Children’s Diabetes Foundation at Denver Fall 1997

Scientific Advisory Board:Richard S. Abrams, M.D.Associate Clinical Professor of Medicine,University of Colorado School ofMedicine; Rose Medical Center, DenverJules Amer, M.D.Clinical Professor of Pediatrics,University of Colorado School ofMedicine; Partner, Children’s MedicalCenter, DenverM. Douglas Jones, Jr., M.D.Professor and Chairman, Department ofPediatrics, University of Colorado Schoolof Medicine; Pediatrician in Chief,The Children’s Hospital, DenverBrian Kotzin, M.D.Professor of Immunology,University of Colorado School ofMedicine; National Jewish Center forImmunology and Respiratory Medicine,DenverAke Lernmark, M.D., Ph.D.Robert H. William Professor, Departmentof Medicine, University of WashingtonSchool of Medicine, SeattleAli Naji, M.D., Ph.D.J. William White Professor of Surgery,Hospital of University of Pennsylvania,PhiladelphiaGerald Nepom, M.D., Ph.D.Scientific Director and Director ofImmunology and Diabetes ResearchPrograms, Virginia Mason ResearchCenter, SeattleJulio Santiago, M.D.Professor of Medicine and Pediatrics,Washington University, St. Louis,Missouri; St. Louis Children’s Hospital

Advisory Board:Mrs. Alan AngelichMr. and Mrs. Rand V. AraskogMrs. John AylsworthMr. Michael BoltonMrs. Joseph BroughtonMrs. Franklin L. BurnsMr. Michael CaineThe Honorable Ben Nighthorse

Campbell, U. S Senate, ColoradoMs. Natalie ColeMr. Phil CollinsMr. Lodwrick M. CookMrs. John CoweeMr. and Mrs. Robert A. DalyMrs. Thomas P. D’AmicoMr. Tony DanzaMr. Neil DiamondMr. Placido DomingoMiss Donna DouglasPresident and Mrs. Gerald R. FordMrs. Joseph FranzgroteMr. David FosterMr. Kenny GMr. David GeffenMr. Merv GriffinMr. Bob HopeMs. Whitney HoustonMrs. Walter ImhoffMr. Michael JacksonMr. and Mrs. John H. JohnsonMr. Quincy JonesMrs. Michael JultakDr. Henry A. KissingerMrs. Robert KniselyMr. Howard W. KochKevin J. Lafferty, Ph.D.The Honorable and Mrs.

Richard D. LammMs. Sherry LansingMr. Jay LenoMr. Paul MarcianoMr. Walter MatthauMiss Dina MerrillMr. Myron M. MillerMr. Roger MooreEvelyn and Mo OstinMr. Ronald O. PerelmanThe Honorable Federico PeñaMr. Sidney PoitierPresident and Mrs. Ronald ReaganMr. Lionel RichieMrs. Sheldon RogerMr. Kenny RogersThe Honorable Roy RomerGovernor, State of Colorado

Mrs. Roy RomerMiss Diana RossMr. Lewis RudinMr. George SchlatterMs. Maria Shriver and

Mr. Arnold SchwarzeneggerAlan and Sandra SilvestriMr. Steven Spielberg and

Ms. Kate CapshawMrs. Robert J. StewartMrs. Robert TuckerMrs. Thomas N. TuckerMiss Joan van ArkMrs. Peter WeingartenThe Honorable Wellington E. WebbMayor, City of Denver

Mrs. Luanne WellsMs. Barbera Thornhill

and Mr. Gary L. WilsonThe Honorable Pete WilsonGovernor, State of California

Mr. Henry WinklerMr. Stevie Wonder

Executive Board:Mrs. Marvin DavisChairpersonRichard S. Abrams, M.D.Jules Amer, M.D.Miss Amy DavisSteven Farber, Esq.The Honorable Sherman G.

FinesilverMr. Gerald S. GrayCharles Halgrimson, M.D.Associate Dean, University ofColorado School of MedicineMrs. A. Barry HirschfeldM. Douglas Jones, Jr., M.D.Mrs. Dana Davis LipmanMrs. Nancy Davis RickelEx-officio Member:George S. Eisenbarth, M.D., Ph.D.Executive Director, Barbara DavisCenter for Childhood Diabetes,University of Colorado HealthSciences Center; Professor ofPediatrics and Medicine, Universityof Colorado School of Medicine

Foundation Directors:Christine LernerSue Palandri Continued on page 2

DIGITAL IMAGING COMES TOTHE BARBARA DAVIS CENTER

—William Jackson, M.D., BDC Director of Ophthalmology Services

Twenty-first century, innovative, highlycomplex digital eye cameras have

arrived at the BDC. Through thegenerosity of Miss Amy Davis and theCourtenay C. Davis Foundation and theRichard A. Perritt Charitable Foundation,we are privileged to incorporate digital(electronic) technology at the Center.

What is a digital camera? What does itdo? Why do we need it?

Top: Dr. Jackson with patient. Right: Retinal picturetaken by the BDC digital-imaging machine.

First, a thumbnail overview is inorder. Photography as an artand science is about 150 yearsold. Crude retinal pictures werefirst captured about 100 yearsago. The retina is the light-sensitive tissue in the back ofthe eye. It is the “film” in theeye, or “camera.” Digital photoswere first used over 70 yearsago. Technology has accelerat-ed greatly in the past fewdecades. The happy “marriage”of the camera with powerful andflexible computers has broughtretinal imaging to the point thatthe electronic image challengestraditional film-based methods.

Film is sharper at the presenttime. However, film may be ator near its limits. On the otherhand, there appears to be greatlikelihood that digital images inthe computer will improve sig-nificantly.

This new photography haschanged much of what we do inthe eye department. The abilityto obtain, store, and transmitretinal pictures via telephoneline and satellite enhancespatient understanding and com-pliance. The patients love thisnew technique, as they canimmediately see the picture.The center has resident doctorsfor training in eye conditionsassociated with diabetes. Thistechnology has greatly facilitat-ed teaching.

As many of you know, diabetescan affect the eyes and damagethe vision. It is vitally importantfor patients to have their eyesevaluated on a regular basis.The exact timing of this variesfrom patient to patient.

Traditional techniques aredemanding, time consuming andexpensive. The new technologycaptures and stores an imageimmediately. There are no

developing chemicals used.

I am very hopeful that digitalimaging will be used for all ofour clinical needs. We at theBDC have as our mission a com-mitment to the preservation ofvision. A team approach worksbetter—together we can made adifference. The future is here now!

P.S. The physical plant of theeye clinic will be enlarged thisfall—very exciting! Pardon ourdust!

BDC MISSIONSGeorge S. Eisenbarth, M.D., Ph.D.,

Executive Director

Aristotle is quoted as saying,“You are what you do.” TheBarbara Davis Center doesmany things and has severalmissions. Most participants atthe Center, whether staff orpatients, contribute to many ofthe functions. The Center isdevoted to:

Excellent clinical care to pre-vent morbidity (particularlylong-term complications ofdiabetes), the rare death fromdiabetes, and to improve thequality of life for individualswith diabetes. Patients at the

Center and health care providershave seen an evolution (but notthe revolution we desire) in dia-betes care. This care isdesigned to prevent complica-tions such as eye disease andkidney disease. For example,ninety percent of blindness for-merly associated with diabetescan now be prevented. It canonly be prevented if youngadults with diabetes are properlyexamined by an opthamologistonce a year. (Many of you willhave seen the new eye digital-

imaging equipment.) Anotherexample of changing clinicalcare is the new rapidly actinginsulin, Humalog®, which wasstudied in detail at the Center.This insulin has become animportant new addition to ourtherapeutic choices.

