It wasn’t easy, but our editors have selected ASweetLife’s 10 best diabetes stories of 2012. From research and technology stories to tales of baking, racing, and personal triumph, 2012 had it all. Many thanks to our readers for your loyalty and support. We wish everyone a very happy and healthy 2013, and may it bring in the best diabetes stories, hopefully ones that hint a diabetes cure is near.
Diapep277: Slowing the Progression of Type 1 Diabetes
by: Jessica Apple
When Mike enrolled in the Phase II trail of Diapep277, he was told it was a potential diabetes vaccine. This notion of vaccine was somewhat confusing. Mike, after all, had type 1 diabetes. Diapep277 wasn’t going to prevent it like the chicken pox vaccine prevents chicken pox. But the notion of a vaccine is more complex than that. “The immune system, like the brain, learns from experience,” said Cohen. “A vaccine is a signal or set of signals that teaches the immune system how to respond to a particular situation. We could call Diapep a ‘therapeutic vaccine’ – probably it would be clearer to call it a specific modulator of the immune system – a signal that helps the immune system to make desirable decisions in how it should relate to the body.”
Mike’s Diapep277 trial took place in 2002-2003. The study coordinator told him the participants were divided into three groups – high dose recipients, low dose recipients, and a placebo group. Then, Mike did not know which group he was in. He now knows he did receive Diapep277. Throughout the study, doctors monitored Mike closely. They were checking for residual beta cell function by a measurement of C-peptide (C-peptide is a protein produced along with insulin, and its presence in the body is a sign of insulin secretion, or beta cell function.) In order to measure beta cell function, Mike was given glucagon injections and then blood was drawn to learn his body’s response to the glucagon. The study also measured his HbA1c. “What was most surprising was the lack of side effects,” says Dr. Mariela Glandt who led a follow-up trial to Mike’s under Prof. Itamar Raz at Hadassah Hosptial in Jerusalem. “Patients had no complaints.” Read more
Why I Chose Metformin
by: Max Apple
I began taking metformin 500 mg twice a day and I started reading even more about the effects of carbohydrates on a body like mine that was becoming more insulin resistant by the year. My reading influenced above all by Gary Taubes, Good Calories Bad Calories and other works promoting fats over carbs has been pretty convincing.
When I began taking metformin, I felt as if I was like a teenager taking precautions against acne. I wasn’t sick, and had only the beginnings of feeling tenderness beneath the skin. But after a few months of reading about diet and diabetes I’m not only more certain of my decision to go on metformin, I am doing everything I can to purge carbs from my diet.
I’m also trying to go back to my old ways of regular exercise. For many years I ran three miles at noon every day with the same friend. When I moved to a new job in a less friendly running climate I switched to a stationary bike and a treadmill. But even adding TV and books didn’t make me look forward to exercise and, gradually, I realized that what for years was built into my schedule had become something I had to force myself to do.
I miss the outdoor experience of running, but even more, I miss my old friend. The camaraderie and friendship that developed over years was something that silent reading and passive TV watching couldn’t replace. There’s nothing I can do about missing my friend on a daily basis, but recognizing that the problem is more emotional than physical has helped me go back to regular exercise. That realization, along with the rising A1c, has made even the treadmill look pretty good. Read more
A Baker Resurrects a Diabetic Cookbook From 1917 (Sort of…)
by: Carolyn Ketchum
My friend, Jessica Apple, editor of A Sweet Life Diabetes Magazine, came across an old diabetic cookbook and thought it might make good story material. And by old cookbook, I mean really old. As in written almost 100 years ago. Diabetic Cookery, by Rebecca W. Oppenheimer, was published in 1917, at a time when such cookbooks didn’t really exist for diabetics in need of carbohydrate restriction. In fact the preface begins like this, “The author would feel diffidence in publishing a cook book when so many other excellent ones already exist, if it were not that she is treating a special field.”
It is important to note that Oppenheimer’s book was published five years prior to the discovery of insulin in 1922, at a time when type 1 diabetics died quickly from the disease, and type 2 diabetics had little to rely on for treatment. Focusing on food that diabetics could ingest without taxing their precious beta cells too much, made Oppenheimer’s diabetic cookbook somewhat revolutionary.
