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Andrea: The Death of a Diabetic


Clyde Freeman Herreid
Department of Biological Sciences
University at Buffalo


In chronicling the life and death of a woman who developed diabetes as a teenager, this case study explores such basic science topics as metabolism, hormones, cell receptors, eye anatomy, and immunology as well as issues in nutrition, exercise, stem cell research, transplantation, drug delivery systems, genetic engineering, and health care. The case has been used in a physiology course as part of a unit on metabolism and hormonal control.


  • To learn the functions of the pancreas, especially the endocrine functions.
  • To learn the function of insulin and glucagon in the regulation of blood sugar.
  • To learn about the complex activities regulating nutrients in the body, especially the interactions of the liver, gut, adrenal gland, pancreas, and body cells.
  • To learn how high blood sugar over the long term affects the organs, especially the cardiovascular system.
  • To learn about the structure of the eye and how diabetes affects vision.


Diabetes mellitus; juvenile diabetes; diabetic; Type 1; Type I; Islets of Langerhans; endocrine; blood sugar; glucagon; insulin; pancreas

Topical Areas


Educational Level

Undergraduate lower division, General public & informal education



Type / Methods




Subject Headings

Physiology  |   Biology (General)  |   Medicine (General)  |  

Date Posted


Teaching Notes

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Montgomery Academy
Montgomery, AL
This case study reads very similar to Steel Magnolias. This is a misrepresentation of type 1 diabetes in this day and age. Yes, the complications mentioned in this study were a reality many years ago, and still are if the diabetic in question does not care for his or herself. In this day and age, modern insulins, continuous glucose monitoring, insulin pumps, and blood sugar testing have made the management of diabetes much better. Women with diabetes can have perfectly healthy children with a planned pregnancy. Diabetics who take care of themselves do not go blind, loose limbs, and have kidney failure. The newer technology for eye repair means that even severe retinopathy can be combated. This evidence has been out since the mid 90's when the DCCT was published. This case needs to be updated or amended to reflect this.

National Center for Case Study Teaching in Science
University at Buffalo
Buffalo, NY
We appreciate Laura's comments, and instructors reviewing this case study will benefit from reading them. This case is based on actual events and conditions at the time that the author's sister suffered and died from diabetes. As Laura has noted, many things have changed. Users of our cases should always feel free to adapt, amend, and update any of the cases in our collection. They do not need to be used "as-is." But for some of our users, the case, in its entirety or excerpted, may serve an instructional purpose in an historical context (in fact, the case itself sets the storyline within an historical context: "I had a sister who had diabetes. She died when she was 39. If she had lived a century ago, she would have been dead by the age of 14, shortly after we discovered she had the disease. Had she been born today, she probably would have lived a full life because gene therapy would soon be able to replace her defective genes....").

Kathy Connolly
Rolling Meadows High School
I worked as a Med Tech before I taught and use clinical situations like this to let my students know how serious diabetes can be for many. There are combative diabetics who may refuse to follow the treatments offered today. There are also the issues and mortality rates seen in developing countries. Look at the care today for the ebola patients treated in the US versus in Africa. Many patients still lose limbs later in life due to the chronic aspect of the disease. Many patients can't afford the best treatments and healthcare. I don't see this changing drastically even with the Affordable Health Care Act for the poverty stricken.