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Diabetes Connections with Stacey Simms Type 1 Diabetes
6 minutes | Dec 3, 2021
In the News.. oral insulin tested for T1D, FDA looks at new tubeless pump, Bigfoot Clinic Hub & more!
It's "In the News..." the only diabetes newscast. Top stories this week include: #T1D oral insulin study moves ahead, FDA gives breakthrough designation to new SIGI tubeless pump, study shines light on PBM profits, China demands huge drop in insulin prices and Bigfoot Biomedical launches their Clinic Hub -- Join us LIVE every Wednesday at 4:30pm EST Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Episode transcription below: Click here for iPhone Click here for Android Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I’m going to link up my sources in the Facebook comments – where we are live – we are also Live on YouTube and in the show notes at d-c dot com when this airs as a podcast.. XX In the News is brought to you by The World’s Worst Diabetes Mom, Real life stories of raising a child with diabetes. Winner of the American Book Fest Prize for best new non-fiction. Available in paperback, on Kindle or as an audio book – all at Amazon.com. You can also get a big discount right now at diabetes-connections.com – use promo code celebrate to save $4 XX Our top story this week.. More good news for mice.. and maybe some day for people. Yale researchers are looking at an oral medication for type 1 diabetes. These lucky mice had metabolic function restored and inflammation reversed. There are a lot of studies going on to make oral insulin work – liquid insulin is destroyed in the stomach before it hits the bloodstream. This research involves a nanoparticle drug vehicle that can not only bring insulin to the pancreas safely, but the casing itself has therapeutic benefits. It’s made out of an acid that seems to reduce the rogue immune cells that destroy the beta cells in the first place. The team says that the nanoparticles could also be used to carry other molecules, which could help with other conditions. https://newatlas.com/medical/oral-insulin-pill-prevents-type-1-diabetes/ XX A new tubeless pump is making its way through the US regulatory process. The FDA gives breakthrough device designation to AMF Medical’s Sigi (SIG-ee) Insulin Management System. This is a patch pump, like Omnipod, but it’s rechargeable and re-usable – you get two so you don’t have to go without while it’s charging. It’s also an ACE pump, that’s alternate control enabled which means it can interact with CGMs and controller devices like smartphones. This designation isn’t FDA approval, but it should speed up the review. In the press release the company says, “Clinical study data has shown that Sigi™ is delightfully easy to use.” Which is kind of a nice thing to see in a write up like this. https://sigipump.com/amf-medical-receives-fda-breakthrough-device-designation-nbspfor-its-sigi-insulin-management-system/ XX Big news from the UK this week – they announced everyone in England with type 1 will be eligible for CGMs covered by the National Health Service there. This was preceeded by coverage for the Libre flash glucose monitor. That program was supposed to start at 20% but almost 50% of people with type 1 have opted in and the results in terms of better health and lower a1cs have really been outstanding. Next up, leaders there say they want CGM covered for anyone using insulin, regardless of diabetes type. https://pharmaceutical-journal.com/article/news/nice-proposes-wider-use-of-glucose-monitoring-devices-for-type-1-diabetes XX New research into insulin pricing is shining a light on the middle men.. many of us have known about PBMs for a long time. Researchers at USC found that drugmakers’ share of revenue from insulin sales has dropped in recent years — and a greater share is being siphoned off by pharmacy benefit managers, drugstores, wholesalers and insurers. In 2014, 30% of insulin revenue went to PBMs. By 2018, those same middlemen were receiving 53%. Terrific write up as usual by David Lazurs in the LA Times – he lives with type 1 and I always love his stuff. I’ll link this one up. The researchers here say since the PBMs are getting a greater share, there’s pressure on the drug’s manufacturers to keep raising prices so their own profits don’t suffer. It’s worth noting that these findings were possible because of newer state laws bringing greater transparency to insulin sales. https://www.latimes.com/business/story/2021-11-30/lazarus-healthcare-insulin-prices XX What works to bring down the price of insulin? Ask China. They decided a round of price cuts is due and as a result, 42 insulin products from companies in China and abroad took an average 48% price drop. Otherwise, they wouldn’t have been used in that country’s public hospitals. Lilly gave up the largest discount: After a 75% reduction, the price of Humalog went down to about $3 per pen. China has been making pharma cut prices for the last few years for other medications. This is the first time insulin has really been affected. https://www.fiercepharma.com/pharma-asia/novo-nordisk-sanofi-eli-lilly-cut-insulin-price-china-s-latest-vbp-off-patent-drugs XX Bigfoot releases some information and reaction to their Clinic Hub. This is how endos and clinics use the data from the Bigfoot Unity System to support patients. Unity launched this summer – it’s their smart pen program. When you think about multiple daily injections whether it’s for type 1 or type 2.. it’s hard for health care providers to see what’s going on day to day.. are doses correct, when they’re giving, etc. Unity can also include CGM data. This is the launch phase of Clinic Hub.. Bigfoot says they’ve also added streamlined patient onboarding and more flexibility for patient updates and prescription management. https://www.drugdeliverybusiness.com/bigfoot-biomedical-touts-cloud-based-program-for-managing-diabetes/ XX I’m including the Vertex news here.. we reported this back in October but you probably had everyone you know send you that New York Times article about a cure for type 1 – at least in one guy.. I won’t rehash everything here.. it’s about stem cells, one patient off insulin but on immunosuppressive drugs.. Personally, I’m very hopeful, but the Times write up overly simplified a lot of this, in my opinion. Good write up in Healthline that I’ll link to. https://www.healthline.com/diabetesmine/vertex-type-1-diabetes-research XX In the UK lots of attention on their Strictly Come Dancing competition… when it became apparent contestant Nikita Kuzmin wasn’t hiding the Libra glucose monitor on his arm. He wasn’t hiding much.. he took off his shirt for this performance. Loads of social media comments applauding him.. for both. By the way, his dance partner, Tilly Ramsey is the daughter of professional chef Gordon Ramsey.. and they were eliminated from the show this round. https://www.express.co.uk/life-style/health/1528577/strictly-come-dancing-nikita-kuzmin-health-diabetes-type-1-symptoms -- quick reminder that the podcast this week is with the UK co-lead on diabetes, Dr Partha Kar. We had a great chat about access and their Libre program and his whole philosophy.. really fun episode. Next week you’ll hear from the folks at ConvaTec, they make almost all the pump insets and they have some great info for us all. you can listen to wherever you get your podcasts or if you’re listening to this as on a podcast app, just go back an episode. That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
53 minutes | Nov 30, 2021
Type 1 Diabetes & Evidence-Based Hope
Is the news about diabetes better than many of us believe? A deeper look into some important studies with two leaders in the diabetes community. Join the Diabetes Connections Facebook Group! Dr. Bill Polonsky of the Behavioral Diabetes Institute and Dr. Steve Edelman, founder of TCOYD and an endocrinologist who lives with type 1, join Stacey to talk about how to go through the evidence that’s sort of hiding in plain sight.. to live well with diabetes. Sign up for our newsletter here Tell me something good: a young woman’s letter to a major clothing company sparks a change – it’s all about the pockets. Thanks to Athleta for a new product! This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. More about the DCCT Trial More about the EDIC Trial ----- 00:00 Show open: what's on this week? 1:15 Stacey welcome: 250 shows! Check out our search page and browse by subject or keyword 5:00 Interview with Drs. Polonsky & Edelman 48:30 TMSG: new sweatshirt from Athleta inspired by a teen with type 1 52:00 You can still pre-order Stacey's book. Available everywhere in just a few weeks! ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android
33 minutes | Nov 30, 2021
Think big (and don't be an idiot) - Dr. Partha Kar on the future of diabetes care
When you have a national lead on diabetes who really seems to listen to patients and delivers on some big ideas, you get our attention. Dr. Partha Kar is the diabetes co-lead of NHS England. We talk about access, getting more out of your doctor’s visits and what he sees in the future of diabetes tech. Dr. Kar's announcement (after our interview was taped) that CGM or Flash Glucose Monitoring will be available to all people in England with type 1 diabetes This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode Transcription Below: Stacey Simms 0:00 Diabetes Connections is brought to you by. Dario Health – Manage your blood glucose levels. Increase your possibilities. By Gvoke HypoPen, the first pre-mixed autoinjector for very low blood sugar. And By Dexcom. Take control of your diabetes and live life to the fullest with Dexcom This is Diabetes Connections with Stacey Simms.\ This week when you're a national leader on diabetes, and you really seem to listen to patients and you deliver on some big ideas, you get our attention. Dr. Partha Kar says it shouldn't be that unusual. Partha Kar 0:39 And I also feel that clinicians sometimes believe that people living with type 1 diabetes won't be able to handle the truth, so to speak, oh, you can't tell them when you can. They're all adults are surrounded by adults, and they deal with tough calls in their lives all the time. You know, Stacey Simms 0:57 Dr. Kar is the diabetes co-lead of NHS England. Yes, this is a US centric show. But I've followed him on social media for a long time. And I've loved what he has to say. We'll talk about access, getting more out of your doctor's visits, and what he sees in the future of diabetes tech. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show, I am your host, Stacey Sims, and we aim to educate and inspire about diabetes with a focus on people who use insulin. If you're part of our mostly American audience, I hope you had a really good Thanksgiving, I hope the travel was safe. If you had to go anywhere, I hope the food was great. And I hope the family was okay to really hope you had a great holiday. If you're part of our international audience, which is still pretty big, I would expect it to be bigger this week, just because of who we're talking to. And that is Dr. Partha Kar, national specialty advisor for diabetes with NHS England. And this is one of those times where I just was interested to see what somebody had to say, as I mentioned in that the opening teaser, I followed him online for quite a while. And I thought you might be interested as well. And boy, when I put it in the Facebook group, you all were thrilled. So I hope you enjoy the interview. He didn't have a ton of time to talk to me. But that is to be expected. But I'm really happy with the questions I was able to ask. And you know, just the fact that he was able to share some information with us, even though his his health system is is markedly different than ours here in the States. Before we jump in, I do want to take a moment this is a little self promoting. But gosh, guys, I got such exciting news recently. And that is that I won this huge book price. Yes, I know the book came out a while ago, but I won best new non fiction in the American Book fest. This was of course for the world's worst diabetes mom real life stories of raising a child with type 1 diabetes. And it kind of took me didn't kind of it really took me by surprise. I had entered it earlier this year, I had forgotten about it. When we got the email, my publisher kind of emailed me quickly and said, you know, being a finalist is really nice. And then she said no, no, wait a minute, you. That was kind of my reaction to it was laughing. But I won. So I know you're asking, Okay, the world's worst diabetes mom came out in 2019. How did we win an award in 2021. The book fest the American Book, festival boards are kind of rolling. So you're eligible for almost three years. So this year's books were from certain dates in 2120 20 in 2019. This was our first time entering the book, and it was actually our last chance to enter. So boy, I'm so excited. I'm really proud of the book. And I have some news coming in December. I have some more book news that was already planned before this award. But thank you for letting me indulgent, do a little patting myself on the back. It was not easy to write and get it out and do everything we needed to do for it. And boy, you all have been so supportive, considering I haven't been able to do any kind of book tour at all right? I mean, it came out at the end of 2019. I think I went to two or three places. And that was it. And just like everybody else in 2020. It hasn't been the same since I'm hardly alone in that. So more book news coming up, and Dr. Partha Kar in just a moment I should probably tell you just a little bit more about him if you're not familiar. He has been a consultant in Diabetes and Endocrinology on the national level there in the UK since 2008, clinical director of diabetes from 2009 to 2015. And here's the full title national specialty advisor diabetes with NHS England. And there are so many things that he's been involved with, most recently, very prominently getting the FreeStyle Libre being available across the country over there and I will talk about that specifically. Being very involved in language matters. Getting CGM available to all t one D pregnant patients. And he hinted this week that a big announcement was coming. So I will link that up in the show notes so you can find out we talked The week before Thanksgiving here in the States, so timing wise full bit tricky, but he was announcing something big and I will include that to the best of my ability. Okay, Diabetes Connections is brought to you by Gvoke Hypopen. Almost everyone who takes insulin has experienced a low blood sugar – and that can be scary. A very low blood sugar is really scary. And that’s where Gvoke HypoPen comes in. Gvoke is the first autoinjector to treat very low blood sugar. Gvoke HypoPen is premixed and ready to go, with no visible needle. That means it’s easy to use. How easy is it? You pull off the red cap and push the yellow end onto bare skin – and hold it for 5 seconds. That’s it. Find out more – go to diabetes dash connections dot com and click on the Gvoke logo. Gvoke shouldn’t be used in patients with pheochromocytoma or insulinoma – visit gvoke glucagon dot com slash risk. Partha Kar Welcome to Diabetes Connections. Thanks so much for making some time for me and my listeners. Absolute pleasure. Thank Partha Kar 5:55 you for asking. Stacey Simms 5:56 I gotta tell you, I'm a little nervous. I'm a huge fan. I'm just following you on social media. And then I put into my Facebook group like I always do. You know, do you have any questions for this guest? We've got a part of the car coming up. I have very few questions from the group. But I have lots of oh my gosh, I love him. Tell him we love him. Tell him. Thank you. Thank you. And I'll tell you specifically why they're thanking you in a moment. But you do have a quite a big fan club over here. So going in, I guess I'm trying to butter you up. But going in, you should know that. Partha Kar 6:24 No, it's very quiet, very kind. I always see this, you know, at the end of the day, it's my job to do as well. But you know, the love and blessings you get is just makes it stronger. So yeah, no, absolutely. Thank you. Stacey Simms 6:35 You're welcome. Let me just start off by asking you, you do not live with diabetes? How did you get into the position that you were in today? Why this field for you. So I think Partha Kar 6:43 a lot of it was, you know, when we are when we are training, you pick your subjects as you go along. And then I sort of gravitated towards Diabetes and Endocrinology because I thought there was an opportunity here to talk to a lot of people, you know, be a part of their journey throughout life. So it was quite good. And I like talking, and then sort of more towards type one, because I think I get got to realize the more senior I got a lot of attention, quite understandably, was into type two diabetes. And that's, you know, the bigger volume number, etc. But I think what I found that there's not a lot of things being done for type one as a trade back of that. So it's been more of a, let's see what we can do in the space. Let's try and help people. And I think just being an advocate, so to speak. So yeah, that's probably how it's graduated over the course of time. One of Stacey Simms 7:31 the things that we've observed, just following your social media here in the US, is the adoption and use of libre for many more people, can you talk a little bit about how that came about? Partha Kar 7:41 So I think Libre, I'm in freestyle Libre first came into the market on 2014 2015. And I think it started to sort of gradually make its way into the UK setting and the sort of people would buy it funded. And I think it sort of started taking off in 2016 2017. And that's when I sort of got into the job. And for me, people are always asking why this particular device, I think it's not the device, I think it's more of a mass device. And I think there'll be more competition coming along. But to me, it's be a very good example of what self management can do. I mean, simply put, if you see more of your numbers and more of your trends, you tend to intervene more and do better. So that's been the device and it's been a battle to try and get it into people's lives as you go along. As you're the system here is slightly different. You have to justify every single thing you do, because you're saying, Well, this is why we're trying to do it. And it's a funny place to be in because you know, you're you're sort of fighting, so to speak against other conditions, that doesn't feel right, either trying to justify why you needed more compared to X or Y. And I think that's the challenge. And then people start looking at well, actually, there isn't a randomized control trial, which showed y or Zed and I can't fund it. And I try and explain to people it's not just about the RCTs, or the randomized control trials all the time. It's not just about doing one see, it's about the quality of life and what it does do so yeah, I think I think that's how it came about. And then driving it through, pick up or take up around the country sort of battling with regions. So yeah, it's it's been a journey in the half, so to speak. Can you Stacey Simms 9:14 get a little bit more specific in terms of how many people now in your system do have access and do use the freestyle? Partha Kar 9:20 Yeah, I mean, I think we got I mean, given round, figure wise, we've got about 200, we got a quarter of a million people with type 1 diabetes, and I think about 53% of them are on it right now across the country, and of all our cards land. Well, I think it should be available, either, you know, Libre or its equivalent should be available to everybody, everybody, very soon. Stacey Simms 9:42 So yeah, I mean, the reason I wanted to ask that is because first of all, it's already such a big number comparatively speaking too much for the rest of the world. Certainly, I've got to imagine you're starting to see better outcomes too. Yeah, Partha Kar 9:53 absolutely. I mean, it's coming through your h1 HB ones is a better I mean, I can tell you from my own clinical practice, people are huge changes. We're seeing it across the country and the data we're collecting and guess what admission levels are down. People feel happier your HP once he's down, it's doing what it says on the tin. Stacey Simms 10:08 What would be the ultimate goal? Is it with that device? Is it then moving on to other CGM? Or do you want to kind of get as many people as possible in this one? Partha Kar 10:15 Oh, no, absolutely. I've always maintained I'm a Libre or freestyle Libre is has been the tip of the spear. I think there was a lot of things there, which was about showing people the what is possible, because before that, in the world of the NHS technology has always been seen as a Okay, well, let's see what we can do. I mean, for example, insulin pumps have been around for so long. We even had nice guidance on it available since 2008. But the pickup rate really low 15% 16%. Really many reasons behind it. And CGM for isn't traditional CGM like Dexcom. Really low again, 4% 5%, or there abouts. But I think this was about showing what could be done if you really pushed on it hard. And I think it's opened up many, many doors. You know, subsequently, because of that, we're looking at competition coming along, we're looking at every single pregnancy with type 1 diabetes not having access to a Dexcom, or Medtronic device, we're doing trials and closed loop, suddenly, it has become a flagship, and due to luck, serendipity or default, it's worked out as one of the projects, which has really, really played out well in the NHS. And so a lot of people are looking at it. And for me, that was always the purpose. It's the tip of the spear. If you can show you could do it with one, there's no reason you can't. And it's definitely not the end goal never has been. I think the end goal would be that every every person with type 1 diabetes, irrespective of the age has the ability to choose whatever technology they so can, whether it's flash, whether it's traditional CGM, whether it's a pump, or whether it's a closed loop, partnership salutely. Stacey Simms 11:44 And I'm just a little bit more about the Libre, I'm curious to obviously the biggest objection many people would have had would have been cost. But inside your organization or external critics, what were their objections thinking going into something like this, Partha Kar 11:57 I think the NHS always is a very traditional setup. And I think they're very good when it comes to drugs to pharmaceutical products. For example, pharmaceutical companies will do massive randomized control trials to show Okay, here is the drop in HBO and see, and thereby you can calculate it. The problem is with technology company, they necessarily haven't done that. If you look at Frisco Librem, the initial studies that came out, they never showed any change in HB one C, primarily because they chose a lot of people's age 20 with the excellent to begin with. And you're sitting there going, Well, that was a mistake, I think, for companies not to take up the trials, because straightaway to a lot of policymakers, you don't have any room to maneuver, because you're banking yourself completely on the ability that will show improvement of hypos and quality of life. Now, the other problem, I suspect has been there nice, which is our governing body, so to speak, who you know, looks at evidence, they're quite slow at coming off the blocks. Sometimes it can be too late in the technology world by the time you assess, you know, right now they're assessing Libre one you are Libre 123 out. So what are you assessing? There's got to be nimble and quick. That's been that was the obstacle people saying that. So I think there were that level of obstacle Well, nice having said so so why should be, there's also a lot of people who fundamentally believed that this was just a gizmo and this was just shiny toy, and we shouldn't give it to people with diabetes, they should or for example, they had to earn it, you know, they have to either have complications to have it, or they should be testing 10 times a day to get it, which I think is pretty silly. Because you know, the whole point of doing this exercise is to target people are finding it difficult to test and find giving it to people to stop them from having complications. But there you go, it's a very traditional set of thinking, which is what has been the challenge trying to break through? Stacey Simms 13:39 Yeah, do we have similar issues in the states where they're doing trials? And you always see like, well, they're a one see went from 7.3 to 6.9. And that's wonderful. But you know, we need to reach the people who's a one sees our 10.5 100%, right, because of either education or access, or whatever it is. I know, I know, you're struggling with that as well. Yeah, Partha Kar 13:58 So, for example, you know, we have learned from that, you know, we, when we collected the real world data with Libre, we showed exactly what he said, the higher the higher your starting age, we want to see the better your outcomes. And you're like, Well, that's obvious. So what we're doing with those with Kevin, so what you're doing with closed loops right now, so we're running a real world trial evaluation throughout the country, it's about 34, five centers around the country, adults and pediatrics doing it. And guess what we see, again, the higher your agency, the better you're a flattening of your agency. So it's not rocket science. And I always am flabbergasted when people doing trials go like, no, let's just pick the people's controller really good. And as you said, but that goes against the whole deprivation thing that we discuss about because we know people who come from very deprived backgrounds will have worse control. So if you really want to tackle deprivation, you need to control that and you need to tackle that. So the thinking needs to be far more refined than what it is at the present moment. And hopefully we're trying to show some ways of doing so. Stacey Simms 14:54 So one of my listeners said, I want you to please let parked the car know how much I appreciate In his posts, she goes on to say, there's not much I appreciate more than medical professionals who treat us like real people and don't talk down to us. Where did you learn your bedside manner your style or what you know what we as as not your patients see on social media because that's one of the things I think that very much resonates with people is that you're you're very plain spoken and you don't talk down to people with diabetes right back to our conversation, but first Diabetes Connections is brought to you by Dario health. And you know, over the years, I find we manage diabetes better when we're thinking less about all the stuff of diabetes tasks. That's why I love partnering with people who take the load off things like ordering supplies, so I can really focus on Benny, the Dario diabetes success plan is all about you, all the strips and lancets you need delivered to your door, one on one coaching. So you can meet your milestones, weekly insights into your trends with suggestions for how to succeed, get the diabetes management plan that works with you. And for you. Dario is published studies demonstrate high impact clinical results, find out more go to my dario.com forward slash diabetes dash connections. Now back to Dr. Kar, talking about how he has developed a good bedside manner and respect for his patients. Partha Kar 16:20 I think it's come with time, if I'm very honest, and most likely, it's not like a suddenly over a bed. And one day I decided to become like this. And I think what I've realized over the course of time is their Medical School doesn't teach us consultations, kills diseases, a lot of stuff, right? It's just teaches us what the book said, which is my Insulet physiology, how it works, doesn't really teach us a lot about interaction with human beings, which is what we did with some things like the language matters and stuff and people found language matters. Interesting. I found that just human sense, you know, common sense, human, it's not that difficult to be nice to people. And we somehow are not we somehow, and I think social media teaches me a lot of stuff. I think my patients teach me a lot. And I don't say that in a glib way, because things like, you know, I will do transitional or young adults clinic. And I remember these words from this young girl who sat there looked at me and said, If he took an exam sometimes, you know, and I want to watch that. And she said that, I don't know. It just feels like I'm going to be asked what I'm doing with judgment, what I'm doing, you know, when I sat down, but like, that's not right, that's wrong. Why are we making people feel like that way? And then we are wondering why they're not coming back to our clinics. So a lot of my consultations were very honest, not about diabetes, with my patients they're very much about could be a football or movies. I mean, yesterday, when just watch the internals and today in clinic, we were talking about one of my patients, and that was the conversation, what did you think about that paid the post credits, what was it, and I think you build a rapport with people, they trust you more, you get along more. So I like to keep it very plain. And I also feel that clinicians sometimes believe that people living with type 1 diabetes won't be able to handle the truth, so to speak. Oh, you can't tell them when you can. They're all adults and or, or in or surrounded by adults, and they deal with tough calls in their lives all the time, you know, how to get a mortgage, you know, how to get your car or dealing with ups and downs, or the Why wouldn't they be able to they live with it. So I've always benefited that by turning around and saying I can't do this for you. It's outside my expertise. And I think finally, I'm also trying with my other role trying to deconstruct the myth, and the and the whole thing that doctors are built around them so that there's some sort of, you know, material human beings here for to burn themselves to the altar, normally not, you know, we trained professionals, like a fireman or a policeman and trying to do my best. And sometimes I'll get it wrong, sometimes I'll get it right. But at least I want to portray across that I'm trying and trying my best. And we'll see where we go from there. Stacey Simms 18:50 You know, it brings up an interesting point, because I consider myself a very strong advocate with my doctors, for myself and for my children. But I still hear you get intimidated, you do very much respect my doctors, any advice for patients who who want to have a difficult conversation with their physician who want to start broaching that, hey, treat me like a partner and may not know how to start? Partha Kar 19:12 Yeah, I mean, I think it's really difficult. It's really difficult to do that. Because I think this is why it's a bit like I always give the example of let's say, sexism. Now. It's not the it's not just the job of women to go and solve sexism, is it. I mean, it's men have got an equal part, you will not understand nuance as a man or a woman goes through, but you know, when it's wrong, and you can turn around and say, Nah, guys don't do that. Right. So I think what I would encourage rather my clinical colleagues to say that, look, it's not tricky to sort of have that feedback and saying your approach may not be the right thing. And I think this younger generation coming through which does that. So my advice to patients who would like to do that would be to, I think doctors feel very challenged as soon as you challenge them. It's an ego thing. Don't forget that we have been taught in medical school that we are the top of the top there is no Nobody better than us, right? When you're told that for five years, seven years, eight years, 10 years of your life that there was nobody better than you, it's very difficult to then sit in a space. And if somebody challenges you to actually take that on board, so there is a bit of that complex that has happened over the course of time. So the way to approach that would be to probably do it from a slightly different angle. And rather than pointing out the mistake and say, What would you say? What do you think if we did this? Do you feel like so I think you try and do that there'll be some people who are open to the idea of saying, I don't agree with that, and you go with it. But I think the biggest advice I can give is find an ally, was also a clinician who will do that for you. So in meetings, when I go to, I always see myself as that sort of advocacy role return rentable. And now I don't agree with that. Because I know I've spoken to a lot of people who want to agree with that. So that is the sort of fine balance to strike, it will change, doctors are changing. And you know, if you've been long enough in the system, the 90s, were different to 1000s were different, and now is different, but doctors are evolving slowly takes a long time to get you got good get rid of you got complex. Stacey Simms 21:02 Another question from one of my listeners who wanted to know, Brexit to will, or already has had an impact on diabetes care or supplies, Partha Kar 21:11 hasn't affected supplies, because we actually knew there was going to be a problem. So we planned and we worked with the industry to make sure we had good suppliers. And there will always be teething trouble as we go along with this. But no, we don't expect, he says Fingers crossed. We have some plans in place in case of anything, but Brexit is one of those political things in life, isn't it? So we just have to ride the storm with it as we go along. So Stacey Simms 21:34 this is an American based podcast, mostly because I'm American, we do have listeners all over the world, which I'm very, very grateful for. But our healthcare systems are so different. I'm curious if you have any advice, or any lessons that you think we could learn from how how you all do it? Partha Kar 21:53 Yeah, I mean, so I think the debate about healthcare becomes incredibly emotive on both sides of the Atlantic. I think that's the problem. So when you turn around, people start saying, so for example, if you challenge the NHS, people go like, well, you don't like the NHS, because you want to make it privatized to you. And you will? Um, no, not really, I'm just saying that there are gaps in the prison system as we fund it, for example, we say it's equal to all well, not really, if you come from a deprived community. Right, now we've got issues with race. So as I've said, if you're a black child, your chance of getting a continuous glucose monitor is half of that of a wide shot. This isn't the NHS which professes to be equal to everybody. It's not right. So the challenge is there, even however, the funding is, I think my advice to in the US setting would be it's so vast and so big. Taking aside the politics, which is so difficult to do, obviously, I think too much attention is focused when it comes to chronic disease on the to the three parts, which I think of type 1 diabetes, I think I see it as self management, peer support, and access to train professionals. That's the three things on which good type 1 diabetes care sets. And the US system is incredibly good about doing number three, too, it makes it more and more expensive, because we don't have any trained professionals. And so you end up having to really top load that bit. If you switched a lot of the attention to one and two, self management with technology of peer support, you probably will have better outcomes, I don't think it's about the make of the system. And it's insurance based or public funded. And that's where the politics comes in. It's about the switching of that mentality where you get peer support and self management as being a main key focus and investment into but the US system, partly the UK as well. But the US system hinges heavily on number three. And that's why you the costs are so out of control. That's my view, at least Stacey Simms 23:38 we've seen it in our own experiences. And people who listen to this podcast know that that peer community matters immensely with camps and communities and meetups. And it's incredible. It makes such a difference. Absolutely. You mentioned language matters. Can you speak a little bit about that for people who aren't familiar? Yeah, I Partha Kar 23:55 mean, I think there's a fair few versions of that. I'm the principal of that was built in Australia in 2012. And again, it's nothing dramatic. It's not I mean, became it basically saying just be nice to people. You know, I think you've got embroiled in this whole debate for a bit of time. Because it was done in the States. There was papers out of him that we picked up in the UK, different countries have done it and people get stuck up in the Oh, is it is it about calling somebody a diabetic or a person with diabetes, it's not lots of people don't mind being called diabetic, some people do mind being called diabetic, that's not about that what the document is about. The document is very, very simply about trying to be less judgmental about people whose lives you don't leave. Right? If you're saying to somebody, or you know, I'm not sure you're you should be doing that in the morning, when you don't know what like the lead. You don't know that they're having to, you know, rush to drop off their kid to school and do this and do that. It's not easy to then go you should have a very structured breakfast and take your insulin on time. Well, that's fine for you to say, but that for that individual. They might have two kids to drop off and then go to work while trying to make sure you know their husbands had their work. It's It's not easy. So I think that's what it's about don't don't try and judge others whose lives you don't leave lid. So that that was pretty much it. Stacey Simms 25:08 I think that the libre goal that you have I know you're not done with and you wouldn't call it a an ultimate success yet has been tremendous. What is next? Is it trying to get more pumps covered? Is it trying to get more equality as you've already mentioned, racial and economic lines, Partha Kar 25:23 closed loops, I think I think is, is the is the next target, I think more more access to closed loops, more access to all the types of different loops that are available, and you touched upon it, irrespective of your deprivation, ethnicity, that's going to be huge for because going ahead, I want more people to have access to technology, because I think technology is an enabler sort of ticks, that box of self management, it also encourages more peer support. So if we did that, together well, and did more standardized training for healthcare professionals that I think that's the sort of ultimate goal. But I think closed loops are going to be the thing I suspect the focus and target on as we go ahead. Stacey Simms 26:01 Fabulous. And I'll let you go. I know you got to run. But we are speaking during Diabetes Awareness Month, and you put out a video very plain spoken as you do, saying, basically, be nice. Don't judge, don't be an idiot. And you have a two minute long video explaining this. What was the reaction? I mean, it's a very plain statement, but at the same time, it's quite blunt. Yeah, I Partha Kar 26:21 mean, I think I see the debates between and it's so silly, some of the stuff that goes on, on social media and wider and I can understand people do it because they have a book to sell, or a podcast or blog or whatever they want to do, or Twitter likes, but the simplistic narratives and never helped people, you know, we could we could turn around and say, Well, if you eat too many cakes, you will have type two diabetes, there is not a single evidence base that will support that statement. Yes, people say that right? You know, and I think that's the problem. And then that rolls into how did your child have diabetes? You give them too many cakes, and you sitting there going like what how uneducated Are you didn't come up with a statement like that. And it's so frustrating to see that. So I think the reaction has been good. I mean, I've always been known for my and I genuinely think when people don't know something, I'm very happy to explain it to them in today's day and age. If people say that, Oh, I didn't know that type 1 diabetes is an autoimmune disorder has got nothing to do with your diet or your lifestyle, then I'm sorry, you were just uneducated. And that's my bottom line to that. So you haven't even made the simple effort to open Google. So things like that. And I think that was the that was the idea of that is Diabetes Awareness Month. Just be aware of different types. Be nice to people don't judge others and you know, at least at least do some research and you've got Google on your smartphone. So simple. Stacey Simms 27:41 Okay, last question. You mentioned the eternal is no spoilers. I haven't seen it. But I know you're a big Marvel fan. How was the movie? Partha Kar 27:47 Oh, it's good. I really enjoyed it. It's as a standalone, it works really well. And my only big tip also is mistake for the after credits. Very good, especially the last one. Very, very good. All right. Stacey Simms 27:58 Well, thank you so much for spending so much time with me. I really appreciate you being here. Thanks very much. Partha Kar Pleasure. You're listening to Diabetes Connections with Stacey Simms. More information at diabetes connections.com. Of course, there's always a transcript as well. I will link up how to follow Dr. Kar on social media, I highly recommend his Twitter feeds. And he is just very informative, very straightforward. And he's always willing to admit when he makes a mistake or something funny happens. I mean, he's just let's face it. He's just a human being online, which is why I think so many of us respond to him so well, that I liked a lot of the advice he gave there for us to take to our doctors, we really have to be straightforward with them. So many times they don't even realize what they're doing or how they're talking to us. Sometimes they do and they're they're just jerks. But most of the time, I think they want to have a good relationship with us. At least that has been my experience. There's only been one doctor, in my my experience. I'm not talking about Benny, because we've been very lucky with him. There's only been one doctor that I have fired. And I fired him from my hospital room because oh my gosh, was he talking down to me? So don't be afraid to do it. Alright, Diabetes Connections is brought to you by Dexcom. And we were watching TV the other night. My husband and I are really into the expanse now, which is a sci fi show that's been out for a while. We are totally binging it, we're going through every season. So we're watching that. And the Dexcom went off the alert on my phone and Benny was upstairs in his room. And you know, for some reason, it took me back to the days when we basically had blood sugar checks on a timer. If you're of a certain age you remember this we would check doing a finger stick the same time every day at home and at school and whenever extra we needed to. It's really amazing to think about how much our diabetes management has changed with share and follow. I didn't stop the movie to check on him. I knew what was going on. I mean, I could decide whether to text him or go up and help out for this instance. I did absolutely nothing because I didn't need to using the share and follow apps have really helped us talk less about diabetes. which I never thought would happen with a teenager. Trust me Benny loves that part too. That's what's so great about the Dexcom system. I think for the caregiver or the spouse or the friend, you can help the person with diabetes manage in the way that works for your individual situation. Internet connectivity is required to access Dexcom follow separate follow app is required. learn more, go to diabetes connections.com, click on the Dexcom logo. If you're listening as this episode goes live, Happy Hanukkah, we will be marking night three as you're listening again, if you're listening when the episode first airs, and Paul hits early this year, that my daughter's already packing school, but that's how it goes. I hope your life because they're yummy and your Hanukkah guilt is delicious. And you're not stressing out too much about diabetes, and you're able to enjoy what the holiday has to offer. Looking ahead. I mean, what am I going to say? Here? We are December. Oh my goodness. So we've got some great shows coming up. We've got a conversation next week with the folks at convatec. They make all of the insets except for Omni pod. But if you use a Tandem Medtronic, yep, so mid, those pumps, they make your insets. So we had a really good conversation about how to make those better, some good information for the community from them. And I'm hoping that'll be an ongoing conversation. And we have a lot of good stuff in the works for the rest of this year. Going into January, does he I would ask is if you have listened to this far and you are not signed up for our newsletter, please make sure to do that I send out an email every week along with the show. And quite often there is more information in there than just a week's episode. We do surveys, we do research opportunities that I get from companies. There's a lot of info in that. And as we move forward next year, and I'm branching off into other projects, I'm gonna be using that newsletter to communicate more and more about things, not just the podcasts that I think are of your interest, but I don't spam you or anything dumb like that. So go ahead, you go to diabetes connections.com a little pop up will come up. If you don't see it, just scroll down. There's a little newsletter thingy that'll help you sign up there. Thank you to my editor John Bukenas from audio editing solutions. Thank you so much for listening. We are back on track for our newscast this week. So I will see you back here Wednesday on Facebook or YouTube Live for in the news. And then on Friday, we turn that into an audio, podcast whatever works better for you. Feel free to join me in whatever way is the best. I'm Stacey Simms Until then be kind to yourself. Benny 32:24 Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged
40 minutes | Nov 23, 2021
"Wait Wait.. Don't Poke Me!" The Diabetes Game Show
It’s time for one of our favorite episodes of the year! Wait Wait! Don’t Poke Me, the diabetes game show! Taped this time around for the Children with Diabetes Friends for Life fall conference. If you’re familiar with NPR’s Wait Wait Don’t Tell Me, a lot of this will sound familiar, just with a diabetes twist! Our panelists tackle trivia, limericks and we try to "bluff the listener" with tales of diabetes in the wild. Can you guess which Olympian with T1D really had a wildlife encounter? Big thanks to our panelists: Nia Grant, Kyle Banks and Matt Point. They all have a connection for FFL and took time out of their busy schedules to goof off with me. There is a video version of this show over on our YouTube channel if you prefer to play along over there. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode transcription coming soon
7 minutes | Nov 19, 2021
In the News.. T1D gene replacement therapy, BG finger scan, insulin on Olympic skis and more!
