Children’s Diabetes Foundation at Denver

GENETICS AND DIABETES— Pam Fain, PhD

Research Geneticist at the Barbara Davis Center

For years, it has been known thatdiabetes runs in families, as is thecase for many if not most other

diseases. However, until recently, it wasvery difficult to identify the genes that

– Continued

Winter 1996

Scientific Advisory Board:Richard S. Abrams, M.D.Associate Clinical Professor of Medicine,University of Colorado School ofMedicine; Rose Medical Center, DenverJules Amer, M.D.Clinical Professor of Pediatrics,University of Colorado School ofMedicine; Partner, Children’s MedicalCenter, DenverM. Douglas Jones, Jr., M.D.Professor and Chairman, Department ofPediatrics, University of Colorado Schoolof Medicine; Pediatrician in Chief,The Children’s Hospital, DenverBrian Kotzin, M.D.Professor of Immunology,University of Colorado School ofMedicine; National Jewish Center forImmunology and Respiratory Medicine,DenverAke Lernmark, M.D., Ph.D.Robert H. William Professor, Departmentof Medicine, University of WashingtonSchool of Medicine, SeattleAli Naji, M.D., Ph.D.J. William White Professor of Surgery,Hospital of University of Pennsylvania,PhiladelphiaGerald Nepom, M.D., Ph.D.Scientific Director and Director ofImmunology and Diabetes ResearchPrograms, Virginia Mason ResearchCenter, SeattleJulio Santiago, M.D.Professor of Medicine and Pediatrics,Washington University, St. Louis,Missouri; St. Louis Children’s Hospital

Advisory Board:Mrs. Alan AngelichMr. and Mrs. Rand V. AraskogMrs. John AylsworthMr. Michael BoltonMrs. Franklin L. BurnsMr. Michael CaineThe Honorable Ben NighthorseCampbell, U. S Senate, Colorado

Mr. Phil CollinsMr. Lodwrick M. CookMrs. John CoweeMr. Robert A. DalyMrs. Thomas P. D’AmicoMr. Tony DanzaMr. Neil DiamondMr. Placido DomingoMiss Donna DouglasMs. Natalie Cole FischerPresident and Mrs. Gerald R. FordMr. David FosterMr. Kenny GMr. David GeffenMr. Merv GriffinMr. Bob HopeMs. Whitney HoustonMrs. Walter ImhoffMr. Michael JacksonMr. and Mrs. John H. JohnsonMr. Quincy JonesMrs. Michael JultakDr. Henry A. KissingerMrs. Robert KniselyMr. Howard W. KochKevin J. Lafferty, Ph.D.The Honorable and Mrs.Richard D. Lamm

Ms. Sherry LansingMr. Jay LenoMr. Paul MarcianoMr. Walter MatthauMiss Dina MerrillMr. Myron M. MillerMr. Roger MooreEvelyn and Mo OstinMr. Ronald O. PerelmanThe Honorable Federico PeñaMr. Sidney PoitierPresident and Mrs. Ronald ReaganMr. Lionel RichieMrs. Sheldon RogerMr. Kenny RogersThe Honorable Roy RomerGovernor, State of Colorado

Mrs. Roy RomerMiss Diana RossMr. Lewis RudinMs. Carole Bayer SagerMr. George SchlatterThe Honorable Patricia SchroederU.S. House of Representatives,First District, Colorado

Ms. Maria Shriver andMr. Arnold Schwarzenegger

Alan and Sandra SilvestriMr. Steven Spielberg andMs. Kate Capshaw

Mrs. Robert J. StewartMrs. Robert TuckerMrs. Thomas N. TuckerMiss Joan van ArkMrs. Peter WeingartenThe Honorable Wellington E. WebbMayor, City of Denver

Mrs. Luanne WellsMs. Barbera Thornhilland Mr. Gary L. Wilson

The Honorable Pete WilsonGovernor, State of California

Mr. Henry WinklerMr. Stevie Wonder

Executive Board:Mrs. Marvin DavisChairpersonRichard S. Abrams, M.D.Jules Amer, M.D.Miss Amy DavisMiss Dana DavisMs. Nancy DavisSteven Farber, Esq.The Honorable Sherman G.Finesilver

Mr. Gerald S. GrayCharles Halgrimson, M.D.Associate Dean, University ofColorado School of MedicineMrs. A. Barry HirschfeldM. Douglas Jones, Jr., M.D.Ex-officio Member:George S. Eisenbarth, M.D., Ph.D.Executive Director, Barbara DavisCenter for Childhood Diabetes,University of Colorado HealthSciences Center; Professor ofPediatrics and Medicine, Universityof Colorado School of Medicine

Photo

MartinCrabb

Jonathon is a patient at the Barbara Davis Center for Childhood Diabetes

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cause disease. The humangenome, which refers to theentire collection of genetic infor-mation in humans, consists ofabout 100,000 genes. The iden-tification of a gene that has spe-cific effects on disease suscepti-bility was once like finding aneedle in a haystack. This situ-ation changed in the late 70sand early 80s when researchusing recombinant DNA technol-ogy began to show that it waspossible to map and clonehuman genes. With the ability tomap and clone disease genes, itshould be possible to predictwhich relatives are at highestrisk for disease. Perhaps moreimportantly, it will be possibleto study the specific mecha-nisms and genetic pathwaysinvolved in disease pathogenesisand to use these results todevelop and implement moreeffective therapies.

Human GenomeProject

In recognition that the new tech-niques in molecular biologymight be used to identify genesthat cause disease, the Board onBasic Biology of the NationalResearch Council's Commissionon Life Sciences established theCommittee on Mapping andSequencing the Human Genometo assess the implications of thenew findings, which heldpromise for revolutionizing thefield of human genetics. In1988, the Committee recom-mended the initiation of theHuman Genome Project, anambitious effort aimed at map-ping and sequencing the entirehuman genome. In 1989, theNational Institutes of Health(NIH) formed a division knownas the National Center forHuman Genome Research(NCHGR), which along with theDepartment of Energy (DOE),has been the major source of

funding for the projected 15-year $3-billion Human GenomeProject. As similar efforts weresupported in other countries,many laboratories in the U.S.and around the world began thetask of generating DNA markersand constructing genome mapswhile many of the same andother laboratories began to usethe markers and maps to identi-fy disease genes. Within 5 yearsof the initiation of the HumanGenome Project the number ofknown genes increased from afew hundred to nearly 5,000.Although this still representsonly 5-10% of the total estimat-ed number of genes, the globaleffort to map and sequence theentire human genome is expect-ed to be completed on schedule.

