital," says Kelly. If you are concerned about your child's risk for diabetes, speak to your doctor. For referral to a physician, please call the Joe DiMaggio Children's Hospital Physician Referral Service toll-free at (866) JDCH-DOC.