Clinical education of families,patients and health careproviders. Probably the mostwidespread education comesthrough the manual,Understanding Insulin-Dependent Diabetes, by Dr. H.Peter Chase, with over 25,000copies in print. The whole textof the book is on our web site:http://www.uchsc.edu/misc/diabetes/bdc.html

Research

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Continued from cover page

Training of first-rate physicianscientists and basicresearchers. Young doctorsfrom throughout the world cometo the Center. They are usuallyin Denver for one to three yearsto receive mentor-based train-ing. They then return to theirhome countries or states to setup their own laboratories orclinical programs. The trainingis very much like the apprentice-ships of the past, where boththe mentor and the trainer workas a team and the learning is by“doing.”

Develop preventative therapy.In animal models, diabetes is areadily preventable disorder. Itis “only” a matter of time beforethe same is true in man. Ourgoal is to shorten that timeperiod with an emphasis on thedevelopment of immunologicvaccines for the prevention ofdiabetes.

Cure type I diabetes. Morethan 20 patients with specialand severe diabetes-relatedproblems have been cured bypancreas transplantation, eitherwith a combined kidney andpancreas transplant or lessoften with a pancreas transplantalone. Dr. Mark Stegall fromthe University of ColoradoDepartment of Surgery andTransplantation has one of thebest records for such transplan-tation in the world. At the sametime, he directs a research labo-ratory at the Center. Currenttransplantation requires the useof immunosuppressive medi-cines. The medicines availableare much better than five yearsago, but are still too toxic. It islikely that the next stage in cur-ing diabetes will be the develop-ment of effective islet transplan-tation. The eventual goal ofsuch transplantation withoutimmunosuppression requiresmore basic research. The acqui-

sition of this basic knowledge isa major task of Centerresearchers.

BARBARA DAVISCENTER OUTREACHCLINICS

— Robert H. Slover, M.D.

The Barbara Davis Center hasbeen involved in providing careand education to a large com-munity outside the Denver areasince it opened. As part of ourmission, we have continued toexplore programs to bring up-to-date care and opportunities forinvolvement in current researchto as large a population as pos-sible. Over the years we haveopened outreach clinics in anumber of areas and have usedthem as a forum for educatingmedical care providers, parents,and youngsters. We currentlyhave outreach clinics in Billings,Montana and in Casper,Wyoming, as well as in Durangoand Colorado Springs, Colorado.

The oldest Barbara Davis Centeroutreach clinic is held inBillings, Montana. Dr. H. PeterChase organized this clinic withthe diabetes team at St.Vincent’s Hospital, and he andPhysician’s Assistant SandyHoops have run it with nursingand dietitian support from theCenter. Once a year we spendan intense three to four daysseeing about 100 patients. Wehave the exceptional support ofa fine nursing staff and we bringtwo nurses and a dietitian fromthe Center. Patients travel tothis clinic from all over theState of Montana, and fromIdaho, eastern Washington, andnorthern Wyoming. Local physi-cians join us for the clinics, andwe are able to provide lecturesfor medical staff and an eveningwith the parents.

Dr. Phillipe Walravens andSherrie Harris, R.N., organizeand attend the clinics inDurango and Casper. TheCasper clinic provides care forpatients throughout Wyoming,as well as education for theproviders in the state. Some 60patients attend the clinic, andsome of them alternate thesevisits with trips to the Center

itself. The Durango clinicserves about 40 patients insouthwest Colorado and theFour Corners area. Again, localphysicians attend, and the out-reach includes medical educa-tion. Both clinics are held twicea year.

The newest outreach clinic forthe Center is in ColoradoSprings. When Pediatric NursePractitioner Cathy Johnson andI joined the Center, we contin-ued to see many of the militarypatients who had previouslyreceived care at FitzsimmonsArmy Medical Center. For sev-eral years we provided outreachcare at Evans Army CommunityHospital at Fort Carson. In thepast year, we have moved to theMemorial Hospital PediatricSpecialties Clinic in ColoradoSprings. Here we can providecare not only for military

Barbara Davis Center

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patients, but also for other chil-dren and adolescents in thecommunity. We hold this clinicmonthly with a nurse and adietitian participating in thecare.

Outreach clinics are labor-inten-sive and expensive to operate.However, they provide a greatlyneeded service and importanteducation to the communities.We receive many letters ofappreciation and are committedto this effort. We are eager tofind new ways to effectively con-tinue this service and welcomeyour comments!

ANGELA’S INSULININFUSION

— Angela Reid, age 10

This is the daily diary kept byAngela Reid during her stay inChildren’s Hospital in July, 1997as part of the DiabetesPrevention Trial. Angela does nothave diabetes but is at risk todevelop diabetes because shehas islet antibodies. This wasthe third year Angela traveledwith her family from Kansas Cityto Denver for the infusion ofinsulin. Angela is a brave littlegirl.

— H. Peter Chase, M.D.

DAY 1I checked into The Children’sHospital in Denver last night. Ilike to spend the first night inthe hospital without the IV’sbecause then I can do lots ofneat things. My whole family iswith me this year and my bigbrother, Tim, stayed with me lastnight. Tim is 16 and my mostfavorite brother. We stayed uplate and watched TV!

Dr. Chase came in at about 7:30this morning. We were walkingin the hall when we first sawhim. It was great! He evenremembered me. The dietitiancame and I got to pick out thefood I’ll be eating while I’m here.My favorite is PIZZA!

The nurses put “EMLA®” on myarms where they would be start-ing the needles so it wouldn’thurt. They were able to putboth lines in one arm this year.It’s my right arm and that’s whymy Mom is writing this for me.The nurses put a board on myarm to remind me not to bend it.Now I can go to the playroom! Ilove that place!

The playroom has a pool tablefor older kids, lots of arts andcrafts, games and books. Ipainted some plaster shapestoday. Sandy is the lady whogets volunteers to be in theplayroom. I help the volunteers,since I know where the suppliesare in all the cupboards!

My arm started hurting later, sothe nurse put something warmon it and helped me to relax it.Mom and the nurse think I am“anticipating” too much andshould try not to think about it.Dad is already losing hispatience. He doesn’t know howreally hard it is.

The library cart came by and I

checked out three books to read.I’m going to be playing videogames and watching TV later.They check my blood while I’msleeping and I don’t even knowit. The nurses do it less timesat night. I can also sleep as lateas I want to.

DAY 2

My Dad stayed with me lastnight. He can stay right here inthe room in the window seat.They have extra sheets, blanketsand pillows for parents. He tookpictures of me and Dr. Chase.Dad gets really tired of sittingaround.

The nurses check my bloodsugar every 30 minutes all daylong. I got “low” today anddrank juice. It was yummy!

Today I made more things in theplay room. My Mom and Dadand I visited other floors in thehospital and looked at more dollcollections and doll houses.There are really neat murals onthe walls everywhere. There arehot air balloons, trains, ele-phants, dolphins, Alice inWonderland cards and neatbirds. All the walls have art-work made by other kids, too. IfI’m not back on the unit, thenurses will page me over thewhole hospital. That’s kindafun.

My arm hurts more today. Thenurse took off the boards andcarefully bent my arm at theelbow. A heating pad helped itfeel better.

My Mom is staying with metonight. She brings her ownfood, ‘cause she has diabetesand can’t eat sugar, but she alsohas celiac disease and heartproblems and there’s a lot ofstuff she can’t eat.

Barbara Davis Center

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We had a dog visit today. It wasa Portuguese Water Dog namedDillon. He was really fun. Hecould shake hands and roll onthe floor. They have a “prescrip-tion pet” program where lots ofdifferent dogs come to visit.

DAY 3

Dr. Chase came this morningand thanked all of us for helpingwith research. He took myMom, Dad and Tim over to seethe Barbara Davis Center. Mysister, Stasi, stayed here withme. We played games, watchedvideos and played Nintendo.They have lots of games andmovies to play. In one of thehalls there’s a train that runs ona track clear up at the ceiling!

