The use of technologically advanced systems to monitor the sugar levels of students with Type 1 diabetes around the clock have increased dramatically over the last several years.

Henry Rodriguez, MD

Approximately 50 percent of children with Type 1 diabetes under age 18 use continuous glucose monitor systems (CGM for short), according to the American Diabetes Association (ADA) – and the percentage is expected to grow as the technology becomes less expensive, easier to use, and mounting evidence shows that CGM can help reliably control blood sugar at a lower cost than “finger-stick” devices. The CGM systems actually measure sugar in the thin layer of fluid surrounding skin cells, providing a good reflection of blood sugar levels.

Henry Rodriguez, MD, is medical director of the USF Diabetes & Endocrinology Center, which has conducted school nurse trainings in diabetes management for Hillsborough County.  He is also a co-chair of the national ADA Safe at Schools Working Group that will soon release guidelines for the use of CGM and sensors in school settings.

Dr. Rodriguez says that school systems in Florida and across the country must be better equipped to respond to the latest generation of CGM devices that measure sugar levels with sensors and wirelessly send that information to a receiver or the patient’s cell phone app. The student’s real-time data can also be shared with several followers, including a school nurse and a parent or guardian. Some of the newer FDA-approved devices can predict hypoglycemia (low blood sugar) and provide alerts to avert it. Some can even communicate with insulin pumps and adjust insulin delivery to assist in preventing high and low blood sugars.

The CGM includes a sensor (fine electrode) the width of a hair placed under the skin with a transmitter clipped onto a plastic base. The hand-held receiver can be kept in a pocket or bag. Through an app, a cell phone can take the place of the receiver, offering the opportunity to share data wirelessly or through cell service.

“Children spend a large part of their day at school, so our school systems will have to come to terms with helping manage the chronic care needs of students with diabetes who wear these newest devices,” Dr. Rodriguez said, “particularly those who aren’t old enough to do self-care.”

That means making sure that the diabetes medical management plans required for individual students are updated to keep pace with changes in standards of diabetes care – and incorporate provisions for CGM agreed upon by parents/caregivers and school staff to improve coordination of care, he said.

As many as 25 million Americans have been diagnosed with diabetes, with more than 700,000 new cases appearing each year.

Henry Rodriguez, MD, (left) medical director of the USF Diabetes Center, with honoree Sam Fuld. — Photo by Dave Scheiber

By Dave Scheiber, USF Foundation

ST. PETERSBURG, Fla. – Throughout his eight major league seasons, Sam Fuld was known for his dazzling defense and smart, all-out style of play that made him a staple of ESPN highlight clips and a fan favorite of the Tampa Bay Rays. But his impact has also been felt powerfully off the field through an ongoing partnership with USF Health.

The annual Sam Fuld T1D Sports Camp has been held since 2012 at the University of South Florida, providing an important outreach to children and families dealing with the life-altering disease of Type 1 diabetes. Each year, faculty and staff of the USF Diabetes Center provide medical supervision for the campers, ages 8 to 17.

Fuld, diagnosed with the condition as a child, has become a national role model and spokesman on the T1D front – with his USF camp at the core of his work. And on Thursday night, Feb. 15, the new member of the Philadelphia Phillies front office was honored at the Governor’s Baseball Dinner in an annual gathering of Major League baseball luminaries at Tropicana Field.

Fuld was greeted by a loud ovation from a crowd that included MLB Commissioner Rob Manfred, a host of officials from the 15 clubs in Florida’s Grapefruit League and an array of past stars of the game. He began by expressing his gratitude for being recognized by MLB and the Florida Sports Hall of Fame, and thanking the team on hand that has played a key role in making the camp a reality for the past seven years: Henry Rodriguez, MD, the USF Diabetes Center clinical director;  Amanda Terry, PhD, research faculty member for the center; and volunteer camp coordinator Craig Bobik, a fellow diabetic who has assisted Fuld since the event’s inception.

But rather than simply say a few passing words, Fuld used the opportunity to educate and spread awareness about type 1 diabetes (T1D). Called to the podium by veteran Rays broadcaster Dave Wills, on a stage set up in right field at the Trop, he opened his remarks by noting, “I’ve been a diabetic since age 10, a little over 25 years now. I know that most of you are probably a little unfamiliar with Type 1 diabetes so bear with me.”

