STUNNING PERFORMERS Dazzle the 19Th CAROUSEL of HOPE BENEFITING Children’S Diabetes Foundation

children’s diabetes foundation at denver — WINTER 2010 All Carousel of Hope photos: © Berliner Studio All Carousel

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

conic artists Jennifer Lopez and Marc Anthony, Gladys Knight, Akon and Jay Leno joined with Honorees Maria Shriver I 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) 1. 2.

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1. Jay Leno

The Carousel of Hope 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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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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1. Qunicy Jones, Honoree 6. 7. 2. Cheryl Tiegs, Frances Fisher 3. Garcelle Beauvais, Paul Sorvino 4. Larry Gilman, Donna Mills 5. Gladys Knight, Lisa Raye McCoy

The Carousel of Hope 6. Vanna White 7. Don Rickles, Kathy Griffin, Bob Newhart

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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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6. The Carousel of Hope

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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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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5. 6. The Carousel of Hope

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

8 9 (Continued from Cover) More than 1,000 guests attended Ring Award for her inspiring and Percy Gibson, Clive Davis, the 2010 Carousel of Hope Ball humanitarian efforts. Maria’s Jane Fonda, Berry Gordy, presented by Mercedes-Benz, meaningful speech deeply Kathy Griffin, Tom Hanks and raising nearly $2.4 million touched the audience. Last Rita Wilson, Anjelica Huston, for research and clinical care year’s Brass Ring honoree, Randy Jackson, Rickey Minor, programs for diabetes at the Clive Davis, followed with a Les Moonves and Julie Chen, Barbara Davis Center for warm introduction of Barbara Dermot Mulroney, Bob and Ginny Childhood Diabetes, where over Davis who generously thanked Newhart, Joanna and Sidney 5,000 children and adults receive every guest for attending and Poitier, Don and Barbara Rickles, care. joining in the fight against the Carole Bayer Sager and Bob Daly, global epidemic of diabetes. Jolene and George Schlatter, The evening would not be She updated the audience on Judge Judy Sheindlin, Rod Stewart possible without the help of the Center’s programs and and Penny Lancaster, Sela Ward, genius TV veteran, George the advances being made for Raquel Welch, Vanna White, Schlatter and his skilled children everywhere. In closing, Garcelle Beauvais, Thora Birch, production crew, talented she mentioned a quote from Brandy, Maksim Chmerkovskiy, music director, Rickey Minor, Christopher Reeve, “Once you Billy Davis & Marilyn McCoo- and Jay Leno, who once again choose hope, all things are Davis, Bob Evans, Frances reprised his role as the Master of possible.” American Idol’s Fisher, Daisy Fuentes, Lisa Rinna Ceremonies. Randy Jackson welcomed Quincy & Harry Hamlin, Nicky Hilton, Jones to the stage as he was Paris Hilton, Rick & Kathy Hilton, The Children’s Diabetes honored with the Foundation’s Beverly Johnson, Don Johnson, Foundation would like to thank distinguished Humanitarian Tamala Jones, Susan Lucci, Nigel the evening’s presenting sponsor Award on the 25th Anniversary of Lythgoe, Chris Massey, Kyle Mercedes-Benz USA, and major “We Are The World.” Massey, Benny Medina, Donna sponsors GUESS?, American Mills, Nancy O’Dell, Sumner Airlines, sanofi-aventis U.S., The unforgettable evening Redstone, Leah Remini, Mimi The Beverly Hilton Hotel and included performances by great Rogers, Mira Sorvino, Paul our angel sponsors Ron Burkle, artists Jennifer Lopez and Marc Sorvino, Lara Spencer, Alana Sarah Siegel-Magness and Gary Anthony, who performed a duet Stewart, Alan Thicke, Cheryl Magness and Robert and Kelly of “No Me Ames.” Together the Tiegs, Louis van Amstel, Buzz Day. Reem Acra illuminated couple sang in perfect harmony Aldrin, Joan van Ark and Ben the ballroom with her beautiful lighting up the room with love Vereen. donated tablecloths in shades of and song. Jennifer Lopez then pink. Lush flower arrangements took control of the stage in a During the live auction one lucky with over 10,000 flowers flown fiery performance of “Let’s Get winner walked away with the in from Ecuador were created Loud”, which set the tone for stunning Mercedes-Benz 2011 by Fred Gibbons of Treefrogs, the evening of entertainment as CL63 AMG for $170,000. The who has served as the event’s each person in the room was live auction also included two exclusive florist since 1990. singing and dancing. American incredible trips courtesy of St. We also thank Angelica Huston R&B singer and songwriter Regis Hotels, one throughout for allowing us to use the Akon was next as he ruled the Europe and another to Hawaii sculptures of the late beloved stage, performing his hit songs and Tibet, with airfare to begin Robert Graham for the honoree “Angel” and “Sexy Chick.” The and end the trips donated by The Carousel of Hope awards, and Moët Hennessy Featured Performer, legendary American Airlines. USA, our exclusive spirits artist Gladys Knight’s grand sponsor. The evening was also finale had guests on their feet, generously supported by many swaying and singing with her corporations and leaders from to classics “Neither One of Us” the entertainment industry. and “Midnight Train to Georgia” leaving everyone euphorically The show began with Savannah wishing for more. Robinson’s a capella rendition of the “Star Spangled Banner.” Some of the many celebrated Tom Hanks and Rita Wilson guests included: Halle Berry, then introduced First Lady of Stevie Wonder, Adrien Brody, California, Maria Shriver, who Jackie Collins, Joan Collins was the recipient of the Brass