DAY 4

Only one more day after today!My arm still hurts. Mom says,“Just keep your mind off yourarm and go play in the playroom.” Dad bought me a littleblue leather purse with fur on itfor being so good. Dad’s reallygetting tired of the hospital andwishes this was all over. Stasi’seven tired of playing hospital.She says she wants to go home.I don’t want to take a showertoday either. I’ve done almostall the things I want to do in theplay room.

DAY 5

Today is my last day! I got theneedles out right before noon,but I ate my lunch here ‘cause itis my favorite, PIZZA! We tookmy picture with the nurses andsaid goodbye. I ran all the wayto the Ronald McDonald Houseand beat everyone!

Mom’s note: Angela did prettywell this stay. She was antici-pating the pain, though, longbefore it was there. Having

been a patient many times, Iknew what it was like to be“trapped” in the hospital.Angela needed to be encouragedto do things she could do on herown. Otherwise, she expectedothers to do things for her, likefeeding her! Once she had theneedles out, she continued thisdependence and it created a lotof conflict among the familymembers. She even refused todress herself, claiming the armhurt more than when the nee-dles were in. We had to redirecther focus to be able to walk outof the hospital with a smile onher face. Within a few hours,she was back to her very active,cheerful self. Now, everyonetalks about how we’ll do thisnext year.

Subject: Insulin Types & Activity

— Submitted by Cindy Geissler

I am a 31-year-old female withtype I diabetes for 16 years.For the first eight years with

diabetes, I used pork/beef Lilyinsulin and only injected oncedaily. At that time, from 1981 to1986, I did not have a blood glu-cose meter and I’m sure my sug-ars were consistently high.From 1986 to 1988, I usedpork/beef NPH insulin and R,along with checking my bloodsugar and started using my ownsliding scale, adjusting the R towhat my sugars read in the a.m.and p.m., even though my dia-betes educators said not to dothat. I was willing to take therisk of low blood sugars whiledoing this because I was sotired of being tired. Now I amglad I obeyed my own gut feel-ing, because I gained so muchexperience in learning how myown body reacted to insulin.When I became pregnant in1988, I was switched toHumulin® NPH and R, mixing ittwice daily. After about twoweeks, I remember the contrastof how I felt after beingswitched to human insulin. Forthe first time in my life sincedeveloping type I diabetes, I feltas close to “normal” as I hadphysically felt before the age of14. You can’t imagine my reliefin this discovery, especially withthe added stress on my body dueto my pregnancy! I can honestlysay that this was the healthiestperiod of my life. I attributethat success in part to thegenetic engineering of humaninsulin!! Thank you to all of youwho have worked in theresearch of a close to perfectmatch of insulin.

Barbara Davis Center

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TO ACCESS THE BARBARA DAVIS CENTERWEBSITE ON THE INTERNET:

http://www.uchsc.edu/misc/diabetes/bdc.html

LETTERS TOTHE WEB

Cindy Barton

http://www.uchsc.edu/misc/dia-betes/bdc.html

NEW OUTPATIENTHEALTH CARE PLANFOR COLORADO’SCHILDRENThe Colorado Child HealthPlan (CCHP) is a new state pro-gram which provides outpatienthealth insurance for Colorado’suninsured children ages 17 andunder. CCHP provides coveragefor children who previouslydid not qualify for Medicaidcoverage and who have beenunder a program called theColorado Resident DiscountProgram (CRDP). The old pro-gram provided almost no reim-bursement to the Barbara DavisCenter ($3 per day per subject);thus, the Center wrote off$69,500-worth of health care forindigent children in 1996.

The Colorado Child Health Plancosts $25 to families, and thereis a $2.00 copayment for eachvisit. You can visit your primarycare provider including physi-cians, clinics and mid-levelpractitioners, or participatingspecialty providers with anauthorized referral from yourprimary care provider. Servicesincluded are immunizations,well-child check-ups, care foracute illness, injuries, chronicillness, certain lab, x-ray andevaluations (some must be pre-authorized), and outpatientsurgery (when pre-authorized).In a truly life- or limb-threaten-ing emergency, the child can betaken to the nearest hospitalemergency room and the care iscovered. For other emergen-cies, you first need to call yourdoctor’s office.

You can call and ask to have anapplication sent to you at:1-800-359-1991 (outsideDenver Metro area), or 303-372-2160 (in Denver Metro area).The application is available in

Spanish and English and con-tains income guidelines andother helpful information. If youthink your income is too high,you should still apply, becauseyour expenses may reduce yourincome enough to qualify.

VOLUNTEERSNEEDED FORANTIOXIDANT TRIALUNDERWAY AT BDC

— H. Peter Chase, M.D.,Clinical Director

The purpose of the antioxidanttrial at the BDC is to determineif antioxidants will help preventthe eye and kidney complica-tions of type I diabetes. In thefirst six weeks of the trial, 28people were enrolled. A total of100 subjects ages 14 to 50 withtype I diabetes will be asked toparticipate in the double-blindtrial. All subjects will be askedto take four tablets twice daily.Half of the subjects will receivea tablet containing antioxidants,e.g.: vitamins A, C and E, andmicronutrients, e.g.: zinc, mag-nesium and potassium, all of

which are available over-the-counter. The other half of thesubjects will receive a placebo(inert) tablet, as this is howresearch must be done to deter-mine if there is an effect.People taking various vitaminsmust discontinue them for 30days prior to entering the trial.The human subjects committeerequires all subjects to be told,“There is no evidence that thepresent study will offer any ben-efits to you.” This is a routinestatement required for allresearch trials.

A unique aspect of this trial isthat people with type I diabetesages 14 to 50 will be invited toparticipate. This means that insome cases, teenagers as wellas their parents may join thetrial. Those who enter willreceive the most modern andcomplete eye and kidney evalua-tions possible. The eye examswill include photographs usingthe new digital-imaging (TV)equipment at the center. Thisallows the retinal pictures to belooked at as they are taken andprevents the need to retake

Barbara Davis Center

6

Mr. Davis Schore, Vice President of LiForce International, Inc. presenting a check toDr. H. Peter Chase, BDC Clinical Director and Principle Investigator of the antioxi-dant trial. Carol Koehler, R.N. center, is nurse coordinator of the trial

pictures a week later due to poorquality. The urine microalbuminswill be done similarly with a newimmunologic method that obtainsresults in seven minutes ratherthan in three weeks.

Qualified individuals who areinterested in participating in thetrial can phone Kevin Wanebo,Research Associate at theCenter (303-315-5857), formore information. People whosmoke or who were previoussmokers are excluded. Womenwho plan on starting a family inthe near future are also exclud-ed. This will be a three-yeartrial, so people who are expect-ing to move out of the areashould not participate.Participants will be paid $250for the first year and $200 foreach of the second and thirdyears to help defray travel, park-ing and other costs.

DURATION OF PATIENTAPPOINTMENTSDuring the past few months,with personnel changes, newpatients and studies going on,we are aware that there havebeen problems with the amountof time patients have had towait during appointments. Weare making adjustments in theappointment schedule and tryingto address the problem.

We will give patients a quickquestionnaire to complete, high-lighting the issues to be dis-cussed and which team mem-bers they need to see. We antic-ipate patients will spend approx-imately 30 minutes with eachmember of the team, and if pro-longed time is required, we mayneed to reschedule the appoint-ment. We are also requestingthat patients try to be on timefor appointments. If you areover 30 minutes late for ascheduled appointment, you maybe asked to reschedule so wedon’t have to rush an appointment.

We will continue to evaluate howappointments are going and willmake changes to provide thebest care in the most expedi-tious manner possible.

dAZPEDIATRIC NURSEPRACTITIONERCLINICSThe Barbara Davis Center hastwo certified pediatric nursepractitioners, Carolyn Banion andCathy Johnson. Patients will beable to make appointments withthem and make alternative visitswith the patient’s pediatricendocrinologist. This shoulddecrease waiting time forappointments and hopefully make

visits shorter, while continuingthe care you expect. If you havequestions about these clinics,please contact either the appoint-ment desk at 303-315-6399,Carolyn Banion, 303-315-3963,or Cathy Johnson, 303-315-3836.

