An NCI-designated Comprehensive Cancer Center
By Abe Rosenberg | November 1, 2019
Sampath Rangasamy
Among the many talented diabetes researchers at City of Hope, there are several for whom the mission is deeply personal because they are type 1 diabetics themselves. Here are a few of their stories:

Jeannette Stratton: “I Cried Like a Baby”

At the slightest urging, Jeannette Stratton rattles off a list of the many type 1 diabetes research projects at City of Hope. A self-described “nerd,” she comes across as an authority on the disease, as well as someone familiar with every inch of the Duarte, California, campus.
She is both.
At City of Hope for nearly two decades, Stratton does one of those “keep-the-wheels-turning” jobs. As administrative program manager for the Islet Cell Transplantation Program, Stratton writes grant applications, crafts protocols, handles regulatory paperwork and maintains reams of data for each patient, tracking their progress.
Her formidable skills took something of a back seat, however, when she wrote her public (LinkedIn) profile:
I am a type 1 diabetic with a biological science background and extensive clinical research experience.”
Why mention type 1 diabetes first?
“It’s something I have to think about every moment of every day,” she said. “I’m inseparable from it.”
She was 18 and in college when she found out.
“I was overconfident,” she recalled. “I figured I could easily control my blood sugar, do the injections. Basic math, right?”
A few near-death experiences convinced her otherwise.
“I had many problems the first five years. Several times I had to be rescued because my blood sugar dropped so low, I fell unconscious.” 
Things improved after Stratton was fitted with an insulin pump, but the learning curve was steep for the entire family, none of whom had any experience with type 1 diabetes.
Then, in a bizarre twist, Stratton’s mother was diagnosed with the same illness. Mom took it in stride.
“Now we call daily to check in on each other,” Stratton said. “We joke about it and move on. We have a friendly competition where we compare our quarterly A1c results and see who ‘won.’” As an administrator, Stratton doesn’t interact directly with study patients, but bonds with them nonetheless through their data. She sympathizes with their blood sugar management struggles before transplant and celebrates each milestone they achieve after.
And she remembers the first one: the first successful islet cell transplant, after four years of hard work building the program.
“I was preparing a graph” showing how the patient — so sick pretransplant she’d had multiple car accidents caused by low blood sugar — was now off insulin and no longer needed it. “When we plotted her blood sugars and showed how drastically they fluctuated before transplant and how stable they became after, it really hit home.” Suddenly Stratton realized what was possible.
“I wept at my desk,” she remembered. “I cried like a baby.”
So, urgency, yes. But also joy.
“I love the challenge,” she said. “I love learning something new every day.
“And I especially love going to a place where so many people are working so hard to find a cure for what I have.”

Patrick Fueger, Ph.D.: “I Knew I Had It”

