Sainsbury fronts up over diabetes

Concerned dad joins drive to fight back against incurable illness

Mark Sainsbury with his diabetic son, Hunter. Photo / Marty Melville

Mark Sainsbury has spent decades in the limelight, but has always kept his twin children out of it … until now.

The popular broadcaster is speaking out about his son’s battle with incurable type-1 diabetes in a bid to raise money and awareness.

The former Close Up host will compere a fundraising dinner on Saturday night for Diabetes Youth Auckland, an organisation he says was a major support when his son, Hunter, was diagnosed with the auto-immune disease at the age of 10.

“It was a huge thing for him, suddenly having to inject himself with insulin several times a day,” Sainsbury said. “You think, you poor little guy, how is he going to deal with this? It seems so unfair.

“But if you spend any time in a children’s ward you learn there are people with bigger issues.”

He said the first sign was Hunter becoming lethargic and drinking a lot of water. “He got more and more gaunt. He was misdiagnosed at first, but on that weekend he looked so emaciated we took him straight to the children’s ward.

“After a blood test, a doctor told us he was diabetic – which we knew nothing about.”

Youth Diabetes case workers were fantastic, he said, guiding the family through what to expect. “There’s the whole thing of being different and having to shoot up. I injected him the first time and after that he did it all himself. He was really amazing. He basically took charge.”

Sainsbury recalls a couple of times when Hunter experienced a frightening drop in sugar levels, including on a disastrous family skiing trip.

“The brand new 4WD broke down and he suddenly started acting really strangely. We thought he was just goofing around but it was actually a massive low and we had to get a glucose shot into his thigh.”

He said the incident also proved an eye opener for his twin sister and her friend. “I think they sometimes thought we were easier on him, and suddenly they saw the fitting and stuff and it was real to them. Not just a sympathy card, but very dangerous and frightening. It made everyone realise just how serious it was.”

Of all people with diabetes, it is estimated about 10 per cent have type 1, which most often occurs in childhood but can occur at any age. Early symptoms include thirst, passing more urine, weight loss, being very tired and mood changes.

Sainsbury says Hunter, who recently returned to Wellington after time in the Northern Territory with his sister, gets an eye test every year and keeps a close watch on his circulation.

Sainsbury insists children with type-1 diabetes can live a regular life but stops short at describing it as normal – and says as a parent the concern is always there.

“Even when they leave home you can’t help but worry about what will happen if they don’t eat, and what if they have a low,” he said. “But at the end of the day they have to manage it themselves. You can’t sit and watch them 24 hours.”

Sir Bob Jones will be the guest speaker at Saturday’s fundraising dinner. The proceeds will support local children and teens with type-1 diabetes.

Herald on Sunday

By Amanda Snow Email Amanda

Madison Clinic Helps Young Diabetes Patients Manage Their Own Care

When children are diagnosed with type 1 diabetes­ – one of the most common chronic conditions of childhood – parents typically shoulder the burden of managing their care.  

This includes a rigorous daily routine of supervising what the child eats, checking blood sugar levels, administering insulin and keeping regular medical appointments. It’s a big job, and as children become independent adults, it’s one they must gradually take upon themselves. 

The Madison Clinic aims to improve the lives of patients and their families and to ease the burden of diabetes through compassionate and individualized management with emphasis on education, empowerment, and use of advanced technologies.

Visit the clinic’s website for more information.

This process of “transition” is important for maintaining optimal health, and it is highly influenced by socio-economic and cultural factors.

UCSF psychologist Diana Naranjo, PhD, an assistant professor of pediatrics, is particularly interested in how the health care transition occurs in ethnic minority families. Her work is part of a broad effort to smooth the transition process for all young adult patients at the Madison Clinic for Pediatric Diabetes at UCSF Benioff Children’s Hospital.

An Extra Developmental Challenge

Patients in the transitional age group­­ – 18 through 30 – face special challenges when it comes to managing their diabetes.

Diana Naranjo, PhD

“Young adults, who are still evolving decision-making skills, often feel ‘I’ve been dealing with this my whole life. I want it to go away,’” said Naranjo. 

