Mary Tyler Moore (1936–2017):Diabetes Educator and AdvocateDiabetes Care 2017;40:732–735 | https://doi.org/10.2337/dci17-0015

Having a dream is what keeps you alive.Overcoming the challenges makes lifeworth living.

dMary Tyler Moore

“Who can turn the world on with hersmile?” So began the theme song forthe popular The Mary Tyler MooreShow, which aired on the CBS televisionnetwork from 1970 to 1977. With thepassing of Mary Tyler Moore, the show’sstar, on 25 January 2017, the diabetescommunity lost an individual who for de-cades not only brought smiles to her au-diences, but also changed the world forpeople living with diabetes, researchersseeking its cure, and health care providersfor those with the disease.

A LIFE IN THE SPOTLIGHT

Born inBrooklyn,NY, in 1936, youngMarymovedwith her family to Los Angeles, CA,when shewas 8 years old (1,2). There, shedeveloped a love of show business, andher early efforts as a danceropeneddoorsinto the world of television. Many trib-utes published since her passing havehighlighted Ms. Moore’s creativity andsuccess as a performer; her remarkabletalent encompassed dancing, acting, andsinging. From 1961 to 1966, she playedLaura Petrie, thewife,mother, and home-maker on The Dick Van Dyke Show (3). Inthe 1970s, on The Mary Tyler MooreShow, shewasMary Richards, themodern,

forward-thinking, fearless yet vulnera-ble producer at a local Minneapolis,MN, television news station who spokeher mind but also fostered teamworkand a sense of camaraderie among herquirky coworkers (4). For her dramaticrole as Beth Jarrett in the acclaimed1980 film Ordinary People, in which sheconvincingly conveyed a parent’s heart-breaking challenge of surviving a child(5), she was nominated for an Academy

Award for Best Actress in a Leading Role.Whether performing on television, in afilm, or on a theater stage, Ms. Mooreloved her craft and felt called to use hertalents, time, and fame to help others.

AN UNEXPECTED DIAGNOSIS

Ms. Moore’s commitment to bringingabout positive change for others wasmanifest in her openness about dealingwith life’s challenges, including her diag-nosis with diabetes.

At the age of 33 years, during her timeon The Mary Tyler Moore Show, she wasdiagnosed with type 1 diabetes (6). Later,she described being initially incredulous,having never expected that somethinglike this could happen to her. It took heronly a short time, however, to fully appre-ciate the seriousness of her diagnosis, andher response was to become vigilantabout managing the disease. Her publicstatements about type 1 diabeteshuman-ized the condition and gave voice to thethoughts and experiences of many othersliving with the disease. Her acknowledg-ment of her diagnosis became their ac-knowledgment. Her acceptance thatliving with type 1 diabetes would be anall day, every day undertaking with novacations helped them to accept theirown condition. Her courage in the faceof constant fear of long-term complica-tions lent courage to others facing thesame fear.

Mary Tyler Moore delivering testimony at a U.S.Senate hearing for JDRF’s Children’s Congress,2003.

1Department of Pathology, Immunology, and Laboratory Medicine, and Department of Pediatrics, University of Florida Diabetes Institute, University ofFlorida, Gainesville, FL2Past Senior Director, International Partnerships and Cure Therapeutics, JDRF, New York, NY

Corresponding author: Mark A. Atkinson, atkinson@ufl.edu.

© 2017 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit,and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.

Mark A. Atkinson1 and

Concepcion R. Nierras2

732 Diabetes Care Volume 40, June 2017

PROFILESIN

PROGRESS

A CHAMPION OF EDUCATION

Ms.Moore’s openness about her life withdiabetes, as well as her struggles to con-trol her blood glucose, did not just makeher a role model for people with the dis-ease; she was also tireless in encouragingeveryone to learn more about the disor-der. She championed the understandingthat individuals with type 1 diabetes donot look any different from others andthat they hold a unique position fromwhich to educate friends, neighbors,schoolmates, coworkers, and colleaguesthat type 1 diabetes is not “just” a disor-der in which one cannot eat sweets andfor which the major challenge involvesovercoming a fear of injections. To bevery clear, Ms. Moore knew that peoplewould say, “Mary Tyler Moore has diabe-tes.” Nonetheless, she accepted the riskthat her transparency about living withtype 1 diabetes might negatively affecther career and chose to act on the boldnotion that her fame could help raiseawareness for the greater benefit of ev-eryone with the disease.In the early 1980s, she became in-

