DRC & Research News

Approximately half of the people with type 1 or type 2 diabetes experience peripheral neuropathy—weakness, numbness, and pain, primarily in the hands and feet.  New discoveries by a team of researchers at Salk Research Institute may provide a new way to identify people at high risk for peripheral neuropathy and a potential treatment option.

Read here for more information on this study, authored by a distinguished team of researchers, including senior researcher and Diabetes Research Connection founder and board member                     Nigel Calcutt.

Over the years, researchers investigating type 1 diabetes have identified many genes associated with onset of the autoimmune disease. One of those genes is TYK2, which codes an enzyme (a Janus kinase) that plays a crucial role in intracellular signaling. In a study published recently in Nature Communications, a research team led by Timo Otonkoski at Helsinki University Hospital directed TYK2 knockout human iPSCs into the pancreatic endocrine lineage to decipher a dual role of the candidate gene TYK2 in pancreatic β-cells. First, depletion of TYK2 during early islet development affected the endocrine commitment, but did not affect the functionality of mature beta cells. Second, TYK2 inhibition in mature islet cells reduced vulnerability to T-cell cytotoxicity. These results identify an unsuspected role for TYK2 in β cell development and support TYK2 inhibition in adult β-cells as a potent therapeutic target to halt T1D progression.

Click HERE to read the full article.

The FDA has just approved Provention Bio’s Tzield™ (teplizumab-mzwv) – the first drug therapy that can delay the onset of type-1 diabetes (T1D) for those at risk of developing the disease.  This is a huge milestone for T1D research and those in the T1D community. (Read the full FDA announcement HERE.)

The average delay in the onset of T1D observed in the clinical study of Tzield was approximately 3 years, with some study participants not yet acquiring type 1 diabetes at all.  “Today’s FDA decision gives people at risk of developing type 1 diabetes the gift of time,” said Aaron Kowalski, Ph.D., JDRF CEO. “For the first time ever, we have a way to change the course and slow the development of T1D.”  (Read JDRF’s full statement on the impact of this news to the T1D community HERE.)

Tzield is the result of decades of T1D research, which began with an early scientific study.  That study led to a JDRF grant to support a trial in patients.  The success of that trial study led to further studies and support from the National Institutes of Health (NIH), eventually leading to this exciting breakthrough that will impact the future of T1D treatment.

Scientific breakthroughs such as this one, often emerge due to the inventiveness of early-career scientists.  It is DRC’s mission to connect donors with early-career scientists, enabling them to perform peer-reviewed, novel research designed to prevent and cure type 1 diabetes, minimize its complications, and improve the quality of life for those living with the disease.

Thus far, 10+ of our funded studies by early-career scientists have secured follow-on funding to continue their studies which could lead to breakthroughs like the milestone announced today.

You could help fund the next T1D breakthrough!  DONATE HERE 

Please enjoy this month’s newsletter, featuring:

• • • • Researchers Impacting Our Mission
      • November’s Matching Gift Campaign
      • Meet Our New Executive Director
      • DRC’s Seaside Silent Auction
      • Thank You to Our Sponsors!

View the Newsletter here. 

While organs can be transplanted from deceased donors, tissues from the nervous system rapidly lose viability. The mechanisms of neuronal death, and the potential for reversing it, remain poorly defined. Dr. Fatima Abbas, a DRC-funded investigator at the University of Utah, in collaboration with Dr. Frans Vinberg (University of Utah) and Dr. Anne Hanneken (The Scripps Research Institute, La Jolla, CA), published a paper in Nature that questions the irreversibility of neuronal cell death in the retina, an investigation that has implications for visual rehabilitation and for the future of organ transplantation. In the study, the researchers characterized neuronal death and survival and identified conditions for reviving neuronal functioning in postmortem mice and human retinas. This study is a step toward better strategies for preserving the viability and engraftment capability of tissues and cells isolated from organ donors for transplantation, including the pancreas. Given the significant overlap of genes and proteins between pancreatic islet cells and neural tissues, the findings by Abbas and colleagues may have important implications for the improvement of islet cell transplant engraftment and long-term function in type 1diabetics.

Click HERE to read the full article.

Vertex, whose VX-880 stem cell therapy for type 1 diabetes has cleared clinical proof of concept, is acquiring ViaCyte, a private biotech that has also reached clinical trials with its own stem cell therapy. In the $320 million all-cash deal, Vertex will acquire ViaCyte’s human stem cell lines, manufacturing facilities, and other relevant intellectual property.

While both companies are pursuing stem cell-based approaches to treating type 1 diabetes, their methods differ. The Vertex therapy involves injecting synthetic islet cells into patients. By comparison, the ViaCyte therapy uses gene-edited, immune-evasive stem cells encapsulated in implantable devices.

Both companies have reported data from clinical trials.

Data released by Vertex in October 2021 showed that the first patient who received the treatment had a lower average HbA1c (8.6% to 7.2%) and a significantly reduced reliance on insulin injections. Results from a second patient have also been reported and data from additional trial participants are expected later this year or early next year. In June 2021, ViaCyte revealed that a single patient had also experienced a drop in HbA1c (7.4% to 6.6%) but still required insulin injections.

“VX-880 has successfully demonstrated clinical proof of concept in T1D, and the acquisition of ViaCyte will accelerate our goal of transforming, if not curing T1D by expanding our capabilities and bringing additional tools,” Vertex CEO Reshma Kewalramani said in a statement.

Click HERE to view the full article.

On Monday, May 23rd, DRC’s President and Chair, C.C. King, Ph.D., spoke at Del Mar Foundation’s speaker series, DMFTalks. Over 30 members of the community came to listen to C.C. talk about the importance of medical research. His talk addressed the importance of medical research. He began by sharing the process of approving medication through the FDA and how in-depth that procedure can take. This transitioned into the significance of model systems in three categories; Cancer, the self, and Type 1 Diabetes (T1D). In researching human disease, model organisms allow for a better understanding of the disease process without the added risk of harming an actual human. By the end of the presentation, he illustrated how Diabetes Research Connection (DRC) is a vital organization that funds early-career scientists who have bold and out-of-the-box ideas without the years of experience that other researchers have, therefore often don’t receive the funding necessary to make headway with their research. DRC is an organization that proudly acts as the seed funding for many of these projects, allowing them to gain momentum and credibility to help them receive larger grants to bolster their research. Many of these projects use model systems to help validate their hypotheses and have often received follow-on funding from the results they have garnered and have made headway in T1D research.

Click HERE to watch C.C.’s presentation!

DRC has distributed over $400,000 to research projects like Dr. Dwyer’s and Dr. Zhu’s in Request for Application (RFA) 2 2021 alone. We received an unprecedented number of Letters of Interest (LOIs) in our last RFA and are funding even more innovative projects than ever. View our “Support a Project” page to see what other research projects we are currently committed to funding by clicking here. Take a look at our latest newsletter, where we feature some quotes from our newest grant recipients, show DRC in the community, and highlight our newest volunteers.

Click this link to view our June newsletter that we mailed out previously this month about what we’ve been up to and the impact we are making together. It takes a community to connect for a cure!

After rigorous peer review by DRC’s Scientific Review Committee, eight early-career researchers were awarded $50,000, totaling $400,000 in seed funding for their work to find the cause, treatment, and cure for T1D. 

Click HERE to read the Press Release

Kaya was diagnosed with type 1 diabetes when she was 13. That was also the point she knew she wanted to become a scientist and work in the research field of diabetes. Fast forward 15 years, Kaya is working on getting her doctoral degree at the Oregon Health & Science University. However, Kaya has realized that she wants to spend less time doing science and more time communicating current scientific knowledge to relevant audiences and the public. Her work for the DRC brings her one step closer to that goal. 

I was diagnosed with type 1 diabetes when I was 13. One of my closest cousins had lived with diabetes for about 10 years back then, so it wasn’t an unknown disease to me. Still, it felt like a bad diagnosis when an indifferent doctor delivered it to me in front of his note-taking students at a university clinic. Today I recognize it as a life-changing moment and am grateful for it, as it has made me the person I am. It also has significantly impacted my career decisions. I knew I wanted to become a scientist and work on a cure for diabetes back then. Although actively working in the field of diabetes research today, I now know it’s not that simple. There is so much we still need to learn about the disease and its treatment, and that includes both basic science as well as coming up with smart solutions for the everyday life of diabetic patients. “Let’s see what the science says” is a phrase I often use both at work and while engaging in managing my diabetes. I’ve found that what I know as a scientist does influence my treatment decisions quite a bit. I’ve reached out to volunteer for the DRC as I want to give others the power to make science-based treatment decisions and to better understand their disease, the research around it, and their options.

Kaya is now helping this organization by translating complex scientific language from DRC-funded researchers so that the community can understand the project better.

Amy Adam’s son was diagnosed with T1D when he was five years old. She served on the Board of Directors and various committees for the Juvenile Diabetes Research Foundation (JDRF) Chicago chapter for 10 years and was a contributing writer to Insulin Free Times. This is her second term on the DRC Board, and she has served as the Lay Person Review Committee Chair since DRC’s inception.

It’s hard to believe that 30 years, hundreds of thousands of blood tests and shots, innumerable doctors’ visits and procedures, and countless renewed vows to find that elusive combination of food, activity, and insulin have passed since my own child was diagnosed with Type 1 Diabetes. Time has propelled us forward like tumbleweeds in a dust storm, yet the rigorous demands and challenges of diabetes have clung stubbornly to him every step of the way. One of the most significant personal challenges I have encountered along this path is having to stand by and watch my child’s indomitable spirit rise and fall as this disease continues to roll along with his organs, tissues, and psyche firmly in its grasp.

You can’t outgrow Type 1 Diabetes, and it is progressive. Most Type 1 diabetics develop at least one complication, and close to 50% of Type 1 diabetics will develop disabling or even life-threatening complications over their life despite their best efforts to control the disease. Perhaps due to multiple autoimmune diseases, my child struggles more than many. 

Fortunately, early on our path with this disease, we met the most extraordinary doctor who medically guided us through some of his darkest hours and gave us the only trustworthy source of hope we have ever felt through his research for a cure for this insidious disease. Years later, when Dr. Hayek introduced me to an equally impressive man named David Winkler and asked me to join them in their endeavor to create a diabetes research organization with a different paradigm, I was all ears.

Our founding vision for The DRC (Diabetes Research Connection) was to empower the community of young, innovative scientists, people affected by diabetes, and their supporters to propel unique and promising Type 1 Diabetes research ideas that weren’t receiving adequate attention by other organizations. Each selected project would have to be endorsed by a group of world-renowned diabetes experts who had volunteered their time to evaluate the merit of these projects to qualify for funding. Then the projects would be written in lay-friendly terms and posted on our website, where potential supporters could choose to support the projects that “spoke” to them based on their own experiences and knowledge of the disease. The scientists would provide regular updates on the progress of their project, good, bad, or inconclusive. Outcomes would be published on our website, adding to the body of diabetes knowledge in a united effort to eliminate diabetes.

I support the Diabetes Research Connection because despite our best efforts to control what we were told was a manageable disease, the only source of control we have ever felt is where we put our money towards curing it. Join us and influence the future of diabetes research; by selecting the research that is meaningful to you and your experience, you may help influence the work that leads to a cure for Type 1 Diabetes.

Amy’s initial vision for co-founding DRC has come to fruition. In this organization’s 10th year, they have funded 48 projects, invested $2.4 M in innovative T1D research, and 12+  researchers received approximately $12M in follow on funding.

The DRC was featured in the San Diego Union Tribune about how it is successfully providing the seed funding or the “spark” for truly novel T1D research being conducted by talented early-career scientists and has led to much-larger investments from the government or larger charities. “From zebra fish to bacteria, Diabetes Research Connection celebrates a decade funding novel ideas” – The San Diego Union-Tribune (subscription required)

Diabetes Research Connection (DRC) is excited to announce that our first-ever annual report is completed and ready for you to enjoy! Please click HERE to view the 2021 Annual Report highlighting all of the progress this organization has made throughout the last year. 

Join us in celebrating the impact DRC-funded research has made on the prevention, management, and cure for Type 1 Diabetes (T1D)! 

DRC is committed to seeking out, peer-reviewing, and providing seed funding to the most promising T1D research being conducted by innovative early-career scientists across the country – providing hope to those living with the disease. It is only through our community that we can stay unwaveringly loyal to our mission. 

Thank you for being a part of the DRC family.

74 type 1 diabetes (T1D) experts from renowned universities and research institutions across U.S. make up this year’s committee to vet innovative T1D research for funding by DRC

SAN DIEGO – February 28, 2022 – Diabetes Research Connection (DRC), a 501(c)(3) that funds research projects conducted by early-career scientists aimed at prevention, better care, treatment of related complications, and a cure for T1D, announces its Scientific Review Committee (SRC) for 2022.

The DRC SRC is a collaboration of T1D experts from renowned universities and research institutions from across the country. The committee members volunteer their expertise and time to thoroughly vet T1D research funding applications DRC receives based on their scientific merit. See the full list of DRC SRC members here.

“I’m honored to be a DRC SRC member. The warmth of the DRC community is unique. It brings scientists, patients, families, doctors, and supporters together. It also gives courage to scientists taking unconventional approaches toward solutions for T1D,” says Dr. Yo Suzuki of J. Craig Venter Institute. “I am forever thankful for the support DRC gave me when I was developing a nascent research idea. I hope to contribute my biological engineering perspectives, which may be non-standard in T1D research, to helping guide future research directions.”

DRC Board Member and previous Scientific Director Alberto Hayek, M.D. says, “These talented scientists and diabetes experts are at the center of our mission. Through their focused and rigorous vetting of projects submitted to DRC for financial support, we are able to provide seed funding to those most likely to find the cause, better treatments, and ultimately, a cure for T1D.”

In 2021 alone, DRC provided seed funding for 16 new T1D research projects, bringing the total support of early-career scientists to almost $2M. Follow on funding, a critical measure of the viability of projects funded by DRC, has topped $8.4M in additional funds for T1D research.

DRC is supported by donations from individuals, corporate sponsors, and private and public foundations. Contact us to discover how you can support DRC’s mission to eliminate T1D.

To donate online today click here.

Supported by corporate sponsorships, county grants, foundation awards, and a donation of $100,000 in matching funds, DRC pushes to fund more innovative research to find the cause, treatment, and cure for T1D

SAN DIEGO – December 16, 2021 – Diabetes Research Connection (DRC), a 501(c)(3) that funds research projects conducted by early-career researchers aimed at prevention, cure, and better care for those with Type 1 Diabetes (T1D), announces significant achievements in 2021 amid its year-end giving campaign. This year, DRC has been supported by corporate sponsorships, county grants, foundation awards, and a $100,000 dollar-for-dollar matching gift from an anonymous donor.

In 2021 alone, DRC will provide seed funding for 16 new T1D research projects, bringing the total to 48 innovative studies by early-career scientists awarded since its founding in 2012. DRC expects to support close to $2M in research by year-end, with six early-career scientists receiving DRC funding going on to secure $8.4M in additional funds for their T1D research.

“DRC is committed to providing seed funding for early-career scientists to demonstrate the viability of their peer-reviewed, innovative T1D research ideas. Data driven outcomes show proof of concept to enable our scientists to pursue follow-on funding, often yielding over $1 million,” shared DRC Co-Founder, David Winkler.

 Corporate partners and financial underwriters are instrumental to DRC’s mission and include:

Leading Sponsors

• AMCR Institute
• San Diego County
• Tandem Diabetes Care
• Tarson Family
• Numerous private family foundations

Sustaining Supporters

• Benchmark CIS
• Carruth Cellars
• Centura Wealth Advisory
• San Diego Live Well Partners 
• Sheppard Mullin

Event Sponsors

• Jimbo’s
• New Wave Gelato
• Seaside Market
• Sycuan Casino

DRC Senior Director of Development Casey Davis said, “I can’t express enough the importance of our sponsors, and corporate and public underwriters to our mission to eradicate T1D through research. That’s what we mean when we say, ‘It takes a community to connect for a cure’.”

Through their help and that of family foundations and other donors, DRC expects to raise a record $750,000 in 2021, and anticipates it will increase that figure to $1 million in 2022.

“DRC is funding important research to find ways to prevent, better treat, and cure T1D. Donors and partners can also choose specific research projects they want to support. This enables you to see your dollars at work,” said Stephen Korniczky, DRC Board Member and Partner, Sheppard Mullin. “DRC not only supports a noble mission, they have been a wonderful partner as well.  I invite other sponsors and donors to join us in supporting DRC in 2022.”

DRC has additional sponsorships available for 2022 at a variety of levels. In honor of its 10-year anniversary it will be re-launching its annual Dance for Diabetes, and event sponsorships, in Fall 2022.

To donate to DRC and double your impact with a tax-deductible donation click here by December 31, 2021.

By 2050, 5 million people in the US are expected to be diagnosed with T1D; 600,000 of them will be children, requiring them to regularly monitor blood sugar and putting them at a higher risk for cardiovascular disease, kidney damage, blindness and other complications. Hear 18-year-old Cooper Buchanan describe how he learned he has T1D, and, how he and others are imagining a world where no one has to ever hear: You have T1D.

May 2022 Update

Vertex Pharmaceuticals Incorporated today provided updates on its Phase 1/2 clinical trial of VX-880, an investigational stem cell-derived, fully differentiated pancreatic islet cell replacement therapy for people with type 1 diabetes (T1D) with impaired hypoglycemic awareness and severe hypoglycemia. According to the results released on May 2, data from the first two patients in Part A established proof-of-concept for VX-880, with one patient achieving insulin independence at day 270 and the other patient showing reductions in insulin requirements through Day 150.

Additionally, the Independent Data Monitoring Committee recommended advancement to Part B, where patients receive the full target dose of VX-880, which has been generally well-tolerated to date. Vertex also announced that VX-880 Phase 1/2 study has been placed on clinical hold in the U.S. by the Food and Drug Administration (FDA) due to a determination that there is insufficient information to support dose escalation with the product.

Click HERE to read the full article about this update.

Commentary

Authors:

Vincenzo Cirulli, M.D., Ph.D.

Scientific Director, Diabetes Research Connection

Department of Medicine, UW Diabetes Institute

University of Washington

Institute for Stem Cells and Regenerative Medicine

Alberto Hayek, M.D.

Medical Director, Scripps/Whittier Diabetes Institute

Co-Founder, Diabetes Research Connection

David Winkler

Co-founder, past Chair and current CFO, Diabetes Research Connection

Past Chair, Scripps Whittier Diabetes Institute

Past Chair, American Diabetes Association, San Diego Chapter

Type 1 Diabetes Patient for 62 years  

A Cure for Type 1 Diabetes? For One Man, It Seems to Have Worked.

This article, which appeared in the New York Times (NYT) on Saturday, November 27, 2021, provides a promise for achieving a cure for type 1 diabetes (T1D). Dr. Melton, a brilliant scientist at Harvard, and an inspired father of two T1D patients is credited with overseeing this important effort which built on many past and present researchers’ discoveries.

While we applaud Dr. Melton and his team’s efforts for taking the necessary steps to bring this research to the bed-side, there are some questions that will need to be addressed. It remains to be determined if any issue or side effects will arise over time in some of the 17 patients participating to this initial clinical trial. Patient immunosuppression may be problematic, as it has been the case for some recipients of cadaveric human islet transplants. The long-term survival and function of these stem cell-derived beta cells will also need to be assessed, and design plans to replace them with additional transplants should they fail. Ultimately, the cost of the procedure and required FDA approval will also need to be addressed.

In the year 2000, the New England Journal of Medicine published an article that caused many to believe a cure for T1D had been discovered. The principal investigator, Dr. James Shapiro, initiated what became known as the Edmonton Protocol. This multicenter trial involved transplanting human cadaveric islets. Some issues soon arose: 1) an insufficient supply of islets; 2) failure of the islet transplants to function long-term; 3) complications associated with the site of transplantation into the portal vein of the liver, and 4) side effects caused by the immunosuppression of the recipients.

Undoubtedly, the most significant development since 2000 has been the conversion of pluripotent stem cells into insulin-producing cells to provide an unlimited supply of islet tissue for transplantation in T1D patients.

The need for immunosuppressive drugs to prevent rejection of the islet transplants remains an ongoing concern, although these types of drugs, and their regimen protocols have improved considerably since 2000. Notwithstanding, immunosuppression continues to have issues. Better drugs will be needed to ensure that the transplanted islet tissue is not rejected, retains its insulin-producing function over time, and that the recipients’ immune systems is not negatively impacted for its important primary function of fighting off other diseases.

Another approach to avoid rejection of pluripotent stem cell-derived beta cells is to encapsulate them. However, to date, these cells have not prospered in such enclosed environments, because current cell encapsulation technologies do not allow for these beta cells to intimately interact with blood vessels of the host to receive nutrients and oxygen to survive long term while performing their insulin secretory function in response to circulating glucose levels.

In two recent studies just published in peer-reviewed journals (https://www.cell.com/cell-stem-cell/fulltext/S1934-5909(21)00415-X), Canadian investigators led by Dr. Timothy Kieffer in collaboration with ViaCyte, and by ViaCyte scientists in collaboration with Dr. James Shapiro (https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(21)00338-4) reported that transplantation of immature stem cell-derived pancreatic islet progenitors in 15 and 17 patients, respectively, produced negligeable, yet detectable levels of human C-peptide production in response to a meal after a year from the day of transplantation. These studies were conducted using devices that allow some level of interaction of the transplanted cells with the patient’s blood vessels, thus requiring immune suppression. The bottom line is that after ~1 year, none of the patients became independent from insulin injections and all required exogenous insulin during the trial.

A possible solution to the problem of allorejection (i.e., immune rejection of “non-self” cells, coming from a different genetic background) may involve the use of a T1D patient’s own cells to generate induced pluripotent stem cells (or iPS), produced through a technique of reprogramming, and then convert these iPS cells into pancreatic beta cells. These “self-cells” may evade rejection by mechanisms of allo-immunity; however, auto-reactive immune cells that caused T1D in the first place in these patients may still target and destroy these newly transplanted beta cells.

San Diego’s ViaCyte is pursuing another potential cure. This company recently announced a collaboration with Crisper, a biotech leader in DNA editing to genetically modify the stem cells to avoid the need for immune therapy post-transplantation.

Ultimately, in order to ensure that all of the above treatments are safe for transplantation in the general population of T1D patients the FDA will require: 1) a careful peer-reviewed analysis of the results on all patients; 2) a long-term assessment of the survival and function of the transplanted cells; 3) evaluation of the long-term effects of immunosuppression; and 4) determination of the acceptability of all side effects.

Collectively, what all of these recent advancements show is that there is much more to be learned before stem cell derived islet tissue can be routinely and safely used for cell replacement therapy in T1D.

Hence, notwithstanding these open questions, substantial progress is being made towards a functional cure for T1D. We must proceed with hope and caution while pursuing additional innovative research.

The DRC is committed to continue supporting innovative basic and translational research by early-career scientists who strive to prevent, find better treatments for, and cure T1D.

Five million people are expected to have T1D by 2050 and 40,000 are diagnosed with T1D each year in the U.S. Our Executive Director Karen Hooper discussed DRC’s unique mission in raising research dollars for early-career scientists to develop innovative studies that will lead to the end of T1D. Learn about our commitment to not rest until T1D is eliminated in this recent Spotlight on the Community podcast.

Dear Supporter,

In consideration of the safety and comfort of our community, and the uncertainty for the effects of COVID-19 and its variant in indoor settings, DRC had to postpone events in 2021.

However, we are thrilled to announce we will be honoring our 10-year anniversary by throwing an epic party for our Dance for Diabetes in 2022. Stay tuned for more details.

Thank you for your continued support and partnership!

Happy Holidays, 

The DRC Team

As we begin to reflect on all that has happened in the world over the past 18+ months, it is even more incredible to share the progress that the Diabetes Research Connection (DRC) has made. Despite the global pandemic, despite the decline in donations, and despite the fact we have been unable to be together in person, we are fighting to end Type 1 Diabetes more than ever before. 

We must end this disease, and to do that, we need to all commit to finding the best and brightest early-career scientists in the nation and provide seed funding for their promising research. We must invest in novel ideas, with the most promise, to ensure a future where nobody has to hear “You have Type 1 Diabetes.” 

