Diabetes Can Be Controlled But It Is a Constant Struggle!

Philipp was diagnosed with type 2 diabetes right after knee surgery in 2005 and his diagnosis was like a little odyssey. Before jumping into the interview with Philipp, here is what he shared about his diagnosis journey.

mySugr loves to show the many different faces and stories of people with diabetes in the real world. They do their own photoshoots and feature real people living with diabetes instead of using stock photos.

“I was diagnosed with diabetes in 2005, during the evaluation and testing to discover anything that would delay the total left knee replacement surgery.

Nobody mentioned anything about diabetes when I had blood work done the week before surgery.

But upon being admitted hours before my 8am surgery, I was told I was a borderline diabetic. I anxiously asked what does that mean? The technicians at the attending nurse stated that I had a predisposition to having diabetes.

As far as I was concerned, I either had diabetes or I didn’t. I couldn’t grasp the concept of borderline.

After surgery, and in the recovery room when I woke up, I didn’t think anymore about it.

However, once I was delivered to the ward and further tested that evening, I was told that I was now a full-blown person with diabetes. That was a shock, and I began gathering information from the staff. How could I go from borderline diabetes to having diabetes overnight? I wasn’t told what kind of diabetes I had until hours into the second day of my hospital stay. That is when I was diagnosed as type 2.

Upon my third day prior to my release, I was told that I was being prescribed oral diabetes meds and not insulin.

Several weeks later, I was dehydrated and became extremely thirsty and began drinking 32 oz. “slushy” drinks from the 7-11. One every hour.

It became so intense the next day. While my wife was at work, I became so concerned that I drove myself to the VA emergency room. After waiting more than 1 hour I was seen in the ER and after testing my blood sugar level, it was well over 300.

I was blessed for driving to the ER because my vision was super blurry and traffic was almost non-existent. What guided me mostly were the lane dividers that I could hear to guide me, muscle memory for guiding the vehicle and knowing how far away the VA was from our home.

The experiences that are key here are extreme thirst, extreme body temp rise, the extreme need to urinate multiple times in an hour, visual impairment, and potential for bad decision making that can wind up in a very serious situation.

 

1. What was your biggest fears/concerns when you were diagnosed with diabetes?

That it was a mistake. I wasn’t overweight, I exercised regularly and watched what I was eating.

2. What’s the hardest part/biggest struggle for you in living with diabetes day-to-day?

First was the prescription for diabetes medication that the result was not managing my sugar level. Second, not believing this disease couldn’t be eliminated. Third, monitoring my sugar regularly and the levels did not fall below 200.

3. What piece of advice would you give to a person who is newly diagnosed with diabetes?

My advice would be to research as much as possible to get accurate and reliable information regarding diabetes. Do not believe that diabetes can be eliminated. Diabetes can be controlled but it is a constant struggle.

4. Is there a phrase/statement about diabetes that drives you crazy?

Yes! The statement that diabetes can be eliminated by a regulated diet of certain meds drives me crazy.

5. When you think of the word “freedom” in terms of diabetes, what does that mean to you? What would make you feel more free?

Freedom for me would mean that diabetes can be cured in a certain amount of time.

Source: diabetesdaily.com

Connecting Type 1 Diabetes Researchers: The Sugar Science

This content originally appeared on Beyond Type 1. Republished with permission.

By Monica Westley

As a scientist and a parent of a child with type 1 diabetes, I was compelled to fully understand the etiology of the disease. I created a group called “The Sugar Mamas” to connect parents to live, interactive interviews with researchers. I reached out to scientists and scheduled regular “Lunch and Learns.” After each Skype call, parents went away feeling hopeful and inspired. It was a powerful connection for parents to understand how hard scientists were working on this disease. Last fall, I shared my process and helped Beyond Type 1 implement the connection of their community to researchers as well. I am a true believer in the adage, “the more information, the better!”

Creating The Sugar Science

Through countless interviews with researchers in the type 1 diabetes (T1D) field, I began to understand recurring pain points in the scientific community that was hindering more rapid progress. With the data in hand and a personal call to action, I began to build a digital platform in March 2020. We currently are a devoted and dedicated team of 23 talented volunteers, the majority with a close connection to T1D. Together we created The Sugar Science (TSS) to serve the wishes of scientists and catalyze a cure.

Our platform has already received endorsements from top researchers in the T1D world, including Dr. Douglas Melton (Harvard) and Dr. Alice Long (Benaroya), who act as our advisors. The Diabetes Research Connection (DRC), as well as Unanimous A.I., have partnered with us. Gaining validity, we were semi-finalists for the Women Who Tech grant, and we won a Google grant.

TSS revitalizes scientific communication in the same way that our social communications have transformed by digital tools over the last decade. Social networking and AI tools on the TSS platform are poised to bring together a field that has been silo-ed for decades, not due to the considerable effort of scientists, but due to the multi-factorial nature of the disease.

Providing Tools

Online meeting

Image source: Beyond Type 1

The Sugar Science provides tools that scientists working in T1D have requested. Current tools include The Collaborator, Thought Experiment, and KG.

The Collaborator is “speed dating” for ideas. Scientists post just three slides with short descriptions of their idea. The community gives feedback as to whether this is a “good idea,” and other scientists can connect to collaborate. A “match” can submit a fast-tracked grant to the DRC for funding.

