Falling Into Place – Restarting My Life with an Ostomy

It was an exciting day as I stepped out of my car door, onto a new college campus.  It was an environment filled with more new people than I could count, and of course a jumble of emotions one cannot control.   Oh yeah, and not to mention the ostomy I was sporting along with a suitcase full of supplies and all the medications I would need for the semester.  Entering college was hard, and with a chronic illness I expected it to prove even more challenging.  Surprisingly, I was wrong.

You may be asking, “what is an ostomy?” An ostomy is an artificial opening on the stomach, created during an operation such as a colostomy or ileostomy.  It is a “new” channel for waste to exit the body during the digestive process.  It can be temporary or permanent.

My Story

I thought life could not throw me any more surprises after nearly ten years of being diagnosed with Inflammatory Bowel Disease (IBD), and of course I was wrong!  I “restarted” my life two years ago when I came out of surgery with my ostomy.  Although it has been the hardest battle, I feel I have truly won.  I have my life back, and there is nothing more that I could ask for.  I have learned that every day is a new day and what you make of it is up to you.

Attending college and moving away from home was one of the accomplishments I was able to achieve with starting this “new life.”  It was the best feeling until I got there and thought “what are people going to think of me? How do I explain my disease or do I even have to? Do people even know what an ostomy is? What if….?” The list goes on and on, and although I tried to tell myself to move forward confidently, it was only human to have these questions.

The only way I found answers was through my experiences.  I found that people are going to think of you the way you think of yourself, so be confident and kind.  Explaining my Crohn’s went one of three ways; either people were really interested and asked questions, some already knew what it was, and others were extremely confused and just said “oh okay, well feel better.” Explaining Crohn’s was easy to me.  On the other hand, I was very nervous about explaining my ostomy. To me the circumstances of explaining my ostomy were much harder for a number of reasons.  Chronic diseases can also be known as invisible illnesses, and up until I had an ostomy everything about my illness was just that, invisible.  Although it was and is extremely frustrating to explain how sick you are when you “look fine,” it is also sometimes easier to not explain at all. I was always secretly happy that no one could “see” my disease.

My new ostomy took away that invisible feeling. The clothing I wear is just like everyone else, and more times than not, if not at all, no one can tell I have an ostomy.  The toughest situations I have had were going to the beach and going out on dates. I was so worried about what I would wear, especially when it was time to hit the beach.  It took a while but I found my niche, and that would be anything high-waisted!  These clothes allow me to be comfortable and cute at the same time.  Everyone is different, I know people who go to the beach and do not cover up their ostomy, which takes a lot of guts. No pun intended.

Dates can also be hard because sometimes your date may want to cuddle up with you and watch a movie, or something like that. It is hard for individuals with an ostomy as it can take a while to open up and share your life about living with an ostomy.

 

Life Moving Forward

I am in the process of finally learning how to let go and live my life.  I have learned you do need to tell anyone about your ostomy or your scars until you are ready.  If they cannot accept you, they are not worth another second of your time.  Either people are supportive but know that your ostomy does not define you, or they are too caught up in their own lives and do not even know you have one!  Most people do not care.  What a relief!

Although many others do not mind, it does not make it easier to live life with an ostomy.  Personally here are a few tips I find to be helpful while living with an ostomy:

  • Do not label yourself as someone who has an ostomy. You are still the person you are, and the person you want to become.  Just like before, you can accomplish anything.
  • An ostomy does not limit you by any means. I have been hiking, tubing, and spent all winter snowboarding down some of the biggest mountains in New England. Guess what, during these trips I did not have to worry about the bathroom as much so I had more fun!
  • Your self esteem will change because your life is changing, but you have to get back out there because once you do you will never turn back.
  • Although at times it may seem like everything is crashing down, tomorrow will be better.  Life does get better.

Living with a chronic illness day to day is not easy, but living through experiences over time can help.  Free yourself of all the things you think you are “supposed” to be.  All that matters is that you are happy, and if you are, then you are doing something right.  College and my experiences has taught me to feel comfortable in my own skin.  Once you are, everything else will fall into place.

