Targeting Type 1 Diabetes (Sponsored Content)

Summary

Odd Lots Podcast - Episode Summary: Targeting Type 1 Diabetes (Sponsored Content)
Release Date: June 22, 2025
Hosts: Joe Weisenthal and Tracy Alloway
Produced By: Bloomberg Media Studios and Vertex Pharmaceuticals

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Introduction to Type 1 Diabetes

In the latest sponsored episode of Bloomberg's "Odd Lots" titled Targeting Type 1 Diabetes, hosts Joe Weisenthal and Tracy Alloway delve deep into the complexities of Type 1 Diabetes (T1D), a chronic disease affecting over 8 million people globally. The episode highlights personal stories, historical context, and cutting-edge research spearheaded by Vertex Pharmaceuticals aimed at finding a cure for this relentless condition.

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Madison Carter's Journey with Type 1 Diabetes

The episode begins with the compelling story of Madison Carter, an award-winning investigative reporter from Atlanta, Georgia, who has been living with Type 1 Diabetes since childhood.

• Early Diagnosis and Challenges
  Madison shares her childhood struggles:

  "People will tell you I go for everything I say, everything that needs to be said, like I have no fear, like I don't have a lot to lose." (01:02)

  Diagnosed at age three after exhibiting severe symptoms such as extreme weight loss, constant thirst, and fatigue, Madison recounts the emotional and physical toll of managing her condition from a young age.

• Personal Tragedy and Resilience
  A poignant moment in her life was the sudden death of her younger sister, Cameron, who also had T1D:

  "I would call her the good diabetic. Like, she really did everything she needed to do. And I was kind of in that phase of doing just enough to stay alive. And she died." (06:00)

  This loss profoundly impacted Madison, leading her to take a year off from diabetes management. However, her determination saw her resume her self-care practices, emphasizing the daily grind required to live with T1D.

• Embracing Technology
  Madison highlights advancements that have improved her quality of life:

  "Having a continuous glucose monitor is probably one of the best inventions. So now I can glance at my blood sugars and I can then pick up my insulin pump, which is right next to that device, and just input the numbers." (16:04)

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Understanding Type 1 Diabetes

Dr. Erin Kowalski provides an in-depth explanation of T1D, outlining its physiological impact and the critical importance of insulin:

• Physiology of T1D

  "Our pancreas produces insulin, a special hormone that the body needs to process glucose... Those insulin-producing cells in the pancreas are destroyed." (04:17)

  Without insulin, glucose remains in the blood, causing hyperglycemia and leading to severe complications if untreated.

• Historical Context and Advances
  Reflecting on a century since insulin's discovery, Dr. Kowalski remarks:

  "Before the discovery of insulin in 1921, every single type one person died." (07:34)

  The episode also touches on the landmark DCCT trial of 1983, which established the link between high blood sugar and long-term complications, underscoring the necessity of intensive blood sugar management.

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Vertex Pharmaceuticals' Innovative Approach

Dr. Felicia Pagliuca, Vice President and Disease Area Executive for T1D at Vertex Pharmaceuticals, discusses the company's strategic focus on understanding the causal biology of diseases to design transformative therapies.

• Cell Therapy Research
  Vertex is pioneering cell therapy as a potential treatment for T1D by replacing the destroyed insulin-producing beta cells:

  "Science has advanced to a place where even a decade ago, it was unthinkable... to think that you could make replacement islet cells in the laboratory." (10:55)

• Collaborations and Expertise
  The episode highlights the role of Dr. Doug Melton, a distinguished fellow at Vertex and a leading stem cell researcher, whose personal experience with T1D in his family fuels his dedication:

  "My wife had to deal with the fact that she was also breastfeeding Sam at the time... she looked at me more or less and said, look, you're a scientist. Go do something about this." (12:18)

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Dr. Doug Melton's Personal Motivation and Breakthroughs

Dr. Melton shares his personal impetus to combat T1D after his son was diagnosed, driving him to develop functional insulin-producing cells from human stem cells.