It's In the News... the only Diabetes newscast! This week learn about: The DIY #WeAreNotWaiting movement gets a medical write up in the Lancet, a big move for #T1D stem cell therapy and identifying the cause behind a common #T2D condition. We also look at coffee & gestational diabetes and find out why the molecular structure of insulin pictured on an Olympic-hopeful's skis -- Join Stacey LIVE every Wednesday at 4:30pm EDT Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode transcription below: Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I’m going to link up my sources in the Facebook comments – where we are live – we are also Live on YouTube and in the show notes at d-c dot com when this airs as a podcast.. XX In the News is brought to you by The World’s Worst Diabetes Mom, Real life stories of raising a child with diabetes. Bit of breaking news here.. we just found out today we won a pretty big deal prize. American Book Fest announced The World’s Worst Diabetes Mom is the winner of their Best New Non-Fiction category! Huge thanks to the judges and to Spark Publications. How about that? You can find the book – it’s my book if that’s not clear - in paperback, on Kindle or as an audio book – all at Amazon.com. -- XX Our top story.. a stamp of professional approval for the do it yourself #WeAreNotWaiting movement. Over 40 doctors, legal experts, and other healthcare professionals published a consensus statement in The Lancet, one of the most prestigious and respected medical journals. The authors conclude: “Although we do not suggest that open-source AID systems be universally recommended over commercial options, strong ethical reasons support the use of open-source AID systems, with safety and effectiveness data derived from real-world evidence." Essentially, they say it’s time for the medical industry to take these methods seriously, and to establish some standards and protocols to help further access and safe use. https://mashable.com/article/doctors-approve-diy-diabetes-tech-treatments XX Stem cell therapy for type 1 moves forward. CRISPR therapeutics and Viactye announce approval for a clinical trial application. We’ve covered this before and talked to ViaCyte on the podcast. They’ve been moving forward with stem cell research and you may know Crispr as a gene editing platform. The idea is that together these companies could find a functional cure for type 1. This is a Phase 1 clinical trial designed to look at safety and efficacy. They expect to start enrolling patients by the end of the year. https://finance.yahoo.com/news/crispr-therapeutics-viacyte-inc-start-133000366.html XX A new study suggests a lack of a specific molecule in red blood cells may be the root cause of vascular problems in people with type 2. Red blood cells are important for many reasons, one of which is maintaining what’s called cardiovascular equilibrium. This is partly achieved through the production of nitric oxide. This is a problem in people with type 2 and these researchers speculate it’s because they have much less of something called micro-RNA-210 than those without diabetes. Interestingly, blood sugar control through medication appeared to cause no major improvement here – it didn’t affect the red blood cells. https://www.medicalnewstoday.com/articles/scientists-identify-new-cause-of-vascular-injury-in-type-2-diabetes XX Good news for pregnant coffee lovers: Consuming a low amount of caffeine during pregnancy could help to reduce gestational diabetes. This is one of those confusing health issues that seem to change every year.. right? Drink more coffee, drink less coffee.. this study says if you’re already drinking coffee or any caffeine, about two cups a day is just fine and may reduce your risk of gestational diabetes. If you’re not already a coffee drinker, there’s really no reason to start. There were no statistically significant differences in blood pressure, preeclampsia, or hypertension between those who did and did not drink caffeine during pregnancy. https://www.news-medical.net/news/20211111/Low-amount-of-caffeine-intake-during-pregnancy-may-help-reduce-gestational-diabetes-risk.aspx XX The government of Japan announced this week that a company there has developed quote - the world's first blood glucose level sensor that requires no blood sampling. The sensor uses cutting-edge laser technology for a much brighter infrared laser, enabling anyone to hold a fingertip over its light for about 5 seconds to easily measure their blood glucose levels. The company is now working on mass production. Not a lot of info here but the website says 2023 is their goal for launch. http://www.light-tt.co.jp/?lang=en&fbclid=IwAR0h6rlJKXwxEuUDQ8O0_KFYLCg885_pITiVE9xPjgsIXLPCaK9cuJntjSo XX Scotland has become the world’s first country to begin routine testing of C-peptide levels in patients with type 1 diabetes. Couple of goals here they say… first to identify people who have retained robust natural insulin production and second.. to see some who might not have type 1 at all. C-peptide is a substance that is created as a byproduct of natural insulin production. A preliminary study looked at 850 people with type 1 and found that about 13% had more than what’s thought to be the usual expectation of insulin production. They also found that 5.1% were reclassified to type 2 diabetes and 1.6% were reclassified to monogenic diabetes. Many of those people didn’t need to take insulin any more. One quick note – I’ve seen this article floating around which says that half of the people in this study did NOT have type one. That’s not the case at all. The only thing I can think is that someone misread the 5.1% reclassified to type 2 and misread it as 51%? But it’s a tiny number. Many more people are misdiagnosed as type 2 when they have LADA or type 1. https://www.diabetesdaily.com/blog/why-scotland-is-now-testing-the-c-peptide-levels-of-everyone-with-type-1-diabetes-691720/ XX Finally Something really unique for Diabetes Month. A ski company has created a custom set – with the pattern of the chemical composition of insulin. I’ll show it here and in the FB group for those listening.. Lauren Salko is a cross racer who lives with type 1. Elan Skis worked with her to design the skis and they’re donating all the profits to Children with Diabetes.. It’s the Limited edition Ripstick 94 W ski. Lauren Salko has an eye on next year’s Olympics.. we’ll be watching. https://elanskis.com/lauren-salko quick reminder that the podcast this week is all about less stress for the holidays. It’s an ask the D-Moms and guys.. I got an amazing message from a mom who said she quote – cried tears of relief listening to it. I remember how tough it is at first.. but really, we can make great memories and worry less. Let the Dmoms help! you can listen to wherever you get your podcasts or if you’re listening to this as on a podcast app, just go back an episode. That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
40 minutes | Nov 16, 2021
Ask the D-Moms Holiday Edition - More Fun, Less Stress (we promise!)
With Thanksgiving almost here and the winter holidays around the corner, we know that diabetes stress is about to ratchet way up. The D-Moms are here to help! Moira McCarthy joins Stacey to talk about everything from holiday travel, long car rides, well meaning relatives and holiday gifts centered on T1D. And of course, FOOD! Get advice to keep your children with T1D safe and happy so you can make terrific memories without freaking out about "perfect" blood sugars. Previous D-Mom Holiday advice here Adults with T1D give their take on the holidays: This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode Transcription below: Stacey Simms 0:00 Diabetes Connections is brought to you by Dario health. Manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first pre mixed auto injector for very low blood sugar, and by Dexcom, take control of your diabetes and live life to the fullest with Dexcom. Announcer 0:20 This is Diabetes Connections with Stacey Simms. Stacey Simms 0:26 This week, Thanksgiving is almost here and many holidays just around the corner. Ask the D moms is here to help more McCarthy and I answer your questions and share our own stories to help you make more wonderful memories with less stress, even if that means doing things differently for a special occasion. Moira McCarthy 0:44 And the reality is in this long, long, long, long, long lifetime marathon diabetes, you need to just chill a mile here and there. And by doing this and saying to your children, we're going to turn this off. This is okay. Don't worry about it. You're fine. You're modeling that for them and you're giving them the confidence and the courage to know that they can be okay. Yeah, Stacey Simms 1:06 she said turn this off. She's talking about something I dare to say and do about Benny's CGM. We also talk about long car rides well-meaning relatives and holiday gifts centered on diabetes. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show. I'm your host Stacey Simms always so glad to have you here. You know, we aim to educate and inspire about diabetes with a focus on people who use insulin. And yes, this time of year. I mean, it's the holidays are stressful without diabetes, right. But I'm already seeing in my local group, the stress ratcheting up, somebody said to me the other day that they feel like even though they're not necessarily doing more than they did before the pandemic as more people are venturing out and traveling. They feel like they're really busy. And I think a lot of it has to do with the fact that we haven't been very busy for the last year and a half, really. So there's gonna be more pressure on this holiday season. There's going to be more travel, there's going to be I don't know, it'll feel like higher stakes and especially if you are new to type one, that first year those first holidays, those first milestones are incredibly stressful. So Moira and I are here to help you out you probably already know. But just in case Moira McCarthy is a dear friend of mine. She is the author of many books about raising kids with diabetes, including the amazing raising teens with diabetes, which has that fabulous photo of a teen rolling her eyes right on the cover. I love that cover. You'll hear how long her daughter Lauren has lived with type one. She's a very successful adult now living on her own. And if you are brand new, my son Ben, he was diagnosed almost 15 years ago. He is almost 17, which is really hard to believe so most of my stories have to do with the early years. We're not out of the teens yet, and Moira will help kind of pick it up from there. And I always look to her for guidance as well. One funny thing about Thanksgiving this year, we have a set menu, right? We have our traditions. My husband is the cook in the family and we've always hosted Thanksgiving. He does something a little different every year, but it's really up to him. But Benny has been working in a grocery store for the past six or seven months now. And he is really jonesing for a sweet potato casserole with marshmallows, which we don't usually do nothing do with diabetes. It's just not our style. We generally save the marshmallows for dessert. But my mom who makes our sweet potato casserole every year has valiantly stepped up and says she will make one for him. Because at the grocery store. He has been seeing the display and he's like Mom, it's just sweet potatoes, brown sugar, sweet potatoes, marshmallows, sweet potatoes, brown sugar, like they have this. And he took a picture that I saw the last time I was there. I mean, it's one whole side of a produce display. So this poor kid, he is really dying for that that marketing worked on him. He wants those marshmallows. My daughter is the canned cranberry sauce person, right. You know you make that beautiful, homemade cranberry sauce with the whole cranberries. Are you you boil it down? No, we have to have it in the can with the jelly lines on it. I prefer that as well. I have to admit. Alright, Moira and I talking about real stuff just a moment. But first Diabetes Connections is brought to you by Gvoke Hypopen. Our endo always told us that if you use insulin, you need to have emergency glucagon on hand as well. Low blood sugars are one thing – we’re usually able to treat those with fact acting glucose tabs or juice. But a very low blood sugar can be very frightening – which is why I’m so glad there’s a different option for emergency glucagon. It’s Gvoke Hypopen. Gvoke HypoPen is premixed and ready to go, with no visible needle. You pull off the red cap and push the yellow end onto bare skin – and hold it for 5 seconds. That’s it. Find out more – go to diabetes dash connections dot com and click on the Gvoke logo. Gvoke shouldn’t be used in patients with pheochromocytoma or insulinoma – visit gvoke glucagon dot com slash risk. Moira, welcome back. I am so excited to talk to you What a week. I didn't even think about this when we planned. This is a big week for you and Lauren, Moira McCarthy 5:04 it is yesterday, October 28. At 2:35pm was exactly her 24th diaversary. My daughter has had type 1 diabetes for 24 years. I can't even believe it. It's crazy. Stacey Simms 5:22 But I have to ask you the time had you know the time. Moira McCarthy 5:25 So I don't know why I know the time. We were at a doctor's appointment, and I know what time the appointment was. And I know what happened when I got there. So I don't know. It's just drilled into my head. And then there's people I meet that are like, I can't even tell you what day my kid was diagnosed. But for some reason, it just stuck with me. And as a little kid Lauren, like celebrating every year, so I sent her flowers yesterday. No, I don't care. 24 hours or so give us Do you Stacey Simms 5:51 mind, maybe just a little bit of how she's doing maybe a little update. If this is someone's first time joining us for Deimos. Moira McCarthy 5:57 I'd be happy to so my daughter Lauren was diagnosed. Well, I just said the date. So basically the beginning of kindergarten when she was six years old, right after her sixth birthday. I can remember feeling like the world was gonna end. But we had a really great medical team from the beginning who were saying to us, you are going to live the life you lived before. We're just going to add steps to it. And Lauren at six years old was saying I'm gonna lead you're not gonna, you know, let this hold me down. Now has it been all rainbows and butterflies? Absolutely not. We have had challenging days. We've had challenging weeks, we've had challenging years in her teen years. But right now, I think, well, first of all, what everybody cares about most is her physical health. She is 100% healthy. She has the labs that a person without diabetes would have if you checked, you know, her kidney and her eyes and everything else. Emotionally, she's really doing great. She has a long struggle with burnout. But I think she really has figured out a way to deal with that when she recognizes it coming up. And the most important lab of all I always say is she's incredibly happy. She has an amazing career and lives in the middle of Washington, DC all by herself, and I don't follow her on share. And I never worry about her. She has 8 million friends and I couldn't be prouder of her and the life that she is building as a young adult. So that's where she's at pretty good. Right? Despite diabetes, that's fine. Stacey Simms 7:28 I love hearing that, as you know. And as you listen, you may know, I have followed Moira and Lauren story for many, many, many years since before more and I knew each other. So I always kind of look ahead. It's like my time machine of what could happen with us. Where could he go? And of course, he's never leaving our hometown, going to a scary place far away like DC he's gonna He's going to live here. And Moira McCarthy 7:51 Sunday dinner every week Stacey Simms 7:53 is nice. That's so nice. So I'm glad she's doing so well. Like you're doing so well. And you know, gosh, I heard something recently about diversity that made me smile. Instead of the diversity you're you're on the new level. So Lauren has reached level 24. Moira McCarthy 8:08 I like that. That's really funny. And her boyfriend is a big video gamer so he'll like that. Stacey Simms 8:13 Oh, that's good. Yeah, Benny's approaching level 15. And I am one of those people who I always have to look up the date. I just know it's the first weekend of December, but I never. Yeah. Alright, so we are in that time of year where it's not just our kids diver series. It is holiday time. And after I rewound the Halloween episode that we did a couple of years ago and I got a lot of questions and people asked us to do a follow up for Thanksgiving and looking ahead to the winter holidays. And I got some great questions. So I was wondering more if you wouldn't mind sharing though, you know, the first holiday season that you and Laura and your whole family had to address this you guys want a very different routine? Yeah, we can be a little more difficult but would you mind sharing what that was like that first year? Moira McCarthy 8:59 I will and and I think it's good to hear because it can help people see how far we have come daily care for this disease. We may not have a cure yet, but what it looks like on a day to day basis is completely different. So Lauren was diagnosed in October so Thanksgiving was our first big holiday and I remember we were going to my in laws and back then you took a moderate acting or we called it long acting, but it was really middle acting insulin called NPH that peaked a bunch of times during the day and then you took regular which you had to take it wait 30 minutes and then eat exactly what you had dose for it exactly 30 minutes which was super fun with a six year old child I will tell you and no waiting in between. So I had reached out to my in laws ahead of time and asked them if they could work the meal around the time that it would work best for her to eat and they said yes and I I move some things around with A doctor to kind of compromise with them, you know, so we changed what time we gave everything starting, like two days before to be ready for Thanksgiving. And then we showed up and they were like, oh, yeah, we decided on a different time. Oh my gosh, the world is ending. But the world didn't end. You know, we figured it out. We got through it. What I will say for these holidays, for people who are new to it, it's not always going to feel this scary and confusing and daunting. I think the first 12 months, you go through every holiday, every special event, every family tradition for first time. And then the second year, you're like, Oh, I remember this from last year, and it gets a little better. And then the third year, you're, you're sailing. That's my theory, and I'm sticking to it. Stacey Simms 10:43 I would absolutely agree with that. I also kind of suffered and I'll say suffered from this feeling out of the box, that it had to be perfect. Because I remember one just show everybody that we were okay. Especially my mom, I wanted her to not worry. And know that we were we were just fine. And for some reason that got tangled up in my brain by thinking this has to go perfectly and I can't make a mistake. And of course that lasted about three Moira McCarthy 11:06 seconds. Yeah, we're really with a toddler with type one, and you want to put together a perfect Thanksgiving. Why don't we do that to ourselves, though, you know, but feelings of control at a time when you feel like you've lost control? Stacey Simms 11:21 Night? Exactly. Alright, so let's get to some of the questions that came in. I got one in my local group. And this was about travel. And the question was, we're driving along distance. And I guess we could talk a little bit about flying or other modes of transportation. But this particular case, we're driving along distance, you know, six or seven hours to a relative's house. Any ideas or tips for helping me and the question here was about stable blood sugars. But I'm also going to kind of throw in there. How do I make this trip? easier on the whole family? Yeah, I'm I have a lot of ideas that maybe you do too. Moira McCarthy 11:56 Well. So I guess my first idea would be for special occasions and events, stable blood sugars aren't the most important thing ever. I don't think there's anything wrong with trying, of course, we want to try but the first thing I'd say is if it doesn't go perfectly, that's perfectly fine. I am quite sure if you ask your medical team to help you with the plan. That is one of the things they will say to you. That's the first thing. So I mean, what did you do on long car rides? For us it I don't remember it impacting her blood sugar that much, you definitely have to have snacks in the car and like more than you ever think you're going to need in your life, because you never know when you're going to get stuck in a traffic jam from a car accident or something like that. You know what it is be prepared, and then you don't need it. We tend as a family, not just for the person with diabetes, but for everyone to try to stop every 60 minutes and get out of the car and stretch and move around and breathe fresh air and then get back in. I think that helps Stacey Simms 12:56 us How about depressive we don't my husband would have fit? No. So in my Moira McCarthy 13:01 father, he would never do that. That's probably why I do it. I grew up driving from Minnesota to Massachusetts and like never being allowed to get out of the car. So Stacey Simms 13:10 I would say for us we actually did struggle a lot with long car rides, because we did a lot of trips, especially to my parents in Florida, which is like a nine or 10 hour road trip. And we found that Benny's blood sugar would go very high. Just you know, an hour or two in the car and looking back, it's probably because toddlers never stopped moving. So his insulin dosage was all based on constant activity. So when he was sitting still, just looking back that's my assumption. Also, as you mentioned, you know everybody's eating in the car Right back to our conversation, but first Diabetes Connections is brought to you by Dario health. And, you know, we first noticed Dario, a couple of years ago, we were at a diabetes conference, and many thought being able to turn your smartphone into a meter. It's pretty amazing. I'm excited to tell you that Dario offers even more now, the Dario diabetes success plan gets you all the supplies and support you need to succeed, you'll get a glucometer that fits in your pocket unlimited test strips and lancets delivered to your door and a mobile app with a complete view of your data. The plan is tailored for you with coaching when and how you need it. And personalized reports based on your activity. Find out more go to my dario.com forward slash diabetes dash connections. Now back to the D mom's and I'm talking about what we did when we realized Benny's blood sugar would always go pretty high in the car. What we did was talk to our endocrinologist about adjusting doses giving more insulin when he was in the car, giving more insulin for food when he was in the car. And that was a real trial and error for us because, you know we have to be really conservative about that you're not going to be changing basal rates by enormous amounts and so it may not quote unquote work the first time you do it, but I think you know we're doing Talking about stable blood sugars, I hope that this person means is like maybe kind of sort of in range. You know, when I see somebody talking about stable blood sugars, I usually think like, it's not going to be a steady line at 95, right? We're just trying to keep them from skyrocketing and staying there. And even if that happens, which happened to us a ton, it's fine, and you fix it. When the baby was younger, and the kids were younger, I was much more mindful about healthy eating. You know, they're 19 and 16. And it's like, they buy half their own food. Now anyway, I don't know what they're eating. But we used to get coolers the big cooler, and fill it with, you know, healthy fruits and veggies and hard boiled eggs and carrot sticks. And you know, and then of course, everybody would want to stop for fast food and ruin everything. Right? Moira McCarthy 15:39 So I made the assumption, and perhaps I shouldn't have that by stable, she meant within that range. If this mom is suggesting that her child should have a straight line across my answers quite different. I have no idea going on the assumption that what she means is within their range. And my answer was based on that what I meant was, if you go above your range, or below your range, I think it's okay. I don't think that if you're going to celebrate with a family, the most important thing is, is staying in your blood sugar range, I think the most important thing is enjoying the time and loving your cousin's and running around and having fun and staying within a an area that is safe. And by safe. I mean, you're not you don't need to get in an ambulance, I guess. And maybe my advice would be talk to your medical team, take some ideas that we have on your idea, I think that's a great idea. My only caveat would be the doctors probably going to want you to err on the side of your child being hired. The first time you do this, as you mentioned, you did it after some trial and error, I'm not sure a new parent to diabetes should just, you know dial way up on their kids insulin because they're going to be in the car for nine hours, I think you should take it slowly and go a time or two or three and see what happens. And then make decisions like that after that. But for now talk to your team. They're they're going to say what I said, and they're going to support you and say, Don't worry about going out of range. You know how to do corrections, here's when and here's why to do a correction and then take it from there. Stacey Simms 17:12 And like you said, some kids sit in the car and nothing happens. Right? They don't go super high. That's why can't do Moira McCarthy 17:17 assumption, right. That's why you have to wait and see what happens. One quick Stacey Simms 17:22 thing about the car that I learned the hard way you mentioned about you know, be prepared for traffic be prepared for you know, delays, if you have and we all do I think have a you know a diabetes kit. Make sure it's where you can reach it, especially if your child is very young, right? I mean, there's a lot of kids, they're older, they can have it the backseat with them. I'll never forget packing everything we needed and leaving it in the trunk or like the way back of the minivan. And then we were delayed. And I'm like I need a new inset like says it was leaking, or we'd like crawl through the car. Moira McCarthy 17:54 That's a really good tip. So put it Stacey Simms 17:57 up to the front seat with your pack, even if you just pack a couple of things. And we had so many car adventures. Okay, the next question, I loved this one, because this just I could picture this one I know you can do more. So Deborah said we are in the first year of diagnosis, I just realized I don't know what to do about our Christmas cookie tradition. We make a bunch and give them to relatives we usually eat as we go. Can we still do this with diabetes child is eight and is on multiple daily injections, so no insulin pump yet. Moira McCarthy 18:26 So my answer is eat all the cookies, bake all the cookies, visit all the friends have all the fun, click your fingers if you want to. But then wash your hands, have all the fun and check in with your child's doctor. And what they're going to say is go do all that check at the end of all the fun. If you need a correction, here's what we'd like you to correct. And here's what we'd like you not to correct for they may not want you to correct because sometimes these things involve a little adrenaline high. And again, first times you have to see what's going on. But just have all the fun. Fix it later. If your child gets high during it, it's no big deal. If they get low, you've got cookies. There's an old saying it started with Kelly crewneck, who's a very well known person on the diabetes world on the internet. And she said people with diabetes can't have cookies, dot dot dot with poison in them. Right? The only cookies you can't have. Stacey Simms 19:26 I think that's fantastic. And it took me back listening to that about we know we don't have a Christmas cookie tradition. But we certainly you know, I think most people with little kids love to bake. And it's just such a fun activity to do with them. And in the first couple of weeks with shots, it was so difficult. You know, Binney ran away from us. He didn't want anything to do with it. But after a little while, he didn't really care as long as we didn't make a big deal and make him stop what he was doing. So and we bought after, which I know is like bananas that people admit to bolusing after these days, but I think it's so much less Moira McCarthy 20:00 Streisand gets really super smart, particularly with a small child. Stacey Simms 20:04 And so for something like this, like we would bake, and then I would kind of try to estimate like, what did he licked the spoon? Did he eat the crumbs? You know, when you do a guess? And in my case, I would always get a little less because he was teeny tiny. And then we would eat the cookie, and a couple hours later, we would correct and move on. Now. I don't know, I feel like the fun as you said, the memories of that time, you know, outweighed the quote, unquote, out of range blood sugar, I'm sure his blood sugar went out of range. And he might have been low, because they sometimes they just get really excited. And you know, he might have been high, but he's, they're healthy. Moira McCarthy 20:39 You know what, I think this, this mom, and anyone who's considering these kind of questions over the holidays should think about too, when I look back on Lauren's life, these 24 years with type one included, I don't remember that her blood sugar went higher low. I don't remember what her diabetes did one day, I remember that the cookie swap was fun. And so that's why I think it's important to focus on the fun, within reason with a kid with diabetes, you know, Stacey Simms 21:12 oh, yeah, that's a great way to put it. And I'm realizing as he gets older, I have a lot of those same feelings. I'm so glad it didn't stop us. I'm sure at the time. My heart was pounding, right, especially at first, I'm sure I was worried. I'm sure I was thinking, Am I doing this the right way. But look, you know, you have those fabulous pictures and those great memories. So that's a great way to put it. Alright, so let's talk about well meaning relatives. More Hi, Moira. And Stacy. My aunt thinks she knows everything about diabetes. She has type two and is always lecturing me about not letting my second grader eat, quote, bad foods. Holidays are the worst. I'm sorry to laugh, because she wants us to have sugar free desserts. There's so much going on. In that question. Moira McCarthy 21:59 Bless her heart, right. You know, I mean, what do you do? It would depend on what kind of person she is. And if they have, if they have a relationship that she could, I would call her ahead of time and say, Look, we're working on adjusting Stevie's life, whatever the child is, and, and there's a lot of things he's dealing with right now. So I'm just asking you, if you have anything you want to say about it? Could you say it to me now over the phone before we go, and let's just avoid talking about diabetes other than Hey, how you feeling? I'm really glad you're doing well at the holiday because I don't want him to feel sad when he has all this on his mind. That's a great way to put it. Who knows what she'll do. Right, right. Stacey Simms 22:45 I mean, you have you have well meaning relatives who want to help you have nosy relatives who think they're helping, it all depends on my mother for the first year or two she wants to make she makes one of those sweet potato casseroles, not always with marshmallows, but it's got a ton of sugar in it. And so she made it sugar free. And I didn't really notice but it's not something Vinnie was going to eat much of anyway. Yeah, when he was he was three at his first Thanksgiving with diabetes. But she meant well, but what I found worked over the years, and I still use this, even though he's his own advocate. Now, I really found that saying, Our doctor says, which I made up, but our doctor says helped everything. So I would say to somebody like this. Oh, you know, thank you so much for thinking about my son. I really appreciate it. I gotta tell you things with diabetes have changed so much now. And our doctor says that he can eat these foods and as long as we can dose with insulin, you know, we know what we're doing. He's helping us or our doctor says that Thanksgiving should be a date, like every other day or whatever it is. But people would never listen to me. Listen to what my doctor Moira McCarthy 23:46 says my my words for that was always her medical team. Yeah. sound very official, our medical team is me. But they don't need to know that. The one thing I'll say, though, is it's also okay, if it's not super aggressive, and really out of line. I think it's also okay to teach our children to show some people a little grace. And sometimes and all this even when people are wrong, maybe at the family thanksgiving, or Hanukkah, or whatever party isn't the time to say, Do you know what I mean? Great. And so if someone makes a sugar free thing, and your kid hates sugar free, you say to your kid, please just put a tiny slice of that on your plate and then push a couple pieces around under something. And it'll be fine. They met Well, yeah, you know, yeah, say and then afterwards, you can say hey, he really liked that. But FYI, next time, you don't even need to do that make the same delicious pie, but you don't need to make it sugar free. Right Stacey Simms 24:41 on everything. And that's a good point. Because we're so in our society today, we're so ready to fight. We're so ready to be on the defensive. And so I think that that's a great point just to be able to say we really appreciate it. We know how you meant it, you know, just thanks and then have the discussion later on. Yeah, Moira McCarthy 24:57 but if they're over the top aggressive about about telling your child what they do wrong with their diabetes, then you need to have a conversation ahead of time. That's right. Stacey Simms 25:04 Or you know, even in the moment if this sometimes you see, you know, I made this for these kids who don't have diabetes and look at this wonderful vegetable plate I made for your child like they're having cupcakes, but you could have the carrot that it's okay. Moira McCarthy 25:17 It just jello Jaguars. My daughter was locked up. I always have to bring a tray of jello jugglers This is before acting. And Stacey Simms 25:25 that is so funny. I'm so sorry for sugary jello. jigglers Woohoo. Oh, my gosh. Okay, another question. How do I dose for all of the grazing that goes on during Thanksgiving and holiday gatherings? This is kind of similar to the Christmas cookies, or I would think our answer is going to be but in some homes, right? It's not just one set meal. It's we showed up and we're starting to eat and we don't stop for seven hours. Oh, yeah. Moira McCarthy 25:51 My house isn't that yours? Stacey Simms 25:53 Isn't? No, no, no. Moira McCarthy 25:57 Not every house was like that on a holiday. Seriously, this is interesting. All right, well, I guess I'll answer this first, then talk to your medical team. Ask them about planning different times during the day for check ins. And then just let your child have what they're going to have. And at the check in times that you agree with your doctor, it may be every two hours, it may be every three hours, it may be twice I don't know. They'll they'll help you decide. You see where they're at. You look at what's going on what they're going to be doing next. And then you do a correction of corrections needed. That's it. Stacey Simms 26:31 Go, I'm going to add a layer to that. Yes, please do. For those who are addicted. I don't know anyone like this. I certainly have never been like this anyone who's addicted to their Dexcom. So if you're listening to more thinking, how am I supposed to check every two hours when the Dexcom or wherever three hours, whatever the most no more thinking how am I gonna check at those intervals, when my Dexcom is blaring every five minutes, okay, stay with me, people consider turning your Dexcom high alarm off, and then look at your child's Dexcom High Alert off, and then only looking at it as recommended by your care team. It will take away an enormous amount of stress. Even if your child goes high. And you bolus it's not going to happen right away. You know this, it takes a long time for insulin to work, right. So you're not really doing yourself any favors by checking it every five minutes. I know it's hard. Ask your doctor. But that has helped me more than the years when I was glued to it listening for this a lot. Moira McCarthy 27:34 And you know, I think that's really wonderful advice. Because there's nothing wrong with freeing up the family to enjoy a good time. If it's so important to you that you keep them in a certain range and you want to watch it all day, then go ahead. But I think what you suggested and what you just said you do is such a good model for your child, because as you care for your child, you're modeling how they should care for themselves later. And the reality is in this long, long, long, long, long lifetime marathon diabetes, you need to just chill a mile here and there. And by doing this and saying to your children, we're going to turn this off, this is okay. Don't worry about it, you're fine. You're modeling that for them. And you're giving them the confidence and the courage to know that they can be okay. If they're not doing, you know, 150%. So I love that answer. Stacy, you get a gold star. Yeah, Stacey Simms 28:34 it's funny to think about, but that's actually how we use Dexcom. And how everyone use Dexcom intil. Gosh, I'll probably get the