NASCAR's Ryan Reed Racing to Stop Type 1 Diabetes

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InvestIgate. InFORM. InsPIRe. OCTOBER 2016 NASCAR’s Ryan Reed Racing to Stop Type 1 Diabetes

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www.DiabetesHealth.com / DIABETES HEALTH 3 ®

October 2016 • Issue 220 • Volume 25 • Number 5

InvestIgate. InFORM. InsPIRe. In This Issue

21 26 16

COVER STORY 26 Dancer Doesn't let Diabetes HEALTHY LIVING interfere With Her Dreams 13 living With type 1 16 nasCar’s ryan reed racing to stop type 1 Diabetes • erin stapley has dreamed of RESEARCH REPORTS becoming a professional dancer • When he’s racing in nasCaR’s ever since age 10, when she 21 advances in Diabetes research Xinity series, driver Ryan auditioned for and made the presented at aDa Conference Reed keeps a close eye on his anchorage Ballet Company in alaska. dashboard monitors, which track • Could getting more sleep lead to his blood sugar along with his lower a1c scores? car’s tire pressure, RPMs and water 28 Diabetic Grandmother stays temperature. upbeat While Battling Cancer FOOD FOR THOUGHT FEATURES • ten years ago, Connie Reed had no job, no health insurance and 30 Bufalo Chickpea salad 8 man Controls type 2 Diabetes no way to pay for the insulin she Without meds for 25 years needed to manage her type 2 diabetes. DIABETES CROSSWORD PUZZLE • When Bonny Damocles was diagnosed with type 2 diabetes, 18 Crosssword puzzle he asked his doctor if he could try COLUMNS • test your knowledge to see how diet and exercise before starting well you understand diabetic the recommended medications. making a Diference problems. 19 rising Country star inspires 5 letter from the publisher 31 Crosssword solution

kids With type 1 Diabetes • From Ballet Dancer to grandmother, Five Inspiring People • When country singer Ben Rue isn’t on the road, you can sometimes ind him working with kids who 11 ask nadia have type 1 diabetes, sharing stories • Medicare stopped Covering My about overcoming the challenges novo nordisk Insulin that come with the disease.

4 www.DiabetesHealth.com / DIABETES HEALTH Making a Difference

FROM Ballet Dancer tO gRanDMOtheR, Five inspiring PeOPle

the articles for this 10. In the four years since, she has learned to assembling issue of Diabetes fold her disease into her dancing life, with health was a pleasant, inspirational task. along hopes of someday landing roles with the with the thousands of articles published each american Ballet theater: “Dancer Doesn’t Nadia Al-Samarrie was year about diabetes—some grim and others let Diabetes Interfere With her Dreams,” not only born into a family too abstract and specialized for most readers— page 26. with diabetes, but also there are the articles about people from all married into one. walks of life who have learned to address their Older people deserve their diabetes heroes, diabetes in resolute, often courageous ways. too. Despite all sorts of bad consequences She was propelled at a and obstacles posed by type 2, grandmother young age into “caretaker We proile ive such people, a fascinating Connie Reed has steadfastly taken them on mode,” and with her cross-section of the diabetes community: and come out still thriving on the other side: knowledge of the scarcity “Diabetic grandmother stays Upbeat While of resources, support, and When race car driver Ryan R eed hits speeds Battling Cancer.” page 28. understanding for people of 200 miles per hour, he not only checks with diabetes, co-founded his speedometer and oil pressure, he also UpDate From the aDa Diabetes Interview–now takes quick glances at a dashboard monitor tanya Caylor reports on some research Diabetes Health magazine. that tracks his blood sugar. Read about it in indings from the always exciting and “nasCaR’s Ryan Reed” on page 16. incisive american Diabetes association’s Nadia’s leadership annual scientiic sessions, held this year has spanned 25 years, Is it possible to control type 2 diabetes in new Orleans. among the topics: the establishing the magazine without medications? the best answer is that glucagon pump works well in preventing as a preeminent consumer some type 2s can attain very low a1c’s with hypoglycemia; and the bionic pancreas is and professional resource. just diet and exercise. that’s what Bonny moving ever closer to reality. see “advances With our profound Web Damocles has been able to do for a quarter in Diabetes Research Presented at aDa presence, Diabetes Health of a century. “Man Controls type 2 Diabetes Conference,” page 21. leads the way with an Without Meds for 25 Years” on page 8 will tell you how he did it. informative blend of Megan esler keeps us up to date with life as a type 1 from her “living With type 1” column content and technology, singer Ben Rue is quickly rising in country on page 13. delivering Nadia’s enduring music ranks despite a diagnosis of type 1 at vision to investigate, age 14. he refused to let his diabetes stand in Don’t forget our crossword puzzle (page 18), inform, and inspire. his way, and has used it as an inspiration that and our Bufalo Chickpea salad recipe on extends beyond his career to helping young page 30. people with type 1: “Rising Country star Inspires Kids With type 1 Diabetes,” page 19. here’s to inspiring people!

Fourteen-year-old alaskan ballet dancer erin — nadia al-samarrie Founder, stapely was diagnosed with type 1 at age publisher, and editor-in-chief

www.DiabetesHealth.com / DIABETES HEALTH 5 6 www.DiabetesHealth.com / DIABETES HEALTH www.DiabetesHealth.com / DIABETES HEALTH 7 Feature

man controls Type 2 Diabetes

Without meds for 25 Years “so I drastically reduced my stair-running Tanya Caylor time to practically none on some days and started eating the wrong foods for Bonny Damocles was me: steaks, fried chicken, pork chops, and When diagnosed with type 2 other high-fat foods.” then one day, out of diabetes, he asked his doctor if he could curiosity, he tested his blood sugar. “It was try diet and exercise before starting the 486 mg/dl. I nearly fainted.” recommended medications. these days Damocles does his stairs exercise granted a reprieve, he immediately began in four 25-minute increments, primarily the most grueling workout he could think of: before meals. he knows better than to let up. running stairs. Because his export business allowed him to work from his Midland, “I know, as all type 2 diabetics know, that Mich., home, where he served as the primary once a diabetic, always a diabetic. I will caregiver for a son with Duchenne muscular never get rid of this disease.” dystrophy, he broke his workouts up into segments totaling two hours per day. he too mUch oF a gooD thing quit eating sugar and most processed foods. When Damocles and his family immigrated When he reported back to his doctor 10 days to the United states from the Philippines later, his blood sugar had dropped from 468 in 1972, the 5-foot-7 management analyst to readings in the 130s and 140s. weighed less than 130 pounds.