10 The Silent Auction, chaired by Dennis Hopper, Tony Bennett, Crystal Bowersox and many Nancy Davis and Dana Davis, Ross Bleckner, Nancy Ellison, more. was composed of nearly 450 Frank Gehry, LeRoy Neiman, items and included an Avjet trip Firooz Zahedi and many more. This year’s wonderful gift bags for 7 to Las Vegas or Monterey designed by GUESS?, included an on a Gulfstream 150 or Hawker Celebrities once again helped extraordinary array of generous 800XP. Other vacation spots in several ways, including gifts from GUESS? including included stays at The Resort MAKE LOVE NOT TRASH totes a scarf, eyewear, men’s and at Pelican Hill in Southern personally signed by Kenny women’s watches, also donations California, the Peninsula Hotel “Babyface” Edmonds, Selma from the Los Angeles Lakers’, in Hong Kong, Hotel Le Bristol Blair, George Clooney, Clint MAC, The Walt Disney Company, in Paris and the Grand Wailea Eastwood, Harrison Ford, Jackie Collins, Urban Behavior, Resort Hotel and Spa in Hawaii. Scarlett Johansson, Bill Maher, Tina Sinatra, Wen, Carita USA, Lavish dining experiences Julia Louis-Dreyfus, Mike Myers Decléor, Avjet, Amanda Dunbar, included: dinner for 20 in the and Ben Stiller. Handbags Bagatella Handbags, Beverly private dining room at Mr. Chow, for Hope was supported by Hills Plastic Surgery, Canvas Wolfgang Puck dinner for 12 at celebrities Shirley MacLaine, Pop, M Salon, OPI, Nubius CUT with wines; Il Piccolino; Maria Shriver, Kelly Preston, Organics, Raven Spa and the Toscana; Chateau Marmont; The Cindy Crawford, Angela Bassett, Ranch. French Laundry. Fashion items Candice Bergen, Carol Burnett, this year featured donations Joy Behar, Goldie Hawn, Jackie The Carousel of Hope has from many fashion icons such as Collins, Anjelica Huston, raised more than $75 million Donna Karan, Giorgio Armani, Julianne Moore, Thora Birch and since 1978 to critically combat Chanel, Monique Lhuillier, Oscar Joan van Ark who donated one the diabetes epidemic, which de la Renta, Fendi, Devi Kroell, of their special handbags and afflicts one in three babies born Saks Fifth Avenue, Neiman autographed key chains by Linea today. These essential funds are Marcus and more. Other Auction Pelle and Braggables. raised by Children’s Diabetes items included donations from Foundation to fund programs for home teams the LA Lakers, Brand new this year was Canvas more than 5,000 children and and LA Dodgers; jewelry from for the Cure, a project that adults who receive specialized Tiffany & Co. and Nancy Davis’ featured original miniature care for diabetes management Peace and Love; and the popular canvases painted by celebrities and prevention of complications Art Gallery with art donated by including art by John Travolta, and on reaching for the cure. Anjelica Huston, Josh Groban, leading contemporary artists 1. Barbara Davis such as Ed Ruscha, the late George Clooney, Cindy Crawford, Bill Maher, Penny Marshall, 2. Mavis & Jay Leno

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11 The carousel of hope diabetes symposium

he 2010 Carousel Peter Butler, MD, Professor of profit organization with the mission of Hope Diabetes Medicine, Chief of the Division of educating and motivating people Symposium, of Endocrinology, Diabetes and with diabetes to take a more active “Pathways for Hypertension and Director of role in their condition. t Future Treatment Larry Hillblom Islet Research and Management of Dabetes,” Center, University of California, Dr. George Eisenbarth, MD, addressed new insulin delivery Los Angles, CA PhD, Executive Director of systems including continuous Dr. Butler is a clinical investigator the Barbara Davis Center glucose monitoring. It also with clinical practice at UCLA for Childhood Diabetes and concentrated on new oral focusing on care of patients with Professor of Pediatrics, medications for type 2 diabetes diabetes and research focusing Medicine, and Immunology along with the emerging increase on abnormal insulin secretion, at the University of Colorado in obesity and type 2 diabetes in the causes of beta cell death School of Medicine, Aurora, CO children and young adults. The and the possibility to foster islet Dr. Eisenbarth first characterized Symposium assembled a group of regeneration in humans. type 1 diabetes while at Joslin as experts whose work engages with a chronic autoimmune disease that the multi-faceted challenges facing Steve Daniels, MD, PhD could be predicted prior to clinical the implementation of this new Chairman of the Department of symptoms. His immunogenetics 2010 Symposium technology to benefit of people Pediatrics at the University of lab investigates autoimmunity in with diabetes. Colorado School of Medicine, natural history studies, including Aurora, CO twins, and in the NOD mouse Jeffrey A. Bluestone, PhD, A.W. Dr. Daniels is a Pediatric with the goal of predicting and and Mary Margaret Clausen Cardiologist who has focused his preventing diabetes. He is received Distinguished Professor; former clinical work and research on ADA’s 2009 Banting Prize for Director of the Diabetes Center Preventive Cardiology. His interests Outstanding Lifetime Scientific at the University of California, include the effects of diabetes, Achievement. San Francisco at the University hypertension and obesity on the of California, San Francisco, CA cardiovascular system. Satish K. Garg, MD, MBBS, Dr. Bluestone established the DM, Director, Adult Clinic, UCSF/JDRF Center for Islet Steve Edelman, MD, Professor Barbara Davis Center, Professor Transplantation and serves of Medicine in the Division of Medicine and Pediatrics, on the California Institute of Endocrinology, Diabetes & University of Colorado Health for Regenerative Medicine Metabolism at the University of Sciences Center, Aurora, CO Diabetes Disease Team, as well California at San Diego (UCSD), Dr. Garg¹s research interests as comprehensive research CA and the Veterans Affairs (VA) include the early detection and and clinical programs aimed Healthcare System treatment of renal and retinal at marrying cutting-edge islet Dr. Edelman is also the founder complications of type 1 diabetes cell-specific stem cell biology and director of Taking Control of and the development of new with novel immunotherapies as a Your Diabetes (TCOYD), a not-for- diagnostic and therapeutic treatment for type 1 diabetes. 12 tools related to clinical diabetes Endocrinology Research Center Dr. Robert Slover, MD, Director 2010 Symposium management that include new at the Barbara Davis Center and of Pediatric Clinical Services, insulin analogs and glucose the JDRF-BDC Autoimmunity Barbara Davis Center, Aurora, CO sensors, etc. He currently Prevention Center. Dr. Slover is the Colorado principal serves as the Editor-in-Chief of investigator (PI) for the STAR 3 the Diabetes Technology and Marian Rewers, MD, PhD, study. STAR 3 is a randomized, Therapeutics Journal. Clinical Director, Barbara Davis multi-center two-arm study Center, Aurora, CO to compare the efficacy of the Matthias Hebrok, PhD, Dr. Rewers is Professor of MiniMed Paradigm REAL-Time Hurlbut-Johnson Distinguished Pediatrics and Preventive Medicine system versus multiple daily Professor in Diabetes Research, at the University of Colorado and injections (MDI). He has been Interim Director of the Diabetes is a pediatric diabetologist and involved in 12 research projects Center, University of California, an internationally-recognized as either PI or Co-PI, has 12 San Francisco, CA physician scientist. He has publications and has been invited Dr. Hebrok’s research focuses on made important contributions to over 35 speaking engagements. the understanding of how islets to our understanding of the of Langerhans, the endocrine etiology of type 1 diabetes and Phil Zeitler, MD, PhD, Professor component of the pancreas, are its macrovascular complications of Pediatrics and Clinical formed during organogenesis, how by creating large prospective Science at the University of their function is regulated in the cohort studies: DAISY, CACTI and Colorado Denver and Medical mature organism and how changes an international consortium, the Director of the Children¹s in gene expression might allow Environmental Determinants of Hospital Clinical Translational islet regeneration. Diabetes in the Young (TEDDY). Research Center of the Colorado Clinical Translational John C. Hutton, PhD, Research Jay S. Skyler, MD, MACP, Science Institute, Aurora, CO Director, Barbara Davis Center; Professor of Medicine, Dr. Zeitler is Attending Professor, Department of Pediatrics, & Psychology at the Endocrinologist at the Children¹s Pediatrics and Cellular and University of Miami, Miami, FL Hospital and the Barbara Davis Structural Biology, University of Dr. Skyler is Associate Director Center for Diabetes, where he is Colorado Denver, Aurora, CO for Academic Programs in the Director of the Type 2 Diabetes Dr. Hutton’s laboratory provides Diabetes Research Institute and and Metabolic Syndrome Clinic a strong training environment is Chairman of the NIH-sponsored and Director of the Pediatric in molecular cell biology, Type 1 Diabetes TrialNet, an Endocrinology Training Program. biochemistry and immunology international network conducting He currently serves as Study Chair emphasizing basic research clinical trials to prevent type 1 of TODAY, a national, NIH-funded, on insulin secretion and the diabetes or interdict the type 1 multi-center trial examining pathogenesis of type1 diabetes. diabetes disease process. treatment options for adolescents He heads the Diabetes and with type 2 diabetes and TODAY Genetics Study. 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.

