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I am honoured and humbled to have the opportunity to attend and represent adults with Type 1 Diabetes at the World Diabetes Congress which is happening right now in Cape Town, South Africa. No less than TWELVE thousand people from 160 countries have come together to talk about anything and everything in the world of D. It's very exciting and inspiring!! This is my half-time report. I wanted to get some exciting news and things I've learnt in the first few days of the conference to you ASAP. Type
1 on the Agenda. Insulin Saves Lives. Why exactly rates of Type 1 diabetes are rising around the world, Prof Lefebvre told the delegates, was one of the great mysteries of our time. The main message in regards to Type 1 was that those horrific photos we've seen of emaciated children dying before insulin was discovered in the early 20th century, still happens today and the Porfessor stated, repeatedly: "This is unacceptable." He was
encouraged that the issue was gaining pace, with the cover of Lantus
journal 3 weeks ago addressing the issue of insulin availability. He
applauded the work of Australian organsiation Insulin for Life, and
explained that the IDF now have a formal contract with them to support
their work. Also explained that one of the drug companies had offered
to 48 of the poorest countries in the world insulin at 20% of the regular
cost and only a very few took up the offer - and even in these countries
insulin was still sold to people with diabetes at the original price.
"This is unacceptable." We have a long way to go. He went on to show some very interesting work he and his team had done to develop advice about the amount of carbohydrate required or the amount of insulin reduction required to do different types of exercise for different amounts of time, and different body weights. He has done a lot of work into different types of exercise causing sugars to go up or down and why it's different. These tables are published in the Canadian Journal of Diabetes, March 2006, in an article by Perkins and Riddell. There were many references in his talk to "Toronto insulin" which made me laugh. I eventually worked out they meant regular insulin as opposed to Humalog or Lantus or any of this new- fangled stuff, the original Banting & Best stuff discovered in Toronto! UN
Resolution on Diabetes President of the International Diabetes Federation and Australian paediatric endo, Professor Martin Silink, has said that the resolution will also "ask for all member organisations to establish national policies on the treatment, prevention and care of diabetes." Could mean we get some guidelines for ADULTS with Type 1 at last! Here's hoping. Lots of people here are wearing lovely blue circle badges in support of the Resolution. I think it's just the big wigs who get them! The campaign around this is called Unite for Diabetes, and has its own website: http://www.unitefordiabetes.org
The Miracle of Pregnancy, and Wonder of Husbands! Nicole gave a terrific talk about her experience of becoming a mother earlier this year. She spoke of the fear and anxiety of being pregnant with diabetes in a really touching and powerful way. She pulled her endo Lois Jovanovic up on stage - who was one of the first people, 25 years ago, to say "why can't diabetic women have babies? let's see if we can find a way that we can?" and has since, literally, written the book on it. This tiny, passionate woman is however somewhat controversial, as I'm sure your endo can confirm! Nicole and Dr Jovanovic spoke of some research that Nicole participated in during her pregnancy where Dr J is showing that pregnancy is indeed a miracle in many ways, and the growth factor it produces may be actually causing islet regeneration in women with Type 1 during their pregnancies. This does of course stop at labour and may go part way to explain why many women find that things go absolutely haywire immediately after the birth, they said. I was intruigued to hear that Nicole found participating in this research was a terrific distraction from all her fears and worries during the pregnancy and helped her keep calm and focused. Another
interesting point came up in question time where Nicole talked of the
support her husband provided, primarily helping her work through fears
and anxieties about pregnancy that stemmed from being told she'd never
have children at diagnosis - just 15 years ago - but also that upon
proposing to her she said she wouldn't give him an answer until he had
experienced at least the physical elements of diabetes for 3 days -
worn a pump, done test, carb counted etc. He did so, and she said yes,
of course. I wonder how our Aussie guys would feel about this demand?
The thought of that conversation in my relationship is making me laugh
out loud, but maybe it's worth a go? I do like her style! Interestingly she started by saying that patients can have hypo unawareness but so can professionals have hypo unawareness - meaning the impact of hypos is highly under-estimated by many health professionals, and should, for example, be a question asked and discussed at every annual review, which it is not currently in many places. Professor Amiel also said that at least 25% of people who have had Type 1 >15 years will have hypo unawareness - but studies of the brain have shown it impairs a part of the brain that means you can very easily be unaware that you are unaware. I must dash back to the conference now, so will write up my copious notes and photos of her slides a bit later. Also, the following session on whether non- invasive continuous monitoring is ever going to arrive was also good. Answer is it's a long way off, but a few promising places to watch that I will write more about next time. Kate
Gilbert Published December 6, 2006 Last reviewed January 1, 2007
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