DAVID GRANOVSKY

Posts Tagged ‘insulin’

WHAT DOES THE FOXO1 SAY? HERE’S MORE INSULIN!

In ALL ARTICLES, BUSINESS OF STEM CELLS on July 5, 2014 at 10:20 am
It May Take Guts to Cure Diabetes -Human GI Cells Retrained to Produce Insulin

Imagine taking cells from your gastrointestinal tract and then switching off one gene, the FOXO1 gene, and then ending up with insulin producing cells.  From gut cell to diabetes fighter in one easy gene switch-off.  Scientists did this successfully in 2012 in mice and recently in humans.  What does the FOXO1 say? ‘Here’s more insulin!’  Awesome.

The next step is where it gets…awkward.  I’d like this information to generate a gene therapy protocol or to improve success rates in stem cell/Diabetes treatment protocols,  etc.  But that’s not the way our system works.  The next step is to find a drug that inhibits the FOXO1 gene so it “…could retrain cells inside a person’s GI tract to produce insulin…”  Unfortunately, this drug will also have side effects as all drugs do which will create other symptoms requiring other drugs to mitigate.  And so it goes.

When will US Diabetes patients be able to benefit from a medical protocol based on this discovery?  An educated guess puts it at:
7-10 years for clinical trials and drug development for a name brand Pharma product and then 10-15 years for the drug patent to open up to an affordable generic.
Sorry Diabetes patients.

New York, NY (June 30, 2014) “By switching off a single gene, scientists at Columbia University’s Naomi Berrie Diabetes Center have converted human gastrointestinal cells into insulin-producing cells, demonstrating in principle that a drug could retrain cells inside a person’s GI tract to produce insulin…The Columbia researchers were able to teach human gut cells to make insulin in response to physiological circumstances by deactivating the cells’ FOXO1 gene.”

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PANCREAS STEM CELL DISCOVERY

In STEM CELLS IN THE NEWS on December 17, 2012 at 9:00 am

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Professor Len Harrison

A significant step discovered in the fight against Type 1 diabetes.  An Australian team of scientists and researchers led by Dr. Ilia Banakh and Professor Len Harrison have developed a technique to manipulate isolated stem cells for the adult pancreas to become insulin-producing beta cells capable of producing insulin in response to glucose.  “The discovery could bring closer the time when people with type 1 diabetes will be able to produce their own insulin and be free of the multiple daily injections”.

-DG

The discovery was made by scientists from the Walter and Eliza Hall Institute and provides further evidence that stem cells don’t only occur in the embryo.

The ability to produce the hormone insulin is crucial for controlling blood sugar (glucose) levels.  In people with type 1 diabetes the body’s immune system destroys the insulin-producing beta cells of the pancreas, leading to a potentially fatal elevation of blood glucose levels.  People with type 1 diabetes rely on multiple daily injections of insulin, or an insulin infusion pump, to control their blood glucose, but control is not perfect and they are at risk of serious long-term health complications.

Dr Ilia Banakh and Professor Len Harrison from the institute’s Molecular Medicine division have not only identified and isolated stem cells from the adult pancreas, but developed a technique to drive these stem cells to become insulin-producing cells that can secrete insulin in response to glucose.

Professor Harrison said that insulin-producing cells had previously been generated from cells in the adult pancreas with ‘stem cell-like’ properties. “But what Dr Banakh has done is pinpoint the cell of origin of the insulin-producing cells and shown that the number of these cells and their ability to turn into insulin-producing cells increases in response to pancreas injury. This is exciting, because it means that the potential to regenerate insulin-producing cells is there in all of us, even as adults,” Professor Harrison said.

“In the long-term, we hope that people with type 1 diabetes might be able to regenerate their own insulin-producing cells. This would mean that they could make their own insulin and regain control of their blood glucose levels, curing their diabetes. Of course, this strategy will only work if we can devise ways to overcome the immune attack on the insulin-producing cells, that causes diabetes in the first place,” Professor Harrison said.

