Podcasts about a1cs

Join Sandra & Dr. Nykkia Sellers, a board-certified NP and diabetes expert, as she shares how game-changing treatments like GLP-1 meds (hello, Ozempic!) and personalized care are transforming diabetes management. From reversing high A1Cs to the future of endocrinology and chronic disease management, this episode is a must-listen for NPs ready to elevate their practiceFollow Nykkia on Instagram: @thediabeteswellnessNPCheck out Nykkia's Diabetes Care Practice: www.mydcwellness.comGo to NP Charting school's website and get  your comprehensive list of smart phrases  that you can copy & paste into your EHR to immediately save time charting! www.npchartingschool.comCheck out our eBooks designed specifically for NP students navigating the clinical setting! https://bit.ly/SuccessNPebook

Support the D.A.W.G.Z. @ patreon.com/MSsecretpod Read Peter's Book  'Outlive: The Science and Art of Longevity' and Listen to The Drive Podcast @ https://peterattiamd.com/ Go See Matt Live @ mattmccusker.com/dates Go See Shane Live @ shanemgillis.com yo0o00o. Bonus ep for you guys. Surprise. Matt hit the podiums w/ Dr. Peter Attia. Check out his book 'Outlive: The Science and Art of Longevity' and listen to his pod The Drive Podcast. Also say a prayer for Matt's A1Cs (he just got diagnosed with pre-diabetes). Please enjoy. God Bless. 

Traditional clinical weight loss interventions can be costly, time consuming, and inaccessible to low-income populations and people without adequate health insurance. Today's guest, Dr. Gary Bennett, has developed an Interactive Obesity Treatment Approach, or iOTA for short, that represents a real advance in this area. Dr. Bennett is Professor of Psychology and Neuroscience, Medicine and Global Health at Duke University, where he is also Dean of Trinity College of Arts and Sciences. Interview Summary You know, in this time when people are talking about more expensive, and kind of more intrusive interventions, like the big weight loss drugs, it's nice to know that there may be alternatives that could be accessible to more people. Could we start off with you telling our listeners what the iOTA approach is and how it works? Sure. This is an approach for weight management. It's useful for weight loss or preventing weight gain or maintaining one's weight after you've lost weight. The idea here is that it's a technology that's designed to be highly accessible, and useful for a range of different types of populations. So, as you described, we have developed and tested this primarily for folks who are medically vulnerable, who are low income, who are racial, ethnic minority, who live in rural communities, and where we have traditionally had real difficulty reaching populations with effective weight loss tools. So, iOTA is a fully digital approach. It uses technologies smartphone apps, but it can also use text messaging, interactive voice response, those are like robocalls, automated telephone calls, websites. We've tested this on a wide range of different types of technology platforms, and we've tested it in a range of different types of populations all over the country and indeed even in other countries. So, give us some examples of what kind of information people might be receiving through these various forms of media. The underlying kind of technology, the underlying approach, I should say, for iOTA is actually reasonably simple. It operates from the perspective that creating weight loss is really about making an energy deficit. That is to say, helping people to consume fewer calories than they are expending. The realization we had years ago is that you can get there, you can create that calorie deficit in a whole host of different ways. Some people diet, some people try to get more active, there are limitations around that kind of approach. But fundamentally, you can also just get there by asking people to do some reasonably straightforward behaviors. Like not consuming sugary beverages, or consuming fewer chips, cookies and candies. Or changing the amount of red meat that they put on the plate. And, if you frame those things out as goals, then you can prescribe those goals to people in ways that make sense to them personally. The trick though is actually in the idea of personalizing those goals to the given individual. And that's where technology comes in and gets very helpful. The case is, if you have a large library of these goals, you'd want to try to provide these in a highly personalized way. That really are aligned with what people's needs are and noting that those needs may change over time. So, what we do with iOTA is deliver a very short survey. That survey then helps us to be able to look into our library of goals and pick the ones that are most useful for our users. We prescribe those goals, and then we ask folks to self-monitor those goals. Self-monitoring or tracking is an extraordinarily powerful part of behavior change science. And so, we ask them to track using one of our technologies: the chat bot or the text message or interactive voice response or the smartphone app. Every time that we receive data from one of our users, we give them highly personalized feedback that is designed around principles of behavior change science. And then over time we also give them support. We do support sometimes from a coach or sometimes from a layperson, sometimes it's even from a physician. And over time what we find is that this kind of an iOTA approach helps people to lose weight, prevent weight gain, have weight loss maintenance, but it also has a cascade of other types of effects, some of which we didn't really even anticipate producing. This reminds me of something that I've fought for years, that nutrition and weight control can get incredibly complicated and down on the weeds in a fascinating way from a academic point of view. But that you can get to the goal line with just a few simple things. You might be 80% to the goal line just by eating less junk food and eating more fruits and vegetables and getting mired in that last 20% becomes confusing. It sounds like that's exactly what you're doing. That you kind of picked some of the big things that people can do, establish goals around them, and then provide a behavioral path for getting to those goals. That's precisely our thinking. And the thing I'd add to that is part of the challenge in weight control is making those types of changes for long amount period of time that it takes to produce and sustain weight losses. One of the things we know is that any kind of behavior change, but particularly behavior change for weight control purposes just requires an extraordinary amount of engagement over a very, very long time. So, I'm fond of saying to our teams and to others I'm really much less concerned with strategies that produce weight changes at a month or two months. Because the real question for us is how do we create technologies that can support users as they enter the 10th month or the 12th month? Fundamentally, what we're really after here. It's not really weight loss, but it's really the changes in a whole range of health parameters. So cardiometabolic function, the indicators of the development of various cancers, diabetes parameters, those kinds of things. And it takes time and effort to produce those changes via the weight control, changes that we're hoping to produce with these technologies. What kind of results are you getting from this and does the iOTA program in fact make it easier for people to stay on track with their health goals? Yes, it's a really interesting set of findings over more than a half dozen trials in the last bunch of years. If I were to summarize, I'd say we get pretty modest weight losses relative to say, what you might get with a very intensive weight loss intervention or with a drug or certainly with surgery. But what's different is that those weight changes do tend to be sustained over time. So, they're modest, but they last. And the really interesting finding for us is that people stay very engaged with these technologies. On average, people tend to use new apps pretty feverishly in the first month after they downloaded, or they put it on their phone one way or another. And then most people, about 70% of the time, people move away from those apps, they disengage. When we look back about a year after people started using iOTA, it's very, very common for people to be engaged with our technologies 80-85% of the time. That is to say, they're still tracking their goals at about 80% fidelity after a year. That's really terrific. and it's one of the reasons I think that we're able to see sustained losses, even though those losses aren't very large. And again, my goal here is much less - this is a public health approach - I'm much less interested here in trying to produce large weight losses for cosmetic reasons and those kinds of things. This is really an effort to try to create a very highly disseminatable, inexpensive treatment that is accessible to large numbers of folks. In trials, we certainly have seen changes in blood pressure and various cardiometabolic parameters like lipids. Those changes tend to be larger in certain populations. When we tested this in China, we saw very, very large dips in lipids. And those too also do tend to be sustained. The biggest surprise for us over the years has been a relatively consistent set of findings that suggest that people have improved wellbeing on the backend of participating in one of these kinds of treatments. They tend to feel less stressed, have more energy, and have better quality of life. In fact, we've seen very, very large reductions in depressive symptoms in study after study. I'll just add tangentially that's notable for us in the populations in which we work, because these are not populations for whom weight is very closely tied with one's emotional state. That is to say, the patient populations in which we work tend to have more tolerance for heavier body weights compared to other populations. So, when we see weight loss in our trials, we don't often expect to see that accompanied by improvements in depressive symptoms. But we see it in study after study after study. So, we've been really pleased with this broad array of impacts that this technology seems to produce. It's nice to hear the positive results. And I also like your aspirations because a smaller weight loss, better maintained is a much better outcome than a larger weight loss regain, which is typically the case. And the fact that you're getting these corollary effects in other areas of life, like mental health and things like that is very impressive. Are there other stories you could tell from people that have been on the program that might be illustrative? Oh yes. What happens most often in our studies is that at some point one of our patients approaches me and says, "You know, I've tried everything. I've tried dieting, tried this app and that app and this is just so easy. I've been able to stick with it for a long time." That happens a lot. And it always, always pleases me greatly because at the end of the day we're really trying to create these technologies for real people to use over a very, very long period of time. I find that exciting. We've had a number of people over the years who have gotten off their hypertension medications or have had seen changes in their diabetes, their A1Cs as a measure of diabetes. And it's just really exciting because then it's one of the things that I think gets us up in the mornings to do this work. That is exciting. How has it been especially influential among people who otherwise have limited access to care? We really started this work because of a series of observations that I made early in my career when I started working in community health centers. Community health centers are often primary care units in many major metropolitan areas, and often in rural settings as well. Their primary intention is to serve patients who are medically vulnerable, and often patients who are poor. On those settings, the providers in those settings are just doing extraordinary work. And I started to spend time there and was trying to understand how we might think about situating this kind of technology and these kinds of public health style interventions within those care settings. And the observation I made over and over and over again was that, even in these care settings that are really designed to serve patients who have low income or come from limited income backgrounds, weight control and behavior change in general was just not the highest priority. These physicians are dealing with all manner of acute and chronic health crises. And they just didn't feel that managing a patient's weight was the best use of their limited clinical time and attention with patients. The challenge of that, of course, is that, for patients who have obesity, that can be a primary cause of many of the acute and chronic conditions that my physician colleagues were treating. And so what I began to observe was that patients who have the greatest need for comprehensive obesity care are often the least likely to receive it. And this is borne out by national data, which suggests that if you're a person from a medically vulnerable background and you have obesity, you're dramatically less likely to receive high quality care from the health system. And then there are a whole range of financial constraints that limit your ability to be able to acquire that care in the commercial market. And so there are really many, many people, really, tens of millions of folks out there without options. So, that's really why we started developing these tools. And I'm very pleased to say that the underlying approach that we develop with iOTA has been leveraged in a variety of weight control interventions that are being used in other places. The next frontier for us is to really think about how to disseminate this in a more widely accessible way. We've begun having conversations with metropolitan areas. Cities where health departments are thinking about doing these kinds of things. Some of these technologies have found their way into other systems. And increasingly as we have begun to test these approaches in clinical care settings, we certainly have seen ongoing use of these technologies in the community health centers where we originally came up with some of these ideas. So, much more work there to be done but I'm hopeful. Do you see a role for this approach in conjunction with or as a companion to the weight loss medications that are getting so much attention now? Yes, I do. One of the things that's notable about this generation of weight loss medications is that they do not have an indication that they should be accompanied with a behavior change intervention. So, the other way to say that is that most weight loss drugs that we've seen in years past have received FDA approval, contingent on their combination, their use, alongside a behavior change intervention. And the GLPs, the ones that are most recently emerged, don't have that indication. Nevertheless, we know a couple of things. One is that these are medications that are designed to be used for very long time in order for fat, weight loss to be sustained. And there are a number of people who increasingly are interested in transitioning off of these medications and beginning to engage weight control on their own. So, my sense is that technologies like iOTA can be very useful in helping people make those transitions off of drug. I think the technologies we've created can be very, very useful as an adjunct to try to help to maintain motivation for weight loss. And to think about addressing some of the related behaviors that can help people to experience an overall improvement in their health. So, becoming more physically active and making changes in stress and wellbeing as an adjunct to the weight loss that's being produced by the drugs. I have to tell you, I'm very, very concerned about the cost of these medications. I'm very pleased by their efficacy, but I'm extraordinarily concerned about their cost and their limited accessibility. I expect that will change. But during this period of time, I'm very concerned about the creation of additional disparities, patient's ability to seek really high-quality care. I'm glad you raised that point. So, where do you see the work going next with IOTA? Well, I see it going in two directions. One, we are thinking about dissemination. Where can you embed this kind of approach inexpensively in ways that allow the greatest number of users. The emergence of artificial intelligence technologies, notably the large language models, really help in that regard because they allow us to deliver that kind of core iOTA special sauce more flexibly in a range of different technologies. And even more inexpensively than we can do right now. iOTA is extremely cost effective and with AI delivery it could be even more so. And then the other path I see is really what you asked before. And it's how do we think about using these technologies as an adjunct to medication treatment, which I think will become even more common over the next couple of years. I hope that it becomes a more common approach that's used to treat the patients who have the highest risk of obesity and all of the chronic health conditions that travel along with it. Bio Gary Bennett, a professor in the department of Psychology & Neuroscience who also holds appointments in Global Health, Medicine and Nursing, is the founding director of the Duke Digital Health Science Center. For 20 years, he has been studying how incorporating digital strategies into clinical treatment of obesity can improve health outcomes. His development of the Interactive Obesity Treatment Approach (iOTA) has been supported by over $20 million in grants from the National Institutes of Health.

Diabetes technology is getting better and better. We have automated insulin systems that link pumps and CGMs, and smart insulin pens that have precise calculations and reminders. It's been quite the evolution over the past few years! But outcomes – time in range, A1Cs, aren't exactly where experts thought they might be. I'm talking to Dr. Stephen Ponder about why that is, how a social media post he shared about this caused a strong reaction, and what does work for better long term outcomes. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom  Edgepark Medical Supplies Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com    

It's In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: a new study looks at pancreatic exocrine-endocrine “crosstalk,” weekly basal for T1D moves forward, a Chinese company gets European approval for its CGM, a look at air pollution as a cause of T2D, lots of info and advocacy for Diabetes Awareness Month including some movies and documentaries. Links and transcript below Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Take Control with Afrezza  Omnipod - Simplify Life Learn about Dexcom  Edgepark Medical Supplies Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode Transcript: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX In the news is brought to you by Edgepark simplify your diabetes journey with Edgepark XX It's Diabetes Awareness Month so you're going to see a lot of advocacy posts and hear about all types of diabetes and technology and advances. It's always diabetes awareness month around here, so I'm not going to talk about each and every one of these campaigns.. but I'll share more on social. XX Our top story this week, In the largest study of its kind, researchers at Vanderbilt University Medical Center have identified unexpected alterations in the exocrine tissues of the pancreas that occur in the two major forms of diabetes, and with aging and obesity. They're calling this a report on pancreatic exocrine-endocrine “crosstalk.” I'm not going to do it justice, it's pretty complex, so please check out the show notes with all the links. They say their work, published in the journal Diabetes, represents a significant advance in understanding how Type 1 and Type 2 diabetes, alter the digestive enzyme-secreting exocrine portion of the pancreas. Not just the parts that make insulin. The pancreas has been very difficult to study because it is surrounded by other vital organs, hard to access, and it quickly deteriorates. Pancreas tissue for study must come from deceased donors or fragments of surgical specimens and those are hard to come by. This group says they were able to study an unprecedently large and well-preserved group of tissue samples from 119 donors. https://news.vumc.org/2023/11/01/pancreas-crosstalk-may-influence-course-of-type-1-and-type-2-diabetes/#:~:text=VUMC%20Reporter-,Pancreas%20%E2%80%9Ccrosstalk%E2%80%9D%20may%20influence%20course%20of%20Type,1%20and%20Type%202%20diabetes&text=In%20the%20largest%20study%20of,and%20with%20aging%20and%20obesity. XX Another promising study about Insulin icodec, a once-weekly basal injection – this time for type 1 diabetes. We've been following this for a while and the results of the year-long phase 3 clinical trial are in. After 26 weeks, once weekly basal looks just about the same as daily basal in terms of overall diabetes control. The group that received daily injections had their A1Cs go down to 7.1, the group that got the weekly basal was at 7.15. These researchers say it's very promising, but further analysis of CGM data and real world studies are needed to keep moving forward. https://www.technologynetworks.com/drug-discovery/news/weekly-insulin-for-type-1-diabetes-has-the-potential-to-be-as-effective-as-daily-regimens-trial-380487 XX air pollution raises risk of type 2 diabetes, says a landmark study out of India. This was a seven year study of 12,000 people and showed Inhaling polluted air increases the risk of type 2 diabetes, the first study of its kind in India has found. When inhaled, PM2.5 particles – which are 30 times thinner than a strand of hair – can enter the bloodstream and cause several respiratory and cardiovascular diseases. India is one of the worst countries in the world for air pollution. These researchers say “Until now, we had assumed that diet, obesity and physical exercise were some of the factors explaining why urban Indians had higher prevalence of diabetes than rural Indians,” said Dr V Mohan, chairman of the Madras Diabetes Research Foundation and one of the authors of the paper. “This study is an eye-opener because now we have found a new cause for diabetes that is pollution.” https://www.theguardian.com/global-development/2023/nov/01/air-pollution-raises-risk-of-type-2-diabetes-says-landmark-indian-study-acc XX Time-restricted eating, also known as intermittent fasting, can help people with Type 2 diabetes lose weight and control their blood sugar levels, according to a new study published in JAMA Network Open from researchers at the University of Illinois Chicago. Participants who ate only during an eight-hour window between noon and 8 p.m. each day actually lost more weight over six months than participants who were instructed to reduce their calorie intake by 25%. Both groups had similar reductions in long-term blood sugar levels, as measured by a test of hemoglobin A1C, which shows blood sugar levels over the past three months. Senior author Krista Varady said that participants in the time-restricted eating group had an easier time following the regime than those in the calorie-reducing group. The researchers believe this is partly because patients with diabetes are generally told to cut back on calories by their doctors as a first line of defense, so many of these participants likely had already tried — and struggled with — that form of dieting. And while the participants in the time-restricted eating group were not instructed to reduce their calorie intake, they ended up doing so by eating within a fixed window. Just over half the participants in the study were Black and another 40% were Hispanic. This is notable as diabetes is particularly prevalent among those groups, so having studies that document the success of time-restricted eating for them is particularly useful, the researchers said. The study was small a https://today.uic.edu/intermittent-fasting-diabetes-weight-loss/ XX XX New CGM approved in Europe. Sibionics CGM says they have more than 600-thousand users for their GS1 CGM, mostly in hospitals. It's a 14 day no calibration system with data sharing. They also make a Continuous Ketone Monitoring System(CKM). The company, based in China, says GS1 CGM products will gradually become available for pre-sales in EU countries, the UK, and other European countries. https://www.prnewswire.com/news-releases/sibionics-achieves-milestone-receiving-ce-mark-for-its-groundbreaking-gs1-continuous-glucose-monitoring-system-301974051.html XX XX Commercial – Edgepark XX Couple of movie updates for Diabetes Month! We've been following Pay or Die since it was in production, and it's now in selected theaters with a digital release on Paramont Plus coming Nov 14th. All about the high price of insulin – and the personal cost – this release means the movie is eligible for an Oscar nomination for best documentary. XX The short film Type 1 is also available to stream.. you may recall we talked to the writer behind this project is Noah Averbach-Katz, who appeared in Star Trek Discovery. His wife Mary Wiseman has a starring role and the whole Star Trek community got behind this project. The two star in the short movie which explores the barriers to insulin access put in place for diabetics through a Type 1 diabetic and his wife during their desperate search for insulin. It's presented in partnership with with T1 International and it's the film directorial debut of Anthony Rapp, the original Mark in RENT and current star of Star Trek: Discovery. https://playbill.com/article/watch-anthony-rapp-directed-short-film-type-1 XX This is where in the past I've talked about what's coming up next week on the show.. well now we have two shows! In the news will appear in both DC1 and DC2 feeds.. but the weekly interview shows will only occasionally cross over. I'll try this and see how it goes – next week on DC 1 – Dr. Mike Natter – he's an adult endo who lives with type 1, he's also an artist and has a huge following on social media. We'll find out why – he's also used the new Beta Bionics iLet pump and lets us know what he thinks about that. Next up for DC 2 – professional golfer Ken Duke talks about his diagnosis and how he manages diabetes on tour. Join us again soon!

Get ready for an insightful journey with our guest, Lisa Rosan, an independent diabetes educator, who walks us through her life's path and the experiences that led her to her current role. Listen as she shares her initial journey in child development, nursing, and the different roles she's played in the healthcare field. Lisa brings her passion for teaching and helping others understand their bodies, and she gives an inside look into her role as a health coach. She emphasizes her drive to empower people to manage their diabetes and sheds light on her hard-earned credentials as a certified diabetes care and education specialist. Stay tuned as Lisa enlightens us about diabetes and the crucial role of independent diabetes educators. She explains the difference between Type 1 and Type 2 diabetes and the importance of lifestyle changes to prevent prediabetes from escalating into full-blown Type 2 diabetes. She also stresses the importance of understanding A1Cs and their role in diabetes management. Lisa explains the long-term complications of diabetes and how insulin can change the game when it comes to managing the condition. Don't miss out as Lisa Rosan talks about her services and the unique approach she uses to help her clients. She discusses how she navigates through the stages of change, the role of food and movement, and how to adjust insulin doses. Finally, she shares her experience with virtual health coaching, emphasizing the potential benefits of this mode of coaching. Listen as Lisa shows us how she uses modern communication tools to create a successful relationship with her clients, making diabetes management a more navigable journey for everyone involved. Check out Lisa's website: www.leftrightdiabetescoaching.com (16:37 - 18:12) Understanding Prediabetes and Preventive Measures (21:23 - 22:57) Risk Factors for Type 2 Diabetes (28:54 - 29:35) Importance of Blood Sugar Levels (31:37 - 33:19) The Risks and Management of Diabetes (39:53 - 40:55) Navigating Online Information for Personalized Planning (47:03 - 48:15) Understanding Medications and Glucose Metabolism Keywords: Diabetes, Type 1 Diabetes, Type 2 Diabetes, Prediabetes, A1C, Insulin, Lifestyle Changes, Diabetes Management, Diabetes Coaching, Virtual Health Coaching, Blood Sugar Data, Stages of Change, Food, Movement --- Send in a voice message: https://podcasters.spotify.com/pod/show/kannafitness/message

  BEN TZEEL Founder, Registered Dietitian, Certified Diabetes Care & Education Specialist, Certified Strength & Conditioning Specialist  Hi, I'm Ben, registered dietitian, strength coach, and T1D vet of over 20 years who specializes in providing you with the blueprint to amazing blood sugars... So you can eat the foods you love, do the things you love, and live life on YOUR terms, NOT diabetes' terms. Over the years, I've had the pleasure of using my professional and personal experiences to help thousands of people with diabetes to improve their A1cs, transform their bodies, and feel FREE again. My team and I are here to show you (and your loved ones) how to find what works most effectively for YOU, so you can sustain these results in the short term, but also for life. Let's Connect! info@yourdiabetesinsider.com https://www.yourdiabetesinsider.com/     Check us out on social media! https://www.instagram.com/manoftzeel/ https://www.youtube.com/channel/UCCKY-bj9cAg4pEGPe9HWXsA   ______________________________________________   This episode of the Happy Diabetic Kitchen podcast is sponsored by my diabetes supplier, US MED. US MED offers free shipping and a 90-day supply with every order. To see how they can simplify your diabetes care call 1-877-840-8218. I made the call... so pleased that I did! Can you feel the love? www.usmed.com/happydiabetic     There is a much better solution... U S Med!      