“Continue what you are doing,” his doctor told “Where we came from, we seldom ate him. “these are very encouraging results.” chicken, beef, and pork because they were expensive,” he said. “We had no pizza and twenty-ive years later, the 80-year-old no packaged foods like corn chips and When Bonny still runs stairs and watches his diet tortillas. We ate mostly leafy vegetables, Damocles was rather than using medication to control dried beans, ish, nuts, fruits, seaweed, diagnosed with type his diabetes. his a1c tests typically canned sardines, canned salmon, and once 2 diabetes, he asked range from 5.2 to 6.3 percent; his most in a long while, canned corned beef.” his doctor if he could recent result was 5.8. he reports no try diet and exercise diabetes complications and considers Damocles had worked in the Manila mayor’s before starting himself in excellent health. oice. his wife worked in the Philippines Patent Oice. Both had engineering the recommended But he knows he hasn’t conquered degrees. “although we felt then that we medications. diabetes. about 3½ years after his were doing well in life,” he said, “we had no diagnosis, after a long streak of excellent house, no car, no jewelry, no savings, none blood sugar readings, a friend suggested of anything except the big dream to reach he was cured. Damocles believed him. the U.s. someday.”

8 www.DiabetesHealth.com / DIABETES HEALTH Stay Inspired with the Publication that was Nominated for “Best in Health” in 2014 When The Wall Street Journal quoted a major public figure who called Diabetes Health the best weapon against diabetes, what did he say? Former Chrysler Motors President Lee Iacocca said: “Diabetes Health magazine provides the best, most unbiased information to the diabetes community. I highly recommend it.” What makes Diabetes Health different from any other publication out there? Diabetes Health magazine is a lifestyle publication for those living with diabetes or the people who care for them. Whether newly diagnosed or experienced with diabetes, readers are delighted and impressed by the articles written by people living with type 1 and type 2 diabetes. Other contributors include family members who care for those with diabetes. In fact, our founder and publisher, Nadia Al-Samarrie, was not only born into a family with diabetes, but also married into one. Nadia’s articles are published nationally online by many news outlets. She has also been featured on ABC, CBS, NBC, and Fox television on “America’s Premiere Experts.” Nadia was propelled at a young age into “caretaker mode,” and with her knowledge of the scarcity of resources, support, and understanding for people with diabetes, co-founded Diabetes Interview—now Diabetes Health magazine. With Nadia’s leadership, Diabetes Health magazine was nominated for “Best in Health” by the Western Publishers Association in 2004 and 2014. Subscribe Now and Stay Motivated With A Publication That is Dedicated to make Your Life Easier - You Deserve the Gift of Diabetes Health Starting with your first issue you can expect to: ~ Get inspired by everyday heroes and celebrities living with diabetes ~ Gain a new perspective on living with type 1 and type 2 diabetes ~ Learn about the latest in medical devices, medication options, and products and stay on top of the latest research on diabetes ~ Try making one of our yummy recipes ~ Giggle reading one of our cartoons or test your knowledge on diabetes in one of our crossword puzzles. 4 ways you can pay for your subscription: mail, credit card, or email. You can also buy a gift for a friend or family member OR for your pharmacist. Please complete, and mail your subscription to PO Box 1199 Woodacre CA 94973-1199. Make your checks payable to Diabetes Health magazine. You can also email subscribe@diabeteshealth to assist you with your subscription. TO SUBSCRIBE: PRINT: 1 year - 4 print issues ❑ $19.95 PRINT & 1 year - 4 print, 6 digital issues ❑ $29.95 2 year - 8 print issues ❑ $29.95 DIGITAL 2 years - 8 print, 12 digital issues ❑ $37.95 3 year - 12 print issues ❑ $39.95 3 years - 12 print, 18 digital issues ❑ $65.95 DIGITAL: 1 year - 6 digital issues ❑ $11.95 GIFT FOR 1 year - 60 print issues ❑ $19.95 2 year - 12 digital issues ❑ $9.95 FAMILY & 2 years - 120 print issues ❑ $39.95 3 year - 18 digital issues ❑ $7.95 FRIENDS 3 years - 180 print issues ❑ $49.95 GIFT FOR PHYSICIAN’S OFFICE, 1 year - 60 print issues ❑ $19.95 PHARMACIST OR NURSE: 2 years - 120 print issues ❑ $39.95 3 years - 180 print issues ❑ $49.95 ✄ SIGNATURE DATE

