A personal story for American Diabetes Month

As I was finishing my last semester of middle school in Virginia, I was eager to transition into high school and pursue a higher level of learning. My older brother would be graduating from Virginia Tech soon, and I aspired to one day to become a thinker like he was.

Over the next few months, I began losing weight at a rate that surprised many (including myself).  But I was also out in the backyard lifting weights. Perhaps some thought, “Well, he’s eating less and exercising…”, and this was sufficient to squash any medical intrigue. 

It wasn’t until someone noticed my protruding Adam’s apple one day after church, and I felt like a specimen in a study, that I realized something was wrong. I was constantly thirsty and had relentless trips to the restroom as a result. I had almost a complete loss of appetite and spent many long afternoons napping on the couch rather than going outside. 

One day I decided to enter my chronic symptoms into WebMD and see just what I might be suffering from. I saw a moderate match for diabetes mellitus, and my heart sank. I thought, “Well, WebMD certainly isn’t the place I should be diagnosing myself, and maybe these symptoms are related to something else.”

In mid-April 2007, I was sent home with what I and the nurse thought was a mild fever.  My mother thought that I was upset by the mass shooting that had just happened at Virginia Tech, and I stayed home for the remainder of the week. That Friday, I was watching TV in bed and my mother went downstairs to make breakfast and let the school know I wouldn’t be back until next week. I decided to take a shower and get ready for another day at home. 

About halfway through the shower, my breathing became labored as if I had just run a marathon. I wasn’t sure what was happening but decided to sit down in the shower and catch my breath. The heavy breathing persisted, and I felt panicked. I toweled up and threw on some clothes and went down to tell my mom something was wrong. She called emergency services, and the next thing I knew I was on the porch trying to slip on shoes while medics prepared a stretcher to load me into the back of an ambulance.

I was very anxious at our local hospital in Fredericksburg. I was loaded with IVs and had many samples of blood collected. I felt confused. 

It must have been an hour or so before they packed me back up into an ambulance, explaining that I needed higher-quality care at a hospital in Richmond.  My parents got in the car and followed me down I-95, and soon I was lying in an ICU bed. 

The first night, a well-spoken physician approached me and my family in the hospital room and informed me that I had Type 1 diabetes.  Part of me wanted to pat myself on the back; the other part of me was simply shocked.

I was admitted with diabetic ketoacidosis, Kussmaul breathing, a blood pH of 6.9 and a blood glucose level exceeding 500 mg/dL.  I spent three days recovering on saline/bicarbonate drips and was started on fluids and insulin therapy. 

Flash forward 13 years, and I can barely remember what life was like before my diagnosis. Checking my blood sugar before and after every meal and administering about five injections a day has become the new normal. 

For those out there with a recent diagnosis of diabetes mellitus, 21^st century medical care and understanding has afforded you the opportunity to experience a full and fruitful life. This November, if you have diabetes, think about how you can set reasonable goals and make good choices to improve your health and make your endocrinologist happy.

For those without diabetes, think about how you can advocate for and make a difference for the tens of millions of domestic diabetics.

Recent diabetes research in ASBMB journals

Smooth-sailing for high-density lipoproteins in beta-cell protection: Researchers at the University of Zurich and University Hospital Bonn hoped to investigate the mechanism by which high density lipoproteins (HDL, the good ones) inhibit the loss of pancreatic beta-cells mediated by endoplasmic reticulum stress.  Through both cellular pharmacology studies and chromatographic analysis the team was able to determine that HDL protection of beta-cells involves the generation, transportation, and mobilization of cholesterol activators of a specific protein (SMO, smoothened GPCR).  Read more about their recently published findings in the Journal of Lipid Research here!

Secrets of the Type-1 diabetic urinary peptidome: Researchers from Toronto and Milan hunt for clues as to how the peptidome of diabetic youths with Type-1 Diabetes differs from their non-diabetic peers, and whether signature peptide secretions might provide clues as to pathogenesis and onset before clinical manifestation.  Through a variety of ­in-vitro techniques including discovery and targeted mass spectrometry as well as cellular assays, the team was able to identify kidney-specific uromodulin proteins as differentially expressed between the two cohorts.  Find out more about their research in this 2020 paper published in Molecular & Cellular Proteomics here!

The sweet science of GLUT4: Insulin-responsive glucose transporter type 4 (GLUT4) was discovered in 1988, and has since become a foundation for the understanding of cellular glucose transport in response to insulin.  Researchers here chronicle the history of the protein and summarize key findings of its mechanism in the regulation of sugar so important for diabetics everywhere.  Sit down and enjoy a good read with their paper, published last summer in the Journal of Biological Chemistry here!