NewsNotes Spring 2023

Children’s Diabetes Foundation Board Members

EXECUTIVE BOARD:

Mrs. Barbara Davis, Chairman

Ms. Dana Davis, Executive Director

Mrs. Arlene Hirschfeld, Emeritus

Mr. Cameron van Orman, Vice Chairman

Richard S. Abrams, M.D., Treasurer

Mr. Shane Hendryson, Secretary

Mrs. Lori Finch

Stephen Daniels, M.D., Ph.D.

Chairman of Pediatrics

The Children’s Hospital, Denver

Mrs. Nancy Davis Rickel

Daniel Feiten, M.D.

Mr. Wayne Forman

Mr. Robert Garelick

Mrs. Deidre Hunter

Mr. Shawn Hunter

Mr. Steve Lucas

John J. Reilly, Jr., M.D.

Vice Chancellor for Health Affairs & Dean, School of Medicine, University of Colorado Denver

Mr. Ken Rickel

Mrs. Stacy Mendelson Robinson

Marian Rewers, M.D., Ph.D.

Ex-Officio Member

Mr. Joseph Smolen

Mrs. Tracy van Orman

Mrs. Cindy Wells

SCIENTIFIC ADVISORY BOARD:

Richard S. Abrams, M.D.

Director, Colorado Preventive Medicine, Rose Medical Center; Clinical Professor of Medicine UCD

Mark Atkinson, Ph.D.

Professor of Pathology & Pediatrics, Director, University of Florida Diabetes Institute

Ezio Bonifacio, Ph.D.

Professor for Preclinical Approaches to Stem Cell Therapy, Center for Regenerative Therapies, Dresden, Germany

Robert Eckel, MD

Professor of Medicine, Physiology and Biophysics, University of Colorado School of Medicine

Matthias Hebrok, Ph.D.

Professor in Residence and Director, Diabetes Center, University of California, San Francisco

Steven Kahn, MB, Ch.B.

Professor of Medicine, Director of the Diabetes Research Center, University of Washington

Rudolph Leibel, MD

Professor of Pediatrics and Medicine, Co-Director, Naomi Berrie Diabetes Center, Columbia University

Alvin Powers, MD

Professor of Medicine, Molecular Physiology/Biophysics, Division Director, Vanderbilt University

William Tamborlane, MD

Professor of Pediatrics, Yale University School of Medicine

Children’s Diabetes Foundation NewsNotes is published quarterly by the Children’s Diabetes Foundation. If you would like to submit an artwork , article or a letter to NewsNotes, Please send your submission to cdfcares@childrensdiabetesfoundation.org.

Miriam Andolini, Editor

Zachary Reece, Graphic Designer

THE SPRING BRASS RING

THE 45TH ANNUAL BRASS RING LUNCHEON & FASHION SHOW RAISES AN ASTOUNDING $425,000!

On March 31, 2023, The Guild of the Children’s Diabetes Foundation (CDF) held their annual luncheon and fashion show benefiting patient programs at the Barbara Davis Center for Diabetes (BDC). This year marked numerous debuts for the event! The event took place at a new location, the Sheraton Denver Downtown Hotel, that featured an open airy space for the silent auction and registration area, as well as a grander ballroom that allowed for an expanded runway and stage.

CBS News Colorado’s Michael Spencer led the event as the Master of Ceremonies; Michael was charming, funny, and passionate for the cause. He spent time gathering fun facts from the kids during the morning rehearsal that added a bit of surprise for the parents watching the show. It was truly a moment to remember! Presentations included a compelling speech from Co-Chairs Lori Finch and Carol Hamer, finishing with the powerful quote “Courage doesn’t always roar. Sometimes courage is the quiet voice at the end of the day saying, I will try again tomorrow.”

The prayer given for lunch was written and delivered by CDF Advocate, Emerson Weis, who was diagnosed at three years of age. She wrote “Living with diabetes can be really hard so, give us patience and grace as we deal with the highs and lows.” Everyone in attendance can relate to this statement. Great job Emerson, you were so brave and gave the perfect prayer!

This year pioneered the rebranding of the hero walk in honor of Dr. Robert Slover, one of our own heroes, to “Slover’s Heroes” The kid’s walk features type 1 children and adolescents that embody Dr. Slover’s life’s work, care, and dedication to advocating for those living with type 1 diabetes. The format for the kid’s walk featured two type 1 heroes walking side by side with a few fun facts shared for each hero; it was followed by a heart-warming video in honor of Dr. Slover and his service to the BDC and the patients he saw throughout the years he served as the Director of the Pediatric Clinic. Dr. Slover’s video ends with a message that will live on forever for all of us, as he says, “in many ways these kids are my heroes”

Attendees enjoyed lunch while auctioneer, Halie Behr, kicked off the live auction with four unique packages that raised $39,000 alone. Packages included a wonderful trip for six guests to attend a live filming of America’s Got Talent, a wine tasting party for 12 from celebrity chef Troy Guard and Napa's VGS Château Potelle, an exquisite 14-karat white gold chain link necklace from GNAT Jewelry Atelier, as well as several Inspirato luxury travel packages that included a 6month membership giving guests expert pre-trip travel planning, enabling them to stay at Inspirato properties with daily housekeeping, and to utilize onsite concierge services while visiting other vacation destinations.