An autoimmune disorder in which the body attacks the pancreas, type 1 diabetes requires that patients take over the metabolic balancing act that this organ performs in healthy individuals. That requires a daunting series of tasks that must be performed every day. If poorly controlled, the disease can cause serious short and long-term consequences.

Managing type 1 diabetes often conflicts with normal developmental behaviors, said Naranjo.

Experimentation with drinking alcohol, for example, has extra risks for youth with diabetes because it can affect blood sugars and impair judgment. Young people may also struggle with how to disclose the demands of their disease when starting an intimate relationship.

Guiding the Transition Process

The Madison Clinic is working to ease the transition process for all its young adult patients. These efforts are led by a team that includes pediatric diabetes specialists Saleh Adi, MD and Stephen Gitelman, MD, endocrinologist Roger Long, MD, and Megumi Okumura, MD, a specialist in chronic disease management.

Patients complete an annual survey that Naranjo and the team have developed that helps identify how much teen and young adult patients know about their disease – with questions about their knowledge of medical management, insurance, sex and drugs. 

Transition coordinator Marcela Arregui-Reyes sits down with every patient age 16 or older to complete the survey and prioritizes specific areas where more education is needed.  With most patients making four visits to the clinic each year, the goal is to fill in the most important educational gaps at each visit.

How Transition Differs for Minority Families

Ethnic minority patients in the transitional age group often wrestle with additional challenges, according to Naranjo.

As they reach adulthood and age out of public healthcare systems for children with chronic illness, some may be left uninsured or with very limited healthcare options.  This can lead to poor diabetes management and higher utilization of emergency room services.

Madison Clinic for Pediatric Diabetes at UCSF’s Mission

Bay campus

Naranjo, who is fluent in Spanish, has a special interest in cultural differences in patients’ perceptions about diabetes and its care.  

The Madison Clinic serves a higher-than-average percentage of minority patients with type 1 diabetes, making it a good site for researching these differences. Roughly 25 percent of the clinic’s families are Latino, and African-American families are proportionately higher than in the overall U.S. population of patients with diabetes.

Naranjo has gathered detailed information from 20 clinic families so far, using a combination of surveys and in-depth interviews with patients and family members.  One emerging pattern, according to Naranjo, is that Latino parents do not necessarily value transition in the same way that the medical world does.  The transition model used in medical settings is designed to help young adults take over monitoring their health, making their own appointments and interfacing with insurance companies or other agencies.  

“Latino parents often wonder ‘Why should I burden my child in that way?’” said Naranjo.  Many Latino families continue living together longer into adulthood than non-Latino families, and consequently, parents continue to play a big role in their young adult’s diabetes management.

Latino children may also look at the transition process differently, particularly if their parents are uninsured and struggling to treat their own chronic health problems, such as high blood pressure or type 2 diabetes.

Naranjo will continue her research in the coming year. In the meantime, her findings suggest that health transition specialists may need to tailor the information they give to minority families to match different perceptions of living with a chronic disease.

Oregon Faith-Healing Parents Charged With Manslaughter In Daughter's Death …

On Friday, Travis and Wenona Rossiter were brought before a judge in Linn County, Ore., and plead not guilty to charges of manslaughter for their daughter Syble’s death. In February, the 12-year-old girl died in their home because of complications due to type 1 diabetes. She did not receive medical treatment for the condition.

“The 12-year-old had a treatable medical condition and the parents did not provide adequate and necessary medical care to that child,” said local police Captain Eric Carter. “And that, unfortunately, resulted in the death of her on February 5 of this year.”

Although unconfirmed, the couple is rumored to have withheld medical treatment in favor of faith-based healing.

The Rossiters attend the Church of the First Born, a church that allegedly encourages its members to seek faith-based interventions for illnesses instead of modern medical treatment. Its website cites biblical verse James 5:14, “If any be sick, call for the elders of the church, let them pray over him, anointing him with oil in the name of the Lord.”

Syble suffered from type 1 diabetes, formerly known as juvenile diabetes, a condition in which a person is unable to produce insulin. Without insulin therapy, type 1 diabetes is fatal. The most common cause of death among pediatric diabetics is diabetic ketoacidosis. Resulting from the buildup of fat metabolites called ketones, diabetic ketoacidosis  is characterized by vomiting, dehydration, confusion, and eventually leads to coma and death if left untreated. The clinical details of Syble’s death have not been made public.

