Dr. Emily King is a pediatric endocrinology fellow. She also has Type 1 diabetes. Her Journey with diabetes began at age eight when she was diagnosed in elementary school and began having to step away from the class to prick her finger every day to manage glucose levels. She hopes one day she as well as her pediatric patients with diabetes will no longer have to live the diabetes lifestyle filled with needles and pumps and pills.  She confides, though, that having diabetes made her want to be a doctor.

How has diabetes affected your life as a physician?

With diabetes, you’re constantly thinking about ‘Where did you come from? When did you last eat? When are you going to exercise? Where are you now? Where are you going?’ You always have to have that in the back of your mind.

If I never got diabetes, I don’t think I would be a physician because that was my main exposure to the medical world as a child. I decided I wanted to help people and help kids and families and take care of them just like how my doctors took care of me. It definitely was a big motivating factor for me to pursue a career in medicine.

I love taking care of kids with diabetes and I think it’s because I can understand some of their struggle and I feel very motivated to try to support them with managing their diabetes and helping their parents navigate the daily aspect of diabetes management.

What kind of cases of diabetes do we see at Harbor and what treatment do we give them?

Harbor we have as many children with Type 2 diabetes as Type 1 and that’s because of the childhood obesity epidemic. With Type 2 diabetes, it depends on how insulin-deficient they are. Some of the kids are very insulin deficient, they require as much insulin or more than someone with type 1. Some kids, we manage their Type 2 in the form of a pill. Others, we manage with diet alone and lifestyle changes and there is the potential for some of them coming off of all medical therapies completely if they follow the regimen we put them on now and they lose weight – sometimes their diabetes can come away.

How is diabetes different from other autoimmune diseases?

I think that diabetes is a really unique disease because the patient is the doctor. All day, every day, the patient is making decisions to intervene on their health and some of these therapies can be life-threatening. They’re constantly using data that they have to make decisions on their medication for their management of diabetes.

How has diabetes health care changed recently?

They’re developing more sophisticated insulin pumps and better, more accurate continuous glucose monitoring systems. There was a device that was released that is the first device that is an artificial pancreas, a closed loop system, in which a closed glucose monitoring system is connected and communicates with the insulin pump to tell the insulin pump how much insulin to administer based on the blood sugar. It still requires a lot of input from the patient but it’s a more automated system from the pumps that we have now. That’s one step towards the artificial pancreas.
There’s also a lot of research that is looking at how to actually cure diabetes whether through cell transplants and other types of therapies looking at preventing the attack on the pancreas.

Why have we seen an increase in prevalence in diabetes?

With Type 2, we know that it’s partly because of the childhood obesity epidemic. With Type 1, there are many hypotheses and theories out there. Some theories like the hygiene hypothesis say that some kids are not exposed to as many germs so their immune system isn’t strong enough – their body sees the pancreas as foreign and attacks it.

There’s also hypothesis that say that being further from the equator increases the prevalence of autoimmune diseases like Type 1 and multiple sclerosis. There’s other theories like some research looking at cow’s milk early in life. They don’t know exactly why, but there are many theories out there.

jdrf

What is the Juvenile Diabetes Research Foundation?

JDRF is the only international nonprofit organization with a mission to cure Type 1 diabetes. There are 1.2 million Americans with Type 1 diabetes. JDRF has their annual walk in many major cities throughout the US where they raise money to support research that is aimed to cure, treat, and prevent Type 1 diabetes. I’ve been doing this walk every year since I was a child growing up in Nashville, TN. The past two years I’ve been happy that we’ve had a Harbor-UCLA team do the walk here in Pasadena. Several of my colleagues from the pediatric endocrinology group have walked and helped raise money and they’re very supportive.

What do you hope to be the future for diabetes?

Ideally, there would be a cure for diabetes. I think we’re still far – there are a lot of challenges. What I see in the near future and hope for our pediatric patients is the development for these devices like the artificial pancreas that effectively cures diabetes. It doesn’t really cure it but you’ve got a machine that is on auto pilot and manages diabetes the way your pancreas should do. That is what I see as the potential for the near future.

Learn more about diabetes: