2010 fall/winter
TRANSCRIPT
STUNNING PERFORMERS dazzlE THE 19TH CaROUSEl OF HOPE BENEFITING CHIldREN’S dIaBETES FOUNdaTION
conicartistsJenniferLopezandMarc Anthony,GladysKnight,AkonandJay LenojoinedwithHonoreesMariaShriver andQuincyJonesandpresenters
TomHanks,RitaWilsonandRandyJackson,ProducerGeorgeSchlatterandMusicDirectorRickeyMinortomakethe2010Mercedes-BenzCarouselofHopethemostglittering,glamorousandgorgeouseventinthe24-yearhistoryofTheCarouselofHopebenefitingtheBarbaraDavisCenterforChildhoodDiabetesandtheChildren’sDiabetesFoundation.
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children’s diabetes foundation at denver — Winter 2010
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All
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The
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1. Jay Leno
2. Maria Shriver, Honoree
3. Jane Fonda
4. Dana Davis, Barbara Davis
5. Raquel Welch
6. Kenny Rickel, Paul and Lynn Palmer, Isabella and Mariella Rickel, Nancy Davis Rickel
ON THE COVER
1. Tom Hanks, Rita Wilson, Barbara Davis, Maria Shriver, George Schlatter
2. Halle Berry
3. Marc Anthony and Jennifer Lopez, Featured Performers
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The Carousel of H
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1. Garcelle Beauvais
2. Gladys Knight, Featured Performer
3. Clive Davis, Stevie Wonder, Barbara Davis
4. Nancy O’Dell
5. Kelly & Don Johnson
6. Barbara Davis, Daisy Fuentes
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1. Qunicy Jones, Honoree
2. Cheryl Tiegs, Frances Fisher
3. Garcelle Beauvais, Paul Sorvino
4. Larry Gilman, Donna Mills
5. Gladys Knight, Lisa Raye McCoy
6. Vanna White
7. Don Rickles, Kathy Griffin, Bob Newhart
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The Carousel of H
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1. Bob Evans & Guest
2. Jennifer Lopez
3. Bob Daly, Barbara Davis, Carole Bayer Sager
4. Harrison Fuller
5. Lara Spencer
6. Nigel Lythgoe, Alana Stewart, Marc Anthony
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1. Halle Berry, Olivier Martinez
2. Berry Gordy, Eskedar Gobeze
3. Percy Gibson, Joan Collins
4. Sidney and Joanna Poitier
5. George and Jolene Schlatter
6. Brandy, Maksim Chmerkovskiy, Lisa Rinna, Harry Hamlin
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The Carousel of H
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1. Barbara Davis, Adrien Brody
2. Akon
3. Sela Ward
4. Alan Thicke, Tanya Callau
5. Paris Hilton
6. Dr. Nancy Larco, Head of Diabetes at Medecine Interne Maladies Metabolique and Dr. Philippe Larco, leading Haitian Immunologist, who returned to Port au Prince the day after the Ball to help with the Cholera epidemic
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The
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1. Rickey and Karen Minor
2. Barbara Davis, Steven Graham Angelica Huston
3. Christopher Backus, Mira Sorvino
4. Gregg Davis, Barbara Davis, Harry Davis, Elena Davis, Hudson Davis, Julie Davis
5. Kathy and Rick Hilton
6. Robert & Kelly Day
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The Carousel of H
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1. Jackie Collins, Dieter Abt
2. Julie Chen, Les Moonves, Leah Remini
3. Marc Anthony
4. Savannah Robinson
5. Randy Jackson
6. Lili Zanuck, Barbara Davis, Sherry Lansing
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The
Car
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the2010CarouselofHopeBallpresentedbyMercedes-Benz,raisingnearly$2.4millionforresearchandclinicalcareprogramsfordiabetesattheBarbaraDavisCenterforChildhoodDiabetes,whereover5,000childrenandadultsreceivecare.
TheeveningwouldnotbepossiblewithoutthehelpofgeniusTVveteran,GeorgeSchlatterandhisskilledproductioncrew,talentedmusicdirector,RickeyMinor,andJayLeno,whoonceagainreprisedhisroleastheMasterofCeremonies.
TheChildren’sDiabetesFoundationwouldliketothanktheevening’spresentingsponsorMercedes-BenzUSA,andmajorsponsorsGUESS?,AmericanAirlines,sanofi-aventisU.S.,TheBeverlyHiltonHotelandourangelsponsorsRonBurkle,SarahSiegel-MagnessandGaryMagnessandRobertandKellyDay.ReemAcrailluminatedtheballroomwithherbeautifuldonatedtableclothsinshadesofpink.Lushflowerarrangementswithover10,000flowersflowninfromEcuadorwerecreatedbyFredGibbonsofTreefrogs,whohasservedastheevent’sexclusivefloristsince1990.WealsothankAngelicaHustonforallowingustousethesculpturesofthelatebelovedRobertGrahamforthehonoreeawards,andMoëtHennessyUSA,ourexclusivespiritssponsor.Theeveningwasalsogenerouslysupportedbymanycorporationsandleadersfromtheentertainmentindustry.
TheshowbeganwithSavannahRobinson’sacapellarenditionofthe“StarSpangledBanner.”TomHanksandRitaWilsonthenintroducedFirstLadyofCalifornia,MariaShriver,whowastherecipientoftheBrass
RingAwardforherinspiringhumanitarianefforts.Maria’smeaningfulspeechdeeplytouchedtheaudience.Lastyear’sBrassRinghonoree,CliveDavis,followedwithawarmintroductionofBarbaraDaviswhogenerouslythankedeveryguestforattendingandjoininginthefightagainsttheglobalepidemicofdiabetes.SheupdatedtheaudienceontheCenter’sprogramsandtheadvancesbeingmadeforchildreneverywhere.Inclosing,shementionedaquotefromChristopherReeve,“Onceyouchoosehope,allthingsarepossible.”AmericanIdol’sRandyJacksonwelcomedQuincyJonestothestageashewashonoredwiththeFoundation’sdistinguishedHumanitarianAwardonthe25thAnniversaryof“WeAreTheWorld.”
TheunforgettableeveningincludedperformancesbygreatartistsJenniferLopezandMarcAnthony,whoperformedaduetof“NoMeAmes.”Togetherthecouplesanginperfectharmonylightinguptheroomwithloveandsong.JenniferLopezthentookcontrolofthestageinafieryperformanceof“Let’sGetLoud”,whichsetthetonefortheeveningofentertainmentaseachpersonintheroomwassinginganddancing.AmericanR&BsingerandsongwriterAkonwasnextasheruledthestage,performinghishitsongs“Angel”and“SexyChick.”TheFeaturedPerformer,legendaryartistGladysKnight’sgrandfinalehadguestsontheirfeet,swayingandsingingwithhertoclassics“NeitherOneofUs”and“MidnightTraintoGeorgia”leavingeveryoneeuphoricallywishingformore.
Someofthemanycelebratedguestsincluded:HalleBerry,StevieWonder,AdrienBrody,JackieCollins,JoanCollins
andPercyGibson,CliveDavis,JaneFonda,BerryGordy,KathyGriffin,TomHanksandRitaWilson,AnjelicaHuston,RandyJackson,RickeyMinor,LesMoonvesandJulieChen,DermotMulroney,BobandGinnyNewhart,JoannaandSidneyPoitier,DonandBarbaraRickles,CaroleBayerSagerandBobDaly,JoleneandGeorgeSchlatter,JudgeJudySheindlin,RodStewartandPennyLancaster,SelaWard,RaquelWelch,VannaWhite,GarcelleBeauvais,ThoraBirch,Brandy,MaksimChmerkovskiy,BillyDavis&MarilynMcCoo-Davis,BobEvans,FrancesFisher,DaisyFuentes,LisaRinna&HarryHamlin,NickyHilton,ParisHilton,Rick&KathyHilton,BeverlyJohnson,DonJohnson,TamalaJones,SusanLucci,NigelLythgoe,ChrisMassey,KyleMassey,BennyMedina,DonnaMills,NancyO’Dell,SumnerRedstone,LeahRemini,MimiRogers,MiraSorvino,PaulSorvino,LaraSpencer,AlanaStewart,AlanThicke,CherylTiegs,LouisvanAmstel,BuzzAldrin,JoanvanArkandBenVereen.
DuringtheliveauctiononeluckywinnerwalkedawaywiththestunningMercedes-Benz2011CL63AMGfor$170,000.TheliveauctionalsoincludedtwoincredibletripscourtesyofSt.RegisHotels,onethroughoutEuropeandanothertoHawaiiandTibet,withairfaretobeginandendthetripsdonatedbyAmericanAirlines.
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TheSilentAuction,chairedbyNancyDavisandDanaDavis,wascomposedofnearly450itemsandincludedanAvjettripfor7toLasVegasorMontereyonaGulfstream150orHawker800XP.OthervacationspotsincludedstaysatTheResortatPelicanHillinSouthernCalifornia,thePeninsulaHotelinHongKong,HotelLeBristolinParisandtheGrandWaileaResortHotelandSpainHawaii.Lavishdiningexperiencesincluded:dinnerfor20intheprivatediningroomatMr.Chow,WolfgangPuckdinnerfor12atCUTwithwines;IlPiccolino;Toscana;ChateauMarmont;TheFrenchLaundry.FashionitemsthisyearfeatureddonationsfrommanyfashioniconssuchasDonnaKaran,GiorgioArmani,Chanel,MoniqueLhuillier,OscardelaRenta,Fendi,DeviKroell,SaksFifthAvenue,NeimanMarcusandmore.OtherAuctionitemsincludeddonationsfromhometeamstheLALakers,andLADodgers;jewelryfromTiffany&Co.andNancyDavis’PeaceandLove;andthepopularArtGallerywithartdonatedbyleadingcontemporaryartistssuchasEdRuscha,thelate
DennisHopper,TonyBennett,RossBleckner,NancyEllison,FrankGehry,LeRoyNeiman,FiroozZahediandmanymore.
Celebritiesonceagainhelpedinseveralways,includingMAKELOVENOTTRASHtotespersonallysignedbyKenny“Babyface”Edmonds,SelmaBlair,GeorgeClooney,ClintEastwood,HarrisonFord,ScarlettJohansson,BillMaher,JuliaLouis-Dreyfus,MikeMyersandBenStiller.HandbagsforHopewassupportedbycelebritiesShirleyMacLaine,MariaShriver,KellyPreston,CindyCrawford,AngelaBassett,CandiceBergen,CarolBurnett,JoyBehar,GoldieHawn,JackieCollins,AnjelicaHuston,JulianneMoore,ThoraBirchandJoanvanArkwhodonatedoneoftheirspecialhandbagsandautographedkeychainsbyLineaPelleandBraggables.