It's In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: Amazon Pharmacy will automatically apply insulin coupons, a new study shows A1Cs are going down for people with T1D who have access to technology, pollution and gestational diabetes study and a wild study that looks at how a parasite might help prevent type 2. Don't miss Moms' Night Out!  Please visit our Sponsors & Partners - they help make the show possible! Take Control with Afrezza  Omnipod - Simplify Life Learn about Dexcom  Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Transcript:  Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines happening now XX In the news is brought to you by Edgepark simplify your diabetes journey with Edgepark XX Amazon's online pharmacy will automatically apply manufacturer-sponsored coupons to more than 15 insulin and diabetes medicines to help patients access discounts pledged by the drug industry. With the new program, patients using Amazon Pharmacy will no longer have to search for and manually enter coupons from the three largest insulin makers, Novo Nordisk (NOVOb.CO), Eli Lilly (LLY.N), and Sanofi (SASY.PA), to lower the cost of their insulin to as little as $35 for a month's supply, the company said. Novo, Lilly and Sanofi announced in March that they would slash their insulin prices by at least 70% by or in 2024, but many reports some patients were finding it difficult to get already discounted generic insulin from pharmacies at the promised lower price. Amazon Pharmacy will also automatically apply available discounts to diabetes-related medical devices from manufacturers Dexcom and Insulet, including continuous glucose monitors and pumps, as well as to other cardiometabolic medicines such as Novo's powerful weight-loss drug Wegovy. https://www.reuters.com/business/retail-consumer/amazon-pharmacy-automates-discounts-help-insulin-patients-get-pledged-prices-2023-08-15/ XX New study will look at Liver Targeted Insulin (LTI) in Type 1 diabetes.. Directing insulin action to the liver may help restore normal liver physiology for people with Type 1 diabetes, leading to better glucose control and overall health outcomes. Jeremy Pettus and a team of researchers are working to determine the mechanism of action and evaluate the safety profile of the Liver Targeted Insulin Pettus lives with type 1 and is an endocrinologist who is also the xx at TCOYD. “Living with Type 1 diabetes is extremely tough,” said Pettus. “One of the major barriers to helping patients with Type 1 diabetes achieve normal glucose levels is that injected insulin simply does not get to the ‘right' places. Normal insulin has its main effects in the liver, but patients with Type 1 diabetes must inject insulin into the fat tissue. Doing so makes the insulin act very slowly, can lead to weight gain and can cause deadly low blood sugars. This project seeks to attach a molecule to insulin that can help direct it to the liver. In doing so, much of the normal physiology may be restored and patients may get better results.” Pettus is working with the company Diasome to conduct a single center clinical study with 14 patients with Type 1 diabetes to test the safety, tolerability and effectiveness of the novel LTI. If this study finds that the LTI is active and preferentially targeting the liver, the findings could spur research and development efforts in the LTI space, leading to additional clinical trials and eventually a novel insulin available that could help improve clinical outcomes. https://today.ucsd.edu/story/2m-grant-drives-research-on-novel-insulin-in-type-1-diabetes XX Good news about A1c reduction in people with type 1.. but it's limited for those with access to technology. The new findings from a study involving patients at the Barbara Davis Center for Diabetes Adult Clinic between January 1, 2014, and December 31, 2021. They show that as technology use has increased, A1c levels have dropped in parallel. Moreover, progression from use of stand-alone continuous glucose monitors (CGMs) to automated insulin delivery systems (AIDs), which comprise insulin pumps and connected CGMs, furthered that progress. On the flip side, A1c levels rose significantly over the study period among nonusers of technology. "We cannot rule out provider bias for not prescribing diabetes technology among those with higher A1c or from disadvantaged socioeconomic backgrounds," Karakus and colleagues write. Also of note, even with use of the most advanced AID systems available during the study period, just under half of patients were still not achieving A1c levels below 7%. "The technology helps, but it's not perfect," Shah observed. This study is the first to examine the relationship of A1c with technology use over time, in contrast to prior cross-sectional studies. "The intention here was to look at the landscape over a decade," Shah said. https://www.medscape.com/viewarticle/995738 XX Can a parasite help with type 2 diabetes? This is kind of gross but very true.. In the first clinical trial of its kind, a team led by scientists from James Cook University in Australia inoculated volunteers with human hookworm larvae (Necator americanus) to see if these parasites can improve their metabolic health. The two-year study included 24 participants, each of whom showed heightened insulin resistance at the start of the trial. By the end of the investigation, researchers found those who were infected with hookworms showed a significant reduction in their insulin resistance scores compared to those who were given a placebo. In recent decades, scientists have noticed that in places where parasitic worms are endemic, people report fewer metabolic and inflammatory diseases. I'm sure I don't have to say this – but more study is needed. No one is recommending you try to get a parasitic infection https://www.sciencealert.com/radical-trial-shows-hookworms-may-protect-people-from-type-2-diabetes XX https://www.medicalnewstoday.com/articles/simple-blood-test-may-predict-future-heart-kidney-risk-for-people-with-type-2-diabetes XX Exposure to air pollution early in pregnancy—and even shortly before conception—increases a woman's risk of developing gestational diabetes, according to a new USC study out in The Lancet Regional Health—Americas. "Interestingly, we found gestational diabetes risk wasn't associated with long-term air pollution exposure but was associated with air pollution in a relatively short but critical periconceptional window, from five weeks before to five weeks after conception," said first author Zhongzheng "Jason" Niu, a postdoctoral fellow in population and public health science at the Keck School of Medicine of USC. The researchers also found the association between air pollution and gestational diabetes was more pronounced among study participants experiencing prenatal depression. The mechanism connecting ambient air pollution and gestational diabetes remains unclear, researchers say, but an interplay among impaired glucose metabolism, inflammation and hormonal changes could be to blame. Prenatal depression, with disrupted immune and hormonal functions, could make the case worse. https://news.usc.edu/209509/exposure-to-air-pollution-early-in-pregnancy-increases-risk-of-gestational-diabetes-study-finds/ XX Commercial – Edgepark XX A look at Tandem's bolus by phone feature shows it seems to be helping people with “low bolus frequency” give insulin more. Last year, the t:connect app was updated to allow people with the tslim x2 pump to initiate bolusing from a smart phone or the pump itself. This study looked at those who gave less than three boluses per day prior to the smartphone bolus update – the media number was 2.2. After the smartphone option, that number rose to 2.7. https://journals.sagepub.com/eprint/QYVHSJUZKND8JJAKRUTG/full XX Great story from Diabetes Daily about two brothers with type 1 who are creating a low or almost no sugar beer. This is in Ireland and I don't know exactly how to explain it quickly.. “Normally, the reason that the beers have sugar in them – which is what will mess with your blood sugar levels – is that there are unfermentable sugars that remain in the beer, sugars that the yeast isn't able to convert into alcohol. It's just a byproduct of how you make it. But this enzyme glucoamylase actually breaks down these unfermentable sugars and makes them into fermentable sugars, so the yeast can convert all of the sugar into alcohol, and there will be no sugar left in the beer at all. Brut beers are usually done in a clean, bitter, highly fizzy IPA style, almost like a beery champagne, but Seán has tried the glucoamylase in other recipes as well. “Normally it's only a pale ale or IPA that people put this enzyme into. But I really like German wheat beers. So I decided I'd try and make a wheat beer with this enzyme as well.” “It did exactly what it was supposed to do. You end up with no sugar at the end, and a really tasty beer. So I've been doing it with a few others – a rye, and a Kolsch, and all the sugars completely ferment out.” “We've had some fun in naming them as well. The first one, the IPA style, we call it Insulin, because it keeps the levels down. The wheat that I like to make we have now called Diawheaties.” And his non-diabetic friends approve: “Everyone seems to like it. They tend to be quite nice, easy-drinking beers. We wouldn't make them just for the zero sugar if they were no good. They're as good as the normal beers.” https://www.diabetesdaily.com/blog/how-two-irish-brothers-with-type-1-diabetes-brew-their-own-zero-sugar-beer-689869/ XX MNO update On the podcast next week.. tandem diabetes celebrity panel from friends for life – Hollywood, the NFL and NASCAR. Last week's episode was Benny off to college That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.  

Sue was last on the podcast in March 2022. Her initial episode has been one of the most popular episodes of the podcast. I think a lot of people resonate with her story both for the incredible way she reversed her Type 2 diabetes and lost 100 pounds. I was thrilled at the opportunity to catch up with Sue to see how things have been going for her. Sue thrives on consistency and has been able to maintain both her weight and healthy A1Cs over the last year. While her year has not been without challenges, she has pushed through any issues she has faced and has continued on with her lifestyle. She is an inspiration to me and many others. I hope you enjoy this update episode!Her original episode from March 2022 can be found here:https://stream.redcircle.com/episodes/a31705b1-ed33-4bff-b167-b7cfaa90b4e2/stream.mp3

David Dikeman is a 19-year-old type one diabetic diagnosed at the age of 9. Since diagnosis, he has followed Dr. Bernstein's low-carb high protein protocol and has consistently attained A1cs at 5.0% and below while averaging blood sugar in the 80's. David is a passionate advocate for low carb type 1 diabetes management and has spoken at children's hospitals and nutrition/metabolism conferences. David served as the executive producer for Dr. Bernstein's 'Diabetes University' YouTube channel and was instrumental in the founding of the TYPEONEGRIT group on Facebook. David is currently a pre-med student at Baylor University and has worked with Dr. Eric Westman to develop an online course at Adapt Academy titled 'Type 1 Diabetes Management & Diet'. https://adaptyourlifeacademy.com/type-1-diabetes-management-and-diet/ David on Instagram: https://www.instagram.com/david_dikeman/ Timestamps: 00:00 Trailer 00:47 Introduction 04:16 Being diagnosed type 1 diabetic as a child 08:26 Managing blood sugar control on type 1 diabetes 11:00 Type 1 diabetes nutrition advice 14:33 Using a continuous glucose monitor 18:10 Being active in sports as a type 1 diabetic 21:36 Sleeping as a type 1 diabetic 25:12 David's daily insulin dosage 29:06 David is healthier than average American 32:33 David's studies 35:48 How much protein does David eat in a day 39:50 Cafeteria at David's school 42:55 Endocrinologist reaction to David's blood sugar management 46:23 Low-carb recipes 50:14 Where to find David See open positions at Revero: https://jobs.lever.co/Revero/ Join Carnivore Diet for a free 30 day trial: https://carnivore.diet/join/ Book a Carnivore Coach: https://carnivore.diet/book-a-coach/ Carnivore Shirts: https://merch.carnivore.diet Subscribe to our Newsletter: https://carnivore.diet/subscribe/ . ‪#revero #shawnbaker #Carnivorediet #MeatHeals #HealthCreation   #humanfood #AnimalBased #ZeroCarb #DietCoach  #FatAdapted #Carnivore #sugarfree  ‪

Dr. Shannon Westin, Dr. Ezra Bernstein, and Dr. Nadir Arber discuss increasing cancer prevention and early detection with a one-stop-shop comprehensive cancer screening center. TRANSCRIPT The guest on this podcast episode has no disclosures to declare. Dr. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, our podcast where we get in-depth on manuscripts that have been published in the Journal of Clinical Oncology. I am your host, Shannon Westin, GYN oncologist and social media editor of the JCO. And I am thrilled to be discussing this very interesting paper entitled “Data From a One-Stop-Shop Comprehensive Cancer Screening Center,” focused on asymptomatic screening. And this very important work was published by these two authors who are joining me today. We have Dr. Nadir Arber, professor of Medicine and Gastroenterology, head of the Integrated Cancer Prevention Center, head of the Cancer Prevention section of the European Society of Medical Oncology at Tel Aviv Sourasky Medical Center in Tel Aviv, Israel. And we're also joined by Dr. Ezra Bernstein, Fulbright fellow and researcher at the Integrated Cancer Prevention Center that we're going to be discussing today at Tel Aviv Sourasky Medical Center in Tel Aviv, Israel. And he's also, impressively, a resident in internal medicine at the New York University, so he's a gentleman of many talents and quite busy. Welcome. Dr. Ezra Bernstein: It's great to be here. I had a slow clinic day. Dr. Shannon Westin: Oh, I was going to say I'm impressed you, as a resident, could find the time. So we're really excited to have you, and you certainly have a bright future ahead of you as an oncology practitioner. So let's get started. I think certainly most of our listeners are quite familiar with the benefits of cancer screening. But I think it would be great if you all could level set and review the benefits at the patient level as well as at the healthcare system level. Dr. Ezra Bernstein: Sure. So I think, kind of breaking it down, on the patient level, the scientific community has made incredible progress over the last several decades in not only the understanding of the biology of cancer, but also that's translated into the treatment of cancers, from genomic sequencing to targeted therapy, which you now have specific small molecule inhibitors for specific mutations in each cancer. But despite all these incredible improvements and advances and the ability to treat many cancers, the greatest prognostic factor is still often the stage of diagnosis because the chances of survival and the chances of complete cure increase dramatically if the disease is detected in its earlier stages. So earlier detection and diagnosis can greatly reduce mortality, it can increase treatment effectiveness, and ultimately improve the quality of life for the cancer patients. On a healthcare system level, often when you're doing screening, you're discussing cost-effectiveness. And so the thing about the healthcare system, which we didn't really address in our paper–we initially were going to, but we think we're going to do a follow-up paper on this–the cost of cancer care is very high. In Europe, the total cost of cancer care in 2018 was $199 billion. And then I think the last data I saw was the US, in 2015, the total cost of cancer care was $183 billion. So, on a healthcare system level—and those are just the costs of cancer care; there's tons of other costs that go into when patients have cancer: lost wages… So I think that it's crucial not only for the patient but also for the healthcare system to help catch these cancers earlier. Dr. Shannon Westin: Yeah, I completely agree. I think we have such great guidelines on how we should be screening our patients. I think there's a number of different areas where providers can look to understand what they should be doing with the patient in front of them. What do you think are some of the barriers of implementation of this guideline-based cancer screening? Dr. Ezra Bernstein: That's a crucial question. We have the guidelines, especially in the US; we have our grade A recommendations: colon cancer, cervical cancer. We have our grade B recommendations: mammography. And lung cancer. So a big hurdle, especially in the US now with the recommended screenings at this point, is just getting people to do it. You look at the US, and for Pap smears, it's pretty good; 80% of the population is up to date with PAP smears. Mammography, a little bit less, low 70s. And then colon cancer screening, a little bit less. So how do we get these up, and what's the barriers? And that's kind of the idea behind the Integrated Cancer Prevention Center is it's cost, it's time, and it's also awareness. And this kind of gets into a little bit of the theory for what kind of created the Integrated Cancer Prevention Center is the idea that if you do a one-stop-shop approach where patients come in in a single visit and they get screened for all the recommended cancers, so they don't have to do multiple appointments, they don't have to take off work multiple times, and they can get it all done at once, that automatically leads to 100% compliance for those screenings that they do during that day. So that was kind of the theory behind it is you're able to remove a lot of the barriers to the implementation of the guideline-based cancer screening. The other thing is awareness and just making sure that patients are aware. I think it's actually great timing with this paper. They haven't done it so much lately, but the NFL, the National Football League, they were actually running a campaign for the first few games of the season where—you know, you have millions and millions of American viewers—it was called Intercepting Cancer, and they were highlighting the importance of screening and prevention. They gave a link, which is great, but it really just links you to your providers in your area to then go ahead and screen individually. That initiative was important in getting more awareness, but still, there's the cost and the time issues that are still barriers. Dr. Nadir Arber: Let me just emphasize what Ezra brilliantly says. He said that the best therapy of cancer is prevention, so increase early detections. I'm a gastroenterologist, so I'm fairly aware of preventions. I do colonoscopy, I found the polyp, I take it out, I prevent colon cancer. In other cancers, it's not that obvious, especially colon cancer. But then to detect it at an early stage, it means when the patients have no symptoms. When there are symptoms, mostly—not all, but mostly—it's too late. And then, when somebody feels good and well, it is not acceptable, it's not possible to go to all these different facilities and to have the referral. You want to go to screen for colon cancer, you go to your GP, who sends you to a gastroenterologist, you get the colonoscopy, then you come back, go to another GP, then you have to screen for prostate cancer. So you ask him, “Can you send me to a urologist?” They send you to a urologist. And they send him for a PSA and then free PSA and the rest of it. And then, if you do it on one stop, this is the only way that is feasible, for maybe the five major or six major cancer screening, there is no doubt and no questions. But then, with Ezra, we have learned that there is more than that. It's not only screening, but it's also case finding. Patients come to me for different reasons. They came to the center to be screened for skin cancer, breast cancer, colon cancer. So let's just tell him, “Can you open your mouth?” And then five minutes, not more than that, an oral surgeon checks your mouth. It is not cost effectiveness to call the patients to come to check, but he's coming for another reason. This is what you call case finding. People are not that aware about the difference between screening and case findings, and I would like to emphasize before I let the floor to you, so I'm not speaking about cost-effectiveness; I'm speaking about cost saving. It saves money. It does not cost; it saves. Actually, I was in Singapore when maybe I was invited to Singapore by the Singapore government. They heard about my concept and invited me to speak, and like we have just said, and that it's going to be published in the JCO, in the journal. And they told me—and they were very impressed—“We are going to do it because it's going to save money for us.” And I said, “But how you are going to implement it?” They said, “We are a democracy; we cannot force the people to do it, but we are going to offer them free of charge. Free, because we understand that if they do, the government are going to save money.” But if they offer it free of service, free of charge, and then somebody does not want to do it and he has cancer, it is his problem. It's like somebody has a car, buying a new car. He's not obliged to make insurance for the car, but if he doesn't do it and something happened to the car, he cannot come to the government or the insurance company or his spouse and complain. It's his problem. I think when you understand it, and we understand that it's cost-saving and it's a win-win situation, then we can make a big step ahead, and this is the way to go. Dr. Ezra Bernstein: I think Professor Arber brings up a very interesting point that I'm just going to make real quickly when he talks about kind of the case findings and the screening for something like oral cancer and skin cancer, which aren't currently grade A or grade B recommendations by the USPSTF, but in the context of a one-stop shop, it kind of changes the game a little bit. It's one thing to go to your dermatologist once a year in terms of screening for skin cancer, but if you're already at a one-stop-shop center screening for skin cancer, screening for thyroid cancer, and things which aren't currently—the thyroid is a little bit different, but screening for certain cancers aren't currently recommended for because they're not cost-effective, it changes the game a little bit in the concept of the unique setup that Professor Arber started. Dr. Nadir Arber: And at the same times, we also measure blood pressure, we measure sugar, hemoglobin, A1Cs, and other things that are known, but not only for cancer, but the patient is scanned when he's there. And also, if we found something—and we have the data, between 1% to 2%, we do find cancers—then we can help the patient to solve it on the spot because he's in the hospital, so we can arrange whatever he needs. So the patients like it. They appreciate. They know that they're in safe hands. And if you like, “I need to do ultrasound. I have some very suspicious legion,” I can do it on the spot. Vaginal ultrasound, Pap smear, now we do it for HPV, DNA. So everything is on the spot, and we give solutions if something happens. People need—they found something or anything, so we can do everything. For this is the way of modern medicine. Ezra and myself have been working for many years. But eventually, it's going to catch up because this is the right things to do. The modern medicine, the way we see it in the future, is turning from sick care to health care. This is the way to go. This is one of these when we are advancing the technology and everyone is health conscious. Dr. Shannon Westin: I really appreciate you kind of giving that laundry list of all the things you're doing because I do think you're exactly right, that people are doing a better job around the kind of the most common screening tests. I'm a gynecologist by trade, so Pap smears are part of my daily activity. But I think mammograms, Pap smears, colon—I think that's more common. But this is a great way to kind of get screening for all of those other things. Like, I know a friend who just got diagnosed with an oral cancer, and it's like nobody's screening for those things. And you're right, Ezra, where they say that it's not cost-effective to have a visit just for that, but if you can encompass it all in one visit, it just makes so much sense. So I think that that takes us into the current study. Can you kind of just take us through briefly the design and your outcomes that you looked at? Dr. Ezra Bernstein: Yeah. So it was a retrospective analysis of over 17,000 patients that have visited the ICPC, the Integrated Cancer Prevention Center, between 2016 and 2019. And as Professor Arber was saying, patients come in, they're mailed a questionnaire beforehand, they ideally fill it out before, but they'll then meet with an internist or an oncologist. And they'll go over the questionnaire, they'll go over family history, risk factors, and then it will be really a tailored screening exam for that. They'll get the classic recommended screenings based on if they're due for a mammogram, if they're due for a Pap smear, and then from there– Do you want me to go through in detail or just kind of overall? Dr. Shannon Westin: I think overall is fine, yeah. Dr. Ezra Bernstein: Overall? Okay. So they do their screening test, they'll get some blood work done, and then if there's anything abnormal, then as Professor Arber was saying, the great thing is you get worked up right there. So they'll get TFTs, thyroid function tests. If those are abnormal, then they'll indicate a thyroid ultrasound needs to be done. They do all their screenings, all their testings. Most of it is done there. Professor Arber, do they do the biopsies there too if there needs to be a biopsy? Dr. Nadir Arber: Yes, obviously. But what is Ezra also referring, we are trying to do precision medicine. When somebody is coming to us, like you said, the woman, so we are measuring her Tyrer-Cuzick score and to see, if it is high, then we send her to do an MRI, if it is above 20%. Dr. Shannon Westin: So what were the outcomes that you measured in the study? Dr. Ezra Bernstein:  So, after they did all the screening, our main outcomes were the number of malignant lesions detected and then also what stage were they detected. Basically, if the cancer was found within a year of a visit to the ICPC and it was found as a direct result of the screening done that day or if there were recommendations for follow-up that then led to a successful detection, we counted that as a malignant cancer that was successfully detected through the ICPC. Dr. Shannon Westin: What about the results? Were they as expected? How did your detection rates compare to kind of, say, the general population? Dr. Ezra Bernstein: A successful cancer screening program is always going to have a shift in detection of cancer to earlier stages, which is exactly what we saw, which was great. We then compared it to the Israeli general public over a similar time period, and the percentage of cancers found at a metastatic stage at the ICPC, that was lower for all cancers. Just going through: Colon was 20% versus 46.2% in the general populations. There was no metastatic, cervical, or uterine cancer found. Prostate was 5.6 versus 10.5, lungs 6.7 versus 11.4, as well as renal, which isn't recommended we screen for, but that was 7.7 versus 10.3. Dr. Shannon Westin: That's so incredible. I guess the other thing I thought was really nice that you did is looking at patient satisfaction and making sure—we're very much focused on patient experience and satisfaction right now in medicine. So what were your findings there? Were the patients satisfied with the process? Dr. Ezra Bernstein: Yeah, so this is something that we started doing towards the end of the study period. So we really had respondents from 2019. There was about 1300 patients who responded on a Likert scale, 1 to 10. The average response was 8.35. So it's really good response. I try to go back there whenever I can, and it's always bustling. People are coming back. Professor Arber can speak—he's interacting with the patients every day. But talking with just friends who have heard of it, every time I bring it up, “Oh, that's amazing. We love that program.” Dr. Shannon Westin: Were there any limitations or weaknesses to the mechanism? Dr. Ezra Bernstein: The main limitations and weaknesses were that it was a one-arm study; it was not a randomized controlled trial, whereas randomization would control for generalizability as well as other confounders. And as with all cancer screening, there's the issues of the lead time bias, the concept that cancer is detected earlier through screening, but the length of time a person survives with the cancer does not. So survival time is falsely lengthened. There's also time bias, which is the idea that more indolent and less aggressive diseases with longer survival times are more likely to be detected through screening, artificially inflating survival time. So that's always present in cancer screening. In addition, the most reliable measure for determining the efficacy of a screening program is cancer-related mortality rates, and that's from the time of randomization as opposed to the time of diagnosis. And given the study design, that's just something that we weren't able to do. And any successful screening program such as ours is going to have the natural shift in the incidence of cancer to an earlier stage. But some of that can be attributed to overdiagnosis, the diagnosis of indolent diseases that are never going to actually cause harm, which has been heavily studied in the case of breast cancer with mammography. But it's not something that can be really proven; it's just more—overdiagnosis is more of a theory, and it can be hypothesized. So you're going to have overdiagnosis, you're going to have lead time bias, you're going to have a length time bias with any screening program, but in particular with ours, I think it's mainly the randomized control trial aspect, which is the gold standard. Dr. Shannon Westin: Yeah, that makes sense. Okay, well, and then the final—let's give a call to action here. So how do we implement this more broadly? What's kind of necessary to get something like this up and running? Infrastructure, personnel, yeah? Dr. Ezra Bernstein: So to implement this intervention more broadly, you really need the want from the general public and whoever's going to help implement this. And I think we're starting to see that with, as I mentioned, the recent program that the NFL is running about intercepting cancer. And then, to actually implement it, I'm going to leave some of it to Professor Arber, who did an amazing job setting up this program. But I think it makes the most sense setting it up within a hospital setting because you'd need certain imaging modalities within a clinic. And then, depending on which specific cancers you're screening for, you're going to need specialists able to screen for those cancers. Primary care, they can screen for skin cancer, but really, it should be someone with more training, dermatologists, to do that kind of screening. But Professor, I don't know if you want to jump in and talk about what you think it would take to set it up. I know you did an amazing job setting it up. Can't imagine the amount of work and coordinating. Because at the clinic in Tel Aviv, you have many different specialists coordinating every day. It has got to be quite difficult. So I don't know if you have anything to add, professor. Dr. Nadir Arber: I think everything in medicine, in order to be successful, has to be simple. We are physicians. We are simple people. And this is a way that you are able to do this screening. Because first, from economy, it's cost saving. It doesn't cost money for the government, for the health providers, but also for the patients. If somebody feels well, there is no way that he will go all this saga of going to the GP and have this referral to five, six specialists. And when we understand also the issue of cost and case finding on top of the screening, then we understand that this is the only way that this screening program—when people are feeling healthy, no symptoms, the only way that once a year, they can afford it. If I break my leg or have a rectal bleeding or have a chest pain, I go to the special physician because I have symptoms. But if I have no symptoms, then only once a year, I would like to go to a special place which has all the expertise which the GP cannot provide and then to implement it. This is the only way, and this is simple. And we are happy that you took the lead, and with this initial project, that should be multiplied everywhere. This is the only way. Now we understand that the best therapy of cancer is prevention or at least early detections. And also, Ezra maybe mentioned that we also teach for lifestyle modifications. If needed, we are doing genetic testing; that is going to be very important. I don't know if Ezra mentioned that we are checking for this polymorphism in the APC genes that we have shown in the [inaudible]. Carriers of this APC can have double the risk of having cancer. Dr. Shannon Westin: Well, this has been such a fascinating discussion, and I'm just so glad that you both had the time to spend with us today to review this. I think this is an incredible intervention, and I really do hope that we can mimic this across the States and across the world. So, again, listeners, this has been JCO After Hours. We're discussing “Data from a One-Stop-Shop Comprehensive Cancer Screening Center,” focused on asymptomatic screening. We're so glad that you joined us today. Please do check out our other podcasts on the JCO website. Be well. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.      