It’s an unusual club, to say the least.
Patrick Fueger was 12 when he was diagnosed with type 1 diabetes.
He wasn’t surprised. He’d seen it before.
“I knew I had it,” he recalled. He recognized the symptoms: fatigue, thirst, multiple bathroom breaks. It was all very familiar. His older brother had been diagnosed a few years earlier.
“I hid [the symptoms] from my parents,” he said. “I didn’t want to tell them. I saw what my brother’s illness did to the family. Everything changed. All the yummy food was taken out of the house. It was annoying!”
Also annoying: all the well-meaning, insensitive remarks.
“People started asking, ‘Did you eat too much candy?’ or, ‘Will I catch it from you?’” he remembered. “Plus everybody became self-appointed endocrinologists, shouting ‘Don’t eat that!’ all the time.”
“That’s a lot to handle when you’re a kid.”
And diabetes wasn’t through with the Fueger family.
Eight years later, Fueger’s younger brother became the third sibling to develop the disease.
“When he was little, he would always say he wanted to get diabetes, just like us,” Fueger said. “He wanted that bonding experience, to be part of the club.”
Eventually, the bonding for all three brothers did come: at special summer camps established for children with diabetes, where, instead of being known as “the sick ones,” kids are able to concentrate on being kids.
Meantime, an idea was beginning to percolate in Fueger’s mind.
“They put you in the hospital right away [when you’re first diagnosed] to teach you how to manage your diabetes,” he said. “I was in a ward with lots of other kids, some with diabetes, some with cancer, some much sicker than I.
“It gave me perspective. I felt a need to help somehow.”
He set out to become a pediatric oncologist, but along the way several professors took note of his inquisitive nature and steered him toward research, providing him with a “eureka!” moment:
“I realized I could investigate the science of diabetes,” he said, “and I’d have the tools to understand it.”
These days, as associate professor in the Department of Molecular & Cellular Endocrinology, Fueger digs into the mechanics of islet beta cell biology, pursuing more eureka moments, like the likelihood that type 1 and type 2 diabetes may have more in common that once thought.
“In both diseases, there may be common pathways that get disrupted.” he said. “Are there other commonalities? It’s possible that what we learn about type 1 diabetes could one day be applied to type 2.”
He’s also focused on the metabolism of fatty liver disease, which he calls “a ticking time bomb, especially for people with diabetes.
“Half of all Americans have too much fat in their liver, putting them at risk for liver cancer, which is very tough to treat. Understanding its metabolism may help us prevent it.”
To aid in that understanding, Fueger founded and directs City of Hope’s Comprehensive Metabolic Phenotyping Core Facility, where lab animals’ body composition and metabolism can be measured with unprecedented precision. This includes an assay for “in vivo” (or “live”) beta cell function not found anywhere else on the West Coast.
Complex work for sure, but Fueger relishes it, and he always remembers what it’s for. He keeps his brothers updated and he stays in touch with old camp friends. What does he tell them?
“There are a lot of people working really hard, day and night, to try and get rid of this disease.”

Sampath Rangasamy, Ph.D.: “I Can’t Tell What Life Would Be Like”

After living some 30 years with type 1 diabetes, TGen researcher Sampath Rangasamy, Ph.D., looks forward to the day when his disease is eradicated, though he can’t quite grasp what that means.
“If we get a cure, oh my God,” he exclaimed. “I can’t tell what life would be like!”
As a child in rural India, Rangasamy dreamed of becoming a farmer. “It looked like a cool job,” he recalled.
But when he was in middle school, the telltale symptoms of diabetes began showing up, and one day he fell into a coma. His father rushed him to the hospital on the back of his motorcycle.
Suddenly Rangasamy was very ill, and very different. Type 1 diabetes is rare in India, and until recently it carried a social stigma as well. Rangasamy’s parents kept their son’s condition a secret while he struggled to hide it from his schoolmates.
“Looking back I can’t believe I did that,” he said. “Somehow I managed. But it was a very stressful time.”
Adding to that stress was the lack of appropriate tools: no glucose meters or insulin pumps, and the only available insulin was animal-based. Rangasamy developed serious allergic reactions.
And his career plans changed.
“I decided I need to become a doctor and cure this,” he said.
His many hospital stays depressed his grades and put medical school out of reach, but Rangasamy embarked on a self-teaching binge, learning everything possible about type 1 diabetes.
A couple of decades and two Ph.D.s later, Rangasamy is immersed in the genetic sources of a daunting complication of diabetes: diabetic retinopathy, which can cause blindness. The National Institutes of Health has awarded City of Hope affiliate TGen a $2.8 million grant to use genomic sequencing to identify genes associated with the condition and establish a molecular profile that can predict the severity and treatment of the disease.
One possible cause of retinopathy may be inflammation of the eyes’ tiny blood vessels, prompted by an over-abundance of sugar. Those smallest of vessels, Rangasamy theorizes, which are the most flexible in the body, may also be most susceptible to inflammation.
“And because small vessels feed the larger ones and ultimately the organs, this is where we need to find ways to prevent it,” he explained.
He knows he’s searching for his own sake.
“I’ve been lucky so far,” he said. “I’m in good health. But the longer you live with type 1 diabetes, the greater the risk of complications. Within 15 years, the majority of type 1 patients develop retinopathy.”
But buoyed by the now 2-year-old Wanek Family Project for Type 1 Diabetes, Rangasamy is optimistic.
“I strongly believe we’ll find a cure.”
To support diabetes research at City of Hope and join our quest for a cure, click here.

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