http://www.wehi.edu.au/uploads/Harrison_PLOS_One_Final.pdf

PANCREATIC STEM CELLS, ONE STEP CLOSER TO A CURE

In SCIENCE & STEM CELLS, STEM CELLS IN THE NEWS on December 12, 2012 at 9:00 am

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Millions of people in the United States suffer with type 1 diabetes and are unable to produce sufficient insulin. “As of 2010, 25.8 million people—8.3% of the population—have diabetes; 1.9 million new cases of diabetes were diagnosed in people aged 20 years or older in 2010.” (http://www.cdc.gov/diabetes/consumer/research.htm) “… About 27 percent of those with diabetes—7 million Americans—do not know they have the disease. Pre-diabetes affects 35 percent of adults aged 20 and older. (http://www.cdc.gov/media/releases/2011/p0126_diabetes.html) The potential to transplant insulin-producing cells into patients suffering from Diabetes would be a critical step forward and could offer hope for a long-term cure.
-DG

The potential to one day treat type 1 diabetes using transplants of insulin-producing beta-cells derived from pancreatic progenitors may have just crept a tad closer, if findings by a group of researchers at the University of California, San Diego (UCSD) can be verified. The team has identified a cell surface marker on a subpopulation of cells in the pancreas that appears to identify them as pancreatic stem cells (PnSCs), a cell type which has never actually been firmly demonstrated in human or animal tissues.

A current approach to cell replacement therapy for diabetes involves the transplantation of pancreatic islets, which involves numerous transplant procedures. Although it is feasibly possible to derive insulin-producing cells from either human embryonic stem cells (hESCs) or induced pluripotent stem cells (iPSCs), there are technical issues which have yet to be solved. What is ideally needed is a source of stem cells derived directly from the pancreas that can readily be prompted to differentiate into the desired cell type.

Research by Alberto Hayek, Ph.D., and colleagues now indicates that human pancreatic ductal cells that express the cell surface stem cell marker stage-specific embryonic antigen 4 (SSEA4) may represent this elusive population of PnSCs that has long been postulated but never quite isolated. The cells, located in the exocrine portion of the adult human pancreas but not inside islets themselves, also express ductal, pancreatic progenitor, and stem cell protein markers. Interestingly, the investigators found that SSEA4-expressing cells isolated from fetal pancreatic tissue additionally express a recognized marker of endocrine progenitor cells.

Notably, when the UCSDF team then isolated adult human pancreatic SSEA4+ cells and cultured them in media containing high levels of glucose and B27 supplements, the cells formed aggregate-like spheres and differentiated readily into pancreatic hormone-expressing cells.
“Accumulated evidence supports the concept that pancreatic stem/progenitor cells may originate in the pancreatic duct, where they reside in a quiescent stage,” the authors remark. “We are first to identify SSEA4+ cells in the adult human pancreas with characteristics of pancreatic progenitors. Further clonal analysis would confirm their stemness…. The discovery of specific markers for the identification and purification of human PnSCs would greatly facilitate studies aimed at the expansion of these cells and the development of targeting tools for their potential induction to insulin-producing cells.

Dr. Hayek et al., report on their findings in BioResearch Open Access, in a paper titled “Is stage-specific embryonic antigen 4 a marker for human ductal/stem/progenitor cells?”

http://www.genengnews.com/gen-news-highlights/pancreatic-stem-cells-could-they-treat-diabetes/81247218/

ADULT Stem Cell Therapy Reverses Diabetes – CBS 42

In VICTORIES & SUCCESS STORIES on January 18, 2012 at 9:12 am

ADULT Stem Cell Therapy Reverses Diabetes

BIRMINGHAM, Ala. (Ivanhoe Newswire)- Type 1 diabetes is caused by the body’s own immune system attacking its pancreatic islet beta cells and requires daily injections of insulin to regulate the patient’s blood glucose levels.

A new method found in the BioMed Central’s open access journal BMC Medicine uses stem cells from cord blood to reeducate the T cells in a diabetic’s blood to restart the pancreatic function and reduce the need for insulin. In Stem Cell Educator therapy, lymphocytes were separated from a patient’s blood over immobilized donated cord blood stem cells. After two or three hours in the device the revamped lymphocytes are returned to the patient. Progress was checked at 4, 12, 24 and 40 weeks after therapy.

After 12 weeks results showed an increase in C-peptide levels. C-peptide is a protein fragment created from insulin that can be used to determine how well beta cells are working. Levels increased at 24 weeks and remained the same at the end of the study, meaning that the patient’s daily dose of insulin could be reduced. Also results showed that the glycated hemoglobin (HbA1C) indicator of long term glucose control also dropped for people receiving the treatment.