Fuld talks to some young campers before a sports clinic at the USF baseball field.

Among his points over the next five minutes: T1D is an unpreventable autoimmune disease that attacks the pancreas, robbing the body of its ability to produce insulin, which regulates blood sugar. The result is that those afflicted with the condition become dependent on insulin injections via pens or pumps, and a lifetime of daily finger pricks to test blood glucose levels.

“I have my insulin pens with me all the time,” he explained.  “I’m also constantly monitoring my blood sugar, on average seven or eight times a day where I prick my finger and maybe almost six times a day when I’m injecting myself.”

Fuld, a mathematics and statistical standout from Stanford University, did some calculating earlier in the day and came up with some eye-opening results: “I guess in my T1D career, you could call it, I’ve now administered a shot about 55,000 times and I’ve pricked my finger about 68,000 times.”

But harder than the daily regimen of injections and finger pricks, Fuld continued, is the constant vigilance and diligence required to manage T1D, which can be lethal if left unchecked.  “It’s an emotionally and mentally taxing disease, so a lot of what we do at the camp is just give these kids a break. We create an environment where they feel comfortable and they’re normal, and they get to just share experiences and learn from one another.”

Fuld spoke about the variety of sports the camp offers, as well as the counselor/coaches who have T1D themselves. “They’re incredible role models. And I’m excited to continue the camp here for many years to come. I have no visions of stopping until we find a cure, and I’m really excited to be part of the T1D community in this great Tampa Bay area.”

The comment was greeted with loud applause as Fuld left the stage, soon greeted by guests wanting to pose for photos or talk to him about his message. Meanwhile, Wills added over the mic: “I’ve been doing Rays games for a little more than 13 seasons, and I’ve been around the game for about 25 years and all I can say is baseball needs a few more Sam Fulds. Sam is one of my favorites of all time, and I wish him nothing but the best as he moves into the front office of the Phillies.”

USF Health pediatric endocrinologist Verena Jorgensen, MD, was among the USF Diabetes Center staff providing medical supervision at the 2018 Sam Fuld T1D Sports Camp held in early February at the USF Tampa campus recreation facilities. 

Though he’ll soon be relocating to Philadelphia with his wife and four young children, Fuld will be back at USF come February 2019 – ready to provide a weekend of fun and normalcy for a new round of campers living in the challenging world of T1D.

To learn about how to participate in the 2019 Sam Fuld T1D Sports Camp at USF or the USF Diabetes Center, visit health.usf.edu/medicine/diabetes.

//www.youtube.com/watch?v=MFt3m8Cihzk

Friends and supporters gathered  Nov. 14 to celebrate the fifth anniversary of the opening of a new facility for the USF Diabetes Center on the fifth floor of the USF Health Morsani Center for Advanced Healthcare, and to recognize the impact the Center has had since then on patients and families coping with diabetes.

The USF Diabetes Center Fifth Anniversary Celebration, held on World Diabetes Day, was attended by the center’s friends and supporters.

Surrounding the demonstration kitchen in the USF Diabetes Center, founding benefactors, current patients and their families, and supportive USF Health faculty and staff mingled and shared memories that spanned the five years. Guests then moved to the on-site classroom to hear updates on the Center’s progress. Remembering when the original space was only a shelled out, incomplete floor, Henry Rodriguez, MD, medical director and pediatric endocrinologist, recalled the excitement for designing a space with patients in mind.

“Back when this floor and the floor above us was all shelled space, when you could see from one end of the building to the other, we walked through a taped off area of the Diabetes Center,” Dr. Rodriguez said. “Since that time, we have done some pretty remarkable things. We have grown over the years and continue to expand our providers, our research team and our patient population.”

 Dr. Henry Rodriguez talks about what’s on the horizon in the next 5 years.

Dr. Rodriguez also presented statistics that mark the reality of diabetes for more than 30 million Americans, offering greater insight into the disease’s prevalence, impact, and projected increase in the number of diagnoses.