year wrong. But until, let's say 2015 Because Dexcom share did not exist, right? So at school, our child would like many others basically used his Dexcom receiver as a no finger stick monitor. Right. So at the time of day were Benny would normally have done a finger stick, he just looked at the receiver showed it to his teacher. And that was it. We started using it like that. So I think it makes it a little easier if you come home from the hospital, like a lot of families do attuned to every alarm. These things may seem like an astronomical ask, but you really can do it. And I would also add with the grazing, we you know, we were grazing experts, because I had a two year old with type one who was diagnosed. I mean, a few years after Lauren, so you know, was not on that very regimented timing. So Benny could pretty much eat all day, like a normal two year old. I mean, obviously not all day, but you know what I mean? Several times a day, and we just had to give them fast acting. So it makes it it does make it a little more difficult, right? It's not but it's not something you do every single day, either. So I think that you know, you've got to kind of let go a little bit, but it's not harmful and it can make these ladies have these wonderful memories. Alright, and finally, this question, I'm a little stymied by this one. What's the Christmas present for a child with die? beedis Moira McCarthy 30:01 Okay, a good Christmas present for a child with diabetes is what they put on their Christmas list. If you want to give diabetes related gifts for Christmas, that's all good and fine. I knew someone who gave their child quote unquote, their insulin pump for Christmas and like, their heart was in the right place, and the child felt great, but it just made me a little sad. I guess if your child puts insulin pump on their Christmas list, though, that's different. But even then I think I'd say no, Santa doesn't need to bring you medical stuff, we can just get that went whenever you need it. There are toys and animals and things like that. If someone's interested in actually, diabetesMine is having me do a list of them that's going to run in late November, early December. We can link that on this after Oh, that would be great. Like Stacey Simms 30:54 the American Girl doll stuff and road kid kits. Fabulous. Moira McCarthy 30:59 And then I don't mean that there's anything wrong with that stuff. I just think that you should give your child gifts that they want as a child, not as a child with diabetes. Yeah, Stacey Simms 31:09 I think a lot of that depends on how your family celebrates and what gifts you're giving. We are We joked in our family for Hanukkah, when I was growing up, you would get everything from the toy that you really, really wanted to the dictionary that you did not ask for to the socks that you need it right so if your gift giving is like that mixed up, and it's you know, if your family expectation is that kids will get super useful stuff in all the kids not just the kid with diabetes, then I guess I could see it. But I'm with you, I think unless it's something really fun like one of those add on what your list is going to be made up but like, what are those stuffed pancreas like? silly things like that. And yeah, accessories for dolls and fun stuff. It's just like a useful medical thing. I think you've got to be very careful and know, the child like especially a parent to a kid is one thing but if you're like the fun and or you're the family friend thinking this will be a big hit. I just be a little careful. One of the things I saw in another group was you know, there's a newly diagnosed child which they get the family and the most popular response was don't get them anything quote diabetes related, get them fuzzy slippers, and a gift certificate for babysitting or you know a trip to the movies and get them something fun and engaging. Moira McCarthy 32:22 Get them something normal and and pushing back on what you said I still even if my family did that stuff, I still wouldn't give my child like a box of syringes. So core. I like if you're giving your kids toothpaste for Christmas, because that's what you do, then give your kid with diabetes toothpaste for Christmas treats the same way you treat your other kids when it comes to gifts. Stacey Simms 32:42 That's a good point. I think if anybody ever gave Benny any diabetes related gifts, and no one would ever mind my family would have ever done that. But Moira McCarthy 32:49 one time in our family Yankee swap, I used a syringe box, like for the gift and whoever opened it thought it was syringes and we're like, I don't get it. And I'm like, Oh, for goodness sake. It's just a box. Stacey Simms 33:03 Open it up. Is a Yankee swap like a Secret Santa. Moira McCarthy 33:07 Yeah, kind of but you you could take gifts away from like a one white elephant. I don't know. I'm sorry. That's a white Jewish lady. It's like we're from different worlds, Stacy. Stacey Simms 33:21 Oh, you New Englanders. Moira McCarthy 33:24 Bless my heart. Stacey Simms 33:26 We do have one funny story. So on Christmas day in Gosh, I'm looking back already. This was this is eight years ago. So on Christmas Day, we started the Dexcom. The very first time we ever used the G four platinum. Vinnie was nine. Oh no, the g4 Platinum pediatric. So Vinnie was nine years old. And we were sitting around a Christmas day at my mom's house like you do. And we said, let's start the Dexcom. Why don't we will put it on we had been instructed on how to do it. Of course, again, I don't know if I can emphasize this enough. We do not celebrate Christmas. I don't think I would do this. Christmas. So but we put it on and I will never forget because that was you know, Christmas Day. Gosh, so yeah. Merry Christmas kid. That was the big horrible insert or two. Moira McCarthy 34:14 But then it could have Chinese food before the movie, right? Stacey Simms 34:18 Really my house. Moira McCarthy 34:21 I know you. Stacey Simms 34:23 That's great. So normally at the end here, we talk about where we're going in the diabetes community. Of course, you know, there's no diabetes events going on now. And I'm really, really hoping they come back next year. But I mean, I'm doing some virtual events. I'm reaching out, but I cannot wait to be in person again more. Moira McCarthy 34:39 I feel you. I can't believe I was just thinking about this the other day because my Facebook memory was, I guess right before the pandemic I was in Buffalo, New York speaking at a big diabetes event at this time and they were all these pictures and people posting about interesting things they learned and how happy they were going to be and I was like, oh, I want to go back somewhere. I think we're We're gonna see things start bubbling up I do believe friends for life is going on this summer I'm hoping I'll be there I haven't heard yet but um I know that's probably happening and I think JDRF is going to start doing some smaller half day programs in the near future knock on wood so I hope we're in the same place to Stacey that's what I hope not only we get out and speak but you and I are in the same place. Stacey Simms 35:22 Yeah. Oh my god, Moira McCarthy 35:23 it's all about us. Stacey Simms 35:26 Why not? I was kind of pausing because I don't remember when we saw each other live to look that up. At the end of the show. Moira McCarthy 35:33 I think it's been at least two years Stacy that's really weird. Stacey Simms 35:37 It has to be it has to ah, I miss you. Moira McCarthy 35:40 Me too. We talk every day practically. I miss you as a as a human life form. Stacey Simms 35:50 Well, the next time we get together we can we can do a Yankee swap. Moira McCarthy 35:52 Yeah. And and a white elephant, white elephant. Stacey Simms 35:57 Well, if I don't speak to you have a wonderful Thanksgiving, enjoy your family and your adorable grandchildren. And give Lauren my best and tell everybody we said hi. Same here Moira McCarthy 36:07 and make sure those kids yours know that I still think they're awesome. Announcer 36:16 You're listening to Diabetes Connections with Stacey Simms. Stacey Simms 36:21 I will link up some information, including to an episode we did with adults with type one and their take on Thanksgiving. I'll put that in the show notes along with the transcription for this episode, you can always go to diabetes connections.com. Every episode starting in January of 2020 has a transcription. And there's lots more information there. I got to tell you more. And I make it sound pretty easy now, right? But those first couple of years, it's so stressful because you're trying to have a nice holiday. You're trying to project confidence, you know, we're doing great. Diabetes won't stop us. And then you're freaking out, you know, what did you eat? Should we pre bolus what's gonna happen now? Am I gonna be up all night? You know, it's, well, you know, who's got the carb count? Is it accurate? Spoiler, the carb count is never accurate. It's never accurate. I hope you know that. We're estimating everything, even packaged foods. Even somebody who weighs in measures, everything is a total guess, on carbohydrates. So just do the best you can. And it's you got to get through that I think you've just got to get through that experience. There is no other teacher like experience and diabetes, you've got to make mistakes, you've got to kind of be upset, you gotta be worried you got to get through it. But if you let yourself I think as a parent, you really can get to a place where you're like sure marshmallows on sweet potatoes, we can figure that out and go from there. And if you hated my advice to turn the Dexcom off, let me know I would love to hear from you. You can yell at me all you want. Let me know if you try it though. And if it works for you, I don't want to cause more stress. I promise. Diabetes Connections is brought to you by Dexcom. And hey, listen, I'm all about using the technology in a way that helps you thrive with diabetes. So when I say turn it off, it's not a knock on Dexcom. It's sharing how we use it to help us make great choices. Live well and be happy. I stand by that you know we have been using the Dexcom system since he was nine years old. We started back in December of 2013. And the system just keeps getting better. The Dexcom G six is FDA permitted for no finger sticks for calibration and diabetes treatment decisions, you can share with up to 10 people from your smart device. The G six has 10 Day sensor where the applicator is so easy. I have not done one insertion since we got it but he does them all himself, which is a huge change from the previous iteration. He's a busy kid, knowing that he can just take a quick glance at his blood glucose to make better treatment decisions is reassuring. Of course we still love the alerts and alarms and that we can set them and turn them off how we want. If your glucose alerts and readings for the G six do not match symptoms or expectations use a blood glucose meter to make diabetes treatment decisions. To learn more, go to diabetes connections.com and click on the Dexcom logo. A couple of quick housekeeping notes we will have a regular episode next week. Our regular episodes are on Tuesdays. So we will have one for you next week. We will not have an in the news edition of Diabetes Connections. Thanksgiving week though. I will not be doing that live on Wednesday and there will not be an episode Friday the 26th I will say if anything really big happens if we get an FDA approval, you know something like that. I'll probably pop on and give you an update. I you know, I know we're all waiting for something so I can't promise I won't do it. It's not it's like the news person in me I was in you know, I've been doing this since I was 19. So if something breaks, I'm gonna have to jump on. Even if Slade is like, you know, making turkey behind me. We'll figure it out. But right now again this week, the week of the 16th. We will have the regular in the news on Wednesday, which will become an audio only podcast on Friday. The following week. We will have a regular episode, but there will be no in the News episode Thanksgiving week. All right. With that thank you to my editor John Bukenas from audio editing solutions. Thank you so much for listening I’m Stacey Simms I will see you back here for in the news this week until then be kind to yourself Diabetes. Benny 40:10 Connections is a production of Stacey Simms media All rights reserved. All wrongs avenged
6 minutes | Nov 12, 2021
In the News.. Tandem & Omnipod updates, T1D kids & COVID and more!
It's "In the News..." the only diabetes newscast. This week we find out about: SGLT2 inhibitors, more evidence this T2D med works for T1D, Tandem & Insulet earning calls: what you need to know, Which kids with T1D did even better during COVID? How you sleep could increase risk of gestational diabetes, what's going on for Diabetes Awareness Month and lots more! Have 5 minutes? Give it a listen! -- Join us LIVE every Wednesday at 4:30pm EDT Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode transcription below: Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I’m going to link up my sources in the Facebook comments – where we are live – we are also Live on YouTube and in the show notes at d-c dot com when this airs as a podcast.. XX In the News is brought to you by The World’s Worst Diabetes Mom, Real life stories of raising a child with diabetes. Available in paperback, on Kindle or as an audio book – all at Amazon.com -- XX Our top story, evidence that SGLT-2 inhibitors can help kidney and heart health in people with type 1. These are diabetes drugs that are already shown to lower blood sugar levels – they have brand names like Invokana and Jardiance – but they are not approved for T1D in the United States. The problem is that they can lead to DKA even with normal glucose levels. However, they are approved in Europe and many advocates say they can be used safely if people no to monitor closely. https://www.news-medical.net/news/20211107/Study-examines-benefits-of-SGLT2-inhibitors-in-individuals-with-type-1-diabetes.aspx XX Some tidbits in Tandem’s third quarter investment call last week. CEO John Sheridan says they plan to ask the US FDA this year to approve Control IQ down to age 2 – right now it’s only approved to age six. Also asking for expanded labeling for people with type 2. Mobile bolus or bolus by phone still out there waiting for approval – Sheridan says the FDA last asked them any questions in August. He says they have three initiatives for 2022: filing for the Tsport pump, integrating the upcoming Dexcom G7 and moving ahead with their partnership with Abbott’s Libre. Sheridan thinks it’ll be a matter of a few months before Tandem pumps integrate the G7 saying, “When it comes to Dexcom, we've integrated three generations of their sensors already. We're on the fourth. We know how to do this” I hadn’t heard this, but Sheridan says the Libre had a bit of a hiccup with the FDA approving it as an iCGM, that’s a newer designation… because taking vitamin C can throw the readings off.. but he believes they’ve addressed that. We’ll follow up. https://www.fool.com/earnings/call-transcripts/2021/11/03/tandem-diabetes-care-inc-tndm-q3-2021-earnings-cal/ XX Insulet also had their quarterly call – CEO Shacey Petrovic says she’s still optimistic about Omnipod 5 being approved this year.. she says they’ve had a lot of back and forth with the FDA in the last few months and that’s what makes her more confident. Other tidbits.. Omnipod reports that 80% of their customers were previously on multiple daily injections only .. no prior pump experience. They think when Omnipod 5 comes out there will be more competitive switchers from other pumps. They reiterated that it will be a limited release when approval comes with a gradual rollout in the US. https://www.fool.com/earnings/call-transcripts/2021/11/04/insulet-corporation-podd-q3-2021-earnings-call-tra/ XX Really interesting news about some children in the US with type 1 during the pandemic – they had more time in range and lower A1Cs during the first year of the pandemic compared to the year before. They also saw their doctors more, even though 90-percents of the visits were virtual. This was a group of kids ages 1-17 all of whom use a CGM. The researchers say they want to take a closer look to try to figure out why this was the case: speculation ranges from more oversight from parents to flexibility in schedules. I can say this definitely happened in my house.. however I’ll also throw in that my son started on his first hybrid closed loop system in Jan 2020 just before the pandemic– Tandem’s CIQ - and that made a huge difference, especially when we were stuck at home and he was eating at 2am. They don’t mention the insulin delivery system here.. just that every kid had a CGM. https://www.healio.com/news/endocrinology/20211108/metrics-improve-for-us-children-with-type-1-diabetes-using-cgm-in-first-year-of-covid19 XX Something called sleep-disordered breathing may play a role in gestational diabetes and insulin resistance. There isn’t a lot of research here.. This study looked at women who had risk factors for obstructive sleep apnea, a form of sleep disordered breathing that has been linked with high blood pressure, heart disease, and Alzheimers. The data suggests those with it may enter pregnancy at higher risk for gestational diabetes and recommend more screening. They added further investigation is needed to see if treating the breathing issue in early pregnancy could improve glucose levels. https://www.contemporaryobgyn.net/view/women-with-sleep-disordered-breathing-linked-to-insulin-resistance-and-gestational-diabetes-risk XX Fun story in football this week: Mark Andrews and Blake Ferguson will face each other in the big Thursday night NFL game. Andrews is with the Baltimore Ravens, Ferguson plays for the Miami Dolphins. They both live with type 1. It’s thought this is the first time two NFL players with T1D have faced each other. They each use Tandem pumps, btw, so expect to see some posts from that company promoting the game. XX Big grant for Beyond Type 1’s DKA Awareness Campaign. The Helmsley Charitable Trust is giving them more than $300-thousand dollars for their grassroots messaging movement. This provides posters to schools and communities and sends literature to pediatricians. Almost 50% patients under the age of 18 in the U.S. are in DKA when diagnosed with Type 1. https://beyondtype1.org/beyond-type-1-receives-300985-helmsley-charitable-trust-grant-for-dka-awareness-campaign/ XX Lots of good stuff happening for Diabetes Awareness Month.. Dexcom is partnering with Nick Jonas and Patti LaBelle… they say to help the diabetes community feel seen and heard, while advocating for improved access to diabetes care. Nick Jonas has been sharing people living with diabetes on Instagram and that’s been really fun to see. Patti LaBelle lives with type 2. She spoke to Congress earlier this month to talk about better access for people with Type 2 diabetes, especially in communities of color. XX Great round up of this kind of stuff – what the big organizations are doing for Diabetes Awareness Month over at Diabetes Mine.. I’ll link that up in the show notes; https://www.healthline.com/diabetesmine/diabetes-awareness-month-2021#dexcom XX quick reminder that the podcast this week is our first ever tech roundtable. Really great discussion with two guys who follow this stuff very closely – Kamil Armacki better known as Nerdabetic and Chris Wilson. We go through everything in front of the USA FDA, some stuff that’s approved in Europe and talk about what’s coming next. you can listen to wherever you get your podcasts or if you’re listening to this as on a podcast app, just go back an episode. Next week: holiday help – ask the Dmoms is back to help you through what can be a stressful time of year. That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
54 minutes | Nov 9, 2021
Diabetes Tech Round Table: What are we waiting for?
At this point in 2021, we thought there would be several new pieces of diabetes technology on the market. COVID delayed several FDA submissions and approvals so where do we stand? Stacey sits down with Kamil Armacki, AKA Nerdabetic, and Chris Wilson to talk tech. Both Kamil and Chris keep a close eye on everything from filings to clinical trials to investor calls and neither is affiliated with any diabetes company. There is also video of this if you prefer to watch over on the YouTube channel. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Episode transcription below Click here for iPhone Click here for Android Stacey Simms 0:00 Diabetes Connections is brought to you by Dario Health. Manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first premixed auto injector for very low blood sugar, and by Dexcom, take control of your diabetes and live life to the fullest with Dexcom. This is Diabetes Connections with Stacey Simms. This week, I wanted to try something a little different as we enter the end of 2021. And look ahead to next year, I thought it would be a good time to sort of take stock of diabetes Technology. Welcome to another week of Diabetes Connections. I'm your host, Stacey Simms. And we aim to educate and inspire about diabetes with a focus on people who use insulin. And while this community likes to say we are not waiting, frankly, there was a lot of stuff that we are waiting for right now, I asked a couple of friends who really have their finger on the pulse of this stuff to come on and share their thoughts. The only problem we really like to talk. So this is a longer episode than I expected. And frankly, it's not just that we'd like to talk there's just a lot of technology that we are waiting for. So to that end, I'm just going to jump right in, we'll do the quick add that we always do at the top and then we'll get to the panel. There is also video if you prefer to watch our conversation that's over on the YouTube channel. I'll link it up in the show notes but we are not showing any product. So it's really just about whether you prefer audio or video. Alright, Diabetes Connections is brought to you by Dario health. And the bottom line is you need a plan of action with diabetes. We've been lucky that Benny’s endocrinologist has helped us with that and that he understands the plan has to change as Benny my son gets older, he wants that kind of support. So take your diabetes management to the next level with Dario health. Their published studies demonstrate high impact results for active users like improved in range percentage within three hypoglycemic events. Try Dario’s diabetes success plan and make a difference in your diabetes management. Go to my dario.com forward slash diabetes dash connections for more proven results and for information about the plan. And as always, this podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. All right, welcome. We're trying something new on Diabetes Connections. And that is the first of its kind kind of tech panel. And I am joined in this conversation by Chris Wilson and Kamil Armacki . And these are two guys that I'm gonna let them introduce themselves a little bit, but that I follow for technology news, as well as for some analysis. So thank you both for jumping on with me. You're not industry people. But let me ask you to kind of describe yourselves first, Chris, you are somebody that I always turn to for the insight and information about technology. But this is not what you do for a living? Chris Wilson 3:00 No, not really. I sort of jumped into the online diabetes online community when I reached a point where I had access to insurance and could actually look at diabetes technology because it became affordable. And at that point sort of started jumping into a lot of the groups and online discussions tried to figure out what I was interested in for myself at the time. And then over time, I wound up being asked to join the admin team of a couple of the bigger Facebook groups getting involved on Twitter and other platforms. And so now i is part of that role. I sort of find and analyze listen to the investor calls that the companies do, you know, sort of keep an ear to the ground here what people's sales reps and endos are whispering about to to their patient populations and glean some information from that. I've also been a frequent participant in research, especially in clinical trials. I was in the clinical trial for the G6 that prove that acetaminophen didn't interfere with it. I was in the clinical trial for the Xeris Gvoke. I was in the clinical trial for the Ilet, which is still apparently ongoing. I've got a fair amount of experience for playing with stuff that isn't necessarily out yet. And sort of seeing things from a different perspective than just the end product that people see when they finally get a prescribe from their doctors. Stacey Simms 4:23 That's great and comedic view or better known as Nerdabetic. On social media, many people probably recognize your Omnipod. Those are Omnipod pods lit up right behind you. Kamil Armacki 4:34 That is absolutely right. That is 550 inch LED Omnipods. Most of them this is very DIY. Most of them actually placed with LED lights and painted and we saved them on a temporary wall kind of thing and we glued them off. So we had this is one of the proudest things I've ever done as Nerdabetic I also can't really take credit my dad that 95% I only paid a couple of walls, and I feel like I'm taking all the credit. So massive shout out to him. Stacey Simms 5:07 I love it. I love it. And as Nerdabetic, you are known for interviewing CEOs getting all sorts of tech information out there. And we'll probably mentioned this at least once later on, you do a lot of both, you do some 3D printing, right to see what the items might look like. Yeah, so Kamil Armacki 5:23 I've been running my YouTube channel for I think four years at this point, just when I started university, and I just graduated this summer. So it kind of it was over four years ago. So you just been trying out different things within within that channel. One of them was 3D printing. I'm absolutely fascinated by that technology. I don't own a 3D printer. But I think it is a very interesting way of giving an idea, a bit of a tangible feel to it. So for doing that, and all of those things they mentioned. And most recently, I had the honor of speaking to some pretty pretty important people in the industry to see what's been happening over there as well. Stacey Simms 6:01 Cool. All right. And Kamil is in the UK, obviously, you sound like you're based in the UK, but you are there now, which means some of this discussion will include information from the US FDA, or at least we're gonna speculate about that same thing, European CE mark, but some differentiation of products there. But I just thought it'd be fun to talk to you guys. So all right, we've got it out there. And I'm a diabetes mom, I read stuff, I listen to stuff, I don't think quite as much as Chris, or Kamil, but that's my knowledge base. So just to be clear, nobody who works for the FDA, nobody who works for diabetes company, we are just observing and birth speculating, which I think would be some pretty fun and interesting conversation we'll see. So let's start by talking about what is in front of the FDA right now, because this year, and last year had seen some big delays due to COVID. So we're waiting. I mean, it's been a long time. Let's start with Omnipod 5. And that is, of course, still as we are speaking, I mean, who knows what will happen today or tomorrow, but it is still in front of the FDA. But what's interesting is when they submitted and Phil, I know you talked to their CEO recently I talked to her I believe right before they submitted, it was going to be very different from the other commercial hybrid close loops in that the range was going to be lower. In other words, your blood sugar range, initially, I believe, was supposed to be able to get below 100 As a set point, but now it's 110. And they do have all sorts of really interesting other features. What did Shacey Petrovic, the CEO of Omnipod share with you recently, when you talk to her anything changed, or anything that stood out to you? Kamil Armacki 7:36 Yeah, so I've spoken to her a couple of weeks ago at this point. And the product that they've submitted to the FDA, for my understanding, has a target glucose, which goes as low as 110, and can be customized up to 150 milligrams per deciliter. In terms of the actual product, I think I'm very excited about Omnipod 5, because it will be the first product, the first pump, which actually talks directly to the Dexcom G6 continuous glucose monitor. So there'll be no need to carry a physical controller, which obviously, I think makes sense for a product like Omnipod because you know, you wear it on your body. And so it will connect directly in terms of actual updates to submission as of a couple of weeks ago, she said they still expect an A by the end of the year, with a limited release in the US. And during that interview, which was slightly kind of European focused. We talked about many things including Omnipod on the runway during Italy's Fashion Week in Milan. But she also mentioned that they are hoping to bring that technology to their to Europe to the UK, once they get their FDA approval. Stacey Simms 8:48 When you said the first one or the only one do you mean in the UK? Because we've got Dexcom talking to Tandem, at least here in the States. Kamil Armacki 8:55 First one where you don't need so where the pod talks wearable talks throughout behind okay. Yeah, I thought directly to the G 610. Stacey Simms 9:05 Is control IQ approved in the Kamil Armacki 9:06 UK stupid question. Yes, we have. So at the moment, we have control IQ and seven ATG which we will I'm sure mentioned Oh, yeah. Okay. I didn't come EPS actually. So we have three other countries across Europe. They have other systems like dialup as well, France, Germany, but we don't have that one here. Yeah. Hashtag Brexit. Stacey Simms 9:28 I was gonna say show off, but then right. It's not in the UK. Lots of and there's other systems coming to that we may get to, Chris, anything that you have heard over the last year in terms of Omnipod? Five. I mean, I just feel like we're kind of waiting. Chris Wilson 9:40 I mean, just from my view on the outside. I think that insolence estimates of hopefully getting it before the end of the year, probably right. I know that it did qualify as a breakthrough device. So it's supposed to have a faster review at the FDA, but we're still dealing with the COVID backlog with all kinds of stuff. For me, there's things that we probably expected six months ago, there's still pending. And I know there's always rumors circulating that this got approved, but it hasn't been released yet. And so half the time I'm going and checking the FDA database for what approvals were announced in the last week. Kamil Armacki 10:16 Only Chris does this kind of stuff. Stacey Simms 10:20 I did have an interesting question from a listener who was talking about Okay, so as we're taping, Dexcom g7 has not yet been submitted to the US FDA, it has been submitted in Europe. And her her thought was like, Oh, my gosh, if Omnipod has been sitting there all this time, and Dexcom hasn't even submitted, how much longer is it going to take? And my point to her was, it's not as though Omnipod and these other submissions are just sitting in a file cabinet. Right? I mean, they are actively being looked at. You're both nodding. Can you tell me a little bit about what we know I mean, these submissions again, they don't just land on a desk and then one day someone opens them and rubber stamps them. Back to our conversation in just a moment, but first Diabetes Connections is brought to you by Gvoke Hypopen and you know, low blood sugar feels horrible. You can get shaky and sweaty or even feel like you're going to pass out there are a lot of symptoms and they can be different for everyone. I am so glad we have a different option to treat very low blood sugar. Gvoke Hypopen is the first auto injector to treat very low blood sugar. Gvoke Hypopen is pre mixed and ready to go with no visible needle before Gvoke people needed to go through a lot of steps to get glucagon treatments ready to be used. And this made emergency situations even more challenging and stressful. This is so much better. And I'm grateful we have it on hand, find out more go to diabetes connections.com and click on the Gvoke logo. Gvoke shouldn't be used in patients with pheochromocytoma or insulinoma visit Gvoke glucagon.com/risk. Now back to Chris answering my question about FDA submissions. Kamil Armacki 12:00 Yeah, so for the pandemic, the main reason as to as to why we have a backlog is that regulators that used to regulate that were in charge of regulating medical devices like continuous glucose monitors, hybrid closed loop systems. And this is across actually Europe and US it's very similar, simply because of the pandemic, they were actually responsible for overseeing all of the medical queries related to the pandemic from, you know, vaccines emergency authorizations. So that's what we call when a product is used in a slightly different way to kind of simplify it. And so using a CGM and hospital was a good example of that we seen an emergency authorization of that, so they've kind of, you know, dos thinks took priority. So too, you know, that's where we have a backlog, but now they from my understanding, kind of back on on track, and, you know, four hands on that backlog, working their way through it. Chris Wilson 12:57 There's just only so many people to do the work. And I mean, even when stuffs in development, there's always a lot of back and forth between the company that's developing it and the FDA, what are you going to require us to do, and so then they alter the product design sometimes to make it fit what the FDA wants, and that can even go into is as deep as the training modules. And the other information that gets given to patients when the product is prescribed, they're looking at all of that they're looking at human factors testing are people you know, able to follow the directions and use it the way that it's intended to be used, are they going to do something stupid and mess it up? They're looking at all of that. And then they're going through all of that data on all the different aspects of the devices and needing to decide, okay, is this safe enough to actually be effective? And there are different standards in Europe versus in the US? The FDA has much higher safety thresholds, whereas the European standard is basically does it do what it says it's going to do? Kamil Armacki 13:58 And just to close up Omnipod 5, I think FDA has added it Chrissie would agree this is just my personal opinion. I think FDA has been pretty scared of going to full control. And the biggest today there isn't an insulin pump, which offers, you know, remote bolus capabilities. And that's part of Omnipod 5, you know, that's what they've submitted to them. So, you know, my speculation would be that if actually they didn't submit full control within that first submission, maybe we already you know, maybe it would be here already. You know, it is an area that FDA has been very cautious about. So I guess that's a significant factor contributing to to the to the backlog as well to the delight. Stacey Simms 14:40 Well, and that brings us to our next item that's in front of the FDA. Thank you for setting that up. So Tandem has also submitted in the last year and is waiting for bolus by phone. You know, that's not the official name of it. But I agree with you. I think the FDA is really taking a very, very careful look at that bit of technology. And Tandem, you know, I believe, to your point, Chris, there has been some back and forth. You know, they don't issue press releases. Every time they asked for that, but it is happening, I think, to me, you know, as a mom of a kid who takes his phone everywhere, you know, this is something that I cannot wait for. I mean, bullets by phone just seems like such a basic capability in 2021. But of course, it's a medical device, and it's your phone. Chris, are you hearing anything? Or do you have any opinion on that? Chris Wilson 15:29 I mean, at least as far as Tandem goes, I think there's less of a risk because you still actually have the physical pump that can be used to do something if for some reason, there's a problem with the phone. If you're relying exclusively on the phone, you've got to worry about what happens if it gets lost. What happens if they're dead batteries? What happens if you unlock it and hand it to your kid to play a game and the kid goes into your bolus app and accidentally gives you 15 or 20 units of bolus while they're chatting around? I mean, all of those things need to need to be taken into consideration and mitigated as much as possible. Stacey Simms 16:01 I wonder Kamil, it's interesting to think about Omnipod because they've when I've talked to them, I've always asked like, why can't you put some buttons on the pod. And their point was, and I think this leads to Chris's point from the phone, their point has always been well, it's for safety with the pediatric patients, they don't want the kids touching the pod pressing buttons, this makes perfect sense. I was a parent of two small children, they're gonna touch everything. But it's kind of the flip side now on the phone, right. So it's an interesting look to see what you trade off in a way. Kamil Armacki 16:31 So actually, to that point, in the UK, we do have an insulin pump from rush called accucheck. Solo. And on the high level, it's kind of like a nominal pot, where the pot like device that you put on your body and actually has two buttons on it. So you can actually bolus from the patch itself. And the way they've actually engineered it is that you need to press both buttons at the same time, ensure that you don't kind of you know, lean on the you know, you could very easily lean on a button and just press it, you know, other companies have gone down that route as an Omnipod. To use that I do use a monopod. So I use Dexcom and