SUMMER CAMPMEMORIESWith the “dog days of summer”behind us, kids from 8 through17 brought home warm andhappy memories of their daysspent at Diabetes Camp at spec-tacular Glacier View Ranch inWard, Colorado. Each summerone week is set aside forcampers from 8 through 12years old and a different week isreserved for teenagers.Professionally trained staff andphysicians from the Center arealways on hand at camp to man-age the health care needs ofcampers and to assure thateveryone has a great time.

Thanks to all the wonderful staffand medical personnel who giveso generously of their time atDiabetes Camp. Families ofchildren with diabetes can seekfinancial assistance for theirchild by applying through TheGuild of the Children’s DiabetesFoundation at (303) 863-1200and (800) 695-2873.

Barbara Davis Center

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DO YOU QUALIFYFOR THE

ANTIOXIDANTTRIAL?

You have type I diabetes

You are between 14 to 50years old

You are a lifetimenon-smoker

You are not pregnant

Participants will be paid$250 for the first year and$200 for each of the secondand third years to defray

travel, parking andother costs.

Qualified individuals who areinterested in participating in

the trial can phoneKevin Wanebo, ResearchAssociate at the Center

(303-315-5857).

PIMA cabin roommates posed for a photo while eating abedtime snack of sugar-free ice cream

QUESTIONS ANDANSWERS

— H. Peter Chase, M.D.,Clinical Director

Q: Our son has afternoonsports from 5:00 p.m. to 6:00p.m., three afternoons aweek. Although we usuallyeat at 6:00 p.m., it is often7:00 p.m. before we eat din-ner on those nights. Howwould you recommend wehandle the eating and theshots on those nights?

A: Different families handlesports and diabetes in differentways and often come to the bestsolution by trying different alter-natives. Usually a good snackprior to the practice and waitingto give the insulin after sportsare over, when dinner is to beeaten, works the best. Bloodsugars may be high after sports,secondary to adrenaline outputduring the exercise (a normalresponse to exercise, and adren-aline raises blood sugars).However, if the person has“delayed hypoglycemia,” or lowblood sugars, several hoursafter the exercise, then a lowerdose of short-acting insulin (andsometimes of the long-acting)

should be used. The delayedhypoglycemia is a result of thesugar going from the blood backinto muscle, to replace thesugar that was “burned” in themuscle as a result of the exer-cise, and/or that came out of themuscle in response to the higheradrenaline (epinephrine) levels.

It is definitely more work to han-dle the diabetes around sportsactivities. However, the payoffsin the long run make the extrawork well worthwhile. Sportsimprove cardiovascular condi-tioning, and one study even sug-gests they may relate to betterperipheral circulation in lateryears. Diabetes is a compro-mise, and in this case we maycompromise ease of control forlater cardiovascular benefits.

Q: Do children of familieswho regularly attend a reli-gious institution (church, syn-agogue, mosque or whatever)do any better with their dia-betes than children of fami-lies who do not participate ina religion?

A: There are so many factorsthat influence diabetes controlthat it is usually impossible toseparate out one factor, and I

am not aware of studies thathave been done in this area.However, those who participatein religious youth groups areless apt to become involved withsmoking, drugs or alcohol, all ofwhich are bad for good diabetescontrol. They may also tend tobe from families that do thingstogether, and in general havemore family support for diabetesmanagement or other issues.Peer groups are particularlyimportant for teenagers, and thepeer group of a religious youthgroup might be healthier andmore supportive of a healthylifestyle than some other peergroups which may not have apositive atmosphere. This is anarea that still needs more inves-tigation.

8

Questions & Answers

STp

DO YOU LOVECHILDREN? VOLUNTEERSSTILL NEEDED AT THE

CENTER.

We need people to work ahalf day or one whole dayper week to check in

patients as they arrive at theBarbara Davis Center. Dutieswill be to check the heightand weight of the patientsand perhaps take bloodpressure readings.

This is a great opportunity towork with and help ourwonderful children!

Call the Center at 315-6399.

AN URGENT REMINDERWith flu season coming, checkurine ketones if a person withdiabetes vomits even one time.

• Check to make sure your urineketone strips are not outdated.

• Have suppositories available incase of vomiting.

• Call the Center (daytime), oremergency pager (nightime)immediately if moderate orlarge ketones are found.

• Parents are urged to monitorall children under the age of 18.

TENNIS ENTHUSIASTACES HER DIABETESMANAGEMENTBarbara Davis Center patientLaurie Matson is a 15-year-oldsophomore at Loveland HighSchool and a terrific tennis play-er. As a member of the #3 dou-bles team for her school, sheand her partner took second atthe class 5A Northern Regiontournament in April, qualifyingthem for play at the state tour-nament held in Denver last May.After three days of play, they fin-ished in third place. Laurie andher partner were named to theAll-Conference team forNorthern Colorado and to theLoveland Reporter-HeraldSpring Players of the Year.

Laurie was diagnosed withinsulin-dependent diabetes atage 11 and began using aninsulin pump in January. Thepump has proved to be a greatconvenience for her while play-ing tennis tournaments, sinceshe is never certain of when andhow long play will take. In addi-tion to tennis, she participates

in mixed choir and is on staff atthe high school newspaper.

Editor’s Note: Laurie’s mother, whowrote this article, states, “The BarbaraDavis Center has always encouragedLaurie to do whatever she wants andto adjust accordingly, despite dia-betes.” She adds, “Dr. Slover, CathyJohnson, Sandy Hoops, Susie Owen,Gail Speigel and Jana Gaston are sohelpful!”

FUTURE FARMEREXCELS AT LIFEAt the 1997 National WesternStock Show, Ryan Ness of Byers,Colorado participated in theCatch-a-Calf program whichconsisted of 16 very determinedteenagers trying to catch eightcalves. Of course, only halfwalked away with a calf. Ryanwas one of the lucky ones.

Two years ago, Ryan’s worldturned upside down. He and hisfamily were told that Ryan haddeveloped type I diabetes. Sincethen, Ryan has not slowed downone bit. He continues to playhigh school football, basketballand baseball. He holds an officein the school’s Future Farmersof America (FFA) and is on theirsoils and crops judging team.

Due to the required travel tosports and FFA events, Ryan hashad to adjust his schedule toaccommodate careful manage-ment of his diabetes. He is alsoin a position to educate hispeers and teachers about dia-betes—that you can live with itand continue with life—it justtakes a bit of extra planning.

Ryan is on the honor roll atschool, and at home he isrestoring a “:50” Chevy Apachepick-up and assists his fatherand brother operating farmmachinery on their family farm.

Ryan and his brother have beenin the local 4-H Club since the

third grade, showing sheep andworking on other projects.

It’s Ryan’s love for animalswhich led him to the Catch-a-Calf program. He got the 800 lb.Angus “calf” he named “Pete” onMay 17, 1997. He is responsi-ble for its well being, feedingand care at least twice a day, aswell as halter breaking andtraining. Ryan has alreadyshown his calf at the local coun-ty fair. Pete behaved himselfvery well and took third in hisclass. As a grand finale, Ryanwill show Pete at the 1998National Western Stock Show.

Winner’s Circle

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“BDC patient Kelly Rheem, fea-tured in the spring 1997 edition of

NEWSNOTES, has made theNational Soccer Team and will begoing to the Olympic Festival.”

Kelly, the sky’s the limit!

— H. Peter Chase, M.D.

Laurie Matson, 15, BDC patient andNorthern Colorado All-Conferencetennis team member

BDC patient, Ryan Ness, and his 800 lb. Angus, “Pete.”Ryan will enter Pete as a contender in the 1998National Western Stock Show

WHEN WILL THEREBE A CURE?Hi, my name is ClarissaSandoval. I am 13 years old,and I am in 8th grade. I havebeen a diabetic since I wasseven years old. Since thenthere have been more and morethings coming out, such asHumalog®. To me, it’s really notmuch of a difference. It’s almostthe same—I still have to givemyself shots every day. So, I’mhoping some scientist can comeup with a pill for children.