BrandnewthisyearwasCanvasfortheCure,aprojectthatfeaturedoriginalminiaturecanvasespaintedbycelebritiesincludingartbyJohnTravolta,AnjelicaHuston,JoshGroban,GeorgeClooney,CindyCrawford,BillMaher,PennyMarshall,
CrystalBowersoxandmanymore.
Thisyear’swonderfulgiftbagsdesignedbyGUESS?,includedanextraordinaryarrayofgenerousgiftsfromGUESS?includingascarf,eyewear,men’sandwomen’swatches,alsodonationsfromtheLosAngelesLakers’,MAC,TheWaltDisneyCompany,JackieCollins,UrbanBehavior,TinaSinatra,Wen,CaritaUSA,Decléor,Avjet,AmandaDunbar,BagatellaHandbags,BeverlyHillsPlasticSurgery,CanvasPop,MSalon,OPI,NubiusOrganics,RavenSpaandtheRanch.
TheCarouselofHopehasraisedmorethan$75millionsince1978tocriticallycombatthediabetesepidemic,whichafflictsoneinthreebabiesborntoday.TheseessentialfundsareraisedbyChildren’sDiabetesFoundationtofundprogramsformorethan5,000childrenandadultswhoreceivespecializedcarefordiabetesmanagementandpreventionofcomplicationsandonreachingforthecure.
1. Barbara Davis
2. Mavis & Jay Leno
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2010
Sym
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he2010Carousel ofHopeDiabetes Symposium, “Pathwaysfor FutureTreatmentandManagementofDabetes,”addressednewinsulindeliverysystemsincludingcontinuousglucosemonitoring.Italsoconcentratedonneworalmedicationsfortype2diabetesalongwiththeemergingincreaseinobesityandtype2diabetesinchildrenandyoungadults.TheSymposiumassembledagroupofexpertswhoseworkengageswiththemulti-facetedchallengesfacingtheimplementationofthisnewtechnologytobenefitofpeoplewithdiabetes.
Jeffrey A. Bluestone, PhD, A.W. and Mary Margaret Clausen Distinguished Professor; former Director of the Diabetes Center at the University of California, San Francisco at the University of California, San Francisco, CADr.BluestoneestablishedtheUCSF/JDRFCenterforIsletTransplantationandservesontheCaliforniaInstituteforRegenerativeMedicineDiabetesDiseaseTeam,aswellascomprehensiveresearchandclinicalprogramsaimedatmarryingcutting-edgeisletcell-specificstemcellbiologywithnovelimmunotherapiesasatreatmentfortype1diabetes.
Tprofitorganizationwiththemissionofeducatingandmotivatingpeoplewithdiabetestotakeamoreactiveroleintheircondition.
Dr. George Eisenbarth, MD, PhD, Executive Director of the Barbara Davis Center for Childhood Diabetes and Professor of Pediatrics, Medicine, and Immunology at the University of Colorado School of Medicine, Aurora, CO Dr.Eisenbarthfirstcharacterizedtype1diabeteswhileatJoslinasachronicautoimmunediseasethatcouldbepredictedpriortoclinicalsymptoms.Hisimmunogeneticslabinvestigatesautoimmunityinnaturalhistorystudies,includingtwins,andintheNODmousewiththegoalofpredictingandpreventingdiabetes.HeisreceivedADA’s2009BantingPrizeforOutstandingLifetimeScientificAchievement.
Satish K. Garg, MD, MBBS, DM, Director, Adult Clinic, Barbara Davis Center, Professor of Medicine and Pediatrics, University of Colorado Health Sciences Center, Aurora, CO Dr.Garg¹sresearchinterestsincludetheearlydetectionandtreatmentofrenalandretinalcomplicationsoftype1diabetesandthedevelopmentofnewdiagnosticandtherapeutic
Peter Butler, MD, Professor of Medicine, Chief of the Division of Endocrinology, Diabetes and Hypertension and Director of Larry Hillblom Islet Research Center, University of California, Los Angles, CA Dr.ButlerisaclinicalinvestigatorwithclinicalpracticeatUCLAfocusingoncareofpatientswithdiabetesandresearchfocusingonabnormalinsulinsecretion,thecausesofbetacelldeathandthepossibilitytofosterisletregenerationinhumans.
Steve Daniels, MD, PhD Chairman of the Department of Pediatrics at the University of Colorado School of Medicine, Aurora, CO Dr.DanielsisaPediatricCardiologistwhohasfocusedhisclinicalworkandresearchonPreventiveCardiology.Hisinterestsincludetheeffectsofdiabetes,hypertensionandobesityonthecardiovascularsystem.
Steve Edelman, MD, Professor of Medicine in the Division of Endocrinology, Diabetes & Metabolism at the University of California at San Diego (UCSD), CA and the Veterans Affairs (VA) Healthcare System Dr.EdelmanisalsothefounderanddirectorofTakingControlofYourDiabetes(TCOYD),anot-for-
THE CaROUSEl OF HOPE dIaBETES SyMPOSIUM
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2010 Sym
posiumtoolsrelatedtoclinicaldiabetesmanagementthatincludenewinsulinanalogsandglucosesensors,etc.HecurrentlyservesastheEditor-in-ChiefoftheDiabetesTechnologyandTherapeuticsJournal.
Matthias Hebrok, PhD, Hurlbut-Johnson Distinguished Professor in Diabetes Research, Interim Director of the Diabetes Center, University of California, San Francisco, CA Dr.Hebrok’sresearchfocusesontheunderstandingofhowisletsofLangerhans,theendocrinecomponentofthepancreas,areformedduringorganogenesis,howtheirfunctionisregulatedinthematureorganismandhowchangesingeneexpressionmightallowisletregeneration.
John C. Hutton, PhD, Research Director, Barbara Davis Center; Professor, Department of Pediatrics and Cellular and Structural Biology, University of Colorado Denver, Aurora, CODr.Hutton’slaboratoryprovidesastrongtrainingenvironmentinmolecularcellbiology,biochemistryandimmunologyemphasizingbasicresearchoninsulinsecretionandthepathogenesisoftype1diabetes.HeheadstheDiabetesand
EndocrinologyResearchCenterattheBarbaraDavisCenterandtheJDRF-BDCAutoimmunityPreventionCenter.
Marian Rewers, MD, PhD, Clinical Director, Barbara Davis Center, Aurora, CODr.RewersisProfessorofPediatricsandPreventiveMedicineattheUniversityofColoradoandisapediatricdiabetologistandaninternationally-recognizedphysicianscientist.Hehasmadeimportantcontributionstoourunderstandingoftheetiologyoftype1diabetesanditsmacrovascularcomplicationsbycreatinglargeprospectivecohortstudies:DAISY,CACTIandaninternationalconsortium,theEnvironmentalDeterminantsofDiabetesintheYoung(TEDDY).
Jay S. Skyler, MD, MACP, Professor of Medicine, Pediatrics, & Psychology at the University of Miami, Miami, FLDr.SkylerisAssociateDirectorforAcademicProgramsintheDiabetesResearchInstituteandisChairmanoftheNIH-sponsoredType1DiabetesTrialNet,aninternationalnetworkconductingclinicaltrialstopreventtype1diabetesorinterdictthetype1diabetesdiseaseprocess.
Dr. Robert Slover, MD, Director of Pediatric Clinical Services, Barbara Davis Center, Aurora, CODr.SloveristheColoradoprincipalinvestigator(PI)fortheSTAR3study.STAR3isarandomized,multi-centertwo-armstudytocomparetheefficacyoftheMiniMedParadigmREAL-Timesystemversusmultipledailyinjections(MDI).Hehasbeeninvolvedin12researchprojectsaseitherPIorCo-PI,has12publicationsandhasbeeninvitedtoover35speakingengagements.
Phil Zeitler, MD, PhD, Professor of Pediatrics and Clinical Science at the University of Colorado Denver and Medical Director of the Children¹s Hospital Clinical Translational Research Center of the Colorado Clinical Translational Science Institute, Aurora, CO Dr.ZeitlerisAttendingEndocrinologistattheChildren¹sHospitalandtheBarbaraDavisCenterforDiabetes,whereheisDirectoroftheType2DiabetesandMetabolicSyndromeClinicandDirectorofthePediatricEndocrinologyTrainingProgram.HecurrentlyservesasStudyChairofTODAY,anational,NIH-funded,multi-centertrialexaminingtreatmentoptionsforadolescentswithtype2diabetesandTODAYGeneticsStudy.
.
2010 Davis awarD winnerJEFFREy A. BLUESTOnE, PhD Duringthepast25years,Dr.Bluestonehasauthoredover375publicationsondiabetesandimmunitywhilestudyingtheregulationofT-cellsinresponsetoautoantigensandtransplantationantigens,supportingthedevelopmentofhelpinthedevelopmentofanewgenerationoftolerogenicdrugsthatwill“turnoff”selectedpartsoftheimmunesystem,leavingthedisease-fightingcapabilitiesintact.HehasreceivednumerousawardsincludingtheJDRFGrodskyBasicScienceAward,theMaryTylerMoore&RobertLevineExcellenceinClinicalResearchAwardandaJDRFScholarAwardfromJDRF,aswellastheAmericanSocietyforTransplantationRocheDistinguishedResearchAward.
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ype1diabetes isoneofthe mostcommon chronicdiseases inchildren.Unfortunately,thefearoflowbloodsugars(hypoglycemia)preventsmanyfamiliesfromachievinggoodcontrolofthediabetes.Hypoglycemiaisscary,andwhenseverecanresultinseizuresorunconsciousepisodes.Althoughexerciseisrecommendedforallyouthwithregulardiabetes,hypoglycemiaduringorafterexerciseisoneofthemostfrequentlyidentifiedspecificcausesofseverehypoglycemia.
ThreelandmarkstudiesintheCTRC(ClinicalTranslationalResearchCenter)atChildren’sHospitalhavebeenimportantinmakingexercisesafeforchildrenwithType1diabetes.Thefirsttwostudieshavebeenperformedaspartofaworkinggroup(DirecNet)ofpediatricendocrinologistsattheBarbaraDavisCenter/DenverChildren’sHospital,YaleUniversity,StanfordUniversity,Nemour’sChildren’sHospitalinFlorida,andtheUniversityofIowawithcoordinationbytheJAEBCenterforHealthResearchinTampa,Fl.