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these days he indulges in fresh fruit. When he and his wife go out to eat twice a week, he sticks to unsweetened dishes low in fat, salt, and Msg. he knows from the When that opportunity came, through a U.s. diabetes forums he consults regularly that program that encouraged Filipino degree his carbohydrate intake, which he estimates holders in certain ields to immigrate, they at 60 percent of his diet, is higher than went for it. recommended. his blood sugar typically rises to 180 after each meal. But because he though their family of six arrived in now eats only twice per day, interspersed america “totally broke,” owing thousands with vigorous exercise, his evening reading of dollars for plane tickets, they quickly invariably falls below 100. found jobs that paid much better than what they were used to. suddenly even Damocles describes a typical meal as two the most decadent foods were easily bananas, a grilled chicken breast, a scoop of afordable. Over time, Damocles’ weight nonfat plain greek yogurt, a plain cheese or crept up to 165 pounds. peanut butter sandwich and some unsalted cashews. When he suddenly lost 20 pounds within two weeks in 1991, despite nearly constant “avoiding one meal a day is giving me more hunger, he feared he had cancer. his son time to be more productive, healthier and arnold’s courageousness in dealing with a have an easier time and efort to manage debilitating, eventually fatal condition put my diabetes,” he says. every other problem in perspective, but Damocles couldn’t help worrying he now tests his blood sugar only sharing the facts what this might mean for his periodically, to make sure his diet-and- about diabetes may family. given his initial fears, he exercise program is working. But on testing be diicult, but it is was “very, very happy” to learn he days he may use up to 10 strips, to see how his readings luctuate. crucial in forging a had type 2 diabetes instead. lasting relationship. DietarY changes paY oFF his regimen may sound like a lot of work, according to Ullman, looking back, Damocles blames but to Damocles it’s worth the efort. open communication his diabetes on a lack of physical is the best way for activity combined with too much “I save a lot of money for not using pharma couples to handle of the goodies he came to love drugs, for not going to the gym, for not diabetes. in america: hot dog sandwiches, needing nice shoes and nice clothes pizza, fried chicken, potato by exercising in our house, for eating chips and his personal favorite carbohydrates – which are the cheapest from their early years in Chicago, “big beef foods – and for testing my blood sugar only sandwiches with jalapeno peppers.” 100 times per year.”

10 www.DiabetesHealth.com / DIABETES HEALTH Ask Nadia

ask nadia: Medicare stopped Covering My novo nordisk Insulin

Dear Nadia, My mail order company that fulills my insulin orders just informed me that I can no longer get my Novo Nordisk insulin? They said that Medicare will only cover Eli Lilly’s insulin. carefully and call them should you need Should I choose to continue to buy Novo clariication on the description of beneits. Nordisk’s insulin, my co- payment will be $200 for my prescription. the good news is that you can appeal Medicare coverage for your novo nordisk My insulin preference is Novo Nordisk because insulin. When speaking to the plan request I tend to experience more hypoglycemia the “Medicare Prescription Drug Coverage episodes when using the Eli Lilly insulin. and Determination.” this is going — Ed to be the form you complete since your pharmacy and submit in asking Medicare informed you about Dear ed, to make an exception for your how wonderful for you to have learned novo nordisk insulin coverage. the insulin formulary, which insulin works best for you when it additionally, speak to your ask them to provide comes to diabetes self-management. People prescribing physician to discuss you with information do respond diferently to the insulin brands; your appeal. they will need to on how to reach out from hypoglycemic episodes to getting support your claim as to why an to the medicare plan allergic skin reactions when injecting. exception should be approved. to discuss your drug coverage. then reach since your pharmacy informed you about Once you submit your request, the insulin formulary, ask them to provide expect to receive a response out to the plan and you with information on how to reach out within 72 hours. request “evidence of to the Medicare plan to discuss your drug coverage.” coverage. then reach out to the plan and I have included a link to the pdf request “evidence of Coverage.” Read this form below so that you have an

www.DiabetesHealth.com / DIABETES HEALTH 11 Ask Nadia

about nadia: nadia was not only born into a family with diabetes but also married into one. understanding of what will be asked of she was propelled at a young age into you and the options that are available for “caretaker mode,” and with her knowledge coverage under the exception clause. of the scarcity of resources, support, and understanding for people with diabetes, co- ReQUest FOR MeDICaRe PResCRIPtIOn founded Diabetes Interview now Diabetes DRUg COveRage DeteRMInatIOn health magazine.

You might also be interested in reading nadia holds 14 nominations for her work as these related Medicare coverage articles: a diabetes advocate.her passion for working in the diabetes community stemmed asknadia: Why Medicare Covers some from her personal loss. she has used her Insulin Pumps experience as a caretaker to forge a career in helping others. asknadia: Why Doesn’t Medicare Cover the OmniPod Insulin Pump nadia has been featured on aBC, nBC, CBs, and other major cable networks. her Disclaimer: publications, medical supply business and nadia’s feedback on your question is in no website have been cited, recognized and way intended to initiate or replace your published in the San Francisco Chronicle, The healthcare professional’s therapy or advice. Wall Street Journel, ann landers, lee Iacocca, Please check in with your medical team Entrepreneur magazine, Houston News, Phili. to discuss your diabetes management com, Brand Week, Drug Topics, and many concerns. other media outlets.

12 www.DiabetesHealth.com / DIABETES HEALTH Healthy Living

that’s What D-Friends are for Meagan Esler

how life puts It’s funny you together with people who are dealing with the same health issues. Maybe there are just so many of us struggling with diabetes that it’s natural to ind each other, or maybe we are in the right place at the right time. at the time I was in full panic mode. My friend stopped in and wanted some help I manage a charity store where I meet all with some consignments. I went outside kinds of donors, customers, consignors, and with him where it was hot enough to fry volunteers. I’m surprised at how many I pancakes on the parking lot asphalt. I had meet that have diabetes. I met a man who been wearing my glasses which I never wear mentioned his type 2 diabetes to me when out so I wasn’t used to them. I was having he was shopping one day and he turned the worst time focusing and out to be one of my best donors/customers/ was feeling nauseated. My maybe there are just so consignors. after I shared that I live with glasses were sliding down many of us struggling type 1 diabetes, he shared his a1c with me. my face in the extreme heat. with diabetes that it’s I think he is the only person other than my I told him I couldn’t stand husband that I’ve shared mine with (before in the blazing hot-box truck natural to ind each my recent Diabetes Health post where I he had parked there in the other, or maybe we are shared it with the D-Community). It’s hard summer sun and that I wasn’t in the right place at the for me to share that number, but easier with feeling well. I pointed out the right time. people who understand the challenges of pieces we could accept for diabetes. consignment and went back inside. he followed me into One day I wasn’t feeling well and was the shop and asked what he could get me. worried about some vision issues I had he said he’d run and get me something to been having. I was so worried that it was eat. he had igured I was low. I explained my diabetes. thankfully, it wasn’t but it wasn’t that kind of ill, rather my vision

