In 1982, Zach Leigh was among a handful of children who helped launch the Scripps Whittier Diabetes Institute.
Forty years later — his 9-year-old handprints still visible in a preserved chunk of concrete set during a ceremony for the budding institute — nearly everything about diabetes has changed.
Leigh, now a digital mapmaker, father and husband with a fondness for mountain biking, recalls that his hopes four decades ago had a lot to do with the urine strips that were used back then to track blood sugar levels. In addition to being inconvenient, especially for grade-school kids looking to fit in with their peers, the strips were not particularly accurate. They didn’t change color until glucose levels hit 200 milligrams per deciliter, a point at which the situation was already out of control.
“By the time those strips showed anything in the urine, you were already hours too late,” Leigh said.
His young self would be astonished at where things stood for Type 1 diabetes in 2022, he said.
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Today, Leigh is enrolled in a clinical trial through Whittier that gives him early access to the latest closed-loop blood glucose monitor, which is equipped with an automatic insulin pump. The device can both detect his blood sugar in near real time using a tiny needle embedded just under the skin and also deliver micro doses of the drug he needs to keep his blood sugar well-balanced day and night.
The system can even transmit its data to his smartphone for easy viewing and transmission to his doctor.
Those without diabetes might think it’s the convenience of this technology that would so impress Leigh’s childhood self. And surely he would have been awed. But there is something deeper that only people who have coped with the disease for decades can truly understand.
For so long, Leigh explained, diabetes was a private matter handled largely behind closed doors. It was hard for one person with diabetes to recognize another unless they happened to see testing supplies, insulin syringes or other unmistakable items.
But wearing an automatic glucose meter creates a telltale bump under a person’s shirt near the midsection that others wearing the same device can easily spot.
“It has kind of opened up a whole new world to talk to other diabetics because you can see them,” Leigh said. “It’s like a club in some ways. It’s camaraderie.”
The Scripps Whittier Diabetes Institute, just north of Scripps Memorial Hospital La Jolla, originally was called the Whittier Institute for Diabetes and Endocrinology. It is named for late philanthropist N. Paul Whittier, who contributed $5 million in seed money to get the organization off the ground.
The institute has performed its own research throughout its four decades, operating first out of its own building on the Scripps La Jolla campus, then relocating nearby to 10140 Campus Point Drive at the Scripps Health system’s headquarters when expansion caused the original structure to be torn down .
Whittier recently has become known for his extensive behavioral research around blood sugar control for Type 2 diabetics. The institute has received millions in federal grants to document and teach its “promotora” model, which has demonstrated real gains in diabetes control using peer educators in the Latino community to help people with the disease live healthier lives through diet and exercise. Most recently, efforts have explored using digital means, turning to text messaging as a two-way conduit to deliver real-time advice and encouragement.
As methods have evolved, so has medication. dr Athena Philis-Tsimikas, an endocrinologist and Whittier’s director, said that when she started treating patients 30 years ago, only human insulin and two medications — metformin and sulfonylureas — were available for the treatment of diabetes.
Though both medications could stimulate the pancreas to produce more insulin, they sometimes overstimulated, causing weight gain and other side effects.
Over the ensuing decades, science has delivered better drugs — often called SGLT2 and GLP-1 inhibitors — that can reduce the amount of glucose the body absorbs or stimulate insulin production. Both have less risk of overshooting balanced blood sugar levels and may cause those who take them to lose weight. Taken appropriately, the drugs have been shown to reduce the number of patients who die from complications of diabetes.
“When I started my career, there were only three ways to treat diabetes,” Philis-Tsimikas said. “Now there are over 14 different categories of medication available.
“Just needles alone have come so far. I’ve heard stories of patients sharpening their own needles and boiling them to sterilize them, and now the needles in the injection pens we use to deliver insulin are so fine you can’t feel them going into the skin.”
Though many of the medicines and technologies are made by companies based outside San Diego, Whittier has always served as a critical point of access for the nationwide clinical trials that have brought them to market. At least a dozen trials are regularly available with a staff of experts on hand to help clients determine possible risks and benefits of participation and whether they qualify to participate.
Paul Whittier’s seed money for the institute that bears his name helped lure Dr. Willard VanderLaan — an endocrinologist who was then director of an existing diabetes research center at Scripps Clinic — to Scripps’ main hospital in La Jolla. VanderLaan also was the personal physician of Olive Whittier, Paul’s first wife, who died of diabetes complications in 1976.
Whittier’s philanthropy as chairman of MH Whittier Corp. of South Pasadena accelerated with the sale of Bellridge Oil Co. to Shell Oil in 1979 for the then-record sum of $3.65 billion. The family also is known for its partnership in the Rodeo Land and Water Co., which platted and sold Beverly Hills to movie stars.
Much of the money was used to fund the Confidence Foundation, a charity still active today that is named for the ship that took family progenitor Thomas Whittier from England to New England in 1638.
The foundation has continued to support the organization it helped create. It is now in the fifth year of a $1 million gift to establish the Paul and Lucy Whittier Endowment for Diabetes Education and Research.
Confidence Foundation trustees Arlo Sorensen and Linda Blinkenberg, both of whom knew Paul Whittier and have worked with the family since the 1960s, said support has been occasional rather than continuous, linked to new initiatives as they are proposed.
Whittier, who died in 1991 at age 87, wanted his gifts to be seeds that could grow into trees with deep enough roots to support themselves, Blinkenberg said. So additional gifts have been for new branches rather than propping up the old trunk.
“We’re very proud of what they’ve done with Paul’s gifts,” Blinkenberg said. “They’ve made great progress at being able to grow themselves.”
“It has just been a great example of how to use philanthropy to make something bigger than yourself happen,” Sorensen said.
The comprehensive grant database maintained by the National Institutes of Health lists more than $30 million in federal research grants awarded to the Whittier Diabetes Institute and Scripps Health for diabetes research.
The list of scientific inquiry includes basic research into core questions that have, with the work of many others in many other places, gradually improved the lives of diabetics worldwide. In 1985, VanderLaan earned support to delve into the role of insulin control by pituitary peptides, a topic further explored by Dr. Andrew Baird in the 1990s.
Others, such as Dr. Alberto Hayek, achieved international recognition and support for research transplantation of islet cells, which are critical for production of insulin. ◆