 Dr. Rodriguez comments on the USF Diabetes Center’s TrialNet Clinical Center.

Henry Rodriguez, MD, medical director of USF Diabetes Center

“I don’t need to convince anyone here of the urgency of looking at prevention to improve the lives of those affected by diabetes,” Dr. Rodriguez said. “Diabetes is expensive, because medical expenses for people with diabetes are double that of people who do not have diabetes. It’s also demanding, because it requires constant vigilance. And it’s a pain, because individuals with diabetes report a lower quality of life compared to the general population.”

 Dr. Rodriguez shares some advances in diabetes research.

The conversation turned to Jeffrey Krischer, PhD,  Distinguished University Health Professor and director of the USF Health Informatics Institute, which has an internationally renowned team of experts in Type 1 diabetes and related autoimmune disorders.  He offered details about new research that may impact current knowledge on how diabetes works and how it can be treated.

“Research is my passion and, as evidenced by the growth of our program over the last five years, my passion extends to helping children and adults who are affected by Type 1 diabetes,” Dr. Krischer said. “In the last five years, the amount of research here has grown and continues to grow. We have more to offer and more ways we can benefit our patients who come to us for care. We are a blend of both clinical care in a warm and supportive, multidisciplinary setting, and access to the latest, state-of-the-art therapies and research advancements that you can only find in this kind of setting.”

Jeffrey Krischer, PhD, Distinguished University Health Professor and director of the USF Health Informatics Institute

 Dr. Jeffrey Krischer explains the role of the USF Health Informatics Institute.

In answering a guest’s question about coordinating information among the multiple clinical centers, Dr. Krischer said, “Some 200 (clinical centers) participate with my office directly and we coordinate all of that research worldwide. So it’s done right here, on this campus, less than a tenth of a mile away from where we’re sitting right now. All of those programs look to us for these results. Research is complex these days and requires coordination, and I’m really proud of the fact that this is where it’s happening.”

 Dr. Krischer on the questions scientists seek to answer about diabetes and related autoimmune disorders.

The USF Diabetes Center opened in 2011, coinciding with World Diabetes Day, a day that marks the birthday of Frederick Banting, who co-discovered insulin in 1922. Today, the Center sees primarily patients with Type 1 diabetes, with about half adults and half children and adolescents.  Most patients live in the region served by USF Health, but many are from across the state.

Key milestones for the USF Diabetes Center include:

• 2011: Ribbon Cutting that opened the USF Diabetes Center’s new facility on the fifth floor of the USF Health Morsani Center for Advanced Healthcare.
• 2012: The inaugural meeting of the Tampa Bay Diabetes Society, offering patients and families a resource for support and services.
• 2013: The USF Diabetes Center begins an Insulin Pump Program that provides new technology to patients and enhances patient care.
• 2014: USF named one of 19 TrialNet Clinical Centers in North America.
• 2015: USF Health consolidates the diabetes and endocrinology services to offer more streamlined care and expanded service locations.
• 2016: Sam Fuld’s Sports Camp, partnered with the USF Diabetes Center, is recognized by the Florida Sports Hall of Fame.

Photos by Eric Younghans, USF Health Office of Communications. 

Henry Rodriguez, MD, clinical director of the USF Diabetes Center, joined U.S. Rep. Kathy Castor at USF recently to host a roundtable discussion by community experts and advocates taking action to treat and prevent diabetes.

The Oct. 12 event in the USF Student Marshall Center was conducted in collaboration with the Arthur Green Jr. Memorial Foundation, LIFT Health, Inc., and the American Diabetes Association (ADA).   It drew representatives from across the Tampa Bay area, including the USF College of Public Health, Tampa General Hospital, JDRF, the YMCA, Tampa Family Health Centers, and the Pinellas County Urban League

In a discussion moderated by Rep. Castor, the participants talked about the need to raise awareness about the growing epidemic and how they might work together more effectively to maximize resources for people with diabetes and prediabetes. In Florida, diabetes affects more than 2.3 million people in Florida, or 13 percent of the state’s population. The ADA estimates that people with diabetes have medical expenses 2.3 times higher than those without diabetes. The metabolic disease a leading cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.

