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For youthful Conner Kurz, birthday diabetes detection was a blessing
By Harold Reutter
harold.reutter@theindependent.com
A diagnosis of Type 1 diabetes is not the early birthday present Conner Kurz was anticipating 18 months ago.
But that’s exactly what he got.
“It was almost my birthday,” Conner said. “It was three days until my birth-
day.”
Instead of getting started on his summer vacation, Conner spent time at St. Francis Medical Center, followed by a stay at Children’s Hospital in Omaha to learn how to care for his diabetes.
But in some respects, Conner was lucky, according to his mom, Katie Kurz, a teacher at Barr Middle School. Conner’s grandmother, Betty Schwenk, is a nurse and his grandfather, Gary Schwenk, is a Type 1 diabetic.
That means Conner’s family has some familiarity with diabetes, Kurz said. In fact, his grandmother’s instincts led Conner to getting the official diagnosis.
Kurz had one more week of teaching left at Barr Middle School, while Conner had just finished his fourth grade year at St. Libory Elementary. As a result, he was staying with his grandparents while his mom worked.
“He was guzzling milk,” said Kurz. “He complained of a stomachache and that he didn’t feel well. He was lethargic.”
That raised the alarm for Mrs. Schwenk, who knew diabetes’ symptoms. She used her husband’s glucometer to test Conner’s blood glucose and got a suspiciously high reading.
When Kurz picked up Conner later in the day, the grandmother sent the glucose monitor along so another test could be made. Kurz checked Conner’s blood glucose levels a couple hours after he ate his evening meal and got a reading of 600.
That was not just a suspiciously high reading, but was also an alarming one. A reading of 600 is the point where a person with Type 1 diabetes starts flirting with diabetic coma or even death. The home test immediately sent Conner to St. Francis Medical Center. There, he was diagnosed with ketoacidosis, which can be life threatening.
Kurz said her family’s familiarity with diabetes soon became much more intense.
She said they learned Conner’s A1C — a test to measure a person’s average blood glucose over the previous three months — was 13, perhaps not surprising for someone with undiagnosed diabetes. A person with well-controlled Type 1 diabetes will have an A1C well below 7.
After Conner’s blood glucose levels were brought under control, he was transferred to Children’s Hospital in Omaha to learn how to live with diabetes.
The results of his education are obvious.
At school, Conner has a backpack of supplies. One is an “insulin pen” or easily calibrated hypodermic that lets Conner inject himself with Lantus, an insulin that lasts 24 hours with no peaks or valleys. Lantus provides the “basal” insulin Conner needs to maintain good glucose control around the clock.
He also has an insulin pen of Humalog, a quick-acting insulin that peaks in two hours. Humalog is used as a “bolus” for each meal, with the insulin’s rise and fall corresponding to the time it takes to digest food. The number of units of Humalog injected must match the carbohydrate grams eaten at each meal. Conner now knows the ratio of insulin units to carbohydrate grams he must take at each meal.
If matching insulin units to the number of carbohydrate grams was all it took to maintain healthy glucose levels, then Type 1 diabetes would be easy to manage.
Unfortunately, it’s more complicated than that.
If a person engages in strenuous physical activity, his or her blood glucose levels fall. If they fall too far, a person can lose consciousness. To counterbalance a steep fall in glucose levels, a person with Type 1 diabetes must eat fast-acting carbohydrates.
Kurz said Conner is adept at detecting low blood sugars. But she also recalls a time late at night when she went into his bedroom and put her hand on Conner’s forehead, discovering that it was clammy and sweaty, a sure sign of low blood sugar. Conner had to be awakened so he could take something to raise his blood glucose.
High levels of stress, on the other hand, can cause a person’s blood glucose to spike. Illnesses also can cause blood sugar to climb too high. Kurz said when Conner becomes sick — especially when it is an illness that induces vomiting — it can be very difficult to maintain glucose control.
That’s all much more than a sixth-grader — or his family — should have to worry about.
“We grieved over this,” Kurz said. “We probably still are a little.”
Conner, though, has adapted. Kurz said she often asks Conner to name something he is grateful for. When she recently asked, Conner said he was grateful for his diabetes, because it could have been something worse.
Indeed, Conner needs to care for his diabetes, but he maintains the interests typical for a sixth-grader. He absolutely loves being a left-handed pitcher during the summer in St. Libory. He also is on the Barr wrestling team and in Barr’s after-school program. Conner is in sixth-grade honor choir, sixth-grade band and on the Barr Student Council.
As for Kurz, she said she is coming forward with her story in part because November is National Diabetes Awareness Month. But she wants people to know there is support for families with children who have Type 1 diabetes.