Photos: © www.JensenSutta.com

Following the live auction was an emotional video telling the story of two sisters, Anna and Ellie Belz, whose family shared their story and struggle of their daughter having type 1 diabetes while knowing their second daughter has the markers to get type 1 diabetes later in life. During the special appeal, attendees raised their paddles to make donations ranging from $500 to $50,000. At each level, Behr explained specific opportunities that could be funded, such as groundbreaking research, providing continuous glucose monitors to a pregnant type 1 moms in need, helping patients upgrade to an automatic version of their insulin pump who otherwise could not afford it, holiday assistance for families, depression screenings, and supplies, insulin, or travel costs for clinic visits for those who live out of town.

Featured fashion brand, Club Monaco, closed out the event with their inaugural runway show with over 35 different looks from their 2023 spring collection. The collection included suits, sets, separates, dresses, outerwear, and accessories for men and women.

In total, the event welcomed nearly 600 attendees and raised over $425,000 through ticket sales, sponsorships, live and silent auctions, and the special appeal. Benefiting The Guild of the Children’s Diabetes Foundation, to help fund research, diabetes awareness and education, assist families in need, provide scholarships for T1D students, host year-round T1D soccer camps, and sponsor activities for children and their families.

CDF would like to extend special thanks to our Presenting Sponsor, Eva Schoonmaker, for her tremendous support of the Brass Ring Luncheon & Fashion Show and The Guild of the Children’s Diabetes Foundation. We are also incredibly grateful to our Premier Sponsors Boomi and MDC/Richmond American Homes Foundation, our Official Wine Sponsor Acrobat & Foley Family Wines. In addition, we would like to thank Jay’s Valet, Gina Comminello from THE LOOK Salon & Med Spa, and Charlie Price for their continuous support of the event. Brass Ring Luncheon’s Official Media Sponsor was Colorado Expression and the Broadcast Partner was CBS News Colorado.

SPRING BRASS RING

Dexcom presents

An evening to benefit the Children’s Diabetes Foundation and the Barbara Davis Center for Diabetes

Saturday, October 28, 2023

Hyatt Regency Denver

Black-tie, 5:30 p.m.

Featuring an intimate performance by Grammy winning hit-maker David Foster and star of stage and screen Katharine McPhee. Foster will also serve as the evening’s Master of Ceremonies.

Additional entertainment will be announced soon!

Scan to purchase tickets today!

Learn more at www.ChildrensDiabetesFoundation.org

Satish Garg, MD, is Professor of Medicine and Pediatrics at the Adult Clinic of the Barbara Davis Center for Diabetes (BDC) of the University of Colorado School of Medicine in Denver, Colorado. He joined the faculty of the Barbara Davis Center in 1992 and became the Founder and Director of the Adult Clinic. Dr. Garg will be presented with the Founders Award at The Carousel Ball in honor of his incredible service and dedication to the Barbara Davis Center and the role he has played in advancing adult diabetes care and advancing clinical research.

Juli & Joe Smolen will be presented with the High Hopes Tribute Award at The Carousel Ball in honor of their incredible support and partnership with the Children’s Diabetes Foundation. The Smolen’s community involvement is part of the very fabric that makes up their family. Joe is involved in numerous notfor-profit organizations. Juli enjoys volunteering with several events through CDF and the advocate program with her daughter Abbey such as Run for the Ring 5K & Kid’s Fun Run, Brass Ring Luncheon & Fashion Show, the Holiday Assistance program, and The Carousel Ball.

Honor our Honorees by placing a tribute ad in The Carousel Ball printed program book given to every attendee. The journal is a legacy printed program that allows the memories of the event to last for a lifetime.

Place your order for a journal ad by scanning the QR code below or by contacting Morgan Palmer at Ads@ChildrensDiabetesFoundation.org

Visit www.ChildrensDiabetesFoundation. org/event/the-carousel-ball-2023 for more information.

BARBARA DAVIS CENTER & DIABETES NEWS

Congratulations Dr. Satish Garg for being named the winner of the ATTD Lilly 2023 Insulin Centennial Award. This prestigious award is given to doctors who have made significant contributions to diabetes treatment. Dr. Garg has been an international leader for insulin therapy in both type 1 and type 2 diabetes, with expertise in clinical trials and methods of insulin delivery. Dr. Garg joined the BDC in 1988 and founded the adult clinic as senior faculty in 1992. He has also served as the director of the ATDC Keystone Diabetes conference since 2005.

New therapy first to target type 1 diabetes disease process

Written by Debra Melani, CU Anschutz Medical Campus News

A Barbara Davis Center for Diabetes patient became the first person in Colorado to receive a newly approved drug aimed at delaying onset of clinical stage type 1 diabetes. Erik Aeling was the first person in Colorado to receive the newly approved drug. The Aelings also know what a blessing it could be for them and families like theirs to delay the start of type 1 for Erik; in turn delaying the financial strain of diabetes, the number of years Erik will live with this daily challenge, and the possible complications type 1 comes with. Join us as we celebrate this milestone and donate to CDF today!

Eli Lilly has a ripple effect on making insulin more cost effective for T1Ds

Every day patients make critical decisions in rationing their insulin and we are hopeful this will help stop families from having to make such sacrifices. Thank you to Eli Lilly, Novo Nordisk, Sanofi!