• Scientific Breakthroughs
  A pivotal moment came around 2013-2014 when his team successfully programmed these cells to respond to glucose levels:

  "The moment where we had a test and when we added glucose, the cells squirted out insulin, and then we knew we were on the right track." (13:59)

• Vision for the Future
  Dr. Melton expresses optimism about the advancements:

  "We now know the problem and we just have to do it." (15:21)

  He affectionately carries a vial of insulin-producing cells as a reminder of the progress and the potential for a cure.

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Personal and Professional Reflections

Madison Carter reflects on how her condition has shaped her personality:

"I was like, I don't want to take the shot. I don't want to do this again tomorrow. I don't. I don't want to. Not that I wanted to die, but I just did not want to work this hard to be alive." (15:49)

Despite her challenges, Madison remains a symbol of resilience and determination, advocating for better treatments to alleviate the burdens faced by those with T1D.

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Conclusion: A Hopeful Path Forward

The episode concludes with a message of hope, emphasizing the collaborative efforts of scientists, medical professionals, and patients in the fight against Type 1 Diabetes. Vertex Pharmaceuticals' innovative research, combined with personal stories like Madison Carter's, highlight the potential for groundbreaking treatments that could transform the lives of millions affected by T1D.

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Notable Quotes:

• Madison Carter on fearlessness:

  "People will tell you I go for everything I say... like I have no fear." (01:02)

• Dr. Erin Kowalski on Dr. Doug Melton's inspiration:

  "Think about cells as being a cause of disease, but think about cells as being a solution to diseases." (09:54)

• Dr. Doug Melton on managing his son's T1D:

  "You're a scientist. Go do something about this." (12:18)

• Madison Carter on technology improving her life:

  "Having a continuous glucose monitor is probably one of the best inventions." (16:04)

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Final Thoughts

Targeting Type 1 Diabetes offers a profound exploration of the challenges and advancements in managing and potentially curing Type 1 Diabetes. Through personal narratives and expert insights, the episode underscores the relentless pursuit of a cure and the hope it brings to millions worldwide. For those interested in the intersection of health, technology, and personal resilience, this episode of "Odd Lots" is both informative and inspiring.

Transcript

[Jordan Goss Poirier]

Since you're a subscriber to this Bloomberg Podcast, we thought you'd be interested in a six episode sponsored podcast called Targeting the Toughest Diseases. Produced by Vertex Pharmaceuticals and Bloomberg Media Studios, it explores the innovative tools, methods and unique philosophy Vertex Pharmaceuticals is using to search for treatments for some of humanity's most challenging diseases. Here's a recent episode.

[Madison Carter]

I'm so goal oriented. I'm always just charging ahead like we're going to get it done by any means possible.

[Jordan Goss Poirier]

Focused and fearless. That's the best way to describe Madison Carter. Those qualities have helped Madison break a lot of important stories. As an award winning investigative reporter in Atlanta, Georgia, she's investigated white nationalists, political corruption and the parole system. Those are stories that take a lot of guts to cover. And Madison has done it all without hesitation.

[Madison Carter]

People will tell you I go for everything I say, everything that needs to be said, like I have no fear, like I don't have a lot to lose.

[Jordan Goss Poirier]

That fearlessness comes from a dark place.

[Madison Carter]

It's because of my diabetes. I'm like, I could die at any second.

[Jordan Goss Poirier]

Hi, I'm Jordan Goss Poirier, a member of the University of Southern California's center for Health Journalism. This is Targeting the Toughest Diseases produced by Bloomberg Media Studios and Vertex Pharmaceuticals. In this series we look at some.

[Dr. Erin Kowalski]

Of humanity's most challenging diseases and how Vertex, a Boston based biotech company, is using innovative tools, methods and a unique philosophy to search for treatments and cures. Today, we're targeting type 1 diabetes, a chronic disease that affects more than 8 million people around the world, a number that's expected to increase rapidly. In the US alone, approximately 1.4 million people, including nearly 170,000 under the age of 20, have type 1 diabetes.

[Madison Carter]

I don't think I ever had the opportunity to be a kid.

[Jordan Goss Poirier]

Since she was three years old, Madison's life has included a highly controlled diet, constantly measuring her blood sugar levels and insulin shots.

