Sheila Robinson still remembers the day her daughter, Brenna, then age 11, was
diagnosed with juvenile diabetes. She noticed in the fall of 2006 that
Brenna was tired and not feeling well.
"We thought she could rest over Christmas vacation," Shelia Robinson
said. "But the symptoms increased and by then, Brenna was drinking
gallons of water with frequent urination."
Sheila, who is a nurse, called their doctor where labs were drawn
showing Brenna's blood sugar was 507 - well above the normal range of
Diagnosed with type 1 diabetes, Brenna was admitted to St. Luke's
Hospital where doctors started her on insulin injections four times a
"The night before we took her to the hospital, we talked about her
diagnosis, getting shots and possibly an IV, what she will and won't be
allowed to eat," said Shelia. "It was a rough night. Brenna was very
upset at first. She thought she'd always have to have shots, and
Brenna's a bad shot taker. The hospital staff was really great, and gave
her lots of education. Brenna learned to do the finger poke, handle
shots and check her blood sugar levels."
What got Brenna and her family through the initial days was their
referral to St. Luke's Diabetes Education, where they met with a nurse
and dietitian team to learn about diabetes and how to manage it.
"Their education started while she was in the hospital," said DeAnn
Jurgensen, the nurse who worked with the Robinson family. The family
learned the skills they needed until they came in for outpatient
"We strive for a seamless transition from inpatient care, to home, to
outpatient education," said Jurgensen. "What was special about the
Robinsons is that the entire family - her mom, dad, older sister and
Brenna - attended every single one of our sessions. Usually, it's just
the mom and child. But this is just a special family. Initially family
members are invited talk to about any issues they may have. There's so
much fear and anxiety in the beginning."
Over a course of about six sessions, they learned about diabetes, how
it affects the body and how to manage it through changing life
situations; how insulin works and how to adjust it; how to incorporate a
diet and exercise program; how to prevent long-term complications and
how to handle sick days.
Insulin pump therapy
Last fall, Brenna started using an insulin pump and is doing very
well. An insulin pump is a pager-size device that delivers insulin
through a cannula that the patient inserts under the skin and changes
every three days. A pump delivers a tiny amount of insulin continuously
throughout the day. At meal time, the pump user programs a larger amount
of insulin to be delivered to cover the meal. The pump gives Brenna the
flexibility to make insulin dose changes in response to different
situations in her day.
"We help the patient use the pump to try to mimic what a natural pancreas would do," Jurgensen said.
A few months after she started using an insulin pump, Brenna started
using a continuous glucose sensor. She inserts a glucose sensor under
her skin, which continuously senses her glucose and sends the data to
her insulin pump. Brenna can glance at the screen on her pump throughout
the day to see what her blood glucose level is and if it is rising or
falling. She can make adjustments in her food intake or insulin dose to
avoid low blood glucose (hypoglycemia) instead of having to experience
the symptoms of hypoglycemia and take time to treat it. The sensor also
offers her parents comfort because the pump will alarm, if her blood
glucose drops below a preset level in the night.
"At this time, the pump does not respond to the data received from
the glucose sensor," said Jurgensen. "This technology will be available
in the next few years. When it is available it will be like an external,
Periodically, Sheila uploads the information from Brenna's pump and
sensor to the pump company's web site where Jurgensen can review the
data and discuss changes in Brenna's pump settings with Sheila.
Early detection and treatment
St. Luke's Diabetes Education staff recommends early treatment and
education after a diagnosis of type 1 diabetes. Teamwork is essential
for good diabetes management.
"A child with type 1 diabetes may have a large team including
parents, doctors, nurses, dietitians, teachers, coaches, siblings and
extended family," said Jurgensen. "We try to work with as many of these
team members as possible so everyone knows how to help this child/family
cope with diabetes."
An estimated 35 children in the U.S. are diagnosed with juvenile
diabetes every day. In total, about 17 million people in the U.S. have
diabetes, of which about 1.4 million have type 1 diabetes.
"I cried for a couple of days after the initial diagnosis," said
Shelia. "But I've learned to think about it altogether differently. I
don't want it to be the only thing I think about when it comes to
Brenna. It's a part of our life, but not the main thing."
Overcoming another hurdle, the family even went to Brenna's school to talk about diabetes with her classmates.
"Rumors were flying," said Sheila. "So we talked to students in her
class, explained that she might need extra snacks and insulin for the
rest of her life, and suggested some steps to take in case she started
Now Brenna takes it all in stride.
"She's pretty matter of fact about it," said Sheila. "She never
really complains about it. She just knows it's something she has to do."
Today, Brenna is an active 12-year-old who is in drama class at
school, plays the cello and piano, swims and loves to hang out at the
pool in the summer with her friends.
Plus, she only needs to make an occasional visit to St. Luke's
Diabetes Education to discuss concerns or make adjustments as she grows.
"She's doing phenomenally, both physically and emotionally," said
Jurgensen. "Brenna is coping very well because she has such a supportive
To learn more about St. Luke's Diabetes Education call (319) 369-7440 or visit our Diabetes section.