Omnipod in a DIY setting. And yeah, I love the simplicity of it. So yeah, massive, massive fan. Stacey Simms 17:14 I think it's just all trade offs. Right. I mean, there's no perfect system, I don't think but people want to perfect. Exactly. Right. Exactly. Chris, what do you use? If you don't mind me asking? Chris Wilson 17:25 I am on a Tandem with control IQ, although I don't use it exactly as designed. I've been working with better bullet strategies and playing with the modes that have put that it gets put in be an exercise or sleep that change some of the the targets that it's trying to hit to get it to behave a little bit more like I think it should. Stacey Simms 17:47 So you're using Ctrl Q and Kamil, you're using Kamil Armacki 17:50 loop? Yeah, that's right. Yeah. on any iPhone. Yeah. Stacey Simms 17:53 All right. I don't want to move on from Tandem quite yet. But I want to talk about loop in a moment. So we've got bolus by phone in front of the FDA, which we also think could come approval could come by the end of the year, but Tandem moved their submission for TSport. Right. They were going to submit that in 2021. Chris, they are moving that to 2022. Right. Chris Wilson 18:12 That was the last that I heard. Yes. To me. Stacey Simms 18:16 I see you nodding. Kamil Armacki 18:17 Yeah, I agree that that's what my understanding of the T sport is, I think they had some communication with FDA with the phone control, which obviously plays into T sports as well. Like the point Chris was making, you know, there's no display I don't think on the although, you know, it's a patch, you know, it's kind of moving into that kind of tubeless to pipe bridge mode kind of pump. So yeah, I'm pretty sure they've decided it's pushed back further. Stacey Simms 18:48 And I should have set that up better if you're not familiar with a tee sport is a very tiny version of the T slim it is been to me it looks kind of like a beefed up cartridge and it sticks somehow to your body. There is still a tube and there is still an inset, but it kind of I don't know if it dangles off, or it sticks some I don't know. So they haven't they haven't released that I've asked a bunch of people when Lily a while ago was coming up with its own pump and it was supposed to be inset and sticky. I'm still trying to figure out how it supposed to stick to your body with an inset and they haven't really explained that. So maybe at some point, but clearly you made a 3D version of this yourself right? Didn't you like mock up a Teesport at one point and freak everybody out? Because we thought you had one? Kamil Armacki 19:27 I did. So just on that entire idea in general, there's actually a pump in it's been kind of out here in Europe and has been taken off the market and I think it's coming back at some point called collider which uses a similar idea of where three colors bright colors. Yeah, so So that's kind of it's an interesting concept because you have an infusion set and like a sticky dye upon your body. And I think it that's what Tandem has gone off as well. But yeah, I did. It's very interesting how people often will look at especially on YouTube because it's a very visual form, they will look at a picture without watching the video. And yeah, a lot of people thought I had some insider info on the T spot, which was a very interesting experiment and a lot of comments about that go like, where did you get this? And I'm like, I didn't Freeview print hello, it's 2020. Kamil Armacki 20:19 Be careful, be careful, hey, Chris Wilson 20:21 I need to take some of the blame, actually, I think for potential delays on the other Teesport, I was involved in some of the Human Factors testing. And based on some of the questions that I got asked afterwards, I think I may have done some things that they weren't expecting it some stupid things or something that was not dissipated. So that may actually be the source of some of the Stacey Simms 20:45 Alright, well, if you can't answer I understand what the heck could you have done? What Chris Wilson 20:52 I think it was, it was just in case of directions weren't necessarily clear. Or I was expecting, you know, think about this, rather than actually do it. I obviously can't go into specifics. But needless to say, I clearly wasn't doing everything that they expected as part of the tasks in the testing. So who knows that may be part of the the reason that things got delayed, but hey, if it prevents somebody else from doing the stupid things that I did, and having a problem later on, then that's actually a good thing. And actually, Kamil Armacki 21:24 I'm so glad that you did, Chris, because so many companies have tried this idea of you know, having a patch and in a short tube. So novo, they went out of business Kaleido also really struggling, we don't really know if they're gonna come back. And Tandem is now trying, they're kind of stab at it. No one has really made this idea work. So Stacey Simms 21:43 yeah, it's a good point. But one thing I do like, again, I don't have diabetes, I don't wear the devices. But the idea I like is that with an inset, you do have a choice of how it connects angled or what the cannula length is, or steel, you know, with Omnipod, or you don't have as many options in terms of how it connects. Now, many people will say to counter that, well, you have many more options of where you can put it, you know, so it really just depends on how you wear it where you're comfortable with. But I think that's why they keep trying cumulus because there's that different kind of inset that people can use. So who knows? But I think that's a really good point. Chris Wilson 22:18 Well, it's a great example of how your diabetes may vary. Yeah, no one solution is going to work for everyone. So that's why it's important that we have these options. Stacey Simms 22:27 Alright, so let's talk about loop. One of the other submissions. This is such a laundry list in front of the FDA is tide pool loop. And that was submitted earlier in 2021. It's been very quiet, but it is it's hanging out there. Anybody here anything? Anybody know anything? Any comments? Chris Wilson 22:45 I really haven't heard anything. I mean, it's so pure speculation. Obviously, this coming from the open source community is going to be subject to a lot probably more scrutiny than if it's coming from an established player. And I was not entirely clear on exactly what the trials for approval looked like. It sounded like some of the DIY data from DIY loot may have actually been used as part of the submission. So I would imagine that that's probably at least one of the things that may be taking a little bit extra time because I'm feeling the FDA is probably going to look a little bit more closely at that than they would if it was coming directly from Insulet. Or someone else. Stacey Simms 23:28 That's a good point and was used I believe, that's what they told me earlier this year was a lot of that open source a lot of that DIY community data was put in so you wonder what then the FDA came back and asked for no, no, what we really need is or no, that is enough. I mean, we'll find out later, but it's very interesting stuff. Kamil Armacki 23:46 And in some ways, it is a perfect storm, because it is using, you know, using that DIY technology, which is just absolutely amazing. I mean, the whole title team has been so tremendous in this project. So it's you know, taking that DIY, but then also the phone control point that we mentioned earlier, where it's an Omnipod. So actually, you know if your battery dies, I'm sure everybody's asking those questions. You know, if your iPhone dies, how is the child going to bolus? I'm sure that those are the questions that you know regulated system has to they need to have that usually answers for that. So I'm sure they face in similar scrutiny on the phone point just like Omnipod 5 does with eventually Stacey Simms 24:26 this just occurred to me and again, I don't use the system so that's probably way to think about it, but these DIY systems that already use the phone can you use your watch to control them to Kamil, I wonder if that's something that's done? Yes. Kamil Armacki 24:39 It's it's just like with Dexcom you still need your phone. So phones like the the house the home of the of the whole system, you can remotely you know, bolus and enter carbohydrates and Al's meals etc. Using your Apple Watch. Bought a phone is still required to actually do all of the calculations the brain behind all of it on Omnipod, five doc, this all happened on the pod both title loop that's all happening on the phone just like with a DIY system. Oh, yeah, that's a really good point. So you really need that to to make this system work. And there are all of those you know, your phone die in, you know, someone's stealing your phone cases that you know, I'm sure FDA is wants answers for Stacey Simms 25:22 it to be clear, because a lot a lot of information there. I think this is a good point Omnipod 5, as you said, controlled by the pod. So you lose your phone, it keeps on trucking, it's going to deliver basil, the loop will continue a tide pool loop and loop DIY, whatever it's called right now is all controlled by the phone. So if your phone dies, the system won't continue. Kamil Armacki 25:40 Well, so by design, it will always deliver background insulin in the way that it's intended. I mean, my phone dies, sometimes you know, it's live, right? I'm a 23 year old. Me because it is difficult to keep it charged in the pub. So you know it does happen. So and those are kind of a real world cases that you know, I'm sure FDA is also asking about. So with the DIY system, and I would assume with Title loop as well. But that is just my speculation. When your phone dies with the DIY system, it automatically goes to the default background rates for you kind of bolus because you need your phone to do that. And I would assume it would be relatively similar of tide pool loop, because I don't think there would be making a separate backup device like Omnipod just doing with Omnipod 5. Okay, Stacey Simms 26:31 thanks. Alright, last item that is in front of the FDA, I think is the Medtronic 780, which is already available in Europe. Right back to our conversation, but first Diabetes Connections is brought to you by Dexcom. And if you're a veteran, the Dexcom G6 continuous glucose monitoring system is now available at Veterans Affairs pharmacies in the United States. qualified veterans with type one and type two diabetes may be covered and pick it up your Dexcom supplies at the VA pharmacy may save you a lot of time to connect with your doctor for more information. Dexcom even has a discussion guide you can bring with you I know it can be hard to know what questions to ask, get that guide, find out more about eligibility at dexcom.com/veterans. Now back to Kamil answering my question about whether the Medtronic 780 is available in Europe? Kamil Armacki 27:34 That's right. Okay. So 780 G has been here for it's been approved last summer. So kind of just as COVID was kind of a couple of months in, and it's been rolled out across various countries in Europe. I think we got it in the UK earlier this year. Well, I think the 770 G's, the newest version that you guys have in the US. So the 700 pumps, they all have Bluetooth built in. So you can have your pump alarms, all of that on your phone, no control. But you can view everything by the 780s, kind of the newest pump in that line, which has a new brain new algorithm. In my view, it is completely different. Because actually, it's not really made by Medtronic. It's made by an Israeli company called Dream met. Stacey Simms 28:23 So that's free. That's right. The algorithm is from Dream Med, I've interviewed them, I forgot to actually Kamil Armacki 28:28 said that in one of my videos, and Medtronic wasn't really happy with me. So Stacey Simms 28:32 I feel like we have it's ours. Now. It's been, Kamil Armacki 28:35 they officially said something like it's built by a dream met with Medtronic engineers. So you know, it is a partnership. And that's apparently true. You know, I have no reason to deny that. So I'm sure they work together on it. But you know, the the foundation of seven ATG is actually completely different. It's not like they took 670 and added a couple of capabilities. You know, it's a great we design I mean, on the outside, it looks the same, but actually the the actual brain inside is completely different. And I guess one of the one of the key things that we mentioned is actually the ability to have your glucose set as low as 100. You know, people have diabetes across Europe, they've they've been really kind of enjoying that. And it has automatic corrections as well. So a lot of people listening to this might not be as techie as we are. So just in simple terms, it kind of matches control IQ, I would kind of say in terms of the feature set, maybe slightly better, because you can reduce your target to 100, which I know a lot of people have been asking about. I don't know if you agree, Chris, without saying it's kind of at the same level as control like you Chris Wilson 29:37 from a tech perspective. Yeah, they both the the key difference or the key feature there is the automated correction boluses, which is what differentiates what they call an advanced hybrid closed loop from just a standard hybrid closed loop, which is what the 670 and 770 were, it's nice to see more high tech options coming to the market from more players. says it gives people more options. Stacey Simms 30:01 That's interesting, though about any kind of criticism for mentioning dream, Ed, because I mean, control IQ was developed by type zero technology, right? Wasn't it like a University of Virginia thing that then Tandem bought? Yeah, well, Chris Wilson 30:14 it got bought by Dexcom Dexcom, bought type zero and then license the tech to Tandem. So Stacey Simms 30:22 interesting times. And we should also mention that all the Medtronic systems use their sensors. This is not yet a mix and match world, I believe the Medtronic sensors, and I keep hearing that they're much better, but still need to be calibrated. So even the latest version No, your shake your head, Kamil tell Oh, that's right. We're waiting for that approval in the US. Kamil Armacki 30:42 Well, so. So guardian for has been approved in three guardians. And so that's the no calibration version. And it's I know, like one person who's using it. So it's not I think they slowly roll in and out. They haven't really started shipping it yet. But it's basically what we all know, as guardian free just with with no calibrations. As far as I'm understanding the accuracy is not improved. It's kind of the same, if not slightly worse, from a margin perspective with Guardian four, compared to Guardian three. And yeah, I think it's in the FDA backlog as well. I'm gonna go ahead and Stacey Simms 31:21 just double check that on my end only because it'll be good to know the actual mark from their studies and things like that. So we'll pop that into the show notes. But I think you're exactly right, because I was just doing the time. It'll be interesting to see what the time shift is, in terms of episodes being released, because we were just doing our game show. Wait, wait, don't poke me for friends for life. And I actually I can't believe I forgot I asked this question about Guardian four. Because the codename for it or at least the in house name for it was Zeus. So we had been talking about Zeus for Medtronic for a long time, no calibrations I know this is the I get in the weeds of the trivia and then I forget what I know. So thanks for correcting me. Alright, and then Alright, let's talk about Dexcom. Because Dexcom g7, as we're taping g7 has not been submitted to the US FDA, but it has been submitted for European approval. Kamil, you had Dexcom CEO on your show, wearing and showing off the device. I was so jealous when I saw that I'm gonna yell at Kevin Sayer. Next time I talked to him. But yeah, tell us what that was like and what you thought of it when you saw it. Kamil Armacki 32:27 You know, I've been the massive Dexcom advocate, I pay for my own decks because I'm not an ambassador, I just genuinely it's been a life changing product for me. And yeah, it's been it's been an honor speaking to him. So you've spoken to him a couple of weeks after they announced that they submitted for the for the European European approval. I mean, it looks tiny, as I'm sure you've seen, if you've seen the video, I'm incredibly excited to see kind of how that one develops, and from literally a couple of days. So they kind of in the investors call, like Chris was saying, I also sometimes tune into those, and they confirmed that the expecting to get that approved in Europe by the end of the year. Stacey Simms 33:07 It's interesting. And Chris, maybe you could speak to this, for people who might not be that familiar, the Dexcom technology, while it is very different from the G6, the speed at which it might get approval, Europe is one thing, right us is another this is not like an insulin pump, we don't expect it at least to take quite as long as insulin pumps are different systems because it's not putting insulin into your body, right? It's just measuring, Chris Wilson 33:28 but it is being used to calculate doses of a high risk medication, which is insulin, there's definitely still some concern as far as how accurate it is. And if it's off it, how off? Is it? Is it going to cause a problem? But I'm really excited with the clinical data that they presented. I think it was at EASD Earlier this year, showing that the g7 the marred the that measure of accuracy that they use is actually now under 8%. With the g7 which I mean we're getting into how much more accurate can we reasonably get just because there's so much variation in human body that I mean, you can take six fingerprints from six different fingers and get six different answers from his standard meter. The fact that we're really dialing in the accuracy is as tight as we can and actually ever since is almost in the same boat with their new Wow, what any product they had. I think two versions I recall, but that's coming as well. And the the 180 day version as long as we're talking CGM. Yeah, there is no absolute answer for anything. This is actually I was in a study last Thursday, where they were seeing how long I could go without insulin. But as part of it, they're they're monitoring it with a y si, which is this reference grade laboratory meter that they actually do a blood draw and they centrifuge it down. And then they measured the glucose level in the plasma without any of the blood cells in it. And that device in the lab was actually not putting out the correct numbers, there was some sort of hiccup, they had to restart it to get it to come up. But my Dexcom was matching, and then they compared it to multiple Ultra accurate fingerstick meters and set to figure out what was going on. But, you know, nothing's perfect. This was, you know, elaborate reference glucometer. That's the most accurate one that you can get. And they don't even make them anymore. Stacey Simms 35:23 I will never forget, when Betty was little like poking the same finger, you said six different fingers, who put the same finger three times in a row because it was confusing or something. And it was always three different numbers. It's crazy. Chris Wilson 35:33 I just think it's important that people keep in mind that you know, nothing is ever going to be perfect. whatever device you're wearing, however, you're measuring your stuff, there's always going to be variation, it's never going to be exactly the same number every time on every device Stacey Simms 35:46 you mentioned ever since that's the CGM that goes under your skin. And then the transmitter goes on top. And Kamil, you are you've got a little bit are you using the libre as well like to test it out? Or did you? What did you show us earlier, Kamil Armacki 36:00 I am trying the free celebrate free, which is like the newest version. It's not available in the UK, I should make it very clear. But someone bought it for me in Germany. And they imported it over to the UK is actually it's actually been a very interesting over here. Because obviously it's it's not available in the UK. So I had to enter freestyling briefly, there was no physical receipt, but you need to get an app. So only use your phone, you can only use your phone, there's no physical reader, there's no physical device, which I don't know how that's going to work with, you know, children going to school and you know, having to carry phones, but anyway, but it's not available in the British App Store. So I had to create a German Apple ID. And everything on my phone is German. So I gem Apple Music, German podcasts, everything is in German, it's still English. But other than that I have been enjoying my German lifestyle over the last I've had it for four days now. So it's been it's been fun. Stacey Simms 37:03 What are the different features like what's I'm not as familiar with the Libre system. So what is new with the three, Kamil Armacki 37:08 it's much smaller, it's much smaller compared to the first two. And on a high level, it works exactly like you would expect a CGM to work like Dexcom web, no scan and it just always shows the value and the glucose your trends alarms ever found on your phone. So they kind of made it work in exactly the same way as at the center of Dexcom. But most importantly for me, they keep them the same price. And I think that's very important for a lot of people have diabetes here in Europe because I mean, Libra has been a giant success in the UK for example, just because actually, because of its price point it is accessible to the National Health Service. So it is you know reimbursed to you know, vast majority pretty much every single person of type one who wants it to get can get it. And libre two is the same price point is libre one and now libre free. In Germany, when they did launch, it's also the same price. So they keeping it the same, which is which is very reassuring Stacey Simms 38:08 process, we'll see what happens in the US. But that is very reassuring for our friends in Europe. I went device I meant to ask about and didn't but I don't think it's been submitted. And that is beta bionics and the iLet. And Chris, you kind of alluded to this much earlier in our talk, because you were I believe in one of those trials, Chris Wilson 38:25 I was at least told that I was patient number one at the trial site that I was at. Stacey Simms 38:33 But we don't think we don't know for sure they have not submitted down or have they? Chris Wilson 38:38 Well, I keep hearing parents and other patients still people diabetes, still saying, you know, I just finished my time in the primary phase of the trial for the eyelids, or now my kid is going into the extension phase, things like that. So if the trial is ongoing, clearly, I don't think they've they've submitted yet. It's definitely more hands off. I won't lie my time and range did go down a little bit when I was on it. Stacey Simms 39:03 But your your time and range we should specify is extremely high. Chris Wilson 39:06 Right? My 90 day average right now is 94% a week going into the current trial, the arm of the trial that I just finished was actually 97. Stacey Simms 39:20 So it's all relative, but otherwise. Yeah. But it's a good point in that, you know, the eyelid is much more hands off, as you mentioned, Chris Wilson 39:32 right? It's you know, no correction boluses there's not even mechanism to do it. All you can really do is tell it when you're eating and give it a rough guesstimate as to the meal size. So I would imagine especially for people who want to be more hands off with their diabetes and have good control because of the control wasn't bad by any stretch of the imagination, that it'll be a very good option for a lot of people once it does get approved. And this is the Insulet only version. We've still got The version with insulin and glucagon having both a gas and a brake will definitely make it easier to drive the car going forward in the next version. So we're looking forward to, to them starting the trials on that as well. Stacey Simms 40:13 Yeah, it is all relative. I mean, I just think about my son, you know, he misses a couple of meal boluses a week for sure. And I think he would happily trade off control, you know, to just have that kind of stuff be taken care of. It's so interesting to see how I mean, I'm, I'm, I know, we're gonna get somebody questions as Chris gets so much time and range, what is he doing with control IQ? So that'll be another episode tips and tricks from Chris to or maybe the maybe the tips and tricks, Kamil is just spent a lot of your time in diabetes trials? Yeah. I mean, I kidding. I know. That's not it. But Kamil Armacki 40:48 well, you're my time and ranges, but it's knowing me about? Very, very happy with it. I like to say that my time and happiness, though is 98. If not 100%? Kamil Armacki 41:00 Go? And that's what matters. Yeah, right. Stacey Simms 41:04 Absolutely. Chris Wilson 41:05 I mean, that we joke about doable, do a lot of trials. And it helps. But there is definitely some truth to that. I mean, I get to talk to and interact with some of the top endocrinologist in the world, right? Sometimes, you know, on a weekly basis. So I'm going into the clinic to have an injection of something that they're testing out or to check in and let them download the data from the device that I'm testing in half the time we're chatting while they're doing other stuff. And you know, discussing the theories that underlie a lot of this stuff. And it definitely deepens your understanding, if you want to really understand diabetes, more and more like an endocrinologist does that say, it's a great way to gain some experience? Stacey Simms 41:49 Let's talk a little bit. We've talked about what's happening and what we're waiting for. So let's talk a little bit about what we're excited for. And not just the products that we mentioned. But if there's anything else that's on your mind, I'm curious what you guys who live with diabetes, you use these devices, you follow this tech? Chris, what are you looking forward to? And I mean, it could be something that we talked about, or something that's like maybe 10 years from now, Chris Wilson 42:10 I think probably the thing that that's most interesting, I mean, to a certain extent, the tech we even if it's not there yet, we know where it's going. Yeah, where it's sort of the end point is the point is you were a sensor, you were a pump, and it does everything for you, and you don't need to worry about it. But beyond that, I think one of the things that I'm most excited about is seeing the medications that were originally designed for type twos being used in more type ones. Yeah, since most type ones do have some insulin resistance, it's actually you know, a known thing that happens, it's partly just due to the fact that normally, insulin gets made on in the middle and spreads out to the edges, and we're infusing it from the edges and having it go into the middle of the circulation. But things like I know, Stacy, you've mentioned in the past the SDLT, two drugs that help us her pee out the excess sugar from your blood, those have shown really great improvements in kidney health, cardiovascular outcomes, and making those safer for type ones, since it can cause an issue with going into DKA even though your blood sugar's stay relatively normal. That was actually the the test that I was last Thursday was checking a new drug that as an add on to help reduce the chance of that happening if you're a type one on one of these medications, but there's lots of different classes of medications that are coming out things that not only enhance the function of insulin, but potentially block some of the functions of glucagon to help improve things since they've documented that. A lot of type ones the the sort of regulation and counter regulation in insulin, the insulin glucagon axis, I guess, it does happen with a fair amount of frequency in people with type one. So that may be something moving forward. And actually, it's not even necessarily just diabetes. They're testing this medication that they were trying to lay on me as an enhancement for cancer immunotherapy. Wow. In North Carolina, I somebody was asking me about something. And so I went on the clinical trials website, it was digging into what said he's looking at this drug and found a study that they were looking at it to see if it'll enhance the ability of some immunotherapies for breast cancer. So I mean, a lot of this stuff may even have ripple effects outside of diabetes. Stacey Simms 44:33 That's really amazing. All right. That's a great point. I love that. All right. You know, you don't have to go outside of technology. I mean, that is still technology gets medication, but can we what are you looking forward to? Are you looking at down the line? I'm Kamil Armacki 44:46 going to keep this one very, very simple. I'm just looking forward to seeing more access to all of this. I feel like in terms of getting incredible technology. I feel like we could summarize all of this all of today's talking Massive tech, right? We have incredible continuous glucose monitors even better on the market. And even better versions of them are common over the next year or so with g7, libre free etc. Same with pumps, that technology so sadly, isn't really accessible to so many people. And this applies to so many regions, so many countries in the UK, we now have an a trial of 1000 people with diabetes trial in closed loop technology to hopefully have our national proof that it does work is self restraint and actually seeing all of this because, you know, it's like every single country wants their own proof even though you know, there are so many trials from all over the world proven that yes, actually, it does help people. But you know, it is a very bureaucratic process. So I'm just looking forward to actually see in 1000s, if not millions of people have access to CGM. And then if they choose to hypertrophic therapy. Stacey Simms 45:55 That's wonderful. All right. Before I let you go, this last question, it's not really a great follow up to our discussion about access. But this is one that it just honestly, it drives me bananas, and I want to get your opinion on and that is this every other day, I feel like someone is asking me when the Apple Watch is going to monitor blood glucose with non invasively. Right, that I know, right? You're gonna get the watch, it's gonna read your blood glucose and then move on. And I get these questions all the time by people outside the diabetes community, frankly, who read about it or hear about it. What's your take? I mean, I know what's coming. I hope it's coming. I don't want to I feel like I'm the hope killer. I go on these threads. And I'm like, unless you see a clinical trial, right. It's not going to happen. But I feel like it is coming it will be useful to some people sometime, right? Chris Wilson 46:44 I think, absolutely. I think there's a couple of companies that are pretty far along. In the process of actually doing non invasive glucose monitoring. I think you had an episode recently, where you mentioned one where they look at the eye, yeah, within the eye, which is cool. I've heard of a couple of different texts that are technologies that are being introduced, using either heat at low levels infrared, to potentially sense it, or radio signals, believe there's a company in Israel that's working on that as well. Yeah, they're probably not good enough to necessarily dose insulin from yet, but they're getting there and the tech keeps getting smaller and more portable and stuff, I think there's a company in Germany that's got the tabletop scale right now, where you can just basically put a finger into on the sensor and it will give you an estimate of your blood sugar in there hoping to scale that down to being a portable device that will be non invasive, and then eventually a wearable device that will be non invasive. So it's, it's definitely coming, but the stuff takes time, there's so figuring out serve a lot of the ways that the various sensing technologies interact with the body and figuring out exactly how best to estimate your blood sugar from the readings that they get back. So it's coming. I've seen presentations with actually impressive accuracy, especially considering that it's non invasive, but I don't see it any time at least probably not in the next couple of years, but especially integrated into a consumer device like an Apple Watch. Kamil Armacki 48:13 I completely agree with Chris I think especially as someone living with diabetes we tend to look at this from a you know, kind of a medical point of view but if this ever were to happen, it's really a health companion and I think that entire trend have actually seen a lot of what I would consider mainstream technology companies you know, Apple Samsung, you know, those kinds of players becoming more involved in health is a good thing because I think you know, we've heard of so many stories of you know, people using you know, Apple watches and you know being alerted that actually your heart rate is too low or too high and actually you know, if you deploy that kind of capability on you know, a population scale you know, with with millions of people using Apple Watches, it really drives you know, big changes and cold drives colossal impact on you know, general population you know, how we live our lives for if ever does happen I mean, we hear about this all the time and literally this year I think it was six or seven days after Apple Watch Series seven came out there was already a rumor saying the Apple Watch Series eight Yes. Well habit and I saw on Twitter and I just went I just did this emoji six days, six days the longest amount of time we can have without any rumors about Apple Watch. Stacey Simms 49:39 It just shows you how much money is in it Kamil Armacki 49:43 It’s click bait, interesting topic because you know it is the next frontier that you know everyone is trying to tackle. Yeah, so I understand the excitement bore and sometimes I'm probably causing it because I have talked about as well. In my in my printer diabetic days, I I was excited about it. I've been excited about as Nerdabetic, and we can't not be excited. Stacey Simms 50:05 Well, even this episode, someone could clip out what Chris said it's coming. Kamil Armacki 50:09 Yeah. But we do need to be realistic about it that even when it comes in, you know, 1015 years, it probably won't really have any tangible impact on any buyer lives. Chris Wilson 50:21 Maintaining being realistic, that's a very good point. Because it reminds me of the vertex announcement a couple of weeks ago, with the the first patient of their trial, got infusion of stem cell derived Ilet cells, and is, you know, 90% reduction in insulin use. And everybody went nuts over that. And I wound up posting a big, long thread on Twitter explaining that really like this isn't the hard part yet. It's great that they're this far, it's awesome that people are pursuing different avenues, I hope they succeed. But this isn't going to be something that people are going to have in the next couple of years to just go in and get your eyelid infusion. And then you don't need to worry about measuring your blood glucose or worrying your pump or taking injections anymore. Stacey Simms 51:10 I heard a great point on that, which was if they've sent a press release, it's quite different than if they've submitted a for publication in a clinical journal. It was a little bit, I'll say a little meaner than that. I think the quote was something like, you know, if it's a press release, they're looking for money, if it's a journal they're looking for, you know, approval. There's some truth to that, though. And I think that that's a good thing for us to keep in mind as we stay very hopeful is a very hopeful crowd. And as we stay realistic, as well, I think we've run the gamut. There's always so much more to talk about. So I hope you'll come back on when these things maybe we hear more, they start to get approved, or we just talk about different things. But this was great. Thank you both so much for jumping on. Chris Wilson 51:50 It's always fun to talk to you, Stacey. Stacey Simms 51:51 Oh, thank you, thank you. It's always great to get caught up on this stuff and kind of speculate and talk about it. So thanks so much. I appreciate you guys both being here. And we will put lots of links in the show notes and everywhere else we can find them so that people can find you on social and follow your musings and your thoughts, but I really appreciate it. We'll talk to you soon. You're listening to Diabetes Connections with Stacey Simms. Lots of information there. I'm going to link up a couple of articles some things we referenced at diabetes connections.com. At the homepage for this episode, there is a transcription as well as always, what do you think? I mean, I know it was long, and there were a lot of things to get through. But I'd like to do that on a more regular basis, maybe with some different people in the community. Love to hear feedback from you what questions you have, what topics you'd like us to tackle. But man, those guys, really they know the ins and outs of all of this, they really keep their finger on the pulse. So we'll follow up. We'll do more on that. This was taped, as I said the very first week of November 2021. So in a couple of days between now and when the episode comes out, maybe something else was approved. If it happened, we will follow up on it here. All right, thank you, as always to my editor John Bukenas from audio editing solutions. We've got in the News Live every Wednesday now 4:30pm Eastern Time, on YouTube and on Facebook Live on both channels, and then we turn it around into an audio podcast episode that airs Fridays. So I hope to see you back here for that until then be kind to yourself. Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged
6 minutes | Nov 5, 2021
In The News.. Sugarmate update, new BG meter approved, T1D scholarships and more!