Dave holds a Ph.D. in physics and is a father of two boys, the older (David) having been diagnosed with type 1 diabetes at age 9. That took the family on a journey of exploring healthy lifestyles. Dave and his family are active in the low-carb type 1 diabetes community. Find Dave on Twitter: https://twitter.com/DikemanDave  Timestamps 00:00 Trailer 00:46 Introduction 01:48 Theoretical physics Ph.D. 04:38 Dave's children: David and Hayden 05:27 Hayden's talk about glucose variability and why we have a hard time matching glucose 06:15 David's type 1 diabetes diagnosis 08:03 Losing a lot of weight before type 1 diabetes diagnosis 09:43 Time a type 1 diabetic starts losing weight till the diagnosis 10:42 Type 1 diabetic long term complications 12:30 Adjusting doses for type 1 diabetics 13:49 Cutting down carbs 14:20 Bernstein's book and the law of small numbers 15:44 Life expectancy of a type 1 diabetic 16:48 A1Cs of type 1 diabetics 17:56 Digestion issues for type 1 diabetics 18:22 Gray and white matter ratios for type 1 diabetics 19:01 Mainstream attitude towards low-carb diets for type 1 diabetics 20:24 Covering protein 21:51 Who is Dr. Bernstein? 23:53 Life expectancy for type 1 diabetics 25:48 Honeymoon phase 28:18 Dosing for type 1 diabetics 31:00 Variables in dosing 33:14 Correcting insulin 34:51 Mis-dosing insulin 35:50 Overwhelming with insulin 37:02 Downsides of insulin 39:05 Cancer rates in type 1 diabetics 40:23 Parents of type 1 diabetics 42:16 Parents joining type 1 diabetic kids in diet change 43:15 Blood sugars of type 1 diabetics 44:54 Being a type 1 diabetes athlete 47:13 Advice to run high blood sugar 51:27 Low blood sugar at night 53:33 What a father will do for his type 1 diabetic kid 55:18 Disease leading one to a very healthy lifestyle 57:16 Type One Grit page on Facebook 58:54 Dr. Eric Westman and ADAPT Academy 61:01 CGM sensors with pumps built-in 63:17 Double diabetes 65:50 Adusting for exercise-induced insulin sensitivity 68:14 Let Me Be 83 70:18 Closing See open positions at Revero: https://jobs.lever.co/Revero/ Join Carnivore Diet for a free 30 day trial: https://carnivore.diet/join/ Book a Carnivore Coach: https://carnivore.diet/book-a-coach/ Carnivore Shirts: https://merch.carnivore.diet Subscribe to our Newsletter: https://carnivore.diet/subscribe/ . ‪#revero #shawnbaker #Carnivorediet #MeatHeals #HealthCreation   #humanfood #AnimalBased #ZeroCarb #DietCoach  #FatAdapted #Carnivore #sugarfree  ‪

This week Heather and I go off about our experiences at the endocrinologist… Obviously we've had some good experiences with endos but we have a lot to say about the bad ones. We talk about our worst times going to get our A1Cs checked, some horrible things that the doctors have said, anxiety around going to the ends, how to advocate for yourself, what we wish they knew, and more!This episode is for entertainment purposes only and is not medical advice. We are just speaking from our personal experiences which may be completely different from your own. Consult your doctor before making any changes. Connect with Heather on instagram @holson_11 and @milifeinnumbers. Find me on Instagram and Tiktok @thrivabetic. Find the blog here and The Thrivabetic book here.If you enjoyed this episode please share it with a friend and leave me a rating/review on Apple Podcasts and/or follow me on Spotify. 

Welcome to the podcast! Parents of T1D kids have so many unique experiences that most people don't understand. By finding community and support, we learn that we are not alone, and we have hope through the difficult times. Today's show tackles questions about helping teenagers become more independent, not letting “diabetes talk” take over the parent/child relationship, and how to combat diabetes burnout and depression. Join us to learn more!Show Highlights:Guest #1: Angela is the mother of Jake,15; he was diagnosed at age 12. Jake is trying to be more independent with his management, but it's been a big struggle to have him remember to check his blood sugar and take his insulin appropriately.How Angela feels like their relationship is focused solely on diabetes management, and she wants it to be differentAngela's question: “How much do I let him do, and how do I balance our relationship beyond diabetes talk?”JoAnne's answer: “I would vote for the relationship to be the primary focus right now. Jake is at the age where higher A1Cs are normal, and it's very difficult to hit the A1C target. Being empathetic toward him about what he's going through is important, as well as keeping your relationship strong with him. I'm not saying to let go of safety concerns, but talk to him and name what has happened in the relationship. Let him know that you would like to ‘talk at him' less about diabetes. Find a way with him to hand over control to him and let him know that you trust him on this important issue, but let him know that he deserves support. Take it one step at a time, and praise him along the way for whatever he is doing right.”Guest #2: Anna is the mother of Charlie, age 5; he was diagnosed in November 2021.Still in the “honeymoon phase” after diagnosis, Charlie takes ½ unit of long-acting insulin; he does not feel his highs and lows.His parents rely 100% on technology to gauge his highs and lows, and his normal personality tends to be irritable and difficult.Why Anna feels caregiver burnout and mourns the ease of their old lifeAnna's question: “How do I combat the depression of being his caregiver and pancreas 24/7? Do you have tips and strategies to get out of the ‘diabetes depression' that we are dealing with?”JoAnne's answer: “I think your experience is normal. Community is very powerful and grounding, and I'm a big proponent of family camp because it's good for everyone in the family. Find ways to get community support into your daily life at home; diabetes is too much of a burden for one parent to carry alone. Charlie needs to learn that there is a big network of people who can help him and you. Do your best to normalize your experience; most of it is just the swing and sway of the first year with diabetes.” Resources:Visit my website for available resources: www.diabetessweettalk.com For help with the emotional and parenting challenges of facing T1D management, join one of our live recording sessions by clicking the banner at the top of the homepage.For a more hopeful future for you and your T1D child, consider the After Diagnosis coaching course at www.diabetessweettalk.com/courses. Experienced T1D parents can find help in the Put Diabetes in Its Place course at www.diabetessweettalk.com/courses. Mentioned in this episode:Get Help After Diagnosis!Get back to...

Top stories In the News this week, United Healthcare announces changes to how they cover insulin for some, a new study looks at CGM use in people with type 2 over the age of 65, another company begins islet cell clinical trials, a new tool to treat diabetic neuropathy pain, gestational diabetes is on the rise, and more. Learn more about the T1D Exchange: https://t1dexchange.org/stacey/ 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! ----- Episode Transcription Below (or coming soon!) Please visit our Sponsors & Partners - they help make the show possible! *Click here to learn more about OMNIPOD* *Click here to learn more about AFREZZA* *Click here to learn more about DEXCOM* 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. XX In the news is brought to you by T1D Exchange! T1D Exchange is a nonprofit organization dedicated to improving outcomes for the entire T1D population. https://t1dexchange.org/stacey/ XX Our top story.. United Healthcare says it will have no “out of pocket” expenses for insulin starting January first. It's doing the same for other critical drugs like glucagon, epinephrine and albuterol. Looking into this a bit more, though, it's not the boon it first seems. This only covers certain eligible patients. Stat news says about a quarter of United Healthcare's patients will qualify but I saw a few commentators say it could actually be less than 5-percent. UnitedHealth Group shared that it earned $5.1 billion in profit for the second quarter of 2022. https://kstp.com/kstp-news/top-news/united-healthcare-says-no-out-of-pocket-expenses-for-insulin/ XX Not too surprising but a good study about people with type 2 using CGMs. This was for people using basal insulin only and over 65 years old. They found when given a CGM, their A1Cs went down an average of 1 full point with fewer lows. These are the kinds of studies that may seem obvious to us but that are needed to show insurers they need to cover. https://www.liebertpub.com/doi/10.1089/dia.2021.0494 XX New device approved to treat pain associated with diabetic peripheral neuropathy. The DyAnsys' First Relief system is set behind the ear – its an adhesive, nothing surgical. It features three small, acupuncturelike needles that reach through the skin behind the ear to access the nervous system. Once in place, the device continuously emits low-level electrical pulses over the course of several days at a time; the FDA cleared the system for repeated treatments spanning up to eight weeks. https://www.fiercebiotech.com/medtech/fda-clears-wearable-neurostimulator-dyansys-treat-pain-diabetic-nerve-damage XX Another company having success with islet cell transplants. ProtoKinetix announced they're completely safety objectives and will start phase 1 clinical trials of their molecule PKX-001. Not much to report here yet, but I didn't want to news of the Vertex/Viactye merger to over shadow that there are other efforts going on here. https://www.businesswire.com/news/home/20220720005086/en/ProtoKinetix-Successfully-Completes-Phase-1-Clinical-Trials-for-the-Treatment-of-Type-1-Diabetes-in-Islet-Cell-Transplants XX Roche and Insulet settle their lawsuit.. this was a patent issue and both companies were suing each other. Insulet will give Roche 20-million dollars and Roche has agreed not to sue Insulet for five years. This was set to go to trial next week. https://seekingalpha.com/news/3855728-insulet-to-pay-20m-to-settle-patent-lawsuit XX Gestational diabetes is on the rise, climbing 30% between 2016 and 2020, according to a new study by the Centers for Disease Control and Prevention.The CDC analysis showed that cases increased 13% during the first year of the pandemic alone, a much larger spike than the previous annual increases of about 5%. Experts say that the sharp increase during Covid may be because the disease accelerated people's adoption of a sedentary lifestyle and led to pandemic-related physical and emotional stress. experts are concerned outcomes in 2021 may be worse, when Covid hit harder. If anything, the authors and experts said, the new finding is likely an undercount. Relying on birth certificate data, which the CDC study did, can miss cases that are not captured by a physician on those forms. “If you think about it, somebody who's doing 20 deliveries in a night, or ten deliveries in a night, is just kind of trying to get those reports and certificates out there,” said Morgan. “They're not paying as much attention to some of those details.” https://www.statnews.com/2022/07/20/as-diabetes-during-pregnancy-grows-more-common-experts-point-to-a-need-for-preventive-care/ XX Right back to the news in a moment but first As I mentioned, The T1D Exchange Registry is an online research study, designed to harness the power of individuals with type 1 diabetes. It's a research study conducted online over time, designed to foster innovation and improve the lives of people with T1D. Personal information remains confidential and participation is fully voluntary. Once enrolled, participants will complete annual surveys and have the opportunity to sign up for other studies on specific topics related to T1D. By sharing opinions, experiences and data, patients can help advance meaningful T1D treatment, care and policy Sign up at T1DExchange.org slash Stacey (that's S-T-A-C-E-Y). XX /about-us/ XX Next week on the podcast I'm talking to Sebastien Sasseville who recently completey the absolutely exhausting sounding Race Across America. We'll talk about how you manage type 1 – and everything else – when you're spending more than 20 hours a day on a bike for 12 days! The long format episode out right now is with the folks at Diabetes Wise – that's a website to help you choose diabetes technology.. they've added information for doctors – this may help you educate your heathcare providers on why you want the pump or cgm system that you do.. Listen wherever you get your podcasts That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

The topic of today's episode really lights me up. It's not just talking about A1C in general that lights me up but more so diving into the tangible steps to focus on at every level.Here's the thing: Everyone has their unique, personal journey with diabetes, AND… in the past 7 years of working with T1Ds, I've learned that many of us have similar experiences and challenges while trying to lower our A1Cs. So, in this episode we're going to discuss exactly where your focus needs to be based on your current A1C and break down the tangible next steps you need to take to achieve your goal.BONUS! Two exciting opportunities we have going on this week: This Saturday, July 23, 2022, we are having a FREE, in-person T1D meetup in NYC. If you're in the tri-state area, come spend some time with me and other T1Ds! RSVP HERELast week we held our A1C Shift and Insulin Sensitivity Masterclass. Over 1,000 people have registered so far. We are offering it again Wednesday, July 20th at 8pm EST and Thursday, July 21st at 12pm EST. Save your (free) seat HERE. Hit the subscribe button and rate and review to help this podcast rise! Follow me @lauren_bongiorno and @riselyhealth on Instagram to stay in the loop for when new episodes drop.Send me a DM to introduce yourself with any feedback, questions, or suggestions on topics you'd like us to cover in future episodes.RESOURCES FOR YOU: More T1D tips HERE. Access our Cornerstone Classes HERE.Grab your own Diabetic Health Journal HERE.Disclaimer: Nothing you hear on the Reclaim your Rise podcast should be a substitute for personalized professional medical advice. Please always consult your physician or other medical professional before making any changes to your diet, insulin dosages, or healthcare plan. 

Howie is an adult living with type 1 diabetes and also the parent of a type 1. Show notes for people who are Bold with Insulin Get your supplies from US MED with the link or 888-721-1514 Learn about the Dexcom CGM You may be eligible for a free 30 day supply of the Omnipod DASH  InPen from Medtronic Diabetes Get Gvoke Glucagon  CONTOUR NEXT ONE smart meter and CONTOUR DIABETES app Learn about Touched By Type 1 Tak the T1DExchange survey A full list of our sponsors  How to listen, disclaimer and more Apple Podcasts> Subscribe to the podcast today! The podcast is available on Spotify, Google Play, iHeartRadio, Radio Public, Amazon Music and all Android devices The show is now available as an Alexa skill. My type 1 diabetes parenting blog Arden's Day Listen to the Juicebox Podcast online Read my award winning memoir: Life Is Short, Laundry Is Eternal: Confessions of a Stay-At-Home Dad The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here or buy me a coffee. Thank you! Follow Scott on Social Media @ArdensDay @JuiceboxPodcast Disclaimer - Nothing you hear on the Juicebox Podcast or read on Arden's Day is intended as medical advice. You should always consult a physician before making changes to your health plan.  If the podcast has helped you to live better with type 1 please tell someone else how to find the show and consider leaving a rating and review on iTunes. Thank you! Arden's Day and The Juicebox Podcast are not charitable organizations.

It's "In the News.." got a few minutes? Get caught up! Top stories this week: The Federal Trade Commission probes the prescription drug middleman industry, once a week basal insulin moves forward, DIY insuln dosing systems get a thumbs up at ADA Scientific Sessions, Sernova's stem cell system releases great findings and more! Learn more about the T1D Exchange 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! ----- Episode Transcription Below (or coming soon!) Please visit our Sponsors & Partners - they help make the show possible! *Click here to learn more about OMNIPOD* *Click here to learn more about AFREZZA* *Click here to learn more about DEXCOM* 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. we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast. XX In the news is brought to you by T1D Exchange! T1D Exchange is a nonprofit organization dedicated to improving outcomes for the entire T1D population. https://t1dexchange.org/stacey/ XX The Federal Trade Commission will launch an inquiry into the prescription drug middleman industry.. requiring the six largest pharmacy benefit managers to provide information and records. They're looking at PBMs such as CVS Caremark; Express Scripts, Inc.; OptumRx, Inc.; Humana Inc and more. The largest PBMs are now vertically integrated with the largest health insurance companies and wholly owned mail order and specialty pharmacies. In these roles, pharmacy benefit managers often have enormous influence on which drugs are prescribed to patients, which pharmacies patients can use, and how much patients ultimately pay at the pharmacy counter. https://www.ftc.gov/news-events/news/press-releases/2022/06/ftc-launches-inquiry-prescription-drug-middlemen-industry?utm_campaign=https://www.ftc.gov/news-&utm_content=1654622484&utm_medium=social&utm_source=twitter XX Confirming what many of you have known for years.. an open-source automated insulin delivery system -- also known as a do-it-yourself system -- was both safe and effective for patients with type 1 diabetes. This is from the CREATE trial, designed to test DIY system, presented for the first time at the ADA Scientific Sessions. This system was made up of the OpenAPS algorithm from a version of AndroidAPS implemented in a smartphone, paired with the DANA-i insulin pump and Dexcom G6 continuous glucose monitor. The researchers previously published additional information in the Journal of Diabetes & Metabolic Disorders. https://www.medpagetoday.com/meetingcoverage/ada/99109 XX Stem cell study showing great results. Sernova says the first three patients of six total continue to be insulin independent following treatment. One of the patients has been insulin-free for more than two years, while the other two have been free of the need for medication injections for six months and three months, respectively. At this point, the other three patients in the study have not had the device long enough to determine measurable results. The first three all have A1Cs in a normal, nondiabetic range. Sernova's Cell Pouch is an implantable device that releases the primary donor islets. The device is implanted under the skin in a minimally-invasive procedure. We're talking to Sernova for next week's show; long way to go here but another good result for stem cells. https://www.biospace.com/article/sernova-cell-pouch-device-keeps-type-1-diabetes-patient-insulin-free-for-two-years/ XX Getting closer to once-a-week basal insulin. New study says Novo Nordisk insulin icodec achieved better results than Lantus in some aspects of the study and that overall it was – this is interesting wording – non-inferior. Another previous study showed it also matched well to Tresiba, but that Tresiba caused fewer lows than the once-weekly basal. This study was about type 2 diabetes but insuln icodec is in other trials for people with type 1. https://www.biospace.com/article/novo-nordisk-scores-phase-iii-insulin-win-strengthening-market-position/ XX New partnership between Diabeloop – which makes an automated insulin algorithm - and SOOIL which makes pumps. These are two French companies that have been working together since 2020 but this new announcement was delayed by COVID. They want to bring the product – Diabeloop's DBLG-1 I controller and SOOIL's Dana ACE Pump to the US, Europe and Korea. https://www.drugdeliverybusiness.com/diabeloop-sooil-automated-insulin-diabetes/ XX Civica continues to move ahead with the development of its affordable insulins. They've announced they'll partner with the German company Profil for the clinical trials. Civica plans to set a maximum recommended price to the consumer of no more than $30 per vial and no more than $55 for a box of five pen cartridges. Contingent on FDA approval, Civica anticipates that its insulins will be available for purchase beginning in 2024. https://www.healthcarepackaging.com/supplier-news/news/22262909/civicarx-civica-selects-profil-as-clinical-trial-partner-for-affordable-insulin-initiative XX New study out of Israel shows that obesity in teenagers may lead to type 1 diabetes a few years later. The study, of nearly 1.5 million Israeli teenagers, found that those who were obese were twice as likely to develop type 1 diabetes by young adulthood, versus those in the normal weight range. The senior researcher on the study says it's not clear why obesity would raise the risk of type 1. They think it may the a trigger in people with genetically susceptible. Obesity also has other effects — including vitamin D deficiency and alterations in the gut's bacterial makeup — that could impair immune function. https://www.usnews.com/news/health-news/articles/2022-06-06/obesity-in-teen-years-might-trigger-type-1-diabetes XX Right back to the news in a moment but first we've got a new sponsor. As I mentioned, The T1D Exchange Registry is an online research study, designed to harness the power of individuals with type 1 diabetes. It's a research study conducted online over time, designed to foster innovation and improve the lives of people with T1D. Personal information remains confidential and participation is fully voluntary. Once enrolled, participants will complete annual surveys and have the opportunity to sign up for other studies on specific topics related to T1D. By sharing opinions, experiences and data, patients can help advance meaningful T1D treatment, care and policy Sign up at T1DExchange.org slash Stacey (that's S-T-A-C-E-Y). XX XX XX On this week's long format episode, you'll hear my conversation with Dexcom's CEO Kevin Sayer. We get more information about the G7 launch, after FDA approval of course and I asked him your questions about everything from IOS issues to airport scanners. Next week, Sernova joins me to explain their stem cell pouch technology Listen wherever you get your podcasts That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