What are the implications of theHuman Genome Project withrespect to identifying genes thatcause diabetes and whatprogress has been made in thisregard? To date, most of thedisease genes that have beenidentified cause so-called"Mendelian" disorders in whichone gene is responsible for thedisease in most cases.However, Mendelian disordersare usually very rare. Althoughin some cases diabetes and/orautoimmunity can be attributedto a specific gene, in most casesdiabetes is caused by the inter-action of two or more genes.The genes involved may differ indifferent people, making it evenmore difficult to identify thesegenes. Even so, it has long beenknown that a gene or geneswithin the major histocompati-bility complex (MHC) on humanchromosome 6 can increase therisk for diabetes. The ability toidentify and study specific MHCvariants and their effects on dia-betes susceptibility has beengreatly enhanced by improve-ments in DNA sequencing andother technology. In particular,

researchers at the BarbaraDavis Center for ChildhoodDiabetes have determined thatat least one MHC variant actual-ly protects carriers against theoccurrence of diabetes.

Family Studies

Many laboratories andresearchers including theBarbara Davis Center are nowactively involved in family stud-ies of diabetes with hopes ofmapping and cloning othergenes that influence the risk fordiabetes and/or complicationsresulting from diabetes. Theresults to date indicate that theinsulin gene on human chromo-some 11 or a gene nearby mayincrease the risk for diabetes,especially in offspring of affect-ed fathers. About 10 othergenes have also been implicat-ed; however, the significance ofthese results remains unclear.It is now becoming evident thatunravelling the complexities ofthe genetics of diabetes andother common diseases mayrequire novel study designs andmethods of analysis. There hasalso been a very recent movetowards focusing on the geneticsof autoimmunity as a moreeffective means of understand-ing the genetics of diabetes thanthe study of diabetes per se.Although the genetics of dia-betes is a relatively new area ofresearch at the Barbara DavisCenter, researchers at theCenter are internationally recog-nized experts on the autoim-mune response and its relation-ship to diabetes. Studies arenow underway or in the planningstages to combine this experi-ence with Human GenomeProject technology andresources with the expectationthat the Center will gain similarrecognition as leaders inresearch into genetic causes ofautoimmunity and diabetes.

Research Report

Research Report

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FUNDING THE FUTURE— George Eisenbarth, MD, PhD

Decreased funding from theNational Institutes of Health tosupport the training of youngscientists and decreased clinicalsupport, with cutbacks in med-ical care funding, threaten toeliminate a generation ofphysicians and scientistsdevoted to curing Type I dia-betes. In response to this crisis,at the Barbara Davis Center weare very grateful for the recentestablishment of two fellow-ships.

The first, the Kovler FamilyFellowship, has provided$30,000 per year to support theannual training of one fellow.The first recipient of the KovlerFamily Fellowship is PeterGottlieb, MD, the newest physi-cian and scientist to join theCenter's staff. Dr. Gottlieb'sstudies focus on creating T cellswhich will prevent diabetes andallow islet transplantation tosucceed. We are very grateful toJonathan Kovler and his familyfor their generous support.

The second fellowship, theDonough O'Brien Physician-Scientist Fellowship, wasendowed by the Children'sDiabetes Foundation and namedfor Donough O'Brien, MD, thefirst director of the Center (andstill a very active Center mem-ber). This fellowship is specificfor physician-scientists. Giventhe current climate, physician-scientists have been describedas a "dying breed."

At the Barbara Davis Center wewill do all we can to nurture andtrain young scientists, and suchfellowship support is essential.The bulk of the training of a fel-low is an "apprenticeship."Some of the most important bio-medical discoveries of the last

several decades have been madeby young scientists, at times inspite of their older mentors, andas we struggle to cure diabetes,we need their creativity.

LEGISLATIVE ALERT!!!— Angela Junk

There are currently two billsbefore the United States Houseand the Senate which wouldincrease funding for diabetesresearch. These bills, known asThe Diabetes Research Act of1995, define a strategy to savemillions of lives and billions ofdollars each year, and moreimportantly, will bring us closerto the CURE. The bills call for$155 million to be appropriatedfor diabetes research at theNational Institute of Diabetesand Digestive Kidney Diseaseswith an additional $60 millionfor this purpose at other nation-al institutes for each of the fis-cal years 1996 through 2000.Each year this nation spendsover $100 billion to fight thedevastating complications ofdiabetes; that's almost 15% ofour total health care budget. Inrequesting just over $200 mil-lion dollars each year, we hopeto cure diabetes—saving lives,saving dollars.

At present, it is extremelyimportant that these bills obtainas much support as possible;please write to your congress-men and congresswomen andurge them to become cospon-sors of House Bill HR 1656 andSenate Bill S1437. Tell themwhat it is like living with

diabetes; tell them what acure will mean to you.

You can learn who your repre-sentatives are by contactingyour local county commission-er's office. Write to yourSenators at the United StatesSenate, Washington, DC20515 and to Representativesat the United States House ofRepresentatives, Washington,DC 20515.

For more information andsample letters, please contactAngela Junk at the Children'sDiabetes Foundation, (303)863-1200 or (800)695-2873.

A SPECIAL GIFT FORRESEARCH!

Congratulations to Alex Steineron his Bar Mitzvah! Alex andhis sister, Abigail share a com-mon bond: They hope for a curefor diabetes. Abbie was diag-nosed with IDDM in July 1994and is a patient at the BDC.Alex, who is not diabetic, askedthat friends and family makedonations to the Children’sDiabetes Foundation in honor ofhis special day.

The Foundation thanks Alex andhis family for this thoughtful giftto bring diabetes closer to thecure.

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CASE MANAGERS— H. Peter Chase, MD

The Barbara Davis Center forChildhood Diabetes is imple-menting a policy of "CaseManagers" for each of ourfamilies. You may select theperson you feel most comfort-able dealing with as your casemanager. This person may beany member of the medical team(nurse, doctor/CHA, social work-er, dietitian).