Thought Experiments (TE) is a tool where scientists can post controversial (or not) ideas and the community can weigh in. Scientists whose answers gain “likes” from the community will gain a reputation. These scientists will be invited to participate in a SWARM AI event, tackling the toughest questions in type 1 diabetes along with experts in the field.

KG is the Knowledge Graph. We are building a knowledge graph to reflect all historical papers against a backdrop of negative data. This will give scientists studying T1D a new perspective on work that has already been done in the field as well as show places where work needs to be done.

Moving Forward

Overall, we remain true to our mission: to help T1D scientists connect, collaborate, and fund their best ideas. TSS features podcasts and interviews with scientists. We are scheduling “off the record” private brainstorms. We want to elevate young scientists interested in T1D and support them. In this spirit, we are hosting a PITCH COMP for post-docs and graduate students who study T1D on September 25, 2020. It will be a chance to shine for labs looking to connect, and the best pitches will be awarded funding. This event is particularly meaningful with the COVID-19 pressures that the scientific community is experiencing.

Please feel free to support our mission. The general public can donate (we are a tax-deductible foundation) on our website, via our socials or using Amazon Smile. All donors will receive our monthly digital newsletter.

As a parting comment, I would say for myself and my team, for us it is all about a cure. We know first-hand what this disease is like, what it does to those who have it and their families. As an all-volunteer organization, no one is paid. And yet, we are getting things done, moving forward. Our team at The Sugar Science is all about the end game: a cure.

Source: diabetesdaily.com

How Telemedicine Improves Diabetes Care

How Telemedicine Improves Diabetes Care

By Heather Nelson

Rapid advances in telehealth have provided doctors a level of convenience (1) that lends itself to well-rounded patient care. In this article, we will highlight some benefits of telemedicine relating to diabetes management.

Rise of Diabetes Distance Care

Telemedicine is the use of technology in delivering medical care to patients from a distance (2). Once considered necessary for rural or underserved communities, telemedicine has transformed over the past 50 years into a vibrant, integrated service utilized by hospitals and physicians around the globe (3).

Diabetes telemedicine has combined the wonders of technology and the necessity of recurring specialty care to enable providers to be more proactive. One effect of telemedicine on the management of diabetes is that providers are able to help their patients see improved HbA1c levels (4).

As always, in the grand scheme of diabetes therapy solutions, the measuring stick has always been the almighty HbA1c. As technology improves, doctors are seeing the added benefits of reading telehealth data from sensors to measure Time-In-Range as well (TIR) (5).With both of these in mind, a new treatment option can succeed or fail based on the ability to improve HbA1c ranges consistently or provide greater time in optimal blood glucose range. This seems to be no struggle for telemedicine.

The benefits of telemedicine in diabetes distance care are so promising that the CDC (Centers for Disease Control and Prevention) ran a 2-year study in rural Alabama and Georgia (6). The outcome showed decreased hemoglobin A1c as well as average reduced travel time of over 78 minutes per visit. Based on their findings, the CDC declared that “diabetes care delivered via telemedicine was safe and was associated with time savings, cost savings, high appointment adherence rates, and high patient satisfaction.”

Additionally, another study found lower HbA1c levels as well as improved blood pressure and cholesterol levels after just one year of telemedicine (7).

These studies might seem great on paper, but you might be asking yourself…

“How can telemedicine help me manage my diabetes?”

Well, I’m so glad you asked. Welcome to “Telediabetes”!

We all know that diabetes is a chronic disease that requires regular and constant monitoring. Some providers wish to see their patients bi-annually, while others request quarterly or even monthly check-ups. The practical challenges of regular office visits can sometimes prove challenging, and in the gap of in-office care and at-home management, the person with diabetes flounders. This gap is precisely where telemedicine shines.

4 Reasons Why Real-time Feedback No Longer Requires Face-Time Appointments

  • Is the driving distance to your endocrinologist office making those quarterly visits hard to squeeze into your lunch hour? Transmit your health records and let telemedicine connect you for guidance in basal rates adjustments or dosing tweaks with less time off work.
  • Is prohibitive weather keeping you from talking with your mental health practitioner about diabetes challenges? Log into a portal and send a message detailing your snow-day concerns straight away. They can respond via email or video conference to provide real-time support and encouragement.
  • Are school absences piling-up making it hard for your child to miss another half-day for their monthly appointment? Simply log-in, upload the latest chart data you’ve been keeping, and let their doctor analyze the trends and suggest small changes. These tweaks can make a big impact in keeping them at optimal health while keeping them in school and learning (8).
  • Have travel challenges made your food dosing questionable? Send a message to your certified diabetic educator (CDE) and let them guide you to healthier solutions and safer swagging.

Whatever reason you have to miss out on those essential office visits, telemedicine doesn’t judge. Telemedicine understands.

With Great Tech, Comes Great Responsibility

The rapid advances of tracking devices and sensors mean we can readily gather reliable glucose data in a fairly simple manner. But that’s not the full picture your healthcare team will need. We all know that taming the diabetes monster requires a multi-faceted approach. The rise of newer and better diabetes management technology has perfectly poised the diabetic community to benefit from telemedicine and all it has to offer including lifestyle modifications, mental health checks, and more. But we must have solid data to reap those benefits.

The best way to take advantage of all the rewards of telemedicine is to provide good and useful data. The more data you can afford, in a succinct and readable format, the better distance care your provider can give. Utilizing technology means you should be able to provide food records, insulin doses, basal and bolus rates (for our pump-loving friends) as well as activity, health events, and other biometrics like Ketones, HbA1c readings, weight and body measurements.