Dr Yong Zhao, from University of Illinois at Chicago, was quoted as saying, “We also saw an improved autoimmune control in these patients. Stem Cell Educator therapy increased the percentage of regulatory T lymphocytes in the blood of people in the treatment group. Other markers of immune function, such as TGF-beta1 also improved. Our results suggest that it is this improvement in autoimmune control, mediated by the autoimmune regulator AIRE in the CBSC, which allows the pancreatic islet beta cells to recover.”

Source: BMC Medicine, January 2012

Stem Cell Therapy Reverses Diabetes – CBS 42 Birmingham, AL News Weather Sports.

Medical News: Stem Cells Help in Type 1 Diabetes – in Endocrinology, Diabetes from MedPage Today

In VICTORIES & SUCCESS STORIES on January 12, 2012 at 9:33 pm

Medical News: Stem Cells May Help in Type 1 Diabetes – in Endocrinology, Diabetes from MedPage Today.

Action Points  


    • A study in 15 patients, 12 of whom received the treatment, found that lymphocytes “re-educated” by passage with cord blood stem cells, were effective in treating patients with type 1 diabetes with and without residual beta cell function.
  • Both insulin requirements and glycated hemoglobin levels decreased significantly in the treated patients with effects lasting out to 40 weeks.

Therapy using the patient’s lymphocytes passed through a device with cord blood stem cells may “educate” the patient’s cells to provide safe, lasting treatment for patients with type 1 diabetes, according to the results of a small Chinese study.

Those patients with moderate diabetes and some residual beta cell function (Group A) exhibited improved fasting C-peptide levels at 12 and 24 weeks post-treatment, Yong Zhao, PhD, of the University of Illinois at Chicago, and colleagues reported online in BMC Medicine.

Patients with more severe disease and no residual beta cell function (Group B) also showed improvement at every follow-up…

INTESTINAL STEM CELLS RESPOND TO FOOD BY SUPERSIZING THE GUT

In STEM CELLS IN THE NEWS on October 27, 2011 at 6:24 pm

Request more treatment info.

INTESTINAL STEM CELLS RESPOND TO FOOD BY SUPERSIZING THE GUT

SO now we know that stem cells change your body all the time to deal with changes in your environment and what you eat.  Is it getting clearer? – David

Intestinal stem cells respond to food by supersizing the gut

BERKELEY —

A new study from University of California, Berkeley, researchers demonstrates that adult stem cells can reshape our organs in response to changes in the body and the environment, a finding that could have implications for diabetes and obesity…

Intestinal stem cells respond to food by supersizing the gut.

DIABETES CLINICAL TRIALS

  • FIRST USE OF CORD BLOOD TO ALTER COURSE OF TYPE 1 DIABETES, June 25, 2007 – (I’ll bet nobody heard of this one!)transfusion of stored, autologous (i.e. the person’s own), umbilical cord blood into a group of children newly diagnosed with type 1 diabetes appears to have reduced their disease severity, possibly re-setting the immune system and slowing the destruction of their insulin-producing cells, according to a report presented today at the American Diabetes Association’s 67th Annual Scientific Sessions. –http://parentsguidecordblood.org/content/media/m_pdf/ADA_T1D_PR-06-25-07.pdf(The ADA in 2007 knew stem cells can treat Diabetes type 1 in children!)
  • Diabetes type 1 stem cell clinical trial – Enrollment 11/2003-4/2008, follow-up until December 2008 – https://repairstemcell.wordpress.com/2009/09/14/type-1-diabetes-stem-cells-clinical-trial/
  • Why no diabetes clinical trial s in the US when mice were cured of diabetes type 1 in the 1990’s? –  Weissman, a professor of pathology and developmental biology at Stanford University, states: “Stem cells are rare, self-renewing, and can regenerate body tissues.” He repeatedly expressed frustration that while many of his discoveries seemed to hold remarkable potential for life-saving treatments, commercial or regulatory hurdles have prevented his scientific research from benefiting human beings. One example is, his mid-’90s research on type I diabetes, in which he demonstrated the ability to fully cure type I diabetes in mice using stem cells. Even though the experiments avoided political controversy by using adult/repair stem cells, which do not come from embryos, Weissman ran into a road block when pharmaceutical companies refused to sponsor clinical trials. The therapy went nowhere. “The pharmaceutical companies had put profit over principle, preferring to keep diabetes sufferers dependent on costly insulin than to cure them once and for all.” – https://repairstemcell.wordpress.com/2009/09/13/research-from-90s-cures-type-1-diabetes/

If you or a loved one is interested in receiving FREE information on currently available stem cell treatments for DIABETES or PERIPHERAL ARTERY DISEASE, please contact me at dsgrano@gmail.com or for other options, go to: CONTACT ME

HOPE FOR DIABETES SUFFERERS

In ALL ARTICLES on October 27, 2011 at 2:05 pm

THERE IS HOPE

I am continuously amazed at the wet blanket attitude that is projected by so many in light of significant stem cell breakthroughs.