The case manager is your con-tact person at the Center. Whenthe social worker or dietitian isthe primary case manager, asecondary case manager (usual-ly a doctor or nurse) will also beassigned to help with medicalproblems. The case managerpolicy will help to develop thebest individualized treatmentprogram for the person withdiabetes in your family.

It is hoped that case manage-ment will result in better bloodglucose control, increasedpatient and family satisfaction,and avoidance of hospitaliza-tions for a diabetes-relatedcause. The Center suggests thatyou attempt to reach your casemanager first for help with rou-tine diabetes care or with acuteproblems (moderate or largeketones, illness, severe hypo-glycemia). However, back-uppersonnel will always be avail-able when you cannot contactyour case manager.

ADA SUMMER CAMPANNOUNCEMENTDiabetes Camp this year will bedivided into two sessions: TeenCamp is scheduled from July7th to 13th for boys and girls13 to 17 years old. July 14thto 20th are the dates forJunior Camp for campers 8 to12 years of age.

Children with diabetes in theseage groups are eligible to attendDiabetes Camp at Glacier ViewRanch in Ward, Colorado. Thecost of the camp is $300.00 perchild; financial assistance isavailable. Donations to supportthese "camperships" are mostwelcome as well.

For complete information aboutcamp or to make a donation tosponsor a camper, call theAmerican DiabetesAssociation, Colorado Affiliate,at (303)778-7556 or(800)782-2873.

Sandy Hoops shares a laugh withPatrick Willems.

IT'S BEEN FUN … ANDMORE!Dear KIDS, parents, staff, andcolleagues:

I am writing this letter to thankall of you for contributing to theunique experiences I have hadover the past fifteen years at theBarbara Davis Center. All of

you have filled my professionallife with ideas, knowledge,humor, sorrow, joy, some failureand frustration, but most of allyou have filled it with FUN!!

I will begin a new phase in myprofessional life by joining thefaculty of the Child HealthAssociate/Physician AssistantProgram at the University ofColorado Health SciencesCenter on March 1st. This is anexciting time for the P.A. profes-sion and our program will beexpanded over the next fiveyears making it one of thelargest (and oldest) P.A. pro-grams in the country. I will bethe clinical coordinator for theprogram and will assist in sitevisits, development of new rota-tions, and ongoing evaluationsof current clinical experiences.This too will be filled withchallenges.

I am a clinician at heart andtherefore will continue to have aTuesday clinic at the Center. I’mjust not ready to say goodbye100%. I do hope I will be ableto see you at other events aswell; camp is high on my list,the ski trips, and of course, theannual Halloween party. AgainTHANKS for everything!

As always,

Sandy Hoops

Barbara Davis Center

JanssenPhotography

QUESTIONS ANDANSWERS

— H. Peter Chase, MD

Q. Is there any way to know ifthe pop received at fast foodrestaurants, theaters, andother places is truly "sugar-free" or the regular sugar-containing pop?

A. This question is asked fre-quently and the answer is "yes."Probably the cheapest way totest is by using the Test-Tape, aroll of yellow tape which can bedipped into the pop. It turnsgreen if there is sugar in thepop. The Diastix, the sugar-onlypart of KetoDiastix, or the distalsugar block on KetoDiastix willalso change color if there issugar present. Unfortunately, itis more common than most peo-ple realize for the wrong pop tobe served, probably in the rangeof 20% of the time (one glass infive). As sugar pop is one of themost concentrated sources ofsugar (approximately 10 tea-spoons per can), it usually rais-es the blood sugar level to the200 to 400 mg/dl level. This isespecially true if it is consumedwithout other foods which slowthe absorption of the sugar, orat a time when Regular insulinis not taken to allow the sugarto enter the cells.

Q. What is happening with thenew rapid-acting form ofRegular insulin?

A. The FDA (Food and DrugAdministration) approved thenew analogue, Lyspro, onFebruary 29, 1996. We hadhoped for the rapid 6 monthFDA approval, but that was notpossible. In fact, the new edi-tion of the “Pink Panther” bookhas the curves of the activity ofthe new analogue in dotted lineson page 46. A table of the activ-ity is also found on page 49.

(As books are usually a yearbehind progress, this has to beone of the first times a book hasscooped the availability of aproduct!)

It will now take about threemonths for the FDA to completeall the paperwork. Only thencan the first bottle of insulin bemade by Eli Lilly, Inc. for com-mercial sale. It therefore lookslike late summer or early fallbefore the big switch begins. Itis likely that most people willuse the new analogue ratherthan Regular insulin. With onsetof activity in 10 minutes, it willno longer be necessary to wait30 to 60 minutes to eat aftertaking the shot.

Data from the Barbara DavisCenter (published in DiabeticMedicine, Volume 13, page 47,1996) showed that the totalnumber of reactions decreasedby half using the new analogue.This was because all of theactivity of the new analogue isgone by four hours after theshot. In contrast, with the cur-rent human Regular insulin,some people get late peaks ofactivity in the four to eighthours after their shot, and sub-sequently experience reactions.

Although we now frequently usethe insulin regimen of one ortwo shots of Ultralente insulinwith Regular insulin before eachmeal (as described in the med-ical journal AdolescentMedicine, volume 12, page 373,1991), it is likely that this regi-men will now become even morepopular with the new insulinanalogue. The DCCT showed in1993 that equally good sugarcontrol could be achieved withthis regimen as with an insulinpump. The new analogue can betaken with Ultralente at break-fast and dinner without delayingthe onset of activity of the new

analogue. This is amazing initself as Ultralente does causesome delay in the onset of activ-ity of the current human Regularinsulin. Hopefully, the resultwill be improved sugar controlwhile needing to increase onlyfrom the current two shots tothree shots per day. The thirdshot will probably be a smallprice to pay for the improvedsugar control and the resultantreduction in eye and kidneycomplications.

THE BRITISH REALLYARE COMING!The British Diabetic Associationhas provided us with the namesof two teenagers who will bejoining us for the Teen DiabetesCamp on July 7th to 13th, 1996.They are:

Sarah Swann — 15 years oldfrom Sheffield, England.

Richard Wishart — 13 yearsold from Orkney, Scotland

A youth-worker from York,England, Ms. Moira Bradbury,will be joining these two youngpeople.

Questions & Answers

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If there is a Centerfamily who perhaps

has a teenage boy andgirl and would like tohelp host Sarah,Richard and Moira,

please call Dr. Chase at(303)270-7451.

