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Managing Celiac Disease and Type I Diabetes Inspires Annie to be a Nurse
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No one knew that little Annie had a gastrointestinal condition. Minor skin rashes and occasional bloated tummies are normal for many toddlers. However, when her parents switched pediatricians, Annie’s new doctor also noted that she was at a significantly lower weight and size than what a 3-year-old should be. Lab work showed that Annie had celiac disease. The autoimmune condition causes inability to digest gluten, proteins found in many whole grains such as wheat, rye and barley.
After receiving her diagnosis, Annie starting seeing a pediatric gastroenterologist (GI doctor) at the University of Maryland Children’s Hospital (UMCH). There, she had an endoscopy where a camera attached to a flexible tube allowed doctors to see inside her digestive tract. The test revealed damage to her small intestine, typical of celiac disease, preventing her from absorbing full nutrition from her food. It now made sense why Annie was small for her age and also had eczema – the skin condition often accompanies celiac disease.
Life with celiac disease would be an adjustment, but the team at UMCH was there to support Annie and her family. A dietitian taught them how to avoid gluten. Annie now sees pediatric gastroenterologist Samra Blanchard, MD, at UMCH every six months for routine bloodwork, which “always comes back clean,” says her mom, Terri. Once a year, she also receives testing and treatments to make up for any vitamin deficiencies caused by following a gluten-free diet.
However, celiac disease wasn’t the only chronic condition that Annie would face. Just as she was beginning Kindergarten, she started waking up in the middle of the night, asking for very sugary foods.
“Other times she was extremely thirsty and wanted to drink water,” says Terri. “I also noticed a fruity odor on her breath, and she smelled sick.”
Worried about Annie’s new symptoms, Terri called Dr. Blanchard, who told her to immediately bring Annie to the Emergency Department at UMMC. With a very high blood sugar reading, Annie was hospitalized and diagnosed with type 1 diabetes, another autoimmune disorder. She was started on insulin and quickly improved. While still at the hospital, Annie’s family received the information they needed about managing her new condition.
“We have long known that there is a connection between celiac disease and type 1 diabetes,” says Dr. Blanchard. “For patients like Annie, I work closely with my endocrinology colleagues such as Dr. Newton, who treats diabetes, to make sure my patients receive complete, multidisciplinary care.”
Today, Annie is healthier with a better appetite than before. Ironically, Terri says that Annie’s diabetes treatment – she must monitor her blood sugar and inject herself with insulin – seemed to help her grow. Annie and her family routinely visit endocrinology at UMCH for follow-up.
“[The caregivers at UMCH] become part of your family,” Terri says. “It feels good to be part of the UMMC community.”
Annie must think so too; despite spending so much of her young life at the hospital, she one day aspires to be a labor and delivery nurse.