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Finally … a silicone skin for the Dexcom G4!!!

Dexcom Cases: Big News!
Posted on April 21, 2014 by Laddie

If you use the Dexcom G4 and have been searching for the perfect case for your receiver, I have great news for you!  Yesterday on Facebook I read that Tallygear has come out with a silicone skin that is similar to the cases that many of us use on our cellphones.

In the year and a half that I have been using the G4, I have invested more money than I care to admit trying to find the perfect case for my G4 receiver.  The black leather case provided by Dexcom is huge and extremely masculine.  Great if you want to wear the receiver on your belt, but incredibly clunky if you like to keep it in your pocket.  I tried a few cases designed for Blackberry phones and they almost worked.  But not quite.  A few other cases from Amazon were quickly returned or tossed in the trash.

I ended up using two cases that were okay, but not exactly what I wanted. The first was a case that I found out about in the Dexcom Users group at TuDiabetes.  It was designed by the friend of a Dexcom user and was manufactured with 3D printing at Shapeways.  It has been my main case, but the color has faded terribly.  Although my receiver has survived more than one fall while in this case, I’m not convinced that the case provides much protection especially as it has gotten older and more flimsy.  You can check out this case here.

The other case that I have used was purchased at Tallygear.  It is a lycra fabric case with a clear plastic front that completely encases the G4 receiver. It […]

T1 Diabetes is Complicated…Even for Doctors

Published on April 7th, 2014 | by Claresa Levetan MD, FACE

In 1923, Dr. Elliott Joslin said, “Insulin is a remedy primarily for the wise and not for the foolish, be they patients or doctors. Everyone knows it requires brains to live long with diabetes, but to use insulin successfully requires more than brains.”

Diabetes is a hard disease to understand for both patients and doctors. Too often, we boil it down to insulin, or the lack thereof, but there is so much more to it than that. Even if you are very careful with what you eat and are right on top of your insulin therapy, good A1C control can be difficult to maintain. That’s something that even medical professionals have a hard time understanding, partly because we’re just beginning to grasp all that goes into internal glucose control.

It can be hard for a general practitioner to keep up. Recently, during a lecture to physicians, I put the following multiple-choice question on the screen:

What is the hormone that is co-secreted from the beta cell in equal concentrations as insulin?
a) Amylin
b) Glucagon
c) Somatostatin
d) GLP-1
e) Islet Ghrelin

Don’t feel bad if you don’t know which to choose. In a room of some 50 physicians, none gave the correct answer of amylin.

As a hormone, amylin is a relativelynew kid on the block. It was discovered in 1987, and for the first few years afterwards no one knew quite what it did. I was excited to learn about this hormone because I thought it played a key role in stabilizing A1C levels, a goal which is hard to achieve with just insulin therapy alone. It turns out that it might be the Robin to insulin’s Batman in that it regulates excess […]

NYTimes: Even Small Medical Advances Can Mean Big Jumps in Bills

By ELISABETH ROSENTHAL
APRIL 5, 2014

lt’s the most expensive thing I own, aside from my house. CATHERINE HAYLEY, whose diabetes was diagnosed when she was 9, describing the digital insulin pump that helps keep her alive. Credit Luke Sharrett for The New York Times

MEMPHIS — Catherine Hayley is saving up for an important purchase: an updated version of the tiny digital pump at her waist that delivers lifesaving insulin under her skin.

Such devices, which tailor insulin dosing more precisely to the body’s needs, have transformed the lives of people with Type 1 diabetes like Ms. Hayley. But as diabetics live longer, healthier lives and worries fade about dreaded complications like heart attacks, kidney failure, amputations and blindness, they have been replaced by another preoccupation: soaring treatment costs.
“It looks like a beeper,” said Ms. Hayley, a 36-year-old manager here for an environmental services company, referring to the vintage 2007 pump on the waistband of her jeans. “It’s made of plastic and runs on triple-A batteries, but it’s the most expensive thing I own, aside from my house.”
A new model, along with related treatment supplies, prices out at tens of thousands of dollars for this year and will cost her about $5,000, even with top-notch insurance. “It’s great,” Ms. Hayley said, “but it all adds up.”

Traditionally, insurers lost money by covering people with chronic illnesses, because they often ended up hospitalized with myriad complications as their diseases progressed. Today, the routine care costs of many chronic illnesses eclipse that of acute care because new treatments that keep patients well have become a multibillion-dollar business opportunity for device and drug makers and medical providers.
The high price of new treatments for diabetes, rheumatoid arthritis, colitis and other chronic […]

ViaCyte’s Upcoming T1D Clinical Trials!

March 21, 2014 by Michael Anderson

The VC-01 combination product is expected to be implanted under the skin of the patient through a simple outpatient surgical procedure. The cells are then expected to further differentiate to produce mature pancreatic cells that will synthesize and secrete insulin and other factors, thereby regulating blood glucose, commonly referred to as blood sugar levels.

