diabetes 1

10 Fast facts about insulin

All you need to know about your medication – and how to store it.

  1. Insulin is a hormone that controls the amount of glucose in the blood. It acts as the “key” that lets glucose (from food) leave the blood and enter the cells of the body.
  2. People with diabetes either do not make enough of their own insulin (Type 1 diabetes), or the insulin their body makes is not as effective as it should be (Type 2 diabetes). As a result, most people with diabetes need to take medication, in tablet form or insulin injections.
  3. While it is often possible to control Type 2 diabetes with diet and exercise at first, eventually insulin will be necessary for most people with Type 2, as diabetes is a progressive condition.
  4. There are three different kinds of insulin: short-acting, long-acting and combination.
  5. Short-acting insulin is taken at mealtimes to cover the glucose released from the food that is being eaten.
  6. Long-acting insulin has a slow release and works as a basal (background) insulin for a number of hours – it is usually taken once or twice a day in addition to short-acting insulin.
  7. Combination insulin is a mixture of long-acting and short-acting insulin, often prescribed to Type 2 diabetics.
  8. Insulin must only be taken on prescription from a doctor, as it is essential to take the right dose (prescribed for you) at the right time.
  9. Storing insulin correctly is important: it should not get too hot (over 30°C) or freeze. Spare insulin should be kept in the fridge, and the pen you are using can be kept at room temperature for 1 month. Always keep insulin out of direct sunlight.
  10. Learning how to inject properly will make the injections as pain-free as possible.

All about LifeinaBox

Have you heard about LifeinaBox?
I’ve been hearing a lot about it lately – it’s a “device that will revolutionize the transport of medication worldwide.”

Here’s what they say about it…

LifeinaBox is the world’s smallest fridge, and the culmination of many years of research to produce a universal solution that will allow users to travel any place, any time, knowing that their medication is kept at exactly the right temperature. Suitable for any heat-sensitive medication such as insulin, growth hormones, arthritis or multiple sclerosis medications, it allows users the freedom to travel anywhere, anytime, knowing that their medication is kept at exactly the right temperature.

This state-of-the-art device uses a combination of thermoelectric energy and batteries that will allow the user to be mobile with his medications under any conditions for up to 24 hours without the need to recharge his device. Operating on 110V or 220V or with a car cigarette lighter, LifeinaBox is totally environmentally friendly and contains no hazardous gases, tubes, coils or compressors.

The greatest inventions are often born out of simple necessity. Who would have an idea as absurd as making a fridge just to carry medication? We asked Uwe Diegel, co-founder of LifeinaBox, to tell us a little more about his idea…

How did you come up with the idea for LifeinaBox?

My brother, Dr Olaf Diegel, visited me in France in the infamous heatwave of summer 2003. Olaf is a well-versed traveler and is used to travelling with his insulin and keeping it cool using iceboxes and cooler bags (insulin, like many other medications, is sensitive to heat and should be stored at a temperature between 2 and 8°C).

Olaf booked himself into a small hotel near Auxerres in France. When he arrived at the hotel, he noticed that there was no fridge in his hotel room (even though he had particularly insisted on this when making his booking). He needed a fridge to store his insulin. So he arranged with the clerk at the entrance desk to keep his insulin in the fridge in the kitchen.

Olaf does not speak French, coming from New Zealand. A few hours later, Olaf needed his insulin and went down to reception to ask for it, only to discover that it was placed in the freezer by accident by someone in the kitchen. He is thus obliged to have the night pharmacy opened just to get some fresh insulin.

We decided to design the idea of a portable fridge and our prototype actually worked quite well, so we sent it to an industrial design contest run by NASA in the USA. The product became a winner at the contest, received unexpected publicity and became the subject of an international story on the CNBC TV network.

When and where will Lifeinabox be available to South Africans?

We just launched LifeinaBox on the 12th of September on the Indiegogo crowdfunding platform. Crowdfunding platforms are places where people can pay for a product in advance at a preferential rate, paying in advance, so that their money can be used to accelerate production. We are already on our 9th generation of working samples and are nearly ready to go into mass production at the beginning of 2018. So the physical delivery of LifeinaBox should be by the April/May 2018. LifeinaBox is by definition a product that is born global and that will be launched in all countries at the same time. But the quickest way for people to get their hands on a LifeinaBox is to order on the crowdfunding campaign, as the first waves of production will be dedicated to people who have already placed an order.


