Tuesday, April 28, 2009

Closest analogue to severe food allergies = Type I (juvenile) diabetes?

Occasionally, when I explain to someone the precautions we must take with Ainsley at school and elsewhere, he or she will say, "It's kind of like she's diabetic, huh?" Given that my dad is a Type I (aka juvenile or insulin-dependent) diabetic, I have quite a lot of experience with this condition to be able to compare the two.

As I have mentioned before, my dad has been diabetic most of his life. He acquired the condition at the age of 27, after becoming very ill with a virus that he believes attacked his pancreas. He didn't know for a while afterward that anything was wrong, but after he began having symptoms (abrupt mood swings, sweating profusely, needing to urinate really often), he went to a doctor and was finally diagnosed. As I am sure most of you know, being diabetic means your pancreas doesn't produce insulin (or, in the case of a Type II diabetic, enough insulin), which converts the sugars circulating in your blood stream into usable energy.

So a Type I diabetic must take insulin to live, and must constantly monitor his blood sugar level to ensure it stays within a normal range and to determine how much insulin to take. If he or she doesn't take enough, the blood sugar runs too high and it overwhelms the body (as I have learned, this is usually a slow process - dangerous, but very slow and with several warning signs, such as sweating and urinating a lot and becoming very tired).

If he accidentally takes too much insulin, on the other hand, his blood sugar runs too low This is usually a more acutely dangerous problem. Someone's blood sugar can dip too low very fast, and the person can lose all awareness of the problem (acting drunk or otherwise out of it) or even pass out.

Ever since my dad learned he was diabetic, he has had to severely limit his sugar intake, take 2-3 insulin injections per day, and checks his blood sugar about 5 times a day. Currently, he lives in a retirement community and we have someone check on him twice at night because he is a "fragile diabetic," meaning he can have low-blood-sugar episodes without warning. I dread any late-night phone calls because I know they probably mean my dad has had such an episode. Thankfully - and knock on wood - we have only received two of those phone calls in the past year.

I have thought a lot about the similarities between severe food allergies and insulin-dependent diabetes and agree that they are very alike in terms of (a) the chronic nature of the conditions (they are both conditions that can be managed but not really treated), (b) the fact that both require the person to diligently avoid certain foods and (c) both can result in the person having a serious/life-threatening medical incident with little warning. Sometimes I actually think it was serendipitous that I had a diabetic father because it preprogrammed me to be vigilant and careful with Ainsley's food-allergy condition.

I must say that, of the two - Type I diabetes and severe food allergies - I think that, generally, food allergies are the easier condition to live with, because a food-allergic child doesn't have to take insulin injections (or have a pump or anything else to administer insulin) and there is more hope on the horizon for a "cure" or at least good treatment options for food allergies than for diabetes. Of course, a food-allergic person also has the hope of growing out of all or most of her allergies.

In my mind, the only thing worse about food allergies than diabetes is that a food-allergic person can die within just a few minutes of eating an allergen, whereas if a diabetic person eats sugar, his blood-sugar might go above the normal range, but it would be a relatively slow process and the only treatment would be to take extra insulin to bring the sugar back down. Additionally, although low blood sugar can result in an acute medical emergency, even if a person goes unconscious from low blood sugar, there would usually be enough time for someone to give the person glucose (in the mouth or under the tongue) or for the paramedics to arrive to administer it intravenously (at least I believe this to be true - my dad has had incredibly low blood sugars several times in his life, resulting in him being basically comotose, and has still been brought back to normal after we have waited several minutes for paramedics to arrive).

In any case, my knowledge and experience with both of these conditions means I feel deep empathy for any parent of a diabetic or severely food allergic child. I would give almost anything for my dad to have a working pancreas and for my daughter's immune system not to attack her body when she eats otherwise benign food items. Sometimes I marvel at how far medical treatments have come, but then I think about how there still isn't a cure for either diabetes or food allergies and realize how far we still have to go.

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