Nurse details efforts to get help for diabetic girl

Molly Ball

Tuesday, Nov. 16, 2004 | 9:25 a.m.

Cheryl Botzet knew all about juvenile diabetes; she was well acquainted with the specifics of her young daughter's condition.

And she didn't want help from medical professionals, according to nurses who came into contact with the mother and daughter before the daughter died of a diabetes-related condition.

Because of her mother's spotty monitoring of Ariel Botzet's diabetes, "The little girl is lucky not to have landed in the hospital with DKA (diabetic ketoacidosis)," Colorado nurse Molly-Jayne Bangert wrote in an e-mail in November 2002, referring to the condition that killed Ariel less than two years later.

District Judge Sally Loehrer ruled on Monday that jurors in Botzet's trial will be allowed to hear from the nurses, who said in a hearing that they had expressed concerned about the high blood sugar levels of Ariel, then 9 years old.

Botzet, 38, is charged with first-degree murder for the death of Ariel in February 2003 of ketoacidosis, an acidifying of the blood that is brought on when diabetics don't receive insulin injections.

JoAnn Crownover, the nurse for the Alamosa School District in Alamosa, Colo., said she first met Botzet when the two had apparently just moved to the district in May 2002.

"I was very impressed at that first meeting with her knowledge base about diabetes," Crownover said of her first conversation with Botzet. "My only concern was that...she did not want the school's cooperation in taking care of Ariel at all."

Botzet said all monitoring and treatment of her daughter's diabetes was being done at home and the school shouldn't worry about it, Crownover said.

"I wouldn't have expected a Type I diabetic to come to school without the parents working closely with the school," Crownover said. Type I, or juvenile onset, diabetes is a chronic condition that can only be treated with insulin.

On the contrary, Crownover said, Botzet resisted drafting a plan for her daughter's care while at school, though such plans are required by Colorado law.

Several times that fall, when Ariel had entered fourth grade at Evans Elementary, the girl reported to the nurse with headaches, which can indicate high blood sugar, Crownover said.

On one such occasion in September, Crownover said, she tested the girl's blood sugar at 507 milligrams per deciliter; anything over 240 is said to be cause for further testing.

But each time, Botzet would simply take the girl home from school, Crownover said.

"Cheryl always gave me the impression that she really did not want the school to deal with Ariel's diabetes," Crownover said, describing Botzet's demeanor as "abrupt."

Crownover said she spoke to Ariel privately and convinced her to see Bangert, a diabetes educator for the San Luis Valley Regional Medical Center, by telling her about Bangert's background as a former cheerleader for the Kansas City Chiefs professional football team. That got Ariel excited, Crownover said.

Bangert, herself a Type I diabetic, testified that when she met the pair, in late August of 2002, the girl's blood sugar was "off the charts."

The blood sugar levels indicated by a hemoglobin test required immediate action, Bangert said.

"Either the nutritional guidelines need to be modified or the insulin regimen needs to be recalculated" when someone's blood sugar is that high, she said.

Bangert, whose life goals shifted from dancing to diabetes education when complications forced her to have part of one foot amputated at the age of 26, said she twice supplied Botzet with emergency insulin out of her personal supply "to get her (Ariel) through the night."

Bangert said when she first contacted Botzet she found the mother defensive about the prospect of learning about diabetes.

In an Aug. 31 letter to Botzet's physician, Bangert wrote that she had told Botzet that the girl's elevated blood sugar was such that a test of the girl's urine to check for acids called ketones was called for.

Botzet had said that "she did not need to be told how to manage her daughter's diabetes but that they had checked the ketones," Bangert wrote in the letter.