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

ype 1 diabetes during 48% of nights following in the two above studies. He is one of the a day when the children had found that discontinuation of most common exercised, and on 28% of nights the insulin during exercise and chronic diseases when the same youth spent administration of half of the T in children. the night in the hospital after usual insulin for 45 minutes Unfortunately, the fear of low a day without exercise. This after the exercise, followed by a blood sugars (hypoglycemia) was published in the Journal of 20% reduction of basal insulin prevents many families from Pediatrics 147: 5 28, 2005. from 9pm to 3am essentially achieving good control of the prevented low nighttime blood diabetes. Hypoglycemia is An important second study sugars. As these changes in scary, and when severe can focused on preventing the insulin delivery are only possible result in seizures or unconscious low blood sugars during the for youth using an insulin episodes. Although exercise is afternoon exercise session. pump, the administration of a recommended for all youth with Youth using an insulin pump medicine , terbutaline, was also regular diabetes, hypoglycemia turned off the pump (no insulin) studied. This can be used by during or after exercise is one during the 60 minutes of youth using injections and not of the most frequently identified exercise and for 45 minutes using an insulin pump. This specific causes of severe after the exercise. Low blood medicine prevented low blood hypoglycemia. sugars were approximately 1/3 sugars at night but caused blood as common when the insulin was sugar levels to be too high. Three landmark studies in the discontinued (16% of children) Further studies will be needed CTRC (Clinical Translational as on another day when insulin to determine the correct dose of Research Center) at Children’s was continued for the same terbutaline. Hospital have been important youth (48% low). This was in making exercise safe for published in Diabetes Care 29, In summary, knowledge from children with Type 1 diabetes. 2006. these three landmark studies, The first two studies have been all done in collaboration with performed as part of a working In a third study (currently in The Children’s Hospital and group (DirecNet) of pediatric press: Journal of Pediatrics), the Barbara Davis Center for endocrinologists at the Barbara Dr. Craig Taplin (a 3rd year Childhood Diabetes, should help Davis Center/Denver Children’s Endocrine-Diabetes fellow to make life safer and easier for Hospital, Yale University, at The Children’s Hospital/ the 3,000 children with Type 1 Stanford University, Nemour’s Barbara Davis Center studied diabetes followed at the Center, Children’s Hospital in Florida, methods to prevent the delayed as well as for the millions of and the University of Iowa with low blood sugars during the children with diabetes around coordination by the JAEB Center night. The same afternoon the world. for Health Research in Tampa, Fl. exercise program was used as Barbara Davis Center An initial study developed the 60 minute treadmill methodology important websites used in all later studies. The Children’s Diabetes Foundation initial study found that during www.ChildrensDiabetesFoundation.org the exercise, one out of four of the children had blood sugar Barbara Davis Center for Childhood Diabetes levels below 60 mg/dL and half www.BarbaraDavisCenter.org of the children had values below Juvenile Diabetes Research Foundation 70 mg/dL. The children stayed www.jdrf.org in Children’s Hospital overnight to study the incidence of American Diabetes Association delayed nocturnal hypoglycemia www.diabetes.org (low blood sugar levels). Surprisingly, lows occurred Children with Diabetes www.ChildrenwithDiabetes.com

14 Barbara Davis Center Taming the needle fearfulness is nonetheless If changing technique doesn’t very important to address. It is work and your child has some Shot Monster important to know that anxiety of the following symptoms, then — Rita Trujillo Hughes, LCSW, CDE, about shots is mediated by a consulting one of the clinical Clinical Social Worker real biological response. The social workers on the team physical symptoms are real. might help. Even when kids ust a minute...” Queasy stomach, sweaty palms, don’t complain of anxiety or “I have to go shaky hands, and pounding painful shots, these behaviors do something hearts are not uncommon. suggest that we may need to look first....” “You’re a little closer: J mean!” “I HATE Sometimes, pain with shots SHOTS!” triggers anxiety that can lead * Your child stalls around shots to difficulties with injections. or has elaborate rituals about Sound familiar? Are shots or Incorrect injection technique how they should be done. set changes at your house a may be causing some pain. struggle and a battle? You are Though we know that shots * Takes a long time to actually certainly not alone. Preliminary aren’t going to be absolutely do the injection or “hunts and study suggests that perhaps painless 100% of the time, pecks” looking for just the right a third of all children, teens with proper preparation and spot. and adults have some degree technique, shots should be of needle anxiety that makes relatively pain free most of the * Refuses to rotate sites and has injections a challenge. However, time. Shots ought to feel like a a favorite spot that usually ends the majority of these kids don’t small pinch (at least that’s what up puffy from overuse. necessarily say that shots we strive for). Cold insulin and hurt. Their behavior tells us so. some types of insulin might be * Demands control and refuses Needle fears range in degree contributing to discomfort and help with injections from anyone, from mild to severe. True these are issues that your nurse even when help from a parent needle phobia (where the level educator can review with you has been recommended by the of anxiety is so heightened that and make suggestions that might doctor. people might faint at the sight of make a real difference. a syringe) is less common, but * “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.

