I just had a lovely dip down to 38 mg/dl, so when I first saw a headline indicating that scientists had figured out a way to derive insulin from safflowers, I thought it might be time for another glucose tablet. But now that my blood sugar has rebounded, I can confirm that I was not, in fact, hallucinating: according to Canada’s CTV News, researchers at the University of Calgary have figured out a way to genetically manipulate safflower flowers to produce insulin. According to the article, “By inserting a human insulin gene into the plant, the safflowers become little insulin factories. Their seeds are then ground, the oil extracted, and the insulin harvested.”

More details:

[T]esting has found that the plant-produced insulin acts like the real thing when given to healthy volunteers.

“The insulin that they are making from the safflower works identically in the body and is chemically identical to the insulin we make from our pancreas,” Hollenberg told CTV.

The insulin the company is producing is officially called SBS-100, but its developers are dubbing it “Prairie insulin,” in honour of the region where safflowers grow so well.

Their work comes as insulin use rises every year, with more people with type 2 diabetes needing to use insulin because their diabetes medications are no longer working. The Calgary scientists say plant-based insulin could help meet that increasing demand.

Each acre of safflower flowers could produce more than one kilogram of insulin, which could treat 2,500 diabetic patients for one year. That means just 16,000 acres of safflowers could meet the world’s total demand each year.

I’m still not clear-headed enough to check their math, but regardless — this so-called Prairie Insulin has already gone through Phase 2 trials indicating that it’s safe for use in  humans, so it’s now on to phase 3 trials: seeing how it works in people who actually have diabetes. If it’s approved, it’ll further cement Canada’s reputation as the insulin capital of the world (it’s where insulin was discovered, after all). My question: what with all the bio-patenting going on, do you think there’s any chance a safflower insulin could qualify as generic?

To most people, eight days in Hawaii sounds like a dream.  And while I’m not a sit-on-the-beach kind of person at all — in fact, I hate both the sun and salt water — I am currently one of those people.  My husband and I are on Kauai right now, and there are enough activities — from hiking the Na Pali Coast to kayaking the Wailua River — to keep me very well entertained.

But bringing diabetes to paradise is challenging. Most of my vacations tend to be in cities — or, if not urban areas, places where it’s warm enough that I’m not tempted to jump into every body of water that I come across. As such, it’s no problem wearing an insulin pump or a continuous glucometer — I tuck them under my clothes, keep my shirt on, and enjoy my travels.  Hawaii’s different — not only is there the fashion challenge of matching bathing suits with insertion sites (those I don’t care about too much) and coming up with clever ways to tuck a pump into a sundress, but there’s the basic issue of the water: oceans and diabetes gear are not a good match.

I have adhesive problems with my CGM when I’m at home lying in bed, so I realized there was really no point in trying to get my sensor to stick to my skin for an hour’s snorkeling, let alone a week by the water. (Plus the fact that I doubt the electronics would react well to salt water.) So that’s out the window — it’s back to finger sticks. And then there’s the question of the pump: I’m careful to disconnect it and close up the catheter with the little plastic cap that comes with every QuickSet — but how effective are those really when it comes to keeping water and bacteria off of my puncture wound? (Not so much, if my last site was any indication — hello, red, swollen skin.)  And, of course, there’s the insulin problem: take the pump off while you swim, and you’re risking a high blood sugar when you come back to shore. Some people I know deal with this situation by going “untethered” while on vacation — temporarily switching back to just shots. But it’s been a long time since I’ve been on Lantus, and switching back — especially when I’m getting so much exercise — scares me. So my pump is still on.

All this is worth it, of course — I’ve only been here three days and so far have had schools of fish follow me while I swam, and watched a pod of breaching humpback whales (whale-watching = very diabetically friendly). I’m also finding that spending much of the day outside moving around can do a good job of  counteracting one of the other main dangers in paradise: the fruity cocktail. (I mean, seriously, people — are you trying to kill me?) But even when I manage to say no to strawberry daquiris, I’m also having an unexpected reaction to spending so much time outside: a day in the sun (which I had today, despite my best sunblock efforts) makes my skin feel  hot in exactly the same way as a high blood sugar. So I’m sitting here on the couch, several hours after eating, completely convinced that my blood sugar is sky high. In reality, I’m just dehydrated. Maybe I should reconsider that daquiri after all.