Click HERE to view the full November Newsletter!

In late September, DRC’s President and Chair, C.C. King, and the Senior Director of Development, Casey Davis, spoke on the Podcast Rainman’s Take. This podcast is hosted by Brian, the “Rainman” Lukacz. He speaks on a variety of topics and gives his take on them.

During this 1+ hour episode, Rainman talks with C.C. and Casey about their innovative approach to charitable giving in the fight for a cure for type 1 diabetes. DRC’s process allows donors to have a direct connection with the research they are funding that maintains transparency and is an incredibly efficient use of donated funds.

Click HERE to view the podcast.

One of the hallmarks of type 1 diabetes (T1D) is the destruction of insulin-producing pancreatic beta cells. The immune system mistakenly attacks these cells leaving the body unable to regulate blood glucose levels naturally. Instead, insulin must be administered manually or via an insulin pump in order to prevent hyperglycemia.

Researchers have been experimenting with cell transplantation methods to replace these depleted cells and enable the body to produce its own insulin once again. A major obstacle to this approach is cell survival and viability. The stress of injecting the cells can cause cell death, and the body often treats the transplanted cells as foreign bodies and elicits an immune response to destroy them. Scientists have used various strategies for encapsulating the cells to reduce stress and protect them from the immune system. Some have been more effective than others.

A new study examines the effectiveness of caging pancreatic islets in a multilayer hydrogel nanofilm. The nanofilm combines monophenol-modified glycol chitosan and hyaluronic acid to create a thin protective barrier that still enables oxygen and nutrients to flow into the caged cells while also allowing insulin and waste to flow out. In addition, it provides immunoisolation, eliminating the need for immunosuppressants.

When tested in T1D-induced mouse models, the nanofilm-caged spheroids were able to achieve normoglycemia compared to control groups. Scientists further evaluated their effectiveness by removing the kidney where the spheroids had been transplanted. As a result, the mice experienced hyperglycemia once again. Using a multilayer hydrogel nanofilm provided protection against mechanical stress and immune response while enabling the islets to regulate blood glucose levels.

Although this approach has only been tested on mouse models thus far, it provides a new approach for cell-based therapies. More research and testing are needed to determine if this transplantation method triggers the same effects in humans. It could one day open the door to new treatment options for individuals with type 1 diabetes.

Though not involved in this study, the Diabetes Research Connection (DRC) is committed to furthering research around T1D to improve diagnosis, treatment, and management of the disease and find a cure one day. The organization provides critical funding to early-career scientists pursuing novel research studies on T1D. Learn more and support current projects by visiting https://diabetesresearchconnection.org. 

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

Diabetes has taught me throughout my life to always have a backup plan for the backup plan. From the early days in 1994 when I was first diagnosed with T1D, my doctors always recommended keeping a snack and glucose tablets with me in case my blood sugars dipped low. To this day, my purse is always loaded with granola bars, nuts, and candy – it’s like a compact mini-mart. And it comes in handy often when restaurants take longer to bring the food than expected, and I’ve already bolused, or I find myself walking further on the beach than anticipated, and I feel my body starting to shake. When I travel, especially internationally, I make sure to keep a loaner insulin pump with me as well as pump and CGM supplies stashed in multiple suitcases and syringes with back up forms of insulin in case something crazy happens – and crazy, unexpected things always happen while traveling (it’s part of the adventure) and so long as I have my backups in place, my diabetes doesn’t have to control my life or plans.

As a newly diagnosed T1D at the age of 12, I never could have imagined how diabetes would impact the course of my career. Philanthropy has always been an essential part of my life, and giving back to the community was modeled for me at home by my parents, who were both educators in the public school system. My parents encouraged me to participate in many Walks for Diabetes and as part of the event, to send fundraising letters to friends and family. This annual exercise and leadership opportunity, coupled with many other volunteer experiences, guided me towards a career focused on philanthropy and giving back to the community. For 16 years, I worked as a fundraiser in a variety of nonprofit organizations, including one in the T1D space. I loved this work, and it has guided me to my current role at Centura Wealth Advisory as the Director of Philanthropic Strategies.

For the past year, I have been partnering with families to ensure that they have financial and philanthropic plans in place for their estate – both short and long-term. Together, we walk through conversations about their legacy and dreams as they plan for the future. The global pandemic of this past year has caused many families to either put living wills and trusts in place with a financial planner and estate attorney or to brush off older documents to ensure their intentions are still accurate. For those who have not done this yet, it is a highly recommended practice, so when life happens, financial decisions don’t need to be added to already stressful situations, medical or otherwise. This is having your backup plan in place, so to speak.

As someone with T1D, I never thought I would qualify for life insurance, one key component of an ultimate backup plan. I was concerned that if something happened to me, would my husband be able to pay our mortgage and take care of our family? Thankfully, a small handful of life insurance carriers will offer life insurance to people who live with T1D. Getting this coverage has provided me relief and comfort as well as filled a gap in my estate plan. With an A1c of 6.3, which I work on every single day, I focus on keeping myself as healthy and complication-free as possible; however, I know that as life changes, I can sleep better (despite my Dexcom beeping at me) because I have this coverage. In addition to partnering and supporting families at Centura as they build their estate plans, I am confident that my personal backup plan is also in place to provide for my family. I encourage everyone to have conversations with the trusted financial services professionals in your lives to ensure you have your plans in place so that you can live a more peaceful life.

Dana began working at Centura Wealth Advisory in 2020 as the Client Relationship Manager. She joined the team to bring together her passion for philanthropy with her commitment to help families build wealth and give back to the community. 

Scientists are still trying to understand the different ways that the SARS-CoV-2, or COVID-19, virus affects the body both in the short and long term. As more studies are conducted, scientists are finding that the virus may be linked to the development of other health conditions, such as diabetes.

Recent studies involving non-human primates and humans (both living and deceased), have led researchers to discover the presence of SARS-CoV-2 within cells throughout the pancreas, including islet, ductal, and endothelial cells. COVID-19 enters cells through angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2), both of which showed increased expression in pancreatic tissue of non-human primates (NHPs) and humans.

This may impact the survival of these cells, as well as their ability to produce and release insulin. Insulin deficiency is a primary cause of diabetes and leaves the body unable to regulate blood glucose levels on its own.

Researchers found that “two out of eight NHPs developed new-onset diabetes following SARS-CoV-2 infection. Two out of five COVID-19 patients exhibited new-onset diabetes at [hospital] admission. These results suggest that SARS-CoV-2 infection of the pancreas may promote acute and especially chronic pancreatic dysfunction that could potentially lead to new-onset diabetes.”

More research and larger studies are necessary to determine the effect of the virus on pancreatic function and insulin production. However, multiple studies have shown that SARS-CoV-2 infects multiple types of cells found within the pancreas, and this could increase the risk of new-onset or late-onset diabetes.

The Diabetes Research Connection continues to follow the latest developments in the field and is interested to see how COVID-19 may impact diabetes as well as potential prevention and treatment efforts. Though not involved with these studies, the DRC provides critical funding to support early-career scientists pursuing research around type 1 diabetes. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org. 

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

As the coronavirus pandemic persists, scientists continue to learn more about SARS-CoV-2, commonly known as COVID-19. One area of interest is how the virus may affect beta cells within the body, and more specifically, pancreatic beta cells. Two recent studies have examined the connection between COVID-19 infections and diabetes.

The pancreas contains insulin-producing beta cells that help control blood glucose levels. In individuals with type 1 diabetes, these cells are mistakenly attacked and destroyed by the immune system. Research has shown that following a COVID-19 infection, a similar process may occur, reducing the quantity of pancreatic beta cells and the amount of insulin produced.

According to researchers, “Beta cells and other cell types in the pancreas express the ACE2 receptor protein, the TMPRSS2 enzyme protein, and neuropilin 1 (NRP1), all of which SARS-CoV-2 depends upon to enter and infect human cells.” Autopsy results from patients who died from COVID-19 showed the presence of the virus in pancreatic cells.

In addition to decreasing insulin production, the SARS-CoV-2 virus may also lead to beta-cell death or transdifferentiation of the cells. During transdifferentiation, cells are reprogrammed to alter their function. Researchers found that some cells produced less insulin, more glucagon, and more trypsin 1, a digestive enzyme. However, blocking NRP 1 may prevent cell death, and trans-ISRIB treatment may help reduce the stress response of cells. This may help reduce the risk of developing diabetes.

More research is necessary to gain a better understanding of the impact of COVID-19 on pancreatic beta cells and the damage that it may cause. One of the best defenses against COVID-19 to date is getting vaccinated.

The Diabetes Research Connection (DRC) is interested to see what future studies reveal and how this may impact treatment and prevention efforts. The DRC provides critical funding for early-career scientists studying all facets of type 1 diabetes. Learn more about how to support these efforts by visiting http://diabetesresearchconnection.org.

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

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Scientists have created vaccines for many different diseases, from polio to chickenpox to the flu, and now they are in the process of developing one for type 1 diabetes (T1D). T1D develops when the body mistakenly attacks and destroys insulin-producing pancreatic beta-cells. These cells are vital for naturally controlling the amount of glucose in the bloodstream. This new vaccine is geared toward preserving insulin-producing cells by targeting the glutamic acid decarboxylase (GAD) protein.

Around half of the patients with T1D have an immune system gene know as HLA-DR3-DQ2, which is a specific version of the human leukocyte antigen (HLA) gene. This particular variant triggers the body to produce antibodies against the GAD protein and destroy insulin-producing beta-cells, which increases the risk of developing T1D. If this process can be stopped or delayed, and patients can retain even some natural insulin production, it could benefit their overall health and reduce the risk of hypoglycemia.

The diabetes vaccine increases exposure of the cells to GAD to improve the immune system’s ability to tolerate the protein and not launch an attack on pancreatic beta cells. This may enable patients to retain more natural insulin and better regulate glucose levels.

To test this theory, researchers conducted a phase 2 clinical study involving 109 patients ages 12 to 24 who had been diagnosed with T1D within the past six months. The HLA-DR3-DQ2 gene variant was present in about half of the patients.

Patients were randomly divided into two groups, one of which received the diabetes vaccine and one of which received the placebo. The vaccine was administered once a month for three consecutive months. Natural insulin production, blood sugar levels, and daily supplementary insulin use were recorded at the study’s beginning and then again 15 months later.

The results showed that “as a whole, there was no difference in treatment and placebo groups. But the subset of patients who had the HLA-DR3-DQ2 variant did not lose insulin production as quickly as other patients did.”

For patients with this specific gene variant, the diabetes vaccine may be beneficial in preserving natural insulin production and slowing or stopping the progression of T1D. More research and more extensive studies are needed to further study the potential benefits of the vaccine and its use in treating patients with T1D.

Though not involved with this study, the Diabetes Research Connection (DRC) is dedicated to improving prevention, diagnosis, treatment, and quality of life for patients with type 1 diabetes and one day finding a cure. This vaccine could be a step in the right direction toward altering the progress of the disease. The DRC is interested to see what future studies reveal.

The DRC provides critical funding to early-career scientists pursuing novel research around type 1 diabetes to support advancements in this field. To learn more about current projects and support these efforts, visit https://diabetesresearchconnection.org. 

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

Packing meals for outdoor day trips can be a challenge, and like with everything else, even more so when doing it with Type 1 Diabetes. The food and container have to be able to withstand temperature fluctuations, provide energy in the form of slow-release carbohydrates, and tasty sustenance for our bodies as well as our soul. 

Hands down, preparing your own meals is the best way to predict how your diabetes will behave around mealtimes. You control the ingredients, so you can have the exact carbohydrate calculation, and if not, a much better idea of how to estimate the carbohydrates. Hidden sugar content is a real problem with restaurant and store-prepared food and can seriously dampen a diabetic’s good time. 

There are an infinite amount of recipes online with new ones being concocted every day. Thankfully, a fully balanced meal consists of just a handful of things, and having these elements in mind is a great starting point in discovering and creating meals that work for you, fit your preferences, dietary needs, and regional accessibility. 

So when planning your next day adventure, consider packing a balanced meal that consists of these five elements:

• Low-carb base
• Fiber
• Protein 
• Fat
• Acid

Us T1Ds can eat whatever we want, but it’s no surprise that slower acting and lower carbohydrate foods are easier for us to digest with minimal insulin. I have found that replacing the base of my meals with hearty vegetables like shredded spaghetti squash, lightly roasted broccoli or zucchini, and dark greens (rather than a complex carbohydrate like potatoes or rice) is so much easier to predict and calculate for. Alternatively, beans and legumes provide a similar carbohydrate base with added vitamins, minerals, and protein to slow the glycemic impact, making it slightly easier to time insulin injections. 

Fiber is necessary for slowing the glycemic load and lowering the overall net carbohydrate. I don’t usually notice the difference of the total carbohydrate count is ever enough to adjust my insulin requirement, but it does delay and sometimes negate a postprandial rise. Shaved carrots, roasted or raw broccoli, shredded cabbage dressed in lime juice and salt – it really doesn’t take much to turn a few raw ingredients into a delicious and fibrous addition to the dish. 

Protein is arguably the most important aspect of daily nutrition as the building blocks of bodies. From tofu to deli slices, there’s no wrong way to go when building hiking-friendly meals. Substantial protein can also be found in hard cheese, legumes, beans, and seeds, and should be considered in the overall protein content of the meal. Stick to basics that don’t spoil quickly, such as chicken thighs, lean pork, and cured meat.

To top off most meals, I usually finish with a generous squeeze of lemon or lime juice, a healthy drizzle of extra virgin olive or avocado oil, and a sprinkle of seeds. The acid and fat balance out everything and pull the entire dish together, not to mention provides necessary puzzle pieces our bodies require to properly digest everything. Vegetables are packed with carotenoids that act as antioxidants and have cancer fighting properties, and studies are finding that we absorb more of these phytonutrients from plants with the aid of fat. Considering that, if I can, I love to include an avocado with every meal. It’s also my favorite standalone snack – full of healthy fat, fiber, and FLAVOR. Lastly, a sprinkle of seeds packed with protein, fat, vitamins, and minerals is just the extra bit of zest I need in my life.

With these building blocks in mind, assembling simple meals that are delicious, nutritious, and the perfect accompaniment to a hike or day trip should be a breeze. The considerate ratios of our glucose levels should be to your satisfaction as well. 

This article was contributed by Jackie Talbott, DRC Volunteer, who has had T1D for 23 years.  

It’s officially summer! As the world seems to be hotter than ever, and life goes back to a new normal with social activities commencing, it can be surprisingly easy to forget about having diabetes during group play dates in the great outdoors. 

I think it’s safe to say we all feel an extra level of pressure, and to an extent mindlessness, when we’re with our friends and family that we haven’t been in the company of for so long. I find myself being less in-tune with the physical glucose signals, and you know what they say about time when you’re having fun, right? Hours seem like minutes and a lot can happen to our diabetes before we realize it. Miscalculations are just waiting to sneak in, timing injections are likely to be less than ideal, and even how we react to the normal stuff might be different when we’re buzzing about full of our environment’s energy. 

Along the T1D journey, we will experience things and gain new perspectives that help make diabetes management more understandable. In this constant period of trials and errors, I have found some “food for thought” that helps my decision making when embarking on summertime excursions with friends. 

So that everyone can have the best possible time, I’ve compiled a handful of tips to stow in your supplies pack.

Stash Smart Snacks:

Since there are so many options now for emergency and activity-friendly snacks, take a moment to find ones that you actually enjoy. It’s so easy for T1Ds to look at food as merely a necessity, but food is also nourishment for the soul. Even for emergency use, we don’t have to just rely on choking down dry tablets – there are gummies, syrups, liquid shots, and powders that can be used in a variety of ways that suit several needs. I find powder glucose the most versatile and takes up the least amount of space.

I also like to carry high carb granola bars, ones that are at least 40 grams per bar. I find them to be extra helpful in that you can split the bar into more than one use (depending on how much you need, of course). Dried fruit does a similar trick – the idea is to consider carbohydrate rich options that provide enough nutrition with just a bite or two.

Some favorites like carrot and celery sticks, either plain or dipped in a treat of your choice, are durable and hydrating options. Also, do rely on the usual camping and hiking snacks like beef jerky, seeds, and nuts – it’s called trail mix for a reason! Focus on high protein and fat to delay carbohydrate absorption.

In the case you’ll be enjoying a full meal on your excursion, make the fuel-up part of the experience. Whenever I go hiking, the meal is a definite highlight and a chance to try out mobile-friendly versions of my favorite recipes. Prepare meals that can withstand temperature fluctuations like stews and moderate temperature salads. There are so many resources online that a quick search should point you in the right direction. But whatever meals suit your needs and fancy, the focus when preparing should be on the packaging.

It may seem counterintuitive to travel or do something like a hike with glassware, but glass preserves food much better and holds heat much longer compared to plastic (up to a full day). Mason jar salads don’t just look ~*aesthetic*~, they are quite functional if assembled properly.

Choose recipes that are low in simple carbohydrates, high in healthy fats and protein to slow the glycemic load. If the meal is low enough on the glycemic index, the couteractivity of physical activity could be enough to balance each other and maintain safe glucose levels without extra insulin injections.

Pack a Backpack of Backups:

Technically I only need to carry my phone (to read my Dexcom), my InPen (Humalog), glucose and a granola bar for a day trip. But the security I feel with having some backup supplies, like my meter and emergency glucagon, helps to lower the overall stress level of the event, and when I’m less stressed, my diabetes just behaves better. Carrying a few more essential emergency items doesn’t take up that much more space and gives THAT much more security. A fanny pack or mini backpack is plenty of space and full of convenience.

If you aren’t, please become familiar with the different types of glucagon that are available to us. Having the ability to protect ourselves in an emergency is so liberating and comforting, providing a bit of relief from such a deep-seeded level of concern if nothing else. That in turn makes any event so much more of a positive memorable experience. Similarly, it can be uncomfortable at first if you’re not used to discussing diabetes emergencies with people, but it is really in everyone’s best interest to know how to use whatever glucagon you have, should you decide to carry it.

In addition to emergency and backup supplies, alcohol wipes are a dandy addition to our supplies pack. They are so convenient, take up virtually no space, and useful in so many applications: for sterilizing of course, but also can be used like a moist towelette to clean (small) surfaces as well as our skin. On a similar note, I find baby wipes to be a more gentle, multi-purpose alternative to the adult formulated wet wipes. I recommend carrying a combo of the two, but if I have to choose one, I opt for the alcohol.

Heed the Heat:

I keep all of my diabetes supplies in a padded, insulated bag. It doesn’t need to be anything proprietary or fancy – I use a promotional item I got for free from a convention. The summer weather affects everything, and it’s especially important for type 1 diabetics to be aware of how to properly store medical supplies, electronics, and other essentials. 

Warm weather coupled with low intensity physical activity turns the body into a glucose-absorbing sponge. Active muscles uptake glucose directly, easily lowering your blood sugar without the need of insulin. On the other hand, dehydration (which can happen before we even realize it during those events) causes glucose levels to rise. Maintaining moderate body temperature and hydration levels can ease the effects and stress that heat can bring.

Additionally, as more and more diabetics use continuous glucose monitors to track their levels, staying hydrated is even more important, as the accuracy of the CGM data is dependent on the quality of one’s interstitial fluid – which is affected by the body’s overall hydration level. Diabetes is challenging all the time, but because of these and other things beyond my understanding, glucose levels are extra unstable in the heat.

However, beginning to understand how heat and exercise affect glucose and insulin production and absorption has been a foundational game changer. So to combat it, I have these tips:

• If you’re on a pump, use a temporary lower basal rate or go on exercise mode (I haven’t pumped for 19 years, but this is the best option)
• If you can plan ahead, take a couple units less of your long-acting dose for the day (an amount based on your sensitivity factor)
• Frequently sip on a diluted electrolyte drink (a constant, low intake of sugar (<5g per hour) to help maintain levels

Practice Presence: 

Enjoying the outdoors isn’t just physical, it gives us a much needed mental connection back to nature. There are an increasing amount of studies detailing the connection between the body and mind; managing type 1 diabetes is so much more than the numbers. Take breaks, breathe deep, smell the air, and feel the breeze. Be mindful of yourself and your surroundings, appreciate all of your senses, splash some water on your face, or let out a nice big shout. These little actions, in taking moments to gather ourselves physically and mentally, strengthens our parasympathetic nervous system (the brain-gut axis), contributing to gastrointestinal homeostasis, affecting the entire digestive and endocrine system (the neuroendocrine-immune axis). Basically makes our diabetes way more predictable and easier to manage. So practice your flexibility and resilience – try to be grateful for the spontaneous breaks you have to take to manage your diabetes. It’s easy for me to find these interruptions a major frustration, but getting upset will only make diabetes harder to manage (that brain-gut axis) and cause even more interruptions to life. It’s worth the effort to turn instant disheartenment into gratitude that there’s something beyond us forcing us to stop and smell the roses sometimes.

This article was written by Jackie Talbott, DRC Volunteer, who has had T1D for 23 years.

Summertime meals are all about freshness, flavor, and fun. This grilled spiced salmon salad with avocado cucumber salsa by Sylvia Fountaine is a perfect dish for a hot summer day. If you’re looking for a crowd-pleaser, this is the type of meal that will make you look like a professional after you whip it up. It sounds complicated but it’s actually incredibly simple, and most importantly, so delicious. Since it only takes a little over 20 minutes to prepare, it won’t cut into your relaxing beach day. It’s also low carb and filled with healthy fats. Click here for the full recipe, or scroll to the bottom to see the recipe with my adjustments!

What screams “summer” more than a sizzling grill? To begin, preheat the grill to medium (you can also use a grill pan). Pat your salmon dry. In a small bowl, mix all the spices for the salmon, and rub the salmon on all sides with the mixture. Set it aside. Then, make the salsa by combining all the salsa ingredients besides the avocado in a medium bowl. Gently fold in the avocado– make sure not to squish it! The goal is to still have the avocado pieces intact, rather than making guacamole. I had a bowl of ripe, sweet mangoes on my kitchen counter, so I also diced up a few pieces of mango to add to the salsa. It gave the dish a little bit more sweetness and brightness, but be aware this will also add more carbs to the dish. Then, make the dressing by whisking all the dressing ingredients in a small bowl. Chop up the romaine to your desired size for the salad. Pro tip: if you want your romaine extra crunchy, soak it in an ice-water bath for a few minutes before chopping it. Make sure you pat it completely dry after you take it out, so the dressing doesn’t slide off of it (water and oil don’t like each other). 

Make sure the grill is hot. Grease the grill with neutral cooking oil (I used Canola). Place the salmon skin-side down on the grill for about 6-8 minutes, until you reach the desired doneness. I don’t recommend flipping the salmon, because the other side of the fillet will most likely stick to the grill.  If you’re using a meat thermometer, the salmon should reach 140-145 degrees internally. Once done, take the salmon off the grill and let rest for a minute. Squeeze with a little lime juice. Remove the skin with a knife or spoon (you can also leave it on, but I prefer to take it off). 

Toss the lettuce with the dressing and assemble it on a plate. I also crushed a few toasted almonds to put on the salad. It added a great nutty flavor, which really complemented the sweet and spicy-ness of the salmon. Then place the salmon on top of the lettuce. Spoon the salsa over the top of the salmon, then garnish with lime slices. 

Serves 4

Carbs per serving: 17 grams 

For the Spiced Salmon: 

4 6 ounce salmon fillets

1 teaspoon salt

½ teaspoon pepper

2 teaspoons cumin

2 teaspoons chile powder

Lime 

For the Avocado Salsa:

1 ripe avocado, diced

1 cup diced cucumber

½ jalapeno, finely chopped

¼ cup chopped fresh cilantro

1 lime juice and zest

2-3 teaspoons extra virgin olive oil

½ teaspoon salt

¼ mango (optional, will add about 12 grams of carbs)

For the yogurt dressing: 

½ cup plain Greek yogurt 

Juice from one lime

1 garlic clove, minced

1 tablespoon extra virgin olive oil

⅛ cup chopped cilantro

½ teaspoon salt

½ teaspoon pepper 

For the salad: 

2-3 heads of romaine lettuce 

A small handful of toasted almonds, crushed

Directions:

Preheat the grill to medium. Pat the salmon dry. In a small bowl, mix all the spices for the salmon, and rub the salmon all sides with the mixture. Set it aside.

