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OPINION: S'more calculations for diabetes

The other morning, when our 10-year-old granddaughter joined me for a trip to the bank to deposit some checks, the teller surprised us with a campfire-style treat.

The bank was offering ready-to-cook s'mores — you know, a couple of graham crackers, a square of chocolate and a puffy marshmallow, all tucked neatly in a sandwich bag. Well, who doesn't jump at the chance to boost his bank balance and get a free s'more, one of America's favorite childhood treats? The granddaughter and I walked out of the bank with big smiles, thinking of our after-lunch dessert to come.

When we got home and showed our treasure to Grandma, she began calculating the grams of carbohydrates inside that simple sandwich bag. That's because our granddaughter has Type 1 diabetes, diagnosed when she was about 18 months old. Her pancreas doesn't produce insulin. The insulin her body needs but doesn't produce on its own is provided through injections, and she must be aware of how many grams of carbs go into her body every time she eats something.

Turns out, a typical s'more has quite a lot of carbs, many more than a person would routinely want to give a kid with diabetes as an after-meal treat. Grandma did the calculations and decided we could split the treat in half, which the granddaughter and I found acceptable. I don't need all that much dessert, not for specific medical reasons but just because the more I age, the less the weight I put on wants to go away.

When you subtract 18 months from 10 years, you find that this granddaughter — and her parents, sisters and grandparents — has been monitoring her blood and calculating intake of carbs and necessary doses of insulin for eight and one-half years, nearly nine now. Basically, she considers everything she intends to eat before it goes into her mouth. Where you or I might pass a dish of candy or chocolates and pluck up one or two without a moment's thought, this child always has had to ask if it would be OK to have a piece of candy. It isn't the end of the world, but it's a thing.

It brings to mind an instance when she was only 3 or 4 and a friend offered her some candy. The granddaughter replied heatedly, "Are you trying to kill me? I have diabetes." Over-reaction, perhaps, but it's a deadly serious condition. She and her family manage, but they always know it can be deadly.

The family has considerable experience with Type 1 diabetes. Two of the 10-year-old's big sisters have it, too. They manage, and to all outward appearances it's no big deal with either one. Here are a couple of glimpses into what it can be, though:

One sister is out of college, married and working a steady job in Sioux Falls. She's been living with diabetes for at least 22 of her years. She's gotten good at it, but as a teenager, she once was in a diabetic coma that put her in the hospital and had all of us fearing she might not come out. She did, but it's possible the episode caused long-term damage to some organs. She's aware of that as she goes about her days.

The other sister with diabetes just finished grad school and works in the area of diet and nutrition. She's conscientious about her diet and her disease. She missed nearly all of her senior cross-country season because, try as she might, she couldn't keep her blood readings in line enough to run. And, she has had surgery for diabetic retinopathy, which, most simply put, is a complication of diabetes that involves some bleeding in the eyes. It's scary, and a young woman starting a career and planning a wedding shouldn't have to worry about such things.

I know the world has many, many terrible diseases. Many of them probably are more difficult to handle and more immediately deadly than Type 1 diabetes. But this is the one my granddaughters live with, every day of their lives. If they make it look easy, believe me, it isn't. They've just gotten really good at it.

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