NewsNotes - Winter 2010

All Carousel of Hope photos: © Berliner Studio

children’s diabetes foundation at denver — WINTER 2010

STUNNING PERFORMERS dazzle THE 19th CAROUSEL OF HOPE BENEFITING children’s diabetes foundation

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conic artists Jennifer Lopez and Marc

Anthony, Gladys Knight, Akon and Jay

Leno joined with Honorees Maria Shriver

and Quincy Jones and presenters Tom Hanks, Rita Wilson and Randy Jackson, Producer George Schlatter and Music Director Rickey Minor to make the 2010 Mercedes-Benz Carousel of Hope the most glittering, glamorous and gorgeous event in the 24-year history of The Carousel of Hope benefiting the Barbara Davis Center for Childhood Diabetes and the Children’s Diabetes Foundation.

(Continued on Page 10)

The Carousel of Hope

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1. Jay Leno 2. Maria Shriver, Honoree 3. Jane Fonda 4. Dana Davis, Barbara Davis 5. Raquel Welch 6. Kenny Rickel, Paul and Lynn Palmer, Isabella and Mariella Rickel, Nancy Davis Rickel ON THE COVER 1. Tom Hanks, Rita Wilson, Barbara Davis, Maria Shriver, George Schlatter 2. Halle Berry 3. Marc Anthony and Jennifer Lopez, Featured Performers

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The Carousel of Hope

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1. Garcelle Beauvais 2. Gladys Knight, Featured Performer 3. Clive Davis, Stevie Wonder, Barbara Davis 4. Nancy O’Dell 5. Kelly & Don Johnson 6. Barbara Davis, Daisy Fuentes

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The Carousel of Hope

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1. Qunicy Jones, Honoree 2. Cheryl Tiegs, Frances Fisher 3. Garcelle Beauvais, Paul Sorvino 4. Larry Gilman, Donna Mills 5. Gladys Knight, Lisa Raye McCoy 6. Vanna White 7. Don Rickles, Kathy Griffin, Bob Newhart

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The Carousel of Hope

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1. Bob Evans & Guest 2. Jennifer Lopez 3. Bob Daly, Barbara Davis, Carole Bayer Sager 4. Harrison Fuller 5. Lara Spencer 6. Nigel Lythgoe, Alana Stewart, Marc Anthony

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The Carousel of Hope

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1. Halle Berry, Olivier Martinez 2. Berry Gordy, Eskedar Gobeze 3. Percy Gibson, Joan Collins 4. Sidney and Joanna Poitier 5. George and Jolene Schlatter 6. Brandy, Maksim Chmerkovskiy, Lisa Rinna, Harry Hamlin

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The Carousel of Hope

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1. Barbara Davis, Adrien Brody 2. Akon 3. Sela Ward 4. Alan Thicke, Tanya Callau 5. Paris Hilton 6.

Dr. Nancy Larco, Head of Diabetes at Medecine Interne Maladies Metabolique and Dr. Philippe Larco, leading Haitian Immunologist, who returned to Port au Prince the day after the Ball to help with the Cholera epidemic

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The Carousel of Hope

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1. Rickey and Karen Minor 2. Barbara Davis, Steven Graham Angelica Huston 3. Christopher Backus, Mira Sorvino 4. Gregg Davis, Barbara Davis, Harry Davis, Elena Davis, Hudson Davis, Julie Davis 5. Kathy and Rick Hilton 6. Robert & Kelly Day

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1. Jackie Collins, Dieter Abt 2. Julie Chen, Les Moonves, Leah Remini 3. Marc Anthony

The Carousel of Hope

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4. Savannah Robinson 5. Randy Jackson 6. Lili Zanuck, Barbara Davis, Sherry Lansing

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The Carousel of Hope

(Continued from Cover)

More than 1,000 guests attended the 2010 Carousel of Hope Ball presented by Mercedes-Benz, raising nearly $2.4 million for research and clinical care programs for diabetes at the Barbara Davis Center for Childhood Diabetes, where over 5,000 children and adults receive care.

The evening would not be possible without the help of genius TV veteran, George Schlatter and his skilled production crew, talented music director, Rickey Minor, and Jay Leno, who once again reprised his role as the Master of Ceremonies.

The Children’s Diabetes Foundation would like to thank the evening’s presenting sponsor Mercedes-Benz USA, and major sponsors GUESS?, American Airlines, sanofi-aventis U.S., The Beverly Hilton Hotel and our angel sponsors Ron Burkle, Sarah Siegel-Magness and Gary Magness and Robert and Kelly Day. Reem Acra illuminated the ballroom with her beautiful donated tablecloths in shades of pink. Lush flower arrangements with over 10,000 flowers flown in from Ecuador were created

by Fred Gibbons of Treefrogs, who has served as the event’s exclusive florist since 1990.

We also thank Angelica Huston for allowing us to use the sculptures of the late beloved Robert Graham for the honoree awards, and Moët Hennessy USA, our exclusive spirits sponsor. The evening was also generously supported by many corporations and leaders from the entertainment industry.

The show began with Savannah Robinson’s a capella rendition of the “Star Spangled Banner.”

Tom Hanks and Rita Wilson then introduced First Lady of California, Maria Shriver, who was the recipient of the Brass

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Ring Award for her inspiring humanitarian efforts. Maria’s meaningful speech deeply touched the audience. Last year’s Brass Ring honoree, Clive Davis, followed with a warm introduction of Barbara Davis who generously thanked every guest for attending and joining in the fight against the global epidemic of diabetes.

She updated the audience on the Center’s programs and the advances being made for children everywhere. In closing, she mentioned a quote from Christopher Reeve, “Once you choose hope, all things are possible.” American Idol’s Randy Jackson welcomed Quincy Jones to the stage as he was honored with the Foundation’s distinguished Humanitarian Award on the 25th Anniversary of “We Are The World.”

The unforgettable evening included performances by great artists Jennifer Lopez and Marc Anthony, who performed a duet of “No Me Ames.” Together the couple sang in perfect harmony lighting up the room with love and song. Jennifer Lopez then took control of the stage in a fiery performance of “Let’s Get Loud”, which set the tone for the evening of entertainment as each person in the room was singing and dancing. American R&B singer and songwriter Akon was next as he ruled the stage, performing his hit songs “Angel” and “Sexy Chick.” The Featured Performer, legendary artist Gladys Knight’s grand finale had guests on their feet, swaying and singing with her to classics “Neither One of Us” and “Midnight Train to Georgia” leaving everyone euphorically wishing for more.

Some of the many celebrated guests included: Halle Berry, Stevie Wonder, Adrien Brody, Jackie Collins, Joan Collins

and Percy Gibson, Clive Davis, Jane Fonda, Berry Gordy, Kathy Griffin, Tom Hanks and Rita Wilson, Anjelica Huston, Randy Jackson, Rickey Minor, Les Moonves and Julie Chen, Dermot Mulroney, Bob and Ginny Newhart, Joanna and Sidney Poitier, Don and Barbara Rickles, Carole Bayer Sager and Bob Daly, Jolene and George Schlatter, Judge Judy Sheindlin, Rod Stewart and Penny Lancaster, Sela Ward, Raquel Welch, Vanna White, Garcelle Beauvais, Thora Birch, Brandy, Maksim Chmerkovskiy, Billy Davis & Marilyn McCooDavis, Bob Evans, Frances Fisher, Daisy Fuentes, Lisa Rinna & Harry Hamlin, Nicky Hilton, Paris Hilton, Rick & Kathy Hilton, Beverly Johnson, Don Johnson, Tamala Jones, Susan Lucci, Nigel Lythgoe, Chris Massey, Kyle Massey, Benny Medina, Donna Mills, Nancy O’Dell, Sumner Redstone, Leah Remini, Mimi Rogers, Mira Sorvino, Paul Sorvino, Lara Spencer, Alana Stewart, Alan Thicke, Cheryl Tiegs, Louis van Amstel, Buzz Aldrin, Joan van Ark and Ben Vereen.

During the live auction one lucky winner walked away with the stunning Mercedes-Benz 2011 CL63 AMG for $170,000. The live auction also included two incredible trips courtesy of St. Regis Hotels, one throughout Europe and another to Hawaii and Tibet, with airfare to begin and end the trips donated by American Airlines.

The Silent Auction, chaired by Nancy Davis and Dana Davis, was composed of nearly 450 items and included an Avjet trip for 7 to Las Vegas or Monterey on a Gulfstream 150 or Hawker 800XP. Other vacation spots included stays at The Resort at Pelican Hill in Southern California, the Peninsula Hotel in Hong Kong, Hotel Le Bristol in Paris and the Grand Wailea Resort Hotel and Spa in Hawaii.

Lavish dining experiences included: dinner for 20 in the private dining room at Mr. Chow, Wolfgang Puck dinner for 12 at CUT with wines; Il Piccolino; Toscana; Chateau Marmont; The French Laundry. Fashion items this year featured donations from many fashion icons such as Donna Karan, Giorgio Armani, Chanel, Monique Lhuillier, Oscar de la Renta, Fendi, Devi Kroell, Saks Fifth Avenue, Neiman Marcus and more. Other Auction items included donations from home teams the LA Lakers, and LA Dodgers; jewelry from Tiffany & Co. and Nancy Davis’ Peace and Love; and the popular Art Gallery with art donated by leading contemporary artists such as Ed Ruscha, the late 1.

