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Keen (left) and Charley Bartholomew. The Flagstaff siblings were both diagnosed with Type 1 diabetes in 2018 and recently received a grant to help pay for costs associated with managing the condition.
A Flagstaff family recently received a $13,000 grant from UnitedHealthcare Children’s Foundation (UHCCF) to help with the cost of doctor visits, medications and supplies for two of their children’s diabetes treatment.
Flagstaff residents Mollie and Rob Bartholomew have three kids: 15-year-old Kelty, 12-year-old Keen and 11-year-old Charley. The two youngest were both unexpectedly diagnosed with Type 1 diabetes only months apart from each other in 2018.
Keen was 8 when a routine doctor’s appointment led to the discovery that he had a high level of ketones in his urine, signaling unusually high blood sugar. His mom remembered being told at that appointment, “You need to go to the ER, because he has Type 1 diabetes.”
“I was like, ‘What?’” she said. Other than the test results, he hadn’t shown signs that anything was wrong.
Keen was discharged after half a night in the hospital, yet the family returned the next morning for an extended education course in how to manage Type 1 diabetes.
“It’s all day, three full days of education, where you’re learning what Type 1 is, how to count carbs, how to give yourself a shot,” Mollie said.
The same thing happened four months later during a well-check for Charley, who was 7 at the time.
Michael Mortensen, DO, an endocrinologist at Flagstaff Medical Center, described Type 1 diabetes as “an autoimmune condition where the immune system attacks the cells in the pancreas that make insulin (pancreatic beta cells). When these cells are destroyed or damaged by the immune system, they do not make enough insulin — which causes elevated blood sugars.”
What causes the condition is not fully known, he said, but there is often a genetic component and sometimes an environmental trigger.
It is usually diagnosed using blood tests to determine the presence of antibodies associated with the condition, as well as measurements of how much insulin the pancreas produces.
While Type 1 diabetes is usually diagnosed in childhood, Mortensen said, adults can also receive a diagnosis.
“There is a misconception that Type 1 diabetes is only diagnosed in children,” he said. “Many Type 1 diabetics are misdiagnosed as Type 2 diabetics simply because it started in adulthood.”
Type 1 diabetes is a chronic illness, requiring lifelong treatment.
The Bartholomew parents said it costs an average of $300 to $350 a month to pay for insulin, pumps and glucose monitor supplies for just one of their kids. About $125 of that cost is just for insulin.
The family is now in its third year receiving a grant to help with the cost of treatments, and Mollie says they use the money for pump and monitor supplies, backup supplies, insulin and co-pays for the endocrinologist appointments needed every three months.
She recently finished grad school, and said the money has been helpful while the family’s income was slightly lower due to her studies.
“One of the most fulfilling parts of our commitment to help people live healthier lives is the opportunity to support the needs of children and families,” said Heather Cane, UnitedHealthcare Arizona’s CEO. “ … Knowing that money will support Arizona families who face out-of-pocket medical bills because of their children’s health challenges means those parents can concentrate on what’s really important: their kids.”
Mollie said her kids’ reactions to their diagnoses have been “evolving” — though generally diabetes is an annoyance for them at most.
She said Keen has been matter-of-fact about his diagnosis, focusing on what he needs to do to treat it.
“Initially, he took it really easily. He was like, ‘OK, I can do it,'” she said. “He just did what he had to do, and I think that continues to be his personality around it.”
It also helped that family friends (they lived in Gilbert at the time) offered help and worked to understand ways they could help Keen manage his diabetes.
“It’s huge,” Mollie said. ” … Nobody thought it was a big deal, nobody thought it was weird, nobody put him at the weird lunch table or anything. I think for him it was a really easy transition, and I think he’s never been embarrassed about it.”
Receiving a diagnosis had a larger impact on Charley, in part because she’d seen Keen’s experience with the disease.
“She was super bummed, because I think she knew what it meant,” Mollie said. “ … She had seen her brother go through it and she was like, ‘I don’t want any part of that.’ She kept saying, ‘Are you sure?’”
Mollie said she’s seen Charley become more confident in responding to her diabetes, including with similar help from friends and their families.
She also said she’d noticed some additional difficulties girls face with the diagnosis.
“Figuring out how to make it work for a girl [means] additional steps and additional annoyance, and I think she feels all that,” she said.
For example, clothing options like rompers, dresses and bathing suits don’t usually have easy places to hold the pump — which are often clipped onto waistbands.
So Mollie learned to sew and began adding pockets to some of Charley’s clothes. She said there have been positive aspects of the diagnosis, however.
“The one thing I think is a huge positive out of it is that it forces kids into a level of responsibility that other kids don’t have. That’s been, I think, a total blessing. It just makes them more responsible in other areas because they’ve already learned how to be responsible with their bodies,” she said.
For the first six months after diagnosis, Keen and Charley would check their blood as many as 15 times a day (before and after eating or exercising) using a blood checker, then calculate how many carbs are in their meals and give themselves a shot based on insulin ration.
They now use insulin pumps, which look like a “tiny iPhone,” Mollie said.
It attaches to their belts and bodies, and administers the correct amount of insulin based on the number of carbs they’re eating.
The kids have also switched to using a higher-tech method of checking their blood, using a Dexcom glucose monitor rather than a pricker. It sticks into a spot on their arm and collects information on their blood sugar, sending it to an app the kids, their parents and figures such as the school nurse can access and monitor as needed.
Mollie said her advice for families with a Type 1 diagnosis is to find other people dealing with the condition to act as a support network. She told the story of a family on Keen’s former hockey team, who after learning of his diagnosis (their son also has Type 1) arranged a cookout with other local families who had kids with Type 1 diabetes.
“They had all these kids over and they were swimming together and they all had Dexcoms and they all had pumps,” she remembered. ” … It allowed Keen to just not feel alone.”
The group of families also helped each other, sharing supplies and information as needed.
“That would probably be my biggest advice for people: to not isolate in that,” she said, saying the Junior Diabetes Resource Foundation (JDRF) local connections and even support groups can be a good way to start.
She added: “Getting comfortable with it comes with time, carb-counting comes with time, but if you just didn’t have somebody who was also going through it, or your kids didn’t have people to [say], ‘Yeah, I know somebody else who has it,’ I think that would be the worst.”
More about UHCCF, including information about this grant, is available at uhccf.org.
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Keen (left) and Charley Bartholomew. The Flagstaff siblings were both diagnosed with Type 1 diabetes in 2018 and recently received a grant to help pay for costs associated with managing the condition.
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