Diabetes Prevention and Protection

by Scott Whyte
Advisory Board Member

November is Diabetes Awareness Month, and in my current role as Chief Strategy Officer for ClearDATA and my former role as VP for IT for Dignity Health, one of the largest hospital systems in the country, you’d expect me to have awareness. But my knowledge of diabetes springs from more than my professional endeavors, it comes from being a parent.

Nine years ago, my wife and I were preparing for a vacation when both our nine-year-old and eleven-year-old sons became very ill, suddenly vomiting profusely. We took them to our pediatrician where the physician tested their blood, suspected Type 1 Diabetes, and sent us immediately to Phoenix Children’s Hospital. Fortunately, this impressive facility was close by, and our sons were immediately admitted to the Pediatric Intensive Care Unit. They were diagnosed with severe diabetic ketoacidosis. It’s horrifying still to think of how close of a call that day was for us all.

While in the hospital we began what many families ultimately face – the long road to understand the overwhelming nature of this disease, and the care needed to keep our sons alive and in stable health. From blood tests to injections, it was rough, but perhaps the hardest part was grappling for an answer when my nine-year-old asked from his hospital bed, “Dad, will I ever get better?” We were thankful to have access to highly-skilled doctors and care teams, and insurance that makes the care needed possible, but sadly I had to tell my son, ‘Right now, there is no cure for Type I Diabetes.’

The boys were doing a great job adapting, and are for the most part, having well managed blood sugar levels. About 18 months after those days in the ICU, we were starting to get our feet under us again when our daughter’s school nurse called us. They, like us, had noticed how frequently she needed to use the restroom. Because frequent urination can be a Type 1 Diabetes indicator, we immediately tested her blood sugar, and the level was above what the meter could read topping out at 400. We tested on another meter with the same result, so we knew the diagnosis. We headed for the hospital where she was immediately admitted, but where we fortunately avoided ICU this time around. And because she had seen her brothers deal with diabetes for a year and a half, the onboarding process was less rocky though still emotional. Now we had three children with Type I Diabetes. Our fourth son was then tested for the predisposition and somehow escaped this fate.

Over the course of our experiences we’ve learned a lot about diabetes and some of it bears mentioning for anyone reading. Primarily I’d like to stress these three things:

  • there is a huge and increasing incidence of both Type 1 and Type 2 Diabetes in this country;
  • it takes a tremendous toll on human life and on our nation’s fiscal resources; and
  • there is tremendous progress being made to manage the disease and protect the health of patients thanks to emerging technologies including smart insulin, closed loop insulin pumps and great support provided by JDRF, the American Diabetes Association, and the College Diabetes Network (CDN).

It’s important to understand the difference in Type 1 and Type 2.  Type 1 is an autoimmune disease where the damaged pancreas cannot produce insulin.  Type 1 often, though not exclusively, presents in juveniles, is fatal if not treated, is not related to behavior, obesity or exercise and only occurs in less than 1 percent (though growing) of the population.  The Type 1 Diabetic is insulin dependent and must have a insulin injections or an insulin pump in order to survive.

Type 2 diabetes is a metabolic disease closely correlated to genetics and behavior. Type 2 is reaching epidemic proportions with over 25% of the population over 65 living with the disease. If caught in the early prediabetic stages, diet and exercise can control Type 2, and if it’s beyond that, medications are proving useful. Type 1 is more taxing on the body of the patient and harder to manage hour by hour, but both Type 1 and Type 2 can lead to blindness, kidney damage, heart disease and amputation. In addition to the human toll, the expense to the country is staggering at over $325 billion per year in the United States.

According to the American Diabetes Association 100 million Americans are either diabetic or prediabetic and most that are prediabetic don’t know. Please learn the signs.

All that said, my coworkers often call me an optimist, and as is my nature, I do see signs of hope even as this disease continues to sweep our country. There’s been a surge of educational materials and websites, monitoring devices, coaching and nutritional programs to try to get those with Type 2 or prediabetes to reduce weight, exercise, and lower blood sugar. For those who do become insulin dependent, the advances that have been made have been a great help. Continuous Glucose Monitors (CGMs), and insulin pumps can provide for more stable levels than manually given injections each day. Devices can wirelessly transit readings to the patient’s or family’s smart phones – I can pull up my children’s blood sugar level and recent history on my phone in an instant because the app is communicating in the cloud. At the most advanced medical innovation stage, biologic approaches are taking healthy pancreatic insulin producing beta cells and encapsulating those in a plastic like membrane that allows the cells to send out insulin; but prevents the immune system from attacking and killing the beta cells. It’s basically a stick of gum sized implant inserted once every three years. And from a research perspective, much of what we are learning is helping not only those with diabetes, but also those with other autoimmune diseases like Addison’s and Crohn’s Disease. And JDRF lobbying efforts are reducing the costs for patients on Medicaid or Medicare.

But as I see in my work all of the time, with these devices comes the threat for malware and ransomware. It’s a more recent topic as medical record hacking and ransomware attacks have been skyrocketing. As a former hospital CIO, I can tell you that the biomedical equipment in a hospital is often times a key vulnerability and vector of attack because those devices often are maintained by a few resident experts and don’t have the same standards for patching, virus protection and other hardening that prevents intrusion, detection and remediation. I’m glad to be working with a company dedicated to making healthcare better every single day by protecting and modernizing healthcare IT across providers, insurance companies, life science companies and software companies designing and delivering these apps.

And I’m glad to see new companies arriving on the healthcare scene like Livongo who works to empower people with chronic conditions live better lives,  and Canary Health whose self-management platform puts people back in charge of their health.

Learn more about them and learn more about diabetes at the American Diabetes Association so you help to prevent this disease in the lives of those you love, and protect those who have it.

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