NewsNotes - Spring 2020

NEWSNOTES CHILDREN’S DIABETES FOUNDATION — SPRING 2020

EXERCISE AND TYPE 1 DIABETES PAGE 6

THOMAS LENNON TYPE1LIFTING.COM

NEWSNOTES FEATURES 5

HEART HEALTH

Children’s Diabetes Foundation Board Members EXECUTIVE BOARD: Mrs. Barbara Davis, Chairman Dana Davis, Executive Director Mr. Cameron van Orman, Vice Chairman Richard S. Abrams, M.D., Treasurer

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EXERCISE AND TYPE 1 DIABETES

Mrs. Arlene Hirschfeld, Secretary

CONTROL IQ

Mrs. Nancy Davis Rickel

Stephen Daniels, M.D., Ph.D. Chairman of Pediatrics The Children’s Hospital, Denver Steven Farber, Esq. Daniel Feiten, M.D. Mr. Wayne Forman

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FINDING MY STRENGTH BDC STAFF SPOTLIGHT

Mr. Shane Hendryson Mr. Shawn Hunter

UPCOMING EVENTS

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COMMUNITY CORNER

Mrs. Marcela de la Mar Mr. Ken Rickel John J. Reilly, Jr., M.D. Vice Chancellor for Health Affairs & Dean, School of Medicine, University of Colorado Denver Mrs. Stacy Mendelson Robinson Marian Rewers, M.D., Ph.D. Ex-Officio Member Mr. Joseph Smolen

Ezio Bonifacio, Ph.D. Professor for Preclinical Approaches to Stem Cell Therapy, Center for Regenerative Therapies, Dresden, Germany

Matthias Hebrok, Ph.D. Professor in Residence and Director, Diabetes Center, University of California, San Francisco

Mr. Steve Lucas Mrs. Tracy van Orman

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Mark Atkinson, Ph.D. Professor of Pathology & Pediatrics, Director, University of Florida Diabetes Institute

Robert Eckel, MD Professor of Medicine, Physiology and Biophysics, University of Colorado School of Medicine

Mr. Robert Garelick Mrs. Deidre Hunter

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SCIENTIFIC ADVISORY BOARD: Richard S. Abrams, M.D. Director, Colorado Preventive Medicine, Rose Medical Center; Clinical Professor of Medicine UCD

Steven Kahn, MB, Ch.B. Professor of Medicine, Director of the Diabetes Research Center, University of Washington Rudolph Leibel, MD Professor of Pediatrics and Medicine, Co-Director, Naomi Berrie Diabetes Center, Columbia University Alvin Powers, MD Professor of Medicine, Molecular Physiology/Biophysics, Division Director, Vanderbilt University William Tamborlane, MD Professor of Pediatrics, Yale University School of Medicine

NewsNotes is published quarterly by the Children’s Diabetes Foundation. If you would like to submit an article or a letter to NewsNotes, send information to Brent@ChildrensDiabetesFoundation.org.

Zachary Reece, Graphic Designer Brent McDaniel & Dana Davis, Editors

Facebook.com/ ChildrensDiabetesFoundation

@CDFdiabetes

@CDFdiabetes

CDFcares@ChildrensDiabetesFoundation.org 303-863-1200 • 4380 S. Syracuse St., Ste. 430 Denver, CO 80237

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BY SARIT POLSKY, MD, MPH

Originally published to DiabetesSisters.org October 2019

Pregnancy can be an exciting time for a woman and her family, but it can add extra layers of emotions and stress for women with diabetes. As pregnancies in women with pre-existing or new diabetes can be more complicated than pregnancies in women without diabetes, here are a few key messages: 1. In women who have diabetes already (preexisting diabetes) or who are at high risk of developing diabetes during pregnancy (gestational diabetes), it is important to plan ahead. Women who do not want to become pregnant and who are sexually active should use accepted forms of contraception. Women should get pre-conception counseling from the right specialists: a diabetes provider (one who cares for women in pregnancy) and an obstetrician. If a woman has an advanced complication of diabetes already (like eye, kidney, or heart disease), then she should also get pre-conception counseling from the specialist who cares for the complication.

Pre-conception counseling visits include testing for certain diseases (like rubella, syphilis, etc.), discussion about medications that may need to be changed prior to conceiving, and information in this article. Optimally, women with diabetes should have a hemoglobin A1C level of 6.5% or less prior to conception, if they can achieve it without significant hypoglycemia (low blood sugars).

2. After conception, it is critical to obtain and maintain near-normal to normal blood glucose levels. For women with pre-existing diabetes, we recommend having an A1C of less than 6% as the pregnancy progresses. Women should establish care with providers quickly after a confirmed positive pregnancy test. For women with pre-existing diabetes, a high-risk obstetrician is recommended.