This week, the top diabetes stories and headlines in the news include: the popular Sugarmate app loses Dexcom connection, interesting study about internal clocks and type 2 diabetes, the FDA approves new "POGO" BG meter, T2D remission might be more common than thought, Type 1 college scholarships and lots more. -- Join us LIVE on Facebook and YouTube every Wednesday at 4:30pm EDT Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Episode transcription below: Click here for iPhone Click here for Android Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I’m going to link up my sources in the Facebook comments – where we are live – we are also Live on YouTube and in the show notes at d-c dot com when this airs as a podcast.. XX In the News is brought to you by The World’s Worst Diabetes Mom, Real life stories of raising a child with diabetes. Available in paperback, on Kindle or as an audio book – all at Amazon.com -- Top story this week.. Big issue for a popular app – users of Sugarmate have been told as of this week – November 4th to be precise – customers in the US will lose connection. Those outside the US have seen issues since October. This is because of a change Dexcom made to its servers. Sugarmate says Dexcom is working with them to fix the issue – basically they’re going to join the Dexcom Partner API – we’ve told you about that, it’s how third party apps can talk with Dexcom.. In the meantime, Nightscout is probably the best alternative if you use Sugarmate. Quick note: Tandem acquired Sugarmate last year. And you’ll recall that Dexcom does own a small piece of Tandem. So it looks like this will all probably work out.. but exactly how in the long run will be interesting to watch. -- https://help.sugarmate.io/en/articles/5678010-faqs-sugarmate-and-dexcom-connection?mkt_tok=MzQ4LVJYVi03MDUAAAGAgZ5w-m8YKeY90ybxznIKZ4b4XWStjdvSjf7vH3dNx8PMDzDa9sJP0En6odZtM-Z4UthLL9z7MNV86wnQ4R9o61-islyzvtyvg13By4FB5A&fbclid=IwAR39j2vxjr3JuUbcQdruIAttCSuRl5dD1jVbdNKrm1b5JQpuyYlQiwH1xXs XX A study of “dented” internal clocks seems to build evidence for a theory that people who work late or irregular hours are more at risk for diabetes. Researchers at the University of Pennsylvania created a timing mismatch by altering the function of a molecule within the brains of mice.. shortened their circadian rhythms from 24 to 21 hours. These mice gained more weight, had higher blood sugar, and fattier livers. This all corrected when the researchers changed their environment – sleep and meals – to match that shorter, 21 hour day. They say it might be a good idea for shift workers to try to do the same – eating meals and going to bed in a cycle that works better for them. https://www.pennmedicine.org/news/news-releases/2021/october/a-dented-internal-clock-provides-insight-into-shift-workers-weight-gain-and-diabetes XX New Blood glucose meter gets FDA approval. This is the POGO … with 10-test cartridge technology. The strips and lancers are loaded inside already, so you don’t carry anything separate. You just put your finger down and press the button. They’re calling this automatic blood glucose monitoring or ABGM. On the inside it’s still a basic finger stick and blood collection. But you don’t see any of that on the outside. Of course, there’s a Bluetooth connected app for you and your healthcare team to use. The product is called POGO. the app is Patterns. https://finance.yahoo.com/news/pogo-automatic-one-step-blood-113000135.html XX New numbers out for diabetes around the world and the International Diabetes Federation says it’s a pandemic of unprecedented magnitude. The IDF says more than 10-percent of adults worldwide live with diabetes.. by 2045 that number will be one in eight. The report also says that one in two people with diabetes across the world who need insulin cannot access or afford it. The theme of World Diabetes Day this November 14th is Access to Diabetes Care. https://www.prnewswire.com/news-releases/diabetes-is-a-pandemic-of-unprecedented-magnitude-now-affecting-one-in-10-adults-worldwide-reveals-the-international-diabetes-federation-301413238.html XX Good news for people with type 1.. when more intensive glucose management starts early, it greatly reduces the future risk of heart and kidney issues. This info comes from a look back at the DCCT and EDIC trials – which are 100% worth looking into if you aren’t familiar with them. By the way, in these trials “intensive” glucose control was pegged at an A1C of 7 and the riskier group had an A1C of 9 or above. The earlier the A1C was brought down to 7, the less risk of complications. https://www.endocrinologyadvisor.com/home/topics/diabetes/type-1-diabetes/earlier-intensive-type-1-diabetes-treatment-reduces-long-term-cardiovascular-and-kidney-complications/ XX How common is type 2 remission? It’s hard to say but a new study from Scotland suggests it’s more common than we might think. These University of Edinburgh scientists say in Scotland, it’s one in 20. They looked at everyone in the country over the age of 30 with type 2, based on A1C levels -that’s about 160-thousand people. Then they said during the study year, 77-hundred people went into remission, which means their A1Cs dropped to 6.5 without medication. Those people were older, had lost weight since their diagnosis, had no history of glucose lowering therapy or bariatric surgery, and generally had healthier blood readings at the time of their diagnosis. https://www.sciencealert.com/reversing-type-2-diabetes-seems-to-be-more-common-than-scientists-realized XX College scholarship contest to tell you about. Senita (sen-EE-tuh) Athletics is partnering with Insulet to award four $5,000 scholarships to people with type 1 diabetes. In honor of National Diabetes Awareness Month, the athletic fashion wear maker is looking for 'Senita Scholars.” The co-founders have a younger brother with type 1 and their fitness gear is known for really good pockets. To be eligible, students across the U.S. must be either a graduating senior in high school or a current undergraduate and have type 1 diabetes. Applications close on Nov. 30. https://finance.yahoo.com/news/senita-athletics-partners-insulet-corporation-150000801.html XX Lots of events happening around the diabetes community for this awareness month. Friends for Life virtual starts next week as does Together T1D. I mention this because it’s got a powerful lineup, with Olympian Charlotte Drury, Pietro Marsala, the first person with T1D to get a commercial pilot’s license in the US and more… XX And finally, a big happy diaversary to a previous guest of the podcast – Yerachmiel Altman is marking 60 years with type 1 on November 8th. I’ll link up my episode with him.. he worked on early insulin pumps and has worn every bit of tech you can think of.. Wishing you continued good health and thank you for sharing your experience and wisdom with us. -- quick reminder that the podcast this week is with Ken Rodenheiser – a diabetes educator who now works with Dexcom. He explains how he went from angry and lonely as a teen, to helping others start off on the right foot at diagnosis. It’s a great story you can listen to wherever you get your podcasts or if you’re listening to this as on a podcast app, just go back an episode. That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
45 minutes | Nov 2, 2021
From Angry T1D Teen to Diabetes Educator: Meet Kenny Rodenheiser
Kenny Rodenheiser is a diabetes educator, and a big part of the Children with Diabetes community. But when he was diagnosed as a young teenager, he felt angry and isolated and wanted nothing to do with anything like a diabetes conference. Kenny talks about what changed his mind, his road to becoming an educator and his current role at Dexcom. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Episode transcription coming soon Click here for iPhone Click here for Android
6 minutes | Oct 29, 2021
In the News.. Israel implant for type 2, sports study for T1D kids, Tidepool period project and more!
This week, In the News our top stories include: Israeli researchers test an implant for type 2 remission, a new sports study looks at kids with type 1 on multiple daily injections, a new camera app to turn your old meter into high-tech info, the Tidepool period project, type 1 in the World Series and more! Join us LIVE every Wednesday at 4:30pm EDT Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Episode transcription below: Click here for iPhone Click here for Android Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I’m going to link up my sources in the Facebook comments – where we are live – we are also Live on YouTube and in the show notes at d-c dot com when this airs as a podcast.. XX In the News is brought to you by Real Good Foods! Find their breakfast line and all of their great products in your local grocery store, Target or Costco. XX Our top story: Lucky mice but will it work in people? Israeli scientists say they have a one-time implant that brings blood glucose into non-diabetic range. The implant is healthy tissue grown in a lab – the glucose dropped by an average of 26-percent and stayed there the four months of the study. The engineered cells absorbed sugar, improved glucose levels and also improved absorption in other muscle cells. Long way to go before this is tried in people. https://www.timesofisrael.com/diabetes-reversed-in-mice-for-4-months-after-one-time-implant-from-israeli-lab/ XX Sports and kids with type 1 can be a tough balance, especially on multiple daily injections. A new study called the Car-2-Diab trial looked at what changes work well for teens during exercise. There’s a lot here, so I’d urge you to follow the link I’ll provide, but basically everyone in this small study experienced overnight hypos and some high BG just after exercise. The most common fix was a drop in total basal insulin. These researchers say sports and type 1 have a – quote - “irreducible level of confounding factors.” Which.. from personal experience, I can say.. I agree. https://www.endocrinologyadvisor.com/home/topics/diabetes/type-1-diabetes/execise-impacts-insulin-doses-in-children-with-type-1-diabetes/ XX Big new study about Medtronic’s 780G pump, available in Europe and in front of the US FDA right now. This looked at 3200 kids age 15 and younger. Time in range was 74% overall and overnight 82%. The 780G uses the Guardian Sensor 3 as a hybrid closed loop where you still bolus for meals. Overall these kids saw a 12-percent bump up in time in range.. which is a better boost than Medtronic’s first hybrid closed loop system, the 670G. https://www.fiercebiotech.com/medtech/medtronic-s-newest-minimed-insulin-pump-improves-glycemic-control-children-study XX Good write up about adults with type 1 which make up more than half of all new cases of type 1. This summary in the ADA publication Diabetes Care shows that there are big differences between adult and childhood onset, many of which aren’t understood. This also points out that misdiagnosis occurs in nearly 40% of adults with new type 1 diabetes, with the risk of error increasing with age. https://care.diabetesjournals.org/content/44/11/2449 XX New app to retrofit a regular old blood glucose meter and make it a bit more high tech. Computer vision technology developed by University of Cambridge engineers can read and record the glucose levels, time and date displayed on a typical glucose test.. it does this with just the camera on a mobile phone. The technology, which doesn't require an internet or Bluetooth connection, works for any type of glucose meter, in any orientation and in a variety of light levels. The app is called Gluco-Rx Vision. You think about a lot of the services and programs that have popped up that require Bluetooth and remote monitoring – this helps people take advantage without having to buy a new meter. https://www.myvetcandy.com/newsblog/2020/11/14/computer-vision-app-allows-easier-monitoring-of-diabetes XX Tidepool gets a boost for it’s Period Project… from Amazon. The Tidepool Period Project is trying to address the unmet needs of people with diabetes who menstruate. This funding from Amazon Web Services will go to supporting prototype concepts and user interface designs at Tidepool. There’s not a lot of data on diabetes and periods despite the fact that we all pretty much know anecdotally that there’s a lot going on in terms of glucose levels and hormones. Kudos to Tidepool for gathering this info for future research. https://www.thedailytimes.com/business/diabetes-and-femtech-intersection---tidepool-receives-aws-financial-support-for-tidepool-period-project/article_7b5c40fb-3020-5428-aa0b-69ea242675ec.html XX More to come, including diabetes in the world series.. But first, I want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Real Good Foods. Where the mission is Be Real Good They make nutritious foods— grain free, high in protein, never added sugar and from real ingredients—we really like their breakfast line.. although Benny rarely eats the waffles or breakfast sandwiches for breakfast.. it’s usually after school or late night. Or sometimes it’s dinner. You can buy Real Good Foods online or find a store near you with their locator right on the website. I’ll put a link in the FB comments and as always at d-c dot com. Back to the news… And it’s sports news! As of this taping the Atlanta Braves have won Game 1 of the World Series.. with Adam Duvall getting a 2-run home run. We’ve high-lighted Duvall here before.. he was diagnosed with type 1 at age 23. We’ve seen a lot of posts on social media of him taking the time to meet with families during the season, signing autographs and taking photos with his pump. Good stuff. -- And finally.. Just as the newest Apple watch was released - without blood glucose monitoring.. rumors are already swirling about the next version of the watch. As we’ve said.. you’ll know it’s real when they start clinical trials.. but Dexcom’s Chief Technology officer talked to me this week about their new agreement with Garmin and looked ahead to the G7 and possible non invasive blood glucose monitoring. Interesting stuff you can listen to wherever you get your podcasts or if you’re listening to this as a podcast, just go back an episode. That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
37 minutes | Oct 26, 2021
"Amplify the Value of CGM" - Dexcom's Jake Leach talks about Garmin, the G7 and Dexcom One
With Dexcom announcing a big new agreement with Garmin this month, it seemed like a good time to check in on a few issues. Stacey talks with Dexcom’s Chief Technology Officer Jake Leach about Garmin, the upcoming Dexcom G7 and Dexcom One. She asks your questions on everything from G7 features to watch compatibility to the future and possible non invasive monitoring. Just a reminder - the Dexcom G7 has not yet been submitted to the US FDA and is not available for use as of this episode's release. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Previous episodes with Jake Leach: https://diabetes-connections.com/?s=leach Previous episodes with CEO Kevin Sayer: https://diabetes-connections.com/?s=sayer Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode transcription below: Stacey Simms 0:00 Diabetes Connections is brought to you by Dario Health. Manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first premixed auto injector for very low blood sugar, and by Dexcom take control of your diabetes and live life to the fullest with Dexcom. Announcer 0:20 This is Diabetes Connections with Stacey Simms. Stacey Simms 0:26 This week Dexcom announced a big new agreement with Garmin this month seemed like a good time to check in on a few issues, including what happens to the watches and insulin pump systems that work with G6, when Dexcom G7 it's the market. Jake Leach 0:41 We're already working with Tandem and Insulet. On integrating G7 with their products have already seen prototypes up and running, they're moving as quickly as possible. Stacey Simms 0:49 That's Chief Technology Officer Jake leach who reminds us that the G7 has not yet been submitted to the US FDA. He answers lots of questions on everything from G7 features to watch compatibility to the future and possible non invasive monitoring. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show are we so glad to have you here I am the host Stacey Simms, and we aim to educate and inspire about diabetes with a focus on people who use insulin. You know, my son Benny was diagnosed with type one right before he turned to my husband lives with type two diabetes. I don't have diabetes, I have a background in broadcasting. And that is how you get the podcast. And when I saw the news about Garmin, and Dexcom. I knew you'd have some questions. And I thought this would be a good chance to talk about some of the more technical issues that we're all thinking about around Dexcom. These days. I should note that since I did this interview with CTO Jake Leach on October 19. And that's exactly one week before this episode is being released that Dexcom released some new features for its follow app. I did cover that in my in the news segment. That was this past week, you'd find the link in the show notes. And as I see it for that news that release in the update, the big news there is that now there is a widget or quick glance on the followers home screen, it depends on your device, you know, Apple or Android, there's no tech support, right from the follow up, and a way to check the status of the servers as well. And I think that last one should really be an opt in push notification. If the servers are down, you should tell me right, I shouldn't have to wonder are the servers down and then go look, but that is the update for now. And again that came out after this interview. So I will have to ask those questions next time. And the usual disclaimer Dexcom, as you've already heard, is a sponsor of the show, but they only pay for the commercial you will hear later on not for any of the content you hear outside of the ad. I love having them as a sponsor, because I love that Vinnie uses the product. I mean, we've used Dexcom since he was nine years old. But that doesn't mean I don't have questions for them. And I do give them credit for coming on and answering them. Not everybody does that. I should also add that this interview is a video interview, we recorded the zoom on screen stuff. You can see that at our YouTube channel. I'll link that up in the show notes if you would rather watch and there always will be a transcript these days in the show notes so lots of options for however it suits you best. I'm here to serve let me know if there's a better way for me to get this show to you. But right now we've got video audio and transcript. Alright Jake leach in just a moment. But first Diabetes Connections is brought to you by Dario health and you know one of the things that makes diabetes management difficult for us that really annoys me and Benny, it's not really the big picture stuff. It's all the little tasks that add up. Are you sick of running out of strips do you need some direction or encouragement going forward with your diabetes management? Would visibility into your trends help you on your wellness journey? The Dario diabetes success plan offers all of that in more you don't the wavelength the pharmacy you're not searching online for answers. You don’t have to wonder about how you're doing with your blood sugar levels, find out more, go to my dario.com forward slash diabetes dash connections. Jake leach Chief Technology Officer for Dexcom thanks so much for joining me. How are you doing? Jake Leach 4:22 I'm doing great, Stacey. It's a pleasure to be here. Stacey Simms 4:24 We really appreciate it. And we are doing this on video as well as audio recording as well. So if we refer to seeing things, I don't think we're sharing screens or showing product. But of course we'll let everybody know if there's anything that you need to watch or share photos of. But let me just jump in and start with the latest news which was all about Garmin. Can you share a little bit about the partnership with Garmin? What this means what people can see what's different? Jake Leach 4:49 Yeah, certainly so I'm really excited to launch the partnership with Garmin. So last week we released functionality on the Dexcom side and Garmin released their products, the ability to have real time CGM readings displayed on a whole multitude of Garmin devices by computers, and a whole host of their watches. So they've got a lot of different types of watches for, you know, athletics and different things. And so you can now get real time CGM displayed on that on that watch. So they're the first partner to take advantage of some new technology that we got FDA approved earlier in the year, which is our real time cloud API. So that's a a way for companies like Garmin to develop a product that can connect up to users data through the Dexcom, secure cloud and have real time data, we've had the capability to do that with retrospective data that three hour delayed, many partners are taking advantage of that. But we just got the real time system approved. And so Garmins, the first launch with it. Stacey Simms 5:50 Let me back up for just a second for those who may use these devices, but aren't as technologically focused. What is an API? When you got approval for that earlier in the summer for real time API? What does that what does that mean? Yeah, so Jake Leach 6:03 it's a API is an application programming interface. And so what it really means is, it's a way for software applications, like a mobile app on your phone, to connect via the Internet to our cloud with very secure authentication, and pull your CGM data in real time from from our cloud. And so it's basically a toolkit that we provide to developers of software to be able to link their application to the Dexcom application, and really on the user side, to take advantage of that feature, you basically enter in your Dexcom credentials, your Dexcom username and password. And that is how we securely authenticate. And that's how you're basically giving access to say, for example, Garmin, to pull the data and put it down onto your devices. What other Stacey Simms 6:51 apps or companies are in the pipeline for this. Can you share in addition to Garmin? I think I had seen Livongo Are there others? Jake Leach 6:58 Yeah, so Livongo so Tela doc would purchase the Lubanga technology, they've got a system. They're also in the pipeline for pulling in real time CGM data into their application. And so they're all about remote care. And so trying to connect people with physicians through, you know, technology, and so having real time CGM readings in that type of environment is a really nice use case for them. And so and for the for the customers. And so that's, that's where they're headed with it. And we've got kind of a bunch more partners that are in discussions in development that we haven't announced yet. But we're really see this, the cloud API's are interfaces as a way to expand the ecosystem around a Dexcom CGM. So we really like to provide our users with choice. So how do you want your data displayed? Where do you want it? And so if you want to right place, right time for myself, have a Garmin bike computer so I can see CGM readings right on my handlebars, I don't have to, you know, look down on a watch or even thought phones, it's really convenient. That's what we're about is providing an opportunity for others to amplify the value of CGM. Stacey Simms 8:06 This was a question that I got from the listener. What happens to the data? Is that a decision up to a company like Garmin, or is that part of your agreement, you know, where everybody's always worried about data privacy? And with good reason? Jake Leach 8:19 Yeah, data privacy is super important area when when you're handling customer information. And so the way that it works is, when you're using our applications at the beginning, when you sign up, there's some consents, you're basically saying this is what can be done with my data. And the way we design our systems is, for example, with the connection to the Garmin devices, the only way they can access your data is if you type in your credentials into there, it's like it's almost like typing your username and password into the web to be able to access your bank account. It's the same thing, you're granting access to your data. And each company has their own consents around data. And so we all are required by regulatory agencies to stay compliant with all the different rules to Dexcom. We take it very seriously, and are very transparent about what happens with the data that's in we keep it in all of our consent forms that you click into as you as you work through the app. Stacey Simms 9:13 But to be clear to use the API or to get the Dexcom numbers on your garmin, you said earlier, you have to enter your credentials, Jake Leach 9:19 you have to you have to enter your Dexcom username and password. And that's how we know that it's okay for us to share that information with Garmins system because you are the one who authorized it. Stacey Simms 9:30 Right. But that's also how you were going to use it. You just said you have to enter your name and password for them to use the information. So they just have to read individually like okay, Garmin or Livongo or whomever. Yes. Your individual terms of services. Jake Leach 9:42 Yeah, for each each application that that you want to use you it's important to read the what they do with the data and how to use it. Stacey Simms 9:49 That's really interesting. And Has anything changed with Dexcom? It's been a long time since we've talked about how you all use the data. My understanding is that it was blinded, you know, you're not turning around over to health insurers and saying yeah, done on this day this or are you? Jake Leach 10:03 No, no, not at all, we basically use the information to track our product performance. So we look at products there. So it's de identified, we don't know whose product it was, we just can tell how products are performing in the field. That's a really important aspect. But we also use it to improve our products. So we when we see the issues that are occurring with the use of the product, we use it to improve it. So that's, that's our main focus. And the most important thing we do with it is provided to users where, where and when they need it. So you know, follow remote monitoring that the reason we built our data infrastructure was to provide users with features like follow and the clarity app and so forth. Stacey Simms 10:36 Do those features work on other systems? Can I use Garmin to share or follow? Jake Leach 10:41 Not today? So right now, it's, it's basically intended for the the person who's wearing the CGM. It's your personal CGM credentials that you type in to link the Carmen account. And so for today, it's specific around the user. Stacey Simms 10:57 I assume that means you're working on for tomorrow. Jake Leach 10:59 There's lots of Yeah, lots. Stacey Simms 11:02 Which leads us of course to Well, I don't have to worry about that right now. Because you can't use any of this without the phone and the Phone is how we could share it follow. So it's not really an issue yet. Jake, talk to me about direct to watch to any of these watches. Yeah, where do we stand? I know G6. It's not going to happen. Where are we with G7? Right back to Jake answering my question, you knew I was gonna bring that up. But first Diabetes Connections is brought to you by Gvoke Hypopen. And when you have diabetes and use insulin, low blood sugar can happen when you don't expect it. That's why most of us carry fast acting sugar and in the case of very low blood sugar, why we carry emergency glucagon, there's a new option called Gvoke Hypopen the first auto injector to treat very low blood sugar Gvoke Hypopen is pre mixed and ready to go with no visible needle. In usability studies. 99% of people were able to give Gvoke correctly find out more go to diabetes connections.com and click on the Gvoke logo. Gvoke shouldn't be used in patients with pheochromocytoma or insulinoma. Visit Gvoke glucagon.com/risk now back to Dexcom’s jake leach answering my question about direct to watch Jake Leach 12:19 That's a great question and a really exciting technology. So direct to watch is where through Bluetooth, the CGM wearable communicates directly to a display device like a watch. So today, G6 communicates to the phone and to insulin pumps in our receiver are the displays. With G7, what we've done is we've re architected the Bluetooth interface to be able to also in addition to communicating with an insulin pump or a receiver and your mobile phone, it can also communicate with a wearable device like a Apple Watch, in particular, but other watches have those capabilities, with G7, reducing the capability within the hardware to have the direct communication director watch. And then in a subsequent release, soon after the launch to commercial launches of G7, we'll have a release where we bring the director watch functionality to the customers, there's the Bluetooth aspect, which is really important, you got to make sure it doesn't impact battery life and other things. But there's also the aspect of when it is direct to watch, it becomes your primary display. And so being able to reliably receive alerts on the watch was something that initially in the architecture wasn't possible. But as Apple's come out with multiple versions of the OS for the watch, they've introduced capability for us, so that we can ensure you get your alerts when you're wearing the watch. And so that was a really important aspect for us. And it's also for the FDA to ensure that if that's your main display, you've walked away from your phone, you have no other device to alert you that it's going to be reliable. And so that's exciting progress of last couple years with Apple making sure that can happen. You know, Stacey Simms 13:56 we're all excited for Direct to watch. Obviously, it's a feature that many people are really clamoring for. But you guys promised it first with the G five in 2017. Do you all kind of regret putting the cart before the horse that way? Because my next follow up question is why should we believe you now? Jake Leach 14:15 Yeah, you know, it Stacy's a good question. So we are hand was kind of forced because Apple actually announced it before we did. So they basically said we're opening up this capability on the watch to have the direct Bluetooth connectivity. And of course, we were excited to have someone like Apple talking about CGM on that kind of a stage. But then as we got into the details of actually making it work, we, you know, continually ran into another technical challenge after another technical challenge, and I totally agree. I wish it would have been two years later that they talked about at the keynote, but I'm comfortable that we've gotten past those types of issues. And so and it is built into G7. So we've got working systems and so it will introduce it rather quickly with G7 Stacey Simms 14:56 and to confirm G7 has been submitted for the CE mark Because the approval in Europe, but has not yet, as you and I are speaking today has not yet been submitted for FDA approval in the US. Jake Leach 15:06 Yeah, we're just we're just finishing up our submission, we get some validations that we're running on some of the new manufacturing lines to make sure we can build enough of these for all the customers, we want to focus to move over to G7 as quick as possible. And so we'll we'll submit you seven to the FDA before the end of this year, Stacey Simms 15:22 just kind of building off what you mentioned about Apple and making these announcements or, you know, sometimes Apple lets news get out there. Because they I don't know if they seem to enjoy it. I'm speculating. I don't have any insight track at Apple. But I wanted to ask you, I don't know if you can say anything about this. For the last year, every time I talk to somebody who's not getting the diabetes community, but they're on a technology podcast, or they're, they're hearing things about non invasive blood glucose monitoring, right, the Apple, Apple series seven or some watch this year, we're supposed to have this incredible, non invasive glucose monitoring was gonna put Dexcom and libre out of business, it was gonna be amazing. Of course, it didn't happen. But a bunch of companies are working on this. And Apple seems to be really happy to say maybe, or we're working on it, too, is Dexcom listening to these things. I mean, obviously, they're not here yet. They they are going to come. I'm curious if this is all you kind of happy to let that lay out their speculation. Or if you guys are thinking about anything like this in the future, Jake Leach 16:17 we pay a lot of attention to non invasive technologies. We have a an investment component of our company that looks at you know, early stage startups. We also have many partnership discussions around CGM technologies. And so when it comes to non invasive, I think we'd all love to have non invasive sensors that are accurate and reliable. You know, for many, many years since I've been working on CGM, and many years before that, there has been attempts to make a non invasive technologies work. The challenge, though, is it's just sensing glucose in the human body with a non invasive technology is not been proven feasible. It's just there's a lot of different attempts and technologies have tried, and we pay close attention. Because if if something started to show promise, we become very interested in it. And basically making a Dexcom product that uses it, we just haven't seen anything that is accurate and reliable enough for what our customers need. That's to say, there could be a use case where a non invasive sensor doesn't have to be as accurate and reliable as what what Dexcom does. And so maybe there's a product there. But we're very focused on ensuring that the accurate, the numbers that we show, the glucose readings that we present to users are highly accurate, highly reliable, that you can trust them. And so when it comes to non invasive, we just haven't seen a technology that can do that. But I know that there's lots of folks out there working on it. And we're, we stay very close to the community. Stacey Simms 17:40 Yeah, one of the examples I gave a guy who doesn't he does an Apple technology podcast, and he was like, you know, what, what do you think? And I said, Well, here's an example. He would a scale, and you have no idea if it's accurate. But you know, that once you step on it that that number probably is is stable, then you know, okay, I gained 10 pounds, I lost 10 pounds. But I have no idea if that beginning number makes any sense at all, you might be able to use that if you are a pre diabetic, or if you're worried about blood glucose, but you could never dose insulin using it because you have no idea where you're starting. So I think that's I mean, my lay person speculation. I think that's where that technology is now and to that point, but other people outside the diabetes community are looking to one of the more interesting stories, I think, in the last year or two has been use of CGM and flash glucose monitoring for people without diabetes at all, for athletes, for people who are super excited and interested in seeing what their body's doing. So we have companies like levels and super sapient. And you know, that kind of thing using the Liebreich. I'm curious of a couple of parts of this question. If you think you want to answer it is Dexcom. Considering any of those partnerships with the G7, which is much more simple, right? fewer parts and that kind of thing. Jake Leach 18:46 Yeah, that's a great point, Stacey. So yes, G7 is a lot simpler. It was designed to be to take the CGM experience to the next level. And part of that is just the ease of use the product deployment the simplicity, someone who's never seen a CGM before, we want to be able to walk up approach G7 And just use it. There's a lot of opportunity we feel for glucose sensing outside of diabetes. Today CGM are indicated for use in diabetes, but in the future, with 30% of the adult population in the US having pre diabetes, meaning the glucose levels are elevated, but not to the point where they've been diagnosed with diabetes. There's just so much opportunity to help people understand their blood