First they say: “stem cell treatment has enabled patients with type 1 diabetes to go for as long as four years without insulin injections”

…pretty awesome huh?

Then they say: “the team warned the treatment may only work in those very recently diagnosed”

…oh, really…bummer.

Let’s just overlook that “recently diagnosed” actually means “recently developed symptoms” (I am fairly sure they don’t mean a 75 yr old grandmother who was “recently diagnosed” as having lived with diabetes for 55 years.) and as my friend the actuary likes to say: “Let’s just concentrate on the numbers.”

  • · Diabetes Prevalence – Total: 23.6 million children and adults — 8.0% of the population — have diabetes.  The total prevalence of diabetes increased 13.5% from 2005-2007.
  • · Diagnosed: 17.9 million people
  • · Undiagnosed: 5.7 million people (24%!)
  • · Pre-diabetes: 57 million people
  • · 1.6 million new cases of diabetes were diagnosed in people aged 20 years or older in 2007.

http://www.diabetes.org/diabetes-statistics.jsp

———————–

Ok, those are the numbers….So how SHOULD this article have been written?

How about…

World celebrates as new results prove diabetes pandemic can be stopped in it’s tracks with early detection!  Government to spend 10 million on improved early diabetes detection. (wait, where would they get the money…oh!) Money to be saved from not having to spend 100 million on late stage diabetes treatments.

Or….

5.7 million undiagnosed diabetes victims can now be saved from the trials of diabetes, amputation, blindness, kidney disease…etc with a single blood test.

Maybe you can come up with a different slant?

Point is; this is HUGE news!  Can we now cure every diabetic in the world?  No.  But we can potentially cure MILLIONS and this is a time for celebration for those people…and a time for optimism for the potential cures for others who are more advanced (as the science improves)…not a time for warnings of limitations.

But no, they stick to the glass is half empty position and say:
“It would be wrong to unnecessarily raise the hopes of people living with diabetes about a new treatment for the condition on the back of the evidence provided in this study.”

But you know what I think?

I think caution is good…but we are talking about people who are living with diabetes!  In my book, that makes them pretty damn tough already.  They are not little kittens and they don’t have to have their hopes “managed” or “spoon fed” to them.  In fact, raising their hopes may be EXACTLY what they need to survive through one more day of diabetes related pills and insulin, threats of blindness and amputation, reduction of lifespan, kidney and liver disease…etc. etc.

So celebrate the victories, embrace the hope and ALWAYS remember:

“If you lose hope, somehow you lose the vitality that keeps life moving, you lose that courage to be, that quality that helps you go on in spite of it all. And so today I still have a dream.” Martin Luther King, Jr.

And as far as false hope, there is no such thing. There is only hope or the absence of hope-nothing else. – Patti Davis

 

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“There is only hope or the absence of hope-nothing else.

DAMN STRAIGHT!

DIABETES and STEM CELL TREATMENTS AVAILABLE

In ALL ARTICLES on October 24, 2011 at 9:15 am

Anyone interested in treatment info with one of the best stem cell diabetes doctors in the world can contact me or fill out this form: 
TREATMENT INFORMATION REQUEST – PATIENT QUESTIONNAIRE

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Can stem cells cure Diabetes – type 1?

In VICTORIES & SUCCESS STORIES on August 31, 2009 at 12:00 pm

Can stem cells cure Diabetes – type 1? See the results of this one year study of adult stem cell treatment of Diabetes type – 1. C-peptide levels, insulin levels, insulin dosage requirements and HA1c levels.

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Can stem cells cure Diabetes – type 2?

In VICTORIES & SUCCESS STORIES on August 31, 2009 at 12:12 pm

Can stem cells cure Diabetes – type 2? See the results of this one year study of adult stem cell treatment of Diabetes type – 2.  C-peptide levels, insulin levels, insulin dosage requirements and HA1c levels.