With insulin therapy administered through injections or an insulin pump, people with type 1 diabetes can live nearly as long as the general population. 

The church websites explains that its members should comply with local health officials. “If you choose not to take your child to a doctor, then we urge you to immediately notify the county health department and the state department of human services using our corporate forms.”

Tragically, if the Rossiters are found guilty, they would not be the first parents deemed liable in the death of a child within the church. In 2012, Brandi and Russel Bellew, also of the Church of the first Born, pleaded guilty to criminally negligent homicide after their son, Austin Sprout Creswell, died at age 16 from an untreated infection secondary to a burst appendix. At least 22 children associated with the Church of the First Born have died from lack of medical treatment since 1964, according to the group Children’s Healthcare Is a Legal Duty.

A neighbor interviewed by local CBS affiliate KOIN 6 News described Syble as a quiet girl who enjoyed riding her bike. “She seemed shy to talk to people because they picked apples out of my yard,” the neighbor said.

Type 1 Diabetes Drug Proves Effective in Clinical Trial

An experimental drug designed to block the advance of type 1 diabetes in its earliest stages has proven strikingly effective over two years in about half of the patients who participated in the phase 2 clinical trial.

Jeffrey Bluestone, PhD

Patients who benefited most were those who still had relatively good control of their blood sugar levels and only a moderate need for insulin injections when the trial began. With the experimental drug, teplizumab, they were able to maintain their level of insulin production for the full two years – longer than with most other drugs tested against the disease.

Results are published online in the journal Diabetes, and will appear in the November issue of the print edition.

The treatment did not benefit all patients. Some lost half or more of their ability to produce insulin – a drop similar to many of the controls not receiving the drug. Reasons for the different responses are unclear, but likely involve differences in the metabolic condition of the patients and in the severity of their disease at the trial’s start, the researchers said.

Kevan Herold, MD, PhD

“The benefits of treatment among the patients who still had moderately healthy insulin production suggests that the sooner we can detect the pre-diabetes condition and get this kind of drug onboard, the more people we can protect from the progressive damage caused by an autoimmune attack,” said Jeffrey Bluestone, PhD, co-leader of the research and A.W. and Mary Clausen Distinguished Professor at UC San Francisco, who collaborated in developing the drug. 

The clinical trial was led by Kevan Herold, MD, PhD, a professor of immunobiology and deputy director for translational science at Yale University. He and Bluestone have collaborated on four previous clinical trials of the experimental drug.

“We are very excited by the efficacy of the drug,” Herold said. “Some of our patients and families have described a real impact on their diabetes.”

Bluestone, an immunologist who is now executive vice chancellor and provost at UCSF, developed teplizumab in collaboration with Ortho Pharmaceuticals in 1987. He is a leader in research that aims to understand how and why the immune system attacks the body’s own tissues and organs, and to develop drug strategies to eliminate the autoimmune response without producing severe side effects.

Catching Diabetes in Earliest Stages

The results underscore the importance of diagnosing and treating diabetes in its earliest stages, the researchers said. Current treatment studies include “pre-diabetes” patients who have abnormal blood sugar levels but do not need to take insulin.

Formerly referred to as juvenile diabetes because it disproportionately strikes children, type 1 diabetes is caused by an autoimmune condition in which the body’s immune system destroys insulin-producing beta cells in the pancreas. Even with insulin treatments, the blood glucose levels fluctuate abnormally, and as the disease progresses, diabetes increases the risk of kidney failure, heart disease and other serious disorders.

According to JDRF, as many as 3 million American have type 1 diabetes, and each year, more than 15,000 children and 15,000 adults are diagnosed with the disease in the United States. For reasons still unknown, the incidence of type 1 diabetes is increasing, and the age of onset is decreasing.

Controlling Autoimmune Reactions

Teplizumab is one of a number drugs under active investigation to control autoimmune reactions. Teplizumab uses an antibody targeted against a molecule called CD3 to bind to the immune system’s T-cells and restrain them from attacking beta cells.

