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19th Annual Shooting Stars JDRF Walk to Cure Diabetes Sunday, October 26, 2014 in Newport Beach, CA

For a contribution of $45 (or MORE!), walkers will receive a VERY COOL Shooting Stars Team T-Shirt along with FREE pastries, bagels, and coffee or juice. Questions or to Register email joanne@TheSavvyDiabetic.com. If you are unable to attend but would LOVE to donate on-line go to: http://www2.jdrf.org/goto/ShootingStars.

Got Unused but NOT Expired Insulin? Send it to Insulin For Life USA

What do you do when you have insulin that you are no longer using … OR you have fresher insulin with the old stuff left over … OR you have other diabetes supplies that you are not using?

Please consider sending it to Insulin for Life USA, a wonderful non-profit organization  that believes that the SOLUTION to the global PROBLEM of insulin access is possible; one where patients with diabetes, their health care providers, and industry share diabetes supplies that otherwise would go to

waste with those in need.  As they say, sharing what you no longer need will save lives. They provide the shipping form and information on how to send your supplies.  They will of course also take donations!  And you will get a receipt for taxes.

What they need:

Insulin vials
Insulin pens
Insulin cartridges
A1c Test Kits
KetoStix
Glucagon
Glucose meters
Glucose strips
Lancing devices
Syringes
Pen needles
 Lancets

I Wore a GREEN Wristband at the Friends for Life Conference 2016

Yup, I wore GREEN!  What a unique experience at the Children with Diabetes Friends for Life Conference, 2016!

After I had the good fortune to attend Diabetes Hands Foundation’s MasterLab 2016, I was able to take in the programs at the Friends for Life International Children with Diabetes Conference 2016, held at the same Orlando World Center Marriott.

And OH, what an amazing conference with an extensive exhibit hall, fantastic speakers, programs for all ages (Moms, Dads, Single Parents, Adults with T1, Significant Others, Grandparents, Childcare, Tweens and Teens, College kids, Siblings) and all topics … and conference attendees who were all so happy to be there.  Wow!

As I was registering, under press privileges, I was given a GREEN wrist band, to wear for the duration of the conference.  When I asked why I had a GREEN band and others had an ORANGE band, I was told: GREEN is for the PWD (Person with Diabetes) and ORANGE is for Others (non-diabetic, perhaps parents, grandparents or siblings of the PWD).

 

INTERESTING!  I have never been obviously identified, except that I have always worn a medical ID bracelet.  But I never felt that I stood out, so loudly, as DIABETIC.

My first thought: I don’t like to be so publicly identified. Suddenly, here I was, a GREEN!  Everyone could tell.

Then I started looking around … and noticing GREENs and ORANGEs.  If I saw a GREEN, I inwardly felt a kinship.  When I saw an ORANGE (and there were many more ORANGES), I thought, how nice that all these people were here to support and learn about life as a GREEN.

I even saw an amazing group of siblings called Orange Team Siblings. I’m sure that there are significant issues between T1s […]

Lucky Me! Thank You DHF MasterLab and Lilly Diabetes

What an honor!  I was chosen to receive a scholarship (underwritten by Lilly Diabetes) to attend the Diabetes Hands Foundation MasterLab 2016, a few weeks ago.  I was flown to Orlando, staying at the Marriott World Center … for a packed day of speakers, to learn so many aspects of ADVOCACY.  It was intense and I was struck by the range of interests amongst the attendees (about 115 outspoken folks with diabetes.  Indeed, it was an amazing advocacy training camp.

I must admit, at first, that I felt intimidated.  I recognized some names of attendees but not much more.  So, at breakfast (which, as was lunch, was filled with healthy food choices), I just plopped myself down at a table and introduced myself.  The connections were instant and suddenly everyone was talking.

I did not know what to expect and had not come with a specific agenda for a advocacy topic.  My mind rattled around with lots of ideas:  Medicare CGM coverage, Medicare Omnipod coverage, more patient access and involvement in product development, shining light on the new hot topic of gut and the microbiome, how to improve doctor-HCP-patient relationship … I could go on.

We were given a Personal Advocacy Plan workbook which was really well written, ranging from leading questions to action plans to action dates to social media campaigns.  Quite comprehensive.

I froze like a deer in headlights.  Which topic should I choose?  What criteria would I use to even choose the topic?  Would I have to share my work at the end of the day?  There wasn’t opportunity to interact and grow ideas with all these amazing advocating diabetics (a change from previous years) … but I was here and it was now.

