Children who have had enterovirus infection are around 50 percent more likely to have type 1 diabetes
Arden had the Coxsackievirus prior to her type I diagnosis...
from science daily.com
A new study published in Diabetologia (the journal of the European Association for the Study of Diabetes) shows that children who have been infected with enterovirus are 48% more likely to have developed type 1 diabetes. The study is by Dr Tsai Chung-Li, China Medical University, Taiwan, and colleagues.
"Type 1 diabetes is considered to be caused by complex interaction between genetic susceptibility, the immune system, and environmental factors," say the authors. "Though the cue for genetic predisposition has been elucidated, evidence also points to involvement of enterovirus (EV) infection, including viruses such as poliovirus, Coxsackievirus A, Coxsackievirus B, and echovirus."
To investigate the link between EV infection and subsequent type 1 diabetes, the researchers used nationwide population-based data from Taiwan's national health insurance system. They looked at type 1 diabetes incidence in children aged up to 18 years with or without diagnosis of EV infection during 2000-2008.
Overall incidence of type 1 diabetes was higher in the EV-infected children than in the non-EV infected group (5.73 vs. 3.89 per 100,000 people per year, showing a 48% increased incidence rate in EV-infected versus non-EV-infected children). Hazard ratios of type 1 diabetes increased with age at diagnosis of EV infection, with a more than doubling of the risk of type 1 diabetes (2.18 times increased risk) for children aged over 10 years at entry. No relationship of allergic rhinitis or bronchial asthma to type 1 diabetes was found.
The authors point out that despite countries such as Finland and Sweden having the highest incidence of type 1 diabetes worldwide, they are thought to have low background rates of enterovirus infection, suggesting that genetic factors are a large component of the high type 1 diabetes rates in those countries. But they add: "Regions such as Africa, Asia, South America have a low but increasing incidence of type 1 diabetes and high prevalence of enterovirus infection; environmental factors like enterovirus infection may play a vital role in increasing incidence in these regions."
They add: "Taiwan has relatively low type 1 diabetes incidence; we believe that the marked escalation of the said incidence in recent decades can be largely attributed to the highly endemic spread of enterovirus infection in Taiwanese children, given that there has been little gene flow and genetic drift in such a short period."
They conclude: "This nationwide retrospective cohort study found a positive correlation of type 1 diabetes with EV infection. Our results suggest that preventive strategies, such as an effective vaccine against EV infection, may lessen the incidence of type 1 diabetes in Taiwan."
The journal article referenced can be downloaded as a PDF from Diabetologia here
FDA Approves Dexcom SHARE
I just received a note from Dexcom letting me know that their long-awaited SHARE device has been approved by the FDA!
The note went on to say that Arden was nominated by a Dexcom employee to receive the device as a gift which was an absolutely wonderful surprise that, even though I've never once accepted anything free in the eight years that I've written this blog, I am happy to accept. After reading the email I immediately watched this quick video about the device and had a rather unexpected response.
I was smiling as the video played, excited to try SHARE and happy that the FDA approved the device when out of no where the voice on the video said, "Telling parents where their glucose levels are... allowing a good night's sleep". I burst into tears. I am so incredibly tired from eight years of diabetes and broken sleep that the thought of overnight relief caused me fall apart for a moment. The mere idea that I won't have to get out of bed and walk across our house to check Arden's CGM is elating. From what the video indicated the SHARE does much more but at the moment, I'm just happy be able to stay in bed. The announcement from Dexcom isn't all good news as I am left with an amazing but now unless skill. You see, I can make turns in the dark without bumping into walls by using the indicator lights on our smoke detectors as my guide. Do you have any idea how long it took me to become proficient at that?
I'll be posting an in-depth review for you as soon as possible (Dexcom did not ask me to do that, actually the only thing that I was asked to do in exchange for receiving a SHARE is complete a short survey after using the device for 30 days). My upcoming review will include a detail disclosure.
In the meantime please join me in celebrating our new lives full of unbroken sleep and unstubbed toes. I can't wait to unburden myself from the anxiety of wondering if those three beeps mean a falling BG or just a fantastically stable number that is hovering a few points below Arden's indicator threshold.