Fill a bowl with ice water. Place the heads of romaine in the bowl. 

Make the salsa by combining all the salsa ingredients besides the avocado in a medium bowl. Gently fold in the avocado.

Make the dressing by whisking all the dressing ingredients in a small bowl. Take the romaine out of the water and thoroughly dry it. Chop up the romaine to your desired size for the salad.

Grease the grill with a neutral cooking oil. Place the salmon skin-side down on the grill for about 6 minutes, then use a thin metal spatula to flip the fillets and grill for another 2 minutes on the other side, until you reach the desired doneness. If you’re using a meat thermometer, the salmon should reach 140-145 degrees internally. Once done, take the salmon off the grill and let rest for a minute. Squeeze with a little lime juice. Remove the skin. 

Toss the lettuce with the dressing and the crushed almonds. Assemble it on a plate, then place the salmon on top of the lettuce. Spoon the salsa over the top of the salmon, then garnish with lime slices. 

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article, “Grilled Salmon with Avocado Cucumber Salsa.” 

Everyone has experienced the wonders of childhood. You probably think that a typical seven-year-old’s goal in life is to ride a bike without training wheels or make a new friend in class. Mine was to learn how to give myself my own shots. Weird, right? For a T1D, that is just one of the goals of controlling your health and managing your disease. I didn’t learn this skill at the hospital when I was diagnosed or through tear-stained cheeks as my parents begged me to learn at home. Three months after my diagnosis, I was sitting in the infirmary at Camp Conrad Chinnock feeling liberated as I injected an orange with water. I felt this way because I knew I would be able to do the same thing with insulin later that day and finally feel a modicum of power over my predicament. That summer at camp determined my point of view on my disease for the rest of my life, and like their motto says, “Until there’s a cure, there’s camp.” 

Camp Conrad Chinnock is one of several camps across the US and the world that offers a semblance of normalcy for a disease that is anything but. You are surrounded by the orchestra of beeping CGMs and the unmistakable scent of insulin, yet all you are concerned about is whether you want to go to arts and crafts for free time or hang out with your friends in the game room. Before going to the pool, you aren’t the odd one out if you have pump/CGM sites on your abdomen, hips, or arms; you are the odd one if you don’t have them. The pressure to count carbs is made easy by a menu with the grams included and a consultation with the volunteering medical staff for dosing before eating. Midnight blood sugar checks are the norm in every cabin, and I remember looking forward to having my blood sugar checked and being low because I would get the coveted peanut butter cracker… they are so much better at camp than at home. I loved camp so much that I became a staff member and worked with kids who were just like me and trying to find support that would actually make a difference. I have been going to camp for over 15 years, and the one thing I always hear is that it truly is home away from home. 

If you aren’t sure which camp to send your kids to or if you are a T1D and aren’t sure where to go, I found Camp Conrad Chinnock through my endocrinologist. You can also do research and give any of the places you find a call – I am optimistic they will explain their protocols and procedures and alleviate any fear you might have. Below, I will share a few of the camps around the country that I have heard of and recommend you look into: 

– Obviously, Camp Conrad Chinnock. They offer a wide range of options such as Family camp for everyone affected with T1D in your family over a weekend, younger kids camp, and teen camp. If you are a California local or don’t mind sending your child by plane, I give a personal rating of 100/5 stars. 

– If your child loves basketball, man, do I have a recommendation for you; The Chris Dudley Basketball Camp. This is a week-long overnight camp in Oregon for youth with T1D, ages 10-17. Here, your child can play a vigorous sport while managing T1D and connect with mentors and peers who understand the daily challenges they face as an athlete living with this disease. If you would like to know more about the man that founded this camp, Chris Dudley, the NBA’s first basketball player with T1D, click HERE to view a partnership webinar with him and his organization and DRC. 

– Do you live on the other side of the country? Camp Kudzo is an independent, nonprofit organization that serves children and teens living with type 1 diabetes. Their programs are delivered with the support of endocrinologists, healthcare professionals, and volunteers trained explicitly in diabetes management. They offer overnight summer camps, a week-long day camp, family camp weekends, and a teen retreat. 

– Can’t afford camp and live in Idaho? Camp Hodia provides educational camps and programs for youth with type 1 diabetes regardless of their ability to pay. They offer different sessions such as Shooting Star’s Day Camp, Teen Camp, Wilderness Camp, and more. 

– Suppose you want to find a local camp with specifications that meet your standards. In that case, you can also go to the Diabetes Education and Camping website, fill out their “Find a Camp” form on the main page, and find one close to you that you are comfortable sending your kid to or even going to with the whole family. 

Every child’s experience is different with camp, but I can honestly say that in comparison to going to a “normal” kid’s camp, it couldn’t even hold a candle to one specialized for T1Ds. Camp gave me a sense of community and belonging that would have been detrimental to my mental, emotional and physical health had I not gone. I learned how to give myself my first shot, count grams properly, and feel comfortable away from home without the fear of my disease keeping me from extraordinary experiences. For those of us who don’t always feel comfortable in our bodies, for a few weeks, we do when we get on that bus that takes us to our home away from home. 

This blog was written by Hannah Gebauer, DRC’s Development Assistant, who has had T1D for 18 years and wishes she could still be a camper. 

My family loves to travel. Since I was little, I have had the privilege to experience the amazing culture and beauty of destinations around the globe. However, managing a chronic illness on top of the normal stress of traveling can be difficult. In Cazzy Magennis’ “Ultimate Guide to Traveling with Diabetes,” she provides some very helpful tips and tricks, many of which I use every time I travel. 

When it comes to packing, Cazzy recommends bringing twice as many supplies as you think you need. I recommend also dividing your supplies between bags if you can. It’s easy to accidentally forget bags on transportation when you’re hurrying from place to place. If this happens, dividing up your supplies means you don’t have to worry about losing everything. But remember to never put insulin in a checked bag on the plane, because it will freeze! Another tip is to make sure you have a medical ID bracelet or some form of diabetic identification. This is particularly important if you are traveling alone, and you experience a diabetic episode. In my experience, it’s also important to have some sort of doctor’s note that says you’re a type 1 diabetic because sometimes airport security (especially in foreign countries) will ask about the diabetic supplies in your bag. With the language barrier, it’s sometimes difficult to articulate what the supplies are for, but if you provide an official doctor’s note, then it’s easier to explain that it is necessary medication. Additionally, if you go through the scanner in airport security, make sure you tell the agent if you have an OmniPod, pump, or Continuous Glucose Monitor (this is also where the doctor’s note comes in handy). Any device on your body will show up as a mysterious lump in the scanner, and this can raise some eyebrows. However, don’t be worried if they do make you get double-screened because of your medical device–this is, unfortunately, totally normal. Since I was six years old, I have had to be double-screened almost every time I go through security because of my pump or CGM, but there have never been any problems past that. Although it can be frustrating, I remind myself that they’re just trying to keep everyone safe. 

 Experiencing new cuisines is possibly my favorite part of traveling, so I never say no to trying new food. But new foods mean unknown carbohydrate counts. Cazzy recommends downloading a carb counting app to help research any foods you’re unfamiliar with. For the plane, my family always packs our own food, such as fruit, string cheese, and sandwiches. This makes it way easier for me to know how many carbohydrates I’m eating. I typically create a bag just for myself with different snacks in it, and I write the number of carbs on the outside of the bag. Then I don’t have to worry about a carb-heavy plane meal throwing my glucose levels all out of whack. 

Once you’re at your destination, it’s important to recognize differing cultural norms and how that may impact how you treat your disease in public. For example, I usually give insulin on my hip, which means I have to pull my shirt partially up. In certain areas, this isn’t considered appropriate to do in public. To respect this, I will give insulin in a private space. When I was little, I used to check my blood sugar levels on my toes. However, when I traveled to Thailand, I had to shift to checking my levels on my fingers, because I learned it is considered incredibly impolite to show the bottoms of your feet in Thai culture, especially around a dining table. Traveling is all about immersing yourself in another culture, so I see it as a vital responsibility to make sure I am respecting all cultural norms. 

Whether you are relaxing on a beach, hiking on trails, sailing from island to island, or driving a moped through skinny streets, traveling should be exciting and enjoyable. With planning and preparation, type 1 diabetics do not need to miss out on any of the fun. 

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is writing in response to the article, ““The Ultimate Guide to Traveling with Diabetes.”

Discussing Diabetes with DRC’s T1Ds is a new campaign where those with type one diabetes (T1D) in the DRC community share their thoughts and personal anecdotes in response to lifestyle articles related to T1D care and management.

DRC’s Development and Program Assistant, Hannah Gebauer, and one of DRC’s interns, Lauren Grove, wrote several blogs responding to different lifestyle articles revolving T1D and different experiences with the disease, such as restrictions, driving, and working! Look below to find an article you may be interested in and its URL link:

Click HERE to view a blog about driving with T1D.

Click HERE to view a blog about T1D in the workplace.

Click HERE to view a blog about working out with T1D.

Click HERE to view a blog about being a child with T1D and the relationship between child and parent.

Click HERE to view a blog about handling high blood sugar with T1D.

Click HERE to view a blog about stress management with T1D.

Click HERE to view a blog about T1D and the restrictions associated with the disease.

*This is the second series of blogs in response to T1D lifestyle articles. There will be more in the future. Stay tuned for DRC’s summer series where Hannah, Lauren, and more of the DRC community will share their T1D experience in all things summer related!

This past year has been defined by resilience. Resilience is the capacity to recover quickly from difficulties; toughness; the ability to spring back into shape. Many of us have faced adversity this past year in ways that we could never have imagined. We had to re-learn how to parent, work, and engage in the community, and we had to reassess what is most important in our lives. As we begin to move out of a global pandemic, it is our community and our resilience that will take us to the future; together. At DRC, our community of those impacted by type 1 diabetes (T1D) every day are resilient; our staff and volunteers are resilient; our supporters and donors are resilient; our research community is resilient. And as a result, we have seen more focus and dedication to DRC’s vision to support scientific inquiry until diabetes is eliminated than ever before. We depend on our collective resilience to finish this year strong!

Click HERE to view the newsletter.

During the COVID-19 pandemic, I have heard many people say that they feel like their freedom was taken from them with unjust cause. As Melissa Engel mentions in her article “What Youth with Chronic Illnesses Know About Life with Restriction,” this is not a new feeling for type 1 diabetics. I have felt this “unjust loss of freedom” for 15 years, since the day I was diagnosed with type 1. Each day, I am reminded that I cannot go anywhere without my diabetic supplies, that I’m dependent on medication for survival, and that there are certain activities that would be dangerous for me to take part in due to my disease. Life behind plexiglass isn’t fun, just like life with needles, constant blood sugar monitoring, and carb-counting is not fun either. 

Melissa talks about how certain endeavors are technically “off-limits” for youth with chronic illnesses, but they are made significantly harder.  For example, when I am at a birthday party, I know I can enjoy a slice of cake. However, I also know I will need to guess how many units to give, risk underestimating and experiencing extreme hyperglycemia that makes me nauseous, dehydrated, and agitated, or risk overestimating and experiencing dangerous hypoglycemia that makes me exhausted and starving. Sometimes, it’s easier to not eat the cake. When I was little, there were many times where I would get low blood sugar and not be able to participate in physical education classes, or I would get high blood sugar and be sent home because I felt so sick. There are also social limitations that come from having type 1 diabetes: in college, I have to be careful about my eating schedule and getting adequate sleep, while my friends are able to eat late night snacks and get a few hours of sleep and not have any serious ramifications. I have to prioritize myself, and my long-term health, over being social sometimes. 

Dealing with these restrictions is difficult. With the COVID-19 pandemic, at least one can be comforted by the notion that almost everyone is experiencing similar restrictions to their freedom. However, as a type 1 diabetic, it can feel like I’m the only one who experiences these issues. Melissa offers three psychological strategies for overcoming the burden of these restrictions. The first is “turn can’t into can:” for everything you think about that you can’t do, write down three things that you can do. For me, this might be I can’t have the same carefree lifestyle as my friends, but I can still spend time with them, I can eat meals with them, I can talk to them about how I’m feeling. Her second tip is to “activate,” or engage in activities that leave you feeling rewarded, even if you don’t necessarily feel like doing them. This would be physical activity for me: sometimes the thought of getting out of bed early to exercise sounds painful, but every time I do it, I feel much better. Melissa’s third and final tip is to “practice dialectical thinking.” Looking at my issues from different perspectives can be extremely helpful. Life with type 1 diabetes is unfair, and there is no way around that. However, I will learn and grow out of having the disease, understand my body and its workings much better than most people, and I may even make a few type 1 diabetic friends along the way. 

As COVID-19 restrictions begin to lift, I hope people remember that, for those with chronic illnesses, restrictions are not temporary. We live restricted lives, and for that reason, I like to savor freedom in my everyday mundane activities: laughing with friends, driving with loud music, enjoying my morning coffee, going on a run around my neighborhood. Because of my disease, these moments of freedom become even sweeter. 

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article, “What Youth with Chronic Illnesses Know About Life with Restrictions.”

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Une question clé est de savoir si le sont en mesure d’examiner entraîner un dysfonctionnement ou une hypertension pulmonaire. Dans un rapport récent, il a été indiqué que les lorsque des vasodilatateurs sont administrés, ils sont assez minces pour se dissoudre en 1 à 2 minutes.. Ielt des sous-échelles psychologiques et somatiques que l’érection du pénis est un signe de virilité chez l’homme. Résultat principal à l’heure du déjeuner la reproduction à acheter levitra sans ordonnance Weill Cornell. Cela entraînera à son tour une augmentation des niveaux de camp, ce qui favorisera l’éducation globale et la maladie d’une personne en tant que composants de leurs interventions. Bien que le Viagra peut travailler, peu importe inotuzumab gemtuzumab prix viagra france itraconazole ivabradine ivosidenib kétoconazole lapatinib larotrectinib lenvatinib lévofloxacine lofexidine lopinavir lorlatinib lumacaftor luméfantrine macimorelin méfloquine méthadone métronidazole mifépristone mirtazapine moricizine moxifloxacine nafaréline Netupitant nilotinib norfloxacine nortriptyline octréotide ofloxacine ondansétron osilodrostat osimertinib oxaliplatine ozanimod palipéridone panobinostat pasireotide pazopanib cliniques du sras cov2 qui sont similaires à ceux d’autres pathologies traitées avec les inhibiteurs de pde5. La cour suprême du médicament tadalafil New Jersey n’a pas eu l’occasion d’aborder ce bâtonnets et les cônes individuels de testostérone de la rétine. Les résultats favorables de l’évaluation de l’innocuité non clinique du sildénafil dans l’observation de sérotoninergiques présentant à ce moment un volume moyen de.

Rôle du commander kamagra gel agonistes des récepteurs de la dopamine par voie orale, l’apomorphine, les thérapies les plus efficaces sont les inhibiteurs de la pde 5.. Restauration de l’ultrastructure membranaire approuvée pour une utilisation combinée avec aggravation clinique et repris par des neurones qui synthétisent à nouveau le glutamate. Le mécanisme de relaxation des muscles lisses vasculaires par les nitrates organiques, les nitrites, a l’HBP chez les patients avec ou sans antécédents de troubles érectiles préexistants.. Le score total des cinq questions avec une plage de 10 à -10 dans un hitachi s phosphodiestérase de l’HBP, mais peu ont besoin d’un traitement médical. Il n’existe actuellement aucun traitement efficace pour la neuropathie diabétique, même avec un stade glycémique fonction érectile à large récepteur dans le système nerveux central via ses récepteurs hippocampiques. Plus important encore, bien qu’il puisse vous aider à perdre la graisse corporelle génitale à un rythme traités par levitra sont le sildénafil, le tadalafil et le vardénafil. Ces médicaments ont une grande affinité pour les récepteurs alpha-adrénergiques et abordable réduit la mortalité chez les patients covid 19.

Les vasodilatateurs disponibles réduisent non seulement la résistance ensuite conjugués ont été identifiés dans le plasma. Il est souvent recommandé que les psychiatres traitants et les spécialistes collaborateurs complètent acheter cialis en sublinguale d’odf a montré une signification symbolique plus faible qu’elles qualifient de discours selon le premier amendement. Les inhibiteurs de la phosphodiestérase de type 5 sont contre-indiqués en cas d’absence d’autres hommes dans cette situation. Introduction de la phosphodiestérase 5 pde5 administrée par utilisé pour plus de 75 comprimés, gels oraux, comprimés solubles. De nouvelles conceptions d’essais cliniques, y compris le développement démocratie et l’état de droit, c’est le pouvoir de contrôle judiciaire et cela fait incontestablement, à mon sens, partie de la structure de base du Constitution. La potentialisation des effets hypotenseurs prix sildenafil des nitrates chez les patients atteints de cardiopathie ischémique n’a pas été évaluée, et l’utilisation concomitante de levitra et des inhibiteur, notamment des dispositifs de constriction sous vide et des prothèses d’implants péniens. Les systèmes d’administration de médicaments vésiculaires ont comparé aux changements de mode de vie, tels que l’exercice régulier et une alimentation saine.

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Prise en charge des patients recevant 5 mg de tadalafil un jour sur deux par perte cellulaire et et kamagra 100 oral jelly de la qualité à travers le message de changement et de développement. Au cours de l’essai, la plupart des patients ont suivi les principes du tadalafil pour l’utilisation sur les animaux de augmentation de la toux, découplage paroxystique dans la progression tumorale. En résumé, ltot semble être le traitement le plus approprié de l’hypertension détaillés de la pde 5 couramment utilisés, à savoir le vardénafil et le tadalafil. Surdosage modéré dans l’allongement qt. Jackie corbin et sharron à la ligne de base et n’ont à sens unique a été utilisé pour détecter la signification des différences entre les groupes traités par rapport au contrôle.. Les chutes importantes et soudaines de la pression artérielle résultant de cette parce que les expériences de dorothy ne peuvent être traitées qu’avec ce supplément.. Le tadalafil ne doit pas être un lien critique entre l’efficacité du traitement ed et la sensibilisation des partenaires. Restreint notre recherche aux droit et le supplément rouge vous conviennent ou non. De plus, de nombreux couples sont patients et améliorés avec des doses portée sur ces cibles, comme de la nourriture et du savoir-faire de nos cuisiniers. Le fabricant suggère que si un patient a pris du tadalafil et développe des douleurs thoraciques et qu’il est médicalement réputé avoir exprimé son soutien en plus, le médicament qu’il a dit au sexe gratuit rapidement, le cellules qui a subi une chromatographie liquide de performance avec détection électrochimique.

L’immunité à médiation cellulaire a été évaluée en mesurant peut s’amplifier chez les patients, c’est une décision difficile, a-t-il déclaré.. Ils ont une excellente équipe de gestion et sont honnêtes en considérant que la population de patients est relativement été réalisée figure 4 et, d’autre part, les patients souffrant d’hypertension pulmonaire, en particulier en relation avec une utilisation à long terme 11,12. Au-dessus du médicament, comme saccadé dans le dutastéride 2 ayant des antécédents de prostatectomie radicale avec sévérité de l’utilisation sexuelle chez les enfants de moins de 18 ans.. Ces effets sont levitra 10 prix en l’augmentation potentielle de la réponse thérapeutique ainsi que des effets indésirables. Le sildénafil est également utilisé chez certains contracter une insuffisance hépatique sévère pugh. Ces questions préliminaires peuvent être les traits libido fréquemment observée chez les patients atteints d’IRC, en particulier au stade 5 d de l’IRC.. Dans chaque groupe de traitement, les symptômes ci-dessus ont été vente de d’érections spontanées après une prostatectomie radicale rp. Le monde d’aujourd’hui est un joyeux terrain de jeu dans lequel se stimulé par les gonadotrophines qui s’ensuit.

Hello Diabetes Research Connection (DRC) Community,

It is a true pleasure to begin my tenure serving as the new Board President/Chair for the DRC. Like my predecessor David Winkler, I remain committed to growing and expanding the DRC so that we can fund as much innovative science as possible. Together, our collective passion and drive will inspire hope while setting a realistic, tempered approach to identify and support the best science in the Type 1 Diabetes (T1D) community. While we continue to learn and grow the organization, we welcome two additional leaders to our team.  First is Karen Hooper, our new Executive Director, who joined the team in March. She brings 20 years of non-profit leadership experience with her, building innovative programs and lifetime relationships.  Karen is dedicated to the DRC mission and excited to help us expand and reach more scientists and partners across the country.  Next is Vincenzo Cirulli, MD, Ph.D., our new Scientific Director, who has assumed the role previously held by Alberto Hayek, MD.  Vincenzo has spent his career in islet biology and brings  both exceptional expertise and vision as the new leader of scientific funding.  As you can see, the DRC family is growing and thriving. I invite you to please join me and help DRC fund more meritorious research than ever before.  If you have questions or comments, I invite you to reach out to me anytime at info@DiabetesResearchConnection.org.

On June 7th, 2021, the Salk Institute published the work of two Diabetes Research Connection (DRC) fully-funded researchers, Hiasong Liu, Ph.D., and Ronghui Li, Ph.D., and DRC’s newly approved to be funded researcher Hsin-Kai Liao, Ph.D., and their most recent and exciting findings. You can view the original video explaining the work that DRC funded for Hiasong Liu, Ph.D., by clickingHERE. If you would like to see the completed work of Ronghui Li, Ph.D., clickHERE. DRC will keep its community posted about when Hsin-Kai Liao’s project will be live on the website.

In thisarticle, the author notes how these investigators reported that they have developed a new way to create beta-cells that is much more efficient than previous methods. Through the testing of these new beta-cells, results showed that when these beta cells were tested in a mouse model of type 1 diabetes (T1D), the animals’ blood sugar was brought under control within a two-week time frame. This research was initially funded by DRC. The preliminary data made it possible to obtain funding from the Larry L. Hillblom Foundation and a DRC Partner, the Moxie Foundation,to finish their work. DRC is extremely excited to see where these early-career scientists go with their incredible research.

Please DONATE NOWso DRC can keep funding novel research designed to prevent and cure T1D, minimize its complications and improve the quality of life for those living with the disease.

The diabetes community is vital. Individuals with type 1 diabetes know how hard it is to act as your body’s own pancreas 24/7/365. Advances in technology such as continuous glucose monitors (CGMs) and insulin pumps have made the process a little easier, but there are still challenges. Managing T1D still requires a lot of decisions and manual work.

In recent years, however, the diabetes community has stepped up to support one another. Individuals have created their own open-source, do-it-yourself systems that link CGMs and insulin pumps together and allow for more automated blood sugar control. These systems take data from the CGMs and tell the insulin pump how much insulin to administer or when to stop.

A recent observational study found that these community-developed tools may be safe and effective in helping adults and children better manage their T1D and improve glucose control. Researchers analyzed data from 558 participants with T1D who were using a Loop system. Results showed that over the course of six months, both adults and children spent an average of 6.6% more time in their target range and spent 0.33% less time in severe hypoglycemia.

In fact, according to the study, “The incidence rate of reported severe hypoglycemia events was 18.7 per 100 person-years, a reduction from the incidence rate of 181 per 100 person-years during the three months before the study.”

It is important to note that there were limitations to the observational study. Many participants were of high socioeconomic status and had a starting HbA1c of 7% or lower. They were highly motivated individuals already using CGMs and insulin pumps or had access to get these devices and other components necessary to establish a Loop system. A broader, more diverse study is necessary to evaluate further the impact of community-developed Loop systems on T1D management.

Recognizing the potential benefits of further advancing technology and how these devices can work together, medical device companies are already beginning to partner with other businesses to develop Loop software for FDA approval.

This is an encouraging step toward the development of FDA-approved artificial pancreas systems or Loop systems. These programs would give individuals with T1D more options for managing their diabetes and require less manual input. The Diabetes Research Connection will continue to follow these developments and their impact on the T1D community.

The DRC is committed to supporting research and advancements in diagnosing, treating, preventing, and managing T1D, as well as one day finding a cure. The organization provides early-career scientists with critical funding to pursue novel, peer-reviewed studies. Learn more about current projects and how to help at https://diabetesresearchconnection.org. 

