As The Chat Room Turns

6:26:15 PM EST
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At first glance Jessica Jackson appears to be modeling the latest in wireless communication devices. Strapped to her waistline is a small rectangular piece of plastic that resembles a pager.

But Jackson isn't waiting on a phone call or sending text messages with the device. She's using it to survive.

The apparatus Jackson wears is an insulin pump. And it's the reason the Gator's 6-foot-3 freshman center has been able to continue her basketball career after being diagnosed with type 1 diabetes at the age of 10.

  "It is amazing that she is a diabetic and can come out here and play at the level we do," Gators senior forward Brittany Davis said. "It's just amazing she has been able to do that."  

 Jackson did it well at Craigmont High School in Memphis, Tenn., where she was voted to The Associated Press Class AAA All-State first team and was a finalist for the McDonald's All-Star game her senior season.  

But playing at Florida as a diabetic has been a different experience. Practices and games are more strenuous. And the intensity and duration of workouts can affect the body's blood-sugar levels.   To counteract this change, Jackson now wears her insulin pump during practices, workouts and games.  

Insulin pumps deliver a regulated flow of insulin into the body through a catheter under the skin. Jackson straps the pump to her abdomen, under her jersey, while on the basketball court. And it's made a big difference for her.  

"My endocrinologist thought it would be best to wear this pump during exercises," Jackson said. "Everything has been working out a lot better since."  

Jackson seems to handle her condition with maturity, which is why she's prepared for what could be coming. Jackson will likely become an inspiration for diabetics."  

 She already got a small taste of that reality recently while visiting her endocrinologist. "There were kids there who hadn't seen the pump or who were interested because I'm playing basketball and I have diabetes," Jackson said. "They just have a lot of questions.

"I plan on, in the future, going to talk to some kids who have diabetes and feel like they can't play sports because of their condition."

Jackson has already had an effect on her coach, who said she has become well educated about the condition in recent months.   "I think she has a huge opportunity to be an inspiration to young people who desire to play sports and are diabetic," Peck said. "She has demonstrated that even though you are a diabetic there are still plenty of things you are able to do."   Peck said Jackson's condition didn't deter her during the recruiting process. In fact, Peck was most concerned about a torn ACL Jackson suffered her sophomore year of high school.   "But now when you watch her play," Peck said. "You can't see signs of either."

Jackson, whose height and wingspan have drawn comparisons to former Florida All-American center Vanessag Hayden, wore the insulin pump during the Gators' two exhibition wins this season.   She scored seven points and grabbed four rebounds in 22 minutes. Jackson is expected to be a key reserve this season in crowded Florida frontcourt. She says she's not concerned about playing time. Just being on the court is satisfaction enough.  

 "There are a lot of people who feel like they can't play their sport anymore once they are diagnosed," Jackson said. "I know a lot of people who stopped playing their sport because they were diagnosed with diabetes. Sometimes it can be tough, it can be stressful. But you've got to work through it."  

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5:58:42 PM EST
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Kory Koontz can wrestle a rope around a steer's hind legs in a few seconds. To compete against the best rodeo cowboys, he's got a trusty horse, a two-gallon hat and dusty boots.

He also has an insulin pump, a blood glucose monitor, lancets, and a pocket full of test strips.

If you see Koontz pricking his finger in the chute at this weekend's Interstate Batteries Texas Stampede at American Airlines Center, that's because he's monitoring his blood sugar. Diagnosed with Type 1 diabetes at age 16, Koontz credits the pump with improving his control of the disease.

The Sudan, Texas, resident also has a good handle on team roping. He and partner Jake Barnes rank second entering the final leg of the Pace Picante Series, which concludes the regular season. The top 15 in each event qualify for the Wrangler National Finals Rodeo on Dec. 2-11 in Las Vegas.

Koontz, the heeler, depends on Barnes, the header, to get a rope around the steer's horns so that he can rope the legs. Timing is critical as the teammates work against the clock.

"You want a partner that's dependable," Barnes said. "You wouldn't know Kory was any different than any other guy."

