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Insulin Insulin
First sighting: Pernaz is a child diabetic. At the time diabetes was diagnosed her GTT (Glucose Tolerance Test) was 550 %/mg and ketoses was 4+.

Possible pathological trigger: At the age of eight years, Pernaz had complained of pain in abdominal area around the navel alongwith acute pain in legs. The consulting GP prescribed and administered an injection dose of the drug, Baralgan. Other ailments if any: Mumps and pnemonia patch once and occasional sore throat and cough in the past years.

Prescription
Should check blood sugar level atleast once in two days.
Insulation intake by injection on thigh or stomach twice–thrice a day.
Take meals and medication at regular intervals and exercise regularly as prescribed.

Case history: 14 year old Pernaz’s mother kept telling her that she was losing weight. At that time Pernaz was not aware of the fact because she used to get hungry even between meals. Though what she noticed was that her thirst for liquids had increased especially during nights and as a result she was also urinating more frequently. One evening her mother jokingly related an old grandma’s tale: If an ant was seen in the commode then someone in the family was suffering from diabetes.

Since she was overweight and over 40 years, her mother, Ruchi decided she would do a blood sugar test as a precaution. But Pernaz insisted that she was the one who had diabetes.

The initial shock: Ruchi took Pernaz to a clinic–laboratory run by the nuns of Fatima Convent nearby in the city. After giving her fasting blood sample, Ruchi told Pernaz to pick up her reports while returning from her school which was near the lab. In the evening, when Ruchi returned home she was shocked to see the report: Pernaz’s blood sugar level was 550mg % with ketoses at 4+. Ruchi immediately rang up their family doctor and child specialist Dr. Ranade and told him about it. Dr. Ranade asked her a question: “What is Pernaz doing right now?” Ruchi replied: “She is playing downstairs with other children”. To this Dr. Ranade said: “Then there has been some mix–up. At 550mg % blood sugar and ketosis of 4+, she should be in coma and not playing.” Dr. Ranade then suggested that the tests be repeated at another clinic. The tests were repeated along with a urine culture but the reading remained unchanged. The tests were rerun thrice again, but the blood sugar level was the same each time. Dr. Ranade then recommended that Pernaz should be admitted to hospital. A shocked Ruchi took Pernaz to Jehangir hospital where she was admitted to the Intensive Care Unit.

An attack of hypoglycemia: Taking the insulin dosage regularly and in right amounts is necessary or a diabetic can suffer from hypoglycemia.

Today: Today Pernaz is 22 years old, no longer a child but a young woman. Inspite of the presence of insulin ampoules, disposable syringes and glucometer (handy instrument to measure blood sugar) in her day–to–day existence, she is eager to lead a normal life like any other person of her age. She doesn’t like hiding the fact that she is a diabetic. Her friends are amazed that diabetes can happen to someone so young. They’re surprised when she tells them that it happens to kids younger than herself, she says. Her friends also wonder why she cannot have medication in the form of tablets instead of with the help of syringes. Pernaz like other diabetics regularly attends sessions organised by Endocrinologist Dr. Yagnik under whose care she has been since hospitalisation for diabetes. The sessions keep her up–to–date on what is being done for diabetics like herself. “We discuss about how to take care of our sugar level, how to use syringes and where, learn about new medicines and generally exchange our experiences at the sessions at K.E.M. hospital”, she states.

Pernaz’s mother voices: “Diabetic children are intelligent like normal children. If anyone says that they can’t do well in academics because they have diabetes, it is all hogwash”. Pernaz is lucky to have parents who love her and can take care of her.

It is well documented that medication and treatment for diabetes is lifelong and expensive.

Ruchi believes that firstly the government should mobilize programmes to make people aware about diabetes like it was done with polio awareness programmes, because she is the belief that: Prevention is better than cure. “Diabetes is not a illness that happens to the rich alone. The poor too suffer from it.

In the villages if a little boy goes into coma they think it is the work of a witch. Which is not right. He could have been suffering from coma and would need a life saving drug like insulin to recover. Secondly, the government should think seriously about subsidising insulin to make it available to broader masses”, Ruchi advocates.

There is also a diabetic from a rural area whose parents know nothing about diabetes. He comes to the hospital once in a month to collect medicines and syringes, says Pernaz. “There could be so many diabetics who stop treatment because it is expensive”, Pernaz adds.

Ruchi would like Pernaz to stand on her two feet. “Diabetes is not a disease. It is a deficiency, Diabetic children are better off than children who have Thalessemia or chronic heart disease”, her mother retorts.

In the past one year Pernaz received a few job offers, but her mother wasn’t keen to let Pernaz take it up because she would be working in shifts. Recently Pernaz has received a job offer that she would like to take up. What will Pernaz do after she takes up a job? Her mother would like her to get married after a couple of years. Does this intelligent, brave and gritty diabetic who while attempting to save a man and his child from being overrun, almost lost her life, have a future?