I took […]

Savvy Updates 7/21/2016: CGM Benefits Shot Takers, Sleep & Diabetes Risk, Human Gut Microbiome, Intensive BG Control and Kidneys

CGM Benefits Injection Users, according to the results from Dexcom’s DIaMonD Study, presented at the ADA Scientific Sessions in June, 2016 and reported by www.diaTribe.org, 6/28/2016.  According to Dr. Howard Wolpert of the Joslin Diabetes Center, healthcare providers should consider recommending CGM to ALL patients with Type 1 diabetes who have not attained their glucose goals, not just those on insulin pumps.  Currently only about 7% of MDI users with Type 1 use CGM.

DIaMonD adds to the evidence that CGM improves time-in-range, reduces highs and lows, and improves A1c. This does not come as a surprise since glucose value and trend can be observed every five minutes and alarms sound for lows and highs, allowing people to recognize patterns, tighten the feedback loop, and take action to improve.
I’ve always said that if I were forced to choose between using a pump or using CGM, hands down, I’d choose my CGM.  Even though it is not perfect and you have to make sure not to overreact and overcorrect with such instantaneous data, it gives me trends and patters as well as annoying but necessary alerts.
By the way, DIaMonD stands for Daily Injections and continuous glucose Monitoring in Diabetes.
Read more: Does CGM Benefit Injection Users? Yes!
 

Men Who Sleep Too Much OR Too Little May Have Impaired Insulin Sensitivity … BUT NOT WOMEN, according to a study published on June 29, 2016 in the Journal of Clinical Endocrinology & Metabolism, and reported in EndocrinologyAdvisor.com.
Really?!?!?  Wow, that’s wild!
Compared with men who slept about 7 hours a night, the men who slept the most or the least were more likely to have impaired insulin sensitivity and beta-cell function, putting them at increased risk for diabetes.
However, the researchers found that compared with […]

FDA Advisory Meeting on CGM: Votes in Favor of Expanding CGM Use!

FDA’s Advisory Committee meeting just voted to recommend approval of the expansion of the Dexcom G5 CGM label. Thank you DPAC (Diabetes Patient Advocacy Coalition)!

 

The results are in and the FDA panel has voted the following for the labeling change of the Dexcom G5 Continuous Glucose Monitoring System:

Is there reasonable assurance that the Dexcom G5 Continuous Glucose Monitoring System is safe for the proposed indications of use?  YES: 8 NO: 2
Is there reasonable assurance that the Dexcom G5 Continuous Glucose Monitoring System is effective for the proposed indications for use? YES: 9 NO: 1
Do the benefits of the Dexcom G5 Continuous Glucose Monitoring System for the proposed indications of use outweigh the risks of the Dexcom G5 Continuous Glucose Monitoring System for the proposed indications for use. YES: 8 NO: 2

Thanks to everyone who shared support with FDA through the DPAC petition or other means. Patients’ voices are an important consideration in decision-making and we have shown with this success that we are being heard. This is just a quick thanks for being part of the good news.

Please remember that this is just an FDA Advisory Panel which sends recommendations to the FDA for a final ruling. But it is a great step in the right direction! Next, maybe Medicare will remove the caution of CGM being simply “precautionary”, and thereby affording Medicare coverage for CGM.

ADA 2016 Scientific Sessions ~ Artificial Pancreas, Finding a Cure, Better Cannulas

From the American Diabetes Association 2016 Scientific Sessions, held in New Orleans, June 2016.

Artificial Pancreas: Several new products in development show tremendous improvements in glycemic control and reductions in hypoglycemia … and they are not far off now.

Medtronic’s insulin-only hybrid closed-loop 670G system is the  furthest along … premarket approval submission to the FDA is expected this summer.

Close behind is the “bionic pancreas”, developed by Dr. Ed Damiano from Boston University.  A fully integrated dual-chamber device, called the iLet will come out by Beta Bionics, a public benefit corporation, working with Denmark-based Zealand Pharma.  One chamber will hold insulin, and the other chamber, with a separate infusion set, will hold a new stable glucagon analog.  The iLet single change device will reach the market first, due to the torturous regulatory path.

I had the opportunity to hear Dr. Damiano speak this month, to see the data charts of the amazing effectiveness of the dual chamber system … and to actually see the iLet prototype.  I wish I had this device NOW! (More on this in an upcoming post.)

Read more:        Coming Soon: ‘Artificial Pancreas’ Options for Diabetes
Artificial Pancreas is Coming, Other Highlights from ADA 2016
 

A Cure for Type1: A press conference called Beta-Cell Replacement pointed to 2 possible cures, still a ways off.

Dr. David Cooper at the University of Pittsburgh is working to genetically engineer pigs to produce beta cells that wouldn’t trigger their recipients’ immune systems (instead of forcing recipients to take large doses of immunosuppressant drugs).  That’s right, fix the pig, not the human!

