Show Me The Money: Diabetes Research Funds Continue To Fall Well Short Of A Cure

Ever since I started my blog, I wanted to “republish” this small section of James Hirsch’s fair and honest book, “Cheating Destiny: Living with Diabetes.”

Hirsch writes about the many researchers, scientists, doctors and advocates who are still working on “conquering” but maybe not “curing” diabetes. Of course, money is one issue. Ronald Kahn of the Joslin Diabetes Center in Boston has tried to calculate the government’s neglect of diabetes research funding. More than 20 million Americans have diabetes, Type 1 and 2, which translates to about 7 to 8 percent of the total U.S. population.

Dr. Denise Faustman

Dr. Denise Faustman, a veteran diabetes researcher, made Wall Street Journal Headlines in 2006 in a story titled: “Confirming Hope on Diabetes: A Controversial Therapy for Diabetes Is Verified.” Her story is included in Hirsch’s book.

Consider these stats about our country’s lack of public support for a growing diabetic epidemic.

  • Public spending on diabetes is about $50 per diabetic, based on 2007 financial data.
  • The average cost of care per diabetic — what you spend on medicine, equipment, etc — is between $10,000 and $20,000.
  • 32 percent of the nation’s Medicare budget is spent on people with diabetes.
  • Since 1980, the NIH budget for diabetes has increased by 240 percent to $1.1 billion.
  • NIH total expenditures have grown by 261 percent, thus the percentage allocated for diabetes has declined as the number of diabetics has doubled.
  • In 2004, the NIH spent about $68 for each diabetic compared to $16,936 for each patient with West Nile virus.

“Our investment in the future, the future of all these people, amounts to less than half of one percent of what we’re spending on the disease,” Kahn told Hirsch, adding that even the tire industry spends at least 3 percent of its sales on research. “It’s simply not enough. I can’t say that if we invested ten times as much we’d move ten times faster, but we would move faster.”

So why would the West Nile Virus receive more funds than Diabetes, you may ask? Hirsch contends that the perception of insulin as a kind of cure — or at least a potent remedy — has made other diseases seem to be a larger threat. Infectious diseases, in general, receive priority for government funding. That makes sense to me because government’s job is to protect us against epidemics, but it does not address the obvious lack of public funding for Type 1 diabetes, an auto immune disease that also strikes suddenly,  without warning and is largely unpreventable. I could not “guard” against the Type 1 diabetes bug bite, although researchers believe that genetic and environmental factors do contribute to a person’s chances.

In today’s recessionary economic climate, I understand that taxpayers can not support every worthwhile disorder or disease. A few years ago, well about 40 years to be exact, President Richard Nixon declared a “war” on cancer and urged Americans to spend money to defeat it. Although some cancers are beatable today, I don’t think anyone would say we’ve won that war? And 40 years ago a group of angry and fired up parents formed JDRF, to raise money for better research and finding a cure for their children suffering with Type 1 diabetes.

Today, hoping for a cure is still a good thing. May is my anniversary month — I’m living 14 years with this uninvited house guest. I still believe things will get better in the near future for me and the 3 million Americans living with Type 1. However, hoping for a cure may also be unhealthy for the person living with diabetes.

As Hirsch, also a Type 1 diabetic and father of a child with the disease, correctly concludes: “If I believed (a cure) was ‘around the corner’ or five years away or even possible, it would have been easy to lapse into bad habits. Why go through the daily demands, frustrations and indignities of tight glucose management when a medical miracle would soon deliver me from my burdens? Diabetes is too taxing, too unforgiving, to hold out hope. It’s the ultimate paradox of the disease: if you have it, you have to live your life as if you’ll never be cured.”

Hematocrit-ically Incorrect: My Quest Continues For The Diabetes Holy Grail — The Closed Loop AP

My quest for the Holy Grail — wearing the closed-loop, artificial pancreas technology  at UVA — hit a small speed bump on the road this week. My search results: U.S. Food and Drug Administration’s health guidelines 1, Mike Anderson clinical trial participant 0.

Artificial Pancreas Inside SmartPhone Prototype

When it is ready, the AP Algorithm will run on any SmartPhone and fit in your pocket.