For women who were already using insulin or who will need to start insulin during pregnancy, there are shifts in insulin requirements over the course of the pregnancy.

Women tend to be sensitive to insulin in the 1st trimester, increasingly resistant to insulin in the 2nd and 3rd trimesters, then sensitive again right after delivery. For women with gestational diabetes, glucose-lowering therapy includes diet therapy, oral medications, and/or insulin.

Women with diabetes generally have more obstetric visits than women who do not have diabetes. They have frequent ultrasound examinations and fetal non-stress testing. Some women may also be started on aspirin therapy to lower the risk of developing preeclampsia (a disorder with high blood pressure in pregnancy and damage to another organ, like the kidneys or liver). It’s important to work with the obstetric and diabetes teams to ensure that all the proper screening and monitoring is performed.

3. The risks to the mother and baby can be higher in pregnant women with diabetes compared to those without diabetes.

These risks include fetal loss (miscarriage, stillbirth), abnormal fetal growth (babies born too small or too large for their gestational age), birth defects, high blood pressure conditions for the mother (e.g., preeclampsia), pre-term delivery (delivery before 37 weeks), cesarean delivery, and for the baby to be born with low blood sugars, low oxygen, and trouble breathing. There are many more possible risks as well.

Tighter glucose targets are recommended in order to reduce these risks.

BARBARA DAVIS CENTER

PREGNANCY AND DIABETES

4. Women should be monitoring for new development of and progression of diabetes complications.

Pregnancy can put a strain on a woman’s eyes, kidneys, and heart.

Therefore, these and other organ systems should be monitored throughout the pregnancy.

Pregnancies associated with diabetes require more monitoring and are at higher risk than those without diabetes. It’s important to plan ahead, work with experienced providers, and pay closer attention to managing glucose levels and watching out for possible complications.

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FOR VALENTINE'S DAY THIS YEAR, CDF ADVOCATES DECORATED HEARTS FOR EMPLOYEES AT THE BARBARA DAVIS CENTER! ADVOCATES PERSONALIZED MORE THAN 250 VALENTINES, THEN HUNG THEM UP OVERNIGHT AS A SURPRISE FOR THE BDC STAFF TO FIND IN THE MORNING.

WE CANNOT THANK THE BDC STAFF ENOUGH FOR ALL THEIR INCREDIBLE WORK. HAPPY VALENTINE'S DAY! 4

According to a Harvard-led study published in the

American Heart Association's journal Circulation, keeping type 1 diabetes under tight control through medication and monitoring may help prevent an immune reaction that attacks the heart.

Dr. Myra Lipes, the study's senior author and an investigator at Harvard Medical School's Joslin Diabetes Center in Boston, and other researchers looked at data from a broad clinical trial involving type 1 diabetes patients who were randomly split into two groups.

People in one group tightly controlled their blood sugar levels with intensive insulin treatment and frequent glucose monitoring, while those in the other were looser with their regulation and had higher blood sugars. At the start of the experiment, participants were free of heart disease and had regular blood pressure and cholesterol levels.

The researchers found that people exposed to higher blood sugar levels were more likely to develop an autoimmune response to the heart proteins that was linked to later development of heart disease, including calcium buildup in heart arteries, heart attack, bypass surgery and death.

"It wasn't something in the blood itself that triggered this reaction," Lipes said. "It's that the high glucose levels injure the heart muscle tissue, and we postulate that the immune system of people with type 1 diabetes overreacts to this heart injury."

People with type 1 diabetes have a higher risk of developing heart disease than the general population, but the reason why hasn't been clearly understood. In fact, people with both types of diabetes are known to be at higher risk for heart disease, just for different reasons.

DIABETES NEWS

HEALTHY HEARTS ARE HAPPY HEARTS

The study points out that the difference for patients with type 1 diabetes may stem from the creation of antibodies that attack the heart, said endocrinologist Dr. Robert H. Eckel, a professor of medicine at the University of Colorado.

"They don't occur in everybody, but the control of the diabetes relates to the formation of these antibodies against heart proteins," said Eckel, who was not involved in the study. "In type 2 diabetes, you just don't see these antibodies being developed." The study stresses the importance for patients with type 1 diabetes to keep their condition under control, he said.

While diabetes does increase the risk of mortality and increase the risk for heart disease, the good news is that we have seen an overall reduction in heart disease risk among American adults with diabetes over the last several decades.

"First of all, control your diabetes to prevent losing your eyesight, to prevent your kidneys from failing, and also to keep your nerves functioning normally," Eckel said. "But now, we know that better control of your blood sugar seems to prevent this autoimmunity against the heart from occurring."