Aninitialstudydevelopedthe60minutetreadmillmethodologyusedinalllaterstudies.Theinitialstudyfoundthatduringtheexercise,oneoutoffourofthechildrenhadbloodsugarlevelsbelow60mg/dLandhalfofthechildrenhadvaluesbelow70mg/dL.ThechildrenstayedinChildren’sHospitalovernighttostudytheincidenceofdelayednocturnalhypoglycemia(lowbloodsugarlevels).Surprisingly,lowsoccurred
T
laNdMaRk STUdIES ON ExERCISE aNd HyPOGlyCEMIa IN yOUTH wITH TyPE 1 dIaBETES
— H. Peter Chase, MD and Rosanna Fiallo-Scharer, MD
Bar
bara
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rduring48%ofnightsfollowingadaywhenthechildrenhadexercised,andon28%ofnightswhenthesameyouthspentthenightinthehospitalafteradaywithoutexercise.ThiswaspublishedintheJournalofPediatrics147:528,2005.
Animportantsecondstudyfocusedonpreventingthelowbloodsugarsduringtheafternoonexercisesession.Youthusinganinsulinpumpturnedoffthepump(noinsulin)duringthe60minutesofexerciseandfor45minutesaftertheexercise.Lowbloodsugarswereapproximately1/3ascommonwhentheinsulinwasdiscontinued(16%ofchildren)asonanotherdaywheninsulinwascontinuedforthesameyouth(48%low).ThiswaspublishedinDiabetesCare29,2006.
Inathirdstudy(currentlyinpress:JournalofPediatrics),Dr.CraigTaplin(a3rdyearEndocrine-DiabetesfellowatTheChildren’sHospital/BarbaraDavisCenterstudiedmethodstopreventthedelayedlowbloodsugarsduringthenight.Thesameafternoonexerciseprogramwasusedas
inthetwoabovestudies.Hefoundthatdiscontinuationoftheinsulinduringexerciseandadministrationofhalfoftheusualinsulinfor45minutesaftertheexercise,followedbya20%reductionofbasalinsulinfrom9pmto3amessentiallypreventedlownighttimebloodsugars.Asthesechangesininsulindeliveryareonlypossibleforyouthusinganinsulinpump,theadministrationofamedicine,terbutaline,wasalsostudied.Thiscanbeusedbyyouthusinginjectionsandnotusinganinsulinpump.Thismedicinepreventedlowbloodsugarsatnightbutcausedbloodsugarlevelstobetoohigh.Furtherstudieswillbeneededtodeterminethecorrectdoseofterbutaline.
Insummary,knowledgefromthesethreelandmarkstudies,alldoneincollaborationwithTheChildren’sHospitalandtheBarbaraDavisCenterforChildhoodDiabetes,shouldhelptomakelifesaferandeasierforthe3,000childrenwithType1diabetesfollowedattheCenter,aswellasforthemillionsofchildrenwithdiabetesaroundtheworld.
IMPORTaNT wEBSITESChildren’s Diabetes Foundation
www.ChildrensDiabetesFoundation.org
Barbara Davis Center for Childhood Diabetes www.BarbaraDavisCenter.org
Juvenile Diabetes Research Foundation www.jdrf.org
American Diabetes Association www.diabetes.org
Children with Diabetes www.ChildrenwithDiabetes.com
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TaMING THE SHOT MONSTER
— Rita Trujillo Hughes, LCSW, CDE, Clinical Social Worker
ustaminute...” “Ihavetogo dosomething first....” “You’re mean!”“I HATESHOTS!”
Soundfamiliar?Areshotsorsetchangesatyourhouseastruggleandabattle?Youarecertainlynotalone.Preliminarystudysuggeststhatperhapsathirdofallchildren,teensandadultshavesomedegreeofneedleanxietythatmakesinjectionsachallenge.However,themajorityofthesekidsdon’tnecessarilysaythatshotshurt.Theirbehaviortellsusso.Needlefearsrangeindegreefrommildtosevere.Trueneedlephobia(wherethelevelofanxietyissoheightenedthatpeoplemightfaintatthesightofasyringe)islesscommon,but
needlefearfulnessisnonethelessveryimportanttoaddress.Itisimportanttoknowthatanxietyaboutshotsismediatedbyarealbiologicalresponse.Thephysicalsymptomsarereal.Queasystomach,sweatypalms,shakyhands,andpoundingheartsarenotuncommon.
Sometimes,painwithshotstriggersanxietythatcanleadtodifficultieswithinjections.Incorrectinjectiontechniquemaybecausingsomepain.Thoughweknowthatshotsaren’tgoingtobeabsolutelypainless100%ofthetime,withproperpreparationandtechnique,shotsshouldberelativelypainfreemostofthetime.Shotsoughttofeellikeasmallpinch(atleastthat’swhatwestrivefor).Coldinsulinandsometypesofinsulinmightbecontributingtodiscomfortandtheseareissuesthatyournurseeducatorcanreviewwithyouandmakesuggestionsthatmightmakearealdifference.
Ifchangingtechniquedoesn’tworkandyourchildhassomeofthefollowingsymptoms,thenconsultingoneoftheclinicalsocialworkersontheteammighthelp.Evenwhenkidsdon’tcomplainofanxietyorpainfulshots,thesebehaviorssuggestthatwemayneedtolookalittlecloser:
*Yourchildstallsaroundshotsorhaselaborateritualsabouthowtheyshouldbedone.
*Takesalongtimetoactuallydotheinjectionor“huntsandpecks”lookingforjusttherightspot.
*Refusestorotatesitesandhasafavoritespotthatusuallyendsuppuffyfromoveruse.
*Demandscontrolandrefuseshelpwithinjectionsfromanyone,evenwhenhelpfromaparenthasbeenrecommendedbythedoctor.
*“Forgets”todoshotsorevenskipssomeinjections.
*ApersistentlyhighA1cevenwheninsulinisincreased.
*Youngchildrenconsistentlycryaboutshotsandparentsfeeltheyhavetowrestlewiththeminordertogetthejobdone.
Whenkidsanticipateandexpectpainwithaninjection,theymaybegindoingthingsthatactuallyheightentheiranxietyandtheirperceptionofpain.Forexample,theymayholdtheirbreathandtensetheirbody.Theymaywiggleandstruggle,makingitmoredifficultforaparenttodoaninjectioneasily.Thesebehaviorswillprobablymakeshotshurtmoreandthelongerthestrugglecontinues,theharderitistochange.
Barbara D
avis Center
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Photo: © Janssen Photography
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needle Anxiety (Fear of shots)Itisnowknownthatneedleanxietyofsomedegreeoccursinalmosteveryone.Childrenandadultshaveworriesaboutshots.Inapersonwithdiabetes,weusedtoassumethatthisanxietywouldjustgoawaybecausetheyhadtohaveshotseveryday.Wenowknowthatneedleanxiety,ifstrong,doesn’t“justgoaway”.Therearesomethingsthatcanbelearnedtoreducethisanxietyifweidentifyitisaproblem.
Firstofall,anxietyaboutshotsisnormal.Whenwefearsomething,wegettenseandholdourbreath.Ourheadisfilledwiththoughtsaboutpain.Parents,whohavetogivetheseshots,canbejustasneedleanxiousastheirchild.Remember,thatthesyringesthatarenowusedforinsulinaremuchsmallerandhaveshorterneedlessothatshotsaremuchmorecomfortablethesedays.Withafeweasytechniques,shotscanbelessstressful.Thediabeteseducatorsinourclinicalwayshaveparentsorsignificantotherspracticeinjectionsoneachotherusingsalinesolution.Thepracticenearlyalwaysreassuresthemthatgivinginsulininjectionstotheirchildisnotthetraumatheyimage.
Tensingcanmakeshotshurt.Sotakeacoupleofdeeprelaxingbreaths(“breatheinthroughthenoseandbreatheslowlyoutthroughthemouth”)andtrytoimageyourselfmadeofjell-o.Byrelaxingthetension,shotscanbedonemorecomfortably.Sometimesalittledistractioncanhelprefocusthemindfromfeartosomethingelse.Watchingcartoonsorlisteningtosomefavoritemusicwithheadphonescanhelpthemindfromthinkingtoomuchabouttheshotsandaids
Sometimesapersonwithdiabetesdoesn’tgetovertheirstressaboutshots.Afewsymptomsthatmightindicatethisisgoingonare;
FpersistentlyhighHbA1c
Fachildwantingtodoalltheirownshots-particularlywhentheywanttodotheshotinaroombythemselves(someshotswillprobablybemissed)
Flackofsiterotation(hypertrophy,orhardtissueattheinjectionsite)
Fmissedinsulinshots
Fexcusesforwantingto“putoff”theshot(stalling)
Fparentalfearorworryaboutinjectionsorblooddraws
Thepsychosocialmemberoftheteamcanbeveryhelpfultochildrenorparentswithsortingoutthisproblem.Treatmentcanincludebehavioraltechniquesandpurposefuldistraction.ThelatterincludesTV,music,toys,blowingbubblesandbooks.Sometimesinjectiondeviceshelptheproblem(Inject-Ease)though
theydonot“cure”it.Behavioraltechniquesincludelearningtorelax,rewardprograms,systematicdesensitizationandbiofeedback.Asfearofshots,bloodorinjurydecreases,theHbA1cusuallyimproves.
Thefirststepinmakingshotseasierisidentifyingwhenkidsarehavingmoreanxietythantheyshould.Ifyoufeelshotshavebeentoomuchofabattlearoundyourhouselately,youmightmentionthatatyournextvisitandwe’llseehowwecanhelp.
Bar
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TakING dIaBETES TO SCHOOl CONFERENCE
— Regina Reece
heBarbaraDavis Centerfor Childhood Diabetesheld itsannual,“TakingDiabetestoSchool”conferenceonFriday,October15thattheNighthorseCampbellNativeHealthBuilding,locatedattheCUAnschutzMedicalcampus.ThisprogramwasstaffedbytheBDCPediatricClinicaswellasMichellePassamaneckofADA,KathleenPatrickofColoradoDepartmentofEducationandAmyReevesofMedtronicDiabetes.
Therewere90attendeesrangingfromclinicaidstoschoolprincipalswhoenjoyedaninformationpackeddaywheretopicsincluded:WhatisDiabetes,Psych-SocialIssues,NutritionManagement,SchoolHealthPlans,andtheImportanceofaSchoolNurse.
Therewerealsohands-onworkshopsintheafternoonthatcoveredthefollowingareas:PumpsandSensors,HowtoHandleHighandLowBloodGlucoseLevelsandtrainingonvariousbloodglucosemonitorsandonhowtousesyringesandinsulinpensonpediatricpatients.
Aspecialappreciationisexpressedtothefollowingsupporterswhomadethisprogrampossible:AbbottDiabetesCare,AmericanDiabetesAssociation,AnimasCorporation,BD,theChildren’sDiabetesFoundation,theColoradoDepartmentofEducation,TheGuildoftheChildren’sDiabetesFoundation,LillyUSA,LLC,MedtronicDiabetes,NovoNordisk,Inc.andsanofi-aventis.