Dr. Henry Rodriguez, clinical director of the USF Diabetes Center, joined U.S. Rep. Kathy Castor in a recent diabetes roundtable discussion that brought together community providers and advocates.

“Diabetes is very expensive,” said Rep. Castor, adding that the cost of diabetes care can cause financial havoc to the health care system and personal lives. “We need to fight for research so that USF and other places around the country have the funds they need to tackle this disease.”

Rep. Castor introduced Dr. Rodriguez as a member of the team headed by Dr. Jeffrey Krischer, the world’s top-funded National Institutes of Health principal investigator with a longstanding commitment to diabetes research. Dr. Krischer and his team are making powerful strides in organizing, coordinating and analyzing clinical trial data in type 1 diabetes and related autoimmune disorders, which can lead to advances in treatment and prevention.

“Diabetes is a club you don’t want to belong to,” said Dr. Rodriguez, who focuses on prevention and clinical management of type 1 diabetes through partnerships with primary care providers and research collaborators. “It’s critically important that we coordinate and collaborate across the spectrum in fighting this disease.”

Also at the discussion was Lena Young Green, whose husband Arthur died in police custody in 2014 after suffering an acute hypoglycemic episode. Green’s death led to a Florida law providing more training for law enforcement officers regarding how to recognize and respond to diabetic emergencies, in which a person’s symptoms can resemble those of someone who is intoxicated or impaired.  Also present was State Rep. Ed Narain of Tampa, who helped sponsor the legislation.

Roundtable participants spoke about the need to marshal and coordinate resources to help prevent Type 2 diabetes in children identified as prediabetic and to motivate patients and their families to use the tools they need to manage diabetes on a daily basis.

Janice Zgibor, PhD, an associate professor in the USF College of Public Health, who recently published a book on integrated diabetes care, challenged providers to “think outside the traditional medical model” in breaking down the barriers to effective diabetes treatment and prevention.

For example, it may work better to bring diabetes education to the patient at their primary care providers’ offices rather than refer patients out to other locations, Zgibor said. “People trust their primary care doctors and like that they don’t have to make extra appointments.”

The roundtable drew representatives from across the Tampa Bay area, including the American Diabetes Association, JDRF, the YMCA, Tampa General Hospital, Tampa Family Health Centers, and the Pinellas County Urban League

Dan Vukmer, JD, senior associate vice president of network integration for USF Health, suggested the group may want to include representatives from managed care and health insurance plans, who have an vested interest in keeping a community healthy, in future discussions.

Pattye Sawyer-Hampton, MA, director of health initiatives for the Pinellas County Urban League, emphasized the importance of family support in helping people manage diabetes.

“When someone lives with diabetes, it affects everyone in their family,” she said. “The patient needs continual family support to eat right and exercise, monitor their blood sugar and keep doctor appointments.”

Rep. Castor concluded the gathering by outlining some action steps, including her intent to share with the diabetes roundtable participants information about federal grant funding available and how to apply and to reach out to primary care providers and health plans.

Photos by Ryan Noone, USF Communications & Marketing

Major league baseball outfielder Sam Fund is surrounded by young campers at the diabetes sports camp he hosts each year at USF.

This year’s Sam Fuld USF Diabetes Sports Camp attracted a record number of kids from Florida and across the country and added more sports to the mix of those practiced by the youngsters.

Held at the USF Athletic District this past weekend, Feb. 1 and 2, the 3^rd annual camp was hosted by Sam Fuld, a major league baseball outfielder diagnosed with type 1 diabetes at age 10.  He conducts the camp in partnership with the Tampa Bay Rays, the USF Diabetes Center, and Florida Diabetes Camp.

Youngsters, ages 8 to 17 with type 1 diabetes, along with a sibling or friend, participated in many sports including baseball, softball, tennis,  football, soccer, golf, and cheerleading.  This year, volleyball and dance were added, bringing more excitement to the camp. 

Fuld pitches to a camper during one of the baseball sessions.