What I’m writing for is to askhow long it is going to be untilsomebody finds a cure. It’s not-that bad to be unable to eatsugar sweets, but the shots arewhat get on my nerves.Sometimes it hurts so much Ijust scream!

Thank you for reading my letterand please write back if youhave an answer.

Respectfully, Clarissa Sandoval

Editor’s Note: Clarissa attends StellMiddle School in Brownsville, Texasand is a member of the National JuniorHonor Society, Student Council andparticipates in numerous sports includ-ing track, volleyball, basketball andcheerleading. One day, Clarissa plansto be a doctor of endocrinology.

TO CLARISSA, FROMDR. KLINGENSMITH

Dear Clarissa,

You are very right, there havebeen many “advances” in dia-betes care since you were diag-nosed. We have learned a greatdeal about diabetes care and theimportance of good sugar con-trol from the Diabetes Controland Complications Trial (DCCT):blood sugar testers have gottensmaller, faster and smarter; weknow better how to adjust car-bohydrate intake to exercise toprevent low blood sugars; carbo-hydrate counting can allow youto eat some sweets if you adjustyour insulin for this; andHumalog® insulin makes insulintreatment better and more con-venient.

Sometimes doctors seem to getcarried away with the wondersof all these advances and don’tseem to notice that, for children,the real facts haven’t changedmuch. Having diabetes stillmeans shots every day and the“advances” may mean you areasked to take three or even four

shots each day instead of one ortwo.

The scientists at the BarbaraDavis Center are working veryhard to find a cure for diabetes.Dr. Ron Gill is the director ofthe new Division ofTransplantation Immunobiology,which will coordinate the effortsof the Barbara Davis Center andthe University of ColoradoDepartments of Medicine,Surgery, and Immunology. Theyare exploring methods to trans-plant insulin-producing cellsthat will not require immuno-suppressive drugs (see theSummer 1997 Research Editionof NEWSNOTES). Unfortunately,this is not a simple problem andprogress is painfully slow to allof us, especially to children.

While you are waiting for a curefor diabetes, try to be patientwith your doctor when she isexcited about a new “advance”and remind her that all the tasksshe asks of you are not easy.Ask about treatment for needlediscomfort. It may sound unbe-lievable, but our social workcounselors and psychologist canhelp our patients have less painwith their injections through atreatment called “needle desen-sitization.” This treatment takesone to six sessions and can helpimmensely. Also, don’t think youare alone in having pain withyour shots. We have found thatmany children “suffer insilence.” Check out the nextissue of NEWSNOTES when RitaTemple-Trujillo, L.C.S.W., willgive a report on our experiencewith the treatment of needlepain and fears.

Clarissa, I hope this helps you,and don’t give up.

Sincerely,

Dr. Georgeanna

Winner’s Circle

10

Clarissa Sandoval, 13, of Brownsville, Texas

FEEDING THE CHILDWITH DIABETES:INFANCY THROUGHPRESCHOOL— Markey Swanson, R.D., C.D.E.

Food is an important and enjoy-able part of life. Learning to eatand enjoy a variety of foods is ajob which children learn, withhelp, throughout the growingstages of life. Just what roleshould a parent play in theprocess of feeding a child?What responsibility belongs tothe child in eating development?

Each of us can recall a varietyof experiences related to food,some good and some bad. Inorder to make this process aspleasant as possible, EllynSatter, in her book, Child ofMine: Feeding With Love andGood Sense, suggests that it is aparent’s job to provide good foodchoices and a child’s job tochoose what and how much toeat. For most parents, this taskis easier said than done.Understanding growth andchanging food behaviors helpsmake a parent’s job simpler.

When a child is born, feedingtime consumes a major part ofhis or her waking hours. Mostof the interaction a parent will

have with an infant is food relat-ed. At this stage, breast milk orformula provides all nutrition.Progression through the firstyear allows for the introductionof a variety of new foods as wellas a number of flavors and tex-tures. During this time, infantsbecome very adept at indicatinglike or dislike of a new food. Asthey learn the mechanics of eat-ing, the tongue will thrust foodfrom their mouths. They mayspit it out and may experimentwith the foods offered. Anyattempt by parents to forcefoods will be met with a tightlyclosed mouth, a turned head anddetermined rebukes.

Continued progression throughthe toddler years must allow forfood exploration. This is a timeof learning and great curiosityabout life in general, and food isno exception. At this time, achild is feeding himself or her-self—a very messy process butone which fosters the develop-ment of many fine motor skills.Growth has slowed and behav-iors are erratic. Do not expectthat your child’s eating patternswill be consistent. Try to pro-vide consistent meal and snacktimes and allow “eating toappetite.” Children have a goodsense of hunger and fullness.Keep in mind that toddlers aresmall people and require smallportions, approximately onetablespoon per year of age ofeach food offered. Make surethat safe foods are provided.Cut round foods like hot dogs,cooked carrots and grapes inquarters so that your child willnot choke. Provide choiceswhich are easy to chew andavoid items like peanuts andraw carrots. DO NOT getuptight about how much or howlittle your child eats—this issomething which you cannotcontrol.

Continued on page 12

Cook’s Corner

11

DOUGH BALLSIf you like to eat cookie dough, you’ll lovethese!

INGREDIENTS:

1/4 cup sugar-free, maple-flavored syrup1/4 cup crunchy peanut butter1/4 cup dry milk powder2/3 cup corn flake cereal1/3 cup quick-cooking oats1/4 cup chopped raisins

PREPARATION:

In mixing bowl, stir together syrup and peanutbutter. Add remaining ingredients and mixwell. Grease hands with margarine and formdough into balls approximately 1 inch size.Place on plate and cover with plastic. Chill (atleast 30 minutes), then serve. Keep remaindercovered in refrigerator.

NUTRITION INFORMATION PER SERVING:

number of servings: 18serving size: 1 ballcalories: 50carbohydrate: 6 gramsprotein: 1.5 gramsfat: 2 grams

RAGGEDY ANN SALAD

INGREDIENTS:

1/2 hard cooked egg (head)1/2 oz. grated cheddar cheese (hair)1/2 small peach (body)lettuce leaf (skirt)(4) 2-1/2 inch celery sticks (for arms and legs)raisins or Craisins [dried cranberries] (forhands, feet, nose and eyes)sliver of maraschino cherry (mouth)

NUTRITION INFORMATION PER SERVING:

number of servings: 1carbohydrate: 10 gramsprotein: 7 gramsfat: 4 gramsThis makes a meal for a preschooler. Simplyadd milk and a “mini” muffin, and it’s complete!

Nutrition News

Preschoolers are learning tobecome good eaters. They reallywant to please adults and willmimic you in many ways, so besure to provide a good examplewhen it comes to your eatingbehaviors. Using utensils is adeveloping skill at this age, andspills are fewer than in toddler-hood. Keep in mind, however,that many foods will still be con-sumed as finger foods. Nutritionis important, so make snackscount. By allowing your child tohelp with food preparation, heor she will have added incentiveto try new foods. When yourchild refuses to eat a new food,do not assume that they do notlike that food. Repeated expo-sures to a new food is an impor-tant step in learning to accept afood as part of the diet.

When your child has diabetes,should your approach to feedingbe different than for a child whodoes not have diabetes? Theanswer is simple—NO! Healthyeating is healthy eating!However, diabetes does add adimension to food and nutritionthat usually causes a great dealof anxiety. Learning diabetesmanagement skills is an impor-tant part of developing and sus-taining a healthy attitude towardfood and avoiding food battles.