Barbara D
avis Center
T
lIlly CONFERENCE
— Regina Reece
Type 1 Diabetes Experience-Based Learning Program
heBarbaraDavis Centerfor Childhood Diabetes(BDC) hostedthe“Type1DiabetesExperience-BasedLearningProgram”forLillyUSA,LLC(acompanythatdevelops,manufactures,marketsandsellspharmaceuticalandanimalhealthproducts).
ThistwodayprogramheldonOctober19-20,2010wasdesignedtoaidtheLillyteamof50individualsfromthebasicsof,“WhatisDiabetes?”tothemostcurrenttechnologyinthediabetesrealmsuchasusingContinuousGlucoseMonitoringdevices(CGMs).
COnFEREnCE DIRECTOR: GeorgeannaKlingensmith,MD,DirectorofPediatricClinicalCareandTranslationalClinical
ResearchattheBDCandtheChildren’sHospital,puttogetheranimpressiverosterwiththefollowingBDCclinicalstaff:
PHySICIAnS:H.PeterChase,MDGeorgeEisenbarth,MD,PhDRosannaFiallo-Scharer,MDRobertSlover,MD
nURSE PRACTITIOnER:StephanieKassels,DNP(c),FNP-BC,CDE
nURSES:GeorgiaKoch,RN,BSN,CDELaurelMesser,RN,MPH,CDE,SarahMorey,RN,BSNSusieOwen,RN,CDEKathySmith,RN,BSN,CDESallySullivan,RN,CDEGracielaTellez,RNLibbieTuthill,RN,BSN,CDE
SOCIAL WORKERS:LisaMeyers,LCSW,CDEDanaShepard,LCSWRitaTrujilloHughes,LCSW,CDE
DIETITIAnSLoiseGilmer,MD,RD,CDEGailSpiegel,MS,RD,CDE
Participantsalsoattendedabreakoutsessionthatprovidedtheopportunitytohavehandsonexperiencewithessentialdiabetescaretasksthatfamiliesneedtomasterinordertosafelymanagediabetesathome.Thesetasksincludedinsulininjections,bloodglucosemonitoringandrecognitionofmildandmoderatehypoglycemiaaswellasthetreatmentofseverehypoglycemiawithglucagon.
Wealsohadauniqueopportunitytopresentapatientandparentpanelsessionwherecasescenariosweregiven,aswellashaveaquestionandanswersessionduringthistime.
TheBDCislookingforwardtoofferingthisprogramwithLillyin2011.
T
Photo: © Janssen Photography
18
eareproudto announcegreat newsonthe searchforthe newDirectorofPediatricDiabetesServicesatBarbaraDavisCenterandTheChildren’sHospitalDenver.Aftermonthsofanintensivesearchprocessthatincludedseveralexcellentcandidates,thepositionwasofferedtoDr.RobertSlover,AssociateProfessorofPediatrics.Dr.SloverisexpectedtotakethenewpositiononJanuary1,2011.
RobSloverearnedhisMDdegreefromtheUniversityofUtahMedicalSchoolin1975.Hedidhispediatrictraininghere,attheFitzsimonsArmyMedicalCenterin1975-1978,andisagraduateofourPediatricEndocrinologyandDiabetesFellowshipprogram(1980-1982).RobhasbeenonthefacultyoftheSchoolofMedicine,UniversityofColorado,since1990andontheBDCfacultysince1994.Forthepastfiveyears,hehasservedastheDeputyDirectorofPediatricDiabetesServices.HisresearchinterestsincludeContinuousGlucoseMonitoring,artificialpancreas,CysticFibrosisrelateddiabetesandtransitioncare,amongmanyothers.Robisanoutstandingclinicianandeducator.
OneofthemaintasksfacingRobandallofusistofurtherstrengthenourcollaborationwithChildren’sHospital,Denver’sincreasingpatientload,bothambulatoryandinpatients,andwithincreasingcomplexityofdiabetescare.
Welookforwardtoworking
dR. SlOvER NaMEd NEw dIRECTOR OF PEdIaTRIC SERvICES
— Marian Rewers, MD, PhD, Clinical Director for Barbara Davis Center for Childhood Diabetes
W
closelywithourTCH-basedcolleaguesandwithmultiplechildren’sservicestooptimizeoureffortsforthebenefitofchildrenandyoungadultswithdiabetes.WecongratulateDr.Sloverinhisselectionforthisimportantleadershipposition.
OnbehalfoftheBarbaraDavisCenterandChildren’sDiabetesFoundation,wewouldliketothankDr.GeorgeannaKlingensmithfor17yearsofheroutstandingserviceastheDirector.GeorgeannahaschaperonedtheServicethroughchallengingtimes.First,sheledtheconsolidationofoutpatientdiabetesservicesattheBDCin
1994.Morerecently,GeorgeannahasbeeninstrumentaltoestablishingexcellentPediatricDiabetesServicesonthecampus.Theclinicvolumehasquadrupledunderherwatchandsohasthestaffandfunding.I’mhappytotellyouthatGeorgeannaisstayingattheBDCandagreedtocontinuemanyofhercurrentactivities,includingpatientcare,teaching,leadingtheT32traininggrantandworkingastheprincipalinvestigatoronseveralstudies,e.g.,PDCandExchange.
Marian Rewers, MD, PhD, Professor, Pediatrics & Preventive Medicine, Clinical Director, Barbara Davis Center
for Childhood Diabetes.
Bar
bara
Dav
is C
ente
r
Photo: © Martin Crabb
19
Barbara D
avis Center
BaRBaRa davIS CENTER aT FITzSIMONS dONOR wall
dONOR wall FORM
Name________________________________________________________
Address______________________________________________________
City_____________________________State______Zip_______________
Homephone_____________________Workphone____________________
Cellphone___________________E-mail____________________________
Amount$___________________
_____________________________________________________________
(Nameasyouwishittoappearondonorwall)
MakecheckpayabletoChildren’sDiabetesFoundationor
qVisa qMastercard qAmericanExpress
Nameoncard_________________________________________________
Card#________________________________________________________
Mailpaymentto:
Children’sDiabetesFoundation—DonorWall
777GrantSt.,Ste.302
Denver,CO80203
syourchilda patientatthe BarbaraDavis Center?Areyoua patientattheBarbaraDavisCenter?Doyouhaveaspecialinterestindiabetes?Thisisanopportunityforyou,yourfamilyandyourfriendstohaveapresenceattheCenterbypurchasingaplaceonthedonorwall,ornamingrightsonaroom—alastingsymbolofyoursupport.HelpUsCatchtheBrassRing—aCureforDiabetes.Levels1,2and3willalsobeentitledtonamingrightsonaroomattheBarbaraDavisCenter.ForinformationcallChrissyat303-863-1200.
I
FUNdING OPPORTUNITIES:
LEVEL 1 $50,000 and above
LEVEL 2 $30,000 to $49,999
LEVEL 3 $10,000 to $29,999
LEVEL 4 $1,000 to $9,999
LEVEL 5 $100 to $999
Photo: © Steve Groer Photography
20
Que
stio
ns a
nd A
nsw
ers QUESTIONS aNd
aNSwERS—H. Peter Chase, MD
What is the main cause of low-blood sugar seizures in youth and can they be prevented?
Preceding exercise isdescribedas themain recognizedcontributingfactorforseverehypoglycemiainyouth.Preventioninvolves“thinkingahead.”Peopleusinginjectionsneedtoreduceinsulindosagesbothforthetimeofexerciseandforthenight.Extrasnacksmaybeneeded.Peopleusinginsulinpumpscanusea“0”to50%temporarybasalduringtheexercise(sometimesbeginning30minutesbefore),andan80%temporarybasalratefrom9p.m.to3a.m.Theuseofacontinuousglucosemonitor(CGM)withalarmsforlowscanalsobeveryhelpfulinprevention.
My doctor has found my child to have high transglutaminase antibodies that are associated with celiac disease. Does my child need to have an intestinal biopsy before considering a gluten free diet?
— From Dr. George Eisenbarth, MD, PhD
Childrenwith type1diabetes areathigher riskforceliac disease,anillnessinwhichgluteninthedietfromanumberofsources(e.g.wheat)causesthebody’simmunesystemtoattacktheinnerwall
oftheintestine.Whenchildrenhavesevereceliacdiseaseassociatedwithweightlossanddiarrhea,avoidingglutenusuallymakesthesymptomsgoawayandallowsthechildtogrownormally.Nowadayswescreenforceliacdiseasewithasimplebloodtestforanantibodythatappearsintheblood,termedtransglutaminase.Ifhighlevelsoftheantibodyarefound,werecommendabiopsytoconfirmthediagnosis,asceliacdiseaseisalife-longdiagnosisandnosingletestisdiagnostic.Thebiopsyisusuallydonewithanesthesiasothechildisnotconsciousfortheprocedure.Atubewithacameraisswallowedandatthefirstpartofthesmallintestineseveralpiecesoftheintestinearetakenthroughtheswallowedtube,eachaboutthesizeofapenciltip.Thebiopsyisthenanalyzedbythedoctorsunderamicroscopetoconfirmadiagnosisofceliacdiseaseanddeterminetheamountofintestinaldamage,ifany.
Manychildrendonothavesymptomsofceliacdiseaseeventhoughtheyhaveantibodiesintheblood.Highlevelsofantibodiesusuallyindicatethatthereisdamagetotheintestine,andingeneralwerecommendbiopsyonlywhentheantibodylevelsarehigh,unlesstherearealsoceliacdiseasesymptoms.Inmanychildrenwithoutsymptomswithhighlevelsoftheantibodythereisseveredamagetotheintestine.Itisremarkable,butevenwithseveredamage,withaglutenfreediettheintestinecangrowbackandbenormalaslongasglutenisavoided.Ingeneralwithadiagnosisofceliacdiseasewerecommendlife-longavoidanceofgluten.Itisveryimportanttohaveafirmdiagnosisforpeoplewithsymptomsorhighlevelsofantibodies,andthustherecommendationforconfirmationthroughabiopsy.
Q:
Q:a:
a:
Photo: © Martin Crabb
21
Carousel D
aysCHIllS aNd THRIllS FOR HallOwEEN
^̂ ^ reativejuices wereflowing atTheGuild’s 27thAnnual HalloweenPartyforChildrenwithdiabetes.TheextravaganzatookplaceintheGreenCenteratTheSchoolofMineswiththehelpofthePhiGammaDeltaFraternity.Witches,Pirates,andBuzzAldrinhimselfwereseendecoratingpumpkinsdonatedbyGuildMembersRobertandJudyVillano.Thereweregamesandprizesgaloreaswellasgoodiebagsfilledwithtoysandalternativesnacks.