Last Monday, I made a new pilgrimage on I-64 West to Charlottesville to take my health screen, step 1 of my hoped-for-admittance into a Mother’s Day weekend outpatient trial at the UVA Center for Diabetes Technology. If I passed the screen I would be rewarded with 2 overnight stays in an economy hotel adjacent to the university and the opportunity to actually “Wear” a working prototype of the closed loop artificial pancreas technology!

At the heart of the system is a novel hand-held device developed by a UVA research team, led by Patrick Keith-Hynes, PhD, and Boris Kovatchev, PhD. The device uses a “smart” algorithm that automatically delivers insulin and regulates a person’s blood sugar levels — taking much of the burden of constant monitoring off the patient. Inside the normal looking droid phone would be the “brain,” that would be smart enough to take over my glucose management for 24 hours and achieve nearly perfect control without my assistance. In this hospital test, a “straight line” means life NOT death for Type 1 diabetics. To say I was excited to see the APP in action, would be the understatement of the year.

To make a long story fit into a blogger’s attention span, however, I did not pass the FDA-required screen because my Hematocrit came back with a score of 39.5.  The FDA minimum threshold for acceptance — 40.0.

Yes, I missed it by “that” much. So, I wondered, am I sick if I couldn’t score a 40? And why is my Hematocrit costing me a date with the APP? Hematocrit is a blood test that measures the percentage of the volume of whole blood that is made up of red blood cells. This measurement depends on the number of red blood cells and the size of red blood cells.  Normal results vary, but in general are as follows:

  • Male: 40.7 – 50.3%
  • Female: 36.1 – 44.3%

Normal value ranges vary slightly among different laboratories, and you should always consult with your doctor on lab results before making changes to diet.

When Daniel Cherñavvsky, MD,  called me with my UVA lab results I could not believe it. However, this was not a score that could be “managed” or “finessed” or worked around, Dr. Danny said. The FDA requirements are in place for the health and safety of clinical trial participants like me. The “irony is,” I’ve passed this same Hematocrit screen twice before and participated safely in two clinical trials where blood was drawn continuously for 12 hours! The new outpatient AP trial is only taking blood via finger sticks, so, I’m confident I’m “Iron Man” enough for this new study.

The good news about the bad new is that the May trial is the “proof of concept,” the first of what should be many more outpatient clinical trials in the coming months at UVA and four other universities in the USA and Europe.

So, I’ve got some work to do in the coming months if I wish to qualify.

  • Eat more red meat. Eat more leafy green vegetables.
  • Check with my Endo and start taking a low-dose, slow release iron supplement once a day.
  • Exercise as much as possible, drinks lots of water and get more rest.

I wonder if that’s how all great explorers prepared for their quest? So check back here very soon for a real-time,  live blog report of the closed-loop AP in action. The future is coming thanks to the awesome team at UVa. Together, We R the Cure.

HealthLine.Com Ranks Top 17 Best Blogs: Passionate Type 1′s Educate And Chronicle Their Struggles, Successes

Diabetes is a condition that affects millions of people around the world. Several eloquent and compassionate people who face diabetes have chosen to write about their experiences in blog form, chronicling both their struggles and their successes. In addition to being compelling reading, these bloggers’ stories bring together the online community of those whose lives are affected by diabetes.

After poring over many, many diabetes blogs, looking for the best of the bunch, we have collected seventeen of the best diabetes blogs for you to read. We trust that you will find these bloggers’ writings and experiences to be sources of both helpful information and hope. The Diabetes Online Community #DOC is a great source of support for me. Together, We R the Cure!

Published March 29, 2012
Written by Leah Snyder

Is Type 1 Cure Research Funding Focused Enough? A New Report Worth Reading

Until yesterday, I had never heard of the JDCA, the Juvenile Diabetes Cure Alliance, in my 14 years of living with Type 1D and volunteering in my local diabetes community.

Diabetes Advocates Push Congress For Federal Research Funds

Chris Schutt, his son, Ned, American Idol Singer Elliott Yamin and I advocate for sustained federal research funds with U.S. Rep. Eric Cantor, R-VA, in 2009.

Now I have. This month, the JDCA has introduced its latest report , “Is Type 1 Cure Research Funding Focused Enough?”

