Achieving a 6.0% A1c by Eating 40 Grams of Carbs Per Meal

My 6-Month Experiment

“6.0”. I didn’t think I heard him correctly. I asked my endocrinologist to repeat himself. “I said 6.0%. You’re A1c was 6.0%.” My mouth gaped in astonishment. Practically non-diabetic. The lowest A1c I have ever had in my 10+ years of type 1 diabetes.

How Did I Do It?

Over the past ten years since my diagnosis with type 1 diabetes, I would consider myself a “good diabetic”. That means multiple fingersticks a day, remembering to bolus at mealtimes, and an overall idea of what kinds of foods were entering my body. My A1c hovered between 6.8-7.4% — which my doctors thought was just fine. I had a strong desire to lower my A1c, but nothing in the past seemed to significantly work.

About a year ago, I began medical school and became inspired to take better control of my diabetes. I began doing a lot of reading on the subject and started to toy with the idea of lowering my carb intake. There have not been many (if any) conclusive studies on the effects of low-carb diets in type 1 diabetics, yet I had a hunch that something like that could be my long-desired solution. I decided to perform a six-month-long clinical trial testing the effects of a low-carb diet on a particular type 1 diabetic — me.

The Rules

I recognized that diabetes is a lifelong condition and that any new diet I would undertake would have to be sustainable over a long period of time. Many popular diets only allow minuscule portions of daily carbs, and I knew that would not be maintainable long term. I didn’t want my diet to be unbearable and rebound. I, therefore, decided at the start that my diet was not to lose weight, and was not to start eating healthier. I allowed myself to eat cookies, cake, etc. (although I did naturally end up eating more vegetables in order to stick to the rules of the diet).

The diet consists of just one golden rule, plus 2 common sense rules.

The Golden Rule:

  • Maximum 40g of carbs at one sitting (eating to treat/prevent a low doesn’t count)

The Common Sense Rules:

  • Don’t eat any foods that make my blood sugar go wonky (some examples for me are pizza, bagels, and deep-fried foods)
  • Always try to bolus at least 15 minutes before eating

As part of The Golden Rule, each “sitting” is separated into three-hour chunks. For example, let’s say I eat lunch one day consisting of a hamburger (meat is zero carbs, the bun is 25g) and an apple (15g). Two hours later, I find myself hungry. What are my snack options at this point? Well, since I already reached my 40g maximum and it is within three hours of my meal, I must wait one more hour (i.e., three hours from my lunch), at which point the clock resets. I can then eat a snack up to 40g. However, let’s assume my lunch consists of just a tuna sandwich (2 slices of bread=30g). Two hours later, I find myself hungry. What are my options at this point? I can eat up to 10g of carbs because my lunch was 10g shy of the 40g limit.

I also toyed with the idea of imposing a daily maximum on carb intake, but I later nixed it. As mentioned, I wanted this diet to be highly sustainable long term, and I felt that a daily carb maximum might impede that goal. Also, diabetes diets that impose daily carb maximums are somewhat controversial in the medical field. Some medical professionals believe that such diets could even be harmful to people with diabetes, and I wanted to stay clear of that controversy.

Why Did I Think It Might Work?

Most people who start low-carb diets are trying to lose weight. Although I did lose a few pounds since I started this diet, this was not at all my intention in this endeavor (although truthfully, it was nice to finally fit into my wedding suit again). The reason I began doing this is twofold:

Reason #1: The Post Prandial Spike

Following a meal, there is inevitably a spike in blood glucose. The size of the spike is proportionate to many things (the types of carbs eaten, the timing of insulin injection, etc.). However, my personal experience has shown that for me, the spike is most directly related to the number of carbs I eat. Therefore, fewer carbs = smaller spike. (Similarly, giving at least 3 hours between meals allows time for the spike to come down).