Beyond the tracking of data itself, presentation also matters. Clearly you can’t courier-pigeon over a stack of origami-worthy paper logs and in this day and age, you shouldn’t have to. Organize your logs into a format that is easily accessible for your healthcare provider. If they need CSV, Excel sheets, or PDFs, provide what they can read.

How mySugr PDF Reports Makes Data Sharing Easy

If you are reading this and genuinely shocked to learn that you need to log things like insulin dosing and food intake, allow us to usher you out from under your rock and into the age of technology by introducing the reporting feature in the mySugr app! Indeed we believe you are the captain of your pancreas. As such, the ability to harness all your well-tracked data into usable information for you and your doctor is a key focus of our app. Using the reports feature you can quickly:

  • View your own data at a glance, anytime, to see trends.
  • Select your own time period to see only the data you wish to discuss. No more information overload or sifting through months of records needlessly.
  • Send preferred data to your doctor via email for quick communication about necessary formula changes. Even select from one of our three output formats for optimal communication.
  • Stay in constant communication and more!

Using the data in these reports, you can truly be the master of your own fate. The reports are meant to empower you as you discuss your treatment decisions with your provider, making the conversation more constructive and putting you back in the driver’s seat of your care.


And for our US friends in the diabetic online community (DOC), we still have our fabulous bundle! mySugr has over 2 million registered users to-date and a 4.6+ rating on the App Store and Google Play. The mySugr Coaching service is second-to-none and utilizing our monthly subscription gets you:

  • Blood glucose meter
  • Lancing device (with a box of refills…so that’ll last you basically forever, amiright)
  • Unlimited test strips (new shipments arrive before you even run out!)
  • The mySugr Pro App (that includes the ability to estimate the HbA1c!)
  • Diabetes coaching (with a pretty top-notch team)
  • Free shipping

And all the tech-support a person could need!

Indeed, we believe telemedicine is here to stay (9) and with good reason!

People living with diabetes can find more freedom and a better quality of life with the rising accessibility of a healthcare team armed and ready to interpret and predetermine the many responses to all the data we track.

As always, mySugr stands on the edge of change ready to help usher in this new age with open arms and glucometers for all Rise up mighty warriors and embrace the freedom of “telediabetes”!


(1) Wicklund E. Leveraging Primary Care Telehealth for Convenience and Quality. https://mhealthintelligence.com/features/leveraging-primary-care-telehealth-for-convenience-and-quality(2) White LA, Krousel-Wood MA, Mather F. Technology meets healthcare: distance learning and telehealth. Jan. 2001. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3116779/

(3) eVisit: The Ultimate Telemedicine Guide | What Is Telemedicine? 2018. https://evisit.com/resources/what-is-telemedicine/

(4) Hompesch M, Kalcher K, Debong F, Morrow L. Significant improvement of blood sugar control in a high risk population of type 1 diabetes using a mobile health app – A retrospective observational study. Poster presentation at ATTD 2017, Paris, France.

(5) Beck R, Bergenstal R, Riddlesworth T, Kollman C, Li Z, Brown A, Close K. Validation of Time in Range as an Outcome Measure for Diabetes Clinical Trials. March 2019.

(6) Xu T, Pujara S, Sutton S, Rhee M. Telemedicine in the Management of Type 1 Diabetes. 2018. http://dx.doi.org/10.5888/pcd15.170168

(7) Steven Shea, MD, Ruth S. Weinstock, MD, PhD, Justin Starren, MD, PhD, Jeanne Teresi, EdD, PhD, Walter Palmas, MD, Lesley Field, RN, MSN, Philip Morin, MS, Robin Goland, MD, Roberto E. Izquierdo, MD, L. Thomas Wolff, MD, Mohammed Ashraf, BA, Charlyn Hilliman, MPA, Stephanie Silver, MPH, Suzanne Meyer, RN, Douglas Holmes, PhD, Eva Petkova, PhD, Linnea Capps, MD, Rafael A. Lantigua, MD, PhD, for the IDEATel Consortium. A Randomized Trial Comparing Telemedicine Case Management with Usual Care in Older, Ethnically Diverse, Medically Underserved Patients with Diabetes Mellitus. Jan-Feb. 2006. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1380195/

(8) Please note that all mySugr products have a minimum age limit of 16 years for the mySugr Logbook and 18 years for the mySugr Bolus Calculator (for more details please read mySugr’s General Terms & Conditions).

(9) Klonoff David C., M.D. Using Telemedicine to Improve Outcomes in Diabetes—An Emerging Technology. July 2009. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769943/

Source: diabetesdaily.com

What It’s Like as a High-Risk Individual Six Months into the COVID-19 Pandemic

Let’s face it: type 1 diabetes has always been a huge annoyance. There’s nothing fun about always living on your toes, and there’s nothing normal about eating in your bed in the middle of the night. But the good news is that type 1 hasn’t stopped me from doing anything in life. I went to college thousands of miles away from home, traveled to numerous countries alone, and have held a successful career at Google for nearly five and a half years now. And even the things I worried about most as a young teen – like how it’d affect friendships and relationships – turned out to be a non-issue. The right people have always been by my side and supportive.

Type 1 has shaped me and even improved my life in such significant ways – and while of course, I’d get rid of it in a second if I could – I’m very appreciative of the personal growth, responsibility, and resilience it’s instigated. I’ve always tried focusing on the positives of type 1 – if I’m “stuck with it,” I might as well own it, control it to the very best of my ability and determine a way to thrive. And for over 12 years with this mentality, I’m fortunate that I have thrived with type 1.

