Party Like It’s World Diabetes Day!

written by Sarah Howard
Coordinator of the Diabetes-Obesity ScienceServ

sarah-howardUsually, “diabetes” and “party” are never mentioned in the same sentence. The reasons are obvious: diabetes is a horrible, life-changing and life-threatening diagnosis. More than 400 million adults worldwide have diabetes, and more than half a million children under 15 have type 1 diabetes. One in seven infants worldwide are exposed to their mother’s high glucose levels in the womb. (Source: IDF Diabetes Atlas, 2015).

In addition, international scientists are now researching the role of environmental chemical exposures in diabetes. Convincing laboratory and epidemiological evidence has been published suggesting that exposure to “metabolic disrupting” chemicals may contribute to the development of diabetes in later life, especially if the exposure occurred early in life. (Source: Heindel et al. Parma Consensus Statement on Metabolic Disruptors. 2015.)

But if you have lived with diabetes, you are probably up to your ears in statistics and studies. Every now and then you need a break. And so, we celebrate World Diabetes Day every year on November 14, to honor the birthday of Sir Frederick Banting, the man credited with discovering insulin and saving millions of lives. In 2016, this day also happened to be the 10-year anniversary of my son Teddy’s type 1 diabetes diagnosis. So clearly, it was time to party!

I have never acknowledged Teddy’s diagnosis day (or “diaversary”) in any way before, although many people do something special for their child on that day. We decided to host a surprise party for him, which would really be a surprise since he did not even know his diagnosis date, and would not be suspected anything. I had a lot of fun thinking of party ideas during the week prior, which was a welcome change from the daily grind of type 1 diabetes management.

We invited two of Teddy’s friends who have type 1 diabetes along with their families, as well as few of his closest friends and their parents—who are my reliable babysitters. Part of the purpose was to thank these babysitters, who have watched him at their house — even at sleepovers– allowing him to feel like a normal kid. We had everyone over for dinner at our house. One family babysat Teddy for the few hours prior to the party so we could set up the house and surprise him. He was indeed surprised! After dinner, we started in on the fun!

Show the diabetes piñata how you really feel

blog11-14-16shdiabetesdaydropofbloodWho loves having diabetes? No one. What better way to express your true feelings about diabetes than to whack a diabetes piñata. How can you make a piñata that represents diabetes? Well, what is diabetes? High blood sugar. So I made a paper mache piñata in the shape of blood drop (which just happens to be the same shape as a balloon), color it red, and fill it with candy. Easy! Plus, it’s a great way to get rid of Halloween leftovers!

Guess how many

IMG_20161114_085207.jpgAnyone with diabetes likely has a lot of diabetes-related things lying around. Cabinets full of things. I put some of these things in clear containers, and everyone guessed how many items were in each jar. Winners received either a “low blood sugar treatment kit” (i.e., candy) or a “high blood sugar snack kit” (i.e., cheese). I actually did count the number of syringes, lancets, pen needles, and used insulin pump batteries—all things that we happened to have lying around in abundance. I did not count the numbers of used needles (too dangerous) or used test strips (too gross), but picked random winners. And then there was the jar of empty Halloween candy wrappers. I had asked, “How many carbs?” We called it a tie, since one kid wrote “0” (“because there are no carbs in the wrappers,” which is technically correct), and one who wrote “100,000” (because that was the closest to my answer, “too many”).

Where’s the alarm?

Wait, do you hear that? What’s that alarm? Is someone high? Is someone low? Is someone’s pump out of insulin? Is there a low battery? There’s an alarm going off somewhere in the house, quick, find it! (It was my alarm clock, set to go off at a random time in the middle of the party).