Immunotherapies are designed to treat organ transplant rejection and autoimmune diseases, including multiple sclerosis, Crohn’s disease, rheumatoid arthritis and asthma. The use of these agents in type 1 diabetes is emerging based on work in preclinical models and clinical trials.

The journal’s print edition will include a commentary by Jay S. Skyler, MD, chairman of the National Institutes of Health-funded Type 1 Diabetes Trial Net, an international network of researchers that also studies teplizumab for prevention of type 1 diabetes. Skyler writes that the new results make a compelling case for U.S. Food and Drug Administration approval to launch a much larger-scale, phase 3 clinical trial of the drug’s effectiveness.

The study focused on 52 participants, most of whom were less than 14 years old, who had been diagnosed with “new-onset type 1 diabetes” within eight weeks of the trial’s start. All 52 were treated with the experimental drug for two weeks at diagnosis and again one year later, and their capacity to produce their own insulin to control their blood sugar was compared with a non-treated group.

Because the participants received daily insulin injections before and throughout the trial, researchers instead monitored their blood levels of C-peptide, a molecule produced in the pancreas at the same rate as insulin.

Watch this video to learn more about the groundbreaking work of the UCSF

Diabetes Center.

This research was a project of the Immune Tolerance Network (NIH contract #NO1 AI15416), an international clinical research consortium supported by the National Institute of Allergy and Infectious Diseases and the Juvenile Diabetes Research Foundation. It also was supported by NIH grants UL1 RR024131 and UL1 RR024139.

Co-authors on the paper and collaborators in the clinical trial with Herold and Bluestone include Stephen E. Gitelman, MD, UCSF; Mario R. Ehlers, PhD, and Peter H. Sayre, MD, of the Immune Tolerance Network (ITN), San Francisco; Peter A. Gottlieb, MD, University of Colorado;  Carla J. Greenbaum, MD, Benaroya Research Institute, Seattle; William Hagopian, MD, Pacific Northwest Diabetes Research Institute, Seattle; Karen D. Boyle, MS, and  Lynette Keyes-Elstein, DrPh, Rho Federal Systems Division, Chapel Hill; Sudeepta  Aggarawal, PhD, and Deborah Phippard, PhD, ITN, Bethesda; James McNamara, MD, National Institutes of Allergy and Infectious Diseases.

Conflict of interest statement: Jeffrey Bluestone has a patent on the teplizumab molecule. Kevan Herold has received grant support from MacroGenics, Inc., a company that owns rights to the drug.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.

May reveals she has type 1 diabetes

Theresa May, the home secretary, has insisted she will continue to pursue a frontline political career despite being diagnosed with type 1 diabetes.

May, 56, revealed that doctors told her two months ago she was suffering with the chronic illness and must now inject herself with insulin at least twice a day for the rest of her life. The Conservative politician, widely tipped as a future party leader, said that while the illness had caused health setbacks, these would not interfere with her role as a prominent member of David Cameron‘s government.

“The diabetes doesn’t affect how I do the job or what I do. It’s just part of life … so it’s a case of head down and getting on with it,” May told the Mail on Sunday.

The home secretary’s revelation follows speculation that she had undertaken a drastic weight-loss programme over the past 18 months as part of a style makeover in preparation for a possible Conservative leadership bid. She said, however, that although she had been attempting to adopt a healthier regime since taking office in 2010, her illness was partly the cause of her weight dropping nearly two stone.

“It was a real shock and, yes, it took me a while to come to terms with it,” she said. “It started last November. I’d had a bad cold and cough for quite a few weeks. I went to my GP and she did a blood test which showed I’d got a very high sugar level – that’s what revealed the diabetes.

“The symptoms are tiredness, drinking a lot of water, losing weight, but it’s difficult to isolate things. I was drinking a lot of water. But I do anyway. There was weight loss but then I was already making an effort to be careful about diet and to get my gym sessions in.”