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DIABETES NEWS

THE UPS AND DOWNS OF EXERCISE WITH T1D It should come as no surprise that physical activity and exercise play an important role in your overall health and that’s true whether you have type 1, type 2, or no diabetes at all. While exercising with type 1 diabetes has its own unique set of challenges, it’s certainly not something you want to ignore.

Physical activity, whether that’s going to the gym to workout for an hour or cleaning the house on Saturday afternoon, can have vastly different effects on different people with type 1. Your body’s response to exercise will depend on a lot of different factors like the intensity and duration of your exercise, type of activity, and your blood sugar levels before you begin.

Some people experience a drop in blood sugar levels during or following exercise, so it’s important to be prepared with a drink or snack to raise your blood sugar quickly, especially if you’re trying a new activity and you’re not sure how it will affect you.

The opposite might be true for others, where they experience high blood sugar during or following exercise. This might happen during high-intensity workouts when your body is producing more stress hormones that raise glucose levels. If you wear an insulin pump, you may be able to adjust your doses to compensate for a workout, but touch base with your doctor you make sure you’re on the right track.

There are plenty of options to stay active with type 1 diabetes, and in Colorado, you will be in good company. A recent CDC study showed the Centennial state had the lowest rates in the country for self-reported inactivity. That means 83% of Coloradans are doing physical activity at least once a month including running, golf, gardening, or simply walking for exercise.

According to the US Department of Health and Human Services, the biggest health benefits occur with even a small amount of physical activity over nothing at all. It doesn’t have to be a huge change or throw you out of your normal schedule. Here are a few suggestions to get you up and moving around a little more in your daily routine:

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• Take a lap or two around the block when you go check the mailbox.

• If you work in an office building, take the stairs instead of the elevator.

Work on a high floor? Get off a few floors below and walk the rest of the way up.

• Add in a few simple stretches to get the blood flowing while you wait for the shower to warm up.

• Try a new activity class at your gym or neighborhood recreation center.

Like anything when you have type 1 diabetes, you’ll want to keep an eye on your blood sugar levels when changing your normal pattern of behavior. As mentioned, exercise can have different effects on blood sugar for different people. So, if you’re starting from a more sedentary lifestyle and working your way up to vigorous activity, take it easy until you get a feel for the new changes and check in with your doctor to keep them in the loop. If you’re feeling good and want to strut your stuff, join us for the Run for the Ring 5k & Kids Fun Run this August!

Thomas Lennon, featured in our cover photo, is a personal trainer who was diagnosed with type 1 diabetes at the age of 35. Determined that the diagnosis would not stop him from reaching his fitness goals, he created Type 1 Lifting, a t-shirt company and podcast, to send the message that you can still do amazing things when you have T1D. A portion of the company’s sales are donated to the Children’s Diabetes Foundation. Learn more at Type1Lifting.com.

Did you know that anyone with type 1 diabetes (or other disabilities) can apply for a free lifetime access pass to US national parks? You can obtain your pass through the mail, which involves a $10 fee for processing, or you can get it in person at more than 60 federal recreation area sites in Colorado to avoid the processing fee. Either way, the pass itself is free and lasts a lifetime.

The America the Beautiful Access Pass provides admittance to the pass owner plus passengers (in a single, private, non-commercial vehicle) to more than 2,000 recreation sites managed by five federal agencies. Photo identification may be required to verify ownership. At many sites, the Access Pass provides the owner a discount on Expanded Amenity Fees, such as camping, swimming, boat launching, and guided tours.

You will be required to include a signed statement from a licensed physician stating that you have a permanent disability. Here’s an example statement that should be printed on your physician’s letterhead and dated:

To begin the application process online or find a complete list of recreation areas that issue in-person passes, visit store.usgs.gov/access-pass or search “America the Beautiful Pass” online.

To Whom It May Concern:

DIABETES NEWS

FREE NATIONAL PARK PASS FOR PEOPLE WITH TYPE 1 DIABETES

This letter is to certify that Name is a patient at the office/center.

He/she has Type 1 Diabetes, which he/she is treated for here. If you have further questions or concerns, please call: XXX-XXX-XXXX. Diabetes is a permanent and physical impairment that substantially limits one or more major life activities including, but not limited to, the operation of the endocrine and digestive systems (major bodily functions). As such, diabetes is a physical disability under the Americans with Disabilities Act (ADA), 42 U.S.C. 12102; 28 C.F.R. 35.104.

Signed, Licensed Physician

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DIABETES NEWS

ADVANCED TECHNOLOGIES & TREATMENTS FOR DIABETES CONFERENCE UPDATES Several doctors from the Barbara

Davis Center were able to attend the 13th International Conference on Advanced Technologies & Treatments for Diabetes in Madrid, Spain this February. Dr. Paul Wadwa and Dr. Laurel Messer presented data from Control-IQ hybrid closed-loop and Basal-IQ technology studies conducted inpart at the BDC.

