In the 13 years since being diagnosed with diabetes at age 2, 15-year-old Anna has endured approximately 13,688 insulin shots and 17,364 finger pricks. With all those needle sticks comes a maturity well beyond Anna's age. Living with diabetes is a constant concern for Anna and her family, but thanks to UNC's Division of Pediatric Endocrinology, it's just a part of everyday life they can -- and do -- manage. This is Anna's story.

Dealing with Diabetes

Anna was diagnosed with type 1 diabetes when she was just 25 months old and has been under the care of UNC pediatric endocrinologist, Dr. Ali Calikoglu, ever since.Though Anna is only 15 years old, her parents, Julie and Richard describe the stubborn but good-natured teen as very mature for her age.

“When every day you have to worry about your life, I think you grow up faster than everybody else,” explains Julie of her wise-beyond-her-years daughter.

The Raleigh, N.C. family’s worries began 13 years ago. Two-year-old Anna was recovering from a cold when she began exhibiting signs of extreme thirst. The toddler couldn’t seem to get enough water. She soaked diaper after diaper during the day, and her urine volume was so great during the night that her diaper would burst. Then there was the lethargy.

Looking back, Anna’s parents know these as classic early symptoms of diabetes, but at the time, they simply attributed them to their daughter feeling under the weather. Still, they made an appointment to see Anna’s pediatrician.

Based on Anna’s symptoms, the pediatrician did some blood work and found Anna’s blood sugar was, as she suspected, extremely high. She immediately sent the family to the emergency department at UNC but not before providing a diagnosis: Anna had type 1 diabetes.

While the cause of type 1 diabetes is not known, researchers have determined it is most often a result of the body's own immune system mistakenly attacking and destroying the insulin-producing cells in the pancreas. Without enough insulin to regulate the amount of glucose in the blood stream, Anna’s blood sugar had built up to life-threatening levels.

Anna was admitted inpatient. She spent her first night at UNC in intensive care on an intravenous insulin drip, followed by three days in pediatric ward. When she was finally discharged, Anna and her parents returned home a changed family.

“We had to watch everything she ate, and she had to eat at very certain times,” recalls Julie of Anna’s medical routine in the five or so years following her diagnosis. “It was a very strict routine. We were checking her sugars four times a day and giving two shots of insulin a day. I was afraid to go to sleep.”

When Anna turned 7 or 8, the family transitioned to counting carbohydrates. Anna received a shot of insulin at every meal, the dose dependent upon what she ate. It was a marked improvement in lifestyle, remembers Julie, despite the additional shots and finger pricks each day.

And it is a routine that continues, even today, except now Anna can check her own blood sugar and administer her own insulin shots, often six or more a day.

“I can't just stop and eat whenever I want to,” explains Anna. “I have stop, check my blood sugar, think about how many carbohydrates are in whatever I'm going to eat and then take Anna has been an animal lover for as long as her family can remember. She volunteers at the Wake County SPCA and hopes to one day become a veterinarian.the insulin to cover the carbs. I also have to make sure I always have my insulin, meter, and any sort of snack that I might need if my blood sugar goes low.”

“Thinking about the logistics, it's the first thing we do in the morning and last thing before she goes to bed at night,” says Julie of the deliberate preparation that goes along with managing her daughter’s disease. “But things have gotten easier. We used to have to use a syringe; now we use disposable pens. And glucose meters have gotten much quicker, from 30 seconds to now just five seconds.”

While Anna’s diabetes is a constant consideration in her everyday life, she hasn’t let it define her, not by a long shot. She’s an avid swimmer and has a fanatical love of animals of all kinds, particularly dogs. Her current pets number four: a boxer named Olive, a black terrier-dachshund mix, Audrey, a mean spirited cat that goes by the moniker Beanie, and Hope the guinea pig. Audrey and Beanie are rescues. Anna hopes to one day attend N.C. State University’s School of Veterinary Medicine.

“I take the bunnies and other small critters out so they can exercise, play with all the cats and answer people’s questions about the adoption process,” Anna says of her volunteer work at the Wake County SPCA. “I love knowing I can make a difference in the lives of animals by finding them a good, safe, forever home and that people are happy with their new pets, as well.”

Dr. Ali Calikoglu, Anna’s pediatric endocrinologist since her diagnosis at 25 months old, has no doubt Anna will do anything she sets her mind to.

“Diabetes is a chronic disease that can make one’s life very difficult, and most children with diabetes have times when they become depressed, but this has never happened with Anna,” reflects Dr. Calikoglu, who is chief of the Division of Pediatric Endocrinology. “She’s always been very compliant and understanding—both qualities that not only help her manage her diabetes but will serve her well throughout her life.”

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