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TRAVEL TIPS— Markey Swanson, RD, CDE

Summer soon will be upon us—warm weather, shades, sunscreen—and the family VACA-TION! No matter your destina-tion, prior planning will makeyour excursion a much moreenjoyable adventure!

Begin by salvaging that schoolbackpack. It makes a greattravel tote for each individualchild. Enlist the help of yourchild and begin packing.Whether you are traveling bycar, bus, plane, or train, thetravel tote will provide hours ofpersonalized fun and is easilyportable. Depending upon yourchild's age, the following listshould trigger your imagination.Include those items which willprovide maximum entertainmentfor your child.

Books and toys: colorbooks,paperbacks, activity books,crossword or word puzzle books,finger puppets, pocket games,card games.

Markers, crayons, or coloredpencils.

Mini box camera for yourchild's personal trip memories.

Postcards and stamps for theolder child.

Stickers and sticker book.

Tapes or CDs and player withheadphones.

Parents must also have a wellprepared travel tote! The itemsparents must include may not beentertaining, but can certainlypreserve the pleasure of thetrip. Remember, "an ounce ofprevention..."

Consider the following:

"Baby Wipes" for quick cleanup.

Glucose tablets or small boxjuices for treating low bloodsugars.

Insect spray (as needed).

Sunscreen.

Plenty of insulin, strips,glucagon, meter, etc. (Be sureto keep insulin cool!)

Plenty of individual snacks thatare easily portable and do notrequire refrigeration: granolabars, crackers or cookie pack-ets, dried fruit, fruit rolls orbars, trail mix packets, break-fast bars.

Medical Packet which includesphone numbers, identification,insurance card, etc.

First aid items: Tylenol®, ban-dages, antiseptic cream, etc.

Family travel games: travelbingo, magnetic checkers.

Keep in mind, your mode oftransportation will have a directimpact upon what you are ableto include in your travel tote.

If traveling by car, try to plansmall, active excursions in themorning and afternoon nearsnack time. The activity will bea welcome change of pace andshould have a positive impact onblood sugar levels. When possi-ble, pack a cooler with addition-al snacks and drinks which mayrequire refrigeration. Suchsnacks are often better choicesthan can be made at a "quick-stop" shop. However, when"quick-stop" shopping is neces-sary, keep in mind that frozentreats are often a welcomechange for the items kept in thetote or cooler. Choose all-fruitfrozen bars or low fat ice creamor yogurt treats. Most will haveapproximately 15-30 grams ofcarbohydrate, adequate for asnack time.

The family vacation should be—above all—FUN! It helps to beprepared, so give some of thesesuggestions a try. One lasttip—don't forget to take yoursense of humor with you! BonVoyage!

Nutrition News

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FAKE FAT: THEOLESTRA STORY

— Markey Swanson, RD, CDE

Fat in the diet—it has been theenemy for a long time. It's badfor the heart and bad for thehips! But now that the Food andDrug Administration (FDA) hasapproved Olestra—"fake fat"—for use in snack foods, will ouroverall health be improved?

Perhaps a look at the history ofthe fat market would be enlight-ening. Proctor and Gamble, theproducer of Olestra, has beenan innovator and marketer ofcooking fats for nearly a centu-ry. In 1911, P&G introducedCrisco®, the first all-vegetableshortening. Crisco® replacedthe use of highly saturated lardin the cooking and bakingprocess. In the 60s, Crisco®Oil was introduced, providingAmericans with an even lesssaturated fat selection. And justa few short years ago, in 1987,P&G began marketing Crisco®Puritan® Oil, the first canola oilproduct to be marketed in theUnited States. Again, an evenless saturated fat was availablefor consumption.

Now Olestra has been intro-duced. It provides no fat calo-ries which can be absorbed bythe body! How can that be pos-sible?

Normally, the body receives fatfrom foods in the form of triglyc-erides. Triglycerides have a por-tion of a sugar molecule as themajor structural foundation withthree fat structures attached.The body has digestive enzymeswhich separate each fat piecefrom the structural base, makingthem small enough to beabsorbed. Olestra is much larg-er, having at least six fat struc-tures attached to a much largerfoundation. The digestive

enzymes are not programmed totackle such a large glyceride, soOlestra passes through thedigestive system without beingabsorbed.

If the body cannot absorb fat, asis the case with Olestra, a sig-nificant number of calories areeliminated. For the diet foodindustry, this may be a plus, butas part of the eliminationprocess, there is the possibilityof experiencing one of the morenoticeable side effects ofOlestra ingestion: intestinalcramping, gas, and/or diarrhea.

Several nutrients are absorbedfrom the gut by virtue of theirattachment to other nutrients.Fat soluble vitamins A, D, E,and K, as well as carotenoids,are absorbed for use in the bodyalong with fat molecules. If fatmolecules are no longer beingabsorbed, as with Olestra prod-ucts, the body is not receivingthese nutrients. Even thoughsuch nutrients may be availablein other fat-containing foods, ifthose foods are consumed at thesame time as a product madewith Olestra, they will be elimi-nated as well. Some recentstudies have indicated that thiseffect could be compensated forby adding extra nutrients to theOlestra-containing foods. Inresponse to these studies, vita-mins A, D, E, and K have beenadded to foods which areprocessed with Olestra.

The FDA, in a recent statement,has determined that availableinformation establishes thatOlestra is safe for use insnacks. We as consumers willfind several Olestra–containingsalty snack items available inthe supermarket within the year.Such snacks will be labeled withthe following information:

This product contains Olestra.Olestra may cause abdominalcramping and loose stools.Olestra inhibits the absorptionof some vitamins and othernutrients. Vitamins A, D, E, andK have been added.

On the positive side, some nutri-tion experts have found that it iseasier for people who are tryingto cut fat intake to adapt to alower fat intake when they havethe option of choosing some oftheir favorite high fat foodsmade with Olestra. Olestragives the taste and texture thatcomes with fat without the fatcalories. Ultimately, decreasedfat intake can result in very pos-itive health benefits, though thequestion remains: Will Olestrabe helpful or harmful in theachievement of reduced fatintake?