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DIABETES CLINICAL TRIALS

  • FIRST USE OF CORD BLOOD TO ALTER COURSE OF TYPE 1 DIABETES, June 25, 2007 – (I’ll bet nobody heard of this one!)transfusion of stored, autologous (i.e. the person’s own), umbilical cord blood into a group of children newly diagnosed with type 1 diabetes appears to have reduced their disease severity, possibly re-setting the immune system and slowing the destruction of their insulin-producing cells, according to a report presented today at the American Diabetes Association’s 67th Annual Scientific Sessions. –http://parentsguidecordblood.org/content/media/m_pdf/ADA_T1D_PR-06-25-07.pdf(The ADA in 2007 knew stem cells can treat Diabetes type 1 in children!)
  • Diabetes type 1 stem cell clinical trial – Enrollment 11/2003-4/2008, follow-up until December 2008 – https://repairstemcell.wordpress.com/2009/09/14/type-1-diabetes-stem-cells-clinical-trial/

Images from above are from these articles:

  • Why no diabetes clinical trial s in the US when mice were cured of diabetes type 1 in the 1990’s? –  Weissman, a professor of pathology and developmental biology at Stanford University, states: “Stem cells are rare, self-renewing, and can regenerate body tissues.” He repeatedly expressed frustration that while many of his discoveries seemed to hold remarkable potential for life-saving treatments, commercial or regulatory hurdles have prevented his scientific research from benefiting human beings. One example is, his mid-’90s research on type I diabetes, in which he demonstrated the ability to fully cure type I diabetes in mice using stem cells. Even though the experiments avoided political controversy by using adult/repair stem cells, which do not come from embryos, Weissman ran into a road block when pharmaceutical companies refused to sponsor clinical trials. The therapy went nowhere. “The pharmaceutical companies had put profit over principle, preferring to keep diabetes sufferers dependent on costly insulin than to cure them once and for all.” – https://repairstemcell.wordpress.com/2009/09/13/research-from-90s-cures-type-1-diabetes/

If you or a loved one is interested in receiving FREE information on currently available stem cell treatments for DIABETES, please contact me at dsgrano@gmail.com or for other options, go to: CONTACT ME

Research confirms presence of stem cells in human milk

In ALL ARTICLES on May 26, 2010 at 3:14 am

Research confirms presence of stem cells in human milk

Reporter
Tuesday, May 25, 2010 AT 12:00 AM (IST)

PUNE: Gynaecologist and infertility specialist Dr Satish Patki from Kolhapur and technical director, Stempeutics Research, Malaysia and senior scientist, National Centre for Cell Science Pune, Dr Ramesh Bhonde have collaborated on a research in which they have demonstrated the presence of stem cells in human milk.

They have also documented for the first time in literature the potential of these stem cells, isolated from human milk to differentiate into various other types of cells like insulin producing cells of pancreas, bone cells etc.

“We are floating stem cells derived from breast milk as a drug for neonatal diseases like sepsis, respiratory diseases and others, which lead to infant mortality. Oral stem cell therapy only works in the case of infants. The stem cells from mother’s milk can be cultured and stored in stem cell banks,” said Dr Bhonde…

via Sakaal Times.

Double transplant for type 1 diabetes brings troubles, gifts

In ALL ARTICLES on January 11, 2010 at 3:05 pm

Double transplant for type 1 diabetes brings troubles, gifts
Updated 1/11/2010 12:05 PM ET    E-mail | Save | Print

Enlarge    By Dan MacMedan, USA TODAY

Immersing himself in a hot bath while taking anti-nausea pills brings Scott Bowles some relief from cyclic vomiting syndrome.

By Scott Bowles, USA TODAY

Ten years ago Tuesday, USA TODAY’s Scott Bowles had a kidney and pancreas transplant to treat his juvenile diabetes. He kept a journal of the experience, which ran as a series in the newspaper and in his book, The Needle and the Damage Done. Bowles, 44, a film reporter in Los Angeles, looks back at the decade and life after the surgery.

Albuquerque, April 7, 2009
Denzel Washington is going to have to wait.
The star is on a nearby stage, rehearsing

But I’m not going to make it. I’m on the floor of a publicist’s darkened office, on my back, trying to slow my breathing and fight off the nausea and heart palpitations that are racking my body.
READ MORE: Type 1 diabetes’ effect on daily life
Again.