Reason #2: The Guessing Hypothesis

Guess how much a single banana would cost you at your local grocery store. Go ahead, guess a price. You may have guessed 15 cents. 25 cents? 50 cents? One dollar? $1.50? The actual price is about a quarter. You may have guessed a quarter (you may have even bought a banana before and this, therefore, was not a guess). Or you may have been off by a bit. You may have even been off by a lot. However, most likely your guess was not off by more than a dollar. Now guess the price of 500-seat Boeing 747. Go ahead, think of a number. A quick Google search priced it at $357 Million. Was your guess off by a couple million? The point here is clear: when dealing with larger values, our estimates tend to have larger ranges of error. By keeping the carbs low, we are giving ourselves a better chance of correctly estimating our carb intake.

Conclusions

My main goal was to achieve better control of my blood sugar and somewhat lower my A1c. Yet, since the start of my diet, I’ve reaped numerous benefits and gained far more than I could have expected. My A1c has dropped a full percent, a stark reduction to a degree I had not anticipated. My day-to-day blood sugar has become much more predictable, and those horrible whacky-blood-sugar days that all people with diabetes experience have become much less common. Additionally, my average daily insulin usage dropped from 50.2U a day to 40.8U – almost a 20% decrease! As a nice fringe benefit, I lost a few pounds and really feel better overall.

One thing that people often ask is if my lower A1c came at the expense of more frequent hypoglycemic episodes. When I started this diet, I did indeed see a slight increase in hypos along with my tighter glucose control (however, I cannot quantify this with an exact number because I don’t have records of my hypo occurrences prior to starting this diet). Once I began noticing that my lows were becoming more frequent, I made a conscious effort to keep an eye on my CGM (Continuous Glucose Monitor) and be more aggressive in preventing them. Following that adjustment, I believe I have been having just as few hypos as I did before I started this diet.

I want to point out that my 40g maximum per meal is a completely arbitrary amount. It’s an amount that is feasible for me and is also fewer carbs than I was normally eating per meal. If you are reading this and thinking that you could never manage on such a meal plan, I would suggest coming up with your own maximum-carb-per-meal formula and giving it a try. Every person with diabetes is different, and this plan may not be the solution for everyone looking to gain better control of their blood sugar. However, this diet has had huge advantages for me, and I believe that there are aspects of it from which every diabetic can gain.

This article is not intended to be a substitute for professional medical advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition.

Source: diabetesdaily.com

Rare Until It Happens to You: The Kycie Terry Story

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

By Jordan Jendricks

Jamie Terry doesn’t know what exactly it is about her daughter that resonates so deeply with people. But there’s something about the combination of her curly blond hair, striking blue eyes, and the circumstances around her unfortunate and preventable death that have incredible staying power, inspiring countless others to action.

“There have been many times that I’ve thought about that. There are sick children all over the world, why Kycie? But there’s something about her and I truly believe she was here on a mission. She’s still on a mission. I just think there’s a reason behind it all.”

Because even now, five years after her tragic passing, strangers from around the world still reach out to the Terry family about their little girl. They remember Kycie and her story, which has reached thousands and saved an untold number of lives. Kycie’s father, Josh, has lost count of how many other parents have thanked him, explaining they, too, might have lost a child if not for his daughter’s story.

“I don’t know why it went as viral as it did. I think she just has a face, too. And you can see how heartbreaking it was and how hard she worked to try and get back. If you lose a child or you lose a family member, to think that they died for nothing, it’s that much harder. To know that she’s made a difference in other people’s lives and helped save other people’s lives, and saved a lot of heartache and struggles, it’s more doable.”

Kycie Jai Terry was the second youngest of six children and the only girl. After four boys, Jamie remembers crying tears of joy over her fifth ultrasound and the realization she would finally have a little girl. She remembers her daughter as a vibrant child, who loved to dress up, ride bikes and catch lizards; who was a little bit of everything and unique, as her name suggests.

“I don’t think I realized at that time, but now I think there’s a reason that she has this unique name because you Google her and she pops up and it’s because she needed to make a difference in the world.”