How much will it cost?

LifeinaBox is quite an expensive device to produce, because we need it to basically last forever. The expected price in South Africa would be somewhere between R2800 and R3000. Next year we will launch LifeinaTube, which is a much cheaper device because it will only hold a single insulin pen.

Where can it be used – must it be plugged in? Can it be taken on planes?

It can be plugged in just about anywhere, from 110 to 240V, in a car’s cigarette lighter, or with a battery pack. We are still developing the battery packs and will be able to have 3, 6, 12 or maybe even 24 hours of battery life. We are really working quite hard on the batteries to give it more mobility. Right now I am already at 12 hours, but I am sure that by launch time I will already have a 24 hour battery. It is for people to take to work (so they don’t need to put their medication in the work fridge), in the car for long car trips, at home (so that the children don’t have access to medication in the kitchen fridge) and it can also be used on a plane.

What’s your LifeinaBox elevator pitch?

Nearly 4% of the worldwide population is prisoners of its medication that has to stay in the fridge at all times. LifeinaBox is the world’s smallest fridge for the safe transport and storage of fragile medication. LifeinaBox gives millions of people worldwide the freedom to travel anywhere, any time, knowing that their medication is at exactly the right temperature.


What makes your life sweet?

I still, 30 years later, wake up in the morning and can’t wait to get to work. My work is wonderful, because I always strive for perfection. I never think of my products as medical devices, but more as tools for the heart. And if you can touch the hearts of people the possibilities are infinite.
My first career was as a concert pianist, so I still spend a lot of time behind the piano, especially with my children who are also musicians and artists.

Raising a diabetic child

We were just sent this advice about raising children with diabetes… It takes a family to raise a diabetic child, as we all know! Do you have anything to add?

Hearing the diagnosis for the first time can be overwhelming and will leave any parent and child with mixed emotions – it’s unfair, it’s exhausting, it’s stressful, it’s scary and it’s tough to manage.  Yet there is nothing on earth that any parent could have done better to prevent their child from living with Type 1 diabetes. It is estimated that there are now more than half a million children aged 14 and younger living with Type 1 diabetes according to the 7th IDF Diabetes Atlas.

According to Dr Ntsiki Molefe-Osman, Diabetes Medical Advisor at Lilly South Africa, Type 1 diabetes is a disorder of metabolism caused by the body’s immune system which attacks the cells in the pancreas that produce insulin.  “Children are not born with it, rather it develops over time and there is usually a genetic predisposition.  In children, Type 1 diabetes presents commonly at around 14 years of age and younger.  This means that Type 1 diabetes is a lifelong condition, it is serious, and managing it needs to be done diligently as poor control of the condition today will have lifelong repercussions.  When a child is diagnosed with Type 1 diabetes, so is the entire family who all need to adapt to a new lifestyle.”

“The importance of good glycaemic control can’t be emphasized enough,” says Dr Ntsiki Molefe-Osman.  The basic 101 of managing and preventing the complications of Type 1 diabetes is careful daily management of blood glucose and sustaining tight glucose control as close to normal levels as possible.”

“Diabetes is a progressive disease, which left unchecked will cause organ damage. This has significant health repercussions for later on in life – from kidney failure, heart failure, blindness, nerve damage (diabetic neuropathy) and as a result loss of limbs. What you do for your diabetic child today and the responsibilities you teach your teen in managing Type 1 diabetes, will influence the quality of life they can expect to live later in life,” explains Dr Molefe-Osman.

Why do Type 1 diabetics need insulin?

People living with Type 1 diabetes do not produce any insulin at all, so it needs to be replaced with insulin injections.  Insulin moves blood sugar into body tissues where it is used for energy. When there is no insulin, sugar builds up in the bloodstream. This is commonly referred to as high blood sugar, or hyperglycaemia – it is dangerous and has many side effects. Fortunately when the blood sugar is stabilised with insulin treatment, these symptoms go away.

It can be managed

While a diabetes diagnosis for your child may come as a shock and will mean that lifestyle adjustments will have to be made, it is important to remember that with consistent control and the support of a healthcare provider, people living with Type 1 diabetes can live full, active lives.