Unlike other diabetes camps, every coach at this camp has type 1 diabetes and has been a successful professional or collegiate athlete in his or her sport.  The coaches share a special connection with the campers in dealing with the daily challenges of type 1 diabetes.  The positive messages the campers receive about living with the chronic disease are as important as the chance to catch fly balls, kick field goals or serve tennis balls.

With growing national appeal, the camp attracted 117 campers and their families from 12 states in addition to Florida including Arizona, Georgia, Illinois,  Maryland,  Nebraska, New Hampshire , New Jersey, New York, North Carolina, Pennsylvania, Texas and Virginia.

Dr. Henry Rodriguez, medical director of the USF Diabetes Center, with Fuld.

“Our goal from the outset has been to grow each year and we feel confident that the 2014 camp was even better than the previous two,” Fuld said.

“Adding volleyball and dance further broadened the array of options for the campers, and it gave us the chance to bring in even more coaches who serve as such great role models. Each year, the camp provides the campers with opportunities to share stories and learn from the experiences of other kids and adults with similar histories.”

Henry Rodriguez, MD, medical director of the USF Diabetes Center, and other USF Diabetes Center medical staff and partners provided medical supervision for the campers along with counselors from Florida Diabetes Camp.  Tampa Bay Rays players  Sean Rodriguez and Brandon Gomes visited the camp on Sunday to sign autographs and support Fuld.   Rodriguez even pitched during the Sunday morning scrimmages.

Fuld checks his blood sugar reading before heading out on the baseball diamond to coach.

Fuld  also addressed hosting future camps.

“I can tell you that it does not matter what team I play for or where I play, even if it is in Japan,” he said.  “Because of our great partnership with the USF Diabetes Center, Florida Diabetes Camps, and USF Athletics, the camp will continue here at USF for years to come as our impact on others with type 1 diabetes has been amazing.”

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Kids and their families wait to check in for camp.

Dr. Rodriguez helps out with registering the young campers.

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A USF golfer gives a camper some guidance on his putting technique.

Juan Bustabad, right, minor league baseball manager and short stop, and former major league pitcher Bill Gullickson, were among the coaches.

Coaches from the diabetes sports camp, all of whom live with type 1 diabetes, pose for a group photo with Sam Fuld, center.

The USF Health Morsani Center for Advanced Healthcare was bathed in blue light in celebration of World Diabetes Day on Wednesday night, Nov. 14.   Inside the USF Diabetes Center, the spirit of the universal celebration was represented by the blue clothing worn by many guests, including patient Hailey Platz, 4, her sister, mother and grandmother, who all sported powder blue T-shirts decorated with a blue circle, the global symbol for diabetes.

Counterclockwise from center: Emma Platz, 3, and her sister Hailey, 4, a patient of the USF Diabetes Center, with their mother Heather Platz and grandmother Trish Godbey, who decorated the blue shirts they wore with the World Diabetes Day logo.

The Platz family of Tampa was among the more than 100 patients and family members, community partners, staff, volunteers and others who gathered to help reinforce the USF Diabetes Center’s commitment to increase awareness of diabetes and shed light on ways to prevent and more effectively treat the pervasive disease that affects people of all ages.

This was the center’s second annual celebration of World Diabetes Day, exactly a year following the 2011 ribbon-cutting ceremony marking the official opening of its new expanded clinical space on the Morsani Center’s fifth floor.   Friends of the center gathered again to mingle, tour the center, watch a cooking demonstration by a Carmel Café’s chef in the teaching kitchen and sample the diabetes-friendly hors d’oeuvres. 

The fountain sculpture outside the USF Health Morsani Center for Advanced Healthcare was illuminated blue for the World Diabetes Day celebration.

Hosts Jeffrey Krischer, PhD, director of the USF Diabetes Center, and USF Health pediatrician Henry Rodriguez, MD, the center’s clinical director, updated guests on the center’s progress.

“It’s an opportunity to celebrate how far USF has come in our goal to establish a world-class, multidisciplinary diabetes center that focuses not only on providing state-of-the-art care, but also on making sure our patients benefit from the latest advances in treatments and technology,” Dr. Rodriguez said.   

Jeffrey Krischer, PhD, director of the USF Diabetes Center, has made USF the world’s epicenter for type 1 diabetes research.