The SHARE costs $299. You can find more information, see an overview, read frequently asked questions and browse all of the details about the SHARE on Dexcom's site –
Today is good day... I'm going to go watch that video again!
10/23/14: Arden's SHARE arrived today - see the unboxing pics here!
Take the DOC Asks the FDA survey
from diaTribe.org:
Please help us tell the FDA what truly matters to patients at www.diaTribe.org/survey - this takes five minutes and will help immensely. All the feedback will help inform a November 3 patient-led meeting with FDA drug/device leadership.
from diaTribe.org:
Here's the background - On November 3, the FDA will host an unprecedented discussion between the diabetes community and senior agency leadership (both drugs and devices). The event will be live webcast from 1 - 4 pm Eastern time, and will include a panel of patients (T1 and T2), as well as representatives from JDRF, American Diabetes Association, and diaTribe. As a community, our job is to present the numerous challenges we as patients face each day, and we need as many opinions as possible to be a part of this discussion! With JDRF, ADA, and dQ&A input, we have created a survey posted at www.diaTribe.org/survey. We are asking all people with diabetes to take the survey (~5 minutes) and share thoughts on what's important when it comes to living with diabetes. This feedback will go directly to FDA and help influence the conversation on November 3. The registration info for the webcast will be posted soon.
It's Diabetes Cure Season
I remember exactly where I was and what I was doing the first time that I read about promising research to cure type I diabetes. My daughter Arden was two years old, it was early fall, just a few months after her type I diabetes diagnosis and my emotions were volatile.
I read the article with precision focus, it promised that researchers had cured type I diabetes in lab mice and told of the goal to begin human trials as soon as they could secure funding – after all, research is expensive.
I woke my wife and told her about this amazing news saying, "Arden is only going to have diabetes for a few years, they cured it in mice". I was crying uncontrollably.
That moment happened over eight years ago and since then countless lucky mice have been cured but it was only recently that I came to understand why we see so much hopeful, yet ultimately crushing news articles about diabetes cures in the fall.
It's diabetes cure season. Diabetes awareness month is November and the media; television news, newspapers and online sources pay close attention to matching their stories with the calendar, because it's what works and how things have always been done. Let me explain...
Have you ever seen me on television, heard me on the radio or read something about me that was focused on parenting and mentions my book, Life Is Short, Laundry Is Eternal: Confessions of a Stay-At-Home Dad? If you have, did you happen to notice that all of those appearances happened in early summer, you know, around Father's Day.
Maybe you read my piece about head injuries as they relate to football, the one that ran on Huffington Post three days before the Superbowl?
Producers need content and they want that content to be relevant to the calendar. People need exposer and they (me included) take it where they can get it. So whether it's a writer trying to let people know about their parenting memoir, or a researcher wanting to get wide exposer for their work so that they can attract more research dollars – if you pay close attention to the calendar, you'll see that the "news" you are being given is carefully scheduled and targeted to your emotions and the events that are about to happen in the world. The news is marketed to you to elicit clicks, shares and word of mouth.
Much of the diabetes cure research that we will hear about in the coming weeks is very promising and I am one-hundred million percent behind all of it. Please just keep in mind that is was also very promising research six months ago, but now is when you are going to read the big news, on every media outlet – all from reputable institutions.
Don't misunderstand, one of these researchers is going to figure it out and I hope that it happens soon and perhaps even is one of the methods that is being bandied about today. But when I woke up this morning to see all of you on social media feeling like I did eight years ago, it broke my heart to remember how I felt after the moment had passed and I realized that the promising lab mouse cure wasn't going to take away Arden's type I diabetes – at least not any time soon. I didn't decide to write this post until I opened up my text messages and saw that my brother also read today's cure "news" and asked me if the article was legitimate.
The answer that I owe my brother but cant bring myself to send him... that news article is legitimate but it isn't going to cure Arden now. I love you for wanting that for her and I am so sorry that these thoughts are part of your day. I wanted you and everyone reading this to understand how these news cycles work because I know how shattering it is when they turn from Diabetes Cure Found! to Thanksgiving Treats That You Can Make at Home.