Watch the interview with Dr. Satish Garg here:

Read full article here

Read more at these links:

Four new automated insulin delivery systems

In 2023, Dr. Paul Wadwa has authored the first paper in NEJM on Control-IQ in young children and Dr. Greg Forlenza has authored the first paper in JAMA on use of Verapamil to prolong islet survival in new onset diabetes. The BDC team conducted the FDA approval studies for the Medtronic 780G, Tandem Control-IQ, Insulet OP5, and Beta Bionics iLet. We anticipate that by the end of the year there will be four excellent automated insulin delivery systems on the market in the United States and all were developed and studied as part of the work of our team at the BDC.

Verapamil is a calcium channel blocker medication originally FDA approved in 1981 to treat heart arrhythmias which is also used to treat high blood pressure. Basic science studies showed that it also inhibits a protein necessary for cell death in islets due to high blood sugar. Our one-year randomized controlled trial funded by JDRF showed that it helped significantly improve islet survival. It is a once daily oral medication for which the generic costs $8-12 per month even without insurance.

The Medtronic 780G with Guardian 4 CGM is the first Advanced Hybrid Closed Loop device from Medtronic. The system achieves >70% time in target range for the average user without the need for finger-stick testing. It also has an advanced algorithm to detect if a meal has been eaten without the user bolusing and then minimize hyperglycemia after the meal. The Adult Diabetes Clinic under Dr. Satish Garg and the Pediatric Diabetes Clinic under Dr. Robert Slover conducted the FDA approval testing on the system resulting in FDA approval of the ACHL algorithm and the updated sensor.

Photography: Ryan Wuller, Creative Multimedia Manager in the CU Anschutz Office of Communications

Interventions in people newly diagnosed with type 1 diabetes mellitus

Written by Claire Greenhill Nature Reviews Magazine

Type 1 diabetes mellitus (T1DM) is characterized by a gradual loss of functional β-cells, leading to reliance on insulin and increased risk of complications resulting from hypoglycaemia and hyperglycaemia. Preserving β-cell function, particularly in patients newly diagnosed with T1DM, has been a focus of research for many years, but success has been limited. Furthermore, in the 1980s a theory was put forward that high glucose levels exacerbated the decline in β-cells (termed the glucotoxicity theory). In a single trial design, two papers have examined two potential approaches for preserving β-cell function: verapamil and tight glycaemic control.

The researchers used a factorial design to enable them to test two hypotheses in one trial. The trial included 113 patients aged 7–17 years who had been diagnosed with T1DM within the previous 31 days. The trial was conducted at six centres across the USA. To test the glucotoxicity theory, 61 patients received automated insulin delivery (to facilitate tight glycaemic control), with the remaining 52 receiving standard care with a continuous glucose monitor. Patients were followed up regularly for 52 weeks, with a visit at 6 weeks after randomization and then at 13, 26, 39 and 52 weeks from the diagnosis of T1DM. At most visits (except the visit at 6 weeks), blood samples were taken to measure HbA1c levels and participants underwent a 2-hour mixed meal tolerance test to determine C-peptide levels.

Patients in the automated insulin delivery group achieved better glycaemic control than the patients in the standard care group, with a mean time in glucose range of 78% versus 64%. However, there were no statistical differences in the area under the curve for C-peptide after 52 weeks. These results indicate that tight glycaemic control did not prevent the decline in β-cell function. “This trial’s results put to rest further testing of the glucotoxicity theory,” say authors Gregory Forlenza and Roy Beck. Although tight glycaemic control does not preserve β-cell function, it can have other beneficial effects, particularly in terms of reducing the risk of microvascular complications of T1DM.

Verapamil is a calcium channel blocker that is already approved for other indications. In vitro work indicates that verapamil reduces β-cell apoptosis and a small trial in adults newly diagnosed with T1DM indicated that verapamil preserved β-cell function. “These promising results led us to design a much larger trial and conduct the trial in a paediatric population, which had not been previously studied with verapamil,” explain Forlenza and Beck.

Of the 113 patients included in the tight glycaemic control trial, 47 received vera pamil (with 22 also receiving automated insulin delivery) and 41 received placebo (with 20 also receiving automated insulin delivery).

The mean C-peptide area under the curve was 0.66 pmol/ml at baseline and 0.65 pmol/ml at 52 weeks in the verapamil group, compared with 0.60 pmol/ml and 0.44 pmol/ml in the control group. These results represent a 30% relative treatment effect. A few patients experienced adverse effects, but verapamil was generally safe and well tolerated.

Over the course of T1DM, C-peptide levels usually increase shortly after diagnosis and then gradually decline. A similar pattern was seen in this study; however, C-peptide levels remained stable for longer in patients who received verapamil compared with those who received the placebo.

The authors suggest that these findings could have important clinical implications, given the lack of options for preserving β-cell function in people newly diagnosed with T1DM. “In view of its being readily available as a generic drug at low cost, once a-day oral administration and a good safety profile, we expect that as the trial’s findings becomes widely known, verapamil will be prescribed frequently for newly diagnosed T1DM,” say Forlenza and Beck.

The researchers acknowledge several limitations of their studies, such as the small sample size and the need to only include children weighing >30 kg due to the available dosing options for extended-release verapamil. “As with many studies, the results answer one question but raise many other questions that will need to be addressed in future studies,” say Forlenza and Beck. For instance, this trial was not designed to determine how long verapamil treatment should be continued for, or whether initiating verapamil treatment several months or years after a T1DM diagnosis would be beneficial. Whether verapamil treatment would be beneficial in the earlier subclinical stages of T1DM or in children younger than those included in this study could also be explored.

