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Marie Cohen raises awareness of diabetes after the death of her son Mikey

Marie Cohen devotes much of her time to child deaths.

Heartbreaking cases of abuse. Dead in the cradle. The painful neglect of vulnerable children in the District. As a member of the DC Child Fatality Review Board, Cohen is haunted by the deaths she investigates.

But no death haunts her like the case of Michael “Mikey” Cohen: her son.

“Mikey was no longer a child. He was 25,” said Cohen, 63. “Among the things I’m used to seeing on this team — gun violence, or it’s natural deaths, babies — I’ve never seen , now that I’ve been on this committee for five or six years, I still haven’t seen DKA.

DKA, diabetic ketoacidosis, is what killed his son, a kinetic, wry, genius-crazed mathematician who was working on his doctorate at the Massachusetts Institute of Technology when he wasn’t making his usual weekend call to mom and dad .

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Looking back, the signs were there in recent years that he had type 1 diabetes as an adult. As a child growing up in Takoma Park, he had no signs of illness.

“I know people who first met him felt the same way: a dynamo,” Cohen said. “He was curious,” she said. He had “an intellectual curiosity. He was working on something until he figured it out. He was a very small child, very talkative, very verbal, always asking questions.

Mikey started studying computer programming, won prizes for the Math Olympiads and even went to Romania to participate in competitions. For a time, his parents – his social worker and political analyst mother; his father, Thomas Cohen, a professor and associate chair of the physics department at the University of Maryland, believed that Mikey would also be a physicist.

But he found his passion in computers. Not in programming, but in theoretical algorithms. He was always taking a full load at MIT, at least six classes at a time. “He never seemed stressed,” Marie Cohen said.

Few of his peers – at MIT, mind you – could follow.

“His thirst for knowledge was truly contagious: when we organized a reading group, we informally named it ‘The Michael Cohen Fan Club’ with the stated goal of learning enough to be able to understand everything Michael said” , according to an entry in his funeral book that was signed by six students. “While we can’t say we were successful, we certainly learned a lot of optimization along the way.”

His work soon landed him an internship at Facebook, where he was an engineer during his sophomore year at MIT. After that, they were a little surprised by his weight gain.

It was understandable, they told themselves, given the endless catering Facebook does for its employees. But it was also irrelevant for Mikey, who hated pizza and was a picky eater who preferred East Asian or Mediterranean cuisine. He wasn’t one to pound carbs.

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After Facebook, he returned to MIT to complete his undergraduate degree in mathematics and begin work on his doctorate. When they next saw him, he was back to his usual slim build.

“We said to him, ‘Your pants are falling off, but you look great! You don’t have that Facebook weight anymore!” Marie says Cohen.

It was diabetes that was wreaking havoc on his body. Mikey’s immune system was destroying insulin-producing cells in his pancreas, and when his body couldn’t get enough glucose for fuel, it started breaking down fat cells instead, creating chemicals called ketones. This mix of ketones, extra glucose and dehydration created the state of diabetic ketoacidosis, which is dangerous for many and was fatal for Mikey.

Type 1 diabetes is becoming more prevalent in the United States. A 2020 report from the Centers for Disease Control and Prevention found a 30% increase in type 1 diabetes over the previous two years, and scientists aren’t sure why. Among the factors and hypotheses: genetics, weakened immune responses caused by poor hygiene, the possibility of a new virus or increased case notification through better communication.

DKA has hospitalized and killed more diabetics in recent years. Much of this, according to congressional testimony, is due to the fact that the price of insulin has recently skyrocketed. Humalog, an insulin produced by Eli Lilly and commonly used by diabetics, has gone from $21 a bottle when it was introduced in 1996 to $275 today, an increase of 1,209%. Thus, diabetics who have been carefully monitoring and managing their disease for years may not be able to afford lifesaving insulin, and DKA can prove fatal within hours.

That wasn’t Mikey’s problem. He didn’t know he was diabetic.

“Nobody. No sign of a family history of diabetes,” Marie Cohen said. not gone.”

Type 1 diabetes used to be called “juvenile diabetes” because it is often diagnosed in young patients. And type 2 diabetes is the type that is usually discovered later in life and usually follows inactivity and weight gain. There have long been divisions within the medical and diabetes community over the naming and treatment of the two types.

None of this was on Marie Cohen’s radar when her son was at the University of California, Berkeley with his MIT cohort in the fall of 2017. But he seemed tired and irritable in their weekly phone calls, which was unusual.

Then, when it came time for their usual weekend call, Mikey didn’t answer. His parents got nervous. They had one of the Berkeley advisers with him watch him in his carriage apartment, where he lived alone.

“I’ll never forget that sound,” Cohen said, recalling that September night. “Tom dropped the phone. He just hit the ground. He said, “Mikey is dead.”

The California medical examiner suspected DKA, primarily because there were no signs of trauma, struggle, or drugs. And partly because Mikey left two giant clues.

“Two trash bags full of empty soda bottles,” Cohen recalled. “He was thirsty. This is one of the clearest signs of DKA. The autopsy proved the examiner right.

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Cohen is trying to refine CDC data to determine how many undiagnosed cases of type 1 diabetes kill people each year.

Diabetes is the seventh leading cause of death in America, according to the CDC. According to the Beyond Type 1 awareness campaign, nearly 50% of people with DKA had no idea they had diabetes at all. But Cohen is trying to find a way to read all those death certificates to figure out how many people died on the way. his son did.

It’s not a comfort, but it gives him a reason to work. In the meantime, she’s working with Beyond Type 1 to raise awareness of the signs of type 1 diabetes, so anyone who loses weight rapidly and struggles with headaches, gets irritable, goes to the bathroom often, and drinks a ton of liquids will know to go to a doctor and do a test.

Mikey would have turned 30 last month. His work in theoretical mathematics and computer science advanced the field, solving problems that had plagued it for more than 50 years.

“By the age of 25, Michael was already becoming an iconic figure in the fields of spectral graph theory, linear algebra, and optimization,” wrote scholars from the Simons Institute for the Theory of Computing, in a tribute to Mikey. “He made progress on a number of fundamental and notoriously difficult problems: designing better algorithms for the k-server problem, computing the stable distribution of a random walk in nearly linear time, solving Laplacian linear equations faster than sorting and developing new approaches to many sampling problems in linear algebra.

His research was “spectacular,” according to Jonathan Kelner, Cohen’s PhD co-supervisor and associate professor of applied mathematics at MIT.

“He had already established himself as a world leader in his work. … He really was a star,” Kelner told the Daily Californian of Berkeley. “He was as talented a person at his level as someone who had been in his field for 30 years.”

He did most of this, his peers said, in his head.

“He was a total character. There was no one like him. He was just different,” Marie Cohen said. “One of his advisers said he was a once-in-a-generation talent.”

He made a difference in his life, says the MIT community in numerous tributes, blog posts and articles. Along with his information campaign, Cohen hopes his death will also make a difference.