In the closing paragraph of my last blog post, I tried to strike a balance between hope and realism when describing ViaCyte’s VC-01 combination product and pending clinical trials aimed at a virtual cure for Type 1 diabetes.

The possibility/probability of successful clinical trials makes you anxious, optimistic, and fearful of another big letdown. It also leaves you with lots of questions. So I contacted ViaCyte to say “Thank You” for presenting at the JDRF Research Summit in Bethesda, MD last month  and asked a few follow-ups.  To my delight, I got an email response from a person named “Howard” at the San Diego-based company.

Q: How will you recruit or identify prospects for the upcoming clinical trials?

A: Currently, ViaCyte is still in preclinical development with our diabetes product VC-01; we are not conducting any clinical trials at present.  However, we do anticipate completing the necessary preclinical studies and filing an application with the FDA so as to be able to proceed with human trials sometime later this year.  Note that when the clinical trial starts, ViaCyte will adhere to Good Clinical Practice (GCP) guidelines, which preclude the Sponsor (ViaCyte) from having direct contact between clinical study subjects.

Q: How does the proprietary device ” KNOW” when and how much insulin to release?  Are the stem cells smart enough to automatically ” sense ” the amount of glucose in […]

What does Diabetes look like?

from The Human Trial and Lisa Hepner …

The challenge of making a film about this disease is that you can’t see it. People with diabetes look healthy, and it’s only when the complications become dire – blindness or renal failure – do they appear to be battling a serious disease. We’ve been thinking about how to best illustrate what’s going on inside a body of someone with diabetes (type 1) versus someone who doesn’t have diabetes.

Check out the graphs below. Both present one week of blood sugars for a diabetic and a non-diabetic. You can see that even a diabetic in relatively good control doesn’t come close to what your body does naturally. Elevated blood glucose over time translates to long-term complications, and all the frightening stats that we read about.

Person without type 1 diabetes

 

Person with type 1 diabetes
(filmmaker Lisa Hepner’s blood sugars)

Insulin Envy

By Ginger Vieira

I have insulin envy. Not every day (well, yes, every day). But some days it feels stronger than others.

You insulin-producers. I envy you.

I have insulin envy.

I envy that moment when you get up in the morning and—instead of immediately pricking your finger to bleed for the millionth time—you just start your day.

I envy that moment when you eat your breakfast peacefully while watching the morning news…or even in a rush as you head the door…and—instead of calculating carbohydrate quantities and insulin doses and jabbing another sharp object into your flesh, and hope it all works out the way it’s supposed to—you just eat your food. Period. You eat it. Enjoy it. Taste it. And move on.

I envy your workday that flows uninterrupted by low blood sugar sweats, headaches, and a desperate search for the juice box that will save your life. I envy your business meetings where you can focus on the discussion instead of secretly worrying that the reason you’re starting to feel hot and flushed isn’t because your boss turned the heat up but because your blood sugar is plummeting.

I envy your ability to hop up during your lunch break, pop into the gym or local yoga class without a second’s thought as long as you’ve got your gym clothes and sneakers. You just go. You show up, you start. You enjoy. And then you eat your lunch quickly as you drive back to your office. No planning or priming or temp-basaling or carb-estimating or worrying or pricking or lows or highs.

Just exercise. I envy your ability to just show up and exercise.

Envy. Envy. Envy.

I envy that moment when you decide you’re ready to go to bed and fall asleep…and […]

What You Should Know About Flying with an Insulin Pump

A Sweet Life > Features > What You Should Know About Flying with an Insulin Pump

Melissa Lee | March 04, 2014

 

I’ve been pumping insulin for the last 14 years, and I travel frequently.  In fact, I’m on an airplane every couple of months.

I always struggle with my blood glucose during air travel, and attribute the in-flight fluctuations to the stress of travel, or the crappy fast food breakfast I probably had prior to boarding (must have miscalculated those carbs), or even to sheer diabetes randomness. It was only recently, however, that I learned something critical about insulin pumps and airplanes, something that I hadn’t ever been told – not by device companies, not by my medical team, not by my online friends.

When flying with an insulin pump, you should always disconnect it during takeoff and landing.

This isn’t a US FAA recommendation; this isn’t about turning off your electronic devices. And this certainly isn’t because your diabetes management makes Miss Manners uncomfortable in flight.

It’s physics.

When I was being trained on my current pump – the Asante Snap – by Asante’s Chief Product Architect, Mr. Mark Estes, he was surprised that I had never been told to disconnect when flying with an insulin pump. He asked to me to think about how delicately my ears handle takeoff and landing.

Now consider what that kind of pressure change during ascent and descent do the subtle workings of an insulin delivery device.