Dennis Hopper, Tony Bennett, Ross Bleckner, Nancy Ellison, Frank Gehry, LeRoy Neiman, Firooz Zahedi and many more.

Celebrities once again helped in several ways, including MAKE LOVE NOT TRASH totes personally signed by Kenny “Babyface” Edmonds, Selma Blair, George Clooney, Clint Eastwood, Harrison Ford, Scarlett Johansson, Bill Maher, Julia Louis-Dreyfus, Mike Myers and Ben Stiller. Handbags for Hope was supported by celebrities Shirley MacLaine, Maria Shriver, Kelly Preston, Cindy Crawford, Angela Bassett, Candice Bergen, Carol Burnett, Joy Behar, Goldie Hawn, Jackie Collins, Anjelica Huston, Julianne Moore, Thora Birch and Joan van Ark who donated one of their special handbags and autographed key chains by Linea Pelle and Braggables.

Brand new this year was Canvas for the Cure, a project that featured original miniature canvases painted by celebrities including art by John Travolta, Anjelica Huston, Josh Groban, George Clooney, Cindy Crawford, Bill Maher, Penny Marshall,

Crystal Bowersox and many more.

This year’s wonderful gift bags designed by GUESS?, included an extraordinary array of generous gifts from GUESS? including a scarf, eyewear, men’s and women’s watches, also donations from the Los Angeles Lakers’, MAC, The Walt Disney Company, Jackie Collins, Urban Behavior, Tina Sinatra, Wen, Carita USA, Decléor, Avjet, Amanda Dunbar, Bagatella Handbags, Beverly Hills Plastic Surgery, Canvas Pop, M Salon, OPI, Nubius Organics, Raven Spa and the Ranch.

The Carousel of Hope has raised more than $75 million since 1978 to critically combat the diabetes epidemic, which afflicts one in three babies born today. These essential funds are raised by Children’s Diabetes Foundation to fund programs for more than 5,000 children and adults who receive specialized care for diabetes management and prevention of complications and on reaching for the cure.

1. Barbara Davis 2. Mavis & Jay Leno 2.

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2010 Symposium

The carousel of hope diabetes symposium

t

he 2010 Carousel

of Hope Diabetes

Symposium,

“Pathways for

Future Treatment and Management of Dabetes,” addressed new insulin delivery systems including continuous glucose monitoring. It also concentrated on new oral medications for type 2 diabetes along with the emerging increase in obesity and type 2 diabetes in children and young adults. The Symposium assembled a group of experts whose work engages with the multi-faceted challenges facing the implementation of this new technology to benefit of people with diabetes.

Jeffrey A. Bluestone, PhD, A.W. and Mary Margaret Clausen Distinguished Professor; former Director of the Diabetes Center at the University of California, San Francisco at the University of California, San Francisco, CA Dr. Bluestone established the UCSF/JDRF Center for Islet Transplantation and serves on the California Institute for Regenerative Medicine Diabetes Disease Team, as well as comprehensive research and clinical programs aimed at marrying cutting-edge islet cell-specific stem cell biology with novel immunotherapies as a treatment for type 1 diabetes.

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Peter Butler, MD, Professor of Medicine, Chief of the Division of Endocrinology, Diabetes and Hypertension and Director of Larry Hillblom Islet Research Center, University of California, Los Angles, CA Dr. Butler is a clinical investigator with clinical practice at UCLA focusing on care of patients with diabetes and research focusing on abnormal insulin secretion, the causes of beta cell death and the possibility to foster islet regeneration in humans.

Steve Daniels, MD, PhD Chairman of the Department of Pediatrics at the University of Colorado School of Medicine, Aurora, CO Dr. Daniels is a Pediatric Cardiologist who has focused his clinical work and research on Preventive Cardiology. His interests include the effects of diabetes, hypertension and obesity on the cardiovascular system.

Steve Edelman, MD, Professor of Medicine in the Division of Endocrinology, Diabetes & Metabolism at the University of California at San Diego (UCSD), CA and the Veterans Affairs (VA) Healthcare System Dr. Edelman is also the founder and director of Taking Control of Your Diabetes (TCOYD), a not-for-

profit organization with the mission of educating and motivating people with diabetes to take a more active role in their condition.

Dr. George Eisenbarth, MD, PhD, Executive Director of the Barbara Davis Center for Childhood Diabetes and Professor of Pediatrics, Medicine, and Immunology at the University of Colorado School of Medicine, Aurora, CO Dr. Eisenbarth first characterized type 1 diabetes while at Joslin as a chronic autoimmune disease that could be predicted prior to clinical symptoms. His immunogenetics lab investigates autoimmunity in natural history studies, including twins, and in the NOD mouse with the goal of predicting and preventing diabetes. He is received ADA’s 2009 Banting Prize for Outstanding Lifetime Scientific Achievement.

Satish K. Garg, MD, MBBS, DM, Director, Adult Clinic, Barbara Davis Center, Professor of Medicine and Pediatrics, University of Colorado Health Sciences Center, Aurora, CO Dr. Garg¹s research interests include the early detection and treatment of renal and retinal complications of type 1 diabetes and the development of new diagnostic and therapeutic

Matthias Hebrok, PhD, Hurlbut-Johnson Distinguished Professor in Diabetes Research, Interim Director of the Diabetes Center, University of California, San Francisco, CA Dr. Hebrok’s research focuses on the understanding of how islets of Langerhans, the endocrine component of the pancreas, are formed during organogenesis, how their function is regulated in the mature organism and how changes in gene expression might allow islet regeneration.

John C. Hutton, PhD, Research Director, Barbara Davis Center; Professor, Department of Pediatrics and Cellular and Structural Biology, University of Colorado Denver, Aurora, CO Dr. Hutton’s laboratory provides a strong training environment in molecular cell biology, biochemistry and immunology emphasizing basic research on insulin secretion and the pathogenesis of type1 diabetes.

He heads the Diabetes and

Endocrinology Research Center at the Barbara Davis Center and the JDRF-BDC Autoimmunity Prevention Center.

Marian Rewers, MD, PhD, Clinical Director, Barbara Davis Center, Aurora, CO Dr. Rewers is Professor of Pediatrics and Preventive Medicine at the University of Colorado and is a pediatric diabetologist and an internationally-recognized physician scientist. He has made important contributions to our understanding of the etiology of type 1 diabetes and its macrovascular complications by creating large prospective cohort studies: DAISY, CACTI and an international consortium, the Environmental Determinants of Diabetes in the Young (TEDDY).

Jay S. Skyler, MD, MACP, Professor of Medicine, Pediatrics, & Psychology at the University of Miami, Miami, FL Dr. Skyler is Associate Director for Academic Programs in the Diabetes Research Institute and is Chairman of the NIH-sponsored Type 1 Diabetes TrialNet, an international network conducting clinical trials to prevent type 1 diabetes or interdict the type 1 diabetes disease process.

Dr. Robert Slover, MD, Director of Pediatric Clinical Services, Barbara Davis Center, Aurora, CO Dr. Slover is the Colorado principal investigator (PI) for the STAR 3 study. STAR 3 is a randomized, multi-center two-arm study to compare the efficacy of the MiniMed Paradigm REAL-Time system versus multiple daily injections (MDI). He has been involved in 12 research projects as either PI or Co-PI, has 12 publications and has been invited to over 35 speaking engagements.

Phil Zeitler, MD, PhD, Professor of Pediatrics and Clinical Science at the University of Colorado Denver and Medical Director of the Children¹s Hospital Clinical Translational Research Center of the Colorado Clinical Translational Science Institute, Aurora, CO Dr. Zeitler is Attending Endocrinologist at the Children¹s Hospital and the Barbara Davis Center for Diabetes, where he is Director of the Type 2 Diabetes and Metabolic Syndrome Clinic and Director of the Pediatric Endocrinology Training Program.

He currently serves as Study Chair of TODAY, a national, NIH-funded, multi-center trial examining treatment options for adolescents with type 2 diabetes and TODAY Genetics Study.

2010 Symposium

tools related to clinical diabetes management that include new insulin analogs and glucose sensors, etc. He currently serves as the Editor-in-Chief of the Diabetes Technology and Therapeutics Journal.

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2010 Davis Award Winner Jeffrey A. Bluestone, PhD During the past 25 years, Dr. Bluestone has authored over 375 publications on diabetes and immunity while studying the regulation of T-cells in response to autoantigens and transplantation antigens, supporting the development of help in the development of a new generation of tolerogenic drugs that will “turn off” selected parts of the immune system, leaving the disease-fighting capabilities intact.

He has received numerous awards including the JDRF Grodsky Basic Science Award, the Mary Tyler Moore & Robert Levine Excellence in Clinical Research Award and a JDRF Scholar Award from JDRF, as well as the American Society for Transplantation Roche Distinguished Research Award.

