Preschoolers are world-famous for frequent and urgent bathroom trips. So in 2003, Bridget Gutzmer was only mildly concerned when her daughter Logan, then three years old, was making several bathroom trips each night.
When a visit to the doctor ruled out a urinary tract infection, there didn’t seem to be anything to worry about.
She was also starting to get tired,” says Bridget, who lives in the West End with her husband, Tom, and two daughters. “But we attributed that to her waking up three or four times a night.”
But when the four of them piled into the car to visit family in Rochester, N.Y., Bridget found the frequent bathroom stops more worrisome.
We were stopping constantly,” she says. “She was putting out a lot of urine, but she was hardly drinking anything.”
Worried about dehydration, Bridget called Logan’s pediatrician from the road. She received troubling advice: “When you get to Rochester, take her to the ER.”
So, after leaving Logan’s big sister, Lauren, in the care of family members, the Gutzmers got shocking news in a hospital 500 miles from home.
Logan was diagnosed with diabetes.
Type 1 diabetes, once known as juvenile diabetes because of its typically early onset, is a chronic illness in which the body no longer produces insulin. Without this important hormone, the body cannot properly convert food into healthy energy. The resulting excess of sugar in the blood leads to fatigue and excessive urination, two of the most common initial symptoms.
Type 2 diabetes, in which insulin is still produced but not processed efficiently, is more commonly found in adults.
Both of these conditions, if not treated, can cause high blood sugars,” says Alyssa Wehrmeister, a registered dietitian and certified diabetes educator with Children’s Hospital of Richmond. “That can put a patient at risk for complications, such as damage to the heart, kidneys, eyes and nerves.
Fortunately, the care of diabetes has come a long way. Years ago, a child with type 1 diabetes faced multiple daily insulin shots, as well as a complicated set of steps to test blood sugar throughout the day. Now, insulin pumps deliver a controlled dose of insulin throughout the day, keeping blood sugar on a more even keel, and glucose meters have become much more user-friendly.
Diet also plays a significant role.
After diagnosis, the children and their families need to learn how to read labels and measure foods in order to accurately count the carbohydrate content of the foods they eat,” says Wehrmeister. “We counsel these patients on healthy nutrition behaviors, well-balanced meals, and not going overboard on carbohydrate intake.”
Even with improvements in its day-to-day management, diabetes requires the understanding and cooperation of everyone in a child’s life.
“They need to be surrounded by love and support to cope with this challenge,” says Wehrmeister. “Diabetes does not change who the patient is, but they must adapt to the new routine and the daily responsibilities. They have to routinely check blood sugars throughout the day, take insulin shots a few times a day, and count their carbohydrates at all meals And snacks. This is a lot of responsibility for a child.”
Wehrmeister says that calls for everyone around the child to understand the disease. In her work, she provides training to school nurses and parents alike, so that they can recognize and respond to complications in a child with diabetes.
There are 24 million people in the U. S. who have diabetes,” says Rhodes Ritenour, a Richmond attorney who was diagnosed in 1983 at the age of 5. “But you really have to quadruple that number to see the full impact of diabetes on families.”
Ritenour says his parents didn’t know much about the disease until his diagnosis. But they quickly learned as much as they could in order to help their son.
“My parents, our extended family, our church family, all of them helped me deal with it,” he says. “My parents made sure I understood everything the doctors told us, made sure we had the right foods in the house, made sure I saw all the specialists I needed to.”
In college, Ritenour had the opportunity to pay that comfort forward. When his pediatric endocrinologist had a newly diagnosed child in the office, he would call Ritenour to come and speak with the family.
“I think it was helpful for parents who were as surprised as mine had been to see what diabetes looks like in 10, 15 years,” he says. “I could tell them how important it was to take care of things, but also that my life wasn’t really limited.”
In law school, Ritenour became interested in legal advocacy for diabetes patients, who may encounter discrimination in the workplace. He serves on the Richmond Leadership Board of the American Diabetes Association, working to raise funds for a cure and to advocate for quality of life measures for diabetes patients.
“It breaks my heart to hear of a child being diagnosed, because I know what that’s like,” he says. “The difference was that I had health insurance, access to great doctors, a family, church and a small town where I was looked after. What about kids who don’t have those best circumstances?”
Ritenour and his wife of two years, Alana, have started a support group for area families dealing with diabetes. The group includes children and adults with type 1 and type 2 diabetes, and their siblings, parents, spouses or children.
“It’s important to have a family that is engaged and interested in your care,” says Ritenour. “As a child, you have to have parents who encourage you. As an adult, I’m happy to have a spouse who is proactive. She pushes and encourages me to manage it.”
Being proactive and encouraging has helped the Gutzmers as well. Seven years after her diagnosis in a Rochester ER, Logan Gutzmer is a thriving 10-yearold. She wears an insulin pump, and while she’s found it to be an awkward accessory with dresses, it doesn’t slow her down as a competitive gymnast.
She’s a responsible child,” says her mom, Bridget. “She’s pretty independent in managing her pump, and she’s not embarrassed about it. It’s part of her.”
Bridget says the family has come a long way since the diagnosis, and she has advice for other parents dealing with the news.
“Every day gets a little easier,” she says. “You adjust to your new normal, and things are really okay.”