Living, growing, and learning to deal with diabetes

A father to father letter, both with children with diabetes:

To: Ray Allen
Boston Celtics
226 Causeway St
Dear Mr. Allen,

On the surface, you and I don't have much in common. You're a rich, famous basketball player who can get the best table at any restaurant in Boston. I'm just a writer in the 'burbs who has to wait in line at Bertucci's, which is never pretty.

But we actually have something very much in common. Your 17-month-old son, Walker, was just diagnosed with Type 1 diabetes, requiring insulin each day to live. My son, Garrett, was diagnosed at age 3. He is now 7, and during your playoff run, he wore his favorite Celtics shirt - No. 20 - so often that the numbers are scraping off.

There is never a good time to discover that your child has diabetes, but I can imagine that your circumstance - on the morning of an NBA championship game - was more difficult than most. It may have lacked the Bloody Sock's visual drama, but I hope your play in Games 5 and 6 receive their proper acclaim in Boston sports history.

Walker is now part of a sobering national trend. It used to be rare that a child his age developed diabetes. Now it's not. The government doesn't formally track these numbers, but any pediatric endocrinology clinic in America will confirm significant increases in diabetic children, particularly age 3 and younger. No one knows why.

I won't pretend to know everything about diabetes, because as you'll soon discover, you learn something new every day. But I can offer you a few tips.

As you know by now, the essential challenge of this disease is trying to maintain near-normal blood sugars by balancing insulin, diet, and exercise. That Walker is so young poses special challenges. He cannot clearly express his needs. His food consumption may change dramatically from day to day. His growing body will require continued recalibration of his insulin. Some days will seem, to you, as if he will never be under control.

It's enough to make anyone crazy, so my advice is this: Never panic, never get angry, and never give up. The problem is not your son. The problem is the diabetes, and adjustments can be made.

The fact is, Walker is quite lucky, at least compared to many other children with his condition. You will have the resources to get him quality care - the best doctors, medical supplies, and education - that money can buy, and Boston is blessed with some of the world's finest clinics for diabetic children.

Walker was also diagnosed at a time of unprecedented technological and pharmaceutical breakthroughs for improving treatment - including better insulins, insulin-delivering devices, blood-glucose meters, and continuous glucose monitors - and we have a much better understanding of the molecular underpinnings of the disease. The future for better care is bright.

Granted, that is little solace to a 17-month-old, who must get daily shots and finger pricks and who will never know what life was like before diabetes. But you would be surprised. Children have an easier time adjusting than diabetic adults, even though adult-onset diabetes (Type 2) typically does not require injections. Of course diabetic kids get frustrated, but they are resilient, high-spirited, and very brave.

The silver lining in the diabetic surge is that youngsters no longer have to feel isolated or alone. Diabetic playgroups are now plentiful, and I happen to know of diabetic children in your community. Walker should play with them or others. He can even play with Garrett. (We have a hoop.) When Walker gets older, he can go to a diabetic camp and experience a new world of friendships. You can tell Walker he's not alone, but he won't believe it until he sees it.

Your son will not have to curb his dreams, nor you yours. At some point, you can tell Walker that people with diabetes have climbed Mount Everest, won Olympic gold medals, and fought in wars. They've even played in the NBA. Your boy will do whatever he wants to, and if he's like his father, he'll do it well. The game just started, and the ball's in his hands.

James S. Hirsch
education > living with diabetes