Got any tips to share on how to vacation with diabetes (besides leaving at home)? Do tell.

This morning I was feeling inspired by the interview I did with JDRF’s Aaron Kowalski about the Artificial Pancreas Project,  so I did a little google searching about artificial pancreases.  I was looking for recent news, but instead I came across this article from the New York Times, published on December 7, 1999 — just over 10 years ago. In 1999 I didn’t even have diabetes — I was a college junior, happily eating carbohydrates without fear. But people with Type 1 diabetes might have read this article and gotten a little excited. Check out its lede:

One day soon, perhaps as soon as a few years, many diabetics may forever throw away the lancets they use to prick their fingers for blood sugar tests and the needles they use to inject themselves with insulin.

Instead, they may be wearing bracelets or even earrings smart enough to sense and report glucose levels continuously to an artificial pancreas: a surgically embedded pump that dispenses just the right amount of insulin into their bloodstreams.

Whoof, that’s funny, isn’t it? I think living with diabetes requires a certain level of gallows humor to begin with, but there’s something especially cruel about how every couple years (or, hell, months) a news report comes along promising that “within a few years,” the hassles and burden of living with diabetes is going to be removed. (And with cute earrings, to boot.)  The problem is that “within a few years” is the equivalent of “tomorrow” — forever pushed into the future. Also depressing: as recently as 1999, there were only an estimated one million people in the United States. Today, there are closer to three million.

But part of the article is actually very inspiring —  because while we might not be wearing glucose-sensing jewelry yet, some of the hypothetical technologies it describes actually have come to exist. Take, for example, the end of this paragraph (it starts with the mandatory explanation of what can happen if things go wrong):

Diabetics who can maintain normal or close-to-normal levels of blood sugar, or glucose, reduce the risk of grave complications like amputation, blindness, nerve damage, heart disease and kidney failure. A continuous glucose sensor, even one that is not yet connected to an automatic insulin dispenser, might help to reduce these risks. It might also be a valuable alarm clock when blood sugar drops. When that happens, people sometimes lose consciousness.

And guess what? It’s 2010 and, while still not widely in use, we have continuous glucometers — three different kinds to choose from. Hell, mine woke me up just last night to warn me of an impending low. That’s pretty amazing. And then check out this:

Dr. Siegel pointed out that the technology [i.e. getting a fully closed loop artificial pancreas] still had many challenges to overcome. ”We have one arm of it, the insulin pump,” he said. ”When a reliable, miniaturized sensor is in place to monitor glucose constantly, the artificial pancreas will be far closer to reality.”

That was the point that Aaron Kowalski made to me about last week’s announcement to create the first commercial partially closed loop system: today, unlike in 1999, all the components are actually on the table. Like all good diabetics, Kowalski — who’s  had type 1 for some 25 years — knows better than to put a hard timeline on things. But he’s still optimistic — and as a consequence, so am I. The artificial pancreas is going to happen. And I hope that if I write this same blog post in 2020, what seems hypothetical today will have become reality.

For as long as I can remember, my father has communicated with me through newspaper clippings. This is not to say this is the only way we can talk — far from it, luckily — but my father is a voracious reader. He rarely appears in public without some form of newsprint poking out of his back pocket, and spends countless hours at the dining room table working his way through stacks of Wall Street Journals and back issues of the Economist. Armed with a red pen and a paper cutter, he creates messy stacks for me, my mother, and anyone else who has made it into his inner circle of newspaper clippings, and then stuffs them into envelopes (ones he’s recycled from credit card offers, usually, with clear plastic windows and the return labels crossed out) and puts them in the mail.

I love my dad’s articles, but there’s a problem: he tends to wait till the envelope is full (or, for that matter, he’ll let a stack of newspapers build up for months and then plow through them in an afternoon). So oftentimes, the articles are from several months — if not years — in the past. I’ve developed a quick test: if it’s yellowed around the edges, I make sure to check the date.

I bring this up because in the hands of a reader like my dad, the “email this” link on the computer is a dangerous tool. Can you imagine? No need to clip, no need to carry a pen — you just click and send. You could share hundreds of articles this way, maybe even thousands.

