WellesleyWeston Magazine

SUMMER 2013

Launched in 2005, WellesleyWeston Magazine is a quarterly publication tailored to Wellesley and Weston residents and edited to enrich the experience of living in two of Massachusetts' most desirable communities.

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Type 1 Diabetes Update ing glucose – or blood sugar – levels leads to blindness, kidney failure, already memorized numbers for many common foods) and adjust amputation, and strokes. their pumps to provide an offsetting dose of insulin, called a bolus. Until a century ago, a diagnosis of Type 1 diabetes was a death Diet, though, is just one of many factors that affect blood sugar lev- sentence. But with the discovery of insulin in the 1920s, patients els. Others include exercise, stress, hormones, time of day, illness, even have been able to control the disease by injecting themselves with changes in the weather. Too much insulin can send blood sugar levels the hormone. plummeting and can cause sudden loss of consciousness. After just Both Ashley and Kelley wear insulin pumps, which they've pro- an hour of ice skating – even though he had eaten several glucose grammed to supply themselves with their baseline insulin needs. tablets – Gus found that his blood sugar level had fallen from 158 to When they eat, they total the number of carbohydrates (they've 53, half the normal level. STATE: NO "SMOKING GUN" A year after announcing that the prevalence of Type 1 diabetes is higher than national norms in parts of Wellesley and Weston, the top state investigator feels confident enough to say this much about the cause: There's no "smoking gun." "If there was some obvious environmental factor, we would have seen and said something by now," says Suzanne Condon, director of the Bureau of Environmental Health at the state Department of Public Health. Investigators are now immersed in the labor-intensive job of identifying potentially hazardous sites in the area and their proximity to homes of children with Type 1 diabetes. They've identified 17 possible culprits, primarily underground storage tanks from closed gasoline stations and other businesses. They are also looking at areas near railroad lines, where chemicals may have been used to curb vegetation. Condon says one hypothesis is that petroleum distillates have migrated through groundwater, releasing fumes through cracks in basements. Researchers are plowing through data from various state agencies, building from scratch a geographical database. Under scrutiny are three contiguous census tracts in north Wellesley and south Weston, home to a total of 16,466 people as of 2010. The DPH found that the prevalence of diabetes was more than 6 in 1,000 among those ages 19 and younger; that's three times the estimated prevalence nationwide. Whatever the culprit, it appears to be disproportionately triggering Type 1 diabetes in people who have a family history of the disease. More than 30 percent of the Type 1 individuals in the cluster have relatives with the disease; that compares with national estimates of from 5 to 10 percent. Concurrently, researchers are looking at the prevalence of Type 1 diabetes in other parts of Massachusetts that have similar demographic characteristics as the cluster area – one that stands out for its affluence. Median family income in the three census tracts ranks near the top in the state. "If this is environmental, it is likely to be something unusual and oddly unique in an area where We l l e s l e y We s t o n M a g a z i n e | s u m m e r 2 0 1 3 the risks may already be higher simply because of the kind of people who already live there," Condon says. Condon says that only within the last decade have researchers started focusing on possible links between autoimmune diseases like Type 1 diabetes and environmental hazards. Condon hopes to have a better idea later this summer about a timeframe for releasing findings. She is relying on a small staff already stretched by other public health studies and on summer interns who are majoring in the field. As far as she knows, this is the only cluster study of its type in the United States. 100 DPH Study Highlights Z 17 The number of potentially hazardous sites identified by the state near the homes of children with Type 1 diabetes Z 6 in 1,000 The prevalence of diabetes among those ages 19 and younger Z 3x The prevalence of diabetes compared to the estimated national average Z 30%+ Number of Type 1 individuals with relatives that have the disease compared to the national estimate of 5 to 10 percent

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