Photo: © Janssen Photography 15 Needle Anxiety (Fear Sometimes a person with they do not “cure” it. Behavioral diabetes doesn’t get over their techniques include learning of shots) stress about shots. A few to relax, reward programs, It is now known that needle symptoms that might indicate systematic desensitization and anxiety of some degree occurs in this is going on are; biofeedback. As fear of shots, almost everyone. Children and blood or injury decreases, the adults have worries about shots. F persistently high HbA1c HbA1c usually improves. In a person with diabetes, we used to assume that this anxiety F a child wanting to do all their The first step in making shots would just go away because they own shots - particularly when easier is identifying when kids had to have shots every day. We they want to do the shot in a are having more anxiety than now know that needle anxiety, if room by themselves (some shots they should. If you feel shots strong, doesn’t “just go away”. will probably be missed) have been too much of a battle There are some things that can around your house lately, you be learned to reduce this anxiety F lack of site rotation might mention that at your next if we identify it is a problem. (hypertrophy, or hard tissue at visit and we’ll see how we can the injection site) help. First of all, anxiety about shots is normal. When we F missed insulin shots fear something, we get tense and hold our breath. Our head F excuses for wanting to “put is filled with thoughts about off” the shot (stalling) pain. Parents, who have to give these shots, can be just as F parental fear or worry about needle anxious as their child. injections or blood draws Remember, that the syringes that are now used for insulin are The psychosocial member of much smaller and have shorter the team can be very helpful to needles so that shots are much children or parents with sorting more comfortable these days. out this problem. Treatment can With a few easy techniques, include behavioral techniques shots can be less stressful. and purposeful distraction. The The diabetes educators in our latter includes TV, music, toys, clinic always have parents blowing bubbles and books. or significant others practice Sometimes injection devices help injections on each other using the problem (Inject-Ease) though saline solution. The practice nearly always reassures them that giving insulin injections to their child is not the trauma they image.

Barbara Davis Center 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 Photos: © kentmeireisphotography.com 16 Photo: © Janssen Photography Barbara Davis Center Taking Research at the BDC and the Children’s Hospital, put together Diabetes an impressive roster with the to School following BDC clinical staff: Conference Physicians: H. Peter Chase, MD — Regina Reece George Eisenbarth, MD, PhD he Barbara Davis Rosanna Fiallo-Scharer, MD Center for Robert Slover, MD Childhood Diabetes held Nurse Practitioner: t its annual, “Taking Stephanie Kassels, DNP(c), FNP- Diabetes to School” conference BC, CDE on Friday, October 15th at the Nighthorse Campbell Native Nurses: Health Building, located at the Georgia Koch, RN, BSN, CDE CU Anschutz Medical campus. Laurel Messer, RN, MPH, CDE, This program was staffed by the Sarah Morey, RN, BSN BDC Pediatric Clinic as well as Susie Owen, RN, CDE Michelle Passamaneck of ADA, Kathy Smith, RN, BSN, CDE Kathleen Patrick of Colorado Sally Sullivan, RN, CDE Department of Education and Amy Graciela Tellez, RN Reeves of Medtronic Diabetes. Libbie Tuthill, RN, BSN, CDE

There were 90 attendees LILLY Social Workers: ranging from clinic aids to CONFeRENCE Lisa Meyers, LCSW, CDE school principals who enjoyed Dana Shepard, LCSW an information packed day — Regina Reece Rita Trujillo Hughes, LCSW, CDE where topics included: What Type 1 Diabetes Experience- is Diabetes, Psych-Social Based Learning Program Dietitians Issues, Nutrition Management, Loise Gilmer, MD, RD, CDE he Barbara Davis School Health Plans, and the Gail Spiegel, MS, RD, CDE Importance of a School Nurse. Center for Childhood Participants also attended a Diabetes (BDC) There were also hands-on breakout session that provided hosted the “Type workshops in the afternoon that T the opportunity to have hands 1 Diabetes Experience-Based covered the following areas: on experience with essential Learning Program” for Lilly USA, Pumps and Sensors, How to diabetes care tasks that families LLC (a company that develops, Handle High and Low Blood need to master in order to safely manufactures, markets and Glucose Levels and training on manage diabetes at home. These sells pharmaceutical and animal various blood glucose monitors tasks included insulin injections, health products). and on how to use syringes and blood glucose monitoring insulin pens on pediatric patients. and recognition of mild and This two day program held moderate hypoglycemia as on October 19-20, 2010 was A special appreciation is well as the treatment of severe designed to aid the Lilly team of expressed to the following hypoglycemia with glucagon. supporters who made this 50 individuals from the basics of, “What is Diabetes?” to the program possible: Abbott We also had a unique most current technology in the Diabetes Care, American Diabetes opportunity to present a patient diabetes realm such as using Association, Animas Corporation, and parent panel session where Continuous Glucose Monitoring BD, the Children’s Diabetes case scenarios were given, as devices (CGMs). Foundation, the Colorado well as have a question and Department of Education, The answer session during this time. Guild of the Children’s Diabetes Conference Director: Georgeanna Klingensmith, MD, Foundation, Lilly USA, LLC, The BDC is looking forward to Director of Pediatric Clinical Medtronic Diabetes, Novo offering this program with Lilly Care and Translational Clinical Nordisk, Inc. and sanofi-aventis. in 2011. 17 Dr. Slover named new director of pediatric services — Marian Rewers, MD, PhD, Clinical Director for Barbara Davis Center for Childhood Diabetes

e are proud to announce great news on the search for the W 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 Photo: © Martin Crabb past five years, he has served as closely with our TCH-based 1994. More recently, Georgeanna the Deputy Director of Pediatric colleagues and with multiple has been instrumental to Diabetes Services. His research children’s services to optimize establishing excellent Pediatric interests include Continuous our efforts for the benefit of Diabetes Services on the Glucose Monitoring, artificial children and young adults with campus. The clinic volume pancreas, Cystic Fibrosis related diabetes. We congratulate Dr. has quadrupled under her Barbara Davis Center diabetes and transition care, Slover in his selection for this watch and so has the staff and among many others. Rob is important leadership position. funding. I’m happy to tell you an outstanding clinician and that Georgeanna is staying at educator. On behalf of the Barbara the BDC and agreed to continue Davis Center and Children’s many of her current activities, One of the main tasks facing Diabetes Foundation, we would including patient care, teaching, Rob and all of us is to further like to thank Dr. Georgeanna leading the T32 training grant strengthen our collaboration Klingensmith for 17 years of and working as the principal with Children’s Hospital, her outstanding service as investigator on several studies, Denver’s increasing patient load, the Director. Georgeanna has e.g., PDC and Exchange. both ambulatory and inpatients, chaperoned the Service through and with increasing complexity challenging times. First, she led Marian Rewers, MD, PhD, Professor, of diabetes care. the consolidation of outpatient Pediatrics & Preventive Medicine, Clinical Director, Barbara Davis Center diabetes services at the BDC in We look forward to working for Childhood Diabetes.