Tour the diabetes museum

I have had type 1 diabetes for 17 years, and my son has had it for 10. We have a lot of old supplies gathering dust in the basement. I put them in shoeboxes on display, and even my son enjoyed looking at these things he did not even remember—like the junior insulin pen he used when he was 1 year old. He has been on a pump so long he didn’t even know what an insulin pen looked like. We had his old pumps too—you never know when these things will come in handy. In fact, it is because of these supplies that my husband has been able to make us artificial pancreases, which require the use of old pumps. (We also had his “Artificial Pancreas Lab” on display in the museum.)

What do you get someone with diabetes?

Blog11.14.16SHDiabetesDayPancreas.jpgWe got him a new pancreas. The fuzzy, stuffed kind that are available on Amazon. He slept cuddling it last night. He also learned what a pancreas looks like, apparently he had thought it was round. One friend with diabetes made him a booklet of hilarious Diabetes Memes that only those with diabetes could fully understand. My favorite gift, however, was presented by another friend, who made a shield and holy grail out of aluminum (since the 10 year anniversary is tin/aluminum). He then knighted Teddy and read this proclamation:

Hear Ye, Hear Ye!
Be it thus noted that Sir Theodore Howard
Has these yon 10 years passed
Fought the good fight against
The dread diabetes type 1

May he be successful
In his continued valiant efforts
To banish the dread diabetes
With the holy grail of diabetes cures
So that over the next 10 years
We may yet again gather to celebrate
The vanquished foe

We dub thee Sir Teddy
And his heroic knights of the Howard table

Time to celebrate

With cake, decorated to look like a continuous glucose monitor. The cake says his blood sugar is 40 and going down rapidly, meaning it must be time to eat cake! But of course it has to be accompanied by ice cream, since you want some fat and protein to balance out those carbs.

And then it was over. We had a couple of low blood sugars during the course of party, and presumably a couple of highs as well, considering four of the attendees had type 1 diabetes and a lot of carbs were consumed. But we all survived. To help ensure that we keep surviving, we gave out expired glucagon kits as party favors, so our friends could practice using them. With their help, and the help of scientists studying diabetes around the globe, we are not just surviving, but partying as well.

11.29.16CallDiabetesCDC.jpgIn fact, two of my favorite diabetes scientists, Dr. Mary Turyk and Dr. Robert Sargis, will be speaking on a CHE call on Tuesday, Nov. 29 at 10 am PST/ 1 pm EST. They will discuss their research on Chemical Contributors to Type 2 Diabetes. Please join us! And thank you to everyone around the world, including friends, family, researchers, advocates, and all who help make this disease more bearable. If you could all fit in my house, I’d have you over for cake and ice cream as well.

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Commentary: 25 Years of Endocrine Disruptor Research – Great Strides, But Still a Long Way to Go

written by Laura N. Vandenberg, PhD
Assistant Professor and Graduate Program Director of Environmental Health Sciences, University of Massachusetts Amherst School of Public Health and Health Sciences

Laura N. Vandenberg

Laura Vandenberg (Credit: umass.edu)

Reprinted with permission from Environmental Health News

Cancer. Diabetes. Autism. Infertility. ADHD. Asthma. As the rates of these diseases increase over time, the public and researchers alike have focused on the role the environment might play in their cause and progression. Scientists in the field of environmental health sciences are not satisfied just to know that the environment contributes to human disease – they want to know how.

This week [ScienceSeptember 18-20], researchers, public health advocates, government officials, and industry spokespersons will meet at National Institutes of Health (NIH) to celebrate 25 years of scientific research on one aspect of environmental health: endocrine disrupting chemicals (EDCs). These are compounds that alter the way hormones act in the body, often by mimicking or blocking their actions. Just a few examples of widely used consumer products that contain EDCs are plastics, electronics, flooring, some personal care products, and furniture treated with some flame retardants.

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Scientific Consensus Statements on the Role of Environmental Chemicals in Diabetes, Obesity, and Metabolism

written by Sarah Howard
Coordinator of the Diabetes-Obesity Working Group

Sarah Howard

Two worldwide gatherings of experts have published consensus statements on the role of environmental chemicals in diabetes, obesity, and metabolism:

The Parma Statement was based on a workshop held in Parma, Italy, in May 2014, and the Uppsala Statement was based on a workshop held in Uppsala, Sweden, in October 2015.

