Not many people have heard this story – until now. Of course my loved ones know that I have type 1 diabetes, but knowing I also have diabetes complications was something I did not wish for them.

It was June 1^st 2009, four days before my 24^th birthday, when the Ophthalmology Department at my nearest hospital told me I could be blind in two years or less. I will never forget that moment.

Diabetic retinopathy means that the tiny blood vessels inside the retina at the back of my eye are damaged. Retinopathy is not a word most people are familiar with, but if you ask someone who has a family member with diabetes, they will probably know something about this condition.

According to JDRF, nearly all people with type 1 diabetes show some symptoms of diabetic retinopathy, usually after about 20 years of living with diabetes. After 20 years, around 20-30% of people with type 1 diabetes will develop advanced diabetic retinopathy.

For me there were no warning signs or symptoms, however many people experience blurred or distorted vision that makes it difficult to read, watch TV or see people’s faces.

Soon after the diagnosis of diabetic retinopathy I began 12 weeks of intensive laser treatment, which I wouldn’t wish on anyone. The procedure gave me blurred vision, sore weeping eyes and headaches, though not everyone experiences such intense side effects. Laser treatment is the main procedure for treating retinopathy, it is designed to slow the progression of the disease and decrease the risk of vision loss.

Luckily the laser treatment has meant that my risk of diabetic retinopathy decreased from 100% to 30%, which is a great result. I am now very aware that people with type 1 diabetes should take a positive approach to their eye health. This should include annual visits to an eye care professional, carefully management of BGLs and a healthy diet. As someone with type 1 diabetes, I know this is easier said than done.

Type 1 diabetes can be unkind. I did nothing wrong to get this disease. I didn’t eat sweet things when I was growing up – mum wouldn’t let us. In time I discovered that being angry was not doing my body and my blood sugar levels any good. It has taken me years to find a way to be positive about this disease.

I never thought diabetes complications would happen to me. I was 14 when I was diagnosed with type 1 diabetes, and 24 when I was diagnosed with retinopathy. It feels like my diabetes complications have come at least 10 years early.

The day I sat down in the chair for the laser treatment I said to myself, “I will fight you and I will win”. But I was also thinking about life if I went blind, that my family would have to re-home our family dogs so we could get a guide dog, and how upset everyone would be.  Facing the possibility of going blind was terrifying for me.

The fears prevailed for a time and unfortunately I was forced to put my studies on hold and leave my teaching course at university. I had some very dark days. I will get back to those studies in time, and for now that’s okay.

This year I received news that the doctors are pleased with my progress. My checkups are now 6 monthly instead of 3 monthly. So now I am focusing on my goals; getting well, being healthy and happy. I will go through life as Jason, not a diabetic. Type 1 diabetes is just one part of who I am.

I wanted to share this story in the hope that I can connect with others who are facing a tough time. I also want to call on any young people who are adjusting their insulin to influence their weight – please don’t do it. I found out later that high BGLs and not meeting HbA1c targets is the main cause of diabetic retinopathy.

Be happy about who you are, keep fighting and remember, type 1 diabetes only comes to good looking people!

By Jason Triggs with thanks to Vision Australia and JDRF International

In 2009 the Walk to Cure Diabetes is a celebration of hope and progress towards a cure for type 1 diabetes. This year, two of the participants from Melbourne – a healthy little girl and a middle aged woman battling health challenges – highlight the progress that has been made in diabetes management over the last few decades.

Billie is 8 years old and her family is one of the top fundraisers for the Walk to Cure Diabetes. She is on an insulin pump, which is proven to reduce the risk of diabetes complications. Despite the daily pain and burden of managing type 1 diabetes, her health prospects are improving all the time thanks to new knowledge of the disease and its complications.

Billie Angelone

Billie’s health is excellent but her mum Nicky is very aware of the implications of diabetes management. Nicky says that trying to get Billie’s blood sugar in the healthy range is like walking on a tightrope. “It’s a huge responsibility because it can affect her future health.”

Karen was 8 when she was diagnosed with type 1 diabetes and is now in her early 40s. She lost a brother and several childhood friends to complications of type 1 diabetes. What’s more, she recently suffered a major heart attack, brought on by the stresses on her body.

Karen Irwin

Karen said, “I have a burning passion to help raise awareness of the disease and everything that goes along with it.”

Karen and Billie together joined the Melbourne Walk to Cure Diabetes in October. They reflect two of the many different faces of the type 1 diabetes community, but are joined together by shared hope for a cure.

Thirty years of data from international trials show that the rate of serious complications amongst people with type 1 diabetes is lower that was has been reported historically.

Researchers from the JDRF-funded Diabetes Control and Complications Trial (DCCT) and the Epidemiology of Diabetes Intervention and Complications Trial (EDIC) have analysed the incidence of long-term type 1 diabetes complications amongst trial participants and found that the rate of type 1 diabetes complications has changed dramatically, particularly for people who intensively manage their condition.