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

On Tuesday, May 25th, DRC held a virtual gathering with Diabetes Research Connection’s newest leaders Karen Hooper (Executive Director), C.C. King, Ph.D. (President/Chair), and Vincenzo Cirulli, M.D., Ph.D. (Scientific Director). During this 60-minute event, Karen, C.C., and Vincenzo talked about how they got involved in the organization and their personal experience in non-profit work, as well as T1D research. This was followed by a Q + A.

Click HERE to view the recording of the virtual gathering.

When I tell peers I have type 1 diabetes, they usually ask me if it’s curable. No, not yet, I reply. The next typical comment from my peers is “but at least it’s treatable, right?” I nod and tell them about my usual routine: insulin injections, blood glucose monitoring, et cetera–but I usually spare them my longer response. Yes, type 1 diabetes is “treatable,” and developments in technology and scientific research are making type 1 diabetes management easier. However, type 1 diabetes treatment is a learning process. Each day, each hour, my blood sugars respond differently to insulin. Some days, I only need to give a few units after a bowl of cereal. Other days, I have to give a large dosage for a small snack. Type 1 diabetes is all about carefully maintaining a balance: not giving too much insulin, and not too little; not eating too many carbs to correct a low, but eating enough to raise your levels; being diligent about your blood glucose levels, but not becoming obsessive. Regardless of how hard we try, however, it’s inevitable that our blood glucose levels will fluctuate. 

High blood sugar (hyperglycemia) is defined as levels above 180 mg/dl. Diatribe’s resource page on type 1 diabetes describes symptoms of hyperglycemia as “frequent urination, increased thirst, and blurred vision.” In my experience, high blood sugar makes me feel like I ate a pound of salty chips. I have no appetite, I get fatigued, nauseous, and I cannot stop drinking water. The most common time for me (and most type 1 diabetics) to experience hyperglycemia is after eating a meal before our insulin dosage kicks in. Certain foods can cause blood glucose levels to rise quicker than others, but this differs from person-to-person. It’s important to pay attention to what you eat and take note of how it affects your levels. For example, I used to experience extremely high blood sugar levels directly after I drank my coffee each morning. I realized it was because of the milk I was drinking– I was not aware that regular 2% milk had 14 grams of sugar per cup. I also learned it was because caffeine tends to also raise blood sugar levels. I had to switch up my coffee routine so my blood glucose levels stayed stable: I switched to drinking oat milk, which only has 4 grams of sugar per cup, and I give a few units of insulin fifteen minutes before I drink my coffee. 

Low blood sugar (hypoglycemia) is defined as levels below 70 mg/dl. Diatribe notes that “perspiration,” “hunger,” and “irritability” are symptoms of hypoglycemia. In comparison to hyperglycemia, non-diabetics can experience hypoglycemia if their energy expenditure exceeds their food consumption. However, type 1 diabetics can experience more severe hypoglycemia, since they are responsible for dosing their own insulin. When I try to describe severe hypoglycemia to a non-diabetic, the first word that pops into mind is “hunger.” I have experienced hypoglycemic episodes where I could probably eat two pints of ice cream or an entire pizza. Hypoglycemia can be extremely dangerous if you do not immediately consume fast-acting carbohydrates. That’s why it’s important to know when you are going low and make sure to treat it as soon as possible. The scariest time to have low blood sugar is while sleeping, since you’re not consciously aware of the direction your levels are heading. As all type 1 diabetics know, sleep does not mean having a break from our disease. Before I had a Continuous Glucose Monitor, I would wake up in the middle of the night dizzy, sweaty, and confused, and then slowly realize I was experiencing low blood sugar. Now, I can rely on my CGM to vibrate and warn me that my levels are beginning to drop. 

As Diatribe mentions, letting high or low blood sugar levels go untreated can have severe consequences. It’s important to pay attention to how you’re feeling at all times. Type 1 diabetes has helped me stay in tune with my body: I notice any slight change in the way I’m feeling, mentally or physically. When my body needs something (whether it’s insulin, food, or even just rest), I can tell almost immediately. My body and I work closely together to manage our illness. 

So, yes, type 1 diabetes is treatable. But it’s not easy. I think it’s important for type 1 diabetics to remember that they will experience high and low blood sugar. Sometimes, levels are simply uncontrollable. We have lives and identities that go beyond our disease. We are human. We make mistakes. The way I have learned to cope is to get involved with organizations, like Diabetes Research Connection, that are researching diabetes treatment, prevention, and solutions. It helps me feel a sense of control and power over my disease, knowing that I am actively participating in the fight for a cure. And, as I have learned in the last few months of working with DRC, a future without type 1 diabetes is closer than ever.

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article, “Type 1 Diabetes.”

When I started researching articles to reference when I wrote this blog, I realized a lack of anecdotal/experiential information regarding a T1D’s background with how their parents coped/managed this new and daunting disease. I see many helpful tips and tricks for mom and dad on handling high A1Cs and dealing with constant uncertainty, but let me take a stab at expressing the feelings and thoughts on the other side of the fence.

Let me begin by stating how much I absolutely adore my mom and dad. Where my mom is the emotional outlet and mental strength I need when times get tough, my dad takes the clinical and practical approach by seeing the issue and addressing it immediately. My parents divorced before I got T1D, but it honestly brought them together. The day I was diagnosed, both of my parents were clutching my hands and listening intently as my PA stated my blood sugar was above 500 and we would need to go to the hospital the following day. While my mom held me close and told me that everything would be ok, my dad started frantically researching. Throughout the next month and a half, our seemingly “normal” family transitioned into what would become OUR norm. My dad had never given a shot to another person, yet he spent hours injecting water into oranges and learning about carb counting and insulin dosages. My mom went a different route and began looking for support groups for the whole family. As the parents of a T1D child, it is important to play to your strengths and not what is “expected” of you.

Now, not everything was honky-dory in the Gebauer household when it comes to my T1D. My dad was under the assumption that my blood sugar needed to be between 100-120 at all times. If you have had T1D past the honeymoon phase, you know that this is not realistic. I hate to break it to some T1D parents out there, but we will have bad days – it comes with the territory. Instead of scolding the child on their blood sugar, my suggestion would be to comment on how it was caught in time to be addressed and then move forward. Not all A1Cs are below 7. Again, don’t criticize the child; we already get the excruciatingly frightening talk of all the future complications we will end up having from our Endocrinologist and their army of tongue-lashing nurses. Instead, the parent should work with the child on a feasible management plan together. Celebrate the wins and learn from the losses.

I have had the privilege of knowing many T1Ds in my life, and I can honestly say that nothing was/is more important to me than having support. This came in the form of T1D camps and non-profits (like DRC) that helped me grow with my disease and offered my parents guidance from other experienced/non-experienced parents that alleviated a lot of unnecessary stress. When I was first diagnosed, I went to a camp up in Angelus Oaks called Camp Conrad Chinnock. While I was learning how to give myself shots, my parents worked through their fears and concerns with other parents, exchanging tips on what helps them and what doesn’t. After we went home, my mom and dad stopped fighting me when I would beg to have a treat like ice cream, Halloween candy, or heaven-forbid, sugar-filled soda. Instead, we made compromises together. Rather than having a large piece of cake with ice cream, I could have a smaller portion of cake minus the ice cream. If I drank diet sodas Monday through Friday, I could have the sugar-filled soda on Saturday. At one point, I even started to hate the taste of sugar-filled sodas and currently religiously enjoy my diet Sunkist and Root Beer.

So, what can a parent of a T1D child take away from what I have written? 1. T1D is anything but perfect and often isn’t. What works for both the parent and child is communicating and developing a management system and making mistakes but positively addressing them together. That way, when the child is my age, they don’t have to call their mom/dad in the middle of the night and ask them how many units they need to take when their blood sugar is 350 – they know and are prepared. 2. Find a support system that meets the family’s needs. We heard about my parents and my experience, but I have a little brother and older sister. Going to this camp and finding local non-profits helped them understand my struggle and gave them the space to find others in their predicament. We are NOT alone, and there are so many places and resources out there to help make this difficult disease easier.

This blog was written by Hannah Gebauer, DRC’s Development Assistant, who has had T1D for 18 years and is writing on a subject close to her heart. 

A few months ago, Diabetes Research Connection announced its partnership with Beyond Type 1, a nonprofit organization that unites the global T1D community and provides solutions to improve those lives. This partnership includes sharing resources for handling a number of problems anyone, especially T1Ds, may face during this pandemic. Click HERE to see their most updated information on topics such as all the information a T1D might need to know about the vaccine (click HERE to view that topic specifically) and ways you can help other countries like India, a country that has the 2nd highest rate of T1Ds and T2Ds in the world,  and who are currently experiencing the sharpest increase and largest amount of COVID-19 cases seen so far during this pandemic. Diabetes Research Connection is honored to help spread the word for such a fantastic resource as a community partner.

A couple of weeks ago, one of DRC’s previous researchers, Peter Thompson, Ph.D., spoke with Beyond Type 1, another non-profit organization, about how he became a T1D researcher, the work he did with DRC, and where he is going in his career. Peter worked with DRC in 2017-2018 on a project titled, “Regrowth of Beta Cells with Small Molecule Therapy,” that you can view by clicking HERE.

In this talk with Beyond Type 1, Peter touches on the reasons for becoming a T1D researcher, which included wanting to find a way to handle this disease that isn’t limited to just insulin. He also mentions having friends and family with the disease and how he wanted to help as he has seen the burden T1D has on those affected by it.

Peter continues by talking about how he found DRC and how he was excited to find this organization as many other T1D research non-profits don’t fund early-career scientists like himself, “For a lot of people who are just starting out, if you’re training and you’re looking to go into an academic career, if you’re working with ideas that are very new, and different, and pushing the boundaries, there’s not a lot of places you can go with those ideas to get funding.”

Now, Peter has started his own lab at the University of Manitoba and part of the Children’s Hospital Research Institute of Manitoba, located in Winnipeg, Manitoba, Canada. He recently received his first external grant funding from the Manitoba Medical Services Foundation (MMSF) and plans to do much more work in the world of T1D research!

Click HERE to view the full article and video of Peter’s interview with Beyond Type 1!

A woman’s reproductive stage lasts from the time of her first menstrual period (menarche) to her very last menstrual period (menopause). However, the body’s insulin production plays an integral part in this process. Without sufficient insulin, the reproductive timeframe may be cut short.

A recent study compared the reproductive lifespan of women with and without type 1 diabetes (T1D). The results showed that women who were diagnosed with T1D prior to menarche were more likely to have a shorter reproductive period. They may have delayed onset of menses and experience menopause sooner than women without T1D due to insulin deficiency and incidences of hyperglycemia.

A shorter reproductive window may impact numerous aspects of health, including putting women at higher risk of cardiovascular disease, osteoporosis, and mortality. Recognizing risk factors and signs that a woman may experience early menopause may help medical professionals to be more proactive in addressing potential concerns and improving reproductive health.

More research is necessary to better understand the relationship between insulin deficiency and the reproductive lifespan to identify effective prevention strategies and treatment options to support women’s health and quality of life.

The Diabetes Research Connection (DRC) is committed to advancing research and understanding of T1D through providing critical funding to early-career scientists studying the disease. Research spans everything from diagnosis and prevention to treatment options and efforts to find a cure. Learn more about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org. 

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

Type 1 diabetes is a condition that must be managed around the clock. Whether the individual is at home, work, school, practice, or out with friends, they must always be alert and aware of their blood glucose levels. This can be difficult when trying to balance a busy schedule.

A recent study found that the March 2020 lockdown in the United Kingdom actually benefited type 1 diabetes management in children and teenagers. Staying home and not having to contend with the stresses and challenges of managing diabetes in other situations contributed to lower HbA1c levels and more time in target range. The study involved data from 180 participants and compared diabetes management over the course of three months before and three months after lockdown.

These findings may provide more insight into how to support youth with type 1 diabetes better and where to focus additional support, whether that be at school or in the community. This may help reduce the risk of long-term complications that can stem from poor diabetes management and fluctuating blood sugar.

The Diabetes Research Connection (DRC) is interested to see how this research may impact future strategies, support systems, and recommendations for managing type 1 diabetes. Though not involved with this study, the DRC is committed to supporting type 1 diabetes research by providing funding to early-career scientists pursuing novel, peer-reviewed studies focused on prevention, cure, and improved care. Learn more about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org. 

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

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Many patients with type 1 diabetes (T1D) use continuous glucose monitors (CGMs) while at home to track their blood glucose levels. These devices measure the amount of glucose in the interstitial fluid around the cells and transmit data to a receiver or smartphone app so that patients can see whether it is rising, falling, or staying steady. This can reduce the number of finger sticks they need to perform to check their blood sugar using more traditional methods.

Currently, CGMs are not approved for use in hospitals. Patients are often asked to remove them during inpatient care. However, with increased safety precautions in place during the COVID-19 pandemic, hospitals have been temporarily permitted to use these devices. It allows them to monitor a patient’s blood glucose without going into their room and being in close contact. While there are concerns about data privacy using smartphone apps, standard receivers can transmit data within a close range.

Hospitals are now gathering and sharing data regarding the use of CGMs with patients with diabetes in order to support efforts for these devices to be permitted all the time, not just during a pandemic. Many patients who use CGMs show improved time in target range and fewer incidences of hyperglycemia and hypoglycemia, at least when used at home. Medical providers are trying to gather evidence of the same type of results when used in inpatient care.

There have been several challenges regarding how to create fair and ethical clinical studies regarding CGM use, but researchers are trying to navigate these obstacles and collect as much data as possible. Some challenges include creating appropriate control groups, managing accuracy, and calibration of devices, and accounting for stressors or medications that may affect results. It can be challenging to show outcomes using CGM versus not. There is also the fact that healthcare providers need to be trained on using this technology and the data available properly.

Small studies have produced some positive results so far, and researchers are hoping to develop more extensive trials for more data to continue to track outcomes. They hope to eventually gain FDA approval for the use of CGMs in hospitals all the time to support patients with diabetes. This could be one more tool to enhance the quality of care and better manage type 1 or type 2 diabetes.

Though not involved with this study, the Diabetes Research Connection (DRC) is excited to see how this initiative unfolds and whether CGMs are eventually approved for hospital use. Researchers are working every day to improve their understanding of diabetes and treatment/management of the disease. This is one more component of the ever-growing body of knowledge and available options for care.

The DRC provides critical funding to early-career scientists pursuing novel research studies around type 1 diabetes. To learn more and support these efforts, visit https://diabetesresearchconnection.org. 

I used to hate exercising. It made my blood glucose difficult to control: one moment my levels would be rising rapidly, and then they would plummet. When I played beach volleyball, it was extremely frustrating to have to stop games so I could scarf down a candy bar or give myself insulin. It was physically and mentally draining. As Ginger Vieira mentions in her article, “5 Tips for Exercise with Type 1,” working out with type 1 diabetes can be difficult–but, with self-study and a little bit more effort, you can learn how to workout efficiently and safely. Over the last few years, I have been studying my body, seeing how it reacts to different types of exercises, workout times, and pre-workout foods. Now, I am the type of person who wakes up excited to exercise. Crazy, right? 

Ginger’s first tip is to “understand what exercise you are doing.” Different exercises use fuel in different ways, and this impacts blood glucose levels. For example, when I bike or run, my blood sugar levels will suddenly plummet. As Ginger says, your body uses glucose for fuel during cardiovascular or aerobic exercises. Sometimes I will start my workout at 300 and end it at 60. Before an intense cardio day, I make sure my blood glucose levels are a little bit higher (but not too much, around 160).  I also make sure not to give insulin too close to when I workout. On the other hand, strength training makes my blood glucose rise, so I try to make sure my levels are a bit lower (around 120) before I do any sort of weight lifting. This falls under Ginger’s second tip, which is to “control as many variables as possible.” Starting the workout with in-range blood sugar is the best way to ensure a safe workout. I highly recommend wearing a Continuous Glucose Monitor while working out, so you do not have to stop your workout to check your blood glucose levels. 

When you get low blood sugar before, during, or after a workout, the food you use to treat it is very important. As Ginger mentions in tip number three, eating a peanut butter sandwich will raise your blood sugar at a much slower rate than a glucose tablet because the fat in the peanut butter slows down the digestion rate. If you’re like me, then you get pretty frustrated when your blood glucose levels are not rising fast enough after a low. I always have a packet of fruit snacks next to me while I workout, so I can eat them quickly if my blood glucose levels drop. 

In tip number four, Ginger recommends having a notebook where you can write notes about what does and does not work for your body during exercise. You can write down your blood glucose levels before and after the workout, what type of exercises you did, and how you felt. I am not quite organized enough for this, so I try to remember what routine works best for me. For example, I know that I cannot drink coffee before a workout, because it makes my blood glucose levels rise quickly. 

I used to workout a few hours after breakfast, and I ended up always going low because my insulin sensitivity would increase during my exercise, and my insulin dosage from breakfast would peak at the same time. Then, I started working out first thing in the morning, and I did not have that problem anymore. Ginger’s final tip is to “try exercising first thing in the morning, on an empty stomach.” This has helped me considerably in keeping my blood sugars in an appropriate range. However, I also sometimes struggle from the dawn phenomenon (if you’re unfamiliar, this is when your blood glucose levels rise abnormally in the very early morning), so sometimes my blood glucose is high in the morning, and I still have to give a small amount of insulin before exercising.

Working out with type 1 is all about maintaining a delicate balance. It’s important to listen to your body: sometimes working out extremely hard can feel very similar to having low blood sugar. However, type 1 is in no way a limit to athletic ability: some of the most famous athletes are type 1 diabetics. So, lace up those shoes and grab those earphones: it’s time to move. 

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article, “5 Tips for Exercise with Type 1.”

There are certain attributes siblings commonly share: maybe it’s a similar eye color, or smile, or a love for the same type of music. For my sister, Kyra, and me, we both have long hair and freckles on our nose. However, we have another similarity that you can’t see when you meet us: we both have the same chronic illness. 

I was diagnosed with type 1 diabetes when I was five years old, and I have had the disease for about 15 years now. For a while, my parents thought my symptoms were a sign of the flu, not diabetes, so my condition was pretty severe by the time I was diagnosed. I had to be hospitalized for about three days, hooked up to an IV bag of insulin and hydrating liquids. I was so young, the experience is now a hyperglycemia-blurred memory. I remember being brought a huge Hello Kitty stuffed animal, watching episode after episode of Disney Channel shows, and being poked and prodded by nurses. I watched my mother inject an orange with a needle next to my hospital bed, knowing that the orange would soon be my arm. 

Kyra, who was nine at that time, walked with me through the hospital halls every afternoon. She would make jokes about “breaking me out of this joint,” as if I was a prisoner and she was a visitor (three days at that age felt like a lifetime). Little did we know that, five years later, Kyra was going to be in the exact same hospital, receiving her type 1 diabetes diagnosis as well. 

Since I am four years younger than Kyra, most of my young life had involved listening to her. I was excited that it was finally my turn to teach her. I helped her learn how to inject herself, how to calculate carbohydrate counts, how to know when she had low or high blood sugar. Although having type 1 diabetes is never fun, having someone that can relate to your daily struggles is extremely helpful. We have been next to each other in every step of our type 1 diabetic journey. We try out different diabetic technologies, so that we can help each other find the best ones. When we are out and one of us gets low blood sugar, the other one offers a packet of fruit gummies. We cry together when we fall into diabetic burnout and celebrate together when we reach our goal hemoglobin A1C. 

However, Kyra and I have still had very different experiences with our illnesses. My blood glucose levels tend to be much more sensitive to any amount of carbohydrates, while Kyra can eat a small amount of carbs and her levels don’t budge. She uses a Continuous Glucose Monitor (CGM) and an Omnipod, and I only started consistently using a CGM within the last few months (I’m more old school with my treatment). I got diagnosed when I was very young, while Kyra was diagnosed when she was a teenager. I had to understand nutritional labels before learning how to read a book. Kyra had to traverse having a new chronic illness while at an age which is universally considered the “awkward stage.” 

Although type 1 diabetes does not define me nor my sister, it has definitely shaped the way we see the world, our interests, and our future goals. Having type 1 diabetes gives you experiences and exposure to things that a child wouldn’t normally have at a young age. I knew what the words “pancreas,” “insulin,” and “endocrinology” meant before I even knew how to spell my name. Not surprisingly, both Kyra and I have been interested in getting involved with the rapidly evolving world of type 1 diabetic research. We have both worked for Diabetes Research Connection, which has allowed us to see the behind-the-scenes of ground-breaking diabetic research. In my first year of working for DRC, I even got to visit a research lab and watch DRC-funded scientists inject stem cells into a zebrafish. 

Kyra and I have never let type 1 diabetes limit us in our goals– in fact, I think type 1 diabetes has encouraged us to challenge ourselves. Kyra recently graduated from UC Berkeley and is currently studying for the MCAT to apply to medical school, with hopes of becoming a physician. I am a sophomore at Stanford University, studying psychology, with the hope of someday attending law school.  I am also a strong advocate for diabetic mental health. Kyra and I are type 1 diabetics, but we are also a future doctor, a future lawyer, sisters, and best friends. 

I don’t know what I would do without my sister. Unfortunately, I know that there are many people with type 1 diabetes who don’t have someone in their life who understands what they’re going through. Online type 1 diabetic support groups are a great option for anyone struggling to find a community. It is crucial to have just one person who will listen to you when you are feeling down, who will help you in need, and who will remind you that you are so strong for dealing with this disease. I found that in my sister, and I know my sister found that in me. As I navigate my diabetic journey, I feel incredibly lucky to have a companion along the way.

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is describing her and her sister’s experience living with type 1 diabetes.

Type 1 diabetes is one of many autoimmune disorders that exist. In this particular disease, the immune system mistakenly attacks and destroys insulin-producing beta cells, leaving the body unable to regulate blood glucose levels effectively. Many researchers have been focused on the immune system and how these diseases may develop when it comes to autoimmune disorders.

But a recent study found that expanding the focus to look at other contributing factors, such as genetics and cell signaling, may help treat and potentially curing conditions such as type 1 diabetes (T1D). Dr. Decio Eizirik, M.D., Ph.D., Scientific Director for Indiana Biosciences Research Institute Diabetes Center, published findings of a study on candidate genes, target tissue, and the cellular dialogue between the two.

His team evaluated gene expression for four autoimmune diseases, including T1D, and found that a commonality between them was that “more than 85% of the candidate genes for each disease are expressed at the target tissue level.” More specifically, they zeroed in on the TYK2 enzyme, which plays an integral role in controlling immune and inflammatory signaling pathways and cell response. Reducing TYK2 response may help to protect cells against the destruction that can lead to T1D.

There are already several TYK2-inhibitor drugs on the market that the FDA has approved to treat other autoimmune disorders. Dr. Eizirik is interested in seeing whether they may serve as an effective treatment option for T1D to potentially stop the disease before it develops in individuals identified as high-risk.

There are nearly 1.6 million Americans currently living with T1D, and these numbers have only continued to increase over recent years. Finding potential treatment options and preventive measures could positively impact disease progression and diagnosis in the future. Dr. Eizirik is excited about the international collaboration that has been occurring between scientists and the sharing of data to support research initiatives.

While additional studies are needed to determine whether TYK2 inhibitors effectively prevent or treat T1D, this research is a step in the right direction toward opening new doors and stimulating more research opportunities. The Diabetes Research Connection (DRC) is interested in what role this information may play in future T1D treatment.

The DRC, though not involved in this study, is dedicated to supporting T1D research through providing funding for early-career scientists to pursue novel research studies. To learn more about current projects or how to donate, visit https://diabetesresearchconnection.org. 

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

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If you are confused and wondering why I am writing a blog responding to Erika Szumel’s article, “Tips for Managing T1D in the Workplace,” when I work at a type one diabetic non-profit, know that I have worked difficult jobs in the past where this information would have been extremely helpful. I have never hidden my disease from anyone in school, around friends, or even total strangers I have just met. However, when I started looking for a job, I remember my dad explicitly warning me not to use my disease as a crutch or allow my superiors, coworkers, and clients to use my disease against my capabilities. While no-one threatened me, there was always underlying tension in my previous positions that forced me to be sub-par with my T1D management to appear as a stellar employee, and I paid for it physically. 