I was game for the challenge of trying out some of these old recipes, and Jess and I corresponded a bit about some of the funny ingredients listed. It seems that even back in Oppenheimer’s day, almond flour was a standard low carb ingredient for many sweets and baked goods, so I was set there. But I was fairly certain I wasn’t going to be able to get my hands on any Aleuronat Flour or Lyster’s Prepared Casein Diabetic Flour, whatever those might be. And although saccharin is still fairly common as an artificial sweetener, I hadn’t a clue as to how much would be contained in a “saccharin tablet”. Still, I thought it would be fun to recreate a few of these old recipes and see how they compared to some of diabetic cookery around today. Read more
Celebrating My Ten Year Anniversary of Life with Type 1 Diabetes
by: Michael Aviad
Having diabetes has changed the way I eat and exercise. It has motivated me to do things I never thought I could do (and continues to do so). I’ve run six marathaons, and I’ve signed up for my seventh. Diabetes has also made me reevaluate my life. I look at things in a different way. I don’t measure success by a job position or a salary. I have an entirely new sense of what’s important. Diabetes helped me put family first and made me appreciate life, not just as a whole, but in the minute by minute. It’s a kind of appreciation that may only come when you know the chance of death is, if I may quote the Rolling Stones, “just a shot away.” Read more
I also discovered a parallel world of diabetes that I didn’t know existed ten years ago. Then, I felt totally alone. Now I know there is a world full of inspiring people with diabetes, people I am lucky to work with, people I haven’t met, but who inspire me to do better and to be stronger. I am part of a community based around a disease which somehow seems to be a healthier community than most. Our community transcends borders, age, race and gender (maybe John Lennon was writing about this world).
Proving the Hygiene Hypothesis?
by: Karmel Allison
The hygiene hypothesis, first put forth by the British epidemiologist David Strachan in 1989, suggests that the cleaner our environment becomes, the more common allergic illnesses become. Under normal circumstances, cells of the immune system circulate throughout the body and recognize antigens, small fragments of microbes or parts of your body (so-called self). A correctly developed immune system is trained to distinguish self-antigen—molecules made by the body that are supposed to be there—from pathogens—foreign invaders that present a threat to the body. According to the hygiene hypothesis, a crucial part of this training process is exposure early in life to germs and bacteria that help the body recognize what outsider molecules really look like. Without this early exposure to pathogens, the immune cells skew towards an auto-reactive or over-reactive response, getting worked up when they see self-antigen or other non-threatening antigen. This overreaction can lead to allergies, asthma, and perhaps also autoimmune diseases like type 1 diabetes. Read more
The hygiene hypothesis sounds plausible, especially in light of studies that have found increasing rates of diseases like type 1 diabetes in developed and developing countries. However, proving the hygiene hypothesis or finding the mechanisms by which it might operate has been very difficult.
Faustman Lab Research: How Excited Should You Be?
by: Catherine Price
Interestingly, in both mice and humans, BCG itself doesn’t appear to be doing anything to the white blood cells – known as insulin-autoreactive T cells — that are responsible for destroying insulin-producing cells. Instead, BCG increases the body’s production of a different type of molecule called Tumor Necrosis Factor – TNF for short. It’s TNF, not BCG, that appears to kill the insulin-autoreactive T cells.
Faustman had originally hoped to administer TNF directly, but TNF is not approved as a drug; the approval process would have taken years, and no drug companies were interested in spending millions of dollars developing an experimental treatment that, if successful, would reduce the market for their other diabetes products. Instead, Faustman and her colleagues searched for an approved drug with a great safety profile that increased levels of TNF. BCG fit the bill.
It’s worth noting that this is not the first time BCG has been studied – several previous trials have failed — and several members of the diabetes research community that I spoke with were extremely skeptical about BCG in general, as well as this particular trial. (Faustman believes previous trials failed because of a lack of knowledge about mechanism and incorrect dosing.) Read more
Laying Blame: Why Do People Get Diabetes?
by: Alex O’Meara
People get diabetes because they’re fat. They get diabetes because they don’t exercise. They get it because they’re lazy and they lack discipline in controlling their appetites. They get diabetes because they’re out of shape slobs. People get diabetes because they deserve it.