“Our research program is focusing on therapies that may preserve the ability to produce insulin in newly diagnosed patients, working with basic scientists to mark the progression of diabetes, and investigating new avenues to promote the growth of (insulin-producing) beta cells,” he said. “It’s really the collaboration and coordination of all those efforts that will help us make a major contribution toward finding a cure for type 1 diabetes and improving the lives of those who live with the disease every day.”

Henry Rodriguez, MD, clinical director of the USF Diabetes Center, updated guests on the center’s progress over the last year.

The center’s accomplishments over the last year include:

–          An expansion of clinical services to approximately 1,500 patients – primarily children and adults with type 1 diabetes, but also adults with type 2 diabetes requiring intensive therapy and pregnant women with diabetes

–          Addition of several pediatric endocrinologists and a diabetes nurse educator with expertise in insulin pumps

–          Launch of the  patient-based diabetes management system MyCareTeam, which integrates with the Allscripts electronic health record so that patients or their family members can track blood sugar readings, communicate electronically with members of the diabetes care team, and receive online coaching.

–          More classes for all patients affected by diabetes, including such topics as routine care, stress management and use of new technologies.

A chef from Carmel Cafe treated those attending the USF Diabetes Center event to a cooking demonstration, complete with diabetes-friendly appetizers and recipes to take home.

–          Through the international Type 1 Diabetes TrialNet consortium, coordinated by the pediatric epidemiology center led by Dr. Krischer, USF continues to identify those at higher risk for type 1 diabetes and offer them opportunities to enroll in prevention trials. Dr. Rodriguez chairs the TrialNet Natural History Pathway to Prevention Study, which oversees the worldwide screening of people at higher risk for type 1 diabetes.

–          Started four clinical trials investigating therapies for children with type 2 diabetes.

–          Applied for a Juvenile Diabetes Research Foundation Translational Center grant, which drew upon interdisciplinary collaboration with researchers across USF.

–          Strengthened partnerships, including working with the American Diabetes Association and JDRF at the national and local levels, and building education and research collaborations with diabetes care providers across the Tampa Bay region

–          Working with Hillsborough County School Board to advocate for a more comprehensive policy covering care of students with diabetes.

USF Diabetes Center staff, volunteers and community partners provided information about diabetes management and clinical research opportunities.

Hailey was diagnosed with type 1 diabetes in March, and her mother Heather Platz says even at a young age her daughter shows remarkable understanding of a disease that requires a commitment to daily blood sugar checks, insulin injections and lifestyle changes.

In addition to checking her own blood sugar (with supervision), Hailey is mindful of what she eats and has everyone around her “counting carbs,” Platz said.  “She’s definitely a lot more mature than the average 4 year old child and very responsible about taking care of her diabetes.”Both Hailey’s mother and sister Emma, 3, are enrolled through the USF Diabetes Center in TrialNet, a study to learn more about how type 1 diabetes develops in at-risk individuals, including siblings of those diagnosed with type 1.   

Type 1 diabetes is an autoimmune disease in which the immune system attacks and destroys the body’s cells that produce insulin. Proteins known as autoantibodies are markers of the damage, and can often be detected in the blood up to 10 years before someone is diagnosed with type 1 diabetes. 

Hailey Platz, left, and younger sister Emma take time out for play at the USF Diabetes Center celebration.

 When Emma was screened for these insulin antibodies, the test indicated she had several.

“As a result, she may qualify for the oral insulin study,” Heather Platz said.  “It would be really good to get her on a prevention track, because her risk of developing type 1 is significantly higher than normal… If there’s anything we can do to help delay or prevent the onset of diabetes, we’re all for. Even if the research doesn’t help Emma, it may help end up helping other children.”As her daughters laugh and play while enjoying evening’s festivities,  Platz says the USF Diabetes Center’s team has helped the family cope with the stress of living with a child who has diabetes.

“Since Heather’s diagnosis, everyone has been so good about explaining everything and answering every question. The Center’s staff is always available for us when we need them,” Platz said. “It’s such a positive experience coming here.”

– Photos by Eric Younghans, USF Health Communications