INTERNATIONAL DIABETES CLOSED LOOP PROTOCOL-5 (DCLP5) STUDY RESULTS Tandem Diabetes Care, Inc., announced positive data presented this February on its automated insulin delivery technologies, including data from a study of the t:slim X2™ insulin pump with ControlIQ™ advanced hybrid closed-loop technology demonstrating increased time in range (70 mg/dL -180 mg/dL) in children ages six to thirteen.

Details from the Protocol 5 (DCLP5) of the National Institutes of Health-funded International Diabetes Closed Loop (iDCL) program, an international consortium of academic centers led by the University of Virginia, were presented by Dr. Paul Wadwa, Associate Professor of Pediatrics, at the Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, and the protocol chair for this trial.

“This study demonstrated that in school-aged children with type 1 diabetes, who often struggle with diabetes management for a variety of reasons, use of Control-IQ technology led to improved glucose control during both the day and night,” said Dr. Wadwa. “We are thrilled with these results and are hopeful that this system will ultimately offer a valuable treatment option to benefit children with type 1 diabetes.”

Time in range (70 mg/dL – 180 mg/dL) for children using Control-IQ technology for 6 months increased from 53 percent to 67 percent, compared to those in the control group who increased from 51 percent to 55 percent using sensor-augmented pump therapy alone. During the overnight period, sensor time in range with Control-IQ technology was 80 percent compared to 54 percent in the control group.

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The t:slim X2 insulin pump with Control-IQ technology uses Dexcom G6 CGM values, in conjunction with other variables such as insulin on board, to predict sensor glucose levels 30 minutes ahead and adjust insulin delivery accordingly. If glucose values are predicted to drop below 112.5 mg/dL, basal insulin delivery is reduced, and when predicted to be below 70 mg/dL, basal insulin delivery is stopped. If glucose values are predicted to be above 160 mg/dL in the next 30 minutes, basal insulin will be increased. If glucose values are predicted to be above 180 mg/dL, Control-IQ technology calculates and delivers a correction bolus with a target of 110 mg/dL once an hour as needed.

Control-IQ technology also offers optional settings for sleep and exercise that will change treatment values to better match the different physiologic needs during these activities.

Details from a longitudinal satisfaction study of commercial users of Basal-IQ technology were presented by Laurel Messer, RN, PhD, CDE, Assistant Professor of Pediatrics at the Barbara Davis Center for Diabetes at the University of Colorado Anschutz Medical Campus.

Basal-IQ technology uses CGM values to help reduce the frequency and duration of low-glucose events by predicting glucose levels 30 minutes ahead and suspending insulin if they are expected to drop below 80 mg/dL or if a CGM reading falls below 70 mg/dL. Insulin delivery resumes as soon as sensor glucose values begin to rise.

This study included 541 commercial users with T1D or caregivers of T1D minors who completed the Diabetes Impact and Device Satisfaction questionnaire prior to Basal-IQ start, and 2, 4, and 6-months post-initiation. The study included people switching from Multiple Daily Injections (MDI), non-Tandem insulin pumps, and current Tandem pump users. Study aims were to measure device satisfaction (e.g. ease of use, trust, perception of glucose control) and diabetes impact (e.g. perception of sleep quality, fear of lows, interference with daily activities).

DIABETES NEWS

REAL WORLD SATISFACTION WITH BASAL-IQ TECHNOLOGY

Basal-IQ technology increased device satisfaction in former MDI and non-Tandem pump users, and sustained satisfaction across all user groups.

Additionally, a reduction in diabetes impact was observed by the midpoint of the study and sustained over 6 months for all user groups.

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OVER $40,000 RAISED ON COLORADO GIVES DAY

THANK Y

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U!

BY JEN TILDEN, LCSW

Clinical Social Worker, Barbara Davis Center

Fear of needles is quite common, especially for children

and teens. While this can complicate even the occasional flu shot, the fear of needles can become a significant barrier to management for people with type 1 diabetes.

The social work team at the BDC works with patients and families to assess whether needle anxiety is affecting diabetes management. If we do identify some needle anxiety, we then support the family by offering interventions to work through that anxiety. Some techniques, like distraction by watching a video or listening to music, can help patients get their minds off the needle.

Other techniques like mindfulness, relaxation, and deep breathing exercises help them not feel as anxious. These can be effective with anxiety around insulin injections and finger pokes. Sometimes, though, patients need extra support, especially when it’s time for a blood draw.

Blood draws are an important part of care at the BDC because we want to make sure that our patients are healthy and catch any problems before they get worse. Because of that, we ask that patients get a blood draw at least once a year. But blood draws can be a terrifying experience for someone with needle anxiety, and it can be hard to use other techniques like distraction or mindfulness when patients are already so scared. For blood draws, we offer a numbing cream (called EMLA cream) that can make the actual needle insertion less painful, but because the worst part of a blood draw is often all the fear and anxiety that come beforehand, we decided we needed another strategy.