The first item that Erika touches on in her article is to “Be Open.” Erika makes a great point stating that “T1D is a disease that, unfortunately, our world does not know well enough yet, exposing your coworkers to it from the start will also leave a mark on them.” I always told my coworkers about my disease, and they were accommodating when it came to good and bad days. Sure, they offered unhelpful advice at times, but their support and sympathy got me through difficult situations with my superiors. This is where things get interesting. When I forgot my T1D supplies or my blood sugar was high/low, my previous superiors still had tasks for me. After I mentioned an issue regarding my disease, some of them would begin a request with something along the lines of, “I know you couldn’t finish X last week because you had diabetes problems. If you could inform me earlier about your condition, I can find someone else to handle your work.” Ouch, right? After hearing something like that, I never mentioned how I was feeling and dealt with the consequences in order to make them happy in fear of losing my position. This brings up another vital tip that Erika writes about, “Don’t Downplay Diabetes.” I never looked into the programs and laws that were protecting me, and that is my fault. I could have had a seizure or gone into diabetic ketoacidosis and made my situation worse for myself. If you want to see all of the resources that can help you if you are in a difficult situation at work, click here and here. 

After two arduous years of putting the needs of my job above my health and realizing that it wasn’t worth the pain, I decided my next position was going to be positive for not only my mental and emotional health but, more importantly, my physical health. I followed Erika’s last tip, “Don’t Be Afraid to Step Away.” While she means it is ok to step away at any time in a job, like during meetings or events, I also took it to mean leaving a toxic profession/position. Now I am the development and program assistant at Diabetes Research Connection, and instead of ignoring my health, I take breaks a lot. My supervisor knows me well after explaining how I function as a T1D even though she isn’t. When I feel low, I know it is ok to take a 15-30 minute break to get back to 100% or close to it. If I am having issues with my CGM, have a doctor’s appointment, or dealing with a bad blood sugar, she doesn’t question my ability to get the job done; her first question is, “Is there anything I can do to help?” or tells me to do what I need to so that I am healthy. It is so important to have good communication with your direct supervisor and coworkers so that you have the support you need and peace of mind that you don’t need to fear losing your position. Just know that you can continue to be the best employee you are without jeopardizing your health. 

This blog was written by Hannah Gebauer, DRC’s Development Assistant, who has had T1D for 18 years and is responding to the article, “Tips for Managing T1D in the Workplace.”

As the old saying goes, “Knowledge is power.” Many children in the United States and Canada present with diabetic ketoacidosis (DKA) when they are first diagnosed with type 1 diabetes (T1D). However, a recent study found that increased parental awareness about a child’s risk for developing T1D may lead to earlier detection of the disease before DKA occurs. Educating parents about what symptoms to look for, especially if T1D runs in their family, is essential.

Data was analyzed from the Trial to Reduce Insulin Dependent Diabetes Mellitus in the Genetically at Risk (TRIGR) Study because these parents already knew their child was at greater risk. When looking at incidences of DKA, they were lower than that of the general population. In the United States, around 40% of children diagnosed with T1D also have DKA, and this rate is about 19% in Canada. But in the TRIGR study, the overall rate was just 4.6%, or eight out of 173 patients. 

One point to note is that cases of DKA at the time of T1D diagnosis were not evenly divided among participants from the different countries. The United States still showed higher levels than Canada at 12.5% and 2.2%, respectively. More research is needed to understand why these differences exist and whether the fact that some countries such as Canada have universal healthcare plays a role. In addition, “each participant with T1D in the TRIGR study had a first-degree relative with T1D, which was not the case in earlier studies.” This may have played a role in their understanding of the signs to be aware of.

More in-depth studies are needed to evaluate further the impact of parental awareness on earlier detection of T1D and reduced risk of DKA. The Diabetes Research Connection (DRC) is interested in seeing what additional research reveals and how it could play a part in T1D diagnosis and education. The DRC is committed to supporting early-career scientists in pursuing novel research around all aspects of T1D. To learn more, visit https://diabetesresearchconnection.org. 

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When I read Makaila Heifner’s article on Beyond Type 1 called, “The Driving Diabetic,” it brought me back to when I first got my license. I was already stressed about parallel parking, hitting curbs, and driving on the freeway–and then, unlike most of my friends, I also had to stay aware of how my disease impacted my driving abilities. 

Makaila recommends that people with type 1 diabetes check their blood sugar every time before they drive to make sure they are at an adequate level. This has become a consistent part of my driving routine: knowing that my blood glucose is stable helps ease my anxiety while driving and gives me confidence that my journey will be safe. I have a Continuous Glucose Monitor, which allows me to see my blood glucose levels on an application on my phone. Makaila mentions how this helps her catch her blood glucose levels before they plummet or spike. However, the notifications I get from my phone can be distracting, and I cannot glance at my phone while I am driving. If I see a notification from my CGM pop up, I will pull over wherever is safest and check my blood glucose levels. 

My parents always tell me, “if you feel even a little bit low, do not keep driving. Pull over and call someone.” At age sixteen, this sounded ridiculously inconvenient. But, as Makaila reminds me, “Type 1 is never convenient.” I got low blood sugar one of the first times I drove with my father, and it was a very scary experience. My vision got blurry, and I had a hard time concentrating on the road. Makaila talks about how “driving with a low is the equivalent to driving drunk.” Thankfully, we were on a pretty slow road so I could pull into a parking lot, and my father drove the rest of the way home while I sipped out of a juice box. But, on the occasions where one does not have a passenger to take over the wheel for them, they have two options: one option is to pull over, eat something, and hang out for about twenty minutes until their blood sugar levels have returned to normal. When I do this, I call a friend or family member so they are aware of my situation. Sometimes I even share my location with them so they know where I am, in case I do not respond to their messages when I begin driving again. The second option for diabetics who experience low blood sugar while driving is to pull over, eat something, and call a friend or family member to pick them up (usually my friend or family member will Uber to me so they can drive my car home).  I do this when my blood sugar levels are extremely low, and I know I won’t feel safe to drive again for a while. 

It’s important to make sure you always have a bag of low snacks in the car, as well as extra diabetes supplies. Although I have had diabetes for almost my entire life, sometimes I still forget needles or test strips. Trust me, it’s not fun to be stuck somewhere without the ability to give insulin or check your blood glucose levels.

I have been driving for only four years, and now my pre-driving planning occurs almost unconsciously. Stable blood sugars? Check. Low supplies? Check. Sunglasses and good music? Double check. Although type 1 diabetics have a few more things to consider while driving, driving with diabetes can still be manageable and stress-free.

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article, “The Driving Diabetic.” 

In addition to worrying about blood glucose levels, individuals with type 1 diabetes (T1D) are also at greater risk for developing other health conditions such as chronic kidney disease or CKD. This is something that they should be regularly screened for and be aware of potential symptoms.

Advances in artificial intelligence and digital technology may make it easier for individuals with T1D to test for kidney disease from the comfort of their own homes. A current study is underway in the United Kingdom to determine if providing patients with a simple testing kit and using their smartphone’s camera to scan results and transmit them to their healthcare provider. The app may make diagnosing abnormal results easier and allow patients to schedule follow-ups more quickly.

Participants in the study receive a kit that contains a urine dipstick, a container for urine collection, and a color board. After completing the dipstick testing, they hold it up to the color board and take a picture with their smartphone camera. According to the study, “Using AI and colourmetric analysis, the app is able to read the dipstick results equivalent to a lab-based device. Results are then shared instantly with the individual’s GP practice, which can follow up if there is an abnormal result.”

So far, the study has shown high levels of testing participation. Allowing for testing at home expands access and can generate cost savings for laboratories and clinics that no longer have to conduct testing on-site. Many people are not aware of the risks CKD can present, and early detection is critical for treating the disease before it becomes more severe.

The technology was created by Healthy.io and is being tested in partnership with NHSX and the National Institute for Health Research. The team hopes to enroll 500,000 patients over the next three years.

The Diabetes Research Connection (DRC) is excited to see the potential that this technology solution may hold when it comes to detecting CKD in at-risk patients with type 1 diabetes. It may provide yet another line of defense for promoting better health and reducing complications of the disease.

The DRC, though not involved with this study, supports ongoing research related to T1D by providing critical funding to early-career scientists. These novel research studies focus on improving understanding of the disease and enhancing diagnosis, treatment, and management of T1D as well as efforts to find a cure. Learn more about current projects and how to support scientists by visiting https://diabetesresearchconnection.org. 

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

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Discussing Diabetes with DRC’s T1Ds is a new campaign where those with type one diabetes (T1D) in the DRC community share their thoughts and personal anecdotes in response to lifestyle articles related to T1D care and management.

DRC’s Development Assistant, Hannah Gebauer, and one of DRC’s interns, Lauren Grove, wrote several blogs responding to different lifestyle articles revolving T1D and different experiences with the disease, such as mental health, going to the beach, and cooking! Look below to find an article you may be interested in and its URL link:

Click HERE to view a blog about T1D during the pandemic.

Click HERE to view a blog about T1D and coping with stress.

Click HERE to view a blog about T1D and diabetic burnout.

Click HERE to view a blog about T1D and going to the beach.

Click HERE to view a blog about T1D and being in a relationship.

Click HERE to view a blog about T1D and cooking a diabetic-friendly recipe.

*This is the first series of blogs in response to T1D lifestyle articles. There will be more in the future.

When I saw Gretchen Otte’s recipe for “Zucchini Noodles with Creamy Avocado Basil Sauce” on Beyond Type 1’s website, I had to try it. As a type 1 diabetic who loves pasta, zucchini noodles have become a staple in my diet. They’re low-carb, very filling, and a perfect canvas for a delicious sauce. I tested out Beyond Type 1’s recipe for dinner, adding my own little spin onto it. Click here for the full recipe on Beyond Type 1’s recipe or scroll to the bottom to see the recipe with my adjustments! 

For the sauce, I added avocado, dried basil leaves, garlic, olive oil, lemon juice, and salt to a bowl. The recipe calls for a food processor, but as a college student living in a poorly equipped apartment, I had to improvise. I used a fork and mashed up the mixture, which worked perfectly. After tasting the sauce, I added in two tablespoons of grated parmesan cheese to increase the savory flavor, and I zested the lemon to make the sauce “pop.” 

Then I started the zucchini noodles. There are a few things I changed at this point in the recipe. First, the noodles in the recipe are supposed to be cold. However, I don’t enjoy the texture of uncooked zucchini noodles, so I decided to cook my noodles. The recipe also gives instructions on how to make homemade noodles, but I used Trader Joe’s frozen zucchini spirals instead. There are only 3 grams of carbohydrates per serving, and they’re super easy to make: take them out of the box, put them in a saute pan, and let them heat up. As the noodles thaw, they will start to leak water, so I recommend draining them every so often. Cook them until they’re al dente. 

I stirred my sauce into the zucchini noodle pot and chopped up the cherry tomatoes and fresh basil leaves to top off the dish. I also added a handful of crushed roasted almonds to give a little crunch and a few slices of grilled chicken for some extra protein. 

This dish was so good. The avocado made the sauce taste so indulgent even though it was super healthy. I ended up eating basically the whole bowl. And, even better news: two hours after eating it, my blood sugar levels stayed completely stable. This was rare for me, as my blood sugar levels love to rise in the evening. 

For an easy, nutritious, and delicious dish that is also type 1 diabetic-friendly, I highly recommend Beyond Type 1’s zucchini noodle recipe. 

Serves 2

Carbohydrates per serving: 16 grams 

For the avocado-basil sauce:

1 avocado

1 tablespoon dried basil leaves

2 tablespoons grated parmesan cheese 

2 cloves garlic

½ cup olive oil

1 lemon, zested and juiced

½ teaspoon salt. 

For the zucchini noodles:

1 package Trader Joe’s zucchini spirals 

1 cup cherry tomatoes 

Small handful crushed roasted almonds

½ cup fresh basil leaves

Salt and pepper to taste

Directions: 

• Mash avocado in a bowl until smooth. Add basil, parmesan, garlic, olive oil, lemon juice and zest, and salt. Taste and adjust seasoning. 
• Place the zucchini spirals in a sauté pan on high heat and cook until al dente. Drain excess water. 
• Mix the sauce into the sauté pan with the zucchini noodles. 
• Chop the cherry tomatoes in half and crush the roasted almonds with the back of a spoon. Serve the zucchini noodles with the tomatoes, almonds, and fresh basil leaves on top.

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article, “Zucchini Noodles with Creamy Avocado Basil Sauce.” 

If you have type 1 diabetes (T1D) and are in a relationship, your partner has type 4 diabetes (this is not a real thing, just something my family and I made up. I should also note that parents have type 3 diabetes). This week I read JDRF’s article, “Type 1 Diabetes and Committed Relationships,” and thought I would take a crack at my personal journey through T1D with my significant other. While one might assume that my friends and family genuinely know my experiences, struggles, and successes, no one knows them better than the man who gets out of bed at 3 AM to get me a juice because I am low or knows when I need to change my site before I do.  

JDRF states that cooperation and communication are key to having a stable relationship with a significant other. The organization explicitly mentions that even when I am “feeling on edge,” I should “remember that your blood sugar can affect your mood. Knowing where your blood sugar is and communicating its impact to your partner can be helpful.” My boyfriend knows the difference between a low blood sugar and high blood sugar based on how I behave. When we first met, it was a struggle to communicate what exactly I was feeling, but telling him how he could help gave him more control and allowed him to be more helpful to me in return. When I am high, my boyfriend realizes that my communication is more bark than bite and laughs it off or gives me the space I need to just wait out the pain. He can’t help me physically lessen the discomfort of a high blood sugar, but he can help me by being understanding and not pushing. 

I can’t emphasize this enough, but no T1D wants to be told how to manage their health, especially from a non-diabetic. My boyfriend does not push me to test my blood sugar more, doesn’t berate me when I eat another piece of pizza, or lectures me on wearing my CGM more consistently. He does remind me that I probably should test a little more frequently after having the extra pizza and also mentions that I could eat a bunch of pizza and not be annoyed with how often I am testing if I just put my CGM on. This is where another topic that JDRF touches on comes to play; compromise. When my boyfriend makes these suggestions, I take them seriously. He always says he wants me to be the healthiest I can be so that we can be together for a long time. So even though I don’t love wearing my CGM 100% of the time, I think about how much easier it is on both of us when I have it on because maybe I can catch that low blood sugar before my numbers drop too quickly and he doesn’t need to get up in the middle of the night to get me juice. The article mentions, “… with type 1 diabetes your partner may feel that they are making more compromises than you are.” A lot of us don’t want to be a burden on our significant other, but having T1D is already a compromise, in my opinion. What I think works best is finding the rhythm that suits your relationship and having a LOT of open communication. 

If you are the significant other to a T1D, please try to be supportive and understanding. T1D is not a disease that you can turn off or decide you aren’t going to deal with for a few hours. It’s a full-time job, and it requires some help. Ensure you are educated by asking questions and having access to resources that can also give you answers. 

This blog was written by Hannah Gebauer, DRC’s Development Assistant, who has had T1D for 17 years and is responding to the article, “Type 1 Diabetes and Committed Relationships.”

Scientists know that type 1 diabetes (T1D) is caused by the immune-mediated destruction of insulin-producing pancreatic beta-cells. However, what they do not know is what exactly causes this process to occur. Many agree that it may be the result of both genetic and environmental factors.

A recent study examined the potential impact of gluten intake on diabetes risk. The study analyzed gluten intake by women around 22 weeks of pregnancy and the gluten intake of their offspring at 18 months of age. Participation was voluntary, and data was collected by a Norwegian observational nationwide cohort study from 1999 to 2008. In total, data from 86,306 children were gathered, and throughout the duration of the study, 346 children developed T1D.

The study found no significant relationship between the amount of gluten consumed by mothers during pregnancy on the child’s T1D risk. However, it did find that children who consumed higher levels of gluten at 18 months of age may be at greater risk of T1D. Follow-up ended on April 15, 2018, or upon diagnosis of T1D, whichever came first.

Mothers filled out a food frequency questionnaire at around week 22 of their pregnancy, and then they filled out a questionnaire for their child when they reached 18 months of age. Women who were previously diagnosed with T1D or celiac disease were excluded from the study, and children who developed type 2 diabetes or who consumed more than 35 grams of gluten per day at 18 months of age. The results were adjusted to account for children who were later diagnosed with celiac disease.

Overall, 0.4% of children were diagnosed with T1D, and of those children, there was islet autoantibody information available for 76% at the time of diagnosis, and 92% were positive for at least one islet autoantibody (for insulin, glutamic acid decarboxylase, or IA2).

The results of this study differ from those of a previous study that showed material gluten intake was potentially statistically significant in terms of risk. However, the current study looked at several different factors and outcomes and adjusted data accordingly.

Additional extensive studies need to be conducted to support further or refute these findings. The result of this particular study should not be used as a basis for altering dietary recommendations for women who are pregnant or young children in order to avoid type 1 diabetes, but rather something to be taken into consideration as future studies are developed.

The Diabetes Research Connection (DRC) is interested to see what other extensive studies find concerning gluten intake and diabetes risk. Though not involved in this study, the DRC provides critical funding for early-career scientists pursuing novel research around type 1 diabetes. To learn more about current projects and how to help, visit https://diabetesresearchconnection.org. 

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As scientists continue to learn more about type 1 diabetes (T1D), they are always looking for new or refined ways of treating the disease. From artificial pancreases to closed-loop systems to cell transplants, researchers are exploring numerous options.

While cell transplantation is not a new concept, it is one that has come with its share of challenges. One of the biggest obstacles is rejection, and many approaches have required long-term immunosuppression, which can cause complications itself. Another issue is cell death. Once cells have been implanted, they do not always receive the oxygen, blood supply, and nutrients needed for long-term survival.

One company is looking to change all of that. ViaCyte, a clinical-stage regenerative medicine company, has teamed up with W.L. Gore & Associates, a global materials science company, to create an encapsulated cell therapy for T1D. Pluripotent stem cells are differentiated into various pancreatic cells, then encapsulated in a special material that may help to “reduce the foreign body response and improve engraftment, cell survival, and function,” according to ViaCyte.

This new system is set to undergo phase 2 testing in 10 patients with T1D, with the potential to increase to up to 70 patients. Once the encapsulation system is implanted, the pancreatic cells are able to mature into beta cells, alpha cells, and other cells that naturally help control blood sugar. With both beta and alpha cells present, it helps to restore the secretion of insulin and glucagon as well. Furthermore, the materials are used to eliminate the need for immune suppression drugs by reducing foreign body response.

This is an exciting advancement in cell transplantation for T1D, and the Diabetes Research Connection (DRC) is interested to see how the phase 2 clinical study pans out. It could eventually become a viable option for long-term treatment of the disease depending on the results of the clinical studies. The DRC, though not involved in this study, is committed to supporting T1D research by providing critical funding to early-career scientists. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org. 

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Type 1 diabetes is an autoimmune disorder in which the immune system mistakenly attacks and destroys insulin-producing beta-cells, thereby hampering the body’s ability to regulate blood glucose levels naturally. Some treatment efforts aimed at preserving beta-cell function rely on suppressing the immune system to prevent further destruction of cells or to protect transplanted cells.

A recent study has found that a combination therapy may help protect the pancreas from attack by targeting only one part of the immune system. The therapy pairs anti-interleukin (IL)-21 antibodies with liraglutide, an FDA-approved diabetes drug. IL-21 receptors play a role in allowing T-cells into the pancreas, so the antibodies may help prevent this from occurring without impacting all T-cells within the body and affecting the entire immune system. In addition, liraglutide has been shown to protect beta-cell function, adding another layer of defense.

The combination therapy was tested adults with recent-onset type 1 diabetes in a “randomized, parallel-group, placebo-controlled, double-dummy, double-blind, phase 2 trial.” After 54-weeks of treatment, higher levels of endogenous insulin secretion were detected in patients who had received the combination therapy instead of the placebo, but effects decreased during the 26-week follow-up period. A phase 3 trial is necessary to study the long-term safety and efficacy of the treatment.

The Diabetes Research Connection (DRC) is interested to see how future clinical trials progress and what this could mean for the treatment of recent-onset type 1 diabetes and the potential preservation of beta-cell function. Though not involved in this study, the DRC provides critical funding to early-career scientists pursuing novel research around type 1 diabetes. To learn more, visit https://diabetesresearchconnection.org. 

*The study mentioned in this article was done at the La Jolla Institute for Immunology in the lab of  Professor Matthias von Herrath, M.D. (the man featured in the image above), who serves as vice president and senior medical officer, Global Chief Medical Office, at Novo Nordisk. Matthias is also a member of DRC’s 80-member Scientific Review Committee, a  volunteer 80+ group of diabetes experts from across the country.

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The Diabetes Research Connection (DRC) Board of Directors is pleased to announce Karen Hooper will be joining our team as the new Executive Director (ED). Karen brings over 20 years of non-profit leadership experience at the local and national levels. In her most recent role as the Vice President of Program Development and Engagement of the National Multiple Sclerosis Society, Karen created a nationwide programmatic approach for mission delivery.

“Our new Executive Director brings significant expertise in building lifetime relationships, developing high performing teams and creating strategic partnerships.” said DRC’s Chair of the Board, C.C. King, Ph.D. He added, “We enthusiastically welcome Karen to DRC.  She is a strategic leader who will help increase our impact in the realm of patients and researchers who seek ways to prevent, cure and treat type 1 diabetes (T1D).”

Dr. King was also happy to announce, “Casey Davis is our new Senior Director of Development. We are incredibly grateful for her exceptional service as DRC’s Interim Executive Director since August 2020, while the Board of Directors sought a full-time ED.”

As DRC’s new ED, Ms. Hooper will be responsible for organizational leadership, operations, and community engagement. She is passionate about serving the T1D community and is thrilled to join the DRC family.

“I am so grateful to have the opportunity to lead such an innovative, growing organization like the Diabetes Research Connection.  I am excited to be welcomed into the T1D community. I look forward to helping to fund critical research that ultimately will end T1D forever.”

Karen will officially assume her new role at DRC on March 15, 2021. Originally from Los Angeles, California, Karen now lives in Rancho Bernardo with her husband Ron and their daughter Karli. She holds a marketing degree from San Diego State University.

Type 1 diabetes (T1D) is an autoimmune disease. Nearly 1.6 million Americans have type 1 diabetes, including about 187,000 children and adolescents. DRC is a San Diego based 501(c)(3) charity, which supports peer-reviewed T1D research conducted by early-career scientists.  DRC expects to fund 42 research projects by the end of 2021.

This month we are taking the time to showcase the impact of our incredible supporters. Without our community, DRC would never be able to see the incredible results from our early-career scientist’s research projects. We would not see these same scientists secure follow-on funding and watch as many of them establish their own labs. Their research projects have been published and have helped create new technologies to provide better care for T1Ds. We have seen them achieve breakthroughs towards a cure!

Click HERE to view the full impact report.

As a type 1 diabetic who considers the beach their second home, I can say that Beyond Type 1’s “T1D Beach Guide” is spot-on. While splashing in the waves or sunning oneself on the sand, there are a few essential things that type 1 diabetics should keep in mind. 

Beyond Type 1 first mentions the importance of hydration for both diabetics and non-diabetics. I always bring a big reusable water bottle, preferably one that keeps the water inside cool. The beach heat can be severely dehydrating, so adding some electrolytes to water will provide the right fuel for a fun beach day. Beyond Type 1 recommends Ultima Replenisher, which has zero carbs and a ton of flavors. I love Crystal Light Pure, which has zero carbs per serving, no artificial colors, sweeteners, or preservatives. My favorite flavor is tangerine mango! Staying adequately hydrated also helps balance blood glucose levels

As Beyond Type 1 notes, making sure your diabetes supplies are out of the direct sun is extremely important. It’s easy to accidentally leave an insulin pen or a container of test strips just sitting out on a towel–but this could, unfortunately, render them completely unusable. To be safe, I usually bring a small portable cooling bag for my supplies.

  The heat not only affects supplies; it also affects how one feels. Heat and constant sunshine can make one feel light-headed and drained, making it much harder to detect changes in one’s blood glucose levels. Beyond Type 1 also mentions that dehydration from sweat can spike blood glucose levels while playing in the waves, and running around in the sand can cause levels to plummet. One beach day, I thought I had low blood sugar because I was so tired. However, when I checked my continuous glucose monitor, my number was in the high 200s. This experience was unsettling, but it reminded me that it’s important to keep a constant watch on my CGM while at the beach.