Both focus on guiding future scientific research in the field, but also contain recommendations for policy makers, health care providers, and other professionals. Both call for reducing environmental chemical exposures, especially in early life, to help prevent the development of metabolic problems later in life.

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Which Chemicals Are Linked to Diabetes and Obesity? Perhaps More Than We Think.

written by Sarah Howard
Coordinator of the Diabetes-Obesity Spectrum Working Group

Sarah HowardResearchers from the National Institute of Environmental Health Sciences (NIEHS), EPA, research centers and universities have just published an article, Prioritizing environmental chemicals for obesity and diabetes outcomes research: a screening approach using toxcast high throughput data (Auerbach et al. 2016).

The intent of this project was to use new rapid screening methods to identify chemicals that may be able to affect biological processes linked to the development of diabetes and/or obesity. The researchers screened 1860 chemicals and found that, “the spectrum of environmental chemicals to consider in research related to diabetes and obesity is much broader than indicated from research papers and reviews published in the peer-reviewed literature.”

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Top 10: 4th Quarter 2015

This is the last of CHE’s public quarterly Top 10 lists. We have selected studies and issues that we feel are significant in the field of environmental health, either because of their impact, their implications or their insight. Topics are listed in no particular order. Comments are welcome, as is always true with our blog posts. Corrected in an update 1/6/2016.

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Top 10: 3rd Quarter 2015

We present the ten most significant news or research stories in environmental health of the last quarter, in CHE’s view. The first three items are statements from major scientific or health organizations summarizing large bodies of research and drawing conclusions about the interaction of our environments and our health. These reports join a growing list of statements and documents (see compilations of consensus statements and of resolutions and scientific statements on CHE’s website).

Additional items in this list present notable new research, new policy developments, new focus or new thinking on their respective topics.