BARBARA DAVIS CENTER

NEEDLE ANXIETY IN DIABETES CARE

A few months ago, thanks to CDF’s Guild and the Helping Hand Program, we added a new tool to help our patients with a fear of needles: virtual reality. Now, when we know a patient has needle anxiety, we ask the patient to watch a 3D video on a virtual reality headset while we do the draw.

The virtual reality headset provides a more immersive experience than other distraction techniques and so is more effective. By keeping the patient’s focus on the video, we can reduce the anticipatory fear, overall distress and perception of pain. Sometimes, the patients get so caught up in the virtual reality that they don’t even realize what has happened until the blood draw is over.

While virtual reality does not work for everyone, it has helped make blood draws less distressing for many of our patients with needle anxiety. If you know that your child needs a blood draw but struggles with needle anxiety, feel free to let our social work team know at the start of the visit that you need support, and we would be happy to do what we can to make it a more comfortable experience.

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FINDING MY STRENGTH

BY TRYSTAN HENDERSON Recipient of the Charlotte Tucker Scholarship

My name is Trystan, and I was diagnosed with type 1 diabetes

on March 26, 2012. I had been sick for a while. My mom stayed up many nights with worry, not being able to sleep. She knew something was wrong, but nobody had any idea how serious my condition actually was. I had lost so much weight and looked so sickly that even my teachers were constantly asking if I was ok. Every morning, I got incredibly sick to my stomach, but I pushed through school even though I felt worse than I had ever felt before. I was young, so I didn’t think much of it. Feeling so bad became my new normal. I went through my water bottles like I was in the Sahara Desert. I didn’t know drinking so much water was weird. For a while, my family and I thought I was just going through a growth spurt, so increased thirst must be normal, right?

Wrong.

My mother decided something was really wrong. She took me to the doctor and I was diagnosed, and I am so incredibly thankful for my diagnosis. That sounds weird, right? Well, I mean it. I mean it not only because my diagnosis saved my life, but because it made me who I am today. That day changed my life forever. I used to suppress the memory of that day and all the pain that it brought. Now, I am extremely thankful for my type 1 diabetes. If you are reading this and you think I am crazy or you have diabetes and wish with all your heart and soul that you didn’t, please reconsider.

Diabetes has brought a lot of pain into my life, as it does for everyone living with it. Initially, I was so jealous of those who do not have it. I would genuinely become infuriated at anyone who complained about their flu shots or made jokes about how they were going to get diabetes because they ate so poorly. I thought to myself, “How can they complain when I get so many shots and so many finger pricks?” and “Why does everyone assume I got sick because I ate poorly?” I hated the stigma that came with the word “diabetes.” I didn’t want people to think I was unhealthy and responsible for my disease. I hated explaining to new friends that I was diabetic because it was something that I had no control over, and I did not think they would understand.

Aside from anger and jealousy, diabetes also came with a lot of stress, not only on myself, but on my friends and family members. It has given me days where I feel sick and horrible due to bad blood sugars. It has given me fears of dying early, going blind, and losing my feet. Diabetes has taken away a lot of my time that I could’ve spent on other things. It has made me frustrated, furious, and devastated. Now, after listing all of these negative effects of my diabetes, I probably sound really crazy for sticking by my claim that I have learned to accept it and be grateful for it. Allow me to explain why.

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Since March 26, 2012, every day shows me the challenges of balancing different aspects of my life and managing my disease. At first, this was really difficult. Accepting the truth was the hardest part of my diagnosis. Since there is no cure (yet!), I had to learn to be ok with the fact that the rest of my life will be filled with the requirements of diabetes. I would never have the choice to give up. I was in it for the long haul. If you are still trying to accept this, just know that it is going to be ok. Everyone has struggles, and the cards you were dealt were the ones you were meant to get. Even those who do not have diabetes have problems. The people who once infuriated me when they would complain about a single shot have problems that I did not know about. I take things for granted that others do not have, just as they take for granted the lack of needles and carb counting that I have. No one lives a life that is worry free, so be grateful of your blessings. Do not dwell on the negatives of diabetes. Having it makes you strong, just as every other difficulty in life does.

“When your only option is to be strong, you will become stronger than you ever thought was possible.”

There is a cliché quote that many people find comforting. It goes along the lines “your disease does not define you.” This quote drives me crazy. Your disease does define you. It makes you who you are. It sets you apart from everyone else. It makes you stronger than you could have been without it. My diabetes does define me, and I am proud to say that. All of those negative things I listed before have given me strength, persistence, and resilience to life’s challenges. I didn’t know how strong I could be until being strong was my only choice. My diabetes has made me who I am today.

