NEW COMFORT FOR DIABETICS UNTIL A CURE IS FOUND, TECHNOLOGY CAN HELP MANAGE THE DISEASE.

Byline: Evan Henerson Staff Writer

Baillee Ford has the medical portion of her life mapped out.

Diagnosed with Type 1 diabetes at age 3 1/2, the Oak Park fifth-grader has been testing her own blood glucose levels since the age of 6. She got her first insulin pump last July and in a couple of years she hopes to add the GlucoWatch Biographer once the new blood-glucose monitoring device - approved by the U.S. Food and Drug Administration in March - goes into greater use.

``Then they'll find a cure and I won't have to use the pump anymore,'' says Baillee, 9, with the same matter-of-fact tone you might say, ``and then I'll catch a bus downtown.''

To a certain extent, Baillee's optimism - both that there will be a cure and that Type 1 diabetics like herself will be the beneficiaries - is more than a mere childhood wish. With new knowledge of diabetes' causes and great advancements in its treatment, researchers are optimistic the increasingly common disease will one day be brought under control.

Some say it already has, enough so that even an Olympic gold medal- winning swimmer like Gary Hall Jr. can continue to live and thrive in his area of excellence even though he has to check his glucose levels and inject himself with insulin several times a day.

Diabetes affects the human body's ability to produce insulin, a hormone needed to move blood sugar - known as glucose - into cells needed to energize the body. In Type 1 diabetes, the body does not produce insulin, so the hormone has to be taken via injection. With Type 2 diabetes, beta cells continue to make insulin, but the body somehow becomes resistant to the hormone. Gestational diabetes, sometimes developed by pregnant women, often goes away following delivery.

No one has yet figured out how to manufacture an artificial pancreas - the gland that produces insulin - but that's a future doctors and researchers at Northridge-based MiniMed Inc. - one of the largest manufacturers of diabetes care products - say many diabetics will live to see. It's simply a matter of creating a glucose monitor that can communicate with an insulin delivery system - thereby performing the same function as the pancreas.

Meanwhile, the development of different types of insulin and insulin delivery systems, the insulin pumps and glucose monitors, the pills and insulin sprays are designed to make living with diabetes more manageable than it has been in the past. The GlucoWatch uses a small electrical current that takes fluid samples from the skin every 20 minutes and sounds an alarm when the wearer's glucose levels get dangerously high or low.

``I can do more now than I ever could,'' said Dr. Ann Peters, director of the Clinical Diabetes Programs at USC. ``We get better outcomes than ever before. Because of the technology, we can make people have a much more normal life.

``I saw a 14-year-old yesterday, who runs track. She has incredible potential. I said, 'We can do this. We can perform the things we need to do.' I don't think I could have said that with such confidence five years ago.''

Widespread Type 2

Of course, you can look at these developments from a considerably less optimistic perspective. The reason so much research goes into diabetes is because the disease - particularly the metabolic Type 2 form linked closely to obesity - is so widespread. About 16 million Americans have diabetes. And Type 2 diabetes, the most common form, is also the form less likely to yield a cure anytime soon.

Until a cure is found, Type 2 diabetics like Leonard Measer of Encino watch the technological developments.

``When an article about a new sensor comes out, I call and get all the information I can,'' says Measer, who works as a volunteer at the Diabetic Care Center at Encino Tarzana Regional Medical Center. ``Unfortunately, a lot of the new stuff that comes out is quite expensive and not really reliable.''

The infusion pump, which delivers a steady stream of insulin to the body, is no longer new and is far from unreliable. MiniMed introduced its first pump at the American Diabetes Association convention in 1983. The first-generation MiniMed 502 was later followed by pumps that became increasingly easier to program, and implantable pumps. The company has captured 80 percent of the market. Its major competitor is Switzerland-based Disetronic Medical Systems, whose U.S. headquarters are in Minnesota.

Industry validation came with landmark Diabetes Control and Complications Trial (DCCT), a 10-year study that ended in 1993. The DCCT concluded that intensive management of diabetes, either through multiple injections of insulin or through pump therapy, can dramatically reduce the onset of diabetes complications. Keep your blood sugar under control and you'll delay complications by 15 years and live five years longer, the study concluded.

``The industry for the first time, said, 'We have a pioneering technology, something that has never been created before to be able to micro-dose insulin,' '' said Deanne McLaughlin, manager of corporate services for MiniMed. ``Then the insurance industry started hopping on board, saying, 'Now we understand the importance of pump therapy. This is proof that this technology can save health-care costs.' ''

A person who uses a pump dispenses with insulin injections, but takes on the responsibilities of programming and monitoring the device. A young pumper like Baillee Ford, who uses a Disetronic pump, shares those responsibilities with her mother, Lori Ford, the librarian at Baillee's school. Between Ford and the school nurse, all of Baillee's meals are covered.