So there's much talk these days about weight stigma, in fact, we recorded a number of podcasts ourselves on the topic, and I believe it's very important, but this is our first podcast on another form of stigma. One that is powerful, often overlooked, and highly important to address. Our guests today are Matthew Garza and Nick Cuttriss. Matthew is Managing Editor at The diaTribe Foundation. And the dia in diaTribe derives from diabetes. The foundation's mission is to, and I'm quoting here, "to improve the lives of people with diabetes, prediabetes, "and obesity, and to advocate for action." I've served on an advisory board for diaTribe, and very much admire their work. Nicolas Cuttriss is a pediatric endocrinologist, and is founder of the ECHO Diabetes Action Network, and also has served on an advisory committee for the diaTribe Foundation. Matthew and Nick have been integral to a novel and welcome program on diabetes stigma that launched recently, that can be seen at the website, dstigmatize.org. Interview Summary   So Matthew, let's start with you. So can you explain what is diabetes stigma, and how does it relate to stereotypes around food and obesity?   Mathew – Absolutely. So in general, we know that stigma refers to the experiences of exclusion, rejection, prejudice, that blame and shame that people unfairly experience based on some characteristic or perceived difference. And in this case, that's diabetes. And this might look like negative attitudes towards people with diabetes. It might be hurtful or insensitive jokes made at their expense. And in some cases, it can even be outright discrimination. While there are many forms that diabetes stigma can take, such as being singled out for wearing a visible diabetes device, like a continuous glucose monitor for example, or an insulin pump, it could also be the stigma that's associated with having a chronic condition that does require, in some cases, daily medication. What we're seeing is that most of the research actually shows that the bulk of the stigma associated with diabetes stems from the misunderstanding that poor choices and unhealthy behaviors are the sole cause of this condition. And that people who have been diagnosed with diabetes somehow brought it on themselves. And this is attributed to both people with type 1 and type 2. And the stigma comes from lots of different sources. So it can be external from the media in shows or on the news. It can come from your friends and your family, from coworkers, healthcare professionals in a clinical setting. And sometimes it can even happen within the diabetes community. We often see that in defending themselves from the harmful stereotypes associated with diabetes, that people with type 1 can sometimes unintentionally redirect that stigma back onto people with type 2. And in regards to how this form of stigma specifically relates to food and obesity, it really goes back to what I was saying that unless you have diabetes or unless you know someone close to you that has diabetes, a lot of time, your only real knowledge of the condition is that it's connected to eating too much sugar, right? Or eating too much junk food, and that that somehow caused this. And a lot of times, it's associated with obesity or having excess weight. And then, on top of that, especially in America, we have this culture that there's this really problematic assumption that health is primarily a matter of individual responsibility. And this creates this stigmatizing narrative that blames people with diabetes for bad choices, and it sets up this us versus them. And it makes us treat people with diabetes differently because somehow they did this to themselves. But all of these beliefs oversimplify this really complex biological condition. And it overlooks all of those other, the systemic factors, such as environmental and socioeconomic context that people live in. Their access to healthy food options, to healthy grocery stores, for places to exercise. And so the more that we can kind of separate out diabetes from these misconceptions about food or sugar being its only cause, I think it's the better that we can support people and make sure that everyone is getting the care that they deserve.   Boy, have you painted a detailed picture of that and I appreciate it, and I can imagine that navigating this world of stigmatizing events must be especially difficult for children. But let me ask you, overall, what are the negative impacts of diabetes stigma?   Mathew - Absolutely, so there's so much research that I think still needs to be done to get a picture of the prevalence, the impacts, and the interventions that can address diabetes stigma. And thankfully, we've had some really great leaders in the field who have started to lay the groundwork to show all of this. And we see that diabetes stigma, and especially the language that we use to talk about diabetes has extremely negative effects. People with diabetes report feelings of fear, embarrassment, blame, anxiety, low self-esteem as a result of experiencing stigma. And this can translate into really harmful mental health conditions such as depression or higher levels of stress that drive unhealthy behaviors and can increase a person's risk for developing even greater health complications. You know, I know that Rebecca Puhl has touched on this a lot in her research on weight bias that we have this idea that potentially having this stigmatizing attitude will somehow motivate people. And in this case, motivate people with obesity or excess weight to improve their current habits. But actually, it has the opposite effect, and it causes things like harmful disordered eating or leading people to avoid physical activity altogether. And in the same vein, we see it happening with diabetes as well, that the stigma associated with the condition actually leads to worse self-care and worse diabetes management. So for example, we've talked to people, and seen in the research that they report injecting insulin only in public restrooms or at home, that they might choose to make an unhealthy food choice to avoid declining what is being offered to them. And even manipulating their glucose logs or lying about the management that they're doing just to avoid criticism from significant others or from healthcare professionals. And specifically, when the stigma is from healthcare professionals, it can actually inhibit people from seeking the necessary care that they need. One of the really concerning things that we've seen recently is that the research shows that people with diabetes fear being exposed for having diabetes or being labeled as disabled. And it discourages them from being open about their diagnosis in a way that is also influencing those who might be at risk, because it's acting as a barrier overall to awareness about the condition and to prevention. And it's increasing those feelings of isolation right after a diagnosis. And so the sheer breadth of all of these negative effects is why we believe that addressing diabetes stigma is such an essential missing element of effective diabetes care.   Well, in a very short time, you've mentioned a number of very troubling consequences, and you can see how these things would feed on each other and you'd have this cascade of negative effects that could really impact just about every part of a person's life. So Nick, let's turn to you. So research on both diabetes and weight stigma has shown that people often report feeling stigmatized in healthcare settings. So what experiences are common in these settings, and how can healthcare professionals advise people on the relevant issues like lifestyle change without making stigma worse?   Nick - So Matthew touched on it earlier in terms of stigma around when people are diagnosed with diabetes, they are blamed and shamed “that it's your fault.” But then, it's also perpetuated after diagnosis, and healthcare professionals putting blame and shame on patients for, quote, "being uncontrolled." And there's a marker, the A1C, which many healthcare professionals use. And we report EDIS rates in terms of quality improvement. And A1C less than 9% is how the health system separates out between people who are, quote, "controlled or uncontrolled." And the majority of people living with type 1 diabetes and type 2 diabetes have A1Cs that are greater than 7%, and they're not able to meet the targets. And so we, as healthcare professionals, need to become more explicit in working to overcome these implicit biases we label our patients as uncontrolled and perpetuating this stigma. A couple examples of what we can do in the healthcare professional setting is focusing on our language. And diaTribe has a great resource on their website, or you can look at the dstigmatize.org website to watch a couple video clips and really understand how language matters. So not labeling someone as diabetic, but they're a person living with diabetes before diabetic. They don't have good or bad blood sugar control. Their numbers are high, their numbers are low. Using descriptives, not saying, "Let's test someone's blood sugar," but checking someone's blood sugar. They're not on trial for their diabetes. And I think us as healthcare professionals need to realize when the majority of people living with diabetes aren't able to meet targets, it's not their fault. It's our fault. It's the delivery of healthcare that's failing, and it's not the patients who are failing. And we need to be more empathetic to them. And then, when it relates to obesity, similarly, when almost 50% of adults in the US are obese, and more than half are obese and overweight, we need to stop labeling them as obese and their fault when it's the majority of people who have this. I just had a colleague in the healthcare professional arena come to me last week, he said, "Nick, you know what? They put obesity on my diagnosis, I'm so upset." And this is someone who is trying to address their weight and get newer medications that help address the weight. But the healthcare professionals said, "No, you need to try more." So I think we need to change our approach of how we label our patients, and how we approach them with this blame and shame.   Well, and it's easy to see how people who feel stigmatized and have difficulty in the medical settings with the healthcare professionals they're interacting with would be more likely to avoid care, and that could exacerbate their condition. So let me ask this, do you see any signs that this issue is being addressed in the medical profession? Does it come up in med school training? Is it part of continuing education? Is it on the radar anywhere?   Nick - I wish it was more systematically. I think maybe at some institutions where there are champions for people living with diabetes, where a student might get a lecture, but unfortunately, I don't see it there. And I think that's what's so exciting about diaTribe dStigmatize initiative is really to get more broader reach and get the basics. So in medical school, we get into all these details in terms of cause of diabetes and medications. But I think if we could just back up on the humanistic level and know how to talk to people with chronic conditions, we'll train the next generation of leaders much more humanistically and have better outcomes if we can focus on the basics of how to interact with people living with chronic conditions, and getting rid of this blame.   It sure would be nice to see some of those things happen. So I'd like to ask a question of both of you. So it's clear that addressing diabetes stigma is a complex challenge. So what does diaTribe think needs to happen to begin combating this problem? And, Matthew, let's start with you.   Mathew - Thank you both so much for mentioning dStigmatize; that's what we're really excited about. We just launched this online resource that we hope is going to be the first step, because when we started to look at what is the landscape of resources out there for someone who wants to make sure that they are able to understand what the problem is and how to address it, there really was no centralized location. So what we wanted to do is bring resources together to make it a one-stop shop that anyone who wanted to learn about how to identify this form of stigma, why it might be harmful, or hear the real life stories from people with diabetes, about their condition, and about how stigma has affected them, that they would be able to do that in this one place. And we launched this resource primarily because we think that there's two very essential first steps that we need to take. And the first is that in order to address this public issue, we have to shift away from that really pervasive blame and shame mindset, right? So we want to reframe the way that people are thinking about diabetes, so that it's viewed as this complex, but manageable condition that nobody asks for. And not that it's somehow a failure of personal responsibility. So part of that has been that we've been really grateful that so many members of the diabetes community have been so open to sharing their stories because it's really helping us paint a picture of what diabetes actually looks like, and the ways that stigma affects people on a day-to-day basis. And then, the second part that our website really addresses is that language. And so leaders like Jane Dickinson, Susan Guzman, and Jane Speight have all been really key in making sure that language is seen as one of those tenets when it comes to addressing diabetes stigma, that the words that we're using to talk about diabetes currently lack that kind of awareness, and consideration, and even empathy at times. But because language matters and it has real impacts on the way that people with diabetes view themselves, how healthcare providers view people with diabetes, and how the general public views them, we wanted to create very specific language guidance directed at people who might write, or talk, or communicate about diabetes in some way, that encourages them to use words and phrases that are neutral, that are nonjudgmental. And at its very core, that are based on the facts, and actions, and physiology or biology that can actually help people, right? We want to get away from using all those terms that Nick was talking about like bad glucose levels or controlling their diabetes, because those just aren't actually factual when it comes down to it. Looking forward, dStigmatize is just the first step. We think that there's so many other initiatives aimed at getting more research funding to really explore this issue and its impacts. We think that there's the potential for media advocacy campaigns, similar to what GLAD did at the beginning of the LGBTQ Civil Rights Movements in addressing the negative representation of people who are LGBTQ in the media that a similar thing could be done because there's so many negative portrayals of diabetes and inaccurate portrayals in the media. And then, finally, the campaigns that influence the general public's attitudes towards diabetes. One of the key next steps might be influencing healthcare providers' interactions because like both of you said, we know that the research shows that this is a key area where people are experiencing stigma. And this is also a group that I think truly wants to make sure that their patients are feeling empathy, and that they're able to help them in any way that we can. And so I know that this actually is a very specific intervention that Nick has been doing a lot of work around and can speak to the importance of.   It's a very comprehensive effort you're discussing. So Nick, what would you like to add to that?   Nick – Yes, so, I'm a hyperspecialist in pediatric endocrinology, and there's just not enough adult endocrinologists or pediatric endocrinologists to care for people living with diabetes. And we just need to recognize that frontline healthcare professionals have more of an opportunity, more touch points to make a difference than a specialist like me. And we really must do everything to support frontline healthcare professionals in overcoming diabetes stigma. So as founding director of the ECHO Diabetes Action Network formed to combat system failures in our society in how we educate clinician and approaches to medical management for people with diabetes. And we're seeking to democratize diabetes specialty knowledge, so they can reach frontline healthcare professionals and power underserved populations living with diabetes. So an example of the efforts to target frontline healthcare professionals and improve care, we've launched a monthly educational series focusing on diabetes and disparities in the primary care setting. And then, the initial focus was attention to CKD and diabetes, and we're going to be moving focus areas moving forward. And we'll do a block on cardiometabolic issues, and obesity-related diabetes disparities. And then, also, we'll collaborate with diaTribe on launching one for addressing diabetes stigma and behavioral health, just to name a few. So for more information, feel free to visit echodiabetes.org, and join us for being a champion for people living with diabetes in the primary care setting.   Bios   Matthew Garza is the Managing Editor of DiaTribe. Matthew Garza joined the diaTribe Foundation in 2020 after graduating with honors from Johns Hopkins University's Whiting School of Engineering where he majored in Biomedical Engineering and minored in the Study of Women, Gender, and Sexuality. As an undergraduate Matthew was heavily involved in research, working in the Hopkins Translational Tissue Engineering Center. His research focused primarily on stem cells, three-dimensional matrix scaffolds, and surgical outcomes for transgender patients. He has a passion for understanding more about the socioeconomic determinants of health and how they affect health outcomes, primarily for the LGBTQ population. Matthew swam for the Hopkins varsity swim team and was the president of the Student Athlete Advisory Committee and Hopkins's Athlete Ally chapter. He enjoys swimming, running, hiking, and backpacking in his free time and he will never turn down the opportunity to eat good food or listen to good music.   Dr. Nicolas Cuttriss is a social entrepreneur and a practicing pediatric endocrinologist and public health professional with a unique dedication to health disparities and improving the quality of life of people living with diabetes. He currently serves as Founding Director and CEO of the ECHO Diabetes Action Network after serving as Director of Project ECHO Diabetes and Project ECHO Diabetes in the Time of COVID-19 at Stanford University. Prior to joining Stanford, Dr. Cuttriss served as the first pediatric endocrinologist for the University of New Mexico Project ECHO Institute ENDO teleECHO clinic to democratize diabetes specialty knowledge by empowering primary care providers to care for patients with complex diabetes who lack access to routine diabetes specialty care. Clinically, Dr. Cuttriss founded and serves as Medical Director for ENDO Diabetes & Wellness, a medical practice specializing in diabetes and telehealth where he also supports and consults with medical groups and hospital systems around the country to address barriers to routine diabetes specialty care. Dr. Cuttriss also serves as co-Founder & Chairman of the Board of AYUDA (American Youth Understanding Diabetes Abroad), a 501c3 global health volunteer organization that empowers youth to serve as agents of change in diabetes communities aboard.

It's "In the News..." Got a few minutes? Get caught up! Top stories this week: An FDA hiccup for Vertex, Omnipod 5 starts wider rollout, New peek at Dexcom G7 features, Beta Bionic study info, "Hey Alexa, predict my blood sugar" and Healthline shuts down their main source of diabetes news and information. -- Join us LIVE every Wednesday at 4:30pm ET 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! ----- Episode Transcription Below (or coming soon!) Please visit our Sponsors & Partners - they help make the show possible! *Click here to learn more about AFREZZA* *Click here to learn more about OMNIPOD* *Click here to learn more about DEXCOM* 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. we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast. XX In the news is brought to you by T1D Exchange! T1D Exchange is a nonprofit organization dedicated to improving outcomes for the entire T1D population. https://t1dexchange.org/stacey/ XX Our top story – bit of a surprise for Vertex – the FDA puts a clinical hold on their newest trial. This is the company that made big headlines last fall – that New York Times article likely sent to you by everyone you know about a stem cell cure for type 1. That's when Vertex reported data on the cell therapy from a single patient who achieved a “robust” restoration of islet cell function after receiving a drug called VX-880. That response is going strong they say at day 270. This week, Vertex showcased results from another patient and said a third patient has received the full dose. A company spokesman says they're surprised by the clinical hold given the evidence so far and there have been no serious adverse events. They say they'll work with the FDA to get the trial moving again as soon as possible. https://www.fiercebiotech.com/biotech/unwelcome-surprise-vertex-fda-slaps-hold-phase-12-diabetes-cell-therapy-study XX Insulet announces that Omnipod 5 has completed the Limited Market Release and will be rolling out to a wider audience soon. Those who signed up for what they call the interest list will be notified first – we're told watch for that email this week. If you haven't signed up, sit tight. Omnipod 5 still isn't yet available through all insurers and at every pharmacy, but the roll out will continue slowly through the year. https://www.omnipod.com/current-podders/resources/omnipod-5/faqs?fbclid=IwAR1fghbXl4uP4H3z8DGovriAocpZyDyPzLdPzME_taonv3_ZfPC3XqukHJY XX We're learning more about Dexcom's G7 – approved in Europe and in front of the US FDA right now. Sensors will have a bit of a grace period – they'll keep working 12 hours after the 10 days are up. You'll also be able to silence the urgent low and sensor fail alarms for six hours – that's new. I'm talking to CTO Jake Leach for next week's long-format show and he's got a lot of info to share. I asked as many of your questions as I could, so please come back for that one. XX New study results about the iLet, the insulin only bionic pancreas from Beta Bionics. This is one of the many studies presented at A-T-T-D.. People in the study saw about half a point come off their A1Cs after 13 weeks and there was no increase in hypoglycemia. They also saw more than 2 and a half hours more time in range. The iLet is unique in that you only enter your weight and tell the pump system when you're eating – there are no basal rates or a need to enter carbs. No timeline for release but the company says its regulatory submission is currently under FDA review. https://www.globenewswire.com/news-release/2022/04/30/2433019/0/en/The-iLet-Bionic-Pancreas-Significantly-Reduced-HbA1c-and-Improved-Time-in-Range-vs-Standard-of-Care-for-a-Diverse-Range-of-People-with-Type-1-Diabetes.html XX Amazon.com's online pharmacy PillPack has agreed to pay almost 6-million dollars to resolve claims that it overcharged government health insurance programs by dispensing more insulin injector pens than patients needed. That's the headline, but -editorial here – this story just shows a lot about what's wrong with our system. Many of us have had this happen – used to be if you had a prescription for insulin pens, they'd just give you the box of 5 – even if the prescription was written for 3 or 4. Now, they have to break open the box and count out the exact amount. It's not as though a patient was over-charged.. and that's not the focus of this lawsuit. This was about government health insurance programs. I get it, we're all paying for that in our taxes, but there's got to be a better way. Maybe pass that co-pay cap, or let Medicare negotiate prices or just cap the price overall. Then this issue – and many others – goes away. https://www.reuters.com/legal/litigation/amazon-unit-pay-58-mln-insulin-overbilling-2022-05-02/ XX Walmart Health's telehealth company MeMD launched a virtual care diabetes program this past week. The initiative, known as the Walmart Health Virtual Care Diabetes Program, was developed for employers and payers as a standalone offering or as part of a comprehensive telehealth program. It's a partnership with the ADA and includes a consultation with a licensed medical provider to discuss patient history, eating habits and more. https://www.healthcareitnews.com/news/walmart-launches-telehealth-program-aimed-diabetes XX Right back to the news in a moment but first we've got a new sponsor. As I mentioned, The T1D Exchange Registry is an online research study, designed to harness the power of individuals with type 1 diabetes. It's a research study conducted online over time, designed to foster innovation and improve the lives of people with T1D. Personal information remains confidential and participation is fully voluntary. Once enrolled, participants will complete annual surveys and have the opportunity to sign up for other studies on specific topics related to T1D. By sharing opinions, experiences and data, patients can help advance meaningful T1D treatment, care and policy. Sign up at T1DExchange.org slash Stacey (that's S-T-A-C-E-Y). XX An Australian company joins the diabetes conversation on your Alexa device. Jade Diabetes says their My Jade skill can centralize logging, dose calculation and dose management. It can also suggest dose changes within 3 hours. They say “Jade is the only system to use accurate predictions to alert patients of future risks at a given time.” It uses info from CGMs, connected glucose meters, digital pens and data from Apple Health. https://www.businesswire.com/news/home/20220504005004/en/Jade-Diabetes-makes-Diabetes-Simpler-with-Alexa-Insulin-Dosing XX Really sad to hear that Healthline has decided to close down what I think has been just one of the best sources of Diabetes news & info.. Diabetesmine. It was started by Amy Tenderich after her diagnosis in 2003 and acquired by Healthline in 2013. I've had her and Managing Editor Mike Hoskins on the show many times. Amy's amazing other project – D-Data Exchange will live on. These are the bi-annual #DData forums connect experts, advocates and innovators developing data platforms, apps, algorithms and next-gen devices to take full advantage of data-driven diabetes care. You may recall the term We Are Not Waiting was coined at the first D-Data exchange – it's a cool place to be! The next one is coming up June 2nd, more info in the show notes. https://summer2022-ddata.eventbrite.com XX On this week's long format episode, you'll hear about the Mental Health Plus diabetes conference.. the organizers said every conference has one session on mental health – we really need more. So they did it. Love that! Next week, as I mentioned, Dexcom's Chief Technical Officer on the G7, some interesting new info.. and I asked him all of your questions. Listen wherever you get your podcasts That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.  

It's "In the News..." Got a few minutes? Get caught up! Our top stories this week include increased risk of  type 2 after having COVID-19, CGM gets high marks as a telehealth device, Ypsomed pump picks a new partner, more study on the TB vaccine for type 1 and T1D: The Movie update! -- Join us LIVE every Wednesday at 4:30pm ET 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! ----- Episode Transcription Below (or coming soon!) Please visit our Sponsors & Partners - they help make the show possible! *Click here to learn more about OMNIPOD* *Click here to learn more about DEXCOM* 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. we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast. XX The news is brought to you by The World's Worst Diabetes Mom: Real Life Stories of Parenting a Child With Type 1 Diabetes. Winner of best new non-fiction at the American Book Fest and named a Book Authority best parenting book. Available in paperback, eBook or audio book at amazon. XX People who recover from a mild case of COVID-19 appear to have an increased risk for subsequent new-onset type 2 diabetes… but not other types of diabetes. This is from a big new study in Germany. It lines up with previous studies of more seriously ill patients with COVID 19 who had increased rates of type 2 in the months following. This was more than 35-thousand patients – no prior history of diabetes. The risk of developing type 2 increased by 28-percent if the person had COVID, again even a mild case. The researchers say anyone who tested positive for COVID should be aware and get screened for diabetes in the months and years following. https://www.medscape.com/viewarticle/970600 XX Big new study that – interestingly – talks about the CGM as a telehealth device. It looked at how doctors continued to care for children with type 1 before and after the first year of the COVID pandemic. The use of CGMs increased significantly among those with non-commercial insurance… from 24 percent in 2019 to 35 percent by the end of 2020. Another finding in this same study.. those with higher A1Cs, racial minorities, and those with non-commercial insurance were more likely to have high rates of DKA. But the implementation of telehealth and CGMs increased parental oversight which resulted in better care at home and lower than expected hospitalization rates. I want to dig a little deeper here because a lower hospitalization rate during the first year of the COVID pandemic overall.. was found to be tied to a lot of fear about going to a hospital during that time. https://mhealthintelligence.com/news/telehealth-helped-maintain-type-1-diabetes-care-among-kids-during-pandemic XX Swiss pump maker Ypsomed announces the software they'll use for their automated insulin delivery. Ypsomed will partner with CamDiab's CamAPS app. The launch will start in select major countries in Europe, with other territories to follow over the course of 2022. This includes a hybrid closed loop – like Omnipod 5 and Control IQ - as well as smartphone control.. it's compatible with Dexcom's G6. It'll start on Android then roll out on iOS.. Ypsomed is partnering with Lilly to come to the US – we've had them on the show before talking about this. They hope to submit to the FDA this year. https://www.drugdeliverybusiness.com/ypsomed-partners-with-camdiab-on-smartphone-based-automated-insulin-delivery/ XX The FDA is due to make a decision on Teplizumab by August 17th. This is a drug that has been shown to delay type 1 diabetes. Last year the FDA turned down Provention Bio, asking for a resubmission with more information. The company is also running the phase 3 PROTECT trial of teplizumab. That's in newly-diagnosed type 1 diabetes patients. They hope to expanding the indications for the drug. https://pharmaphorum.com/news/fda-sets-august-decision-date-for-proventions-type-1-diabetes-drug/ XX More study underway into the tuberculosis vaccine as a treatment for type 1. This is Dr. Denise Faustman's lab – they're recruiting 150 teen with type 1 for pediatric clinical trials of the shots. Faustman's work is controversial because her studies have been very small and many experts say they don't show significant improvement. But Faustman says the vaccine appears to help patients with Type 1 diabetes by altering their immune system and that even though no one in her trials is off of insulin, there is improvement. https://www.bostonglobe.com/2022/03/21/metro/could-100-year-old-vaccine-treat-type-1-diabetes-mgh-researchers-are-working-find-out/ XX If you're watching live, today is the last day to back the Kickstarter for Type 1 The Movie. We talked about this on last week's podcast episode – Noah Averbach Katz is an actor who lives with type 1 and is making a movie where diabetes is front and center. Since Noah and his wife are on Star Trek Discovery, that community has jumped in to really amplify this. It's been great to see and he's well over his goal. If you're watching or hearing this after March 23rd, you can follow the link anyway to stay up to date on the project. I gave and I'm excited to see how it all turns out! https://www.kickstarter.com/projects/noahak/type-1?ref=thanks-tweet XX On this week's long format episode we're going on a deep dive about stem cell research with the folks at Viactye. They're working on two fronts now.. encapsulation AND gene editing with the people at CRISPR. Next week you'll hear from JDRF about the new non-profit insulin they've backed. Why will this effort from Civica RX be different? We'll talk about it. Listen wherever you get your podcasts That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

In the News... top stories this week: A second glucose-regulating molecule discovered, CGM use closer to diagnosis helps T1D kids, Lilly discontinues "Journey Awards," study on Dexcom use in hospitals, and why does this concept car share a diabetes tech name? -- 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! ----- Episode Transcription:  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. All sources linked up on our Facebook Page and at Diabetes-Connections 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. XX Our top story.. You know insulin helps regulate blood glucose. Now scientists have discovered a second molecule in the body that seems to do the same thing. It's produced by fat tissue but uses a different molecular pathway.. so it's hopeful this could get around insulin resistance. These scientists say the hormone, called F-G-F-1 suppresses breakdown of fat cells into free fatty acids and regulates the production of glucose in the liver. Because it does this in a different way from insulin, they're calling it a second loop. Very early here but very intriguing.   XX New study out of Stanford says setting children and teens up with a CGM shortly after a T1D diagnosis.. results in a lower A1C a year later. They looked at kids diagnosed in 2018 to 2020… and compared that group to other children diagnosed four years earlier. In that first group, about 90-percent started CGM in the first month.. in second group it was under 2-percent that started that early.  At diagnosis, the children in the newer cohort had higher A1c s. At 6 months and 12 months after diagnosis, the patients in the new cohort had significantly lower A1Cs than the other kids. These researchers say the news is more evidence to get insurers to cover the devices. https://healthier.stanfordchildrens.org/en/kids-early-use-of-diabetes-technology/ XX A new risk factor for type 2 mostly affects women, and it's in about 10-percent of the population. A new study says about one in 10 adults has a lump in their adrenal glands that, though otherwise harmless, increases production of certain hormones that increase the risk for Type 2 and high blood pressure. About 70% of those with them were women, most of whom were 50 years old or older. It's called mild autonomous cortisol secretion and these researchers say we should start screening for it. https://www.upi.com/Health_News/2022/01/03/adrenal-tumor-diabetes-blood-pressure-study/2471641237308/XX XX After almost 50 years of honoring people with diabetes with anniversary medals, Lilly Diabetes is phasing out the Journey Awards. Awards were given to patients for 10, 25, 50 and 75 years. A Lilly spokesperson confirmed the news to me today.. saying “We periodically need to re-assess and prioritize programs as the environment and our business shifts. We believe our decision will allow us to focus on programs that we hope bring the most value to people living with diabetes.” They encourage people to check out the Joslin Medalist program and I'll link that up. Joslin.org/research/our-research/medalist-program-study XX Movement on a couple of court cases involving insulin makers. Sanofi lost its appeals court bid to revive patents on Lantus. You'll recall that last year, Viatris got approval for Semglee, it's long-acting insulin, which is basically the same thing and is approved for the same indications as Lantus. Sanofi is facing an antitrust lawsuit accusing it of obtaining some 20 patents in an effort to delay competition. Viatris has been knocking out the patents in court. https://www.bloomberg.com/news/articles/2021-12-29/sanofi-loses-bid-to-revive-lantus-solostar-insulin-pen-patents XX A federal judge has pared down a class action lawsuit accusing the biggest insulin makers of racketeering. Novo Nordisk, Sanofi and Eli Lilly  are accused of scheming together to inflate prices. However, the US District Judge ruled that claims under the racketeering laws of several states (except for Arizona's) must be dismissed… because the laws do not allow claims by plaintiffs who bought the drugs through intermediaries, such as insurance companies, rather than from the drugmakers directly. The same judge did allow these RICO claims to proceed earlier this year in a separate class action against the companies brought by direct purchasers. https://www.reuters.com/legal/litigation/sanofi-lilly-escape-state-racketeering-charges-insulin-price-battle-2021-12-17/ XX New look at CGM accuracy in hospitals, mostly for people with type 2. This study looked at the Dexcom G6 and didn't measure how it influenced care, just whether the readings were accurate compared to finger sticks.  As you'd imagine, the readings were less accurate at the extreme highs and lows, but the researchers concluded CGM technology is a reliable tool for hospital use. The FDA allowed expanded Dexcom use in hospitals less than two years ago, so this is still very new. https://pubmed.ncbi.nlm.nih.gov/34099515/   XX Dexcom partners with another new company.. this one is called SNAQ.  Snaq is a diabetes app that is designed to track both your diet and your blood glucose… and can give you nutritional info of your food just by taking a photo with your smart phone. Good write up & review on that  from Diabetes Daily which I'll link up. Apparently, it works pretty well! The partnership means all US based SNAQ users can automatically view Dexcom CGM Data together with their meals inside the Snaq App https://www.diabetesdaily.com/blog/we-tried-the-snaq-diabetes-app-695058/   XX Hat tip to our friend Nerdabetic who spotted this ridiculous story. LG Electronics introduced a new in-vehicle infotainment concept tailored to autonomous vehicles. It's designed to blur the distinction between home and car .. This is a car cabin that can turn into a space where passengers work, watch TV, exercise or experience camping virtually. The name? LG Omnipod It was presented at the Consumer Electronics Show this week. No comment yet from Insulet, the makers of the Omnipod with which most of us are already familiar. http://www.koreaherald.com/view.php?ud=20220103000636 XX   Before I let you go, a reminder that the podcast this week is all about diabetes in media, a really deep dive into how representation on screen influences those watching. Listen wherever you get your podcasts or if you're listening to this as on a podcast app, just go back an episode. Next week's episode will be a little bit delayed.. released either very late Tuesday evening or early Wednesday morning. I'm set to talk to the CEO of Dexcom on Tuesday and I want to get that to you as soon as I can.. rather than hold it. So thanks for your patience on that. That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

Last time on the 3FUniverse, the show ended abruptly with the internet cutting out.  Nick found Chief again after the internet behaved.  Chief starts off by throwing out ideas for the podcast.  Will the 3FUniverse be the future home of a Career Field Manager All Call for the AFSC?  The Chief and Nick talk about lessons learned, and Nick reveals his anxieties about hosting and Chief reveals how harsh reading Facebook comments can be.  "You don't have to be Perfect to be amazing".  Chief teaches Nick this mantra and the two discuss Retired Chief Perkins and what it was like starting out as the 3F2 CFM.  Then the two discuss the legend of Nick showing up to the previous conference with a sleeping bag and no hotel room.  The pair talk about how important being connected and together at the conference is and brining that message back to everyones workcenters is.  Shoutouts to Gretchen Hanes, and Julie Tinsley! Will Chief even get to go to the conference?  Funding is an issue for Chiefs? Listen to find out!Sometimes both Chief and Nick miss being A1Cs, and they reminisce over the "good ole days" for a minute.  Chief then tells us her plans for retirement, mainly 6 months of not working is step one.  Step two?  You'll have to listen and hear for yourself!Later on, they breakdown what is important in the career field, 2096s, SoTs and the Air Force of post World War Two and beyond.  That guy in the corner with the cigars, ugh.  Finally, TFTR 2.0 is like MySpace?  Tom will be there with custom music for our training pages?PART THREE COMING SOON...after the holidays!As always, enjoy, and leave feedback for the show.HAPPY HOLIDAYS from the 3FU team!-Rate the show on Apple and Google podcasts, and hit up the 3FUniverse page on Facebook and interact with us!!! As always, like share, and subscribe to the show on Facebook and LinkedIn! Keep the conversation going:https://www.facebook.com/3FUniverse https://www.linkedin.com/company/3funiverse#innovation #leadership #connectedness #podcasting #3F2 #3FUniverse #TRNG #UTMNWO #culture #cultivatingculture #futureAirmen #vaccines #StrongOpinions #professionaldevelopment #authentic #success #AirForce #collaboration #opportunity #Running This podcast is hosted by Buzzsprout and is available on most major podcast providers.Disclaimer: The appearance of external links on this site doesn't constitute an official endorsement on behalf of the U.S. Air Force. The podcasts on this site are individually owned and don't necessarily represent Air Force positions, strategies or opinions.Be a ⭐️ of the

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.  

