Top 5 takeaways from TCOYD
TCOYD is a conference specifically for Type 1 Diabetics.
This is my first year attending TCOYD, a conference specifically for people with Type 1 Diabetes! Covering everything from research updates, funny skits, to opportunities to meet people just like me, it was an awesome experience. To top it all off, it was also in San Diego. Hurricane Hilary almost crashed our party, but it all turned out fine! I wanted to go over some of the best tidbits I learned while I was there.
DISCLAIMER: I am not a doctor, if you have questions about your health, talk to your doctor! Duh!
Dr. Polonsky gave a great talk discussing “The emotional side of diabetes”. Considering the fact that T1D is a chronic illness, there are many situations where it can be exhausting, overwhelming, and disheartening. Beyond just normalizing the stress that comes with Diabetes, one quote I took away was when he mentioned: “The biggest obstacle to dealing with what’s going on in my pancreas is dealing with what’s going on in my head.” Definitely an insightful talk and in an area I rarely see mentioned by people with Diabetes.
Teplizumab is officially on the market. This is an FDA approved drug that can delay the onset of Type 1 Diabetes. See this FDA article about it. If you recall, type 1 diabetes is an auto-immune disease. Which means, at some point the body gets confused and starts attacking your pancreas. This new drug is a monoclonal antibody (hey, where have I heard that before!) that modifies T cells in a way that prolongs the pancreas’ ability to create insulin. Now unfortunately this treatment is only available to a narrow population of people without type 1 diabetes who are being screened for type 1 antibodies (most likely due to a sibling having type 1), but this is awesome progress! Unfortunately the ship has most definitely sailed for me, all my beta cells are long dead thanks to my immune system, but this could be huge for the sister/brother of someone with Type 1 Diabetes. (We know there is also a genetic component of type 1 diabetes, that is probably linked to all of auto-immunity, but it is not yet strongly understood.)
Open Source Pancreas
Loop is an open source pancreas system. Basically a lot of people became fed up with the current state of insulin pump technology (the thing that we wear that delivers insulin to our bodies), so they decided to create their own open source insulin delivery system. I had heard of this before, but it required a a funky piece of hardware to use, but now that is no longer true! Now we can download an iOS app and control our insulin pumps directly. The WeAreNotWaiting community is incredible! This new insulin delivery system was shown to have a radical improvement on patients time in range which equates to way better health outcomes! This open source system is so advanced, some users on it, don’t even have to bolus for meals, the algorithm handles it for them. I am super interested in trying it myself.
Like all things we do in life, the personal connections are the ones that always stick with us the most. I met a bunch of super awesome people at the conference, and I can’t wait to see them next year.
Who am I kidding, I couldn’t fit it into just 5. Here are some random ones.
Some of the faster acting insulins are causing inflammation in people. So it turns out that if you had a pump site (the needle that delivers insulin to the body) with just saline, you could keep it in for a month with no effect. But it seems that when insulin is delivered through the pump site, the insulin itself causes inflammation. This is further exacerbated by fast acting insulins, which increase blood flow to the area, thus increasing white cell access, increasing inflammation. (Dang immune system strikes again)
GLP-1, if you havent heard of it yet, ask your doctor! Increased time in range, more and more type 1’s starting to use it (if it’s available from their insurance, don’t get me started on how much insurance sucks.)
And this last one is somewhat controversial in the type 1 community, but i think it is important to mention. Anything over 70 percent time in range DOES NOT have any evidence for increased benefit. Some diabetics believe that the only acceptable time in range is 100 percent, which is virtually impossible to do without a pancreas. The reason they think this is important is because they believe it is the only way to reduce long term complication. The evidence does not back that up. It shows the goal should be 70 percent. I see this as a good thing, because 70 percent is an attainable goal with existing technology, and it should be good knowing that we as type 1s can elimanate our chance for long term complications by reaching a 70 percent time in range (and live a relatively normal life while doing it).
Even more wild, the newest research is showing type 1 diabetics on average live LONGER than normal people. Crazy how far we have come.