Patient of the Week – Noelle Parziale

By CDH/PIO
May 13, 2009

 

Noelle Parziale of Springboro is an active 7-year-old, who enjoys swimming, ballet and soccer. Noelle also has type 1 diabetes. Her mother Karen Parziale remembers the time three and a half years ago when she learned 3-year-old Noelle had diabetes.

Noelle had wet the bed two nights in a row, which was highly unusual, so I thought she had a urinary tract infection. I called her pediatrician and made an appointment,” she recalls. Her pediatrician took a urine sample and performed a blood test. He came back into the room and told Karen that Noelle’s blood sugar levels were so high they did not even register on the equipment in the office. He then told Karen she needed to take Noelle to Dayton Children’s emergency department right away.

“I was in total shock,” Karen recalls. “I’ll never forget the drive to Children’s. Noelle’s elder sister, who was then 7, was in the back seat crying. Our cat had died from diabetes a month earlier and she thought the same thing would happen to Noelle.”

Noelle was hospitalized at Dayton Children’s for about five days, with two of those days spent in the pediatric intensive care unit. She was diagnosed with type 1 diabetes. During that time, the Parziales met with Maria Urban, MD, a pediatric endocrinologist at Dayton Children’s, as well as members of the care team, who educated them about diabetes, counting carbs, checking Noelle’s blood, giving insulin and nutrition and exercise.

The Parziales have been “thrilled” with the care they have received at Dayton Children’s. “Dr. Urban and her staff are so wonderful. They are always willing to answer all our questions. They encourage me to be proactive in Noelle’s care. Dr. Urban is always willing to listen to my observations about Noelle and work with me to determine what’s best for her.”

Cynthia Cohoon, RN, is the diabetes care coordinator at Dayton Children’s. “Type 1 diabetes is the most common form of diabetes diagnosed in children,” she says. Cohoon explains that type 2 diabetes, formerly known as adult-onset diabetes, is on the rise in children. This type of diabetes is most likely to occur when someone is overweight.

“No one knows for sure what causes type 1 diabetes,” Cohoon says.

According to the experts, genes play some role in diabetes, but it does not always run in families. For some unknown reason, the body sees its cells as foreign and starts making antibodies against those cells. In diabetes, these antibodies attack and destroy the insulin-making cells in the pancreas so they are not able to make insulin anymore. A virus or other environmental factors may cause this to happen, which means the body will need another source of insulin to get energy from food.

This other source of insulin most often takes the form of insulin shots. According to Karen, Noelle gets four to six shots every day: two in the morning, one after lunch and dinner, and others as needed. Checking her blood sugar level and giving shots as needed has affected the family’s lifestyle.

“We are very fortunate that there is a full-time school nurse at Incarnation Catholic School in Centerville, where Noelle just finished first grade,” Karen says. “She gives Noelle her shots as needed and calls me if we need to make a judgment call. That’s been wonderful.”

Karen explains that her family is more conscientious of nutrition. “Noelle is on a regimen, but the whole family eats a lot of whole grain breads, pasta, fresh fruits and vegetables. We avoid sugary, processed foods. We also need to think long term about Noelle’s health, since diabetes can lead to heart disease, stroke, and kidney, liver and eye damage.”

Karen makes it a point to keep Noelle “positive and empowered. There are so many new treatments on the horizon, I want to let her know there is hope for her and others like her.”

The Parziales’ attention to Noelle’s health has paid off: The active 7-year-old competes on a swim team and soccer team and takes ballet classes. She is a youth ambassador for the Juvenile Diabetes Research Foundation International (JDRF) and will be attending a summer camp sponsored by the Dayton Area Diabetes Association.

At Dr. Urban’s invitation, Noelle recently spoke to a group of medical students at Wright State University Boonshoft School of Medicine about what it’s like to have diabetes. “She loved it,” Karen says. “Afterward she told me ‘Wow, I’m actually helping these people who are going to be doctors.'”

Source: Childrens Dayton