Allowing your child with dia-betes to “eat to appetite” is adifficult concept. What if theblood glucose is high. . . or low?What if it’s not snack time andyour child with diabetes is hun-gry? What if it’s meal time andyour child with diabetes is NOThungry? All of the “what if’s”are more than a little bit scaryat first. But most of the infor-mation on healthy eating behav-iors is and should be consistent,whether or not your child hasdiabetes. Offering three mealsand three snacks is appropriatefor young children and is very

consistent with a diabetes regi-men.

Blood glucose monitoring and aparent’s educated response toblood glucose values can be thecornerstone of diabetes andfood management. With a fewguidelines, most parents ofinfants and young children withdiabetes manage very well:

• Allowing for higher “target”range blood glucose values willreduce the number of incidentsof hypoglycemia in infants andyoung children. Blood glucosevalues should remain at 100 orabove for this age child.

• Recognize the symptomswhich your infant or young childexhibits when experiencing alow blood glucose, and knowhow to treat a hypoglycemicreaction. Such symptoms willbe your clue to test the bloodglucose. If this is not possible,treat as you would for a lowblood glucose. Offering a smallamount of a high sugar (carbo-hydrate) liquid, such as juice orsweetened soda, will bring theblood glucose up, and then afood source appropriate for ageshould be offered (1-2 ounces ofjuice or soda for an infant, fol-lowed by breast milk or formula;2-3 ounces of juice or soda forthe toddler and pre-schooler,followed by a small snack).

• Use appropriate kinds andamounts of insulin. Manyinfants will be managed nicelyon two or three injections ofintermediate-acting insulin, suchas NPH or one or two injectionsof a long-acting insulin such asUltra-lente®. With the advent ofthe very quick-acting insulin,Humalog®, it is possible to injectinsulin after a toddler orpreschooler has eaten, with theamount given to be determinedby the amount of carbohydrate

food consumed at a meal. Inthis manner, a child is allowedto “eat to appetite” and theappropriate insulin response ismade.

• When insulin has been admin-istered and your child refuses toeat the meal which you haveprepared, let the blood glucosevalue guide your decision-mak-ing process. If the blood glu-cose value is on the lower endof target range, you may offer asimple replacement meal suchas a bowl of cereal, or encour-age your child to drink a glass ofmilk. If the blood glucose valueis high, it is appropriate to letyour child determine if he or shewill eat and allow their“appetite” to guide their deci-sion. Determine when theinsulin you have given will be“peaking” so that you will beprepared should your child needa snack at that time.

• Understand insulin actionsand peak times so that you knowwhen possible low blood glu-coses are likely to occur.

• Allow for more carbohydrateconsumption when your child ismore active. Perhaps your childwill eat a larger meal or snackto provide adequate fuel forhigher activity levels, or youmay choose to offer juice orsnacks during the activity.

Be sure to keep in mind thatfood consumption should be apleasurable experience.Following a few simple guide-lines can help parents relax andrespond to food so that food bat-tles can be avoided. The simplerecipes on page 11 will be fun toprepare with your children.

In next NEWSNOTES: Feedingthe Child With Diabetes -Grade School and MiddleSchool.

Nutrition News

12

FOUNDATIONTHANKS A PRICELESSEMPLOYEEThe Children’s DiabetesFoundation would like to extendits heartfelt thanks to DorothyHarrington for her dedicationand enormous help in service toCDF for over 16 years. Dorothy,who recently retired, juggledresponsibilities as ManagingEditor and Guild Guide Editor ofNEWSNOTES and lent invaluableassistance to Christine Lerner,Director of Development.Among her many assignments,Mrs. Harrington was the talent-ed organizer of the biennialscientific symposiums held atthe time of The Carousel ofHope, in Beverly Hills, Californiaand assisted at Carousel Balls,formerly held in Denver. Herincredible writing, editing andorganizing abilities, her wonder-ful sense of humor and herunstinting generosity will bemissed by the entire CDF staffand members of The Guild, aswell as the employees and vol-unteers at the Barbara DavisCenter for Childhood Diabetes.

B̂LIZZARD MAKESHALLOWEEN PARTY AWHITEOUTThe blizzard of 1997 was hor-rendous, and forced the cancel-lation of The Guild’s annualHalloween Party for childrenafflicted with diabetes and theirfamilies. It was an unavoidabledecision out of concern for thesafety of so many people whowould have courageously bravedthe treacherous weather toattend. Unfortunately, schedul-ing conflicts made it impossibleto move the event to anotherdate on such short notice. Welook forward to next year’sHalloween Party, which will bebigger and better than ever!

Guild Guide

13

GUILD ANNUAL MEETINGMonday, January 12, 1998

Social Hour 10:00 AM, Meeting 10:30 AM

Speaker and Luncheon to Follow

European Cafe

Denver Tech Center

I-25 & Belleview • 5150 South Quebec

Greenwood Village, CO 80111

Guest Speaker: Dr. Andrea Van Steenhouse

PROPOSED SLATE OF OFFICERS

President Marty Jensen

President-Elect Suzy Love

Treasurer Margy Epke

Treasurer-Elect Cindy Schulz

Recording Secretary Sally Frerichs

Corresponding Secretary Cindy Straughan

303-863-1200 OR 800-695-2873 FOR INFORMATION

GUILD GUIDE

14

BRASS RINGLUNCHEON WEAVESITS MAGIC

— Linda Huebner

On September 11th, The Guildof the Children’s DiabetesFoundation pulled off the fash-ion coup of the year at its annu-al Brass Ring Luncheon andFashion Show* held at the HyattRegency in Denver. The event,expertly chaired by Diane Sweat,raised a record $120,000 forCDF and was attended by 800guests. Florence Ruston wasChairman Emeritus of theluncheon and fashion show, andJerry Schemmel was a wonder-ful Master of Ceremonies.

Diane Sweat extended thanks toher committee of almost 100volunteers and to NeimanMarcus for their invaluableefforts in presenting the enor-mous fashion event.

Guild President Linda Broughtonspoke to the audience of thecrucial need to continually raisepublic awareness on the symp-toms of diabetes and introducedadorable nine-year-old BDCpatient, Katie Higgs. Katietouched many hearts as she

expressed thanks for all the doc-tors and staff at the Center andtold of her greatest wish that acure would soon be found fordiabetes.

Under the skillful direction ofCristel Dikeman and NancyHusted, Neiman Marcus present-ed The Art of Fashion, a verita-ble feast for the eyes, withdesigns for every woman fromcollections of American andEuropean designers such asMoschino, Giorgio Armani,Gucci, Oscar de la Renta,Ognibene Zendman, Escada,Donna Karan, Badgley Mischka,St. John, Valentino, andEmanuel Ungaro. What’s won-derful and “in” this year?Fashion hits were leoparddesigns, velvet, high heels,boots and beaded Oriental-stylehandbags. Short, colorful cock-tail dresses are back, as aremagnificent beaded gowns formore formal occasions with fullor fitted skirts, some in

asymmetrical designs. Applauserose in waves as the elegant anddistinctive apparel for daytimeand evening wear appeared onthe runway.

Following the show in the ball-room, guests enjoyed a fabulousluncheon in the Moulon Rougeroom and the Imperial Ballroom.A special Patron Receptionchaired by Marsha Bolen washeld at Neiman Marcus onSeptember 12th.

“. . .Let’s make thisgeneration of childrenwith diabetes the last.”

— Guild PresidentLinda Broughton

Left, Guild President Linda Broughtonwith Brass Ring Luncheon ChairmanDiane Sweat

L to R, Melba Todd, Regional FashionCoordinator for Neiman Marcus, Dallas,Texas and Cristel Dikeman, GeneralManager of Neiman Marcus, Denver

Underwriting was provided byDr. David Margolis, TheHonorable and Mrs. HarryRuston, Sullivan HayesBrokerage, and WestStar Bank.Sponsors were Jon D. WilliamsCotillions, Country ManorEnterprises, and Mrs. and Mrs.Melvin Gart. Corporate tablesponsors were Resumes: OnLine Inc., and Wells Fargo Bank.

