CALGARY — A doctor who treated a starved diabetic boy 10 years before his death thought the child's mother should undergo a psychiatric assessment.
Emil Radita, 59, and his wife Rodica Radita, who is 53, are charged with first-degree murder in the death of their 15-year-old son.
Alexandru, who was one of eight children, weighed less than 37 pounds when he died in 2013 of complications due to untreated diabetes and starvation.
"I don't believe she really had an understanding of what diabetes was."
B.C. pediatrician Paul Korn was recalled to the witness stand at the trial in Calgary on Wednesday for cross-examination.
After Alexandru was admitted to hospital in Surrey, B.C., in October 2003, his mother's odd behaviour in refusing to accept a diabetes diagnosis from three years earlier, as well as a failure to provide proper treatment, made Korn think a psychiatric assessment would be a good idea, he said.
"The information that had been presented to me up until that time, in terms of what had happened in 2000, what had happened in 2001, what eventually ended up happening in 2003 — and everything in between — was very unusual,'' Korn recalled telling an RCMP officer at the time.
"I'd been doing pediatrics for 20 years at the time and this was really, really odd. I thought a psychiatric assessment was something that should be considered.''
Suggested parental capacity assessment
Korn also suggested a parental capacity assessment for the Raditas, although he did say he didn't believe the mother's behaviour was intentional or malicious.
The doctor didn't believe the Raditas were targeting Alex or withholding nutrition from him "per se,'' but was concerned about their "bizarre understanding'' of how to manage his medical issues.
"I don't believe she really had an understanding of what diabetes was or what it meant or what the outcome would be if he wasn't treated,'' Korn testified. "I don't think she had an understanding that, untreated, this was a fatal condition.''
Alexandru Radita's parents are on trial in his death. (Photo: Facebook)
The doctor recommended that Alexandru's mother be allowed to remain at his bedside, even though he was being turned over to children's services.
"He was in a very, very fragile state. The mother had been looking after him continuously ... and my feeling was at that time (that) to separate mother from Alex could lead to a very bad outcome for Alex,'' Korn told court.
"He was in a very tenuous state and we weren't really sure that he was going to live in the first few days of his admission to the ICU.''
"I don't think she had an understanding that, untreated, this was a fatal condition."
Justice Karen Horner, who is hearing the case without a jury, has yet to decide if the evidence from British Columbia will be admitted.
Crown prosecutor Susan Pepper urged the court to accept the evidence because it provides "background and narrative.''
"It's about his whole life. He didn't just arrive in Alberta as a blank slate,'' said Pepper, who argued the narrative is complete "with near-death experiences and complete recoveries.''
Not unlike an abusive relationship: prosecutor
She also said it puts into context the relationship between Alexandru and his parents, who she says fostered a complete dependence on them by isolating their son from school and the community.
"This isolation was necessary to allow the Raditas to treat Alexandru's diabetes in an idiosyncratic and dangerous way,'' Pepper said.
"The relationship between Alex and his parents is not unlike an abusive domestic relationship where the abuser isolates the abused in a bid to establish total control over the victim.''
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Commonly referred to as Juvenile Diabetes, because it’s often diagnosed in childhood. However, it can also be diagnosed in adults. Type 1 diabetics have a pancreas that produces little or no insulin, which requires insulin management through medication that is usually injected.
Type 2 diabetes is a chronic condition that almost always develops in adulthood — which is why it’s sometimes referred to as adult-onset diabetes. "About 90 per cent of diabetics are Type 2, meaning that their ability to produce adequate levels of insulin is highly compromised and they have significant levels of insulin resistance,” says Dr. Barry Sears, president of the Inflammation Research Foundation. "The combination leads to significant increases in a variety of additional disorders — in particular heart disease and Alzheimer’s — in addition to the standard problems of loss of vision, increased amputation, and kidney failure."
Insulin is a hormone. It’s produced by the islet cells of the pancreas, and its role is to regulate glucose levels in the blood. The pancreas secretes insulin into the bloodstream, where it works to allow sugar to enter the cells and lowers the level of sugar in your bloodstream. As blood sugar drops, the secretion of insulin from the pancreas does too. While both types of diabetes involve insulin and the functioning of the pancreas, there are key differences in their causes and treatments.
