In this blog I try to focus on new developments in diabetes technology (devices and software). I know there are many readers who are very interested in learning more about what's available and what's coming.
But I realized that there are many folks with diabetes who'd also like to know more about some of the basics in diabetes 'technology'. Maybe learning about testing for foot problems with monofilaments. Or techniques for using an insulin pump more effectively.
Is this a suitable place to write about more of the basics, or are there enough blogs and communities out there that already cover this stuff? I'd be interested in knowing what you think. And I know I can depend on you to let me know.
Maybe this would be a good time for some of the blog lurkers to leave a first time comment, I'd value your opinion.
I got laid off from work on Tuesday. Of course, my first thought is health insurance. Seriously.
Not where I'll get my next job, or how can we afford our house, food, etc. Having a chronic illness really changes my perspective on things that might be challenging when I don't have a job. (It also means I'll never be on programs like Survivor.)
I had to make two additional trips to the office to pick up all my books, I have way too many technical books.
I did get a severance package and I've already signed up for unemployment insurance. We're going to cut back to essentials and we'll can stretch things to the early fall. In this economy that doesn't seem like enough time to land a new job.
If you don't already know, I work as a software designer and developer. I usually focus on user experience, how software feels to the user. It goes beyond how it appears (forms, pages, etc.). But I've been in tough situations before and, if necessary, I'm happy to work at anything that comes along. So if I end up with a job in a hardware store, or washing windows that's fine with me. These are all honorable jobs. I may not be doing what I'm best at, but I'll be keeping out of mischief and making a living.
Please don't feel sorry for us. We're doing just fine. God has blessed us in many, many ways. So we're trusting in him, dusting off our resumes, and starting our search for new jobs.
In the meantime, I'll blog about this transition and how we're doing for a while. So stay tuned.
Dr. Faustman, whose lab is doing research into a possible cure for type 1 diabetes, has a new web site.
The new site design includes information about the current phase 1 clinical trials for the diabetes cure. The support section provides information about organizing an event to support the research work. And the news section lets you read all of the newsletters produced by the lab.
Dr. Faustman plans to start phase II trials later this year. To support this work we need to raise $25 million. You can now donate directly to this work from another part of the support section of the site.
The new layout makes it much easier to read all the current information about Dr. Faustman's research. Now all we have to do is wait for more news about the progress!
You may have noticed that the FDA isn't doing a great job approving new diabetes treatments and diabetes technology.
This isn't accidental, they are tightening requirements in a way that make it much harder to get FDA approval for new diabetes treatments.
With our new president later this month comes a change of FDA leadership. It's an ideal time to try and work to get changes in the FDA.
We've created an online petition and we're asking you to sign. You do not need to have diabetes to sign, so please pass the word on to family and friends.
Amy Tenderich has posted some quotes from Rebecca Killion on the FDA changes. Rebecca is a patient representative on the FDA advisory committee for diabetes related drug.
We, the undersigned, appeal to the leadership of the U.S. Food and Drug Administration (FDA) to reduce barriers to innovation in diabetes treatment development, in the interest of public health.
The FDA's job is to protect the safety of patients in its use of drugs and medical devices and to advance public health by speeding innovations that make medicines and technology more effective, safer and more affordable. That is its mission.
But we believe the FDA has adopted a stance of excessive caution in its regulation of diabetes drugs and technology that is counter to its duty to serve patient needs.
Specifically, it has established new rules that will impair research and innovation into diabetes therapy. (A copy of the letter sent to manufacturers in November 2008 can be found at http://www.diatribe.us/fdaletter (PDF).)
This worries us. For example, new requirements for additional multi-year long-term outcome studies prior to approval for drugs with no cardiovascular signals will assuredly discourage research and innovation to the detriment of public health.