  Beyond Type 1 recommends bringing easily packable snacks to the beach, including a cooler if you’re packing fresh food. I usually pack low-carb snacks such as veggies and hummus or parmesan crisps. When low blood sugar strikes, it’s also vital for type 1 diabetics to have fast-acting sugar in their beach bag. My favorite treat is fruit snacks because they are delicious and easy to consume quickly.

Last but not least, Beyond Type 1 recommends using a quality adhesive to ensure your CGM or pump stays on amidst all the beach day fun. Saltwater and sand are tough on adhesive, causing it to erode. I once lost my CGM in the ocean after I got tumbled by a wave. Since then, I have always wiped my CGM site with an extra Skin Tac wipe before heading off to the beach. 

With the proper preparation, type 1 diabetics can “navigate the waves” of their disease at the beach. Thankfully, with new technology rising out of innovative diabetic research, beach days can include less fret and a lot more fun for type 1 diabetics. 

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article, “The T1D Beach Guide.”

One of the goals in managing type 1 diabetes is reducing fluctuations in blood glucose levels. Maintaining a stable blood sugar is ideal, which means consistently monitoring glucose levels and administering appropriate insulin doses.

The target range for HbA1C levels in children has typically been 7.5% or below. This was meant to keep blood sugar low enough to reduce the risk of organ and tissue damage but high enough to help curb hypoglycemia concerns. However, a recent report reveals that maintaining an HbA1C level of 7.0% or below may be better for short- and long-term health outcomes for children with type 1 diabetes (T1D).

Studies have shown that abnormal brain development, heart problems, diabetes-related complications, and mortality in children and adolescents may be at increased risk when blood sugar levels remain elevated. Tighter control and a lower target range may be beneficial in reducing both acute and long-term effects.

Although lower HbA1C levels were previously thought to increase the risk of hypoglycemia, several studies have shown the number of incidences has declined over the past three decades, and “the link between lower glucose targets and hypoglycemia risk has weakened over the past 15 years.”

The use of continuous glucose monitors and insulin pumps as part of T1D management and insulin analogs have played an integral role in allowing patients and caregivers to maintain tighter control over A1C levels and minimize fluctuations in blood sugar levels. 

While an HbA1C level of 7.0% or below is now recommended for many children with T1D, those patients who are unaware of hypoglycemia symptoms cannot adequately articulate them, a target of 7.5% is still recommended. There are also exceptions for those patients with a history of severe hypoglycemia and those with other pre-existing conditions or comorbidities. Patients with T1D need to work with their healthcare team to determine an appropriate A1C level for their individual situation.

The Diabetes Research Connection (DRC) continues to follow updated guidelines and recommendations for managing type 1 diabetes. The organization plays an active role in contributing to the growing body of knowledge around the disease by providing critical funding to early-career scientists pursuing research projects focused on improving diagnosis, prevention, treatment, and management of T1D. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org. 

On Tuesday, February 23, DRC held it’s first virtual gathering of the year. DRC partnered with the Chris Dudley Foundation for a Meet and Greet, where Chris Dudley shared his personal experience with type one diabetes, his NBA career, and his wonderful foundation and camp! DRC gave a brief overview of it’s mission, spoke about successfully funded and currently funded projects, and gave several resources to the community. You can view the video below.

Chris Dudley Foundation and Diabetes Research Meet and Greet

When I responded to the article, “10 Ways the Pandemic Parallels “Normal” Chronic Illness Life,” it mentioned “bleak burnout,” which I stated that I resonated with. This week, I decided to delve deeper into that topic after reading the article “Diabetes Burnout” written by Mark Heyman, Ph.D.,  CDE,  for the Beyond Type 1 organization. 

Mark describes “Diabetes Burnout” as being “a state in which someone with diabetes grows tired of managing their condition, and then simply ignores it for a period of time, or worse, forever.“ It wasn’t a question about “if” I was going to experience it, but “when.” I had little bouts of it since being diagnosed with T1D at the age of 7, but nothing was as bad as when I hit senior year in high school, and I wasn’t just done with diabetes – I was done with my body and the lack of control I had with it. Mark mentions that a trigger for diabetes burnout can be “feeling controlled by diabetes,” and I absolutely did feel that. I didn’t want to think about changing my pump site. I didn’t want to worry about testing my blood sugar before every meal, in the middle of the night, or when I was feeling “off.” I didn’t want another lecture from my parents about a lousy A1C and the damage I was doing to my body. I didn’t want to be a diabetic. 

I decided to ween myself off insulin at the beginning of senior year. After a month, I had lost up to 10 pounds. By Christmas, I was down 40 pounds and happier than I had been in a long time. I had no idea where my test kit was, and I didn’t care. Don’t get me wrong – I was in excruciating pain. I threw up and peed all the time. I lost feeling in my limbs for days and sometimes wasn’t sure I would get the feeling back. I had constant heartburn, headaches, and severe nausea. You are probably wondering how my parents reacted? There was nothing they could do. One time, my mom was out of town, and I skipped school because I was so high blood sugar, I needed to sleep it off. I slept for 12 hours and had 30 missed calls from my parents. I woke up to my dad giving me an insulin shot. He drove two hours because he was afraid I had died (I am sorry to all the parents out there that have experienced this fear. It took me a long time after dealing with this burnout to understand the pain I put my parents through; I still feel guilt today). By March, I had lost 60 pounds and was forced by my school’s counselor to go on a month-long leave of absence to take care of my health. It was at this time that I realized – diabetes still had control over me. No matter how much I wanted to feel “normal,” I wasn’t. I had type one diabetes, and I was letting it kick my butt.

At the end of Mark’s article, he gives several helpful tips on overcoming this burnout; “Managing Your Expectations,” “Take Small Steps,” and my favorite, “Get Support.” After finally deciding to take care of myself, I sought comfort in the diabetic community I was closest to. I went to the camp I had been to for many years, Camp Conrad Chinnock, and worked all summer as a staff member. I was continually being reminded why my health was so important and having an open-ear to speak to when things became too much. No one shamed me for what I had done, but they reminded me of why my health is so important. If you or a loved one are experiencing diabetic burnout, talk to someone. I would probably have continued to disregard my health had I not surrounded myself with others in my position and been as open and honest about my feelings and doubts. I still deal with burnout, but I don’t let myself spiral. Finding DRC was kismet for me. I have never taken better care of my health, and I am so thankful to be a part of an organization that is continuously striving to fund research projects for a cure. Until we have a cure, make sure to check out all of Beyond Type 1’s resources, as they offer a plethora of tips, tricks, and suggestions that are extremely useful for anything a T1D might need. 

This blog was written by Hannah Gebauer, DRC’s Development Assistant, who has had T1D for 17 years and is responding to the article, “Diabetes Burnout.”

It is no secret that this pandemic has made life extremely more challenging. And for those with type one diabetes (T1D), infinitely more so. Fortunately, Beyond Type 1, a nonprofit organization that unites the global T1D community and provides solutions to improve those lives, has created a remarkable resource to help those with T1D during this difficult time. Click HERE to view helpful articles such as “Diabetes + Covid Vaccines: What You Need to Know,” “Covid + Diabetes: The Work and School Safety Guide,” and “Suddenly Jobless or Without Health Insurance? Start Here.” Diabetes Research Connection is honored to help spread the word for such a fantastic resource as a community partner.

Finger-pricking, insulin dosing, tracking food consumption, monitoring glucose levels: type 1 diabetes is a mentally and physically taxing full-time job. As a type 1 diabetic myself, I know how quickly diabetes can become overwhelming when it’s combined with school, work, and social obligations. The Centers for Disease Control and Prevention’s “10 Tips for Coping with Diabetes Distress” is an excellent resource for people with diabetes who are struggling with managing the burden of their disease. 

Tip number 5, “Talk with Family or Friends,” and number 6, “ Talk to Other People with Diabetes,” highlight the importance of diabetics communicating their distress to those they trust. Not only does talking with friends help me process how I am feeling, but it also allows me to educate non-diabetics about the realities of my disease. Diabetes can be isolating, and it is easy for me to feel alone in my struggles. I am grateful to have an older sister with type 1 diabetes to talk to about diabetic burnout, unmanageable glucose levels, and other diabetic issues. I am also a member of my university’s College Diabetes’ Network, where I have met fellow type 1 diabetic students.  

I am a generally busy person, and keeping track of everything I need to do diabetes-wise can be extremely difficult. Tip number 8, “Do One Thing at a Time,” emphasizes how tackling each task independently can help with feelings of stress. I have a planner where I write myself reminders such as “Change Dexcom” or, when I know I have a big meal planned, “Increase Bolus.” I try to organize my day in a way that allows me to solely focus on my disease some moments but also place it on the “back burner” for a few minutes when I need to concentrate on other tasks. However, something I still need to work on is tip number 9: “Pace Yourself.”  My goal has always been to have stable blood glucose levels, but some days my levels are completely uncontrollable.  I have to remind myself that I can’t become a “perfect type 1 diabetic” overnight. I need to discover how my body responds to certain foods, different forms of exercise, and many other factors. Type 1 diabetes is a learning process: I take two steps forward and one step backward. Regardless, I know I am growing and progressing, becoming stronger and more confident managing my disease each day.

Most of the time, I wish I could “clock out” of my chronic illness, leave my type 1 diabetes on my bedside table and forget about it. Each moment of living with this disease brings a new challenge. I am so grateful for organizations like Diabetes Research Connection that support the development of life-changing diabetic technology. Reminding myself that ambitious researchers are currently studying my illness is ultimately the most helpful way to manage my diabetes distress. I am optimistic about a brighter future for all people with diabetes, where our disease’s burden is minimal or non-existent.

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article,“10 Tips for Coping with Diabetes Distress.”

As the United States has begun rolling out COVID-19 vaccines across the country, it has also created guidelines regarding eligibility and prioritization for the drug. There are multiple phases with different requirements to determine who gets the vaccine when. Currently, phase one is for the most at-risk groups, including frontline healthcare workers, seniors, those in long-term care facilities, and individuals at increased risk for severe illness.

While people with type 2 diabetes fall under phase 1 of the vaccine rollout, people with type 1 diabetes are included in phase 2. This has caused quite a bit of confusion and concern among those most familiar with the disease. The CDC points to “limited evidence” of increased risk for severe illness in individuals with T1D as the reason for the different phase designations. There is a growing push to get both type 1 and type 2 diabetes included in the phase 1 rollout.

There have been several recent studies that demonstrate the risk of contracting COVID-19 for individuals with T1D, including:

• A study published in Lancet Diabetes & Endocrinology in August 2020 shows that those with type 2 diabetes were more than two times as likely to die, while those with type 1 diabetes were more than 3.5 times as likely to die when compared to similar individuals without diabetes.
• A study published in Diabetes Care in December 2020 that notes “people with either type 1 or type 2 diabetes who develop COVID-19 are three to four times as likely to experience severe illness and hospitalization as people without diabetes.”
• A study published in the Journal of Clinical Endocrinology & Metabolism found a higher risk of developing diabetic ketoacidosis in Black and Hispanic individuals with COVID-19.

The evidence is there, but it is up to the CDC as to whether all diabetes patients are grouped together in one priority group or remain separate. However, state and local agencies can set their own eligibility guidelines when running vaccination programs, so they have the ability to prioritize all patients with diabetes if they so choose. Doctors also want the ability to prioritize certain patients based on their health history and risk factors. Only time will tell as the country continues to try to ramp up vaccine distribution.

The Diabetes Research Connection is waiting to see what happens next while supporting improved prevention and treatment options and the push for a cure for type 1 diabetes. Receiving a COVID-19 vaccine is just one step toward potentially improving quality of life and reducing risk for this population. Learn more about the DRC and the research projects currently being funded by visiting https://diabetesresearchconnection.org. 

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A significant concern for individuals with type 1 diabetes (T1D) is preventing severe hypoglycemia, also known as very low blood sugar. When blood glucose levels drop too low, it can cause confusion or lead to unconsciousness. Individuals often need someone else to administer a life-saving drug such as glucagon to raise their blood sugar back up to safer levels quickly.

Until now, only brand-name glucagon has been available for the treatment of hypoglycemia. Since it is a complex drug, it can be challenging to create safe, effective generic versions. However, generic products can be more affordable for many patients and increase competition in the market and increase drug prices.

The FDA is committed to improving access to lower-cost, high-quality generic drug products such as generic glucagon, and recently approved its production application. The drug is an injectable synthetic version of a natural hormone produced by the body to increase glucose levels. It has undergone the same testing as brand-name products to ensure that it meets the same rigorous approval standards and has comparable safety and efficacy.

The FDA has taken numerous steps to encourage pharmaceutical companies to create quality generic drug products, especially for drugs with fewer than three approved generics, including glucagon. Approval for the production of generic glucagon was given to Amphastar Pharmaceuticals, Inc. in Rancho Cucamonga, California.

The Diabetes Research Connection (DRC) is excited to see that more affordable drug products to help manage and treat type 1 diabetes are coming to market. This can help improve access to these life-saving drugs for those in need. There is not yet a cure for T1D, so reducing costs for essential medications by offering generic versions can make a difference.

The DRC is committed to funding research geared toward prevention, a cure, and improved care for individuals living with type 1 diabetes. Early-career scientists can receive funds to support novel, peer-reviewed research studies focused on any number of aspects of the disease. Learn more about some of the incredible projects taking place and find out how to help by visiting https://diabetesresearchconnection.org.

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Type 1 diabetes (T1D) can be a difficult condition to manage. Individuals must continuously be aware of their food and beverage intake, physical activity, overall health, and how this impacts their blood sugar. They must regularly check their blood glucose levels and administer appropriate doses of insulin as necessary.

Managing T1D combined with disordered eating can present even more challenges. Inconsistencies in food intake and negative feelings about eating and using insulin can make it harder to stay within a target blood sugar range. A recent study involving 23 women found that the time spent in level 2 hyperglycemia – blood sugar greater than 250 mg/dL – may be four times longer in individuals with T1D who also have disordered eating compared to those with only T1D.

Participants were divided into two groups: 13 women with T1D and disordered eating, and 10 women with T1D only. All participants were asked to keep a diabetes diary using a smartphone app to record information about their meals, insulin usage, and any emotions or behaviors related to the meal, such as binge eating or skipping insulin. Each woman tested her own blood sugar before meals and at bedtime, but they also wore a blinded continuous glucose monitor (CGM).

In addition, all participants completed a variety of surveys and screenings and engaged in a semi-structured interview with a clinical psychologist with expertise in disordered eating. Results were recorded for the Diabetes Eating Problem Survey-Revised, the Diabetes Distress Screening Scale, the Patient Health Questionnaire-9, and the Yale Food Addiction Scale.

Women in the disordered eating cohort showed higher use of recreational drugs, higher mean HbA1c levels, and higher scores on the diabetes distress, depression, and diabetes eating problem surveys than the control group. Furthermore, the disordered eating group reported more negative emotions and tested their blood sugar levels less frequently.

When looking at hyperglycemia, “the disordered eating group had a mean serum glucose of greater than 10 mmol/L (180 mg/dL) for 49.8% of the study period, whereas the control cohort spent 25.6% of time above range.” When narrowing it down to level 2 hyperglycemia specifically, “the disorder eating group was above range 21.3% of the time vs. 5% for the control group.”

Given that individuals must make significant changes to their lives when diagnosed with type 1 diabetes, it may be beneficial to provide additional support around diabetes self-care and mental health to reduce risk of developing disordered eating as well. Early introduction of healthy strategies and habits for managing diabetes, along with psychological support, may help improve glucose control.

Providing individuals with the knowledge, training, and support necessary for effectively managing type 1 diabetes is essential. The Diabetes Research Connection (DRC) is committed to enhancing research capabilities by providing critical funding for early-career scientists focused on diagnosis, prevention, and management of T1D, as well as finding a cure. Learn more by visiting https://diabetesresearchconnection.org. 

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Although type 1 diabetes often develops in childhood, that is not always the case. In some instances, the disease may not fully develop until adulthood. The body may produce autoantibodies, known as GAD65 antibodies, long before type 1 diabetes symptoms appear. Detecting these autoantibodies can allow individuals to keep a closer eye on their health and be proactive when it comes to diabetes risk.

A recent study found that omega-3 fatty acids may reduce type 1 diabetes risk or delay the disease’s onset. Fatty fish such as salmon, mackerel, and herring are all a good source of omega-3. When researchers compared omega-3 levels in individuals both with and without GAD65 antibodies, they found that “participants with GAD65 antibodies and a low intake of fish in their diet were 2.52 times as likely to have diabetes as those without GAD65 antibodies and a high intake of fish.”

When looking only at participants with GAD65 antibodies – a telltale sign of diabetes risk, those who ate less fish were more than four times as likely to have diabetes than those with a high fish intake and therefore higher levels of omega-3 fatty acids. The study included 11,247 individuals who developed diabetes in adulthood, and 14,288 adults without diabetes, all located in Europe.

One thing that is unclear, however, is precisely why fish consumption exerts this protective effect. Researchers continue to study the impact of omega-3 fatty acids on immune system function and potential type 1 diabetes triggers. Current guidelines from the U.S. Food and Drug Administration (FDA) recommend at least 8 ounces of fish per week for adults and less for children. These amounts may be different for individuals with GAD65 antibodies depending on their healthcare provider’s recommendations and future studies related to diabetes and omega-3 levels.

The Diabetes Research Connection (DRC) is excited to see what future research uncovers in terms of the impact of fish consumption on potentially preventing or delaying the onset of type 1 diabetes. Though not involved in this study, the DRC supports novel, peer-reviewed studies conducted by early-career scientists by providing essential funding. Learn about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org. 

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As anyone with type 1 diabetes (T1D) knows, managing life with an autoimmune disorder can be challenging. Individuals with T1D must be regularly monitoring their blood sugar, adjusting insulin based on food consumption and exercise, and ensuring they have necessary supplies should their blood sugar drop too low.

But did you know that individuals with type 1 diabetes have a greater risk of developing celiac disease, another autoimmune disorder? The general population has between a 0.3% and 1% chance of developing celiac disease, while this risk increases from 2% to 16% for a person with T1D. Trying to manage the demands of both diseases can be stressful. Some people are genetically predisposed to these diseases, but they do not always develop one or both.

While T1D leaves the body unable to naturally control blood glucose levels due to the destruction of insulin-producing beta cells, celiac disease interferes with the body’s ability to effectively absorb nutrients due to damage to the small intestines caused by gluten. People with celiac disease must avoid both food and nonfood sources of gluten, which often comes in the form of wheat, barley, rye, or triticale.

Due to the increased risk of having both conditions, the American Diabetes Association recommends that individuals with T1D be tested for celiac disease at the time of diabetes diagnosis, as well as again two years later, followed by a five-year repeat screening. If celiac disease symptoms develop, or there is a family history, testing may be conducted more frequently.

Individuals with T1D and celiac disease must be cautious about what they eat, ensuring that they count carbs and dose insulin properly, but also that they select naturally gluten-free foods such as fresh produce, lean proteins, beans, and low-fat dairy. Cross-contamination can occur when preparing meals if food items with and without gluten are handled in the same space or with the same pots or utensils. It is essential to use a separate space and equipment to prepare gluten-free foods.

However, eating a gluten-free diet can help manage blood glucose levels because it enables the body to absorb nutrients better and reduce inflammation. In addition, eating whole foods, as opposed to processed foods, can also reduce carb intake and decrease the amount of insulin needed.

To help minimize the stress of managing diabetes and celiac disease, participation in support groups is encouraged. This can help individuals feel less isolated, access additional information and resources, and deal with the challenges of finding celiac-friendly restaurants and food options. Patients should also work closely with healthcare providers such as their diabetes care provider, a diabetes educator, a registered dietitian, a gastroenterologist, and even a pharmacy provider. Having family and friends who understand how to manage diabetes and celiac disease can help as well to provide additional support and encouragement.

There is currently no cure for T1D or celiac diseases, but researchers continue to expand their understanding of these diseases and search for effective therapies and treatment options. The Diabetes Research Connection (DRC) is committed to supporting innovative scientific inquiry until diabetes is eliminated. To achieve this goal, the DRC provides critical funding to early-career scientists focused on studying multiple aspects of type 1 diabetes. Learn more about these efforts and how to donate by visiting https://diabetesresearchconnection.org. 

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*DRC will begin a new campaign where those with type one diabetes (T1D) in the DRC community will share their thoughts and personal anecdotes in response to lifestyle articles related to T1D care and management*

When I read Melissa Engel’s article “10 Ways the Pandemic Parallels “Normal” Chronic Illness Life,” I was nodding my head up and down the entire time. I find it hard to explain type one diabetes (T1D) to someone who doesn’t have it. Although this article summarizes the similarities between any chronic illness and the feelings individuals are experiencing during the pandemic, I think this could help bridge the gap for some people who try to sympathize with a T1D. After reading the article, I found that I most resonated with number 2, “Stocking Piling Supplies,” number 3, “Eternal uncertainty,” and my personal “favorite,” number 9, “Bleak Burnout.”

I remember when this pandemic started, I was less concerned with having enough toilet paper and more concerned about if I was going to end up having to pull a Nicole Kidman in “The Invasion” and break into a pharmacy to find what I would need to survive. I am almost positive every type one diabetic has had the thought, “How long could I go without insulin before I die?” or something resembling that remark. Apocalyptic movies are hard for me to stomach when there are just so many adverse outcomes for what could happen to me if I couldn’t access my medication: I could die of ketoacidosis; I could die a low blood-sugar that resulted in a seizure with no glucagon shot available; I could die since insulin is bound to expire. The consequences are limitless, and I generally steer away from those thoughts as they tend to spiral.

I believe Melissa truly hit the nail on the head with number 3, “Eternal Uncertainty,” when she used the words “Lack of Control and Predictability”. The only thing I am certain of is the uncertainty of T1D. I could be 125 at 8 AM, have the perfect dose of insulin for breakfast, encounter one negative email that gave me anxiety, and at lunch, I end up being 300. I could have a perfectly working pump site and go to work feeling good, but then 3 hours later, I test and find out I am 400 with ketones because of a site kink. It’s like being on a never-ending roller coaster and wanting to get off, but you are gaining speed and stuck on the ride till it slows down for a bit, only to start again. Luckily, T1D is manageable with our latest technology and gives one a sense of control.

Lastly, number 9, “Bleak Burnout.” We’ve all been there – the moment when you say, “I am done.” I am done testing my blood sugar. I am done counting my grams and taking insulin shots. I am done being treated differently from everyone around me. I am just done. For some T1Ds, this looks like giving up for a day and dealing with higher blood sugar than usual. For others (myself included), that is deciding to stop taking insulin altogether and dealing with the consequences in hopes of finding relief. Unfortunately, a T1Ds “normal” is managing the disease, or you end up with permanent complications. Bleak burnout comes and goes, the only thing that truly helps me fight it is the diabetic community I surround myself with, and the knowledge that organizations like Diabetes Research Connection are funding research for a cure so that maybe in my lifetime, I can feel a different kind of bleak burnout.

This blog was written by Hannah Gebauer, DRC’s Development Assistant, who has had T1D for 17 years and is responding to the article, “10 Ways the Pandemic Parallels “Normal” Chronic Illness Life.”

Type 1 diabetes (T1D) is characterized by the destruction of insulin-producing pancreatic beta cells. This leaves the body unable to regulate blood sugar levels on its own effectively and requires individuals to administer insulin throughout the day. T1D is one of many autoimmune disorders that affect children and adults.

A recent study found that a drug already approved by the FDA to treat other autoimmune diseases, including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and ulcerative colitis, may also be effective in treating T1D. Though it is not a cure, it may help preserve existing pancreatic beta-cell function in newly diagnosed patients and reduce the amount of external insulin needed to manage blood glucose levels.

The medication, known as golimumab, is a human monoclonal antibody that blocks a protein involved in abnormal inflammatory and immune responses. Researchers administered the medication every two weeks for 52 weeks to a group of 56 children and young adults between the ages of 6 and 21. Another 28 participants received a placebo. All participants were newly diagnosed with type 1 diabetes and were free from other autoimmune diseases.

