1 diabetes. Ask your doctor or nurse for more information on

this important project.

*Our research paper, Glargine Basal-Bolus Insulin Regimen Versus Insulin Pump Therapy: A Comparison of Gycemic Control was published in the June issue of the Journal of Pediatric Endocrinology and Metabolism. This study showed equivalent Hemoglobin A1C values when patients on basal bolus insulin regimens using Lantus were compared to youth using insulin pumps over a 3 year period. Of interest, Hemoglobin A1C’s trended up in both groups after each therapy was started, most likely related to “diabetes

burnout”.

(Continued on page 7)

It’s hard to believe that summer is over, and it’s back to school time. In spite of a hurricane, earthquake and other not so minor distractions, a lot has been happening at the BD Diabetes Center. Let me share some

highlights:

*Our High Risk Family Focused Diabetes Program continues to grow. We presented research related to improving collaboration between the diabetes care team and families of youth with diabetes at the American Family Therapy Academy National Meeting in Baltimore this June. In addition, we shared our experience caring for high risk adolescents with diabetes in an abstract published by the American Diabetes Association this Spring. We are looking forward to presenting a poster on our more effectively working with

high risk youth at the International Society of Pediatric and Adolescent

Diabetes in Miami in October.

*With invaluable assistance from Elaine Nussbaum’s daughter Deborah and Grace Flores, a college student in the Seed Program, we have recruited close to 500 patients for the Type 1 Diabetes Exchange, a unique national database which plans to follow over 30,000 adults and youth over a 20 year period, in order to learn more about the best ways to care for type

Winter is coming and you know what that means…

it is FLU SEASON!!

This is a reminder to...

GET YOUR FLU SHOT!!

From the Director’s Desk, Harold Starkman, MD

B D D I A B E T E S C E N T E R

F O R

C H I L D R E N

A N D A D O L E S C E N T S

The Glucose Monitor F A L L / W I N T E R 2 0 1 1 V O L U M E 1 , I S S U E 2 ,

Goryeb Children’s Hospital

Morristown Medical Center

100 Madison Ave.

Morristown, NJ 07960

Phone: (973) 971-4340

Fax: (973) 290-7367

The Team

Physicians:

Harold Starkman, MD, Director

Tymara Berry, MD

Barbara Cerame, MD

Daisy Chin, MD

Frances M. Guevarra, MD

Lawrence Silverman, MD

Nurses:

Frances Melchionne, EdD, RN, CDE

Clinical Coordinator

Laurie Ebner-Lyon, RN, APN, CDE

Elaine Nussbaum, RN, APN, CDE

Christine Wagner, RN, MS, CDE

Nutritionist:

Connie Shirtz, RD, MS, CDE

Social Worker:

Nicole L Pilek, MSW, LCSW

Administrative Staff:

Donna Parente, Office Manager

Debby Ace, Endocrine Coordinator

Cheryl Baldwin

Ashaki Graham

Sheryl Irons

Joann Millman

Christy Murillo

Medical Assistants:

Martha Ortiz

Pamela Solomon

Pierre the Pancreas

P A G E 2

Insulin pump precautions: Airline Travel

SWEET TALK with team member CHRISTINE WAGNER Christine Wagner was a neonatal clinical nurse specialist, is a certified diabetes educator, and has earned a certification in advanced diabetes manage-ment. She received her bachelor’s degree in nursing from Villanova University, and her master’s degree from

Columbia University.

Chris started her career at Morristown Medical Center in 1980, and worked in adult intensive care, pediatrics and the neonatal intensive care unit (NICU). She left the Medical Center for five years to be home with her

three beautiful children. She returned in 1991 and worked as the inpatient clinical nurse specialist in the NICU. She also went on to positions in the pediatric emergency room and then the adult diabetes center. In 2004, Chris accepted a position at the BD Diabetes Center for Children and Adolescents. We hope this is her final destination at

MMC!

When not at work, Chris enjoys

yoga, cooking for her family

and friends, and spending time

at the beach.

3. After the airplane lands, disconnect the pump and prime with 2 units of insulin, then

reconnect.

