By Leslie Wade
Producer CNN Medical News

I had the pleasure of meeting pop star Nick Jonas when he and his band were touring in Atlanta, Georgia, in late August. I know he's had media training and been in front of cameras for years, but I was impressed with his composure as he told me about his journey with a disease that affects one in 300 teens.

Nick Jonas talks about living with diabetes.

Four years ago Nick, the youngest member of the Jonas Brothers band, spent three days in the hospital. He'd lost 15 pounds in the previous three weeks and he and his family knew something was terribly wrong. Nick had developed type 1 diabetes - his body was no longer producing insulin, a hormone needed to convert sugar into energy for our bodies.

Nick made a promise to himself that day. "My commitment to myself, when I was on my way to the hospital, was that I would not let this slow me down. And I didn't," said Nick.

Nick and his family jumped into action, learning all about diabetes and how to treat the disease. "I was devastated. I didn't know anything about diabetes, had no knowledge,” said Nick's mother, Denise Jonas. “I knew he was very ill just by looking at him."

"We had to take steps to have everyone in our family and my brother, who toured with the boys on a regular basis, trained on how to care for Nick. How to monitor him, how to administer his insulin shots, how to test his blood, how to give him a glucose shot if for some reason he passed out and went into a diabetic coma. It's a lot of work," said Denise.

After leaving the hospital, Nick was determined to write a song about his experience. But the piece didn't come together for another 2½ years. "I was having one of those days where it [the blood sugar] was out of range, things were not where I wanted them to be with my diabetes. I sat down at the piano and wrote the song and it came out in 15 minutes," explained Nick.

His song "A Little Bit Longer" seems to touch a chord in teens with diabetes, some of whom feel stigmatized and ashamed to have the disease. "He's had a great voice in helping encourage children and teenagers with type 1… to let other people know they have it,” said Denise Jonas. “I didn't realize how much of the population was ashamed."

Nick's doctor, pediatric endocrinologist Francine Kaufman of Children’s Hospital in Los Angeles, California, also knows about the concerns of teens. "The real driving force for a teen is to be just like every other teen, so having anything different - and particularly a chronic illness - sets you apart and many, many of these teenagers feel it, " explained Dr. Kaufman.

Nick is trying to raise awareness and money for diabetes through the band's Change for the Children Foundation. (He's also a paid spokesperson for Bayer, which makes a device to monitor blood glucose levels.)

Nick checks his blood sugar 10 to 12 times a day and his doctor says he takes his disease seriously. "Nick does what somebody with diabetes needs to do: wears an insulin pump, worries about how much insulin he's taking, monitors his blood sugar, stays healthy and gets exercise," says Dr. Kaufman.

But if the demands of his schedule mean a skipped meal before show time his brothers sometimes have to improvise. "I just give them a look and tell them to cover for me while I go off stage and take care of some stuff," says Nick. Which usually means grabbing a little apple juice, orange juice or a bit of food to normalize his blood sugar before heading back out on stage. "All of the crew on the tour are aware that I'm diabetic and they all know how to react in case of an emergency or a situation where I may need assistance," says Nick.

And fortunately those times are rare - a testament to his promise to himself four years ago: Nick, now 17, has not let diabetes keep him from sharing his craft and living his dream. "I'm just thankful to be able to be out here doing what I love with diabetes... and if there is something that I can do personally to inspire and encourage somebody that means the world to me, " says Nick.

Question: Do you or anyone you know struggle with telling others about diabetes? Tell us your story.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

Volunteering at Tides

By Alani Gregory
CNN Medical Intern

Just imagine going to a restaurant and ordering a plate of food. Before you even take a bite, you must estimate the serving size of each food on the plate. Then, you must correctly estimate the amount of carbohydrates in that food, add it all up, and then give yourself insulin. Now imagine doing this every time you eat! That’s the harsh reality of living with diabetes.

When I entered my freshman year of college, like every overachieving-“Grey’s Anatomy”-watching- pre-med student, I began my quest to rid the world of all its health maladies. I was immediately drawn to an organization called T1DES (Type 1 Diabetes Education and Support), a student-run organization that provides access to diabetes education and support for children in inner-city New York. One application, a background check and an interview later and I was in. My first day, I sat in disbelief during training, when the facts and figures were spelled out. According to the CDC, 23.6 million children and adults in the United States suffer from type1 or type 2 diabetes. Every year, 15,000 children learn they have type 1 diabetes. That’s 40 children each day, according to the Juvenile Diabetes Research Foundation International.

Much of the focus on diabetes has been on reducing type 2 diabetes – the form of the disease in which the body either becomes resistant to insulin or doesn’t produce the necessary amount. In most cases, type 2 diabetes can be prevented with exercise, healthier eating, and regular doctor visits. With the great diabetes initiatives under way, I rarely hear any projects geared towards type 1 diabetics.