Where Things Went Wrong

Kycie

Image source: Beyond Type 1

Kycie was diagnosed with type 1 diabetes on January 30th, 2015 while in DKA (diabetic ketoacidosis). Where her story differs from many who live with undiagnosed type 1 and go into DKA is that she ultimately experienced cerebral edema, a condition where fluid builds up around the brain, causing pressure and swelling. This complication was occurring unbeknownst to the healthcare providers treating her at the time, wreaking havoc on Kycie’s brain and nervous system as she slept in her ER room bed. Less than 1% of pediatric patients in DKA experience cerebral edema, making it rare, though this statistic was of little comfort to the Terry family. As Josh puts it, “It’s always rare until it happens to you.”

As he recalls, Kycie’s initial symptoms started with a headache, then a stomachache. It seemed like she might have had a stomach flu, then strep. But she didn’t get better with antibiotics; in fact, she worsened. She didn’t want to eat, she only wanted fluids, and she was suddenly remarkably skinny. The Terrys felt an urgency to take their daughter to the hospital as her condition only seemed to get worse. She was extremely lethargic once there, and Josh recalls her fruity breath, a tell-tale sign of ketones. Sure enough, the doctor quickly revealed the cause of the problem: “She has type 1 diabetes.”

But Kycie’s blood sugar was difficult to control. Later, the Terrys would learn that during this time in the ER, doctors were focusing solely on treating her diabetes without realizing that she had experienced any brain damage, or that it was growing worse. With blood sugar readings over 1,100 mg/dl (61 mmol/L), Kycie was in severe DKA and needed to be life-flighted to a children’s hospital five hours away. After landing, she suffered a seizure on the ambulance ride from the airport to the hospital. Four hours later, she was intubated, on a ventilator, unresponsive and in a diabetic coma.

An MRI was completed after Kycie was in a coma for over 24 hours, revealing for the first time the cerebral edema. Doctors told the Terrys that they didn’t expect her to live, but Kycie fought, ultimately coming to breathe again on her own before waking up. She spent the next 111 days in the hospital to relearn basic functions, after which she was able to go home and live with her family for another month and a half, though her life was entirely different. It was suddenly a feat for the five-year-old to hold her own head up, smile, or roll over by herself. Josh remembers feeling torn and heartbroken to see his daughter’s life suddenly so difficult.

“I remember sitting up there and thinking what a horrible situation she was in – a situation I wouldn’t want to be in. If I was in that place, I wouldn’t want to live that life,” he shares. “At the same time, she’s my little girl and it’s my job to protect her and my job to be there for her. It was a really hard place to be.”

Kycie

Image source: Beyond Type 1

The family continued on, taking care of their daughter and treasuring the few good times during otherwise long days. They documented their new normal, sharing feel-good moments and milestones on social media.

Kycie then caught a virus that led to pneumonia and another hospitalization, setting back some of her progress and making her less responsive. Though she was able to return home after growing stronger, in the early morning hours of July 11th, her oxygen levels were extremely low and her parents were poised to take her to the hospital yet again. Before they could leave the house, the second youngest Terry passed away peacefully in her father’s arms. She was a few months shy of her sixth birthday.

Her Legacy Lives On

Kycie is well-known now in the diabetes community, her story having touched so many all over the world. Beyond Type 1’s Warning Signs Awareness Campaign, which began in 2016, was inspired by her story and the reality that both misdiagnosis and missed diagnoses are problems that can be solved through education and awareness. Josh and Jamie both can’t underscore enough the importance of being able to recognize the signs and symptoms of type 1 diabetes.

“To get an early diagnosis is so critical. If you can catch type 1 before DKA, you’ve saved yourself the possibility of brain damage,” Josh explains. “And so that early recognition is so vital, not just because of the scariness of DKA, but because of the unknown that comes with it.”

Jamie reflects on her own lack of knowledge about diabetes in general and how Kycie’s situation truly opened her eyes to a chronic illness that affects so many on a daily basis.

“I knew nothing about it. And the thing that’s crazy with Kycie is it all happened so fast. Within five days, she had a traumatic brain injury,” she explains.

Jamie sympathizes with everyone who manages type 1 diabetes, having gotten a small taste of the complexity of the disease while caring for Kycie’s type 1 diabetes (T1D) the short time she was able: “That’s what is heartbreaking to me. Anyone that ever comes up to me and tells me they have type 1, the first thing I say to them is ‘I’m so sorry’ because it’s so much to take on. And we didn’t even get to.”

