Closed-loop system improves CGM metrics for older adults with type 1 diabetes as reported by Michael Monostra for Healio.com/endocrinology, 6 July 2021.  

Older adults with type 1 diabetes had more time in range and less time below range with closed-loop insulin pump therapy compared with a sensor-augmented pump, according to a presenter.

“Closed-loop therapy safely improved all CGM outcomes compared with sensor-augmented pump therapy among older adults with long-duration type 1 diabetes,” Sybil A. McAuley, MBBS, PhD, FRACP, senior research fellow at the University of Melbourne in Australia and an endocrinologist at St. Vincent’s Hospital in Melbourne, told Healio. “Even with a strong trial comparator of sensor-augmented pump therapy, the glycemic benefits of closed-loop, notably increased time in range and less time below range, were clinically and statistically significant, and were sustained for the duration of the trial.”

By the way, as I searched for images of older adults using insulin pumps/closed-loop systems, I found VERY FEW photos showing seniors!  Mostly kids and beautiful young people.  Age bias?

Read more:  Closed-loop system improves CGM metrics for older T1Ds

FDA knocks back diabetes prevention drug, crushing its maker’s shares was published by Jacob Bell for BioPharmaDive.com, 6 July 2021.  

The Food and Drug Administration has decided not to approve what could have been a first-of-its-kind medicine meant to delay the onset of Type 1 diabetes, an autoimmune disease which affects more than 1 million people in the United States.

Provention Bio, the New Jersey-based company developing the medicine, said it received a rejection letter on July 2. In the letter, the FDA took issue with a so-called bridging study that looked at how Provention’s medicine gets absorbed and takes effect in the body when made with drug product from two different sources.  Provention said it expects to collect data that could address the FDA’s concerns before the end of September, from a sub-study of the large, late-stage clinical trial currently testing its medicine, known as teplizumab. In the meantime, the company’s shares are trading at just over $6 apiece, down 30% from last week and 65% since the start of this year.

While managed with insulin shots, Type 1 diabetes can still shorten expected life spans by more than a decade. A drug that prevents the disease, even for a time, could therefore be revolutionary for the millions of people living with it.  Provention hopes it has such a drug in teplizumab, an engineered antibody that’s supposed to regulate the immune system by targeting a cluster of proteins known as CD3.

Read more:  FDA knocks back diabetes prevention drug

Hitting A Nerve: Introduction to Neuropathy was written by Cheryl Alkon for diaTribe.org, 6 July 2021.  

Neuropathy is the term used to describe any damage to nerves in the body (for example, an injury from a car accident can damage the nerves). Diabetic neuropathy, or diabetes-related neuropathy, is the term used to specifically describe the nerve damage from high glucose levels (hyperglycemia) over the long term.  Diabetes can cause three main types of neuropathies: peripheral neuropathy (medically referred to as distal symmetric sensorimotor polyneuropathy), autonomic neuropathy, and focal neuropathy. 

With painful neuropathy, “treatments are generally to try to manage symptoms,” Memering said. “Medications such as Neurontin [gabapentin, a drug used for pain and seizures], Lyrica [pregabalin, a drug used for pain and seizures], or Cymbalta [duloxetine, a drug used for chemical balance in the brain] may be used to help with pain associated with painful peripheral neuropathies. These medications can be very effective, but it may take a few weeks to adjust and find the right dose. However, people should know that the medications can also be somewhat sedating.” Other drugs that may be effective include drugs used for mood disorders such as venlafaxine, nortriptyline, or amitriptyline, said Dr. Low Wang, but they may have side effects at higher doses and with older age.

Dr. Robert Gabbay, the chief scientific and medical officer for the American Diabetes Association said that neuropathy “is a very active area of research to identify new and effective treatments.”

Read more:  Hitting A Nerve: Introduction to Neuropathy

Empathy: The Most Critical Skill in Medicine was written by Amy Faith Ho, MD for MedPageToday.com, 9 July 2021.  

According to Dr. Amy Ho, a practicing ER physician with an ear for narrative medicine — that is, storytelling in medicine, “there are few things more core to the pillars of medicine than the concept of “empathy.” Now empathy is something we hear about from day one in medical school, nursing school, or PA school. Hey, it’s even something we hear in pre-med! It’s probably something we even wrote about in our admissions essays. And that’s because empathy is a critical part of care. You cannot care for a patient if you cannot relate, commiserate, and feel with them.”

There is an extreme distinction between empathy versus, say, sympathy. Because empathy is understanding and sharing the feelings of another person — it’s putting yourself in their shoes and feeling what they feel. Sympathy is understanding, but from your own perspective, in your own shoes.

Medicine is ultimately a collaboration between the provider and the patient. It shouldn’t be about us doing things to a patient, it’s about mapping out a journey of care that best fits their needs. To do that, you need to understand their needs and have empathy for them.

Read more:  Empathy: The Most Critical Skill in Medicine

Life in 2050: A Glimpse at Medicine in the Future was reported by Matthew S. Williams for InterestingEngineering.com, 4 July 2021.  By 2050, the ways in which we watch our health, seek medical advice, get treatment, and what we’re treated for will change dramatically.

While it is safe to say that more people will be able to live longer, healthier lives in the future, it’s also likely that future generations will face health threats that are less common, or even unknown, today. To break it down, the field of medicine will be impacted by developments in the five following categories:

• • Big data, biometrics, and the internet of things
  • Machine learning, AI, and advanced analytics
  • Climate change and environmental health hazards
  • “Internals,” robotics, nanorobotics, and bionics
    
  • Genetic engineering and bioprinting

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