It has been 10 years since I opted to treat my diabetes with a kidney and pancreas transplant, a decision that, for the first time, I’m beginning to question.

I find myself on a hospital gurney with frightening regularity lately. Where once I was going to the hospital every six to eight months, now I’m there every six to eight weeks. My weight is down to 139, lighter than I was in college. Three days without nausea or a racing heart feels like a good stretch of health.

More frightening, doctors aren’t sure how to keep my body from breaking down. They’ve diagnosed me with two post-transplant illnesses: cyclic vomiting syndrome (CVS) and atrial fibrillation. CVS is a powerful wave of nausea that hits without warning and can last hours, leaving me heaving long after my stomach is empty.
The nausea depletes me of electrolytes and minerals, which sends my body into the more dangerous complication: atrial fibrillation, a condition in which the heart pumps twice as fast as normal but circulates only 60% of the blood, raising the risk of a blood clot and stroke.

Today, I’m in the throes of both complications. I’m rushed to New Mexico University Hospital, where nurses are having trouble finding a vein. I’ve had so many blood draws over the decade that my veins have scarred and it’s difficult to find one that’s usable.

They try two sticks in the left arm. No luck. One in the right. Same result.
A nurse suggests mining my neck. I close my eyes: This is the one place I thoroughly feel the needle. The vein works all right; it’s dashing us both in arterial spray, too much for her to secure an intravenous tube. Finally, she sinks the needle between the fingers of my right hand and finds a vein.
After a bit, I feel the medications open my lungs and nudge me toward sleep.
But not before I think to myself: I can’t keep doing this.

Los Angeles, July 14
My doctor for the past 10 years, Michael Brousseau, has me in his office. My mother is here, too. She has traveled from Atlanta to meet with physicians and brainstorm.

Brousseau is frustrated. I’m on a dozen anti-nausea medications — some of them designed for cancer patients on chemotherapy — yet nothing works with consistency.
He connects me with two more specialists, who will focus on my stomach and heart. “Something has to work,” he says. “Because right now, you’re not functional.”

The words throw me. I had this surgery Jan. 12, 2000, as a salvo against the disease, which over 20 years claimed both kidneys, one-third of my sight and almost all hope that I’d reach 50 with my vision and limbs intact.
And for five years, it seemed, the transplant was the solution. To this day I’ve had no rejection episodes and not a drop of insulin.

But the new complications are frighteningly quick and forceful. I was never staggered by an insulin reaction or high blood sugar as I am by these side effects.

We drive home, and I excuse myself to the bathroom. I run a hot bath (the one treatment that seems to settle my nausea) and turn up the radio so Mom can’t hear me lose my composure in the tub.
Maybe I don’t beat my body’s demons. Maybe I already was as healthy as I’m ever going to be.

July 16
Mom and I are walking through the mall when I lose my balance. The new medications are interacting poorly, leaving my head swimming and my legs unreliable. I flop in a mall seat while Mom goes for something to drink.
A woman who has been watching from a nearby bench walks toward me. She holds a package of gum and offers me a piece.

I’m not sure how to respond, so I take it and thank her. She shakes her head — she doesn’t speak English — but smiles and offers another piece.
The gum does nothing, the gesture everything. By the time Mom is back, I’m already feeling better, energized by the random kindness of the woman, who nods and smiles as Mom and I pad off.
This disease can offer such odd, sweet consolation prizes.

Sept. 16
A nurse calls me at home, the first time I’ve heard from my insurance company unsolicited.
“It appears you’ve been having some complications of late,” she says. “Is there anything we can do?”
I’m cautious. I’m getting two dozen bills, letters from hospitals and benefits explanations every month now, and I must be signaling a red flag with the insurance company. My anti-rejection drugs have jumped from $1,200 a year to $2,800. And that doesn’t include hospital stays, ER visits or nausea medications that run $150 a week.
No, thank you, I tell her. We have specialists working on it.

She presses a little more, asking for some details of my recent hospitalizations. She gently asks whether this is a new problem or something “that might have been pre-existing.”
I freeze. I know what that phrase means. It means you’ve become too expensive to keep healthy. No, I say flatly before getting off the phone, it’s a new problem.

Fortunately, I didn’t have to lie. This is new. I could use help. But I’m not sure she’s offering it, and I would have told her my nose wasn’t a pre-existing condition if my insurance were at stake.

