We are killing ourselves with idle luxury. A delightful path perhaps, but our over consumption of unburned fats and sugars is leading 24 million Americans toward a slow and very painful diabetic end. While this epidemic explosion is new, diabetes is an age old disease, and one Princeton’s Novo Nordisk has been batting for 90 years.
To explain the business side of fighting an epidemic, the Princeton Regional Chamber of Commerce has invited Henrik Rasmussen, Novo Nordisk’s North American vice-president of clinical, medical, and regulatory affairs, to present “Diabetes: The Silent Killer” on Thursday, August 7, at 11:30 a.m. at the Marriott Princeton Hotel and Conference Center. Cost: $45. Visit www.princetonchamber.org.
As a practicing physician, researcher, and medicinal developer, Rasmussen has worked on all sides of treatment. A native of Denmark, Rasmussen earned his medical degree in cardiology in 1985 from the University of Copenhagen. He then spent five years in practice in that city, prior to moving to England to work as Pfizer’s head of global clinical research. After six years he came to the United States, serving as chief medical officer for three biotech firms in the Washington D.C. area. He has held his present position at Novo Nordisk for the last year and a half.
Novo Nordisk holds a uniquely strong position in the diabetes treatment field. Currently the world’s largest producer and seller of insulin, the firm is one of the few pharmaceutical companies dedicated to fighting a single disease, with a multiplicity of treatment options. It also boasts a long historical tradition.
In l922, shortly after Canadian scientists John Macleod and Frederick Banting developed purified insulin, Danish doctor August Krogh contacted them in hopes of finding a cure for his diabetic wife, Marie. Krogh, a Nobel Prize winner in physiology, saw the possibilities of this drug and upon returning to Copenhagen founded the Nordic Insulin Laboratory, which grew into Novo Nordisk. Today the company’s 25,000 employees supply treatments reaching into 179 nations. Marie Krogh, treated by her husband, lived until 1943, when she died of breast cancer.
Although treatments keep advancing, Rasmussen remains pessimistic about curbing diabetes’ spread. “We expect the 24 million American cases to hit 60 million by 2060,” he says. “And it is not just America. We are seeing diabetes flood through Europe and even well into third world countries.”
Cause and effects. The human body has developed a nicely balanced system for eradicating those extra sugars that are not burned off in immediate exercise. As we eat, the pancreas secrets the hormone insulin, which gobbles up the remaining glucose. It also prevents fat from being released from the liver as triglicerides, which can harm proteins, kidneys, and more. The body gets the necessary nutrition and the blood stream remains clean.
Or so it goes unless your pancreas has no insulin-producing capabilities. The result is Type-I diabetes, occurring in approximately 10 percent of diabetes victims. If, however, you have followed a strict regimen of fast-food gluttony and physical sloth for several years, you may join the other 90 percent of diabetes patients. In Type-II diabetes the insulin simply can’t keep up with all the sugars being stuffed down the gullet, and the system cannot be cleansed effectively.
In either case, the result is the same — sugars accumulate and the kidneys weaken. Proteins cannot do their job. Blood vessel walls begin to weaken and blood begins to escape through them. Blindness can occur as the delicate eye vessels break and further vessel damage leads to gangrene and the need for amputation of limbs. Thus the old doctor’s warning, “Cut down, before I must cut you down.”
Alas, no headaches, shortness of breath, or aching joints signal the onset of diabetes. Particularly for the more lifestyle-engendered Type-II, only the blood test reveals the disease. The fasting blood sugar level, (sampled before eating breakfast in the morning) should be below the 100 mark. Those rating 100 to 120 are called pre-diabetic and should consult a doctor. “I cannot stress enough the need for annual testing and early diagnosis,” says Rasmussen. “Catching and treating it at the onset can literally add years to one’s life.”
Towards that end, Novo Nordisk has a Diabetes Bus driving across the U.S. offering free screenings to all comers.
Type-II. Two thirds of American adults are overweight. Thirty-three percent are truly obese. “The correlation between obesity and diabetes is virtually absolute,” says Rasmussen. This is the key factor for the 90 percent suffering diabetes, and it’s fixable.
“In most all cases, Type-II diabetes is completely reversible with a change in diet and exercise,” Rasmussen says. However, he admits, this is scarcely as simple as it sounds. Our entire culture is dedicated to dangling the wrong foods in front of us, and the need for hard, calorie-burning exercise in most of our daily lives is nearly nonexistent. Exercise must be sought out, as must the right foods.
Most individuals, upon hearing a diabetes diagnosis, as Rasmussen puts it, “try halfheartedly, fail, and then decide it is much easier to just take a pill.” For those seeking pharmaceutical treatment, Novo Nordisk has offered Prandin, and the newer, Prandinet. Both these pills stimulate insulin excretion, so the body can absorb more glucose. The company’s latest offering, Liraglutide, is currently in phase III of testing and is proving successful with a totally new form of operation.
Liraglutide works to delay the metabolizing of sugars into the blood stream so they can be handled more easily by the existent insulin. Secondly, because of this digestive delay, the body feels full longer, thus the drug also acts as an appetite suppressant. The advantage to Liraglutide’s method is that no amphetamine-style metabolism boost is involved.
Type-I. For those who simply have no insulin to produce, the sole answer is to keep a steady, measured supply coming in externally, for life. Typically congenital, Type I diabetes may be inherited from either side of the family and makes its presence known early on.
Since there is no insulin to dispel the sugars, the body tries desperately to force the glucose out through the urine. This makes the victim ever urinating and ever thirsty — the primary symptoms. Also, since insulin also is a growth hormone, the youngsters afflicted tend to be underweight and small. With a solid insulin regimen, a full and active life is possible. But it is a life of very attentive monitoring.
Novo Nordisk makes three types of insulin — a rapid acting, a more sustained, longer type, and a mixture of each. The administration of these is based on the diabetic’s daily meals and activities. Some years ago an insulin pump was introduced, allowing the diabetic to add measured doses through a surgically implanted port. Yet most people, Rasmussen notes, still prefer the injection method. Additionally, Type-I diabetics always carry sugar candies in the case of over-exercise or a slight insulin overdose.
Each year Billie Jean King, WTT Charities, and Novo Nordisk give four scholarships to young competitive tennis players with diabetes. “This last year, we gave one to the 16-year-old who won the Junior U.S. Tennis Championship,” Rasmussen says. “It goes to show what can be achieved if you don’t allow yourself to make excuses.”