www.DiabetesHealth.com / DIABETES HEALTH 13 Healthy Living

was sanding a stubborn drawer and had worked for nearly an hour. as he showed me the piece near the end, I noticed his which was scaring me. I think he knew how hand was shaking. he was sweating and worried I was. he politely left his items and appeared to be having a really low blood agreed that I’d call him later with prices. sugar. I gently asked if he needed a snack and he agreed. I hurried to the kitchen that afternoon he stopped back at the in back and grabbed one of my juice shop for his paperwork. he handed me a boxes, some crackers, and a water bottle. big bunch of sunlowers and said he hoped I set them on a table next to him and I was feeling better and that he mentioned the carb count and he drank Whether you need knew I needed cheering up. after the juice. a short time later he was back to a friend to lean on my initial shock and blurting out himself and he remarked how funny it was when you are scared of “You didn’t have to do this, you that sometimes we need someone else to diabetes complications, really shouldn’t have” I thanked see it to realize we are low. he returned him and said something about the unopened crackers and water and said or when dealing with how just looking at them really the juice was perfect. a low blood sugar, it’s does cheer one up. he just said to good to know we are not feel better and went on about his Whether you need a friend to lean on when alone. every little act day. you are scared of diabetes complications, of kindness can mean or when dealing with a low blood sugar, so much to someone another day when he was at it’s good to know we are not alone. every dealing with a chronic the shop preparing an antique little act of kindness can mean so much to armoire for sale, he was working someone dealing with a chronic illness. We illness. hard at getting all the pieces need all the support and sunlowers that we together from the move. he can get.

14 www.DiabetesHealth.com / DIABETES HEALTH www.DiabetesHealth.com / DIABETES HEALTH 15 Feature

nascar’s ryan reed Racing to stop type 1 Diabetes Tanya Caylor

the 22-year-old is not only living his dream racing in but inspiring others with the Drive to stop When he’s nasCaR’s Diabetes campaign. Xinity series, driver Ryan Reed keeps a close eye on his dashboard monitors, the son of former nasCaR driver Mark the son of former nascar which track his blood sugar along Reed, Ryan began racing go-karts at age 4. driver mark reed, ryan began with his car’s tire pressure, RPMs and as a teenager growing up in California, he racing go-karts at age 4. as water temperature. would grab some fast food after school, go work on race cars until 10 p.m., “then grab a teenager growing up in Reed was told his racing career a sugary energy drink and get home to do california, he would grab was over when he was diagnosed some homework so my mom wouldn’t be some fast food after school, with type 1 diabetes at age 17, that mad at me.” go work on race cars until it was too dangerous to risk the 10 p.m., “then grab a sugary disorientation of hypoglycemia (low Reed was in the process of moving to north energy drink and get home blood sugar) at 200 mph. Carolina to begin his own nasCaR career to do some homework so my when he began losing weight and “drinking thanks to advances in diabetes- tons of water.” Devastated by his diagnosis, mom wouldn’t be mad at me.” monitoring technology, however, he googled “athletes with diabetes” and

16 www.DiabetesHealth.com / DIABETES HEALTH Feature

came across the story of IndyCar driver Charlie Kimball. Kimball’s doctor, anne Peters, had a practice just two hours from Reed’s parents’ home. he talked the receptionist into an appointment the very camps. the passenger door of his race next day. car bears the name of a diferent diabetes patient every month. Peters got Reed a Dexcom continuous glucose monitor to mount on his dashboard. “sometimes they’ll come out to the race she also insisted he adopt the mindset of a track and get their picture taken beside their professional athlete who fuels his body for name on the door,” he says. “the idea is to optimum performance. he hired a personal let the racing be a part of someone else’s trainer and switched from a “typical teenage life, too.” other drivers had lots of diet” to one that includes “a decent amount questions for him at irst. of healthy carbs” such as whole grains, along While Reed would rather not have with lean protein and healthy fats such as diabetes, there have been many they weren’t suspicious avocado. positives along the way. or unfriendly, he says, “just curious about my “every nasCaR driver has to go through a “I understand my body so much situation.” they’ve since more now because of diabetes,” he health screening,” Reed said. “ann worked gotten used to the no. 16 closely with nasCaR on all of that. she told said, noting that he runs and bikes car emblazoned with the me to focus on learning to manage my and recently completed his irst 5K. word diabetes in giant diabetes and driving my race car.” “that was my irst race that wasn’t in a race car.” letters, relecting the Other drivers had lots of questions for him at support of eli lilly and irst. they weren’t suspicious or unfriendly, Reed especially appreciates his the american Diabetes he says, “just curious about my situation.” strong connection with the diabetes association. they’ve since gotten used to the no. 16 car community. around three-fourths of emblazoned with the word diabetes in giant all nasCaR fans either have diabetes letters, relecting the support of eli lilly and themselves or a family member who does, the american Diabetes association. Dexcom according to www.drivetostopdiabetes.com. has also been “a huge supporter” of his foundation, Ryan’s Mission, along with the “Probably the most rewarding thing is the Drive to stop Diabetes. time I spend with kids, seeing how much it means to them,” he said. Reed now serves as a diabetes advocate both on and of the track, visiting children’s through his racing, he hopes to show kids hospitals, support groups and summer that they, too, can achieve their dreams.

www.DiabetesHealth.com / DIABETES HEALTH 17 Crossword Puzzle

DiaBetes health crossWorD pUzzle test your knowledge to see how well you understand the articles in this magazine. If you would like to sign up to receive a weekly puzzle, please email puzzle@ diabeteshealth.com. In the subject area write "add me to your weekly word puzzle list." If you would like us to create a puzzle for you and our players, send your 8 words to [email protected] and we will post your challenge online. In the subject area write” create my special word puzzle." We can all have fun posting and solving your word puzzles.