Koontz, the diabetic, depends on the pump to deliver insulin that his pancreas does not. He gave himself injections until about three years ago, when he read a story about golfer Scott Verplank using the pump while playing PGA Tour events.

The pump mirrors the pancreas in that it provides a constant flow of insulin. Koontz programs how much insulin to deliver with a couple touches of the computerized pump. He said the pump works well for him because he has fewer dramatic changes in his glucose readings. With a hectic lifestyle that includes spending about 180 nights on the road, he has more freedom. He eats whenever he wants, counts his carbohydrates and then punches that number into the pump.

"It just makes each day a little easier," Koontz said. "The more you can keep your blood sugars level, the better you feel. When you're going up and down, it adds stress, and you don't need that in the arena."

Koontz, 34, used to ignore advances in diabetic care. He went eight years without seeing a doctor while he was taking injections.

But as he got older, he found that he was intentionally keeping his blood sugars high to avoid lows. Low blood sugar causes confusion and affects coordination.

An avid golf fan, he took great interest in Verplank's story. Now Koontz seems like a model patient. He usually tests his blood sugar eight times a day and tries to limit fats and sugars.

He also tries to help other diabetics by preaching the merits of the pump. A feature on ESPN and a cover story in Diabetes Forecast magazine resulted in a bunch of letters and e-mails. He figures he has converted about 25 people to the pump.

"Just since I've been speaking out, people have come up and said they read the story and switched to the pump and it has really helped them," he said. "That's a great feeling."

Koontz, with $1.02 million in career earnings, has competed in 13 NFRs. He isn't the only rodeo cowboy with diabetes. He helped persuade world champion steer wrestler Luke Branquinho and saddle bronc rider Jess Martin to use the pump. Branquinho and Martin disconnect when competing. Koontz keeps his in his pocket.

It's not unusual for the cowboys to trade tips on care. Koontz's insurance does not cover his diabetic supplies, and that adds up. A box of 100 test strips costs almost $100.

"In Austin, Kory showed me how to use a squeeze bolus," Branquinho said, referring to a pump setting that staggers insulin delivery to account for high-carb meals. "Learning how to operate the pump is the main thing. I had good control with shots. But I have even better control now, and it's easier."

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5:50:49 PM EST
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Ok...I know I said YOU DO THE RESEARCH...but I decided to help ya...with just a little bit of effort I found the information below...understanding of diabetes...of how diabetes work....of what happens during a low...if you understand this...then you didn't have to do any research...did ya?

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5:48:03 PM EST
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Episodes of extremely low blood sugar (hypoglycemia), particularly at an early age, can have an impact on spatial memory performance in children with type 1 diabetes, according to the results of a new study.

As lead investigator Dr. Tamara Hershey told Reuters Health, "this study tests and supports a common hypothesis that severe hypoglycemia experienced early in life is riskier for cognitive function than severe hypoglycemia experienced later in life. We focused only on a spatial memory task which has previously been shown to be sensitive to repeated hypoglycemia."

Hershey, of Washington University School of Medicine, St. Louis, Missouri, and colleagues studied data from three independent studies involving 103 diabetic children and 60 children without diabetes between 6 and 18 years old. The findings are published in the journal Diabetes Care.

The 2-hour battery of cognitive measures included evaluation of short (5-second) and long (60-second) spatial memory and reactions. This involved recalling locations and responding to shapes shown on a computer screen.

Children who had had more than three episodes of severe hypoglycemia showed reduced performance on the longer-delayed spatial response test. This was particularly the case when severe hypoglycemic episodes began before the age of 5 years.

The age at which type 1 diabetes developed and estimates of chronic high blood sugar levels did not influence performance.

The researchers conclude that "the developing brain of very young children may be more vulnerable than the brain of older children to the negative effect of severe hypoglycemia on longer-term spatial memory."

However, Hershey added that "more research needs to be done on how this effect relates to everyday life. This information could eventually be used when assessing the benefits and risks of tight (sugar) control...at very young ages."

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5:45:51 PM EST
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This is from the exact same website as above...

