Savvy Updates, 9/13/21: Dexcom Follow App Research, Non-invasive BG Monitoring, FDA & Dietary Supplements, Melatonin & Sleep, diaTribe Musings

PARTICIPANTS NEEDED FOR RESEARCH SURVEY from the University of Utah College of Nursing

T1Ds over 60 years of age or older
who use Dexcom CGM (any version)
who use or have used the Dexcom Follow app

I’ve lived with T1D for over 56 years and am are volunteering with Dr. Nancy Allen of the University of Utah on a research project about T1Ds over the age of 60 and the Dexcom CGM app … to be funded by NIH (National Institutes of Health). It’s a fast, easy survey … should take no more than 5 minutes … no personal information is needed. PLEASE share this survey with any T1D who is 60+ years old and a user of Dexcom products!

The interesting goal is to understand and share etiquette for better communications between CGM users and those who “follow” your app … what they should and shouldn’t say or do, trying to understand what works well, what is annoying or offensive. Totally new realm of research as the aging T1D population is growing fast.

From Dr. Nancy Allen:

We are developing programs to meet the needs of older adults with type 1 diabetes.

Please consider completing this survey that will inform us about your experiences using the continuous glucose monitor with the Dexcom Follow app to share your glucose data with a family member or friend.

You will not be asked for any identifying questions in this survey and this data will only help us to build an intervention to help you and your family/friends to use this technology as you grow older (or rather more experienced!) with diabetes.

Nancy A. Allen PhD, Adult Nurse Practitioner

Co-Chair of the Diversity Equity, Inclusion and Outreach Committee

Associate Professor, University of Utah College of Nursing

https://redcap01.brisc.utah.edu/ccts/redcap/surveys/?s=34NPJFJLAHYMKJHX

A Review: Products for Monitoring Glucose Levels in the Human Body with Noninvasive Optical, Noninvasive Fluid Sampling, or Minimally Invasive Technologies was published in the Journal of Diabetes Science and Technology, via the Diabetes Technology Society, 2021.

Based on favorable technological features, consumer features, and other advantages, several bloodless products are commercially available and promise to enhance diabetes management. Paths for future products are discussed with an emphasis on understanding existing barriers related to both technical and non-technical issues

FDA, FTC issue warnings for dietary supplements claiming to treat diabetes was reported on Healio.com/endocrinology, 10 September 2021.

The FDA and the Federal Trade Commission issued warning letters to 10 companies that market unapproved supplements to treat diabetes and urged consumers not to use the products, which may be harmful.

The warning letters, posted Sept. 9, were issued to the following companies: Live Good Inc.; Pharmaganics LLC; Lysulin Inc.; Nuturna International LLC; Phytage Labs; Ar-Rahmah Pharm LLC; Metamune Inc.; Holistic Healer & Wellness Center Inc.; Radhanite LLC; and Aceva LLC. The letters claim the companies are illegally selling dietary supplements that claim to cure, treat, mitigate or prevent diabetes, in violation of the Federal Food, Drug and Cosmetic Act. In an announcement, the FDA is urging consumers not to use these or similar products because they have not been evaluated by the FDA to be safe or effective for their intended use and may be harmful.

“Dietary supplements that make fraudulent claims to treat diabetes are unapproved new drugs that could potentially harm consumers who use these products instead of seeking safe and effective FDA-approved treatments,” Cara Welch, PhD, acting director of the Office of Dietary Supplement Programs in the FDA’s Center for Food Safety and Applied Nutrition, said in a press release. “The FDA is committed to protecting U.S. consumers from products and companies that make unlawful claims to treat or prevent diabetes, and we’ll continue to hold companies accountable by alerting the public about products that place consumers at risk.”

Closed loops and eyes. What are the potential links? was posted by Tim Street of Diabettech.com, 9 August 2021.

As soon as you start on commercial APS systems with targets around 100-110, it’s going to do its damnedest to ensure that it maintains glucose levels at these numbers. The question for me here (and others) is “How fast will someone’s glucose levels drop once they start using a commercial system?”.

Why is this important? Well, if the population that is using these systems fall into those with higher HbA1c levels, we know that a rapid drop in HbA1c can cause significant issues to the eyes. In fact, it stipulates that a >2% reduction in HbA1c is a major risk factor. Where these systems may well work for those who have previously struggled to maintain lower glucose levels, why don’t they allow for a slower reduction in average glucose levels? We know that the lower limit was imposed to meet FDA concerns about hypos, and the costs of trials, but surely higher limits should therefore not be an issue?

Wouldn’t it make sense to set these systems up to limit the possibility of known effects of rapid glucose level drops from the word “go” rather than wait for epidemiological data and wider population trials to see if anything happens? Or is that an issue with the initial clinical trials that were undertaken where the participants all started with relatively low values for HbA1c?

Melatonin safe sleep aid for adults with metabolic diseases was reported on Healio.com/endocrinology, 26 August 2021.

Melatonin may be a safe sleep aid for people with metabolic diseases and for healthy adults, and data suggest a beneficial glucose effect, according to findings published in Clinical Endocrinology.

“Melatonin treatment does not significantly affect fasting plasma glucose levels in a pooled analysis of 603 healthy adults and patients with glucose-metabolic diseases,” Esben Stistrup Lauritzen, MD, a doctoral student at the Steno Diabetes Center and Aarhus University Hospital, Denmark, and colleagues wrote. “Likewise, a subgroup analysis with healthy participants in one group and patients with glucose-metabolic diseases in another group revealed that melatonin treatment did not affect fasting glucose levels in either group. Interestingly, fasting insulin levels were significantly reduced in the 278 individuals included, although the effect was small. Furthermore, the insulin sensitivity and BMI trended to improve with melatonin treatment.”

A friend/follower of The Savvy Diabetic sent this re melatonin and blood pressure: Melatonin in chronic kidney disease {thanks so much, Suzie}

diaTribe Musings – Diabetes Data: A Roadmap to Better Management was presented by diaTribe.org, 7 September 2021.

The last five years have generated more data from people living with diabetes than the prior fifty. This explosion of data is driving changes in everything from personal behavior to therapy and technology, transforming the landscape of diabetes care. Data is no longer mainly for engineers and researchers, it’s a tool all of us use every day! How we use and produce data has transformed modern life living and working with diabetes, in both obvious and hidden ways. Many are working with this data, developing new ways for improving diabetes care. From patients interpreting their basic glucose monitoring data and using more advanced glucose profiles that contextualize A1c, to global data efforts that seek to expand life-saving care over diverse and disparate populations, this data revolution is changing how we think about and treat diabetes in big and small ways.

Our highly-regarded speakers are Chris Boulton, Head of Diabetes, Sanofi; Jeff Dachis, CEO and Founder, One Drop; Holly McGarraugh, Principal, McGarraugh Consulting; and David Price, MD, Vice President of Medical Affairs, Dexcom. The panel is moderated by diaTribe Founder Kelly Close.