Apple to halt sales of some Apple Watches in US by Samantha Murphy Kelly for CNN.com, 18 December 2023.

Apple plans to stop selling some versions of the Apple Watch in the United States to get ahead of what could be one of the most momentous patent disputes in years.  The company said it will no longer be selling its Apple Watch Series 9 and Apple Watch Ultra 2, starting 21 December 2023 on Apple.com and from retail locations after 24 December 2023.

The decision to take one of its most popular products off the shelf follows an ongoing dispute with medical device maker Masimo over its blood oxygen feature. Apple has routinely marketed its smartwatch as a life-saving device, which has helped launch the Apple Watch into the stratosphere, making it the most popular watch sold around the world. In October 2023, the US International Trade Commission ruled that Apple violated Masimo’s pulse oximeter patent, which uses light-based technology to read blood oxygen levels. President Biden has 60 days to review the ruling before a ban could go into effect. 

“While the review period will not end until December 25, Apple is preemptively taking steps to comply should the ruling stand,” the company said in a statement. It added: “Apple strongly disagrees with the order and is pursuing a range of legal and technical options to ensure that Apple Watch is available to customers.” The company said, if the order stands it will “continue to take all measures to return Apple Watch Series 9 and Apple Watch Ultra 2 to customers in the U.S. as soon as possible.”

UPDATE, 3 January 2024: Apple Watch sales resume after latest twist in Masimo patent case by Susan Kelly for HealthCareDive.com.  

A federal appeals court granted Apple’s emergency motion to pause the ITC order while it considers the company’s request for a longer stay of the ban, according to court documents. Analysts said it is unclear how long the appeals process will take.  Read the update:  Apple Watch sales resume after latest twist in Masimo patent case

Read more: Apple to halt sales of some Apple Watches in US


Single ‘smart’ insulin injection regulates glucose levels in mice and minipigs up to one week by Bob Yirka for MedicalXPress.com, 29 December 2023.

A team of chemists, polymer scientists, and drug delivery specialists at Zhejiang University, working with a pair of colleagues from the University of North Carolina at Chapel Hill, has developed a type of “smart” insulin that when tested in mouse and minipig models successfully regulated blood glucose levels for up to one week after just one injection.

In their paper published in the journal Nature Biomedical Engineering, the group describes how they created their insulin, how it works, and how well it performed when given to diabetic mice and minipigs.

The new smart insulin is a modified form of the type of insulin already in use—the researchers added gluconic acid, which when injected into the body transforms into a complex as it bonds with chemicals in the blood. Such complexes result in the insulin being trapped inside a natural polymer, and that results in alterations to signaling. Different amounts of insulin are released depending on blood glucose levels. This, the research team found, allowed for more insulin to be automatically released into the blood when it is needed (such as after a meal) and less when it is not.

Read more:  Single ‘smart’ insulin injection regulates glucose levels in mice and minipigs


Zealand Pharma. The other Danish pharmaceutical company doing interesting things by Tim Street for diabettech.com, 18 December 2023.

Zealand Pharma has had a partnership with BetaBionics since 2016 to produce Dasiglucagon, the stable version of Glucagon that’s intended to work in a dual hormone automated delivery system. But they do so much more.

ZP8396 is their Amylin analogue called Petrelintide.  Amylin analogs are interesting because, in T1D, they are one of the hormones missing when we lose beta cells and are responsible for slowing stomach emptying. They also appear to help in weight loss. There is currently only one available, Pramlinatide, which has a license in the US, and pretty much nowhere else. It was approved in 2005 and is known as Symlin. Clinical trials in type 1 suggest that its use reduced Hba1C by between 0.3 and 0.7 percentage points, and also reduced weight in both type 1 and type 2 diabetes. One of the main benefits of use in type 1 is that by slowing stomach emptying, the rate of glucose increase can be mitigated, as most people with type 1 who don’t have complications have faster stomach emptying than non-t1ds.

Read more: Zealand Pharma. The other Danish pharmaceutical company doing interesting things


Nightscout is TRENDING in the TOP TEN, as posted by Lane Desborough, one of the founders of the Nightscout cloud-based app, 20 December 2023.

Nightscout (also known as CGM in the Cloud) is an open-source cloud application used by people with diabetes and parents of kids with diabetes to visualize, store and share the data from their Continuous Glucose Monitoring sensors in real-time. Once setup, Nightscout acts as a central repository of blood glucose and insulin dosing/treatment data for a single person, allowing you to view the CGM graph and treatment data anywhere using just a web browser connected to the internet.

Read more: Welcome to Nightscout


AFREZZA: Inhalable Insulin and Some Hacks for Using It, shared by Jack Griswold, long-time T1D/advocate

Afrezza® is the only ultra rapid-acting inhaled insulin that starts lowering blood sugars in ~12 minutes for adults living with type 1 or type 2 diabetes.  Afrezza is designed to work differently from other mealtime insulins. Afrezza uses an insulin inhaler to quickly deliver rapid-acting insulin into the lungs and bloodstream via insulin powder. When Afrezza is taken at the beginning of a meal, it starts lowering blood sugar in as little as 12 minutes. And just as Afrezza enters the body quickly, it also leaves the body fast (within 1.5-3 hours, depending on dose). 