While I naturally have a cautious personality, I’m a firm believer that it’s useless to worry about things out of your control. But what about things that are in your control? When COVID-19 first started earlier this year, it was clear that if I stayed home, stayed away from people, got deliveries versus going shopping myself, etc., I’d have a very low likelihood of contracting COVID-19. I’m very fortunate that I have a job that allows me to work from home, complete control over my home environment, and no responsibilities such as children right now, where their wellbeing would also be a key factor in my decisions. So yes, while I knew I was in control, I didn’t know what great expense that would come at, nor that it would last so long.

Photo credit: Caroline Levens

I’ll admit I had a heightened sense of concern early on in COVID-19. I bought an N95 before COVID-19 was even known to be spreading in the US and was self-quarantined by the first week of March. And up until recently, I felt my COVID-19 experience was probably one collectively shared by nearly everyone – of course, everyone had cabin fever, and COVID had affected their plans, friendships and relationships in unexpected and unfortunate ways.

Then COVID fatigue seemingly blanketed the nation – myself included. The mentality that “well, if this is seemingly going to go on forever, I’ve got to start living my life again. I can’t stay inside forever. The death rate is extremely low anyway. I’d probably be fine. Or whatever I’d experience has got to be better than a year or so cooped up inside.”

And just like that, for the very first time in my life, type 1 felt like it was limiting what I could do. My thoughts and COVID-19 exhaustion was shared with mass America, but I didn’t have the privilege to act on them. And somehow it made it much harder when I felt like the only one still sheltering in place – which, of course, I’m not. There are millions of high-risk individuals – and loved ones of high-risk individuals – experiencing the same thing. But it sure doesn’t help seeing pictures of friends on social media living a life I long for so much right now. I recognize that it is my decision how to respond to COVID-19, but to me, it feels practically synonymous to my immune system declining all invites on my behalf.

To be fair, there are many type 1’s who have largely resumed their normal lives, though many of them are children and have a lower likelihood of experiencing severe complications, or are in lower-risk areas. But at this point in COVID-19 – I personally feel I can’t let up. Health is one of my very top personal priorities, and the truth is, I don’t know what kind of experience I’d have if I were to contract COVID-19, both short term and long term. And to clarify, it’s not just type 1 that has me on my guard – I’m also immunocompromised and have several other autoimmune diseases.

There’s a heavy emotional toll that comes with being part of a high-risk community. Early on in the pandemic, I questioned where type 1 fit in the picture when they said diabetes was a high-risk factor. It was also known that obesity was a huge risk factor, so I was skeptical if it was diabetes in itself that was the risk or intertwined with the risk posed by obesity, which is strongly correlated to type 2. Then came a study out of the UK with thousands of diabetics that showed actually type 1s had significantly higher death rates than type 2s. I personally lost a type 1 friend from my teens, and he was 26, one year younger than me. I’ve read about countless stories that range from minor cold-like symptoms to months of enduring fatigue to permanent lung damage and more.

Riding out sheltering in place is hard – but if I were to have a severe case of COVID-19 that damaged my health, I’d never be able to forgive myself. So I continue doing the best I can. And no doubt it’s come with sacrifices – I couldn’t attend my grandma’s funeral, it put a strain on a relationship I was in, l didn’t get to say a proper goodbye to friends who moved away for good, and even though I’m a total homebody and introvert at heart, I’ve experienced loneliness for the first time.

I know long-term this is just another part of the type 1 journey in life. The level of gratitude I’ll have for the most simple things will be immeasurable post-COVID-19… hugging a grandparent, going grocery shopping, having lunch with a friend. With any luck, I won’t have any future experiences where I feel type 1 is stopping me again, but if I do, I’ll be better equipped to handle it.

So why am I writing this? There’s been so much criticism towards those still staying home, those still wearing masks in outdoor settings, those not sending their children back to school, and it’s really uncalled for and disrespectful in my opinion. You have no idea what someone else is going through, and many of the highest-risk conditions are invisible.

In summary, if you’re not high-risk and are comfortable resuming your normal life, recognize that’s a privilege many aren’t fortunate enough to have. For millions of people at home for one reason or another – be it type 1, older family members, or other medical conditions – we’re still riding out an isolating quarantine, compounded by the stressor of uncertainty and the unknown timeline. So keep in mind that everyone is experiencing COVID-19 differently, and trust that other people know what’s best for them, just as you know what’s best for you. Your pandemic may have “ended,” but others still have to be as on guard as they were months back — all while not knowing if it’s the beginning, middle or end of this wild ride.

Source: diabetesdaily.com

Sun-Dried Tomato, Spinach and Artichoke Frittata

This content originally appeared here. Republished with permission.

One of the nice things about frittatas is that you can use pretty much any ingredients you have. It doesn’t have to be complicated at all! And it’s super easy to keep your frittatas Whole30, Paleo, Low Carb, Keto, and of course, absolutely delicious.

Just choose a few simple ingredients that you enjoy that also work with your way of eating. Remember, Google is your best friend if you aren’t sure about something.

