Matching Patients to Devices: Diabetes Products Are Not One-Size-Fits-All Gary Scheiner, MS, CDE Think about the last time you went to buy a new car. Did the dealer tell you, “This is the car we sell, so this is what you get”? Or, did he or she ask about your needs—size, style, price range, features—and try to find you a good match? If the dealer wanted to keep you as a customer, he or she surely took the latter approach.
Now think about medical devices for your patients with diabetes. Doesn't this deserve some thought as well? After all, we are not talking about a car; we are talking about equipment needed to maintain health and, perhaps, sustain life. Just as certain types of cars are better suited for certain people, some blood glucose meters, insulin pumps, pen devices, and continuous glucose monitors are better matches for certain patients. Recommending the same medical device to everyone who walks into your office does a disservice to your patients and may set you up for poorer clinical outcomes and time wasted on troubleshooting.
The following is a discussion of the features of various diabetes management devices, the advantages they offer, and the types of patients who are most likely to benefit from them....
Global Call for Free Academic Movement for International Dialogue Itamar Raz, MD1, Stephanie A. Amiel, FRCP2, George Alberti, FRCP3, Naim Shehadeh, MD4, Stefano Del Prato, MD5, Paul Zimmet, MD, PHD6 and William T. Cefalu, MD7 + Author Affiliations
From the 1Diabetes Unit, Hadassah University Hospital, Jerusalem, Israel; 2King’s College London, London, U.K.; 3King’s College Hospital NHS Foundation Trust, Denmark Hill, London, U.K.; the 4Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel; the 5Section of Diabetes, University of Pisa, Pisa, Italy; 6Melbourne, Australia; and the 7Joint Program on Diabetes, Endocrinology and Metabolism, Pennington Biomedical Research Center, Louisiana State University (LSU) System, Baton Rouge, Louisiana, and LSU Health Sciences Center School of Medicine, New Orleans, Louisiana Corresponding author: William T. Cefalu, email@example.com. The recent meeting of the International Diabetes Federation (IDF), the World Diabetes Congress 2011, took place in Dubai in December 2011. The fact that Dubai was chosen as the venue for this international congress became controversial because it was perceived by some prospective attendees that it might limit participation based on nationality or religion as a result of strict entry laws and/or fear for the security of some participants....
Xeris Pharmaceuticals Awarded Phase I-II NIH SBIR Fast Track Grant to Advance Stable, Non-Aqueous Glucagon for Bi-Hormonal Artificial Pancreas
Austin, TX, Jul 31, 2012 (GlobeNewswire via COMTEX) -- Xeris Pharmaceuticals, Inc. ("Xeris"), an Austin-based, emerging biopharmaceutical company developing patient-friendly injectable treatments for diabetes and other diseases, was awarded a Small Business Innovation Research (SBIR) Phase I grant for $336,793 to advance the company's room-temperature stable, non-aqueous glucagon formulation for the advancement of a bi-hormonal pump artificial pancreas. The funding represents the initial installment of a Phase I-II Fast Track SBIR grant, with the potential for a total award of $1.05 million with additional Phase II funding. The grant was awarded on July 30 by the National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), an institute of the National Institutes of Health (NIH) which funds research on diabetes and other metabolic diseases....
July 30, 2012 (WPVI) -- My daughter just finished her camp at Gloucester County College and I got teary eyed when I met her counselor.
I was nervous about enrolling her in a mainstream camp because of some special needs. It was the first time that she was out of the house all day without someone trained to deal with her Type 1 Diabetes.
The first day of camp, we went over all of my daughter's needs and the contents of her medical bag. We also briefed the counselors on how to handle an emergency. They were attentive and asked excellent questions, which lead us to feel comfortable leaving her......
A gift of insulin, A Delhi project seeks to help underprivileged children suffering from type I diabetes, Business of Life......
Currently the DDF has a one-year cap on the programme; it’s looking for more sponsors and donors to keep the programme going. “Besides cost, there are many challenges for acceptance of insulin therapy,” says Dr Wangnoo. “Lack of education regarding the benefits of insulin therapy, social stigmas and the oft repeated notion (which of course is absolutely false) that insulin is the last stage of treatment are the issues we grapple with all the time. This is where diabetes education comes in handy. DDF works hard in this field too.”
“But even small achievements help us take the work forward and tell us that we are on the right track,” says Dr Wangnoo.