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.  

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.

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 media.relations@garmin.com, 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.

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.

It's In the News... the top diabetes stories of the past seven days! This week, what did lockdown mean for BG trends, Provention Bio keeps fighting for Teplizumab, the FTC shuts down diabetes schlockmeisters and if you're still using the Dexcom G5 - you need to hear this... Join Stacey live on Facebook each Wednesday at 4:30pm EDT to watch live. 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 and links 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.. What did COVID lockdown mean for blood sugar trends? A new study says when they had to stay at home, people with type 1 significantly improved while the opposite happened for those with type 2. You should know these studies all come from European countries with pretty strict lockdowns and they're an aggregate – a look at a bunch of previously conducted studies. With type 1, time in range improved significantly in 83% of the studies looked at here.. with type 2, almost half of the studies showed a clear decrease in blood sugar control, with higher A1Cs. So what happened? There's a lot of speculation but these researchers suggest less exercise and more snacking and more stress is to blame for the type 2 numbers..  although in my opinion the same could be said for all people with diabetes. They also suppose that the lockdown gave parents more time to look after kids with type 1 and gave young adults a more predictable routine. I hope another study is done on this in the US where, frankly – access to insulin & health care providers may have become more of an issue during the pandemic https://www.news-medical.net/news/20210913/COVID-19-lockdown-linked-to-improved-glycemic-control-in-type-1-diabetes.aspx XX Bit of an update - Provention Bio moving forward to answer the FDA's questions and hopefully resubmit. This is for Teplizumab the first drug shown to prevent type 1 diabetes for – so far- up to three years.. although the FDA turned it down in July. Provention says they continue to collect data and are moving to set up what's called a Formal Type A meeting to submit that new information. The company's CEO says they believe they're making significant progress to address the observations cited by the FDA and continue to work with urgency.   https://finance.yahoo.com/news/provention-bio-provides-potential-timing-113000253.html?soc_src=social-sh&soc_trk=tw&tsrc=twtr   XX Bunch of schlock-meisters got called out last week by the US FDA and FTC – that's the Federal Trade Commission. 10 companies got warning letters alleging they were selling illegal dietary supplements to cure or prevent diabetes. Regulators wrote the products cited in the warning letters are considered unapproved new drugs – they include things like turmeric, bitter melon, ginkgo biloba and more.. The report cites the increasing cost of insulin and other diabetes medications as a reason why people are turning to alternatives, even if they aren't proven.. Please.. be careful out there. https://www.naturalproductsinsider.com/supplements/regulators-target-diabetes-supplements-recent-warnings-about-claims   Quick additional FTC note – they held a virtual open meeting today. Two people from the diabetes community spoke about rising insulin prices. If you'd like to learn more I'll link up the information. https://www.ftc.gov/news-events/press-releases/2021/09/ftc-announces-tentative-agenda-september-15-open-commission XX We don't talk a lot about shots – multiple daily injections – but here's some good news about the basics. New study shows rotating sites and using smaller needles really do help. You've likely heard of LY-po-hy-PER-tro-fee.. it's when lumps of fat or scar tissue form under your skin. These Belgian researchers did a six month study where they provided smaller pen needles and did a lot of education, including an online platform where they taught proper injection techniques, including not re-using needles. They reduced what they called unexplained high blood glucose significantly and glucose variability decreased as well. A1Cs stayed about the same. https://onlinelibrary.wiley.com/doi/10.1111/dme.14672 XX No surprise but still disappointing –  insurance is what's dictating whether young children are more likely to use a CGM regularly. This was published in Diabetes Technology & Therapeutics. Those on public or government insurance often face more obstacles. This was a study of children ages 1-6 years, within two months of diagnosis. 82-percent used a CGM at least once during the study period.. but they divided everyone into 4 groups – always used CGM, stable use, inconsistent use or never used. Families with private insurance were more likely to be in the always group or the stable group than those with public insurance. And.. The “always” group had an A1C that was 1.3% lower than the “never” group https://www.healio.com/news/endocrinology/20210907/private-insurance-determines-cgm-use-by-young-children-with-type-1-diabetes XX More to come, including a Dexcom G5 update! 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… Heads up if you're still – somehow – using the Dexcom G5. More than a year ago, Dexcom stopped selling the G5 and G4.. but – and thanks to the listeners who brought this to my attention – the G5 app is now sending out a notification.. On October 4th the Dexcom G5 app will no longer be available. As they've shared with us on the podcast many times, they've been transitioning everyone over to the G6 and will soon move on to the G7. No timeline on that btw I know you're going to ask. But as far as we know, it hasn't been submitted to the FDA and Dexcom has said it will go for European approval first. -- And finally don't forget to send me your Dear Dr. Banting audio! What would you say to the man credited with the discovery of insulin? All the details and how to send it to me is in the show notes. -- Please join me wherever you get podcasts for our next episode - The episode out right now is all about the new Walmart Insulin.. will it save you money? That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.  

It's "In the News..." the top diabetes headlines of the past seven days. This week: Why is COVID more dangerous with diabetes? A new study says technology (like pumps and CGMs) doesn't help "Diabetes Distress," more screening recommended for "social risk" of type 2, bioartificial pancreas research and there's a T1D Superhero movie in the works! -- Links and transcript below 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   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.. type 2 diabetes has been identified for a while now as one of the main risk factors for severe COVID-19. New research from the University of Michigan says the culprit appears to be an enzyme called SETDB2, which is part of the reason why wounds don't heal well in some people with diabetes. Put very simply, as levels of this enzyme went down, inflammation during COVID went up. There is already a protein – Interferon – that is known to increase levels of this enzyme.. These researchers hope their findings will help in clinical trials of interferon or other treatments. They also say it's important to go through a patient's medical history to better target treatment for COVID. https://medicalxpress.com/news/2021-09-people-diabetes-severe-covid-.html XX Interesting study about young adults and what these researchers call Diabetes Distress. The study shows Distress – which they don't really define, but what sounds like depression or burnout or other mental health struggles – is associated with higher A1Cs. Not too much of a surprise, but they also found it doesn't matter if these young adults using insulin pumps or CGMs or just multiple daily injections. This Yale study was done by looking at past surveys of more than 400 people aged 18-29 in NY. They found that while users of insulin pumps and CGMs have overall lower A1Cs, the benefit of device use diminishes when high diabetes distress is present. https://www.healio.com/news/endocrinology/20210908/diabetes-distress-associated-with-higher-hba1c-for-young-adults-regardless-of-device-use XX Certain racial and ethnic minorities develop type 2 diabetes at a younger age than white Americans. That means , current diabetes screening and prevention practices for them may be inadequate and inequitable This Northwestern Medicine study says American adults are diagnosed with type 2 at an average age of 50, but for Black and Mexican American adults it's 4 to 7 years earlier. And more than 25% of that group report a diagnosis before turning 40. Recommended screening time is important not just for better health but because screenings are almost always only covered by insurance when the U.S. Preventive Services Task Force recommends them. If that sounds familiar, that's the group that recently announced new guidelines that lowered the recommended age from 40 to 35 to start screening adults who are overweight or obese for type 2 diabetes. Future research should consider whether even earlier screening is indicated among individuals with exposure to social risks, the study authors said. https://medicalxpress.com/news/2021-09-black-mexican-american-adults-diabetes.html XX Very early on but promising results for what's being called a bio- artificial pancreas. This is a tiny implantable device that holds insulin-secreting cells in a compartment protecting them from the body's autoimmune response. The micro-encapsulation device has the potential to be an autonomous system that would not require constant refilling and replacement of insulin cartridges, according to these researchers. The prototype has two separate chambers — one that collects nutrients from the device's surroundings, and one that houses the protected cells. Lots of work before this one's ready for clinical trials https://interestingengineering.com/a-bioartificial-pancreas-could-substantially-enhance-type-1-diabetes-treatment XX More to come, including news about a T1D superhero movie, 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— I was in Target this week and I saw the new Entrée bowls, I bought the Lemon Chicken and the Lasagna. The Lemon chicken was great! It uses hearts of palm pasta instead of regular noodles which I thought sounded odd but really tasted good. 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… And a Big boost for diabetes camps. Lilly Diabetes will commit nearly $1 million over the next three years in a joint effort with the Helmsley Charitable Trust to the Type 1 Diabetes Camps Initiative. The money is going specifically to non-profit diabetes camping organizations nationwide serving low-income youth living with T1D. and help diabetes camps adapt to the physical requirements of COVID-19 and better serve youth living with T1D via capital improvements. https://www.prnewswire.com/news-releases/lilly-diabetes-joins-the-leona-m-and-harry-b-helmsley-charitable-trust-to-pledge-significant-funding-to-type-1-diabetes-camps-initiative-301368797.html XX A new movie with a superhero who lives with type 1 is coming to theaters next summer. Called “Gum-she: The Type 1 Protector,” it's created by Jermaine Hargrove, diagnosed with type one 15 years ago as an adult. The main character Justice Johnson has diabetes but it's not the cause of her superpower. That comes from the bubble gum she's always chewing and she's able to shoot gum from her palms to help her save the world. The American Diabetes Association is partnering on the film and  promoting it.. one of the big themes is health equity.. There is a great article in diabetes mine all about this, I'll link that up. In it, Hargrove says Bubble gum brings everyone together. Like music: it's everywhere.” I'm excited about this – but I have to say – if this had come out when my kids were little – I would be hiding all of the bubble gum. If you watch the teaser trailer – she is shooting bubble gum everywhere! Using it to create bridges and running around like spider man. So.. it looks really cute but knowing my kids? Again.. I'd have to hide the gum. Watch for the trailer on world diabetes day – nov 14. The full film will be released next summer. https://www.healthline.com/diabetesmine/a-new-diabetes-superhero-movie-you-wont-want-to-miss https://gumshe.com/ XX Please join me wherever you get podcasts for our next episode - The episode out right now is with Ethan Orr – the Colorado high school swimmer removed from his meet because of his the medical tape over his CGM. And send me your Dear Dr. Banting audio! What would you say to the man credited with the discovery of insulin? All the details and how to send it to me is in the show notes. That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.  

It's In the News - the only weekly diabetes newscast! This week's headlines include: Lawsuit against insulin makers moves ahead Mixed news for Teplizumab Peep the pump at Pixar Antacids to help type 2? #T1D up K2 Join Stacey live on Facebook to watch 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 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 when you have the time. XX In the News is brought to you by Inside the Breakthrough. A new history of science podcast full of “Did You Know… Stuff” XX The top story this week.. one step forward, one step back on a lawsuit involving all three insulin makers. A federal judge dropped anti-trust claims – but the case will move forward under federal racketeering laws. That means Eli Lilly, Novo Nordisk and Sanofi face organized crime charges. The Judge says the plaintiffs plausibly alleged schemes of unlawful bribery and mail and wire fraud. The other defendants in this case are pharmacy benefit managers Express Scripts, CVS Health, and UnitedHealth. Lilly, Novo Nordisk, and Sanofi are accused in the lawsuit of inflating the official list price of insulin while the actual prices negotiated by pharmacy benefit managers remained flat due to massive rebates from drug companies. https://news.bloomberglaw.com/pharma-and-life-sciences/sanofi-novo-insulin-price-suit-advances-with-trimmed-claims XX In a separate development, Lilly announced they have spent one billion dollars on Protomer Technologies – a company who's been working on what they call smart insulin. These proteins that can sense concentrations of specific molecules and adjust to create variable doses. This pipeline includes an insulin product that adjusts to different glucose levels in diabetic patients. In 2020 Lilly led an investment round that gave them 14% of the company. This deal gives them the rest. We've heard about glucose-responsive insulin for a while now, JDRF has funded a lot of the research. A spokesperson says this significant milestone brings the promise of the game changing technology one step closer to the clinic. https://www.biospace.com/article/lilly-buys-protomer-for-1-billion-plus-for-next-generation-insulin-products/ XX Mixed news for Provention, the makers of teplizumab. The US FDA says no to the drug shown to delay type 1 diabetes in those most at risk. It made it through an FDA advisory panel earlier this year, but the full FDA issued what's called a Complete Response Letter or CRL which means they've completed the review and won't approve in its current form. However, earlier this week, the company got good news from the UK. Teplizumab was awarded an Innovation Passport – a new designation that is meant to fast track investigational medicines through the regulatory process there. https://www.fiercebiotech.com/biotech/provention-bio-slapped-fda-rejection-for-diabetes-hopeful-teplizumab https://finance.yahoo.com/news/teplizumab-awarded-innovation-passport-united-110000773.html XX An Australian study shows good outcomes with closed loop therapy for older adults with long time type 1. This study looked at 30 healthy adults aged 60 and older who'd previously used an insulin pump. They used the Medtronic 670G either in manual or auto mode for four months at a time then switched to the other mode for another 4 months. They all spent more time in range when in the closed loop stage.. and biggest benefit was seen overnight. Less hypoglycemia was a big benefit for this group. These researchers say they want people to know that older age is not a barrier to closed-loop therapy and closed-loop has important clinical benefits Bit of an editorial here: I would not call the 670G or really any current commercial pump offering a closed loop. To me, if you're still bolusing for meals, that's a hybrid closed loop or partial loop, but potato potahto perhaps. https://www.healio.com/news/endocrinology/20210706/closedloop-system-improves-cgm-metrics-for-older-adults-with-type-1-diabetes XX Pixar released the teaser for it's next movie.. Turning Red and eagle eyed members of the DOC spotted what looks like a CGM and a purple insulin pump – maybe an older model Medtronic? I heard from a source at Pixar with type 1 who says this was absolutely on purpose It is definitely intentional to include better representation of the real world, whether it is wheelchair users, crutches, pumps/cgms, hearing aids, and more…  This initiative is largely credited to our characters art and crowds departments. I'm working with the Pixar PR folks and hope to have more info and an interview as the movie is closer to release. XX A class of drugs widely used to treat heartburn and stomach ulcers, improve blood sugar in patients with diabetes when added to their usual treatment. These drugs are known as proton pump inhibitors – they include Prilosec and omeprazole. They suppress acid and affect certain hormones that are important in glucose regulation. They did not prevent diabetes.. but these researchers say if somebody is already on a PPI and they are doing well, it might also be helpful for their diabetes. Those with higher A1Cs benefited the most. https://www.webmd.com/diabetes/news/20210702/antacids-aid-blood-sugar-control-in-people-with-diabetes XX More to come, but first, I want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Inside the Breakthrough is a podcast that mixes historical wisdom with modern insight – it's a science show that's also entertaining. I love it. They cover everything from accidental discoveries to famous names in science to old myths hand washing to and even a horse poop crisis in New York City – luckily averted. And this all actually relates to diabetes! Listen to Inside the Breakthrough wherever you listen to podcasts.. Back to the news… XX A new attempt to climb K2 – the second highest mountain on earth - something accomplished by only one person with type 1 diabetes before. Right now, Jerry Gore – diagnosed as an adult - is acclimating at base camp. Gore is 60 years old and has been climbing for 40 years. He hopes to raise money for his charity, Action4Diabetes, which provides healthcare and support to disadvantaged young people with Type 1 diabetes in South East Asia. https://www.justgiving.com/fundraising/jerry-gorek2?experiments=b2c_059_donate_to_yourself_v3&successType=StaticDonateButtonClick?utm_source=twitter&utm_medium=socpledgemobile&utm_content=jerry-gorek2?experiments=b2c_059_donate_to_yourself_v3&successType=StaticDonateButtonClick&utm_campaign=post-pledge-mobile&utm_term=MdnpGx3vR XX Congrats to Sebastien Sasseville who just biked across Canada in 15 days. We told you about this trip when he kicked off two weeks ago.. I don't think anyone expected the weather to do what it did – Canada broke several heat records – and there were storms and wind. Sasseville lives with type 1, he did this to raise awareness for access to technology. He's climbed Everest and has completed several grueling extreme races & posted on his Instagram: “This was the hardest thing I have ever done, and could not have done it without the crew. They kept me safe and alive, I will be forever grateful. We did it boys!!! Chase life experiences and create memories with people you love. That is my best advice for a fulfilled life.” Congratulations to Sebastien and crew! XX That's Diabetes Connections – In the News.  If you like it, share it. And feel free to send me your news tips. Stacey @ diabetes dash connections dot com. Please join me wherever you get podcasts for our next episode -Tuesday –  a conversation with just a great guy.. he's 81 and he's lived with type 1 for more than 62 years. Thanks and I'll see you soon

It's "In the News..." the only LIVE diabetes newscast! Top stories this week: Walmart private label insulin, Omnipod 5 pediatric study, Afrezza pediatric study, Stem cell updates, A new extreme challenge for a T1D ultra-athlete Join Stacey live each Wednesday at 4:30pm EDT at the Diabetes Connections Facebook page 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 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 when you have the time. XX In the News is brought to you by Inside the Breakthrough. A new history of science podcast full of “Did You Know… Stuff” XX The top story this week - Walmart launches the first-ever and only private brand analog insulin at a discount off the list price. This new brand ReliOn Novolog will have vials priced at $72 and a package of pens at $85 – compared to the list price of $289 and $558 respectively Walmart worked directly with Novo Nordisk for the manufacturing of this insulin which will be in regular stores this week and in Sam's Club locations in mid-July. Interestingly, this price is not below the one offered already by using coupons from groups like GoodRX or even the insulin manufacturers assistance programs. If you need help paying for your insulin, I'll link up more info on that as well. https://finance.yahoo.com/news/walmart-launches-private-label-insulin-at-discount-122021367.html?ncid=twitter_yfsocialtw_l1gbd0noiom https://www.goodrx.com/novolog XX As expected, loads of info and studies from the ADA scientific sessions virtual conference that just wrapped up. Please check the links I'll include because these are just highlights. XX Insulet is out with the results of their latest pivotal trial for the Omnipod 5 Automated Insulin Delivery System in very young children. The system improved time in range and reduced A1C in children 2 through just under six. I can tell you from experience, this is a tough age group for many reasons, including the fact that they can't self-treat or really tell you what's going on. Parents and caregivers reported significantly improved sleep quality Another Omipod 5 study with people aged 6 through 70 showed similar improvements. The system is awaiting FDA approval. XX ViaCyte, Inc. released preliminary clinical data from its stem cell-derived islet cell replacement therapy for people with type 1 diabetes. They show the implanted pancreatic cells produced their own insulin – which increase glucose-responsive C-peptide levels, increased time in range, and reduced A1C. This method protects the stem cells in a pouch – that's put very simply – Viactye is working on several different methods toward a functional cure. https://www.prnewswire.com/news-releases/viacyte-reports-compelling-preliminary-clinical-data-from-islet-cell-replacement-therapy-for-patients-with-type-1-diabetes-301320084.html XX Another company on the same track.. Sernova Corp also showing their  Cell Pouch transplanted with insulin-producing islets is safe and effective. One patient has finished the trial and has now remained insulin independent – that means no requirement for injectable insulin - for 14 months with optimal glucose control. This is a person who's lived with type 1 for 47 years.. https://www.thenewswire.com/press-releases/1k3wFKYMv-sernovas-principal-investigator-presents-interim-data-and-positive-patient-outcomes-of-phase-i-ii-t1d-study-at-the-american-diabetes-association-81st-scientific-sessions.html XX More from ADA conference - In two small studies, the ultra-rapid acting insulin Afrezza was found to be safe in children with type 1 and adults with type 2 diabetes. Inhalable insulin is currently only approved for adults so the goal here was to look at safety.. which looks good. But it's also worth noting that . Time in Range increased from 39% at baseline to 62% which is more than four additional hours spent in range each day! https://diatribe.org/top-highlights-day-1-ada-scientific-sessions-2021 XX New info in on Medtronic's Extended-Wear Infusion Set. This is the pump inset that lasts seven days. This study shows that 75% of the time it makes it to the full seven days – Medtronic's 3 day infusion sets have a 67% survival rate. Device failure rates were very low – 8 cases out of more than 3-thousand sessions. Satisfaction was high – with people citing convenience of use, ease of insertion, and comfort of wear. This extended wear set is approved in Europe, available in Finland and has been submitted to the US FDA. https://diatribe.org/day-2-3-highlights-ada-scientific-sessions-2021   XX More to come, including news on Control IQ and an endurance athlete starts an amazing new trek.. but first, I want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Inside the Breakthrough is a podcast that mixes historical wisdom with modern insight – it's a science show that's also entertaining. I love it. They cover everything from snake oil to the actual Eureka moment. There's even an episode about the guy who discovered the importance of hand washing in hospitals and how no one believed him. And this all actually relates to diabetes! Listen to Inside the Breakthrough wherever you listen to podcasts.. Back to the news… XX Control-IQ continues to get high marks. This study looked at adults with an average age of 70 who already had A1Cs around 6.9. Three months after staring Control IQ, time in range increased from 64% to 87% which is 5 and a half hours more each day.  All of these adults had prior experience with continuous glucose monitoring and insulin pumps. XX Former guest of the podcast, Sébastien Sasseville, is off on a mission to cycle across Canada in 14 days! Sasseville is a Canadian endurance athlete – he lives with type 1 -  and it's going to take about 250 miles a day to get to this goal. Sasseville says he's riding to bring attention to the issue of access to technology – he uses the tslim x2 and Dexcom G6 – and to support JDRF Canada's Access for All campaign. He set off on June 28th and is documenting the journey on social media.   Sebastien Sasseville cycles across Canada: https://www.facebook.com/CanadaRuns.   That's Diabetes Connections – In the News.  If you like it, share it. And feel free to send me your news tips. Stacey @ diabetes dash connections dot com. Please join me wherever you get podcasts for our next episode -Tuesday –  a conversation with Dexcom's CEO all about the upcoming G7.. I asked him all of your questions. Our current episode out right now is with Nick Jonas – sharing his thoughts on the new campaign to educate about Time in Range and talking about he manages his T1D during concerts, shooting movies and during TV tapings. Thanks and I'll see you soon