Spinach Artichoke Frittata

Print

Sun-Dried Tomato, Spinach and Artichoke Frittata

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This frittata is great for easy, healthy meal prep to enjoy at breakfast, lunch, dinner, or any time!
Course Breakfast
Cuisine Mediterranean
Keyword egg
Prep Time 10 minutes
Cook Time 25 minutes
Total Time 35 minutes
Servings 4 people
Calories 352kcal

Equipment

  • 8 – 10 inch skillet

Ingredients

Sun-dried Tomato, Spinach and Artichoke Frittata

  • 8 eggs
  • 2 cups fresh baby spinach
  • 1/3 cup sun-dried tomatoes
  • 1 cup artichoke hearts
  • 1 clove garlic
  • 2 tbsp oil see notes below
  • 1/2 tsp salt
  • 1/4 tsp pepper

Serve with:

  • 1 avocado

Instructions

Prep the Veggies

  • If the tomatoes aren't already cut into bite-sized pieces, slice them julienne. Mince the garlic.

Cook the Dish

  • Heat your skillet over medium heat. If the tomatoes were packed in oil, you shouldn’t need to add any oil. If they weren’t, just add a bit of olive or avocado oil. Add in the garlic, tomatoes, artichokes, and spinach. Saute for about 2-3 minutes, just until the spinach is wilted.
  • Meanwhile, crack the eggs in a bowl and whisk them well.
  • Drizzle the olive oil all over the veggies, and do not stir it around. Pour the eggs on top.
  • With a spatula, gently pull the eggs away from the sides of the skillet, letting the egg mixture fill in. Do this several times around the sides of the skillet, but stop once the egg mixture becomes too firm to fill in spaces.
  • Cover the skillet, lower the heat, and cook for another 5-6 minutes, or until the frittata is cooked through. If it’s still a little wet and jiggly in the middle, it needs a few more minutes. Alternately, you can finish the frittata under the broiler for a minute or two, but watch it carefully, especially if your broiler is strong.
  • Allow the frittata to cool slightly, then slide it out of the pan onto a cutting board and slice. Season with a little salt and pepper, serve with sliced avocado, and enjoy!⠀

Notes

  • Sun-dried Tomatoes: I prefer to use tomatoes packed in oil. I find they’re more flavorful and not as dried out.
  • Artichokes: I buy frozen artichoke hearts rather than canned or fresh. There’s no prep needed (just defrost), and they don’t have a brine taste.
  • Spinach: I use fresh baby spinach, but you can substitute frozen spinach if that’s easier. Just defrost it and squeeze out the liquid.
  • Oil: I like to use the oil the tomatoes are packed in — so much flavor! Olive or avocado oil works great too!

Nutrition

Calories: 352kcal | Carbohydrates: 13g | Protein: 14g | Fat: 28g | Saturated Fat: 5g | Cholesterol: 327mg | Sodium: 644mg | Potassium: 763mg | Fiber: 6g | Sugar: 5g | Vitamin A: 2535IU | Vitamin C: 24mg | Calcium: 90mg | Iron: 3mg


Please note that the nutritional information may vary depending
on the specific brands of products used. We encourage everyone to check specific
product labels in calculating the exact nutritional information.

Sun-Dried Tomato, Spinach and Artichoke Frittata Recipe

Source: diabetesdaily.com

What’s Coming and What’s Delayed in Continuous Glucose Monitoring?

This content originally appeared on diaTribe. Republished with permission.

By Albert Cai

Updates and delays from Abbott, Dexcom, Medtronic, and Senseonics

With several clinical trials on hold due to the COVID-19 pandemic, we’re bringing you a roundup of the latest updates on future continuous glucose monitors (CGM). Understandably, the FDA also announced a few months ago that it would focus its efforts on devices related to COVID-19. With the disclaimer that it’s impossible to know exactly when the pandemic will subside, when trials might resume, and how FDA reviews might be affected, here is the latest news we’ve heard from companies.

Click to jump to a product, which are organized alphabetically.

Abbott FreeStyle Libre 2

CGM

Image source: Abbott FreeStyle

What’s new? FreeStyle Libre 2 keeps the same “scanning” feature as the original FreeStyle Libre, but adds Bluetooth connectivity. This is important because it enables optional high and low glucose alerts. Users who enable these alerts will be able to get a notification on their reader or phone whenever their glucose reading goes above or below their specified ranges. Looking ahead, the Bluetooth feature will also allow FreeStyle Libre 2 to be part of automated insulin delivery systems (AID), like Insulet’s Omnipod Horizon.

Like the original FreeStyle Libre, FreeStyle Libre 2 has 14-day wear, is factory-calibrated (no fingerstick calibrations required), and can be scanned with either a phone or a reader device (the reader for FreeStyle Libre 2 is blue, instead of black). Importantly, FreeStyle Libre 2 will be offered at the same price as the original FreeStyle Libre.

When’s it coming? The FreeStyle Libre 2 has already launched in a few European countries (we know of Germany and Norway) and will launch in others soon. In the US, FreeStyle Libre 2 has been under FDA review for over a year. In March, Abbott said that it was working through “some finishing items” and was “very confident” the device would be cleared soon.

Dexcom G7

Dexcom

Image source: Dexcom

What’s new? Dexcom’s G7 will be fully disposable (the transmitter and sensor are combined and thrown away together) and have longer wear (we believe somewhere around 14-16 days). Remember that the Dexcom G6 sensor lasts for 10 days but has a transmitter that is re-used for 90 days. The G7 will be considerably slimmer than G6 and will have a lower cost of manufacturing in bulk, though consumer pricing is not yet determined – we imagine it will be similar. The G7 will keep the same accuracy, no fingerstick calibrations, and Bluetooth connectivity as the G6.