Wonderful research that will one day cure type I diabetes is going on all over the world and there are a ton of good reasons to be hopeful about them, but these articles aren't going to be how we find out that a cure has been found. On the day that happens, the world will celebrate the end of diabetes with a grand spectacle, no one will have to wonder if it is legitimate.
You are all, each and every one of you, in my thoughts today.
Viral Infection May Trigger Childhood Diabetes in Utero
A new study from Tel Aviv University suggests that type I diabetes is initiated in utero.
Reposting in it's entirety from Tel Aviv University - aftau.org
Friday, October 03, 2014 10:26:00 AM
TAU research says prenatal exposure to viruses may cause type 1 diabetes and other autoimmune diseases in children.
The incidence of type 1 childhood diabetes has been increasing rapidly worldwide. If blood sugar levels aren't well-controlled, juvenile diabetes can affect nearly every organ of a child's body. And while long-term complications of the disease develop gradually, they may become disabling and even life-threatening. The exact cause of juvenile diabetes has eluded scientists, but a new study from Tel Aviv University suggests a likely trigger before birth.
In a recent paper published in Diabetic Medicine, Prof. Zvi Laron, Professor Emeritus of Pediatric Endocrinology at TAU's Sackler Faculty of Medicine, Director of the Endocrinology and Diabetes Research Unit at Schneider Children's Medical Center of Israel, and Head of the WHO Collaborating Center for the Study of Diabetes in Youth, puts forth evidence that the autoimmune disease is initiated in utero. According to the research, conducted in collaboration with an international team of researchers, women who contract a viral infection during pregnancy transmit viruses to their genetically susceptible fetuses, sparking the development of type 1 diabetes.
Prof. Laron is internationally known for the discovery of the Laron Syndrome, also known as Laron-type Dwarfism, an autosomal recessive disorder characterized by an insensitivity to growth hormone.
The "right season" for diabetes
"We knew that type 1 diabetes was associated with other autoimmune diseases like Hashimoto Thyroiditis, celiac disease, and multiple sclerosis, so we investigated the seasonality of birth months for these respective diseases in Israel and other countries," said Prof. Laron. "We found that the seasonality of the birth of children who went on to develop these diseases did indeed differ from that of the general public.
"In further studies, we found evidence that viral infections of the mother during pregnancy induced damage to the pancreas of the mother and/or the fetus, evidenced by specific antibodies including those affecting the pancreatic cells producing insulin," Dr. Laron said.
Click for original article.
For the study, Prof. Laron and his team of researchers from Israel, the University of Washington, and Lund University, Sweden, conducted blood tests of 107 healthy pregnant women, testing for islet cell autoantibodies — evidence of diabetes that appears years before initial symptoms do. They also tested for anti-rotavirus and anti-CoxB3 antibodies.
The researchers found a striking difference between women tested in different seasons, suggesting a link to winter epidemics. The concurrent presence of GAD65 antibodies in cord blood and their mothers indicated autoimmune damage to islet cells during gestation, possibly caused by cross-placental transmission of viral infections and/or antivirus antibodies. In other words, during viral epidemics of winter months, ten percent of the healthy pregnant women who had no family background of autoimmune diseases tested positive for damaging antibodies.
Vaccination before conception
In addition, the cord blood antibody concentrations that exceeded those of the corresponding maternal sample, or antibody-positive cord blood samples with antibody-negative maternal samples, implied an in utero immune response by the fetus.
"If our hypothesis can be verified, then preventive vaccine before conception would be useful in stopping the increasing incidence of type 1 diabetes and other autoimmune diseases," said Prof. Laron. "There is no cure for this diabetes, so true intervention would be important not only medically but also psychologically and financially, as the costs of the lifelong treatment of this chronic disease and other autoimmune diseases are great."
Prof. Laron and his international collaborators are currently raising funds to expand their research to include nearly 1,000 women and newborns.