18 www.DiabetesHealth.com / DIABETES HEALTH Feature RIsIng COUNTRY STAR INSPIRES KIDS WIth TYPE1 DIABETES Tanya Caylor

country singer Ben Rue When isn’t on the road, you can sometimes ind him working with kids who have type 1 diabetes, sharing stories about that provides the setting for “Country overcoming the challenges that come with Cloth,” the original song he performed the disease. during June’s Country Music sing-Of before a judging panel that included “Just today, I got a note from a mom of country music star and “american Idol” one of the kids at camp, a 10-year-old who season 10 winner scotty McCreery. he was recently diagnosed,” says Rue, one of drove a tractor and combine at age 11, four national inalists for this fall’s Country helping to harvest grass seed for lawns and Music sing-Of, in a phone interview from golf courses in much the same way other the Diabetes Youth Foundation Camp in farmers harvest wheat. noblesville, Ind. though his lyrics show he clearly loves his the mother, worried about her son’s agricultural roots, Rue always dreamed negative outlook on facing life with of being a country star. On his bio at diabetes, asked if Rue would talk to him, benruemusic.com, he describes the time try to lift his spirits. “so yeah, I’m going to his dad caught him belting out a song connect with this kid tonight.” while standing on a railroad tie. “I was illin’ up one of our tractors with diesel, Rue, 29, went to diabetes camp himself for while looking out in the ield, pretending three years after his diagnosis at age 14. he I was singing on stage in Madison square then spent 10 years as a camp counselor. garden.” now, as a budding country star, he makes rue, 29, went to diabetes even more of an impression on kids. he laughs, remembering a moment camp himself for three that surely generated a lot of teasing “It’s a real blessing to be able to have that over the years from a guy with two years after his diagnosis kind of impact,” he said. “It’s cool that I older brothers. since then, though, he’s at age 14. he then spent have a bigger pad to launch of of, to reach had “one or two of those pinch-me 10 years as a camp more people with my music.” moments where I realize how far I’ve counselor. now, as a come in a fairly short time.” budding country star, he a Farm kiD With Big Dreams makes even more of an Rue grew up on a 2,000-acre grass seed Rue was a scholarship baseball player impression on kids. farm near silverton, Oregon, a small town at Concordia University and played a

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wanted anything connected to me.” It took him a while to learn to live without the sugar and carbs that had been such a big part of his teenage diet.though he now feels like “I can eat anything I want to,” he no longer craves sugar. If he has a sip of year on an independent team in Michigan soda, “it tastes super sweet. I don’t even before realizing he had no future in the like the taste.” major leagues. he moved to nashville 4½ years ago to focus on his music career, a Bigger stage lies aheaD cutting his debut single, “I Can’t Wait (Be though managing his diabetes can be My Wife),” with arista nashville in 2014. diicult as a traveling musician, Rue says, “I rely heavily on technology and my accu- a sUrprise Diagnosis Chek Connect system to make sure I stay on looking back, Rue now realizes he was track with logging what I eat or drink and lucky his diabetes was discovered before testing my blood sugar regularly. My Connect he got sick. his mom, a nurse, brought meter automatically logs my numbers and home a blood sugar-testing kit one day. his lets me access them straight from my phone brothers went irst, scoring in the 80-100 no matter where I am. Because of this, I don’t range. then it was his turn. have to worry as much about my diabetes though managing his and I can focus on my music.” diabetes can be diicult “I was 585, and I thought I won the as a traveling musician, contest,” he says. Rue is looking forward to this fall’s Country rue says, “i rely heavily Music sing-Of inals. a win would earn him on technology and my though he laughs about it now, a $50,000 sponsorship deal with eckrich accu-chek connect in retrospect he can see that the Meats and a chance to work with grammy- symptoms were there. “I was very nominated producer Dave Brainard. system to make sure skinny, 5-10 and 110 pounds at that i stay on track with age.” he was always thirsty, but hadn’t he’s also thrilled to be partnering with logging what i eat or really thought much about it. after his Roche Diabetes Care, the maker of his drink and testing my diagnosis, “I was inally able to grow accu-Chek Connect system, to spread blood sugar regularly. into my size 13 shoes.” diabetes awareness among his growing number of fans. Figuring out the best way to manage his diabetes took several years. “there was “I’m excited to help other people with a deinite learning curve.” as an athlete, he diabetes know that they don’t need to be preferred taking shots rather than using limited by their condition and that they an insulin pump. “I’m so active, I just never can do."