[Madison Carter]

And it's something that I have spent the past couple years in therapy really working through because it's not fair. It's not just that I feel like it's not fair. It is not.

[Jordan Goss Poirier]

When she was just a toddler, Madison started showing signs that something was off.

[Madison Carter]

I was getting really, really skinny, which is weird because the people in my family are not very skinny.

[Jordan Goss Poirier]

She was thin, feeling thirsty all the time and constantly tired.

[Madison Carter]

I would be falling asleep in random places. My mom found me asleep next to my oatmeal one morning, found me asleep on the toilet one day. You know, I'm A toddler. I'm three years old, so that was really strained, especially when I'm supposed to be running around. And one night my mom was putting me to bed, and she said that she could count every single one of my ribs. And in that moment, she picked me up, put me in the back of the car, gave me a Sprite, which later on we would find out was a very bad idea, and took me to Children's Hospital.

[Dr. Erin Kowalski]

When they got there, the medical team found Madison's blood sugar level was dangerously elevated, nearly 200% higher than it should have been.

[Madison Carter]

They told my mom I should be dead. Had she had put me to bed that night, I would have been dead. And that's how I was diagnosed. I think my parents had about a year of giving me injections until I told them to never touch me with the needle again.

[Jordan Goss Poirier]

By the time she was five, Madison was doing all her injections herself.

[Madison Carter]

It was harder for me to see my mom inflict pain upon me than it was for me to just do it myself. Like, seeing her face, that upset me. It wasn't even that it would hurt, because it hurt sometimes when I would do it myself, but I just didn't want her to have that responsibility of feeling like she was hurting me.

[Dr. Erin Kowalski]

Our pancreas produces insulin, a special hormone that the body needs to process glucose, a key source of energy for people who have type 1 diabetes. Those insulin producing cells in the pancreas are destroyed. That means the glucose stays in the blood, resulting in high blood sugar levels, also known as hyperglycemia. The symptoms include increased thirst, hunger, frequent urination, and weight loss. If left untreated, this can lead to excessively high glucose levels and eventually could even be fatal. People with type 1 diabetes rely on giving themselves insulin every single day to survive and have to be super vigilant. Not enough insulin can lead to high blood glucose levels and over time, complications like kidney disease, vision loss, nerve damage, heart attacks, and strokes. Too much insulin can result in low blood sugar. If left unaddressed, blood glucose levels can fall dangerously low and can lead to severe hypoglycemia, resulting in seizures, loss of consciousness, or even death.

[Madison Carter]

I remember it was President's Day weekend. She was playing volleyball, so she had this tournament.

[Jordan Goss Poirier]

Madison's younger sister Cameron, also had type 1 diabetes.

[Dr. Erin Kowalski]

She was 14.

[Madison Carter]

And I got pulled out of class. They said, hey, you know, we're going to take you to the hospital. Your sister had a seizure.

[Jordan Goss Poirier]

Madison rushed to the hospital.

[Madison Carter]

My parents met us at the door and they said she didn't make it. She was dead when they took her in the ambulance.

[Jordan Goss Poirier]

Her sister's sudden death from diabetes devastated Madison.

[Madison Carter]

I would call her the good diabetic. Like, she really did everything she needed to do. And I was kind of in that phase of doing just enough to stay alive. And she died. And that upset me. And I was like, well, what is the point of doing everything you're supposed to do, like my sister Cameron did, if it's still not enough?

[Jordan Goss Poirier]

Madison lost all motivation to manage her own health.

[Madison Carter]

For a year after she died, I told people that I took a year off of being diabetic. The responsibility is the checking your blood sugar, the making sure you're taking your injections or changing your pump. I refused to do, and my mom stepped in and did it for me.

[Jordan Goss Poirier]

After a year, Madison resumed doing her own care. It's a daily grind, but it keeps her alive.

It's a very, very difficult disease to manage.

The constant managing of type 1 diabetes is something Dr. Erin Kowalski knows intimately.

When my brother was diagnosed in the late 70s, you were pretty much told that you had about 20 years before complications would form. Your life would be shortened pretty significantly. You had a very high likelihood of going blind. You had these dosing of insulin issues that could cause severe hypoglycemia and potentially death on a daily basis.