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Barbara Davis Center

Landmark studies on exercise and hypoglycemia in youth with Type 1 diabetes — H. Peter Chase, MD and Rosanna Fiallo-Scharer, MD

T

ype 1 diabetes

is one of the

most common

chronic diseases

in children.

Unfortunately, the fear of low blood sugars (hypoglycemia) prevents many families from achieving good control of the diabetes. Hypoglycemia is scary, and when severe can result in seizures or unconscious episodes. Although exercise is recommended for all youth with regular diabetes, hypoglycemia during or after exercise is one of the most frequently identified specific causes of severe hypoglycemia.

Three landmark studies in the CTRC (Clinical Translational Research Center) at Children’s Hospital have been important in making exercise safe for children with Type 1 diabetes.

The first two studies have been performed as part of a working group (DirecNet) of pediatric endocrinologists at the Barbara Davis Center/Denver Children’s Hospital, Yale University, Stanford University, Nemour’s Children’s Hospital in Florida, and the University of Iowa with coordination by the JAEB Center for Health Research in Tampa, Fl. An initial study developed the 60 minute treadmill methodology used in all later studies. The initial study found that during the exercise, one out of four of the children had blood sugar levels below 60 mg/dL and half of the children had values below 70 mg/dL. The children stayed in Children’s Hospital overnight to study the incidence of delayed nocturnal hypoglycemia (low blood sugar levels).

Surprisingly, lows occurred

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during 48% of nights following a day when the children had exercised, and on 28% of nights when the same youth spent the night in the hospital after a day without exercise. This was published in the Journal of Pediatrics 147: 5 28, 2005.

An important second study focused on preventing the low blood sugars during the afternoon exercise session.

Youth using an insulin pump turned off the pump (no insulin) during the 60 minutes of exercise and for 45 minutes after the exercise. Low blood sugars were approximately 1/3 as common when the insulin was discontinued (16% of children) as on another day when insulin was continued for the same youth (48% low). This was published in Diabetes Care 29, 2006.

In a third study (currently in press: Journal of Pediatrics), Dr. Craig Taplin (a 3rd year Endocrine-Diabetes fellow at The Children’s Hospital/ Barbara Davis Center studied methods to prevent the delayed low blood sugars during the night. The same afternoon exercise program was used as

in the two above studies. He found that discontinuation of the insulin during exercise and administration of half of the usual insulin for 45 minutes after the exercise, followed by a 20% reduction of basal insulin from 9pm to 3am essentially prevented low nighttime blood sugars. As these changes in insulin delivery are only possible for youth using an insulin pump, the administration of a medicine , terbutaline, was also studied. This can be used by youth using injections and not using an insulin pump. This medicine prevented low blood sugars at night but caused blood sugar levels to be too high.

Further studies will be needed to determine the correct dose of terbutaline.

In summary, knowledge from these three landmark studies, all done in collaboration with The Children’s Hospital and the Barbara Davis Center for Childhood Diabetes, should help to make life safer and easier for the 3,000 children with Type 1 diabetes followed at the Center, as well as for the millions of children with diabetes around the world.

important websites Children’s Diabetes Foundation www.ChildrensDiabetesFoundation.org Barbara Davis Center for Childhood Diabetes www.BarbaraDavisCenter.org Juvenile Diabetes Research Foundation www.jdrf.org American Diabetes Association www.diabetes.org Children with Diabetes www.ChildrenwithDiabetes.com

— Rita Trujillo Hughes, LCSW, CDE, Clinical Social Worker

J

SHOTS!”

ust a minute...”

“I have to go do something first....”

“You’re mean!” “I HATE

Sound familiar? Are shots or set changes at your house a struggle and a battle? You are certainly not alone. Preliminary study suggests that perhaps a third of all children, teens and adults have some degree of needle anxiety that makes injections a challenge. However, the majority of these kids don’t necessarily say that shots hurt. Their behavior tells us so.

Needle fears range in degree from mild to severe. True needle phobia (where the level of anxiety is so heightened that people might faint at the sight of a syringe) is less common, but

needle fearfulness is nonetheless very important to address. It is important to know that anxiety about shots is mediated by a real biological response. The physical symptoms are real.

Queasy stomach, sweaty palms, shaky hands, and pounding hearts are not uncommon.

Sometimes, pain with shots triggers anxiety that can lead to difficulties with injections.

Incorrect injection technique may be causing some pain.

Though we know that shots aren’t going to be absolutely painless 100% of the time, with proper preparation and technique, shots should be relatively pain free most of the time. Shots ought to feel like a small pinch (at least that’s what we strive for). Cold insulin and some types of insulin might be contributing to discomfort and these are issues that your nurse educator can review with you and make suggestions that might make a real difference.

If changing technique doesn’t work and your child has some of the following symptoms, then consulting one of the clinical social workers on the team might help. Even when kids don’t complain of anxiety or painful shots, these behaviors suggest that we may need to look a little closer: * Your child stalls around shots or has elaborate rituals about how they should be done. * Takes a long time to actually do the injection or “hunts and pecks” looking for just the right spot. * Refuses to rotate sites and has a favorite spot that usually ends up puffy from overuse. * Demands control and refuses help with injections from anyone, even when help from a parent has been recommended by the doctor. * “Forgets” to do shots or even skips some injections. * A persistently high A1c even when insulin is increased. * Young children consistently cry about shots and parents feel they have to wrestle with them in order to get the job done.

When kids anticipate and expect pain with an injection, they may begin doing things that actually heighten their anxiety and their perception of pain. For example, they may hold their breath and tense their body. They may wiggle and struggle, making it more difficult for a parent to do an injection easily. These behaviors will probably make shots hurt more and the longer the struggle continues, the harder it is to change.

Barbara Davis Center

Taming the Shot Monster

Photo: © Janssen Photography

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Barbara Davis Center 16

Needle Anxiety (Fear of shots) It is now known that needle anxiety of some degree occurs in almost everyone. Children and adults have worries about shots.

In a person with diabetes, we used to assume that this anxiety would just go away because they had to have shots every day. We now know that needle anxiety, if strong, doesn’t “just go away”.

There are some things that can be learned to reduce this anxiety if we identify it is a problem.

First of all, anxiety about shots is normal. When we fear something, we get tense and hold our breath. Our head is filled with thoughts about pain. Parents, who have to give these shots, can be just as needle anxious as their child.

Remember, that the syringes that are now used for insulin are much smaller and have shorter needles so that shots are much more comfortable these days.

With a few easy techniques, shots can be less stressful.

The diabetes educators in our clinic always have parents or significant others practice injections on each other using saline solution. The practice nearly always reassures them that giving insulin injections to their child is not the trauma they image.

Tensing can make shots hurt. So take a couple of deep relaxing breaths (“breathe in through the nose and breathe slowly out through the mouth”) and try to image yourself made of jell-o.

By relaxing the tension, shots can be done more comfortably.

Sometimes a little distraction can help refocus the mind from fear to something else. Watching cartoons or listening to some favorite music with headphones can help the mind from thinking too much about the shots and aids

Sometimes a person with diabetes doesn’t get over their stress about shots. A few symptoms that might indicate this is going on are;

F persistently high HbA1c F a child wanting to do all their

own shots - particularly when they want to do the shot in a room by themselves (some shots will probably be missed)

F

lack of site rotation (hypertrophy, or hard tissue at the injection site)

F missed insulin shots F excuses for wanting to “put

off” the shot (stalling)

F

parental fear or worry about injections or blood draws The psychosocial member of the team can be very helpful to children or parents with sorting out this problem. Treatment can include behavioral techniques and purposeful distraction. The latter includes TV, music, toys, blowing bubbles and books.

Sometimes injection devices help the problem (Inject-Ease) though

Photos: © kentmeireisphotography.com

they do not “cure” it. Behavioral techniques include learning to relax, reward programs, systematic desensitization and biofeedback. As fear of shots, blood or injury decreases, the HbA1c usually improves.

The first step in making shots easier is identifying when kids are having more anxiety than they should. If you feel shots have been too much of a battle around your house lately, you might mention that at your next visit and we’ll see how we can help.

Research at the BDC and the Children’s Hospital, put together an impressive roster with the following BDC clinical staff: Physicians: H. Peter Chase, MD George Eisenbarth, MD, PhD Rosanna Fiallo-Scharer, MD Robert Slover, MD

— Regina Reece

t

he Barbara Davis

Center for

Childhood

Diabetes held

its annual, “Taking Diabetes to School” conference on Friday, October 15th at the Nighthorse Campbell Native Health Building, located at the CU Anschutz Medical campus.

This program was staffed by the BDC Pediatric Clinic as well as Michelle Passamaneck of ADA, Kathleen Patrick of Colorado Department of Education and Amy Reeves of Medtronic Diabetes.

There were 90 attendees ranging from clinic aids to school principals who enjoyed an information packed day where topics included: What is Diabetes, Psych-Social Issues, Nutrition Management, School Health Plans, and the Importance of a School Nurse.

