Jason F. Lopez Whitney M. Young Magnet High School, CPS Ali Cinar, Ph.D. Research Mentor – Illinois Institute of Technol

1. Jason F. Lopez Whitney M. Young Magnet High School, CPS Ali Cinar, Ph.D. Research Mentor – Illinois Institute of Technology This material is based upon work supported by the National Science Foundation under grant No. EEC-0502174. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation. Got Insulin?Understanding and Managing Type 1 Diabetes Mellitus

2. Educational Module Overview • Subject: Regular and honors biology. • Target audience: 9th grade high school students (activities may be adapted for younger or older students). • Time requirement: 2-4 weeks depending on the number of activities chosen and length of classes (educational module was developed for 50 minute periods). • Pre and post assessment questionnaires, matrices, and scoring rubrics. • 10 total activities within the module—three of which can be considered optional—complete with instructional objectives and applications.

3. Focus of Educational Module • Content: (1) Type 1 Diabetes Mellitus; (2) Type 2 Diabetes Mellitus; (3) GlucoSim – online blood glucose simulator; (4) Food Tables – online nutritional guide; (5) carbohydrate digestion; (6) pH; and (7) chemical regulation. • Scientific Inquiry: An inductive, inquiry-based teaching approach should be adhered to during the implementation of the educational module. Scientific inquiry will also be used to measure instructional outcomes (i.e. student performance and knowledge).

4. Focus of Educational Module • Design: Activities in the educational module will introduce students to the engineering design process – how engineers solve problems. • Students will design an original laboratory investigation. • Students will design an original treatment plan for a person with Type 1 Diabetes Mellitus. • Students will design a personal “wellness plan” depending on their own individual eating and exercise habits.

5. Focus of Educational Module • Ethics: Professional ethicsissues pertaining to the involvement of science and/or engineering in Diabetes Mellitus can be discussed throughout the educational module as appropriate. • Disposal of potentially hazardous chemical and the environment. • Health and safety related issues. • Pharmaceutical testing on laboratory animals. • Cure vs. maintenance of Diabetes Mellitus.

6. Educational Module Goals • Students will appreciate how scientists from different disciplines (i.e. biology and engineering) can combine their knowledge to help solve real world problems. • Students will continue to develop the skills that encompass scientific inquiry (i.e. analyzing, measuring, observing, inferring, etc.) and the nature of scientific discovery, knowledge, and processes. • Students will explain the purpose of carbohydrate digestion and the role the pancreas plays in maintaining glucose homeostasis via the secretion of the hormone insulin.

7. Students will develop an understanding of Type 1 Diabetes Mellitus as well as what is involved in managing the disease. Students will appreciate the importance that diet and exercise have on establishing overall well-being, maintaining good health, and reducing the chances of developing Type 2 Diabetes Mellitus. Students will use state-of-the-art computer software to design a nutritional and exercise regimen for a person who has Type 1 Diabetes Mellitus requiring multiple daily injections of insulin. Educational Module Goals

8. Illinois State Learning Standards Addressed (Early High School) • 11.A.4a: Formulate hypotheses referencing prior research and knowledge. • 11.A.4c: Collect, organize and analyze data accurately and precisely. • 11.A.4e: Formulate alternative hypotheses to explain unexpected results. • 11.B.4c: Develop working visualizations of the proposed solutions design (e.g. blueprints, schematics, flowcharts, cad-cam, animations). • 11.B.4e: Develop and test a prototype or simulation of the solution design using available materials, instruments, and technology. • 12.A.4a: Explain how genetic combinations produce visible effects and variations among physical features and cellular functions of organisms. • 12.A.4b: Describe the structures and organizations of cells and tissues that underlie basic life functions including nutrition, respiration, cellular transport, biosynthesis, and reproduction.

9. Illinois State Learning Standards Addressed (Early High School) • 13.A.4b: Assess the validity of scientific data by analyzing the results, sample set, sample size, similar previous experimentations, possible misrepresentation of data presented and potential sources of error. • 13.A.4d: Explain how peer review helps to assure the accurate use of data and improves the scientific process. • 13.B.4b: Analyze a particular occupation to identify decisions that may be influenced by a knowledge of science.