20 www.DiabetesHealth.com / DIABETES HEALTH Research Report advances in DiaBetes research Presented at aDa Conference Tanya Caylor

getting more sleep could lead to lower a1c scores? according to a study presented at the american Diabetes association’s 76th scientiic sessions, held June 10-14 at the largest gathering of researchers focused ernest n. Morial Convention Center in new on the study of diabetes. More than 2,500 Orleans, people who got the recommended presentations were made during this year’s seven to nine hours of sleep per night had conference, which attracted more than lower a1c scores than those who got less. 16,000 participants. here are some of the other indings that were presented: In the study of 25,474 working adults from a large itness and wellness company, Drug lowers death risk: In a study that was collected over three years, 5.7 percent (1,452 published in the New England according to a study individuals) were reported to have diabetes. Journal of Medicine the same the group with diabetes got slightly less day it was presented at the presented at the american uninterrupted sleep on average, with 63 aDa conference, the glucose- Diabetes association’s percent reporting seven to nine hours per lowering drug liraglutide 76th scientiic sessions, night compared with 71 percent of non- was shown to reduce overall held June 10-14 at diabetic participants. however, within mortality levels in a double- the ernest n. morial both groups, the same pattern held true: blind analysis of 9,340 adults convention center in new Optimum sleep correlated with lower a1c with type 2 diabetes at high risk orleans, people who got scores. for heart disease. the drug also lowered the overall risk of heart the recommended seven “sleep duration appears to impact on attack, stroke, kidney disease, to nine hours of sleep per the prevailing levels of hba1c in both and cardiovascular death. night had lower a1c scores individuals with and without diabetes,” than those who got less. according to the authors, led by David Kerr, Participants in the study, director of diabetes research and innovation assigned to either liraglutide at the sansum Diabetes Research Institute in or a placebo, were followed for an average santa Barbara, Calif. of 3.8 years and were seen at 410 sites in 32 countries. they had an average age the aDa’s scientiic sessions are the world’s of 64 years. Participants in both groups

www.DiabetesHealth.com / DIABETES HEALTH 21 Research Report

produced by the pancreas that works in conjunction with insulin to regulate blood glucose concentrations. glucagon raises blood glucose, while insulin has the opposite efect. Both glucagon and insulin production are impaired in people with type 1 diabetes.

took additional medications as needed to the double-blind, randomized, placebo- control their diabetes, high blood pressure, controlled crossover study included 22 cholesterol, or other complications. those in patients with type 1 diabetes who used an the liraglutide group exhibited 22 percent insulin pump or multiple daily injections of lower risk of cardiovascular mortality and insulin and who had reduced hypoglycemia a 15 percent lower risk of overall mortality awareness. During the study, all participants compared with the placebo group, with no wore an experimental device that used a indications of safety issues. continuous glucose monitor to read their blood glucose levels and a pump to deliver “Our results should give patients and small doses of glucagon in response to providers comfort that liraglutide can safely those levels. Participants received either improve outcomes beyond the glucagon or placebo on alternate days “our study found that core treatment of type 2 diabetes,” without knowing which type of treatment using automatic glucagon said lead investigator John B. Buse, they were receiving. delivery reduced verne s. Caviness Distinguished “Our study found that using automatic hypoglycemia by 75 Professor at the University of north Carolina school of Medicine glucagon delivery reduced hypoglycemia percent during the day and in Chapel hill. by 75 percent during the day and 91 percent 91 percent at night,” said at night,” said lead investigator Courtney lead investigator courtney glucagon pump reduces Balliro, clinical research nurse at the Balliro, clinical research hypoglycemia: small doses of Massachusetts general hospital Diabetes nurse at the massachusetts glucagon administered through Research Center in Boston. general hospital Diabetes an automated continuous glucose low blood glucose levels are especially research center in Boston. monitoring system reduced hypoglycemia (low blood glucose dangerous at night, when patients are levels) in patients with type 1 less likely to detect symptoms. Untreated diabetes, according to one study presented hypoglycemia can lead to seizures and other at the conference. glucagon is a hormone complications, including possible cardiac

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arrhythmias that may prove fatal in cases known as “Dead in Bed” syndrome.

Brain changes detected in teens with know if the changes we found are the direct type 2 diabetes: teenagers with type 2 result of diabetes.” diabetes have signiicant changes in total brain gray matter volume and in regions of however, Redel noted that previous studies gray matter involved in seeing and hearing, of adults with type 2 diabetes also show memory, emotions, speech, decision brain volume diferences and cognitive making, and self-control. decline with duration of the disease.

Researchers at Cincinnati Children’s hospital In a future study the researchers may add Medical Center discovered that these teens a larger number of participants, including have six regions with signiicantly less gray a group who are obese without type 2 matter and three with signiicantly more. diabetes, to see if diferences found on MRI they found a relationship between less gray are more closely related to obesity or high matter volume in the brain and the ability to blood sugar. pronounce and sound out unfamiliar words. Previous studies suggested that young progress reported on bionic low blood glucose levels people with type 2 diabetes scored lower on pancreas: In the irst study are especially dangerous cognitive function tests compared with their of a dual-hormone bionic peers. pancreas done in a home setting, at night, when patients participants using the device are less likely to detect the researchers studied 20 teens with type exhibited a 20 mg/dl decrease symptoms. Untreated 2 diabetes and compared them to 20 teens in average blood glucose levels hypoglycemia can without type 2 who were similar in age, race, than during an equivalent period lead to seizures and and sex. all participants in the study had of time using an insulin pump. other complications, high-resolution MRIs. neither group had the bionic pancreas consisted including possible prior neurological or psychological disease of a continuous glucose monitor or prior abnormal MRIs. providing data to a device that cardiac arrhythmias that used an autonomously adaptive may prove fatal in cases “Our results do not show cause and efect,” algorithm to determine how known as “Dead in Bed” said Jacob Redel, lead author in the study much glucagon and insulin to syndrome. and a fellow in the division of endocrinology deliver subcutaneously and when at Cincinnati Children’s hospital. “We don’t to administer it.

www.DiabetesHealth.com / DIABETES HEALTH 23 Research Report

exercise tops weight loss in diabetes prevention: Physical activity, even without weight loss, may help prevent type 2 diabetes in people who are at high risk for diabetes, according to new follow-up data from the landmark Diabetes Prevention Program (DPP) study.