The cause of type 1 diabetes is unknown, but scientists believe genetics and the environment contribute to the body’s own immune system attacking and destroying insulin-producing cells in the pancreas. It can’t be prevented by a simple prescription of more exercise and healthier eating. Organizations including JDRF are currently looking into possible cures such as, pancreatic islet cell transplantation. But, until there is a cure, it is important that programs are created that teach children – the population most affected by the disease – how to manage their diabetes and provide a stigma-free atmosphere.

Once, we had a participant who refused to test her blood sugar in front of anyone. Her mother pleaded with us to help her test in public because not testing could have tremendous implications. Initially, we could not understand why she would not test in public, but quickly realized that she was uncomfortable about having the disease. By the end of the semester, she was testing in front of the other kids. Unfortunately, many children just like her, who feel embarrassed and isolated, don’t have access to programs geared towards their specific needs.

The kids find comfort in meeting people just like them, often showing off their cool insulin-pump cases or sharing stories of when their blood sugar dropped so low they had to be rushed to hospital. If we begin to provide educational venues for children with this chronic disease, then the $58 billion dollars the nation spends annually on type 1 and type 2 diabetes related complications could be significantly reduced. Type 1 diabetes may not be preventable, but its long-term complications such as nerve damage, heart disease, blindness, and kidney disease can be prevented. These educated diabetic children will grow into well-informed adults who are armed with the knowledge to be guardians of their health.
Do you know anyone with type I diabetes? Are there any programs in your area that target children with type 1 diabetes? What else can be done to educate children with the condition?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Jennifer Pifer
CNN Medical Senior Producer

Imani Lesane is one smart cookie. Three years ago, when she was 13, Imani started feeling yucky.  She was thirsty all the time and just didn't feel like herself.  So she started doing a little medical sleuthing on line and figured out what was wrong: She had diabetes.  When Imani told her family, they thought she was crazy. "Old people get diabetes," her mom said.

But Imani was persistent as 13-year-olds are apt to be and persuaded her mom to take her to the doctor.  Turned out, Imani's self-diagnosis was right on: She did have diabetes.  But instead of feeling sorry for herself, Imani took action. She lost 50 pounds and got serious about exercising.  It's not always easy.  Imani injects herself with insulin four times a day.  And if people are eating candy, says Imani, "Oh my goodness ... I have to go to another room."

I thought of Imani the other day while reading a new Centers for Disease Control report on diabetes in America (link to report).  The news isn't good: The number of people living with diabetes has gone up 15 percent in two years.  That comes to about 24 million Americans or about 8 percent of the population.  The news is especially bad for minorities: More than 16 percent of Native Americans, 12 percent of African Americans and 10 percent of Hispanics suffer from the disease. 

So what's going on?  "It is multi-faceted," says Dr. Ann Albright at CDC.  Obesity is a huge part of the equation, for some people it's genetics and for others it has to do with what Albright calls 'the social determinants of health."  For example, if you live in a neighborhood where it's hard to find affordable fresh fruits and vegetables at the local store, it's difficult to make healthy food choices.  And of course, personal choice also plays a role.  "It's hard," says Imani with a sigh.  She has to watch her diet and keeps active.  Dancing is her passion.  The excitement of making her own diagnosis has her thinking about going to medical school.  Her advice to her fellow diabetics: "don't give up."  I have a feeling Imani never will. 

I'd love to hear what you think: why do you think the diabetes rate is going up so quickly? And why do you think it is hitting minorities particularly hard?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Ann J. Curley
CNN Medical Assignment Manager

Which came first, the chicken or the egg? The familiar question entered my mind as I was reading a study in this week's Journal of the American Medical Association regarding diabetes and depression. Why? Because the study found that patients with type 2 diabetes have a higher risk of developing depression and patients with depression have a higher risk of diabetes.

Lead study author Sherita Hill Golden, M.D. of Johns Hopkins University says her research involved two analyses of data generated by a study looking at heart disease and type 2 diabetes. The study involved over 5,000 men and women, ages 45 to 84.

First the researchers looked at people who began the study with symptoms of depression, but did not have diabetes. Those people had a 42 percent higher risk for developing diabetes during a three-year follow-up. Golden speculates that behaviors associated with depression, such as overeating, smoking, and not exercising, help to trigger the diabetes.

A second facet of the study looked at patients in whom type 2 diabetes was diagnosed, who had no symptoms of depression. Those patients showed a 54 percent higher risk for depression during the three-year follow-up period. Golden believes that the stress of managing diabetes can lead to depression for some patients. Although this study focused on type 2 diabetes, Golden says that depression is also common among type 1 diabetics.

Health care providers and patients must be aware of the double-edged sword of diabetes and depression. Identifying and treating both is critical. It’s important to understand that depression, when untreated, can lead to behaviors that can lead to, or worsen diabetes, because people eat poorly and don’t exercise. But there are many treatment options for both conditions that can keep patients healthy and happy.

Do you have diabetes or depression? Are you concerned that one might lead to the other? What are you doing to take care of yourself?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.