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Living with diabetes

Innovative treatment approaches help teen
When Tyler Bren first heard the diagnosis, he had a number of thoughts swirl through his 9-year-old mind.

“What am I gonna do the rest of my life, and what am I gonna be able to do in school or are people gonna look at me different?” Tyler recalled thinking back in 2004.

Those questions are understandable, especially for a boy who just learned he has type 1 diabetes, a disease for which there is no cure and one that requires constant monitoring to keep in check.

Now 14, Tyler, who lives in Dickinson, no longer carries any such fears, thanks largely to the coordinated and innovative care he’s received from his team of providers at Sanford Health.

  Tyler Bren counts on Medcenter One's team approach to help care for his diabetes
Tyler Bren, right, and his family count on Sanford Health's team approach to care for the teenager's type 1 diabetes. Led by Pediatrician Dr. Parag Kumar, left, the team helps Tyler's family successfully manage the disease.

“We’ve got our ups and downs,” said Duane Bren, Tyler’s father. “For the most part, he does very well with it. He’s doing better with it than I would if I had it.” Such an outcome was far from certain initially.

Tyler and his parents first realized something was wrong when Tyler lacked energy much of the time, started drinking more water than normal, lost 10 pounds in a short amount of time and frequently complained of simply not

Dr. Parag Kumar
Kumar, MD


  “He was always wanting to sleep,” said Marge Bren, Tyler’s mother. “He didn’t have the energy or the boost to do just common-day things. He wanted to lay around all day long.”

The symptoms grew progressively worse, and ultimately, the Brens took Tyler to the emergency department in Dickinson. After consulting with an on-call pediatrician in Bismarck, the family was referred to Sanford Health in Bismarck. Tyler was in critical condition, and so he was rushed to Bismarck via ambulance.

That’s when the Brens met Dr. Parag Kumar, a pediatrician; Lyla Timm, a registered nurse in Sanford Diabetes Care Center; and Kelly Fisher, a dietitian. From the moment Tyler entered the hospital, that team started training Tyler and his family on everything they’d need to do to keep Tyler’s diabetes in check.

“We didn’t know anything about diabetes before we started,” Marge said. “The team showed us everything we needed to know.”

By the time the Brens returned to Dickinson, they had a good enough understanding of the disease to successfully manage Tyler’s diabetes.

When the Brens did run into a problem or had a question, someone from Tyler’s care team was always available to answer any questions the family had. That access became even more important when Tyler started using an insulin pump three years ago, a move that meant Tyler no longer had to inject himself with insulin four times a day but one that comes with a steep learning curve.

“Starting the pump and taking care of diabetes is serious business,” Dr. Kumar said, “so we have to be 100 percent accessible.”

Tyler was one of the first children in North Dakota to receive a pump, and Dr. Kumar said he wouldn’t have even thought about the innovative move if it wasn’t for the coordinated care and access Sanford Health can provide with the staff in its Diabetes Care Center.

While wearing the pump makes some physical activities like playing sports a little more challenging, Tyler participates in golf and baseball, and having the device definitely beats multiple injections a day.

“It’s way easier,” Tyler said, “and it just helps me understand and get through life.”

His blood sugar is better controlled now, and he said he can do anything a normal teenager can.

“It is very gratifying as a physician to see him getting better,” Dr. Kumar said. “The entire family has risen to the occasion.”

Dr. Kumar is quick to point out Tyler would not be nearly as successful without the dedication of the Bren family.

“This requires such a commitment from the family and from Tyler,” Dr. Kumar said, “and we’ve been very pleased with how they follow through and are very trusting and follow our advice.”

Click here for more information on Sanford Diabetes Care Center or call (701) 323-5324.

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