 

Diabetes Doesn’t Have You

Chris Dudley played basketball in the NBA for 16 years. The Yale graduate gained notoriety around the league as a voracious defender, energetic rebounder, and formidable shot blocker. He played Center as a member of the Cleveland Cavaliers, the New Jersey Nets, Portland Trail Blazers, New York Knicks, and the Phoenix Suns. Dudley was born in Connecticut, but grew up primarily in the San Diego area of California where he started playing basketball. A bit of a late bloomer, Dudley played Junior Varsity basketball through his junior year of high school when he was first diagnosed with diabetes at the age of 16. Committing to Yale University during his senior year, Chris Dudley played for the Bulldogs from 1983 to 1987 before becoming the first ever Type-1 Diabetic to play in the NBA when we was drafted by the Cleveland Cavaliers in the fourth round of the 1987 draft.

Dudley’s professional career achievements include playing in a total of 886 games, scoring 3,473 points, 375 assists, 1,027 blocked shots, and 5,457 rebounds. The NBA rewarded Dudley with the J. Walter Kennedy Citizenship Award in 1996, and USA Today named him the Most Caring Athlete in 1997.

I was fortunate enough to interview Chris Dudley about his experience playing basketball as a type-1 diabetic.

It was in his spring semester in 1981 after his sophomore year that Chris Dudley started to experience the classic symptoms of increased thirst and frequent trips to the bathroom. His close uncle had diabetes, so after advising Dudley and his dad to test his blood glucose level (BS) at a home test kit from the local pharmacy, he realized he had T1D.

Initially shocked, Dudley remembered that the life expectancy for diabetics was well below that of non-diabetics in the early 80’s. Nearly as important to the 16-year-old was the question of whether or not he would be able to keep playing basketball.

Lucky for Dudley two main factors kept his spirits high in this tumultuous time. One, his endocrinologists in San Diego were fairly progressive in that knew the value of athletics in maintaining steady glucose levels. Although not a lot had been confirmed in this time as it related to the effect on sports and diabetes, his doctors did not deter Dudley from continuing to play. Second, Dudley looked to National Hockey League star Bobby Clarke for inspiration. Bobby Clarke was drafted into the NHL in 1969 as a diabetic, ultimately winning two Stanley Cup Championships and being inducted into the Hall of Fame in 1987. Clarke inspired confidence in Dudley that achieving athletic success was possible for a type 1 diabetic.

Most diabetics typically receive their insulin through two methods: multiple injections via an insulin pen or syringe, or through an insulin pump. Through the bulk of Dudley’s career, he received his insulin through multiple injections, as pump use had not been as highly advertised until the early 2000’s. Dudley commented that he wears the pump to receive his insulin currently, and would have considered wearing the modern day pumps back in his playing days, had they been available.

Other than his impressive doctors back in San Diego, Chris Dudley credits a particular nurse, Molly Meyer (who worked at Yale where Chris played in college) as incredibly instrumental in helping him out to manage his diabetes when it was most important and the level of play was at its highest. When asked about the most important person who currently helps Dudley the most with his diabetes management, he notes that his wife, also named Chris, is responsible for keeping him on top of his health.

Exercise of any kind with diabetes can be arduous. Playing basketball at the highest level for 16 seasons certainly presented unique challenges for Chris Dudley. When I asked him what the hardest aspects of his career were, he spoke about all the spikes in bis blood sugar from adrenaline he experienced, playing night after night in front of ten of thousands of screaming fans. The schedule of an NBA player also presents plenty of variables that may affect his glucose level management, from altitude of certain cities to back-to-back games on the calendar. The lag time for insulin in the 1990’s was also closer to 45 minutes, rather than the 15 to 20 minute absorption rate diabetics are blessed with today. This meant Dudley had to operate with a tremendous amount of foresight to try and keep optimum BS levels for game time.

I asked Dudley to share with me his average game day schedule, including testing times, in order to get a better sense on how regimented an NBA player with diabetes’ agenda must be.

Assuming the game was at home:

    • Dudley would wake up and test
    • Eat Breakfast
    • Prepare to drive into the arena for a pregame shootaround and test
    • Arrive at the arena and test
    • Participate in the pregame shootaround and test
    • Complete a quick workout, this might include a light lift and/or a solid stretching session, all while testing
    • Drive back home and test
    • Take a nap, wake up and test
    • Eat a balanced meal, chock full of protein
    • Relax for a bit and test
    • Drive back to the arena for the actual game and test
    • Get more shots up, complete pregame workout is necessary to get loose and test
    • Prayer/Mediation in the pregame Chapel and test
    • Pregame meeting with the team and test
    • Right before game time test
    • The Trainer will test (4x) throughout game
    • At Halftime test
    • After the game, get changed, test, and drive home
    • At Bedtime, test

If you’re counting at home, that’s roughly 20 times a day that Dudley tested his blood sugar. He notes how convenient it would have been to have been playing professional basketball in the Continuous Glucose Monitoring (CGM) era where he could read a continuous plotting of his blood glucose levels.