Symptoms of type 1 diabetes include the emergence of bedwetting in children, frequent thirst, frequent urination, unintended weight loss, extreme hunger, blurred vision, and fatigue.
With type 2 diabetes, the condition can exist for years before diagnosis. But many of the symptoms are the same as with type 1: blurred vision, unexplained weight loss, excess thirst and urination, fatigue. Also watch for sores or infections that are slow to heal, as type 2 diabetes can affect your ability to heal and fight infection. As well, areas of darkened skin (acanthosis nigrican) in creased areas like the armpits and neck are a sign of insulin resistance.
A variety of factors may contribute to the development of type 1 diabetes, according to the Mayo Clinic, including possible genetics and exposure to certain viruses. Risk factors for the disease include family history and young age, with peaks in outset occurring between ages 4 and 7 and ages 10 and 14.
With type 2 diabetes, the risk factors include having excess fatty tissue, carrying fat around the abdomen, having a family history of diabetes, being inactive, having polycystic ovary syndrome, and getting older. As well, people of black, Asian, Hispanic, and Aboriginal backgrounds are at higher risk of developing type 2 diabetes, though it’s not known why.
Interestingly, the incidence of type 1 diabetes increases as you travel away from the equator, according to the Mayo Clinic, leading some researchers to think it could develop more readily in winter than summer. The highest incidences of type 1 diabetes are found in Finland and Sardinia, for example, where rates are about double or triple those in the U.S. and 400 times those in Venezuela.
It’s unknown exactly what causes type 1 diabetes, but in those with the condition, the immune system attacks the insulin-producing cells of the pancreas. In type 2 diabetes, the islet cells are still functioning as they should, to release insulin — the problem instead is that the pancreas doesn’t produce enough insulin, the body becomes resistant to the insulin, or both. But while we know about some contributing factors, it’s also not known exactly what causes type 2 diabetes.
Type 1 and type 2 diabetes can both have serious effects on your health if not managed. Diabetes can affect your eyes, heart, blood vessels, nerves, and kidneys, though keeping your blood sugar levels well managed does a lot to mitigate these effects. Nerve damage can manifest in loss of feeling or pain, usually beginning in the feet or hands. It could cause gastrointestinal problems or erectile dysfunction. Damage to the blood vessels in the kidneys can lead to kidney failure or kidney disease. Eye problems are also seen in some diabetics, and problems in pregnancy are also a risk.
Prevention of type 2 diabetes can be done in part through dietary choices, and making sure you get enough magnesium may be one of them. "Magnesium plays a pivotal role in the secretion and function of insulin,” Dean says. “Without it, Type 2 diabetes is inevitable.” Measurable magnesium deficiencies is common with the condition, she says, and related to many of the related complications.
Managing stress and anxiety can also help to keep your overall health steady, including possibly staving off type 2 diabetes. "The connection between stress, obesity and diabetes cannot be overlooked,” Dean says. "The stress chemical cortisol signals a metabolic shutdown that makes losing weight almost impossible. Magnesium can neutralize the effects of stress and is known as the anti-stress mineral.” And of course, if you do have diabetes, it’s easier to manage your condition if you aren’t overwhelmed.
There is no cure for type 1 diabetes, though the disease is manageable and treatment has advanced considerably in recent decades. Those with type 1 diabetes must take insulin for the duration of their lives; the physician works with the patient to find the best insulin and dose for blood sugar maintenance. Other medications may be required for related conditions. Not all type 2 diabetics require insulin therapy, but some do. For both types, regular exercise and a healthy diet, along with weight control, can also help keep glucose levels consistent.
For some type 2 diabetics, bariatric surgery may be an option to lose weight and control the disease. However, the surgery does involve serious risks that should be discussed with your physician.
If you suspect you or a family member has type 1 or type 2 diabetes, it’s important to seek medical help as soon as possible. It may be helpful to keep track of your symptoms leading up to the appointment, and go in with a list of your medications and general information about your diet and exercise routines.