OneThousandOne represents the amount of time, verbally, that it takes to count to one second. In this one second of time, a great thing happened at Nebraska Medicine. In fact, several great things probably happened. A patient was cured, a researcher found the missing link, a nurse treated an injury, a doctor comforted a family or maybe a child just smiled.
Fall | Winter 2008

Seeing the World in a New Light

Diabetes Center removes barriers to a better life

For as long as Bridgit Pollpeter remembers, she has had diabetes.

At age 4, Bridgit remembers receiving insulin shots several times a day, alternating the shots to different parts of her body.

At age 6, she had learned to calculate her own carbohydrates and insulin ratio and was injecting herself.

By the time she was a teenager in high school, she remembers ducking to the nurse’s office during the day to keep up with her daily regimen of insulin injections.

“I really had a hard time growing up,” recalls Bridgit.  “Diet restrictions were even stricter back then. I remember always feeling like I was different and just wanting to be like everyone else.”

As a young child, Bridgit often experienced insulin reactions. Insulin levels were more difficult to control then and when they fluctuated too much, Bridgit would experience seizures and hallucinations. “For much of my younger life, I was afraid to be away from my parents because they knew how to handle the situation if my blood sugars were out of control,” she says.

Bridgit had Type 1 diabetes, which results from the body’s failure to produce insulin. Type 1 diabetes is far less common than Type 2, occurring in just 5 to 10 percent of the population. Type 2 diabetes  is one of the fastest growing diseases in the country and is primarily a by-product of obesity and a sedentary lifestyle.  Type 2 diabetes tends to have a genetic predisposition, while Type 1 does not. Today, it is estimated that approximately one quarter of the population is living with pre-diabetes or full-blown diabetes.

Up through high school, Bridgit learned to manage her disease and, aside from tracking her glucose and taking daily insulin injections, Bridgit managed to live a fairly normal life. She swam, played soccer and participated in track, dance, cheerleading, music and theater.

It was while Bridgit was attending college, however, that her health spun unexpectedly out of control. She fell ill numerous times, lost weight and over several months made multiple visits to the emergency room. But no one could pinpoint the source of her illness. Her situation worsened. She developed pneumonia and a viral infection. She spent nearly three months in and out of the hospital. At one point, Bridgit says she was close to death. “I felt so sick, I didn’t even care if I died,” she recalls.

After several months, in which Bridgit battled for her life, she finally pulled out of it but not without losing an important part of her health. The viral infection had complicated her diabetes, causing diabetic retinopathy that eventually stole her eyesight.

But surprisingly, this is where Bridgit Pollpeter’s story shines.

If you should ever meet Bridgit, you’ll realize that the loss of her vision has not set her back one bit. If anything, it has made her stronger, more confident and even more determined to succeed.

“It’s only an obstacle if you let it be,” says Bridgit, now 27, married, an honors student at the University of Nebraska at Omaha and a nanny for her sister’s two children. “If I have to do something differently, then I figure it out.”

James T. Lane, MD, and Beth Pfeffer

Bridget says she remembers the day her ophthalmologist gave her the news that she would likely lose all of her vision. It was one month after her second hospital stay.  “My dad started balling,” recalls Bridgit. “My vision had been slowly deteriorating, so by this time I was in acceptance of it. I had been so sick that I was just happy to be alive. There was nothing I or the doctors could do to change it, so I had to make the choice to move on or wallow in self pity.  I knew it was going to be a challenge, but I just told myself, ‘This is happening, so now I have to move on and deal with it.’”

Bridgit’s struggle to regain her health during this difficult time was also a turning point in her lifelong struggle with Type 1 diabetes. At one point, she was seeing a half dozen doctors due to various complications that had developed during her year-long illness. One of those specialists was James T. Lane, MD, endocrinologist and director of the newly opened Diabetes Center at The Nebraska Medical Center.

Self-Programmed insulin pumps have
eliminated the need for daily insulin
injections for many diabetes patients.

“Things changed drastically when I started seeing Dr. Lane,” recalls Bridgit, who was living with her parents at the time. “Up until then, I had always relied on my family as my safety net when I experienced adverse reactions due to low blood sugars.  But Dr. Lane was so positive, encouraging and supportive. He gave me the confidence to break out on my own. I probably wouldn’t be where I am today if it weren’t for Dr. Lane and the rest of his staff.”

Dr. Lane set Bridgit up with an insulin pump which allows her to maintain better control of her insulin levels. Bridgit programs the pump daily to deliver a controlled level of insulin, eliminating the need to perform insulin injections each day. A talking glucometer provides her a verbal reading of her blood sugars.

“The introduction of the insulin pump has been a huge advancement in the management of diabetes,” says Dr. Lane. “It has eliminated the need for patients to perform four to six insulin injections daily. Up to one-half of my patients now use an insulin pump.”

Bridgit’s health and confidence has flourished under the care of Dr. Lane and his staff at the Diabetes Center. The center is the only one of its kind in the region dedicated to providing comprehensive care for diabetes patients. The Diabetes Center combines clinical care, counseling, education and research aimed at finding better ways to prevent and treat diabetes. All clinical staff are certified diabetes educators.

