Joy Pape is a board certified diabetes nurse educator. She's well known as much for her bubbly personality as for her years of experience working with PWDs in both inpatient and outpatient settings. She's recently made a career leap that she's very excited about. And you might be too, to hear her describe it...
This has been an exciting year for me. I’ve made somewhat of a career change. I, like many diabetes educators, used to mainly work with people with type 2 diabetes. Oh sure, I've been a pump trainer for years, but other than that, I still mainly worked with people with type 2.
I can honestly say, for the most part I've made the switch, I see more people with type 1 now, and I understand why people with type 1 diabetes feel so left out. On the other hand, there's a lot more going on with type 1 than I was aware of.
The switch didn't happen overnight. I've been a diabetes educator for over thirty years. About 15 years ago, I got involved with the hot topic of lower carb meal plans. Through that I got involved in media. I met a lot of people with type 1, many were writers, producers, actors, etc. I moved to New York City to further my work.
I now work with a Manhattan endocrinologist who sees a lot of people with type 1, and became a continuous glucose monitor (CGM) trainer. I see what people go through more and more. And I understand it’s a lot! Someone once told me, “Having type 1 diabetes is a condition of inconvenience.” How true!
Last summer I realized research was the way to go. So I learned about, and starting working with Tolerx. Tolerx is a world leader in understanding the function of T cells and developing novel therapies that treat autoimmune diseases, diabetes, and cancer by specifically modulating T cell activity. I know that’s a mouthful, but, I thought – “Auto-immunity and diabetes, how interesting! And how cutting edge!”
At the time Tolerx was conducting a phase 3 study (That’s right, a study in people! It’s way beyond the mice stage), called DEFEND. That has now come to a close, with very promising preliminary results. Now DEFEND2, the second phase 3 study has launched and is accepting people newly diagnosed with type 1 diabetes, 12 to 45 years old.
NOTE: Amy talked about Tolerx and DEFEND2 in her blog post, Tolerx: Attacking the Cause of Type 1 Diabetes in People (Not Mice).
This study is looking at preserving beta cell function and protecting the beta cell from further damage with the use of an anti-CD3 antibody, otelixizumab, pronounced o-tel-ix-iz-u-mab. “CD3” is the scientific name for a protein target on the outside of two types of T cells (lymphocytes) that are found in your blood. One type of T cell (killer cell) causes destruction of your insulin producing cells. The other type of T cell (regulatory cell) prevents this destruction by controlling the T killer cells. By using antibodies that stick to CD3, two kinds of useful actions may occur to help correct the type 1 diabetes. One action stops T killer cells and the other promotes the T regulatory cells that inhibit the T killer cells.
Early results have shown that this kind of treatment may result in better control of sugar levels with the use of less insulin. They have also been shown to lessen severe swings of low and high blood sugar levels. Wouldn’t this be great?!
In time we’ll know if this means fewer complications from T1DM and if this improves quality of life.
This whole field is interesting to me, because there’s not only the potential to help people with type 1, but we’re finding so much more about how the immune system is related to so many conditions, such as rheumatoid arthritis, psoriasis, thyroid problems, multiple sclerosis, and celiac disease. I’ve even heard Dr. Jay Skyler say that in clinical studies, even though the treatment was for people with type 1, those who had other auto-immune problems got better too.
One more thing about people with type 1: Through the years, I've noticed something else I think is interesting – I've met quite a few very creative and brilliant people who have type 1. I'm not saying that there aren't smart people who don't have type 1, and I'm not saying that every one who has type 1 diabetes is brilliant, but there seems to be a lot who are... way beyond the norm. Sometimes I've wondered if it has to do with what you've had to do since a kid. On the other hand, not every one of you brilliant ones has had diabetes as a kid. For now I'll watch and wait to see if any emerging science comes from this.
— Joy Pape, RN, CDE
Thanks Joy. We'll take the compliment, and throw it back at you: we're glad to have smart folks like you working on our case