A Cure for Diabetes?!

Researchers in South Florida are taking a huge leap in finding a cure for Diabetes.  They’re unveiling a new bio-engineered organ that might be the key to getting people off of insulin. Scientists are not releasing the information until next month, but we have an exclusive interview with the doctor behind the project.

The building may look like any doctor’s office.  But what is happening at a building at the University of Miami is nothing short of a medical breakthrough.. Dr. Camillo Ricordi, is on the verge of curing Diabetes. He’s already given patients like Antonella Soliani their lives back.  “For me, he is God.”

Soliani, who is from Italy, has been monitoring her blood sugar levels and injecting herself with insulin since she was diagnosed with Type 1 Diabetes at the age of 14. But now, she is free.  “Are you still on insulin? No. I don’t use insulin.” Soliani is one of a select group of people who underwent a clinical trial at the Diabetes Research Institute in Miami. Doctors injected insulin-producing islet cells from a donor organ into Soliani’s liver. She is no longer insulin dependent.

But the problem with implanting these islet cells into the liver is that patients have to be on anti-rejection drugs and that’s not really a cure. But the next phase of the project would create a mini organ that would replace the patient’s pancreas. Dr. Ricordi says this is a step in the direction of a cure.  “It’s a treatment for diabetes now, but it will be a cure when we can do it without anti-rejection drugs.”

Ricordi started this nearly 25 years ago, when he developed a chamber to extract and purify those special insulin-producing islet cells.  Now, almost three decades later, he’s starting these new clinical trials and he believes a cure is within reach.  “I didn’t think it would take so long.”

But for Antonella, the wait it over.  She may not be cured of her diabetes, but she says she is free of it.  “Free. You feel free? Yes, I feel free!”

To read the original article, or watch the video, click here!

Report filed by Suzanne Boyd, CBS 21 News. March 26, 2013.

New Appointment with the Endo

Annoyed by Phone Calls with the Endo (Diabetic Doc)
Annoyed by Phone Calls telling me to test more!

My endocrinologist‘s office called me the other day to simply remind me that I am due for an appointment. I see my endocrinologist every 6 months, and my last appointment was in November.  I guess that is a good thing they called to remind me. The nurse asked if I have been doing ok with dealing with my diabetes, or if I had any questions, I should have kept my big mouth shut!

On a side-note: I have been avoiding all the middle-of-the-night low blood sugars I’ve had in the recent past, but I am sure my hemoglobin A1c number has probably gone up because of it. Yes, I have issues, but what diabetic doesn’t?

So, back to the nurse… I made my appointment. I simply stated that I was getting a lot of lows during the night, and that I changed my basil rates… oh yeah, and that I wanted to get my A1c down.  Then I hung up.

This morning, I got a phone call from Neighborhood Diabetes, the company that mails my test strips. Apparently, my endo’s office called them and said that I need to test my blood sugars more each day! They ordered the company to send me more test strips each month too. My current prescription is for testing 7 times per day. My endo would like to change it to 8 times per day.

I thought the CGM was going to make my life simple, and avoid having to test as much? I guess that ship has sailed. Hopefully the appointment goes over smoothly, even though I am sure I will get a lecture about my A1c — Never fails.

JDRF Experts Weigh in on Better Metrics for Blood-Glucose Control

Technological advances and enhanced treatments over the past 40 years have led to major improvements in blood-glucose control for people with type 1 diabetes (T1D).

JDRF Experts Weigh in on Better Metrics for Blood-Glucose ControlMore sophisticated tools, such as systems to automate some insulin delivery or glucose responsive insulin, could help to improve blood-glucose control. To this end, JDRF continues to lead in the support of technological advances and research initiatives to better treat T1D. These new technologies require new metrics for evaluating performance and outcomes. Hemoglobin A1c (HbA1c or A1c), a test that measures a person’s blood-glucose levels over the past several months, is a key metric, or analytical measurement, used today in T1D management. But since it reflects an average blood-glucose level over the span of 120 days, it is not a good marker for T1D control on a day-to-day basis; the occurrence and frequency of dangerous blood-glucose highs and lows are not represented in the A1c. Experts argue that standardization of metrics to measure the success of a person’s T1D control (minimizing high and low blood-sugar exposure) is important, but A1c should not be the sole measure of control.