Family support is vital

Managing Type 1 diabetes in your child takes a lot of courage and determination.  Imagine the mountain that a child faces knowing that injections will be part of their daily routine.  They may also worry that their condition will preclude them from enjoying all the things that other children get to experience, or lead to them being treated as ‘different’ in their school and peer environment.

It all comes down to how you work together as family to support and guide your child in helping them see their daily treatment regime as a positive step towards a healthy and normal life, rather than as a punishment or burden.  It is important to help your child believe wholeheartedly that with the right control and responsible approach, they can do whatever they want to do.

Managing chronic illness

“Coping with and learning to manage a chronic illness like diabetes is a big job for a child or teen.  It may also cause emotional and behavioral challenges and talking to a diabetes educator or psychologist can help immensely. It’s also important that family, friends, teachers and other people in your child’s network know of and understand the condition so they are alert to any symptoms or signs that their blood sugar is out of control and what to do to help them in an emergency situation,” adds Dr.  Molefe-Osman.

It takes a huge amount of discipline on the part of the parent and child in managing the demanding diet, lifestyle and treatment regimen, so it’s essential to establish a routine that works for everyone concerned.  Establishing good habits early, providing a support structure and ensuring that your child understands why good control is important are vital.  It’s the difference between your child managing their diabetes, or diabetes managing them,” she concludes.

References:

How to help a friend with diabetes

I would like to know to help and support a friend who has diabetes. My friend is a Type 1 diabetic and I’m not always sure how to help him in the tough times.” Markus Vorster

Hi Markus,

You have not said how old your friend is, but much of the basics stay the same. Here are 7 ways to support your friend with diabetes.

  1. First of all, treat your friend like anyone else. It is important for him to realise that his diabetes makes absolutely no difference to your friendship. If your friend is having trouble accepting his condition, be supportive and understanding.
  2. Try not to ‘mother’ him, but do encourage him to look after himself.
  3. Understand that people with diabetes are more prone to mood swings and depression than those who do not have diabetes.
  4. Learn to be able to recognise when his blood sugar goes too low, and know what to do in case he needs help.
  5. Remember, really tough times for diabetics are when they are sick. Blood glucose levels bounce up and down and this makes them feel more ill.
  6. Give him all your support by understanding his condition to the best of your ability.
  7. Get the facts and go beyond the myths and misinformation by talking to your friend, your doctor, or relatives who have diabetes.

As a friend, your understanding and acceptance are very important. The more you understand his circumstances, the less alone your friend is likely to feel.

Empathise, but never sympathise.

Good luck!

– Jeannie Berg, Diabetes Educator

Teens with Type 1

Teenagers with Type 1 diabetes feel especially isolated and alone. It’s bad enough dealing with body changes and hormonal issues, but add to that testing blood sugar, keeping tabs on what you eat and injecting yourself, as well as mood swings, and you can see why teens with Type 1 have a lot to deal with. Understanding what goes into diabetes means you can help your teen feel less self-conscious and different from everyone else.

Photo by Asaf R on Unsplash

Howza’s life with diabetes

Musician, actor and Type 1 diabetic – we find out how Howza fits it all in.

How long have you been diabetic?

Since 2003: I was 21 at the time. I was actually introduced to diabetes from a very young age because my father had Type 2 diabetes, but I was very ignorant – I didn’t know what it was until I got it. But I think the younger you are, the easier it is to adapt your life.

What was your diagnosis like?

You know, all the symptoms kicked in – loss of weight in a very short space of time, dehydration, constantly going to the toilet. I didn’t understand what was going on. When you lose weight like that you instantly associate it with HIV/AIDS, because there’s so much awareness of that. So obviously I panicked… But I did the responsible thing and went to the doctor – that’s when I found out I was diabetic. I wasn’t exactly relieved, the doctors put the fear of God in me by telling me all the things that could happen to me. It was hard to come to terms with…. But I was scared, and I was willing to turn my life around for the sake of living longer.

What’s the biggest challenge of living with diabetes?

Obviously diet and exercising. I was saying to my wife the other day, as much as I enjoy going to gym, it’s never easy. You need to find a way to motivate yourself to go to gym 3 or 4 times a week – self-motivation is important to live a healthy life. Nobody likes gym, in all honesty! But at the end of the day, when you put your mind to it, you’ll end up enjoying it.