These recommendations were

based on a very small study. We

suggest families be aware of the

possibility of hypoglycemia

while wearing a pump during air

travel, and be sure to check

blood sugars frequently during

and after air travel.

Additional travel suggestions for

pumpers include notifying

security if you or your child has

diabetes and carrying a travel

letter which the office can

provide. ALL diabetes supplies

should be carried on board and

in the original package. It is not

recommended that insulin pumps

go through an x-ray scanner.

You should wear your pump and

request a walk through with a

hand scanner if necessary. The

There have been some reports of children experiencing hypoglyce-mia after airplane travel. A small study published in Diabetes Care in September, 2011 (volume 34, pages 1932-33), looked at the effects of changes in atmospheric pressure on insulin pumps. The study placed 10 pumps on com-mercial airlines and found that the pumps delivered approximately 1 unit of excess insulin during take-off. During descent approxi-

mately 0.7 units of insulin was sucked back into the pumps. Mechanical function of the pumps was not affected by air-line travel. Based on the results of their study, the authors made the following

recommendations:

1. Disconnect the pump before takeoff.

2. During the flight at cruising altitude, take the cartridge out of the pump and remove any air bub-bles before reconnecting.

Department of Transportation

does not allow spare lithium

batteries in checked luggage.

Their recommendation is to

carry spare lithium batteries in

your carry-on luggage. If you are

changing time zones, you can

change the time setting on the

pump after reaching your

destination. Always remember to

carry Lantus and Novolog, as

well as written basal and bolus

doses, with you, to be used in the

event of a pump failure while

traveling. The Lantus dose

should be equivalent to the total

24-hour basal dose. The insulin

to carbohydrate ratios and

correction factor remain the

same as in the pump settings.

Make sure you are familiar with

all the pump settings prior to

travel and have them written

down. Being well prepared for

your flight eliminates potential

stress. T H E G L U C O S E M O N I T O R

Chris stops for a photo op with Dr. Goldstein,

a former endocrinologist at the BD Diabetes

Center, at his retirement celebration.

P A G E 3

Alyssa presents the

winner with her trophy

THE INSPIRATIONAL TYPE: ALYSSA ROTHMAN

Each June, the Peter Smith School of Irish Dancing holds an annual dance competition, called a feis. This year, on June 26, 2011, we held the first Dance For A Cure, at our feis. 156 dancers registered to dance and their registration fee was donated to JDRF. There were three age categories and the winner in each category won a perpetual trophy. The winner in the under age 11 category, won the trophy donated in my honor called, Alyssa’s Cup, Finding a Cure One Step At a Time. Each dancer that participated got a special glow-in-the-dark cup and a JDRF bracelet. In addition to the charity dance, we had t-shirts made that we sold our dancers and their

families with the proceeds going towards research for the

cure.

Our first Dance For A Cure

raised over $2600! We hope to hold the charity dance every year and continue to raise money for the cure of type 1 diabetes. Watching so many dancers participate in the charity dance made me feel so happy and proud because I helped to raise a lot of money. I know the money will be put to

good use to help find a cure!

T H E G L U C O S E M O N I T O R

Dance For A Cure

By Alyssa Rothman, age 11

When I was first diagnosed with type 1 diabetes, I knew I wanted to raise money for a cure. While I was still in the hospital, my mom called my Irish dance teacher, Amy Siegel Loxley. Amy’s hus-band, Ryan, also has type 1 diabetes, so she was really knowledgeable and was very helpful and supportive. My mom and I asked Amy if our Irish dance school, Peter Smith School of Irish Danc-ing, could help raise money for the cure. Together, we came up with, Dance For A

Cure, a charity dance that all Irish dancers could participate

in to benefit JDRF.

A Picture Is Worth A Thousand Words…Of Summer Fun!!

Beginning here and the next several pages, patients of the BD Diabetes Center share their favorite photos of the summer. It might be getting cold and winter may be quickly approaching, but hopefully the smiles and good times captured

will warm you right up!

P A G E 4 V O L U M E 1 , I S S U E 2 , F A L L / W I N T E R 2 0 1 1

.

T H E G L U C O S E M O N I T O R

P A G E 5 V O L U M E 1 , I S S U E 2 , F A L L / W I N T E R 2 0 1 1

.