May’s admission follows an intense period of political activity for the home secretary due to issues such as the deportation of radical cleric Abu Qatada and enforcing cuts to police budgets. Her emergence as a strong presence in the cabinet has fuelled rumours that she harbours ambitions to challenge Cameron as Tory leader. Dismissing claims of a “machiavellian plan” to seize power, she demurred when asked whether her illness would prevent her from one day taking the top job. “There is no leadership bid. We have a first-class prime minister and long may he continue.”

Shortly after details of May’s diabetes were revealed, Justin Webb, the BBC journalist and Today presenter whose son also suffers from type 1 diabetes, offered his support via Twitter. He wrote: “Much sympathy for Theresa May who is diagnosed with T1 diabetes. Sonia Sotomayor [US supreme court justice] has it so no bar to high office!”

Tony Ellis, a former assistant editor of the Liverpool Echo now working in the health sector, criticised the Mail on Sunday interview for “ignorant, trivialising and scaremongering” reporting of type 1 diabetes.

According to May, when doctors told her she had the condition, which means her body does not produce insulin, they initially thought she had type 2 diabetes. Around 90% of diabetics have type 2, thought to be primarily caused by obesity, and 10% suffer from type 1, caused by the destruction of islet cells in the pancreas. Despite the more serious diagnosis that followed, May said she is comfortable with the daily regime needed to maintain her health.

“It doesn’t and will not affect my ability to do my work. I’m a little more careful about what I eat and there’s obviously the injections, but this is something millions of people have … I’m OK with needles, fortunately,” she said. “Tiredness – speak to any politician and they will tell you the hours they work. Tiredness can be part of the job. It is full on.”

The Maidenhead MP has been married to banker husband Philip for 32 years. The couple have no children. She first made an impact on politics by declaring in 2002 that the Tories had become “the Nasty party” because of a perceived tough line on issues such as race and welfare.

“There’s a great quote from Steve Redgrave who was diagnosed with diabetes before he won his last Olympic gold medal. He said diabetes must learn to live with me rather than me live with diabetes. That’s the attitude,” May said.

Theresa May reveals she has type 1 diabetes

Theresa May, the home secretary, has insisted she will continue to pursue a frontline political career despite being diagnosed with type 1 diabetes.

May, 56, revealed that doctors told her two months ago she was suffering with the chronic illness and must now inject herself with insulin at least twice a day for the rest of her life. The Conservative politician, widely tipped as a future party leader, said that while the illness had caused health setbacks, these would not interfere with her role as a prominent member of David Cameron‘s government.

“The diabetes doesn’t affect how I do the job or what I do. It’s just part of life … so it’s a case of head down and getting on with it,” May told the Mail on Sunday.

The home secretary’s revelation follows speculation that she had undertaken a drastic weight-loss programme over the past 18 months as part of a style makeover in preparation for a possible Conservative leadership bid. She said, however, that although she had been attempting to adopt a healthier regime since taking office in 2010, her illness was partly the cause of her weight dropping nearly two stone.

“It was a real shock and, yes, it took me a while to come to terms with it,” she said. “It started last November. I’d had a bad cold and cough for quite a few weeks. I went to my GP and she did a blood test which showed I’d got a very high sugar level – that’s what revealed the diabetes.

“The symptoms are tiredness, drinking a lot of water, losing weight, but it’s difficult to isolate things. I was drinking a lot of water. But I do anyway. There was weight loss but then I was already making an effort to be careful about diet and to get my gym sessions in.”

May’s admission follows an intense period of political activity for the home secretary due to issues such as the deportation of radical cleric Abu Qatada and enforcing cuts to police budgets. Her emergence as a strong presence in the cabinet has fuelled rumours that she harbours ambitions to challenge Cameron as Tory leader. Dismissing claims of a “machiavellian plan” to seize power, she demurred when asked whether her illness would prevent her from one day taking the top job. “There is no leadership bid. We have a first-class prime minister and long may he continue.”

Shortly after details of May’s diabetes were revealed, Justin Webb, the BBC journalist and Today presenter whose son also suffers from type 1 diabetes, offered his support via Twitter. He wrote: “Much sympathy for Theresa May who is diagnosed with T1 diabetes. Sonia Sotomayor [US supreme court justice] has it so no bar to high office!”

