Until recently, 21-year-old Don Fitzreiter didn’t have any problems with his diabetes.
“From the time he was seven (when he was diagnosed) to just a few years ago, he was never in the hospital,” says his mother, Crystal Fitzreiter, “he was a very well-controlled diabetic. But beginning his freshman year away at college his blood sugars were around 600.”
At this time, using the pump was fairly new for Fitzreiter, who had started on a pump two years earlier during his junior year of high school.
For this reason, he and his family blamed the pump for his problems, which included a sudden loss of control with the disease, frequent hospital visits and an insulin increase. In fact, the Pennsylvania native started boosting insulin to 1,000 units a day.
Thinking the troubles were due to a technical malfunction, Fitzreiter tried several new pumps. But the problems with his glucose control continued.
A week in the hospital failed to reveal why Fitzreiter was having so much trouble controlling his blood glucose. It wasn’t until his doctor ran a spur-of-the-moment test for insulin antibodies that the answer was found.
Fitzreiter, who has symptoms of both type I and type 2 diabetes, was diagnosed as having insulin antibodies in January 1995. This condition is very unusual for someone so young, doctors said.
It made sense that the answer to these unexplained problems was insulin antibodies. Because he was increasing his insulin doses to such high levels and nothing was happening, it was obvious that his body was rejecting the drug.
Fitzreiter now knows that he had insulin antibodies in his blood and consequently, when insulin was injected, the antibodies would attack the hormone and the insulin would not be absorbed.
Last August Fitzreiter was put on Lispro, a super-fast-acting insulin just approved by the Food and Drug Administration on June 17.
The use of the drug was initially approved by the FDA for a few select subjects who had to participate in a specially directed program. The new insulin will be available late this summer with a doctor’s prescription.
“The Lispro seems to be working out fine now,” said Fitzreiter, adding that the doctors tried both pork and humulin insulin before opting for Lispro.
“My blood sugars have been much better. They usually are in the low 100s and if they get high it’s usually only in the mid 200s.”
Throughout the insulin resistance ordeal, Crystal Fitzreiter said she received much appreciated support from the pump company as well as research consultants, with whom she spoke regularly on the phone while searching for answers to Don’s diabetes questions.
She is glad the doctors finally found an answer to help her son. “He’s been on every kind of insulin, so this is great,” she said. “If anything else goes wrong we’re looking at a transplant and we don’t want that.”
Currently, Don pumps 100 units of Lispro each day through his pump.
Since it’s been proven that the problem wasn’t the pump, the Rochester, New York college student said he likes the convenience the little machine gives him.
At first the pump took a little getting used to. “It’s hard having something stuck to you all the time,” he said.
Fitzreiter, who used to take four shots of insulin a day, is accustomed to wearing a pump and dealing with the concerns that come with it. For instance, at the start of every semester he tells his professors about it, in case the alarm goes off during class.
Despite early difficulties, switching to the pump is a decision the whole family is glad they made.
“The pump is an easier way to control my blood sugars, and better control is so important to all of us,” Fitzreiter said.
Daniel Einhorn, MD adds: Everyone who uses R insulin should at least consider a trial of Lispro. Its impact on after-meal glucose control and lessening risk of hypoglycemia (especially at night) should be quite clear for most people.