We are nearing November and getting excited about meeting the ten 2013 Patient Voices Contest scholarship winners who'll be joining us at our Summit at Stanford School of Medicine.
Today, we're delighted to introduce 27-year-old Amy Tekrony from Canada, who's been living with type 1 for more than 15 years now. And she wasn't the only child with diabetes in their home -- her younger brother Jonathan had been diagnosed about four years before her!
Amy is hoping to become an endocrinologist, so has her eyes on the D-tech scene, with many ideas about how the tools we have could be improved to better assist in our lives with diabetes. Here's what Amy has to say:
DM) Your brother already had type 1 when you were diagnosed... so what was that like?
AT) I was 11 years old, and I had a really nasty boil on the side of my thigh that wasn't healing. I remember that it got so bad that I wasn't able to put my socks on because the strain on my skin was too painful. As a result, my mom took me to a walk-in clinic to get it checked out. The doctor we saw started off asking me routine questions to try figure out what might have caused such an infection, one of which I remember being if I had been in any hot tubs lately. The answers were all no, and he finally said that sometimes diabetes causes such infections that don't heal very quickly. As soon as he said diabetes, my heart sank... my mom and I knew exactly what that meant. My brother had been diagnosed with diabetes about four years earlier and I was also involved in a study that was trying to prevent type 1 diabetes -- because I had the pre-existing genetic marker. The doctor at the walk-in could not diagnose me but suggested we go to the emergency room at the children's hospital.
We first went home and tested my blood sugar on my brother's blood meter. I was 15.5 mmol/L (approximately 280 mg/dl), which was high enough to indicate something was wrong, but low enough to explain why I didn't have many of the symptoms that we were all too familiar with. We went to the hospital, and there they gave me my official diagnosis (my brother was pretty excited to have this to bond over). Since my mother was already familiar with what to do, my brother's and now my endocrinologist gave my mom some insulin doses to start off with and sent us on our way. It was kind of surreal, because my diagnosis almost wasn't that big of a deal, as I did not get sick, and I was sleeping in my own bed that night. I was lucky because I was in the honeymoon phase at my diagnosis, which means I was still producing some of my own insulin, and the transition was pretty smooth. This was very different than my brother's diagnosis, since my family was not aware of the symptoms for diabetes, and he almost died by the time he was diagnosed.
Yikes, sounds scary for your family! How's Jonathan doing now?
He's doing well. He struggles with being a young adult with type 1, as we all do or have, but he's testing more and more and has a great sense for where his blood sugars are by how he's feeling. He always teases me that I test way more often than he does, and his A1c is almost as low as mine. Although we manage our diabetes differently based on our personalities, it's been awesome having someone to grow up with who struggles with the same things I do and who truly understands what living with diabetes is like.
Was it your family's diabetes story that inspired you to become an endocrinologist, and where are you at in that process now?
Actually, when I was first diagnosed and for many years after that, I had a nurse with diabetes. I've always had great endos and healthcare teams, but there was something special about the bond that I had with her, because there was that unspoken connection that we had going through the shared experience. Ever since then, I've wanted to be able to do that for other people too. In addition, I've always been strong academically with an investigative mind and have loved problem-solving, working with people, and sharing my knowledge with others. I recently obtained a master's degree in Biophysical Chemistry, which used most of these skills, but my passion is diabetes, and I would love to be helping people in the endocrinology field.
My current endocrinologist works mostly with pregnant women and those wishing to get pregnant. She teaches residents in her clinic, and she carries out research to improve diabetes treatment. A job such as hers would combine my talent and passion, and I really believe that it's important to do what you love and are passionate about in life. Therefore, I've been applying to medical school for the past couple years and keep getting closer each time. I am currently putting the finishing touches on my medical school applications for this year, and I will hear in January if I get any interviews and find out in May whether or not I have been accepted.
What are you doing professionally now on the road to becoming an endo?
I am currently a Lab Manager/Research Associate for the Head of the Chemistry Department at the University of Calgary, which involves supervising undergraduate and graduate students, doing research, writing and publishing journal articles, and managing the research group's budget. I also serve part time on the weekends at a local restaurant.
What inspired you to enter our Patient Voices Contest?
I inadvertently came across a diabetes blog online a couple of years ago and was shocked by the emotions that surfaced when reading how eloquently someone else wrote about her struggles with diabetes. It was amazing to see that level of understanding of what I was going through in a complete stranger. Since then, I started following blog posts and twitter feeds by many members of the DOC. One such blog was DiabetesMine. I saw the details for the Patient Voices Contest on one of your posts, and thought that it would be a great experience to be able to talk about and even influence changes in the technology that we use to manage diabetes. As many people in the DOC have stated, the technology that we use to manage diabetes is very outdated, but I believe it can be improved and streamlined to make the management of diabetes much less of a hassle, and I'd love to be part of that process. So even though I had never made a video before, I entered and was honored to be selected as one of the contest winners to visit Stanford!
Describe the basic message of your video entry?
I wanted to convey that living with diabetes can be mentally exhausting, but the more effective the technology is that we use to manage our diabetes, the less we will have to worry. For example, I climbed the rock face of a mountain a couple of weeks ago with some colleagues. Since I was going to be waking up at an unusual time, exercising all day in inconsistent bursts, and pretty excited about climbing the mountain, I had no idea how my blood sugar would react. Therefore, I packed way too many supplies, all of which I had to carry up the mountain. On the day we went, I ended up with a post-breakfast high, which came down nicely with a bolus and the hike to the base of the mountain, and then I tested my blood sugar as many times as I could (biodegradable test strips anyone?), and I was at a comfortable range all day.
Everything turned out just fine, but not knowing how my body would react in an unusual situation added an extra exhaustion on top of everything else. It was pertinent that I remained physically and mentally alert at all times because not only could I make a fatal mistake for myself, others were also trusting in me to keep them safe. If I had a completely accurate CGM (continuous glucose monitor), stable glucagon in my pump, and faster-acting insulin, I wouldn't have been quite as worried about my high blood sugar post-breakfast or about testing my blood sugar so frequently, and I could have spent more time focused on what I needed to have a safe climb. Diabetes does not define me, nor do I let it restrict what I can or cannot do, but with improved technology, such as the aforementioned and better data management/storage and communication between diabetes devices, it would make such activities a lot easier with less to worry about.
You realize that faster insulins, stable glucagon, and better CGM tech are all in the works, right?
It is actually quite exciting that there are numerous promising projects and research efforts that are working towards developing all of these things. For example, the JDRF is funding multiple research projects that are developing better CGM technology, an "ultra fast insulin," and stable glucagon, specifically for enhancing the effectiveness of the artificial pancreas. In addition, researchers all over the world are working on these developments, including a chemistry research group at my own university in Calgary, who are working on improving CGM technology. Furthermore, Gu et al. recently published an article in ACS Nano in May 2013 in which they discuss their success in reducing the glucose levels in diabetic mice using an "Injectable Nano-Network for Glucose Mediated Insulin Delivery," or essentially a glucose-responsive insulin. A large dose of this insulin could be injected into the body and then activated with the ingestion of glucose — how cool is that?!
Also, Han et al. published an article in July in Biochemical Pharmacology that shows by modifying fatty chains in glucagon, they can synthesize a more stable form of the molecule. These are all really exciting advances, so I would say, "bring it on!" and "when do you want to start testing it on me?!"
Quick: what's your 140-character Twitter sentiment on diabetes tools & technology?
Diabetes technology needs to be used to make our lives less of a hassle so we have more time and energy to focus on other important things in our lives.
What are you most hoping to bring and experience at this year's DiabetesMine Innovation Summit?
I am extremely excited just to get more involved in the diabetes community and hopefully make lasting connections with other PWD's. Even though all PWDs are afflicted with the same condition and understand what each other are going through, we all take it slightly differently and have distinctive perspectives, so I am excited to build off of this at the Summit and come up with ways to improve the technology we use to manage diabetes. In addition, I know that some devices that are available in the U.S. are not available in Canada, so I'm interested to discuss and compare the differences with people who use them. Overall, I hope to gain insight into the latest diabetes technology advances and to be able to contribute to ideas that will improve diabetes technology in the future.
How do you think this kind of advocacy affects our daily lives in the Diabetes Community?
Optimistically, I hope we can leave the Summit with contributions to concepts that will make having diabetes less of a burden and less time-consuming so that we can use our energy for work, spending time with friends and family, and fun stuff like climbing mountains.