The American DiabetesAssociation and the AmericanDietetic Association have notissued position statements onthe use of Olestra. TheAmerican Dietetic Associationdoes report, however, that itadheres to its long-establishedprinciples of dietary balance:moderation and variety. Inother words, eat healthy—eatsmart! Include variety, lots ofwhole grains, fruits, and veg-gies.

The FDA will continue to moni-tor Olestra and is requiring, as acondition of approval, thatProctor and Gamble conductstudies to monitor consumptionas well as studies on Olestra'slong-term effects.

Nutrition News

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8

Cook’s Corner

Strawberry Yogurt Pops

Nutrition Information:Number of Servings 4; Serving Size 1 pop;

Calories 70; Carbohydrate 5 grams; Protein 2 grams; Fat 0 grams

1 cup fresh strawberries(blended)

1 cup nonfat no-sugar-addedstrawberry yogurt

2 tablespoons "lite" whippedtopping

Equal® to taste

Combine blended strawberries,yogurt, and Equal® until thor-oughly mixed. Divide mixtureinto four 5 ounce paper cups.Cover each cup with a squareof foil. Insert popsicle stick incenter of foil and into yogurtmixture. Keep frozen untilready to eat. Remove foil andcup and enjoy!

French Strawberry Pie — Gail Benson

Nutrition Information::Number of Servings 8; Serving Size 1⁄8th of pie; Calories 200; Carbohydrate 30 grams; Protein 2 grams; Fat 7 grams

1 nine-inch pie crust, baked

Glaze Mixture: 4 cups fresh strawberries, washed and

hulled 3⁄4 cup water 1⁄3 cup honey dash of salt 2 tablespoons cornstarch 11⁄2 tablespoons water (approximately)

Cream Mixture: 4 ounces nonfat cream cheese 1 tablespoon honey 2 teaspoons lemon juice 1⁄2 teaspoon vanilla extract dash of salt 1 cup whipped topping

Glaze Mixture: Pick out 2 cups of bestberries and set aside. Place remain-ing berries in saucepan and chop.Add 3⁄4 cup water, honey and salt.Bring to a boil and boil hard for twominutes. Strain. Make a paste withcornstarch and water; add to strainedjuice. Return to heat and cook untilthickened. Set aside to cool slightly.

Cream Mixture: Mix all ingredientstogether. Turn into baked crust. Place2 cups reserved strawberries on top ofcream cheese mixture. Pour cooledglaze carefully over berries. Garnishwith whipped topping.

Dottie Lamm

1996 GUILD ANNUALMEETINGThe Guild of the Children’sDiabetes Foundation welcomedformer Colorado First LadyDottie Lamm as guest speakerfor the 1996 Annual Meeting.More than 100 members were inattendance at the DenverCountry Club on January 15,1996.

Mrs. Lamm spoke on "ChildrenAround the World," presenting astriking portrayal of the plight ofchildren throughout the world,particularly with respect tohealth and education, as per-ceived in her extensive travels inmany countries. She alsodescribed her participation mostrecently in the Fourth UnitedNations Conference on Womenheld in Beijing in September of1995, to which she was an offi-cial U.S. Delegate. Governorand Mrs. Lamm are involved innumerous activities relating tochildren and population con-cerns. They are members of theAdvisory Board of the Children'sDiabetes Foundation.

Following Mrs. Lamm's presen-tation, outgoing 1995 PresidentGeorgia Imhoff reviewed TheGuild's very impressive yearwhich included a contribution of$20,000 to help furnish anddecorate the beautiful playroomin the new addition to the

Barbara Davis Center.

The Guild also provided salaryunderwriting for two years for aconsulting psychologist on theCenter's staff and, in addition to many personal services for children with diabetes and theirfamilies, awarded 30 scholar-ships of $1,000 each to college-bound BDC youth.

Georgia Imhoff, Dr. John Hutton

The Guild's annual $40,000 con-tribution in support of theCenter's clinical and researchprograms was accepted by Dr.John Hutton who recentlyassumed the position ofResearch Director at the BDC.

The 1996 officers were installedby Georgia Imhoff and the presi-dency transferred to HelennFranzgrote. In her openingaddress, Helenn described howdiabetes had influenced her lifeand affirmed her intent to fur-ther The Guild’s activities onbehalf of children with the dis-ease and research toward thecure. She outlined plans for thecoming year and expressedappreciation to members whowill chair the committees.

Arlene Stein will head the BrassRing Luncheon Committee.

Other committee co-chairmenare: Bob Owen and StacyPreblud, All Sports Picnic; Judy

Villano, Charlotte TuckerScholarship Fund; JaneWeingarten, Helping Hand;Kathy Francescon and RickieJones, Holiday FamilyAssistance; Bob Owen, Ski Trips;Nancy Cowee, Membership;Margie Folkestad, ParentSupport Group; Fay Glick andBillie Stein, TelephoneCommunications; LindaBroughton, Volunteer Luncheon;Kathy Griffis, VolunteerCoordinator for the BDC; FriedaEisenbarth, PlayroomVolunteers; Suzy Love,Halloween Party.

Billie Stein

The meeting closed with a musi-cal surprise—a brief trumpetconcert by Billie Stein. Billiehas a fascinating history: Whenshe was a teenager, Billie found-ed an all-woman jazz bandcalled the Harmony Girls thatbecame a popular vaudevilleact. She played her trumpetwith several of the "Big Bands"of the era, including GlennMiller. She is the last HarmonyGirl, but still plays a hauntingblues style reminiscent of a late-night jazz club. Billie is afounding member of The Guildand remains actively involvedwith The Guild's efforts onbehalf of children with diabetes.

Guild Guide

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Photos this page by Kent W. G

erken, Janssen Photgraphy

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PRESIDENT'S MESSAGE I am honored to accept the posi-tion of Guild President for 1996.It will be my privilege to servewith such a dedicated group ofvolunteers, including 31 newboard members who agreed tocontribute their special talentsto The Guild's work. I am grate-ful to my predecessor and oth-ers, including the CDF staff, whohave provided a solid ground onwhich we all can build.

On a serious note, I'd like you toknow why this position meansso much to me personally.Many of you already know howbadly I would like to see a curefor diabetes.

I was raised in a family wherediabetes lived with us everyday—as an uninvited enemy.Heart trouble, a direct result ofdiabetic complications, took mygrandfather from me far toosoon. Both of my uncles—mymother's brothers—were diabet-ics. And now, in my generation,my brother also lives with theenemy. He has lived with thisenemy for 40 years.