Nov. 1
My good friend Jocelyn Smith is visiting when I feel my hands and feet go numb — the surest signal I’m headed into atrial fibrillation.

Without a word, she jumps into action. She eases me into her car, drives me to the hospital and gives the doctors the rundown on my medications and symptoms. She stays the duration of the six-hour wait for a bed.
Somehow, this trip to the hospital is easier than the others.

Maybe it’s seeing Jocelyn oversee the chaos like a M.A.S.H. nurse. I’ve watched as my friends and family turn into a team of first responders: paramedics, doctors, ambulance drivers. All without asking or asking anything in return.
Not that there’s any way to repay what they’ve given me.

Dec. 11
I’m beginning to understand how dogs improve and lengthen the lives of the elderly. Mine are making this place more homey.

When I’m ill in the bath, I notice, they quit roaming the house and cram into the bathroom. My golden retriever, Teddy, curls up by the tub. Esmé, a diminutive Boston terrier who acts as his orbiting moon, nestles into his belly.
I don’t want to be that crazy dog guy, but I’m convinced their company helps. It’s comforting to reach over the tub and bury my hands into that warm, tangled fur pile, something that could have sprung from Where the Wild Things Are.

I’ve read the studies that say domestic animals have learned over the years to befriend humans to maximize food and shelter from us.
But I prefer to think they can’t stand the thought of me being alone or sick.

Dec. 25
This could be a strange Christmas. Because the nausea and A-fib can strike so suddenly, I can’t risk being on a plane for five hours to visit my family in Atlanta. This will be the first Christmas I don’t make it home for some part of the holiday season.

I wake up ready to dread the day, but my body has surprised me. No nausea, no heart-skipping.
I decide to spend the day visiting people dear to me: Anthony Breznican, who cooks for me more than I do; Luz Elena Avitia, who has become a surrogate parent to my dogs when I’m sick; and Michael Ingram, an old friend who offered me one of his kidneys 10 years ago.

The trip isn’t without risk. Luz and Michael are in San Diego, and the complete drive will take at least five hours — as long as a flight.
But I’m tired of my body caging me. I stuff a few meds in my jeans and hit the road.
The day flies. Everyone is in good spirits, my heart is behaving and by the time I’m driving back, I’ve forgotten how long I’d gone without a moment of nausea.

When I get home, I realize that I haven’t opened any presents under the tree. I know it’s corny, but this Christmas — filled only with people I love — has a Seuss-ian feel to it. I go to bed without touching a gift. I’ll do that tomorrow.
Tonight, I’d like to remain that Who in Whoville.

Jan. 9, 2010
Tuesday marks what I consider my 10th birthday: the day I received my organs.

It also marks the day Valerie and Leroy Flegel took their 21-year-old son, Samuel, off life support.
I have trouble reconciling this. How does that much despair create that much hope?

Samuel was, by all accounts, an extraordinary young man. Born with a learning disability similar to dyslexia, he overcame it to earn his GED and become an engineer for Red River Valley and Western Railroad in Wahpeton, N.D.
He was riding home from a New Year’s party in Fargo in 2000 when he hit a parking lot abutment hidden in snow. By the time police found him, he was brain-dead, though the subzero temperatures kept his body alive.
Now I carry him.

For some reason, I rarely get sick around the anniversary date, and this time is no different. I wake up hungry, energized. Healthy. I hop in the car and drive for a doughnut, something I could never have eaten as a diabetic.
On the drive back, I’m a little angry at myself for being so self-pitying, for questioning this fight. There is no beating diabetes, just changing the complications. But at least I have a chance for better health, something Samuel never got.

And perhaps more than any other anniversary, this one reminds me that I do not fight alone. Through all this, friends have become family and family has become closer than it has ever been. Strangers have offered whatever they have. I think of them and it propels me, literally.
I am awake now, opening up the accelerator as I drive home. Music rattles the windows of the car. I don’t want the drive to end.

I speed past the exit for my house. The morning is bleeding into afternoon, and it’s too warm, too nice to stop moving. I’m going to drive until I run out of gas.
For every day I spend sick or in a hospital, it seems, I receive one that is equally fine. That’s where I discovered the unexpected gift of diabetes, one that I would never return: the capacity to recognize and enjoy the moment.
A nausea-free morning. A symptom-free afternoon. A good day.
Like this one.

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