- Declan Vorster was diagnosed with type 1 diabetes when he was only two years old.
- His parents were overwhelmed and initially felt like their world had "fallen apart".
- But two years later, and with the help of an insulin pump, Declan is living an almost normal life.
1 December 2018 is a day the Vorster family will likely never forget.
Not because it's a birthday or anniversary, but because it's the day their ever-energetic 2-year-old son, Declan, was diagnosed with the lifelong, chronic and potentially deadly condition type 1 diabetes.
His mom, Shalane's, suspicions were raised when Declan complained of being thirsty all the time. The then toddler suddenly and inexplicably craved plenty of tea before bed. Instead of drinking his usual 60ml, he was drinking up to 600ml over a couple of days.
"It didn't sit well, so I decided to take him to the doctor, and they did a blood test. The same afternoon, we got a call saying that his sugar was too high, and he should come back for more tests," Shalane told News24.
The results did not bring good news. Declan's sugar level was 29 – well above acceptable levels of between four and 10.
A visibly emotional Shalane recalled the day she and her husband got the diagnosis.
Highs and lows
Shalane told News24 she became overwhelmed with a debilitating fear of what was next. At the time, she didn't know how she was going to look after her son.
But their endocrinologist Dr Ajay Chiba at the Clinton hospital in Alberton, east of Johannesburg, soon put the first-time parents at ease.
"Our endocrinologist said, 'It has nothing to do with you as parents. It's nothing you guys have done'," Shalane said, adding that the first year was challenging.
"It was quite tough for us, but we got through it… Thank God we have never had a bad situation like Declan going into a coma from his sugar going so low," Shalane said.
"Yes, we have had a lot of highs, and we have struggled sometimes to bring them down; that was before the pump."
For two months after his diagnosis, Declan's parents injected his insulin manually. The couple would take turns waking up every hour to check his sugar levels.
But then Dr Chiba gave the Vorster family their first glimmer of hope. Declan received his first insulin pump, a MiniMed 670G system, in February 2019.
Pump it up
This pump automatically delivers pre-set insulin levels and can stop insulin delivery if one's blood sugar level is low – which it detects through a sensor.
The insulin is administered through an infusion set placed on Declan's bum, as he doesn't have enough fat on his stomach. The infusion set is connected to the pump through a pipe. The pump itself is strapped to Declan's hip.
"I'll be honest, since we got the pump, it has changed our lives for the better," Shalane told News24.
"My husband and I hardly slept every night because we didn't have a sensor to monitor what his sugar is. The pump shows his sugar all the time," she added.
Declan told News24:
Like most children, Declan enjoys milkshakes, chocolate, strawberry, sweets and pizza.
"He can eat everything that another child without diabetes can eat, but he just has to have insulin for it," Shalane said.
"We don't give him a lot of junk. Declan has a good appetite. He loves his food and will eat everything, except maybe baby marrows," she added with a laugh.
Declan is given a bolus – a single, calculated dose of insulin – at every meal, and as a result, carbohydrate counting has become a regular part of daily life for the Vorsters.
Shalane calculates the number of carbohydrates in Declan's food using an app. She then inserts the total number of grams into his pump, which in turn calculates the amount of insulin for the specific meal.
They try to keep Declan's sugar levels between four and six.
Despite being only four years old, Declan understands that he cannot just eat what he wants without taking insulin, unlike his peers.
"I know about diabetes that I didn't eat food that all my friends eat without a bolus," Declan said.
The young boy is beginning to understand his condition more and can tell what his sugar levels are. Shalane is slowly trying to instil some responsibility in him as he gets older so that he knows how to look after himself.
"Declan knows how to prick himself. He is starting to know how to read his numbers. Like he will say, 'Okay, it's 6.0', or whatever his sugar is. He's getting there, but we haven't yet given him the responsibility to type in the number of carbs just yet," she said.
In June this year, his insulin pump was upgraded to the Medtronic MiniMe 780G system, automatically delivering and adjusting Declan's insulin. However, this time in small doses more regularly, and it connects directly with a compatible smartphone. This allows Shalane to view Declan's sugar level trends and insulin delivery on the go.
He will attend Grade R next year, and it's put Shalane at ease.
"When Declan's at school, we can see what his levels are at any given time. Whenever it's mealtime, she (his teacher) sends us a WhatsApp about his sugar levels. So, when we don't hear from his teacher, we can see on the app what's happening."
Declan enjoys playing with the toys in his playroom, riding his bike and watching YouTubers Stephen and Grace Sharer in his spare time.
Shalane told News24 with the pump, Declan can function like any other child.
"People don't ever believe that he has diabetes until I tell them and show them the pump."