Theeventwasahugesuccess!Nooneleftthepartyhungry;thegreatpeopleatPepsiBottlingGroupdonatedDietSodaandBottledWaterandPizzawasservedbyChildren’sDiabetesFoundationVolunteers.FacePaintingandBalloonanimalskepteveryoneentertainedwhilespookymusicandscarycostumeskepteveryoneontheirtoes.PhiGammaDeltaFraternitywassuchahugesupport,supervisinggamesandputtingsmilesonthechildren’sfaces.BigthanksgoesouttoJudyMcNeil,theChairmanforTheGuild,forallofherhardworkandpreparationforthisevent.Allofthevolunteersaregreatlyappreciated;withoutthem,manychildrenwouldmissthesefunHalloweenmemories.
C
22
BOOk ORdER FORM Name ____________________________________________________________________________________
Address __________________________________________________________________________________
City/State/Zip _____________________________________________________________________________
Phone(Day)___________________Phone(Eve)______________________E-mail___________________
Understanding Diabetes 11th Edition$25percopy Quantity______
Managing and Preventing Diabetic Hypoglycemia(Video)$20percopy Quantity______
Understanding Insulin Pumps & Continuous Glucose Monitors2ndEdition$15percopy Quantity______
A First Book for Understanding Diabetes(English)$10percopy Quantity______
Un Primer Libro Para Entender La Diabetes(Spanish)$10percopy Quantity______
All orders must be paid in full before delivery, including $3.00perorderforshippingandhandling.Allowonetothreeweeksfordelivery
Makecheckspayableto:Children’sDiabetesFoundationAmerican Express, Visa, and MasterCardaccepted.
Canadian and Foreign Purchasers:PleaseincludesufficientfundstoequalU.S.currencyexchangeratesandinternationalpostage.
For additional information call 303-863-1200 or 800-695-2873 or visit www.ChildrensDiabetesFoundation.org
Mailingaddress: Children’sDiabetesFoundation 777GrantStreet,Suite302 Denver,CO80203
ThePinkPanther™&©1964-2010Metro-Goldwyn-MayerStudiosInc.
AllRightsReserved
Foun
datio
n N
ews
For additional copies of this publication contact:
Children’s Diabetes Foundation777 Grant Street, Suite 302
Denver, CO 80203Phone: 303-863-1200 or 800-695-2873
Fax: 303-863-1122www.ChildrensDiabetesFoundation.org
The Pink Panther™ & ©1964-2010Metro-Goldwyn-Mayer Studios Inc.
All Rights Reserved
www.pinkpanther.com
UN
DER
STAN
DIN
G IN
SULIN
PU
MP
S AN
D C
ON
TIN
UO
US G
LUC
OSE M
ON
ITO
RS 2
nd
Edition
by H. Peter Chase, MD & Laurel Messer, RN, MPH, CDE
•
2nd Edition
12:4
3
23
NOw avaIlaBlE2nD EDITIOn – UnDERSTAnDInG InSULIn
PUMPS AnD COnTInUOUS GLUCOSE MOnITORS (CGMS)
—H. Peter Chase, MD and Laurel Messer, RN, MPH, CDE
THE OnLy BOOK AVAILABLE FOR PATIEnTS WITH DIABETES COVERnG BOTH InSULIn
PUMPS AnD COnTInUOUS GLUCOSE MOnITORS (CGMs)
ThefieldofinsulinpumpsandCGMsismovingsorapidlythattheneedforasecondeditionofthisbookwasimperative.All
chaptersarenowrevised.However,someoftheimportantchangesarelistedbelow:
•AnattempthasbeenmadetointegratetheteachingaboutinsulinpumpsandCGMs–astheycomplementeachothergreatly.Togethertheyarethetwomajortechnologiesbeingusedfordiabetesmanagementtoday!
•Thechaptersinbasalrates(Chapter5)andinsulinboluses(Chapter6)areupdatedwithlatestinformation–includingafigurefromaresearcharticlepublishedin2010showingtheimportanceofgivingboluses20minutespriortomeals.
•Theadvantagesofaninsulinpumpoverinsulininjectionsinthepreventionofhypoglycemiaduringexercisehavereceivedanewemphasis.
•Thechapter(Chapter14)onPsychologicalAspectsoffersnewwaystodealwithpumpandCGMissues.
•TheoverviewonCGMs(Chapter16)dealswithimportantissuesincludingpracticalmethodsofCGM(orinsulinpump)adhesiveissues.
•Twobrand-newchapterswerecreatedbecausereadersofthefirsteditionstatedtheywantedmoreinformationonhowtoadjustinsulinlevelsbasedon“Real-Time”CGMreadings(Chapter18)andon“Retrospective”CGMreadings(Chapter19).Thesetwonewchaptersprovidetheinformationtohelpanyperson/familymaketheneededinsulinadjustmentstoattainthemostoptimalglucosecontrolcurrentlypossible.
•Theresearchchapter(Chapter20)includesinformationrelatingtorecentstudiesofthe“Bionic”pancreas(usinganinsulinpumpandaCGM)andwherecurrentstudiesareleadingfuturediabetescare.
Theneweditionisavailablebycalling303-863-1200or800-695-2873oratwww.ChildrensDiabetesFoundation.org
Foundation New
s
For additional copies of this publication contact:
Children’s Diabetes Foundation777 Grant Street, Suite 302
Denver, CO 80203Phone: 303-863-1200 or 800-695-2873
Fax: 303-863-1122www.ChildrensDiabetesFoundation.org
The Pink Panther™ & ©1964-2010Metro-Goldwyn-Mayer Studios Inc.
All Rights Reserved
www.pinkpanther.com
UN
DER
STAN
DIN
G IN
SULIN
PU
MP
S AN
D C
ON
TIN
UO
US G
LUC
OSE M
ON
ITO
RS 2
nd
Edition
by H. Peter Chase, MD & Laurel Messer, RN, MPH, CDE
•
2nd Edition
12:4
3
ThePinkPanther™&©1964-2010Metro-Goldwyn-MayerStudiosInc.
AllRightsReserved
24
Your support gives hope for their future.
With love and appreciation, Barbara Davis
Kendall (top photo in pink sweater) was diagnosed with type 1 diabetes, a week after her fourth birthday, in December 2009.
ONE IN THREE BaBIES BORN TOday wIll HavE dIaBETES IN THEIR lIFETIME.
Photo from 2006 Carousel Ball Journal
Photo: © kentmeireisphotography.com
Photo: © Martin Crabb
25
verydayin America35 childrenare diagnosedwith type1diabetes--morethanonechildeveryhour.Ofthe24millionAmericansnowafflictedwithdiabetes,twomillionhavethemostsevereform,type1,andneedinsulintosurvive.Butinsulinisnotacure.Everyonewithdiabetesneedsourhelptoendtheepidemic,andeverydonationcounts.
TheBarbaraDavisCenterforChildhoodDiabetes(BDC)istheleadingworldwidecenter
Foundation New
sREaCHING FOR THE BRaSS RING a CaMPaIGN TO CURE dIaBETES
Eforchildrenandadultswithtype1diabetes.YourdonationstoourannualREACHINGFORTHEBRASSRING:ACAMPAIGNFORTHECUREsupportChildren’sDiabetesFoundation’scommitmenttogiveallBDCpatientsthesamehighqualitycare.Nochildisturnedaway.Insulin,suppliesandclinicvisitscancostupto$800ormoreamonth--afinancialburdenforanyfamily,impossiblefortheuninsuredandimpoverished.Throughyourgiftsweprovidetreatmentandsuppliestonearly30%oftheBDC’spatientswhootherwisecouldnotaffordit.
TheBDC’sworld-renownedclinicalandresearchprogramsincludestemcellandisletcelltransplantresearch,andtestingforgeneticandimmunologicriskofdiabetes.Trialscontinueonavarietyofagents,includinganewvaccinetrialtopreventdiabetesinthosechildrenmostgeneticallyat-risk.
Please,helpuscatchthebrassringbysupportingourCAMPAIGNFORTHECURE.Whenyouhelpchildrenwithdiabetesyouempowerthemtocreateabetterfutureforall.
Countmeinforadonationof$____________________
Donate online at ChildrensDiabetesFoundation.org/C2C❏ EnclosedismycheckpayabletoCDF.
Mycontributioncanbematchedbymycompany___________________________________________________ (nameofcompany)
Chargemycreditcard:❏ Visa❏ MasterCard❏ AmericanExpress
Creditcard#__________________________________________________Expirationdate__________________
Nameoncard_________________________________________________________________________________
❏ IhaveincludedCDFinmyWill.
Yourgiftistaxdeductible.Taxexempt#:84-0745008
HELP US GO GREEn!
Registeronlineatwww.children’sdiabetesfoundation.organdqualifytoWIn An APPLE IPAD!
Weneedyoure-mailaddresstosende-blastswiththelatestnewsonBDCclinicalcareandresearch,announcementsofouractivities,andtheChildren’sDiabetesFoundation’snewsletter,NEWSNOTES.Helpsaveourplanetwhilewehelpchildrenwithdiabetes!
Adrawingwillbemadeofalle-mailaddressesreceivedthroughJanuary2011(whetheronlineorthroughthemail).ThewinnerwillbeannouncedonourwebsiteinFebruary2011.your e-mail address will never be shared with any individual or organization.
Name/Contact_________________________________________________________________________________
E-mailaddress________________________________________________________________________________
Address ______________________________________________________________________________________
City______________________________________________________State__________Zip_________________
Home#_________________________Office#________________________Fax#________________________
❏ PleaseremovemefromallChildren’sDiabetesFoundationmailinglists.
26
Foun
datio
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ews MaNaGEMENT
OF dIaBETES IN yOUTH
JULy 17-20, 2010KEySTOnE RESORT AnD COnFEREnCE CEnTER
orethan400 healthcare providersfrom allover thecountryattendedthe11thbiennialconference“ManagementofDiabetesinYouth”wheretheyreceivedthelatestinformationontheintensivemanagementoftype1andtype2diabetesinchildrenandadults.
Conferenceco-directorsMarianRewersMD,PhD,ClinicalDirectoroftheBarbaraDavisCenterforChildhoodDiabetesandGeorgeannaKlingensmith,ChiefofthePediatricClinicattheBDCputtogetheranoutstandingrosterofrenowneddiabeteseducators,whoalongwithBDChealthcarestaff,providedparticipantswithessentialinformationfacingtoday’shealthcareproviders.