Unlike golf, swimming, or singles tennis, playing basketball as a diabetic is complicated in that you are a member or a team. With that team aspect, comes a level of responsibility and accountability to your teammates. It can certainly be intimidating to talk about your issues as it relates to your disease when you are the only diabetic surrounded by others who know very little about your needs. A member of many different teams in many different cities, Dudley asserts that his teammates everywhere were largely supportive. Even though many of peers never quite understood his condition, they showed a genuine interest. When I asked Dudley what may have contributed to such a positive response, he recalled back to early in his career, when he purposively didn’t miss any games or practices. Dudley credits his durability, at a time when his reputation had yet to be fully molded, to be responsible for players around the league to recognizing Dudley would not lean on diabetes as a crutch or excuse to not work hard and hustle.

Despite an incredible display of toughness and durability, like all diabetics, Chris Dudley has certainly had his fair share of hypoglycemic (or low blood sugar) incidents. One can imagine how stressful it must be to in the heat of the moment in a big game, unsure of whether or not you are just tried form running up and down to court or if you’re experiencing an issue beyond your control. What Dudley feared most wasn’t just playing terribly, it was letting his teammates down and embarrassing himself in front of 20,000 fans. When a diabetic’s blood sugar initially starts to drop, the symptoms mirror that of just being tired. Every athlete’s natural response to fatigue is to push through that feeling, to tell your body it can take on more, when in reality there’s a possibility it truly can not. Dudley was fortunate enough to have had these experiences, but was never forced to miss an entire game. The all to familiar act of having to binge drink juice in order to maintain a normal blood sugar level was definitely a phenomenon Dudley says he experienced.

When I asked him about any particular scary moments he’s faced when having a low, he recalled a game he played against the Denver Nuggets. The game was already decided, causing every player to worry less about execution and more about running up and down to the court and scoring to perhaps leave an impression for the games ahead. Dudley’s blood sugar crashed dramatically, and he ended up leaving the game entirely and needing an IV to deliver glucose and replenish lost fluids. In addition to the increased elevation of the Mile High City, Dudley also suggested he might have been a tad ill, which could have contributed to his erratic BS.

Despite occasional hiccups, it is without question that Chris Dudley found success playing basketball in the NBA. In talking about his greatest achievements as a basketball player, Dudley includes his 16 years of playing professionally, being the first ever type-1 diabetic to play in the NBA, leading the NCAA in rebounding while at Yale, and being amongst the leaders in the NBA in rebounds per minute played. Dudley recalls one his most proud moments to be when he won the Eastern Conference Finals playing for the New York Knicks in 1999. It was the first time in NBA history an 8th seed had beaten a 1 seed, beating the favored Miami Heat 3 games to 2 at home in front of their fans at Madison Square Garden.

Outside of the court, Chris Dudley has been serving the diabetic community through his Chris Dudley Foundation for the last 20 years. Operating out of Oregon, he holds camps through which his foundation aims to empower kids with type-1 diabetes. Dudley promotes achieving dreams by through acceptance, staying active, and taking care of yourself. Dudley adds that his foundation has teamed up with the Portland Trailblazers and the Pacific Northwest Diabetes Union to promote healthy activity and encourage diabetics during the Pacific Northwest Diabetes Awareness week.

I asked Chris Dudley what message he would give a newly diagnosed teenager with professional athlete aspirations, like himself all those years ago. Dudley paused and echoed again acceptance.

“You have Diabetes, Diabetes doesn’t have you”

It’s normal to ask “Why me?” but you cannot get too caught up in wondering what cosmic forces aligned for you to be diagnosed with diabetes. Dudley remarks instead that you should work through it.