The need for improved treatments for the 24 million Americans with diabetes could not be clearer. Many of the drugs available now have tolerability issues [1]. Poorly controlled diabetes increases the risk of devastating long-term complications, including blindness, end-stage renal disease, amputation, and heart disease. Complications cost our country at least $58 billion per year [2] -over twice what is spent on technology and therapy annually [3].
Nearly 50 percent of patients in the US do not meet A1c goals [4] using current therapies and technologies. No therapy today stops diabetes from advancing. As patients are living longer with diabetes and therapies stop working, the need for new therapies increases. We need better technology and drugs that help slow or avoid long-term complications as well as more therapies that cause fewer side effects1 and last longer. And, despite the epidemic in the number of diabetic patients, no drugs are yet available that can prevent diabetes. Innovative, safe, and effective prevention is the key for people at risk and for cost savings to society.
Ironically, excessive regulatory hurdles ensure the continued use of the very drugs and devices that have proven ineffective for many patients.
There is no value in an ideal diabetes drug or device if the regulatory costs are so great that the product never makes it to market. Make rules reasonable.
Due to the very nature of the severity and prevalence of diabetes, the following leaders within the diabetes community, who have signed this petition, implore the FDA for the immediate creation of a Diabetes Advisory Council, whose goal would be to improve options for patients. This council would include practicing endocrinologists, diabetes educators and others communicating directly with patients. Our experience, focus, and keen awareness of the needs of the diabetes community would be an invaluable resource to the FDA as it faces the arduous process1 of evaluating new diabetes treatments. Our aim is to improve options for patients.
We urge the new FDA leadership to recognize the urgent need for more safe and effective treatment options for diabetes and to reduce barriers to innovation. More treatment options will benefit patients. The disease is progressive. Delays in the availability of new treatments will only result in tremendous cost to public health and the economy. Our recommendation can benefit patients without sacrificing their safety.
Pleasesign this petition and tell others about it. Make your voice heard!
Petition sponsors: Kelly Close: Editor, diaTribe Manny Hernandez: President, Diabetes Hands Foundation; Founder, TuDiabetes Amy Tenderich: Creator and Author, DiabetesMine Allison Blass: Author, Lemonade Life Jennifer Block, CDE: Stanford Medical Center, Stanford University Nancy Bohannon, MD: Director of Clinical Research, CVD Risk Reduction Program, St. Luke's Hospital, San Francisco Bruce Buckingham, MD: Professor of Pediatric Endocrinology, Stanford University Stead Burwell: CEO, Alliance Health Networks, Inc. Priscilla Call Essert: Author, My Life As A Pancreas Gina Capone: Co-Founder, the Diabetes Talkfest Blog Fran Carpentier: Author Diabetes, Day-By-Day on Parade.com Kitty Castellini: Founder, CEO, Producer and Host, Diabetes Living Today - Talk Radio David Edelman: Co-Founder, Diabetes Daily Steve Edelman, MD: Professor of Medicine, University of California, San Diego; Founder, Taking Control of Your Diabetes Bernard Farrell: Author, the Diabetes Technology Blog James S. Hirsch: Author, Cheating Destiny Irl B. Hirsch, MD: Professor of Medicine, University of Washington Lois Jovanovic, MD: CEO and Chief Scientific Officer, Sansum Diabetes Research Institute Francine R. Kaufman, MD: Professor of Pediatrics, Keck School of Medicine, USC; Head, Center for Diabetes, Endocrinology and Metabolism, Childrens Hospital Los Angeles; former ADA President Tom Karlya: Author, Diabetes Dad Rebecca Killion: Diabetes advocate David Mendosa: Diabetes Journalist Kerri Morrone Sparling: Author, Six Until Me Jenny Ruhl: Author, Blood Sugar 101 Lisa Shenson: Diabetes Parent & Advocate Scott Strumello: Author, Scott's Web Log Virginia Valentine, CNS, BC-ADM, CDE, CEO, Diabetes Network, Inc. Albuquerque, New Mexico
Notes: [1] "Glycemic Durability of Rosiglitizone, Metformin, or Glyburide Therapy," New England Journal of Medicine, December 7, 2006. ADOPT, a four-year clinical trial of over 4,000 patients, was designed to test the how long diabetes therapies last. In this trial, 23% of those on sulfonylureas (SFUs) and 38% of those on metformin experienced nausea, diarrhea and/or vomiting from taking the drugs. 10% of those on TZDs, 11% on metformin, and 39% on SFUs experienced hypoglycemia. 7% and 14% of those on TZDs experienced weight gain and edema. 12% on women on TZDs experienced fractures. The trial also found that within five years of starting therapy, 15% of those on rosiglitizone (TZD), 21% on metformin, and 34% on glyburide (a sulfonylurea [SFU]) had fasting blood glucose over 180 (~ roughly equivalent to an 8% A1c), suggesting that even if patients could tolerate the therapy, it wouldn't last longer than a few years for many.