Of course, there was a time when I despised my disease and everything that was related to it. I hated people asking me about it. And don’t get me wrong, I still have bad days. I still get upset and question “Why me?” but being comfortable with what your life is composed of will help you enjoy every day. I encourage you to embrace your diabetes. It will bring you peace. I know that sounds incredibly cheesy, but it truly has changed my perspective on life. Diabetes does define you, and that is a wonderful thing. You are you because of your diabetes. Be proud of who you are. You are stronger than before, and you are a reflection of your perspectives.

Have a good perspective and continue pushing forward.

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DR. BRIAN BUCCA, OD, FAAO

The doctors, nurses, and support staff at the Barbara Davis Center for Diabetes are amazing

people, but with everything going on during your visit, you might not have had a chance to really get to know them personally. So, we sat down with Dr. Brian Bucca from the Eye Clinic to learn a little bit more.

Thanks for taking a minute to chat with us. How long have you been at the BDC? It’s a pleasure! In July, I will have been at the BDC for 14 years as Director of Eye Clinic.

You went to school in Alabama and Mississippi, anything you miss about the South now that you’re in Denver?

I left the South and moved to New Mexico in 2001 so I’ve been away for a long time! I have a handful of BDC patients from the South and some have the deepest Southern accents that I’ve missed throughout the years. I could just listen to them talk for hours! I miss the Southern hospitality, the slow pace of life and let’s not forget about Cajun food. I grew up 40min from New Orleans, so I was raised on crab, crawfish and shrimp boils laced with the flavors of cayenne and Zatarain’s seasoning! Mmmm!

Do you have any hobbies to keep yourself entertained?

I’m a man with too many hobbies! Literally a Jack of many trades, but a master of none! Mountain biking, hiking, mountaineering, you name it. What I’ve been doing a lot of lately is photography. I will get up before sunrise and go to Red Rocks or Star K Ranch when the Cottonwood trees are in full color to work on my photography skills.

My wife and I are lovers of music, so we take in shows at multiple venues around the city to see the artists that we love, and we never miss our annual Tedeschi Trucks Band show at Red Rocks! I’ve played the guitar for over 30 years now and playing and creating music is soul-fulfilling and is the gift that keeps on giving.

What’s your bucket list vacation destination?

I’ve been so fortunate to have visited a lot of my bucket list destinations, which mostly revolve around multiday backpacking trips. My dad and I trekked in the Himalaya in 2018, I backpacked the Wonderland Trail that circumnavigates Mt. Rainer, and I’ve found that the Wind River Range in Wyoming should be on every backpacker’s bucket list. That range is much akin to Yosemite but wilder and without all the people. This year’s bucket list trip will be backpacking the Teton Crest trail in August with my dad!

BARBARA DAVIS CENTER

BDC STAFF SPOTLIGHT

What is your favorite pizza topping?

Complicated question indeed! I do love me some pizza! There is no one favorite topping but pepperoni, basil and jalapenos in some combination are usually in the mix.

Thinking back on your many patients, is there a special memory that stands out?

There are many, but I’ll focus on one from my previous career with the Indian Health Service. My average patient on Navajo was 65 years old, with type 2 diabetes, and didn’t speak English. There were many barriers to care: cultural, geographic and obviously, the language barrier. But I took it upon myself to learn enough Navajo to get through an eye exam (mostly commands that allowed me to perform my testing). Well, they just loved the fact that a white man was speaking to them in their native language which earned enormous respect, fostered confidence in my medical advice, and dismantled barriers to care created by the checkered history between our cultures. The patients and my staff ended up giving me the Navajo name “Askei’ Haa’tali” – The Singing Medicine Man, since I used to walk down the hallway whistling and humming whatever tune was in my head. What an honor!

What is your favorite part about working at the BDC? This is going to sound nerdy but I love the process of educating our patients and parents regarding all things diabetic retinopathy! Let’s face it, the thought of losing vision is terrifying to people and it is not lost on me that this places me, as an eye care professional, in a very unique position to motivate patients into making better and more informed decisions regarding their diabetes care.

At the BDC, we have well-informed patients and parents who are curious and always want to know more about diabetes and its complications. Answering these questions necessitates a wide base of knowledge and experience and I love the challenge of communicating answers to these tough questions on a level that everyone can understand.

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FOUNDATION NEWS 16

T1 SKI WEEKEND AT SUNLIGHT MOUNTAIN RESORT On January 11-12, Sunlight Mountain Resort and the

Children’s Diabetes Foundation hosted our first annual T1 Ski Weekend. This was a family-friendly weekend getaway for people with type 1 diabetes, their family, friends, and caregivers with discounted lift passes, equipment rentals, and snowmobile tours.