The Terry family now advocates for safe and early diagnoses of type 1 diabetes, sharing about Kycie whenever they can and working with local hospitals to help improve type 1 protocols. In Josh’s practice as an optometrist, he lectures others in his field on type 1 and the importance of recognizing changes in vision as potential signs. Their family is continually touched by the outpouring of love for their little girl and all they’ve been through, the community they’ve found through their loss and the surprising amount of good that has come out of an otherwise tragic situation.

As Jamie puts it, “There’s no greater title than ‘Kycie’s mom.’ It will always be hard to live without her, but part of the healing journey has been to know that she has saved and continues to save lives.”

Source: diabetesdaily.com

Teenager Builds T1D1 App After Diagnosis with Type 1 Diabetes

T1D1 (which stands for type 1 diabetes from day 1) is an app that was created by a newly diagnosed 13-year-old, Drew M, to help people better manage their condition. Determination coupled with being well-versed in coding led Drew to create this app almost immediately after diagnosis.

I thought it would be nice to hear Drew’s story and how he took his new diagnosis as an opportunity to help others.

Hi Drew, thank you for taking the time to speak with me. I know you were just diagnosed in September of this year. What signs were you showing and what made you see your doctor?

The only reason I went to my doctor was because we noticed I was losing weight while growing. I had lost more than 10 pounds and had grown over an inch over a three month period. I went to my pediatrician and they drew some blood. We left the office and before we even got home, my mom got a call from them and they said, “pack a bag and go to the ER at Children’s National right now!” My blood sugar level was 529 mg/dL and I apparently had large ketones in my urine test.

Drew recovery

Photo credit: Laura Mendelow

I know you were hospitalized, did you get a good education on how to manage this condition?

Yes – I think the diabetes team at Children’s National Hospital was awesome! They had a whole team of people that kept coming in to visit with me. Because of COVID, all group classes were now given one-on-one, so I got a great education.

Although I missed school when I was in the hospital, I still felt like I had math class because there was so much to learn about calculating my numbers and carbs. It felt like a lot to take in, but they did a great job explaining it to me. They taught me how to calculate my insulin doses and count carbs and I practiced on a sponge.

My grandma was diagnosed with type 1 about 10 years ago, when she was 61, so I was pretty familiar with seeing her managing it. That also helped me a lot knowing someone who has T1D so I wasn’t as scared when they told me that I had this disease.

I know you have a passion for coding and had just finished taking a summer course. At what point did it dawn on you that you were fully capable of creating something like this?

We were joking around about it with the nutritionist, Alex, that morning in the hospital. She was showing us some apps to help us out and said it was annoying that there wasn’t one app that did everything. My dad said jokingly, “Don’t worry, Drew will build you one.” When we got home I started looking at different ways to build apps and there are so many platforms now to choose from. I started playing around with it that same day and realized I had enough knowledge of coding that I could actually do it!

The stuff I was doing over the summer was just for fun because my soccer camp and my overnight camp got canceled because of COVID. Basically, I was bored and taught myself how to code using YouTube videos and a few classes that my dad shared with me. I learned how to code video games using Unity, but nothing like this app! I figured I knew enough about how to code that I could figure out how to build an app. It was like a cool challenge to take on.

My dad is a programmer but he had never built an app before either. But I figured if I got stuck, he could help me out. But, he really didn’t know anything about the program I was using, so a few times I got stuck and my dad was like, “I have no idea how to help you with that one, you’ll just have to google it.” So I did.

The platform I was using was limiting, like I couldn’t create a drop-down menu so I would have to learn how to go around the system to create some of the functions I wanted. I just kept teaching myself new things online until I found things that worked.

Drew with his father in the hospital. Photo credit: Laura Mendelow

I know the doctors at the Children’s hospital expressed a desire to create an app that was different than those that already existed. What was their wish list?

