BLOG: TEDx lecturer champions reversal and prevention of type 2 diabetes
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For a while now, I have wanted to write about Sarah Hallberg, DO, who died in March. I was not sure how best to tell the story about this champion whom I was blessed to have met in person.
Sarah was an inspiring speaker. I have rarely attended scientific lectures where a speaker talks so freely from the heart — with utmost passion, sincere compassion, powerfully motivational tone and a touch of humor.
In the days after last Thanksgiving, Sarah wrote on her professional Facebook page that she and her family had planned to celebrate Christmas in early December as her doctors had told her she was likely to be too ill with advanced metastatic lung cancer to celebrate on the actual day.
But when that date arrived, she wrote, she had less pain, her medications were reduced, and scans showed that her tumors had regressed so much that a scheduled biopsy was canceled.
“Miracle? Yes,” she wrote.
I came to tears reading that post.
In the summer of 2020, it broke my heart to learn Sarah’s diagnosis. She announced it publicly, both in the media and on her social media networks, including her professional Facebook page.
In a column published in the Tampa Bay Times newspaper on July 5, 2020, Sarah shared her personal story in a piece titled “I am a Doctor with Stage 4 cancer in a pandemic.”
Sarah wrote: “I have advanced cancer. Stage 4 lung cancer, to be exact, even though I have never smoked, and I am only 48 years old. Cancer is scary enough, but now I am in a real unknown, with so many others like me: dealing with advanced cancer in a pandemic. ...
For me personally, the pandemic has not been all bad. For a mother with terminal cancer, the lockdown has given me time I could never imagine having with my busy kids. A hidden gift in the madness.”
As an endocrinologist, I have been talking in my lectures about Sarah’s impressive scientific work in obesity management — the largest study on reversing type 2 diabetes via weight loss with supervised dietary modification. I was impressed by her courage, scientifically speaking, in challenging the status quo in traditional diabetes guidelines. After becoming aware of Sarah’s work, I found myself obliged to relearn some aspects of the science and management of metabolic syndrome, obesity and type 2 diabetes.
Sarah is among the few scientists and clinicians I have heard emphasize the concept of “pre-prediabetes.” Yes, pre-prediabetes, not prediabetes. That is something I have been preaching (and practicing to a modest extent); something I have called the “shift to the left,” as I explained in a recent Healio interview, when I was asked about what I wish for in the future of my specialty, endocrinology.
I first heard about Sarah a little over 4 years ago. In a WhatsApp group of my alma mater’s medical school — class of 1984, Jordan University — a classmate one day posted a YouTube video and asked for my opinion as the only endocrinologist in my class. The video was Sarah’s TEDx talk at Purdue University on May 14, 2015, titled “Reversing type 2 diabetes starts with ignoring the guidelines.”
In her 18-minute talk, Sarah summarized type 2 diabetes, obesity and metabolic syndrome from a perspective that I had never thought of before, and I was a seasoned diabetologist and a graduate of an endocrinology fellowship program from a prestigious university back in the mid ‘90s. The title of the talk, in itself, is thought-provoking, and the video on YouTube has so far achieved 8 million views, 128,000 likes, and no single dislike.
As Sarah battled cancer, she made clear that she would use her platform, her status and her well-deserved fame to advocate for justice and health equity. In a powerful post on her professional Facebook page, she posted a piece headlined “Clinical trials and health inequity — insights from a research physician and cancer trial participant.”
Sarah wrote about health inequity and her own privilege: “It was hard for me to shift from being a physician to a cancer patient. It seems harder to switch sides yet again from a researcher to a research participant. ... Getting access to the cutting edge of medicine should be an option for everyone — but it’s not, and we need to change that. Despite my late-stage cancer, I am fortunate in many ways. As a physician, I can quickly absorb mounds of research literature and have connections for additional questions or guidance when I need them. I have learned to be a relentless advocate for my patients, and now I am transferring that skill to myself. Oh yeah, I am also an upper middle-class white person, and sadly all these factors really matter.”
After watching Sarah’s TEDx talk, I looked her up, and I was pleasantly surprised to learn that she is a Hoosier, in Lafayette! A “Hoosier” is a resident of Indiana. As a graduate of Indiana University myself, from its endocrinology fellowship, I was pleased to know that Sarah, too, is a graduate of IU.
I called her and introduced myself. She graciously said that she was so happy that an endocrinologist showed interest in her work. I then started searching for her research as well as her lectures and video presentations online. I was impressed and so invited her to be a guest speaker at our institution.
She gave us a spectacular grand round on April 16, 2019, when I had the honor of meeting her briefly and learning in person about her work. At the time, I was not aware of her cancer. I vaguely recall that she did hint to me that she was having some medical issues that limited her travels. She said she was reluctant to travel to Lansing but that she wanted to keep her commitment to the invitation. I was touched by her graciousness.
After that meeting, Sarah and I had a 20-minute Zoom chat about her journey in medicine and life. I expressed my admiration of her untraditional approach in tackling type 2 diabetes management — not by waiting for the disease to occur, but to prevent it. And once it does occur, her untraditional approach to reverse it rather than just control it. In both perspectives, the principal key is to tackle head-on the root cause of type 2 diabetes — that is, obesity.
I call upon my readers to share with me this special celebration of Dr. Sarah Hallberg.
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