Don’t Let a Diagnosis of Type 1 Diabetes Catch You Off Guard
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- Written by Joanne Wallenstein
- Category: Health
The following was submitted by Dr. Debra Etelson, Pediatrics at White Plains Hospital
When my then-nine-year-old son suddenly discovered that he was diabetic, he certainly surprised himself – and his pediatrician mother as well!
We were in the car with one of my older son’s friends, along with my then-3-year-old, who had been diagnosed at 13 months with Type 1 (formerly known as juvenile diabetes) about four months earlier. My older son dutifully demonstrated to his friend how easy it was to check the baby’s blood sugar level, then did the same to himself. The American Diabetes Association (ADA) recommends anyone with a level of 240 or above seek medical attention; his was several hundred above that, so our outing became very serious very quickly.
I’m happy to report that both of my sons – now 17 and 22 – are doing fine. But being aware of how diabetes works, and of what to watch out for, is something every parent should know.
According to the ADA’s latest estimates, about 283,000 Americans under age 20 have been diagnosed with diabetes. That’s roughly 0.35% of that population. Type 1 diabetes occurs when a person’s pancreas produces little or no insulin, which the body uses to convert sugar into energy. Treatment involves using insulin and refining one’s diet and lifestyle to prevent complications; the disease requires continuous insulin, blood sugar monitoring, and carbohydrate counting throughout one’s lifetime.
(For the record, Type 2 diabetes occurs when the body produces insulin, but the cells don’t respond appropriately due to what is called insulin resistance. While there is no cure for either type, diet and other lifestyle changes can help a person reverse – but not eliminate – the disease.)
Type 1 is an autoimmune condition whose exact cause is still unknown, but leading theories attribute it to genetics, environmental factors, and viruses; the latter would certainly seem to be true given what we saw during the height of COVID-19. The incidence rate, or number of new cases, of Type 1 diabetes was rising by 3-4% per year before COVID, increased by 14% during the first year of the pandemic and was 27% higher than the pre-pandemic period in the second year.
Type 1 diabetes can be diagnosed in a child as an infant, roughly 6 months after birth; it usually appears after age 5, though some people don’t get it until they are in their late 30s. Note that, despite the potential genetic component, a mother who is diabetic does not necessarily give birth to a child with diabetes.
What to Watch For
Babies obviously cannot verbalize how they’re feeling, but parents can tell if there’s a chance of diabetes (or other possible healthcare concerns) by observing the following:
• Increased urination (resulting in unusually frequent diaper changes for babies)
• A seemingly insatiable thirst/hunger
• Reports of blurred vision
• Unexplained weight loss
• Lethargy in a previously active child
Lethargy was what brought us in with our youngest child – whose level was at a frightening 900 – and, along with mood swings, had led us to suspect our older child might have developed it as well. Keep in mind that it may take months, if not years, for the above symptoms to manifest themselves, but a blood test during a child’s routine physical can indicate elevated blood sugar levels, both for Type 1 and Type 2.
If a child is diagnosed with diabetes, the rest of the immediate family is typically tested as well. While genetics are believed to play a part in contracting the disease, one family member having it does not mean they all (or any of them) will as well.
When at school or otherwise outside of the house, kids five and up with diabetes can usually self-administer insulin with an insulin pump, which involves installing a soft catheter in the upper arm, belly, hip, buttock, or thigh. Thin tubing connects the catheter to the pump, which can be worn in a pocket, on a belt, or in a pouch.
School nurses are an amazing resource, and they can administer insulin to a child if necessary or preferred.
A diabetes diagnosis can be scary for child and parent alike. But by being aware of warning signs, and of the treatments and support that are available, a happy and healthy life can be possible.
Dr. Debra Etelson is a board-certified pediatrician at White Plains Hospital Physician Associates in Somers. To make an appointment, call 914-849-7075.
Health Matters
The original version of this article was published in Health Matters, a White Plains Hospital publication.
SVAC to Offer Vaccines on 11-24 ... Sign Up Today
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- Written by Joanne Wallenstein
- Category: Health
Based on requests received during the last two Covid clinics, Scarsdale Volunteer Ambulance Corps will hold one last Flu and Covid Vaccine Clinic for ages 5 and above on Friday, November 24th from 10:00am to 2:00pm. Parents requested another clinic for their college students home for Thanksgiving. Interested parties MUST sign up in advance at svacvaccines.timetap.com. No walk-ins will be permitted.
SVAC will be accepting insurance payments for the vaccine for Scarsdale residents. This will be the last vaccine clinic. Since we have to order the vaccines, the cut-off for signing up for the clinic is Monday, November 20th at 9:00am.
At the Board of Trustees meeting on Tuesday November 14, David Raizen, President of SVAC reported that SVAC has vaccinated 500 people in the last two weeks. They are billing the insurance companies for the vaccines. Unfortunately 43 people who had appointments did not show up. Another 200 people were vaccinated at home.
SVAC needs to raise $200,000 to stay afloat in the coming year. They recently mailed out 6,700 appeals for funds and to date have received 370 donations totaling $100,000. Two of these were for more than $10,000. However, they need to raise another $100,000 and ask you to give generously for this essential community service.
