Diabetic U.S. athlete has a point to prove

BY MIKE BEAMISH, VANCOUVER SUN FEBRUARY 11, 2010

The closet of Olympic cross-country skiing is littered with incriminating paraphernalia: vials, syringes and equipment used by cheats to gain a chemical edge.

But nobody in the sport of skinny skis is more open about the use of the needle than U.S. Olympian Kris Freeman, a New Hampshire native who requires them simply to survive.

Indeed, Freeman openly injected himself in plain view to prove two points: that an athlete with Type 1 diabetes can excel at the highest level of sport. Secondly, Freeman's very public injections were a repudiation of those athletes who shoot up illegally and clandestinely.

Follow Kris on Twitter @ http://twitter.com/TeamFreebirdXC

"Up until two years ago, I was taking 12 shots a day -and I was doing it in the open," Freeman said Wednesday. "In the cafeteria, when all of the teams are sitting together, I'd take out my syringe with insulin and stick myself in the stomach with it. The guys who have cheated in the past did it behind closed doors. They were secretive about it. I'm in the open about it. The IOC knows I use insulin, WADA [World Anti-Doping Agency] knows that I use insulin, FIS [the governing body for skiing] knows that I used insulin. Hopefully, I'll win a medal and everybody in the world will know I use insulin."

Diagnosed 10 years ago with Type 1 diabetes, a life-threatening condition that affects the breakdown of food into energy, Freeman was told to forget about an Olympic career. Yet here he is, a decade later -a 10-time U.S. champion and three-time Olympian talking openly about ending an American drought in cross-country skiing that spans 34 years.

Vermont's Bill Koch was the first and last American to win an Olympic medal in cross-country when he took a surprise silver in the men's 30 km at the 1976 Winter Games -a Halley's comet-like performance in a sport thoroughly dominated by Scandinavians and Russians. Since the Winter Games began in 1924, Norwegians, Finns, Swedes and Russians have won 189 of 216 total medals in cross-country skiing. Of those remaining 27 medals, three have been won by Canada, all since 2002.

"I've battled two stereotypes since I was a kid," says Freeman, 29. "The first was that Americans could never succeed in cross-country skiing. People would say, 'You may have won junior nationals, but you'll get your butt kicked in Norway.' Then I got diagnosed with diabetes, and I was told I'd never race again. I like to prove people wrong, and I like a challenge. This is the best team I've ever been a part of. "

Freeman points to Kikkan Randall, a 27-year-old Alaskan with a swath of magenta-tinted hair who is unique both in appearance and accomplishment. She is the first American woman to win a medal at the world championships.

Then there's Vermont's Andy Newell, one of the world's fastest sprinters, and Freeman himself, who has two fourth-place finishes at the worlds.

"It's not a guarantee that we're going to break through for a medal, but it's so possible," Freeman says. "It's not like we're going to need a freak day to do this. We can do it on a plain, even playing field. It just has to be on the right day."

To get his metabolism right, Freeman relies on the OmniPod, a disposable pump that regulates the flow of insulin to keep him from crippling episodes of unbalanced blood sugar.

"For a 15K, I need three times the insulin to go into my body that I do for a 30K," he says. "For a 15K, I'm almost anaerobic [using oxygen more quickly than the body can replenish working muscles] for the whole time. My blood sugar rises. When I'm aerobic [efficiently transporting oxygen], my blood sugar falls. It's a really delicate balance, depending on the exertion."

He must also be vigilant about getting too amped before a race. "My blood sugar can rise just by sitting there," he says. "So, certainly, the Olympics are going to affect me more. I try to listen to calming music. But it's hard to find calming music I like, because I'm very into heavy metal -Guns N' Roses." Of course, a band with an appetite for booze and hard drugs is in no way an extension of what Freeman represents -an indomitable Olympian breaking down barriers for diabetics. Because skiing truly is in his blood.

mbeamish@vancouversun.com

© Copyright (c) The Vancouver Sun

Photograph by: Richard Heathcote, Getty Images, Vancouver Sun

Borrowed from -http://www.vancouversun.com/health/Diabetic+athlete+point+prove/2549954/story.html

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Early Artificial Pancreas Trials Show...

Early Artificial Pancreas Trials Show Benefits for Kids, Teenagers with Diabetes While Sleeping Overnight

LONDON, Feb. 5, 2010 - In a landmark study in children and teenagers with type 1 diabetes, JDRF-funded researchers at the University of Cambridge showed that using a first-generation artificial pancreas system overnight can lower the risk of low blood sugar emergencies while sleeping, and at the same time improve diabetes control.  

Results from the studies are published in the February 5, 2010 issue of The Lancet, available online atwww.thelancet.com. 

The trials tested the safety and effectiveness of a first-generation artificial pancreas system used overnight in a hospital setting with participants between 5 and 18 years of age with type 1 diabetes.  The system combined commercially available blood glucose sensors and insulin pumps, controlled by a sophisticated computer program that determined insulin dosage based on blood glucose levels while the participants slept.

Maintaining recommended blood sugar levels overnight is a major issue for people with type 1 diabetes - and particularly for the families of children with diabetes - because of the possibility of blood glucose dropping dangerously  low during sleep and going unnoticed, which can lead to seizures, coma, and in some cases be fatal.

Notably, the Cambridge study showed that the children and teenagers spent twice as much time during the night within targeted blood glucose levels when their diabetes was regulated with the artificial pancreas system than when they followed conventional "manual" therapy.  And low blood sugars were minimized.

"These studies show that automated systems not only can help people manage diabetes by maintaining good control, they will also improve quality of life for the people with type 1 diabetes and their families by lowering the risk for hypoglycemia," said Roman Hovorka, Ph.D., from the Institute of Metabolic Science at the University of Cambridge, the principal investigator of the study and lead author of the paper. "These results suggest that closed-loop devices may be able to significantly lower the patient's risk of developing complications later in life by reducing or even overcoming the burden of hypoglycemia."  

"Without a doubt, the biggest worry for parents of kids with type 1 diabetes is that their child will have a low blood sugar emergency during the night, when they're hard to identify," said Aaron Kowalski, Ph.D., Assistant Vice President of Metabolic Control at JDRF and Director of the JDRF Artificial Pancreas Project.  "This study is proof of principle that diabetes in kids can be safely managed overnight with an artificial pancreas. We need to redouble our efforts to move the artificial pancreas from a concept in the clinic to a reality in the home of kids and adults with type 1."

The first phase of the Cambridge study compared the effectiveness of a simple artificial pancreas system used overnight with standard blood testing and insulin delivery using a pump.  It showed that the time participants spent in target blood glucose levels (between 70 mg/dL and 140 mg/dL) improved from 39% to 52%.  The second phase of the study evaluated the effects of a using the same artificial pancreas system overnight with the additional variable of the participants eating a particularly large meal, which can impact overnight blood glucose levels.  The results were comparable to the first phase of the research.  The third phase of the study evaluated the effects of moderately intense exercise, which can also impact blood sugar levels.  Using the automated system in this setting showed the greatest improvement in blood sugar control, with the amount of time spent in the target range increasing from 48% to 78%.

"The pooled data from the closed loop studies showed that blood glucose levels were 61% in target, and even increased to 75% in target after midnight when closed-loop became fully effective," said Dr. Hovorka. "Based on these results, this study is a significant step towards an artificial pancreas." 

The Cambridge studies were randomized, controlled trials involving 17 children and adolescents conducted at the Wellcome Trust Clinical Research Facility at Addenbrooke's Hospital in Cambridge, United Kingdom over the course of 54 nights.  Twelve subjects were used for the first study; 6 subjects were used for the second, and 9 for the third.  Some 33 nights were on a closed-loop artificial pancreas system, while 21 nights were controlled (on standard therapy).  During the closed-loop studies, continuous glucose measurements were fed into a computer program every 15 minutes, which calculated the insulin infusion rate; the insulin pump was adjusted manually by a research nurse.  During control nights, the subject's standard insulin pump settings were applied. 

Type 1 diabetes is an autoimmune disease in which the immune system attacks and kills off the cells in the pancreas that produce insulin, a hormone that enables people to convert food into energy.  It affects 3 million American children, adolescents, and adults.

To manage their disease, people with type 1 diabetes need to measure their blood sugar multiple times throughout the day (typically by pricking a finger for a drop of blood), and pump insulin or inject themselves multiple times daily to keep blood sugar levels within a healthy range.  That daily routine continues for life, because insulin administration does not cure diabetes.  

Research has shown that good blood sugar control is a key factor in reducing the risk of the devastating long-term complications of the disease, such as blindness and kidney disease - but that the fear of low blood sugar emergencies often prevents many people from achieving tight control, and remains a constant concern for those who manage their diabetes well.   The landmark Diabetes Control and Complications Trial (DCCT) showed that with intensive insulin therapy, excellent blood glucose control was obtained, but at the expense of a considerable increase in hypoglycemia. 

About JDRF's Artificial Pancreas Project 

This study is the latest development within JDRF's Artificial Pancreas Project, and stems from the progress made since 2006 in the JDRF-funded Artificial Pancreas Consortium, a group of university-based mathematicians, engineers, and diabetes experts that has developed the computer programs needed for an artificial pancreas, and established their scientific feasibility.   These academic studies within the Artificial Pancreas Project are an excellent complement, and essential to JDRF's work with industry participants to develop first -generation systems.

JDRF announced the first major non-exclusive industry initiatives of the Artificial Pancreas Project last month, when it entered into a non-exclusive partnership with Animas, a Johnson & Johnson company, to develop a first-generation artificial pancreas system.  JDRF also announced a non-exclusive partnership with BD (Becton, Dickinson and Company) aimed at developing novel insulin delivery products - a key component of developing safe and effective artificial pancreas systems.    