Dexcom has been developing G7 in partnership with Verily, the division of Alphabet formerly known as Google Life Sciences. There has been mention from Verily that an accelerometer may also be built-in to the G7 device, but we aren’t sure if that feature made it into the final version of G7. Having a built-in accelerometer could allow the G7 to also track physical activity, like a Fitbit or other fitness tracker.

When’s it coming? Dexcom planned on launching G7 in “early 2021,” but with most clinics placing new trials on hold, Dexcom is expecting a “minimum delay of approximately six months.” It’s difficult to know when clinics will be able to conduct trials (and when people will feel comfortable enrolling in trials), but assuming a six-month delay, G7 could be on the US market sometime in the second half of 2021.

Medtronic “Project Zeus” CGM

Abbott FreeStyle

Image source: Medtronic

What’s new? Medtronic’s next CGM, referred to as “Project Zeus,” will reduce the number of required fingerstick calibrations and have improved accuracy (compared to its current offering, Guardian Sensor 3). The new CGM will require day-one calibration (unclear on the number of fingersticks that will be required on day one), compared to Guardian Sensor 3, which requires at least two fingerstick calibrations every day. Medtronic expects Project Zeus to launch with a “non-adjunctive” indication, meaning users will be able to bolus insulin based on CGM reading alone, and not have to perform a confirmatory fingerstick. the new CGM will keep the same seven-day wear, size and shape, and reusable transmitter component as the Guardian Sensor 3 (pictured above).

When’s it coming? The trial for Project Zeus began in June 2019 and is expected to wrap up within the next month. Medtronic expects to submit the CGM to the FDA by the “end of the summer.”

Senseonics Eversense XL (180-day)

Eversense XL

Image source: Eversense XL

What’s new? The “XL” extended life-version of Senseonics’ Eversense in the U.S. will have the same size and features as the original Eversense, but the Eversense XL is implanted for 180 days, rather than the 90-day Eversense. As a reminder, the Eversense sensor is implanted in the users’ upper arm in a clinic and remains there for the sensor duration; a silver-dollar sized on-body transmitter is worn on the outside of the arm to deliver readings to a smartphone. Senseonics is targeting reducing calibrations from 2 per day to 1 per day with same non-adjunctive indication.

When’s it coming? Eversense XL is already available in Senseonics’ European markets. The trial for Eversense XL in the US wrapped up in late March, and Senseonics has previously aimed for FDA clearance in “late” 2020. We aren’t sure whether that timeline has been pushed back due to COVID-19, but the fact that the trial has already completed is encouraging.

Source: diabetesdaily.com

Pump Peelz Does Their Part and Creates Intubation Boxes

We spoke to the founders of Pump Peelz, about the COVID-19 pandemic and important work they’re doing to help.

Hi Scott, thank you so much for taking the time to talk to me. The COVID-19 pandemic has left us all in fear, especially for those who are elderly or have pre-existing conditions. Knowing that we, or someone we love, fits this demographic adds an extra layer to this difficult time.  It is more important than ever to come together and help each other through these uncertain times.

I know you and your wife Emily started Pump Peelz in 2011 with the goal of creating adhesives to help empower people living with diabetes to express themselves and to feel confident in their ability to manage their disease. I know the diabetes community thanks you, and I now wear my Dexcom loud and proud!

How long has your wife Emily been living with type 1 diabetes?

She just celebrated her 10th diaversary in January!

What prompted you to start on this venture of creating adhesives for our community?

Emily was diagnosed while we were both in college. We were taking a few graphic design courses and noticed that at that time there were no graphics, skins, or adhesives for insulin pumps or CGM’s. We took it on as a class project really… and slowly built the business at night for the first few years before taking on Peelz full time and purchasing our own equipment at a specialized facility.

When you heard the virus was picking up speed, what were your first thoughts? Fears? How did you prepare for staying at home?

Emily read to our son, Oliver’s, preschool class for their “Reading Month’ on March 12 and almost immediately after class, the virus started making headlines in our area. We actually had discussed possibly keeping him home for a little while and talking to the teachers to keep us healthy at home. But later that day, his school became canceled indefinitely anyway. I think we have the same fears and concerns as everyone… Our initial fear was for Emily being immunocompromised but we decided to self-quarantine for the past month to keep her and our family safe. We have groceries delivered, we have only one person at the office at a time, and are really keeping busy at home with our 3 year old.

Being that Emily falls under high risk, what extra precautions have you taken? 

She really hasn’t gone anywhere since March 12. We take drives and will go for walks in the park and our neighborhood. We mostly have groceries delivered or I will go by myself with my facemask and gloves… I also keep sanitizer in the car. Our office is stocked with Lysol and cleaning supplies to keep all surfaces clean.

Being that you are a small business, how has COVID-19 affected your business so far?

We’ve tried to find different uses for our machinery to try and help a local medical facility. It has given us an opportunity to be more creative and experiment for the better good. Our main business struggle at the moment is simply keeping up while maintaining social distancing and keep our priority on everyone staying healthy. We’re being open and upfront on our website to let people know that during this time, it’s taking us a little longer to produce products.

An intubation box allows doctors and nurses to safely intubate COVID-19 patients | Photo credit: Pump Peelz

How did your local hospital find you? Did they know that you would have the equipment necessary to create intubation boxes?