There were also hands-on workshops in the afternoon that covered the following areas: Pumps and Sensors, How to Handle High and Low Blood Glucose Levels and training on various blood glucose monitors and on how to use syringes and insulin pens on pediatric patients.

A special appreciation is expressed to the following supporters who made this program possible: Abbott Diabetes Care, American Diabetes Association, Animas Corporation, BD, the Children’s Diabetes Foundation, the Colorado Department of Education, The Guild of the Children’s Diabetes Foundation, Lilly USA, LLC, Medtronic Diabetes, Novo Nordisk, Inc. and sanofi-aventis.

Nurse Practitioner: Stephanie Kassels, DNP(c), FNPBC, CDE Nurses: Georgia Koch, RN, BSN, CDE Laurel Messer, RN, MPH, CDE, Sarah Morey, RN, BSN Susie Owen, RN, CDE Kathy Smith, RN, BSN, CDE Sally Sullivan, RN, CDE Graciela Tellez, RN Libbie Tuthill, RN, BSN, CDE

LILLY CONFeRENCE — Regina Reece

Type 1 Diabetes ExperienceBased Learning Program

T

he Barbara Davis

Center for

Childhood

Diabetes (BDC)

hosted the “Type 1 Diabetes Experience-Based Learning Program” for Lilly USA, LLC (a company that develops, manufactures, markets and sells pharmaceutical and animal health products).

This two day program held on October 19-20, 2010 was designed to aid the Lilly team of 50 individuals from the basics of, “What is Diabetes?” to the most current technology in the diabetes realm such as using Continuous Glucose Monitoring devices (CGMs).

Conference Director: Georgeanna Klingensmith, MD, Director of Pediatric Clinical Care and Translational Clinical

Social Workers: Lisa Meyers, LCSW, CDE Dana Shepard, LCSW Rita Trujillo Hughes, LCSW, CDE Dietitians Loise Gilmer, MD, RD, CDE Gail Spiegel, MS, RD, CDE Participants also attended a breakout session that provided the opportunity to have hands on experience with essential diabetes care tasks that families need to master in order to safely manage diabetes at home. These tasks included insulin injections, blood glucose monitoring and recognition of mild and moderate hypoglycemia as well as the treatment of severe hypoglycemia with glucagon.

Barbara Davis Center

Taking Diabetes to School Conference

Photo: © Janssen Photography

We also had a unique opportunity to present a patient and parent panel session where case scenarios were given, as well as have a question and answer session during this time.

The BDC is looking forward to offering this program with Lilly in 2011.

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Barbara Davis Center

Dr. Slover named new director of pediatric services — Marian Rewers, MD, PhD, Clinical Director for Barbara Davis Center for Childhood Diabetes

W

e are proud to

announce great

news on the

search for the

new Director of Pediatric Diabetes Services at Barbara Davis Center and The Children’s Hospital Denver.

After months of an intensive search process that included several excellent candidates, the position was offered to Dr. Robert Slover, Associate Professor of Pediatrics. Dr. Slover is expected to take the new position on January 1, 2011.

Rob Slover earned his MD degree from the University of Utah Medical School in 1975. He did his pediatric training here, at the Fitzsimons Army Medical Center in 1975-1978, and is a graduate of our Pediatric Endocrinology and Diabetes Fellowship program (1980-1982). Rob has been on the faculty of the School of Medicine, University of Colorado, since 1990 and on the BDC faculty since 1994. For the past five years, he has served as the Deputy Director of Pediatric Diabetes Services. His research interests include Continuous Glucose Monitoring, artificial pancreas, Cystic Fibrosis related diabetes and transition care, among many others. Rob is an outstanding clinician and educator.

One of the main tasks facing Rob and all of us is to further strengthen our collaboration with Children’s Hospital, Denver’s increasing patient load, both ambulatory and inpatients, and with increasing complexity of diabetes care.

We look forward to working

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Photo: © Martin Crabb

closely with our TCH-based colleagues and with multiple children’s services to optimize our efforts for the benefit of children and young adults with diabetes. We congratulate Dr. Slover in his selection for this important leadership position.

On behalf of the Barbara Davis Center and Children’s Diabetes Foundation, we would like to thank Dr. Georgeanna Klingensmith for 17 years of her outstanding service as the Director. Georgeanna has chaperoned the Service through challenging times. First, she led the consolidation of outpatient diabetes services at the BDC in

1994. More recently, Georgeanna has been instrumental to establishing excellent Pediatric Diabetes Services on the campus. The clinic volume has quadrupled under her watch and so has the staff and funding. I’m happy to tell you that Georgeanna is staying at the BDC and agreed to continue many of her current activities, including patient care, teaching, leading the T32 training grant and working as the principal investigator on several studies, e.g., PDC and Exchange.

Marian Rewers, MD, PhD, Professor, Pediatrics & Preventive Medicine, Clinical Director, Barbara Davis Center for Childhood Diabetes.

I

s your child a

patient at the

Barbara Davis

Center? Are you a

patient at the Barbara Davis Center? Do you have a special interest in diabetes? This is an opportunity for you, your family and your friends to have a presence at the Center by purchasing a place on the donor wall, or naming rights on a room — a lasting symbol of your support. Help Us Catch the Brass Ring — a Cure for Diabetes. Levels 1, 2 and 3 will also be entitled to naming rights on a room at the Barbara Davis Center. For information call Chrissy at 303-863-1200.

Funding Opportunities: Level 1 $50,000 and above Level 2 $30,000 to $49,999 Level 3 $10,000 to $29,999 Level 4 $1,000 to $9,999 Level 5 $100 to $999

donor wall form Name ________________________________________________________ Address ______________________________________________________ City _____________________________ State ______ Zip_______________ Home phone _____________________ Work phone ____________________ Cell phone ___________________ E-mail ____________________________ Amount $___________________ _____________________________________________________________ (Name as you wish it to appear on donor wall) Make check payable to Children’s Diabetes Foundation or q Visa

q Mastercard

q American Express

Name on card _________________________________________________ Card # ________________________________________________________ Mail payment to: Children’s Diabetes Foundation — Donor Wall 777 Grant St., Ste. 302 Denver, CO 80203

Barbara Davis Center

Barbara Davis Center at fitzsimons donor wall

Photo: © Steve Groer Photography

19

Questions and Answers

Photo: © Martin Crabb

20

QUESTIONS AND ANSWERS — H. Peter Chase, MD

Q: A:

What is the

main cause of

low-blood

sugar seizures

in youth and can they be prevented?

Preceding

exercise

is described as

the main

recognized contributing factor for severe hypoglycemia in youth.

Prevention involves “thinking ahead.” People using injections need to reduce insulin dosages both for the time of exercise and for the night. Extra snacks may be needed. People using insulin pumps can use a “0” to 50% temporary basal during the exercise (sometimes beginning 30 minutes before), and an 80% temporary basal rate from 9 p.m. to 3 a.m. The use of a continuous glucose monitor (CGM) with alarms for lows can also be very helpful in prevention.

Q:

My doctor has

found my child

to have high

transglutaminase

antibodies that are associated with celiac disease. Does my child need to have an intestinal biopsy before considering a gluten free diet?

— From Dr. George Eisenbarth, MD, PhD

A:

Children with

type 1 diabetes

are at higher

risk for celiac

disease, an illness in which gluten in the diet from a number of sources (e.g. wheat) causes the body’s immune system to attack the inner wall

of the intestine. When children have severe celiac disease associated with weight loss and diarrhea, avoiding gluten usually makes the symptoms go away and allows the child to grow normally. Nowadays we screen for celiac disease with a simple blood test for an antibody that appears in the blood, termed transglutaminase. If high levels of the antibody are found, we recommend a biopsy to confirm the diagnosis, as celiac disease is a life-long diagnosis and no single test is diagnostic. The biopsy is usually done with anesthesia so the child is not conscious for the procedure. A tube with a camera is swallowed and at the first part of the small intestine several pieces of the intestine are taken through the swallowed tube, each about the size of a pencil tip. The biopsy is then analyzed by the doctors under a microscope to confirm a diagnosis of celiac disease and determine the amount of intestinal damage, if any.

Many children do not have symptoms of celiac disease even though they have antibodies in the blood. High levels of antibodies usually indicate that there is damage to the intestine, and in general we recommend biopsy only when the antibody levels are high, unless there are also celiac disease symptoms.

In many children without symptoms with high levels of the antibody there is severe damage to the intestine. It is remarkable, but even with severe damage, with a gluten free diet the intestine can grow back and be normal as long as gluten is avoided. In general with a diagnosis of celiac disease we recommend life-long avoidance of gluten. It is very important to have a firm diagnosis for people with symptoms or high levels of antibodies, and thus the recommendation for confirmation through a biopsy.

^ C

^

^

reative juices

were flowing

at The Guild’s

27th Annual

Halloween Party for Children with diabetes. The extravaganza took place in the Green Center at The School of Mines with the help of the Phi Gamma Delta Fraternity.

Witches, Pirates, and Buzz Aldrin himself were seen decorating pumpkins donated

by Guild Members Robert and Judy Villano. There were games and prizes galore as well as goodie bags filled with toys and alternative snacks.