Industrysponsoreddinnersfeatured:LillyUSA,LLC(GuestSpeaker:Dr.HenryRodriguez),NovoNordisk(GuestSpeaker:Dr.AsheeshDewan)andMedtronicDiabetes(GuestSpeaker:Dr.FranKaufman).
SpecialthankstothefollowingGuestSpeakersandSponsors/Exhibitorsforparticipatinginandprovidingfinancialassistanceforthisyear’sconference:
GUEST SPEAKERS:
H. Peter Chase, MD,ProfessorofPediatrics,BarbaraDavisCenterforChildhoodDiabetes,ProfessorofPediatrics,UniversityofColoradoDenver,Aurora,CO.
Ron Gill, PhD,ProfessorandResearchDirectoroftheTransplantationInstituteColorado,Aurora,CO.
Peter Gottlieb, MD,AssociateProfessorofPediatricsattheBarbaraDavisCenterforChildhoodDiabetes,Aurora,CO
Irl Hirsch, MD,ProfessorofMedicine,UniversityofWashington,SchoolofMedicine,Seattle,WA.
Lois Jovanovic, MD,DirectoroftheSamsunResearchInstitute,SantaBarbara,CA.
David M. Kendall, MD,ChiefScientific&MedicalOfficer,AmericanDiabetesAssociation,Alexandria,VA.
Aaron Kowalski, PhD, ProgramManager,MetabolicProtocol/ResearchDirector,ArtificialPancreasProject,JuvenileDiabetesResearchFoundation,NewYork,NY.
Johnny L. Ludvigsson, MD, PhD, ProfessorofPediatrics,HeadPhysician,DivisionofPediatrics,Linkoping,UniversityHospital,Sweden.
Henry Rodriguez, MD,AssociateProfessorofPediatrics,JamesWhitcombRileyHospitalforChildren,Indianapolis,IN.
Gary Scheiner, MS, CDE, IntegratedDiabetesServices,Wynnewood,PA.
Grace Shih, RD,PackardChildren’sHospital,StanfordMedicalCenter,PaloAlto,CA.
Jay S. Skyler, MD,ProfessorofMedicine,Pediatrics&Psychology,AssociateDirector,DiabetesResearchInstitute,UniversityofMiami,MillerSchoolofMedicine,Miami,FL.
M
Photo: © Vail Resorts
27
William V. Tamborlane, MD, ProfessorandChiefofPediatricEndocrinology,YaleSchoolofMedicine,NewHaven,CT.
William E. Winter, MD,ProfessorofPathologyandPediatrics,UniversityofFlorida,Gainesville,FL.
Phil Zeitler, MD, PhD,ProfessorofPediatricsandClinicalScience,UniversityofColoradoDenver,MedicalDirector,Children’sHospitalClinicalTranslationalResearchCenter,ColoradoClinicalTranslationalScienceInstitute,Aurora,CO.
PLATInUM
sanofi-aventisU.S.Inc.
LillyUSA,LLC
BayerHealthCareDiabetesCare
GOLD
MedtronicDiabetes
NovoNordisk,Inc.
SILVER
AbbottDiabetesCare,Inc.
BDMedical/DiabetesCare
BRASS
AnimasCorporation
AthenaDiagnostics,Inc.
CumberlandHospitalforChildrenandAdolescents
DiamydMedical
InsuletCorporation
LifeScan,Inc.
RocheDiagnostics
SavE THE daTE!
kEySTONE CONFERENCE 4TH BIENNIal
“PRaCTICal wayS TO aCHIEvE TaRGETS IN dIaBETES CaRE”
Friday, July 15, 2011 thru Saturday July 17, 2011
Designed to help health care providers caring for adolescents and adults with diabetes,
Check the Children’s Diabetes and Barbara Davis Center web sites
in January 2011 for more information.
www.ChildrensDiabetesFoundation.orgwww.BarbaraDavisCenter.org
-
Foundation New
sPhoto: © Vail Resorts
28
Foun
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ews
inetyavidgolfers andahandfulof dedicated volunteers assembledatthecrackofdawnatSignatureAviationonNovember4thtoflyawaytoLasVegastoPlayfortheCureattheMcDonaldAutomotiveCarouselClassictobenefittheChildren’sDiabetesFoundation.AcharterFrontierjetflewthefestivegrouptoTheWynnwheretheyplayedonthefabulousWynncourse,andstayedovernighttoenjoytheVegasscenewhilenetting$223,000tohelpfundresearchattheBarbaraDavisCenterforChildhoodDiabetes.LedbyMichaelMcDonaldandDanFullerwhoshareapersonalinterestineradicatingdiabetes,thiseventfollowedtheHealthOneCarouselClassicheldinJuneattheCherryCreekCountryClub.Thecombinedeventsgrossedanastounding$386,000.Wewouldliketoofficiallythankourfly-away
NsponsorsincludingMcDonaldAutomotive,LocktonCompanies,AffinityVideo,BercoResourcesLLCandInterstateRestorations.WewouldalsoliketothankoursupportcrewatFrontierAirlines,TheWynnHotel,AWG,WhatzhotnowCatering,everyoneattheSignatureHangerandallofourgolfers.Itwasasuccessfultournamentanditwouldn’thavebeenpossiblewithoutyou!ThiswasTheCarouselClassic’sfirstyearfortheChildren’sDiabetesFoundation.Plansarealreadyunderwayfor2011withtheJune29theventatSanctuaryGolfCourseandthefly-awayagainatTheWynnearlynextNovember.RavereviewsarestillcominginproclaimingTheCarouselClassicasolidgoldwinner!
Forfurtherinformationortoregisterforthe2011eventswhicharesuretosellout,contactAmyCockerhamat303-863-1200.
SavE THE daTE!
WHAT:High Hopes Carousel Ball
October 1, 2011
WHAT: 2011 Carousel Classic Sanctuary Golf Course
June 29th, 2011
WHAT: The Guild’s High Hopes
Golf Tournament Glenmoor Country Club
July 18th, 2011
WHAT: Keystone Conference 4th
biennial “Practical Ways to Achieve Targets in
Diabetes Care” July 15-17th, 2011
MCdONald aUTOMOTIvE CaROUSEl ClaSSIC a wyNN/wIN
29
BaUBlES, BaNGlES aNd BEadSIf a Bead or a Pearl, a piece of Gold or Silver
Would help toward a cure…
Would you give from your jewelry drawer
To raise money to find a cure.
We have started Jewels for Hope To help save our true ‘Jewels’
Children who live with Diabetes
We are asking you to give a piece of jewelry
Real or costume, it does not matter,
Someone else will treasure it knowing
It will help us toward a cure.
Now won’t you reach into your Jewelry Drawer?
— by Gretchen Pope
To donate contact Susie Hummell at 303-863-1200.
2011 GUIld
OFFICERS2010 GUILD OFFICERS
President:JudyMcNeil
President-Elect: GinaAbou-Jaoude
Recording Secretary: JenniferBarrow
Treasure: AnnieCotton
Treasurer-Elect: GleneenBrienza
Corresponding Secretary: ShelleyLucas
Immediate Past President: SharonKamen
Advisors:SandyBurfittKathyCrapoMartyJensenGailJohnson
CHaRlOTTE TUCkER SCHOlaRSHIP OPPORTUNITIES FOR 2011-2012
heGuildofthe Children’s Diabetes Foundation isalwaysproudtoawardscholarshipstohighschoolseniorsandcollegestudentswhoarecurrentpatientsattheBarbaraDavisCenter.ThescholarshipprogramwasestablishedinmemoryofpastGuildPresident,CharlotteTucker,whoencouragedyoungpeoplefromtheBarbaraDavisCentertofollowhighercareerandeducationalpursuits.
Applicationsfor2011-2012willbeavailableinFebruary2011. PatientswhoarecollegeortradeschoolboundwillbenotifiedregardingapplicationsinFebruary2011.Ifyoudon’treceiveinformationorhavequestions,pleasecallSusieHummellattheCDFofficeafterFebruary14th,2010at303-628-5109or800-695-2873.
T
GUIld MISSION STaTEMENT
TheGuildoftheChildren’sDiabetes
FoundationatDenverraisesfundsforclinical
andresearchprogramsfortheBarbaraDavis
CenterforChildhoodDiabetes.TheGuild
promotesdiabetesawarenessandeducation;
assistsfamiliesinneed;providescontinuing
educationscholarshipsandsponsorssocial
activitiesforchildrenandtheirfamilies.
å
aNNUal MEETING
Monday,January10,2011
DenverCountryClub
1700East1stAvenue
Denver,CO
COFFEE9:30a.m.
MEETING10:00a.m.
Brunchwillbeserved
followingmeetingand
program.
Reservation:$35.00
Pleasemakeyourreservationforthebrunchbysendingacheckto:
Children’sDiabetesFoundationAttn:SusieHummell
777GrantSt.,Ste.302Denver,CO80203
Topaybycreditcard,pleasecallSusieat303-628-5109ore-mailat
Guild G
uide
30
Win
ner’s
Circ
le
Harrison receives care at the Barbara Davis Center for Childhood Diabetes.
This was his prayer at the Carousel of Hope, October 23, 2010.
Dear God,Tonight I have a special prayer for all of the children
suffering with type 1 diabetes. I pray that you keep us brave in our fight, please bless
our parents with patience, and help the doctors working to find a cure.
I thank you for Barbara Davis and all of the loving people here tonight supporting kids like me.
In your name we pray, Amen.Harrison Fuller, Age 7
A PrayerkIdS HElPING kIdS hankyouAspen Academystudents, facultyand HarrisonFullerfor raising$353.00forChildren’sDiabetesFoundationatyourDressDownFundraiser.YourfundswillhelptofurthercareandresearchprogramsattheBarbaraDavisCenterforChildhoodDiabeteswhichcaresfor5,000childrenandyoungadults.
Wearehonoredtohavethestudents,facultyandfamiliesofAspenAcademyjoinusinthefightagainstdiabetes.Weareespeciallyproudtoseekidshelpingkids.Yourgifthasaveryspecialmeaningtoourorganizationandchildrenwithdiabetes.Congratulationsonyourverysuccessfulfundraiser!
ThankyouHarrisonfordoingsuchagreatjobspeakingonbehalfofallofkidsattheBarbaraDavisCenterattheCarouselofHope.Wearesoproudofyou!
TPhoto: © kentmeireisphotography.com
31
Cooks C
ornerCHOCOlaTy PUMPkIN BaRS— Makes 30 bars
InGREDIEnTS1cupall-purposeflour 1cupwholewheatflour 1cuppecans,veryfinelychopped3/4cupgranulatedsugar 2teaspoonsbakingpowder 1teaspoongroundcinnamon1/2teaspoonbakingsoda 1/2teaspoonsalt 4largeeggs,beaten115-ouncecan100%purepumpkin 1/2cupcanolaoil 1/4cup1%low-fatmilk1/2cupminisemi-sweetchocolatechips
DIRECTIOnSPreheattheovento350°F.Lightlyoilorcoata15x10x1-inchrimmedbakingorjellyrollpanwithnonstickcookingsprayandsetaside.