I used to live a very unhealthy lifestyle – eating fast food and drinking every day. That had to change. I’m not saying be a health nut, but you need to find a way to do things moderately. If you’re going to drink, you need to drink responsibly and be aware of your sugar levels. I decided, instead, to stop drinking. But it was difficult for my friends to understand – you’re not drinking, so all of a sudden you’ve become a priest! It wasn’t easy, trust me, that was the most difficult part, especially as a youth. But at the end of the day I became selfish and told myself, “It’s not about them, it’s about me.” If I don’t take care of myself, they’ll still be cool – I won’t.

What advice would you offer to other diabetics?

I always say to people – look, I’m living with it, it’s not the end of the world. As cliché as that might sound, that’s the actual truth. I’m living a healthy, normal life with diabetes. Like I said, I don’t want to put myself on a pedestal and act like I’m perfect. I have my challenges. So when I speak to the youth I try to be as open and truthful as I can, so that they can relate. At the end of the day, the bottom line is that you have to be responsible for your own life.

What makes your life sweet?

My daughter, Tumelo.

Get in touch with Howza: @Howza_SA on Twitter

Type 1 Diabetes and Breastfeeding

To all the diabetic mommies out there:

Being diabetic did you breastfeed your baby? I have found that my sugar dips from the breastfeeding.   think I should stop as I nearly went into a coma, when I came to my sugar was 0.5, but I don’t want to stress my baby out. She does not like taking a bottle from me at all.

The doctors and councilors all seem to have different opinions. I have been feeding my baby less and have now got spiking sugars, I assume from my body adjusting  again. I am very torn because my baby needs me more than my milk.

Has anyone else out there had the same situation?

Thanks,

Candace

A Fabulous Sugar Alternative

IMG_7025I don’t know about you, but sometimes I want something decadent to eat – despite being diabetic. I want a slice of cake with my cup of tea, especially if I’m celebrating with friends and family.

Of course, Sweet Life has always shared recipes for treats as well as ordinary food, because we believe that you can’t be on a diet your whole life, and diabetes is definitely sticking around for your whole life… But still, it made me feel guilty to use sugar in recipes when I know what sugar does to my blood sugar (bad, spiky things!)

That’s why I was so delighted to be given Natreen artificial sweetener to test out. I’ve always been a bit scared of artificial sweeteners because of aspartame, which has been linked to cancer, but Natreen doesn’t have any aspartame which makes me very happy! (Apparently the claims of aspartame being linked to cancer haven’t been proven, so it’s not something that they can shout about any more).

My next concern, though, was what replacing normal sugar with a sugar substitute would do – particularly while baking. I’m very happy to report that the result was exactly the same, and my non-diabetic friends didn’t even notice the difference! I made our special occasion Flourless Chocolate Tart and it was simply fabulous. Best of all, my blood sugar readings were heaps better than if there had been sugar in the cake. That’s because the sweeteners in Natreen (cyclamate and saccharin) don’t have any carbohydrate – as opposed to sugar, which is 100% carbohydrate. I actually asked for a breakdown so that you could see exactly what I was talking about – take a look below:

Calories:

  • 8 drops Natreen Liquid = 1 tsp sugar (4.2g)
  • 100ml Natreen Liquid = 0.96 calories
  • 1 tsp sugar (4.2g) = 16 calories
  • 100g sugar = 387 calories
  • 6.67ml Natreen Liquid = 100g sugar

Carbohydrates:

  • 100ml Natreen Liquid = 0g carbohydrates
  • 100g sugar = 100g carbohydrates

So for those special occasions when you really want something delicious and sweet, I would highly recommend using Natreen instead of sugar… Your blood sugar will thank you!

Diabetes Turned My Life Around

Hi everyone…

It’s so heartening to read all of the posts on your website and learn from all of your experiences! It has inspired me to share my story on your website.

I am a 40 year old Indian male. Two years ago (18 December 2013) to be exact, I had admitted my self to the Umhlanga Netcare hospital. I was just too tired, too run down and did not know what was going on with my body. I had started feeling tired, restless, sleep deprived a few days before. I was also very stressed out and emotionally down due to a lengthy divorce battle and being separated from my children. The doctor attending to me admitted me to ICU. I was undergoing a Type 1 Diabetic Keto Acedosis attack. I lay in hospital for a week. When I was finally discharged, my weight had dropped from around 85 kg to 68kg! I was totally insulin dependent, and was diagnosed as a Type 1 Diabetic at the age of 38.