Dr. Greg Forlenza

Meet the Doctor is our new section introducing various doctors at the BDC. It was so much fun talking with Dr. Brian Bucca who leads the Eye Care Clinic for the Barbara Davis Center. We learned a lot about the advancements of eye care for type 1 patients, found out how he got his start at the BDC, and a few fun facts about him.

HOW DID YOU GET INTO DIABETES CARE?

In 2000, I did an externship with the Indian Health Service in the Four Corners area of New Mexico. The reservation has a very robust 50% population of type 2 diabetes which has probably increased in the past 17 years since I've been gone. I went back to do my residency there, and continued my foray into diabetes, as well as all the other type of systemic processes that go along with that population. After I finished my residency, I started running their diabetes program for three to four years. By proximity of being on the reservation, you're not only managing diabetes, but diabetes complications as well. Unfortunately, it's kind of like a third world country in the middle of the United States with a lot of barriers to care there.

DO YOU HAVE PERSONAL A TYPE 1 CONNECTION?

Since I don't have anybody that's diagnosed in my family, I would say my personal connection with diabetes comes from the 22 years of being in diabetes care. I feel like I know a lot about diabetes through developing those personal connections with patients and identifying with them. As a health care provider, we are always interacting with patients, hearing stories about the difficulties, and the successes that go along with this daily process.

HOW LONG HAVE YOU BEEN WITH THE BDC?

I arrived at the Barbara Davis Center in 2007, so I’ll be coming up on 17 years with the BDC in a couple of months.

WHAT HAS CHANGED WITH DIABETES EYE CARE IN THE TIME YOU HAVE BEEN PRACTICING?

Technology! It has taken an extremely hard disease to manage on an hour, minute by minute, basis. With the closed loop system, it has made it a lot easier to manage diabetes, and it's super successful, so it’s led to better control which leads to less complications in terms of the eyes and presumably other organs of the body. Sometimes lowering that A1C too fast can cause short term issues in the eye. That's a huge driver of reducing complications, which reduces the vision threatening aspect of retinopathy. The second factor has to do with the treatments. One treatment that has come to the forefront in the last 10 or 15 years is an injection in the eye called Vascular Endothelial Growth Factor, or VEGF. What it does is neutralizes that main biochemical distress signal of the eye when the retina is sick, or being worn out by diabetes, the retina releases this VEGF, if you will, and that distress signal gets higher and higher, and that causes those vessels to become leaky, which causes a situation where plasma leaks out into the central vision portion of the retina. It also causes new blood vessels to grow too. So those are the two things that needs treatment, but in terms of the edema, or the fluid that leaks out. That was a major cause of eye loss with diabetes. Before we had this injection, all we had was laser to seal the leak wherever that leak was coming from. So, the idea was to find the fluid first, hopefully, before it got into the central vision, find out where that was leaking. VEGF can take care of that before any of that happens.

WHAT MAKES THE EYE CLINIC AND THE EYE CLINIC TEAM AT THE BDC SO UNIQUE?

I always tell my students and the doctors that rotate through my clinic that we can motivate patients. That is unique to the very important field of eye care. Nobody wants to deal with the possibility or the thought of losing eyesight. We have the ability with the tools available, used correctly, to motivate patients and let them know that their choices have real consequences. What makes our clinic unique is we try to create a fun experience for someone that can otherwise be anxiety provoking for patients. We try to disarm people as best as we can as a team from front desk check-in to checkout. Motivation without alienation is what I call it. We spend a lot of time educating our patients. Purposefully, we don't want this kind of conveyor belt of patients being handed off from doctor to doctor. We want to be able to answer their questions, provide the amount of time for them to be heard, and for education to be given. Education is power and gives them the knowledge to do make better decisions for themselves. It's not only about motivating, but also about congratulating as well. We're always looking for people doing a good job and to tell them, “you're doing such a great job. We know how hard it is.” I think another advantage is having the eye clinic inside the BDC and sharing the same medical record. I can see everything using the same medical record, that an outside entity would not get to see that information. So very seamless continuity of care.

TELL ME ABOUT A PATIENT EXPERIENCE THAT HAS REALLY IMPACTED YOU AS A PROVIDER?

There are individual experiences, but I have to say it's the collection of same experiences that gets me every time it happens. I tell my students this and then everybody who rotates through. Not everybody, but a vast majority of the people that need treatment, are in their 20s and 30s. They're very young, and that's hard to see. You know, it's hard to deal with the possibility of vision loss, and it is hard for them to hear. Some people are like, “Yep, I knew it was coming,” but some people are devastated about the whole thing. So that's a dramatic experience on both ends of the delivery spectrum of delivering that news versus receiving that news.

WHAT DO YOU DO FOR FUN WHEN YOU ARE NOT AT THE BDC? HOBBIES?

I am pathologically addicted to the guitar. I like to play the electric guitar, but I was forced to be quiet, so now I play the acoustic most of the time. I just love it. I've been playing since I was 14. I write songs. I always have a guitar in my hand sometimes to my wife's extreme dismay.

TELL ME ONE FUN FACT ABOUT YOURSELF. I am still a child inside, and therefore I love Legos. I also like Star Wars.

WHAT IS YOUR FAVORITE COLOR?

World Diabetes Day blue. If you ask my staff, I always have some shade of blue on.

WHAT’S YOUR FAVORITE FOOD OR DISH TO MAKE?

Pizza with pepperoni, black olives, and jalapenos is my favorite.

WHAT IS YOUR PET’S NAME?