  1. FIGOInternational Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemical: The global health and economic burden related to toxic environmental chemicals is in excess of millions of deaths and billions of dollars every year, including impacts on health and quality of life. On the basis of accumulating robust evidence of exposures and adverse health impacts related to toxic environmental chemicals, the International Federation of Gynecology and Obstetrics (FIGO) joins other leading reproductive health professional societies in calling for timely action to prevent harm.
    Read CHE’s Blog post on the statement, written by a statement author, and join CHE’s call on the statement on October 30th.
  2. Executive Summary to EDC-2: The Endocrine Society’s second scientific statement on endocrine-disrupting chemicals: The full Scientific Statement represents a comprehensive review of the literature on seven topics for which there is strong mechanistic, experimental, animal, and epidemiological evidence for endocrine disruption, namely: obesity and diabetes, female reproduction, male reproduction, hormone-sensitive cancers in females, prostate cancer, thyroid, and neurodevelopment and neuroendocrine systems.
  3. PlanetaryHealthSafeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health: A growing body of evidence shows that the health of humanity is intrinsically linked to the health of the environment, but by its actions humanity now threatens to destabilize the Earth’s key life-support systems.
    See the infographic that accompanies this report.
  4. California bill leads nation with significant steps to limit antibiotic overuse in meat production: The US Centers for Disease Control and Prevention (CDC) has identified antibiotic resistance as one of the top health threats facing the nation. This action puts California at the forefront of efforts in the US to limit the misuse and overuse of antibiotics in meat production and protect the efficacy of precious antibiotics.
  5. Pesticide exposure linked to diabetes development: New studies, including a meta-analysis, appear to show that there is a link between exposure to pesticides and the later development of diabetes, researchers reported at the annual meeting of the European Association for the Study of Diabetes.
    See more about the meta-analysis: Analysis of 21 studies shows exposure to pesticides is associated with increased risk of developing diabetes.
    Although this meta-analysis and other studies were presented at a conference and have not been published, we felt this topic merited inclusion in the Top 10 because it reinforces the growing number of peer-reviewed studies that suggest a link between diabetes and pesticides.
  6. Assessing the carcinogenic potential of low-dose exposures to chemical mixtures in the environment: the challenge ahead: Our analysis suggests that the cumulative effects of individual (non-carcinogenic) chemicals acting on different pathways, and a variety of related systems, organs, tissues and cells could plausibly conspire to produce carcinogenic synergies.
    See news coverage on this report from the National Institute of Environmental Health Sciences (NIEHS): Exposure to low levels of chemical mixtures linked with cancer and Low-dose mixtures and cancer highlighted at NIEHS symposium, plus CHE’s teleconference call on the report: Theories of carcinogenesis: assessing the carcinogenic potential of low-dose exposures to chemical mixtures in the environment.
  7. Association of child poverty, brain development, and academic achievement: Poverty is tied to structural differences in several areas of the brain associated with school readiness skills, with the largest influence observed among children from the poorest households.
    See a news report on the study, drawing from an interview with the study senior author: Effect of poverty on brains may explain poor kids’ lower test scores.
    As the author notes, this study “closes the loop and adds the missing piece” regarding the connection between poverty, brain development and academic achievement, finding that the effects are mediated by a smaller hippocampus and frontal and temporal lobes and that the decrease in volume of the latter two structures explained as much as 15% to 20% of the achievement deficits found. Of note is that children facing numerous other risk factors for poor brain development were screened out from this study. cumulativeImpactsThe impacts of poverty, nutrition, conflict, disease and other stressors in addition to exposures to toxic chemicals and radiation each may have individual and synergistic effects on brain development. This study brings focus to the role of poverty on brain development and achievement, but because children living in poverty often face other adverse conditions concomitant to poverty, the full effects of poverty are likely even greater than reported in this study.
  8. Two articles on health effects of hydraulic fracturing (fracking): Endocrine-disrupting chemicals and oil and natural gas operations: potential environmental contamination and recommendations to assess complex environmental mixtures and Environmental and health impacts of ‘fracking’: why epidemiological studies are necessary. These articles make the case for concern over serious impacts on health and call for more research, including regarding the endocrine-disrupting potential of chemicals used in the process.
  9. The scandal regarding Volkswagen’s programming cars to avoid emissions control. A flurry of news reports on this situation were published. We present two focusing on human health impacts: Scientists say car emissions rigging raises health concerns and How many deaths did Volkswagen’s deception cause in the US? Because 11 million cars worldwide may be affected, and because diesel-fueled cars account for just 3 percent of passenger vehicles in America but closer to 50 percent in Europe, the health impacts of VW’s intentional undermining of clean air standards could be enormous.
  10. The Center for Public Integrity’s series on occupational exposures and health. CPI’s reports published a long list of articles describing the health impacts of occupational exposures on workers and their families, the failure of current safeguards, the push to weaken even those, and recommendations for reform.

Diseases, Vectors, Specific Chemicals or Life Phases: What’s Your Pleasure?

written by Elise Miller, EdM
Director

When many of us think of air pollution, images often come to mind of smoke stacks and diesel trucks spewing dirty fumes or thick brown smog enveloping cities. We think of people coughing or wearing masks on their faces to breathe, kids being rushed to emergency rooms for asthma attacks. These respiratory and lung conditions are of course part of our global reality today—and sadly so.

But I was truly struck by the plethora of new studies published during the last quarter implicating air pollution in a litany of other health outcomes. These conditions, not often associated with exposures to air particulates and other toxic airborne matter, include diabetes, autoimmune diseases, various forms of cancer, mental health, brain function, and birth defects. Nancy Hepp, CHE’s Research and Communications Specialist, compiled a long list of relevant studies (below) that appeared in journals and other media outlets from April through June 2015 highlighting these concerns.

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