The weekend was organized by Mike Baumli, the Mountain Manager at Sunlight. Mike’s daughter, Emma, has type 1 and is currently a patient at the BDC. He wanted an opportunity for the diabetes community to come together and have fun – a great reminder that you can still participate in any normal activity when you have type 1. Mike’s daughter is a frequent skier herself, so all of the ski patrol at Sunlight have been trained to identify and treat high and low blood sugar episodes. As a special treat before a gluten-free spaghetti dinner together, our T1 Ski group had the mountain all to ourselves on the last run of the day with Sunlight’s ski patrol.

Thanks to a special grant in memory of Mike’s mother, Lynn M. Baumli, some staff from the BDC were able to join in on the fun in Glenwood Springs too. We owe a special thanks to Mike Baumli, his wonderful family, and the amazing staff at Sunlight Mountain Resort for putting together this fantastic weekend. If you’d like to join us next time, mark your calendar now for January 9-10, 2021.

TYPE 1 DIABETES SUPPORT GROUPS Newly diagnosed?

Been doing this for years?

Hit a rough patch?

Want to talk to others with type 1 diabetes?

WHATEVER YOUR SITUATION, YOU ARE WELCOME AT ANY OF THE CHILDREN'S DIABETES FOUNDATION SUPPORT GROUPS. For all ages and relationships to diabetes: - Denver Metro - Douglas County - Colorado Springs - Central Rockies - Rifle - Cheyenne, WY - Sterling, CO (meets every 2 months) - "The Keepers" in Denver parents & caregivers of type 1 teens - Fort Collins type 1 kids under 18 and their caregivers Time and meeting locations vary.

Join our mailing list at ChildrensDiabetesFoundation.org for updates on any of the support groups.

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UPCOMING EVENTS

APRIL 15

Tax Day A new program in Colorado allows you to use a portion or all of your state income tax refund to make an automatic donation to the Children’s Diabetes Foundation. Let your tax preparer know you want to donate or look for the prompt to “Donate to a CO Nonprofit” wherever you file and include our registration number #20023003786.

APRIL 15

1 Sweet Cruise An Alaskan cruise specifically for type 1 families – the perfect combination of diabetes camp and family vacation. If you didn’t already grab a cabin for this year’s cruise, mark your calendar for 1 Sweet Cruise 2021 out of Galveston, TX July 11-18!

JULY 13

Black Project Gives Back 1290 S. Broadway A51, Denver, CO Raise a glass to CDF at our fundraising night with Black Project Spontaneous & Wild Ales in Denver. 10% of all draft pours support CDF!

Tied to a Cure Denver Golf Tournament Pinehurst Country Club, Denver, CO Presented by McDonald Automotive, benefiting the Children’s Diabetes Foundation and the Barbara Davis Center for Diabetes. Register at ChildrensDiabetesFoundation.org

APRIL 25

JULY 16-19

EPIC Diabetes Conference Sheraton Denver Downtown Hotel, Denver, CO Join us for workshops, Q&A sessions, and more with top diabetes experts and industry reps. Type 1, type 2, families, friends, and caregivers all welcome! Register at EPICconferences.org.

MAY 6

Spring Brass Ring Luncheon & Fashion Show Hilton Denver City Center, Denver, CO Enjoy a premiere luncheon, gorgeous runway fashion show featuring celebrated designer Mark Zunino and hosted

by CBS4's Dominic Garcivvva. Plus bid on exclusive experiences, exciting travel packages, sports memorabilia, and more at the live and silent auctions.

MAY 14

40th Anniversary of the Barbara Davis Center 40 years ago today, the Barbara Davis Center for Diabetes opened its doors to serve patients from Colorado and around the world. Since then, BDC staff have treated nearly 25,000 patients with type 1 diabetes. Learn more about the history of the BDC in our Summer 2020 issue of NewsNotes.

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JUNE 19-26

Practical Ways to Achieve Targets in Diabetes Care Keystone Resort and Conference Center, Keystone, CO ATDC is an annual course designed to help healthcare providers caring for patients with diabetes focusing on the challenges in day-to-day management of diabetes and practical ways to overcome those hurdles.