I knew right away that our facility has capabilities beyond what we normally manufacture. I started early on reaching out to our friends in the medical field to let them know that we have the capability of making masks, cutting materials for face shields, or anything else that might come up. It just so happened that our local hospital system heard this and asked us to make an intubation box for their ICU which they currently have in place.

I am sure you have been extremely stressed about the pandemic, what were your initial thoughts about taking on this task?

I try not to stress too much about things I can’t control. This was one thing that was asked of us that I knew we had the capability to produce and something that we could control to help.

It is so amazing that you quickly learned how to create such a necessary and urgently needed product. How exactly were you able to design and produce it?

We launched our Patch+ product late last year which was the most challenging product for us to produce. We had to purchase new equipment, have software designed, and create processes to rapidly prototype and get products out quickly and efficiently. Because we just made it through this project I felt that I understood our machinery enough to know that this task was possible. I quickly found a website called intubationbox.com that had the assembly instructions… I simply modified their steps so that our laser cutter could easily cut out the pieces like a puzzle. Once I figured it out, I saved those files because I thought someone else could also use them.

It looks like you have been sharing this information on social media and hoping that others follow suit and do their part. Where can people find information on how to create intubation boxes?

Go to intubationbox.com and there is a material list sheet of things you can pick up at Home Depot or Lowe’s. You can email me directly at scott@pumppeelz.com and I can send our vector files to anyone that wants them. They can also follow the instructions and use normal hand tools to produce these. I also recommend talking to your local print shop or sign show to see if they could use our files to cut the acrylic sheets.

Ear relief straps for healthcare workers. These go behind your head and hook onto the straps of a mask rather than the straps rubbing the back of your ears. | Photo credit: Pump Peelz

I must say seeing your post about how you are helping out during this time of need was such a ray of sunshine on what seems to be the longest gloomiest day in a long time. How does it feel knowing that you are helping save lives?

That was really nice of you to say that. We can all pitch in just a little to do something bigger than ourselves. That can be simply staying at home to ‘slow the spread’ or it can be offering your sewing services to make masks, offering a 3D printer at a school to make face shields, or building a box. We all have little talents or things that we can do to help each other… this just happened to be ours.

Going forward we are taking the remaining materials from our boxes to make Mask Relief Straps to take the pressure off of the ears of nurses and doctors who are wearing them all day long. You can look up photos on Google to see what I’m talking about!

Thank you so much for taking the time to talk to me. I know personally, I thank you guys every time I can get more life out of my Dexcom thanks to your adhesives, but now you are truly heroes!

Source: diabetesdaily.com

Supporting Older Adults with Diabetes During COVID-19

This content originally appeared on Beyond Type 1. Republished with permission.

By T’ara Smith

With COVID-19 spreading around the world, it’s important to be prepared, not panic, and practice social distancing, especially for people with underlying conditions such as asthma, diabetes, and heart disease. Though people of all ages are susceptible to contracting COVID-19, older adults appear to be more vulnerable. The Centers for Disease Control and Prevention has labeled adults aged 65 and older as a high-risk group for severe illness from COVID-19. It’s also important to note diabetes impacts many older adults — an estimated 33 percent aged 65 and over have diabetes and are at risk of complications like low blood sugar, kidney failure, and heart disease.

At a time like this, it’s important to think about how the COVID-19 public health crisis impacts our elders with diabetes, whether they be our grandparents, friends, or neighbors. Here are some tips on supporting older adults with diabetes during COVID-19:

Help Ensure Medications and Food Are Stocked

Help older adults obtain at least a month’s supply or more of diabetes medications and supplies. If available, have them delivered by the pharmacy. Note that insulin can’t be delivered, so consider picking it up from the pharmacy for them. Health plans are also waiving early refill restrictions and allowing 90-day supplies. America’s Health Insurance Plans has a list of health insurance companies and the steps they’re taking to address the pandemic.

In regards to food, insist on helping older adults set up a grocery delivery service. If those services are unavailable, offer to pick up groceries for them. If your loved one is insisting they shop on their own, many grocery stores have set up a system where the first hour the store is open is reserved for older and immuno-compromised shoppers only. Everything is freshly cleaned and the crowds are smaller.

Stay Informed About COVID-19

We’re learning new information about the coronavirus, which leads to the viral disease COVID-19, every day. Keep up-to-date with changing guidelines and new research by the WHO and CDC. As we learn more about the coronavirus, we’ll be updating the information here. In the meantime, continue to follow WHO and CDC guidelines such as hand-washing, disinfecting high-touch surfaces, avoiding touching your face, coughing into your elbow, and more.

Implement Household Changes

If you live in a multi-generational household, there are varying levels of COVID-19 risks. In this case, it’s important to consider how likely each member is to be carrying the virus, especially if some members are essential workers. Consider implementing household rules such as not sharing personal items like cups, utensils, food, and water. If you have space, designate a bedroom and bathroom for potentially exposed or sick family members. Also, consider limiting or forbidding visitors. People may be carrying the disease without displaying symptoms.

Communicate With Their Healthcare Team

You can support older adults with diabetes during COVID-19 by helping them communicate with their healthcare team. Non-essential doctor’s visits can be held online and these services are offered by health plans. Assist older adults who may not be technologically savvy by setting up virtual doctor’s appointments.

If your loved one is in a nursing or retirement home, contact the facility to learn what measures are in place to handle the public health crisis. Ask what adjustments are going to be made to your loved one’s routine, particularly with blood glucose management.