Most people won’t say this to your face, but that doesn’t mean they’re not thinking it. The extent to which people believe that diabetes is the fault of the diabetic became very apparent, recently, after a finger pointing exchange about blame for the condition by two celebrity chefs. And what that reveals is an underlying societal discrimination of diabetics that could cost people their lives.
In January celebrity chef Paula Deen revealed she had type 2 diabetes. The creator of a hamburger featuring doughnuts in place of a bun was met with a backlash of blame. She was drawn into a kafuffle with fellow celeb chef Anthony Bourdain when he said he thought it was in “bad taste” for Deen to be dishing high fat Southern cuisine while she had diabetes and had not told the public about her condition. The implication was that Deen’s recipe for loaded mashed potatoes was the food equivalent of a loaded gun because, clearly, eating such rich foods leads inevitably to diabetes. Read more
Omnipod Put to the Test
by: Scott Richard
The Rugged Maniac took place on July 15th, so I had a few months to prepare with the Omnipod. Some people train for this type of event in terms of “Will I finish?” or “Will I have the strength or stamina to complete the obstacles?” I approached my training much differently. I knew the distance was manageable. I knew the obstacles were going to be challenging, but doable. The wild card for me was, Would my pod be able to handle the mud?
On the day before the race, I put on a new Pod and moved placed it my lower back, not on my stomach where the previous one had sat. Normally, I would used my arms next (I alternate sites systematically) but I skipped them on this rotation. I did this because I felt that the back was the most secure spot to place the pod. I hoped no one would bump into it there, and that other equipment wouldn’t catch on it and rip it off. I’ve had a few experiences in the gym where I was doing exercises and due to my negligence, my pod got caught on a piece of equipment and ripped off my arm. I wanted to avoid that.
For three full months I had nightmares about my pod coming off during the race. My wife said to me one morning at 3 a.m., “What is the worst that happens? It comes off? Big Deal! You put another one on after you clean up post-race. Go to bed!” Read more
Dario: Turning Your Smartphone into an All-In-One Glucose Meter
by: Michael Aviad
The Dario is an integrated unit that includes a basic adapter designed to connect to the audio jack of a smartphone. When the adapter is connected, a measurement is transmitted to the smartphone, turning the phone into a glucose monitor. The Dario also includes a built in lancing device loaded with disposable lancets and an integrated cartridge holding and dispensing 25 test strips.
The adapter can be used on all iOS devices (including iPhone 5 and iPads) as well as on Android phones. There’s no battery because the device harvests its power from the phone. The data collected is communicated back to the smartphone and is captured by Dario’s data management system.
The first thing that catches the eye when you see the Dario glucose meter is its size. The entire device including the strips and lancets is the size of a cigarette lighter. But as cool as the device looks (it’s really cool) there are many other features which the creators of Dario are proud of. Read more
Grief, A Necessary Part of Accepting Diabetes
I don’t remember the first time I had to inject myself with a needle. I don’t remember being taught how to test my blood sugar. But I have many memories of being diagnosed with type 1 diabetes. In retrospect, the day of my diagnosis was the beginning of a long process of grieving my diabetes. At the time, however, I had no idea that being diagnosed with a chronic illness would involve a grieving process.
Elisabeth Kübler-Ross famously outlined the stages of grief in her 1969 book called On Death and Dying. She described five stages (denial, anger, bargaining, depression, and acceptance) that describe a process by which people deal with grief and tragedy. Many people think of the stages of grief as just relating to loss of a loved one. These stages, however, apply to many types of loss, including divorce, job loss, dealing with terminal illness, or the diagnosis of a life-changing and life-threatening disease like diabetes. The stages are not in a consistent order and people may go back and forth between different stages. Also, not everyone experiences all the stages. The way each person experiences grief is unique. Read more