...Conclusions: We demonstrated that pancreatic islets successfully engrafted and functioned in the isolated venous sac with ability to restore euglycemia in diabetic rats. Therefore, the isolated venous sac offers a new site for transplantation of pancreatic islets. This would be clinically beneficial as an alternative to intrahepatic islet transplantation.
....A 25-year-old Bangladeshi woman with type 1 diabetes gave birth to a baby girl. The mother had been on insulin for more than 20 years with inadequate glycemic control but never ketoacidosis. The baby was small for gestational age (2.4 kg, <3%). On day 2 of her life, the baby was noted to be increasingly hyperglycemic, reaching 312 mg/dL by day 7. Given the clinical suspicion for ND, a trial of glyburide was initiated at 0.45 mg/kg/day, and the baby responded well. The dose of glyburide was titrated to achieve normal serum glucose (0.02 mg/kg/day).....
...Why would anyone want to hack into a medical device, anyway?
I put the question to Jerome Radcliffe, a security researcher and Type 1 diabetic who famously jammed his own insulin pump during a Black Hat security conference presentation last year in order to demonstrate the system’s vulnerabilities.
“Fifteen years ago, people asked who would ever want to break into a computer. Now it happens every second of every day,” he said in a telephone interview. “We see situations where computer systems and accounts are taken hostage in blackmail scenarios. I think that can happen in a hospital.”...
“Diabetic” and “Noncompliant Diabetic”: Terms That Need to Disappear Kyle R. Peters, PharmD “Dr. Johnson, I have roomed your patients. Mr. Jones is a new diabetic in room 1; Mr. Smith, the noncompliant diabetic, is in room 2; and Mrs. Anderson, the gestational diabetic is in room 3. This morning's schedule is filled with diabetics.”
How many of you are gritting your teeth after reading this scenario? Hopefully, all of you; it was painful even writing it. When referring to people with diabetes, we should stop using the labels “diabetic” and “noncompliant diabetic.” These terms expose our ignorance to the management of diabetes and allow us an excuse when patients are not achieving their heath outcome goals.
Nonnutritive Sweeteners: Current Use and Health Perspectives A Scientific Statement from the American Heart Association and the American Diabetes Association Christopher Gardner, PHD, Chair, Judith Wylie-Rosett, EDD, RD, Co-Chair, Samuel S. Gidding, MD, FAHA, Lyn M. Steffen, PHD, MPH, RD, FAHA, Rachel K. Johnson, PHD, MPH, RD, Diane Reader, RD, CDE, Alice H. Lichtenstein, DSC, FAHA and on behalf of the American Heart Association Nutrition Committee of the Council on Nutrition, Physical Activity and Metabolism, Council on Arteriosclerosis, Thrombosis and Vascular Biology, Council on Cardiovascular Disease in the Young, and the American Diabetes Association A 2009 American Heart Association scientific statement titled “Dietary Sugars Intake and Cardiovascular Health” (1) concluded that current intake of added sugars among Americans greatly exceeds discretionary calorie allowances based on the 2005 U.S. Dietary Guidelines (2). For this reason, the American Heart Association Nutrition Committee recommended population-wide reductions in added sugars intake. The present statement from the American Heart Association and the American Diabetes Association addresses the potential role of nonnutritive sweeteners (NNS) in helping Americans to adhere to this recommendation in the context of current usage and health perspectives....
...CONCLUSIONS Contemporary transition practices may help prevent gaps between pediatric and adult care but do not appear to promote improvements in A1C. More robust preparation strategies and handoffs between pediatric and adult care should be evaluated.
....Once I was fast asleep when my Medtronic pump malfunctioned and stopped delivering insulin. It also failed to sound an alarm to let me know that it had stopped working. When I woke five hours later, I was already in full blown ketoacidosis and was rushed to the ER. I ended up staying in the ICU for three days while my levels were re-adjusted. I notified Medtronic of the malfunction, and they promptly sent me a replacement pump.
A few months later, now using the new Medtronic, I was working at my office desk when my pump malfunctioned again. Once again, it didn't sound an alarm that it wasn't delivering insulin. This time, however, I could feel my glucose levels rising. Because I was awake, I was able to test my glucose on my meter and notice the steady increase as time went by.....
