Adam Noble of Berryville, Ark., doesn’t have much time for diabetes. The lanky 14-year-old who wears a size 15 shoe is a quarterback for Berryville High School. He is also on the basketball team and plays the trombone in the school band, in addition to playing the electric guitar and the piano for fun.

Diagnosed with type 1 diabetes a little over a year ago, Adam is insistent that the disease doesn’t stop him from doing the things he wants to do.

“I don’t let it get in the way of anything,” he says. “Especially now that I have my insulin pump – I don’t even think about it anymore. My coaches and my friends are all very supportive.”

Adam visits St. John’s Pediatric Diabetes Program in Springfield every three months to manage his diabetes. The program’s comprehensive medical team includes visiting pediatric endocrinologist Bert Bachrach, M.D., from the University of Missouri-Columbia Children’s Hospital; St. John’s pediatrician and medical director Don Sponenberg, M.D., and other St. John’s pediatricians; nurse practitioner Taryn Vaeth, RN, MSN, CPNP; certified diabetes educators; registered nurses and registered dietitians.

Before the program began in May, Ozarks pediatric diabetes patients had to travel to Columbia for treatment and education.

“Patients can access our services directly by calling 417-841-0228 or through St. John’s Children’s Specialty Clinic. We are housed at St. John’s Clinic-Smith Glynn Callaway because that’s where St. John’s diabetes educators are,” Vaeth says.

St. John’s diabetes educators are available 24 hours a day, seven days a week, including holidays.

NEWLY DIAGNOSED

Newly diagnosed pediatric diabetes patients are enrolled in the program automatically after their hospital stay, which is usually three to four days.

When Adam was diagnosed, he spent three days at St. John’s Hospital-Berryville, where his mom Kristy serves as president. His grandfather was also a patient at the time and the two roomed next door to each other, Adam says.

“I really didn’t even know what diabetes was and I didn’t know anyone who had it,” Adam says. “But I started coming to the clinic and learned about it.”

Before Adam began using the pump, which delivers a steady stream of insulin to his pancreas through a small catheter in his hip, he had to inject insulin four times a day to keep his blood sugars under control. He spent a few days at the University of Missouri-Columbia’s Children’s Hospital to learn how to administer his insulin pump over the summer.

“I still check my blood sugars about five times a day, but that’s no big deal,” he says. “I eat sugar-free desserts and foods made with Splenda. Real sugary stuff like candy doesn’t taste too good to me anymore.”

Adam removes the pump during games and practices to prevent injury and damage to the pump. His coaches and friend Eric Holman keep an eye on him and can tell by changes in his behavior if he needs an insulin shot. He keeps his insulin syringes handy for when that happens.

“Eric knows how to give me my shots and he’s given me quite a few. I think he enjoys it,” Adam says with a grin. “My sister Hannah, who’s 10, also knows how to give them to me if I need her to.”
Adam’s mom Kristy is grateful that they have to travel no farther north than Springfield for Adam’s appointments with Dr. Bachrach.

“I am extremely thankful for the early diagnosis by Adam’s family physician, Dr. Charles Horton, and for his prompt referral to Dr. Bachrach and his team of trained pediatric educators. Working together, Adam now has the confidence to lead a normal lifestyle,” she says.

TYPE 1 & TYPE 2 DIABETES: WHAT'S THE DIFFERENCE?

Type 1 diabetes is the result of the body’s failure to produce insulin, the hormone that allows glucose to enter the cells of the body to provide fuel. This is the result of an autoimmune process in which the body’s immune system attacks and destroys the insulin-producing cells of the pancreas.

People with type 1 diabetes are referred to as “insulin-dependent diabetics” and must take daily insulin injections and regularly monitor their blood sugar levels. Type 1 diabetes is one of the most common chronic diseases in children, according to the American Diabetes Association. It is estimated that one in every 600 children in the U.S. develops type 1 diabetes. Type 1 diabetes accounts for 5 to 10 percent of all diagnosed cases of diabetes in the U.S.

Type 2 diabetes is a metabolic disorder resulting from the body’s inability to produce enough, or to properly use, insulin. It has previously been called non-insulin-dependent diabetes mellitus (NIDDM). Without enough insulin, the body cannot move blood sugar into the cells. It is a chronic disease with no known cure.

Type 2 diabetes is the most common type of diabetes, accounting for 90 to 95 percent of diabetes cases. There is an increase in the number of cases of type 2 diabetes in children and adolescents. The rise may be due to obesity and decreased physical activity among children. The risk for type 2 diabetes increases with age.

“The majority of the 280 children and young adults in St. John’s Pediatric Diabetes Program have type 1 diabetes, which is a much more serious and dangerous disease than type 2 diabetes,” Vaeth says. Type 2 diabetes can often be managed with oral medication, nutrition management and exercise, while all type 1 diabetics must inject insulin or use an insulin pump.”