Millie, she's two years and three months old. Yeah, she's crazy. She's a chocolate lab, we had one before, and they are good with kids.

WHAT MOTIVATIONAL OR INSPIRATIONAL ADVICE DO YOU HAVE FOR TYPE 1S?

As a person with diabetes, you're not destined to lose vision in any way, shape, or form. You have control over whether that happens to you or not by managing your blood sugars. It's not a death sentence for vision. It's completely within your ability, so keep up the good work!

THE LEMONADE WARS

Earlier this year, Blakely’s fourth grade teacher, April Zapata, alongside her P.E. Coach shared some observations they had about Blakely with her mother. Shortly after, she was diagnosed with type 1 diabetes after her mother recognized the symptoms of T1D shared by her teachers. Blakley has been adjusting to her new lifestyle very well, has wonderful support from her parents and teacher by sharing books with the class and type 1 diabetes so they can better understand why her diet has changed, and why she must see the nurse so often.

At the time, April’s class was reading the book, The Lemonade War, which is a story about two siblings that “go to war" to see who can sell the most lemonade in the week before they return to school. Winner takes all the profits from both lemonade stands. This gave April the idea of having her students do the same since they are learning about income, expenses, and profit in their math lessons as well. Ms. Zapata’s class formed four groups and allowed the students to determine which organization they wanted to make money for.

Blakely’s group chose The Children’s Diabetes Foundation (CDF), benefiting the Barbara Davis Center for Diabetes Each group was tasked with marketing, organizing, and selling their lemonade. The group with the greatest profit would earn all the profits from all four lemonade stands and would donate to their selected organization. Blakely did a phenomenal job of marketing and appealing to her customers with a "special jolly rancher treat" in their lemonade. They had matching shirts and all! Their team came out on top with the greatest profit and received all the profits to donate to CDF.

All in all, the kids learned not only about calculating profit, but also about advertising, working together, good sportsmanship, and helping others. The Lemonade Wars, on behalf of Plum Creek Elementary in Lockhart, Texas donated $369.29 to the Children’s Diabetes Foundation to help other type 1 kids.

Congratulations to Blakely for her ingenuity, team building, and generally being an awesome kid! We are so proud of you and how type 1 strong you are!

Blakely and Ms. Zapata

Cara, Mariana, McKeana & Mason

Zoie, Joseline, Makena, Evan, Delilah

Alexander, Mila, James, Jonathan, Eduardo

Allen, Joshua, Blakely, Isabella

IN DENVER, CO, EDUCATING THOSE WITH TYPE 1 AND TYPE 2 DIABETES

The Children’s Diabetes Foundation and the Barbara Davis Center for Diabetes partnered together to bring the EPIC Diabetes Conference back in-person for 2023. Giving patients, families, caregivers, and healthcare providers an in-depth look on improving their diabetes care in an open, supportive environment. Attendees learn through workshops, panels, Q&As, and a keynote presentation with the nation’s top diabetes specialists. This conference is an important part of diabetes education. With so many facets for diabetes care, it’s impossible to learn everything you need to know in quarterly appointments, even after many years of living with the disease.

This year’s conference took place at the Sheraton Denver Downtown Hotel on May 20, 2023. The conference theme was Striving for Lifelong Health, attendees learned about topics such as preventing and managing extreme glucose events, staying happy and fulfilled living with diabetes, and how to take care of the kidneys, brain, and heart.

Dr. Jennifer Sherr, Professor of Pediatrics at Yale University, joined as the keynote speaker to discuss Long-term Strategies for Healthy Living with Diabetes. Dr. Sherr focused on the discovery of insulin, insulin delivery systems, additional therapies to support lowering your A1C, and complications with obesity and cardiovascular health throughout your life.

The EPIC Diabetes Conference features 3 tracks: advanced, adult, and pediatric. Each workshop includes a brief presentation followed by 45 minutes for attendees to ask experts their questions about improving their individual care.

Thank you to King Soopers for providing $10 gift card to all our attendees. A special thanks to our Exhibitors Abbott Diabetes Care, American Diabetes Association, Cequr Simplicity, Diabetes Resource Nurses of Colorado, Connected in Motion, Dexcom, Lilly Diabetes, Medtronic Diabetes, Omnipod, ProventionBio,Tandem Diabetes Care, Type 1 Way Ticket Travel.

This conference was a collaboration between the Children’s Diabetes Foundation and the Barbara Davis Center. Thank you to the EPIC Committee: Sarit Polsky, MD, Gregory Forlenza, MD, Erin Cobry, MD, Dana Davis, and Regina Reece. A special thanks to Sydney Rickert of CDF, her dedication and hard work coordinating the conference was unprecedented.

“The knowledge that was shared and the fact it was more about asking questions and answering questions than just information given."

"Speakers were knowledgeable about the content presented, encouragement, experiences, and suggestions offered by other parents, length of the presentations, time allowed for questions, lunch, snacks offered, and vendor interaction."

"I enjoyed how well each speaker was prepared with visual aids and the organization of their topics they spoke about."

"The whole conference was wonderfully organized. We learned something in each breakout session, with the keynote speakers and introductory speaker. We particularly appreciated Dr. Greg Forlenza’s technology breakout lecture and the ability to talk with him afterwards."

"My 4 year old son was diagnosed Jan 31 2023, so we are trying to learn as much as possible on ever aspect. The speakers were all great and their ability to answer questions was amazing!"