[Dr. Erin Kowalski]

A few years after his brother was diagnosed, Kowalski discovered he had type 1 diabetes as well.

[Jordan Goss Poirier]

Today he's the CEO of JDRF, the world's largest nonprofit funder of type 1 diabetes research.

We are just celebrating the hundred year anniversary of the discovery of insulin, which won multiple Nobel prizes and saved millions of lives. Before the discovery of insulin in 1921, every single type one person died.

That's every single person for centuries.

The disease actually was described in ancient Egyptian and Greek writings. And this observation that people made was the fact that people with this syndrome wasted away.

[Dr. Erin Kowalski]

The term diabetes mellitus was coined because it roughly translates to sweet savage.

[Jordan Goss Poirier]

The sugar would just pass through people, the food would just pass through them, and the sweetness was observed when ants would be attracted to the urine of these people.

Modern times have brought us modern discoveries. Apart from the breakthrough of insulin, there was a landmark study in 1983 called the DCCT trial, which stands for the Diabetes Control and Complications trial. It showed the connection between high blood sugar and complications. It also showed that with more intensive therapy, people with type 1 diabetes could prevent long term eye, kidney and nerve complications. And more recently, there's been huge improvements in glucose monitoring. This includes smartphone apps with Sensors which can monitor blood sugar levels continually.

Not surprisingly, if you have more information, you do better. I certainly think that's been one of the biggest changes in my life and my brother's life.

Despite all those improvements in managing type 1 diabetes, there's still no cure. And people with the disease are still at risk of developing really severe, potentially fatal complications.

[Dr. Felicia Pagliuca]

Type 1 diabetes has such a significant burden on individuals, on families, on communities, and it is a 247 relentless job.

[Dr. Erin Kowalski]

That's Dr. Felicia Pagliuca. She's the vice president and disease area executive for type 1 diabetes at Vertex. They are researching type 1 diabetes at the cellular level, something she first got interested in when she was a student.

[Dr. Felicia Pagliuca]

It was really a lecture that I saw when I was a PhD student by Professor Doug Melton that turned that paradigm on its head that not only could we think about cells as being a cause of disease, but think about cells as being a solution to diseases.

[Dr. Erin Kowalski]

That's what Vertex is investigating. Cell therapy as a potential treatment for type 1 diabetes.

[Dr. Felicia Pagliuca]

Vertex has a really unique research and development strategy that focuses first and foremost on diseases where we understand the causal biology really well so that we can rationally design therapies that could have a major transformative impact on patients if we're successful in developing them.

[Jordan Goss Poirier]

Type 1 diabetes definitely fits that description.

[Dr. Felicia Pagliuca]

Clearly, it's a disease with enormous unmet medical need. It's a disease where we understand that these missing insulin producing islet cells are at the heart of the disease.

[Dr. Erin Kowalski]

And this knowledge is what drives Vertex forward.

[Dr. Felicia Pagliuca]

Science has advanced to a place where even a decade ago, it was unthinkable, it was science fiction, to think that you could make replacement islet cells in the laboratory. And so to be at the moment now, it really feels like a inflection point, and we hope it really will be in the history of the treatment of type 1 diabetes.

[Dr. Erin Kowalski]

The professor who first inspired Dr. Pagliuca to think of cells as living problem solvers was Dr. Doug Melton, one of the world's leading stem cell researchers. A former Harvard professor, he's been in this area of research for more than 20 years, and this year he joined Vertex as a distinguished fellow. But working on an investigational treatment for type 1 diabetes wasn't always on his radar.

[Dr. Doug Melton]

Well, I didn't think much about diabetes until my 6 month old son contracted the disease. From a parental point of view, you have to manage that little baby's blood sugars by pricking their fingers or their toes and squeezing blood out and measuring how much sugar there is and Then inject them with insulin. You can imagine how hard it is in a six month old that doesn't talk.

[Jordan Goss Poirier]

His son Sam was the youngest person at children's hospital in Boston to be diagnosed with type 1 diabetes.