My world seemed to be collapsing around me. First, the divorce/separation from my wife and kids (who mean the world to me), and now finally my health just failing me completely. I just could not cope with anything at that point in time.

Eventually I pulled myself together. I started off my new life by following my Insulin dosage instructions carefully, and by doing relentless research on Diabetes Type 1 and read up on everyting about Diabetes and related topics/posts/blogs etc. I learnt about a balanced Diabetes nutrition and and how to shop, prepare and eat food Diabetes Smart. I eat a low fat, controlled Low GI Carb Diet, with no refined/processed foods. I have developed an exercise routine that I follow religiously. My eating pattern, portion controls and diet have become a daily way of life now. Its embedded in my lifestyle.

When I was going through the Type 1 DKA attack, my blood Glucose was 27 mmol/l, my HbA1C at that time was 18.5 percent and Cholesterol 4.67 mmol/l. Since Dec 2013, I do HbA1c’s every 6 months, together with Cholesterol checks etc. My last two HbA1C’s were 4.90 and 5.10 mmol/l, and Cholesterol 3.67 mmol/l.

I believe that I have my condition under control, and firmly believe that I can still have a meaningful, productive life of good quality, if I maintain my Diabetes Care Routine.

Type 1 Diabetes does not have to be a death sentence, you can turn it in your favour by living and eating healthily and staying positive about your life.

Cheers for now everyone and happy, healthy living!

– Dhiraj

The Diabetes Dawn Phenomenon

Hi,

I’ve been a Type 1 diabetic for 20 years now.  Lately I am suffering horribly from the dawn phenomenon.  My sugar readings are perfect before bed, perfect at 03:00 am when I wake up to test, but absolutely sky high when I wake up in the mornings.

Has anyone experienced this and if so how can it be prevented?

Thank you.

– Frances

Tips for Weight Gain with Diabetes

Morning to you all,

I’m a Type 1 diabetic and have accepted this chronic condition well.

My only problem with it is a loss of weight. I never wanted to be slim ever in my life, but now there’s no way I can maintain my body to get it back to my normal weight.

Do you have any healthy weight gain tips?

Thanks,

– Thahtoow

No More Insulin from Local Clinics?

Hi there,

I was wondering if you could be so kind as to assist me in the following request.
My girlfriend has been a Type 1 diabetic for 23 years and she always collected her insulin from the local clinic.

Last month when she collected her insulin she was told that the government clinics don’t supply insulin anymore, since then it’s been a uphill battle to get insulin.

She doesn’t have medical aid at the moment and therefore we would appreciate it if you can refer us to someone or a clinic that’s able to help in this matter.

Hope to hear from you soon…

Kind Regards,

Giovani

Husband just diagnosed with Type 1 diabetes

Good day

Two weeks ago we just found out that my husband has diabetes Type 1. To be honest we were both in shock, especially when we read more about it, we knew it it a very serious disease. I think we are trying to accept and live with it positively but we are still scared and not sure what will happen as time goes.

We are reading more about it, because we need to know everything about it. It is not easy, especially if you don’t talk and think everything to yourself. The thing is we can’t just talk to anyone because most of people still do not understand out there. So we thought maybe joining Sweet life might help us heal and live positively again.

Thank you
– Nthabiseng

Type 1 diabetes tips

claudine leeThis month, we welcome a new member to our Panel of Experts – Dr. Claudine Lee, a GP from Hilton in KZN. Find out more about her (as well as the rest of the experts) here.

Here are a few tips from Dr. Lee on how to manage diabetes well – and what advantages insulin pump therapy offers. Let us know if you have any questions for her!

Top tips for Type 1 diabetes good blood sugar control :

  1. Regular exercise – one sure way to keep things controlled (it must be a way of life).
  2. Correct food choices in terms of carbs, especially portion size and dosing correctly to “mop up” the carbs without any lows.
  3. Knowing if you are more sensitive to insulin in the morning or evening and adjusting your dose in connection with that.
  4. Knowing your numbers and testing, if you don’t know where your sugar is at you can’t respond to it.
  5. Being on the correct insulin to match your lifestyle/meals/exercise.