Last year, that enemy took mybrother's leg from him. Thisyear, that enemy will send himto dialysis for five hours a day,three days a week, week afterweek for the rest of his life.

I am angry. I am furious thatfor three generations this enemyhas controlled the lives of somany whom I love. However, asall of us know, that anger,though natural, accomplisheslittle. And this enemy doesnot—and never will—respond totemper. Therefore, I channel myhostility as my grandmother andmy mother did before me. I con-tinue to dedicate time and efforttoward activities that will bringabout A CURE THAT I KNOWWILL COME SOME DAY! It isneeded! It is time!

And when that cure does come, Iwill rejoice for all the grandfa-thers who can stick around tosee their grandchildren grow tomaturity. I'll applaud all of thefuture uncles who can sit downto a holiday meal and celebrate,if they choose, with chocolatecake or cherry pie, instead of apiece of fruit. And I'll lead thecheering section for all of thefuture brothers who can livewithout the enemy living withthem day after day after day.

I grew up surrounded by needles,blood sugar checks, orangejuice handy "just in case," andinsulin bottles in the refrigera-tor. Diabetes is personal to me.Diabetes truly is my enemy.

On a more positive note, I amgrateful for the opportunity thathas been given to me. I willstay focused on our purpose—finding a cure. That cure willeliminate my enemy forever andI'll walk a little taller knowingthat I helped, in some smallway, to eliminate this uninvited,unwelcome enemy that was withus too long—but at last is gone.

Warmest regards,

OUR TEAM IS FORMING!The annual membership drive isunderway! Now is the time tojoin or renew your membershipin The Guild of the Children'sDiabetes Foundation at Denverand insure that your name islisted in our 1996 directory.

Our Guild was formed to aidclinical and research programsat the Barbara Davis Center forChildhood Diabetes. Since 1979The Guild has worked tirelesslyto help find a cure for this dev-astating disease. You can helpus continue our mission bybecoming a new member or byrenewing your membership inThe Guild for 1996.

Guild Guide

1996 GUILD OFFICERSHonorary Chairman

Barbara DavisPresident

Helenn FranzgrotePresident-ElectLinda BroughtonTreasurer

Mary Ellen GreeneTreasurer-ElectMarty Jensen

Recording SecretaryMargy Epke

Corresponding SecretaryStacy PrebludPast PresidentGeorgia ImhoffLegal AdvisorShellie Munn

Program ChairmenPaulette BrodyKit Leventhal

Hostess Chairman Sharon Whiton Gelt

AdvisorsAmy Davis

Donna DouglasNancy Cowee

Jane Weingarten

Please help us to help the chil-dren we serve. Mail your mem-bership dues today. Together,we can and will make a differ-ence. With teamwork, we canhelp tomorrow's childrenbecause we acted today.

The Guild welcomes your sup-port. To become a member,please complete the form below.

ALWAYS THERE BEHIND THE SCENES — Rita Temple-Trujillo, MSW, LCSW

The Guild's many areas of ser-vice offer its members manychoices to become a part ofmaking the lives of children withdiabetes healthier and happier.One committee, almost invisiblebut always there, is the Helping

Hand Committee.Working quietlybehind the scenesand in close com-munication withthe social workersand medical staffof the BarbaraDavis Center, thiscommittee's sim-ply–stated purposeis to provide spe-cial assistance tohelp families livingwith diabetes copeemotionally andfinancially in timesof exceptionalneed.

The Helping HandCommittee is aparticularly helpfulresource for manyfamilies at the BDCwho find the finan-cial costs of caringfor a youngsterwith diabetes over-whelming. Insulin,syringes, teststrips and lancetscan easily costupwards of $100per month. Forfamilies withoutinsurance or whodo not qualify with-in the ColoradoResident DiscountProgram, thesecosts can be a for-

midable challenge. Fortunately,a Center family who meets year-ly income guidelines

Jane Weingarten,Helping Hand Committee Chairman

may apply for The Guild'sHelping Hand program andreceive partial assistance withthe cost of supplies. Also, forthose families who come to theCenter from out of town, travelassistance is offered.

The Guild directs a major por-tion of its funding efforts to theHelping Hand program and, inaddition, many individual friendsand groups have made signifi-cant contributions to the pro-gram. Under the leadership ofChairman Jane Weingarten theprogram remains a valuedsource of support for familieswhose children receive care atthe Center.

For additional information, con-tact the Clinical Social Workoffice at the Barbara DavisCenter (303)270-6398.

Guild Guide

11

GUILD MEMBERSHIP FORM

YOUTH MEMBERSHIP Any youth 18 yearsof age or under: Annual dues of $2.00 perperson

ASSOCIATE MEMBERSHIP Annual dues of$30.00 per person

PATRON MEMBERSHIP Annual dues of$50.00 per person

LIFETIME MEMBERSHIP One-time dues of$250.00 per person

Name

Address

City/State/Zip

To actively participate in The Guild as a volunteer, please check your choice(s) below:

_____Barbara Davis Center Patient Check-In_____Barbara Davis Center Playroom_____Brass Ring Luncheon_____All Sports Picnic _____Halloween Party

Make check payable to: The Guild – CDF at Denver, and mail to: The Guild, Children's Diabetes Foundation777 Grant Street, Suite 302 Denver, CO 80203

For information, call (303)863-1200 or(800)695-2873

12

GEARING UP FORSUMMER SPORTS The Children's DiabetesFoundation All Sports Picnicwill be held at Kent DenverSchool on June 29 from 11 a.m. until 2 p.m. Startpracticing for the annual Punt,Pass, and Kick contest. Testyour skill alongside Denver'sprofessional sports stars.

As always, a sugar-free treatstent will entice the hungry ath-letes of all ages and abilities.Clowns, jugglers, carnivalgames, summer sunshine andfriends will again be guaranteed!

The Guild hosts the SportsPicnic, which this year will bechaired by Bob Owen and co-chaired by Stacy Preblud.Watch your mailboxes for theofficial announcement as sum-mer approaches!

For more information, or to volunteer, please call SusieHummell at the Foundation,(303)863-1200 or (800)695-2873.

WHO IS THAT GUY? You know you've seen him some-where . . . was it on the slopes?. . . on a bike ride? . . . at thezoo? . . . the Sports Picnic? . . .driving a limousine? . . . or in apickup loaded with tents?