Here's the context, friends: As you may have noticed over the past few episodes, we have been digging into value-based care here at Relentless Health Value corporate work-from-home headquarters. Many lessons have been learned, and it's important that we sit back and think hard every now and then about how we are going to use these learnings to improve. While this show tackles the Hospital Readmissions Reduction Program (HRRP)—and wow, I was glued to my seat during this interview—the show is really about more than that, which I'll get into in 30 seconds. But let's start here: HRRP was originally part of the Affordable Care Act in 2010. In 2012, HRRP began imposing penalties on hospitals with higher-than-expected 30-day readmission rates for three conditions: heart failure, myocardial infarction, and pneumonia. Spoiler alert: More recently, CABG, THA/TKA, and COPD were added to the list. So basically, if a patient is in the hospital for any of these six things and then is readmitted to the hospital for any reason within 30 days, penalties can happen. Today's guest is Rishi Wadhera, MD, MPP. Dr. Wadhera authored a retrospective analysis in the BMJ about the HRRP, which we will talk about in this health care podcast. His findings are fascinating and relevant on a number of levels.  Dr. Wadhera is a cardiologist at Beth Israel Deaconess Medical Center. He also has a master's in public policy at the Harvard Kennedy School of Government and also a master's in public health from the University of Cambridge. Dr. Wadhera works on policy at the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology.  But here's the larger epiphany that pertains to all value-based care and all quality metrics which Dr. Wadhera brings up in this health care podcast and which my nerd heart could not love more: Goodhart's Law. This law is the root of so very many problems. Goodhart's Law is this (which I learned from Dr. Wadhera): “When a measure becomes a target, it ceases to be a good measure.” In other words, when we set a goal, people will try to take a shortcut to the goal, regardless of the consequences. And sometimes the consequences, paradoxically, are to do worse at the goal. For example, teaching to the test may not actually lead to students who deeply understand a subject. Here's another example, and Rebecca Etz, PhD, talks about this in EP295: If you want PCPs to do an amazing job managing diabetes, for example, the best measures are ones that quantify the doctor's relationship with the patient and the amount of trust between them. The second you start using their panel's average A1C as the performance metric, A1Cs at best don't improve. Why? Bean counters and admins and maybe even goal-oriented clinicians themselves will go right to the end goal, inadvertently skipping a whole bunch of (it turns out) rate-critical steps. It doesn't go well. It's like salespeople who try to close before they build a relationship. Time to goal counterintuitively is slower, and performance is poorer. Anyone building value-based care or quality programs might really want to include Goodhart's Law in their thinking. And anyone trying to achieve value-based care success, improve quality, form collaborations, or make sales might want to remember that old proverb, “Sometimes the shortest way home is the long way around.” You can learn more at Dr. Rishi's Harvard Catalyst profile and the Beth Israel Deaconess Medical Center Web site. Rishi K. Wadhera, MD, MPP, MPhil, is an assistant professor of medicine at Harvard Medical School, a cardiologist at Beth Israel Deaconess Medical Center (BIDMC), and the associate program director of the cardiovascular medicine fellowship at BIDMC. He is also health policy and equity researcher at the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology. Dr. Wadhera received his MD from the Mayo Clinic School of Medicine as well as an MPhil in public health as a Gates Cambridge Scholar from the University of Cambridge. He completed his internal medicine residency and cardiovascular medicine fellowship at Brigham and Women's Hospital in Boston. During this time, he also received a master's in public policy (MPP) at the Harvard Kennedy School of Government, with a focus on health policy. Dr. Wadhera's research spans questions related to health care access, quality, and disparities, as well as understanding how local, state, and national policy initiatives impact care delivery, health equity, and outcomes. Dr. Wadhera has published more than 80 articles to date, and he receives research support from the National Heart, Lung, and Blood Institute (NHLBI) and the National Institutes of Health (NIH). 03:10 What was the Hospital Readmissions Reduction Program intended to do? 05:05 Why did the Centers for Medicare & Medicaid (CMS) think some readmissions were preventable? 05:46 “The spirit of the Hospital Readmissions Reduction Program was to incentivize hospitals to improve … discharge planning, transitions of care, and post-discharge follow-up and care.” 06:54 How has research in the last few years changed the thoughts on the effectiveness of the Hospital Readmissions Reduction Program? 08:14 “The 30-day readmission measure—it's an incomplete measure.” 12:12 “I think patients … are smart, and they know what's going on.” 14:01 “What's happening is, we're just increasing the number of times they need to come back to the ER within that 30-day period.” 14:22 “The weird thing about the HRRP is that when it evaluates hospitals' 30-day readmission rates, it's a yes-no phenomenon.” 15:30 “What CMS does is, it risk adjusts … and that is what we should be doing.” 19:16 “This program has been incredibly regressive.” 19:51 “Poverty, neighborhood disadvantage, housing instability—these factors are out of hospitals' control.” 22:56 “Blunt policies like this that are rolled out nationally probably elicit mixed behavioral responses.” 23:12 “It just makes no sense to take resources away from hospitals.” 25:22 What's the way to improve quality of care globally? 27:19 “CMS's approach to improving quality of care has really anchored … [that] to payment.” 27:49 “It's time for us to rethink what our approach to quality improvement should be.” 31:28 “Policy makers have an obligation to rigorously test the impact of these types of policies before they roll them out nationally.” 34:05 Can you scale health care nationally? You can learn more at Dr. Rishi's Harvard Catalyst profile and the Beth Israel Deaconess Medical Center Web site. @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission What was the Hospital Readmissions Reduction Program intended to do? @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission Why did CMS think some readmissions were preventable? @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “The spirit of the Hospital Readmissions Reduction Program was to incentivize hospitals to improve … discharge planning, transitions of care, and post-discharge follow-up and care.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission How has research in the last few years changed the thoughts on the effectiveness of the Hospital Readmissions Reduction Program? @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “The 30-day readmission measure—it's an incomplete measure.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “What CMS does is, it risk adjusts … and that is what we should be doing.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “Blunt policies like this that are rolled out nationally probably elicit mixed behavioral responses.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “It just makes no sense to take resources away from hospitals.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission What's the way to improve quality of care globally? @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “It's time for us to rethink what our approach to quality improvement should be.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission Can you scale health care nationally? @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission

It's "In the News..." the only LIVE diabetes newscast! Top stories this week: -Apple drops a BG hint in the latest watch update -New info about Dexcom's G7 -Omnipod 5 study released -Diabetes drug shows promise for weight loss -Power of peer support Join Stacey live each Wednesday at 4:30pm EDT 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 Transcription below:    Hello and welcome to Diabetes Connections In the News! I'm so glad you're here! I'm Stacey Simms and each week I'll share the top diabetes stories and headlines of the past seven days.  Whether you're joining me live on Facebook or watching or listening after, I'm here to get you up to speed quickly on what's happening with diabetes technology, research, and our community. Since these are headlines and summaries, as always, you'll find all the sources and links in the Facebook comments and in the show notes at d-c dot com. XX In the News is brought to you by Inside the Breakthrough. A new history of science podcast full of “Did You Know Stuff” XX here's what's In The News this week… Couple of buzzy slides from Apple's World Wide Developer's Conference. First, this one from their WatchOS 8 update.. they didn't use the words blood glucose.. but this slide was shown featuring the graphic “blood glucose highlights.” That likely means pulling the data from existing apps like Dexcom or Dario or One Drop, but there are always rumors about Apple releasing a glucose sensor of their own.  We shall see – thanks to Nerdabetic for bringing this to our attention. Another diabetes shout out in this slide - same presentation - about time sensitive notifications. If you look closely you can see the Happy Bob app, which puts funny messages along with glucose notifications. XX Lots of news out of the recent Advanced Technology and Treatments in Diabetes Conference or ATTD. Dexcom showed this slide about their upcoming G7.  We've reported on this a lot over the last two years, I'll link up our previous episodes. but the new info includes: a 30 minute warm up time as opposed to 2 hours right now, and direct to watch capability. Direct to watch from Dexcom – that means you don't need your phone to see your BG on the watch face anymore - was first announced in June of 2017 with the G5 and that proved more difficult to implement than expected. I'm talking to Dexcom for the podcast later this month so we'll get a update on what this really means. The G7 is a smaller, all in one with sensor and transmitter applied together. It's NOT FDA approved yet so there's no timeline for release. Also, Dexcom put out a study that says people with type 2 who use basal insulin benefit from the use of CGM. The Mobile study took place over eight months. Those who used the CGM increase time in range and showed a full point drop in A1Cs on average. https://twitter.com/ATTDconf/status/1401200753717432328 New data presented on Omnipod 5.. this is just an abstract – full study will be released later this month. This is Insulet's hybrid closed loop system where it works with the Dexcom to keep a user within a targeted blood sugar range. They looked at children and adults ages 6-70 to measure safety of this new system. A1Cs came down, time in range went up, very low occurrence of hypoglycemia and researchers concluded it was safe. The Omnipod 5 operates in two modes, an automated mode and a manual mode. The system provides automatic insulin delivery with customizable glucose targets from 110 to 150, which can be adjusted by time of day. Omnipod 5 with Horizon is in front of the FDA right now so there's no timeline on release.   https://care.diabetesjournals.org/content/early/2021/05/21/dc21-0172   Also at ATTD - DarioHealth looking at outcomes from their highly personalized apps and system. Dario's study found that personalizing the clinical interventions in response to unique individual actions really helps. That's opposed to systems with more generalized predictions. This study showed more frequency in blood sugar testing and monitoring in those who received an personalized intervention. https://www.prnewswire.com/il/news-releases/dariohealth-releases-study-demonstrating-the-impact-of-personalized-digital-interventions-to-improve-self-management-of-diabetes-301305650.html XX Early on here but a new closed loop system that knows when you're eating is being tested – this was a small trial in adolescents and young adults. This is out of UVA – the same place that developed what became Tandem's Control IQ. The researchers say teenagers are particularly prone to skipping meal boluses. This system, known right now as Rocket AP contains an Artificial intelligence bolus priming system that uses CGM to basically decide if you've eaten without bolusing. If it thinks you have, it will automatically dose. The median time in range after a bolused meal was 100% with the Rocket AP system and 93% with the control system, but was a corresponding 83% versus 53% after a meal without a bolus. Again, that's 83% time in range when you completely forget your meal bolus. Bears watching. https://www.medwirenews.com/diabetes/ai-fully-closed-loop-insulin-delivery-type-1-diabetes/19231866 XX Up next.. a diabetes drug is approved for weight loss but first.. quick break – want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Inside the Breakthrough is a podcast that mixes historical wisdom with modern insight – it's a science show that's also entertaining. I love it. The latest episode talks about scientists who knew they were onto something but needed to see things with their own eyes. How actually seeing something like a Kraken? Makes a huge difference. It also meant a name change for what some thought had only been a myth. And this actually relates to diabetes! Listen to Inside the Breakthrough wherever you listen to podcasts.. Back to the news…   The FDA has approved the medication Wegovy (wee-GOH-vee), a higher dose of the diabetes drug semaglutide (semuh-GLU-tide), to be used as a weight management drug in patients with obesity. It's the first drug for chronic weight management that has been approved by the FDA since 2014. It is injected under the skin once a week. People in the study lost an average of 12 percent of their body weight. People with type 2 diabetes lost 6 percent of their body weight. No reason given for the difference and there are some – intestinal side effects – but Wegovy is said to be safer than older weight loss drugs. https://www.healthline.com/health-news/fda-approves-popular-diabetes-medication-for-use-as-weight-loss-drug   XX The power of peer support was shown at ATTD in a presentation by Kelly Close and Diatribe. Their survey showed engagement in the diabetes online community didn't just make people feel better emotionally, which is great, but it also predicted better glycemic outcomes.. those most involved in the community increased their chance of having an A1C under 7. That's Diabetes Connections – In the News.  If you like it, share it. And feel free to send me your news tips. Stacey @ diabetes dash connections dot com. Please join me wherever you get podcasts for our next episode -Tuesday – we're talking to the folks from Beta Bionics for the first time in a long time to get an update on the iLet pump. And the episode that's out right now is all about what college students want you to know. Thanks and I'll see you soon

It's "In the News..." the only LIVE diabetes newscast! Give us five minutes and we'll tell you about: European approval for Medtronic's new no-calibration sensor FDA considers a drug to prevent T1D New info about gestational diabetes A potential type 1 vaccine moves forward Telehealth update (and what's next after COVID) Join Stacey live on Facebook every Wednesday and watch "In the News..." Live! 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 transcription and links below:    May 26, 2021 FB LIVE: Starting soon slide Hi, and welcome to Diabetes Connections In the News! A short weekly newscast full of the top diabetes stories and headlines of the past week. I’m Stacey Simms & whether you’re joining me live on Facebook or watching or listening after, I’m here to get you up to speed quickly XX In the News is brought to you by Inside the Breakthrough. A new history of science podcast full of “Did You Know Stuff” In The News this week.. XX Bit of breaking technology news today as Medtronic gets European approval for its Guardian 4 sensor. This is their newest sensor which requires no fingersticks for calibration or diabetes treatment decisions. Medtronic says they’ll start integrating this sensor into the 780G pump and InPen offerings in the fall. No word on a timeline for US approval for the Guardian 4 sensor. MedT Guardian 4: https://investorrelations.medtronic.com/news-releases/news-release-details/medtronic-secures-two-ce-mark-approvals-guardian-4-sensor-inpen XX   FDA advisory committee may give more information and feedback on the first treatment to delay or even prevent type 1 diabetes as early as tomorrow. They’ll decide if Teplizumab is safe and effective. This is not full FDA approval, but it’s another step toward releasing what is an IV drug, given as a single 14-day course of infusions. If you’ve heard us about the TrialNet studies on this on the podcast over the last few years.. that’s what most of the evidence is coming from. Their studies showed a relative 59% reduction in risk for developing T1D and a delay of diagnosis of 2 to 3 years. https://www.medpagetoday.com/endocrinology/type1diabetes/92784 XX Another new treatment for type 1 diabetes moves into clinical studies.. this is a vaccine that looks like it prevents the destruction of insulin producing cells in the pancreas. DiabetesMine has an excellent report on this and we’ll link that up here so you can read the whole thing. But the Swedish biotech company Diamyd has been working on this immunotherapy vaccine for two decades, including a study where they injected it into the lymph nodes of the study participants. Their large-scale Phase III trials will start this year in Europe and the US and will include more than 300 children and young adults recently diagnosed with T1D. Diamyd vaccine: https://www.healthline.com/diabetesmine/diamyd-type1-diabetes-vaccine XX A new long term study shows that women diagnosed with gestational diabetes are more prone to type 2 and type 1 diabetes later in life. It’s been known for some time that gestational diabetes is linked to the risk of type 2.. but these researchers say auto-antibody testing should be considered in order to have a better understanding of all the risks In this study, 50% of women who experience gestational diabetes go on to develop type-2 diabetes later in life and almost six percent developed type-1 diabetes. This 23 year long study was presented at the European Congress of Endocrinology   Gestational diabetes increases risk for T2 and T1 https://www.eurekalert.org/pub_releases/2021-05/esoe-als051921.php More info to back up what a lot of patients have been saying for a long time. If an endocrinologist  is negative or belittling, people stop listening to them and even stop going for check ups and prescriptions. University of Florida Diabetes Institute polled their minority communities recently and found that the main challenge is support from their endo. Or lack of support These researchers looked at people who missed two or more endocrinology appointments, have experienced diabetes-related complications in the past year and receive primary care at a federally qualified health center. The study found when people from minority or low-income groups report negative and belittling interactions with their endocrinologist, they stop going to appointments. These researchers say they want to look at implicit bias in care and do something about it.     Endo attitudes: https://www.wcjb.com/2021/05/21/university-of-florida-study-uncovers-equity-disparity-within-type-1-diabetes-community/ Telemedicine – no surprise – skyrocketed for people with type 1. From less than 1% before the COVID-19 pandemic to about 95% in April 2020, according to study data. In March 2020, clinics in the T1D Exchange Quality Improvement Collaborative began attending virtual meetings to share progress and best practices with the shift to telemedicine. Researchers collected the monthly number of type 1 diabetes visits and HbA1c values collected from a subset of 11 pediatric clinics and two adult clinics from December 2019 to August 2020.   The researchers noted the proportion of telemedicine visits varied widely at each clinic. About 62% of clinics performed both video and phone visits. Zoom was the most popular platform, used by 62% of centers. More than 95% of clinics also used CareLink, t:connect, Clarity or Glooko to view diabetes data remotely. Most centers had diabetes educators, registered dietitians and social workers participating in telemedicine. However, only 15% of clinics said a psychologist participated in telemedicine. All clinics provided continuous glucose monitor training through telemedicine and 70% provided insulin pump training.   Telemedicine https://www.healio.com/news/endocrinology/20210521/telemedicine-visits-rapidly-increase-at-type-1-diabetes-clinics-during-covid19-pandemic but first.. quick break – want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Inside the Breakthrough is a podcast that mixes historical wisdom with modern insight – it’s a science show that’s also entertaining. I love it. The latest episode talks about when a belief thought to be settled science turns out to be wrong. And to illustrate that point they talk about the horse poop crisis of New York City. It was real and it resolved in a way no one expected. Listen to Inside the Breakthrough wherever you listen to podcasts..  Can a game – with competition – really help people live a more healthy lifestyle? A one year trial with people with type 2 diabetes tracks steps and game elements such as points and levels. Some also received social support from a family member or friend. A third group just got the tracking device. Everyone in the study lost weight and lowered their A1Cs but those who didn’t play the game took fewer steps and tracked less activity overall. A lot of gamified apps have come and gone in the diabetes space.. these researchers say the competitive aspect may be the key. Game study for T2 https://www.mobihealthnews.com/news/gamification-step-count-leads-more-activity-diabetes-focused-study That’s Diabetes Connections – In the News.  If you like it, share it. And feel free to send me your news tips. Stacey @ diabetes dash connections dot com. Please join me wherever you get podcasts for our next episode -Tuesday – we’re talking to the folks from Banting House, the birthplace of insulin. Thanks and I’ll see you then!

: Episode 1844 – On this Monday show, Anna Vocino and Vinnie Tortorich talk their generations, the obesity epidemic, oral health, cholesterol and A1Cs, and more. Https://www.vinnietortorich.com/2021/05/the-obesity-epidemic-oral-health-episode-1844 PLEASE SUPPORT OUR SPONSORS WATCH THIS EPISODE ON YOUTUBE THE OBESITY EPIDEMIC It is fully here. Vinnie was recently at the busiest airport in the country, and most people were overweight. It's no longer people who have ten or fifteen pounds to lose, they are very overweight. The pandemic exacerbate weight gain for a lot of people. Vinnie is angry because good intentions have been stolen and health care cannot keep up. Instead, the health care system medicates people into sick rather than super sick when eating well could get you out of sick entirely. ORAL HEALTH For lots of people, eating well can help your oral health. This way of eating may result in whiter teeth (even if you drink water) and much healthier gums. Anna's oral hygienist didn't believe how good her gums look since she started eating this way. Gum disease is an inflammatory disease, so this makes a lot of sense. FAT DOC 2 IS AVAILABLE ON iTUNES and AMAZON Please also share it with family and friends! Buy it and watch it now on iTunes to get it to the top of the charts. We need it to get big for people to see it. Here's the (BLUERAY, DVD, PRIME) (MAY NOT BE AVAILABLE YET ACROSS THE POND). And the And the https://amzn.to/3rxHuB9 [the_ad id="17480"] PLEASE DON'T FORGET TO REVIEW the film AFTER YOU WATCH!   FAT DOC 1 IS ALSO OUT Go watch it now! We need people to buy and review for it to stay at the top of iTunes pages. Available for both rental and purchase. You can also buy hardcopy or watch online at Amazon. YOU CAN NOW STREAM FOR FREE ON AMAZON PRIME IF YOU HAVE IT! RESOURCES Https://www.vinnietortorich.com Https://www.purevitaminclub.com Https://www.purevitaminclub.co.uk Https://www.purecoffeeclub.com Https://www.nsngfoods.com Https://www.bit.ly/fatdocumentary https://www.belcampo.com https://www.villacappelli.com    

Host: Carol Wysham, MD Guest: Irl Hirsch, MD, MACP Why was there so much discordance between some patients’ GMI and their measured A1C? That’s the exact question Dr. Irl Hirsch from the University of Washington School of Medicine asked and explored in a paper he recently co-authored. And now Dr. Hirsch is here to share his findings.