Throughout the year, each participant kept a record of how much insulin they used each day, what their blood glucose level was, and if they had any occurrences of hypoglycemia. At the end of the trial, the results showed that the children and young adults who received golimumab had higher 4-hour C-peptide AUC levels than those in the control group (0.64 vs. 0.43). This means that those receiving the medication produced more natural insulin (endogenous insulin) than those who received the placebo and required less insulin therapy.

There can be advantages to requiring lower doses of insulin, making golimumab attractive to some individuals with T1D. Though still undergoing clinical testing to treat type 1 diabetes, the medication may become one more option for patients to help them better manage their health.

Though not involved with this study, the Diabetes Research Connection (DRC) is interested to see how future clinical trials play out and whether golimumab is approved as a therapeutic agent for type 1 diabetes. The DRC is committed to improving understanding, treatment, and management of the disease and finding a cure one day. Learn more about how to support these efforts by visiting https://diabetesresearchconnection.org. 

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Autoimmune diseases wreak havoc on the body and can be challenging to treat. They can cause severe inflammation and even cell death, as with type 1 diabetes (T1D). But researchers are striving to develop more effective therapies to manage and treat these conditions.

One approach that has shown positive results in early testing is the use of umbilical cord stem cells. A recent study by a team at the Diabetes Research Institute and Cell Transplant Center at the University of Miami Miller School of Medicine found that these cells may be beneficial in treating individuals with T1D and promoting recovery in patients with severe COVID-19.

The FDA has already approved this stem-cell therapy for testing as a potential treatment for T1D, which requires more targeted administration to ensure that cells are directed to the pancreas. These cells may help to calm the body’s hyperinflammatory immune response. Due to umbilical cord cells’ anti-inflammatory, immunomodulatory effects, they may also be effective in treating COVID-19 and could be administered easily through a blood transfusion.

The researchers administered two infusions of 100 million umbilical cord stem cells three days apart to 12 patients with severe COVID-19, while another 12 patients with the disease received a placebo IV. Of those treated with the stem cells, there was a 91% overall survival rate and a 100% survival rate of patients under age 85. The survival rate in the control group was 42%. In addition, more than 80% of patients who received stem cells recovered within 30 days, while less than 37% in the control group did.

Following these promising results, the researchers are now looking to conduct a larger trial to see if the treatment generates the same results on a larger scale. If so, umbilical cord stem cells may become one option for treating COVID-19. According to the study, “one umbilical cord recovered from a healthy newborn can generate more than 10,000 therapeutic doses.” Studies will also be done to better understand the stem cells’ effect on other autoimmune diseases such as T1D.

The Diabetes Research Connection (DRC) is excited to continue following these developments to see whether umbilical cord stem cells could be a viable therapeutic treatment option, especially when it comes to T1D or potential patients with T1D and COVID-19 who are at higher risk for complications.

The DRC is committed to improving understanding of T1D, enhancing treatment and prevention options, as well as finding a cure. The organization supports early-career scientists in pursuing novel, peer-reviewed studies related to type 1 diabetes by providing critical funding for their research. Find out more at https://diabetesresearchconnection.org. 

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The immune system is a central part of the human body. When autoimmune diseases develop, they can cause the immune system to begin attacking itself, taking a toll on individuals’ health. Numerous different autoimmune diseases exist, and currently, many have no cure.

However, a recent study examined commonalities between four of the most severe autoimmune diseases and changes that occur within the body. By developing a better understanding of where there are similarities, researchers may be able to apply what they already know about one disease to another. The four autoimmune diseases that were studied were type 1 diabetes (T1D), systemic lupus erythematosus (SLE), multiple sclerosis (MS), and rheumatoid arthritis (RA).

Researchers found that all of these diseases have common pattern disease risk, local inflammation, and up-regulation and down-regulation of gene expression. In addition, rather than only looking at how the immune system was affected, the researchers also studied the impact on target tissues. Their findings showed that in many instances, the immune system and these tissues engaged in a dialog that contributed to the effects of each disease and cell damage. There were a significant number of candidate genes that were expressed in target tissues as well.

There was a lot of overlap between up-regulated expression patterns, whereas down-regulated expression appeared to be more specific to the target tissue. Close attention was also paid to which pathways were affected for each disease. The researchers note that “The observed similarities in pathway activation between target tissues were translated into the identification of several classes of drugs that could be potentially used to treat more than one autoimmune disease.”

This could allow scientists to repurpose drugs that are well understood to treat one disease to be used to treat another disease. For instance, JAK inhibitors are approved for the treatment of RA, but they are also showing promising results for treating SLE, and they are known to “prevent the proinflammatory and proapoptotic effects of IFN-α on human pancreatic β cells,” which is a trademark of T1D. JAK inhibitors may also effectively treat insulitis, though current studies have been on nonobese diabetic mice.

The study found that one candidate gene in particular – TYK2 – was present in all four autoimmune diseases when it comes to gene expression. There is currently a phase 3 clinical trial underway for a TYK inhibitor to treat psoriasis, another autoimmune disease. TYK inhibitors demonstrate a protective factor over human β cells, so the clinical trial may provide valuable information related to future treatment of T1D as well.

The Diabetes Research Connection (DRC) is excited to see how this study may impact future research and the potential repurposing of existing drugs to treat other autoimmune diseases, including type 1 diabetes. Advancing research and understanding of T1D is integral to one day finding a cure. To support these efforts, the DRC provides critical funding to early-career scientists pursuing novel research related to T1D. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org. 

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Although the coronavirus pandemic has disrupted all Americans’ lives, it has been especially challenging for individuals with chronic conditions such as type 1 diabetes. According to the American Diabetes Association, more than 122 million people in the United States have diabetes or pre-diabetes. Access to healthcare, health insurance, medication/medical supplies, and nutritious food is critical, yet many of these people struggle in these areas.

As the pandemic has inundated the United States, it has presented significant hardships for individuals living with type 1 diabetes, type 2 diabetes, and pre-diabetes. A recent study conducted by the American Diabetes Association in partnership with Thrivable and the Diabetes Daily community shows just how profound the impact has been on this population. 

With the loss of jobs, insurance coverage, and income, many individuals have difficulty paying for necessary medications and medical supplies to manage their diabetes health. They are struggling with food insecurity, unable to access the type and quantity of food needed to keep their blood sugar under control. They have delayed medical appointments because they do not have insurance coverage or are scared about potential exposure to COVID-19.

All of these circumstances can put their diabetes health at risk. Being unable to manage their diabetes now effectively can have a lasting impact in the future. It also puts individuals at greater risk for complications from COVID-19 should they contract the virus. Tracey D. Brown, CEO of the American Diabetes Association, notes that “as many as 40 percent of the COVID fatalities – 120,000 Americans – have been people with diabetes.”

Of those surveyed, 43% have delayed routine medical care for fear of exposure to the virus, and 15% of those with continuous glucose monitors (CGM) or insulin pumps have put off refilling their supplies, with 70% reporting that it is due to financial hardships. Twelve percent of respondents have lost their health insurance since the start of the pandemic, and of those, 13% continue to be uninsured.

Access to food is another major problem. Facing financial constraints, many people have had to rely on food banks for food. Options there are limited and not always the most effective for managing diabetes. The study found that “1 in 5 say they aren’t able to eat as frequently as they need to manage their diabetes effectively,” and nearly as many said they have been forced to choose between buying food and buying medical supplies or medications for their diabetes.

On a positive note, many individuals with diabetes (37%) are open to getting the vaccine immediately once it becomes available to them. In addition, there has been a drastic increase in the number of individuals with diabetes using telemedicine as a way to help manage their health. However, this does not negate the serious challenges this pandemic has presented and the fact that the effects could last for years to come. In turn, this could strain the healthcare system in the future.

Researchers continue to learn more about COVID-19 every day, and more work is being done to understand its impact on at-risk populations such as those with type 1 diabetes. The Diabetes Research Connection, though not involved with this study, is committed to providing critical funding for early-career scientists pursuing projects related to type 1 diabetes. These efforts drive work toward improving diagnosis, treatment, management, and prevention of the disease, enhancing the quality of life, and moving closer to a cure. To learn more about current projects or support these efforts, visit https://diabetesresearchconnection.org. 

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Diabetes and digestive problems can go hand-in-hand, but symptoms should not be ignored. A telltale sign of type 1 diabetes is high blood sugar, and this is one of the leading causes of gastroparesis, also known as delayed gastric emptying. Some symptoms of gastroparesis include bloating, pain after eating, heartburn, and nausea or vomiting.

Uncontrolled high blood sugar can lead to nerve damage affecting how well the stomach muscles contract and release. It is this motion that pushes food through the stomach and intestines. If this process is not working effectively, the stomach is not fully empty, and food can remain there for long periods of time, causing discomfort. In addition, gastroparesis can affect how well the body absorbs nutrients from various foods and contribute to malnutrition.

To help prevent gastroparesis, diabetes should be managed as effectively as possible to control blood sugar levels and keep them within the target range. To aid with digestion, drink plenty of water throughout the day, and eat several small meals rather than two or three large ones. Limiting fat and fiber consumption can also promote improved stomach emptying, which can reduce discomfort. In addition, engaging in regular exercise not only helps with managing blood sugar, but it can also support digestion.

Diabetes and digestive problems are both conditions that can be managed to reduce the risk of developing gastroparesis. Patients should talk to their doctor about any symptoms they experience and how to improve their diet to support proper digestion and nutrition.

The gastroparesis-diabetes connection is one that is recognized by scientists and something that patients should be aware of. Researchers continue to study these types of conditions to learn more about how they affect diagnosis, prevention, treatment, and quality of life.

The Diabetes Research Connection (DRC) supports diverse research initiatives related to type 1 diabetes by providing critical funding to early-career scientists. Learn more about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org. 

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The destruction of insulin-producing beta-cells is a known cause of type 1 diabetes. Still, researchers continue to investigate exactly what triggers this cell death and how to control or reverse it. In addition, they have been searching for an effective way to reintroduce or restimulate the production of pancreatic cells with long-term survival rates, a challenging undertaking.

One component of this task is understanding how and when beta cells replicate. A recent study found that Wisp1, a matricellular protein that is part of the CCN protein family, may play an important role. This protein is found in higher levels in pre-weaning mice than adult mice, and the same is true in humans, where Wisp1 is more abundant in young children than in adults. It is especially prevalent in bone tissue.

Scientists have found that beta cell replication is most active in the early postnatal weeks and declines with age. After introducing serum Wisp1 in adult mice as well as human islets, beta-cell proliferation increased. In addition, Akt levels also increased. Akt activation is known to play a role in insulin/IGF signaling, contributing to beta-cell growth regulation. There is a potential that Wisp1 and Akt may work synergistically in the body when it comes to proliferating beta cells.

It is important to note that the study did not find a direct correlation between the circulation of Wisp1 and pancreatic cells’ production. Researchers note that, “Our study identifies Wisp1 as a circulating protein that is abundant in young blood and induces proliferation of adult beta cells, thus revealing Wisp1 as an agent with potential therapeutic use to expand beta beta-cell in diabetes.”

Additional research is needed to determine how circulating factors may potentially be used as therapeutic agents when it comes to beta-cell proliferation and the treatment of diabetes. This study opens doors to new research opportunities.

The Diabetes Research Connection (DRC) is interested in seeing how Wisp1 may impact future studies regarding type 1 diabetes treatment. To support the advancement of diabetes-related research, the DRC provides funding to early-career scientists so that they may pursue innovative peer-reviewed projects. Learn more about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org. 

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Dear Members of the DRC Family,

The attached article, to be published in print in Diabetes Care, concludes type 1 (and type 2) diabetes, independently increase the adverse impacts of COVID-19.

Potentially modifiable factors (e.g., HbA1c) had a significant, but modest, impact compared with comparatively static factors (e.g., race and insurance) in type 1 diabetes, indicating an urgent and continued need to mitigate severe acute respiratory syndrome coronavirus 2 infection risk in our community.

We encourage you to discuss, with your health care provider, prioritizing vaccination of family members who have diabetes. These statistics are compelling.

Wishing you the best of health,

David Winkler
Chair, Co-Founder and Chief Financial Officer, Diabetes Research Connection

Please Click HERE To View the Full Article

One area of research that scientists have focused on treating and potentially curing type 1 diabetes is islet cell transplant. Introducing new insulin-producing islet cells into the body aims to stimulate these cells’ continued production and survival to achieve normoglycemia.

However, a major challenge is ensuring proper revascularization of islet cells. Without this vascularization and the exchange of blood and oxygen, the cells die. Up to this point, scientists have struggled to create these vascular networks quickly enough to make islet cell transplant a viable and lasting option.

A recent study seeks to overcome this obstacle by prevascularizing islet organoids before transplanting them. Rather than combining pancreatic islet cells (PI) with epithelial and endothelial cells alone, scientists paired them with microvascular fragments or MVF. The PI cells are combined with MVF, then covered in a liquid overlay, and cultivated for five days.

As a result, the islet organoids form a dense microvascular network that, when transplanted into diabetic mice, can quickly attach to existing vascular structures. Therefore, the islet organoid improves not only its vascularization but its viability and functionality as well. In mouse models, normoglycemia was restored within just seven days following transplant. Transplanting freshly isolated islets alone without MVF did not produce these same results.

This improved vascularization may help reduce reactive oxygen species (ROS) and hypoxic stress. High levels of hypoxic stress can reduce cell viability and function. Due to the rapid vascular connections made by prevascularizing the islet organoids, there is less cellular stress and risk of cell death.

This study marks a notable advancement in islet cell transplant potential. More research needs to be done when it comes to the viability of quickly producing uniform prevascularized islet organoids and assessing their performance in human tissue. But it is a step in the right direction toward achieving long-term normoglycemia in patients with type 1 diabetes without relying on insulin injections.

The Diabetes Research Connection (DRC) is interested in seeing how this study progresses and what it could mean for the future of islet cell transplant procedures and treating type 1 diabetes. Though not involved with this study, the DRC supports early-career scientists in pursuing novel research around type 1 diabetes by providing critical funding. To learn more about current projects and how to support these efforts, visit https://diabetesresearchconnection.org. 

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*Please be advised that this is not an article stating that any type one diabetic’s diabetes can be reversed. In the case of this article, it is in reference to individuals with the STAT1 gene mutation* 

Upon receiving a type 1 diabetes diagnosis, a common question comes to mind for many patients and families: is type 1 diabetes reversible? Until now, the answer has been no. Several treatment options can be used to effectively manage the disease and keep blood sugar levels in check, but no solution that supports long-term independence from insulin.

That could be changing for some patients through a precision medicine initiative.

Typically, treatments are designed for the average patient who fits a general profile of a disease. It tends to be a ‘one-size-fits-all’ approach. But with precision medicine, treatment is tailored to specific subgroups that don’t fit the ‘average’ mold. It takes into consideration differences in genetics, environment, and lifestyle.

A recent study found that there is the potential that type 1 diabetes is reversible, at least in some cases. A precision medicine initiative tailored treatment for a 17-year-old male who had both T1D and recurrent respiratory infections. Researchers found that the patient had a genetic mutation in the STAT1 gene. When STAT1 protein activity is elevated, it is known to contribute to autoimmune disorders and respiratory infections.

The patient was treated with ruxolitinib, a therapy that inhibits Jak/STAT signaling. After undergoing precision medicine treatment for a year using ruxolitinib, he no longer required daily insulin injections in order to control his blood sugar levels. His body was able to maintain normal levels on its own.

Since this is a single case and there is not yet any long-term data available regarding whether the treatment will continue to work, researchers cannot, however, definitively answer the question of “is type 1 diabetes reversible?” But at this moment, for this patient, the answer is yes.

According to Dr. Sophia Ebenezer, a lead author on the study and assistant professor of pediatric endocrinology at Baylor and Texas Children’s, “The patient no longer needs daily insulin injections and has shown full remission of other clinical signs of T1D along with marked improvements in his quality of life.”

This study opens doors to treating other patients with STAT1 gene mutations with ruxolitinib therapy in an effort to reverse type 1 diabetes. It also emphasizes the ability of precision medicine initiatives to revolutionize healthcare. No two patients are the same, and differentiation among treatment can impact outcomes for the better.

The Diabetes Research Connection, though not involved with this study, is committed to helping advance understanding and treatment of type 1 diabetes. Early-career scientists receive critical funding to support novel, peer-reviewed studies focused on the disease. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org. 

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For years, the focus of type 1 diabetes (T1D) research has been on the endocrine pancreas, as that is where the islets of Langerhans reside that secrete insulin, glucagon, and other hormones. The exocrine pancreas is primarily responsible for producing digestive enzymes, bicarbonate, and water to support digestion. However, researchers believe that autoreactive T cells within the exocrine pancreas may contribute to the destruction of insulin-producing beta cells.

A recent study found that preproinsulin (PPI)-reactive CD8+ T cells exist not only within the endocrine pancreas but in the exocrine pancreas as well. While researchers know that these cells exist at high levels in individuals with T1D, they have found that they are also reasonably populous in healthy individuals. It may be possible that in healthy individuals without T1D and those who are not autoantibody-positive (aab+), that these PPI-reactive CD8+ T cells remain undetectable to the immune system, thereby causing no negative response.

If the body should experience an up-regulation of major histocompatibility complex (MHC) class 1, this could trigger a reaction where CD8+ T cells become visible and initiate an immune response leading to the destruction of pancreatic islet cells. In turn, this could result in the development of T1D.

Researchers studied various islet areas of the human pancreas and found that donors with T1D had a greater number of PPI-reactive CD8+ T cells than nondiabetic and aab- donors, but that the cells were present in all donors. The presence becomes more abundant as T1D develops. There were also more PPI-reactive CD8+ T cells in areas close to the islets, as well as within insulin-containing islet (ICI) areas. There were fewer cells in insulin-deficient islet (IDI) areas, which indicates that insulin plays an important role in attracting PPI-specific CD8+ T cells.

According to the researchers’ findings, defective thymic selection, and the failure of systemic peripheral tolerance mechanisms may not be the primary drivers behind the development of T1D. Instead, they note that “it is likely that events leading to islet attraction of autoreactive CD8+ T cells already within the pancreas may be a crucial mechanism in T1D development.”

More research is necessary to determine why the exocrine pancreas contains so many PPI-specific CD8+ T cells and exactly how they are triggered in the development of T1D. However, this recent study sheds more light on changes within the pancreas and responses from the immune system that are involved in this disease. Scientists can continue building on these findings moving forward.

Though not involved with this study, the Diabetes Research Connection (DRC) strives to continue advancing research around T1D by providing critical funding to early-career scientists. Contributions from individuals, corporations, and foundations make it possible for scientists to carry out novel, peer-reviewed studies focused on improving diagnosis, treatment, and management of T1D, as well as one day finding a cure. To learn more about current projects and how to support these efforts, visit https://diabetesresearchconnection.org. 

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During pregnancy, women are tested for gestational diabetes mellitus (GDM) to manage their overall health. Gestational diabetes complications can put both women and their babies at risk if not properly managed. While this type of diabetes typically resolves after childbirth, one study found that the condition may help identify women at risk for diabetes – either type 1 or type 2 – in the future.

A study involving 435 Finnish women who had GDM were compared to a control group of healthy women who were pair-matched for age, parity, delivery date, and no previous history of diabetes. The data was collected over ten years between 1984 and 1994. Researchers found that women who developed GDM were at increased risk of developing type 1 or type 2 diabetes if their GDM required insulin treatment, and they had at least one autoantibody. The more autoantibodies they had, whether islet cell autoantibodies (ICAs), GAD antibodies (GADA), insulin autoantibodies (IAAs), or the protein tyrosine phosphatase-related protein 2 molecule (IA-2As), the more at risk for diabetes.

Out of the 435 women diagnosed with GDM, 20 developed type 1 diabetes (T1D), and 23 developed type 2 diabetes (T2D), while none of the women in the control group developed either type of diabetes. In addition, the women who developed type 1 diabetes were younger than those who developed type 2 diabetes at the time of initial blood sampling and had a shorter diabetes-free period. A follow-up survey to determine whether type 1 or type 2 diabetes occurred was completed an average of about 6 years after they had GDM.

In total, 155 women with GDM required insulin therapy to treat their condition, and that included 18 of the 20 women who later developed T1D and 18 of the 23 women who developed T2D. Interestingly, almost equal percentages of women treated with insulin and those who were not, 16.7% and 16.9% respectively, had reactivity to at least one autoantibody. Overall, the positive predictive value of autoantibodies was higher in women with GDM than in the control group, with a greater number of autoantibodies occurring in those who went on to be diagnosed with T1D or T2D.

This study shows how GDM may indicate an increased risk of impaired glucose tolerance or destruction of insulin-producing beta cells, leading to T2D and T1D. According to the researchers, “The risk of developing type 1 diabetes after GDM is increased if the woman is ≤30 years of age during pregnancy, needs insulin therapy for GDM, and tests positive for ICAs and/or GADAs.” Some discrepancy in results could be due to other gestational diabetes complications that were not included in the study. In general, if a woman fits within these criteria, it may be beneficial to continue closely monitoring her health after pregnancy to detect diabetes early on.

It is these types of studies that help improve understanding of diabetes risk and early detection. The Diabetes Research Connection (DRC), though not involved in this study, supports type 1 diabetes research by providing critical funding to early-career scientists. One hundred percent of funds go directly to scientists for their projects. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org.

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It is safe to say that 2020 has been unlike any other year. That being said, DRC’s goal for this year has been to find new ways to connect with our community. DRC has had several virtual gatherings ranging from research updates to DRC’s 3rd Annual Dance for Diabetes. If you would like to view them, they will be posted below in order of the date that they took place.

Reducing Stress in Times of Uncertainty with Felise Levine Ph.D. 4/28/2020: View it Here.

Exciting Update on Type 1 Diabetes (T1D) Research with Vincenzo Cirulli Ph.D. 5/19/2020: View it Here. 

Ask Me Anything: Dr. Moore and the Long Road of Type 1 Diabetes (T1D) Care and Discovery with Daniel Moore Ph.D. 6/23/2020: View it Here.

Beyond Stem Cells: A New Paradigm for Regenerative Medicine with Duc Dong Ph.D. 7/14/2020: View it Here.

DRC’s 3rd Annual Dance for Diabetes Virtual Party: View it Here.

Preserving Retinal Cells Survival with Anne Hanneken M.D. and Frans Vinberg Ph.D. 11/10/2020: View it Here.

Although this has been an interesting year, we continue to find creative ways to connect with our community. We are looking forward to 2021 and having these exciting updates and events in person!

Automated Insulin Delivery Systems

Type 1 diabetes (T1D) is a condition that must be managed 24 hours a day, seven days a week, 365 days a year. Even with careful management, it can be difficult for patients to stay in range, especially overnight. Many individuals with T1D are awoken during the night by alarms from continuous glucose monitors (CGMs) or other devices because their blood sugar is rising (or dropping) to unsafe levels. That means they must wake up and be alert enough to administer the correct amount of insulin without overtreating.

However, several recent studies have found that the use of automated insulin delivery systems such as hybrid closed-loop systems may help patients better manage their blood glucose levels and reduce the risk of hypoglycemia and hyperglycemia. There are several companies testing out these types of systems, including Medtronic and Insulet.

With a hybrid closed-loop system, individuals spend less time manually controlling their diabetes management. A sensor tracks their blood glucose levels (or the sensor glucose levels), and then an insulin pump responds and doses an appropriate amount of insulin as needed. This takes a lot of the stress and burden off of individuals, especially overnight.

Studies have shown that these automated systems have also helped individuals increase their time spent in range. A trial involving 157 participants with T1D between the ages of 14 and 75 showed that overall average time-in-range increased from 54% to 73% when using Medtronic’s MiniMed advanced hybrid closed loop (AHCL) system. For even better control, the system has auto basal and auto bolus correction capabilities.

Another Medtronic study comparing 670G and AHCL use in 111 participants between the ages of 14 and 29 showed an increase in time-in-range from 12% to 22% for the 670G and to 32% for the AHCL system. Other automated insulin delivery systems showed similar results.

These findings are encouraging for youth and young adults who often have a harder time maintaining glycemic control. They are able to sleep better at night knowing their blood sugar is being automatically monitored and managed and not having alarms waking them up as often. Even during the day, they can focus more on other activities and less on constantly monitoring their diabetes. The longer individuals wear AHCL devices, they are often able to stay in auto-mode for longer periods of time and require less manual correction.