The he asked me if I ever experienced “baggage claim lows.”

Absofrigginlutely.

When I’m shaking from a low as my husband picks up our rental car or I’m fumbling with glucose tablets in my cab, I’ve always just assumed I don’t manage myself as well with the changes to my routine that […]

Is it Time to Rename Type 1 Diabetes?

Published on February 19th, 2014 | by Claresa Levetan MD, FACE

In 1997, the World Health Organization, the American Diabetes Association and other groups universally adopted new nomenclature for diabetes. Diabetes was no longer to be named by whether or not patients required insulin. The names Insulin-Dependent Diabetes and Childhood Onset Diabetes were changed to Type 1 diabetes. Type 1 diabetes was then further categorized by whether it resulted from an autoimmune attack (Type 1a) or a non-autoimmune attack (Type 1b). No changes have been made to the labels since that time.
With what we now know about Type 1 diabetes, it is time to define it by its pathophysiology. In other words, we need to label Type 1 diabetes in a way that incorporates all the underlying problems that cause this disease. Currently T1 is defined as a condition in which there is an autoimmune attack on insulin-producing cells, but many scientists no longer believe that this definition adequately portrays what we now know is happening.

It makes sense that we have, up until now, defined T1 by its autoimmune markers. We often can associate the onset of T1 as occurring after a recent virus, infection, or major illness, at which time the body’s immune system responds by making antibodies to attack the infection. Unfortunately, the immune system also sees the insulin-producing beta cells of the pancreas as foreign invaders and attacks them. Typically, with new onset T1, a blood test often shows an elevation of one of several types of antibodies, the most common being Glutamic Acid Decarboxylase-65 (GAD65) antibodies, which are a sensitive marker for autoimmune attack on the beta cells. So it’s clear that T1 has an autoimmune component, but what we have […]

How to make insulin-producing cells from gut cells

Posted on March 10, 2014 by Stone Hearth News, PHILADELPHIA

Destruction of insulin-producing beta cells in the pancreas is at the heart of type 1 and type 2 diabetes. “We are looking for ways to make new beta cells for these patients to one day replace daily insulin injections,” says Ben Stanger, MD, PhD, assistant professor of Medicine in the Division of Gastroenterology, Perelman School of Medicine at the University of Pennsylvania.

Transplanting islet cells to restore normal blood sugar levels in patients with severe type 1 diabetes is one approach to treating the disease, and using stem cells to create beta cells is another area of investigation. However, both of these strategies have limitations: transplantable islet cells are in short supply, and stem cell-based approaches have a long way to go before they reach the clinic.

“It’s a powerful idea that if you have the right combination of transcription factors you can make any cell into any other cell. It’s cellular alchemy,” comments Stanger. New research from Stanger and postdoctoral fellow Yi-Ju Chen, PhD, reported in Cell Reports this month, describes how introducing three proteins that control the regulation of DNA in the nucleus — called transcription factors — into an immune-deficient mouse turned a specific group of cells in the gut lining into beta-like cells, raising the prospect of using differentiated pancreatic cells as a source for new beta cells.

In 2008, the lab of Stanger’s postdoctoral mentor introduced the three beta-cell reprogramming factors — Pdx1 (P), MafA (M), and Ngn3 (N) — collectively called PMN – into the acinar cells of the pancreas. Remarkably, this manipulation caused the cells to take on some structural and physiological features of beta cells.

Following this report, the Stanger team […]

Research Corner: Ending the A1C Blame Game

Published on December 26th, 2013 | by Claresa Levetan MD, FACE

When glucose sensors first became available in clinical trials some 2 decades ago, I decided to wear a sensor to compare my glucose levels as a non-diabetic individual with glucose levels of my patients. I was excited to have this new tool, which measured 288 glucose readings a day and could be used 3 days at a time, as a resource for patients, particularly for those with blood glucose levels that had been difficult to control.
During my training as an endocrinologist, we didn’t have glucose meters. In the hospital, we used glucose strips that required drawing a significant amount of blood, then waiting and wiping the blood off. You determined glucose range based on how dark the strip became.

While wearing my sensor, I did my best to exercise and eat correctly, but I also indulged in chocolate donuts. Still, when I compared my daily readings with that of a patient with a fabulous A1C of 6.3%, I was shocked. Even with the donuts, my highest glucose over the three days was 103 mg/dL, whereas my patient’s A1C levels could bounce from 50 to 500 mg/dL in moments. There was no comparison.

Here I was patting myself on the back for thinking that I was taking such great care of my patients, when in reality, I learned that comparing A1Cs for people with and without diabetes was like comparing apples and oranges. Even patients who used insulin pumps, ate the same meals every day, exercised daily and “did everything right” can hardly hope to achieve the glucose levels of a person without diabetes. I realized I needed to stop blaming my patients or thinking myself superior.

Research […]