Tony Ellis, a former assistant editor of the Liverpool Echo now working in the health sector, criticised the Mail on Sunday interview for “ignorant, trivialising and scaremongering” reporting of type 1 diabetes.

According to May, when doctors told her she had the condition, which means her body does not produce insulin, they initially thought she had type 2 diabetes. Around 90% of diabetics have type 2, thought to be primarily caused by obesity, and 10% suffer from type 1, caused by the destruction of islet cells in the pancreas. Despite the more serious diagnosis that followed, May said she is comfortable with the daily regime needed to maintain her health.

“It doesn’t and will not affect my ability to do my work. I’m a little more careful about what I eat and there’s obviously the injections, but this is something millions of people have … I’m OK with needles, fortunately,” she said. “Tiredness – speak to any politician and they will tell you the hours they work. Tiredness can be part of the job. It is full on.”

The Maidenhead MP has been married to banker husband Philip for 32 years. The couple have no children. She first made an impact on politics by declaring in 2002 that the Tories had become “the Nasty party” because of a perceived tough line on issues such as race and welfare.

“There’s a great quote from Steve Redgrave who was diagnosed with diabetes before he won his last Olympic gold medal. He said diabetes must learn to live with me rather than me live with diabetes. That’s the attitude,” May said.

The all-diabetic cycling team going against type 1

Phil Southerland started cycling for one reason – so he could eat a chocolate bar. “I started riding so I could eat,” he says. “I was just a young boy, exploring the neighbourhood, taking up time so I could go eat another bar.”

Junk food was banned in Phil’s house: he’s had type 1 diabetes since he was seven months old, so his body doesn’t produce insulin – the hormone responsible for enabling our cells to convert glucose into fuel. Organ failure and diabetic coma are the biggest short-term risks, while long-term complications include blindness, kidney failure, cardiovascular disease and nerve damage – sometimes leading to amputation.

These can be avoided with early diagnosis and good control – yet Phil’s parents were told by doctors it was unlikely he’d live beyond 25. And by 12, lured by the school snack machine, he had developed a potentially dangerous taste for Snickers bars. But he soon realised that cycling seemed to make his insulin injections work better – and what began as an innocent pedal around his hometown of Atlanta, Georgia, led to a passion. By 19 he was competing for his university – and was in excellent health.

“In 2003, I’d just won a big championship, and another racer, Joe Eldridge, came over and introduced himself,” says Phil. “He said I was a real inspiration. He had diabetes and was struggling.” They became friends and, under Phil’s influence, Joe took control of his condition.

“His life changed, his confidence changed,” says Phil. “As he told me this, he said, ‘You’re my hero, and because of you one day I’ll see my grandkids grow up.'” Their meeting proved mutually inspirational. Phil had an idea – to set up a pro team consisting solely of cyclists with type 1. “I thought the bike could be a powerful platform to spread this message of empowerment,” he says. In 2005, Team Type 1 was launched, and a few years later they won Race Across America, a cycling competition covering around 3,000 miles.

The win made history. Not only was the team the first of its kind, but the fact they were doing so well in competition was also groundbreaking, as pro athletes with diabetes were practically unheard of until relatively recently. Last year, the team joined forces with Novo Nordisk, a healthcare company which marketed the first ever synthetic insulin treatment. Now Team Novo Nordisk, it has over 100 members from countries all over the world, including a women’s cycling team and triathletes, who will between them compete in over 500 competitions during 2013.

“Changing Diabetes” is emblazoned on their jerseys. Phil’s idea was to empower type 1 athletes, but also to raise awareness and highlight the importance of exercise, inspiring anybody with diabetes, athlete or not.

“When I was growing up, there weren’t really professional athletes with diabetes that I knew about, and having diabetes was an impediment to getting a professional contact,” says Phil. “Fast forward to 2013 and if you’re a really good cyclist and have diabetes, now your chances of getting a contract are just about the same as somebody without diabetes.”