Luckily — and for reasons I don’t entirely understand — he holds himself back, and I only get a few forwards a week. This means that I actually read them. And there’s an additional benefit: timeliness. Take the article he sent me today, a profile from the Wall Street Journal of Sandra Peterson, the CEO of Bayer HealthCare’s medical division who “is credited with propelling the [company's] diabetes business from a market laggard to a market leader in diabetes monitoring.” It was published today. As in, several hours ago. As far as I know, Sandra Peterson is both a. still CEO of the medical division and b. alive — and might still have time left to enact some of the business advice she dispenses in this interview.

It’s mostly about her overall career — and doesn’t focus much on diabetes. But here’s my take-away: the woman pulls in more than a half a million dollars a year (if not more) working on ways to help people with diabetes. Not a bad job — and it’s interesting to read about how she got it.

Thanks, dad!

This is a bit of a Type 1 rant, but  I have a question I’m hoping other people with Type 1 can help answer: what can we do to clarify the fact that Type 1 diabetes cannot be reversed by changing your diet? Over the past couple days, I’ve had a number of very well-meaning people suggest that I learn more about raw food and its abilities to cure my diabetes. I appreciate their concern — but it reflects a misunderstanding of what this disease actually is. Namely, I don’t have any islet cells. I cannot make insulin. You can feed me all the zucchini “lasagna” you want — I am not going to be cured till someone figures out a way to a. get me more islet cells and b. keep my body from knocking them off again.

I don’t mean to sound like a hater — really, I don’t. (God knows, this is far better than hearing from people who write me comments saying that having diabetes is my fault.)  I also think that eating more raw food, as long as it’s focused on vegetables, not fruit and sweets, definitely can help control your blood sugar — not necessarily because the foods are raw, but because there just aren’t many carb-y vegetables that we we eat uncooked. But in terms of curing my diabetes, the unfortunate truth is that cooked, raw — it doesn’t matter. My problem is in my pancreas. And while I try my best to eat healthy foods  (oftentimes raw), there’s only so much my diet can do.

Today’s a big day for anyone with Type 1 diabetes: JDRF just announced a partnership with the Animas Corporation to develop what they’re calling a “First-Generation Automated System for Managing Type 1 Diabetes.” Translation? They’re trying to make the first-ever artificial pancreas. Very, very exciting. To quote from the JDRF press release:

The Juvenile Diabetes Research Foundation today announced an innovative partnership with Animas Corporation to develop an automated system to help people with type 1 diabetes better control their disease — the first step on the path to what would be among the most revolutionary advancements in treating type 1 diabetes: the development of an artificial pancreas, a fully automated system to dispense insulin to patients based on real-time changes in blood sugar levels.

The plan: Animas will work with DexCom to create an integrated CGM/pump system that will be able to shut off insulin delivery automatically if glucose levels drop too low, and increase insulin levels if your glucose goes too high. The system won’t be a total artificial pancreas — users will still have to program in boluses for meals — but it will still be very helpful for corrections, for maintaining safe levels while you sleep, and just generally keeping you in your target range more often than is normally possible when you’re doing the dosing yourself.

According to Alan Lewis, PhD, President and CEO of JDRF, the Juvenile Diabetes Research Foundation will provide $8 million in funding over the next three years “with the target of having a first-generation system ready for regulatory review within the next four or so years.”

I don’t know about you, but I find that pretty freaking exciting. I’ve always been interested in the idea of a closed loop system, but my interest was especially piqued after interviewing Dan Hurley about his new book, Diabetes Rising. For his research, Hurley actually got to wear an experimental closed loop system (spoiler alert: it was huge, clunky, and required an overnight stay in the hospital), which he describes as such a freeing experience that it “brought tears to [his] eyes.” Hurley writes extensively about what it would take to get to a commercial closed loop system and why the hell it’s taking so long — and, given today’s announcement, his book is more timely than ever. I recommend checking it out — and in the meantime, here’s a big shout-out of appreciation to all the people involved in the new closed loop project. I wish you all the best.

Having diabetes makes me pay attention to all sorts of things that, in my previous life, I could have cared less about. Like, for example, the different ways that cottage cheese and plain greek yogurt affect your blood sugar levels. Or how many grams of carbohydrate are in an avocado .

