City of Hope’s World Diabetes Day Panel
City of Hope, a not-for-profit clinical research center, hospital and graduate medical school, has been helming one of the most respected diabetes research programs out there. Their work focuses on developments in cell transplantation, gene regulation, immune tolerance and a new understanding of diabetes as a complex, multifaceted disease.
On November 14th, World Diabetes Day, City of Hope hosted an hour-long Facebook Live broadcast titled “Celebrating World Diabetes Day: Journey Toward a Cure,” hosted by Beyond Type 1 co-founder, Sam Talbot. The event centered around emerging therapies, treatments and the future of diabetes medicine.
Let’s get together
Sam was joined by a panel of diabetes researchers, advocates and journalists, including City of Hope researchers Bart Roep, Ph.D. and Debbie Thurmond, Ph.D. and journalist Amy Tenderich.
Sam, who was diagnosed with type 1 diabetes at age 12, kicked it off by introducing himself and Beyond Type 1’s motivation as an organization.
“We try to push the levels of advocacy and education,” Sam said.
After expressing high praise for the technological advancements in the type 1 diabetes (T1D) realm since he was diagnosed, Sam announced the presence of “T1D Mod Squad” founders Rebekah Hata and Ana Reinhardt, both moms of T1Ds. First up to the panel was Ava Hata, a junior advocate who discussed her diagnosis.
Having lived with type 1 diabetes for over 13 years, she spoke at length about the differences in experience for every person diagnosed. “There’s no instruction manual for diabetes,” she said, before going on to discuss the benefits of her diabetic alert dogs (DADs).
“When I don’t want to drink another juice from my mom, I will do it for my dog, because when a dog comes up to you and gives you juice, how can you say ‘no?’”
The room then heard from Dr. Bart Roep, Ph.D., Debbie Thurmond, Ph.D. and founder/editor of Diabetes Mine, Amy Tenderich, who also lives with type 1.
The panel included a general overview of type 1 as well as type 2 diabetes—both the causes and differences, as well as some popular discussions within in the diabetes community now.
“Most of what I learned in medical school turned out to be wrong,” Dr. Roep said, “So there have been some major changes.”
Dr. Roep emphasized the promising discovery that most diabetes patients still possess beta cells in their body. “They’re hiding, but they’re there,” he said. “If we can get them back in action, it will be restoring the source of insulin.”
Amy Tenderich highlighted the insulin pricing crisis. “The prices have tripled since 2013, and people are literally dying out there because they are trying to ration their insulin. They can’t afford it,” she said. “So, honestly, that trumps everything else right now.”
Also joining the panel was Rae Sanchini Tobey, JDRF Los Angeles board member and parent of a T1D child, who brought up the importance of the advancements in interoperability between devices. Her son wears a continuous glucose monitor that is able to communicate with his insulin pump: “We want type 1 patients to have choices when they have to decide what devices to wear on their bodies 24/7.”
Rae expressed her excitement regarding the “game-changing” nasal spray form of glucagon.
Dr. Thurmond spoke about the heterogeneousness of type 2 diabetes, as well as prediabetes now being recognized as “a thing.”
“What does a cure for type 2 diabetes look like? Reverse prediabetes,” she added.
Diabetes treatment + advancements
“We are actually at the start of a completely new chapter in treating diabetes,” Dr. Roep said. He feels “excited to go to work every morning” by the fact that doctors are now able to treat the cause of the disease rather than the symptoms, as well as the notion that every patient is profoundly different—and to be able to treat each one of those patients uniquely.
“What I am really excited by is the precision medicine option,” Dr. Thurmond said regarding type 2 diabetes. “It is personalized medicine, because we have, for example, figured out how to make islet (cells) happy again.”
As far as innovation in type 1 diabetes technology, Amy touched on the advancements in closed-loop systems. “These looped systems are making a huge difference for people getting more sleep,” she said, “Overnight, when you are not active and you are not eating, that is a great time for the technology to take over and really keep your blood sugar in check.” Amy also talked about the innovation in diabetes coaching apps—giving people living with type 1 or type 2 the ability to get real time support from a real person, like a certified diabetes educator (CDE), rather than only relying on devices.
Amy noted that insulin pens are also advancing quickly as more Smart Pens are hitting the market, giving people with type 1 and type 2 diabetes (T1Ds and T2Ds) who are currently on multiple daily injections (MDI) more ability to record their dosages and other data, as many pens are linked to their own apps.
What does the future of diabetes look like?
“The things that excite me the most,” Rae said, “Are things like smart insulin.”
The concept behind smart insulin is a once-daily injection that would respond to blood glucose levels and activate when blood glucose levels become too high or respond accordingly when too low.
Amy took care to give credit where credit is due when it comes to continuous glucose monitors (CGMs), which she acknowledged were still relatively new. In an ideal world, she hopes that CGMs become a “standard of care” for newly-diagnosed patients: “They’re getting smaller, which I think will make them more mainstream.”
“I want people to drop their backpacks and really start making their own insulin again,” Dr. Roep said. “We are so close to understanding it,” he said of the concept of T1Ds being able to produce insulin on their own again, “and we can translate that to specific therapies. I think there is good reason for hope now—we’ve got it.”
“30 percent to 40 percent of American adults could be considered to be prediabetic and the majority of them do not know it,” Dr. Thurmond said. “Prediabetes is their last opportunity. If you can resolve that, cure your prediabetes, you aren’t going to get type 2 diabetes. That’s a cure.”
The panel closed out the event by answering a range of insightful questions from the audience such as the true definition of a “cure,” for diabetes, and for the researchers.
To learn more about City of Hope’s quest for a cure, visit cityofhope.org.