"I am a school nurse. I appreciate hearing the frustrations that parents feel including those they've overcome and how. This is the 3rd EPIC I have attended, I have learned many things, both from the parents and the professionals, each time."

"Speakers were excellent! I also liked meeting with the vendors during the breaks."

"Adjunctive therapies and technology updates, research studies, opportunities to share ideas and collaborate with other parents and T1D's in the workshop, opportunity to ask questions of speakers and panelists. The content was excellent and very relevant to my current struggle with my Teenaged T1D in the pediatric track."

"The behavioral/ psychological speaker is so helpful! We like the extra time to ask questions. We like meeting other families with T1D kids and talking with them. This year we were so happy to be back in person! At people we had lunch with became fast friends as we shared diabetes stories and supported one another. It’s such a great event!"

HEALTHCARE PROVIDERS

REGISTER FOR THE IN-PERSON PRACTICAL WAYS TO ACHIEVE TARGETS IN DIABETES CARE

July 12-16, 2023

Keystone, Colorado

Register for our annual, continuing education conference designed for healthcare providers caring for adolescents and adults with diabetes, where you can earn education credits. The University of Colorado School of Medicine designates this live activity for a maximum of 27.75 AMA PRA Category 1 Credits™.

This conference is for: certified diabetes educators, internists, pediatricians, family physicians, physician assistants, nurse practitioners, nurses, dietitians, and all healthcare providers interested in receiving the most up-to-date type 1 and type 2 diabetes information from world-renowned diabetes experts.

Register at: www.atdcconference.com/registration

View program details at: www.atdcconference.com

Questions? Contact Kristi Grounder at Kristi@ChildrensDiabetesFoundation.org or 303-628-5108

SUPPORT THE CAUSE BY BECOMING A GUILD MEMBER

About The Guild

The Guild is the volunteer membership group of the Children’s Diabetes Foundation (CDF), which is the fundraising arm of the Barbara Davis Center for Diabetes (BDC).

Since 1979, Guild Members have symbolized the spirit of pulling together, accomplishing great things individually and as a team. Guild Members have the unique opportunity to be involved in event and program committees to make a difference in our community. The Guild, with its more than 300 dedicated members, continues with fundraising efforts in the tireless fight to conquer diabetes.

Member Benefits

Mission

The Guild’s mission is to raise funds for research, promote diabetes awareness and education, assist families in need, provide continuing education scholarships, and sponsor social activities for children and their families.

Monthly Guild Meetings

Guild Members meet monthly to review program and event updates and connect with the T1D community. Each Guild meeting features a speaker whose subject matter is most often about diabetes research, care, or emotional well-being.

• Attend Guild meetings with engaging speakers to get an inside look at the latest in type 1 diabetes care & research from leading doctors, researchers, & social workers at the Barbara Davis Center for Diabetes

• Connect with a supportive community that advocates for diabetes awareness, research, & betterment of care

• Complimentary Guild Membership Brunch & Charlotte Tucker Scholarship Reception Dinner

• Invitations to member-only events

Programs

Helping Hand

Helping Little Hands

Charlotte Tucker Scholarship

Jewels for Hope

Events

Boo Bash Halloween Party

Run for the Ring 5K and Kids Fun Run

Sponsored Fundraisers

Brass Ring Luncheon & Fashion Show

The Children’s Diabetes Foundation (CDF) is looking for youths with type 1 diabetes (T1D) between the ages of 6 and 18, who want to educate, volunteer, and socialize! These awesome representatives will be the face of CDF and will need to exude a positive attitude about T1D, while educating and creating awareness for diabetes. Advocates will get together for quarterly social events to promote friendship, support, and fun!

Looking to connect with the diabetes community? Consider joining the Children's Diabetes Foundation's Digital Support Group! Anyone can join regardless of their location and connection to diabetes.

Learn more and sign up at childrensdiabetesfoundation.org/support-groups and childrensdiabetesfoundation.org/cdf-advocate-program or email Sydney Rickert at Sydney@ChildrensDiabetesFoundation.org .

RUN FOR THE RING TEAMS

Creating a Team or Race Group is a ton of fun for everyone! Enjoy race day with your friends, family or co-workers. Not to mention, you get to make up an awesome team name, create a fun team t-shirt, or wear a costume!

Team Benefits

Ø Become a Fundraiser – Fundraisers can create their own fundraising page with a custom URL and personal message and images to further their impact.

Ø Free Registration – Fundraise $200 for free registration for the 5K, Kids Fun Run, and Sleep In entry.

Ø Team Awards – Largest Team and Top Fundraising Team will receive a plaque for their team spirit and have full bragging rights!

Friends and Family Teams

Our Type 1 Team Challenge is a great way for friends and family to support their type 1 hero, create visibility and demonstrate that you care about issues affecting your family and community. Participate together by simply creating a race team and invite anyone you’d like to join.

Corporate Teams

Our Corporate Team Challenge is a great way to encourage team building and employee’s healthy habits while demonstrating your corporate support of The Guild of the Children’s Diabetes Foundation. The Guild’s mission is to fund research, promote diabetes awareness and education, assist families in need, provide continuing education scholarships, and sponsor social activities for children and their families. Simply create your organization and invite anyone you’d like to join your team. You can choose to cover the registrations fees for your team. If you don’t want to run or walk, you can also volunteer as a group and get many of the same benefits as running or walking!

There is no additional charge to register a team or as a team member. Setting up your team is easy; register online by following the steps below.