The event was a huge success!

No one left the party hungry; the great people at Pepsi Bottling Group donated Diet Soda and Bottled Water and Pizza was served by Children’s Diabetes Foundation Volunteers. Face Painting and Balloon animals kept everyone entertained while spooky music and scary costumes kept everyone on their toes. Phi Gamma Delta Fraternity was such a huge support, supervising games and putting smiles on the children’s faces. Big thanks goes out to Judy McNeil, the Chairman for The Guild, for all of her hard work and preparation for this event. All of the volunteers are greatly appreciated; without them, many children would miss these fun Halloween memories.

Carousel Days

Chills and Thrills for halloween

21

The Pink Panther™ & ©1964-2010 Metro-Goldwyn-Mayer Studios Inc. All Rights Reserved

www.pinkpanther.com

•

12:43

777 Grant Street, Suite 302 Denver, CO 80203 Phone: 303-863-1200 or 800-695-2873 Fax: 303-863-1122 www.ChildrensDiabetesFoundation.org

by H. Peter Chase, MD & Laurel Messer, RN, MPH, CDE

2nd Edition

Foundation News

Children’s Diabetes Foundation

UNDERSTANDING INSULIN PUMPS AND CONTINUOUS GLUCOSE MONITORS

For additional copies of this publication contact:

2nd Edition

The Pink Panther™ & ©1964-2010 Metro-Goldwyn-Mayer Studios Inc. All Rights Reserved

Book ORDER FORM Name ____________________________________________________________________________________ Address __________________________________________________________________________________ City/State/Zip _____________________________________________________________________________ Phone (Day) ___________________ Phone (Eve) ______________________ E-mail ___________________ Understanding Diabetes 11th Edition $25 per copy

Quantity ______

Managing and Preventing Diabetic Hypoglycemia (Video) $20 per copy

Quantity ______

Understanding Insulin Pumps & Continuous Glucose Monitors 2nd Edition $15 per copy Quantity ______ A First Book for Understanding Diabetes (English) $10 per copy

Quantity ______

Un Primer Libro Para Entender La Diabetes (Spanish) $10 per copy

Quantity ______

All orders must be paid in full before delivery, including $3.00 per order for shipping and handling.

Allow one to three weeks for delivery Make checks payable to: Children’s Diabetes Foundation American Express, Visa, and MasterCard accepted.

Canadian and Foreign Purchasers: Please include sufficient funds to equal U.S. currency exchange rates and international postage.

For additional information call 303-863-1200 or 800-695-2873 or visit www.ChildrensDiabetesFoundation.org Mailing address: Children’s Diabetes Foundation

777 Grant Street, Suite 302

Denver, CO 80203

22

by H. Peter Chase, MD & Laurel Messer, RN, MPH, CDE

2nd edition – Understanding Insulin Pumps and Continuous Glucose Monitors (CGMs) — H. Peter Chase, MD and Laurel Messer, RN, MPH, CDE

12:43

•

THE ONLY BOOK AVAILABLE FOR PATIENTS WITH DIABETES COVERNG BOTH INSULIN PUMPS AND CONTINUOUS GLUCOSE MONITORS (CGMs)

2nd Edition

The field of insulin pumps and CGMs is moving so rapidly that the need for a second edition of this book was imperative. All chapters are now revised. However, some of the important changes are listed below:

• An attempt has been made to integrate the teaching about insulin pumps and CGMs – as they complement each other greatly. Together they are the two major technologies being used for diabetes management today!

• The chapters in basal rates (Chapter 5) and insulin boluses (Chapter 6) are updated with latest information – including a figure from a research article published in 2010 showing the importance of giving boluses 20 minutes prior to meals.

• The advantages of an insulin pump over insulin injections in the prevention of hypoglycemia during exercise have received a new emphasis.

• The chapter (Chapter 14) on Psychological Aspects offers new ways to deal with pump and CGM issues.

• The overview on CGMs (Chapter 16) deals with important issues including practical methods of CGM (or insulin pump) adhesive issues.

Foundation News

UNDERSTANDING INSULIN PUMPS AND CONTINUOUS GLUCOSE MONITORS

NOW AVAILABLE

2nd Edition

• Two brand-new chapters were created because readers of the first edition stated they wanted more information on how to adjust insulin levels based on “Real-Time” CGM readings (Chapter 18) and on “Retrospective” CGM readings (Chapter 19). These two new chapters provide the information to help any person/family make the needed insulin adjustments to attain the most optimal glucose control currently possible.

• The research chapter (Chapter 20) includes information relating to recent studies of the “Bionic” pancreas (using an insulin pump and a CGM) and where current studies are leading future diabetes care.

The new edition is available by calling 303-863-1200 or 800-695-2873 or at www.ChildrensDiabetesFoundation.org

The Pink Panther™ & ©1964-2010 Metro-Goldwyn-Mayer Studios Inc. All Rights Reserved 23

Photo from 2006 Carousel Ball Journal Photo: Š Martin Crabb

One in three babies born today will have diabetes in their lifetime.

Your support gives hope for their future.

With love and appreciation, Barbara Davis Kendall (top photo in pink sweater) was diagnosed with type 1 diabetes, a week after her fourth birthday, in December 2009.

24

Photo: Š kentmeireisphotography.com

E

very day in

America 35

children are

diagnosed with

type 1 diabetes -more than one child every hour.

Of the 24 million Americans now afflicted with diabetes, two million have the most severe form, type 1, and need insulin to survive. But insulin is not a cure. Everyone with diabetes needs our help to end the epidemic, and every donation counts.

The Barbara Davis Center for Childhood Diabetes (BDC) is the leading worldwide center

for children and adults with type 1 diabetes. Your donations to our annual REACHING FOR THE BRASS RING: A CAMPAIGN FOR THE CURE support Children’s Diabetes Foundation’s commitment to give all BDC patients the same high quality care. No child is turned away.

Insulin, supplies and clinic visits can cost up to $800 or more a month -- a financial burden for any family, impossible for the uninsured and impoverished.

Through your gifts we provide treatment and supplies to nearly 30% of the BDC’s patients who otherwise could not afford it.

The BDC’s world-renowned clinical and research programs include stem cell and islet cell transplant research, and testing for genetic and immunologic risk of diabetes. Trials continue on a variety of agents, including a new vaccine trial to prevent diabetes in those children most genetically at-risk.

Please, help us catch the brass ring by supporting our CAMPAIGN FOR THE CURE. When you help children with diabetes you empower them to create a better future for all.

Count me in for a donation of $____________________ Donate online at ChildrensDiabetesFoundation.org/C2C ❏ Enclosed is my check payable to CDF. My contribution can be matched by my company ___________________________________________________

(name of company) Charge my credit card: ❏ Visa ❏ MasterCard ❏ American Express Credit card #__________________________________________________ Expiration date __________________ Name on card _________________________________________________________________________________ ❏ I have included CDF in my Will.

Foundation News

REACHING FOR THE BRASS RING A CAMPAIGN TO CURE DIABETES

Your gift is tax deductible. Tax exempt #: 84-0745008

HELP US GO GREEN! Register online at www.children’sdiabetesfoundation.org and qualify to WIN An apple iPad! We need your e-mail address to send e-blasts with the latest news on BDC clinical care and research, announcements of our activities, and the Children’s Diabetes Foundation’s newsletter, NEWSNOTES. Help save our planet while we help children with diabetes!

A drawing will be made of all e-mail addresses received through January 2011 (whether online or through the mail). The winner will be announced on our web site in February 2011. Your e-mail address will never be shared with any individual or organization.

Name/Contact _________________________________________________________________________________ E-mail address ________________________________________________________________________________ Address ______________________________________________________________________________________ City ______________________________________________________ State __________ Zip _________________ Home # _________________________ Office # ________________________ Fax # ________________________ ❏ Please remove me from all Children’s Diabetes Foundation mailing lists.

25

Foundation News

MANAGEMeNT OF DIABETES IN YOUTH

Photo: © Vail Resorts

July 17-20, 2010 keystone resort and conference center

M

ore than 400

healthcare

providers from

all over

the country attended the 11th biennial conference “Management of Diabetes in Youth” where they received the latest information on the intensive management of type 1 and type 2 diabetes in children and adults.

Conference co-directors Marian Rewers MD, PhD, Clinical Director of the Barbara Davis Center for Childhood Diabetes and Georgeanna Klingensmith, Chief of the Pediatric Clinic at the BDC put together an outstanding roster of renowned diabetes educators, who along with BDC healthcare staff, provided participants with essential information facing today’s healthcare providers.

Industry sponsored dinners featured: Lilly USA, LLC (Guest Speaker: Dr. Henry Rodriguez), Novo Nordisk (Guest Speaker: Dr. Asheesh Dewan) and Medtronic Diabetes (Guest Speaker: Dr. Fran Kaufman).