Two of our very own experts in the field—Aaron J. Kowalski, Ph.D., JDRF’s vice president of treatment therapies, and Sanjoy Dutta, Ph.D., JDRF’s senior director of treat therapies—recently contributed their thoughts on the need for better approaches and standards by which to judge success of T1D control and on how to improve standards of care in a commentary published in the journal Diabetes Technology and Therapeutics. Following is their expert view:

Since the discovery of insulin in 1921, the trajectory of advances in the treatment of diabetes was flat through to the 1970s, when a pivot occurred. In the 1980s, widespread home blood-glucose monitoring became a reality, insulin pump therapy was commercialized, recombinant human insulin became the standard of care. Importantly, these advances saw a major improvement in glucose control and appreciation of the role of hyperglycemia in the development of diabetes complications. More recently, significant new options have been developed to better treat diabetes—continuous glucose monitors, novel insulin analogues, incretins, and many other therapies have added to our treatment armamentarium. Surprisingly, these more recent advances have not led to similar improvements in the HbA1c levels across the population. Instead, today we sit on an “A1c plateau” (1, 2). Bergenstal et al. address what may be the key element of this problem. Although we have seen the introduction of many new treatments, the diabetes ecosystem is not equipped to empower the provider or the patient to maximize the utility of these therapies. It is clear that we have a breakdown between therapeutic efficacy and effectiveness. A ripe place to start to address this problem is through standardization of metrics for the most important marker of diabetes management—glucose levels.

Since the landmark DCCT study, the HbA1c has been the gold standard metric for diabetes control (3). There is obvious justification for this. The DCCT/EDIC and UKPDS conclusively demonstrated the correlation between HbA1c levels and the development of both microvascular and macrovascular diabetes complications (4-8). HbA1c measures a physiologic process by which the hemoglobin molecule is glycated, which is a surrogate for glycation of other proteins in the body and a driver of diabetes complications (9). Therefore, the HbA1c represents a measurable link between glucose levels and the factors driving complications development.

While the HbA1c will likely remain a key metric and measurement in diabetes management, it is not however a good marker for diabetes control on a day-to-day basis, nor for providing insight into strategies to improve glycemic control. HbA1c reflects the glycation of hemoglobin over the lifespan of erythrocytes—approximately 120 days. This is generally represented or considered as reflecting a mean blood glucose over this period of time. A mean speed of 55 mph over the past three months of commuting will never reflect times when a vehicle is racing at 100 mph and far in excess of the speed limit or is slowed to 10 mph in traffic congestion. Similarly, the clinician receives only the most basic of information from the HbA1c measurement and masks the occurrence and frequency of dangerous highs and lows.

We must agree upon the other metrics and standardize them so that information is provided to patients and healthcare providers to truly realize these goals.

Bergenstal et al. have made an important step to do just this. The challenge of defining and prioritizing key diabetes glucose-control metrics was addressed in a workshop with key thought leaders in the field of diabetes, both public and private stakeholders, regulators, and patient representatives. The transition to “big data” is happening in all walks of life and diabetes is no exception, affording a tremendous opportunity to provide data-driven recommendations to patients. Following adoption of a consensus on metrics, tools can and will be developed that present this immense amount of data in ways that can be easily visualized, interpreted, and acted upon. Bergenstal et al. describe one such tool, the Ambulatory Glucose Profile (AGP), that provides a concise and targeted summary to the patient and provider.

The group identified four key metrics that provide much more valuable information in guiding diabetes treatment strategies: time in range (the amount of time a person’s blood glucose is within a healthy range), glycemic variability (exposure to hyperglycemia and hypoglycemia), glycemic exposure (the mean and median of glucose values), and assigned values for blood-glucose ranges signaling hyper- and hypoglycemia. Once these metrics are agreed upon, tools such as the AGP will provide diabetes clinicians a significantly improved and practical means to guide their patients in targeted strategies to improve diabetes management and glycemic control. The profile presents a modal day view of the data that allows for patterns to be identified quickly and simply, which will allow treatment strategies to be developed during an office visit.

However, we are still not close to achieving our goal of minimizing hyperglycemic and hypoglycemic exposure. The recently published T1D Exchange data demonstrating the elevated A1c levels, severe hypoglycemic events, and overall poor control in many people with diabetes should be a call to action for the diabetes community (10). We will rapidly move to more advanced tools—soon to systems that automate some insulin delivery (11, 12). Without consensus within the community on the metrics for success, it will prove difficult to optimize and compare new technologies, and their optimal adoption, use, and effectiveness will be blunted, which is an unacceptable outcome.

In addition, a major unaddressed area and a serious unmet medical need is the extended period of “dormant or silent” diabetes—both types 1 and 2—where HbA1c offers little value as a diagnostic. The AGP provides salient metrics with the potential to standardize the early detection and treatment of “prediabetes,” thus fostering therapeutic and/or lifestyle interventions that lead to the prevention or delay of onset of overt clinical diabetes.

