The Savvy Diabetic


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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 If you are unable to attend but would LOVE to donate on-line go to:

Savvy Updates 8/20/2016: Gut Microbiome, Glucagon, UCI’s Dr. Lakey, 3-Drug Combo for Control

Relationship between the composition of the gut microbiome and diabetes is being demonstrated repeated in studies, as reported in Endocrinology Advisor by Tori Rodriguez, August 11, 2016.

In a twin study by researchers at Harvard Medical School, MIT and Seoul National University in South Korea, published in 2016, there is an altered function and composition of the gut microbiome with biomarkers of subclinical T2 diabetes.  Among other systems and processes, microbiota has effects on the immune system, which indicates that it alters inflammatory markets and T cell subset regulation.  A shift in immune response is significant as it applies to T1 diabetes and may be of particular interest for T2 diabetes.  Indeed, as previous research has shown, “while the microbiome of healthy infants becomes more stable and diverse as they approach toddlerhood, the microbiome of those at high risk of autoimmunity become less stable and diverse, which could result in distinct differences in the autoimmune microbiome between healthy children and those with type 1 diabetes.”

The gut microbiome may increase understanding  of the pathogenesis of type 1 and type 2 diabetes.
“The development of type 1 diabetes seems to be associated with a reduced bacterial diversity in the gut, and this phenomenon appears after seroconversion to positivity for diabetes-associated autoantibodies,” says study co-author Mikael Knip, MD, PhD, professor of pediatrics at the University of Helsinki in Finland. “This indicates that the dysbiosis may be involved in the progression from autoantibody positivity to overt disease but not with the initiation of beta-cell autoimmunity,” he said. Additionally, those who progress to type 1 diabetes show a reduced number of beneficial bacteria and an increased number of bacteria with pathogenic potential.”

Read more: Role of the Gut Microbiome in Diabetes


Glucagon – […]

By |August 23rd, 2016|Extra|1 Comment

Savvy Updates 8/8/2016: Genesis AP by Pancreum, GlySens ICGM and Beta Cell ‘Hubs’

There’s a “new” artificial pancreas in the works, according to Tim Brand of Diabetes Daily, July 25, 2016. This is exciting!

Pancreum ( is a small company in the SF area working on a “low-cost drug delivery platform that will lead to an aritifical pancreas.  They’ve been in development for many years but keeping a low profile in the media.  Their product is called Genesis (I already love the name as my husband drives his favorite car ever, the Genesis!).

According to their website, “You control which components (modules or wedges) to attach to the reusable controller (CoreMD) which can communicate with a hand-held controller (or smartphone) and is programmed to configure itself based on which wedges are detected.  When all wedges are released, you may use the same CoreMD to create any one of the following systems:

A continuous glucose monitoring system (Vigil) by attaching a CGM wedge to the CoreMD;
An insulin delivery device (InsuLean) by attaching an insulin delivery wedge to the CoreMD;
A dual-hormone delivery device by attaching an insulin delivery wedge and a glucagon delivery wedge to the CoreMD;
A closed-loop insulin delivery and CGM device (Mine) by attaching both an insulin delivery wedge and a CGM wedge; or
A closed-loop bionic pancreas device (Genesis) by attaching an insulin delivery wedge, a glucagon delivery wedge, and a CGM wedge.

While they sport the #WeAreNotWaiting, they quote Margaret Mead, significant anthropologist in the 20th century, “Never doubt that a small group of thoughtful and committed citizens can change the world. Indeed, it’s the only thing that ever has”

Read more: The Artificial Pancreas You’ve Never Heard Of: “Genesis”


A TRULY Long-Term CGM is in development by GlySens Inc., a privately held corporation. According to their website (, the GlySens fully implanted sensor—demonstrated up to 18 month […]

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
Glucose meters
Glucose strips
Lancing devices
Pen needles

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, 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
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 … 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!