Success Story - Tameka Harris

Balancing Act

With treatment from the Center for Diabetes and Endocrinology at UMMC Midtown Campus, Tameka Harris is finally in control of her diabetes.

Diabetes isn’t a disease for the complacent. Its management requires focus, dedication and a clinical team that is willing to work diligently until the disease is under control and the patient’s quality of life is restored. Thankfully, 37-year-old Tameka Harris had all of the pieces to get her life back on track.

In 2005, while pregnant with her second child—one of the happiest times of her life—Harris developed gestational diabetes, a type of diabetes that develops during pregnancy and goes away after delivery. A year later she was diagnosed with type 2 diabetes. “Women who have diabetes during pregnancy are at a 50 percent risk of developing diabetes within the next 10 to 20 years,” says Marjorie Pennant, MD, an endocrinologist at University of Maryland Center for Diabetes and Endocrinology (UMCDE) at University of Maryland Medical Center Midtown Campus (UMMC Midtown Campus), specializing in diabetes and thyroid disorders.

Just the Facts

Type 2 diabetes is the most common form of diabetes in the United States and worldwide. Unlike type 1, which typically is diagnosed in childhood or adolescence, type 2 diabetes is directly related to lifestyle choices such as weight gain, poor dietary habits and lack of physical activity. In type 1 diabetes, the pancreas does not make any insulin, while in type 2 diabetes the pancreas either makes too little insulin or the body cannot respond appropriately to insulin, a condition called “insulin resistance,” which is typically seen in overweight and obese patients.

“When we consistently eat foods rich in sugar and other carbohydrates, our blood sugar rises as we digest,” says Angela Ginn, RD, LDN, CDE, education coordinator for UMCDE at UMMC Midtown Campus. “In response, insulin is normally secreted by the pancreas to help the body deal with this overload of glucose, instructing cells to take up the glucose and thereby lowering the blood glucose levels. In patients with type 2 diabetes, like Harris, the pancreas can’t keep up with the amount of rich food, and essentially runs out of its supply."

Treatment Complications

Harris was under the care of a primary care physician who managed her diabetes with an antidiabetic drug that suppresses glucose production in the liver. But the treatment approach wasn’t working well enough for Harris; her diabetes was getting worse over time. Harris’ hemoglobin A1c test, a blood test measuring a person’s average blood sugar level over the course of two to three months, was still quite high at 13 percent. The American Diabetes Association recommends an A1c level below 7 percent. In general, every percentage point drop in an A1c blood test, from 8 to 7 percent for example, reduces the risk of eye, kidney and nerve disease by 40 percent, according to the National Institutes of Health.

Harris then sought another primary care physician at another hospital in Baltimore, but that didn’t work out well either. The treatment plan and patient care were no different than that provided by her original primary care physician.

“The sad part about it is that neither of my primary care physicians gave me any education about diabetes,” Harris says. “I had no idea what it was, how it worked, or what I needed to do. They just told me I wasn’t producing enough insulin and there was too much sugar floating around in my bloodstream. They each prescribed me the same medication and sent me on my way. That was the extent of my treatment plan. My follow-up appointments were five minutes at the most. There was no real patient care.”

In Control

Frustrated with the care she was receiving, Harris decided to go back to her previous primary care physician, who developed a more rigorous treatment plan. After a year with little success, she was then referred to May Alattar, MD, a board-certified endocrinologist at UMMC Midtown Campus.

“Being referred to Dr. Alattar was the best thing that happened to me, ever,” Harris says. “She started by giving me a thorough education on diabetes. I saw diabetes educators for nutrition and for medication management all in the same day.

“The main thing that helped Tameka, and what sets our center apart from others, is that an entire diabetes team takes care of patients, giving them all the tools necessary to help them take control of their disease,” says Dr. Alattar. “We have a multidisciplinary team approach to patient care. With Tameka, her blood sugars were extremely high all day long. We made insulin dose adjustments and requested she send us her blood sugars on a daily basis until her blood sugars were finally controlled. Our diabetes educators were speaking with her on a weekly basis to identify which foods were causing her blood sugar to spike, so that she could lower her A1c level quickly and get her diabetes under control. The bottom line is, if you want to see results with your patients, you have to put in the effort. With Tameka, that meant daily contact.”

Under the care of the diabetes team at UMCDE, Harris’ A1c level went from 13 to 7 percent in under six months. After she was denied an insulin pump, UMCDE was also able to work with her insurance company to get one. Harris no longer has to give herself insulin injections five times a day—the automated pump connected to her skin by a tiny catheter delivers insulin constantly and as needed with the press of a button. “The insulin pump allows me to live my life in a whole new way,” Harris says.

“Before meeting Dr. Alattar and her team, my life was centered around my diabetes,” Harris says. “I basically had to plan all of my activities around meal times and injections. Now, diabetes just fits into my life. I have always been active, now I can stay out all day, travel and not have to worry about running home to test my blood sugar—I can do that on-the-go.”

“I have never been happier with diabetes. I know it’s hard—it’s still hard for me—but if you get a great diabetes team, take your meds regularly and keep the faith, you can get your life back,” Harris says.