A drop in the blood sugar levels, called hypoglycaemia, severe enough to cause seizures or coma in young children with type 1 diabetes does not affect mental ability or behaviour.

Among children with type 1 diabetes, also known as juvenile diabetes, those who develop the disease very early in life have shown signs of decline in mental abilities. Young children with type 1 diabetes are at greatest risk of severe hypoglycaemic events, and this has focused concern on the potential for hypoglycaemic insult to affect central nervous system development. There is some evidence that the region of the brain called the hippocampus is particularly sensitive to prolonged episodes of severe hypoglycaemia.

Researchers from the Princess Margaret Hospital, Australia, compared 41 juvenile diabetic children and adolescents who had a history of hypoglycaemia with seizure or coma to 43 similar diabetic subjects without a history of severe hypoglycaemic events. A subgroup of patients who had a first seizure at an earlier age - at younger than 6 years of age - had more episodes of hypoglycaemic seizures or coma compared with those who experienced a seizure at an older age.

The team conducted a comprehensive series of learning and memory tests, as well as intellectual and behavioural tests and observed no significant differences between the seizure and non-seizure groups on the intellectual, memory or behavioural measures. The number of severe hypoglycaemic events was also not significantly correlated with the memory, intellectual, and behavioural scores. Also, no difference was found between the early first seizure subgroup and non-seizure group, even on those delayed recall tasks studied specifically, given the concern about the potential impact of hypoglycaemia on memory function.

The above results provide some reassurance to doctors treating children with type 1 diabetes with intensive treatment that seizures/coma at a young age does not necessarily result in gross cognitive or behavioural impairment.

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5:40:32 PM EST
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Episodes of low blood sugar (hypoglycaemia), particularly at an early age can affect spatial memory in children with type 1 diabetes.

Researchers from the Washington University School of Medicine, St. Louis, USA conducted a study that tests and supports a common hypothesis that severe hypoglycaemia experienced early in life is riskier for cognitive function than severe hypoglycaemia experienced later in life. They focused only on a spatial memory task, which has previously been shown to be sensitive to repeated hypoglyacemia.

The researchers studied data from three independent studies involving 103 diabetic children and 60 children without diabetes between 6 and 18 years old. The 2-hour battery of cognitive measures included evaluation of short (5-second) and long (60-second) spatial memory and reactions. This involved recalling locations and responding to shapes shown on a computer screen.

Children who had more than three episodes of severe hypoglycaemia showed reduced performance on the longer spatial response test. This was particularly the case when severe hypoglycaemic episodes began before the age of 5 years. The age at which type 1 diabetes developed and estimates of chronic high blood sugar levels did not influence performance.

The developing brain of very young children may be more vulnerable than the brain of older children to the negative effect of severe hypoglycaemia on longer-term spatial memory. However, more research needs to be done on how this effect relates to everyday life.


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5:39:17 PM EST
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NEW YORK (Reuters Health) - Episodes of extremely low blood sugar (hypoglycemia), particularly at an early age, can have an impact on spatial memory performance in children with type 1 diabetes, according to the results of a new study.

As lead investigator Dr. Tamara Hershey told Reuters Health, "this study tests and supports a common hypothesis that severe hypoglycemia experienced early in life is riskier for cognitive function than severe hypoglycemia experienced later in life. We focused only on a spatial memory task which has previously been shown to be sensitive to repeated hypoglycemia."

Hershey, of Washington University School of Medicine, St. Louis, Missouri, and colleagues studied data from three independent studies involving 103 diabetic children and 60 children without diabetes between 6 and 18 years old. The findings are published in the journal Diabetes Care.

The 2-hour battery of cognitive measures included evaluation of short (5-second) and long (60-second) spatial memory and reactions. This involved recalling locations and responding to shapes shown on a computer screen.

Children who had had more than three episodes of severe hypoglycemia showed reduced performance on the longer-delayed spatial response test. This was particularly the case when severe hypoglycemic episodes began before the age of 5 years.

The age at which type 1 diabetes developed and estimates of chronic high blood sugar levels did not influence performance.