Dr. Chad Cowan from the Harvard Stem Cell Institute, a co-founder of CRISPR Therapeutics, is trying to create genetically modified human stem cells that would be invisible to the immune […]

An Interesting Exchange about Diabetes Alert Dogs

I subscribe to www.insulinpumpers.org … a wide-ranging but well-managed forum about living with mostly T1 diabetes.  I can post a question or a comment … responses come back pretty fast.

Today, I read a series of interesting posts about Diabetes Alert Dogs (D.A.D.) … just had to share it with you. (Full names and email addresses have been deleted)

 

 

 

 

 

 

 

 

 

Subject: (Now) Diabetic Alert Dogs

From: Melody

This subject is a little painful for me because I just lost my Diabetic Alert Dog yesterday to a mass on his colon, two weeks shy of his 11th birthday.

I trained dogs for 30 years before training Boone for this job, — training any type of service dog is a large undertaking, usually about 2 years for a reliable medical alert dog with public access training.

And the “washout” rate is high, even among the major guide dog schools, because it’s often toward the end of formal training when the dog reveals that (s)he would rather be a treasured pet, or working in another career.

Not everyone would want to embrace the service dog lifestyle, either.  It’s a big responsibility, it’s time consuming, and it certainly draws attention to the person on the end of the leash.

But . . . a good alert dog can detect a low or a rapidly dropping BG long before the meter or the CGM.   They can dig you out from under the covers during a nocturnal hypo, and knock on the shower door when you’re low.  With more training, they can retrieve a meter kit, find the glucose tabs, get juice from the fridge, fetch a telephone, push a call button, alert a family member.   Mine rode in the back seat while I drove and would put […]

Video: T1 Diabetes in 2016 ~ hilarious skit!

Starring Dr. Steve Edelman, Jeremy Pettus, Dr. Bill Polonsky and Kelly Close … ENJOY!

Smart Insulin Update: Is It Really Smart Yet?

Here’s a great review article from the JDRF-Helmsley Charitable Trust Glucose Responsive Insulin (GRI) workshop last month, as reported by Emily Regier, Alexander Wolf and Kelly Close in diaTribe.org, 5/20/2016.

The theory behind “Smart Insulin”: a next-generation insulin that works automatically in response to blood glucose: the higher the blood sugar, the more insulin is released or activated, and the lower the blood sugar, the less insulin is released or activated.

As noted in this article, the long-term, “best case scenario” idea of the “perfect” smart insulin is very compelling for people with diabetes on insulin: one injection per day, blood sugar levels that stay in zone without hypoglycemia, no more carb counting, no more guessing what dose is correct, no more feeling frightened, and a much safer and less stressful life. That would be my “Dream Insulin.”

The reality, as the leaders emphasized at this meeting, is that glucose responsive insulin (GRI) is still in its infancy, and development will likely proceed in steps: the first generation of these drugs may offer some, but not all, of the anticipated benefits.

Definitely something to watch but don’t hold your breath! Maybe there’ll be a cure before there is smart insulin?!

Read the entire review: Getting to Glucose Responsive Insulin – How “Smart” Will It Be?

 

 

NEWS FLASH: Medicare Told to Cover CGMs

Medicare doesn’t typically provide coverage for continuous glucose monitors (CGMs), as insurors who oversee Medicare coverage have long argued that CGMs are a “precautionary” device rather than a “medically necessary” one. Now, that argument’s premise is facing serious questions in federal court and in the Medicare appeals process.

The first case that successfully pushed back against the policy involved Wisconsin resident Jill Whitcomb, who has had Type 1 diabetes for 40 years. Ms. Whitcomb was first prescribed a CGM by a nurse practitioner, and she used it successfully during a six-month trial. In 2011, she sought to have the device covered under her UnitedHealthcare Securehorizons Medicare plan. The Medicare-insuring contractor denied the claim.

She appealed through the complex Medicare appeal process. Two years later, when she’d reached the administrative law judge (ALJ) level of appeal, a judge determined that even though a CGM didn’t fit into Medicare’s definition of “glucose monitor,” the benefit was indeed available under her plan. UnitedHealthcare appealed to the Medicare Appeals Council, which reversed the decision by arguing that a CGM is a “precautionary” rather than “medically necessary” device. Ms. Whitcomb took her appeal a step further to the federal district court for eastern Wisconsin. In May 2015, a federal judge ruled that the Medicare Appeals Council decision was in error and sent the case back to the council. That’s where the case now stands.

Debra Parrish, a former DHHS staff attorney who now represents Ms. Whitcomb, successfully pushed back against UnitedHealthcare’s outdated understanding of what a CGM does. She also was able to show that a CGM represents a more efficient and less error-prone method of keeping tabs on one’s glucose count, and that the device was more capable of warning the […]