Whisktogethertheall-purposeflour,wholewheatflour,pecans,sugar,bakingpowder,cinnamon,bakingsoda,andsaltinalargebowluntilwellcombined.
Inaseparatebowl,whisktheeggs,pumpkin,oil,andmilkuntilwellblended.Pourtheliquidingredientsoverthedryingredientsandstiruntiljustcombined.Stirinthechocolatechips.
Spreadthebatterevenlyinthepreparedpanandbakefor25minutes,oruntilawoodentoothpickinsertedinthecentercomesoutclean.Transferthepantoawirerackandcoolfor10minutesbeforeslicingintothirty,2x2½-inchbars.
Tip: For maximum freshness, store leftovers in a plastic container or zip-top bag in the refrigerator.
nUTRITIOn InFORMATIOn PER SERVInG (1 BAR):140calories,6gfat(1gsaturated,0.4gomega-3),95mgsodium,16gcarbohydrate,2gfiber,2gprotein,45%vitaminA
aPPlE BlUEBERRy walNUT CRISP— Makes 6 Servings
InGREDIEnTS3largeRedorGoldenDeliciousapples(about2pounds),unpeeledandcutinto1/2-inchpieces(about4cups)2tablespoonsbrownsugar 2tablespoonswholewheatflour1teaspoonvanillaextract 1/2teaspoongroundcinnamon1cupfreshorfrozenblueberries 1/2cupwalnuts,veryfinelychopped1/2cupold-fashionedorquick-cookingoats 2tablespoonsbrownsugar2tablespoonswholewheatflour 2tablespoonsgroundflaxseedorwheatgerm1/2teaspoongroundcinnamon 2tablespoonscanolaoil1/8teaspoonsalt
DIRECTIOnSPreheattheovento400°F.Placetheapples,brownsugar,flour,vanilla,andcinnamoninalargebowlandtosstocoat.Gentlystirintheblueberries.
Placetheapplemixtureinan8x8-inchbakingpanordishandsetaside.
Tomakethetopping,placethewalnuts,oats,brownsugar,flour,flaxseed,cinnamon,andsaltinamediumbowlandstirtocombine.Addtheoilandstiruntiltheoatmixtureiswellcoated.Spreadthetoppingevenlyoverthefruitmixture.
Bake40to45minutes,oruntilthefruitistenderandthetoppingisgoldenbrown(coverwithfoilabouthalfwaythroughifthetoppingbrownstooquickly).
Tip: Top each serving with low-fat vanilla frozen yogurt or a dollop of light whipped cream.
NUTRITIOn InFORMATIOn PER SERVInG: 260calories,13gfat,(1gsaturated,1.8gomega-3),55mgsodium,34gcarbohydrate,5gfiber,4gprotein,10%vitaminC
32
Nut
ritio
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ews wHaT’S THE
SCOOP ON SwEETENERS?
— Gail Spiegel MS RD CDE
hefollowingisan updateonthe sweetenersthat arecurrently approvedbythefoodandDrugAdministration(FDA)andavailableonthemarket.TheBarbaraDavisCenterdoesnotendorseorcondemnanycertainproduct.
Sweetenerscanbedividedintotwogroupsbasedonthecaloriestheyprovide.Thesetwogroupsarenutritive(containcalories)andnon-nutritivesweeteners(donotcontaincalories).
nUTRITIVE SWEETEnERS
Nutritivesweetenersprovidecaloriesandcarbohydratesandincludetwotypesofsweetenersthatarecommonlyused:sugars,sugaralcohols.
SUGARS
Sugarsweetenersincludesucrose(tablesugar),fructose,honey,highfructosecornsyrupaswellasothers.Sucroseandfructosearetheprimarysugarsweetenersthatoccurnaturallyinthefoodsupplyorareaddedassugarsincornsweetenersandsyrups.Sugarsweetenersprovide16caloriesand4gramsofcarbohydrateperteaspoon.
Agavenectar,whichhasrecentlybecomepopular,isasyrupthatisrefinedfromacactus-likeplant.Agavenectarismadeoffructoseandglucose.Agaveis140–160timessweeterthansugar.Oneteaspoonprovides20caloriesand5gramsofcarbohydrate.
SUGAR ALCOHOLS
Sugaralcoholsincludesorbitol,mannitol,xylitol,erythritol,isomaltandhydrogenatedstarchhydrolysatesaswellasothers.Mostsugaralcoholsprovideapproximately8caloriesand2gramsofcarbohydratesperteaspoon.Sugaralcoholsareabsorbedmoreslowlythansugarandeatinganexcessiveamountcancausediarrhea.XylitolisfoundinasweetenernamedIdealSweetener.Sugaralcoholsarefoundinsuchproductsassugarfreecandies,chewinggum,andbakedgoodssuchascookies.Despitebeinglabeled“sugarfree”theseproductsstillcontaincarbohydratesandwillcauseariseinbloodsugars.Erythritolismuchlowerincaloriesandcarbohydratesthantheothersandmaynotcauseariseinbloodsugars.Besuretocheckthenutritionfactsonthelabeltodeterminetotalcarbohydratecontent.
nOn-nUTRITIVE SWEETEnERS
Non-nutritivesweetenersdonotprovideanycaloriesorcarbohydrates.Therearecurrentlyfivenon-nutritive,artificialsweetenersapprovedbytheFDA.Theyaresaccharin,acesulfame-K,aspartame,sucraloseandneotame.Inaddition,Stevia,anaturalsweetenerdoesnotprovidecaloriesorcarbohydrates.
SACCHARIn
Saccharinis200-700timessweeterthansugar.Itprovidesnocaloriesorcarbohydratesandisnotmetabolizedbyourbodies.Itisapprovedforusein100countries,buthasbeencontroversialhereintheUnitedStates.Questionsaboutsaccharin’ssafetyfirstbeganin1977whenstudiessuggesteditcausedbladdertumorsinrats.Saccharinusedtocarryawarningonthelabel,butin2000the
T
NationalInstitutesofHealthremovedsaccharinfromthelistofcarcinogensandCongressremovedtherequirementforwarningnotices.Studiesofhighusersdonotsupportanassociationbetweensaccharinandcancer.SaccharincanbefoundinSweet’NLow®,SweetTwin®andothertabletopsweetenersaswellasfountaindrinks.Theamountofsaccharinineachproductislimitedandmustbeprintedonthelabel.
ACESULFAME-K (ACE-K)
Ace-Kis200timessweeterthansugar.Thissweetenerisnotmetabolizedbythebodyeitherandthereforeprovidesnocaloriesorcarbohydrates.IthasbeenapprovedbytheFDAsince1988.Itisapprovedforuseasageneral-purposesweetenerandisusedinmorethan80countries.Ace-Kdoesnotbreakdownwhenheatedandcanbeusedincookingandbaking.Itiscurrentlyusedinsugarfreeicecreamsandmanysugarfreeordietbeverages,oftentimesincombinationwithsucraloseoraspartame.
ASPARTAME
Aspartameisalso200timessweeterthansugar.Aspartameisbrokendownintoasparticacid,methanol,andphenylalaninebythedigestiveprocess.Theaminoacidsphenylalanineandasparticacidaremetabolizedtoprovidefourcaloriespergram.Becausethissweetenerisveryintenseandweuseitinsuchsmallamounts,itprovidesnocalories.AspartamehasbeenapprovedbytheFDAsince1981.Ithasbeendeemedsafebymajorhealthgroupsandagenciesinover90countries,includingtheWorldHealthOrganizationandtheAmericanMedicalAssociation.Itiscurrentlyapprovedforuseasageneral-purposesweetenerinallfoodsandbeverages.It
33
Nutrition N
ews
breaksdownwhenheatedanddoesnotworkwellincookingandbaking.Thissweetenerisinmanyproducts.Somecommonlyusedproductsthatcontainaspartameareasfollows:Equal,NutraSweet,NatraTaste,dietsodas,sugarfreeJELL-O,lightyogurts,powderedsoftdrinks,sugarfreeicecream.
Aspartamehascausedthemostcontroversyandappearstoreceivemoremediaattentionaboutitssafetythananyothersweetener.StudieshavenotfoundanylinkbetweenaspartameanddiseaseslikeAlzheimer’sormultiplesclerosis.Researchhasnotfoundthataspartameleadstoanincreasedriskofcancereither.Theonlynegativeeffectsthataspartamehasbeenshowntocauseinafewsmallresearchstudiesisworseningmigrainesforsomepatients.
SUCRALOSE
SucralosewasapprovedbytheFDAinApril1998foruseasatabletopsweetenerandindesserts,candiesandnonalcoholicbeverages.Sucraloseis600timessweeterthansugarandprovidesnocaloriesorcarbohydrates.Itismadefromsucrose,butisalteredsothatitismuchsweeterthansugarandisnotabsorbedbythebody.Itdoesnotbreakdownwhenheatedandcanbeusedforcookingandbaking.Sucralosecancurrentlybefoundinmanydietorsugarfreedrinks,sugarfreeicecreamandotherproducts.ItismarketedunderthetradenamesSplenda®andNevella®.Nevellaissoldinregularandprobioticversions.
nEOTAME
ThissweetenerwasapprovedbytheFDAasageneralpurposesweetenerin2002.Neotameisveryintense,40timessweeter
thanaspartameand7,000-13,000timessweeterthansugar.Itcanbeusedinbakingandcooking.Asofthewritingofthisreview,neotamewasnotfoundinanyproductsonthemarket.
STEVIA
ThisisanaturalsweetenerfromthesteviarebaudianaplantfoundinSouthAmerica.Steviarebaudianaisanherbthatis300timessweeterthansugar.Steviacontainsnocaloriesorcarbohydratesanddoesnotaffectbloodglucose.SteviahasbeensoldintheUSinthesupplementaisleformanyyears,butin2008,theFDArecognizedapartofthesteviaplant,knownasRebianaorRebA,assafeforuseinfoodproducts.Youcanbuysteviaingranularandliquidformsfromgroceryandhealthfoodstoresforuseindrinks,cookingandbaking.BrandnamesforsteviaincludeTruvia™andPureVia™.Truvia™contains3gramsofcarbohydratesperpacket,
butthecarbohydratesarenotdigestedorabsorbedbythebodyaccordingtothecompanysotheydonotaffectbloodsugar.Purevia™contains2gramsoftotalcarbohydrateperpacket.SunCrystals™isalowsugarsweetenerthatispartsteviaandpartsucrose(tablesugar).