Heads Up! Recognizing and Dealing with Sports-Related Concussions
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- Written by Joanne Wallenstein
- Category: Health
The following was written by Dr. Steven Andelman, Sports Medicine and Orthopedic Surgery
The arrival of football season – professional, amateur, and school-based – unfortunately brings with it a rise in concussion and suspected concussion cases. But it’s not just on the gridiron that such injuries can occur: any contact sport, including hockey, soccer and lacrosse (and even baseball, wrestling and basketball), understandably sees higher incidences of concussions than non-contact sports.
The Centers for Disease Control and Prevention (CDC) defines a concussion as “a type of traumatic brain injury – or TBI – caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.”
The statistics are sobering. According to the CDC:
• 1.6-3.8 million sports- and recreation -related concussions occur each year in the U.S.
• 10% of all contact sport athletes sustain concussions yearly
• Brain injuries cause more deaths than any other sports injury. In football, brain injuries account for 65% to 95% of all fatalities. Football injuries associated with the brain occur at the rate of one in every 5.5 games. In any given season, 10% of all college players and 20% of all high school players sustain brain injuries
• 87% of professional boxers have sustained a brain injury
• 5% of soccer players sustain brain injuries as a result of their sport
Concussions can occur at any age; various studies estimate that as many as 1.9 million sports- and recreation-related concussions occur 
every year among kids 18 and younger. In 2021, a Journal of the American Medical Association (JAMA) report estimated that girls’ chances of sustaining a concussion is 1.88 times higher than boys, with one reason being that the circumference of a female’s neck is generally about 30% smaller than a male’s.
Symptoms of a concussion can vary widely, from a nagging headache, dizziness, and difficulty maintaining balance to nausea and vomiting, convulsions and, if not properly treated, even death.
Fortunately, concussions today are taken much more seriously than in the past; even as little as 10 years ago, it was not uncommon to hear that an athlete had “had his bell rung” when he appeared dazed – or was even unconscious – after an on-field collision. That perception was more or less eliminated during the 2010s, when the NFL instituted concussion protocols, wherein a player suspected of possibly suffering a concussion is immediately removed from the game and examined by a medical professional. If a concussion is confirmed, the player must undergo a five-step process before being allowed to return to the field.
Most sports played at high schools or in extracurricular leagues have their own concussion protocols in place. In the case of younger children, who may play in a park-and-recreation soccer league, for instance, there may not be a medical professional on hand. In such cases, the child should be removed from the game and, if symptoms persist, they should be taken to a healthcare facility. If the child has lost consciousness, it is imperative to get them to an emergency room immediately.
It should be noted that losing consciousness is not the only symptom of a concussion; over 90% of those who sustain one do not lose consciousness. Similarly, you do not necessarily have to take a blow to the head; any sudden jerking of the head, such as what happens in a whiplash injury, can also be a cause.
Preventing concussions can be complicated. Helmets in contact sports are usually mandatory, but while they can offer some protection, a severe hit can still result in a concussion. After mandating the use of “Guardian Caps," a soft-shell, padded covering that goes on the outside of regular football helmets, during its training camps last year, the NFL reported 52% fewer concussions. According to the NFL, wearing a Guardian Cap can result in at least a 10% reduction in severity of impact if one player is wearing it, and at least a 20% reduction in impact if two players in a collision are wearing it.
However, the NFL season is continuing without the cap and, as mentioned, the threat of a concussion remains even when wearing such equipment.
An untreated concussion can have significant effects, sometimes lifelong and even life-threatening. If you suspect that you or a family member has suffered one, I urge you to see a medical professional as soon as you can. As always, safety is the key.
Dr. Steven Andelman is an orthopedic surgeon at White Plains Hospital Physician Associates who specializes in adult and pediatric sports medicine. For an appointment, call 914-849-7897.
Health Matters: The original version of this article was published in Health Matters, a White Plains Hospital publication.
Sign Up Today for the SVAC Vaccine Clinic on 11-11
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- Written by Joanne Wallenstein
- Category: Health
After a great turn out on Saturday November 4, the Scarsdale Volunteer Ambulance Corps will have another Flu and Covid Vaccine Clinic for ages 5 and above on Saturday, November 11th from 10:00am to 2:00pm. Interested parties MUST sign up in advance at svacvaccines.timetap.com. No walk-ins will be permitted.
SVAC will be accepting insurance payments for the vaccines. The cut-off for signing up for the clinic is Wednesday November 8th at 8am since they need to order the vaccines Wednesday morning.
Since SVAC has to pay for the vaccine in advance, please only sign up if you are sure you can come for your vaccination.
SVAC Offers COVID and Flu Vaccines to Homebound Residents
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- Written by Joanne Wallenstein
- Category: Health
Under its Community Paramedicine program, Scarsdale Volunteer Ambulance Corps is offering COVID and flu vaccines to homebound residents effective immediately. Since New York State is no longer providing the vaccine for free, Scarsdale VAC will bill the vaccine recipients’ insurance company. Those interested in receiving homebound vaccinations should write to covid@scarsdalevac.com.
Scarsdale VAC is considering a Saturday COVID and flu vaccine clinic at the ambulance corps building for anyone three years and older. If you are interested, please email us at covid@scarsdalevac.com. If there is enough interest, a Saturday clinic will be scheduled.
