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An Award-Winning Effort to Manage Diabetes

December 5, 2017

A pair of patients at the SIU Endocrinology Clinic celebrated major milestones in November. Springfield resident Matthew Derber, 31, has been living with Type 1 diabetes for 25 years. Julia Lopez, 38, of Chatham, has been monitoring and self-medicating for 28 years. Matt was diagnosed at age 6 and Julia at age 10.

Type 1 diabetes can occur at any age but is most commonly diagnosed from infancy to the late 30s. Children with the illness face a lifelong struggle to maintain their health against chemical imbalances within their own bodies.

In a person with type 1 diabetes, the pancreas produces little to no insulin, and the body’s immune system destroys the insulin-producing cells in the pancreas. Glucose that cells typically use for fuel instead builds up in the blood, and cells are starved. This causes high blood sugar, which can lead to dehydration, weight loss, diabetic ketoacidosis (DKA) and damage to the body.

People diagnosed with type 1 diabetes must inject insulin several times every day or continually infuse insulin through a pump, as well as manage their diet and exercise habits.

Both Matt and Julia can appreciate how the technology has been refined and improved in a quarter century. Each now wears a Medtronic 670G pump, which has the ability to turn insulin delivery on and off automatically, as needed for the patient. It gives them more flexibility and more confidence in the stability of blood sugars for feeling well and avoiding hypoglycemia, a primary goal for people with diabetes.

Dr. Michael Jakoby, chief of the Division of Endocrinology, presented the Lilly Journey Medal to the pair on November 16 to commemorate their long-term use of insulin to manage the illness. “It’s an opportunity to congratulate them for how much work they’ve done to stay healthy,” he says. “We’re glad to be a part of it.”

A diabetes diagnosis requires a high level of daily problem solving and personal engagement with health outcomes. This can be especially stressful on children and most especially during adolescence.

Julia remembers her father, a St. Louis surgeon, was initially distraught. “But my parents were really awesome in supporting me and helping me manage the shots,” she says. She practiced giving injections to a teddy bear as a child.

Both high school athletes, Julia and Matt said swimming and football practices required extra vigilance to sustain energy and avoid “crashes.” “Your symptoms are subtle variations of what you would feel normally,” says Matt. “You might feel tired or dizzy, which could be from all the exercise you’re doing, or it could be the diabetes.”

In their teens and twenties, the older systems for monitoring blood sugar required more micro-management and preplanning around meals.

Those days are gone. With the new monitors, Julia says there is more flexibility around mealtimes and less stress at night. “Now I tell my diabetes pump when I want to eat and what I want to eat. I’m careful to limit my carbs and sugar intake, but I have a lot more freedom.”

Matt eats very little meat, walks about 5 miles every day and ran a half marathon this summer. “And I couldn't believe how stable I was after the race because exercise increases insulin sensitivity,” he says. “If I did that on my old regimen, I would have had low blood sugars constantly for the rest of the day.” He gives credit to the new system and the team of SIU endocrinologists and educators who have helped him over the years.

For help with management of diabetes and other metabolic disorders, contact the Division of Endocrinology at SIU School of Medicine, 217-545-8000. SIU’s Diabetes Center is accredited through the American Diabetes Association and provides education, research and clinical care for patients suffering from diabetes.


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Photo cutline: Dr. Michael Jakoby, chief of the Division of Endocrinology, presented the Lilly Journey Medal to Julia Lopez of Chatham and Matthew Derber of Springfield, on November 16.