I’ve been living with type 1 diabetes (T1D) since I was 19 years old. Day and night, there are countless calculations I make to manage my blood glucose and anything that can affect my glycemic control. The daily checklist is extensive but vital to my survival. What’s my morning fasting glucose? Do I have enough insulin in my pump and is my continuous glucose monitor (CGM) working correctly? Did I calculate the carbohydrates correctly in what I’m about to eat or drink, and did I factor in effects of fat and protein in the meal to ensure good glycemic control? Is it possible I could become hypoglycemic overnight and will I wake up from my CGM alarm? The list goes on.
I was diagnosed as a junior in college. I had already made the decision to become a physician. However, my diagnosis changed my life and my perspective, highlighting the importance of the need to advance medical research. It was very clear to me that if people hadn’t worked to understand and discover new medicines for this disease, I wouldn’t be here today. More than 30 years later, I am a physician-investigator, having spent 17 years directly caring for patients as an endocrinologist and two decades in pharmaceutical research and development. At home, I now have a teenage daughter living with T1D, bringing the disease even closer to my heart. Both of our experiences with T1D have allowed me to empathize with patients in a way I would not have otherwise experienced.
Over the last few decades, I have witnessed the evolution of T1D management options. I used to measure my blood glucose up to eight times a day with a fingerstick — now I use CGM. I started off giving myself at least six daily injections of insulin — it wasn’t until 10 years later that I switched to an insulin pump. Most recently, I started using a hybrid closed loop system. Now, my CGM directly interacts with my insulin pump and can adjust my insulin rates as needed—and although I still need to be aware and input certain information throughout the day, having this system has improved my quality of life.
Nevertheless, it’s still a tremendous amount of work and mental energy to manage these various systems and to always be tethered to a monitor and pump. While about 50% of patients with T1D like myself achieve target measurements to manage glucose levels, many do not. The need to advance better treatment options with the potential to alleviate the many burdens of this disease have never been more apparent.
For many of us in the T1D community, managing T1D is like driving a car — if you take your eyes off the road momentarily, something adverse could happen. Some liken the constant vigilance and frequent associated worries of T1D to having an additional, very stressful, full-time job: managing T1D imposes a psychological burden in addition to the physical one; anticipating and reacting to your body’s needs at every meal, every night going to sleep, every time you exercise, every time you feel sick. Imagine living with this worry 24/7 and being among the 50% of individuals with T1D who, despite their best efforts and technologies available, cannot maintain their glucose levels in the ideal range.
I joined Vertex in 2019 and now lead the clinical development group for cell and genetic therapies here, which includes our work on T1D. At Vertex, we strive to have an impact on serious diseases by understanding and targeting the underlying biology of the diseases on which we work. In T1D, we see a possibility to transform the disease by addressing its root cause: the destruction of pancreatic beta cells. Our vision is to advance cell and genetic approaches to potentially restore the body’s ability to regulate glucose.
For me, my daughter and the broader T1D community, the work we’re doing today could lead to a future where the management of T1D could be less burdensome, where the mountain of decisions and calculations each day are possibly flattened into the horizon ahead.
To learn more about Vertex Pharmaceuticals, visit global.vrtx.com.