Originally published in 2002, the DPP found In this study, 39 adults with type 1 diabetes that lifestyle changes reduced participants’ used the bionic pancreas for 11 consecutive risk of developing type 2 diabetes by 58 days and their own insulin pump for percent over three years in overweight the same amount of time. there were people with prediabetes. the group no restrictions on diet and exercise. the asked to focus on lifestyle changes, which indings were consistent with three previous included 150 minutes of physical activity per studies done in more supervised settings. week and a modest 7 percent weight loss, were more successful than a group placed “these results, in addition to the results on metformin. Results from that study, from our previous studies, suggest largely funded by the national Institute of that the bionic pancreas, Diabetes and Digestive and Kidney Diseases exercise tops weight loss in as an autonomous system, (nIDDK), an arm of the national Institutes of diabetes prevention: physical could profoundly reduce health, have helped shape medical advice activity, even without weight patient burden and provider on at-risk patients in the years since. loss, may help prevent type involvement in type 1 diabetes management,” said lead the current study is a 12-year follow-up of 2 diabetes in people who investigator edward R. Damiano, 1,793 participants. the new data showed are at high risk for diabetes, professor of biomedical that diabetes incidence was lower for according to new follow- engineering at Boston University. participants who were more physically up data from the landmark Damiano, who has been working active, regardless of changes in weight. Diabetes prevention program on an artiicial pancreas since (Dpp) study. his teenage son was diagnosed “Until now, the importance of physical with type 1 diabetes as an infant, activity in preventing diabetes development recently formed a medical device in the DPP was thought to be due to company called Beta Bionics and is working its role in achieving weight loss and to bring a product to market by the time weight maintenance; however, it was not his son goes to college in 2017. considered a strong key factor alone,” said

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one of the lead investigators, andrea M. Kriska, a professor in the department of epidemiology at the University of Pittsburgh graduate school of Public health. “It is important for health care professionals to look beyond their high-risk patients’ weight, increased. a more involved patient with and also consider their physical activity customized settings can have a large impact levels, when discussing strategies to prevent on their own diabetes management.” progression to type 2 diabetes.” though there is mounting evidence of the patients who interact most with cgms beneits of getting real-time data, CgMs are get biggest beneit: In a study presented still being used by a minority of people with by Dexcom, which is marking its 10-year diabetes, in part because not all insurance anniversary since coming out with its irst carriers cover the cost. continuous glucose monitor, data records of patient use show that those who check their “Despite being around for over 10 CgM results more frequently have lower years now, CgM is still a relatively though mounting average blood glucose levels. new technology for diabetes evidence of the management,” sayer said. “It just the 17.5 million data points, collected takes time to make all of the health beneits of getting voluntarily from patients seeking technical care professionals and their patients real-time data, cgms support, also showed the value of aware of a new technology and are still being used by customizable patient alerts for high and the positive outcomes it drives, a minority of people low blood sugar. according to the study, 92 especially when it’s such a game- with diabetes, in percent of users set their alerts. Of those, 77 changing approach. CgM is changing part because not all percent chose a low glucose level of 80 mg/ diabetes management because it insurance carriers cover dl and 79 percent selected a high glucose ofers a new, better way of thinking alert at 180 mg/dl or higher. about managing glucose levels. We the cost. know that when people learn about “the results show that when patients set Dexcom CgM for the irst time, they their high glucose alert lower, their average are immediately interested and most want and variation of CgM glucose decreased to obtain the device. It’s just a matter of signiicantly,” said Dexcom CeO Kevin sayer. reaching all of the patients and providers “When they set their glucose alert higher, with our message and that’s the focus of our their average and variation of CgM glucose campaign this year.”

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Dancer Doesn’t let Diabetes interfere With her Dreams Tanya Caylor

stapley was diagnosed shortly after returning from ballet camp last summer. at irst she attributed her excessive thirst has dreamed to the summer heat and the strenuous erin stapley of becoming training program she’d recently been a professional dancer ever since age 10, through. But when she experienced a when she auditioned for and made the tingling sensation in the back of her throat anchorage Ballet Company in alaska. while eating breakfast one morning, her mother took her a doctor to check things though the 14-year-old was stunned out. by last year’s discovery she has type 1 diabetes, stapley refuses to let the disease When stapley’s blood was drawn to check interfere with her dreams. for allergies, she learned her glucose level stapley was diagnosed she continues to train up to was a startling 852. she was ordered to ive hours a day, six days a shortly after returning report to the hospital. week, besides maintaining from ballet camp last a normal class schedule “I was just shocked,” she said. “You always summer. at irst she at West anchorage high think this is the kind of thing that happens attributed her excessive school, where she’s a to other people.” thirst to the summer freshman. heat and the strenuous When the doctor left the room, stapley training program she’d If anything, stapley says, the immediately looked at her mom. “Does discovery has sharpened her recently been through. this mean I have to stop dancing?” she focus on the future, because asked. now in addition to dancing, she plans to get involved in diabetes But when the doctor returned, he assured education. her that wouldn’t be necessary.

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stapley has no idea how she developed diabetes. she has no family history. But she didn’t waste time bemoaning her fate, choosing instead to accept it and start educating herself on how she could adapt. her family and friends are supportive. she shares strategies with a couple of other girls she knows who’ve been diagnosed, one at her school and another friend who moved away but still keeps in touch. the tight-knit group of dance buddies who’ve nice, because I don’t even notice it when been traveling with her to san Francisco I’m dancing.” the last few years to compete in the Youth america grand Prix competition remind at this point in her career stapley is her to check her blood sugar and try preparing to audition for summer to avoid tempting her to eat things she programs and investigating boarding shouldn’t. schools for dancers. she’s particularly interested in the american Ballet theatre as a dancer, stapley has always paid more and a program in Russia. attention to her diet than the average she’s been learning to speak at this point in her teenager. she was careful to make sure she Russian in a class at her school. career stapley is “got enough of the good stuf, like protein, preparing to audition for fruit, and veggies,” but didn’t worry too Wherever stapley’s dance summer programs and much about sugar “because I could always career takes her, someday she burn it of” with all that dancing. now she wants to get a job working investigating boarding has to be more careful. with other people who have schools for dancers. diabetes. “I wouldn’t mind she’s particularly stapley was concerned at first about how working for Omnipod, or interested in the she could wear an insulin pump with maybe becoming a nurse american Ballet theatre her dance outfit, but that hasn’t been a who could help people,” she and a program in russia. problem. she wears an Omnipod, which is said. Whatever path that leads both wireless and tubeless. the pod can her down, she wants to show be worn up to three days without being others what she’s already learned: Diabetes changed. “I love it,” she said. “It’s really doesn’t have to slow you down.