T H E G L U C O S E M O N I T O R

P A G E 6 V O L U M E 1 , I S S U E 2 , F A L L / W I N T E R 2 0 1 1

.

T H E G L U C O S E M O N I T O R

From the Director’s Desk (con’t from page 1)

P A G E 7 V O L U M E 1 , I S S U E 2 ,

The BD Center Annual Picnic this June at Schooley’s Mountain Park in Long Valley was a great success, thanks to

the hard work of Nicole Pilek and Connie Shirtz, and “Team D”, our adolescent group. More information on 2011-2012 activities to

follow.

*BD Center doctors and nurses volunteered to help at Camp Nejeda (the NJ diabetes camp) on opening days this summer. In addition, Dr.’s Silverman and Berry volunteered to stay at Camp for one week in August to

care for campers and staff.

*On a less satisfying note, in July, Diamyd, a new medication which was hoped to protect remaining insulin producing cells in newly diagnosed patients with type 1 diabetes was found to be well tolerated but ineffective. This finding led to the termination of this study at the BD Center as well as at other clinical trial

sites in the US and abroad.

Hope to see you at an upcoming

BD Program!

Keirsten is a 10 year old girl living with type 1 diabetes. She doesn’t let it stop her from doing the thing she loves to do most: dance!! Keirsten is a student at the Dance Arts Academy in Boonton, NJ. She competed in Florida at the end of June of this year at the Dance Explosion Dance Competition. All her fellow dancers at the academy are very supportive of Keirsten and her diabetes. She is wonderful throughout the long day at practice...checking her blood sugar and making sure she doesn’t drop.

She doesn’t let it get her down and the results are living proof!

In Keirsten’s own words when she won...The Overalls were next to be an-

nounced and I was sitting on stage waiting for this moment for a long time. I had butterflies in my stomach and all of my friends were in a circle playing the game we made up, “Pass the Squeeze”, which makes you have even more butterflies in your stomach. They started calling the person that took 5th place. Then two of my friends got called for 3rd and 4th place. They called another person for 2nd place that wasn’t in my

dance school. Then the moment came...

websites that you can click on that can provide

support and information without even leaving

the comfort of your homes. Websites like

www.childrenwithdiabetes.com, www.jdrf.org,

www.diabetesnj.org www.diabetes.org,

www.diabetes-exercise.org and

www.thinklikeapancreas.com are invaluable

tools that can provide important information

with the click of the mouse. Websites like

www.calorieking.com can take your handheld

book to a whole new level. Cell phones are not

just for taking calls anymore. They are like

mini-computers. If you have the opportunity,

check out these resourceful websites. Please

share any diabetes-related apps for your

cell phone or iPad. E-mail

Nicole.pilek@atlantichealth.org and I

will include them next time.

We are living during a time when technology

is an incredible part of our daily lives. I

don’t know about you, but it becomes very

obvious during times when we lose

electricity, or cable service or a cell tower is

affected. Technology is a powerful way to

get information quickly to a vast majority

amount of people. Information about

diabetes is no exception. There are numerous

The SOCIAL (Net)WORK(er) notes from Nicole

THE INSPIRATIONAL TYPE: KEIRSTEN DUNN

“We’ve arranged a civilization in which most crucial elements profoundly depend on science and technology.” -Carl Sagan

T H E G L U C O S E M O N I T O R

“The first place high score for the Petite level is……..and they started to play my song, “Yes, Sir”. All my friends cheered for me as I went up to the front of the stage and got my trophy. I felt very excited and I was smiling so hard my cheeks hurt. It was amazing to get this award and I was very proud of myself. Like my dance teacher says,

“It’s all in the way you dance”. :)

P A G E 8

Dietitian Hint:

Counting the carbs in

pasta can be challenging.

If you use the same

brand and shape of pasta

regularly, the carb count-

ing can be made easier.

Usually pasta servings on

the box are given in dry

weight. Weigh the pasta

dry (usually 2 ounces)

and then cook it. After

cooking re-weigh or put

the cooked pasta in a

measuring cup. Write

down the conversion.