To register and create a team please visit www.RunSignUp.com/RunfortheRing

1. Sign up for 5K Race entry, Kids Zone/Fun Run, or a Sleep-In entry

2. Add additional participants you are personally paying for their event registration

3. Select join or create a team

4. Sign waivers for all participants you are registering

5. If creating a new team, choose your team name and set a password (optional)

6. Complete registration process

Find your Team

Search for a team at http://bit.ly/RFTRteams

For more information please contact: Mackenzie Atencio, Guild Program Coordinator Office: 303.863.1200 | Direct: 303.628.5116 | Email: Mackenzie@ChildrensDiabetesFoundation.org

Registering for Run for the Ring is fun for the whole family and gives you the opportunity to make a difference for people affected by type 1 diabetes. Not sure where to start fundraising or feeling a little shy about asking for people to support your cause? Here are a few tips for setting up your Run for the Ring Fundraising page and sharing it with your friends and family.

Fundraising Tips

1. What is your story and who are you running for? Telling your personal story is powerful and helps others know why you are passionate about the cause and why they should get involved.

2. Create an individual or team fundraising page with these simple steps.

Ø Become a Fundraiser, join a Team Fundraiser, or create a Team Fundraiser at http://bit.ly/RFTRfundraisers

Ø Create a fundraising page by choosing your individual or group fundraising name, pick your custom URL and add a personal message/images to be displayed on your Run for the Ring Fundraiser Page

Ø Search Team Fundraisers to join a team fundraiser

Ø Select join or create a team

3. Search Team Fundraisers.

Ø Search Team Fundraisers to join a team fundraiser at http://bit.ly/ RFTRfundraisers

Ø Select “join a team”

4. Set a fundraising goal. People like knowing what you trying to achieve and are compelled to help you when they know what you are working towards.

5. Start today! Registration is now open and race day is August 5, 2023. The more time you have the better!

6. Make a personal donation to your page. To get started make a contribution you are comfortable with and ask friends and family to match your donation. Be specific on what you want them to do, for example you may ask “Please help me to reach my goal of $______” or “Please consider matching my personal donation of $_______ for my team.” Be sure to let them know dates for your fundraising deadlines.

7. Share your page – Now that have your page it’s time to let everyone in your network know! Make personal calls, write emails, send letters or post cards. Include your story and reason for participating and include any information about programs of The Guild and Children’s Diabetes Foundation you find compelling and meaningful.

8. Share on social media! When posting to your social media accounts include pictures of your team from last year and share what you love about the race. This will help get people excited about supporting your team and fundraising efforts. Get friends and family involved and ask them to share your page to their community.

9. Thank every contributor. When you receive a donation, be sure to thank the donor and celebrate their support. Let them know how much their donation means to you and your cause. All donations are tax deductible and donors will receive a thank you letter from the Children’s Diabetes Foundation for tax purposes.

RUN FOR THE RING FUNDRAISING

GIRL SCOUT TROOP 66586 HAVE MADE THE BDC PEDS CLINIC THEIR “HOMETOWN HEROES.”

During "Cookie Season" every Colorado Girl Scout troop chooses a "Hometown Hero"- a local organization they wish to show appreciation for in the form of cookies. This year the girls in Broomfield troop 66586 chose the Barbara Davis Center, where two of their troopmates receive care, as their HTH. Jasmine and Evelyn are patients at the Barbara Davis Center and have shared parts of their diabetes stories with the troop. The girls delivered donated cookies to BDC on behalf of themselves and their troopmates.

Jasmine and Evelyn with Dr. Wadwa

Ellie, CDF Advocate

Cami, CDF Advocate

The 15th edition of the Center’s book Understanding Diabetes became available in December, 2022 (available at Gaven@ChildrensDiabetesFoundation.org or childrensdiabetesfoundation.org). New editions are required every three to five years because changes in care are advancing so rapidly. Some of the changes in the new edition are outlined below:

Revisions in Sick-Day Management (Chapter 16) include new suggestions for changes in insulin dosages related to blood/CGM sugar levels, ketones and food intake when sick (see Table 4). Help is also provided in relation to when to call the diabetes care-provider. The section on the management of vomiting has been enlarged (see Table 5).

Continuous Glucose Monitors (CGM) have been updated in Chapter 29. The FreeStyle Libre3 and the Dexcom G7 systems were made available in 2022 and provide up to 14 days of continuous glucose readings. These systems have been approved by the FDA for insulin dosing so that finger stick blood sugars are not needed. The new CGM metrics include “Time in Range” (TIR) and “Time Above Range” (TAR) which are now being used in clinical management (see Table 4). More than two-thirds of our clinic patients now use CGMs, so this has been a major change in clinical management.

The Artificial Pancreas (AP) systems are again updated in Chapter 30. The Tandem t:slim X2 insulin pump with Control-IQ Technology and the Omnipod 5 Automated Delivery Systems have both been shown to reduce the time spent in hypoglycemia and to increase the time spent “in-range” Both systems use the Dexcom CGM (the Omnipod only with a compatible phone). The MiniMed 780G system is included in the chapter as it is expected to be available in 2023.

Type 2 Diabetes (T2D) information has been updated in Chapter 4 with new goals for blood sugar and HbA1c levels. The many new medications for the treatment of T2D are now included in Table 2 (page 41). The SGLT-2 inhibitors are particularly important as they may help to prevent or reverse early kidney damage from diabetes.