One big source of support is KIDZ, for Kids in the Diabetes Zone. The support group brings together Central Nebraska families who have children with Type 1 diabetes. There are activities for the kids and speakers for the parents. Kurz has also found support from many people who have come forward to tell about their own families’ experiences with Type 1 diabetes.
Kurz said there also are summer camps for kids with Type I diabetes such as Camp Hot Shots in Hastings and Camp Floyd Rogers in Gretna.
She also wants to urge parents and their children with Type 1 diabetes to get good education about controlling diabetes. Kurz would urge people to take a team approach. Their team has included the family physician, nurses on the pediatric unit, dietitians, diabetic educators, physical therapists, an endocrinologist and an ophthalmologist, plus entire school staffs, first at St. Libory and now at Barr.
The family has also put its faith in God, Kurz said.
By Harold Reutter
harold.reutter@theindependent.com
The pancreas of a person with Type 1 diabetes produces no insulin.
Without insulin, a person’s body is unable to convert glucose into energy. In other words, food — especially carbohydrates — eaten by an undiagnosed Type I diabetic is useless. As a result, the body switches to starvation mode to break down its fat stores for energy.
However, that fat is converted to ketones, with the ketones used more slowly than the body produces them. Extremely high ketones, which spill into the urine, can poison the body. At its worst, ketoacidosis can lead to diabetic coma or even death.
All that useless glucose also spills into a person’s urine. Just as bad, the spilled glucose pulls water from the body, resulting in dehydration.
These reactions to having no insulin production are why there are some common symptoms for people with undiagnosed Type 1 diabetes.
They can include dehydration and a raging thirst. Because the body’s fat stores are being broken down for energy, weight loss is not unusual. With the body starving itself, other symptoms can include fatigue and drowsiness. A person also can experience abdominal pain or vomiting.
Barr Middle School teacher Kurz said no one knows exactly what causes Type 1 diabetes. But genetics plays a role. Apparently, so does an environmental “trigger.”
The trigger for her son, Conner, may have been the influenza and pneumonia that hospitalized him almost three months to the day before his diagnosis. Conner had blood work done because of his hospitalization and his blood sugars were normal at that time.
Type 1 diabetes is believed to be an autoimmune disease, in which the body’s immune system attacks beta cells, the pancreas cells that make and release insulin.
Kurz said she and her family are considering getting Conner an insulin pump. Over the longer term, they hope for a cure through stem cell research that will one day result in the manufacture of insulin-producing beta cells.
The goal is producing such beta cells without a person needing immunosuppression drugs that can cause their own health problems.
But that’s exactly what he got.
“It was almost my birthday,” Conner said. “It was three days until my birth-
day.”
Instead of getting started on his summer vacation, Conner spent time at St. Francis Medical Center, followed by a stay at Children’s Hospital in Omaha to learn how to care for his diabetes.
But in some respects, Conner was lucky, according to his mom, Katie Kurz, a teacher at Barr Middle School. Conner’s grandmother, Betty Schwenk, is a nurse and his grandfather, Gary Schwenk, is a Type 1 diabetic.
That means Conner’s family has some familiarity with diabetes, Kurz said. In fact, his grandmother’s instincts led Conner to getting the official diagnosis.
Kurz had one more week of teaching left at Barr Middle School, while Conner had just finished his fourth grade year at St. Libory Elementary. As a result, he was staying with his grandparents while his mom worked.
“He was guzzling milk,” said Kurz. “He complained of a stomachache and that he didn’t feel well. He was lethargic.”
That raised the alarm for Mrs. Schwenk, who knew diabetes’ symptoms. She used her husband’s glucometer to test Conner’s blood glucose and got a suspiciously high reading.
When Kurz picked up Conner later in the day, the grandmother sent the glucose monitor along so another test could be made. Kurz checked Conner’s blood glucose levels a couple hours after he ate his evening meal and got a reading of 600.
That was not just a suspiciously high reading, but was also an alarming one. A reading of 600 is the point where a person with Type 1 diabetes starts flirting with diabetic coma or even death. The home test immediately sent Conner to St. Francis Medical Center. There, he was diagnosed with ketoacidosis, which can be life threatening.
Kurz said her family’s familiarity with diabetes soon became much more intense.
She said they learned Conner’s A1C — a test to measure a person’s average blood glucose over the previous three months — was 13, perhaps not surprising for someone with undiagnosed diabetes. A person with well-controlled Type 1 diabetes will have an A1C well below 7.
After Conner’s blood glucose levels were brought under control, he was transferred to Children’s Hospital in Omaha to learn how to live with diabetes.
The results of his education are obvious.
At school, Conner has a backpack of supplies. One is an “insulin pen” or easily calibrated hypodermic that lets Conner inject himself with Lantus, an insulin that lasts 24 hours with no peaks or valleys. Lantus provides the “basal” insulin Conner needs to maintain good glucose control around the clock.
