Photo by Karin Elton Karis Bell, at left, and her classmates at Park Side Elementary eat cupcakes. Karis has Type 1 diabetes, previously known as juvenile diabetes.

MARSHALL — Karis Bell, a first-grader at Park Side Elementary, brought cupcakes with blue-colored frosting to class last week in recognition of Diabetes Awareness Month.

Before she had the cupcake she had to check in with the school nurse, Cindy Pfeiffer.

Karis has type 1 diabetes and yes, she can eat cupcakes.

Her mother, Alicia Bell of Marshall, wants people to know that “type 1 diabetes is different than type 2 and it’s not about food or an unhealthy lifestyle. Type 1 diabetics can eat anything they want as long as they take insulin since their pancreas won’t give them any. Type 1 diabetes is an autoimmune disease like lupus or multiple sclerosis.”

Bell said type 1 diabetics’ bodies attack their pancreas and “therefore they need to get insulin from another source by injection or pump. Without insulin the body cannot turn carbs into energy and the excess carbs turn to sugar in the blood stream causing diabetic keto acidosis which is life threatening.”

Karis has a pump implant which means fewer needle pokes in the day to test blood sugar levels and to deliver insulin.

An insulin pump is a “computer-drive device that delivers fast-acting insulin in precise amounts at pre-programmed times,” according to the website, childrenwithdiabetes.com.

Karis checks her smart watch, which has Minnie Mouse on it, and a tap tells Minnie to say the insulin numbers.

She got the watch and pump courtesy of a grant.

“We didn’t even have to pay for this,” Karis said.

“It’s a health and wellness grant,” said Pfeiffer. “We’re working for empowering the parents to talk with their providers about it.”

Diabetics must maintain their blood sugar levels within a healthy range.

“We monitor very closely for their lows and highs of their blood glucose level to make sure that they are in range so if they’re high they are not spilling sugar into their urine, which can be very dangerous,” said Pfeiffer. “If they are low, they can go into a coma-type state. So we give them a snack right away.”

Teachers have extra responsibilities to their students.

“We alert all the teachers and staff that work closely with them what signs to work for,” said Pfeiffer.

Some symptoms include “shaky legs, dizziness, sometimes they feel very thirsty,” she said. “Sometimes diabetics don’t read their body real well yet at a young age.”

Karis wears a CGM (continuous glucose monitor) on a spot on her body such as the abdomen and that triggers a message to a phone, which in some cases is a watch.

“It’s pretty amazing, because this sensor that she wears on her body actually triggers a little meter — not all of them have phones,” said Pfeiffer. “We can add how many carbs she eats and then it automatically calculates and give her the right dose. Which means she doesn’t have to be poked with a needle to get her insulin.”

Without it her CGM, she would have to be poked prior to every snack and every meal.

“Like seven,” Karis said.

Pfeiffer sees students with diabetes in her office every school day, many times a day in between other students’ “injuries, tube feedings, headaches, stomachaches, you name it,” she said. “There’s never a dull minute.”

Six Park Side youngsters need to be monitored. Last year there were three. Each kid has their own drawer in her office or share a drawer. The space or drawer contains their medicine, “emergency pens if they need it in an emergency in case they are low. They all have snacks available in case they are low.”

Karis needs a finger poke only if her meter parameters are going off.

“An alarm goes off and then the teacher knows to send her to the nurse’s office and then we will do a finger poke to verify,” Pfeiffer said.

Karis’ teacher, Jamie Brigger, monitors her levels and writes down the information on a paper which goes home to the parents so they can keep track of the day, Pfeiffer said.