The report takes a look at a very important issue relating to cure research. Are the organizations being too broad when it comes to outlining plans for a type 1 diabetes cure and when funding projects? Based on JDCA’s research and the fact that there is no cure on the horizon, the non-profit’s analysis suggests that this is the case. The JDCA report says, “Without clearly defined goals, the non-profits are funding a wide array of research projects. As a result, a lot of money goes into efforts that are not working to deliver a Practical Cure for type 1 diabetes.  This diverts resources from those projects that are working towards a specified cure goal that could help people now living with the disease.”

If you’re living with this chronic disease, you wanted a cure YESTERDAY. It’s been over 40 years since a group of parents founded the JDRF at their kitchen table and yet We R still seeking a Cure.

In order to improve the quality of life for Type 1Ds, it’s important to listen and gather as much relevant information as possible. We must keep asking the researchers, organizations and manufacturers “When?” When we will see real progress. We must push them to be smarter and more targeted with a limited amount of dollars because We R the Cure. We R doing this for ourselves and the generations to come.

The JDCA is a self-funded non-profit that aims to educate donors and prompt transparency in the charitable organizations that raise money to support research.  JDCA says it is an independent analyst of the type 1 diabetes charitable universe and brings a business-like perspective to focus research toward a Practical Cure.  Their mission is to direct donor contributions to the charitable organizations that are most effective at allocating funds to research opportunities that maximize chances of curing type 1 diabetes by 2025.

The Hope And The Promise Of Stem Cells And Other Cell Therapies

Type 1 diabetes destroys the cells in the pancreas which produce insulin. Scientists across the world believe regeneration — finding ways to restore or spike insulin production in Type 1D patients — is possible.

Juan Dominguez-Bendala, Ph.D, Diabetes Research Institute

Juan Dominguez-Bendala, Ph.D., of DRI, believes umbilical cord cells may hold more potential for success in diabetes research than originally thought.

Recently, at the JDRF-sponsored Research Summit in Maryland, Juan Domínguez-Bendala, Ph.D., Director of Stem Cell Development for Translational Research at the Diabetes Research Institute, gave the keynote address on the “Promise of Stem Cells and Cell Therapies.” I was impressed that Dr. Dominguez-Bendala balanced the hype and controversy that normally surrounds Embryonic Stem Cell debate with the need to find multiple cell pathways that may lead to regeneration breakthroughs. I agree with this approach. Why put all of our “eggs”  in one basket, pardon my pun. Let’s aggressively pursue all possibilities!

What follows is an edited transcript of DRI’s podcast with Dr. Dominguez-Bendala. The entire podcast is available on DRI’s site.

Dominguez-Bendala:
“Stem cells have two unique properties. One of them is that they keep dividing all the time so you can get them to expand in very significant numbers. So in a very short period of time you can get as many as you need to treat all the patients that you may want to treat. The other property that they have is that they are like a blank slate. They are naïve. They are simply waiting for instructions to become something. They are waiting to be programmed to become one tissue or another.”

Dominguez-Bendala says that until recently, most research has focused on embryonic stem cells. But now the DRI is studying other types – such as umbilical cord and amniotic stem cells. He says umbilical cord cells could hold more potential than originally thought – and that a specific sub-population of cord cells could, in fact, turn into insulin producing cells.

Dominguez-Bendala:
“If that was the case, then we have another source which is less controversial from many points of views um, than embryonic stem cells and is easily accessible. We can get them all the time from any delivery room in any hospital of the country.”

Reporter:
He says the challenge with cord cells is that they do not grow as quickly or as easily as embryonic stem cells. As for amniotic stem cells, the DRI is collaborating with Dr. Anthony Atala of Wake Forest University, who found these cells have the ability to become many different cell types.

Dominguez-Bendala:
“To date, we still don’t have evidence that they can become pancreatic, but what we know is that we can expand them exactly as we do expand embryonic stem cells so they are very easy to work with and they may have the potential to become pancreatic. So we are very excited about that possibility of using them, but this is brand new.”

Reporter:
As Dominguez-Bendala and his team pursue these exciting possibilities, he says he’s grateful he’s able to do it at the DRI.

Dominguez-Bendala:
“The uniqueness of the Institute is that we have a multidisciplinary team, we are not going to get a cure for type 1 diabetes only from one angle. We need to take care of the autoimmune response, we need to take care of the supply, we need to take care of all the intermediate steps from bench to bedside.”