[Dr. Doug Melton]

My wife had to deal with the fact that she was also breastfeeding Sam at the time. When you're eating food, like a candy bar or an apple or something, you know how much sugar you're taking in, but you can't tell how much sugar you take in or energy from breast milk because you don't know what the volume is. So she's up all night testing his blood sugars and injecting insulin. And she looked at me more or less and said, look, you're a scientist. Go do something about this.

[Dr. Erin Kowalski]

And so he set out to do just that.

[Jordan Goss Poirier]

It was understood that people with type 1 were missing insulin producing cells, also known as beta cells. Dr. Melton figured if the beta cells were missing, they needed to make new ones.

[Dr. Doug Melton]

There was this nice commercial about a man and he would say, time to make the donuts. And so I used to go to the lab and say, time to make beta cells. That was our job.

[Jordan Goss Poirier]

I love that. What are the differences between type 1 and type 2 diabetes?

[Dr. Doug Melton]

Well, type 1 diabetes is caused by the problem that one's immune system makes a mistake. Instead of just attacking foreign entities like a virus, it decides, for reasons we don't understand, to attack the patient's own beta cells and destroys those cells. That is not the cause of type 2 diabetes. In type 2 diabetes, the patient still makes insulin, but their body has a greater and greater demand for insulin. So it's called insulin resistance, meaning that the patient's muscle and fat cells require more and more insulin all the time. Type 2 diabetes can be treated in many cases by changes in diet and exercise. That is not true for type 1. So no behavioral change will prevent or treat type 1 diabetes.

[Jordan Goss Poirier]

What was that aha moment?

[Dr. Doug Melton]

The real turning point was about in 2013, 2014, where we figured out the right factors or molecules to give to the cells that made them respond to glucose. Because the beta cells job is to read or measure the amount of sugar in the blood and then squirt out just the right amount of insulin. So the moment where we had a test and when we added glucose, the cells squirted out insulin, and then we knew we were on the right track.

[Dr. Erin Kowalski]

As part of his work at Vertex.

[Jordan Goss Poirier]

Dr. Melton is helping develop a potential treatment that addresses the root cause of type 1 diabetes. The absence of those insulin producing cells in the pancreas. The company is investigating how to replace those destroyed cells with insulin producing cells and making sure they can get into patients in a way survive and function for a long time. And progress so far gives Dr. Melton confidence in their path forward.

[Dr. Doug Melton]

Let's put it this way, if 30 years ago you had told someone you would take a human stem cell and turn it into functional insulin producing cells, people would have said, yeah, good luck with that.

[Jordan Goss Poirier]

One last thing that Dr. Melton told me, something that made me smile the rest of the day. He says that everywhere he goes, he always carries a little vial in his pocket.

[Dr. Doug Melton]

It has in it cells that have been turned into insulin producing cells. Sometimes I take it out like a snow globe and just turn it up and down and look at it because it reminds me that this is possible. We now know the problem and we just have to do it.

[Jordan Goss Poirier]

Madison Carter is hoping for a better treatment for type 1 diabetes because she doesn't want another generation of young people to feel how she did.

[Madison Carter]

I was like, I don't want to take the shot. I don't want to do this again tomorrow. I don't. I don't want to. Not that I wanted to die, but I just did not want to work this hard to be alive.

[Jordan Goss Poirier]

To ease that burden, she's now looking to technology.

[Madison Carter]

Things have improved so much. Having a continuous glucose monitor is probably one of the best inventions. So now I can glance at my blood sugars and I can then pick up my insulin pump, which is right next to that device, and just input the numbers.

[Jordan Goss Poirier]

And maybe more important than tech, Madison still has her fearless determination.

[Madison Carter]

I had a friend point out to me, she goes, oh, that's why you are the way you are, you know, And I didn't even realize that. I didn't even associate it back to my diabetes.

[Dr. Erin Kowalski]

This is targeting the toughest diseases.

[Jordan Goss Poirier]

A podcast from Bloomberg Media Studios and Vertex Pharmaceuticals.

[Dr. Erin Kowalski]

If you like what you hear, subscribe.

[Jordan Goss Poirier]

And leave us a review. I'm Jordan Ghos Poiray. Thanks for listening.