He also has an insulin pen of Humalog, a quick-acting insulin that peaks in two hours. Humalog is used as a “bolus” for each meal, with the insulin’s rise and fall corresponding to the time it takes to digest food. The number of units of Humalog injected must match the carbohydrate grams eaten at each meal. Conner now knows the ratio of insulin units to carbohydrate grams he must take at each meal.
If matching insulin units to the number of carbohydrate grams was all it took to maintain healthy glucose levels, then Type 1 diabetes would be easy to manage.
Unfortunately, it’s more complicated than that.
If a person engages in strenuous physical activity, his or her blood glucose levels fall. If they fall too far, a person can lose consciousness. To counterbalance a steep fall in glucose levels, a person with Type 1 diabetes must eat fast-acting carbohydrates.
Kurz said Conner is adept at detecting low blood sugars. But she also recalls a time late at night when she went into his bedroom and put her hand on Conner’s forehead, discovering that it was clammy and sweaty, a sure sign of low blood sugar. Conner had to be awakened so he could take something to raise his blood glucose.
High levels of stress, on the other hand, can cause a person’s blood glucose to spike. Illnesses also can cause blood sugar to climb too high. Kurz said when Conner becomes sick — especially when it is an illness that induces vomiting — it can be very difficult to maintain glucose control.
That’s all much more than a sixth-grader — or his family — should have to worry about.
“We grieved over this,” Kurz said. “We probably still are a little.”
Conner, though, has adapted. Kurz said she often asks Conner to name something he is grateful for. When she recently asked, Conner said he was grateful for his diabetes, because it could have been something worse.
Indeed, Conner needs to care for his diabetes, but he maintains the interests typical for a sixth-grader. He absolutely loves being a left-handed pitcher during the summer in St. Libory. He also is on the Barr wrestling team and in Barr’s after-school program. Conner is in sixth-grade honor choir, sixth-grade band and on the Barr Student Council.
As for Kurz, she said she is coming forward with her story in part because November is National Diabetes Awareness Month. But she wants people to know there is support for families with children who have Type 1 diabetes.
One big source of support is KIDZ, for Kids in the Diabetes Zone. The support group brings together Central Nebraska families who have children with Type 1 diabetes. There are activities for the kids and speakers for the parents. Kurz has also found support from many people who have come forward to tell about their own families’ experiences with Type 1 diabetes.
Kurz said there also are summer camps for kids with Type I diabetes such as Camp Hot Shots in Hastings and Camp Floyd Rogers in Gretna.
She also wants to urge parents and their children with Type 1 diabetes to get good education about controlling diabetes. Kurz would urge people to take a team approach. Their team has included the family physician, nurses on the pediatric unit, dietitians, diabetic educators, physical therapists, an endocrinologist and an ophthalmologist, plus entire school staffs, first at St. Libory and now at Barr.
The family has also put its faith in God, Kurz said.
By Harold Reutter
harold.reutter@theindependent.com
The pancreas of a person with Type 1 diabetes produces no insulin.
Without insulin, a person’s body is unable to convert glucose into energy. In other words, food — especially carbohydrates — eaten by an undiagnosed Type I diabetic is useless. As a result, the body switches to starvation mode to break down its fat stores for energy.
However, that fat is converted to ketones, with the ketones used more slowly than the body produces them. Extremely high ketones, which spill into the urine, can poison the body. At its worst, ketoacidosis can lead to diabetic coma or even death.
All that useless glucose also spills into a person’s urine. Just as bad, the spilled glucose pulls water from the body, resulting in dehydration.
These reactions to having no insulin production are why there are some common symptoms for people with undiagnosed Type 1 diabetes.
They can include dehydration and a raging thirst. Because the body’s fat stores are being broken down for energy, weight loss is not unusual. With the body starving itself, other symptoms can include fatigue and drowsiness. A person also can experience abdominal pain or vomiting.
Barr Middle School teacher Kurz said no one knows exactly what causes Type 1 diabetes. But genetics plays a role. Apparently, so does an environmental “trigger.”
The trigger for her son, Conner, may have been the influenza and pneumonia that hospitalized him almost three months to the day before his diagnosis. Conner had blood work done because of his hospitalization and his blood sugars were normal at that time.
Type 1 diabetes is believed to be an autoimmune disease, in which the body’s immune system attacks beta cells, the pancreas cells that make and release insulin.
Kurz said she and her family are considering getting Conner an insulin pump. Over the longer term, they hope for a cure through stem cell research that will one day result in the manufacture of insulin-producing beta cells.
The goal is producing such beta cells without a person needing immunosuppression drugs that can cause their own health problems.
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