Wednesday 11 January 2012

An islet of Langerhans named Jeff

Explaining diabetes is never straightforward. Most people are lucky enough not to have to know what insulin, adrenaline, islets of langerhans or beta cells are, or what they all have to do with one another. But despite not needing to know, most people do show a general interest and I love to be the one to tell them. Any opportunity to put the record straight is a bonus, as far as I am concerned.

So when I was recently out having some coffee at a Krispy Kreme with my brother and neice, the arrival of the food at the table led to the inevitable retrieval of the pump from my pocket and my brother Ben, always keen to show her knew things, pointed out my insulin pump. Intrigued as most children are about new things she piped up, "What's that?".

Now normally anyone who looks that interested in my insulin pump is fair game as far as I am concerned. The problem is, I have never explained diabetes to a 4 and a half year old and explaining an insulin pump often baffles even those who understand diabetes and know the basics of the condition. So how do you manage it with someone who doesn't yet understand what insulin is, let alone the role it plays in the body.

As I thought about what to say and started stumbling over my words and starting over again and again, it dawned on me that perhaps she thought I didn't actually know what diabetes is! Clearly going down the route of "Once upon a time there was an islet of Langerhans named Jeff" wasn't going to go in the right direction and neither would in depth discussions about the pathophysiology of diabetes and lack of ability of the pancreas to produce and secrete insulin into the bloodstream, allowing for the transportation of glucose to the muscles for energy, was also going to confuse the hell out of her.

I looked at my brother in desperation. "How do I explain this?"

"With the truth" he encouraged me.

As I journeyed with her through some of the very basics about how 'when I eat food I can become ill unless I take a medicine called insulin', and explaining that 'my robot' (as Ben described it) helps me to stay well and have energy because it gives me my medicine, it was clear that I was losing her the further into the conversation we got, even if she tried her best to look as though it made sense.

But at least at the age of 4, she has heard the words diabetes for the first time. Hopefully in ten years time, she will be correcting her school friends when they spout 'facts' they have picked up in our media. Hopefully she will be the first generation of diabetic-free people who know what the hell it is all about.

So what is the message of this story and how do you tell a 4 year old about diabetes?

I still have no idea; I just love the idea that we did it in a Krispy Kreme.


  1. When my cousins were younger (and I was on MDI), I used to tell them my pancreas was broken and couldn't make insulin, so I had to inject it instead. It's such a ridiculously simple explanation but when they are that young, they probably can't grasp anything bigger than 'this is the problem, this is how I fix it'. Kind of thing. The details can be saved for a mad auntie science lesson later on ;)

  2. That's a great explanation. I thought of so many ways to explain it afterwards but the version that came out was just garbled and clumsy. In future I'm thinking finger puppets and a catchy Sound of Music-esque sing a long..... :)

  3. As a teacher with type 1 diabetes I frequently had to check my blood or drink juice, and I explained it to my students this way: Insulin is like a delivery truck that carries food to the grocery stores so that people can buy it. Insulin carries sugar to your cells and lets it into the cells to be used as energy. I have no insulin - no trucks! So I have to inject little trucks into my body 5 times per day to do the same job that your pancreas does. This is not perfect. Sometimes my trucks break down and don't work or deliver too many groceries and then arrive empty! I have to keep checking on the trucks by checking my blood and I have to drink juice to send more fuel to the trucks. Obviously the story broke down a bit, but they generally understood and were patient with my testing. Some kids watched me very closely and would ask me to test because "you are acting different". They were quite often right - enough that I always indulged them and thanked them afterwards.

  4. It's amazing how perceptive kids are. I remember spotting my Physics teacher was low when he started acting strange. Although I knew he was diabetic and I was a lot older at the time? Have you read Ginger Vieira's book on diabetes? She has a similar anaolgy with pizzas and delivery drivers taking them to their destination. Another great example

    Thanks for commenting