In order to improve standards of care, we will have to rapidly develop and adopt “composite” metrics for both diagnosis and treatment of individuals with diabetes. To best accomplish our goals, we will need to raise the level of collective education and awareness for accelerated adoption and usage of such metrics—across the entire healthcare spectrum—including patients, physicians, regulators, and providers. Bergenstal et al. have provided a critical step in the right direction. It is time to formalize these recommendations and to standardize outcome metrics that will help guide therapeutic development, accelerate regulatory approval, and improve clinical outcomes.

Original Article can be found here. Written By JDRF Research Team

The Drug Called Insulin

I was just surfing around twitter today, and happened to come across this photo.

It made me giggle, but it is also so true!

diabetic drug called insulin

https://twitter.com/Type1pancreas/status/306594168808013824/photo/1

I like it when I find funny things related to diabetes. It makes me feel good to know I can relate, and not everyone out in the world feels like having diabetes is a life sentence! I certainly don’t, and neither should anyone else. Diabetes is just another thing we need to deal with in life, and if we don’t embrace it, and learn to cope with it, we will be miserable for the rest of our lives!

College Life with Diabetes

I recently read a forum about a Type 1 Diabetic, High School Senior, who is going away to college in the fall. She wanted more insight as to what college life is like for diabetics, and how they were able to cope and manage. It really only feels like a couple of weeks ago that I, myself, started on the magical college ride. After 6 years, 3 different schools, numerous classes and thousands of finger pricks and bolus injections, I will be graduating this may with my bachelors degree!

Being a college student is rough all on its own, but when you thrown in something crazy like Type 1 Diabetes, everything gets all sorts of screwed up! Heavily drinking, partying, staying up really late, doing homework assignments and dealing with roommates is what college life is all made up of!

College Life with Diabetes

In my first year, I dormed with someone VERY similar to myself — minus the diabetes.

On the first day we met, I explained that I was diabetic and told her that if she noticed I was not acting right, to give me some juice. She also put my dads phone number on speed dial JUST IN CASE! There was no issues, but I was happy that she was aware. Only issue during my freshman year that I encountered was that I needed to get special permission from the school to put a mini fridge in my dorm room. Our entire floor shared 2 fridges — but there was NO WAY I was putting, and leaving, my insulin and juice and snacks in there. God forbid someone steals my snacks or insulin when I really need it!

My 2nd year I dormed with a good friend of mine. She knew I was diabetic, bought special sugar-free treats we could both shared, and understood what diabetes was…. but I never really explained to her what diabetes meant and/or entailed and/or what she was going to be in for. As a sophomore, I was on an insulin pump, and was having a good time in college —

with an average BS of about 180. One night, I was up all night working on a paper, super stressed out, and didn’t go to sleep til almost 5am (with class at 9). My roomie went to sleep at normal time, and woke up, left for class, did her normal thing, not realizing that I had slept through my entire class and almost the entire day! I think it was about 1pm when I woke up, tried to get outta my bed, and my legs collapsed. I literally pulled myself across the floor of our dorm to the fridge to get

juice. Took me about 20 mins to do that — but I couldn’t reach my cell phone to call for help either.

Even if I could have gotten my phone, I couldn’t lay there waiting for help either. I somehow made it to the fridge to get some juice by crawling my way across the floor. I sat on the floor for a while, hoping it would go up. I got lucky that EMT’s weren’t called that day. My professor was OK with the situation and didn’t punish me for missing class either. I graduated in 2008 with my Associates Degree in Communication Design from the Fashion Institute of Technology.

After taking some time off, doing miserably at another school, I now attend SUNY Purchase. I went back to school for my bachelor’s, and now am in my senior year. I currently have an apartment with my boyfriend (who’s not a college student) and everything seems to be alright. I tend to have low mornings, but he’ll wake me up because he hears my CGM vibrating. Honestly, my boyfriend has been a lifesaver for me — and I think it is important to know you will always have someone there to help at those times of need.

I could never, and would never, live alone. Life as a Type 1 Diabetic can be scary at times!

Partners Helping to Cope with Diabetes

If you have been reading my blog posts, you will see that I tend to mention my boyfriend helping me cope with diabetes quite frequently. That is because he does help me quite frequently, especially in times of lows.