Special thanks to the following Guest Speakers and Sponsors/ Exhibitors for participating in and providing financial assistance for this year’s conference:

GUEST SPEAKERS: H. Peter Chase, MD, Professor of Pediatrics, Barbara Davis Center for Childhood Diabetes, Professor of Pediatrics, University of Colorado Denver, Aurora, CO. Ron Gill, PhD, Professor and Research Director of the Transplantation Institute Colorado, Aurora, CO.

Johnny L. Ludvigsson, MD, PhD, Professor of Pediatrics, Head Physician, Division of Pediatrics, Linkoping, University Hospital, Sweden.

Peter Gottlieb, MD, Associate Professor of Pediatrics at the Barbara Davis Center for Childhood Diabetes, Aurora, CO

Henry Rodriguez, MD, Associate Professor of Pediatrics, James Whitcomb Riley Hospital for Children, Indianapolis, IN.

Irl Hirsch, MD, Professor of Medicine, University of Washington, School of Medicine, Seattle, WA.

Gary Scheiner, MS, CDE, Integrated Diabetes Services, Wynnewood, PA.

Lois Jovanovic, MD, Director of the Samsun Research Institute, Santa Barbara, CA. David M. Kendall, MD, Chief Scientific & Medical Officer, American Diabetes Association, Alexandria, VA.

26

Aaron Kowalski, PhD, Program Manager, Metabolic Protocol/ Research Director, Artificial Pancreas Project, Juvenile Diabetes Research Foundation, New York, NY.

Grace Shih, RD, Packard Children’s Hospital, Stanford Medical Center, Palo Alto, CA. Jay S. Skyler, MD, Professor of Medicine, Pediatrics & Psychology, Associate Director, Diabetes Research Institute, University of Miami, Miller School of Medicine, Miami, FL.

Photo: © Vail Resorts

William E. Winter, MD, Professor of Pathology and Pediatrics, University of Florida, Gainesville, FL. Phil Zeitler, MD, PhD, Professor of Pediatrics and Clinical Science, University of Colorado Denver, Medical Director, Children’s Hospital Clinical Translational Research Center, Colorado Clinical Translational Science Institute, Aurora, CO. PLATINUM sanofi-aventis U.S. Inc. Lilly USA, LLC Bayer HealthCare Diabetes Care GOLD Medtronic Diabetes Novo Nordisk, Inc. SILVER Abbott Diabetes Care, Inc. BD Medical/Diabetes Care BRASS Animas Corporation Athena Diagnostics, Inc. Cumberland Hospital for Children and Adolescents Diamyd Medical Insulet Corporation LifeScan, Inc.

Save the Date!

Keystone Conference 4th Biennial “PRACTICAL WAYS TO ACHIEVE TARGETS IN DIABETES CARE” Friday, July 15, 2011 thru Saturday July 17, 2011

Foundation News

William V. Tamborlane, MD, Professor and Chief of Pediatric Endocrinology, Yale School of Medicine, New Haven, CT.

Designed to help health care providers caring for adolescents and adults with diabetes, Check the Children’s Diabetes and Barbara Davis Center web sites in January 2011 for more information. www.ChildrensDiabetesFoundation.org www.BarbaraDavisCenter.org

Roche Diagnostics

27

Foundation News 28

McDonald Automotive Carousel classic a wynn/win

N

inety avid golfers

and a handful of

dedicated

volunteers

assembled at the crack of dawn at Signature Aviation on November 4th to fly away to Las Vegas to Play for the Cure at the McDonald Automotive Carousel Classic to benefit the Children’s Diabetes Foundation. A charter Frontier jet flew the festive group to The Wynn where they played on the fabulous Wynn course, and stayed overnight to enjoy the Vegas scene while netting $223,000 to help fund research at the Barbara Davis Center for Childhood Diabetes. Led

by Michael McDonald and Dan Fuller who share a personal interest in eradicating diabetes, this event followed the HealthOne Carousel Classic held in June at the Cherry Creek Country Club. The combined events grossed an astounding $386,000. We would like to officially thank our fly-away

sponsors including McDonald Automotive, Lockton Companies, Affinity Video, Berco Resources LLC and Interstate Restorations.

We would also like to thank our support crew at Frontier Airlines, The Wynn Hotel, AWG, Whatzhotnow Catering, everyone at the Signature Hanger and all of our golfers. It was a successful tournament and it wouldn’t have been possible without you! This was The Carousel Classic’s first year for the Children’s Diabetes Foundation. Plans are already underway for 2011 with the June 29th event at Sanctuary Golf Course and the fly-away again at The Wynn early next November. Rave reviews are still coming in proclaiming The Carousel Classic a solid gold winner!

For further information or to register for the 2011 events which are sure to sell out, contact Amy Cockerham at 303-863-1200.

Save the Date!

What: High Hopes Carousel Ball October 1, 2011 What: 2011 Carousel Classic Sanctuary Golf Course June 29th, 2011 What: The Guild’s High Hopes Golf Tournament Glenmoor Country Club July 18th, 2011 What: Keystone Conference 4th biennial “Practical Ways to Achieve Targets in Diabetes Care” July 15-17th, 2011

If a Bead or a Pearl, a piece of Gold or Silver Would help toward a cure…

Would you give from your jewelry drawer To raise money to find a cure.

We have started Jewels for Hope To help save our true ‘Jewels’ Children who live with Diabetes We are asking you to give a piece of jewelry Real or costume, it does not matter, Someone else will treasure it knowing It will help us toward a cure.

Now won’t you reach into your Jewelry Drawer?

— by Gretchen Pope

To donate contact Susie Hummell at 303-863-1200.

2011 Guild officers 2010 Guild Officers President: Judy McNeil President-Elect: Gina Abou-Jaoude

Annual meeting Monday, January 10, 2011 Denver Country Club 1700 East 1st Avenue Denver, CO

Treasurer-Elect: Gleneen Brienza

Coffee 9:30 a.m.

Meeting 10:00 a.m.

Brunch will be served following meeting and program.

Reservation: $35.00

Corresponding Secretary: Shelley Lucas

Please make your reservation for the brunch by sending a check to:

Immediate Past President: Sharon Kamen

Children’s Diabetes Foundation Attn: Susie Hummell 777 Grant St., Ste. 302 Denver, CO 80203

Recording Secretary: Jennifer Barrow Treasure: Annie Cotton

Advisors: Sandy Burfitt Kathy Crapo Marty Jensen Gail Johnson

To pay by credit card, please call Susie at 303-628-5109 or e-mail at susie@childrensdiabetesfoundation.org

T

he Guild of the

Children’s

Diabetes

Foundation

is always proud to award scholarships to high school seniors and college students who are current patients at the Barbara Davis Center. The scholarship program was established in memory of past Guild President, Charlotte Tucker, who encouraged young people from the Barbara Davis Center to follow higher career and educational pursuits.

Guild Guide

Baubles, Bangles and Beads

CHARLOTTE TUCKER SCHOLARSHIP OPPORTUNITIES FOR 2011-2012

Applications for 2011-2012 will be available in February 2011. Patients who are college or trade school bound will be notified regarding applications in February 2011. If you don’t receive information or have questions, please call Susie Hummell at the CDF office after February 14th, 2010 at 303-628-5109 or 800-695-2873.

GUILD MISSION STATEMENT The Guild of the Children’s Diabetes Foundation at Denver raises funds for clinical and research programs for the Barbara Davis Center for Childhood Diabetes. The Guild promotes diabetes awareness and education; assists families in need; provides continuing education scholarships and sponsors social activities for children and their families.

å

29

Winner’s Circle

Kids helping kids

T

hank you Aspen

Academy students,

faculty and

Harrison Fuller for

raising $353.00 for Children’s Diabetes Foundation at your Dress Down Fundraiser. Your funds will help to further care and research programs at the Barbara Davis Center for Childhood Diabetes which cares for 5,000 children and young adults.

A Prayer

Photo: © kentmeireisphotography.com

We are honored to have the students, faculty and families of Aspen Academy join us in the fight against diabetes. We are especially proud to see kids helping kids. Your gift has a very special meaning to our organization and children with diabetes. Congratulations on your very successful fundraiser!

Thank you Harrison for doing such a great job speaking on behalf of all of kids at the Barbara Davis Center at the Carousel of Hope. We are so proud of you!

Harrison receives care at the Barbara Davis Center for Childhood Diabetes.

This was his prayer at the Carousel of Hope, October 23, 2010.

Dear God,

Tonight I have a special prayer for all of the children suffering with type 1 diabetes.

I pray that you keep us brave in our fight, please bless our parents with patience, and help the doctors working to find a cure.

I thank you for Barbara Davis and all of the loving people here tonight supporting kids like me.

In your name we pray, Amen.

Harrison Fuller, Age 7 30

Ingredients 1 cup all-purpose flour 1 cup whole wheat flour 3/4 cup granulated sugar 2 teaspoons baking powder 1/2 teaspoon baking soda 1/2 teaspoon salt 1 15-ounce can 100% pure pumpkin 1/2 cup canola oil 1/2 cup mini semi-sweet chocolate chips

1 cup pecans, very finely chopped 1 teaspoon ground cinnamon 4 large eggs, beaten 1/4 cup 1% low-fat milk

Directions Preheat the oven to 350°F. Lightly oil or coat a 15 x 10 x 1-inch rimmed baking or jelly roll pan with nonstick cooking spray and set aside.

