From Manama, Kingdom of Bahrain:
My sister has an eight year old diagnosed with type 1 diabetes about a year a half ago, and she is a working lady who suffers a lot in taking care of him and his other brother who is a thirteen year old autistic child. I have two questions:
I know my question is quite general and it is not specific, but it addresses the consequences of having a child with diabetes, and the wishes and ambitions that this situation may create.
- How can we to ease the suffering of children with diabetes and mothers looking after them?
- What are the better treatment choices besides the usual twice daily insulin injections? It seems the insulin pump could help a lot, but until now it does seems it is not within the reach of every family.
- How many years will elapse before a decisive and guaranteed cure for of type 1 diabetes will be accomplished by the relentless efforts of medical researchers? How far is it from reality that beta cells can be implanted with the body's acceptance to them and become finally the final and lasting cure for this evil disease, that is affecting infants and elderly alike?
Clearly your sister has her hands full looking after an autistic child as well as one with type 1 diabetes and managing a full time job in addition. It would depend on where your sister is domiciled as to whether she has a good diabetes care team for her son and is able to take advantage of some of the practical advances such as ultrafine needles, and one of the new glucose meters that are almost painless (like the FreeStyle or One Touch® Ultra) and also of the new insulin regimens using Lantus (insulin glargine) and Humalog. Pumps certainly can be made to work well in an eight year old, but their main advantage is that they offer good control with increased flexibility in the older child and the college student. On the other hand, they can be expensive, and there needs to be experienced support both for initial education as well as for the time it takes for the family to manage on their own.
I am afraid that a cure is still some years away. A Canadian group recently made a big advance in the technology of islet cell transplants, but two big problems remain: the shortage of donors and the need for lifetime immunosuppression. Clinical trials have now begun on at least one protocol to induce graft tolerance after a very short period of immunosuppression. Likewise, there is a great deal of active research in the use of stem cells and genetically engineered cells as surrogates for islets so that there may indeed be a cure before your nephew goes to college.
Original posting 13 Mar 2002
Posted to Daily Care
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