Looking ahead, Dudley has no end in sight for his annual camp until a cure is found. In fact, he is looking to potentially expand his camp across the West Coast. He will continue to work with the Portland Trailblazer and Pacific Northwest Diabetes Union on Diabetes Awareness week and has some very revolutionary ideas for the NBA. In 2015, American sports leagues have used their influence to bring awareness to such causes as Breast Cancer or Military Appreciation. Dudley has expressed a desire for the NBA to potentially join forces with the American Diabetes Association to raise awareness. The month of awareness is in November, as is the beginning of the season, maybe the two associations could even incorporate a color scheme to be worn throughout the league. I, for one, would be ecstatic to see such a notion actually manifest itself.

Before finishing our interview, I told Chris Dudley that I’ve always kept a dynamic Top 4 diabetic athlete Power Rankings, a Mount Rushmore if you will. Diabetic Athlete Gary Hall Jr. introduced me to the idea that diabetes did not have to inhibit your athletic dreams when he won the gold just weeks before my own diagnosis, so he earns a spot. I was playing basketball in high school around the time of Adam Morrison’s heroic performances at Gonzaga, so he earns a spot. Jay Cutler balances his blood sugar levels while playing in the National Football League. Spot. I added myself last both because I came up with this idea and we need a little ethnic diversity. After laughing at my foolishness, Chris Dudley was gracious enough to offer me his Diabetic Athlete Mount Rushmore:

1. Bobby Clarke (NHL): Mentioned earlier in this piece, Bobby Clarke is an NHL Champion and Hall of Famer who had achieved many accolades around when Dudley himself was diagnosed.

2. Ron Santo (MLB): Santo was a star third baseman for the Chicago Cubs from 1960-1973, the Five time consecutive Golden Glove winner also batted .300 and hit 30 home runs in four of his fifteen seasons

3. Bill Collision (Triathlete): Coming out of California, this triathlete was the first ever to win the competition as a diabetic.

4. Chris Dudley (NBA): Chris Dudley was the first diabetic to ever play in the NBA, paving the way for plenty of others to follow in his footsteps. He’s well in his rights to put himself on top of that mountain.

As a player, Chris Dudley embodied grit and determination, he has taken that effort off the court in the present day to encourage and inspire diabetics like him to flourish at the highest level of competition. We should all take a page out of Dudley’s book and accept the terms our lives have given us, but to not be defined or deterred by them. As we work towards both a cure and better methods of management, let this be our battle cry:

“You have Diabetes, Diabetes doesn’t have You!”

For more updates and tips on how to use fitness for diabetes management and prevention. Follow me on twitter @roycHealth !

Going For Gold

Gary Hall Jr. is a three time Olympic swimmer out of Phoenix, Arizona by way of Cincinnati, Ohio. A product of a strong swimming lineage, his father Gary Hall Sr., uncle Charles Keating Ill, and maternal grandfather, Charles Keating Jr., all have competed and won medals in previous Olympic games.

Hall Jr. himself competed in the 1996, 2000, and 2004 Olympic Games, winning a total of 10 medals. At only 21 years of age in the 1996 Olympics, he won two individual silver medals and two team relay golds, including helping set the world record in both the 400 meter freestyle and medley relays. Hall won 2 gold medals in the both individual and relay events in the 2000 Olympics and an additional gold in the 50 meter freestyle in 2004.

Although highly decorated, Greg Hall Jr. had to overcome being diagnosed with type-1 Diabetes Mellitus in 1999 before the 2000 Olympics. He faced a decision whether or not to give up swimming entirely.

I spoke with Gary about that tumultuous time in his career.

Hall was diagnosed in march of 1999, after we underwent the very typical stages of grief and shock he says he remembers there being few diabetic athlete standouts at the time. Most importantly, there were certainly no Olympic athletes.

Two separate doctors told Hall that his diagnosis would mean the end of his career. They told him the strenuous Eight or more hours he would have to spend practicing in the pool would be too great a risk for someone having to regulate their blood glucose levels with insulin injections.

Unsatisfied with this news, the determined Hall eventually sought the advice of Dr. Anne Peters, who he credits most for her encouragement to not give up early on. The UCLA (now USC) endocrinologist and her team worked closely with Hall to utilize his strict workouts positively to control his sugars, rather than as an obstacle. Gary Hall credits Dr. Peter immensely for helping him find a routine that ultimately allowed him to continue competitive swimming at the highest level.