sugar and how it impacts lifestyle choices impact their blood sugar. In the immediate feedback you get from a CGM is just a there's nothing else like it. And so I think, you know, pre diabetes and even as you mentioned, kind of in athletics. There's a lot of research going on right now in endurance athletes, and in weight loss around using CGM readings for those different aspects. So I think there's a lot opportunity we're today we're focused on diabetes, both type one and type two and really getting technology to people around the globe. That can benefit from it. That's where our focus is. But we very much have programs where we look at, okay, where else could we use CGM? It's such a powerful tool, you could think in the hospital, there's so much opportunity around around glucose. Alright, so I'm Stacey Simms 20:13 gonna give you my idea that I've given to the levels people, and they liked it, but then they dropped off the face of the earth. So I'll be contacting them again. Here's my idea. If somebody wants to pay for a CGM, and they don't have diabetes, but they're like paying out of pocket because they like their sleep tracker, and they like this and they like that, or some big companies gonna buy it and give it away for weight loss or whatever. You know, the the shoe company toms, where you buy a pair of shoes and they give one away. People are in the diabetes community are scrimping and saving and doing everything they can to get a CGM. Maybe we could do a program like that. Where if you don't quote unquote medically need a CGM. Your purchase could also help purchase one for an underserved clinic that serves people with diabetes. Jake Leach 20:54 Getting CGM to those folks that didn't need them, particularly underserved areas, clinics. It's so important. I like the idea. It's a that's if there was a cache component that then provided the CGM to those that are less fortunate. I think that's, I like the idea. Next month is National Diabetes Awareness Month. And one of the things we're focused on for the month of November is how can we bring broader access to CGM? It's something we've been working on, you know, since we had our first commercial product, and there's still, you know, many people in the United States benefit, you know, 99% of in private insurance covers the product. You know, a lot of our customers don't pay anything, they have no copay. But you know, that's not the case for everybody. And so there's, there's definitely areas that we need to we are focusing on some of our non profit partners on bringing that type of greater access to CGM, because it's such a powerful tool and helping you live a more normal life. Stacey Simms 21:50 In the couple of minutes that we have left. I had a couple more questions, mostly about G7. But you mentioned your hospital use. And last year, I remember talking to CEO Kevin Sayer about Dex comes new hospital program, which I believe launched during COVID. Do you have any kind of update on that or how it's been going? Jake Leach 22:06 Yeah, so it was a authorization that we got from the FDA to raise special case during COVID, to be able to use G6 in the hospital. And so we had quite a few hospitals contact us early on in COVID, saying, Hey, we've got these patients, many of them have diabetes, they're on steroids. They're in the hospital, and we're trying to manage their glucose. And we're having a hard time because their standard of care in hospitals is either labs or finger sticks. And so we got this authorization with the FDA, we ship the product, many hospitals acquired it, and they were using it pretty successfully. What we'd say about G6 is really designed for personal use your mobile phone or a little receiver device, designed integrated with a hospital patient monitoring system or anything like that. You could imagine in the future that that could be a real strong benefit for CGM, the hospital, you can imagine you put it on, you know, anybody who has glucose control issues comes in the door. And then you basically can help ensure where resources need to be directed based on you know, glucose risk. I've always been passionate about CGM at a hospital. It's one of the early projects I worked on here. Dexcom. And I think it there's a lot of promise, particularly as we've improved the technology. So there's still hospitals today using G 600 of the authorization. And we're interested in designing a product for that market specifically, instead of right now. It's kind of under emergency years. But we think there's there's a great need there. That CGM could could help in basically glucose control in the hospital. Stacey Simms 23:28 That's interesting, too. Of course, my mind being a mom went to camp as well. Right? If you could have a bunch of people I envision like a screen or you know, hospital monitoring that kind of thing. You wonder if you could do something at camp where there's 100 kids, you know, instead of having their individual phones or receivers at camp, it would be somewhere Central? Jake Leach 23:46 Well, you know, what, between with the with the real time API, there are folks that are thinking about a camp monitoring system that can basically be deployed on campuses right now with follow. It's great for a family, but it's not really designed to, to follow a whole camp full of campers. But with the real time API, there's opportunities for others to develop an application that could be used like that. So yeah, there you go. Stacey Simms 24:08 All right, a couple of G7 questions. The one I got mostly from listeners was how soon and I know, timelines can be tricky. But how soon will devices that use the G6? Will they be able to integrate the G7 Insulin pumps, that sort of thing? Sure. It's only Tandem right now. But you know, Omnipod, soon that that kind of thing? Jake Leach 24:26 Yeah, I mean, that's coming. So I'll start with the digital partners like Garmin and others, that is going to be seamless, because the infrastructure that G6 utilizes to move data to through the API's is the same with G7. So that'll be seamless. When you talk about insulin pumps, so those are the ones that are directly connected to our transmitters that are taking the glucose readings for automated insulin delivery. So those systems were already working with Tandem and Insulet. On integrating G7 with their products have already seen prototypes up and running so they're moving as quickly as possible. So once We have G7 approved, then they can go in and go through their regulatory cycle to get G7 approved for us with their AI D algorithms. Really the timing is dictated mainly by those partners and the FDA, but we're doing everything we can to support them to ensure this as quick as possible. Stacey Simms 25:17 Take I should have asked at the beginning, I'm so sorry, do you live with type one I've completely forgotten. Jake Leach 25:21 I don't I made a reference to where I wear them all the time. Because, as you know, kind of leading the r&d team here, I love to experience the products and understand what our users what their experience is. And I just love learning about my glucose readings in the different activities I do. So I don't have type one. But I just I use the products all the time. Stacey Simms 25:42 So to that end, have you worn the G7? And I guess I'd love to know a little bit more about ease of use. It looks like it's, it just looks like it's so simple. Jake Leach 25:51 It is. Yeah. So I've participated in a couple of clinical trials where we use G7, it is really simple. One of the most exciting things though, I have to say is that when you put it on, it has this 30 minute warmup. So the two hours that we've all been used to for so many years, by the time you put the device on and you have it paired your phone, it's there's like 24 minutes left before you're getting CGM. So it's like it's it. That part is just one of the things that you it sounds awesome. But then when you actually experience it, it's pretty amazing. But yeah, the ease of use is great, because it's the applicator is simple. It's a push button like G sex where you just press the button and it deploys. But there's other steps where you're not having to remove adhesive liners, the packaging is very, very small. So we really focused on low environmental footprint. And so it's really straightforward. But probably the most the really significant simplification the application process is because the transmitter and the sensor all one component and sterilized and saying altogether, there's no pieces, there's no assembly required, you basically take the device and apply it and then it's up and running. There's no transmitted a snap in or two pieces to assemble before you you do the insertion. Stacey Simms 26:59 I think I know the answer to this. But I wanted to ask anyway, was it when you applied for the CE mark? And I assume this would be the same for the FDA? Are there alternate locations? In other words, can we use it on our arms? Jake Leach 27:11 And yeah, that is that is a great question. Yeah, our focus with one of our phones with G7 and the revised form factor, the new new smaller form factor and sensor probe was arm were so yeah, arm wears is really important part of the G7 product. Stacey Simms 27:26 I got a question about Dexcom. One, which seems to be a less expensive product with fewer features that's available in Europe. Is that what Dexcom? One is? Jake Leach 27:34 Yeah, so there's a product that we recently launched in Europe in European countries. That is it's called Dexcom. One. And what it is, is it's it's a product that's designed for a broad segment of diabetes, type one, type two, it's a lower price point. It has a reduced feature set from G6. But what it's really about is simplicity. And so in you know it's a available through E commerce solutions. So it's really easy to acquire the product and start using it. It's really to get into certain markets where we either weren't didn't have access to certain customers. And so it's really designed for get generating access for large groups of people that didn't have access to CGM before. Stacey Simms 28:20 What does e commerce solution mean? No doctor Jake Leach 28:23 there. So outside the United States CGM isn't no prescription required for many, many countries. So the US is one of the countries that does require prescriptions, other some other countries do too. But there's a large group outside the US that don't, but it's really around, you can basically go to the website, and you can purchase it over a website. So really kind of nice solution around think Amazon, right. You're going you're clicking on add the sensors and you're purchasing it. It's a exciting new product for us that we are happy to continue developing. Stacey Simms 28:53 I think it might come to the US don't know. Yeah, that's Jake Leach 28:56 good. Good question. Don't don't know. I mean, I think right now we see CGM coverage is so great access is great for CGM in the US it can always be better and extend your focus on that. But it's really for countries where there wasn't access, Stacey Simms 29:08 I would think tough to since we do need a prescription differently. Yeah, Jake, you have been with Dexcom, almost 20 years, 18 years now. And a lot has changed. When you're looking back. And looking forward here at Dexcom. I don't really expect you to come up with some words of wisdom off the top of your head. But it's got to be pretty interesting to see the changes that the technology has brought to the diabetes community and how I don't know it just seems from where I sit and you're probably a couple of years ahead. It seems that the last five years have just been lightspeed. It has Jake Leach 29:39 been things are speeding up in terms of our ability to bring products to market and there's a lot of things one is the development of technology. The other component is working with your groups like the FDA on you know, how do we get products to the customers as fast as possible and that that's been a big part of it right moving cheese six to class to becoming an IC GM that That was a huge part of our ability to get the technology out quickly and also scale it. I think there's a lot of aspects that has been faster. And you know, when I started Dexcom, we had this goal of designing a CGM that was reliable didn't require finger sticks that could make treatment decisions. All that and we were 100% focused on that. And as we got closer and closer, and now we have that which you six and also what you seven, then the opportunity that that product can provide, you start to really understand how impactful CGM can be around the world. And that's what I'm excited about now is I'm still excited about the technology always will be and we still have lots to do on making it better, more reliable and more integrated. But just how much CGM can do around around the globe. There's just so many things. It's beyond diabetes to so very excited about the future. Stacey Simms 30:47 Many thanks, as always, and we'll talk soon, I am sure but I mean, I could never get to say it enough. I can't imagine doing the teenage years with my son without Dexcom. You guys, I know you did it just for me. You did it just in time. Appreciate it very much. He is doing amazing. And I can't he would not be sticking his fingers 10 times a day. So thank you. Jake Leach 31:05 That's great to hear. Thanks, Stacy. Announcer 31:12 You're listening to Diabetes Connections with Stacey Simms. Stacey Simms 31:18 As always more information at diabetes connections.com. And yeah, but that last bit there, I can say nice things. I mean, I really do feel that way. And I can still ask not so nice questions. Like if you're new, quite often, I will open up a thread in our Facebook group. It's Diabetes Connections of the group to gather questions for our guests. And I did that here with Dexcom, there's usually quite a lot of questions, I do have to apologize, I missed a big one. Because of the timing of the interview, I promise I will circle back around next time I talk to Dexcom. And that is all about the updates for iOS and for new phones, and how you know, sometimes Dexcom is behind the updates. What I mean by that is that they lag behind the updates. So you can go to the Dexcom website, I'll put a link up for this for Dexcom products that are compatible in terms of which iOS and that kind of thing. And they are behind. And Dexcom will always say they've said very publicly that they are working hard to catch up. But I guess the question that a few people really wanted to know was why, you know, why do they lag behind? What can be done about that? So they know, but I think it would be a good question to ask. So Sarah and others. I appreciate you sending that question. And I apologize that I didn't get to it this time around. And I'll tell you, you know, it's not something we've experienced, but I think it has to do and I'm speculating here more with the phone with the the newness and the the model of the phone sometimes then for the updates, especially if you don't have your updates on automatic. So I guess I'm kind of saying the same thing. But what I mean by that is Vinny, and I have very old phones. I have an eight. I'm not even sure he has the eight. We are terrible parents and I don't care about my phone, I would still have a Blackberry if that were possible. So I can't commiserate. I'm so embarrassed to even tell you that I can commiserate with the updates, because it's just not something that we have done. Benny, definitely if he were here, trust me. It's like his number. I would say it's his number one complaint that it's really high up on the list of complaints to the parenting department in our house. And yes, Hanukkah is coming. His birthday is coming. There will be some new phones around here. I'm doing an upgrade. I'm sure both of us have cracked phones. Were the worst. Oh, my goodness. All right. Well, more to come in just a moment. But first Diabetes Connections is brought to you by Dexcom. And this is the ad I was talking about earlier in the interest of full disclosure. But you know, one of the most common questions I get is about helping kids become more independent. I get asked this all the time at conferences for virtual chats in my local group. These transitional times are tricky. And we've gone through this preschool to elementary elementary to middle middle to high school. I can't speak high school to college yet, but you using the Dexcom really makes a big difference. For us. It's not all about sharing follow, although that's very, very helpful. Just think about how much easier it is for a middle schooler to look at their Dexcom rather than do four to five finger sticks at school, or for a second grader to just show their care teams a number. Here's where I am right before Jim. At one point, Ben, he was up to 10 finger sticks a day, he didn't have Dexcom until the end of fourth grade not having to do that made his management a lot easier for him. It's also a lot easier to spot the trends and use the technology to give your kids more independence. Find out more at diabetes connections.com and click on the Dexcom logo. I don't know about you, but I am getting a ton of email already about Diabetes Awareness Month and that is November this time of year I usually get I'd say 120 emails that are not snake oil, right one in 20 emails that maybe make sense for something we want to talk about on the show here that I would share on social media and I'm just inundated with nonsense. So I hope you are not as well. But I gotta say Diabetes Awareness Month this year. I've been pulling in My local group and talking about what to do because usually I highlight a lot of people and stories and I'll I'll still do that, I think, but I got to tell you people are, um, you know, this, we're all stressed out. And while it's a wonderful thing to educate, I always think Diabetes Awareness Month is not for the diabetes community, right? We are plenty aware of diabetes, this is a chance to educate other people. And that's why I like sharing those pictures and stories on my page, because the families then can share that with their people. And it's about educating people who don't have diabetes. But gosh, I don't know this year, I'm going to be just concentrating on putting out the best shows that I can I do you have a new project I mentioned last week that we're going to be talking about in the Facebook group. By the time this airs, I will have the webinars scheduled in the Facebook group. So very excited about that. Please check it out. But what are you doing for Diabetes Awareness Month? If you've got something you'd like me to amplify, please let me know. You can email me Stacey at diabetes connections.com. Or you can direct message me on the social media outlet of your choice. We are at YouTube, Facebook, Twitter and Instagram. That's where Diabetes Connections lives. I'm on Tik Tok, or Snapchat or Pinterest. Oh my gosh. All right. Well, that will do it for this week. Thanks as always to my editor John Bukenas from audio editing solutions. Thank you so much for listening. I will be back on Wednesday. live within the news. Live on Facebook and now on YouTube as well. Until then, be kind to yourself. Benny: Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged
7 minutes | Oct 22, 2021
In the News.. Dexcom Follow update, glucose eye scanner, stem cell research and more!
This week "In the News.." our top stories include: New features for Dexcom Follow, Vertex makes stem cell progress on a functional cure for type 1, funding comes through for a eye scan for glucose levels, a new aggregate diet/nutrition study measures T1D risk in babies, Medtronic snaps up a patch pump company and a lot more.. Join us LIVE every Wednesday at 4:30pm ET for the top diabetes headlines of the week. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode Transcription below: Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I’m going to link up my sources in the Facebook comments – where we are live – and new this week – Live on YouTube.. and in the show notes at d-c dot com when this airs as a podcast.. so you can read more if you want, on your own schedule. XX In the News is brought to you by Real Good Foods! Find their breakfast line and all of their great products in your local grocery store, Target or Costco. XX Earlier today, Dexcom released some new features for its Follow app. It now includes a Homescreen Widget to an Apple device, a Quick Glance for Android users. You can submit a Technical Support Request or Request a Callback via Follow’s Contact Menu. I assume that means you can request replacement sensors from within the app? And you can Access the Status page via Follow’s Help Menu to check the status of any of the Dexcom systems. This is version 4.4 of Dexcom Follow and only applies to US users. XX Some news in the stem cell race – a few companies now looking at this as a practical cure for type 1. Vertex announced that the first patient in its islet cell replacement therapy is doing well – with a lower A1C and less insulin needs. The person is on immunosuppressive therapy and does still need to use insulin – although 90-percent less. This caught my eye - this person was diagnosed 40 years ago – this isn’t a recent diagnosis. They also had incredible hypoglycemia, up to 5 episodes a day and pretty much have their life back now. One person does not make a cure but it’s good to see these therapies moving forward. You may recall Vertex acquired Semma and joins ViaCyte which has an encapsulated stem cells – the hope for all long-term is that no immune suppressants would be needed. https://www.biospace.com/article/vertex-s-type-1-diabetes-therapy-shows-promise-in-early-stage-trial/ XX A new eye scan that could help diagnose diabetes is moving ahead. British-based startup Occuity has received investment funding for the Occuity Indigo, a non-contact, optical glucose meter.. The company says it’s different from the failed Google contact lens… the Google version measured fluid.. but the Occuity looks within the eyeball. The company says quote - it is a transparent, stable environment whose glucose levels correlate with those of the blood. The Occuity Indigo sends a faint beam of light into the eyeball and measures the light that bounces back into the device. It can infer glucose levels in the eye based on the refraction of the returning light. https://www.uktech.news/featured/eye-scan-for-diabetes-berkshire-startup-is-developing-revolutionary-medical-technology-with-285m-funding-20211019 XX Medtronic’s in talks to snap up what sounds like a pretty advanced patch pump from an Israeli company called Triple Jump. The Triple Jump system has a compact, fully portable, battery-operated miniature insulin pump and hand-held controller and includes all supporting accessories and sterile single-use disposables. The release here says it will be included in a future artificial pancreas system and that Medtronic plans to integrate Triple Jump's device to improve its pumping capabilities. https://en.globes.co.il/en/article-medtronic-in-talks-to-buy-israeli-co-triple-jump-for-300m-1001387534 XX No surprise but important info – using a flash glucose moniotor can improve A1Cs and reduce DKA cases. Big study in Scotland using the Libre – called a flash monitor because this version isn’t continuous – you have to swipe to see your glucose. The technology has been free in Scotland since 2018 – so use in people with type 1 went from about 3 percent in 2017 to 46 percent in 2020. Improvement was seen across all ages, genders and socio-economic lines. Also.,regardless of prior or current pump use, completion of a diabetes education program, or early flash monitoring adoption. https://www.endocrinologynetwork.com/view/flash-glucose-monitoring-lowers-hba1c-rates-of-dka-in-patients-with-type-1-diabetes XX Controversial but more research into preventing type 1.. new studies showing that longer breastfeeding and later introduction to gluten may reduce the risk. This was a look at aggregate studies in Sweden.. which has the second highest incidence of type 1 in the world. (number one is Finland – I knew you were going to ask) For babies nursed for at least six to 12 months, the risk of developing type 1 went down 61 percent. Gluten at three to six months of age lowered the risk 64 percent. The studies also pointed to a protective effect of vitamin D supplementation during infancy. These researchers are careful to say that this isn’t definitive but instead points to the need for more studies of babies’ diet and vitamin intake and the risk of type 1. https://www.news-medical.net/news/20211018/Breastfeeding-and-later-introduction-to-gluten-may-have-a-protective-effect-against-type-1-diabetes.aspx XX Some early news about type 1 diabetes, pregnancy and the gut microbiome. This study shows pregnant women with type 1 had a decrease in "good" gut bacteria and an increase in 'bad' gut bacteria that promote intestinal inflammation and damage to the intestinal lining. These changes could contribute to the increased risk of pregnancy complications seen in women with type 1 This is very early on.. the next stage of the project was to identify markers that would determine which women with type 1 diabetes might benefit from safe interventions during pregnancy, including dietary changes. https://medicalxpress.com/news/2021-10-dietary-pregnancy-complications-women-diabetes.html XX More to come, including mental health help and a bit of a correction on my part. But first, I want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Real Good Foods. Where the mission is Be Real Good They make nutritious foods— grain free, high in protein, never added sugar and from real ingredients—we really like their breakfast line.. although Benny rarely eats the waffles or breakfast sandwiches for breakfast.. it’s usually after school or late night. He ate like four waffles at ten o clock at night the other day. You can buy Real Good Foods online or find a store near you with their locator right on the website. I’ll put a link in the FB comments and as always at d-c dot com. Back to the news… -- We talk a lot about mental health and diabetes and how there just aren’t enough resources to help. I want to call your attention to a free virtual workshop by the Center for Diabetes and Mental Health. This is tomorrow as you watch me live – and if you’re listening or watching after I’d still urge you to check out the resources. This is from Dr. Mark Heyman who I’ve had on the show and who has his own podcast. Dr. Heyman is a diabetes psychologist and Certified Diabetes Care and Education Specialist and he lives with type 1. https://cdmh.org/ https://www.reimaginet1d.com/c/reimagine-t1d?fbclid=IwAR1dsPn5wefVM3vnypUgRuBf8OA9qL-suMKlbdPZeASRXDyFuneTAYQ3igw XX Bit of a correction to last week’s news.. I had speculated whether the Dexcom/Garmin partnership which uses the name Connect IQ had anything to do with Tandem’s Control IQ. I heard from a lot of you – apparently Garmin’s whole app system is just called Connect IQ.. and has been for years. But I did get that interview with Dexcom I mentioned.. so that will be our long-format interview episode coming up on Tuesday. That’s a chat with the chief technology officer of dexcom The episode out right now is all about Halloween – it’s an ask the d mom conversation with my wonderful friend moira mccarthy. We talk about everything from candy to getting your kids insulin pump under the costume to sugar free candy from well meaning neighbors That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
36 minutes | Oct 19, 2021
Halloween Advice from D-Moms Who've Been There (Classic Episode)
The first Halloween when your child has diabetes can seem impossible, but the D-Moms are here to help! Stacey & Moira McCarthy answer listener questions and share stories about their experiences. They can help make Halloween less scary, more fun and show you that there are a lot of options for your family. Stacey also shares some thoughts about her trip to the She Podcasts LIVE! conference last week. (The Halloween conversation first aired in 2019) Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode Transcription coming soon:
7 minutes | Oct 15, 2021
In the News.. Dexcom and Garmin partner, faster insulin tested, once a week basal and more...
Top stories this week include: a new adjunct therapy is being tested for type 1, Dexcom and Garmin will officially work together (no more DIY needed), once weekly basal insulin study, can psychedelic drugs prevent type 2?! and Australia bets on Rugby for diabetes education Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode transcription below: Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and I am on location this week. I’m at the She Podcasts LIVE conference.. but the news doesn’t wait. So.. these are the top diabetes stories and headlines of the past seven days. As always, I’m going to link up my sources in the Facebook comments – where we are live – and in the show notes at d-c dot com when this airs as a podcast.. so you can read more if you want, on your own schedule. XX In the News is brought to you by Real Good Foods! Find their breakfast line and all of their great products in your local grocery store, Target or Costco. XX Our top story.. There’s a lot of buzz these days around adjunct therapy for diabetes.. basically another treatment along with insulin. Earlier this year, a drug so far just named TTP-399 got FDA breakthrough therapy approval. A new study shows it works well to keep people with type 1 out of DKA. This was small study, 23 people. They found that TTP-399 can help lower blood glucose without increasing the risk of DKA. It’s important because other adjunct therapy.. such as S-G-L-T-2 inhibitors do help lower blood glucose, but the FDA has said they cause too much of a risk of DKA in people with type 1. Those are brand names like Invokana and Jardiance. Pivotal trials of TTP-399 begin later this year. https://www.biospace.com/article/vtv-therapeutics-type-1-diabetes-drug-shows-promise/ XX New partnership announced today - Dexcom and Garmin. You will still need your phone.. I knew you were going to ask.. but with the new Dexcom Connect IQ apps you can now see your Dexcom G6 info on your compatible Garmin smartwatch or cycling computer. Jake Leach, chief technology officer at Dexcom says.. Garmin is the first partner to connect through the real-time API, which we told you about a few months back. Basically, you’ll be seeing more connectivity without having to use a third party, community sourced work around which a lot of people do now. The name here is interesting, right? Connect IQ, very similar to Tandem’s Control IQ. But since Dexcom owns a bit of Tandem, maybe that’s no coincidence. I’ve requested an interview with Dexcom so maybe we’ll find out. garmin.com/newsroom, email firstname.lastname@example.org, or follow us at facebook.com/garmin, twitter.com/garminnews, instagram.com/garmin, youtube.com/garmin or linkedin.com/company/garmin. XX New study about time in range, hybrid closed loop systems and faster insulins. The headline here is that using Fiasp with the Medtronic 670g system resulted in greater time in range. How much? The Fiasp group spend 82 point 3 percent time in range.. the Novolog group spent 79.6 percent time in range. This was over 17 weeks and the participants mostly bolused AT meal times, not before, no prebolusing. The researchers echo what I was going to say here, quote – “While the primary outcome demonstrated statistical significance, the clinical impact may be small, given an overall difference in time in range of 1.9%.” So just a heads up if you see headlines screaming about how much faster Fiasp is because of this study. https://www.endocrinologyadvisor.com/home/topics/diabetes/type-1-diabetes/fast-acting-insulin-aspart-versus-insulin-aspart-closed-loop-type-1-diabetes/ XX People who have tried a psychedelic drug at least once in their lifetime have lower odds of heart disease and diabetes. This is a University of Oxford study published in Scientific Reports. These researchers examined data from more than 375-thousand Americans who had taken part in an annual survey sponsored by the U.S. Department of Health and Human Services. Participants reported whether they had ever used the classic psychedelic substances including LSD, mescaline, peyote or psilocybin. They also reported whether they had been diagnosed with heart disease or diabetes in the past year. The researchers found that the prevalence of both conditions was lower among psychedelic users. While no one is recommending you start taking mushrooms to avoid diabetes.. there’s a growing push to start serious research to investigate the link between psychedelics and cardio-metabolic health. https://www.psypost.org/2021/10/psychedelic-use-associated-with-lower-odds-of-heart-disease-and-diabetes-study-finds-61958 XX Update on the once a week basal insulin I’ve been reporting on for a while.. both Lilly and Novo Nordisk are testing their own version of this.. this most recent study looks at the Lilly version called Tirzepatide. These researchers found it to be safe and effective with lower rates of hypoglycemia and slightly lower A1Cs than daily basals like Lantus or Tresiba. Lots of studies ongoing here, for both brands of potential once a week dosing, including a large phase 2 program that includes people with type 1. https://www.healio.com/news/endocrinology/20211012/novel-onceweekly-basal-insulin-safe-effective-in-type-2-diabetes XX More to come, including how rugby and diabetes education may go together.. But first, I want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Real Good Foods. Where the mission is Be Real Good They make nutritious foods— grain free, high in protein, never added sugar and from real ingredients—we really like their breakfast line.. although Benny rarely eats the waffles or breakfast sandwiches for breakfast.. it’s usually after school or late night. Ugh.. do your teens eat breakfast? You can buy Real Good Foods online or find a store near you with their locator right on the website. I’ll put a link in the FB comments and as always at d-c dot com. Back to the news… -- Getting out of the doctor’s office and into something that people can actually relate to.. Diabetes Australia is using rugby to teach men about the risks of type 2 diabetes. League Fans in Training (League-FIT) is based on a Scottish initiative that used football teams to deliver exercise and nutritional advice to overweight and obese men. The program includes education and goal setting and a rugby league-based exercise session, delivered by coaches and some of the club’s players. What I really like about this is that -from what I can tell - they’re focusing on small changes and not telling these guys to give up everything they like to eat and drink or that they have to become professional players to get a little bit more fit. Imagine if NFL players had a clinic for fans to come and learn a little bit about fitness and nutrition? Again, not to be pros.. just to live a little better and lower risks of type 2. https://www.diabetesaustralia.com.au/news -- On Diabetes Connections this week, we’re talking to a mom with type 1 who has had two children during the pandemic. One last summer and the other just a few days before our interview! That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
33 minutes | Oct 12, 2021
A new mom (twice!) during COVID, Vanessa Messenger shares her story and her new book about T1D
Pregnancy with type 1 is never simple, but this week's guest faced an unusual complication. Vanessa Messenger has had two babies during the COVID pandemic! Vanessa, who lives with T1D, gave birth to her daughter in the summer of 2020. She just had another baby - 15 days before our interview. Her new book is launching this month. Called, "Teddy Talks: A Paws-itive Story About Type 1 Diabetes" it features a little dog who helps explain what kids should know about check glucose, using a CGM, taking insulin and a lot more. Teddy is modeled after Vanessa's real-life dog, who already looks like a character in a children's book. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. . Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode Transcription coming soon
7 minutes | Oct 8, 2021
In the News... Medtronic recall, Inhaled insulin for kids, T1D adults called "forgotten population" and more!
