News of the Center

Message from the Director

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December 2022

 

Dear Friends,

 

It is often hard to appreciate the progress that has been made in the understanding and treatment of diabetes. People with diabetes need to deal with the daily highs and lows of life and

glucose levels and it is often hard to appreciate the progress that has been made in the understanding and treatment of diabetes. The progress has been real for everyone with diabetes, and for those of you that have either supported our research or participated in clinical trials we are seeing the results of your commitment.  Additionally, we are celebrating a monthly cap of $35 a month for people on Medicare using insulin and there is a fight to retain access to CGMs for people on Medi-Cal. feature. 

 

This summer, Aaron Kowalski, the CEO of JDRF and one of the architects of the development of automate insulin delivery (AID) systems took time to celebrate the work involved in closing the loop. Many of you who took part in our early continuous glucose monitor (CGM) trials contributed to the foundation of the multiple systems that are currently on the market.

 

Dr. Kowalski is also a person with type 1 diabetes and he “often jokes that you'll never find somebody who doesn't have diabetes who wears an insulin pump.” He stresses the need to continue to look for a way to prevent, delay and eventually find a cure for diabetes.

 

The first step to delaying the progression of type 1 diabetes (T1D) has just been FDA approved. Tzield (teplizumab), is the first disease-modifying therapy for individuals at-risk for developing T1D in the stage 2 range which is before TID is diagnosed. The treatment delayed the development of T1D for approximately two years. We have more details in our newsletter feature on this exciting development and I recorded a video for Medscape.

 

This development was also possible in part due to the participation of young family members of our T1D patients in the TrialNet program. Their involvement in screening research at diabetes picnics and fund-raising walks led to the understanding of the progression of T1D and identified a treatment target that led to this breakthrough. This is only a start, but first steps are important.

 

Some of the newer GLP-1 and newer GLP-1+GIP based medications for type 2 diabetes (T2D) are also very effective at promoting weight-loss in addition to helping with glucose control. There is now discussion about targeting weight-loss as an initial treatment strategy and driving down glucose numbers to the pre-diabetes range. These new diabetes drugs have become trendy and the word has spread to social media influencers on TikTok and other platforms leading to an annoying shortage of Ozempic and Wegovy from people using it off-label. Who knew that treating diabetes could be all the rage?

 

I was one of the program organizers for this year’s European Diabetes (EASD) meetings and chaired sessions in Stockton discussing health equity as well as type 1 diabetes care.  It was nice to once again meet in-person with colleagues from around the world.

 

Additionally, at the EASD meeting was an update on the UK Prospective Diabetes Study (UKPDS). This is the longest-running follow-up of a randomized controlled trial in type 2 diabetes which confirmed the importance of treating hyperglycemia early. After 44 years the group that was intensively treated to a target A1C of 7% versus 7.9% in the control group revealed that early aggressive treatment extended life from 1 to 2.7 years with fewer cardiovascular, eye and kidney complications. This leads to a clear message - early treatment of T2D leads to a longer and healthier life. The additional data from this ground-breaking and long-running trial informs us of treatment decisions we use today.

 

Although life is largely back to normal post-COVID, we all know that its effects are still with us and people still are dying daily from the disease, although in far fewer numbers. This fall I have been treating people with COVID, RSV and influenza, all of which make diabetes management more difficult. The message is simple: get vaccinated and boosted for every illness where a vaccine is available, control blood sugars, blood pressure and cholesterol levels, and make individual decisions based on your health and risk. I urge people to get out and live, but also want to keep people safe and healthy.

 

We see the progress made in the treatment and now prevention of diabetes that come from supporting and participating in research. The support of our research programs allows us to prove the value of access of critical diabetes technology, and your support now can help improve diabetes care and prevention and set the stage for future breakthroughs. Please consider supporting the clinic in your end-of-year contributions. Here’s how to donate.

 

Wishing you a happy, healthy holiday season and a 2023 filled with joy.