When he returned to swimming competitively, he broke the world record in the men’s 50-meter freestyle race with a time of 21.76 seconds at the 2000 Olympic Games.

Most diabetics are instructed to regulate their diets and control their blood sugars with multiple insulin shots delivered through syringes and pens. Insulin pumps offer a lot of flexibility with the amount of insulin that can be delivered over specific periods of time, but can be burdensome, as they must remain attached to the body. Choosing which method of insulin delivery can be challenging, especially for a world-class competing athlete.

Hall noted that he alternated back and forth between wearing a pump and taking multiple injections as he trained for the Olympics Hall attempted unsuccessfully to wear an Omnipod pump in the water for training and meets as he adjusted to swimming as a diabetic. Unplugging his pump and no longer receiving basal insulin, his blood glucose levels would shoot up hundreds of points after a training session. Here he was competing in a sport where swimmers shave off their body hairs in attempts to gain an edge and facilitate speed. Hall on the hand was wearing injection sites for his pump that would fly off his body, forcing him to try such extreme measures and using duct tape to adhere the sites to his skin in the water. He settled finally on multiple injections for competition.

The daily activities of an athlete are so regimented; it’s nearly catastrophic when there are disruptions. Unfortunately, diabetic athletes are all too familiar with challenges which may disrupt their routines. When I asked Gary Hall what his biggest challenges were, he responded with his beliefs about the lack of resources for diabetic athletes on topics such as: post workout spikes, competition adrenaline spikes, and the differences in blood sugar management between anaerobic and aerobic workouts.

The best way to combat these challenges is to maintain a stringent routine of the same activities before competition. I am well aware that diabetic and non-diabetic athletes alike will follow a particular routine that works for them like a bible. I asked Gary to share with me his routine for the day leading up to a big race:

  • Gary claimed he would test his blood sugar 20-25 times a day.
  • He would carry his blood glucose meter with him at all times all the way up to the Ready-Room before a particular race (A small room near the pool where only competing athletes were allowed 5-10 minutes before each race)
  • After the race he would test again, his blood sugar typically had shot up, sometimes up to 300 points
  • He would then proceed to giving himself a bolus of insulin to get his blood sugar back down to a comfortable level (below 200) before it was time for his heat to participate in the next race

Despite all the precautions we take, diabetic athletes can still fall victim to complications related to their blood sugars. “Going Low” or experiencing hypoglycemia is a condition where blood glucose levels are too low. The body usually undergoes symptoms such as dizziness, sweating, and an elevated heart rate. If not treated, hypoglycemia’s can lead to seizure, coma, or death. Surprisingly, most diabetic athletes or far more concerned with not being able to compete than they are about their own safety.

Gary Hall recalls a hypoglycemic episode at the 2001 Goodwill Games in Australia. He remembered testing throughout the day, but approximately 15 minutes prior to the race, he checked his blood sugar (BS) on his meter and it read 60 mg/dl (anything under 80 is considered low and exercising at a two digit BS is not recommended). He quickly grabbed and drank a sports drink and waiting a few minutes before checking again. After the second reading he realized his blood sugar had actually dropped even more, and it was officially time to panic. He chugged down another sponsored sports drink in the ready room and grabbed a third on the way to the actual race. Holding his third sports drink during swimmer introductions, he gulped it down on the starting blocks legitimately moments before the sound of the gun. With a belly sloshing full of sugary hydrate, he started the race, but unfortunately vomited underwater at the 35 meter mark. Gary Hall Jr. solidified his cult hero status as he completed this task on national television, but still finished second in the race.

Hall admits his biggest fears related to going low include the serious risk of having a Seizure in the pool and drowning, but also the soul-crushing possibility of potentially having to stop what you love to do.  

On a more positive note, I asked Hall what he appreciated about his experiences participating in the Olympics as a diabetic athlete:

“I could not have imagined the level of support from the T1D community. I received letters of support from all over, motivating me to train harder.”

Hall continued to say his greatest accomplishments were being able to represent the USA and win on the greatest stage, and representing the entire diabetic population worldwide.

In November of 2008, Gary Hall Jr. retired from competition. Since retirement, Hall has been extremely involved in health initiatives related to diabetes and Type-2 diabetes prevention.

Alongside groups such as the Aspen Institute, the Clinton Foundation, the American college of sports medicine, and the T1D Exchange, Gary Hall works tirelessly with policymakers to improve the lives of Americans looking to take control of their health.