Baillee's pump, which clips to her waistband like a pager, can be worn during tennis, karate or practically any activity except swimming. Meals are an adventure, with Baillee and her mother figuring out exactly what she'll eat and how much insulin will be needed to keep her blood sugar at the appropriate levels. With the pump, she can be more spontaneous about her food choices. And programming restrictions make sure the doses are carefully regulated.

Baillee's doctor, Dr. Norman Lavin, says he's never had a patient try a pump and return it. Nor is there a stigma with wearing a visible device that identifies the wearer as a diabetic.

``What I like is that they're telling them with some pride, 'Yes, I have diabetes. So what?' It doesn't matter anymore,'' said Lavin, director of the Diabetes Care Center at Encino Tarzana Regional Medical Center.

How an Olympian copes

Hall might be a candidate for an insulin pump, if he didn't spend so much of his time in the pool or the shower. He uses the One Touch Ultra Meter, a pocket-watch-size device that, through a single drop of blood, monitors his blood glucose level. Hall keeps the device, which is manufactured by LifeScan in Northern California, with him at all times.

``It can be a pain having to deal with it,'' admits Hall, who was diagnosed with Type 1 diabetes in 1999. ``But this technology, having a meter like that, is a luxury that people with diabetes wouldn't have had 10 years ago.''

Hall checks his blood glucose levels up to 10 times a day and injects himself with insulin between five and eight times daily. He is, in the view of USC's Peters, ``the poster child'' for diabetes management.

``He became much more conscious of his diet, how he felt, how he swam. It might have helped him become a better swimmer,'' said Peters, who set up a regimen that helped Hall to compete in the 2000 Olympics in Sydney, and win two more gold medals. ``It requires a lot of diligence and intelligence to do what he did. I give him a ton of credit.''

Other doctors who reviewed Hall's diagnosis didn't believe pursuing his athletic career would even be an option. Being diagnosed with diabetes often sends the patient into a tailspin.

``Obviously, my first concern, was, how was this going to impact my life? Am I going to go blind? Am I going to lose my feet? All of that was very scary to have to deal with,'' said Hall, who now lives in Miami.

``I eventually came to terms with the disease and accepted it. I realized that there was a certain amount I could be responsible for - that was properly managing the disease. It really comes down to the patient: How ambitious are they, how motivated?''

Measer found his motivation late. He was diagnosed with Type 2 diabetes at age 50 after experiencing numbness in his feet. Diet modification and increased exercise didn't help and Measer ended up changing doctors.

``We went through the whole process again, the diet and the pills, and ultimately ended up with the needle, which is where I am today,'' said Measer, who works as a security guard with Pinkerton. ``It's under control as far as I and my doctor are concerned, but only through medication. Controlling my diet and exercising aren't doing me any good.''

Measer is still overweight. Nerve damage to his legs and feet prevent him from doing certain activities, but he gets tremendous satisfaction from his volunteer work at the Diabetes Care Center, where he often monitors the phones to help newly diagnosed diabetics. Like many of the people he speaks to, he would love to see a day where he could get rid of the needles and finger pricks, although finding a blood glucose sensor that involved little blood left him in ``seventh heaven.''

Measer used to attend one of the diabetes support groups at Encino Tarzana ... until it started to conflict with a square dancing class.

``Most of us live with diabetes and have regular lives,'' he says. ``You don't have to go through the complications if you control your blood sugar.''

Diabetes facts and figures a growing concern

Some 16 million Americans have diabetes, a number that is expected to rise to 22 million, 300 million worldwide, by 2025. Each day, 2,200 people are diagnosed with the disease, with a new case being diagnosed every 40 seconds. The disease is the seventh-leading cause of death in the United States, killing one American every three minutes. There are more deaths from diabetic complications than from AIDS and breast cancer combined.

Diabetes is the leading cause of blindness in people age 20 to 74 and the leading cause of new cases of kidney disease in the same age group. People with diabetes are two to four times more likely to have heart disease or to suffer a stroke. Tuesday will be the conclusion of the American Diabetes Association's 61st annual Scientific Sessions in Philadelphia, a five-day conference where more than 8,000 doctors, scientists and health-care workers have gathered to attend seminars covering everything from gestational diabetes to ``Recent Advancement in Islet Cell Transplantation'' to ``Diabetes and Cardiovascular Disease in Diverse Populations.''

More than $100 billion is spent on diabetes and its complications every year.

CAPTION(S):

7 photos

Photo:

(1 -- 4 -- cover -- color) Life goes on

New technology helps diabetics cope with disease's daily challenges

(5) Baillee Ford, 9, pricks her finger to measure her blood sugar level at Brookside Elementary School in Oak Park; she has tested herself since she was 6.

Michael Owen Baker/Staff Photographer

(6) This MiniMed insulin-pump system allows diabetics to monitor their blood glucose levels throughout the day.

(7) Diabetes patients may wear insulin pumps such as the MiniMed 508 as they would a pager.

Box: Diabetes facts and figures a growing concern (see text)

Sources: The American Diabetes Association and MiniMed.