It's "In the News..." the only LIVE diabetes newscast! Top stories this week: Medtronic expands its insulin pump recall, Afrezza inhaled insulin pediatric studies to begin, new report says adults w/T1D are a "Forgotten population," new research into type 2 diabetes and statins and more! Join us each Wednesday at 4:30pm EDT live at https://www.facebook.com/diabetesconnections Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode transcript below: Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I’m going to link up my sources in the Facebook comments – where we are live – and in the show notes at d-c dot com when this airs as a podcast.. so you can read more if you want, on your own schedule. XX In the News is brought to you by Real Good Foods! Find their Entrée Bowls and all of their great products in your local grocery store, Target or Costco. XX Our top story this week.. Medtronic has expanded a recall of its MiniMed 600 series insulin pumps to include nearly half a million devices. This is an FDA Class One recall – the most serious type – because the pumps may deliver incorrect insulin doses. The recall was first announced in 2019 for just two models. Medtronic now says it will replace any MiniMed 600 series insulin pump that has a clear retainer ring with one that has the updated black retainer ring at no charge. That’s even if there is no damaged and regardless of the warranty status of the pump. There’s more to this – including directions on how to check if your pump may be affected and who to call. I’ll put all of that here in the FB comments and in the show notes. https://www.usnews.com/news/health-news/articles/2021-10-05/medtronic-expands-recall-to-include-more-than-463-000-insulin-pumps XX Enrollment is under way for the first pediatric trials for Afrezza inhalable insulin. This will involve children ages 4 to 17 living with type 1 or type 2 diabetes. It’s called the INHALE-1 phase three trial. They’re going to look at changes in A1C after 26 weeks.. and then changes in fasting glucose after another 26 weeks. If you’re interested, we’ve got the link for more info to this study and to learn about enrollment. Afrezza was approved for adults back in 2014. https://clinicaltrials.gov/ct2/show/NCT04974528. https://investors.mannkindcorp.com/news-releases/news-release-details/mannkind-announces-first-patient-enrolled-inhale-1-study XX Last week we told you about the Glucagon emergency kit recall from Lilly. Reuters is reporting that the kits were made in a factory previously cited for quality-control violations, including several involving the glucagon product. Lilly had received a report of a patient who experienced seizures even after being injected with the drug, a sign that glucagon was not potent enough to work. The company said the product failure might be related to its manufacturing process, without elaborating. A spokesperson declined to say whether Lilly has received other reports of adverse events related to the Glucagon kits. Separately, Lilly is facing a federal criminal investigation into alleged manufacturing irregularities involving another of its U.S. factories in New Jersey. Reuters is following both stories and of course, we will too. https://www.reuters.com/business/healthcare-pharmaceuticals/exclusive-eli-lillys-recalled-emergency-diabetes-drug-came-plant-cited-by-fda-2021-10-04/ XX Big new report on adults with type 1.. called a forgotten population in this write up. The consensus statement covers diagnosis, goals and targets, schedule of care, self-management education and lifestyle, glucose monitoring, insulin therapy, hypoglycemia, psychosocial care and much more. This is a joint statement from the American Diabetes Association and the European Association for the Study of Diabetes Their last consensus report on type 2 diabetes has been "highly influential," these researchers say.. so they recognize the need to develop a comparable report specifically addressing type 1 diabetes in adults. https://www.medscape.com/viewarticle/960158 XX Adults with Type 2 diabetes on statin therapy may see worsening diabetes symptoms. Important caution: the researchers are quick to say that association does not prove causation, no patient should just stop taking their statins based on this study. These are cholesterol lowering medications with brand names like Lipitor and Crestor.. Statin users had a 37% higher risk for diabetes progression, including extremely high blood sugar levels and elevated rates of disease complications. Nearly half of adults with Type 2 diabetes also have high cholesterol and many of them stop taking statins due to this kind of thing. But that may increase the risk for heart attack or stroke. So definitely talk to your doctor before making any changes. https://www.upi.com/Health_News/2021/10/04/statins-diabetes-progression-risk-study/7261633358483/ XX More to come, But first, I want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Real Good Foods. Where the mission is Be Real Good They make nutritious foods— grain free, high in protein, never added sugar and from real ingredients—the new Entrée bowls are great. They have a chicken burrito, a cauliflower mash and braised beef bowl.. the lemon chicken I’ve told you about and more! They keep adding to the menu line! You can buy online or find a store near you with their locator right on the website. I’ll put a link in the FB comments and as always at d-c dot com. Back to the news… -- DreaMed Diabetes gets FDA approval to expand their platform to people with type 1 and type 2 diabetes. Called Advisor Pro, it’s the first decision support system that has been cleared to assist healthcare providers in the management of diabetes patients who use insulin as well as CGMs and meters. We spoke to these folks on the podcast last year. They say Advisor Pro aims to solve the massive worldwide shortage of endocrinologists by empowering primary care clinicians, to be able to provide expert level endocrinological care to diabetes patients. The company’s founder says the next step is to develop and extend the technology to cover all injectable or oral medications for diabetes. https://www.businesswire.com/news/home/20211006005640/en/ https://diabetes-connections.com/we-treat-the-data-lifting-the-burden-of-diabetes-with-dreamed/ -- Really interesting look at who’s adopting newer diabetes technology. This is from an article over at Dia Tribe where they feature a research study showing that roughly 55% of people with diabetes had positive, open attitudes toward technology. However, another 20% had negative attitudes and did not trust technology, while the remaining 25% either did not want additional data, did not want to wear a device on their body or had a very high level of diabetes distress related to using devices. When they focused on people with type 2.. it turns out the uptake of technology was actually lowest among people aged 18 to 25. This group also had the highest levels of diabetes distress and the highest A1C levels, and many reported that they did not like having a device on their body as their main reason for refusing the devices. Others reported the frequency of alerts and alarms, feeling physically uncomfortable, and cost as reasons for rejecting devices. These researchers say providers need to find ways to avoid making patients feel guilty about their choice of technology as well as watching out for negative judgements for those who use devices but don’t achieve near perfect glucose control. https://diatribe.org/new-tech-and-psychological-toll-diabetes-management Please join me wherever you get podcasts for our next episode - The episode out right now is all about the film Pay or Die an upcoming documentary about insulin access and affordability. – That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
33 minutes | Oct 5, 2021
Pay or Die: A new documentary about the price of insulin
There's a new documentary in the works, all about the struggle of insulin access and affordability. Rachael Dyer and Scott Ruderman, who lives with type 1, join Stacey to talk about their experience making this film and why they think it could make a difference. Pay or Die Film provides an inside look at how the soaring price of insulin in America is threatening—and even taking—the lives of people with type 1 diabetes. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Episode Transcription coming soon! Click here for iPhone Click here for Android Stacey Simms 0:00 Diabetes Connections is brought to you by Dario Health manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first premixed auto injector for very low blood sugar and by Dexcom take control of your diabetes and live life to the fullest with Dexcom. Announcer 0:22 This is Diabetes Connections with Stacey Simms. Stacey Simms 0:27 This week, a new documentary in the works to show people outside the diabetes community the struggle of insulin access and affordability. Rachael Dyer and Scott Ruderman had an experience in Canada that made them say, we got to do this, Rachael Dyer 0:42 where he was paying at home in America up to $450 a vial out of pocket then to have the same vial same manufacturer same everything brought to him for $21 in Canada and to watch Scott just break down and start crying there in the pharmacy and for myself as well. I was left in shock and disbelief, and we just looked at each other as we walked out and said it's time now to make this documentary. Stacey Simms 1:11 We'll talk to Rachael and Scott who lives with type one about their experience making this film and why they think it could make a difference. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show always so glad to have you here. You know we aim to educate and inspire about diabetes with a focus on people who use insulin and insulin access and affordability as you heard is what this week's episode is all about. I'm your host Stacey Simms. My son Benny was diagnosed with type one right before he turned to almost 15 years ago. My husband lives with type two diabetes. I don't have diabetes. I have a background in broadcasting. And that is how you get the podcast In our most recent in the news episode. And that's the previous podcast episode two this one, I explained Lily's new move to drop the price of insulin lispro. Between that and Walmart's deal with Novo Nordisk, which lets Walmart price Novolog, same exact Insulet Novolog. a lot lower. We're seeing some interesting action on the cash price of insulin at the pharmacy. As I've said for years, though, I think it's going to take state and federal legislation to see real systemic change, you still need to jump through a lot of hoops, you still need to know that this is out there, you still need to find coupons in many cases, or you need to, you know, have really good insurance. There's a lot going on, and my guests this week are hoping that their documentary film will help educate people and make a difference. That film is currently in production. It is called Pay or Die. Here's a clip from the teaser, Trailer here: https://payordiefilm.com/film-teaser Stacey Simms 3:17 If that last bit sounds familiar, that's Nicole Holt Smith, who I've had on the show her son Alec died after rationing insulin, and that audio is from her arrest at a protest at Eli Lilly headquarters in 2019. Today, you're going to hear from the filmmaker Scott Ruderman and Rachael Dyer. Scott was diagnosed with type one in 2009. He is an award-winning filmmaker. He's worked on documentaries for Netflix and Hulu in the BBC and HBO, his documentary short piano craftman won Best Director at the Madrid art film festival. He has a long list of credits, as does my other guest Rachael Dyer. She is an award winning journalist and producer who won a Southern California journalist Award for Best International feature, as well as a Clio entertainment grand winning entry for her work on the greatest showmen live the world's first live commercial for theatrical release the story behind Pay or Die in just a moment but first Diabetes Connections is brought to you by Dario Health bottom line you need a plan of action with diabetes. We've been really lucky that Benny’s endo has helped us with that and that he understands the plan has to change as Benny gets older you want that kind of support. So take your diabetes management to the next level with Dario health. They're published Studies demonstrate high impact results for active users like improved in range percentage within three months reduction of a one c within three months and a 58% decrease in occurrences of severe hypoglycemic events. Try Dario’s diabetes success plan and make a difference in your diabetes management. Go to my dario.com forward slash diabetes dash connections for more proven results and free information about the plan. Scott and Rachael, thank you so much for joining me. I appreciate you spending some time with me and my listeners today. Rachael Dyer 5:14 Thank you so much for having us. Stacey. We're really great, great time and looking forward to being here. Stacey Simms 5:19 Let me start if I could with you, Scott, could you live with type one? Just briefly, could you tell us your diagnosis story, you were diagnosed as and as an adult? That's correct. Scott Ruderman 5:29 I was in college, and it was around 2009. And it was my first semester in college I was I was going to Suffolk University in Boston, Massachusetts. And for about two weeks, I really wasn't feeling good. had all the symptoms, I say got very blurry, drinking a lot of fluids. I woke up one morning, and I just couldn't feel my legs from my waist down. It felt like they were being bags, I went to the school infirmary. And they they told me it sounds like type 1 diabetes are just diabetes. But they weren't. You know, they said it's probably not. But when they actually took a glucose reading, they left the room, the nurse came back in and she said, Look, I thought the meter was broken. But I checked my blood sugar and it's fine. Your blood sugar is not, it's not reading on the meter. So it's definitely going to be high, we want to send you an emergency room. So I went to Mass General, and I checked in and I was there for about a week. And then I resumed classes the week after it was it was a really hard week. But it was just one of those things. And I think a lot of type ones could relate that you just have to accept it. And the learning curve is it took a few years to really get on top of it. And then as the newer technology came in, it just got easier to manage. Stacey Simms 6:42 So what led you all to this documentary? I assume it didn't happen as soon as you were diagnosed, Scott, but can you tell us a little bit about kind of what led you down this path, of course. Rachael Dyer 6:53 So this has been a passion project for Scott for some time. And Scott and I actually met working together in the field. So obviously, we're both in the documentary business. And we just finished up working on a documentary together. And then I have a journalistic background. And I had done quite a few stories where I was looking at a lot of Americans traveling to Canada to get alternative medicine up there and their prescription medicine out there because it was a lot cheaper. I hadn't ever focused on insulin, but I had done other stories. So when Scott and I had met in the field and started speaking, Scott had told me that he was a type one diabetic, which I knew nothing about at the time, I knew very, very little about diabetes in general, let alone type one. And I was traveling to Canada because I'm Australian and half Canadian, and I was visiting my family. And I asked God to come with me. And I told him that I done some of these stories about, you know, Americans traveling up there. And Scott didn't believe me at first. And I thought that it was crazy what I was talking about. But we went, we went to Vancouver and we said, Look, I said why don't we just try. Let's see how we go. So he went to a few pharmacies and there and then the pharmacists were great. And we explained our situation, you know, Scott had shown brought in the insulin that he was on. And they, you know, were so generous and welcoming and kind and said to him, Look, what insulin Do you need right now for this trip? What can I help you with? And as Scott likes to explain it, he says it was like he was a kid in a candy shop, just to have that overwhelming experience with insulin that was so inaccessible, and so expensive in America to come forward and have it brought to him where he was paying at home in America up to $450 a vial out of pocket than to have the same same vial, same manufacturer, same everything brought to him for $21 in Canada, and to watch scotches break down and start crying there in the pharmacy. And for myself as well was I was left in shock and disbelief. And we just looked at each other as we walked out and said, It's time now to make this documentary. We have to do something about it. So that led us on our journey. Scott Ruderman 9:19 I have to stay Stacy, to Rachel's point, it was a very emotional experience. It was one of those experiences where you feel joy but kind of frustration and at the same time I think I say this all the time. I really looked at my hands and for the first time I said Well, I'm feeling a little bit more accepted and cared for and thought out for then my experiences going to a pharmacy in the United States where I need more insulin and my prescription. You know, it's not it's not fully made out for the month yet and they're kind of like no, you have to come back next Tuesday and I can walk out of there and they know I could potentially die without my Insulet So it was just quite an experience. And to Rachel's point again, yes, we both said we're making a film about this. Stacey Simms 10:07 So it seems to me that just from what you've said, it looks like it changed a bit though from Why can't we get more affordable insulin in the US? Why can't you like you can in so many other countries walk in and buy what you need to people are dying? And I'm curious, did you realize that as you started this project, or was that always part of the story all along? Scott Ruderman 10:27 For me, when I was doing the initial research, you know, when I realized, the first thing I said, in my head, I wonder what people are doing that can't afford it, and where they're going, and upon my initial research, you know, obviously, people that can't afford to go on Facebook, you know, the clinical black market and media. But then I started reading all these stories about people rationing their insulin, and going into decay and dying just to make ends meet. And that's where things got a little bit more serious. And like, Whoa, this is not just being able to afford it, people are actually losing their life because they can't afford it. And that's kind of where the film kind of took it. It's kind of approach was that this is an issue and people are dying. Stacey Simms 11:09 Rachel, what do you think the film is for? You know, it's very difficult, as you probably know, and as you live with type one, Scott, it's difficult to explain any of this to people who don't live with it day in and day out. I'm curious who you're producing this for, of course, and Rachael Dyer 11:26 I think, you know, with anything, that is a huge challenge with trying to firstly explain an illness, which a lot of people do not live with. And also to, to differentiate between type one and type two, that is obviously a challenge in the beginning. But you know, there are huge differences. And there are huge differences, which we do point out in the film. Obviously, as you know, with your son living with type one as well, it is a life threatening illness, and you are insulin dependent. So you know, we explore that, but also to exploring the medical system in America, which, as anyone who lives here can understand that it is very complicated, which they love for it to be to make everyone think that this is something that we just have to live with. But for me, being an Australian and Canadian, I think, the shock factor from an international audience and not having to not only live with a debilitating illness, but also to then navigate this healthcare system is what we're trying to present throughout the film as well and show the microcosm of this healthcare system in the United States. So I would say that this film is being produced not only for the type one community or the diabetes community, but for not only also to a domestic and international audience to show what is going on in the states and how unjust it is, and how unfair it is for people just to not be able to access life saving medication and medication that in a lot of other countries around the world is affordable and accessible, and you shouldn't be dying because of it. So it's for everyone. Stacey Simms 13:11 I'm curious, too. It's so hard to get this message to be clear, because our healthcare system is so complicated to the point where you can go on social media any day and see people within the diabetes community arguing about whether or not people can afford insulin. In other words, you know, if you start any kind of Twitter chain or Facebook conversation, you'll have everything from you know, mine's covered. 100%. I don't understand what your problem is to why don't we just get a coupon to the president lowered the price of insulin? No, the president raised the price of insulin. It's so confusing at Scott, did you focus on any of that conversation? Or is this more focusing on individual stories? Right back to Scott answering that question, but first, Diabetes Connections is brought to you by Gvoke Hypopen and you know, low blood sugar feels horrible. You can get shaky and sweaty or even feel like you're going to pass out. There are a lot of symptoms that can be different for everybody. I am so glad we have a different option to treat very low blood sugar Gvoke Hypopen is the first auto injector to treat very low blood sugar Gvoke Hypopen is pre mixed and ready to go with no visible needle before gvoke. People needed to go through a lot of steps to get glucagon treatments ready to be used. This made emergency situations even more challenging and stressful. This is so much better. I'm grateful we have it on hand to find out more go to Diabetes connections.com and click on the Gvoke logo. Gvoke shouldn't be used in patients with pheochromocytoma or insulinoma visit g vo glucagon.com slash risk. Now back to Scott answering my question about whether the film looks at the bigger system or focuses on individual stories. Scott Ruderman 14:56 That's a great question. This is a question that's brought up a lot as well. Let's just within our team, you know, this film is really, through, you know, the stories of people that are struggling. And we're capturing those human stories and seeing kind of the lengths, they are going to try to get access to the medication they need financially. And through their stories, we will kind of go into a little bit about the complex system, as well as politically what's happening. But the idea of the film is, this is a very character driven film. And we want people to be able to familiarize themselves with these characters and be able to, you know, say, well, that could be me, or that could be my friend's daughter who has type one or, you know, not even just type 1 diabetes. I mean, there's other medications that are so expensive, that anyone can kind of put themselves in those shoes and be like, what do I do if I can't afford medication. And that's really the shock factor we want to bring through in the film and urgency, because we can go on and on and on and talking about the complexities. But the problem is, it's never going to be solved, unless you're faced with the realities of it yourself. So bringing that to the viewer of making them feel like they are in the position of what our characters are going through is the goal to show the reality of the struggle Rachael Dyer 16:16 to Scott's point that is very much the focus of the film, but we do have experts that we are speaking with that, breaking down the complexities behind it and showing how the system works. And with the experts that we have, they do actually show that the complicated system is being put there for a reason to make people feel like it is more complicated than what it actually is to make it so confusing that people just throw up their hands and say, I can't be bothered, this is just the way it is, which is certainly not the case. And it doesn't need to be the case. So you know, we do have the experts that have come in to break down that process and make it as simple as possible so people can understand this is not the way that it needs to be. Yeah, Stacey Simms 17:03 that's great. Scott, what conclusion do you come from after this? I mean, I agree with Rachel, it's complicated, because it's designed that way. I do think the government will eventually get involved. We're seeing states now start making some changes. I'm not sure the federal government will ever take action. But you know, is it going to be a change in list price? Are we going to need to get rid of pbms? You know, did you draw any conclusions from this? Scott Ruderman 17:28 You know, I think one of the the challenging things is the barriers of entry for just anyone trying to make a change with what's happening. And part of making this film is to kind of shine light on how complicated this system is. And no, this is this film gonna be the ultimate change? No, but it's trying to make the world a better place and down the road, do I think Insulet will be free? No. But I think just recently in the media over the last few years, this issue has been hot. And I think people are catching on and people are realizing that there needs to be more, you know, regulation on this. And prices need to be more affordable. I mean, think about when insulin, the discovery of insulin and Frederick Banting. I mean, the whole reason he sold it for $1 was so no one can make a profit of this. And I think looking at where we are today, I mean, discovery, insulin was a breakthrough discovery for the United States of America. And it's been celebrated. But if people can't afford it, and they're dying, because of it, that's going against the whole idea of making it affordable with bandings purpose to selling it. Hopefully, this is just a wake up call to say, hey, insulin was to to help people not to make profit off. Stacey Simms 18:46 And I before Rachel jumps in, because I know she's half Canadian. Dr. Banting was Canadian, so we have to give the props. I know, I know, you meant you know, the manufacturer in the United States, and really purchasing getting all of that. But tell us a little bit if you could Scott about maybe some of the you said characters tell us a little bit about the people in this piece, Scott Ruderman 19:05 of course. So you know, we have some principal characters, we've been following Nicole Holt Smith, who lost her son Alec, he was rushing his insulin, he couldn't afford, you know, the monthly cost. And he, he went into decay and died. And she's been fighting on the Minnesota State level to try to get access to emergency insulin in Minnesota. And we've been following her kind of battle on the state level. So that's one of our main stories. Another story. We've been following a mother and daughter who've been living out of their car because they need to make ends meet and you know, they're both type one, and they couldn't afford their insulin. So unfortunately, they were living in their car trying to survive, and they're the ones that crossed the border to find cheaper insulin in Canada. So we followed that story. And then we also have another story of a newly died This is during COVID. And the reason we brought that story in is we needed to, we want to cover all angles, we don't want all our characters to be this repetition of, I can't afford insulin, it's they're all struggling in different ways. And our COVID story of being diagnosed on COVID is, is to show the reality of what it's like and how your life just flips with type 1 diabetes, the management side, the physical side, and then again, the financial side. So it's all those aspects are in that story. Rachael Dyer 20:29 Yeah. So just to Scott's point, I think that what we're trying to capture with all of our contributors and following their stories is it is just that it is a financial, emotional and physical burdens that, you know, everyone who is diagnosed with Type One Diabetes goes through on a daily basis. And I think that is the main emphasis that we really focus on throughout the film. And you see it through the stories, you see it through the emotional, physical and financial burden that they go through. And I think where Scott and I work well at both together, but our style as documentary filmmakers, is we are a very small footprint on the ground, a lot of the time, it is just Scott Nye traveling together. So we have a very personal relationship with the people that we film with, and they open up their world and they let us in and we become very familiar with who they are. And you see the heartbreak, you see the tears, you see the joy, and hopefully that is what is going to come across on film and and in the stories and if anyone has a daughter has a mother has a son has a child that is struggling in any capacity, whether it's with type one or something else, I feel as though that they're going to be able to relate. And that's the purpose behind these special stories that we're bringing to the screen. Stacey Simms 21:58 Scott did anything surprise you, as you talk to these folks, when you live with type one yourself, I'm curious if anything that they said or anything they shared, took you by surprise, Scott Ruderman 22:07 not only surprised, but as we kept going back into the fields, and filming, I think, you know, realizing that I am a type one and that this could happen to any day just kind of drop the reality perspective back to me. And I'm feeling what they're saying. Because, again, this I could be in this position. as a freelancer alone, covering my own health insurance, a bad month puts me in a bind. I'm actually the subject of my film in a way. So it's a very interesting connection. And it takes a toll on me. Every time I go and film, I need space after to just process what I'm hearing and what I'm going through, I think filming with Nicole Smith hope of being a mother of, you know, losing her son, I think my mom like what my mom would go through. If I were to pass away because of this and following Nicole. And you know, that's where you kind of see a real mother's purpose of just she's not going to stop being Alex's mother. By doing that she's going to continue to try to make an example that this is not okay, and be a voice for all the mothers out there that do have children diagnosed with type one and could be struggling because when you turn 26 years old, and you're off your parents health insurance as a type one, it's a new learning curve. It's a financial learning curve. And it could be very difficult. It could mean the job you get where you apply. It's not what you want to do in life. It's what can I do, that's going to keep me alive so I can afford, you know, for my insulin to keep me alive. It's a very scary and Nicole always says it's that number 26. And I'm only 31 years old, and I was 26. I remember that moment. It's really hard. Stacey Simms 23:58 Before I let you go, unless each of you this question, why do you work in documentary? This is a it's such a different type of filmmaking. It's so personal. As you said, Scott, you kind of have to recover if every time you talk to somebody, why do you do it? Rachael Dyer 24:12 I'll jump in. I think for me, as I mentioned earlier, my experience and background was as a journalist for over 10 years and you know, I dealt with some really challenging and and hard hitting stories. For the my first four years in America, I was traveling the country and working in breaking news. And for me, with the 24 hour news cycle that has just become so relentless, my personality is one of which I just had to stop being on the ground for less than 24 hours and seeing these people let's hop right and wanting to share their story more and so naturally, I just transitioned over to wanting to be in the documentary space to spend money. more time with individuals learn about who they are and share these really important stories on the world stage. Rather than just jumping in and out for a one and a half minute nice cars. Yeah, for me, it was just important to be there with the people, and spend the time sharing these really relevant stories. Scott Ruderman 25:19 For me. I love storytelling, I think one of the greatest things about documentary is to every project, you're in a different world, you are discovering the lives of people and what they're going through, and to be able to film that and see transformation and see someone change along the way along the process is extraordinary. For me, it's also extremely challenging. And being in a room with a camera and filming people at on the moment. It's in this sense, you know, I like to say in fiction film, you know, the director is God. But when it comes to documentary and nonfiction, God is the director, and you don't know what's going to happen in front of your lens, and to be there and capture a moment that could only happen once and walk away with that and be part of that is what keeps me coming back to make more documentaries. Stacey Simms 26:11 And in general, and maybe just for this one, too. I'm always curious, how much more do you film than you use? Right? I mean, it's got to be hours and hours and hours that you're filming that you're not going to use? Rachael Dyer 26:24 Yeah, I think that's always the fun part. The fun part for us, but definitely not the fun part for the editor when they have hours, and hours and hours of footage to go through. But yeah, like Scott said, I think that the difference between documentary and true documentary is that you do not know a lot of the time what is going to happen, you can only prepare so much. But there is a lot that is unpredictable and doesn't happen and you you know, you want to film that you want to see the change and evolutions in these people. So again, I think it depends on the documentary, the subject matter, but and also to where you initially thought the film might go might not be how it ends up in the Edit. So we're not at that stage yet. So I think we will see but you know, there is a lot that we have filmed but a lot of special moments to within that. Scott Ruderman 27:22 Yeah, another challenging thing about making a documentary. And you know, I just also want to point out there this documentary, until we started actually securing funds was funded out of pocket by me. And one of the hardest things is, you know, we have characters across the nation, West Coast, mid coast, and one of the hardest things is always being there at the right moment. And you know, being able to jump on a plane with all the gear get there and be there in time to capture it. That's a huge cost factor. And you know, that's a decision you have to make. That's one of the challenges about document and you're not with people, you know, we've been filming this for a few years now we're not with our characters fully on for years. It's it's coming back and going. And there are moments where it's exhausting for subjects because we're there and we have to take a break. And then we come back and you know, new development occurs. And that's the beauty of it is following and following and following it seeing that transformation. Stacey Simms 28:17 Well, Scott and Rachael, we really look forward to the completion of this and seeing it and spreading the word. Thank you so much for joining me and sharing your story and we look forward to the release of the movie. Thanks. Thank you watch. You're listening to Diabetes Connections with Stacey Simms. More information at Diabetes connections.com. I will link up the website to Pay or Die and any other information about the timing production, that sort of thing. Of course, there's a transcription along with this episode as there is with every episode since the beginning of 2020. Just a real quick note about our experience with insulin and coupons. And I've shared this story before and it's been about a year now I realize that we decided we had changed insurance right around this time last year, and they wanted to change us from human log to novolog. But he's been doing great. I did not want to make any changes. I mean, you know how it is when things are going well. So we decided we had a little bit of a stockpile, Lino, let's fight it. And it took me a full two weeks of spending a lot of time calling the pharmacy calling my doctor we got some coupons I went to get insulin.org and went through that process and you know, immediately printed out a coupon for human log and said this will be $35 a month. It was not that easy. I took it to the pharmacy and they said nope, it doesn't scan so we had to jump through a lot of hoops. What happened for us was we got a new prior authorization from Benny's endocrinologist and the pharmacy ranted as a new prescription. So that helped us and you know what, I'm afraid knock on wood is word As I'm looking around here, we have not had to do anything else it renewed automatically for 2021. And so far so good. I'll keep you posted. if anything changes, it was a lot of hoops to jump through. I'm grateful I had the time and the knowledge to do so I know not everybody can spend that much time and has that good of a relationship with both their pharmacist and their endo. What a mess. Alright, more to come. But first I want to tell you about another one of our sponsors Diabetes Connections is brought to you by Dexcom. You I want to talk about control IQ. This is the Dexcom G6 Tandem pump software program. And when it comes to Benny, even though I hardly expect perfection, I really do I just want him happy and healthy. I have to say control IQ the software from Dexcom. And Tandem has exceeded my expectations, Benny is able to do less checking and bolusing. And spending more time in range is a once these are the lowest they have ever been. This isn't a teenager at the time when I was really prepared for him to be struggling. And everybody’s sleep is better to with basal adjustments possible every five minutes, the system is working hard to keep him in range. And that means we hear far fewer Dexcom alerts, rural sleeping better. I'm so grateful for this, of course individual results may vary. To learn more, just go to Diabetes connections.com and click on the Dexcom logo. If you're listening to this episode as a first airs, it's the first episode of October of 2021. It's also the beginning of a stretch of really, really busy weeks for me, I am hoping to have an episode every week this month. But please follow me on social it is possible, especially two weeks from now, that's kind of iffy, but I'll see what I can do. I am traveling to New York this coming weekend, I was supposed to go to friends for life White Plains, that is now a virtual event that's going to happen in November. But I'm still going because I have family up there. And I have some plans. So I'm really excited. And then the phone week I'm going to shoot podcasts live, which is a female podcasting event that I've been working on. I'm working with them to help with that event. So I'm really excited about that. And then later in the month, my husband and I are going to go away to celebrate a big birthday of mine. And in between I'm trying to make room for lots of just fun local stuff where I am because yeah, I mean, I don't usually celebrate my birthday all month long. But hey, I'm turning 50 I gotta tell you, I mean, are you Is anybody excited about turning 50? I'm not thrilled right about getting older. But man, I'm thrilled about getting older. I really have mixed feelings about this, because it is a milestone. So I'll be sharing more maybe on social media, we'll see. But I do have a couple of fun announcements coming up. They will be mostly in the Facebook group, or at least they'll be first in the Facebook group. So if you're not in Diabetes Connections, the group please make sure to jump in there. end of October, maybe mid to late October. I've got a couple of announcements. I need your help with some upcoming projects. It's going to be a lot of fun. All right, thank you as always to my editor John Bukenas from audio editing solutions. Thank you so much for listening. I will be back with in the news that's gonna happen every Wednesday at 430. Even as I'm on the road, I've done it before. I don't mind doing it again, from my friend's homes, my sister's house or from hotel rooms. I like doing those in the news episodes live. So those will continue. I'll see you back here in just a couple of days. Until then, be kind to yourself. Benny 33:12 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged
8 minutes | Oct 1, 2021
In the News... Insulin price drop, COVID T1D study, a through-the-skin CGM and more!