Where have you seen him? Atall of the above! That guy isBob Owen, Super Volunteer—and if the occasion is for dia-betes, he'll be there!

Bob has a special connectionwith diabetes. His daughter,Christina, now almost 16 yearsold, was diagnosed at just 16months old, and Bob's intense

purpose since then has been todo anything and everything hecan to make her life healthierand happier. In addition toChristina, his dedication touchesthe lives of countless other chil-dren afflicted with the disease.

Barbara Davis Center skiers willremember Bob for his devotionto the Center's ski program; andwhen he isn't supervising CDFski trips, he helps with thehandicapped ski program atWinter Park.

Since 1980, he has coordinatedthe summer sports eventarranging for tents, games andother activities. Bob is an avidcyclist and for two years has

taken youth from theCenter and Children'sHospital on theCourage Classic 3-day bike ride.

His past assistancewith the multi-faceted CarouselDays is legendary, asare the special trans-port services he pro-vided for CarouselBall guests.

These are just a few things thatcome to mind—it is not possibleto adequately describe theextent of Bob's never-endingwillingness to be on hand whenhe is needed. If it's for dia-betes, he pitches in to help. Heis the quintessential SuperVolunteer and in giving so muchof himself through the years, hehas provided unmatched hopeand encouragement for hun-dreds of children with diabetes.

We can only say, “THANK YOU,BOB”—and please keepstanding beside us as we con-tinue the quest for a cure!

Carousel Days

Photo Don Cudney

Photo Don Cudney

Tawnya Cazier

Tawnya Cazier is from Idahoand was diagnosed with dia-betes at age 12. She is on thefast track to becoming a suc-cessful sled dog racer. Shespends hours every day caringfor and practicing with her teamof four sled dogs at her home inIdaho. Tawnya's goal is to com-pete in the Iditarod held eachyear in Alaska. Dog sledding isa difficult sport, and providesexercise which is an importantpart of staying healthy. It hasinspired her to take the bestpossible care of herself and herdiabetes as she pursues hertwo-fold goal: the Iditarod and acure for diabetes.

Star soccer player Lisa Coberlyled her "Dream Team" to anundefeated 12-0 season and theThurston County, WashingtonSoccer Association to its U-10Championship. Lisa was highscorer with 21 goals and 29assists. When she wasn't play-ing forward she played goalieand allowed only two goals.Now 10, Lisa has had diabetessince she was two years old.She lives in Olympia,Washington and comes to theBarbara Davis Center once year-ly "just to check!"

Erik Witting, from Aurora,Colorado, is a first degree Black

Belt in Tae Kwon Do and in 7thgrade at Horizon CommunityMiddle School. He is 12 yearsold and has had diabetes foreight and a half years. Erikteaches Tae Kwon Do four nightsa week, white belt through red,at Karate for Kids in Aurora. Heis determined not to let diabetesinterfere with his life and fol-lows Tae Kwon Do and activeoutdoor activities—camping,hiking and climbing—for exer-cise to keep blood sugars incontrol while doing what hewants to do.

Lisa Coberly

Eric Witting

Jarrod Pearson, Leilani Nicely

Tooting their own horns areJarrod Pearson, 14, andLeilani Nicely, 16. Both are inthe marching band at ArvadaHigh School, Arvada, Colorado.Jarrod plays a tenor sax andLeilani, the clarinet. They alsoperform with the SymphonicBand. Leilani developed dia-betes when she was fourteenmonths old; Jarrod was fiveyears old when he was diag-nosed. They receive care at theCenter and state that marchingin the band has helped to keepblood sugars lower, althoughextra snacks on long marchesare also essential.

Winner’s Circle

13

Courtesy TH

E NEW ERA: Photo Lisa A. Johnson

14

LEARNING THROUGHSHARING

— Angela Junk

We all need a little help fromour friends. This is especiallytrue for third grader MorganSmith, a patient at the BarbaraDavis Center whose classmatesat Van Arsdale Elementary inArvada raised nearly $900 forthe Children's DiabetesFoundation.

In her own words, here isMorgan’s presentation speech:

“I am Morgan Smith and I amrepresenting Mrs. Gubanich'sclass and the other third gradekids at Van Arsdale. We aredonating this check to theChildren's Diabetes Foundation.

“We had a craft sale as a projectto study money and decided todonate some of the money to theDiabetes Foundation because Ihave had diabetes for two years.I was diagnosed when I was sixyears old and in the first grade.There are also four other kids atVan Arsdale who have diabetes.

“Kids who have childhood dia-betes have to get four fingerpokes a day, or more, and atleast two insulin shots a day, ormore, in order to take care ofthis disease. We also have tofollow a diet and eat betweenmeals to maintain our bloodsugars.

“With this money for researchwe hope that a cure is found.This disease is very complicat-ed. I wish everyone who hasdiabetes well and hope that theycan live through it.”

The children presented theFoundation with an "oversizedcheck" and lots of smiles.Congratulations to the VanArsdale third graders for helpingMorgan and their other class-mates who have diabetes—andfor bringing the CURE a littlecloser!

LAST CALL FORSCHOLARSHIP APPLICATIONS! Applications for the 1996Charlotte Tucker Scholarshipaward must be completed and

postmarked by April 19th to beeligible for consideration.

Students who have receivedtreatment within the last 12months at the Barbara DavisCenter for Childhood Diabetesor at one of the Barbara DavisCenter Outreach Facilities mayapply for this scholarship pro-gram which was established inmemory of a dedicatedChildren's Diabetes Foundationvolunteer. Scholarships may beused for attendance at anyaccredited two or four year col-lege, continuing education, ortrade school.

For additional information or torequest an application form callSusie Hummell at theFoundation office, (303)863-1200 or (800)695-2873.

LEAPING TOWARD A FUTURE FREE OF DIABETES

— Angela Junk

In honor of the last Leap Year ofthe Millennium, February 29,1996, Old Chicago Restauranton Market Street in Denver host-ed a Leap Year Celebration ben-efiting the Children's DiabetesFoundation. David Mun, a bar-tender at Old Chicago and theorganizer of the event, said,"there is no better way to cele-brate a step out of this greatmillennium than to put ourthoughts and hope to the future.We hope the benefit can raisemoney to help find the cure fordiabetes."