 There are a lot of terrific small businesses creating products to help with diabetes management. We've seen families with 3-D printers making insulin vial cases, people who've come up with better ways to make your CGM stick to your body, and  creative clothing with places for pumps. What if you could search through those products in one place? That's the question Adam & Celeste Litt decided to answer when they started their online marketplace, The Useless Pancreas. Adam was diagnosed with LADA a few years ago. He and Celeste share what that diagnosis was like (he was initially misdiagnosed with type 2), how they teach their two boys about dad's diabetes, and what they hope to accomplish with the Useless Pancreas. In Tell Me Something Good lots of teens and young adults with new jobs and a bunch of sports milestones to brag about. 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 (rough transcription, has not yet been edited)  Stacey Simms  0:00 Diabetes Connections is brought to you by Daria health manage your blood glucose levels increase your possibiLitties by g evoke hypo pin, 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  0:28 This week, lots of people get a diabetes diagnosis themselves or in their family and they create a product or write a book or invent something to help others. Adam and Celeste Litt took a   Adam Littt  0:40 broader view. I just see all kinds of different really cool stuff out there. And I think that's part of the magic as well. Stacy is there's so many questions out there. What is the solution for this? How can I help this and you get shipped to all these different places and sites. It's not really in one place and people don't always really know where to go.   Stacey Simms  1:01 Adam was diagnosed with LADA a few years ago, he and Celeste join me to talk about their marketplace for T1D products and services called the useless pancreas. In tell me something good. Lots of teens and young adults with new jobs and a bunch of sports milestones to brag about 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 along. We aim to educate and inspire about diabetes with a focus on people who use insulin. My son Benny was diagnosed with type one right before he turned to more than 14 years ago. My husband that's with type two diabetes. I don't have any kind of diabetes, but I have a background in broadcasting and that is how you get the podcast and Adam Litt who I'm talking to this week. We connected many, many years ago. Well it was a one way connection because Adam used to listen to me on the radio. And it was just funny to think about how you know things like that kind of come full circle. As I always say for the start of every show. You know I have a background in broadcasting here. I live in Charlotte, North Carolina. I worked in radio here for 10 years. I hosted a radio morning show Charlottes Morning News, the city's top rated morning news show, basically, I got up in the middle of the night and got to work by four o'clock in the morning to go on at five for four hours a day trapped in a box with a couple other guys. And we had a great time. But I love that. But after 10 years of getting up at 233 o'clock in the morning, I definitely had had enough. But talking to Adam just reminded me about that connection that you have with your listeners when you do a job like that, you know, he commuted into Charlotte and listened every day. And my son Benny was born in 2004. And I was on the radio at that time. So my listeners went through all of that with me. And then they went through his diagnosis with me. So he knew the story. Well before the podcast, it just took me back because I was very lucky to have the career that I really always dreamed about having when I was a kid. I worked in radio first part time. And then I worked in television for more than 10 years as a local reporter and anchor then came that decade in Charlotte doing radio. And then you know, it's funny, I've really I've spent almost the last 10 years and I hadn't realized it, I left the radio station at the very end of 2012. And I did some freelance work. I worked as a multimedia journalist, it's really a one man band, you know, you're shooting your own stuff for about a year after that just for health insurance. But I've been on my own running my own business for a long time. And I hadn't realized how long until I talked to Adam and we figured out when he must have listened to me. I don't miss getting up in the middle of the night and I don't miss some of the nonsense of working at a radio station like the one I was at and that's another long story. I do feel extremely grateful to have been able to kind of create this radio job for myself and to be able to serve you and do this and have listeners all this time. We're coming up on six years this summer and every time I get a Litttle radio reminder like that I just want to take a moment be thankful so I really appreciate having you here we will talk to Adam in just a moment and his wife Celeste but first Diabetes Connections is brought to you by Gvoke HypoPen and you know 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. Do you focus the first auto injector to treat very low blood sugar? Gvoke HypoPen is pre mixed 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 five seconds. That's it. 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 slash risk. My guest this week saw a gap in the diabetes community and like many of us, they jumped into filling. Adam Littt was diagnosed with LADA A few years after being initially mis diagnosed with Type two if you're not familiar with LADA 80 is latent autoimmune diabetes in adults it's also called type 1.5 it presents a lot like type two but it's really type one it's just slower moving is a really good kind of basic definition of it and i link up more information we've done lots of episodes on LADA but i like to explain it you just you know you never know if this is somebody's first time hearing about it adam and his wife celeste have started a new website it's a marketplace for diabetes products called the useless pancreas and i will link that up as well in the episode homepage it is useless pancreas all one word full disclosure my book is listed as one of the products on that website but they don't pay me any extra to list it there and no money exchanged hands for this interview adam and celeste thank you so much for joining me it's great to talk to you today   Adam Littt  5:48 thanks so much for having us yes thank   Unknown Speaker  5:50 you   Stacey Simms  5:51 yeah this is gonna be fun i have so much to ask you about our charlotte connection and your website and the uselessness of everything that you're doing but let's start at the beginning here if we could adam tell me about your diagnosis   Adam Littt  6:06 sure yeah be happy to go into that stacy so i was a ladder diagnosis the you know late onset type and at first and probably probably very similar to a lot of people's stories out there i was diagnosed as a type two and this was around my mid 30s and you know what stacy after that they diagnosed me type two that was a Litttle pudgy and i said yeah i'm just gonna go ahead i'm going to lose weight i'm going to work out i'm gonna get really fit and when i lost weight when i started losing weight i started losing weight at a pretty rapid rates where people started making some comments like well you're you're getting reasonably thin probably a Litttle you know fitter than where you ought to be and i blew this off i completely disregarded it you know i had my a one c's checked for a couple of years and they were maintaining in the mid sixes and you know everything was fine and but i kept getting healthier and healthier as far as weight control and diet and everything else and it wouldn't budge and then i went off to las vegas with some friends we partied a Litttle bit out there and after that i came back i was feeling really bad the day after i came back as you can imagine from las vegas and it went down in my workplace they're sort of infirmary set up and they took my sugar because i was again a type two in their eyes and it's 250 and they said you know let's go ahead and check you out and they they look they found ketones like you're off to the hospital right now and then you know after that it was the typical story you know you go see the end oh you do the tests you get the diagnosis my a one c somehow went from six and a half to it was 10.5 i think for that three month period so it was some rapid acceleration maybe you know it was just time i guess so anyway and it just gave out and was it las vegas probably not   Unknown Speaker  8:03 well it was also partly your birthday cuz your birthday was my birthday yes   Unknown Speaker  8:07 that was my my diversity is that what they call them   Celeste Littt  8:10 diversity is the day after his birthday   Unknown Speaker  8:14 yes yes there you go   Stacey Simms  8:15 so what during this time kind of what were you thinking you know 30s is young for type two to begin with but it's not extraordinary i mean were you kind of thinking things were funky   Celeste Littt  8:26 you know looking back on it i i think we saw signs and didn't recognize them up until that point so it was a Litttle scary i mean here i am with two young boys and you know thinking oh my goodness now i have one more thing on my plate adam sometimes put refers to the diabetes as his third child   Stacey Simms  8:48 adam had you ever heard of LADA   Adam Littt  8:50 no i had no idea as a matter of fact when my doctor first throughout the term lot i said i don't know what you're talking about she said well it's type one and a half so what do you mean type one and a half so i started looking all this up and stacy you know during this period where they do all the blood work you know you just pop every night and you're looking what is lot and i'm like i hope it's not tied to my biggest fear at that time was again a type two i was pretty well control they'd never had prick myself at all to take my pleasure my biggest fear was oh my gosh are they going to come back and start telling me i have to test my blood sugar once or twice a day well different story now but yeah we went through all that   Stacey Simms  9:31 it is funny what your initial thoughts are when you get that diagnosis because we don't really have any idea right unless you're in it and so let's say i ask you because as you know in many families mom has a lot going on i'm sure adam is very responsible with his as he calls it his child that's their child there but i'm curious too when you heard he had a lot of what first went through your mind   Celeste Littt  9:53 oh wow like i said before i feel like i was overwhelmed it was a change in our lifestyle we actually had to take some time off to really figure out how to manage the type 1 diabetes and how to carry things around and how to deal with all the lows and the highs and there was this learning curve at the very beginning that was just very overwhelming for me especially trying to manage and make sure that he was okay he obviously wasn't on any Dexcom or any pump at this point he would test his blood sugar and it would be really low there were a couple of really scary moments at the very beginning where he had some 30s blood sugar levels and just thinking also just about having to raise these kids by myself there's always that thought in the back of your mind and and or am i gonna wake up and find you know that he didn't make it to the night i was constantly worried about him all night long and just during the day when he was away at work things like that   Stacey Simms  10:52 and did you know that   Adam Littt  10:53 did i know she was worried about me stacy well to that extent no i at all it's nice to to hear she's always been a wonderful caretaker and she carries around two Litters for me stacy wherever we go you can always see the concern obviously it did make me think stacey have you know when i was first diagnosed though i remember i was sitting downstairs with one of these lows that she was talking about and my older son who was still very young at the time she may be honey he was what like seven or eight at that time something like that he was looking down as i was experiencing this this low and shaking and trembling and not knowing what was going on i remember this this vividly and he didn't really know how to help me either and that was actually a reasonably scary moment it was all just brand new so glad we're you know we've learned since then   Stacey Simms  11:45 yeah are the kids kind of on board now i mean they're they're tweens i guess we could call them at this point do they kind of i'm sure they understand more and they they're you know they can help out if needed   Adam Littt  11:55 or though when we when we go out to the golf course they you know they pack smarties in the bag and stuff like that and you know if daddy ever has a severe low whatever it might be they'll go and run and get the two Litter they'll pour it for me and they'll stand by and make sure i'm alright so they're they're good kids   Celeste Littt  12:12 i feel like we've been proactive about that and we've tried to prepare them a lot for how to handle an emergency situation it's really important for me to continue getting them trained in first aid cpr and things like that on a regular basis so as they get older they're just they feel competent enough to deal with a such situation if it were to arise what's the two Litter the lemon lime soda   Unknown Speaker  12:37 hey it's probably sitting on my desk over there dc   Unknown Speaker  12:41 what does it like storebrand   Unknown Speaker  12:42 sprite is from lead oh yeah yeah it works it does a job it's quick   Stacey Simms  12:50 it's funny though because i really feel like i should mention before we go any further that while you and i don't know each other you have known kind of me since benny was diagnosed because and this feels really weird to say like you listen to me on the radio i mean i don't say that to weirdly brag or anything but it is funny how you have these connections with the diabetes community that when you are diagnosed or when your child is diagnosed it's so nice to kind of i know from my experience i knew people before benny was diagnosed is why i'm bringing it up and i was able to say oh my gosh i remember and i remember this kid evan that i had met several years prior and he was this nice normal funny kid i was like okay my kid's gonna be alright because i remember evan is all right and i'm curious do you listen to wb t and we didn't talk about benny all that much but you do remember him having diabetes   Adam Littt  13:37 i do and i remember i remember driving to the same company i still work for every morning and listening to you in the crew on wb t and i remember these sort of snippets and you would talk about benny and what i really heard come through i didn't fully understand even though we do have a connection to family stacey right i have a half brother that was diagnosed in 12 but you know he's you know he lives in new york and we talk whenever but i never flew him sandy but but hearing what at what i heard is i heard the amount of emotion that came through when you talked about it right and that's what i remember from those you know those discussions that you were having and things like that and you know also you know the the passion for what you were doing in the community so that that really did resonate and then you know so many years later i'm diagnosed i run across you again i'm like stacy and she's in the type one community and here it is i'm like i have to go ahead and shoot an email right now and that's that's what i did and now we get to do this really cool talk so   Celeste Littt  14:38 yeah we appreciate it   Stacey Simms  14:40 oh of course of course unless it's funny to think about that vinnie was so young you know i had him while i was working at wb t so it's really funny to think about when did you well i'll ask celeste i'll start with you here when did you all get the idea for the useless pancreas   Unknown Speaker  14:55 how did that come about   Stacey Simms  15:01 Back to Celeste answering my question 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 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. Their 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 comm forward slash diabetes dash connections for more proven results and for information about the plan. Now back to Celeste and how they got the idea for the useless pancreas.   Unknown Speaker  15:54 Well,   Celeste Littt  15:55 it was actually Adams idea. I was visiting some relatives in Florida, and I left him at home that that visit I brought the kids down, we visit the grandparents, I guess we've kind of talked about doing something for the type one community for some time, but we weren't quite sure where we fit in yet. And while I was gone in Florida, he was up here and it just kind of hit him. He was always on a lot of Facebook boards and things regarding diabetes to find the answers to his questions and to see what other people are going through. And a lot of times people always were wondering, well, where can I get this? And what is the solution for this issue that I'm having? And so he came up with that idea? Well, you know what, let's solve these problems. That's pretty much where we started from. And I don't know if you have anything to add to that.   Stacey Simms  16:46 Adam, was there like a item that you will have an aha moment where you thought, Oh, my God, I need to do this.   Adam Littt  16:51 Yeah, there was there actually was Stacey, it's interesting. So yes, less left, I had quiet time. And I guess this is what I do. In my quiet time, I just start thinking of things to keep myself busy. And so yeah, it was, you know, it's amazing, because the type one community, I always in, not in a negative way, Stacy, but I always feel it's just a massive population of just really good people just looking for solutions. But the community is underserved in various ways. And on some of these big boards, like the Dexcom boards, a lot of people would go out there and they would post, you know, whatever they were selling, whether it would be as a hobby as a business just to support their type one child, whatever it may be. And I think this one board had maybe 30,000 people on it massive, you know, creating   Unknown Speaker  17:35 a Facebook group,   Adam Littt  17:37 a Facebook group. Yep, I'm sorry. Yep. Yep. And, you know, the moderator said, No, look, I'm really sorry, but we can't have these solicitations or posts anymore. And somebody else posted up there, you know, that's fine. You know, you put a comment on his post saying, Well, look, you know, we started this Litttle other community. And, you know, you could go ahead and buy and sell on Facebook right here. And I went to that community as well, anyway, you know, and you saw people just trying to go ahead and solution and sell their goods, you saw people looking for them. And I said, you know, this is great, but there's got to be a better way that we can bring this community together and make the transactions easier. And that's how sort of the whole concept came to be Stacy.   Stacey Simms  18:15 So tell me what it is. This is like a flea market almost. For all the diabetes goods and services. Maybe flea market isn't the best word.   Adam Littt  18:23 No, it's it's okay. I mean, that's, that's actually exactly how we started. And we started. And so we started, you know, talking to some of these people on these boards, we said, you know, look, you, you if you want to take it a step further, you know, we'll handle the transactions for you and just go ahead and post it up. And people started started doing that. And we started getting a Litttle bit of traction, the first site we rolled out was really, really terrible. And eventually, it was terrible. It was awful. It really did look like a flea market actually is less right.   Celeste Littt  18:53 But if you think about it at a flea market has multiple vendors all trying to sell products. And so yeah, actually, flea market is not a bad term for what we have at the very beginning.   Stacey Simms  19:01 I like a good flea market. Maybe that's not the best term. We need a better phrase for it. marketplace. marketplace marketplace.   Adam Littt  19:09 Yes. I mean, even eBay, they call it fleabay. Right. You ever heard that term, but anyway. But yeah, it started out pretty awful, Stacy. And you know, as we started going, at least the design, the concept was always there. People loved it. And we had some really early adopters despite the design and the look and feel of the site. And we started talking to some of the larger companies and the larger companies said, you know, we're excited about the idea. We love the concept of bringing everything together in one place, almost like a you know, an Amazon and everything store for type one diabetics, which is really how we started to head but we don't, you know, want to, you know, we want you to just put up everything for us. We want you to sort of host it for us and take care of the business and we just want to be sort of a we want you to be a marketing outlet for us and that that's how we've trained And now states that we handle, we handle everything we handle the really small guys that are selling, you know, like these decorated vials or patches or they have these seat belt Oh, girths. Yes, stickers, a ton of people stickers on Etsy for their kids. And then you know, we move all the way up to the, to the bigger guys that have, you know, these really high end diabetic bags, accessories for supplies, you know, the the insulin cases, the, you know, cases for the various pumps, things like that. So, you know, the idea is, is to get everything under the sun, type 1 diabetes, so all of us all the community can go to one place and find sort of the solutions that they need.   Celeste Littt  20:41 The main goal, I think, is to have people be able to share their solutions with others in the type one community and provide a place to do that someplace, even if you don't have your own website, you can get your own storefront on our website. So you could start out with that, and then move on to a more, you know, larger company setup where we have a drop ship option. It's really for all not just for large companies.   Stacey Simms  21:03 And I'm I won't ask you to play favorites, and everything on the website is fabulous. But have you found anything that you're using? I mean, I'm not I'm not seeing any gLitttery stickers on you.   Adam Littt  21:16 I'm really simple guy, right? So I don't use much in the way of anything, I actually just I keep the basics. Although I you know, I will say I really tend to favor some of the patches out there because you know, I have constant like everybody does with the I wear Omni pod, the word Dexcom. That does tend to peel away. And some of the, you know, some of the CGM patches and the Omni pod patches are really great solutions when you've tried everything else like skin tack and stuff like that. Yeah, those those patches seem to really help beyond that, as Celeste mentioned, I want to say Stacy, the creativity of some of these people on 3d printers, engineers making cases, as less said somebody came up with a design to prevent compression modes where you, you know, put basically a almost like a case around your Dexcom. And you sleep with that. And that seems to help. We've got people out there, we just on boarded a new business the other day that that actually, if the adhesives, if the patches don't work well for you, he's actually got a Litttle Litttle belt to go around and secured or if you're really active. So that seems to help as well. So you just see all kinds of different really cool stuff out there. And I think that's part of the magic as well, Stacy, is there's so many questions out there. What is the solution for this? How can I help this and you get shipped to all these different places, and cites it's not really in one place, and people don't always really know where to go. And now we can present all these options to the type one world,   Celeste Littt  22:51 I wanted to just throw something in there as well. We are worldwide, we have a global type one community. And a lot of times when I'm looking at products, I'm finding different products over in Europe and in Australia and some other countries that I have not seen here in the US yet. And if people aren't searching for something in particular, they are never, they never know what's out there to be able to solve their problem,   Stacey Simms  23:16 you'll ship like if I see something I live in Australia,   Celeste Littt  23:18 well, the cool thing is, is we actually don't carry any inventory, we're only dropshippers. So the companies choose where they will offer their products to where they will ship them to. And a lot of companies will ship to the US or we'll ship to Australia, Europe, UK is very big on our on our community as well. So the more countries that they're able to ship to that the more obviously the more sales they'll get, and the more they'll be able to share their products with other people who can use them around the world. And I want to say as well, Stacy, it's clearly listed on on each of the listings, where where the shipping is, but we will always go ahead and reach out for somebody, if somebody asks us if, you know if they can ship to that particular country, we'll certainly go ahead and contact the vendor and ask them, you know, we want to try to do what we can where we can for both parties. And to be clear, this is a business for you all.   Stacey Simms  24:08 So you are making money on this. We are   Celeste Littt  24:11 okay. Very Litttle. But   Unknown Speaker  24:15 that's the amount of work we're making less 510 cents an hour. Oh,   Celeste Littt  24:19 my goodness, not even not even but it's okay. Right. But I   Stacey Simms  24:23 just wanted to be clear that the way it's set up is that you know, the you are going to make money on the transactions and that kind of thing.   Adam Littt  24:31 We are Yeah, we're a mission driven organization in the sense that we want to serve the type one community but admit it's a for profit business for sure. I mean, as with any startup, Stacey, I mean, most of that gets most of it all of it gets dumped right back into getting the word out advertising listing, you know, and basically soliciting right back out to the community.   Stacey Simms  24:50 Yeah, well, you've heard the podcast I have sponsors, I have no issue with ethically making money, as long as everybody's upfront and clear, as you all are.   Adam Littt  24:59 So yeah. As part of the community aspects of all of this, Stacey is we want, as you know, you just asked, you know, we're making money. Of course, there's markups between, you know, what we, you know, what it sold for, you know, what we pay, and we're trying to give a lot of that right back to the community. So we started an affiliate program where if affiliates want to go ahead and sell for us, they can easily sign up on the website, and they'll get a piece of whatever is sold out there. So, you know, that's one of many ways that we're trying to get the word out and keep the money in the community. And maybe, you know, one of the things to mention as well here, Stacy, is we don't want to limits the marketplace in any way to products. We're already talking with diabetic coaches out there. We talked with somebody just the other day that does lessons, or rather gets together kids groups,   Celeste Littt  25:56 right social groups for diabetic children.   Adam Littt  26:00 Yeah, and we've already talked with people that work with type one, diabetic groups for travel as well, you know, after the whole COVID thing is over, we like to get into all of these things. So you know, people can come to one side and say, you know, hey, I could travel, I could send my kids who grew up or maybe I need nutrition counseling or fitness coaching. And I could buy a set of CGM patches at the same time if I need those.   Stacey Simms  26:22 And Adam, how are you doing? You mentioned you're using an Omnipod, you've got a Dexcom. So it sounds like you're, you've come quite a long way from worrying about checking your blood sugar once or twice a day.   Adam Littt  26:32 Well, I've got a handy two Litter there, right, just in case No, I, I don't know. I was born with a very obsessive personaLitty, Stacy. So   Celeste Littt  26:40 I have to admit he does do well. That's nice to hear.   Adam Littt  26:43 I tend to keep pretty good control. I want to say that part of my retirement for my workplace is probably going to have to be annuitized turned into lifetime income Stacy, I intend to live till 150 just to get all of my money right out of that workplace.   Stacey Simms  26:58 Very nice.   Adam Littt  26:59 You got it to God, it's so I tend to do okay, I'm pretty regimented. I know you know what I eat and what it does to my blood sugar is I live pretty boring lifestyle as far as food, I put my energy into business and and the kids who run me relatively ragged. Thanks for asking. Sure.   Celeste Littt  27:17 I actually I have to say he, he has simplified my life because he does eat almost the same meals for breakfast. And for dinner. And lunch is our main meal with his protein at lunch. So I can't complain so much. He actually does keep things very simple. For me.   Stacey Simms  27:34 That's the difference of having perhaps a husband with type one and a son. As we were saying, for the interview started, I'm not exactly sure what my son is eating what hour of the day, especially with virtual school. Chinese who to two o'clock in the morning.   Unknown Speaker  27:48 That sounds like our tweets, actually. Yeah. That's what they went through last night.   Stacey Simms  27:53 Adam and Celeste, thank you so much for joining me, it's great to talk to you and learn more about this. I'll link everything up so that people can learn more and start snooping around the website and maybe contacting you if they have products. We have some very creative people in the audience as well. But thanks for sharing your stories.   Celeste Littt  28:08 Thank you so much for having us.   Adam Littt  28:10 Thanks so much for your time today. We really appreciate it.   Unknown Speaker  28:18 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  28:24 Lots more information. As always, at the episode homepage, just go to Diabetes, Connections COMM And I like to say every so often, if you are looking for a previous show, or a topic that we covered, if you go to the website, I have a search box on the upper right hand side, it's a really robust search, we have 365 episodes. There's a lot of stuff out there. If you'd like to hear something, many of the newer episodes have transcripts, not the older ones yet we're working on that. But it's just a really easy way to go through what I hope is a good source of information and sort of what I kind of call it a snapshot of the history of the diabetes community for the past five, almost six years. I'm certainly not exhaustive, but really good snapshot of what's been going on in our community since 2015. So definitely check that out at the homepage. Tell me something good is coming up. We have a teen and young adult edition this week. But first Diabetes Connections is brought to you by Dexcom. And I just want to take a moment to talk about control IQ. This is the Dexcom G6 Tandem pump software program. When it comes to Benny's numbers. You know, I hardly expect perfection. I just want him happy and healthy. I have to say control IQ the software from Dexcom and Tandem has exceeded my expectations. Then he is able to do less checking and bolusing and spending more time in range. His last three A1Cs were his lowest ever they keep going down. This isn't a teenager, the time when I was really prepared for him to be struggling. His sleep is better to with basil adjustments possible every five minutes, the system is working hard to keep them in range. And that means we hear far fewer Dexcom alerts, which means everybody's sleeping better. I'm so grateful for this. Of course individual results may vary. To learn more, just go to Diabetes, Connections comm and click on the Dexcom logo.   I went looking for good news stories in a Facebook group that is frequented by parents of teens and young adults. And I've got some really fun stories to share with you. Catherine says Noah is my type one spectrummy 16 year old he had his best report card since third grade three A's and a B plus. He's on new meds new therapist, a new school also doing remote school. So it's quick with reduced social anxiety, fewer distractions and no papers to lose. He actually likes school this way. I gotta say, I know this year has been very difficult, but remote school has been a boon for many kids. I don't know what we're going to do when things go back. It's not for me to say but it would be really nice to figure out a compromise here for some kids like this that it's really working well for. Tammy says my son Cole is a sophomore in college. He was diagnosed at age three and a half. He's now 20 he serves he rock climbs he traveled to Cabo. He's MDI and uses a Dexcom he ran on club teams. He was a varsity runner in track and cross country. Tracy posted about her daughter Sophie, who was diagnosed at age nine. All she posted first was a really cute picture of her daughter saying she finally got her job at Starbucks. So I had to say, Is there more to this story? I do not get it. So Tracy wrote back and said she is a junior in high school and enjoyed bagging groceries at Publix. But her main parents made her quit due to the pandemic. She has attended virtual school since last year. But missed working. She discovered Starbucks was safer, because they only have a few people working there at a time and it's mostly drive thru. It took weeks of email and calling and follow up work to make it happen. She just turned 17 on Sunday. So that's the story. And then Jessica writes in my 17 year old Trenton played in all three games at their state basketball tournament. He's their ninth guy, he even scored a basket. And she posted a really cute picture of Trenton with his parents, I'm going to grab these photos with permission and put them into the Facebook group because they're really fun, especially this one, I have two more good news stories for you. They're very different from one another. But this one is from Alex. And she writes, I was born and raised in Oregon. But I've lived in Argentina since the 90s. Our daughter was diagnosed a Litttle over two years ago. And I learned that in Argentina, they have a diabetes law that guarantees access to insulin strips and all necessary technology for diabetes care as a human right. This love is achieved by a group of moms in 2013. While there are gaps in the system, there is a framework within which you claim access to what you need at a public hospital. The psychological relief she writes, this law provides brings me no end of comfort. And I love that it was achieved by a group of moms. This is the photo of when Congress approved the law. And this is a great photo of moms cheering and hugging and crying. And there's one gentleman in the photo as well. I will put that in the group. What a great story. I mean, wherever you come down on the side of access and insulin for all I know there are different poLittical views. That's fine. You've got to really believe that the psychological stress of trying to afford this stuff is heavy on many, many, if not most people's minds. And I will leave you with a really fun one. And I don't know if she knows that this is kind of an anniversary. So here's the story. Leslie, who I have known for years, you may have heard me tell the story about when Benny was very Litttle another Litttle boy was diagnosed right at the end of Gosh, I'm getting old now was at first or second grade, I want to say was the end of first grade. And Michael and Benny talked it over and everybody felt better about it. But Michael and Benny had also played baseball together and Leslie posted a photo of Michael Vinny no longer plays baseball. He played lacrosse and then he's into then football and now he's he's really into wrestling. But Michael stayed with it and it's done really well. And she posted a photo of Michael as an umpire. He is working as an umpire and the picture is partial gear. This kid you can't even see him. He's like buried in the equipment here. And she says he really enjoyed it. calling home plate is more fun than the basis I have a new appreciation for the discomfort ups must be at games after the many layers required to put on and I said it was an anniversary of sorts because it was this week. It's last week as you're listening. But this week when Leslie sent me the photo that Michael and Benny and another Litttle boy Parker, all played in a baseball game together two teams. This was our Litttle town baseball league for elementary school. So a couple of towns I guess, but two teams and three boys with type 1 diabetes on the same game, and it showed up in my Facebook memories, which is how I know so let's Thanks for sending that in. Thank you all for these great good news stories. This is always my favorite part of the show, send him in, you can email me Stacey at Diabetes, Connections, comm or post them in the Facebook group.   Before I let you go big thank you to jdrf Desert West, which includes chapters in Arizona, New Mexico and Nevada. I participated in their type one talk last week, and I really appreciate you have me out to talk with the world's worst diabetes Mom, I am looking forward to an event with my local chapter, which I don't even know how big my local chapter is anymore. Maybe it's North Carolina, South Carolina and Virginia, I think. But at the end of April, well, April 23, I will be hosting trivia, I'm very excited about this, we're gonna have a big online zoom, but play along trivia. And if you'd like to do something like that, I am more than happy to host it for your chapter, your diabetes group. If you've ever seen my silly game shows or listen to my game shows that I put out here it's not dry trivia. We're not quizzing people, we're not going to do math problems on bolusing. It's lots of fun diabetes news. But you know, in a, I'll give myself credit in a comedic, It's lots of fun diabetes news, but in a fun, interesting, family friendly kind of way. So I would love to do that get in touch. Let me know if that's something you're interested in. You can play over zoom. Everybody needs a separate app on their phone. It's a Kahoot app that lots and lots of schools use. So your child probably already has that and can set you up if you don't have it yourself. Alright, lots of stuff coming up classic episode in a couple of days and we are back to our interview shows on Tuesdays. So please join me then. Thanks as always to my editor john Kenneth from audio editing solutions. thank you as always for listening. I'm Stacey Simms. I'll see you back here soon until then, be kind to yourself.   Benny  36:51 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All rounds avenged