Then you can go back to

making a large pot of

pasta for your whole

family and pull out the

right amount for accu-

rate carb counting.

CARB COUNTING WITH CONNIE, the dietitian

Pumpkin Pie Cheesecake

Ingredients:

1 cup graham cracker crumbs

1/2 cup ground pecans

2 tablespoons white sugar

1/8 teaspoon ground ginger

1/4 cup butter, melted

1 (8 ounce) package cream cheese,

softened

3/4 cup packed brown sugar

3 eggs, beaten

1 (15 ounce) can solid pack pumpkin

puree

1/2 cup heavy whipping cream

1 teaspoon ground cinnamon

1/2 teaspoon ground ginger

1/4 teaspoon ground nutmeg

1/4 teaspoon ground cloves

1/2 teaspoon salt

Directions:

Preheat oven to 350 degrees F.

To Make Crust: In a medium

bowl, combine graham cracker

crumbs, ground pecans, white

sugar, and 1/8 teaspoon ground

ginger. Mix well, then pour in

melted butter. Stir until butter is

evenly distributed. Press mixture

into a 9-inch pie plate. Set aside.

To Make Filling: In a large bowl,

combine cream cheese and brown

sugar. Beat until smooth, then add

eggs, pumpkin puree, and cream.

Mix well. Stir in cinnamon,

ginger, nutmeg, cloves, and salt.

T H E G L U C O S E M O N I T O R

Bake in preheated oven for 35 to

40 minutes, until set in center.

Chill before serving. Garish with

whipped cream and pecan halves if

desired (not included in nutritional

information listed below).

Nutritional Information Serving per recipe: 16

Amount per serving:

Calories: 209

Total Fat: 14g

Cholesterol: 73mg

Sodium: 249.5mg

Total Carbs: 19.1g

Dietary Fiber: 1.3g

Protein: 3.4g

Feel free to substitute low-fat or fat-

free cream cheese and whipped cream

for a heart healthy version.

(recipe courtesy of 2011 allrecipes.com)

THE INSPIRATIONAL TYPE: AMY HOLDAWAY

P A G E 9 V O L U M E 1 , I S S U E 2 , F A L L / W I N T E R

Amy Holdaway decided to

take matters into her own

hands...

Amy was diagnosed with

type 1 diabetes at the

beginning of 2011. At the

time, she was 11 years old.

It was during this past

summer that Amy decided

to have a bake sale to raise

money for something very

important to her and so

many others—the cure for

type 1 diabetes. After

researching organizations,

Amy decided that the

proceeds from her bake sale

would go to the Juvenile

Diabetes Research

Foundation, or JDRF.

Amy’s family and

friends have always

supported Amy, es-

pecially at the time of

her diagnosis and the

months after, and her

bake sale would be no

exception. Amy’s sisters’

and friend spent hours

baking sugar-free and

regular sugar treats to sell.

On a warm, sunny summer

day, Amy and her “support

staff” arranged the goodies

into a beautiful display.

two years ago, and Nicole Pilek, our

social worker, reviewed the

different stages of child

development and how diabetes

influences these stages. Our nurses

shared clinical updates on topics

including continuous glucose

sensors, insulin pens, and proper

injection technique. Techniques of

advanced pumping were presented

by an Animas pump trainer. There

was also an overview of

carbohydrate counting, treatment of

low blood sugar as well as

beneficial exercise guidelines.

While most children had off on

Columbus Day, 58 of their school

nurses were in the amphitheater here

at Morristown Medical Center

learning how to better care for the

students in their school who have

diabetes. School nurses from Morris,

Somerset, Sussex and Essex county

attended the one day program. Dr.

Harold Starkman discussed the High

Risk program that was implemented

It looked too yummy to pass

up and all their efforts would

soon payoff! After about an

hour, the treats were gone

and Amy had raised

$150.00!!

Amazing, Amy!!

Amy takes a

break from

selling

delicious

goodies to

pose for a

picture with

her sisters

and good

friend!

Thank your school nurse if s/he

attended this program. If s/he

wasn’t able to attend, encourage

her/him to join us for the next one!