This morning, I’m surprised to say that I am interested in pig pancreases. I was looking through my google news alerts and came across this article from the daily student newspaper of the University of Pittsburgh (bookmarked in my browser right next to the New York Times). It’s about researchers at the University of Pittsburgh trying to figure out how to use pig islet cells as potential replacements for human islet cells — the same subject Jess wrote about earlier here. To quote:

Pitt researcher Massimo Trucco thinks transplanting these pig [islet] cells into humans with Type 1 diabetes might eliminate the need for insulin shots.

Trucco, whose work is sponsored by the U.S. Department of Defense, said his researchers chose to use genetically altered pig cells because of their successful trials on monkeys. Therefore he thinks the human body will be less likely to reject the cells, as it has rejected other cells researchers have tried.

He said he and his colleagues — researchers from the Netherlands and Australia — transplanted the islet pig cells into monkeys and found that the cells worked in their bodies for more than a year.

(Here’s a link to the entire article.) Before we get too excited about the possibility of getting our bacon to multitask, I should point out — as anyone with Type 1 is probably aware — that simply preventing the body from *rejecting* the new islet cells isn’t going to solve our problem. Since we have an autoimmune disease — which means that our immune system has attacked our own cells — we’ve also got to figure out a way to shut off the response that caused Type 1 diabetes in the first place.

Nonetheless, it’s always nice to hear about creative approaches to figuring out new sources for insulin-producing cells. Perhaps in the future, we will raise pigs for the noble cause of harvesting their pancreases — and BLTs will be a tasty benefit on the side.

I’ve got an interview up today with Dan Hurley, author of the new book, Diabetes Rising — and wanted to write a quick blog post to mention one of my favorite parts of the book: Hurley’s ear for analogies for life with diabetes that are so spot-on that I made my husband listen as I read them out loud.

Consider this simile, courtesy of a systems engineer working on the software to control a closed-loop insulin pump, about why controlling blood sugar is so difficult — especially since, as Hurley points out, it involves only two variables: insulin and sugar level.

“The glucose you measure with a continuous glucose monitor was accurate fifteen minutes ago,” explains the engineer. “The insulin you take does not start acting for twenty minutes, ahs a peak of action around forty-five minutes, and it continues to act for up to three hours. So you are acting on out-of-date data, and you’re using a mode of action that will only kick in much later on. It’s like you’re driving a car down a winding road — but you aren’t able to see that the road turned until you are fifteen yards past it, and turning the wheel will have no effect for two hundred yards more. If you’re driving a car like that, you’d better have a good map.”

So true. Thanks again, Dan, for speaking with us about the book.

For people with diabetes, New Year’s isn’t just a chance to start afresh with some new blood sugar resolutions (I will determine my exact fasting carb-to-insulin ratio. I will!) — it’s an opportunity to celebrate the end of holiday season, and its accompanying smorgasbord of high-carb treats. As I see it, New Year’s day marks smooth sailing till Valentine’s Day.

When I lived in New York, I liked to bring in the new year with what I think must be the most diabetically friendly NYE party ever: the midnight run in Central Park. You gather in sub-freezing weather with thousands of other lycra-clad revelers, all count down to midnight together, and then, at the moment the new year starts, run four miles. I admit that the idea of kicking off 2010 with a midnight jog might not sound like fun to a lot of people — but don’t knock it till you’ve tried it. There’s a Central Park fireworks display, so as you start to run you’re treated to an incredible show bursting directly overhead. The run is also a costume contest, so you’re constantly passing (or being passed by) giant crayons, or salmon, or — my personal favorite — an 80-year-old man naked except for a diaper and running shoes, his chest marked with the words “New Year’s Baby.” (“My wife doesn’t know I’m doing this,” he told me.) As you run, people from the neighborhood stand at the edge of the road shouting happy new year, and instead of water breaks, they have tables covered in small cups of non-alcoholic champagne. Best of all? At the end of the race, there’s a huge dance party.

So in other words, you’re celebrating the new year by exercising and dancing. What could be better for your blood sugar?