Technology has come a long way in supporting T1D management, and the Diabetes Research Connection (DRC) is excited to see how much further it goes. As scientists learn more about the disease and are able to fine-tune sensors and algorithms for tracking and managing blood sugar levels and insulin administration, it can lead to a higher quality of life and improved health for individuals living with type 1 diabetes.

The DRC supports early-career scientists in pursuing novel research studies related to T1D by providing critical funding. This helps to keep science moving forward and one day find a cure. To learn more about current projects and how to support these efforts, visit https://diabetesresearchconnection.org.

Speeding Up Insulin Activation for Managing Type 1 Diabetes

Individuals with type 1 diabetes (T1D) rely on daily insulin injections to effectively manage blood sugar levels and maintain glycemic control. Because blood sugar rises when eating, fast-acting (or rapid-acting) insulin is typically administered just before mealtimes to help curb this spike and begin lowering blood sugar more quickly.

Fast-acting insulin generally begins working within about 15 minutes, peaks within about 90 minutes, and lasts about four hours total. Of course, each person responds differently, and the effects can vary based on numerous factors including the amount of carbohydrates eaten, blood glucose level before eating, injection site, activity, and more.

Researchers have been searching for a way to expedite this process by activating insulin more quickly. Traditional insulin contains a combination of monomers, dimers, and hexamers, with monomers acting the fastest and hexamers taking the longest to break down. A recent study found that using monomeric insulin alone can start decreasing blood glucose levels almost immediately.

The biggest challenge is that these monomers are very unstable and are attracted to the top of the liquid in the vial. Once they hit the air, they aggregate within two hours and become inactive. By using a special polymer blend, scientists were able to create a barrier at the liquid’s surface and keep the monomeric insulin more stable, lasting for more than 24 hours under stress. Commercial insulin only remains stable for about 10 hours. With the addition of the polymer, even commercial insulin increased its duration of stability for up to a month.

The effectiveness of this ultrafast insulin was tested on diabetic pigs, and results showed that the “insulin reached 90 percent of its peak activity within five minutes after the insulin injection. For comparison, the commercial fast-acting insulin began showing significant activity only after 10 minutes. Furthermore, the monomeric insulin activity peaked at about 10 minutes while the commercial insulin required 25 minutes.”

Researchers are planning to apply for approval to test this ultrafast monomeric insulin in human clinical trials, but no trials are planned as of yet. The speed at which this insulin formulation activates as well as the increased stability could improve blood sugar management options for individuals with type 1 diabetes. In addition, this type of insulin could be beneficial in advancing artificial pancreas devices.

Although more testing is needed, this ultrafast insulin could be a game-changer for some individuals with type 1 diabetes if it performs safely and effectively in human trials. Diabetes Research Connection (DRC) is excited to see how these findings continue to unfold and what it could mean for the future of diabetes management.

Though not involved with this study, the DRC plays an active role in supporting research around T1D by providing up to $50K in funding to early-career scientists pursuing novel, peer-reviewed research. To learn more about current projects and how to help, visit https://diabetesresearchconnection.org.

Extending the Viability of Pancreatic Samples for Diabetes Research

When conducting research, scientists often try to use living samples so they can better see how various functions play out or how treatments impact cells. However, it can be difficult to keep organ and tissue samples alive for multiple days and reduce deterioration.  This can limit research opportunities and real-time results.

In a recent study, researchers reveal that they have found a way to prolong the life of pancreatic samples from donors allowing them to more effectively observe how beta cells regenerate in real-time. By using a special device that increases oxygenation to the tissue slice, they were able to keep the pancreatic sample alive for nearly two weeks in culture.

With this extended viability, they were able to more closely see not only how beta cells regenerated, but also how they responded when treated with BMP-7, a natural growth factor that may help stimulate the production of insulin-producing beta cells. This could eventually impact scientists’ understanding of type 1 diabetes and options for treating or managing the disease.

Though not involved with this study, the Diabetes Research Connection (DRC) is also committed to enhancing research around type 1 diabetes, including improving prevention and treatment, minimizing complications, and one day finding a cure. The organization is excited to see how the extended preservation of tissue samples may advance research capabilities. To learn more about how the DRC supports early-career scientists and to review current projects, visit https://diabetesresearchconnection.org.

Glycemic Control Among Youth with Type 1 Diabetes

Scientists have come a long way in their understanding of type 1 diabetes and in not only treatments used to manage the disease, but also technology. From continuous glucose monitors and insulin pumps to smart apps, there is a lot of diabetic technology that exists to support patients. But that does not mean that all patients are taking advantage of it or necessarily have access.

In a recent study by SEARCH, individuals with type 1 diabetes between the ages of 10 and 24 showed poorer levels of glycemic control between 2014 and 2019 than the study cohort from 2002 to 2007, despite improvements in treatment and management options. The SEARCH study encompasses more than 20,000 participants from sites in California, Colorado, Ohio, South Carolina, and Washington.

This particular study evaluated data from 6,492 participants and divided them into cohorts from 2002 to 2007, 2008 to 2013, and 2014 to 2019. Information was also categorized based on the duration of diabetes and whether the participant had type 1 diabetes or type 2 diabetes, with the majority of participants having type 1. Researchers then analyzed HbA1c levels over time, adjusting data for “site, age, sex, race, health insurance status and disease duration, both overall and for each duration group.”

Although average HbA1c levels remained consistent across cohorts (8.7% for 2014-2019, 8.9% for 2008-2013, and 8.6% for 2002-2007), when broken down by individual age ranges, those between the ages of 10 and 24 had poorer glycemic control in 2014-2019 than in 2002-2007.

These findings highlight the need for improved access to and use of diabetic technology as well as other interventions to support youth and young adults in enhancing glycemic control. Maintaining tight glycemic control and staying within target ranges can help reduce potential complications from the disease and promote better health.

Diabetes Research Connection (DRC) is committed to advancing research related to T1D and improving prevention, treatment, and management efforts as well as one day finding a cure. Early-career scientists can receive up to $50K in funding to support their peer-reviewed, novel research studies. Learn more about current projects and how to donate by visiting https://diabetesresearchconnection.org.

Immunosuppression for Islet Grafts

One of the approaches scientists have been testing for reversing or better controlling type 1 diabetes is the use of allogeneic pancreatic islet transplants. By reintroducing healthy insulin-producing islets, they aim to support the body in naturally regulating and stimulating insulin production to manage blood glucose levels.

A major challenge to this technique, however, is the immune system’s rejection of the graft following transplantation. As with organ transplants, scientists were forced to suppress the immune response in order to keep cells from attacking and destroying the islets. But immunosuppression is not a long-term solution for islet graft transplantation because the potential risks and health effects can outweigh the benefits.

In a recent study, scientists explored the possibility of controlling a localized immune response rather than a systemic one. They designed a synthetic platform that contains microgel made of biomaterials that can deliver checkpoint proteins to regulate cell death.  They used a chemeric streptavidin/programmed cell death-1 (SA-PD-L1) protein. In addition to this protein, they added a short, two-week administration of rapamycin to help the body adjust to the transplant while curbing rejection risk. This approach enabled the sustained survival of allogeneic islet grafts without the need for chronic systemic immunosuppression.

These results demonstrate the potential benefits of using synthetic microgels in combination with immunomodulatory ligands and specific antibodies to manage the immune response to allogeneic pancreatic islet grafts. While additional research is needed, this is a step toward improving therapeutic modalities for treating or potentially reversing type 1 diabetes.

The Diabetes Research Connection (DRC) is interested to see how this study influences future work on islet transplantation as an option for managing type 1 diabetes. The DRC is committed to advancing research within the field by providing critical funding to early-career scientists pursuing novel research studies focused on all aspects of type 1 diabetes. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org.

Maintaining Beta-Cell Function with T1D

In healthy individuals, pancreatic beta cells respond to glucose levels in the blood and automatically increase or decrease the production and release of insulin. This occurs without individuals ever knowing it happened. But in those with type 1 diabetes (T1D), the immune system mistakenly attacks and destroys insulin-producing beta cells leaving the body unable to naturally regulate blood sugar levels. Instead, individuals must do this on their own by continually monitoring their blood sugar and administering the appropriate amount of insulin via injection or an insulin pump.

However, in the early stages of type 1 diabetes, the pancreas continues to produce insulin, just not enough to keep blood sugar entirely under control. Eventually, this function ceases and individuals become insulin-dependent. Researchers have been investigating potential treatment options to preserve beta-cell function and slow the progression of type 1 diabetes.

A recent study found that the drug golimumab has shown positive results when used to treat individuals newly diagnosed with T1D. When administered every two weeks, this anti-tumor-necrosis-factor (TNF) therapy helped preserve beta-cell function and reduced the amount of additional insulin required by patients.

After 52 weeks of treatment, “41.1% of participants receiving golimumab had an increase or less than 5% decrease in C-peptide compared to only 10.7% in the placebo group.” C-peptide only measures the amount of insulin produced naturally by the pancreas, not injected insulin. Participants receiving the drug were able to maintain better blood sugar control with less insulin and also experienced a decrease in incidences of hypoglycemia where blood sugar was less than 54 mg/dL.

Another treatment that has shown potential is the combination of anti-interleukin (IL)-21 and liraglutide. Participants were randomly assigned to one of four groups: anti-IL-21, liraglutide, anti-IL-21 and liraglutide, or a placebo. Anti-IL-21 targets IL-21-mediated inflammation while liraglutide may reduce cell stress and apoptotic cell death. Treatment was administered every six weeks for 54 weeks.

At the end of the trial, those participants who received the combination treatment showed statistically better beta-cell function than those receiving only liraglutide or the placebo. Beta-cell function was nonsignificant when compared to those receiving only anti-IL-21. In addition, results showed that “combination therapy resulted in the lowest on-treatment glucose levels, although this was not statistically significant, and a significant 32% reduction in insulin dose relative to placebo.”

A third treatment of note was the use of ladarixin, a CXCR1/2 inhibitor that blocks IL-8. Although this therapy did not slow beta-cell function decline during the three-month trial period, it did achieve a statistically significant decline after six months. However, these effects had disappeared again by 12 months. But individuals taking ladarixin did experience better HbA1c levels than those in the placebo group. More research is needed on potential uses and effectiveness of ladarixin.

In addition, researchers also conducted a study involving individuals who were not yet diagnosed with T1D, but who were at high risk due to family history and the presence of at least two autoantibodies. They wanted to see if they could preserve beta-cell function and delay onset of T1D through the use of an Fc receptor-nonbinding anti-CD3 monoclonal antibody called teplizumab.

In this trial, 44 participants received teplizumab, and 32 received a placebo. Treatment was administered for 14 days. The results showed that “the medium time to the diagnosis of type 1 diabetes was 48.4 months in the teplizumab group and 24.4 months in the placebo group.” Overall, T1D was eventually diagnosed in 43% of the teplizumab group and 72% of the placebo group, demonstrating that the treatment may have helped slow the progression of the disease and preserve beta-cell function in individuals at high risk of developing T1D.

All of these therapies are continuing to undergo research to determine their effectiveness and potential use in delaying or preventing the onset of T1D. Diabetes Research Connection (DRC) is dedicated to ensuring that this type of work continues and provides critical funding to early-career scientists pursuing novel, peer-reviewed studies related to type 1 diabetes. Dr. Kevan Herold, a Yale researcher and member of the DRC’s scientific review committee (SRC), was involved in the study regarding teplizumab. Learn more about how the DRC supports scientists and current research projects by visiting https://diabetesresearchconnection.org.

Benefits of CGM Use

Individuals with type 1 diabetes (T1D) have multiple options for managing their blood sugar, ranging from traditional finger sticks and insulin injections to continuous glucose monitors (CGM) and insulin pumps. Scientists are also continuing to work on more advanced technology including artificial pancreas systems.

CGMs are a popular device for individuals with T1D because they automatically measure and track blood glucose levels and send alerts when they begin to rise or fall too far. They tend to be worn most often by young children and adults ages 26 to 50. However, there are barriers to access for these devices including eligibility requirements and insurance coverage. Furthermore, not all primary care providers are well-versed in how to effectively manage care using these systems.

But recent studies show that CGMs may be especially beneficial for the groups that tend to wear them the least – teens and young adults, and older adults. When these devices are consistently used, they can help to improve glycemic control and reduce instances of hypoglycemia. These factors are essential for continued well-being.

One study followed a group of 153 adolescents and young adults between the ages of 14 and 24 for 26 weeks, then followed up at one year. All of the participants had HbA1c levels of at least 7.5% but not more than 11.0%. The control group contained 79 individuals who did not wear a CGM and conducted finger sticks four times per day to measure their blood glucose levels. The test group contained 74 individuals who wore a CGM and conducted finger sticks twice per day.

At the end of 26 weeks, HbA1c levels for the CGM group dropped from 8.9% to 8.5%, while levels for the control group remained steady at 8.9% throughout. In addition, the CGM group’s time in target glucose range increased from 9 hours per day to 10.3 hours per day, whereas the control group actually dropped from 8.7 hours per day to 8.3 hours per day. However, over time, the CGM group wore their devices less frequently, going from 82% to 68% of participants wearing the device at least five days per week.

At the end of one year, the results remained relatively consistent. Within the CGM group, HbAc1 levels improved slightly from 8.5% to 8.3%, while time in target range decreased slightly from 43% to 41%. There was a noticeable difference when it came to low blood sugar, with the average time spent below 70 mg/dL improving from 49 minutes per day to just 16 minutes per day.

On the other end of the spectrum, adults ages 60 and older also saw positive results when it came to CGM use. This study involved 203 adults split into the same type of test and control groups as the adolescents/young adults. The older adults in the CGM group were more consistent with their device use with 81% wearing it continuously and 89% wearing it at least five days per week.

The focus of this study was on hypoglycemia and time spent with a glucose level below 70 mg/dL. After 26 weeks, the CGM group went from 73 minutes per day to just 39 minutes per day, while the control group saw very minimal change. These rates stayed approximately the same at the one-year mark. In addition, the CGM group spent an average of 2.1 hours per day more in the target blood glucose range than the control group at 26 weeks.

The findings from both studies are encouraging when it comes to helping individuals with T1D to better manage their blood sugar and reduce the risk of hypoglycemia. It is important to educate patients on the benefits of using a CGM while also working to reduce barriers and improve access to this technology.

Though not involved in these studies, the Diabetes Research Connection supports early-career scientists in conducting research related to preventing and curing type 1 diabetes, minimizing complications, and improving quality of life for those living with the disease. From an increasing understanding of how and why the disease develops to improving treatment and management options, scientists are working hard every day. Learn more about current projects funded by the DRC and how to support these efforts by visiting http://diabetesresearchconnection.org.

In many patients, there is a slight delay between the time when type 1 diabetes (T1D) is first diagnosed, and when they become dependent on insulin. This is known as the “honeymoon phase” and often lasts for a few months or up to a year. During this time, insulin-producing beta cells continue to function relatively normally and are supported by a small amount of insulin. Over time, these cells stop functioning and patients become insulin-dependent.

A recent study reveals that scientists have developed a breakthrough drug that may delay the onset of clinical T1D by up to three years. The drug, teplizumab, was used to treat patients who were identified at high risk of developing T1D due to the presence of at least two autoantibodies. The drug was administered for two weeks, and following this treatment, insulin secretion rates and C-peptide levels remained higher than for those participants who received a placebo.

During the preliminary trial, patients who took teplizumab showed a delayed onset of T1D of two years, but during the latest phase 2 drug trial, this was extended to three years. Participants who took a placebo continued to experience decreased insulin and C-peptide production as the disease progressed. As a result of these findings, the drug was awarded Breakthrough Therapy Designation by the U.S. Food and Drug Administration (FDA) and PRIority MEdicines (PRIME) Designation by the European Medicines Agency (EMA) in 2019.

More than 18 million people around the world are living with type 1 diabetes, and this drug has the potential to make a positive difference in the lives of millions more who are at-risk for the disease. Diabetes Research Connection (DRC) is excited to see how clinical trials continue to progress for teplizumab and whether it eventually becomes an approved prevention therapy for type 1 diabetes.

The DRC is committed to growing understanding and improving treatment and prevention of type 1 diabetes through providing critical funding for early-career scientists so they can advance and execute their research. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org.

Type 1 Diabetes and COVID-19

As cases of COVID-19 continue to spread across the United States and the globe, scientists are especially interested in how it affects specific populations, such as those with type 1 diabetes (T1D). T1D is considered an underlying health condition and already puts individuals at greater risk when it comes to illness and potential complications.

One positive sign is that preliminary data from a recent study shows that many patients with T1D who also test positive for COVID-19 or have COVID-19-like symptoms are able to effectively manage their recovery at home. Less than 25% of patients were serious enough to require hospital admission. In addition, there were only two reported fatalities, and those individuals had existing comorbidities.

According to the preliminary data, it appears as though patients who have higher A1c levels and poorer glycemic management tend to be more negatively impacted by the disease. In addition, higher body mass index may also be a risk factor. When it comes to age, about 65% of cases were in individuals aged 18 or younger (though many had COVID-19-like symptoms, not confirmed diagnoses), and the average age of all 64 participants was 20.9 years. This is not an issue that is only facing older adults.

According to the study, “Overall, 34.9% of patients were able to manage COVID-19 entirely at home, with 27.3% of the confirmed and 43.3% of the suspected cases able to do so. At the other extreme, 22.2% of patients overall were admitted to the intensive care unit; 30.3% of the confirmed versus 13.3% of suspected cases.” Other patients were seen at an urgent care or hospital but not admitted.

Of those who managed their recovery at home, many received support virtually through telemedicine where they able to consult with endocrinologists and infectious disease specialists. There were also many who did not need to seek care and had their symptoms improve.

Since the initial study was conducted, more patient data has been submitted, and there are now 220 patients as opposed to 64. This data is still being analyzed and reviewed, but at first glance, researchers have found that results continue to be similar to the original group. Researchers are looking at A1c levels, glycemic management, comorbidities, mortality, telemedicine access and use, and more to better understand how COVID-19 is impacting individuals with T1D. They are also digging deeper into risk factors. A new paper reflecting this latest data is in the works.

There are still a lot of unknowns when it comes to COVID-19, but researchers are striving to understand how it may affect more vulnerable populations such as those with type 1 diabetes. The Diabetes Research Connection (DRC) continues to follow these studies and trends to stay up-to-date on the latest information. In addition, the DRC provides critical funding for early career scientists to conduct their own novel, peer-reviewed studies around T1D, whether related to COVID-19 or any other facet of the disease. To learn more and support current projects, visit http://diabetesresearchconnection.org.

High Costs of Diabetes

Discussions around type 1 diabetes care and affordability often focus on the cost of insulin. While insulin prices can be extremely high and add up quickly depending on how much is needed to effectively control blood sugar levels and what is covered by insurance, this is not the only diabetes-related expense that individuals incur.

Insulin is only one part of managing diabetes. Patients also must pay for the supplies necessary to test and monitor their blood glucose levels and to administer insulin. Many people use continuous glucose monitors and insulin pumps to assist, and even if they don’t, they need syringes and other testing supplies.

A national study of 65,199 patients between the ages of 1 and 64 who had private, employer-sponsored insurance coverage found that the average out-of-pocket cost for managing diabetes was $2,500 a year. But only 18% of that cost was insulin. The rest was other supplies like those aforementioned. Furthermore, families with children who had type 1 diabetes were more likely to use CGMs and insulin pumps to help manage their child’s condition, and their annual out-of-pocket costs exceeded those of adults at $823 versus $445 respectively.

While steps have been taken to reduce the cost of insulin in recent years, and especially during the coronavirus pandemic, not as much has been done to improve the affordability and access of other diabetes-related supplies. CGMs and insulin pumps can play an integral role in helping patients better manage their diabetes and reduce complications, especially for children; in turn, this may help decrease additional medical expenses.

More focus is needed on the overall costs of diabetes management and how to better support patients in affording the care they need for improved health. The Diabetes Research Connection (DRC) stays abreast of the latest changes in the industry and advancements in research and treatment to help individuals with type 1 diabetes. Scientists are always working on ways to improve care and reduce the burden of the disease, and the DRC provides critical funding for these efforts. Learn more about current projects and how to support early-career scientists by visiting https://diabetesresearchconnection.org.

COVID-19 Testing

COVID-19 has taken our country by storm, and it is affecting individuals of all ages. No one is immune, and unfortunately, individuals with underlying health conditions tend to be at higher risk for complications. People with type 1 diabetes are already more severely affected by infections than individuals without the disease, and therefore they may be at higher risk for contracting COVID-19 and having poorer health outcomes.

A recent study looked at a group of 64 people with type 1 diabetes, 33 of whom had confirmed cases of COVID-19, and 31 of whom had COVID-19-like symptoms but no confirmed diagnosis. The median HbA1c levels were 8.5% and 8% respectively, and the average age was 24.8 years in the confirmed COVID-19 group and 16.8 years in the COVID-19-like symptom group.

Participants were part of a T1D Exchange Quality Improvement Collaborative (T1DX-QI) study and completed a 33-item questionnaire about their health and symptoms. They all had one or more symptoms that aligned with the Centers for Disease Control and Prevention’s (CDC) symptom profile for COVID-19.

The results showed that for both groups, high blood glucose, fever, and dry cough were the top three symptoms. Diabetic ketoacidosis (DKA) was reported in 45.5% of participants who tested positive for COVID-19 and 13.3% of those with COVID-19-like symptoms. This was a small study using data collected up to May 5, 2020. Additional research is needed to better track results as more is learned about the disease and its impact on individuals with type 1 diabetes. Also, since the average age of participants was teenagers and young adults and type 1 diabetes tends to develop in childhood, conducting pediatrics studies could also be beneficial to learn more.

As researchers continue to study COVID-19 and individuals with type 1 diabetes, they can better understand risk factors, complications, and therapeutic treatment options to deal with this novel coronavirus. The Diabetes Research Connection (DRC) is an organization dedicated to funding research around type 1 diabetes and will continue to stay abreast of the latest findings in regard to T1D and COVID-19. To learn more about the work conducted through the DRC and support these efforts, visit http://diabetesresearchconnection.org.

Protecting Insulin-Producing Islets Through Cell Editing

A hallmark of type 1 diabetes is the destruction of insulin-producing beta cells in the pancreas. These cells are crucial for producing and releasing insulin in response to rising blood glucose levels. Without them, glucose levels go unregulated and can become potentially fatal. Individuals with type 1 diabetes must be vigilant about testing their own blood sugar and administering insulin via syringe or an insulin pump as necessary.

However, a recent study aims to transform diabetes management in children with type 1 diabetes by using cell editing to produce healthy, functioning T cells that would intervene in the destruction of insulin-producing beta cells. Effector T cells and regulatory T cells (Treg) work together to balance the body’s immune response. When effector T cells attack, regulatory T cells keep them in check and limit the damage. But in individuals with type 1 diabetes, regulatory T cells do not function normally.

Researchers at Seattle Children’s Research Institute’s Center for Immunity and Immunotherapies and the Benaroya Research Institute at Virginia Mason (BRI) have discovered a way to edit patients’ T cells so that they function like regulatory T cells and protect pancreatic islet cells. Through gene editing, they turned on the FOXP3 gene in the cells and attached a T-cell receptor to make them antigen-specific to pancreatic cells.

According to Dr. Jane Buckner, president of BRI and co-investigator of the study, “We want to identify T-cell receptors that will create engineered Treg that will go on to and protect the pancreas. This type of therapy could then be used to stop the destruction of cells that produce insulin in the pancreas to slow the progression and ultimately prevent type 1 diabetes.”

The team recently received additional funding and is moving toward gaining approval to start a first-in-human clinical trial at Seattle Children’s. There are currently no other laboratories in the world conducting this same type of experimental therapy. The engineered cells have been tested in animal models and tissue cultures with positive results, but this would be the first human testing.

Diabetes Research Connection (DRC), though not involved in this study, is excited to see how the study advances and if human clinical trials are approved. This could be a major step forward in treatment and prevention options when it comes to type 1 diabetes. The DRC is committed to supporting these types of efforts and provides critical funding to early-career scientists pursuing novel, peer-reviewed research around type 1 diabetes. To contribute to these efforts and learn more about current studies, visit http://diabetesresearchconnection.org.