Whisk together the all-purpose flour, whole wheat flour, pecans, sugar, baking powder, cinnamon, baking soda, and salt in a large bowl until well combined.

In a separate bowl, whisk the eggs, pumpkin, oil, and milk until well blended. Pour the liquid ingredients over the dry ingredients and stir until just combined. Stir in the chocolate chips.

Spread the batter evenly in the prepared pan and bake for 25 minutes, or until a wooden toothpick inserted in the center comes out clean. Transfer the pan to a wire rack and cool for 10 minutes before slicing into thirty, 2 x 2½-inch bars.

Tip: For maximum freshness, store leftovers in a plastic container or zip-top bag in the refrigerator.

Nutrition Information per Serving (1 bar): 140 calories, 6g fat (1g saturated, 0.4g omega-3), 95mg sodium, 16g carbohydrate, 2g fiber, 2g protein, 45% vitamin A

Apple Blueberry Walnut Crisp — Makes 6 Servings

Cooks Corner

Chocolaty Pumpkin Bars — Makes 30 bars

Ingredients 3 large Red or Golden Delicious apples (about 2 pounds), unpeeled and cut into 1/2-inch pieces (about 4 cups) 2 tablespoons brown sugar 2 tablespoons whole wheat flour 1 teaspoon vanilla extract 1/2 teaspoon ground cinnamon 1 cup fresh or frozen blueberries 1/2 cup walnuts, very finely chopped 1/2 cup old-fashioned or quick-cooking oats 2 tablespoons brown sugar 2 tablespoons whole wheat flour 2 tablespoons ground flaxseed or wheat germ 1/2 teaspoon ground cinnamon 2 tablespoons canola oil 1/8 teaspoon salt Directions Preheat the oven to 400°F. Place the apples, brown sugar, flour, vanilla, and cinnamon in a large bowl and toss to coat. Gently stir in the blueberries.

Place the apple mixture in an 8 x 8-inch baking pan or dish and set aside.

To make the topping, place the walnuts, oats, brown sugar, flour, flaxseed, cinnamon, and salt in a medium bowl and stir to combine. Add the oil and stir until the oat mixture is well coated. Spread the topping evenly over the fruit mixture.

Bake 40 to 45 minutes, or until the fruit is tender and the topping is golden brown (cover with foil about halfway through if the topping browns too quickly).

Tip: Top each serving with low-fat vanilla frozen yogurt or a dollop of light whipped cream.

Nutrition Information per Serving: 260 calories, 13g fat, (1g saturated, 1.8g omega-3), 55mg sodium, 34g carbohydrate, 5g fiber, 4g protein, 10% vitamin C 31

Nutrition News

What’s The Scoop on Sweeteners?

— Gail Spiegel MS RD CDE

T

he following is an

update on the

sweeteners that

are currently

approved by the food and Drug Administration (FDA) and available on the market. The Barbara Davis Center does not endorse or condemn any certain product.

Sweeteners can be divided into two groups based on the calories they provide. These two groups are nutritive (contain calories) and non-nutritive sweeteners (do not contain calories).

NUTRITIVE SWEETENERS Nutritive sweeteners provide calories and carbohydrates and include two types of sweeteners that are commonly used: sugars, sugar alcohols.

SUGARS Sugar sweeteners include sucrose (table sugar), fructose, honey, high fructose corn syrup as well as others. Sucrose and fructose are the primary sugar sweeteners that occur naturally in the food supply or are added as sugars in corn sweeteners and syrups. Sugar sweeteners provide 16 calories and 4 grams of carbohydrate per teaspoon.

Agave nectar, which has recently become popular, is a syrup that is refined from a cactus-like plant. Agave nectar is made of fructose and glucose. Agave is 140 – 160 times sweeter than sugar. One teaspoon provides 20 calories and 5 grams of carbohydrate.

32

SUGAR ALCOHOLS Sugar alcohols include sorbitol, mannitol, xylitol, erythritol, isomalt and hydrogenated starch hydrolysates as well as others.

Most sugar alcohols provide approximately 8 calories and 2 grams of carbohydrates per teaspoon. Sugar alcohols are absorbed more slowly than sugar and eating an excessive amount can cause diarrhea. Xylitol is found in a sweetener named Ideal Sweetener. Sugar alcohols are found in such products as sugar free candies, chewing gum, and baked goods such as cookies. Despite being labeled “sugar free” these products still contain carbohydrates and will cause a rise in blood sugars.

Erythritol is much lower in calories and carbohydrates than the others and may not cause a rise in blood sugars. Be sure to check the nutrition facts on the label to determine total carbohydrate content.

NON-NUTRITIVE SWEETENERS Non-nutritive sweeteners do not provide any calories or carbohydrates. There are currently five non-nutritive, artificial sweeteners approved by the FDA. They are saccharin, acesulfame-K, aspartame, sucralose and neotame. In addition, Stevia, a natural sweetener does not provide calories or carbohydrates.

SACCHARIN Saccharin is 200-700 times sweeter than sugar. It provides no calories or carbohydrates and is not metabolized by our bodies. It is approved for use in 100 countries, but has been controversial here in the United States. Questions about saccharin’s safety first began in 1977 when studies suggested it caused bladder tumors in rats.

Saccharin used to carry a warning on the label, but in 2000 the

National Institutes of Health removed saccharin from the list of carcinogens and Congress removed the requirement for warning notices. Studies of high users do not support an association between saccharin and cancer. Saccharin can be found in Sweet’N Low®, Sweet Twin® and other tabletop sweeteners as well as fountain drinks. The amount of saccharin in each product is limited and must be printed on the label.

ACESULFAME-K (ACE-K) Ace-K is 200 times sweeter than sugar. This sweetener is not metabolized by the body either and therefore provides no calories or carbohydrates. It has been approved by the FDA since 1988. It is approved for use as a general-purpose sweetener and is used in more than 80 countries. Ace-K does not break down when heated and can be used in cooking and baking. It is currently used in sugar free ice creams and many sugar free or diet beverages, often times in combination with sucralose or aspartame.

ASPARTAME Aspartame is also 200 times sweeter than sugar.

Aspartame is broken down into aspartic acid, methanol, and phenylalanine by the digestive process. The amino acids phenylalanine and aspartic acid are metabolized to provide four calories per gram. Because this sweetener is very intense and we use it in such small amounts, it provides no calories.

Aspartame has been approved by the FDA since 1981. It has been deemed safe by major health groups and agencies in over 90 countries, including the World Health Organization and the American Medical Association.

It is currently approved for use as a general-purpose sweetener in all foods and beverages. It

Aspartame has caused the most controversy and appears to receive more media attention about its safety than any other sweetener. Studies have not found any link between aspartame and diseases like Alzheimer’s or multiple sclerosis.

Research has not found that aspartame leads to an increased risk of cancer either. The only negative effects that aspartame has been shown to cause in a few small research studies is worsening migraines for some patients.

SUCRALOSE Sucralose was approved by the FDA in April 1998 for use as a tabletop sweetener and in desserts, candies and nonalcoholic beverages.

Sucralose is 600 times sweeter than sugar and provides no calories or carbohydrates. It is made from sucrose, but is altered so that it is much sweeter than sugar and is not absorbed by the body. It does not break down when heated and can be used for cooking and baking. Sucralose can currently be found in many diet or sugar free drinks, sugar free ice cream and other products. It is marketed under the trade names Splenda® and Nevella®. Nevella is sold in regular and probiotic versions.

than aspartame and 7,00013,000 times sweeter than sugar. It can be used in baking and cooking. As of the writing of this review, neotame was not found in any products on the market.

STEVIA This is a natural sweetener from the stevia rebaudiana plant found in South America. Stevia rebaudiana is an herb that is 300 times sweeter than sugar.

Stevia contains no calories or carbohydrates and does not affect blood glucose. Stevia has been sold in the US in the supplement aisle for many years, but in 2008, the FDA recognized a part of the stevia plant, known as Rebiana or Reb A, as safe for use in food products. You can buy stevia in granular and liquid forms from grocery and health food stores for use in drinks, cooking and baking. Brand names for stevia include Truvia™ and PureVia™.

Truvia™ contains 3 grams of carbohydrates per packet,

but the carbohydrates are not digested or absorbed by the body according to the company so they do not affect blood sugar.

Purevia™ contains 2 grams of total carbohydrate per packet.

Sun Crystals™ is a low sugar sweetener that is part stevia and part sucrose (table sugar).

Today, there are more alternatives than ever for people with diabetes. Food manufacturers are using new sweeteners and combining sweeteners to improve the taste and mouthfeel of sugarfree and low-sugar foods and beverages. Plus, sucrose is no longer restricted from the diet and can be included within the context of a healthy diet. For those who count carbohydrates, foods containing sugar can be substituted for other carbohydrates in the meal plan or extra insulin can be given.

When it comes to sweeteners, each family needs to decide what works best for them.

