By Vicki Johnson, Photos by Beau Gustafson
Kira Fonteneau, Gestational Diabetes
For most women, the news of a pregnancy is one of the happiest times in their life and for nine months it is a chance to plan and look forward to the future. But for Kira Fonteneau, and between two and ten percent of the U.S. population, gestational diabetes strikes, and that fairytale changes.
Kira took a routine glucose tolerance test at her 24th week of pregnancy. This three-part test consists of drinking a sweet liquid drink containing glucose to test for high blood sugar. Samples are collected to test blood sugar and measure those levels. “I missed the first one and then I missed the second one by one point and then I came back into (normal) range for the last one. And if you fail any two then you have gestational diabetes,” Kira explains.
For some during pregnancy, the hormones that are secreted to support a baby creates a barrier to insulin being absorbed and can increase glucose levels. Even eating a normal diet can cause the child to receive more sugar than needed and the baby can grow too large, which poses a danger to both mother and child.
“To be honest, my first instinct was to cry. At the end of the day when you have a baby you want everything to go perfectly.”
For now, besides keeping close tabs on her blood sugar levels, she is focused on keeping the weight and size of the baby down to insure a natural full-term delivery. It is also important that the soon after birth, a child begins producing insulin independently from the mother. “The bigger risk is really to me as far as later on having a 60 percent chance of getting Type 2 if you’ve had gestational diabetes.”
Luckily, Kira can manage her diabetes without insulin. It’s a fine balance between exercise and eating the right low carbohydrate, low sugar foods rich in fiber and fat.
“I make sure my diet contains no more than 30 carbs at breakfast, and at lunch and dinner no more than 60 carbs. And then I can have two 30 carb snacks,” Kira explains.
“For those first few weeks it was like man, I have diabetes. You’ve got all the things that come along with pregnancy and then you can’t eat anything. And what do most people think, I’m pregnant I can eat extra, but not me,” she jokes. “But it’s probably better for me in the long run that it actually forces me to do what I was supposed to do in the first place.”
Fonteneau, a criminal and civil rights lawyer with a demanding litigation practice,
also finds time to support the American Diabetes Association and has been a volunteer and an advocate since 2007. “Since I had a family connection to diabetes, and the person I knew was a child when they got it, it was a no-brainer to do advocacy work in schools for kids. It just made sense,” Kira says. By helping schools and parents of diabetic children communicate and set up 504 plans, children with diabetes are provided with certain accommodations at school to insure their health and safety.
“I started doing that four years ago and haven’t stopped. It was just kind of funny that I would get diabetes afterwards,” she says. Now that she’s learned about her nephew’s Type 1 and is managing her own diabetes, it’s given her a new perspective and a better understanding for those dealing with the disease.
“Before I got pregnant it wasn’t one of those things that I thought would happen to me at all,” Kira says. She and her husband are expecting their first child, a girl, due June 6.
Dr. Nabil Ali, Type 2 Diabetes
As an anesthesiologist at UAB, Dr. Nabil Ali works full days with demanding hours. His job, high in both physical and mental stress and his constant attention to detail and expert knowledge leave him busy and exhausted. Unfortunately, he was too busy working to notice that he had developed Type 2 diabetes.
In the fall of 2009, after a check-up, Nabil was diagnosed with Type 2 diabetes. “I didn’t like it, naturally because I never thought I would have a problem,” he says.
“I didn’t have any symptoms and that’s really the scary thing about conditions like this is that it could creep up on you without you knowing. It’s very important that people get routine health checks and lab tests,” he explains.
The diagnosis was a wake up call for Nabil and he immediately increased his physical activity by speed walking and hill exercises. Already a healthy eater, he began taking daily oral medication to control his diabetes and lost 40 pounds in just under eight months.
“I was not overly overweight but I lacked enough exercise, mostly because of my work and I thought I didn’t have enough time. You can always make time for this, and in order to do regular exercise you really have to have motivation. When you do exercise you really want to like the exercise that you do,” Nabil says.
In the past, Nabil was very active in mountain climbing and even cycled competitively. By January of 2010, Nabil had upped his vigorous physical activity and renewed his passion for cycling. He now rides at least three to four times per week and logs about 5,000 miles per year. Nabil also participates in ADA’s Tour de Cure, a nationwide cycling event and has completed several centuries, which is usually a 100-mile cycling trip. Among one of his favorite paths to ride is the Chief Ladiga Trail, a 33-mile old railroad trail from the Alabama-Georgia state line to Anniston.
“It’s very important when someone has any kind of condition, it’s not only that treatment or the medicine that you are taking but also the active role in your own health, whatever it is,” he says.
For Nabil, all the hard work has paid off and six to eight months after his diagnosis, he was able to put his diabetes into remission. His levels have returned to normal and he’s even been able to cut down on his medications.
As for the increasing problem in Alabama, Nabil believes that health education is the place to start. Poverty, cultural influences and a sedentary way of life are all contributing factors causing an epidemic in the state. “Prevention is a lot easier than trying to cure a disease,” he says. “Weight control, regular exercise, and good eating habits are not impossible things.”
And the good news is that there are cutting edge research and treatment options being developed. Islet cell transplant allows people to receive a new pancreas, through a transplant of one person’s cells to another person, much like organ donation. It’s a risky, expensive and innovative procedure, but not one out of reach. Gene therapy, perhaps the biggest development, would eventually allow gene modification and manipulation to cure any disease, including diabetes.
“I think that’s the future of medicine in many ways if we can conquer that area. It’s not that far fetched, like many things that happened over the years in medicine. There is research ongoing, but that remains to be seen.”