Advantages of insulin pump therapy:

  1. Getting rid of hypoglycemia (lows) especially bad lows.
  2. One prick every 3 days.
  3. Basal rate of insulin matched specifically to you, less insulin used (thus better weight control).
  4. Bolusing for meals is extremely simple and aided to control sugars exactly.
  5. Better control = better wellbeing generally.
  6. For the young: you can decide impromptu to stay over at a friend/function as all you have for the next 3 days for your diabetes is on your person.

 

Just out of hospital…

Hello all you diabetics!

Firstly, I was diagnosed with Type-1 at the age of 4. I recently turned 31, so 27 years of insulin dependency and a happy, healthy life in general.

On 25 January ’14 I was rushed to hospital and diagnosed with DKA – I was in hospital for a total of 22 nights. I also contracted a fungal infection whilst in hospital then also had internal bleeding from my oesophagus because of this infection…. I know, super dramatic stuff!

My question is this: Has anyone else experienced the emotional instability after being released from hospital? Is this a diabetic thing or just my own mental problems…?

I’m crying for the most ridiculous things… Yesterday the laundromat advised me they couldn’t dry my clothes and I burst out crying. Its just not me – I didn’t even need the clothes :-)

What can I do?

Please help!

Adios,
Bonnie

The sweet life at school

Here’s some advice from Novo Nordisk for teachers with diabetic children in their classroom…

One of the many challenges facing busy educators today is how to manage the situation if they have a child with special healthcare needs in their classroom. This is especially true of conditions that can be life-threatening, like diabetes. As up to 3.5 million South Africans are estimated to be living with diabetes, and as up to 45% of all new cases diagnosed are in children, the chances of having a child with diabetes in the classroom are quite high. So it’s important for teachers to know what to do if this is the case.

“Each school should have a formal process for obtaining information about special-needs children,” says Jacquie van Viegen, a diabetes educator at Novo Nordisk, “and all teachers should be notified if there are children with diabetes or other chronic conditions at the school. This enables them to be alert to any changes in the child’s behaviour or to any signs of distress. It also gives individual teachers the opportunity to educate classmates about the condition in general at the beginning of the school year.”

Written instructions and guidelines from parents can be especially helpful, and these can be pinned up in an accessible place in the classroom so that both teachers and fellow learners can refer to them if necessary. Educating classmates about their friend’s condition will also help to eliminate fear and empower them to act if necessary.

Screen Shot 2014-02-18 at 10.39.28 AM“It’s always helpful to include information and discussion on special-needs classmates during the welcoming process at the start of the year,” says van Viegan. “This is important in order to dispel myths about diabetes and other chronic conditions.”

Children may, for instance, need to be reassured that diabetes isn’t contagious, and be enabled with the necessary knowledge to help their friend out should the need arise. Knowing about diabetes will also help them to recognise that, when a classmate’s behaviour is unusual, this may be a sign that they need assistance.

On an everyday level, teachers of younger children in particular should keep a watchful eye over the situation without giving the impression that the child is receiving preferential treatment. They should, for instance, ensure that children with diabetes have a healthy snack before undertaking strenuous exercise, either in the gym or on the sports field. Exercise, like insulin, lowers blood glucose levels, and can lead to low blood sugar or hypoglycaemia.

Similarly, teachers should ensure that children with diabetes always have access to an emergency source of glucose in order to counteract a hypoglycaemic episode should this occur. A ready supply of glucose sweets is always advisable, and a small carton of fruit juice can be a life-saver in an emergency.

“It’s also important for teachers to understand that children with diabetes need to have regular snacks throughout the day,” says van Viegen, “and they should allow them to eat a small yoghurt or another suitable snack in class if necessary. Some children may also need to use the bathroom more frequently than others, and this should be taken into account too.”

And it’s essential for teachers to be able to identify the early warning signs of a hypoglycaemic episode. In general, these include irritability, sleepiness and erratic responses to questions. The child who appears not to be paying attention may, in fact, be getting low on all-important glucose.

“In terms of first-response treatment, glucose sweets or fruit juice usually does the trick,” says van Viegan, “but if the child doesn’t show signs of improvement almost immediately, it’s important to seek medical help.”

Informed and caring teachers can make all the difference to a child living with diabetes or any other chronic condition. They can help to teach them how to live normal, active lives outside the home, and can ensure that they’re well integrated with their peers.

“In fact,” says van Viegan, “the lessons they teach them about coping with the condition in everyday situations are likely to be of great value to them throughout their lives.”

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