The men’s pro cycling team, which has 17 riders, race full-time, on salaries. Others have day jobs, competing in their spare time. Some, such as 20-year-old Stephen Clancy from Ireland, were already serious athletes before their diagnoses. He was climbing the ranks when he found out he had type 1 last year. At first, he feared his dreams were shattered. “The doctors weren’t very inspiring,” he recalls. “One of them said cycling might complicate my blood sugar control, and suggested I try riding for a mile at a time.” After making enquiries, he was invited to spend two months with Novo Nordisk’s development team in the US and was signed up.

Glucose control, however, isn’t just about diet and insulin injections. Lots of factors, including temperature, general health, stress and activity levels, come into play – which is why frequent monitoring is so important. For racers, this poses the problem of monitoring during a race. The team use continuous monitors – small implants under their skin which transmit a reading to a credit-card sized monitor in their jersey pockets. It beeps if levels drop or spike and insulin is needed; the cyclists also carry insulin pens and simply administer a quick jab, all while pedaling. Aside from that, the team look after themselves pretty much the same way as any pro athlete would.

While their motivation – to win races – is the same as for any cyclist, the added bonus is that they’re beating diabetes at the same time. Phil’s evangelical about the wider benefits of exercise – that being fit is hugely important in warding off the complications associated with diabetes, and that the mood-boosting powers of exercise can help people with diabetes feel in control.

There isn’t much clinical data on exercise and type 1, but this is something Phil would like to see change. In 2011 he founded the Diabetes Sports Research Institute and is working with doctors to promote his message.

“We’re in a society where there’s a pill for everything,” he says. “I think every doctor should tell people, diabetic or not, to get out there and exercise.” Meanwhile, the team is going from strength to strength. It has just held its first junior development camp and, as its profile continues to rise, type 1 athletes from all over the world are knocking on the door. “Exercise is the drug that’s never prescribed,” says Phil. “We wear ‘Changing Diabetes’ on our jerseys, and that’s what we hope to do.”

Not Dead Yet: My Race Against Disease: From Diagnosis to Dominance, by Phil Southerland and John Hanc, is published by Macmillan. Available now

facebook.com/TeamNovoNordisk

'Reverse vaccine' a potential treatment for type-1 diabetes

By Noel Morgan, University of Exeter

“Reverse vaccines” could be used to help relieve sufferers of type-1 diabetes from the inconvenience of daily insulin injections. A vaccine usually works by boosting the body’s immune system to fight a certain disease. But in the case of diabetes, which involves the body’s immune system fighting itself, we may need a vaccine that can lower immunity against certain targets.

Type-1 diabetes lasts a lifetime and can have devastating consequences. It occurs when the body ceases to produce sufficient amounts of the hormone insulin to deal with the demand placed on it from the nutrients, particularly sugars, we eat.

The only available therapy for this at the moment is to administer insulin either by injection or via a pump on a daily basis for the rest of the patient’s life. Even then, it is likely that blood glucose levels will fluctuate much more than normal. This can be associated with either hypoglycaemia (when blood glucose levels fall beyond the normal range, leading to impaired brain function) or hyperglycaemia (which, in the long term, can lead to complications such as kidney failure and blindness).

But this new research suggests that vaccinating type-1 diabetes sufferers with specially engineered DNA might help to protect the body’s insulin producing cells.

Cells that search and destroy

The onset of type-1 diabetes often occurs out of the blue and it’s happening to younger and younger patients. Many newly diagnosed cases are in children and while, in the past, the disease occurred most frequently at about the time of puberty, the trend now is for still younger children to develop the illness at an increasing rate.

The reasons for this are unknown but environmental factors may play a role. Among these, it is possible that infection with a virus might either bring on or enhance the progression of the disease. This is important since, if a virus were to be identified as the culprit, this might open the way for a normal vaccination approach.

The underlying pathology of type-1 diabetes is very complex and remains poorly understood. This is mainly because the disease occurs in an inaccessible organ, the pancreas, in patients who usually can go on to live a long and productive life. As a result, the active process has so far been studied in about 170 pancreas samples worldwide in the past century.

Nevertheless, this has shown that the illness is caused by an inappropriate influx of immune cells into the pancreas, resulting in the insulin-producing “beta” cells being selectively targeted and destroyed.