The Foundation would like tothank everyone at Old Chicagofor letting us be a part of theirLeap Year Celebration—manyCDF staff members joined in thefestivities with family andfriends. Old Chicago, you'vemade this event a Leap towardthe Cure we'll never forget!

Special Interest

15

CALENDAR NOTESBDC OUTREACH CLINICS ANDWORKSHOPS

Outreach Clinics

April 17 - Fort Carson ClinicDr. Slover

May 9 to 11 - Billings ClinicDr. Chase and Sandy Hoops

May 15 - Fort Carson ClinicDr. Slover

May 28 to 30 - Casper ClinicDr. Walravens

June 19 - Fort Carson ClinicDr. Slover

Workshops*

June 14 - Preschool Workshop

June 21 - College Transition Workshop

June 27 & 28 - Family EducationProgram

*All workshops are held at the BDC.

For information and/or reservations to attend Outreach and/or Workshopsessions, call the Barbara DavisCenter (303)270-6399.

YOU CAN HELP PREVENT DIABETESThe Barbara Davis Center, with ninecenters nationwide, is participating inthe Diabetes Prevention Trial (DPT),cosponsored by the National Institutesof Health, American DiabetesAssociation, and Juvenile DiabetesFoundation. The hope is to screen60,000 relatives (children, siblingsand parents) of people with Type I diabetes (diagnosed before age 40)who are between the ages of 3 and 45years. Thirty thousand have beenscreened and researchers are seekingan additional 30,000 participants.

The screening requires a simple bloodtest, which takes about five minutes toperform. There is no charge for thetest when administered at the BDC;private laboratories may charge.Applicants for the screening may cometo the Center any day of the week from8 AM to 5 PM.

ADDITIONAL

VOLUNTEERS ARE

URGENTLY NEEDED

FOR THE DIABETES

PREVENTION TRIAL!

CALL THE CENTER FOR

A FREE SCREENING AT

(303)270-6397 OR

(800)572-3999.

BDC PARKING!!

For those coming to the

BDC for appointments or

other visits, garage parking

will now cost $3.75

and we are not asked to

validate tickets. Street

parking is still available.

A child reaching for the brassring on a carousel is symbolicof the most important goal ofthe Children’s DiabetesFoundation—a cure. Your con-tribution on behalf of a loved onewill make a difference. It willsupport treatment programs toassist children with diabetes inleading healthier lives; and it willfund research to help CDF “catchthe brass ring” by finding a cure.

Mark an anniversary, birthday,special occasion; express appreci-ation or make a memorial tributein honor of someone special witha contribution—for any amount—to the Children’s DiabetesFoundation at Denver. Donations are tax deductible. Tax ID #84-0745008

NEWSNOTES is published threetimes per year by the Children’sDiabetes Foundation at Denver.We welcome your comments. If you would like to submit an article or a letter to NEWSNOTESsend information to:

Children’s Diabetes Foundation at Denver777 Grant Street, Suite 302Denver, CO 80203

Christine LernerEditor

Dorothy HarringtonAssistant Editor The Guild Guide Editor

Alice GreenClinic News Liaison

Cindy BartonGraphic Designer

Know the symptoms of Childhood Diabetes:• Loss of weight• Extreme thirst• Excessive irritability• Frequent urination

Enclosed is my Contribution of $ _________________In memory of ____________________________________Or in honor of ___________________________________Occasion _______________________________________

Please send acknowledgements to:(Amount of gift will not be mentioned)

Name ___________________________________________Address _________________________________________City ________________ State _______ Zip ____________

From:Name ___________________________________________Address _________________________________________City ________________ State _______ Zip ____________

The Brass RingFund

Remember a loved one––Help CDF “Catch the Brass Ring”

Children’s Diabetes Foundation at Denver777 Grant Street, Suite 302, Denver, CO 80203

Marriott's Mountain Resort atVail in Vail, Colorado is thelocation for the fourth confer-

ence on Management of Type IDiabetes in the 1990's. The course isdesigned to aid physicians, nurses,dieticians, diabetes educators, socialworkers and psychologists in caringfor the child, adolescent and youngadult with diabetes. Practical day-to-day management will be emphasizedalong with the most current research.Special attention will be given to deal-ing with the adolescent with diabetes.Education of the entire family will bestressed as well as the psychosocialimplications of the disease.

Guest speakers include DenisDaneman, MB, BCh, FRCP(C),Professor of Pediatrics and Chief,Division of Endocrinology, University ofToronto, Ontario, Canada, who willaddress the meeting on "IntensiveDiabetes Management." JeanBetschart, RN, MSN, CDE, Division of

Endocrinology, Children's Hospital,Pittsburgh, Pennsylvania will speak ondiabetes and adolescence.

Betty Page Brackenridge, MS, RD,CDE, of Learning Prescriptions,Gilbert, Arizona will conduct a discus-sion on carbohydrate counting. A lec-ture on exercise and diabetes will bepresented by Jacqueline Berning, RD,PhD, Sports Nutrition Coordinator forthe United States Olympic Swim Team,and Joan Totka, RN, MSN, CDE,Clinical Nurse Specialist - Diabetes,Children's Hospital of Wisconsin,Milwaukee, Wisconsin has scheduled aworkshop on "Case Management inPediatric Diabetes."

The conference is sponsored by theBarbara Davis Center for ChildhoodDiabetes and the Children's DiabetesFoundation at Denver. The ConferenceDirector is H. Peter Chase, MD,Professor of Pediatrics, University ofColorado Health Sciences Center and

Clinical Director of the Barbara DavisCenter.

Tuition is $400 for physicians; $300for allied health care professionals;and $150 for students. Attendancewill be limited to 250. The conferenceis accredited for continuing medicaleducation for physicians and applica-tion has been made for continuingeducation credit with the University ofColorado School of Nursing and theAmerican Dietetic Association.

For additional information and toreceive a conference application tele-phone the Foundation at (800)695-2873 or (303)863-1200.

Nonprofit Org.

U.S. POSTAGE

PAIDDenver, CO

Permit No. 1752

MANAGEMENT OF TYPE I DIABETES IN THE 1990'SSunday, August 11 through Wednesday, August 14

777 Grant Street, Suite 302Denver, CO 80203

Address CorrectionRequested

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