Proceeds from the Brass RingLuncheon and Fashion Showenable children with diabetestreated at the Barbara DavisCenter to receive the best careavailable, while researcherscontinue their quest for the

cure. CDF and The Guild aregrateful for the invaluable con-tributions of so many people forthis very successful event,including luncheon chairmanDiane Sweat and all Guild com-mittee members and volunteers,Guild President LindaBroughton, the Denver NuggetsCommunity Fund—a fund of theRobert R. McCormick TribuneFoundation, Cristel Dikemanand Nancy Husted of NeimanMarcus, Jerry Schemmel, thestaff at the Hyatt RegencyDenver and Pam Newman, KatieHiggs and family, JanssenPhotography and generousunderwriters and sponsors.

*An event of the Denver NuggetsCommunity Fund to benefitcharities such as the Children’sDiabetes Foundation at Denver.The Denver Nuggets CommunityFund is a fund of the Robert R.McCormick Tribune Foundation.

Guild Guide

Special guest speaker, BDC patient Katie Higgs, 8,selects door prize winners from Linda Broughton. Atright, BRL Master of Ceremonies, Jerry Schemmel

Brass

RingLuncheon

Photos:

anssen

Photography

L to R, BRL Chairman Emeritus Florence Ruston andDiane Hutner

15

Carousel Days

16

SKIERS ALERT! - IT’STIME TO HIT THESLOPES!Attention all BDC skiers - Getout the ski gear! Dates havebeen set for this year’s excitingSki Trips to Winter Park for BDCpatients 8 to 18 years old. Costof each trip is $25 and includesbus transportation, ski rental,lift tickets and instruction.What a deal! The payment, reg-istration form and waiver mustbe received at CDF headquar-ters prior to all trips. Skiingabilities range from beginner toadvanced and expert (BlackDiamond runs). We encouragechildren to learn to ski throughthis excellent opportunity. Ifyou live outside the DenverMetro area or did not receive aski trip brochure with registra-tion form, call Susie Hummell at303-863-1200. These populartrips fill very quickly, so pleasenote the dates on your calendarand sign up soon!

Saturday-December 13, 1997

Saturday-December 20, 1997

Saturday- January 17, 1998

Saturday-January 31, 1998

Saturday-February 14, 1998

Saturday-February 28, 1998

OUR ADVENTURE INTHE UNITED KINGDOM

— Jesse Temple, age 16— Christy Owen, age 17

NOTE FROM DR. CHASE: As many ofyou know, two youths from the UnitedKingdom attended diabetes camp inColorado in August, 1996 (see NEWS-NOTES, Fall, 1996, “CamptimeMemories”). The British DiabeticAssociation reciprocated by providingtwo places at a camp in Scotland inAugust, 1997 for 16 to 18 year olds.Christy and Jesse were the twoteenagers from the Barbara DavisCenter who were chosen to go.Boehringer Mannheim Corp. was kindenough to sponsor the cost of the air-fares for the two British teenagers whoattended camp in the U.S. in 1996 andour two students who traveled to theU.K. this year. It was a wonderfulexperience for all, and we are verypleased this exchange took place.

FROM JESSE:What a summer of firsts! Myfirst job, getting my driver’slicense and flying to anothercountry to go to diabetes camp.I was thrilled to get an invitationto go with Christy Owen to aBritish Diabetic Association“holiday” in Galashiels,Scotland. Having had experi-ence with a few summers at theColorado ADA camp at GlacierView, I thought I was a veteranof “camp.” The BDA experiencewas much different, though.First I had to learn how toadjust my insulin schedule to

deal with flying across severaltime zones. Dr. Klingensmithwas very helpful with that, and Iwas able to manage pretty wellthe first day of the trip when theOwens and I were up and mov-ing for 30 hours! Our hosts inLondon, Peter McKeown,Director of Youth Programs forthe BDA, and his wife were won-derful. They walked us all overLondon, and we had a chance tovisit all the things I’d readabout: the Tower of London,Picadilly Circus, WestminsterAbby. . . I was exhausted butexcited.

In Great Britain, 16-year-oldsare considered adults and aremaking plans to either continuewith their schooling or live andwork independently. The BDAcamps are really like vacations.We stayed at a textile collegeand had our own rooms. Wealso cooked for one another. Wecould choose to participate inactivities or not. Unlike camphere, no one asked us aboutblood sugars, because Britishteens rarely test their blood sug-ars or change their insulindoses. I think that may have todo with socialized medicine. Ireally appreciate the things wehave available in this country.We had some very interestingdiscussions and it was neat tolearn about how others view

L to R, Jesse Temple and Christy Owen at Buckingham Palace with a member ofthe Palace Guards.

Carousel Days

17

things. I became aware of thethings I take for granted.

We got to participate in somefun activities. We looked forfossils on the beach, saw castlesand had a terrific time visitingthe Festival at Edinburgh. TheFestival is the largest and one ofthe most famous in the world. Itwas amazing! The music, thegroups, the theater, and thecrafts were interesting and areal celebration of Scottish cul-ture. The countryside and gar-dens in Scotland are beautiful. Ihave always enjoyed the beautyof Colorado, but Scotland wasfascinating.

We also had a day of Paint BallWar! I had a great time eventhough I got blasted a few times.Susie Owen had no mercy. I willnever forget this experience, andI appreciate the hospitality ofPeter and his wife, and MoiraBradbury who were so willing toshow us their neat country andwere such gracious hosts. Theyhave given me memories I willnever forget.

FROM CHRISTY:

Purple moors embrace,Sweet Fragrance rolling over.Dancing memories.

I recently had the opportunity totravel to Great Britain to attenddiabetes camp. Our group flewinto Manchester Airport andwere met by our first host family,Pete and Natalie McKeown.They took us to see Big Ben,Hampden Court, Picadilly Circus,Westminster Abbey where PrinceCharles and Princess Dianawere married, and many otherinteresting places in London andthe outlying area. Pete has dia-betes and Natalie works as adietitian. They were great tospend time with!

After three days in London itwas time to move on to York.We traveled there on a train thatwent 125 miles per hour! Oncewe arrived, we met MoiraBradbury, a woman who came tocamp in Colorado last year.Moira took us to Robin’s HoodBay, where we searched for fos-sils, the York Minster (an amaz-ing cathedral built over Romanartifacts), plus the Jorvik VikingCenter. There we took a ridethat simulates traveling back intime to a Viking village. We alsovisited Whitby, a town on thenorthern coast of England whereBram Stoker based his novelDracula. Moira showed us somuch! It was fantastic. Weeventually had to say good-byeand continue on to our final des-tination, the camp!

The camp was a lot of fun, butwas very different from camp athome. In Colorado, we share acabin with many other campers.In Great Britain, each personhad their own room at theScottish Textile College. Therewas a lot of extra freedom thatwe don’t experience in theUnited States. For example,when we traveled intoEdinburgh, we were told toreturn to a point at a certain

time but were allowed to gowhere we wanted in the mean-time. There were lots of organ-ized activities also, like theatre,paint ball, bowling and horse-back riding. I found this campvery interesting because of theway it was set up, but alsobecause I was able to learnabout how the teens I met treat-ed their diabetes. I was amazedto hear that the teens only test-ed their blood sugars aboutonce a week and they didn’talter their insulin dosages to gowith blood sugars! Most of the16 - to 18-year-olds had neverheard of an insulin pump.Although the differences wereamazing, I was happy to havehad such a learning experience.

I will always remember this tripto Great Britain. I was able togain a better understanding thateven though I am used to thingsa certain way, in other countriespeople my age are taught totallydifferent ideas. It broadened myperspectives, and I had a greattime. As they say in Britain,“Brilliant!”

Passing by the Tower of London, L to R, Jesse Temple, Christy Owen, and SusieOwen, R.N., chaperone.