Well, they wanted a few things. First, it had to be simple and easy to use. And, it had to be something that a person could use from day one of diagnosis. There are so many apps out there but they may require you to have a CGM or a pump or they’re just too much for someone who is recently diagnosed and too complicated for kids to use. They wanted an easy way to calculate your insulin dose and also log your glucose levels.

People who are newly diagnosed are asked to call in every day after diagnosis for about 2 weeks and report their numbers from the last day (e.g. blood sugar, carb count, insulin taken for every meal, snack and at 2 am). So having a feature where you could email your logs straight to your doctor was a big request as well.

Then, they had more detailed ideas like the option to round to the nearest half or whole number. I didn’t even know some pens have half units and others only have whole units. The doctors knew what people needed, and I knew what I wanted as a person who was newly diagnosed, I just had to figure out how to program it on the app.

Your app has become quite a success! Now available on Android and iPhone, T1D1 has over 9,000 downloads already. What sets your app apart from the rest?

I think people like that the app is simple, yet does everything that they need right from the beginning of being diagnosed and has some cool features (like different settings for different meals) that other apps don’t have. Plus it’s completely free and has no annoying ads or any kind of in-app purchases.

Also, I think they like that it was created by a kid and not a big company, so they know I’m not out to make money or collect their data. I’m new to the T1D community but I can already see that people get annoyed when they see companies using their disease to make money off of them.

How long did it take to create this app and can you tell us a little bit about the beta testing process?

The first version took only about a week, but it was super simple. It was basically just a calculator with a few changeable settings. We then showed it to Dr. Marks and the diabetes team at Children’s and they came up with some suggested features. I would build in the features and then send it back to them for review.

Once we had a few features like a bolus calculator and an insulin log, we then reached out to online diabetes communities to see if anyone would volunteer to help us test the app. My dad reached out to groups on Facebook and Reddit and asked for volunteers. I remember that night, my dad was overwhelmed with how many people wrote back offering their help.

At that time, it was only being tested for Apple and we had about 70 beta testers. After a lot of testing, the app got published in the Apple Store on Halloween. So, that was about a month and a half after I started working on it. Then, a few weeks later we were able to get it published in the Android Google Play store.

I know you have received both national and international attention (Fox News, NPR and the Jerusalem Post to name a few!), how does that make you feel?

Honestly, I was so surprised at how it took off. It makes me feel really good knowing that the app will now reach so many more people. One of my main goals is to make the app accessible to as many people as possible and this publicity really helps me achieve that goal. Anyone who has T1D knows how tough it can be to manage this disease 24/7. Hearing stories about how I’ve really helped others, makes me feel so happy and helps me get through the tough moments. And, these stories keep me motivated to continue working on the app to make it the best I can.

Drew with family. Photo credit: Laura Mendelow

I know you are hoping to keep this app payment-free and ad-free. How can people help support you?

If people want to support the app, they can donate on the “support us” page on the IOS version of T1D1 or through the website T1D1.org. All donations are used to keep the app live and make enhancements. All profits get donated straight to JDRF. Another huge way to support us is to spread the word to their diabetes team and by posting about it on social media!

You are clearly an ambitious young man with a ton of determination! Do you see yourself doing more things with coding and diabetes? What do you think you would like to do when you are all grown up?

This opportunity to make an app really helped me to see the possibilities of being a programmer or developer when I grow up. It’s been really cool to talk with other organizations like Tidepool to learn how they integrate technology into improving people’s lives with diabetes. It’s awesome to think that I can use my coding skills to continue to help others with T1D. I now have a pump and am amazed by the pump technology. Who knows what others will create in the future. I’d love to take part in creating that new technology with them to help make all of our lives easier.

Thank you so much for taking the time to speak to me. You are a perfect example of someone who took an unfortunate situation and took the opportunity to help others.

I wish you much success and look forward to watching you thrive in both your future professional endeavors and managing your type 1 diabetes!

Source: diabetesdaily.com

Diabetes Life Hacks: Tools to Help You Thrive

Living with diabetes is a full-time job and one we never applied for. It can be mentally exhausting and emotionally and physically draining. I know I am always looking for any tips or tip-offs that can help me with my diabetes management–whether it be technology, travel perks, or even a new app that tells me to get my act together.