Know that visitation may not be recommended at this time, as assisted-living and long-term care facilities have to consider that visitors may be carrying the disease. Advocates are also urging family members to not panic and do not recommend bringing home loved ones to avoid infection. However, if you’re interested in becoming a caregiver, learn what the caregiver laws are in your state and what health decisions you can legally make on their behalf.

Stay Connected to Prevent Isolation

In the midst of social distancing, feeling isolated can become a real problem. Older adults may be feeling more anxious and overwhelmed than usual. Use things like FaceTime, Google Hangouts, Facebook Messenger, and more to stay connected. Talk about things that aren’t related to COVID-19. However, if they want to discuss the virus and simply need someone to listen, be that person. If you notice COVID-19 is taking a deeper toll than you can handle, recommend professional online therapy services. Some are covered by insurance or have a co-pay. There are other online therapy services like Talkspace and BetterHealth where you can be connected to a counselor.

Source: diabetesdaily.com

Prior Authorization: Getting Diabetes Supplies and Medications Covered by Insurance

This content originally appeared on diaTribe. Republished with permission.

By Divya Gopisetty

What is a prior authorization? Read on to learn more about why diabetes supplies or medications might require a prior authorization and how to go through the process

It can be frustrating to learn that you need a prior authorization when you already have a prescription. Insurance plans sometimes require a prior authorization to cover a diabetes supply, device, or medication, even if your doctor prescribed it to you.

Read on to learn about what a prior authorization is, and how you can make the submission process as smooth as possible.

In this article:

Click to jump to a specific section!

What is a prior authorization?

My pharmacist told me I need a prior authorization. What happens next?

How can I check if I need a prior authorization?

How long do prior authorizations last?

What happens if the prior authorization is denied?

What is a prior authorization?

A prior authorization, also known as a pre-authorization or pre-certification, means that your healthcare provider or device company has to get specific approval from your health insurance company (so that it will pay for it).  The requirements for prior authorization differ between and within insurance plans.

If you need a prior authorization, the pharmacist cannot process your prescription until your healthcare professional has contacted the insurance company. Similarly, a device company may not ship your diabetes device to you until it has prior authorization from the insurance company.

A prior authorization is designed to make sure certain prescription drugs or devices are used correctly and only when medically necessary. Before your insurance plan will cover a certain device or drug, you must show that you meet a set of criteria.

Prior authorizations are most often handled by your healthcare professional’s office, but sometimes are handled by the device company itself (e.g., for CGM).

If you want to see what a prior authorization request form looks like, check out this one for OptumRx.

My pharmacist told me I need a prior authorization. What happens next? 

  1. If your insurance company requires (and has not received prior authorization), your pharmacy will contact your healthcare professional.
  2. The healthcare professional will contact your insurance company and submit a formal authorization request.
  3. Your insurance plan may have you fill out and sign some forms.
  4. Your insurance plan will contact the pharmacy once it has approved or denied the request.

During this process, be sure to communicate with both your healthcare provider and your insurance company to see if they need any additional information. Prior authorizations usually take about a week to process – after that, check with your pharmacy to see if the request was approved. If the request was approved, you should be able to pick up your prescription from the pharmacy.

If it wasn’t approved, your pharmacy should be able to tell you why, and then you can decide to request an appeal.

As someone living with diabetes, you are your best advocate. Be prepared to track down the paperwork to make sure you receive the requested device or medication.

How can I check if I need a prior authorization?

Check your health plan’s policy and formulary (you can normally access these on the insurance company’s website) to see if any of your treatments require a prior authorization. Or, you can call the member services number found on the back of your insurance ID card to speak with someone directly.

How long do prior authorizations last?

Most approved prior authorizations last for a set period of time (usually one year). Once it expires, you’ll have to go through the prior authorization process again.

What happens if the prior authorization is denied?

  • You can request an appeal (which is often successful!)
  • You can pay the full cost for the medication or healthcare supply, without insurance coverage.

Want to learn more?

Check out this easy-to-read resource created by DiabetesSisters on prior authorizations, step therapy, and appeals.

What’s Worked for Other People with Diabetes? Hear from Them!

  • I was denied my first CGM in 2008 by a Blue plan and fought and won by knowing how to Google my payer’s medical policy and prove that I met coverage criteria. It helped that I was given the HCP line phone number by a nurse sympathetic to my cause, but I ended the call with an authorization code. – Melissa
  • My strategy has always been persistence pays (eventually the insurance company will give in, although they may have peculiarities to navigate. The doctor’s office is really key and many have specialists who only deal with insurance company issues [mine does]). I’ve been covered by 4 insurance companies over the past decade while at the same employer if that tells you anything about the evolving insurance market. My experience with Anthem was a hassle but predictable, United Healthcare was easiest to navigate, Aetna was straightforward but a pain and had some weird rules (Why does a precertification inexplicably expire at the end of a calendar year? My chronic illness did not expire at the end of the year.). – Scott
  • Do you have experiences with prior authorizations? Let us know!
diaTribe Series

Image source: diaTribe

This article is part of a series on access that was made possible by support from AstraZeneca. The diaTribe Foundation retains strict editorial independence for all content. 

Source: diabetesdaily.com

Diabetes Care from Parent to Child: Passing the Torch of Care

This content originally appeared on diaTribe. Republished with permission.By Kerri Sparling Transitioning care from parent to child can be a stressful time for families with diabetes – six strategies on how to reduce the burden  Transitioning from my parents being in charge of my diabetes to assuming full care myself didn’t happen overnight. It was a […]
Source: diabetesdaily.com

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