10. National Benchmarks for Science Literacy (AAAS Project 2061; 1993) • Chapter 8 (Health Technology), Section F, Number 7 • Biotechnology has contributed to health improvement in many ways, but its cost and application have led to a variety of controversial social and ethical issues. • Chapter 1 (The Scientific Enterprise), Section C, Numbers 4-5 • Although each [science] discipline provides a conceptual structure for organizing and pursuing knowledge, many problems are studied by scientists using information and skills from many disciplines. (Excerpt) • Current ethics in science hold that research involving human subjects may be conducted only with the informed consent of the subjects, even if this constraint limits some kinds of potentially important research or influences the results. (Excerpt)

11. National Benchmarks for Science Literacy (AAAS Project 2061; 1993) • Chapter 1 (The Scientific Enterprise), Section C, Numbers 5-8 • Acting in their areas of expertise, scientists can help people understand the likely causes of events and estimate their possible effects. (Excerpt) • The strongly held traditions of science, including its commitment to peer review and publication, serve to keep the vast majority of scientists well within the bounds of ethical professional behavior. (Excerpt) • Funding influences the direction of science by virtue of the decisions that are made on which research to support. Research funding comes from various federal government agencies, industry, and private foundations.

12. Background Information • Educational module rationale • Educational module organization • Assumed student prerequisite knowledge • Diabetes Mellitus: An Overview • Symptoms, diagnoses, and treatments of Type 1 Diabetes Mellitus • Symptoms, diagnoses, and treatments of Type 2 Diabetes Mellitus • Useful engineering web sites • Useful scientific inquiry web sites • Professional ethics web sites

13. Educational Module Activities • Activity #1: “What Does a(n) Scientist/Engineer Look Like?” • Activity#2: “Carbohydrates Anyone?” • Activity #3: “What Color is Your Cracker?” Investigative Laboratory Exercise (Optional) • Activity #4: “Testing for Starch and Sugar” Investigative Laboratory Exercise • Activity #5: “Understanding pH: How Acidic is it?” Investigative Laboratory Exercise (Optional)

14. Educational Module Activities • Activity #6: “Digestion of Starch by Amylase” Laboratory Investigation Exercise • Activity #7: “Designing Digestion: An Original Laboratory Investigation” Exercise • Activity #8: “Animals in the Lab” (Optional) • Activity #9: “Type 1 Diabetes Mellitus and Chemical Engineering” • Activity #10: “Type 2 Diabetes Mellitus: A National Epidemic”

15. 2005 RET Workshop Projects • Several pre-assessment questions, Activity #1 (Scientist/Engineer), and post-activity discussion. • Introduction to Activity #2 (Carbohydrates), explanation of the teaching technique involved, and question/answer session.

16. 2005 RET Workshop Projects • Activity #6 (Amylase lab) – Primary Project • “Students” will be able to explain the purpose of carbohydrate digestion as well as how the procedures in the exercise are used to determine whether carbohydrate digestion has occurred. • Students determine if amylase is active in acidic conditions and why the digestion of carbohydrates is important for the human body. • Post-lab discussions will center around how the lab relates to Type 1 Diabetes Mellitus and how “students” can design an additional laboratory investigation based on another factor of digestion. • Ethical issues pertaining to HCl disposal and the environment as well as additional student suggested topics will also be discussed. • Introduction to Activity #7, overview and demonstration of GlucoSim—online blood glucose simulator (time permitting).

17. Materials for Primary Workshop Project • Test tubes with racks • Amylase • Starch • 0.5% Hydrochloric acid • Potassium iodide • 1-mL and 5-mL pipets • Parafilm • Wax marker • Water • pH paper * Materials needed for other module activities will be listed on the specific activity.

18. Evaluation and Assessment • Sample of planned concepts to assess: • Students’ prior knowledge of engineering and engineering careers. • Analyzing and interpreting data presented in the form of graphs. • Glucose homeostasis. • The pH scale and how it affects digestive processes. • Understanding how the pancreas and insulin are involved in Type I Diabetes Mellitus. • Managing Type I Diabetes Mellitus (i.e. diet, exercise, blood glucose simulators). • Students’ ability to synthesize, analyze, and evaluate laboratory data pertaining to blood glucose levels. • Comparing and contrasting Type 1 Diabetes Mellitus and Type 2 Diabetes Mellitus.