Today,therearemorealternativesthaneverforpeoplewithdiabetes.Foodmanufacturersareusingnewsweetenersandcombiningsweetenerstoimprovethetasteandmouthfeelofsugar-freeandlow-sugarfoodsandbeverages.Plus,sucroseisnolongerrestrictedfromthedietandcanbeincludedwithinthecontextofahealthydiet.Forthosewhocountcarbohydrates,foodscontainingsugarcanbesubstitutedforothercarbohydratesinthemealplanorextrainsulincanbegiven.Whenitcomestosweeteners,eachfamilyneedstodecidewhatworksbestforthem.
Photo: © Martin Crabb
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Nut
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ews wHaT’S CONSIdEREd SaFE?
Sugar Substitute Recommended or Acceptable Product
Daily Intake (ADI)* equivalents
Saccharin 5mg/kg**bodyweight 3packetsof For23kg(50lb.)child Sweet‘NLow
Aspartame ADI=50mg/kgofbodyweight 33packetsof For23kg(50lb.)child Equalor 5cansofdietsoda
Acesulfame-K ADI=15mg/kgofbodyweight 8packets For23kg(50lb.)child ofSweetOne
Sucralose ADI=5mg/kgofbodyweight 9packetsofSplenda For23kg(50lb.)child 1.5cansofdietsoda *AcceptableDailyIntakeisdefinedastheamountatwhichthereisnoadverseeffectandareasonablecertaintythatnoharmwillcomefromuse.Itisanamountthatyoucanconsumefortherestofyourlifewithnoconcernaboutsafety.ADIissetbytheFDAandtheJointExpertCommitteeofFoodAdditionsoftheUnitedNationsFoodandAgriculturalOrganizationandWorldHealthOrganization.
**1kilogram=2.2pounds
REFEREnCESPositionofTheAmericanDieteticAssociation:Useofnutritiveandnonnutritivesweeteners,JournaloftheAmericanDieteticAssociation2004;104:255-275.
Porro,J.Sugar’sSweetStand-Ins,DiabetesInterview,Sept.1998,74:18-21.
Schardt,David.SweetNothings:notallsweetenersareequal.NutritionActionHealthletter,May2004.
0Future Newsnotes will be published online at
www.childrensdiabetesfoundation.org.
Remember to register online by January 31, 2011 to qualify to win an I-Pad.
r
35
ExECUTIVE BOARD:
Mrs.BarbaraDavis,Chairman
RichardS.Abrams,M.D.
JulesAmer,M.D.HonoraryLifetimeMember
Mr.PeterCulshaw
StephenDaniels,M.D.,Ph.D.ChairmanofPediatrics,TheChildren’sHospital,Denver
Ms.DanaDavis
Mrs.NancyDavisRickel
StevenFarber,Esq.
RichardF.Hamman,M.D.,DrPHUniversityofColoradoDenverSchoolofMedicineDean,ColoradoSchoolofPublicHealth
Mrs.ArleneHirschfeld
Mrs.DeidreHunter
Mr.ShawnHunter
M.DouglasJones,Jr.,M.D.
RichardD.Krugman,M.D.Dean,SchoolofMedicine,UniversityofColoradoDenver
StacyMendelsonRobinson
Ex-officioMember:GeorgeS.Eisenbarth,M.D.,Ph.D.ExecutiveDirector,BarbaraDavisCenterforChildhoodDiabetes,UniversityofColoradoDenver;ProfessorofPediatricsandMedicine,UniversityofColoradoSchoolofMedicine
SCIEnTIFIC ADVISORy BOARD:
RichardS.Abrams,M.D.AssociateClinicalProfessorofMedicine,UniversityofColoradoSchoolofMedicine;RoseMedicalCenter,Denver
JulesAmer,M.D.ClinicalProfessorofPediatrics,UniversityofColoradoSchoolofMedicine;Partner,Children¹sMedicalCenter,Denver
M.DouglasJones,Jr.,M.D.Professor,DepartmentofPediatrics,UniversityofColoradoSchoolofMedicine;SectionofNeonatology,TheChildren¹sHospital,Denvereeeeeeeeeeee
NEWSNOTESispublishedtwiceyearlybytheChildren’sDiabetesFoundationatDenver.Wewelcomeyourcomments.
IfyouwouldliketosubmitanarticleoralettertoNewsnotessendinformationto:
Children’sDiabetesFoundationatDenver777GrantStreet,Suite302Denver,CO80203
CindyKalkofenGraphic Designer
KatieHicksChristineLernerEditors
Know the symptoms ofChildhood Diabetes: • Loss of weight • Extreme thirst • Excessive irritability • Frequent urination • Bedwetting (previously controlled)
Printed on recycled paper
A child reaching for the brass ring on a carousel is symbolic of the most important goal of the Children’s Diabetes Foundation — The cure.Yourcontributiononbehalfofalovedonewillmakeadifference.ItwillsupporttreatmentprogramstoassistchildrenwithdiabetesinleadinghealthierlivesanditwillfundresearchtohelpCDF“CatchtheBrassRing”byfindingacure.
Markananniversary,birthday,specialoccasion;expressappreciationormakeamemorialtributeinhonorofsomeonespecialwithacontribution—foranyamount—totheChildren’sDiabetesFoundationatDenver.Wenowacceptgiftsonline.
Donationsaretaxdeductible.TaxID#84-0745008
The Brass Ring FundRemember a loved one –– Help CDF “Catch the Brass Ring”
Enclosedismycontributionof$_______________________Inmemoryof_______________________________________Orinhonorof_______________________________________Occasion__________________________________________Pleasesendacknowledgementsto:(Amountofgiftwillnotbementioned)
Name_____________________________________________Address___________________________________________City__________________State________Zip___________FromName_____________________________________________Address___________________________________________City__________________State________Zip___________
Children’s Diabetes Foundation at Denver, Colorado777GrantStreet,Suite302,Denver,CO80203
303-863-1200,800-695-2873,www.ChildrensDiabetesFoundation.org
BrianKotzin,M.D.VicePresident,GlobalClinicalDevelopment,Amgen,Inc.ThousandOaks,California
AkéLernmark,M.D.,Ph.D.RobertH.WilliamProfessor,DepartmentofMedicine,UniversityofWashingtonSchoolofMedicine,Seattle
AliNaji,M.D.,Ph.D.J.WilliamWhiteProfessorofSurgery,HospitalofUniversityofPennsylvania,Philadelphia
GeraldNepom,M.D.,Ph.D.ScientificDirectorandDirectorofImmunologyandDiabetesResearchPrograms,VirginiaMasonResearchCenter,Seattle
WilliamV.Tamborlane,M.D.ProfessorofPediatrics,YaleUniversitySchoolofMedicine,NewHaven,Connecticut
ADVISORy BOARD:Mr.MichaelBoltonSirMichaelCaineMs.NatalieColeMr.andMrs.RobertA.DalyTheHonorableDianaDeGette,U.S.HouseofRepresentatives,ColoradoMr.NeilDiamondMr.PlacidoDomingoMrs.GeraldR.FordMr.DavidFosterMr.KennyGMr.DavidGeffenMs.WhitneyHoustonMr.QuincyJonesMs.SherryLansingMr.JayLenoMr.PaulMarcianoMr.MoOstinTheHonorableandMrs.BillRitter,GovernorandFirstLadyofColoradoSirSidneyPoitierMrs.RonaldReaganMr.LionelRichieMrs.AdrienneRustonFitzgibbons
Mr.GeorgeSchlatterTheHonorableArnoldSchwarzenegger,GovernorofCalifornia,andMs.MariaShriverMr.StevenSpielbergandMs.KateCapshawMissJoanvanArkMs.BarberaThornhillMr.GaryL.WilsonMr.StevieWonder
ADVISORy BOARD, THE GUILD PRESIDEnTS:FoundingPresident,AmyDavisMrs.JamieAngelichMrs.KarenAylsworthMrs.LindaBroughtonMrs.JoyBurnsDr.BonitaCarsonMrs.NancyCoweeMrs.NormaD’AmicoMissDonnaDouglasMrs.MargyEpkeMrs.ChrisFosterMrs.HelennFranzgroteMrs.SallyFrerichsMrs.DebbieGradisharMrs.HelenHanksMrs.MartyJensenMrs.GailJohnsonMrs.SharonKamenMrs.JanetKniselyMrs.SuzyLoveMrs.SallyNewcombMrs.GretchenPopeMrs.CarolRogerMrs.KayStewartMrs.DianeSweatMrs.MelissaTuckerMrs.LorettaTuckerMrs.JaneWeingarten
FOUnDATIOn:ChristineLerner,ExecutiveDirector
Children’sDiabetesFoundation
atDenver,Colorado
777GrantStreet,Suite302
Denver,CO80203
AddressServiceRequested
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PAIDDenver,CO
PermitNo.1752
BdC ExPaNdS TyPE 2 dIaBETES CaRE & RESEaRCH IN PaRTNERSHIP wITH CHIldREN’S HOSPITal
— George Eisenbarth, MD, PhD, Executive Director of the Barbara Davis Center for Childhood Diabetes
herearemanyformsofdiabetes,andforthebest clinicalcareitisimportanttoknowwhichformof diabetesanindividualhas.InchildrenType1diabetes isthemostcommonandresultsforautoimmune destructionofthecellsthatmakeinsulin.Whiletype2diabetesisthemostcommonformofdiabetespresentinginadults,itisincreasinginchildren.AttheBarbaraDavisCenterwediagnoseandcareforallchildrenwithdiabetesandtherearemanyformsmorethantype1and2.Inparticular,wecarefortype2childrenattheBDCandDr.PhilZeitlerofChildren’sHospitalhasaspecifictype2clinicatourcenter.OneofDr.Slover’snewresponsibilitieswillbetoorganizecareofchildrenatChildren’shospitalwhohavediabetesduetocysticfibrosisandcancertherapy.Wealsoarehelpingtodefinehowmanychildrendeveloptype2formsofdiabeteswiththeNationalInstitutesofHealth“Search”studyandwithstudiesofthepathologyofpancreasofyoungadultswhohaveunfortunatelydiedwithdiabetes(JDRFnPODinternationalstudy).
Bothtype1andtype2diabetesareincreasingdramatically.Fiveto10percentofpatientswithtype2diabeteshaveautoimmunetype1diabetes,andfortunately,theanti-isletantibodytestswehavehelpeddevelopnowallowproperdiagnosis.Mostpatientswithtype2diabeteseventuallyneedinsulin.Wearestudyingnewtherapiesapplicabletoboth.
T
Photo: © Martin Crabb