Jeremy Pettus found out he had diabetes on the same day that his brother left home. “We were taking him to college. It was the middle of the summer, over 100 degrees. He was on the 8th floor of his dorm, but the elevator was broken, so we had to go up the stairs, lugging all his supplies,” Pettus says. “And we didn’t know it at the time, but I was undergoing diabetic ketoacidosis.” He was rushed to urgent care and diagnosed with type 1 diabetes. On the same day that his brother took on vast new levels of independence, Pettus found himself saddled with new responsibilities. “Everything changed. All of a sudden I had to be aware of what I ate, check my blood sugars, take insulin,” he says. “Learning the ropes was hard.”
But in an odd way, Pettus considers his diagnosis to be a blessing. “Learning more about my own body, intellectualizing it, was a kind of protective technique,” he says. “And what began as a desire to understand myself expanded into my wanting to help others.”
With a newfound interest in medicine, Pettus attended University of California, Berkeley to study biochemistry. He walked by his brother’s old dormitory on Telegraph Avenue every day. From there, he earned a medical degree from Boston University before completing his residency at University of California San Diego School of Medicine as well as his fellowship in endocrinology, diabetes, and metabolism. He is currently an assistant professor of medicine at University of California San Diego.
As a clinician, Pettus relies on his own experiences with type 1 diabetes to empathize and connect with his patients. “People with type 1 diabetes are used to being judged by their health care providers. They come in defensive, ready to explain why their blood sugars are high or low. But as soon as someone knows that I have type 1, that barrier goes down,” he says. “I tell them that even though I’m an endocrinologist, I have highs and lows every day. Being able to relate on that level makes the meeting less about them trying to deflect or impress me and more about how I can really help.”
Pettus also applies his personal experience through his work with Take Control of Your Diabetes (TCOYD), a nonprofit that provides free diabetes education directly to patients. During its 30-year history, TCOYD typically shared the latest in diabetes information through large in-person conventions with thousands in attendance. However, the COVID-19 pandemic forced the organization to adopt a more virtual approach. Pettus has played a crucial role in that pivot, helping to create podcasts alongside other online content. “We’ve made 10 full-length music videos that are original songs about diabetes. I play guitar, sing, and play piano, and we’ve had fun playing with different genres,” Pettus says. “There’s one in the style of Elton John. There’s an 80’s techno song. There’s one that’s a spin on ‘Margaritaville.’”
“People love it,” he adds. “This isn’t browbeating, this isn’t shaming. This is just how you live well with this disease.”
While Pettus’s clinical and educational work is geared toward patients with either type 1 diabetes or type 2 diabetes, his research is focused on an often-unacknowledged truth. “Type 1 can sometimes be the forgotten stepchild of the diabetes world,” he says. This stems in part from the fact that type 1 diabetes accounts for only ∼10% of total diabetes cases. While research has produced a wide range of new medications for people with type 2 diabetes, people with type 1 diabetes have not seen the same kinds of advances.
“We get really hyperfocused on blood sugars with type 1. Obviously, we need to control glucose levels and insulin is always going to be needed, but I think we’re missing the boat,” Pettus says. “The medications we use for type 2 diabetes—GLP-1RAs and SGLT2 inhibitors, for instance—can have profound effects on metabolism, and I think there’s a real opportunity to use them with type 1.”
Thankfully, with Pettus’s help, the gap between advances in research for type 1 diabetes and type 2 diabetes is closing. “I do think that in the next couple of years we will have drugs beyond insulin approved for type 1 to start using in combination,” he says. He also points to new immunotherapies that can prevent the destruction of insulin-producing β-cells as well as recent advances in cell replacement.
“There’s a newfound interest as we realize we can approach it from all these different angles,” Pettus says. “It’s a great time to be in type 1 research. It’s a great time to have type 1 diabetes.”