The Behavioral/Emotions chapters all have new suggestions. For example, Chapter 20 on teenagers now suggests using a “code-word” for the teen to use when they need the parent to give them space to handle things (page 218). Chapter 17 on Family and Behavioral Concerns has a new section promoting a positive attitude about diabetes (page 193). Chapter 10 on Initial Feelings and Emotions at Diabetes Onset has expanded sections such as about the feeling of grief when a person is newly diagnosed (page 102).

Treatment of Hypoglycemia with the use of Intranasal Glucagon (Baqsimi®) is discussed in Chapter 6. Its use may be particularly important when people are not available who are skilled at giving injectable glucagon (e.g., at many schools). It works just as fast as the injectable glucagon and requires only one step for administration, the depression of the plunger.

Chapter 13 on Exercise has a newly developed Table 3 to help choose supplemental foods to prevent high or low blood/CGM sugar levels with aerobic or anaerobic exercise. Figure 4 in this chapter is also new and suggests insulin and carb-intake changes when using either an insulin pump or with injections. Once again, youth are recommended to have at least 60 minutes of exercise daily and adults should have at least 150 minutes of moderate to vigorous intensity aerobic activity weekly

Chapter 11 on Normal Nutrition suggests limiting carbs to 40-45 percent of daily calories rather than the previous 45 to 50 percent. Protein intake is proportionally increased. Weight management is now discussed in Chapter 11 (page 114), Chapter 12 (page 134) and in Chapter 4 (page 34). As increased weight adds to insulin-resistance, there strategies are important for people with type 1 or type 2 diabetes.

The Latest Versions of Insulin and Available Forms are presented in a new Table 4 in Chapter 9. Likewise, the new more rapid-acting forms of Humalog and Novolog, Apidra and Fiasp, are included for the first time in Table 1 of Chapter 8. The basal insulins are now divided between long-acting and ultra-long-acting.

The Three Stages of Type 1 Diabetes are included for the first time. The new Figure 1 in Chapter 3 defines the three stages of beta cell loss. This is particularly important as a medicine (Teplizumab) has now been approved for treatment of stage 2 to try to delay the onset of type 1 diabetes. The new Figure 2 in this chapter shows the expected changes in CGM glucose levels for the three stages.

The “Core Content Areas” listed at the start of each of the chapters have been completely updated to follow the more “user-friendly” education guidelines from the American Diabetes Association (ADA). These “Core Content Areas” give the main topics covered in each chapter and ensure that this book can be used as a comprehensive diabetes curriculum for diabetes centers throughout the U.S. (including our Center). A clearly defined curriculum is an important aspect of ADA accreditation for diabetes centers and is also often required by health insurance companies to ensure quality of care.

This book is approximately three-times the length of the companion book, A First Book for Understanding Diabetes. It is intended for people of all ages who want to have a more in-depth understanding of the topics. In contrast, the “First Book” is often used initially A combined total of the English and Spanish editions of the “First Book” went to over 40,000 families in 2022. It is available in five languages, while Understanding Diabetes is only available in English.

Children’s Diabetes Advisory Board Members and Guild Presidents

THE GUILD PRESIDENTS:

Founding President, Amy Davis

Mrs. Gina Abou-Jaoude

Mrs. Christy Alberts

Mrs. Jamie Angelich

Mrs. Karen Aylsworth

Mrs. Linda Broughton

Mrs. Tangy Buchanan

Mrs. Joy Burns

Dr. Bonita Carson

Mrs. Lisa Corley

Mrs. Nancy Cowee

Mrs. Dalyla Creaghe

Mrs. Norma D’Amico

Ms. Donna Douglas

Mrs. Margy Epke

Mrs. Lori Finch

Mrs. Chris Foster

Mrs. Helenn Franzgrote

Mrs. Sally Frerichs

Mrs. Debbie Gradishar

Mrs. Katie Grassby

Mrs. Helen Hanks

Mrs. Georgia Imhoff

Mrs. Marty Jensen

Mrs. Gail Johnson

Mrs. Sharon Kamen

Mrs. Janet Knisely

Mrs. Cheryl Lebsock

Mrs. Suzy Love

vMrs. Shelley Lucas

Mrs. Judy McNeil

Mrs. Sally Newcomb

Mrs. Barb Oberfeld

Mrs. Gretchen Pope

Mrs. Carol Roger

Mrs. Kay Stewart

Mrs. Diane Sweat

Ms. Charlotte Tucker

Mrs. Loretta Tucker

Mrs. Melissa Tucker

Mrs. Jane Weingarten

ADVISORY BOARD:

Sir Michael Caine

Mrs. Lisa Corley

Mr. and Mrs. Robert A. Daly

The Honorable Diana DeGette, U.S. House of Representatives, Colorado

Mr. Neil Diamond

Mr. Placido Domingo

Mr. John Elway

Mr. David Foster

Mr. Kenny G

Mr. David Geffen

Mr. Magic Johnson

Mr. Quincy Jones

Ms. Sherry Lansing

Mr. Jay Leno

Mr. Lionel Richie

Mrs. Adrienne Ruston Fitzgibbons

Mr. George Schlatter

Ms. Maria Shriver

Ms. Brenda Richie

Ms. Barbera Thornhill

Miss Joan van Ark

Mrs. Cindy Wells

Mr. Gary L. Wilson

Mr. Stevie Wonder

See complete list at ChildrensDiabetesFoundation.org