Researchers announced that the incidence of type 1 diabetes complications such as retinopathy, nephropathy and cardiovascular disease were significantly lower in the group that used intensive therapy to manage their type 1 diabetes.

In the case of the DCCT trial participants, intensive therapy was defined as use of insulin pump or three or more insulin injections, blood sugar monitoring at least four times per day and monthly visits to their diabetes healthcare team.

The researchers believe that with more people using intensive therapy, the rate of complications amongst people with type 1 diabetes should continue to decline to less than 50% of the levels seen at the start of these trials.

Treatment innovations such as insulin pumps and insulin analogues, increased understanding of type 1 diabetes management, and improved treatment of co-occurring symptoms such as high blood pressure, and abnormal cholesterol have also contributed to this change.

Arch Intern Med 169(14):1307-16

JDRF partners move research forward

Cancer drugs reverse diabetes in mice

Hydrangeas may help prevent diabetes

Vitamin C may help to stop type 1 diabetes damage

Glycemic control influenced by genes

Reducing the risk of diabetic heart attack

A team of researchers from Australia and NZ have made an important breakthrough on the location of genes which may be linked to susceptibility of autoimmune diseases such as type 1 diabetes and multiple sclerosis. The newly discovered gene locations, on chromosomes 12 and 20, appear to be related to the role played by vitamin D availability and metabolism.

Researchers will now finely map these genetic regions and identify the different genetic changes that underpin autoimmunity with the aim of developing therapeutics that prevent or reverse the process.

Nature Genetics published online June 14

top

JDRF partners move research forward

JDRF industry partner, Bayhill Therapeutics, has entered into a commercial agreement with Genentech Inc to commercialise a new therapeutic designed to reverse the autoimmune process that causes type 1 diabetes.

This is the fourth commercial agreement that has resulted from JDRF’s Industry Discovery and Development Partnership program, with other agreements being made with GlaxoSmithKline and Lilly.

JDRF developed the IDDP to help small companies develop innovative ideas and products. By supporting this early stage research, JDRF looks to encourage larger pharmaceutical companies to carry the products through expensive, late-stage trials and regulatory approvals. The ultimate aim of the program is to bring new diabetes therapies to market faster.

top

Cancer drugs reverse diabetes in mice

JDRF-funded researchers in the US have shown that two common cancer drugs can block and reverse type 1 diabetes in mice.

The drugs – marketed as Gleevec and Sutent – prevented mice from developing type 1 diabetes and put 80% of the sample population into remission. Both drugs work by blocking an enzyme that triggers cellular growth and division and plays a key role in inflammation. The study was conducted as part of the Immune Tolerance Network.

Proceedings of the National Academy of Sciences 105(48):18895-900

top

Hydrangeas may help prevent diabetes

A drug derived from the hydrangea root, used in Chinese medicine for centuries, shows promise in treating autoimmune disorders. It works by inhibiting the development of bad immune cells known as Th17 – cells have been implicated in a variety of autoimmune disorders including type 1 diabetes.

The drug, called halofuginone, selectively prevents the development of Th17 cells but has no effect on other aspects of the immune system. In addition, it is relatively cheap to produce, simple to administer and is likely to have considerably less side-effects compared to traditional immune-suppression drugs. This study was partially funded by JDRF.

Science 324(5932):1334-8

top

Vitamin C may help to stop type 1 diabetes damage

Researchers from the Harold Hamm Oklahoma Diabetes Center have used a combination of insulin with a high dosage of vitamin C to minimize the blood vessel damage caused by type 1 diabetes in patients with poor glycemic control. Researchers believe that the anti-oxidant properties of the vitamin C acts to reduce the cellular stress that can result from even a few episodes of high blood sugar, thus reducing the risk of diabetes complications.

While researchers do suggest people with diabetes should eat foods and take multivitamins rich in anti-oxidants, they warn that these results are preliminary and more research is needed to ensure the safety of high doses of vitamin C.

Journal of Clinical Endocrinology and Metabolism published online June 2 2009

top

Glycemic control influenced by genes

JDRF researchers have shown that HbA1c levels are not just dependant on an individual’s diabetes management behavior, but also their genetic make-up.

According to results presented at the recent American Diabetes Association Scientific Sessions, there is one small genetic change in particular that can predict people who are at risk of poor glycemic control.

The identification of this genetic variant (known as a single genetic polymorphism or SNP) gives us an insight into the mechanisms behind glycemic control and why some people react differently to different diabetes management programs.

top

Reducing the risk of diabetic heart attack

It is well documented that carefully controlled blood sugar reduces the risk of kidney failure and neuropathy but researchers in the UK have now conclusively proven it also decreases the risk of coronary heart disease and possibly stroke.

After analyzing five trials incorporating more than 33,000 individuals, researchers were able to identify 17% reduction in heart attack risk and 15% reduction in coronary heart disease in patients maintaining strict blood glucose control with an HbA1c of around 6.6%.

The Lancet published online May 23 2009

top