In the News.. this week: Lilly drops the price of some insulins, this T1D group most likely to be hospitalized if infected with COVID, insulin pumps reduce risk of retinopathy, Novo Nordisk pays investors to settle earnings claims, another through-the-skin glucose monitor and more! Join us Live on Facebook each Wednesday at 4:30pm EDT! Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode transcription below Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I’m going to link up my sources in the Facebook comments – where we are live – and in the show notes at d-c dot com when this airs as a podcast.. so you can read more if you want, on your own schedule. XX In the News is brought to you by Real Good Foods! Find their Entrée Bowls and all of their great products in your local grocery store, Target or Costco. XX Our top story – Lilly announces a big price change on some insulins. Starting this January, the cash price of Insulin Lispro goes down 40%. Lispro is identical to Humalog – the price on that one isn’t changing. Lilly says one in three prescriptions for their mealtime insulin is for Insulin Lispro. I asked Lilly why now and what about Humalog? I’ll put my Q&A in the show notes – you’ll be able to read them at diabetes dash connections dot com and in the Facebook group.. their answers were vague – although one interesting point.. they claim these programs have lowered the monthly out of pocket cost of a prescription for Lilly insulin to 28 dollars.. a decrease of 27% over the past four years. The bottom line here is that you still have to do the work… your pharmacist can substitute lispro for humalog – or the other way around – however the prescription is written.. make sure you ask them to check which is cheaper either with your insurance, with a coupon or with the cash price. It’s a lot of work, but with all of these options, you want to figure out what’s best for you. https://beyondtype1.org/lower-list-price-lilly-insulin-lispro/ XX Adults over 40 with type 1 are 4 times more likely to be hospitalized with COVID 19 than younger people. New study in the Journal of Clinical Endocrinology & Metabolism. This study looked at thousands of people with type 1 from April 2020 to March of 2021 – so it’s worth noting that the recent Delta wave isn’t included here. Hospitalized here means inpatient or ICU not emergency room. This is where it gets really interesting – they adjusted for sex, A1C, race and ethnicity, insurance type and comorbidities – it was being over 40 that still increased the odds. That’s not to say A1C didn’t matter.. The likelihood for hospitalization was higher for all ages with a higher A1C. Also interesting.. there was no significant difference for adverse outcomes between the age groups. They grouped together DKA, severe hypoglycemia and death as the adverse outcomes here.. https://www.healio.com/news/endocrinology/20210928/older-adults-with-type-1-diabetes-more-likely-to-be-hospitalized-for-covid19-than-youths XX Using an insulin pump may decrease the risk of diabetic retinopathy in younger people with type 1. These researchers looked at almost 2000 patients under the age of 21 and found - after adjusting for race and ethnicity, insurance status, diabetes duration, and A1C - patients with pumps had a 57% decreased risk for retinopathy. The thinking here is that it’s about less variability in blood glucose. However, there were disparities in access to pumps, with pump users more likely to be white and have private or commercial insurance. https://www.medscape.com/viewarticle/959758 XX Very early on but potentially big news out of China… this is the DREAM study a phase three clinical trial of a medication called dorzagliatin (DOOR-zuh-GLY-uh-tin)– this is for people with type 2. While it was a small study it has big results.. after a year, 65% of the 69 patients were in remission – that generally means A1Cs under 6.5 with no glucose lowering medication – although the exact definition of remission was not given here. These findings were presented at a recent BioMed Conference in China. https://www.biospace.com/article/hua-medicine-may-be-sending-type-2-diabetes-into-remission-/ XX XX Novo Nordisk shareholders say pants on fire to the insulin maker and get a $100 million dollar settlement. What happened here? Novo allegedly told investors not to worry about insulin pricing pressures from lawmakers and patient groups - that they’d still make plenty of money. But the investors disagreed – saying other insulin makers were warning their investors that profits could fall. This lawsuit has nothing to do with any benefit to patients – it was all about investors who were actually asking for 1.7 billion dollars. Novo agreed to the smaller deal saying they just wanted to avoid the burden of litigation, no admission of wrong doing. https://www.fiercepharma.com/pharma/novo-nordisk-agrees-to-100m-settlement-investors-who-claimed-company-misled-them-about-its XX This is from last week but want to make sure you’ve seen a voluntary glucagon recall. Lilly is recalling a specific lot from their red box emergency kit. It’s lot D239382D so please check. The problem here is that someone reported the vial of glucagon was in liquid form instead of powder – which can mean the glucagon isn’t going to work well in an emergency. If you got this lot – bring it back to the pharmacy or call Lilly. Info in the link and show notes. https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/eli-lilly-and-company-issues-voluntary-nationwide-recall-one-lot-glucagonr-emergency-kit-due-loss XX You might have seen the headline on this one: if you can’t fit into the jeans you wore at age 21 you’re at risk of developing type 2 diabetes. I dug a little deeper on this.. very small study. First. These people weren’t even overweight. They did have type 2 and as part of the study managed to lose fat and the researchers said their diabetes was put into remission. They all followed a weight loss program of a low calorie liquid diet for two weeks – 800 calories a day! They did this three times until they lost 10 to 15 percent of their body fat. The researchers say this “demonstrate very clearly that diabetes is not caused by obesity but by being too heavy for your own body”. What does that mean?! What does it have to do with the headline about jeans at age 21? And what happens to these poor people who were slurping 800 calories a day and are now just back to their normal lives? I’m hoping I missed something big on this one.. https://www.theguardian.com/society/2021/sep/27/people-who-cant-fit-into-jeans-they-wore-aged-21-risk-developing-diabetes XX More to come, But first, I want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Real Good Foods. Where the mission is Be Real Good They make nutritious foods— grain free, high in protein, never added sugar and from real ingredients—the new Entrée bowls are great. They have a chicken burrito, a cauliflower mash and braised beef bowl.. the lemon chicken I’ve told you about and more! They keep adding to the menu line! You can buy online or find a store near you with their locator right on the website. I’ll put a link in the FB comments and as always at d-c dot com. Back to the news… -- We’ve got another through the skin glucose monitor in the news. Know Labs debuted it’s Know-U device which is very small, fits in your pocket and is powered by what they call Bio R-Fid technology. It emits radio waves to measure specific molecular signatures in the blood through the skin. They’ve also got UBand.. which is a bracelet that does the same thing. Do they work? According to a 2018 study 97% of the UBand’s readings were within 15% of the values calculated by the Abbot Libre. But that wasn’t a clinical trial – those are starting this year. https://www.fiercebiotech.com/medtech/know-labs-unveils-pocket-sized-glucose-monitor-swaps-fingersticks-for-radiofrequency -- And finally, maybe the most glamorous photo featuring an insulin pump.. model Lila Moss – daughter of supermodel Kate Moss – walked the Fendi Versace runway at Milan’s fashion week with her Omnipod very visible. Lila Moss has type 1 and while they family has never really mentioned it, she’s been photographed with her pod on before. Lots of write ups about this – great to see the representation -- Please join me wherever you get podcasts for our next episode - The episode out right now is with Marjorie’s Fund – helping people survive diabetes in countries with few resources.. and next week we’re featuring the folks behind the upcoming Pay or Die film about insulin access.. That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
36 minutes | Sep 28, 2021
Access, Education, and Economic Empowerment - The Worldwide Mission of Marjorie's Fund
We have some big problems in the United States in terms of access to and affordability of insulin. But when you look around the world, there are still many other countries with bigger barriers for people with diabetes. This week, we're talking to a group trying to make a difference in some of the places that need it most. As you'll hear, Marjorie's Fund was started to honor the memory of a woman in Uganda who died from type 1 diabetes at the age of 29. Dr. Jason Baker is an endocrinologist who lives with T1D. He explains why he was in Uganda and what happened to make him take the leap to start Marjorie's Fund. You'll also hear from Sandy Narayanan, co-founder who lives with type 2. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode Transcription Stacey Simms 0:00 Diabetes Connections is brought to you by Dario Health manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first premixed auto injector for very low blood sugar, and by Dexcom take control of your diabetes and live life to the fullest with Dexcom. Announcer 0:21 This is Diabetes Connections with Stacey Simms. Stacey Simms 0:27 This week what happens in countries where the most basic diabetes technology - syringes insulin test strips - is incredibly scarce. Dr. Jason Baker, who lives with type one found out when he spent part of his endocrinology studies in Uganda, Dr. Jason Baker 0:43 and I thought to myself, man, if I would have been diagnosed somewhere else than where I was diagnosed, would I be able to be where I am free of complications, having my life not hindered, but actually enhanced by diabetes? Stacey Simms 0:58 Dr. Baker shares how that experience led him to start Marjorie's Fund, now called M Fund. He and his colleague Sandy Narayanan explained the goals of the group and how we can help. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show. I am always so glad to have you here. Hi, I'm your host, Stacey Simms. And you know, we aim to educate and inspire about diabetes with a focus on people who use insulin. Well, for the last few years. I've had a lot of people tell me you have to talk to Dr. Jason Baker. I feel like it's just one of those names here over and over in the diabetes community. Dr. Baker is Assistant Professor of clinical medicine and attending endocrinologist at New York Presbyterian Weill Cornell medicine in New York, New York. He is the co founder of M Fund, the medical director and the board chair. Marjorie's fund, as you'll hear is named after a woman Dr. Baker met in Uganda. She was diagnosed as an adult and she only lived to age 29. During her short life, she was able to advocate and educate her death, it could have been prevented with better resources and she did inspire doctors and patients and many others to carry on this cause. Dr. Baker is joined in this interview by Sandy Ryan on their board Treasurer program committee chair and she lives with type two diabetes. They have a big event coming up and I will link all of the information up at Diabetes connections.com so you can learn more if you would like to help and you've already heard me use interchangeably Marjorie's fund and M Fund. They are in the process of renaming to M Fund. Of course, the legacy of Marjorie is at the core of this organization. So all of that coming up but first Diabetes Connections is brought to you by Gvoke Hypopen, I mean you have diabetes and use insulin, low blood sugar can happen when you don't expect it. That's why most of us carry fast acting sugar and in the case of very low blood sugar, why we carry emergency glucagon, there's a new option called Gvoke Hypopen the first auto injector to treat very low blood sugar Gvoke Hypopen is premix and ready to go with no visible needle. In usability studies. 99% of people were able to give Gvoke correctly find out more go to Diabetes- Connections comm and click on the Gvoke logo Gvoke shouldn't be used in patients with pheochromocytoma or insulinoma visit gvoke glucagon.com slash risk. Jason and Sandy, thank you so much for joining me. I'm really interested to learn more about M Fund and everything that you all are doing. Thanks for being here. Dr. Jason Baker 3:33 Thanks for having us. We're excited to be part of the conversation. Stacey Simms 3:36 Let me start with you, Jason, if I could just tell me a little bit about how M Fund came to be it's quite a story. Dr. Jason Baker 3:43 Yeah, I absolutely love to because it really is a story. I think of all too many people who live with diabetes in this world of ours. And just as an anecdote, you know, I myself have type 1 diabetes and I was diagnosed as an adult I was 24 years young medical student actually, and it changed my life. But when I was diagnosed, I had everything I needed to do a good job with managing and never got any complications don't intend to knocking wood knocking side of my head here. It is a very difficult condition as we know that takes a lot of resources and and as soon after I was diagnosed I started to do some international work and had the opportunity to travel to Africa when I was actually a fellow in endocrinology, so a young trainee in endocrinology. While I was in Uganda, I met some people living with type 1 diabetes and was struck at all of the struggles that they had. And in subsequent travels, I met other people with diabetes and I thought to myself, man, if I would have been diagnosed somewhere else than where I was diagnosed, would I be able to be where I am free of applications, having my life not hindered, but actually enhanced by diabetes, really thriving with diabetes. So it really struck me What a discrepancy there was in access to care for people living with diabetes. And I really felt this huge drive and obligation to help change the narrative. For a lot of other folks who may not have been born in geographic areas or into areas with economic opportunity to get the resources they needed to thrive. On top of this, I was meeting a ton of folks who are doing work in the field of type 1 diabetes and helping kids. So there were a lot of organizations focusing on children living with diabetes, but I realized that you know, there was this rule about how old kids could be and still be part of those programs. And it entered in to my mind at the time like, well, what happens when adults are diagnosed with Type One Diabetes, or diabetes? in general? What happens when they grow up? Where do they get their resources? So these two main themes kind of emerged in my mind about what happens to adults living with diabetes, and what happens to them living in these resource poor areas, and what can I do, and a team that was built around this concept do to improve upon those lives. So the organization was born out of those ideas, basically, giving people of all ages an equal chance working to give them an equal chance to not just survive living with diabetes, but to thrive, to empower them to be able to have the tools they need to thrive? long winded way of answering questions. Stacey Simms 6:44 I'm gonna ask you one more thing to make it even longer. Excellent. I like to talk me to what does it do? What does the fund do? Do you send money to other organizations? Do you go back to the countries you mentioned? Dr. Jason Baker 6:57 Yeah, well, we do both. So we we have three main folks I are focuses of interest, if you will. So we've got an educational component where we focus on diabetes education for healthcare providers, and for patients, we have another component where we focus on access to health care. So we'll do things like running a clinic, helping people to be plugged into their local healthcare system to access care and the like. And then the third thing we do is we have economic empowerment projects, because we really have realized that the folks that were working to help oftentimes don't have an education to literally earn the money, they need to buy the resources locally for managing their diabetes. So we're really into economic empowerment work to give people the economic health, they need to thrive as well. You know, as part of this, we travel back and forth to country to site, do site visits, meet with partners. And unfortunately, COVID interrupted that a little bit this past year, but we're eager to get back boots on the ground. Stacey Simms 8:02 Sandy, let me bring you on, and ask you, why are you part of eM Fund? What's your What's your story? Sandy Narayanan 8:09 That's a good story. Good question. Actually, the story is, I grew up with a father who had diabetes, and was on intensive insulin therapy for pretty much most of the time that he had diagnosed, what had been diagnosed with diabetes. So he passed away when he was just 65. We think it was type two on insulin, it could have been type one, it could have been any other kind of diabetes. And this was an India where I grew up, and we noticed that he was able to access insulin, but there was no monitors, he would basically be on a stick once a week, or once in two weeks to find out how he was doing and to titrate insulin. And there were people you know, who were around us, there's obviously you know, as we know, there's a lot of poverty and, and there's a lot of diabetes in India. And even as I was growing up, I noticed that there were many other than my father, who had diabetes who didn't have the quote unquote, luxury, if you will, of even having insulin or even going out and getting tested once a week to see how they were doing with their glucose management. So I was always kind of interested in diabetes. And then I got diagnosed myself with type two diabetes about now almost 1314 years ago. And there I was checking my glucose at 10 times a day and I was able to do that and I was initially on insulin and initially thought that I myself might have the same type of diabetes that my dad did and that I would need to be on insulin forever. But I really was able to come off insulin within about 10 weeks or so and really within Monitoring and changing my diet and just my lifestyle habits. And so I really thought, oh my goodness, you know, how things have changed since my father's time. And what is happening in countries like India and anywhere else where the resources are not available that I have here when, you know, in America to be able to even manage type two diabetes with 10 strips a day, yeah, I could afford it. I had insurance. I actually, when Jason who was at the time, Dr. Baker to me, and who actually was the one who diagnosed me, he brought up the idea that he was going to do some create a nonprofit for people with type 1 diabetes, I immediately jumped out at I've been toying with the idea of doing something myself truly wanted to give back especially to communities in need, in underserved areas, population, women, I'm very, very interested in ensuring that women have parity in treatment, and in access to care and supplies, and especially with type 1 diabetes, the need for intensive insulin therapy, and the need for monitoring just was my became my passion. And I joined forces with Jason up until then, actually, at the time that I that Jason was starting March respond, I was in corporate human resources, and it created my own business and had been working on what zation effectiveness, etc. So it became sort of a natural complement to Jason's medical and healthcare vision. Stacey Simms 11:33 Jason, the last couple of years, as I've done this podcast now since 2015. And you know, price access all that has been an issue, even in the United States, right, where we, some people have very, very good private health insurance. Some people have public health insurance that covers things. But I feel like the conversation of last couple of years has really shown issues here in the United States where one of the four people are rationing, insulin and that sort of thing. Absolutely. I I know it's difficult, but I have to ask you, how are you all doing? This is not a new effort for you. All right. You've been doing this for almost 10 years? Have you seen things kind of change in the conversation around this? Because so much more of the conversation in this country is about affordability and access? Right back to Jason answering that question. But first, Diabetes Connections is brought to you by Dario. Health. And over the years, I find we manage diabetes better when we're thinking less, but all the stuff of diabetes tasks. That's why I love partnering with people who take the load off on things like ordering supplies, so I can really focus on Benny, the Dario diabetes success plan is all about you. All the test strips and lancets you need delivered to your door, one on one coaching so you can meet your milestones weekly insights into your trends, with suggestions on how to succeed, get the diabetes management plan that works with you and for you, Darrius published Studies demonstrate high impact clinical results, find out more go to my dario.com forward slash diabetes dash connections. Now back to Jason answering my question about access to insulin and high pricing here in the US. Dr. Jason Baker 13:17 Absolutely, I mean, I think you know, it's interesting because it's, it is different, right? So like, if you're thinking about what's happening in some of the countries who don't have national healthcare systems, for example, or who really have a truly disrupted continuous supply chain of insulin, and sometimes not reliably good quality insulin, certainly that don't have test strips, or any of the technologies we have here, you're dealing with kind of almost a warzone situation where you are bringing in opportunity, and in many cases in which there's very limited as certainly for the people who are living in poverty, it has certainly been a conversation with us and all of our partners, as we have done our work largely overseas to help to fill in these gaps of care, to say, Well, what the heck are we doing in our own backyard? And why is it not working? Well here in the United States to you know, what are the problems here in the US? And it's very interesting, Stacey, you asked this because internally, we've been asking ourselves, what more can we do in the US? Well, and we're working on some, yeah, we're working on some projects on that end, but in my opinion, right now, in the US on the US side, we have challenges with number one, using resources that actually we might have access to correctly. And in many cases, those resources may not be used as well because of perhaps underlying depression, anxiety, diabetes, burnout. All of those things that plague all of us living with diabetes at some point or another, unfortunately, it really hinders the ability to do good self care and self management. But then on the opposite end, or not on the opposite, but but complimentary, you definitely have people who don't have access, their co pays are too high, they're in this gray zone in between not having Medicaid seeking care through the emergency room, maybe they're undocumented, lots of reasons that might lead to either rationing or simply not having the supplies. I've had seniors, for example, living with Type One Diabetes, coming into my office crying to me about being in the doughnut hole and not being able to afford their insulin, and being completely overwhelmed by the complexity of some of the insulin assistance programs here that might be intermittently available to people. So there is definitely an issue, definitely an issue in the US with resources being inadequate, or sometimes resources also not being used correctly. But again, you kind of take that particular situation that absolutely exists here, and you pour some kerosene on it, and then you find the situation that we oftentimes deal with that our sites overseas. Does. Does that make sense? Stacey Simms 16:26 Yeah, and I don't want you to misunderstand that. I don't think you did. But you know, I'm certainly not saying that we have to put Americans first and full of solve this before we can help anybody else. I mean, the problems are vast, and they are different. As you've said, Can you give us a little bit of insight into how M Fund has helped? Dr. Jason Baker 16:45 Absolutely. And I can take a first stab at this. And Sandy would love to hear you chime in too. But one of the things that we are extremely proud about is the center that we have opened and have been running for the past five years in a remote region of Uganda kasay, which is bordering the Congo a very, very remote region, which we had become a partner of a few years ago and have subsequently helped to renovate a physical building, which is now housing a diabetes organization in which we are now running a twice weekly medical clinic, along with an Eye Clinic, none of which existed before and which is really serving about 350. folks living in the region with diabetes, who otherwise were unable to get care, due to transportation issues due to monetary issues are due to, again, hospitals being too far from where they live. So we are so proud of this center. And we're also so proud because it's created a system of peer education by which it is our partners are a group of diabetes patients on the ground who, who came together to survive, partner with us and are really helping their compatriots to learn how to better manage their diabetes with pushing educational components, helping with access to healthcare and taking the lead in various economic empowerment projects through this centers. So you know, we have folks who are making art and selling it abroad and locally in the monies come back and help them to have the resources to buy their there and take care of their diabetes and buy their supplies, we have a piece of land that we grow cash crops on there, and the resources go back to the group to help care for themselves with diabetes related costs. Lots of layers of this. And we are very proud of this center that we want to replicate in other locations. So that is kind of where our biggest champion work is right now. I'm helping this group in a remote area of Uganda. And by the way, they're all adults, they're all older, and unable to access other existing programs of aid. So we really feel that this is serving an acute need in that area. And we're we're just really, really proud of it. And again, it always breaks my heart a little bit though, Stacey because when we're asked this question, I think, well, it's great. We're doing these things and other locations doing similar work, but it always strikes me that we need to be doing more in to do so we have to continue to grow as an organization and we have to continue to get more person power to the table in order to do greater outreach to other folks because the more we dig on this in, the more we people we help the more it's uncovered, that there are more people to help and in other ways than we are currently doing. So that's the tricky thing. I think about foreign aid work when it comes to diabetes. It's such a complex and unruly beast, that the more work you do in helping folks, the more you realize you need to do to kind of take it to the next level, you can't go in and just cure something, right? It's like a socio economic project of unknown duration. Right? And we are really excited about the progress we've made so far and helping this group mean, because as a fan, did Stacey Simms 20:29 you want to jump in? Sandy Narayanan 20:30 Yeah, I want to say also, as Jason mentioned, the primary work is in Uganda right now, the biggest number of beneficiaries are there. We also have a very thriving program in Rwanda, originally, the Rwanda Diabetes Association, had a program where they had a group of patients with type 1 diabetes, come to a center, and spend six months there, and actually learn a trade and get diabetes, self education, and self management education. And they had the opportunity to spend time with other patients with type one. So they could have a lot of back and forth and peer support. And we really, in some ways, wanted to lift and shift that model, which we thought was great. But of course, to get other places where you can have a group of people come and spend six months, I mean, six months diabetes camp, if you think about it, would be quite the challenge. So we really, though, took the concept of making sure that that the patients had some form of vocational training or some ability to be economically empowered when they went out back into their communities to live with, with diabetes, and to take away a little bit of the stigma as well, that they might feel, because they see that there are others who have the same condition. Sometimes they're isolated, and they believe it's something that has been sort of there, they're smitten by some curse. Oh, no, yes, way, they can be with other people and get that sense of togetherness and say, Okay, this is something manageable. And this is something I can do. And there is a support system available outside of even the my peers, because they can see that there are organizations helping. So we have helped nearly 120 students graduate from that center. And then when that center moved, we would we have to take a little bit of a break. But we're again sponsoring some people back into they've got a new center now at a different location. And they're starting to get people coming back in learning trades. And we've also established a conduit for people to get tailoring training, for instance. And we set up a tailoring cooperative, where we have people making beautiful backpacks and things like that which have sold on the US market very well through your thrift shop, which is our partner. You know, that is another piece of some of the work we do. Where again, those same three aspects of our work of healthcare, access, health, diabetes, education, and economic empowerment. It's really about motivating and empowering our beneficiaries to thrive Stacey Simms 23:23 in just listening to you talk. It's amazing to me where we are, and people through this podcast, we're so fortunate, we are very technologically advanced, even for the United States. You know, many people who listen to this show are very much do it yourself. They have hybrid closed loops or closed loops that they've made themselves, you know, they have basically the best technology. And to know that there are still people 100 years after the discovery of insulin that are, you know, I know, we have issues here, we've talked about them, but that, you know, think about this as a curse or think about this as a literal curse. Not just you know, Darren, I hate diabetes, it's really kind of hard to listen to. And it's hard to think about it that way. When week after week, I'm saying, well, when is the Dexcom g seven coming out? Why can't it connect to my watch? Right? So Jason and Sandy, what do you need from us? Dr. Jason Baker 24:14 Well, we need support. First of all, we as you as we had mentioned earlier, we want to do more. But we ourselves as an organization, you know, we need more resources, we need person power, we also need financial help. So anybody who's interested in any of our programs, wants to hear more about them, wants to participate in them reach out to us, if you want to support them, we need your support because as an organization, Stacey we work 90% of our funds are private donations. And it is because of all those supporters that we can actually do the work that we do, and COVID has only made our work more expensive and more complicated. So all the more assistance we can get on the financial side. I mean, I hate to always talk money, but to be frank, we need it. You know, we, for example, have a gala coming up on October 12. Unfortunately, it will be virtual. But fortunately given that it's virtual, any of you can attend. So watch for our email, sign up for our emails, attend our gala, hear more about our work, support us. It is because of you that all of us can come together and help our brothers and sisters overseas or even right here in the us who don't have as much as we do. Stacey Simms 25:35 I'm also curious, I know that you're not here to talk about yourself. But you know, you mentioned you were diagnosed as a third year medical student, I think you've lived with type one for close to 20 years now. Yeah, bless Dr. Jason Baker 25:47 your heart. I thought you're gonna say 30. I was in school when I was 10. Yes, exactly. Stacey Simms 25:53 Weren't we all. But as you look back, I'm curious what that was like. I mean, you were learning about medicine, you were learning, I assume how to be a doctor. And then you had to learn how to be a person with type 1 diabetes. What was that like? Dr. Jason Baker 26:05 Well, it's looking back it's actually just slightly embarrassing because truth be told, I was a terrible self diagnostician. You know, medical students are famous for saying they have everything except what they actually have, or making up things. I explained away, Paul a year, you know, having to urinate all the time losing weight to working hard, and having excessive drinking, because of stress, you know, above water. So it's funny. And finally, finally, when I was diagnosed, I had to, you know, I thought, diabetes, me diabetes, no way. And it wasn't in my family, as is the case for most folks. But quickly thereafter, a sitting there in the hospital, being the patient after having taken care of so many patients, I had this experience of being vulnerable and being scared, and for the first time in my young life, having a sense of mortality. And I thought, Man, this really sucks. And then before I left the hospital, I thought, well, what am I going to do with it, it's a sink or swim situation, Baker, so sink or swim, and I said, You know what, I'm going to swim. So I decided that I was going to apply my own personal experience. And I was going to go into endocrinology. So in work in the field of diabetes, and so you know, honestly, I haven't looked back I, I like to think that my self management personal experience in sharing that with patients might set home some cases hopefully help them. But it was scary. It was eye opening to what it's like, being a patient as a medical provider, and definitely changed the trajectory of my career, no doubt about it. Stacey Simms 27:38 Have your fears from that time come true, or you know how I hate to always this this, like big reflection with type one type question. But I am curious, you know, looking back, what would you tell yourself, oh, Dr. Jason Baker 27:51 I would tell myself, be easy on yourself and learn from your mistakes, instead of beating yourself up for when you make a mistake. You know, when you have a high, don't stress over it corrected, but learn so that next time it doesn't happen, be open about diabetes at all times, don't hide it, don't spend any energy in having any shame related to diabetes, but make it part of you, and let it empower you and strengthen you, and use your energies for fighting it yourself, but also helping others to be better educated about it. So they too, don't hide it. I think that those would be the two biggest things that I would go back and tell my young self to remember to hold true. And with that, I think that everybody will do fine and use what they have wisely. Stacey Simms 28:43 Sandy, let me ask you, you know, you're, you're a certified diabetes educator, you're a registered dietician. What do you bring now to your family, to your personal life, when it comes to diabetes Sandy Narayanan 28:52 was the same in some ways, as Jason said, you know, to be able to talk about it to say, you know, when you have diabetes, you don't, and in my case, type two diabetes, that you can manage it with just eating right? Not just, it's not that simple. And I think I do understand that it's not so simple, just because, oh, I'm not insulin dependent. You know, I bet Oh, I just managed my diet and exercise and I can reverse my diabetes, I do understand the challenges. And I bring that in my patient interactions as well. At the same time, I can speak to the fact that you are watching your diet, watching your your eating, making sure that you stay active. These are all important and I think especially to my family and my friends and the people in India and again, women, I certainly bring that message that there is so much available in terms of education and knowledge and alternatives to eating just a carbohydrate rich diet for Since I bring a lot of that in to my discussions with family, many family members with diabetes, my father was very educated I, you know, at the same time, you know, there's, there's only so much you can fight with resources that you have. And so I do bring that as well that you know, a lot of people I know, when I was first diagnosed, you know, I go back to that concept of stigma, there's some shame attached, especially if you have type two, sometimes, you know, it's I eat a lot, and you are sedentary. And so you get type two, right? It's something you bring up on yourself. And I am able to speak to the fact that that's not true, and that we have so many things that are out of our hands. But there are some things that we can do, and what can we do to be able to try for diabetes, and I'm, in terms of, you know, similar to Jason, I went through, I went through a certain period when I wouldn't talk about having diabetes at all. You know, it's really through seeing what people are going through when on our trips abroad, or listening to family and friends, listening to my patients that I realized that it's really important to talk about it, own it, acknowledge it, and seek out as much information as possible to how you can manage. Stacey Simms 31:17 Alright, Did I miss anything before I start wrapping us up here? Dr. Jason Baker 31:20 No other than to congratulate yourself for having an awesome podcast, not because of your guests, necessarily, but putting together an amazing forum for us to discuss things like this. So thank you for having us here and letting us tell you the story of M Fund and our stories. We appreciate it. Stacey Simms 31:37 Jason at the end. Thank you so much for being here. Unknown Speaker 31:40 Thank you so much, Stacy. You're listening to Diabetes Connections with Stacey Simms. Stacey Simms 31:52 Lots more information about Marjorie's funder, M Fund, and the gala and auction they have coming up in October, it's October 12. It's virtual. If I didn't mention that earlier. You can buy tickets and join live, you can donate money, there are there are a lot of ways to help as you can imagine. And there's always more information at Diabetes connections.com, including the transcription that I put out for every episode. So if you know somebody who would prefer to read, please send it their way. And in just a moment, I'm gonna tell you something a little bit embarrassing, and a mixup I have had for a long time about Marjories’ fund. But first Diabetes Connections is brought to you by Dexcom. And you know, when we first started with Dexcom, and it was back in 2013, the share and follow apps were not an option. They just hadn't come up with that technology yet. So trust me when I say I know using shared follow makes a big difference. I think it is really important though to talk to the person you're following or sharing with and get comfortable with how you want everyone to use the system. Even if you're following your young child. These are great conversations to have, you know things like at what numbers will you text, how long will you wait to call that sort of thing. That way the whole system gives everyone real peace of mind. I'll tell you what I do love absolutely about the Dexcom share. And that's helping Benny with any issues using the data from the whole day and night. And not just one moment. Internet connectivity is required to access separate Dexcom follow up to learn more, go to Diabetes connections.com and click on the Dexcom logo. Alright, so you know, I'm never afraid to tell you when I make a mistake and even when it's embarrassing one. So I told you at the beginning of the show that Dr. Jason Baker is one of those names that I'd heard for years. And you know, people had told me to get in touch with him and have him on the show. But every time I heard about Dr. Baker and Marjorie's fund, I thought this was about the dog. Marjorie, do you know what I'm talking about? Does anybody out there understand my confusion. So this is actually kind of a sad story. But it led to a very happy ending. Marjorie was one of the dogs that was crucial inventing and bests experiments which led to the discovery of insulin. They removed these dogs pancreases and then tried to figure out how to keep them alive. And Marjorie, I believe was the first one. She was kept alive for about 70 days, and got quite famous actually, but obviously quite different from what Marjorie's fund is all about. So yeah, a little embarrassing to share would have been a very simple Google search all this time. But I'm really glad that I did get to talk to Jason and to Sandy and to do to finally learn a lot more about the work that they are doing and how we can help. Okay, before I let you go, just a reminder to join the Facebook group if you haven't done so already. If you're on Facebook, it is Diabetes Connections, the group if you'd like to sign up for our email list, that is always easy to do just go to Diabetes connections.com there's a pop up with our latest promotion right now. It's still how to get your gear to stick and you can sign up for that or you can just scroll down to the bottom if you don't want the promotion, you know that's currently running. You can just Scroll down to the bottom and there's a little portion where you can join the newsletter list. If you're not on Facebook, I would urge you to do that. Both of those together really how I get the word out about announcements and fun stuff, surveys, that sort of thing. thank you as always to my editor, John Bukenas from audio editing solutions. Thank you so much for listening. I'm Stacey Simms. I'll see you back here in just a couple of days. Until then, be kind to yourself. Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged
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