volved with an organization founded by

parents of children with type 1 diabetes(known then as the Juvenile DiabetesFoundation and now simply as JDRF). By1984, she had become its InternationalChairman (7).Ms.Moore knew that beingactive in this position would mean inter-acting with young people, and she rel-ished the opportunity. She was not onlyone of them, but also someonewhose lifeproved that a personwith type 1 diabetescould achieve anything. Although thismessage may seem obvious today, onemust recall that, at the time of her diag-nosis, that was not the case. Back then,people diagnosed with type 1 diabeteswere widely considered to be bound forunacceptable morbidity, early mortality,and a lifestyle that in many ways was pre-scribed to be devoid of life. Simply put,Ms. Moore helped to change that view.

A TIRELESS ADVOCATE

Ms. Moore’s impact on people withtype 1 diabetes did not end theredfarfrom it. Beginning in 1995, she led a groupof government relations volunteers, indi-viduals with diabetes, and their familymembers to petition the U.S. Congress

for increased funding for the National In-stitutes of Health (NIH) and, in particular,for special funding for type 1 diabetes re-search. In 1999, JDRF launched its firstChildren’s Congress, with Ms. Moore de-lighting in being the most senior “childdelegate” participating. She would laterexplain that the idea for the Children’sCongress came from another child dele-gate, Tommy Solo, who, at the age of9 years, asked, “Why should adults go toCongress to ask for funding? Kids with di-abetes should go and tell them what it’slike, because we know better than any-one.Maybe then they’ll hurry up andhelpus find a cure.” Ms. Moore encouragedparticipants in the Children’s Congressto ask members of Congress to, as thecampaign’s slogan said, “Promise to Re-member Me” when appropriating fundsfor type 1 diabetes research.

In response to these and other persis-tent charm offensives and advocacy ini-tiatives, from fiscal year 1998 through2017, Congress appropriated a cumula-tive total of $2.46 billion in special fund-ing for type 1 diabetes research, withan additional equal amount to support

Ms.Moore at a press conference in the U.S. Capitol Building inWashington, DC, to help launch the inaugural Fall 2006 issue of the magazineNIHMedlinePlus, of which she was featured on the cover.

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diabetes and education programs for Na-tive Americans, who are disproportion-ately affected by type 2 diabetes. Theso-called Special Diabetes Program (SDP)funding to the NIH augments regularlyappropriated funds that the U.S. Depart-ment of Health and Human Services re-ceives for diabetes research. The SDP hasfostered unique collaborations amongthe NIH, the Centers for Disease Controland Prevention, and the broader researchcommunity to accelerate the pace ofprogress in type 1 diabetes research.Thanks largely toMs.Moore’s leadership,the diabetes research community hasbenefited greatly from the opportunitiesmade possible by the SDP, as illustratedin a few examples below.

A LEGACY OF RESEARCH

Example 1: Genetic DiscoveryIn 2003, only three genes were knownto be associated with type 1 diabetes.Through research supported by SDP fundsand other sources, more than 50 genes orgene regions have now been identified as

being associated with type 1 diabetes (8).The pathways controlled by these genesare being studied for how they contributeto the development of type 1 diabetes,how environmental factors may interactwith them to affect disease development,and how they may be related to otherautoimmune disorders in addition totype 1 diabetes.

Example 2: Epidemiology, DiseasePrediction, and PathogenesisToday, data frombothTEDDY (TheEnviron-mental Determinants of Diabetes in theYoung study) (9) and Type 1 DiabetesTrialNet Pathway to Prevention Study (10)have led to improved disease risk classifi-cations, leading in turn to a recommenda-tion for a new type 1 diabetes stagingclassification (11) for at-risk individualsthat provides a framework for researchinto and development of preventive ther-apies. Clinical trials are ongoing in whichimmune therapies are being tested fortheir ability to help people with newly di-agnosed diabetes (12). Researchers alsonow have access to resources that enable

detailed studies of the human pancreasand immune system in those with or atrisk for the disease (13).