18 Barbara Davis Center Barbara Davis Center at fitzsimons donor wall s your child a patient at the Barbara Davis donor wall form Center? Are you a I patient at the Name ______Barbara Davis Center? Do Address ______you have a special interest in diabetes? This is an opportunity City ______State ______Zip______for you, your family and your Home phone ______Work phone ______friends to have a presence at the Cell phone ______E-mail ______Center by purchasing a place on the donor wall, or naming rights Amount $______on a room — a lasting symbol ______of your support. Help Us Catch (Name as you wish it to appear on donor wall) the Brass Ring — a Cure for Diabetes. Levels 1, 2 and 3 will Make check payable to Children’s Diabetes Foundation or also be entitled to naming rights q Visa q Mastercard q American Express on a room at the Barbara Davis Center. For information call Name on card ______Chrissy at 303-863-1200. Card # ______

Funding Mail payment to: Opportunities: Children’s Diabetes Foundation — Donor Wall 777 Grant St., Ste. 302 Level 1 Denver, CO 80203 $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

Photo: © Steve Groer Photography 19 Photo: © Martin Crabb QUESTIONS AND ANSWERS — H. Peter Chase, MD

What is the main cause of low-blood sugar seizures Q: in youth and can they be prevented?

Preceding exercise is described as the main A: 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 of the intestine. When children Many children do not have exercise (sometimes beginning have severe celiac disease symptoms of celiac disease even 30 minutes before), and an 80% associated with weight loss and though they have antibodies temporary basal rate from 9 p.m. diarrhea, avoiding gluten usually in the blood. High levels of to 3 a.m. The use of a continuous makes the symptoms go away antibodies usually indicate that glucose monitor (CGM) with and allows the child to grow there is damage to the intestine, alarms for lows can also be very normally. Nowadays we screen and in general we recommend helpful in prevention. for celiac disease with a simple biopsy only when the antibody blood test for an antibody that levels are high, unless there are My doctor has appears in the blood, termed also celiac disease symptoms. found my child transglutaminase. If high levels In many children without to have high of the antibody are found, we symptoms with high levels of transglutaminase recommend a biopsy to confirm the antibody there is severe Q: antibodies the diagnosis, as celiac disease damage to the intestine. It is that are associated with celiac is a life-long diagnosis and no remarkable, but even with severe disease. Does my child need single test is diagnostic. The damage, with a gluten free diet to have an intestinal biopsy biopsy is usually done with the intestine can grow back and before considering a gluten anesthesia so the child is not be normal as long as gluten free diet? conscious for the procedure. A is avoided. In general with a tube with a camera is swallowed diagnosis of celiac disease we — From Dr. George Eisenbarth, MD, PhD and at the first part of the small recommend life-long avoidance

Questions and Answers intestine several pieces of the of gluten. It is very important Children with intestine are taken through the to have a firm diagnosis for type 1 diabetes swallowed tube, each about the people with symptoms or are at higher size of a pencil tip. The biopsy high levels of antibodies, and risk for celiac is then analyzed by the doctors thus the recommendation for A: disease, an under a microscope to confirm confirmation through a biopsy. illness in which gluten in the diet a diagnosis of celiac disease from a number of sources (e.g. and determine the amount of wheat) causes the body’s immune intestinal damage, if any. system to attack the inner wall

20 Carousel Days Chills and Thrills for halloween

reative juices ^ were flowing^ at The Guild’s 27th Annual C 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.

21 UNDER 2nd Edition ST ANDING INSULIN PUMPS AND CONTINUOUS GL

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

•

For additional copies of this publication contact: Children’s Diabetes Foundation UCOSE MONIT

43 777 Grant Street, Suite 302 12: Denver, CO 80203 Phone: 303-863-1200 or 800-695-2873 Fax: 303-863-1122 www.ChildrensDiabetesFoundation.org

www.pinkpanther.com S 2nd Edition

Book ORDER FORM Name ______

Address ______

City/State/Zip ______

Phone (Day) ______Phone (Eve) ______E-mail ______

th Foundation News Understanding Diabetes 11 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 Foundation News UNDER 2nd Edition NOW AVAILABLE

ST nd ANDING INSULIN PUMPS AND CONTINUOUS GL 2 edition – Understanding Insulin by H. Peter Chase, MD & Laurel Messer, RN, MPH, CDE Pumps and Continuous Glucose Monitors (CGMs)

— H. Peter Chase, MD and Laurel Messer, RN, MPH, CDE

THE ONLY BOOK AVAILABLE FOR PATIENTS

• WITH DIABETES COVERNG BOTH INSULIN PUMPS AND CONTINUOUS GLUCOSE

For additional copies of this publication contact: Children’s Diabetes Foundation UCOSE MONIT

12:43 MONITORS (CGMs) 777 Grant Street, Suite 302 Denver, CO 80203 Phone: 303-863-1200 or 800-695-2873 Fax: 303-863-1122 www.ChildrensDiabetesFoundation.org The field of insulin pumps and CGMs is moving so rapidly that The Pink Panther™ & ©1964-2010 Metro-Goldwyn-Mayer Studios Inc. OR All Rights Reserved the need for a second edition of this book was imperative. All

www.pinkpanther.com S 2nd Edition 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.

• 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

23 Photo from 2006 Carousel Ball Journal Photo: © 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: © kentmeireisphotography.com Foundation News REACHING FOR THE BRASS RING A CAMPAIGN TO CURE DIABETES very day in for children and adults with The BDC’s world-renowned America 35 type 1 diabetes. Your donations clinical and research programs children are to our annual REACHING FOR include stem cell and islet cell diagnosed with THE BRASS RING: A CAMPAIGN transplant research, and testing E type 1 diabetes -- FOR THE CURE support for genetic and immunologic risk more than one child every hour. Children’s Diabetes Foundation’s of diabetes. Trials continue on Of the 24 million Americans commitment to give all BDC a variety of agents, including now afflicted with diabetes, two patients the same high quality a new vaccine trial to prevent million have the most severe care. No child is turned away. diabetes in those children most form, type 1, and need insulin Insulin, supplies and clinic visits genetically at-risk. to survive. But insulin is not a can cost up to $800 or more a cure. Everyone with diabetes month -- a financial burden for Please, help us catch the needs our help to end the any family, impossible for the brass ring by supporting our epidemic, and every donation uninsured and impoverished. CAMPAIGN FOR THE CURE. counts. Through your gifts we provide When you help children with treatment and supplies to nearly diabetes you empower them to The Barbara Davis Center for 30% of the BDC’s patients who create a better future for all. Childhood Diabetes (BDC) is otherwise could not afford it. the leading worldwide center

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. 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.