Hall is currently promoting “Project Play”, an initiative looking to increase youth access to physical activity and sport. Hall has testified before Congress and believes that when it comes to insurance, discounts that currently exist for corporate gym memberships and safe driving should be extended to children and families who consistently engage in physical activity and sport. He believes American children and families should be rewarded when they proactively protect themselves against obesity and Type-2 Diabetes.

When I asked him how he envisions the rest of us as citizens can help aid the cause, he replied that we should all be advocates. Anyone touched by diabetes in any way should open up and speak about the challenges he or she faces. He recalls that legislation back around the time of his diagnosis would not have allowed him to buy health insurance, despite being able to win a gold medal in the Olympics. Hall doesn’t believe in us as diabetics settling with the rules as they currently exist, and moving forward would like diabetics to have the ability to join the military. Overall, he preaches that more people should get involved.

I too agree more should be done, especially for those willing to work for their health and well being. I think we should all follow Gary Hall’s lead and take it upon each and every one of ourselves to promote initiatives beneficial to our cause.

When asked what other famous athletes or celebrities might’ve inspired Hall throughout his career, he chuckled and replied simply: “The people who touched me most weren’t world champions, they were ordinary folks doing what they loved, who wouldn’t be denied” In august of 2004, a 13-year-old version of myself sat and watched Gary Hall win the gold after a television segment explaining what he had gone through as a diabetic athlete aired. About a month later that boy would receive the news from his doctor that he too was diagnosed with Type-1 Diabetes. After recovering from the initial shock, he remembered Gary Hall Jr., and found comfort in knowing that he too could achieve his highest athletic dreams.

I will always be grateful for the inspiration given to me that year from Gary Hall, his performance encouraged diabetics and athletes across the world not to allow any shortcomings to stand in your way to greatness.

For more updates and tips on how to use fitness for diabetes management and prevention. Follow me on twitter @roycHealth !

Diabetic Super Bowl Champion

The most popular sport in America is football. The NFL dominates conversations between friends, family, and co-workers; as everyone enjoys relaxing on Sundays watching one of the games. Since the Super Bowl is right around the corner, I wanted to highlight Kendall Simmons, a former Pittsburg Steeler Super Bowl Champion and type 1 diabetic.

Kendall Simmons must have felt like he had the world in the palm of his hand. He was a 6 foot 3 inch 315 pound lineman coming out of Auburn. After a tremendous collegiate career in the SEC, the Pittsburg Steelers picked in the first round of the 2002 NFL Draft. He signed a big fat contract, made it through his first training camp; and in his rookie season, he started fourteen games, another tremendous accomplishment. Just when Simmons was on a life high, things took a turn for the worse. He felt unusually tired, weak, irritable and having to use the bathroom non-stop. Over a two and a half week period, he lost 43 pounds and Simmons was diagnosed with Latent Autoimmune Diabetes of Adults (LADA or diabetes type 1.5). Simmons did not want his promising football career to end after just one season in the NFL, so with the help of his endocrinologist, team doctors and coaching staff, Simmons changed his life to manage diabetes. He knew he would have to adjust his diet and be much more meticulous in his daily regiment to keep his career alive.

By the time the first game of the season came (second year in the NFL, first year diabetic), Simmons and his staff had a plan in place to keep him on the field for the Steelers. He would check his blood glucose six to eight times while at the stadium on game day (before the game, between quarters, half time and post-game). Depending upon what his readings were, he would make the necessary adjustments with small snacks if he had hypoglycemia or insulin injections if he had hyperglycemia. Needless to say there were bumps and bruises along the way, but this allowed Simmons to start all sixteen regular games for Pittsburg. Two seasons later Simmons went on to start all twenty regular season and playoff games and lead the Steelers to the championship by defeating the Seattle Seahawks in Super Bowl XL. Simmons continued his career in the NFL until retiring in 2009 with the Buffalo Bills.

Kendall Simmons is an inspirational figure. He is a living example of how when life hits you with adversity, rather than feeling sorry for yourself, you make the best out of the situation. Winning a Super Bowl is the ultimate goal for every football player and Simmons did not let diabetes stop him. He now works with a variety of organizations including the JDRF, Swing 4 Diabetes, and Novo Nordisk to help improve the lives of people with diabetes.

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