“Ian is a pretty good athlete,” says Ken Campbell, the head boys track coach at Northwest High School in Jefferson County, Mo. “I talked to Ian about his diabetes before the season started and he told me there probably wasn’t anything I would need to do. I tried to keep an eye on things and watch for warning signs, but there weren’t any.”
Ian Konecnik is a student at Northwest. He was diagnosed several years ago but that has not slowed his energetic pace of life. The Diabetes Center at SSM Health Cardinal Glennon Children’s Hospital taught Ian and his family a strict protocol for controlling his disease and he has run with it – literally. “I do the hurdles, the long jump, the triple jump and some of the relays,” Ian said. “Diabetes doesn’t affect me much. Every once in a while I have to eat something. That’s about it.” The diabetes doctors, nurses and nutritionists at SSM Health Cardinal Glennon not only counsel patients to remain active – they encourage it.
The standard of care today is very intensive. It is a lot of work,” says Mark Eddy, M.D., Ian’s endocrinologist at SSM Health Cardinal Glennon. “The upside is, it provides really good glycemic control. Participating in some physical activity today is important. Patients who play sports consistently seem to be motivated to take care of their diabetes and have a certain amount of structure built into their lives.”
There are two types of diabetes that prevent the body from regulating levels of blood glucose (or sugar). Children and teens tend to be affected by Type 1, an autoimmune disease that causes the pancreas to stop producing insulin, a hormone that enables the body to convert food to energy. Type 1 patients must closely measure food consumption – measured in carbohydrate counts — and match it with multiple daily injections of insulin. Many patients, including Ian, wear an insulin pump that continually infuses insulin.
Nearly 26 million Americans have diabetes, according to the Juvenile Diabetes Research Foundation (JDRF), and about 3 million may have Type 1.
“The incidence of diabetes in the general population is about 1 percent,” Eddy says. “The youngest patient I have seen was six weeks old. Most people diagnosed as Type 1 are picked up from 6 to 16 years of age. Some individuals are diagnosed into their late 20s or early 30s.”
Type 2 diabetes is a metabolic disorder that prevents the body from effectively using its insulin. It usually is diagnosed in adults but, JDRF points out, “increased obesity has led to a recent rise in cases of Type 2 diabetes in children and young adults.”
If patients strictly adhere to their treatment plan, “they don’t let it stand in the way of achieving their goals,” the Foundation per SSM Health Care style guide says. If not properly treated, diabetes can lead to complications including kidney failure, blindness, nerve damage, heart attacks and strokes. “Years ago it was well demonstrated that there are means of achieving good overall control of diabetes,” Eddy says. “There is hope that this good control will delay the onset of complications.”
During the summer of 2010, Ian seemed to have a very bad intestinal ailment, says his father, Alan. At 2 a.m. his parents took him to the pediatric emergency department operated by SSM Health Cardinal Glennon at St. Anthony’s Medical Center in south St. Louis County. “We thought he had the flu,” Alan said. “As I was carrying him into the emergency room, the doctor saw him and said he knew what the problem was. After about an hour and a half they got him stabilized and put him in an ambulance to take him to Cardinal Glennon.”
The Konecniks spent five days at SSM Health Cardinal Glennon and received a crash course in diabetes management. They were amazed at the flexibility Ian was given to regulate his diet and insulin. “They went over things backwards and forwards. They taught him to read labels and really think,” says his mother, Christina.
“They make it as painless as it can be,” agrees Alan. “It helps that Ian is pretty good at math. The Cardinal Glennon view is, ‘Keep track of your carbs. Dose for it. Go for it.'”
“I look at the labels for the carb counts. In the insulin pump there are ratios of so-many units per carb, so you take your blood sugar, put in that and the carb count and you get the dose for the meal,” Ian says.
“Ian is a responsible, intelligent young man who is pretty self-sufficient,” Coach Campbell says. “For the most part, he is just a normal athlete.” Northwest is a large school with up to 2,500 students, so athletes with medical issues are not rare, he says. “Kids having to take inhalers for asthma is normal. Northwest is tremendous when it comes to kids who have a disability or illness. They go out of their way to make sure everybody has a chance to participate.”
Ian went through three stages of awareness after his diagnosis. “At first I didn’t know what diabetes was. I thought they would do something to treat it and I would go on normally,” he says. “When I found out I would be taking shots forever, I thought it would affect my participating in sports. Once I got everything under control, it was second nature and I knew I could do what I wanted.”
The Konecniks are “a good example of a patient and family working well together to do an excellent job of taking care of diabetes,” Eddy says. Young people who do not control their diabetes can remain active but they raise their risks of complications later in life, he says. “The early complications are usually without symptoms. As those progress, there can be damage to vision. Diabetes is the leading cause of kidney failure in the U.S. As folks get into their 40s, 50s and 60s, the equation becomes more complicated.”
Matt Lunneen, PNP-BC, CDE, is Ian’s pediatric nurse practitioner and certified diabetes educator in the Diabetes Center. “When I was diagnosed with diabetes I was 20 years old. I was a fairly high-performing tennis player on my team at Truman State University,” he says. “We teach families that diabetes is not a disease that should limit you. You do have to be careful. Diabetes is very manageable if you are prepared to troubleshoot some very dangerous situations that can occur, and we invest an incredible amount of time in educating our families in how to approach these situations. You must know how and when to treat hypoglycemia, manage hyperglycemia, balance carbohydrate intake before and after exercise and adjust insulin doses accordingly before and after exercise,” he says.
“And the tricky part is that no two people with diabetes are the same. You must learn your body better than anyone else ever could. And that takes meticulous record-keeping and exceptional maturity, especially in a teenager.”