July 17-20, 2010 keystone resort and conference center ore than 400 healthcare providers from all over M 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 GUEST SPEAKERS: Aaron Kowalski, PhD, Program Center for Childhood Diabetes Manager, Metabolic Protocol/ and Georgeanna Klingensmith, H. Peter Chase, MD, Professor Research Director, Artificial Chief of the Pediatric Clinic of Pediatrics, Barbara Davis Pancreas Project, Juvenile at the BDC put together an Center for Childhood Diabetes, Diabetes Research Foundation, outstanding roster of renowned Professor of Pediatrics, New York, NY. diabetes educators, who along University of Colorado Denver, with BDC healthcare staff, Aurora, CO. Johnny L. Ludvigsson, MD, provided participants with PhD, Professor of Pediatrics, essential information facing Ron Gill, PhD, Professor Head Physician, Division of Foundation News today’s healthcare providers. and Research Director of Pediatrics, Linkoping, University the Transplantation Institute Hospital, Sweden. Industry sponsored dinners Colorado, Aurora, CO. featured: Lilly USA, LLC (Guest Henry Rodriguez, MD, Speaker: Dr. Henry Rodriguez), Peter Gottlieb, MD, Associate Associate Professor of Novo Nordisk (Guest Speaker: Professor of Pediatrics at Pediatrics, James Whitcomb Dr. Asheesh Dewan) and the Barbara Davis Center for Riley Hospital for Children, Medtronic Diabetes (Guest Childhood Diabetes, Aurora, CO Indianapolis, IN. Speaker: Dr. Fran Kaufman). Irl Hirsch, MD, Professor Gary Scheiner, MS, CDE, Special thanks to the following of Medicine, University of Integrated Diabetes Services, Guest Speakers and Sponsors/ Washington, School of Medicine, Wynnewood, PA. Exhibitors for participating Seattle, WA. in and providing financial Grace Shih, RD, Packard assistance for this year’s Lois Jovanovic, MD, Director of Children’s Hospital, Stanford conference: the Samsun Research Institute, Medical Center, Palo Alto, CA. Santa Barbara, CA. Jay S. Skyler, MD, Professor David M. Kendall, MD, Chief of Medicine, Pediatrics & Scientific & Medical Officer, Psychology, Associate Director, American Diabetes Association, Diabetes Research Institute, Alexandria, VA. University of Miami, Miller School of Medicine, Miami, FL.

26 Foundation News William V. Tamborlane, MD, Photo: © Vail Resorts Professor and Chief of Pediatric Endocrinology, Yale School of Medicine, New Haven, CT.

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 Save the Date! Medtronic Diabetes Keystone Conference Novo Nordisk, Inc. 4th Biennial SILVER “PRACTICAL WAYS TO ACHIEVE Abbott Diabetes Care, Inc. TARGETS IN DIABETES CARE” BD Medical/Diabetes Care Friday, July 15, 2011 thru BRASS Saturday July 17, 2011 Animas Corporation Designed to help health care providers caring for Athena Diagnostics, Inc. adolescents and adults with diabetes, Cumberland Hospital for Children and Adolescents Check the Children’s Diabetes and Barbara Davis Center web sites Diamyd Medical in January 2011 for more information. Insulet Corporation www.ChildrensDiabetesFoundation.org LifeScan, Inc. www.BarbaraDavisCenter.org Roche Diagnostics -

27 McDonald Automotive Carousel classic a wynn/win Save the

inety avid golfers sponsors including McDonald Date! and a handful of Automotive, Lockton Companies, dedicated Affinity Video, Berco Resources volunteers LLC and Interstate Restorations. N assembled at We would also like to thank the crack of dawn at Signature our support crew at Frontier Aviation on November 4th to Airlines, The Wynn Hotel, AWG, fly away to Las Vegas to Play Whatzhotnow Catering, everyone for the Cure at the McDonald at the Signature Hanger and Automotive Carousel Classic to all of our golfers. It was a benefit the Children’s Diabetes successful tournament and it What: Foundation. A charter Frontier wouldn’t have been possible High Hopes Carousel Ball jet flew the festive group to without you! This was The October 1, 2011 The Wynn where they played Carousel Classic’s first year on the fabulous Wynn course, for the Children’s Diabetes What: and stayed overnight to enjoy Foundation. Plans are already 2011 Carousel Classic the Vegas scene while netting underway for 2011 with the Sanctuary Golf Course $223,000 to help fund research June 29th event at Sanctuary June 29th, 2011 at the Barbara Davis Center Golf Course and the fly-away for Childhood Diabetes. Led again at The Wynn early next What: by Michael McDonald and Dan November. Rave reviews are The Guild’s High Hopes Fuller who share a personal still coming in proclaiming The Golf Tournament interest in eradicating diabetes, Carousel Classic a solid gold Glenmoor Country Club this event followed the winner! July 18th, 2011 HealthOne Carousel Classic held in June at the Cherry Creek For further information or to What: Country Club. The combined register for the 2011 events Keystone Conference 4th events grossed an astounding which are sure to sell out, biennial “Practical Ways to $386,000. We would like to contact Amy Cockerham at Achieve Targets in officially thank our fly-away 303-863-1200. Diabetes Care” July 15-17th, 2011 Foundation News

28 Guild Guide CHARLOTTE Baubles, Bangles and Beads TUCKER If a Bead or a Pearl, a piece of Gold or Silver SCHOLARSHIP Would help toward a cure… OPPORTUNITIES Would you give from your jewelry drawer FOR 2011-2012 To raise money to find a cure. he Guild of the Children’s We have started Jewels for Hope Diabetes To help save our true ‘Jewels’ Foundation T is always proud Children who live with Diabetes to award scholarships to high We are asking you to give a piece of jewelry school seniors and college students who are current Real or costume, it does not matter, patients at the Barbara Davis Center. The scholarship program Someone else will treasure it knowing was established in memory of It will help us toward a cure. past Guild President, Charlotte Tucker, who encouraged young Now won’t you reach into your Jewelry Drawer? people from the Barbara Davis Center to follow higher career — by Gretchen Pope and educational pursuits. To donate contact Susie Hummell at 303-863-1200. Applications for 2011-2012 will be available in February 2011. Patients who are college 2011 Annual or trade school bound will be Guild meeting notified regarding applications in February 2011. If you don’t officers receive information or have Monday, January 10, 2011 2010 Guild Officers questions, please call Susie Denver Country Club Hummell at the CDF office after President: th 1700 East 1st Avenue February 14 , 2010 at Judy McNeil 303-628-5109 or 800-695-2873. Denver, CO President-Elect: Gina Abou-Jaoude Coffee 9:30 a.m. Recording Secretary: GUILD MISSION Jennifer Barrow Meeting 10:00 a.m. Brunch will be served STATEMENT Treasure: Annie Cotton following meeting and The Guild of the Children’s Diabetes program. Treasurer-Elect: Foundation at Denver raises funds for clinical Gleneen Brienza Reservation: $35.00 and research programs for the Barbara Davis Corresponding Secretary: Please make your reservation for Center for Childhood Diabetes. The Guild Shelley Lucas the brunch by sending a check to: promotes diabetes awareness and education; Immediate Past President: Children’s Diabetes Foundation assists families in need; provides continuing Sharon Kamen Attn: Susie Hummell education scholarships and sponsors social 777 Grant St., Ste. 302 activities for children and their families. Advisors: Denver, CO 80203 Sandy Burfitt Kathy Crapo To pay by credit card, please call Marty Jensen Susie at 303-628-5109 or e-mail at Gail Johnson [email protected] å

29 Kids helping kids Photo: © kentmeireisphotography.comA Prayer hank you Aspen Academy students, faculty and Harrison Fuller for T 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.