Example 3: b-Cell ReplacementIn 2005, the NIH Immune Tolerance Net-work completed the first multicenter clini-cal trial demonstrating that transplantationof pancreatic islets from a deceased donorcan restore glycemic control in individualswith type 1 diabetes (14). The Clinical IsletTransplantation Consortium has con-ducted clinical trials with associatedmechanistic studies to test new strategiesfor improving islet transplantation and tofacilitate the transition of islet transplanta-tion into clinical practice (15). Today, newmethods for large-scale laboratory pro-duction of b-cells, including from stemcells, are being discovered, and re-searchers are investigating strategies toprotect these cells from autoimmune at-tack once they are implanted into aperson with type 1 diabetes. Other ap-proaches for regenerating b-cells are be-ing studied, and innovative technologiesfor testing therapies are being developed.

Ms. Moore testifies at a U.S. Senate hearing for JDRF’s Children’s Congress 2005. The panel to her left includes Douglas Wick (producer, Red WagonEntertainment, Culver City, CA), Gary Hall, Jr. (Olympic gold medal swimmer, Miami, FL), and Allen M. Spiegel, MD (director of the NIH’s National Institute ofDiabetes and Digestive and Kidney Diseases), each of whom also testified about the need for increased type 1 diabetes research funding. Photo credit: LarryLettera, Camera One.

734 Profiles in Progress Diabetes Care Volume 40, June 2017

Example 4: Complications Preventionand TreatmentThe SDP also enabled the establishmentof large-scale collaborative researchgroups that seek to better understandand prevent the complications of diabe-tes. The Epidemiology of Diabetes Inter-ventions and Complications (EDIC) studyis an ongoing follow-up to the landmarkDiabetes Control and Complications Trial(DCCT) (16) that has shown that intensiveblood glucose control can reduce the riskof cardiovascular complications of type 1diabetes. The Diabetic Retinopathy Clin-ical Research Network (17) demon-strated that anti–vascular endothelialgrowth factor (VEGF) therapy is a moreeffective treatment for diabetic macularedema than laser treatment alone. Thisresult dramatically changed clinicalpractice, and anti-VEGF therapy hasquickly become a standard treatmentfor individuals with vision loss from di-abetic macular edema. Additional trialsdemonstrated that three different anti-VEGF therapies are equally effective inpeople with mild vision loss (18), a resultthat will certainly inform personalizedtreatment.The progress enabled by this long-term

investment in diabetes research under-scores the power of partnership amonggovernment, foundations, scientists, andpeople with diabetesdan alliance thatcounted Ms. Moore among its most ef-fective leaders. The cumulative effect ofall of these research efforts has beenthat long-term survival of individualswith type 1 diabetes has dramatically im-proved, and a foundation of knowledgehas been generated that offers more op-portunities for research advancementand greater promise for the future.

A GRATEFUL COMMUNITY

Remembrances of Ms. Moore since herrecent passing have and will continue toinclude accolades for her work as a per-former and an icon for social progress;

she is well worthy of such tributes. How-ever, her impact on research progress indiabetes should be given equal praise. In-deed, because of Ms. Moore, individualswith type 1 diabetes are able to livebetter lives with ever-increasing hopedapriceless gift. In her own unique way,Ms. Moore summarized her view of deal-ingwith diabetes, often saying, “You can’tbe brave if you’ve only had wonderfulthings happen to you.”

So, thank you, Mary Tyler Moore, foryour bravery, your leadership, and yourability to make us smile. We will be smil-ing as we move forward to fulfill yourpassion to find a cure for diabetes andits complications and realize your visionof a world without type 1 diabetes.

Acknowledgments. The authors thank Dr. S.Robert Levine (Ms.Moore’s husband of 33 years),Dr. Amanda Posgai of the University of Florida,and Ms. Mara Buxbaum of ID PR (Ms. Moore’spublicist) for their editorial and literary contribu-tions to this work.Duality of Interest. This article was prepared byConcepcion R. Nierras in her personal capacity.The opinions expressed in this article are thoseof the authors and do not reflect the views ofthe NIH, the Department of Health and HumanServices, or the U.S. government.

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