Finding a ‘reverse vaccine’

In a study published in the journal Science Translational Medicine, Bart Roep at Leiden University and colleagues have tested the validity of this concept in a small group of patients with very promising results. They realised that many patients with type-1 diabetes display a common feature: they generate antibodies to certain beta-cell proteins which circulate in the bloodstream. Among these antibodies are those that attack insulin itself. These often appear early in the course of the illness in young children.

So the researchers tested the idea that they could induce a tolerance to insulin by injecting a specially engineered DNA molecule into patients. This molecule carries the code to produce insulin’s precursor, proinsulin, directly inside the muscles of patients.

This would mean that rather than acting as an alternative supply of the hormone, the DNA would allow proinsulin to be produced and to influence the immune system. This could then raise the patient’s tolerance so that the immune cells that kill off the beta cells in the pancreas might be either reduced or eliminated.

These results represent an important step forward but, of course, the work has been undertaken in only a small number of individuals and, as this was a proof of principle study, it was carried out in adult volunteers rather than in children. The treatment period was relatively short and it is not known how long the effect might be sustained.

Nevertheless, the data suggest that the method worked with minimal side effects and was safe. As such, the authors argue that more extensive testing is warranted to establish whether this “reverse vaccine” approach might have more widespread use. If this proves to be the case, they may have hit upon an important means to improve the lives of patients newly diagnosed with type-1 diabetes.

Noel Morgan receives funding from European Union’s Seventh Framework Programme PEVNET (FP7/2007-2013) under grant agreement number 261441. Additional support is from JDRF’s nPOD-V programme, Diabetes UK and the Diabetes Research Wellness Foundation.

This article was originally published at The Conversation. Read the original article.

mySugr diabetes management app heads to the US, adds Tim Ferriss to …

mySugr Companion, the Austria-based startup that helps diabetes sufferers manage their condition, has launched its app in the US, as well as adding tech advisor Tim Ferriss to the company’s roster.

The app, which is available for iOS devices, helps people suffering from insulin-manageable diabetes to keep atop of their condition in a less tiresome way than traditional methods, and is one of the only ones in the US approved by the FDA (Food and Drug Administration) as a medical device –  a process that in itself took 18 months.

“Currently, 371 million people around the world live with diabetes. Frequent blood sugar monitoring and pattern analysis are key to optimal diabetes control, but the day-in-day-out monotony can lead even the most responsible patients to ‘diabetes burnout,’” mySugr co-founder and type 1 diabetic Fredrik Debong, said.

“mySugr Companion transforms a manual chore into a fun, interactive game […] we’re excited to be able to share our award-winning app with over 12 million Americans who manage their diabetes with insulin,” Debong added.

Managing the condition – a necessity the team knows all too well, as many members suffer from type 1 diabetes – requires checking blood glucose levels and matching food intake to insulin doses several times every day, the very process that mySugr is trying to make more engaging.

mySugr mySugr diabetes management app heads to the US, adds Tim Ferriss to advisory board

In addition to expanding beyond its Austrian roots, mySugr also brought Tim Ferriss into the fold.

Ferriss, who is known for his expertise in advising tech outfits such as Twitter, EverNote, Shopify, Digg and a number of other recognizable names has joined the mySugr’s board of advisors. Did we mention he’s also a best-selling author of books like ‘The 4-Hour Workout’ and ‘The 4-Hour Chef’? So perhaps his interest in getting involved with a health-oriented startup isn’t too mystifying.

➤ mySugr |  iOS

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Wellbeing boards are 'missing a chance' to tackle diabetes

Diabetes UK said some health and wellbeing boards, which were set up under the recent NHS reforms, were risking overlooking the need to improve diabetes care.

The boards are responsible for improving the health and wellbeing for people in their regions as well as reducing health inequalities.

The charity said that the quality of policies in relation to diabetes “varied considerably” among 20 of the boards with some giving “no prominence to diabetes at all”.

The need to improve management of the condition was “often absent” from the policies, the charity said, and more than half of boards were “failing” to translate national guidance into local action.

The charity’s research suggested that many strategies did not clearly distinguish between type 1 and type 2 diabetes. Diabetes UK estimates that 3.8 million people have diabetes including 850,000 people who have type 2 diabetes but do not know it.