I was sitting in the dentist's office this afternoon and looking at some tweets, when this one from Manny caught my eye.
It pointed to his page about the news that Smiths-Medical is getting out of the diabetes market and taking the Cozmo insulin pump off the market.
My jaw almost dropped. I've been a happy Cozmo insulin pump user for about 18 months and I had planned to continue using them. Smiths-Medical distributed and supported the Cozmo pump. They announced today their "intent to stop selling the Deltec Cozmo® insulin pump, and manage an orderly, carefully controlled exit from the diabetes business over time."
Smiths-Medical has created a special web page with all the details about this announcement. It also contains answers to a set of frequently asked questions (FAQs). Basically those of us with pumps will be supported until the end of our warranty and Smiths-Medical will continue to provide supplies and support for the Cozmo pump.
As Kerri pointed out in her post on the announcement, this wasn't a big market for Smiths-Medical and it required a large support organization. So perhaps it was inevitable.
I've enjoyed and benefited from the features and flexibility of the Cozmo pump and I'm sorry to see it disappear from the market. We're now left with three main players in the insulin pump market: Minimed Medtronic; Animas; and Insulet Omnipod. I'd really like to see much more competition.
Perhaps some new ideas will happen as a results of Amy's 2009 DiabetesMine™ Design Challenge. I'd sure like to see another choice when it comes to insulin pumps.
I had an interesting conversation last week with Dick Rylander of Enject. We spoke at some length about their product, the GlucaPen, that they hope to have on the market before long. It's a simpler way to give people Glucagon injections.
Glucagon is a hormone that's produced in the pancreas. When it's released by the pancreas it causes the liver to take it's glycogen reserves and convert it into glucose. So it rapidly raises blood sugars levels. In emergencies, the glucagon reserve can be depleted by people who have type 1 diabetes (thanks for the correction from Mr. Sven below). It's a treatment for extremely low blood sugars where food or liquids can't be given. So it's really only used when there's an emergency.
The picture shows a glucagon kit from Eli Lilly. You may notice that the vial on the left contains a white powder. This must be combined with the liquid in the syringe just prior to use. Reconstituted glucagon has a shelf life of up to 48 hours when refrigerated.
So here's how it works. Your loved one is lying on the floor unconscious. You get the glucagon kit (you did put it in a well-known place, didn't you?). Before you can inject the glucagon into them, you need to follow about a half-dozen steps written on the enclosed leaflet. It's really difficult. One paper says the process "requires a manually dexterous operator who is composed, confident and competent in the whole procedure."
Let's look at the GlucaPen approach. Here's a picture of the GlucaPen prototype.
It will be a single unit, slightly longer and larger than an EpiPen. So you easily carry it with you, or pack it for a trip. And there are two simple steps before using it. These are displayed clearly on the side of the pen.
GlucaPen is looking for your opinions, they have a survey that includes a short video of the prototype being used. There's one survey to complete if you're an adult patient with diabetes, and a different one if you are a caregiver for someone with diabetes.
The GlucaPen folks have been developing this for about three years now and hope to have it on the market before too long. I think it's a great example of innovative design to make living with diabetes a bit easier. I'd love to hear any stories you have about using glucagon and whether something like this might make it easier.
Update: The GlucaPen has been entered in the DiabetesMine design contest, so there's now an animated video showing how it works. You can watch this below.
TuDiabetes.com, the social networking site for "People Touched by Diabetes", was started two years ago. It is a very active community with over 7,000 people and it grows at the rate of 15% every month. At this stage, TuDiabetes has members all over the world.
I asked the founder, Manny Hernandez, what most surprised him since he started TuDiabetes. His answer? The number of people with diabetes who have never met anyone else with diabetes and who have no support group of folks with diabetes.
You only need to spend a little time on the TuDiabetes.com site to realize how much support and sharing goes on there are all hours of the day. People have an opportunity to create groups such as Pumping Our Insulin or Diabetes and Women. TuDiabetes also has an events section where members can organize meetups, or let other members know about upcoming diabetes-related events.
I only wish that more people with diabetes knew about this great resource. If you have any friends or family with diabetes, please spread the word and get them to take a look. It might help them really change how they view living with diabetes.
There are two opportunities to meetup with folks in Massachusetts this month. This coming Sunday a group of us will be getting together in Marlboro for a presentation on the Latest and Greatest Diabetes Technologies. Dr. Howard Wolpert of Joslin clinic will be presenting, he's a great speaker and worth hearing.
The following Saturday, ADA is holding a diabetes expo in Boston. It runs from 10 AM to 4 PM, but a group of us is planning to meetup at 2 PM beside the DESA booth and then gather in the food court area.
You may have heard me say this before. If you're nearby to either of these locations I recommend getting to one of the events.
Meeting up with a group of folks with diabetes is uplifting and supportive. We don't get together and complain about our challenges. We do talk about the latest things we've learned and support those of us who are having some issues. It's fun and liberating to sit down to eat and be with others who are pulling out test kits, injecting insulin or playing with the buttons on their pump. If you've never used a pump or a CGM it's a great chance to talk with others who have and learn some of the pros and cons.
The Dexcom SEVEN continuous glucose monitor has been approved for 7 days of use. I usually get 10 to 11 days of use by restarting the sensor after 7 days have elapsed. Your results may vary, so make sure this works for you before relying on it.
Based on the abstract from the Diabetes Care website, it appears that the results on the 10th day are still fairly accurate. Notice how the difference goes down slightly on the 7th day, showing that the Dexcom is more accurate after it's been in place for a few days.
The median absolute relative difference for CGM versus YSI was 12.6, 11.3, and 14.5% on days 2, 7, and 10, respectively (P = 0.63). CGM performed better on day 10 when compared with self-monitoring of blood glucose as compared with YSI.
I expect to see more papers like this before Dexcom applies to the FDA for 10-day use of the sensors. The good news is that this ultimately means less sensors changes will be needed. It also probably means that Dexcom will raises the price of the sensors.
I do hope that before Dexcom takes this move they improve the adhesion of the sensors. Mine usually look like they're falling off by day 9 and they rarely last beyond day 11 because they peel off.
Have you been able to get sensors to stay in place for longer? What tricks have you used to make this work?
Amy Tenderich of DiabetesMine has just announced the start of the 2009 DiabetesMine Design Challenge. This year the grand prize is $10,000. So you can improve the state of diabetes design and win some serious prize money.
The competition is open from tomorrow March 2, 2009, to end of day (PST) on May 1st, 2009. Each entry is judged on three criteria: Relevance; Clinical Efficacy; Aesthetics. You can submit a video or a paper describing your idea. Full details are on the entry page for the competition.
I know we've got got lots of devices that are efficacious (FDA criteria), but with lousy design. This presents a great opportunity to make life easier for everyone with diabetes.
So think about anything diabetes related that's driving you nuts. Have you some way to fix the problem? Or maybe a completely new idea to make it easier to live with diabetes. I can't wait to see what folks come up with.
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.
It pointed to his page about the news that Smiths-Medical is getting out of the diabetes market and taking the Cozmo insulin pump off the market.
I do hope that before Dexcom takes this move they improve the adhesion of the sensors. Mine usually look like they're falling off by day 9 and they rarely last beyond day 11 because they peel off. 