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Diabetic grandmother stays Upbeat While Battling cancer Tanya Caylor “I try to keep a positive attitude,” she says. “You have to.” her religious faith and sense of humor, along with staying busy ago, as a volunteer, grandmother and bucket- ten Years Connie list tender, all contribute to her sense of Reed had no job, no health insurance and optimism. no way to pay for the insulin she needed to manage her type 2 diabetes. Reed was diagnosed with diabetes a little over 35 years ago, around the time her the laid-of payroll clerk got help from adopted son was born. an agency that works with “i try to keep a positive uninsured residents in DeKalb “a lot of people with diabetes have kidney County, Ind., and now she shows trouble,” she said a few days before her attitude,” she says. her appreciation by volunteering Feb. 25 surgery. “here I am with two good “You have to.” her at st. Martin’s health Care kidneys, and one had to go and get a religious faith and services two days a week. tumor on it. Once I get down to 1½ kidneys, sense of humor, along I will have to be extra careful.” with staying busy as a though her health has gotten volunteer, grandmother considerably more complicated Despite her “cookie monster” tendencies, and bucket-list tender, over the past decade, Reed Reed tries to stay away from sugar as refuses to dwell on her problems. well as artiicial sweetener. though she all contribute to her In addition to diabetes, she’s continued a 67-year ritual of visiting the sense of optimism. being treated for both addison’s Coney Island hot dog shop in nearby Fort disease and Cushing’s disease. Wayne on her 70th birthday in January, she as if that weren’t enough, she recently had notes that she didn’t allow herself to eat surgery to remove half a cancerous kidney. more than a bite or two.

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“that’s hard, because I love those hot dogs,” she said. “But if I want to stay around for my grandchildren and play with them in travel much in earlier years, when she the future, then I’ve got to pay attention to worked long hours as a single mother the present.” after a divorce. now she’s making up for it by doing everything from the beneits that losing more than 100 attending an Indianapolis reed continues to add pounds after bariatric surgery had on her Colts game with her son, to her bucket list. she blood sugar have since been wiped out by Cory, to accompanying her didn’t get to travel much the high dosage of steroids she must take grandchildren, ages 7 and 11, to manage her other health issues. on a school field trip. though in earlier years, when Cory and his family live in she worked long hours “steroids run my sugar levels up,” she virginia, where he’s stationed as a single mother after explained. While recuperating in the at langley air Force Base, he a divorce. now she’s hospital after her recent surgery she was was able to come home for making up for it by doing accidentally given even higher dosages his mom’s surgery. everything from attending than usual, which led to glucose readings an indianapolis colts that were “out of sight.” But once she got Up next, as soon as she’s back into her normal routine they started feeling better: Ziplining and game with her son, cory, coming back down. she is hopeful that exploring caves in southern to accompanying her if a biopsy shows the cancer is gone, her Indiana. grandchildren, ages 7 and endocrinologist can help her ind a better 11, on a school ield trip. balance between steroids and insulin. “I used to say I wanted to make it to 70,” Reed said. In the meantime, Reed continues to “now I guess I’d like to make it to 75. But add to her bucket list. she didn’t get to until then, I’m going to have some fun.”

www.DiabetesHealth.com / DIABETES HEALTH 29 Food for Thought

Bufalo Chickpea Salad ingreDients 1 Can Organic Chickpea 3 Romaine hearts 1 Bag spinach 2 avocado, Chopped 1/2 Red Onion, Chopped 4 Celery stalks 1 Bottle Daiya Blue Cheeze Dairy-Free Dressing 3 tbsp Frank's hot sauce

Directions Drain the can of chickpeas and rinse well. toss the chickpeas in bufalo hot sauce until evenly coated.

Roasting is optional: heat the chickpeas over medium heat in a saucepan with hot sauce and vegetable spread and then roast in the oven at 450 degrees on a baking sheet lined with parchment paper and bake for 30 minutes, tossing halfway through.

Combine all ingredients and toss in a salad bowl with Daiya Blue Cheeze Dairy - Free dressing. approximately six servings. Recipe courtesy of Daiya Foods. For more recipes please visit http://daiyafoods.com/recipes/ nutritional information: salad ingredients: Calories 239; Protein 12g; Fat 9g; Carbs 34g; Cholesterol 0; sodium 246 mg; sugars 6g; Dietary Fiber 18g salad dressing (2 tablespoons): Calories 120; Protein 0g; Fat 13g; Carbs 1g; Cholesterol 0; sodium 220 mg; sugars 1g; Dietary Fiber 0g Disclaimer: nutritional information may vary slightly. For more information please visit https://www.supertracker.usda.gov/myrecipe.aspx

30 www.DiabetesHealth.com / DIABETES HEALTH Crossword Puzzle

DiaBetes health crossWorD pUzzle solUtion If you would like to sign up to receive a weekly puzzle, please email puzzle@ diabeteshealth.com. In the subject area write "add me to your weekly word puzzle list." If you would like us to create a puzzle for you and our players, send your 8 words to [email protected] and we will post your challenge online. In the subject area write” create my special word puzzle." We can all have fun posting and solving your word puzzles.