Technosphere technology, a platform that allows for lung delivery of medicines, is used to deliver Afrezza. The microparticle used in Afrezza consists of two main components: human insulin in its most basic form, combined with an inactive ingredient. These microparticles are inhaled deeply into the lungs, where they are quickly absorbed into the body. As Afrezza passes through the lungs, insulin is released into the bloodstream in less than 1 minute.

MannKind Corporation, maker of Afrezza, is a biopharmaceutical company focusing on the discovery, development, and commercialization of therapeutic products for diseases such as diabetes and pulmonary arterial hypertension. 

The secret to keeping Afrezza fresh is to keep it dehydrated. It absorbs water vapor which enlarges its diameter, making the dust too large to fit down directly into the avioli in your lungs. Once you open the little triple packets, water starts to absorb, limiting it to three (3) days maximum. If one inhales “wet Afrezza,” it doesn’t work at all and you cough it back out. 

Now, here are some tricks and tips for using and keeping Afrezza fresh and usable, from the wisdom of people living with diabetes, shared with me by Smiling Jack (Jack Griswold, who’s closing in on living with T1D for 69 years in March … I’m closing in on “only” 59 years in January!)

Hack #1:  Place the triple packets into an airtight wide-mouth prescription bottle with a 5-gram silica gel desiccant in it. The cartridges are then good for over ten days! FYI: MannKind recommends a 3-day limit for open cartridge packs and 10 days out of the refrigerator. I have purposely opened a cartridge packet and left it in my container with silica gel…. and used it 30 days (out of the fridge) later without any problem. So the 3 & 10 day limits are flexible with a little tweaking.”

Hack #2: WiseDry packets are sold on Amazon (100 costs about $15) and they are re-usable! This will keep the cartridges fresh for ten days or more. WiseDry has colored crystals that change color when they have absorbed max water content. Very handy! Then you bake them in an oven for 15 minutes and they are like new!

Hack #3: Note – Write the date on every packet and inhaler.

Hack #4: “Round the sharp corners” of the packets. They cut fabric and even skin.   

Hack #5:  “I never drink water before inhaling! That will reduce the dose getting all the way down into your lungs.”  Suggestion: Use your diaphragm downward to SLOWLY expand your lungs fully while inhaling, not just puffing your chest out! Immediately afterward, take a small sip of water to avoid coughing.

Many of us who use or at least keep Afrezza at home, for huge carb-loaded meals or stubborn high blood sugars share this opinion:  “Afrezza is by far my most potent High BG recovery tool. It is “magic fairy dust” to me since I can typically recovery in about 1/2 hr from a high BG. My very rapid Apidra liquid insulin is as slow as molasses relatively speaking.”

If you’d like to receive Smiling Jack’s monthly newsletter (just lots of cool info for folks living with diabetes), send an email requesting to be added to the newsletter mailing list. Email to: grismo@pacbell.net.  FYI: He distributes his newsletter using his other gmail address: grismo.griswold421@gmail.com

Read more:  Afrezza by Mannkind


More physician inbox messages, higher patient satisfaction? by Georgia Garvey for AMA-Assn.org, 26 December 2023.

Over the past decade, physicians have had to spend increasing amounts of time on electronic inboxes and health records, an issue that only intensified after the start of the pandemic. It’s work that’s typically unpaid and done before and after clinic, even on nights and weekends during  what Lisa S. Rotenstein, MD, and many others refer to as “pajama time.”

But though that EHR inbox work can be exhausting, it also appears to be valuable to patients, according to a new study co-written by Dr. Rotenstein. She is medical director of ambulatory quality and safety at the University of California, San Francisco, Health, and also directs the Brigham and Women’s Hospital and Physicians Foundation Center for Physician Experience.  Published in the Journal of General Internal Medicine, a study of 133 primary care physicians shows that the more time that they spent corresponding with patients in electronic inboxes, the more likely those patients reported being to recommend their doctor.

What are your thoughts on messaging with your physicians? 
I know I feel much for “cared for” if I can correspond AND get a timely response (or even any response at all).  My few physicians who rarely respond via their portal or delegate that to medical assistants make me feel that they just don’t care to interact.  Have you felt the same way?

Read more: More physician inbox messages, higher patient satisfaction?


Toasting is a tradition that dates back to ancient Greece. The act of raising a glass to wish someone good fortune “came around even before the word,” Paul Dickson, the author of a book on toasts said. For example, Ulysses drank to Achilles’ health in Homer’s “Odyssey,” though the word itself was not used in the poem.  The word came to us through the Middle English “tosten” in the 12th century. The noun, meaning bread that had been browned with heat, and the verb, “to brown bread,” may have derived from the Old French toster, “to roast or grill,” or the Latin torrere, “to burn.”

in the Middle Ages, toast was used to flavor a drink. Sam Sifton, an assistant managing editor for The Times and the founding editor of New York Times Cooking, said that the practice of “toasting” someone stemmed from the days when people would put “pieces of spiced toast into your mead or your wine.” Toasting a person, he said, is like “putting their name in your glass,” as if they add spice or sweetness.

Linguist Dan Jurafsky writes that “flavoring wine with toast” fell out of favor in the 17th century. Around that time, it became customary for English diners to toast to someone’s health. The person being toasted, Mr. Jurafsky wrote, was usually a woman who “flavored the party just as the spiced toast and herbs flavored the wine”; she became known as the “toast” of the occasion. 

Read more: A Toast to a Year and a Word

 

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