A Jeanne Site
California State University, Dominguez Hills
University of Wisconsin, Parkside
Latest update: December 23, 1998
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Staying in School with Diabetes
An Interview With Cookie, a Student Who Is a Diabetic
Cookie discovered she had diabetes Type 2 in 1983, and since that time her diabetes has become progressively worse. Many people ask Cookie, "What is diabetes?" The disease is so pervasive she couldn't ever answer in one sentence.
To understand what it's like to come to school with diabetes, we offer a brief explanation for how diabetes operates in our system. Food is turned into glucose or sugar for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either does not make enough insulin or cannot use its own insulin as well as it should. This causes sugars to build up in your blood.
For Cookie diabetes has caused serious health complications which includes heart disease, kidney failure, lower-extremity swelling, and some blindness. In fact, diabetes is the seventh leading cause of death in the United States, which is a pretty scary fact to have bouncing around in your mind when you're trying to focus on academics.
Urine is made in the kidneys and contains waste from the food and liquids we eat. Our kidneys act as a filter by "keeping in" all essential material and filtering out toxic and other waste products. If high blood pressure damages the filter then it will start to leak some good material into the urine. With current technology you can determine if this kind of damage may have occurred by using a screening urine test for microalbumin. Microalbumin means micro = small or little; albumin = a type of protein; uria = in the urine. Treatment is necessary to control the diabetes.
American Diabetes Association
Information on Type 2 Diabetes
Cookie encountered retinopathy (damage to the small vessels in the eye), neuropathy (damage to the small vessels around the nervous system), and coronary artery disease (damage to the large blood vessels around the heart). Microalbuminuria does not cause these problems, but can identify those people with an increased risk for their development.
The treatment for microalbuminuria is a diet that will lower Cookie's protein intake, low sugar, low cholesterol, and low sodium. Her doctors believe that she should cut down on meat to no more than two to three ounces (the size of a deck of cards) per meal two to three times a day. Cookie's health providers think excess dietary protein can further damage her kidneys. This restriction translates to no more than about eight ounces for an adult man and six ounces for an adult woman per day.
The blood pressure should also be reevaluated. Good blood pressure control is essential to prevent further kidney deterioration. A blood pressure measurement less than 130/85 is considered good for diabetics. Cookie takes medication to lower her blood pressure.
Good blood sugar control is very important. A hemoglobin A1c test shows how well blood sugar has been controlled over a period of time. A value lower than 8 percent is strongly suggested to slow further blood sugar damage to the kidney. Because Cookie has kidney damage and microalbuminuria, she needs to improve her blood sugar management routine and schedule.
Cookie is aware of her medication intake in terms of care not to ingest medications like oral sulfonylurea, oral hypoglycemic such as glyburide, tolazamide, or chlorpropamide without being taken with meals; glipizide, and in some case they should be taken 30 minutes before meals. Cookie‘s skin has become very dry because of the diabetes. She feels as though the disease controls her life and she no longer has a life of her own.
Cookie's daily routine to manage her diabetes is constantly interrupted by her class schedule and her class schedule is interrupted by her diabetes. To help her feel better and to control her disease she must do daily exercise of leg lefts, take her prescribed medications and eat at the proper times. However, her routine is not always possible on days she has to attend classes. The exercise helps increase her circulation, and reduce blood sugar levels. One year ago Cookie could not walk because of the swelling in her legs and feet. In addition to swollen legs and feet her back injury also affect her mobility.
Cookie attends CSUDH and the long hours of sitting in the classrooms causes her stress and that stress causes her blood pressure and blood sugar to rise. She also suffers from impaired memory that is characterize by the diabetes. Nor can she take her medicine and rest while attending classes..
Cookie feels that without her friends and teachers she could not have continued her education. Because of her illness she required continued assistance to get her class assignments completed and delivered in an timely manner. A good study partner is essential to any student's success in the university but it is especially essential when an student like Cookie is handicapped and needs assistance. A friend walks Cookie through assignments and what the professors expect of her; she transcribes Cookie's documents and e-mails them, she studies for examinations with Cookie and sometimes pick up assignments. Friends also offer psychological support to Cookie when her disease seems as though it will take her over.
"What can I say about the professors who have also been there for me when I had to be admitted to the hospital on more than one occasion. The department's new program for distance learning has afforded me the opportunity to continue my education where in any other case I could not do so.This Spring 1999 will be my final year to complete classes toward my BA Degree. I can tell any student who is handicapped that he or she can succeed in obtaining his or her education."