I asked the diabetes online community to share any and all fun tips and tip-offs that can help make our lives a little bit easier and enjoyable.

Here are the top 9 diabetes hacks that the diabetes online community shared:

Dexcom G6 Sensor

1. Restarting Dexcom Sensors

Did you know that you can extend your Dexcom G6 sensors beyond the 10-day cut off? There are quite a few ways to go about it depending on your transmitter code. You can find the right method to use here. This will save you a few pricks and pokes and some money too.

2. Free Admission to National Parks

People living with diabetes (or any other condition that falls under disability) can apply for free lifetime access to US national parks. You can obtain your pass through the mail which involves a $10 dollar processing fee, or you can get it in person to avoid the extra charge. This is a great perk that everyone should take advantage of at some point in their lifetime!

Sulli the Diabetes Guru

3. Sulli the Diabetes Guru

Roche Diabetes Care created a voice-activated assistant in the homes of people living with diabetes. This virtual source of support and information is available around the clock and free of charge on Amazon Alexa and on Google Assistant. Sulli the Diabetes Guru responds to important questions like “What is high blood sugar?”, “Is it okay to eat before my blood test?” as well as sets reminders to take medication and can even tell you where to find the closest blood monitor retailer!

Medal from Lilly Diabetes

Photo credit: Clare Fishman

4. Lilly Diabetes Journey Awards

Did you know you could receive a medal for your valiant effort of managing your diabetes? This program recognizes people who have managed their type 1 diabetes successfully with insulin for 10, 25, 50 and 75 years. Each recipient receives a beautiful award, engraved with their name, along with a signed letter from Lilly’s CEO, Dave Ricks, acknowledging and encouraging their continued dedication. This program helps celebrate each other’s victories and hopes to inspire others living with diabetes.

People living with type 1 diabetes or parents of children with type 1 diabetes in the United States can complete and submit the Lilly Diabetes Journey Awards application here. If you are outside the United States and are interested in learning more about Lilly programs in your country, please contact your local Lilly affiliate for more information.

Lilly also offers other programs such as their Lilly Camp Care Package program, which provides diabetes educational kits, inspirational speakers, insulin, and other supplies to camps for children with diabetes. Lilly also offers college resources after partnering with The College Diabetes Network. CDN realizes that campus life and independence can be hard enough without diabetes. They created a community for young adults living with diabetes through its national network of campus-based chapters and their resources available on their website.

5. Ask Siri for Your Glucose Reading

If you are using a Dexcom CGM, you can take advantage of Siri and ask her any time of the day, “What is my blood sugar?” and she will take the reading from your Dexcom and say it out loud. This has become incredibly useful when I’m driving or don’t have the time to unlock my phone and go to the Dexcom app.

6. Happy Bob App

This app takes mundane diabetes data and turns it into an engaging and positive experience for the user. You can switch between Happy Bob and Snarky Bob to get a different dose of entertainment. Both of which will help ease the stress of this disease and leave you with a smile!

7. Dexcom Overlay

Did you know that Dexcom offers free over-patches to help reinforce the adhesive? There are plenty of great companies out there that offer this as well but be sure to take advantage of this free offer and see how it works for you and/or your child. You can submit a request using this form.

8. Preboarding Before a Flight

As people living with diabetes, we are allowed to preboard all flights. This is helpful to get your luggage in a safe space and make sure you have time to access any supplies or snacks before the plane gets crowded and it’s more difficult to move around. This will help set you up for a comfortable and relaxing flight. Read here for more information on air travel and what you need to know.

9. Sugarmate App

Sugarmate is a companion app for those using Dexcom G5/G6 and boasts many great features such as apple watch integration, will call you if your CGM goes low, and is ignored, even if it is in the Do Not Disturb mode. The newest feature if you own a car with CarPlay and connect your phone, your blood sugar will automatically display on your screen.

Make sure to take advantage of these above diabetes hacks to make living life with diabetes a little easier. Many of the above tips can help change your mindset, improve your mood, and give you a little motivation to keep on thriving.

Source: diabetesdaily.com

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

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