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 COLLEEN KETTLE'S DAUGHTER received the THE MYSTERY DEEPENS news when she was 13. Afraid to be stigma- Now 72, Dr. Gordon Weir has been researching diabetes since he was in medical school. Will he see tized, she hid her disease from her friends. At a cure for Type 1 in his lifetime? school, she wouldn't see the nurse for blood checks or give herself insulin injections for lack of privacy. "I think she was just hoping it would go away," Colleen says. "If you're 13 years old, it's really hard to do everything that's expected of you," says Dr. Gordon Weir, a leading researcher at the Joslin Diabetes Center in Boston, which has become almost a second home for the families in this story. "And we pretty much say, 'Let's get them through this time.'" Colleen's daughter, a senior in college, declined to be interviewed, as she had four years ago when she was asked to be a part of the "Type 1 Diabetes in Our Towns" article. "We get in trouble if we make promises," says Weir, a top researcher at the Joslin Diabetes Center in Boston and a Harvard Medical School professor. "There's no reason something couldn't happen in five years if we got lucky, but my gosh, you get in such trouble when you offer predictions." Weir says he has been encouraged by major strides in diabetes management, which are allowing people to lead long and healthy lives despite the disease. "What's been done for preserving eyesight is just mindboggling," he says as an example. "It used to be that just a certain percent would go blind. Our waiting rooms would have white sticks and seeing-eye dogs." Weir's particular "passion" is research into restoring the pancreas's capacity to make beta cells – the body's key player in turning glucose into energy. His wife and fellow Joslin researcher, Dr. Susan Bonner-Weir, is experimenting with creating beta cells from other cells in the pancreas. Other scientists are pursuing such avenues as transforming embryonic stem cells into beta cells and transplanting part of a pig pancreas to humans. But for those with Type 1 diabetes, creating beta cells solves just half the problem. The challenge remains to discover exactly why the immune system destroys them and how to stop it from doing so. As a science project at Newton Country Day School, Kelley Conley studied one futuristic technique: using nanotechnology to shut down wayward antibodies. "They said it probably won't happen within the next 50 years, but I'm hoping," Kelley says. Other researchers are focusing on creating an artificial pancreas. The device would constantly monitor the body's blood glucose level, supplying insulin when the level is high and glucagon (a hormone that has the opposite effect of insulin) when it's low. Kelley's father, Kevin, a past president of the Joslin board, noted that such a device would have to take into account not only the many internal factors that affect blood sugar, but also have to withstand day-to-day jostling and other external stresses, such as when his daughter Ashley steps out of Her mother said that during much of her the warmth of a ski lodge into the subzero weather on the slopes. As it is, Kevin said, static electricity daughter's teen years her AC1 test results from the lodge's carpet has shut down Ashley's insulin pump. were sky high. The test indicates the aver- every individual – and a host of external factors that range from viruses and bacteria to diet and age blood glucose level for the prior three pharmaceuticals to the materials that go into playgrounds and houses. Complicating disease research is the intricate interplay between genetic susceptibility – unique to If anything, the number of suspects in the Type 1 diabetes mystery has increased in recent years, months. Hers would sometimes register at according to Dr. Mark Atkinson of the University of Florida. At the same time, the number of new cases— nearly 14, twice the desired level. the incidence rate—has accelerated. The prevalence of Type 1 diabetes rose 23 percent from 2001 to 2009 among people under 20, When she went away to college, she man- according to the SEARCH for Diabetes in Youth Study. Worldwide studies have found the incidence aged the disease better, but because her increasing by 3 percent or more a year. numbers had been so high, progress was Ironically, one environment-related hypothesis puts the blame on hygiene rather than hazards. frustratingly slow. That changed when she According to this theory, early exposure to dirt and germs can help build a healthy immune system. And as the incidence has surged, the percentage of cases with a strong genetic link has declined. Not that you can generalize from one family, but Ann Marie Kreft expressed skepticism: "I don't 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 spent a semester in London, much of the think our kids were deprived of any germs," Ann Marie, whose son Gus has Type 1, says. "We time walking the city. All the exercise dra- weren't the Purell household for sure." matically improved her blood sugar level. Cambodia, Vietnam, Haiti, and Ghana who all have Type 1 diabetes." And assuming a correlation between affluence and sanitation, Atkinson notes, "I've got kids in Feeling healthier and more optimistic, she became much more systematic about taking care of herself. 104 So is there hope for an answer? Atkinson, who has been researching diabetes for more than three decades, says we can only keep digging, and he applauds the efforts of those like Ann Marie who are keeping the pressure on. "If it weren't for people like her, this would end up in a back-burner situation."

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