Partners with Type 1 diabetesThere has been numerous times he has woken me up in the middle of the night to test. There has been numberous times when he gets up before me for work, and I don’t budge. He has made it a habit to make sure I am awake and tested my sugar before he leaves for work. There has been other times when I have begun shaking in the middle of the night, where he’s had to shove glucose tablets down my throat, make me put some juice in my body and suspend my insulin pump. If I was alone, it could have been hours before someone found me, or noticed that I didn’t wake up to go to work. But luckily, I have a great guy sleeping next to me.

There are two people in the scenario — the diabetic and their significant other. I guess I have not really noticed how much my boyfriend is affected, if not more than me, by my low blood sugar episodes. He gets frustrated and annoyed with my numberous lows. We have had numerous conversations about changing my bolus to avoid the lows. We have had numerous conversations about eating an extra snack before bed. And there has been numberous times that I thought “It’s not a big deal.”

The thing is, it is a BIG DEAL!

I have learned that sometimes it may just be better to run high or over-treat a low blood sugar, rather than risking the low and going back into the vicious cycle of an annoyed boyfriend. Even with our conversations, I have gone to bed with blood sugars at 200 mg/dL, and still wake up at 40 mg/dL. Despite everything, I am glad that he is there. I do love him for everything he does for me, and just hope that he can understand how difficult it is to control type 1 diabetes.

Thank Goodness for CGM Technology

After another low blood sugar in the middle of the night, I am again so glad that I have a CGM. My continuous glucose monitor (CGM) started to vibrate at 3:10 am last night, awaking both me and my boyfriend.

Omnipod Blood Sugar ReadingsI have it set so that if my blood sugar reaches 60 mg/dL, it alerts me. It also vibrates/alerts twice as much if I continue to drop below 55 mg/dL. When it began to vibrate at 3am, the CGM said my sugar was at 60 mg/dL. When I actually checked my sugar level, I was at 51 mg/dL. Time to run for a snack and some juice!

If I wouldn’t have had my CGM on last night, I wouldn’t have woken up in the middle of the night. I would have probably slipped into a diabetic coma or have seizures of some sort. Yes, CGM technology isn’t ever 100% correct, but the alert and wake-up call was well worth it. I am very pleased to say that I woke up with a blood sugar of 102 mg/dL. I was awake, coherient and able to start another typical day as a Type 1 Diabetic.

Springing Forward, Diabetic Style

I went to bed last night, forgetting about the whole “Spring Forward” thing. Luckily, my cell phone turned back and woke me up at the correct time! My CGM and my insulin pump/glucose meter (they are wirelessly connected) needed to be changed ASAP!

It is a funny thing to think about — everyone always remembers that they need to set their clocks back one hour, but how many of us really remember to change the time on our diabetic devices?

Change the time, diabetes style. What devices did you need to make "Spring Forward"?The last time the clocks changed, I think it took me about a month to actually change the time on my OmniPod insulin pump! I just kept forgetting to do it. When I plugged it into my computer, all my numbers were messed up, and then I remembered what I needed to do. Change the time!

This time, I was right on top of it! As soon as my alarm went off, I looked at my CGM and my meter, and changed the times immediately. I was able to avoid a high I might have had later on this morning. I am glad that I had my little reminder… Bummer that we had to lose an hour of sleep last night, though!

What diabetic devices do you use that you needed to change the time on?

What is a Type 1 Diabetic?

Lots of questions have been floating around on my youtube channel recently about diabetes and how I manage it. Well, what really is the difference between a type 1 diabetic and a type 2 diabetic? Type 1 will NEVER go away and HAS to be managed with multiple insulin injections each day. Type 2 diabetes may be controlled by pills and/or insulin, and usually only affects those who are older, overweight and have eaten too much crap in their lifetime.

I sorry for being so blunt, but it really does rub me the wrong way when people with type 2 diabetes feel that they “know how it feels” to be a type 1 diabetic. Really, you’ve been dealing with diabetes for a few years, have to eat a little bit better, rarely (if ever) had a low blood sugar, and you think you know it all?

Welcome into my world. I’ve been a type 1 since I was 9 years old. I’ve given myself 5+ shots per day, pricked my fingers sometimes over 8+ times per day, and will have no choice but to live with it for my lifetime. That means I have literally pricked my fingers over 30,600 times in my 24 year lifetime, 15 of which I have been a diabetic.

I am not saying that type 1 diabetics and type 2 diabetics are really that much different, but the mentality type 1 diabetics know their bodies better, know how much insulin they need, and understand that it is with them for a lifetime. Type 2’s get off easy, and can manage it, control it, and possibly make it go away. I just wish I had that option.

 

type 1 vs type 2 diabetes
Differences between type 1 diabetic and a type 2 diabetic