Profiles In Courage: Country Singer, Elite Ironman Triathlete Call Diabetes Their Inspiration For Success

It’s what you might call “ironic” or perhaps it’s a family bond among all Type 1 Ds.

Country singer George Canyon and Ironman Triathlete Jay Hewitt came to Richmond recently to share their inspirational stories with the diabetes community. I don’t know if the Canadian singer and the United States athlete know each other or if they’ve ever met. But as the two men told their stories of living and winning with diabetes last March, they reached a surprisingly similar conclusion.

Country Singer George Canyon and We R the Cure Editor Mike Anderson

Country Singer George Canyon, left, and Mike Anderson at March 24 event in Richmond. Canyon said Type 1 diabetes is not an excuse for failing to achieve your dreams in life. George has a new single coming out soon, "Live Life First," with American Idol's Crystal Bowersox. Song is produced by AI's Randy Jackson.

“Do I wish that I didn’t have Type 1 diabetes? Absolutely,” George told a group of children, teen-agers, parents and young adults at the Animas Caregivers seminar in Glen Allen. “But I also think it is why I’ve been successful. I call it a goal-oriented disease. You set goals and you hit them; and you live your dreams.

“The kids I meet with diabetes are the most-driven kids I’ve ever met. We grow up and take responsibility at an early age. Your diabetes won’t stand in your way as long as you believe,” George said.

Just listen to Jay Hewitt, member of the U.S. National team, on his journey from a first-time marathon runner to a world class athlete, who also happens to have Type 1 diabetes.

“High achievers understand that this is a part of life. Your worst moments can be your best opportunities for success,”  Jay said to guests attending the Insulet/ Omnipod reception on March 15 in Richmond. “Diabetes is the best thing that ever happened to me. Am I saying that I’d rather have it than NOT have it? No. Of course not. But the cure is coming. And until it happens, it’s up to me to stay healthy.

“We drag our diabetes with us each step of every day. It’s a ball and chain. So ‘my diabetes’ better be able to swim because I’m going to drown it. It better be able to ride a bike because I’m going to pound it on the street. I will use every cell, every calorie, every ounce of energy that I have to win my race. And no matter how tired I am when I cross the finish line, I always have enough left to turn around and STEP DOWN HARD ON THE NECK of Diabetes. You must make diabetes the best thing that has ever happened to you. Use it as motivation.”

George and Jay gave positive testimony during their Richmond visits. They are “Profiles In Courage” and I thank them for showing us how to live, thrive and make no excuses. We R not Victims. We R the Cure. I recommend you check out George Canyon’s Facebook Page and Jay’s Finish Line Vision website. Also take a listen to George’s music on his You Tube page.

U.S. National Triathlete Jay Hewitt Keeps A Finish Line Vision

Elite Ironman Jay Hewitt has a Finish Line Vision for his life and his Type 1 diabetes.

I am the newest member of their fan clubs! Stay tuned for more from George and Jay’s visits in upcoming We R the Cure blog posts.

The Frederick Banting Foundation: Raising New Capital To Support Unrecognized Technologies

The Frederick Banting Foundation welcomes support from other like minded donors.  We operate in the spirit of Dr. Frederick Banting who discovered insulin in four years with little funding.

Dr. Frederick Banting, Right, and his team of scientists discovered insulin 90 years ago.

Dr. Frederick Banting and his team discovered insulin 90 years ago.

The Frederick Banting Foundation seeks to make transformative investments where our capital can generate significant scientific project towards improving the lives of those suffering with Type 1 Diabetes and eventually towards a cure.  All research projects are personally selected by those suffering with or caring for those with Type 1 Diabetes.  The Foundation frequently partners with leading sponsors of research such as the National Institute of Health, JDRF and the University of Virginia.

We seek to be good stewards of our causes.  The Board contributes generously to the Frederick Banting Foundation.  We also keep Foundation operating costs to an absolute minimum and as a result there is virtually no overhead. This group was established in 2011 by Richmonders Fred and Susan Russell, whose son, William, is living with Type 1 Diabetes.

To discuss a donation call Fred Russell at 804-648-4802 or email him at Fred@BantingFoundation.com.