[2] "Economic Costs of Diabetes in the US in 2007," Diabetes Care, March 2008, page 13.
[3] "Economic Costs of Diabetes in the US in 2007," Diabetes Care, March 2008, page 13.
[4] "Is Glycemic Control Improving in US Adults?," Diabetes Care, January 2008, page 81.
My shoulder has been killing me for the last few days. So far stretching exercises haven't helped all that much.
No problem you say, take a pain killer. That would work except...I'm allergic to everything except acetaminophen. And that causes my Dexcom readings to go haywire.
Within 20 minutes of a dose of acetaminophen (generic form of Tylenol), the Dexcom receiver reports super high readings. Quickly up to 400 and then into HIGH. That continues for about 6 hours in my case. And there's a long list of drugs that contain acetaminophen.
This is because acetaminophen changes the reaction that is used by the sensor to measure glucose values in interstitial fluid.
So I take my tablets and put the receiver far away from me for 6 hours or so.
How can I tell when it's safe to use it again? I carry it around for a few minutes and see if it's still reporting off the wall values. If so, I put it away again.
It's frustrating. If I keep it with me for the duration the high values throw off the statistics reported in the Dexcom software.
I've asked them to change the software so I can mark a set of readings as invalid. I think this is a relatively small software change. That way I can continue to use the receiver and my statistics won't be affected by 6+ hours of values over 400 mg/dL.
If you're having the same problem, do please call Dexcom customer support at 1-877-Dexcom4 (1-877-339-2664) and let them know. Maybe we can influence them to make this fix.
Note: I currently own shares in Dexcom, I work not to let this influence what I say about the company or its products.
I picked up the mail today and opened a letter from my wonderful endo (Dr. Elizabeth Spatola of St. Joseph's in Nashua NH).
Inside it was the latest A1C test and (....drumroll....) my A1c is 6.6%
For me this is the lowest value I've ever had, and I'm more thankful than I can say.
In 2009, I'd like to keep my A1C at around 6.6% for the year. I'm grateful that I can use technology (insulin pump, Dexcom CGM) and rely on many people at TuDiabetes and the entire Diabetes OC (online community) for support and advice. Without all my friends in the d-blogosphere, I think living with diabetes would be a lot harder.
In 2009 may your blood sugars be steady and your diabetes frustrations be few.
For all of us I hope to see some exciting diabetes research development in the next 12 months.
The Diabetes Technology Blog is focused on using technology to life better with diabetes. I review: blood glucose monitors; continuous glucose monitor; blood sugar meters; diabetes software and living with diabetes.
About Me
Name: Bernard Farrell
Location: Massachusetts, United States
I was born in Ireland and now live in the US.
I have had Type 1 diabetes for over 36 years. I struggle with my blood sugar, the same as most people with diabetes.
I wear a Cozmo 1800 insulin pump and a Dexcom SEVEN CGM to track my blood glucose levels.
I'm blessed by God, and every day brings the possibility of a cure.