An extreme snowboarder and an English literature graduate, both of whom have type 1 diabetes, are among the team of bloggers Bayer has assembled for its new UK blog.
They will contribue to the Bayer Diabetes Care blog, details of which can be found in the Digital Handbook’s Pharma Social Media Directory.
Bayer Diabetes Care, which markets a range of blood glucose meters including the Nintendo-compatible Diget, said its blog would include perspectives from its newly-formed BDC panel.
This group comprises healthcare professionals and people with diabetes that Bayer has recruited – and will pay – to provide blog content and comments.
They include professional snowboarder Chris Southwell and English literature graduate and ‘self-confessed rebel’ Lara Wahab, who both have type 1 diabetes, in common with all the BDC patient representatives....
I have Celiac Sprue so I have been truly gluten-free for over a decade now. The following article chronicles the TWO years it took me to figure out that I had celiac disease.
Looking back over those two years I think I appeared a healthy, fit and energetic person. I am known among my friends and family for my dedicated fitness routine and healthy eating. However, I was struggling in the worst way. What no one knew at that time, including me, was that my immune system was attacking my own body. I was seriously ill and getting worse every day.
My illness started with the types of symptoms that you try to ignore. In the beginning, all of my symptoms seemed pretty typical and they were easy to mask. I experienced excessive tiredness in the afternoons, extreme hunger all of the time, but “bloated” every time I ate and experienced intense stomach cramping after every meal. All of these seemed like common problems that others faced. I mean, aren’t all of us tired after lunch and hungry at times? As we get older, don’t we think that we have a potbelly?
My story begins in the fall of 2010, as I purchased my first home and started a new position at work. At this time, I was completely unaware I was on the verge of becoming diagnosed with type 1 diabetes. It wasn’t until I participated in a local health fair sponsored by our hospital that I received a report saying I had a high glucose level (300-400 mg/dl). It was suggested I make an appointment with a doctor, which I did. Further testing concluded I indeed had diabetes.
I sought a second opinion from a specialist, as I was in denial that this could be happening to me. Before my appointment, I researched a lot of information and was still under the hope the previous evaluations were incorrect.
The doctor and I reviewed the symptoms, to which I reported I didn’t recall experiencing. The only indication that I could see was my recent unexplained weight loss of 25 pounds. However, I thought this was just due to my increased exercise routine of being a cyclist and runner. It wasn’t until my follow-up appointment with the endocrinologist that reality set in. My blood tests were again positive for type 1 diabetes....
....Findings highlight a need for improved conceptualization and measurement of distress in individuals with diabetes to distinguish between symptoms caused by illness burden and those indicating a psychiatric disorder.
iabetic patients experience disproportionately high rates of depression, distress, and other psychosocial difficulties (1) that interfere with glycemia and self-care (2). Physicians recognize the frequency and seriousness of patients’ emotional struggles (3,4); however, many report that intervening is challenging because of limited treatment options, time constraints, and perceived lack of psychological expertise (4). Diabetes physicians may not feel comfortable or qualified to assess patients’ emotional difficulties because they have not received formal training in screening for these difficulties and do not have the resources/referral patterns necessary to provide patients with psychological support (4). Inquiring about patients’ preferences for addressing emotional struggles may help guide physicians in providing better support and treatment. As part of a larger qualitative study (4), we conducted in-depth interviews to explore patients’ perspectives about how their diabetes physicians approach emotional struggles during a medical visit....
BEDFORD, MA, Jul 27, 2012 (MARKETWIRE via COMTEX) -- Insulet Corporation PODD +3.57% , the leader in tubeless insulin pump technology with its OmniPod(R) Insulin Management System, announced plans to release its financial results for the second quarter of 2012 on August 8, 2012 after the close of the financial markets.
Insulet will also host a conference call at 5:00 p.m. Eastern Time on August 8, 2012 to discuss its second quarter financial results. During the conference call, material information concerning the Company, its operations, strategies and prospects may be discussed.
To listen to the conference call, please dial (877) 831-5664 for domestic callers and (832) 412-1780 for international callers. The passcode is 15001228. A replay of the conference call will be available two hours after the completion of the call through August 15, 2012 by dialing (855) 859-2056 (domestic) and (404) 537-3406 (international), passcode 15001228. An online archive of the conference call will also be available by accessing the Investor Information section of the company's website at http://investors.insulet.com .
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