T H E G L U C O S E M O N I T O R

2011 School Nurse Program

The maginative Site:

P A G E 1 0 V O L U M E 1 , I S S U E 2 , F A L L / W I N T E R

Wanna share your artistic talent with others? Submit your drawings, paintings, photography or poems to Nicole via E-mail: nicole.pilek@atlantichealth.org

Mail: BD Diabetes Center, Morristown Medical Center, Box 53, Morristown, NJ 07962, Attn: Nicole Pilek or just drop it off at your next appointment. Let the

creative person inside you out!!

The section to inject your creativity!!

T H E G L U C O S E M O N I T O R

Babysitters Wanted: Are you in need of a babysitter or interested in being a babysitter? Are you familiar with diabetes management?

Buddy/Mentor Program: Are you interested in being a buddy or mentor for a family with a

child with diabetes?

College Student Panel: Are you a college student interested in being on our College Student

Panel for our College and Diabetes Program in January 2012?

Please contact Nicole Pilek @ 973.971.6465 or e-mail

Nicole.pilek@atlantichealth.org about any of these programs/services.

THE Corre-X-tion FACTOR...

Dear D the advice column for ’tweens, teens and children written by a fellow patient.

And who’s “D”? That’s a secret we’ll never tell! ;)

Dear D,

Does practice make perfect?

Thanks,

Roxanne

Dear Roxanne,

Practice makes perfect in everything you do! Whether you are into music, sports or school, practice is the key to success. The

same is true with your diabetes care. There are a lot of tasks and scenarios associated with diabetes and each one should be

practiced to the same degree.

You need to practice carbohydrate “carb’ counting and measuring your food portions. Although people like to eat a variety of

foods, we tend to like certain foods over others. Therefore, even if you just practice counting carbs of your favorites, you will get

good at it. In no time at all you will automatically know how many carbs are in your favorite foods. This would allow you to

“eyeball it” when you can’t measure or weigh your food (like at a restaurant or at a party) and be able to tell yourself how many

carbs are on your plate.

You need to practice for different event scenarios in the same way as well. Scenarios such as high activity days – sports,

amusement parks, boardwalk and beach or low activity days – travel, movies, holidays and sick days. Make sure you practice

what to have on hand for these scenarios. Review all the “what ifs”, so you will be prepared for whatever happens. Think about

things like…Will you have enough treatment for highs and lows? Will you have enough insulin? Will you have enough supplies

for your specific diabetes care (pump vs. pens vs. syringes)? When you practice thinking about questions such as these, then you

won’t waste time trying to troubleshoot problems that might arise. By practicing, you will be able to handle any problems

quickly and get to enjoy yourself more.

In order to have good control of your diabetes, you need to practice all the tasks and scenarios. Your situation will be different

from others; only you will know what items you will need to pack. When you practice, you don’t have to think so closely about

what you’re doing, it comes to you naturally!

the section of our newsletter dedicated to the ‘tweens, teens and children

T H E G L U C O S E M O N I T O R

Goryeb Children’s Hospital at

Morristown Medical Center

Box 53

100 Madison Ave

Morristown, NJ 07962

Office Phone #: 973.971.4340

Emergency #: 888.231.5434

Fax #: 973.290.7367

Easier Prescription Refills!

There is a fast, and easy way to get your prescriptions refilled and it’s free!! Our office participates in Relay Health, a web-based secure service for requesting prescription refills. We strongly encourage patients to use Relay Health for efficient and timely renewals. Simply register online at www.relayhealth.com or provide your e-mail address

when you register for your next appointment.

Remember – After hours and weekends,

on-call physicians do not have access to your

child’s chart and cannot authorize

prescription refills.

A Pharmacist can dispense 3 days of diabetes related

supplies without a prescription; this may be an

out-of-pocket expense. It’s always best to request

your prescriptions at your scheduled diabetes

appointments, or by using Relay Health.

BD Diabetes Center for Children and

Adolescents

Think you know everything about diabetes? Check out Pierre

Pancreas and The Keytones at:

THINKLIKEAPANCREAS.COM

T H E G L U C O S E M O N I T O R

From all of us at the BD Diabetes Center…

Have a safe and Happy

Thanksgiving!!