“Much of our program focuses on education and self-management of the disease,” says Beth Pfeffer, RN, BSN, CDE, manager of the Diabetes Center. “We want to teach our patients the skills to be successful at managing their diabetes.”

Losing weight and exercising regularly are the two most effective steps one can take to manage diabetes or reduce the risk for diabetes. Dietitians and exercise physiologists are available to prescribe nutrition and exercise programs for all patients, monitor their programs and track their progress. The center also has an urgent care component. Individuals with acute diabetes complications can be seen in a timely manner, as opposed to going to the emergency room.

“Ross is my rock.”
Bridget Pollpeter

The new Diabetes Center also makes it as convenient as possible for diabetes patients to receive the care they need from a multi-disciplinary team of specialists. “People with diabetes are at risk for a variety of serious health complications that require specialty care,” says Dr. Lane. Located on the campus of The Nebraska Medical Center, patients have convenient access to a full range of specialists, depending on their need. Specialists in ophthalmology, foot and wound care, vascular disease, neurology and urology hold regularly scheduled clinics at the Diabetes Center. The center is working to add clinics for specialists in cardiology, kidney disease and nerve disorders. “A lot of diabetes is about risk prevention,” says Pfeffer. “Our goal is to prevent long-term complications. That involves two critical factors: early diagnosis and careful management of blood sugars; and a multi-disciplinary approach to care. Communication between specialists is critical to prevent complications related to the disease.”

Diabetes is growing at an alarming rate in this country with the greatest increases being seen among adolescents and young adults, says Dr. Lane. In the past, most Type 2 diabetes cases did not develop until about age 40. However, today the disease is appearing in patients at much earlier ages and as young as their teens. Dr. Lane says he hopes the center will have an impact on educating the community about this growing epidemic and provide interventions to reduce its incidence.

Research holds the future for diabetes, says Dr. Lane, and is an area where The Nebraska Medical Center is very much involved. “There is still a lot we do not know about diabetes,” says Dr. Lane. “We are looking at everything from trying to find a screening tool for diabetes, to studying the immune system, to finding the gene responsible for predisposing certain individuals to what causes complications from the disease.”

“Communication between specialists is critical to prevent complications related to the disease.”
Beth Pfeffer

With the support of the staff at the Diabetes Center, Bridgit developed a newly-found confidence in her diabetes management, which gave her the courage to leave home and enroll in the Iowa Department for the Blind adult training facility to learn how to live independently. The training facility helped her learn important blindness skills such as Braille, white cane travel, computer skills for the blind as well as a positive philosophy. “My parents were worried about me, but I knew I finally had to take the initiative,” recalls Bridgit. “I was 23 years old and ready to move forward. Now that I had the confidence to manage my diabetes on my own, I knew I could do the rest.”

Within a week at the training facility, Bridgit met her future husband Ross Pollpeter. From the day they met, they were inseparable, says Bridgit. They were engaged in two months and married in less than a year. “I’ve never believed in love at first sight, or knowing you’ve found the right one when you’ve only dated for a few weeks or so, but I knew this one was right,” says Bridgit. After completing the training program for the blind, the two married and lived in Des Moines for about a year. Bridgit would make the two-hour plus trek to Omaha every three months to visit Dr. Lane and his staff at the Diabetes Center and stayed in touch by phone. “I had so much faith in them, I just couldn’t go anywhere else,” she says.

Ross and Bridgit Pollpeter

Bridgit and Ross are living in Omaha now. Bridgit is in her second year of college at UNO, pursing a degree in creative writing. Ross works for the League of Human Dignity, which provides services to people with disabilities. When he was just 11 years old, Ross was diagnosed with retinitis pigmentosa – a genetic disorder that causes progressive blindness. He still has minimum vision but expects he will lose all of his sight within the next 10 years.

“Ross is my rock,” says Bridgit. “I have yet to meet a sighted person who treats me in the same manner and who has the same understanding.  I live in a world that believes my life is sad and limited. Ross does not believe this though, and that makes him my safe haven. Ross and I do not have a limited vision of the world, but rather the world has a limited vision of us.”

With this type of self-determination, Ross and Bridgit have accepted the challenges of living in a sight-oriented world. They have not let it deter them from reaching their life goals. They use the MAT system for transportation, rely on the white cane to navigate by foot, have learned Braille and computer skills for the blind. “I don’t consider myself disabled,” says Bridgit. “I call it differently-abled. I do all the same things as everyone else. I just may do them differently.”

Ultimately, Bridgit would like to write fiction books. But as far as she is concerned, there are no obstacles as to what she might do. “I have met doctors, lawyers and engineers who are blind,” says Bridgit. “There is no reason that either one (diabetes or blindness) should prevent me from doing anything other than driving a car.”

Previous article in the Fall | Winter 2008 issue of One Thousand And One:
Back on the Fairway