Imagine this: You and your family live in a brownstone apartment in Brooklyn or a split-level ranch in Buffalo. It could be anywhere in the United States. Your child has just been diagnosed with Type 1 diabetes, but the local hospital lacks the necessary supplies and personnel to stabilize him or her. You're instructed to make immediate plans to travel one-hundred, one-thousand or even five-thousand miles to an unfamiliar city for a two-week hospital stay. Once there the nation's finest diabetes specialists stabilize your son or daughter's glucose, treat life-threatening ketoacidosis and swamp you with more meaningful math and science than you've had your entire life.
The importance of glucose control is explained to you: without it, you're told your child may die suddenly and will certainly face debilitating complications and shortened lifespan. But you're then told that with blood glucose control through steadfast and diligent management, your child has a real shot at living a long, healthy life. That with today's technological advances such as insulin pumps and glucose meters, it's highly likely. Optimism takes over despair, or at least spars with it. Thoughts of "Why him/her?" and "What now?" are bumped by "We can do this."

The departure day arrives and you prepare to leave with your child, awaiting only diabetes supplies and release papers. Resolve and worry are minimized, for the moment at least, by your eagerness to leave the stale air and the square rooms of the hospital for the familiar sounds of your neighborhood, the comfort of home-cooking and the hope of a fresh start. A flitting thought morphs into reassuring refrain: He's (she's) got a real chance: a good life is possible.

The nurse enters the room and arranges the diabetes supplies on the table before you. Everything looks familiar, a small testament to the last two weeks' training. But something is very wrong. There aren't enough of those little boxes on the table, for a week let alone a month or more. The nurse confirms your fear, matter-of-factly. "Strips...three per day." Your heart sinks and hope fades.

No, it's not Brooklyn, Buffalo or I suspect anywhere in the United States. But it does exist. I've seen the faces of the children whose HbA1c's are double digit SOS calls for pumps and more test strips. I've seen the tear tracks on the faces of mothers who so desperately just want a fighting chance for their children...


To be continued