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!

Winner’s Circle Winner’s 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 Cooks Corner

Chocolaty Pumpkin Bars — Makes 30 bars Ingredients 1 cup all-purpose flour 1 cup whole wheat flour 1 cup pecans, very finely chopped 3/4 cup granulated sugar 2 teaspoons baking powder 1 teaspoon ground cinnamon 1/2 teaspoon baking soda 1/2 teaspoon salt 4 large eggs, beaten 1 15-ounce can 100% pure pumpkin 1/2 cup canola oil 1/4 cup 1% low-fat milk 1/2 cup mini semi-sweet chocolate chips 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 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 What’s The SUGAR ALCOHOLS National Institutes of Health removed saccharin from the list Sugar alcohols include sorbitol, Scoop on of carcinogens and Congress mannitol, xylitol, erythritol, removed the requirement for Sweeteners? isomalt and hydrogenated starch warning notices. Studies of hydrolysates as well as others. — Gail Spiegel MS RD CDE high users do not support an Most sugar alcohols provide association between saccharin approximately 8 calories and he following is an and cancer. Saccharin can be 2 grams of carbohydrates per update on the found in Sweet’N Low®, Sweet teaspoon. Sugar alcohols are sweeteners that Twin® and other tabletop absorbed more slowly than sugar are currently sweeteners as well as fountain and eating an excessive amount T approved by the drinks. The amount of saccharin can cause diarrhea. Xylitol is food and Drug Administration in each product is limited and found in a sweetener named (FDA) and available on the must be printed on the label. Ideal Sweetener. Sugar alcohols market. The Barbara Davis are found in such products as Center does not endorse or ACESULFAME-K (ACE-K) sugar free candies, chewing condemn any certain product. Ace-K is 200 times sweeter gum, and baked goods such as than sugar. This sweetener is cookies. Despite being labeled Sweeteners can be divided into not metabolized by the body “sugar free” these products still two groups based on the calories either and therefore provides no contain carbohydrates and will they provide. These two groups calories or carbohydrates. It has cause a rise in blood sugars. are nutritive (contain calories) been approved by the FDA since Erythritol is much lower in and non-nutritive sweeteners (do 1988. It is approved for use as calories and carbohydrates than not contain calories). a general-purpose sweetener the others and may not cause and is used in more than 80 a rise in blood sugars. Be sure NUTRITIVE SWEETENERS countries. Ace-K does not break to check the nutrition facts on down when heated and can be Nutritive sweeteners provide the label to determine total used in cooking and baking. It calories and carbohydrates and carbohydrate content. Nutrition News include two types of sweeteners is currently used in sugar free that are commonly used: sugars, NON-NUTRITIVE SWEETENERS ice creams and many sugar free or diet beverages, often times in sugar alcohols. Non-nutritive sweeteners do combination with sucralose or not provide any calories or aspartame. SUGARS carbohydrates. There are currently five non-nutritive, Sugar sweeteners include ASPARTAME artificial sweeteners approved sucrose (table sugar), fructose, Aspartame is also 200 by the FDA. They are saccharin, honey, high fructose corn syrup times sweeter than sugar. acesulfame-K, aspartame, as well as others. Sucrose and Aspartame is broken down into sucralose and neotame. In fructose are the primary sugar aspartic acid, methanol, and addition, Stevia, a natural sweeteners that occur naturally phenylalanine by the digestive sweetener does not provide in the food supply or are added process. The amino acids calories or carbohydrates. as sugars in corn sweeteners phenylalanine and aspartic acid and syrups. Sugar sweeteners SACCHARIN are metabolized to provide four provide 16 calories and 4 grams calories per gram. Because Saccharin is 200-700 times of carbohydrate per teaspoon. this sweetener is very intense sweeter than sugar. It provides and we use it in such small Agave nectar, which has recently no calories or carbohydrates amounts, it provides no calories. become popular, is a syrup that and is not metabolized by our Aspartame has been approved by is refined from a cactus-like bodies. It is approved for the FDA since 1981. It has been plant. Agave nectar is made of use in 100 countries, but has deemed safe by major health fructose and glucose. Agave is been controversial here in the groups and agencies in over 90 140 – 160 times sweeter than United States. Questions about countries, including the World sugar. One teaspoon provides saccharin’s safety first began in Health Organization and the 20 calories and 5 grams of 1977 when studies suggested it American Medical Association. carbohydrate. caused bladder tumors in rats. It is currently approved for use Saccharin used to carry a warning as a general-purpose sweetener on the label, but in 2000 the in all foods and beverages. It

32 Nutrition News breaks down when heated and than aspartame and 7,000- but the carbohydrates are not does not work well in cooking 13,000 times sweeter than digested or absorbed by the body and baking. This sweetener is in sugar. It can be used in baking according to the company so many products. Some commonly and cooking. As of the writing they do not affect blood sugar. used products that contain of this review, neotame was not Purevia™ contains 2 grams of aspartame are as follows: Equal, found in any products on the total carbohydrate per packet. NutraSweet, NatraTaste, diet market. Sun Crystals™ is a low sugar sodas, sugar free JELL-O, light sweetener that is part stevia and STEVIA yogurts, powdered soft drinks, part sucrose (table sugar). sugar free ice cream. This is a natural sweetener from Today, there are more the stevia rebaudiana plant Aspartame has caused the most alternatives than ever for found in South America. Stevia controversy and appears to people with diabetes. Food rebaudiana is an herb that is receive more media attention manufacturers are using new 300 times sweeter than sugar. about its safety than any other sweeteners and combining Stevia contains no calories or sweetener. Studies have sweeteners to improve the carbohydrates and does not not found any link between taste and mouthfeel of sugar- affect blood glucose. Stevia aspartame and diseases like free and low-sugar foods and has been sold in the US in the Alzheimer’s or multiple sclerosis. beverages. Plus, sucrose is no supplement aisle for many Research has not found that longer restricted from the diet years, but in 2008, the FDA aspartame leads to an increased and can be included within the recognized a part of the stevia risk of cancer either. The only context of a healthy diet. For plant, known as Rebiana or negative effects that aspartame those who count carbohydrates, Reb A, as safe for use in food has been shown to cause in a foods containing sugar can products. You can buy stevia in few small research studies is be substituted for other granular and liquid forms from worsening migraines for some carbohydrates in the meal plan grocery and health food stores patients. or extra insulin can be given. for use in drinks, cooking and When it comes to sweeteners, baking. Brand names for stevia SUCRALOSE each family needs to decide what include Truvia™ and PureVia™. works best for them. Sucralose was approved by Truvia™ contains 3 grams the FDA in April 1998 for of carbohydrates per packet, 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. 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 What’s Considered Safe?