19. Evaluation and Assessment • Sample of planned evaluation and assessment tools: • Pre and post assessment assignment complete with matrices and scoring rubrics. • Higher level questioning based on Bloom’s Taxonomy of Cognitive Objectives (Bloom, 1956). • Student design and development of an original laboratory investigation. • Student design and presentation of a diet and exercise regimen for a person with Type 1 Diabetes Mellitus. • Long-range investigative activity that uses actual students’ diet and exercise preferences to assess the risk of developing Type 2 Diabetes Mellitus. • Written laboratory reports/assignments for pH investigation, starch and sugar investigation, and amylase investigation. • Student written reflection after completing personal “health profiles.” • Student-focused committees that conduct a survey to address professional ethics issues involved with Type 1 and 2 Diabetes Mellitus.

20. What is Diabetes? Diabetes is the name given to a condition where there is too much glucose (sugar) in the blood. The body is unable to keep the blood glucose level within normal limits (3.5 - 8.0 mmol/L). Without adequate treatment, the blood glucose level becomes much higher than normal. Normally, eating food containing sugar or starch is a signal for the pancreas to release insulin into the bloodstream. Insulin then helps glucose to enter the body's cells. Thus, insulin is the key to returning blood glucose levels to normal. Created by: Cinar, 2003

21. Type 1 Diabetes Mellitus - Overview • Also known as Insulin-Dependent Diabetes Mellitus. • Previously known as Juvenile or Juvenile Onset Diabetes. • Usually diagnosed in people under 30 years of age. • The pancreas does not make the hormone insulin. Type 1 Diabetes Mellitus is an autoimmune disease; it is a result of progressive and irreversible destruction of the islets (pancreas tissue) by the patient's own immune system. • Nearly 1 million people in the U.S. have Type 1 Diabetes Mellitus.

22. Type 1 Diabetes Mellitus • Symptoms: • Increased production of urine • Excessive thirst • Fatigue • Loss of weight • Increased appetite • Feeling sick • Blurred vision

23. Type 1 Diabetes Mellitus • Diagnosis: • Urinalysis shows glucose and ketone bodies in the urine, but a blood test is required for diagnosis. • Random (non-fasting) blood glucose exceeds 200 mg/dL. • Insulin test (low or undetectable levels of insulin). • C-peptide test (low or undetectable levels of the protein C-peptide, a by-product of insulin production).

24. Type 1 Diabetes Mellitus • Treatments: • Monitoring blood sugar • A healthy diet • Exercise • Maintain a healthy body weight • Medications • Transplantation

25. Type 2 Diabetes Mellitus - Overview • Also known as Noninsulin-Dependent Diabetes Mellitus. • Traditionally diagnosed in people over the age of forty, but is now routinely seen in young children as well. • The body cannot produce enough insulin or does not utilize the insulin it produces efficiently. • Approximately 90% of the 18 million Americans living with diabetes have Type 2 Diabetes Mellitus.

26. Type 2 Diabetes Mellitus • Symptoms: • Increased production of urine • Unusual thirst • Tiredness • Loss of weight • Increased appetite • Feeling sick • Blurred vision

27. Type 2 Diabetes Mellitus • Diagnosis: • Fasting blood glucose level—diabetes is diagnosed if higher than 126 mg/dL on two occasions. • Random (non-fasting) blood glucose level—diabetes is suspected if higher than 200 mg/dL and accompanied by classic symptoms (i.e. increased thirst, urination, fatigue). • Oral glucose tolerance test—diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours.

28. Type 2 Diabetes Mellitus • Treatments: • Self-testing • Diet and weight control • Regular physical activity • Medications • Foot care • Maintaining long-term care

29. Acknowledgements • 2005 RET Cohort of Teachers • Ali Cinar, Ph.D. • Alexander Flueck, Ph.D. • Robert Lapointe • Meriyan Eren • 2005 RET Research Mentors