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Sotomayor's nomination puts the spotlight on type 1 diabetes and innovations in treatment

This article first appeared in the St. Louis Beacon, June 17, 2009 - When Sonia Sotomayor grew up in the South Bronx in the 1960s, she wanted to be a detective, like her hero Nancy Drew. But she suffered from type 1 diabetes, (also known as juvenile diabetes). Back then, many with this illness could not look forward to full and productive lives. Some dealt with complications later in life that led to amputations, blindness, blood pressure problems and strokes.

But diabetes has not slowed Sotomayor, though she did put aside detective work. She earned a law degree from Yale Law School after graduating from Princeton University summa cum laude. After serving on the federal bench, she's poised to be the first Latina on the Supreme Court -- and also the first with type 1 diabetes.

Sotomayor "gives children hope," said Marie Davis, executive director of the St. Louis affiliate of the Juvenile Diabetes Research Foundation , "Now they can say 'I can achieve a lot'." Davis' foundation funds research into finding a cure and improving the quality of life for patients with type 1 and type 2 diabetes. The foundation provided $156 million for research in 2008.

Sotomayor was diagnosed with diabetes at age 8. She will turn 55 on June 25.

If confirmed, Sotomayor wouldn't be the first Supreme Court justice with medical issues. Justice Thurgood Marshall retired in 1991 at age 82 with glaucoma, deafness and heart disease. Justice Ruth Bader Ginsberg is recovering from surgery for pancreatic cancer.

With proper management, most people with diabetes can lead a long and productive life. Diabetes management improved markedly in 1969 with the introduction of the first blood sugar level monitors.

Type 1 diabetes develops when a person's immune system destroys pancreatic beta cells. These cells are the only ones in the body that make the hormone insulin, which regulates blood glucose or sugar. People with type 1 diabetes need to have insulin delivered by an injection or a pump.

Type 1 diabetes generally begins in childhood or young adulthood, although it can develop at any age. There is no known way to prevent the illness.

Since the 1960s, each decade has brought a major advance in managing diabetes. In 1979, the first insulin pump was introduced. It was inconvenient because of its size, which required it to be carried in a backpack. Today, insulin pumps are about the size of a deck of cards. The 1980s and 1990s saw the advancement of insulin, which could be injected 15 minutes before a meal. In recent years, a new type of insulin called glargine was created to last 24 hours.

Almost 18 million people in the U.S. -- or 7.8 percent of the population -- have either type 1 or type 2 diabetes. Another 5.7 million people are undiagnosed.

Others with type 1 diabetes include pop star Nick Jonas of the Jonas Brothers; Mary Tyler Moore, who is also the International Chairman of the Juvenile Diabetes Research Foundation; actress Halle Berry; and Broadway star Victor Garber.

The issue for many is the late-in-life consequences of the illness. People with diabetes can experience blindness, a loss of sensitivity in the extremities, heart and kidney failure, and blood pressure issues.

Sotomayor was "religious" about monitoring her blood sugar levels, attorney and former classmate Rudy Aragon told CNN in an interview last month.  Aragon attended Yale University Law School with Sotomayor and is currently an attorney in Miami. "It's been an issue with her, but she's overcome that. She overcomes it every day."

Sotomayor didn't talk much about her diabetes. Probably only her closest friends knew about it, Aragon said. "It never affected her in law school, not once," he said.

Davis, of the Diabetes Research Foundation, added, "For anyone with a disability, it shouldn't be an issue at all," Davis said. "Obviously she's doing a great job as a judge and I would say that someone who's saying 'well, doesn't that cause you to have a shorter life?', well even if it does, we don't know that tomorrow one of us won't get hit by a bus." 

Sarah Scully, a student at the University of Missouri, is an intern with the Beacon.