Critically High Blood Sugar, Critical Science

In recognition of CHE’s 10th anniversary, colleagues who have been particularly instrumental to shaping CHE this past decade will be invited to write an introduction. This month’s introduction is by Sarah Howard, who serves as the national coordinator for CHE’s Diabetes-Obesity Spectrum Working Group.

“It’s critically high,” the ER nurse informed me, describing my toddler’s blood sugar level. She had just pricked his tiny finger, but it wasn’t enough; she needed a blood draw to see how just how high it really was. Two nurses held down my son, while I tried to comfort him, while he screamed, while they prodded and poked, failing to hit a vein. The pediatric team was called in, and eventually he slept while I heard the result: 798, a number seared in my memory forever, a dangerously high blood sugar level. My 23-month-old little boy had diabetes.

That was five years ago, almost 10,000 needles ago. After the shock of his diagnosis wore off, I started reading more about type 1 diabetes. I found out that type 1 incidence was increasing in children—in 58 different countries around the world. That the increasing type 1 incidence was due to some environmental factors, that genetics alone could not explain it. That the increase was most rapid in the youngest children, the children who, like my son, developed diabetes before their fifth birthday party. This much was clear. What was not clear was why.

I wondered, could toxic chemicals somehow be linked to type 1 diabetes? At first, the idea had not occurred to me; in my mind, like most people, diabetes was linked to things like diet and exercise, or viruses and cow’s milk, not chemicals. But I reread Our Stolen Future, and noticed a sentence buried in the epilogue, “This recent work has emphasized the vulnerability of the brain and the immune system, which appear at least as sensitive as the reproductive system to prenatal disruption from contaminants, if not more so.” The immune system? Type 1 diabetes is an autoimmune disease; were chemicals linked to autoimmunity? What exactly was “this recent work” about the effects of chemicals on the immune system? What did the science say?

It was then, four years ago, that someone told me about an organization called the “Collaborative on Health and the Environment,” who were organizing a call entitled, “Self-Defense: Environmental Impacts on Autoimmune Diseases.” What an amazing opportunity! Three leading experts on autoimmunity would be talking about the role of environmental chemicals in autoimmune diseases, plus an update by one of the authors of Our Stolen Future, Pete Myers, PhD. Not only that, but there was really a group called CHE that put together calls featuring scientists explaining their research to people like me? And I did not need a PhD to participate—in fact, as a patient and a mother I was quite welcome? I listened to the call, asked questions—too many—but the speakers were patient with me and answered my questions.

I wasted no time in joining CHE. I read the “consensus statement” and was thrilled that this organization emphasized prevention and precaution; that CHE called for collaboration among scientists, medical professionals, public health/environmental groups, and even patients and families; that CHE stated outright that “the public believes what scientists have long known—that environmental factors are important contributors to disease and developmental disabilities.”

I went to CHE’s website and listened to other calls that had been archived. I searched the Toxicant and Disease Database to see which chemicals were associated with diabetes, jump-starting my own research. I joined the CHE listserv on metabolic syndrome (now the Diabetes-Obesity Spectrum Working Group). Elise Miller, the Director of CHE, emailed me, and asked if I knew that the National Institute of Environmental Health Sciences (NIEHS) was reviewing the scientific evidence on chemicals and diabetes and obesity, and was organizing a conference on the topic? No, I hadn’t known, but by getting involved in CHE, I was able to find out about events and opportunities like this, and now work closely with NIEHS. CHE was invaluable.

CHE is still invaluable. The science linking chemicals to many diseases and conditions is strong and becoming mainstream knowledge, thanks in part to 10 years of work by CHE. The science linking chemicals to diabetes and obesity is young and relatively unknown, but growing rapidly. CHE is helping to move environmental health science forward and bring it to the public and into the mainstream. While we now understand more about the role of chemicals in the development of many diseases, childhood diseases like asthma and diabetes are still on the increase. I hope that someday we will look back and see how science was critical to informing policy for preventing disease. That someday fewer and fewer children will experience a life-changing diagnosis, be it asthma, allergies, cancer, or diabetes.

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