The eventual, ultimate goal of the JDRF Artificial Pancreas Project is speeding the development of automated diabetes management systems.   The goal of an artificial pancreas has also been embraced by the U.S. Food and Drug Administration, which along with JDRF and National Institutes of Health, brought together scientists, regulators, industry, and patients for scientific workshops n the subject in 2005 and 2008; the FDA has designated an artificial pancreas as one of its "critical path" initiatives. 

An artificial pancreas would measure blood sugar through a continuous glucose monitor (CGM), which continuously reads the glucose levels through a hair-thin tube inserted just below the skin, typically on the stomach.  The CGM would beam those readings to an insulin pump.  In an advanced system, the pump would house a sophisticated computer program that would automatically calculate the necessary amount of insulin, based on the CGM's glucose readings, and deliver the right amount of insulin.

The development of an artificial pancreas system is an essential step towards an ultimate cure for type 1 diabetes - a "bridge to a cure."  

More information about the JDRF  Artificial Pancreas Project can be found online at www.jdrf.org/artificialpancreasproject.  The site includes information for people with type 1 diabetes about research leading to the development of an artificial pancreas, as well as interactive tools, project timelines, chats with researchers, and access to information about clinical trials.

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Section 504 of the Rehabilitation Act of 1973

U.S. Department of Health and Human Services.Office for Civil Rights.Washington, D.C. 20201.(202) 619-0403

YOUR RIGHTS UNDER SECTION 504 OF THE REHABILITATION ACT

What Is Section 504?

Section 504 of the Rehabilitation Act of 1973 is a national law that protects qualified individuals from discrimination based on their disability. The nondiscrimination requirements of the law apply to employers and organizations that receive financial assistance from any Federal department or agency, including the U.S. Department of Health and Human Services (DHHS). These organizations and employers include many hospitals, nursing homes, mental health centers and human service programs.

Section 504 forbids organizations and employers from excluding or denying individuals with disabilities an equal opportunity to receive program benefits and services. It defines the rights of individuals with disabilities to participate in, and have access to, program benefits and services.

Who Is Protected from Discrimination?

Section 504 protects qualified individuals with disabilities. Under this law, individuals with disabilities are defined as persons with a physical or mental impairment which substantially limits one or more major life activities. People who have a history of, or who are regarded as having a physical or mental impairment that substantially limits one or more major life activities, are also covered. Major life activities include caring for one's self, walking, seeing, hearing, speaking, breathing, working, performing manual tasks, and learning. Some examples of impairments which may substantially limit major life activities, even with the help of medication or aids/devices, are: AIDS, alcoholism, blindness or visual impairment, cancer, deafness or hearing impairment, diabetes, drug addiction, heart disease, and mental illness.

In addition to meeting the above definition, for purposes of receiving services, education or training, qualified individuals with disabilities are persons who meet normal and essential eligibility requirements.

For purposes of employment, qualified individuals with disabilities are persons who, with reasonable accommodation, can perform the essential functions of the job for which they have applied or have been hired to perform. (Complaints alleging employment discrimination on the basis of disability against a single individual will be referred to the U. S. Equal Employment Opportunity Commission for processing.) Reasonable accommodation means an employer is required to take reasonable steps to accommodate your disability unless it would cause the employer undue hardship.

Prohibited Discriminatory Acts in Health Care and Human Services Settings Section 504 prohibitions against discrimination apply to service availability, accessibility, delivery, employment, and the administrative activities and responsibilities of organizations receiving Federal financial assistance. A recipient of Federal financial assistance may not, on the basis of disability:

Deny qualified individuals the opportunity to participate in or benefit from federally funded programs, services, or other benefits. Deny access to programs, services, benefits or opportunities to participate as a result of physical barriers.

Deny employment opportunities, including hiring, promotion, training, and fringe benefits, for which

they are otherwise entitled or qualified....

These and other prohibitions against discrimination based on disability can be found in the DHHS Section 504 regulation at 45 CFR Part 84.

For information on how to file a complaint of discrimination, or to obtain information of a civil rights nature, please contact us. OCR employees will make every effort to provide prompt service. Hotlines: 1-800-368-1019 (Voice)

E-Mail: ocrmail@hhs.govWebsite: http://www.hhs.gov/ocr

Your Rights Under Section 504 of the Rehabilitation Act (H-8/June 2000 – revised June 2006 - English)

From - http://www.hhs.gov/ocr/civilrights/resources/factsheets/504.pdf

 

JDRF's Ride to Cure Diabetes.

American Chopper 

Stewart-Haas Racing Bike 

TV-PG (L), CC 

Sr. and the guys design a NASCAR inspired chopper for the Stewart - Haas racing team. Mikey puts his physical capabilities to the test and heads to Death Valley to participate in JDRF's Ride to Cure Diabetes. And Paul Jr. pitches a new line of dog toys. 

Learn more about the ride here - http://ride.jdrf.org/