Alas, California does not have a new year’s run that I’m aware of. So instead we celebrated by having dinner with some friends. Equally fun — but not as good for diabetes. Witness this cake, put together by my husband from Cook’s Illustrated. That is three layers of chocolate, my friends. Nearly flourless cake, a dark chocolate mousse, and a white chocolate cream on top. Oh, and the brown stuff? Chocolate shavings. You can only imagine how good it is.

The weird thing, though — and perhaps this is a testament to nearly nine years of restricted desserts — is that I didn’t have too much trouble resisting. Granted, I have had more white chocolate cream in the past two days than over the past three years combined (that’s what happens when it’s in your refrigerator) but I know, somewhere deep in my soul, that the temporary pleasure of having its three layers dissolve on my tongue would not be worth the feelings of guilt and fear that would ensue. Let them eat cake! My true weakness was the rolls.

Oh, the rolls. My husband’s mom has an amazing recipe for dinner rolls that he has, for some reason, hidden from me until this new year’s eve. After he’d put together his chocolate concoction, he began kneading and shaping what I can only refer to as carbohydrate crack. Check out this photograph (and please note the BD pen needles in the background). Chewy, doughy, yeasty, slightly sweet — put a pat of butter in the middle and you will swear you’ve gone to heaven. (Eat too many of them without enough insulin and you may well have the opportunity.) Dear lord, these are good. So good that I can hardly write about them without wanting to eat one.

So basically, I spent new year’s eve wondering if my husband were trying to kill me.

And then last night I had an incident where I almost did the job myself: it was 4 a.m. and my CGM said 165. I hate letting my blood sugar stay high at night so I began fumbling around with my pump, trying to get the light on so that I could program a correction bolus. I must have woken up in the middle of a deep cycle or something, though, because no matter what buttons I pushed, the light wouldn’t go on. Said deep sleep also really screwed with my understanding of what the pump does (i.e. give you insulin) because it was only after I heard a few ominous ticks that I realized that instead of turning on the light, I was giving myself a bolus. Please note: I have worn the pump continuously for eight years and never, ever done this. I managed to push the suspend button, flicked on the light, and realized I’d given myself two units in my sleep. Which is bad — and necessitated a mouthful of honey and a double check to make sure that the low alarm on my CGM was on (thank god for the navigator). But when I looked at what *could* have happened, I realized just how lucky I was: I had somehow programmed into the bolus wizard calculator that I had just eaten 299 grams of carbohydrates (in other words, theentire chocolate cake). Recommended bolus? 23 units — nearly an entire day’s worth of insulin. What had I actually programmed? 10 units — a number determined by my pump’s predetermined max (which I am now going to lower even more). I don’t even want to think of what would have happened if I hadn’t heard the tick. So I’m going to add a new resolution to my list: don’t let my diabetes management kill me.

A much cheerier note: here’s a photograph of an aquavit-inspired creation my husband made — it’s a bottle of ginger liquor that he froze inside a milk carton with pretty flowers and rosemary sprigs.

I heard on the news this morning that today is the birthday of Mary Tyler Moore, who’s long been the biggest celebrity advocate for people with Type 1 diabetes — which she herself has. It got me thinking about what a difference it can make to have someone famous advocate on your behalf (or, for that matter, come down with your disease). This is  ridiculous in one way (shouldn’t I care about clean water in Africa without having Matt Damon involved?).  But, on the other hand, it makes perfect sense: we care more about issues that we have a personal connection with — and as anyone who has stapled a Tigerbeat poster to their bedroom wall knows, humans are very good at creating imaginary relationships with people who are attractive and famous. So why not put that celebrity status to good use?

I was going to encourage more celebrities to take up the diabetes cause, but then realized that doing so might amount to wishing ill upon their immune systems — there’s a difference, after all, between advocating for clean water and advocating for a disease that you’re unlucky enough to have yourself. So instead, let me say that I am thankful that there are so many prominent people out there right now who happen to have Type 1 diabetes. Like Nick Jonas, for example. Or Sonia Sotomayor. Or, of course, Jay Cutler. (And there are other examples on the Type 2 side as well.)

So, in honor of Mary Tyler Moore’s birthday, I wanted to thank her and all the other celebrities out there who are using their fame to help educate people about and raise money for this disease. I’m very grateful.