The strange thing about writing about diabetes is that you put yourself at risk of really letting it take over your life. Things can get sort of meta — you’re living with diabetes, but then you’re also writing about living with it. (And in many cases you’re writing about how you don’t think it should take over your life.) Well, I just discovered a third level — a meta-meta-level, if you will: dreaming about diabetes.
Yup. Last night I woke up in the middle of the night from a very vivid dream in which my husband’s cousin had diabetes (unclear which kind) and was insisting to me that he had discovered the perfect food for diabetics: French fries.
“They’re great,” he said. “I eat them, and after a half hour, my blood sugar is totally fine!”
I think it’s important to note here that there were other weird things going on in the dream. Like, for example, this conversation was taking place at a trapeze class. But my sleeping mind made a quick assessment of what was truly absurd about the situation, and quickly settled on the French fries.
“You know, that’s actually not true,” I said, as a circus performer sailed overhead. “What’s probably happening is that the fat in the fries is causing them to have a delayed effect on your blood sugar. You really should test again two, maybe three hours after you eat them and see what happens.”
Yes, my friends. I am explaining the glycemic index while I sleep.
The guy insisted that his fry theory was correct, and in proof, held out his glucometer to test his glucose. Except, in another weird twist, it was actually a continuous monitor (could things get any weirder?!?!?) and the screen said 283. I stood there in shock — 283? And this man is telling me his french fries have no effect? THIS IS CRAZY!!!
The scene then cut to me actually on the trapeze, culminated in a routine skin exam at my dermatologist’s office, and then I woke up to an actual message from my doctor saying they had H1N1 vaccine in stock. It was a medical whirlwind, and it all happened between the hours of 4 and 7 am.
So am I alone? Has anyone else had diabetes creep into their dreams?
In more relevant — or at least scientific — news, I just read an update on the results of a recent study with Rituximab, which is a drug originally approved for cancer that’s being experimented with for Type 1 diabetes. A quick breakdown of the science: researchers have long thought (correctly, it seems) that a type of immune cell called T cells are involved in the onset of Type 1. (T stands for thymus, the organ where they develop, and the T cells are thought to be the ones that actually kill the insulin-producing cells.) But recent hypotheses suggest that a different kind of immune cell called B cells might also be involved in Type 1’s development — perhaps by somehow triggering the T cells to attack.
Rituximab destroys B cells. So the hope was that it might help stop the progression of diabetes in newly diagnosed patients — rituximab would destroy the B cells, the thinking went, and thus the T cells would never be triggered.
This study, which took place at UT Southwestern and 14 other centers worldwide and was supported by JDRF, found that rituximab did indeed appear to slow the progression of Type 1 in study participants a year out from the trial start date. That’s great — but there are several caveats. First, it’s not a cure. And second, since rituximab actually destroys B cells, researchers question what’s going to happen further out, once the B cells have a chance to recover. Will the new B cells just pick up where the old ones left off?
Nonetheless, I find all these new immune-modulating drugs exciting (full disclosure: I was in a clinical trial for an anti-CD3 monoclonal antibody — a drug that affects T cells). My hope is that when all the parts come together — stem-cell-derived insulin-producing cells, immune-modulating drugs to shut off the immune attack — we might actually, some day, end up with a cure.