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Carla Greenbaum Part 3, Disease Modifying Therapy For Type 1 Diabetes




In part 3 of this Exclusive Interview, Dr. Carla Greenbaum explains the reason for disease modifying therapy in a conversation with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California.

Carla Greenbaum, MD is Director of the Diabetes Research Program at Benaroya Research Institute at Virginia Mason in Seattle, WA.

Transcript of this video segment:

Steve Freed: So, let me ask you a question. What is disease modifying therapy and why is it needed for type 1 diabetes?

Carla Greenbaum: Well, I should ask you, right? I mean it has been 95 years and we’ve been treating diabetes the exact same way, right? With insulin. Better insulin, shorter insulins, faster insulins, better ways of delivering insulin. But it’s insulin. I mean that was 1922, right? That’s when women got the right to vote. We’ve come a long way, but not in type 1 diabetes. And you have to ask yourself why is it? And partly it’s because we’re a result of our own training. Endocrinologists are very comfortable with handling insulin pumps, are very comfortable with CGM, and yet we don’t have much experience. When I talk to young people and fellows starting out in their career and they want to talk about how to prepare for the future, I tell them they should marry a rheumatologist because they know how to use these kinds of therapies and that will be important. But let me flip the question back to you. Why do we need disease modifying therapy? What we have isn’t very good. And you can take the analogy of juvenile arthritis, also affects young [people], it’s about the same incidence as type 1 diabetes, same number of people have it. We still don’t know what the cause is. We know there’s a long preclinical period of time. And for many years symptom therapy was what was used. Better pain control, better crutches, better wheelchairs for those kids, right? And what changed it? It’s when disease modifying therapy has made it so where now the joints don’t erode, they don’t have the disabilities. And the analogy in diabetes right now, we treat symptoms, we treat the glucose. We’re not treating the disease, which is what we need to move to. So that’s what disease modifying therapy is all about and that’s what I think we need to do.

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