The Frederick Banting Foundation’s “investment” strategy is:

  • to provide funds over several years as a source of more permanent capital,
  • to support projects that might not otherwise get funded especially for projects offering  a compelling risk/reward balance,
  • to avoid supporting institutional overhead,
  • to have ongoing access to project leaders,
  • to receive reports outlining performance to expectations,
  • to involve other like-minded donors, and
  • to obtain confirmatory due diligence in advance of funding.

Utilizing our venture capital experience, the Foundation hopes to select promising research projects where the Frederick Banting Foundation’s funds can accelerate unrecognized or under-appreciated technologies where we believe our funding can be a catalyst to stimulate rapid development or adoption.

Article Reprint Courtesy of The Frederick Banting Foundation

FDA Grants Approval For First Outpatient Artificial Pancreas Trials In The USA; A Long Overdue Step Forward!

Editor’s Note: Dr. Boris Kovatchev of the University of Virginia gave this NEWS FLASH to a sell-out crowd attending the annual JDRF Gala held March 17th at The Jefferson Hotel in Richmond. Later, Dr. Kovatchev told me that his Center for Diabetes Technology team expects to start screening potential trial participants in late April. The “outpatient” trials will be conducted in a Charlottesville area hotel located in close proximity to the UVA Medical Center. This is NOT — THE CURE. But the APP is advanced technology that will — hopefully within 3 years — be available to help Type 1D Americans achieve better glucose control, better A1cs and better health — while we ALL keep working on regeneration, autoimmune research and PREVENTION of this chronic disease! — Mike Anderson

UVA Researchers Start Outpatient AP Closed Loop Human Trials

The Center for Diabetes Technology Team at UVA is part of a worldwide Artificial Pancreas Consortium working to bring a safe and high-tech Closed Loop System to Americans with Type 1 diabetes in the next few years!

NEW YORK, March 19, 2012 — JDRF applauds the recent approval by the U.S. Food and Drug Administration (FDA) of the first outpatient artificial pancreas trial in the United States, marking a critical development in the effort by JDRF and its allies to bring this innovative and lifesaving diabetes technology to people with type 1 diabetes (T1D).

The JDRF-funded study will test an artificial pancreas (AP) system’s ability to function outside of a hospital setting, and is similar to the current outpatient trials being conducted in Europe.

The study is part of the first outpatient trials using an approach developed by the JDRF-supported Artificial Pancreas Consortium, an international research group including teams from Montpellier University Hospital (France), the Universities of Padova and Pavia (Italy), and the Universities of Virginia in Charlottesville and of California in Santa Barbara (USA).

“We commend the FDA for its leadership and this concrete step in meeting its commitment to accelerate the development of artificial pancreas systems. These technologies could truly transform the lives of those living with type 1 diabetes, enabling them to live longer and healthier lives, and preventing some of the personal and financial toll diabetes places on our nation,” said Aaron Kowalski, Ph.D., assistant vice president of treatment therapies for JDRF. “While this is a small feasibility study, this is a major step forward in the field of artificial pancreas research and we congratulate the researchers and the FDA on this important milestone.”

The approval of this milestone study follows a major 18-month long effort by JDRF and allies to ensure a clear and reasonable regulatory pathway for outpatient artificial pancreas studies, and ultimately for AP systems to be approved and made available by the FDA. JDRF-funded studies have shown improved clinical outcomes from early trials of prototype AP systems.  In early 2011, JDRF proposed guidance to the FDA, based on recommendations from an external expert panel.  In the following months, over 100,000 people in the diabetes community signed JDRF’s petition, and numerous leading clinical organizations, as well as over 60 Senators and 250 Representatives joined JDRF in urging FDA to act. The FDA met its promised deadline and released draft guidance for AP systems on December 1, 2011.

JDRF recently completed an evaluation of the draft FDA AP guidance, and submitted comments to FDA on March 3rd.  JDRF believes that the draft contains many positive elements that will encourage research and development of artificial pancreas technologies and lead to their eventual availability in the U.S.

“While there were some areas of concern in the guidance, we have begun a dialogue with FDA about these issues, and we will continue to urge the agency to revise these in the guidance before it is finalized so that we will continue to see more outpatient trials approved, and people with diabetes will ultimately have access to these lifesaving technologies as soon as possible,” added Kowalski. JDRF’s comments can be read here.

Contact: 
Joana Casas, 212.479.7560, mcasas@jdrf.org

Free Educational Event For Families, Caregivers Of Children With Diabetes March 24 In RIC — RSVP Now!

Unfortunately, there are no “days off” if you’re living with Type 1 diabetes.

Country Music Star George Canyon Will Entertain At Free Educational Event March 24 In Richmond, Va. Thanks to Animas and VCU Children's Hospital For Sponsoring This Community Event!

George Canyon, Country Music Singer, Pilot and Family Man Living With Type 1 Diabetes Will Perform March 24. Thanks to Animas Insulin Pumps and VCU's Children's Hospital for Hosting This Community Event!

The Sugar Highs N Lows — the daily grind of finger sticks, carb counting, insulin dosing, low blood sugar emergencies and “supply chain management” –  are a full-time job for me and the 3 million Americans living and coping with Type 1D. I received my diagnosis as a young adult and I’ve been blessed to have a loving spouse, supportive children and a few good friends to lean on in the good and bad times.

Now imagine you’re a child and you develop this chronic disease? It’s a staggering punch. When a young child or teen-ager  in the family gets diagnosed, EVERYONE in the family gets buckled in for the rollercoaster ride. But there is hope and strength in numbers and that’s why your family needs to attend the March 24 event hosted by Animas. This free workshop will offer educational sessions, tips, and strategies for children and families living with diabetes.

Helping each other is critical to managing this chronic disease and overcoming the setbacks. Together, We R the Cure until there is a cure.

Registration starts at noon. Special guest, country music star, George Canyon will be performing and speaking later in the afternoon. Space is limited for this event. You must RSVP.

Location: Mount Vernon Baptist Church
11220 Nuckols Road
Glen Allen, VA 23059
(Parking is Included)

Date/Time: Saturday March 24, 2012
12:00pm – 6:00pm
Registration Begins:  12:00pm
Opening Ceremony Begins at: 12:30pm
Speaker Programs Begin at 1:00pm

RSVP: To Register either Email Joe Manriquez at Jmanriq@its.jnj.com or Call Joe at 1-804-248-9093

Giving Our Kids Roots And The Wings To Fly: I Am No Longer My Son’s Pancreas — Drew Is In Charge

By Lauri Savage
Second in a 2-part Post

Lauri tells a Mom's Story of Sending Her Son to College

Lauri Savage, right, concludes her 2-part series on a parent's fear, hope and joy of giving her son, Drew, the ability to manage his Type 1 diabetes while living on his own.

As I write this post, my son, Drew,  has returned to James Madison University in Harrisonburg, Virginia after his final college spring break.  In about 2 months, he will be a college graduate.

I still remember when we brought him to JMU in the late summer of 2008. I am going to fast forward through my son’s upset stomach on the way to college, our leaving him in his dorm room when he was not feeling very well, and the pain of saying good-bye.

The first week of settling in was challenging for him, as it is for all college freshmen and their parents. However, it became much worse on a Sunday evening.  My son accidentally mixed up his insulin doses, injecting himself with 22 units of humalog, a short-acting insulin, instead of Lantus, a 24-hour slower release insulin.

If you are following this blog, then you know that injecting that much rapid acting insulin is dangerous and scary, as it will lower blood glucose levels too fast.  Luckily, my son realized his mistake and phoned us.  He consumed sugar, ice cream and sweets to balance out the rapid effects of the insulin.  But the insulin was too fast for him.

Ultimately, another resident advisor in his dormitory was called and came to help.  We were on the phone with her, and with Drew’s roommate.  Having the roommate’s cell phone number was a lifesaver, as he stayed in touch with us.  It was necessary to call 911, and our son spent several hours in the hospital emergency room getting his blood sugar stabilized. Although JMU is only two hours away from our home in Richmond, it seems much further when your only child has type 1 diabetes.

While this was not the ideal way to start college life, I always try to find the silver lining.  My son showed maturity and responsibility by knowing when to reach out, calling us to keep us up to date, and ultimately taking care of himself.  He learned early on that he could handle an emergency living on his own.

I think that is a big part of our job as parents of children with diabetes — We must help them transition to adults in charge of their disease.  And we should always be there to support them in the background, because living with diabetes is an ongoing challenge.  Until we find a cure.

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