Nutrition News

breaks down when heated and does not work well in cooking and baking. This sweetener is in many products. Some commonly used products that contain aspartame are as follows: Equal, NutraSweet, NatraTaste, diet sodas, sugar free JELL-O, light yogurts, powdered soft drinks, sugar free ice cream.

NEOTAME This sweetener was approved by the FDA as a general purpose sweetener in 2002. Neotame is very intense, 40 times sweeter Photo: © Martin Crabb

33

Nutrition News

What’s Considered Safe?

Sugar Substitute

Saccharin

Aspartame

Recommended or Acceptable

Product

Daily Intake (ADI)*

equivalents

5 mg/kg** body weight For 23 kg (50 lb.) child

ADI = 50 mg/kg of body weight For 23 kg (50 lb.) child

3 packets of Sweet ‘N Low

33 packets of Equal or 5 cans of diet soda

Acesulfame-K

ADI = 15 mg/kg of body weight 8 packets For 23 kg (50 lb.) child of Sweet One

Sucralose ADI = 5 mg/kg of body weight 9 packets of Splenda

For 23 kg (50 lb.) child 1.5 cans of diet soda

*Acceptable Daily Intake is defined as the amount at which there is no adverse effect and a reasonable certainty that no harm will come from use. It is an amount that you can consume for the rest of your life with no concern about safety. ADI is set by the FDA and the Joint Expert Committee of Food Additions of the United Nations Food and Agricultural Organization and World Health Organization.

**1 kilogram = 2.2 pounds References Position of The American Dietetic Association: Use of nutritive and nonnutritive sweeteners, Journal of the American Dietetic Association 2004; 104: 255-275.

Porro, J. Sugar’s Sweet Stand-Ins, Diabetes Interview, Sept. 1998, 74:18-21.

Schardt, David. Sweet Nothings: not all sweeteners are equal. Nutrition Action Healthletter, May 2004.

0 Future Newsnotes will be published online at www.childrensdiabetesfoundation.org.

Remember to register online by January 31, 2011 to qualify to win an I-Pad.

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Executive Board:

Brian Kotzin, M.D. Vice President, Global Clinical Development, Amgen, Inc. Thousand Oaks, California

Mrs. Barbara Davis, Chairman Richard S. Abrams, M.D.

Aké Lernmark, M.D., Ph.D. Robert H. William Professor, Department of Medicine, University of Washington School of Medicine, Seattle

Jules Amer, M.D. Honorary Lifetime Member Mr. Peter Culshaw

Ali Naji, M.D., Ph.D. J. William White Professor of Surgery, Hospital of University of Pennsylvania, Philadelphia

Stephen Daniels, M.D., Ph.D. Chairman of Pediatrics, The Children’s Hospital, Denver

Gerald Nepom, M.D., Ph.D. Scientific Director and Director of Immunology and Diabetes Research Programs, Virginia Mason Research Center, Seattle

Ms. Dana Davis Mrs. Nancy Davis Rickel Steven Farber, Esq.

William V. Tamborlane, M.D. Professor of Pediatrics, Yale University School of Medicine, New Haven, Connecticut

Richard F. Hamman, M.D., DrPH University of Colorado Denver School of Medicine Dean, Colorado School of Public Health Mrs. Arlene Hirschfeld Mrs. Deidre Hunter Mr. Shawn Hunter M. Douglas Jones, Jr., M.D. Richard D. Krugman, M.D. Dean, School of Medicine, University of Colorado Denver Stacy Mendelson Robinson Ex-officio Member: George S. Eisenbarth, M.D., Ph.D. Executive Director, Barbara Davis Center for Childhood Diabetes, University of Colorado Denver; Professor of Pediatrics and Medicine, University of Colorado School of Medicine Scientific Advisory Board: Richard S. Abrams, M.D. Associate Clinical Professor of Medicine, University of Colorado School of Medicine; Rose Medical Center, Denver Jules Amer, M.D. Clinical Professor of Pediatrics, University of Colorado School of Medicine; Partner, Children¹s Medical Center, Denver M. Douglas Jones, Jr., M.D. Professor, Department of Pediatrics, University of Colorado School of Medicine; Section of Neonatology, The Children¹s Hospital, Denver

Advisory Board: Mr. Michael Bolton Sir Michael Caine Ms. Natalie Cole Mr. and Mrs. Robert A. Daly The Honorable Diana DeGette, U.S. House of Representatives, Colorado Mr. Neil Diamond Mr. Placido Domingo Mrs. Gerald R. Ford Mr. David Foster Mr. Kenny G Mr. David Geffen Ms. Whitney Houston Mr. Quincy Jones Ms. Sherry Lansing Mr. Jay Leno Mr. Paul Marciano Mr. Mo Ostin The Honorable and Mrs. Bill Ritter, Governor and First Lady of Colorado Sir Sidney Poitier Mrs. Ronald Reagan Mr. Lionel Richie Mrs. Adrienne Ruston Fitzgibbons

Mr. George Schlatter The Honorable Arnold Schwarzenegger, Governor of California, and Ms. Maria Shriver Mr. Steven Spielberg and Ms. Kate Capshaw Miss Joan van Ark Ms. Barbera Thornhill Mr. Gary L. Wilson Mr. Stevie Wonder Advisory Board, The Guild Presidents: Founding President, Amy Davis Mrs. Jamie Angelich Mrs. Karen Aylsworth Mrs. Linda Broughton Mrs. Joy Burns Dr. Bonita Carson Mrs. Nancy Cowee Mrs. Norma D’Amico Miss Donna Douglas Mrs. Margy Epke Mrs. Chris Foster Mrs. Helenn Franzgrote Mrs. Sally Frerichs Mrs. Debbie Gradishar Mrs. Helen Hanks Mrs. Marty Jensen Mrs. Gail Johnson Mrs. Sharon Kamen Mrs. Janet Knisely Mrs. Suzy Love Mrs. Sally Newcomb Mrs. Gretchen Pope Mrs. Carol Roger Mrs. Kay Stewart Mrs. Diane Sweat Mrs. Melissa Tucker Mrs. Loretta Tucker Mrs. Jane Weingarten Foundation: Christine Lerner, Executive Director

eeeeeeeeeeee NEWSNOTES is published twice yearly by the Children’s Diabetes Foundation at Denver. We welcome your comments.

If you would like to submit an article or a letter to Newsnotes send information to: Children’s Diabetes Foundation at Denver 777 Grant Street, Suite 302 Denver, CO 80203 Cindy Kalkofen Graphic Designer Katie Hicks Christine Lerner Editors Know the symptoms of Childhood Diabetes: • Loss of weight • Extreme thirst • Excessive irritability • Frequent urination • Bedwetting (previously controlled) Printed on recycled paper

A child reaching for the brass ring on a carousel is symbolic of the most important goal of the Children’s Diabetes Foundation — The cure. Your contribution on behalf of a loved one will make a difference. It will support treatment programs to assist children with diabetes in leading healthier lives and it will fund research to help CDF “Catch the Brass Ring” by finding a cure.

Mark an anniversary, birthday, special occasion; express appreciation or make a memorial tribute in honor of someone special with a contribution — for any amount — to the Children’s Diabetes Foundation at Denver.

We now accept gifts online.

Donations are tax deductible.

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The Brass Ring Fund

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

Children’s Diabetes Foundation at Denver, Colorado 777 Grant Street, Suite 302, Denver, CO 80203 303-863-1200, 800-695-2873, www.ChildrensDiabetesFoundation.org

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PAID Denver, CO Permit No. 1752 Children’s Diabetes Foundation at Denver, Colorado 777 Grant Street, Suite 302 Denver, CO 80203

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BDC EXPANDS TYPE 2 DiabeTES CARE & RESEARCH IN PARTNERSHIP WITH CHILDREN’S HOSPITAL — George Eisenbarth, MD, PhD, Executive Director of the Barbara Davis Center for Childhood Diabetes

T

here are many forms of diabetes, and for the best

clinical care it is important to know which form of

diabetes an individual has. In children Type 1 diabetes

is the most common and results for autoimmune

destruction of the cells that make insulin. While type 2 diabetes is the most common form of diabetes presenting in adults, it is increasing in children. At the Barbara Davis Center we diagnose and care for all children with diabetes and there are many forms more than type 1 and 2. In particular, we care for type 2 children at the BDC and Dr. Phil Zeitler of Children’s Hospital has a specific type 2 clinic at our center. One of Dr. Slover’s new responsibilities will be to organize care of children at Children’s hospital who have diabetes due to cystic fibrosis and cancer therapy. We also are helping to define how many children develop type 2 forms of diabetes with the National Institutes of Health “Search” study and with studies of the pathology of pancreas of young adults who have unfortunately died with diabetes (JDRF nPOD international study).

Both type 1 and type 2 diabetes are increasing dramatically. Five to 10 percent of patients with type 2 diabetes have autoimmune type 1 diabetes, and fortunately, the anti-islet antibody tests we have helped develop now allow proper diagnosis. Most patients with type 2 diabetes eventually need insulin. We are studying new therapies applicable to both.

Photo: © Martin Crabb