Sugar Substitute Recommended or Acceptable Product Daily Intake (ADI)* equivalents

Saccharin 5 mg/kg** body weight 3 packets of For 23 kg (50 lb.) child Sweet ‘N Low

Aspartame ADI = 50 mg/kg of body weight 33 packets of For 23 kg (50 lb.) child 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

Nutrition News 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. r

34 Executive Board: Brian Kotzin, M.D. Mr. George Schlatter Mrs. Barbara Davis, Chairman Vice President, Global Clinical Development, Amgen, Inc. The Honorable Arnold Schwarzenegger, Thousand Oaks, California Governor of California, and Ms. Maria Shriver Richard S. Abrams, M.D. Aké Lernmark, M.D., Ph.D. Mr. Steven Spielberg and Ms. Kate Capshaw Jules Amer, M.D. Robert H. William Professor, Department of Medicine, University Miss Joan van Ark Honorary Lifetime Member of Washington School of Medicine, Seattle Ms. Barbera Thornhill Mr. Peter Culshaw Ali Naji, M.D., Ph.D. Mr. Gary L. Wilson Stephen Daniels, M.D., Ph.D. J. William White Professor of Surgery, Mr. Stevie Wonder Hospital of University of Pennsylvania, Philadelphia Chairman of Pediatrics, The Children’s Hospital, Denver Advisory Board, The Guild Presidents: Ms. Dana Davis Gerald Nepom, M.D., Ph.D. Founding President, Amy Davis Scientific Director and Director of Immunology and Diabetes Mrs. Jamie Angelich Mrs. Nancy Davis Rickel Research Programs, Virginia Mason Research Center, Seattle Mrs. Karen Aylsworth Steven Farber, Esq. William V. Tamborlane, M.D. Mrs. Linda Broughton Richard F. Hamman, M.D., DrPH Professor of Pediatrics, Yale University School of Medicine, New Mrs. Joy Burns Haven, Connecticut University of Colorado Denver School of Medicine Dr. Bonita Carson Dean, Colorado School of Public Health Advisory Board: Mrs. Nancy Cowee Mrs. Arlene Hirschfeld Mr. Michael Bolton Mrs. Norma D’Amico Mrs. Deidre Hunter Sir Michael Caine Miss Donna Douglas Ms. Natalie Cole Mr. Shawn Hunter Mrs. Margy Epke Mr. and Mrs. Robert A. Daly Mrs. Chris Foster M. Douglas Jones, Jr., M.D. The Honorable Diana DeGette, Mrs. Helenn Franzgrote Richard D. Krugman, M.D. U.S. House of Representatives, Colorado Mrs. Sally Frerichs Dean, School of Medicine, University of Colorado Denver Mr. Neil Diamond Mrs. Debbie Gradishar Stacy Mendelson Robinson Mr. Placido Domingo Mrs. Helen Hanks Mrs. Gerald R. Ford Ex-officio Member: Mrs. Marty Jensen George S. Eisenbarth, M.D., Ph.D. Executive Director, Mr. David Foster Mrs. Gail Johnson Barbara Davis Center for Childhood Diabetes, University Mr. Kenny G Mrs. Sharon Kamen of Colorado Denver; Professor of Pediatrics and Medicine, Mr. David Geffen Mrs. Janet Knisely University of Colorado School of Medicine Ms. Whitney Houston Mrs. Suzy Love Scientific Advisory Board: Mr. Quincy Jones Mrs. Sally Newcomb Ms. Sherry Lansing Richard S. Abrams, M.D. Mrs. Gretchen Pope Associate Clinical Professor of Medicine, University of Colorado Mr. Jay Leno Mrs. Carol Roger School of Medicine; Rose Medical Center, Denver Mr. Paul Marciano Mrs. Kay Stewart Mr. Mo Ostin Jules Amer, M.D. Mrs. Diane Sweat Clinical Professor of Pediatrics, University of Colorado School of The Honorable and Mrs. Bill Ritter, Mrs. Melissa Tucker Medicine; Partner, Children¹s Medical Center, Denver Governor and First Lady of Colorado Mrs. Loretta Tucker Sir Sidney Poitier M. Douglas Jones, Jr., M.D. Mrs. Jane Weingarten Mrs. Ronald Reagan Professor, Department of Pediatrics, University of Colorado Mr. Lionel Richie Foundation: School of Medicine; Section of Neonatology, The Children¹s Christine Lerner, Executive Director Hospital, Denver Mrs. Adrienne Ruston Fitzgibbons

A child reaching for the brass NEWSNOTES is published twice ring on a carousel is symbolic of yearly by the Children’s Diabetes eeeeeethe most important goal of eeeethe ee Foundation at Denver. We The Brass Children’s Diabetes Foundation welcome your comments. — The cure. Your contribution If you would like to submit an on behalf of a loved one will article or a letter to Newsnotes make a difference. It will support Ring Fund send information to: treatment programs to assist Children’s Diabetes children with diabetes in leading Remember a loved one –– Foundation at Denver healthier lives and it will fund Help CDF “Catch the Brass Ring” 777 Grant Street, Suite 302 research to help CDF “Catch the Denver, CO 80203 Brass Ring” by finding a cure. Enclosed is my contribution of $ ______Cindy Kalkofen In memory of ______Graphic Designer Mark an anniversary, birthday, Or in honor of ______special occasion; express Occasion ______Katie Hicks appreciation or make a memorial Please send acknowledgements to: Christine Lerner tribute in honor of someone (Amount of gift will not be mentioned) Editors special with a contribution — for Name ______Know the symptoms of any amount — to the Children’s Address ______Childhood Diabetes: Diabetes Foundation at Denver. City ______State ______Zip ______• Loss of weight We now accept gifts online. From • Extreme thirst Name ______• Excessive irritability Donations are tax deductible. Address ______• Frequent urination Tax ID #84-0745008 City ______State ______Zip ______• Bedwetting (previously controlled) Children’s Diabetes Foundation at Denver, Colorado Printed on recycled paper 777 Grant Street, Suite 302, Denver, CO 80203 303-863-1200, 800-695-2873, www.ChildrensDiabetesFoundation.org

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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

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 T 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.