The researchers conclude that "the developing brain of very young children may be more vulnerable than the brain of older children to the negative effect of severe hypoglycemia on longer-term spatial memory."

However, Hershey added that "more research needs to be done on how this effect relates to everyday life. This information could eventually be used when assessing the benefits and risks of tight (sugar) control...at very young ages."

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5:35:14 PM EST
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Yes...I know I just posted two articles from the AMERICAN DIABETES ASSOCIATION web page that say two totally different things...but I thought it was very interesting...so...if you truly wanna know...You do the research...

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5:33:04 PM EST
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What is the problem and what is known about it so far?

Children with type 1 diabetes who frequently suffer from bouts of extremely low blood glucose (hypoglycemia) sometimes have problems with spatial memory, or their ability to remember locations, places, and things like the layout of their homes. Having low blood glucose at a young age may have more of an effect on memory and brain function than having low blood glucose at an older age.

Why did the researchers do this particular study?

The researchers did this study to find out if having very low blood glucose at an early age affects a person's spatial memory for a long time.

Who was studied?

Researchers combined data from three studies to get a study sample of 163 children between 6 and 18 years of age; 103 children had type 1 diabetes and 60 children didn't have diabetes.

How was the study done?

The children were tested in three studies. The children in each study took part in 2-hour mental tests. These tests measured spatial memory as well as verbal and nonverbal intelligence. The study then analyzed the chldren's history of low blood glucose, the ages of when they had low blood glucose, and how having low blood glucose affected how they did on the tests.

What did the researchers find?

The results of the study showed that having very low blood glucose more than three times lowered the affected the children's memory, especially when the instances of low blood glucose happened before the age of 5. The age of type 1 diabetes onset did not have any effect on memory.

What were the limitations of the study?

The limitations of the study are that researchers had no baseline data on the children and had to use lifetime A1C averages (a measure of long-term blood glucose) to measure diabetes control. Also, the results may not be completely accurate because low blood glucose events can easily go unnoticed or unreported.

What are the implications of the study?

This study showed episodes of very low blood glucose have a negative effect on brain and memory function of children with type 1 diabetes. There are many benefits to tight blood glucose control at a young age, and doctors and parents need to carefully weigh the risks and benefits of different treatment plans for childhood diabetes.

 

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5:30:25 PM EST
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A drop in levels of blood sugar, called hypoglycemia, that are severe enough to cause seizures or coma in young children with type 1 diabetes does not appear to result in impairments in mental ability (cognition) or behavior, according to results of a new study.

Among children with type 1 diabetes, also known as juvenile diabetes, those who develop the disease very early in life have shown signs of declines in mental abilities, Dr. Timothy W. Jones, from Princess Margaret Hospital, Perth, Australia, and colleagues report in the Journal of Pediatrics.

"Young children with type 1 diabetes are at greatest risk of severe hypoglycemic events, and this has focused concern on the potential for hypoglycemic insult to impact on central nervous system development," they note. There is some evidence that the region of the brain called the hippocampus is particularly sensitive to prolonged episodes of severe hypoglycemia.

To further investigate, the researchers compared 41 type 1 diabetic children and adolescents who had a history of hypoglycemia with seizure or coma to 43 similar diabetic subjects without a history of severe hypoglycemic events. A subgroup of patients who had early first seizure -- at younger than 6 years of age -- had more episodes of hypoglycemic seizure or coma compared with those who experienced a seizure at an older age.

The team conducted a comprehensive series of learning and memory tests, as well as intellectual and behavioral tests. The researchers observed no significant differences between the seizure and no-seizure groups on the intellectual, memory or behavioral measures.

The number of severe hypoglycemic events was also not significantly correlated with the memory, intellectual, and behavioral scores.

"No difference (was) found between the early first seizure subgroup and no-seizure group, even on those delayed recall tasks studied specifically given the concern about the potential impact of hypoglycemia on memory function," Jones and colleagues report.

They conclude that these results "provide some reassurance to those treating children with type 1 diabetes with intensive treatment that seizures/coma at a young age does not necessarily result in gross cognitive or behavioral impairment."

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