Meredith Whitt, Type 1 Diabetes
Meredith Whitt is an outgoing, spunky, 7-year old, with a voracious appetite and outlook on life. She loves to read, play softball, do gymnastics, ballet, ride horses and be outdoors. You’d never know she was living with Type 1 (Juvenile) diabetes.
After a close friend’s 7-year-old daughter passed away from undiagnosed diabetes, Laurel Whitt wanted to find out more about the symptoms in case she found herself in the same situation. “It’s an epidemic now and people aren’t scared to talk about it and I am surely not. I feel like my duty is to spread the word about the symptoms. Them sharing their story may have saved my child’s life,” Laurel says.
Laurel became aware that her two and half year old, Meredith was urinating frequently and showed excessive thirst and after a trip to the doctor, her fears were confirmed. “I was in shock because I’ve just been told my child has this devastating disease and you really don’t know anything about it. I knew it was serious business so I took a leave of absence from work and we just gradually got our feet up under us and had a lot of support from JDRF,” Laurel says.
The diagnosis affected the entire Whitt family, as they threw away all of the food in the house and radically changed their eating habits. Now, the family eats and drinks only nutritional based, diet, sugar free, fat free and carb-reduced foods.
But still, Meredith doesn’t let diabetes get in her way. She’s endured over 16,000 finger pricks in her lifetime and had one diabetic seizure caused by low blood sugar. She used to give herself a minimum of five shots a day and now receives insulin through her fifth pump in five years, a Medtronic MiniMed insulin pump with a pink zebra cover. “I always have to put in my insulin; if I don’t something could probably go wrong,” Meredith explains. She now pumps insulin called Apidra into her body, which has to be replaced every two to three days. She also continues to check her blood sugar between eight and ten times a day with small finger pricks and a meter.
When Meredith was diagnosed with Type 1, the Whitt’s immediately got involved with the Alabama chapter of the Juvenile Research Diabetes Foundation (JDRF). The organization was founded in 1970 by Philadelphian, Lee Ducat, a mother of a Type 1 child. The group grew as Ducat paired with other families and it has now evolved into the largest charitable organization for Type 1 research with over $1.5 billion donated to date.
And the chapter has been a major source of support and information for the Whitt family. They now participate in the JDRF walk every year and their team, called “Meredith’s Monkeys”, has raised $30,000 in five years.
In June, Meredith will get the opportunity to represent the state of Alabama at the Children’s Congress in Washington D.C. Children’s Congress, which takes place in our capital every two years, allows children to meet face to face with major U.S. representatives and decision makers in government. Meredith, who was chosen out of 1400 applicants, is one of two delegates representing the state of Alabama this June. Among meeting congressman to discuss diabetes, she hopes to meet the President and sightsee.
“I want people to know how hard it is,” Meredith says. Educating people about diabetes and teaching other diabetics how to handle the disease is something that inspires her to keep going.
“I’ve always told Meredith, don’t ever be ashamed that you have diabetes,” Laurel says. “She just has such a good heart about it and she never complains.”
How Alabama Stacks Up:
-Alabama has the third highest diabetes rate with 434,800 known diabetics and 200,000 who may not be aware they have it
-According to the CDC, over 12 percent of people in Alabama have diabetes
-Alabama ranks among the top five states in the nation for the prevalence of diabetes
-Diabetes is the seventh leading cause of death in Alabama
-According to the CDC, Alabama is ranked third in the US for percentages of adults who have diabetes
-Diabetes is costing Alabama businesses more than $3 billion annually
Facts and Figures:
-Five to ten percent of the population has Type 1 diabetes
-As many as three million Americans may have Type 1 diabetes
-Each year, more than 15,000 children and 15,000 adults – approximately 80 people per day – are diagnosed with Type 1 diabetes in the U.S.
-Type 2 affects 90-95 percent of the population and is called the silent epidemic
-Type 2 diabetes can be prevented or delayed
-Gestational diabetes occurs only in pregnant women as Type 1 or Type 2 and accounts for between two and ten percent of pregnant women who get diabetes.
-Those women have a 35 to 60 percent chance of developing Type 2 diabetes within the next 10-20 years
-Gestational diabetes affects about four percent of all pregnant women – about 135,000 cases of gestational diabetes in the U.S. each year.
-17.2 percent of the U.S. diabetic population is 60 years of age or older. Those
65 years and older account for almost 50 percent of the population with diabetes.
-By 2050, CDC predicts that the number of people with diabetes could double or even triple.
-Over 25 million people in the US are living with diabetes
-The diabetes mortality rate is over 30 percent
-In the U.S. a new case of diabetes is diagnosed every 30 seconds; more than 1.9 million people are diagnosed every year
-In 2007, diabetes accounted for $174 billion in health care costs in the US
-By 2015, it is projected that 225 million people worldwide will have this disease.
What to Know and How to Prevent:
-Lose five to ten percent of your body weight and maintain it
-Be physically active (moderate to vigorous activity) for 30-60 minutes five days a week
-Maintain a healthy blood pressure
-Eat foods rich in fiber
-Symptoms of Diabetes: Frequent Urination, Unusual thirst, Extreme hunger/weakness, Unexplained weight loss, Extreme fatigue, Blurred vision, Itchy skin, Slow healing of cuts and bruises, Frequent infections of skin, gums, and bladder, Tingling and numbness in legs, feet and legs
****All statistics and information were gathered from the Alabama Department of Public Health (ADPH), American Diabetes Association (ADA), Juvenile Diabetes Research Foundation (JDRF) and the Center for Disease Control (CDC)