Ihave become increasinglyaware over the last few yearsabout the dramatic impact of

diabetes. According to newlyreleased statistics by theCenters for Disease Control andPrevention, there are currentlyten million people diagnosedwith diabetes in the UnitedStates alone. Fortunately, thereis hope of a cure and throughliving with a strict regimen, indi-viduals with diabetes can effec-tively manage this debilitatingdisease. Studies have shownthat with aggressive self-man-agement training and education,we can dramatically reducediabetes-related blindness,kidney disease, amputations andother diabetes-related complica-tions.

As many of you know, diabetesis of personal importance to me.My mother-in-law has diabetes

and I’ve watched how she caresfor the disease. She activelypractices self-management andleads a remarkably full life. Iknow that when people learn totake care of themselves and areeducated about the disease, theycan dramatically improve theirquality of life. Teaching carefreechildren how to manage dia-betes is an important challenge

we must embrace. Those withjuvenile diabetes, or Type I dia-betes, must monitor their bloodglucose level up to eight times aday and inject themselves asmany as four times a day. Thismeans spending hours per dayfor diabetes treatment. Over alifetime, the average individualwith Type I diabetes will spendclose to 60,000 hours applying

Newt Gingrich

L to R, Marianne and Newt Gingrich with Marianne’s mother, Virginia Ginther. It wasVirginia, a diabetic, who drew Congressman Newt Gingrich’s attention to the impor-tance of education and self-management to control diabetes

Photoby

WilliamR.DavisPhotography

MAKING PROGRESS ON DIABETES— Newt Gingrich, Speaker of the U.S. House of Representatives

18

�

Newt Gingrich,

representing the Sixth District of

Georgia, is Speaker of the United

States House of Representatives.

The Speaker is a member of the

Congressional Diabetes Caucus

and this year was named

Advocate of the Year by the

American Diabetes Association.

�

self-treatment. Those diagnosed withnon-insulin-dependent diabetes, orType II diabetics, also must carefullymonitor their blood glucose levels, aswell as vigilantly manage their dietsand exercise regularly.

To fully realize the impact of diabetes,we must build public awareness. Thestatistics are staggering. Diabetesalone is a leading case of death by dis-ease. The life expectancy of peoplewith diabetes averages 20 years lessthan that of people without diabetes.Middle-aged people with diabetes havea death rate twice as high as middle-aged people without diabetes. Peoplewith diabetes are two to four timesmore likely to have heart and vasculardisease than people without diabetesand are 250% more likely to have astroke. Diabetes is the leading causeof end-stage renal disease, accountingfor more than one third of new cases.It is also the primary cause of non-congenital kidney disease, accountingfor one fourth of all new cases. The

death rate among infants born tomothers with diabetes is two to threetimes as high as for women withoutdiabetes. The average lifetime cost ofdiabetes for a child diagnosed at agethree is $600,000. These statisticsindicate that we must take an aggres-sive stand to fight diabetes.

I am pleased to say that we inCongress, in large part because of thetireless work of advocates, don’tbelieve that we can turn our backs onthe disease any longer. As Speaker, Ihave been fighting hard to make thesystem work more efficiently, whilereducing health care costs. For exam-ple, last year we enacted a health carereform law during 1996 that lowersthe costs of American medicine by cut-ting the bureaucracy and reforminginsurance laws.

You’ll be glad to know that Congress isalso working to pass legislativereforms of the Food and DrugAdministration (FDA) that will make it

easier to take advantage of thedecades of medical breakthroughs thathave brought our nation to the thresh-old of a real revolution in health care.Through FDA reform, previously incur-able diseases such as diabetes, cysticfibrosis, and certain inherited cancersmay now be treatable. FDA reformswill make the federal governmentsmarter while continuing America’sleadership in medical research andtreatment throughout the world.

Through the diabetes research arm atthe National Institutes of Health, theNational Institute of Diabetes andDigestive and Kidney Diseases(NIDDK), Congress increased fundingfor diabetes for fiscal year 1998 byapproximately 7.5%, or approximately$60 million.

As part of the Balanced Budget Act of1997, Congress included a telemedi-cine-diabetes program which allows usto use our ability to communicate bysatellite and fiber optics to treat any

19

A child reaching for the brassring on a carousel is symbolicof the most important goal ofthe Children’s DiabetesFoundation — a cure. Your con-tribution on behalf of a loved onewill make a difference. It willsupport treatment programs toassist children with diabetes inleading healthier lives; and it willfund research to help CDF “catchthe brass ring” by finding a cure.

Mark an anniversary, birthday,special occasion; express appreci-ation or make a memorial tributein honor of someone special witha contribution — for any amount— to the Children’s DiabetesFoundation at Denver.Donations are tax deductible.Tax ID #84-0745008

NEWSNOTES is published threetimes per year by the Children’sDiabetes Foundation at Denver.We welcome your comments.If you would like to submit anarticle or a letter to NEWSNOTESsend information to:

Children’s DiabetesFoundation at Denver777 Grant Street, Suite 302Denver, CO 80203

Christine LernerEditor

Linda HuebnerManaging EditorThe Guild Guide Editor

Cindy BartonGraphic Designer

Dorothy HarringtonAssociate Editor

Alice GreenClinic News Liaison

Know the symptoms ofChildhood Diabetes:• Loss of weight• Extreme thirst• Excessive irritability• Frequent urination

Enclosed is my Contribution of $ _________________

In memory of ____________________________________Or in honor of ___________________________________Occasion _______________________________________

Please send acknowledgements to:(Amount of gift will not be mentioned)

Name ___________________________________________Address _________________________________________City ________________ State _______ Zip ____________

From:Name ___________________________________________Address _________________________________________City ________________ State _______ Zip ____________

The Brass RingFund

Remember a loved one —Help CDF “Catch the Brass Ring”

Children’s Diabetes Foundation at Denver777 Grant Street, Suite 302, Denver, CO 80203

Newt Gingrich

Continued on Back Cover

Nonprofit Org.

U.S. POSTAGE

PAIDDenver, CO

Permit No. 1752

Children’s DiabetesFoundation at Denver, CO

777 Grant Street, Suite 302Denver, CO 80203

Address CorrectionRequested

one affected by diabetes no matterwhere they live. One day, I believethat physicians from all around theglobe will be able to interface with oneanother through telemedicine advance-ments. The United States Army is apioneer in this area. Its vision focuseson allowing the wounded soldier onthe battlefield to have access to thebest brain surgeon in the world if thatwill save his or her life. Soon, thesebreakthroughs will allow the most iso-lated rural hospital to have access tothe best medicine in the world. Thesearen’t the only ways Congress hassought to make government smarter.Right now, the Medicare system willpay for your leg to be amputated, butwill not reimburse you for learninghow to monitor yourself, eat right, andexercise properly in order to avoid thecomplications of diabetes and to avertthe need for the amputation in thefirst place. Medicare improvements inthe Balanced Budget Act of 1997would expand reimbursement to

include diabetes education and sup-plies. By increasing preventative carecoverage, we are seeking to help themany seniors who don’t receive recom-mended diabetes monitoring servicesand who may not know how to effec-tively manage their diseases.

And finally, Congress made an addi-tional commitment of $150 million forjuvenile diabetes research in the hopesof finding a cure for the disease and$150 million for screening of NativeAmericans who are disproportionatelyaffected by diabetes. I believe that wein Congress have begun to makeprogress on the first real changes toour nation’s health care system in ageneration. With your help in buildingpublic awareness, the future holdsgreat promise for the treatment, andultimately, the prevention of diabetes.

Printed onRecycled Paper

Newt Gingrich

HOLIDAYGREETINGS

The Children’sDiabetes Foundationand the BarbaraDavis Center forChildhood Diabetesextend warmest

wishes for a joyfulholiday season and

a New Yearbrimming withhappiness andgood health.