The Barbara Davis Center for Diabetes & The Children's Diabetes Foundation present:

April 25, 2020

9:00 AM to 3:30 PM

Sheraton Denver Downtown Hotel

Pediatric, Adult, and Advanced Workshops

Keynote: Building Connections Workshop and Panel Topics Include: Remote Monitoring $10 Supporters & Caregivers Registration Mental & Emotional Health Advice & Resources Community Connections Workshops Diabetes’ Connection to

by Top Diabetes Other Health Disorders Experts Online Decision Support

Theme: Connectivity Network with Others & Industry Reps

Interactive: Ask Your Questions

Lunch and snacks will be provided

EPICconferences.org 19

M A Y

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C H I L D R E N S D I A B E T E S F O U N D A T I O N . O R G

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C E N T E R

The Carousel of Hope

Celebrating Barbara Davis’s 90th Birthday and the

40th Anniversary of The Barbara Davis Center for Diabetes The film, television, music, and business industries come together for the 34th annual gala supporting the Barbara Davis Center for Diabetes and the Children’s Diabetes Foundation on Saturday, October 10, 2020 as we fight to bring a cure to millions of people living with diabetes.

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PI N E HUR S T C O UN TRY C LU B P RE SEN T E D B Y :

M O N D A Y , J U L Y 1 3, 2 0 2 0

TIED TO A CURE DENVER GOLF TOURNAMENT R ES ER VE Y O U R F O UR SOME NO W A ND S U P PO RT T Y P E 1 DI A BE TE S CA R E A N D R ES EA R CH AT C HI L D RE N SD IA B ET ESF O U N DA T I ON .OR G 22

COMMUNITY CORNER

Welcome to our newest section, Community

Corner, where we celebrate the happy milestones in our type 1 community. If you’d like to share your diagnosis anniversaries, weddings, birthdays, or other special occasions with us, please contact Brent@ ChildrensDiabetesFoundation.org.

DECEMBER 30

Kyle celebrated his 10-year diaversary just before the New Year rolled around. He was only 14 months old at diagnosis and is still going strong. Congrats, Kyle!

JANUARY 1

5-year-old Lexi celebrated 3 years since diagnosis with a big ice cream sundae (and lots of insulin says mom, Lynae). Keep at it, Lexi!

FEBRUARY 6

Kellan celebrated his diaversary 3 years after being diagnosed at 13 months old. His father, Alek, says Kellan has come a long way in the last 3 years and their family is grateful for organizations like CDF. Happy diaversary, Kellan!

MARCH 18

Kayla is celebrating her 11-year diaversary this spring after she was diagnosed at the age of 3.

Mom, Kristy, says Kayla and her brother Kyle (above) are both rock stars. Rock on, Kayla!

Children’s Diabetes Advisory Board Members and Guild Presidents ADVISORY BOARD:

THE GUILD PRESIDENTS:

Sir Michael Caine Mr. and Mrs. Robert A. Daly The Honorable Diana DeGette, U.S. House of Representatives, Colorado Mr. Neil Diamond Mr. Placido Domingo Mr. John Elway Mr. David Foster Mr. Kenny G Mr. David Geffen Mr. Magic Johnson Mr. Quincy Jones Ms. Sherry Lansing Mr. Jay Leno Mr. Paul Marciano Mr. Mo Ostin Sir Sidney Poitier Mr. Lionel Richie Mrs. Adrienne Ruston Fitzgibbons Mr. George Schlatter Ms. Maria Shriver Mr. Steven Spielberg and Ms. Kate Capshaw Ms. Brenda Richie Ms. Barbera Thornhill Miss Joan van Ark Mr. Gary L. Wilson Mr. Stevie Wonder

Founding President, Amy Davis Mrs. Gina Abou-Jaoude Mrs. Christy Alberts Mrs. Jamie Angelich Mrs. Karen Aylsworth Mrs. Linda Broughton Mrs. Tangy Buchanan Mrs. Joy Burns Dr. Bonita Carson Mrs. Nancy Cowee Mrs. Dalyla Creaghe Mrs. Norma D’Amico Ms. Donna Douglas Mrs. Margy Epke Mrs. Chris Foster Mrs. Helenn Franzgrote Mrs. Sally Frerichs Mrs. Debbie Gradishar Mrs. Helen Hanks Mrs. Georgia Imhoff Mrs. Marty Jensen Mrs. Gail Johnson Mrs. Sharon Kamen Mrs. Janet Knisely Mrs. Cheryl Lebsock Mrs. Shelley Lucas Mrs. Suzy Love Mrs. Judy McNeil Mrs. Sally Newcomb Mrs. Barb Oberfeld Mrs. Gretchen Pope Mrs. Carol Roger Mrs. Kay Stewart Mrs. Diane Sweat Ms. Charlotte Tucker Mrs. Loretta Tucker Mrs. Melissa Tucker Mrs. Jane Weingarten

See complete list at ChildrensDiabetesFoundation.org

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Nonprofit Org. U.S. POSTAGE

PAID Children’s Diabetes Foundation 4380 South Syracuse Street Suite 430 Denver, CO 80237

Denver, CO Permit No. 1752

Change Service Requested

SAVE THE DATE!

SATURDAY AUGUST 1, 2020 24

5K KIDS FUN RUN GAMES & MORE!