: Episode 1674 - On this Monday show, Anna Vocino and Vinnie Tortorich talk MacBooks, Serena's birthday, b.s. keto and advertising, keeping A1Cs low, empowering ourselves with good health, and more. Https://www.vinnietortorich.com/2020/09/keeping-a1cs-low-episode-1674 PLEASE SUPPORT OUR SPONSORS You can save 15% through this link! SERENA'S BIRTHDAY This show comes out on September 21st. It's Serena Scott Thomas's birthday! Take to the internet and wish her a happy one. KEEPING A1Cs LOW You want to keep it below 5.6. Anything over this, you're at least pre-diabetic, some doctors have said to Vinnie. Anna and Vinnie think they are vanity-sizing A1Cs. There are drug ads saying "just keep it below 7," but even that isn't healthy. Eating No Sugar No Grains can get and keep your A1C down WITHOUT drugs for those with Type 2 or pre-diabetes. Of course, listen to your doctor, but do some investigation.  While there are plenty of healthy builds and body types, morbid obesity is not healthy. It has the word "morbid" in it. This does NOT mean fat shaming is okay –– it isn't. It is just good to eat healthily. Products like Halo Top are trying to trick us. They aren't healthy, can still move you toward Type 2 diabetes. If you have a lot of weight to lose, do not feel ashamed. Feel empowered because you can get healthier! Body size can also be deceiving -- this goes both ways. FAT DOC IS OUT Go watch it now! We need people to buy and review for it to stay at the top of iTunes pages. Please also share it with family and friends! Available for both rental and purchase. You can also buy hardcopy or watch online at Amazon. YOU CAN NOW STREAM FOR FREE ON AMAZON PRIME IF YOU HAVE IT! Fat Doc 2 is in the works! Keep an eye out. RESOURCES Https://www.vinnietortorich.com Https://www.purevitaminclub.com Https://www.purevitaminclub.co.uk Https://www.purecoffeeclub.com https://www.evamor.com https://www.villacappelli.com Https://www.nsngfoods.com Https://www.crowdcow.com/vinnie Https://www.bit.ly/fatdocumentary http://buyraycon.com/fitness

: Episode 1654 - On this Monday show, Vinnie and Anna talk reversing pre-diabetes with NSNG®,  Marie's recent fall (with a special appearance by Marie!), medical malpractice resolutions, Pelotons and ergometers, and more. Https://www.vinnietortorich.com/2020/08/reversing-pre-diabetes-ergs-episode-1654 PLEASE SUPPORT OUR SPONSORS Our Nut Butters are shipping now!  Promo code "vinnie" for 15% off. REVERSING PRE-DIABETES Many very overweight people are pre-diabetic. This is common among metabolically damaged people who are still eating a lot of sugar. There have been many listeners who, under consultation of a doctor, have brought down their A1Cs to non-pre-diabetic levels with NSNG®. Folks have been dangerously ill and largely reversed it. This is not, however, medical advice. If you have pre-diabetes or diabetes, talk with a doctor. Diet really does play so much into this. Diet can be everything. PELOTONS & ERGOMETERS If you can afford a Peloton, great, but they;'re expensive. Any ergometer machine is really excellent. Most of them have cool programs. They'll have classes, and lessons, and challenges. Vinnie has done some with his Concept 2 rower. FAT DOC IS OUT Go watch it now! We need people to buy and review for it to stay at the top of iTunes pages. Please also share it with family and friends! Available for both rental and purchase. You can also buy hardcopy or watch online at Amazon. YOU CAN NOW STREAM FOR FREE ON AMAZON PRIME IF YOU HAVE IT! RESOURCES Https://www.vinnietortorich.com Https://www.purevitaminclub.com Https://www.purevitaminclub.co.uk Https://www.purecoffeeclub.com https://www.evamor.com https://www.villacappelli.com Https://www.nsngfoods.com Https://www.crowdcow.com/vinnie Https://www.bit.ly/fatdocumentary

: Episode 1617 - On this Saturday show, Andrew Berger joins Vinnie to discuss his weight loss journey, lowering A1Cs with Type 1 Diabetes, saving money with better health, and more! Https://www.vinnietortorich.com/2020/07/lowering-a1cs-type-1-diabetes-episode-1617 PLEASE SUPPORT OUR SPONSORS ANDREW BERGER Andrew is 5'5" and started at 203 lbs. He is now 138 lbs! Vinnie and Andrew met when he did a consult in LA in person - at that point, he weighed 180 lbs. He's a DJ and on the radio. Power 106! LOWERING A1CS Andrew has Type 1 diabetes, and had a 7.8 A1C when he started. Now, he's at a 4.9. He had never see someone with Type 1 do this. His doctor was amazed! At first there was pushback, but then they realized that it was only helping. Since he was 19, he was dieting, and nothing ever worked before NSNG®. It's also saving him a ton of money! FAT DOC IS OUT Go watch it now! We need people to buy and review for it to stay at the top of iTunes pages. Please also share it with family and friends! Available for both rental and purchase. You can also buy hardcopy or watch online at Amazon. YOU CAN NOW STREAM FOR FREE ON AMAZON PRIME IF YOU HAVE IT! RESOURCES Https://www.vinnietortorich.com Https://www.purevitaminclub.com Https://www.purevitaminclub.co.uk Https://www.purecoffeeclub.com Https://www.bit.ly/fatdocumentary

A brief update on COVID-19 and type 1 diabetes recorded March 11, 2020. Stacey talks to Dr. Satish Garg, an endocrinologist at the Barbara Davis Center for Diabetes. Dr. Garg talks about what we know right now, what he's telling patients and advice for anyone with T1D. Find out more about Coronavirus: CDC Info JDRF  Beyond Type 1 DiaTribe ----- Check out Stacey's new 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 One Drop created for people with diabetes by people who have diabetes. By Real Good Foods real food you feel good about eating 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 Welcome back to another episode of the podcast really glad to have you along. And once again, we are doing a short episode on Coronavirus and type one diabetes. I'm your host Stacey Simms. And you know after we put out an episode at the end of February about this, I heard from a lot of people who asked me to keep updates coming. Now as I have said before podcasting isn't really the best medium for breaking news. You can listen to this episode immediately as it comes out. You could be listening to it weeks or months years down the line. But I do think we can use the podcast here to get some good information out. So in the limited way that we can, that's what I'm trying to do. This episode is going to be on the shorter side, maybe 15 minutes of the interview with an endocrinologist just sort of talking about where we are right now and answering some specific questions from listeners. We will have a regular Diabetes Connections, interview and show next week. I'm going to come back after the interview and I'll talk a little bit more about the show going forward. I am recording this on March 11. The same day the interview with Dr. Satish Garg was recorded, obviously, the information may change. That's why I'm telling you the date. Please make sure you check the links in the show notes. They are on the episode homepage, or in the show notes. If you're listening on an app. It's kind of hard to find sometimes, but most podcast apps will have a place that says details or more information and that Where I'm putting the updated links, the ones that will automatically update when it comes to the coronavirus. And one more thing, you're going to hear Dr. Garg mentioned people with type one diabetes as having compromised immune systems. I did press him on this off the air and he says he uses that term to talk about people who have an autoimmune disorder like Type One Diabetes because he says, once you have one autoimmune disease, you're likely to get more like celiac disease or Addison's disease or other auto immune issues. He said, and you will hear him say this, it does not mean that people with type one diabetes are more likely to get sick from viruses like the flu, or COVID 19. With all due respect, I think it was a confusing way to talk about autoimmune conditions. And if you've listened to the show, a compromised immune system is not how anybody has talked about it before. So I did think that was worth pointing out to you. All right here is my interview. It is with Dr. Satish Garg of the Barbara Davis Center for Diabetes. Dr. Garg, thank you so much for spending some time with me. I know you're not only seeing patients but you're trying to reassure patients that I'm sure are calling in about the situation right now. how busy is your office at the moment? Are you fielding a lot of worried calls?   Dr. Satish Garg  3:24 Very many. I mean, my staff is swamped and getting calls and wanting us to write letters because they have Type One Diabetes should they go to work? And not only me and my emails are also we have nine different providers on the adult side here at the Barbara Davis center for diabetes and so many educators and all of them are swamped with these emails and text messages they're getting from patients.   Stacey Simms 3:52 So what are you telling patients who are asking if they should go into work?   Dr. Satish Garg  3:56 We primarily tell them to go on to these websites. JDRF has created a nice website giving guidelines for people with type one diabetes and also tell them to go on our website we posted some through University of Colorado and to coronavirus.gov and that is to the CDC. And if they have some degree of comorbidities, for example, if they are older, older than, you know, 60 or 65, and they have heart disease, hypertension, obviously they have diabetes, they may want to avoid places where there are larger crowds, or they may want to avoid unnecessarily getting in contact with somebody, for example, going for rallies and things like that people need to avoid so general precautions nothing specific to people with type one diabetes, except if they have comorbidities. We do recommend people to get the flu shot but they are specifically not at high risk of getting Any of these infections if their glucose control is good. But their immune system is compromised, because they have autoimmunity, it does get confusing. So the bottom line is that people have tried to maintain their glucose control as best they can to avoid hyperglycemia and avoid wide glucose excursions. And those are the general precautions. And of course, if their glucose control is not good, then they might be more prone to get bacterial infections and other infections, but their immune system is not normal, quote, unquote, on a healthy individual like you and I, who don't have type one diabetes, our immune system is different than the ones with Type One Diabetes. So it makes sense.   Stacey Simms  5:45 Yes, absolutely. I totally understand where you're coming from with that. But bottom line, good glucose control, you are not more likely to get COVID 19 if you have type one diabetes. You said right before we started taping that you had just seen an 84 year old patient with type one, what's your advice for that person?   Dr. Satish Garg  6:05 So we have more than about 400 patients who are older than 60-65 who have type majority of them have type one diabetes and some have type two, but they are requiring insulin therapy. Anybody who is in that age group, I always advise them especially many of them have comorbidities hypertension, hypercholesterolemia, heart disease. So those individuals I tell them specifically avoid, I'm not asking them to quarantine. Of course, if they have dry cough, and they start running fever, they should self quarantine, do advise them not to travel because right now, we don't know how the aircraft and what have you are being cleaned. Avoid large crowds. So just the general precautions that CDC advises that's what we are recommending to go People go they are definitely at high risk, one because of the age, second type one diabetes. And third, they have majority of them have some degree of comorbidities.   Stacey Simms  7:11 You know, one of the questions that we see a lot is, how can I prepare to be self quarantined? You know, a person with diabetes or household that has a person with type one diabetes in it. What are you recommending people keep on hand for two weeks, 30 days?   Dr. Satish Garg  7:28 Well, I think there might have been an overreaction to that people are slightly overreacting. Oh my God, we might suddenly be locked down, like Italy's logged on, like part of China was locked down. I hope that doesn't happen. So people are going on ordering insulin, masks and what have you. We don't anticipate that for example, in the state of Colorado, we only had about 15 to 20 cases now having a tip that they haven't tested a whole lot once you get a lot of people tested that One will really know the hard numbers right now, unfortunately, we do not have the hard numbers to how many people have been really affected by this disease. But we just give general advice to these individual.   Stacey Simms  8:15 You mentioned people trying to stock up on insulin. You know, one of the problems is a lot of insurance companies will not pay for that much, right, people are trying to get the prescriptions renewed. Are you running into that same thing,   Dr. Satish Garg  8:26 most of our patients would have about three months of supply, and if some of the insurance companies won't give them luckily for us at the Barbara Davis center, we have so many samples, we just give them one or two extra pens or vials so that they don't have to worry about it. Again, I'm hoping that this won't be a major event. Let's hope as the temperature turns around, that this virus will be just like what was Spanish Flu back in 1918. That will go through the cycle, but we don't know that a lot of people most of us Do not know the exact cause of this particular virus.   Stacey Simms  9:03 I will defer to you as the medical professional, but you're hoping it's like the Spanish Flu of 1918? That killed an awful lot of people.   Dr. Satish Garg  9:11 Well, but the Times have changed. You're right, that killed millions of people. No, we're not seeing anywhere close to that. Because what healthcare was 1918 100 years later is night and day. For example, back 40 years ago, I used to tell all my type ones, you're not going to live beyond 35 to 40 years of age. Today, I tell all of them, you're going to reach 80-90 years of age, I'm not aiming at 100. But you're going to reach nearly full potential of your life expectancy. So times have changed healthcare quality and what is available had changed night and day. So I think it'll be unfair to say that we're going to see those sort of mortality rates, but we saw back in 1918 because of the health care standards that are changed dramatically.   Stacey Simms  10:01 Um, you know, another listener of mine, I'm reading you some questions that I took from my listeners. And one of them had asked that there are some studies that people with type one have worse outcomes after major events like heart attacks, because of the autoimmune issues that people with type one already have. So she's concerned about that with Corona virus. Is there any indication? I know it's still early that one of the reasons that it kills people is because it does affect the immune system.   Dr. Satish Garg  10:32 So here's the problem, Stacy with that we do not have data to say that affect anything right now we have so few deaths in the US or even worldwide, and leave alone people with type one diabetes now convert to the best of my knowledge. None of the patients with type one diabetes has died. But again, that may be what I know of the numbers. Again, we do not have any for example here, the Barbara Davis center. We don't have any patient with the corona virus, and they have a significant number just like any other clinic of comorbidities. But we don't have any such problem right now. We are telling people in general to avoid travel for example, please don't be on a cruise ship that is a living source of petri dish that you're going to be definitely there is even 1% chance that you can avoid that you should avoid going on a cruise ship. Now, regarding other travel, the University of Colorado has already banned all our personal and domestic and international travel. So some common sense is to be taken into con in the sense if you really don't have to travel anywhere. avoid that. That this thing's bad. Through, hopefully just like a flu virus, and over time, it will all go away, we'll hopefully find a vaccine. And this will be a thing of the past. But right now, there is too much unknown, especially in patients with type one diabetes.   Stacey Simms  12:14 All right, so I have a question for you from Julia, one of my listeners who is actually a flight attendant, so she says, I have no one to ask this question. I don't know if you'll be able to answer it, but we'll give it a try. She says I fly internationally to London. I do everything I should to avoid getting it but I have accepted is likely I will get COVID 19. When this happens, and I'm told to self quarantine, unless it's very life threatening. She says, What should she do for herself in a mild case scenario? So here's the question a person with type one who does get this and is not having a life threatening incident of it. What should they do?   Dr. Satish Garg  12:54 I would do self quarantine. Make sure you have enough insulin, fluids and whatever else necessities of day to day life you need. Yeah, they should be no different course to the best of our knowledge. Again, as you asked me earlier, the effect on diabetes, But again, we have no data that anybody with type one diabetes who is well controlled, behave any differently than the ones who don't have type one diabetes. So, General precautions, you got mild cough, small fever, self quarantine, and you should do fine, just like you would do it for a regular flu   Stacey Simms  13:33 and your regular sick day plan that everybody should have their endocrinologist in ketones, that sort of thing.   Dr. Satish Garg 13:39 Yeah. Great.   Stacey Simms  13:40 You know, we've said well controlled several times, and I know every one is different. And I almost hate to ask this question, having a child with type one for 13 years. So I think I know the answer, but I'll ask it anyway. When you mean well controlled, is there a number again, knowing that everybody's different? Is it an A one C of 7.5? Is it a Is it an in range? The time in range number, you know, when do we start worrying about well controlled type one diabetes, we know an A1C of 14 isn't going to cut it.   Dr. Satish Garg  14:08 So there are many ways here, as you rightly said, for example, somebody at the age of 70 or 80, I probably don't want their A1Cs to be in the 7s, because they have lived their life. They don't have any significant comorbidities. Why don't you just take it easy and avoid the risk of hyperglycemia. Someday in the teenagers 30s and 40s, you probably want to me one sees around seven, with a time in range of 65 to 70%. That's our goal. 70% of our patients use some sort of a continuous glucose monitor, which is what we recommend and that is true for everybody who is at risk of getting Corona virus. That is one advice I would definitely give them that they should go on a continuous glucose monitor if they don't have one just because when you're sick, your blood sugars are To be higher that you need to be rather than having to finger prick every five minutes. Why don't you have a continuous glucose monitor, preferably a Dexcom g six because that is far more accurate as compared to the average Libra, which is cheaper. However most insurance companies pay and thus you can continuously be monitored and adjust your insulin dose accordingly. Rather than having to prick yourself 10 times a day. That's the only advice I would make change, especially to the flight attendant. Also, if she's not using a CGM, I would strongly recommend that to use as one.   Stacey Simms  15:36 It's interesting when you mentioned cost. I did get a question and I know it varies state to state. I know you're a doctor, not an insurance expert. But do you know when a governor declares a state of emergency, you know, in North Carolina, our governor has recently done that it is mostly about federal funding. It's not about emergencies in the street. I think most people recognize that by now. Is there any leeway for people To get extra supplies to be able to pay for things at the pharmacy, like a Dexcom?   Dr. Satish Garg  16:09 Yeah. I mean, I wish I had an answer for that. The only thing I would say is, if that scenario happens, I'm sure we can get a special prior authorization. This is a scenario that nobody has seen or confronted with. So we don't know answers to many of the questions you're asking. However, if one is facing that situation, we could definitely look into it and get a prior authorization for that individual.   Stacey Simms  16:36 Has there been any information coming out of you know, China or Italy or elsewhere, where they've been dealing with this for longer about people with diabetes and about how it reacts with COVID 19. I know when we say diabetes, that they lump everybody in there as one part to separate it, but have you been able to parse anything   Dr. Satish Garg  16:55 and that's what I was going to tell you next one in China. According to To quote unquote, what they say, Type One Diabetes is rare. I don't know to what extent is that rare, they just don't have the information on that attack. Secondly, they lump all diabetes, type one, type two, type two, who has a lot more comorbidity is a very different ballgame falls into those individuals who are more vulnerable and who are elderly. So I don't think those criteria may fit. So we don't have any data to that effect, specifically, type one diabetes.   Stacey Simms  17:30 What are you all doing in your office? As you said, You're seeing patients, you're they're talking to me today? What are you doing to stay safe?   Dr. Satish Garg  17:38 Just the general precautions, asked my staff to make sure they clean all the clinic rooms, we have like 44 exam rooms, clean all the exam rooms, surfaces and whatnot. And again, we've been lucky. None of our patients have yet been at least reported to have any of these coronavirus to so far be unlucky but who knows when you Going to be confronted, I'm sure you must have heard there was a meeting in Boston, where there were 200 biotech people, and I believe 17 or 20 of them have come down with the corona virus. So that is obviously put issue, whether we should have these large gatherings at all. And I would just lastly say to all patients with type one diabetes, just take care of your diabetes, the usual way, it's not a bad idea to have some extra supplies in case like what they have done in New Rochelle in New York area where they're calling it containment, basically, allowing less movement in the community. So it's not a bad idea, do a few extra days worth of the supplies but take care of your diabetes, the usual way as best as possible. I strongly recommend using a continuous glucose monitor does if you were to be infected, you have continuous access to the data. just you glucose management much better. But otherwise there is lack of data in specifically to type one diabetes and there is no different we will behave just like as a non diabetic individual.   Stacey Simms  19:13 Well, thank you so much for spending some time with me. I appreciate it very much. And we'll check back. If any of the information changes or frankly, we get more of it. Right. We'll get it out there. But thank you so much.   Unknown Speaker  19:29 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  19:34 As Dr. Garg mentioned, there is a lot that we as recording on March 11 still do not know especially any kind of breakout information when it comes to type one diabetes. So keep in mind as of right now, when you're hearing people talk about diabetes, they're lumping everybody with every type of diabetes together. You will find more information in the episode homepage including The links that Dr. Guard mentioned at the very beginning of that interview. Alright, so here's the situation on the show going forward. And you know, this may just be for this next week, I have no idea. Like I just said, there's a lot of uncertainty here. But I am not going to make the show all about COVID 19. At least not right now. In the Facebook group at Diabetes Connections, the group, I took a poll, and the vast majority of listeners wanted regular podcast programming with COVID 19 updates as needed. Now, I do come from a news background as you probably remember. So I admit, it's just a little hard for me to pull myself back from breaking news mode. I mean, I'm thinking you know, wall to wall coverage. This is how we would do it. This is how you're seeing media do it, but I hear you, and I'm here for you and to do what you as listeners want to hear. Because I'm getting this episode out early, the next one may not air Tuesday, our episodes usually drop on Tuesdays. If you subscribe to the show, that is probably your best bet. It'll just come to whatever app you use. And if you follow on social media, of course, I will post there, too. So please check back in. And let me know what you're thinking and what you want to hear. And by the way, maybe I should have said this upfront. If I sound a little bit different, it's because I have moved my office. And frankly, I wasn't really ready to record yet, but we moved this up so I don't have everything in its perfect place. Hopefully it sounds just fine. But if it's a little different, that is why All right, thank you so much, john, you can as my editor for rolling with these changes and being able to get these episodes out. I very much appreciated. Thank you for listening. And please check back into the Facebook group, social media or wherever you listen for the next episode. I'll see you back here then.   Unknown Speaker  21:52 Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged   Transcribed by https://otter.ai

Have you ever had a doctor give you a "wake-up call?" or try a "scared straight" tactic? These techniques - and a lot more - blew up on Twitter recently. Stacey noticed that it also seemed that the doctors andhealth care providers who weighed in weren't interested in listening to diabetes advocates online. What's the disconnect all about? Full transcript below Check out Stacey's new 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 This episode of Diabetes Connections is brought to you by The World's Worst Diabetes Mom: Real Life Stories of Parenting a Child With Type 1 Diabetes available on Amazon as a paperback ebook and audiobook at Diabetes Connections.com.   Announcer  0:15 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:26 Welcome. This is one of our mini episodes, shorter episodes that I put together starting at the beginning of this year, just when I have something to say, news to share or anything that doesn't fit in the traditional longer format interview show that we do every week that drops on Tuesdays. I am your host, Stacey Simms, and I want to talk to you today about well, I really want to talk to your doctors about something, but we'll get to why and maybe how to share with them. I want to talk to you about what are doctors think of diabetes, and I don't really mean our endocrinologists Just to hopefully know what they're talking about and stay up to date. I mean, the other doctors that we see or we bring our children to pediatricians, the doctors, the dentists, you know what I mean, right? There seems to be this disconnect between what the diabetes online community which doesn't speak in one voice, I get it. But what we have learned over the years and what we talk about all the time, in terms of there's a hashtag language matters, right? There's this disconnect between what we as patients want, which is no blame and shame. Work with me, help me with resources, give me the information, let me make my decisions. And the physicians who many many, many times want to scare patients straight, you know, we're gonna give them a wake up call. We're going to show them how bad they're doing and that will make them do better. And this disconnect played out on Twitter recently and I want to share with you how it went and then I would ultimately was shared at a medical conference. Before I jumped right in though I do want to Say with those doctors who are you know, in the scare em  straight kind of school, I really do think the intentions there are good. I don't know any doctor who wants their patient to walk around with a 14 A1C, you know who obviously isn't feeling well and is going to be in poor health. I don't think any doctor wants that. The question is, why don't some doctors listen to their patients more? Why don't they seem to believe us when we tell them what we think works and doesn't work. So that's my perspective. today. Let's go through what happened. There's a guy on Twitter. His name on Twitter is @DGlaucomflecken. He says he's an ophthalmologist, a comedian, and a speaker. On February 17. He tweeted, “Want to know why diabetic eye exams are so important. I can take a 28 year old with an A1C of 14, show her a picture of a normal retina, then a picture of her diseased retina. Then a picture of what her retina could look like in 10 years with an A1C of 14. Very effective wake up call.”  And he posted the pictures that he had just talked about now. Kind of an innocuous tweet a couple of years ago, I probably wouldn't have thought anything of it. But and I was not alone here. There were some telling language in this that made me want to speak up. I'm going to link this up if you want to go through the Twitter thread. It is ginormous because a lot of people chimed in as you can imagine. I'm going to read a few tweets here. I'll just read first names from the people who tweeted this out. So these are the advocates who tweeted back Megan wrote, “As someone who works in eye casualty for a while and has type 1 diabetes. I have heard doctors have similar conversations. I then also seen patients walk away upset and distressed. Living with diabetes can be filled with anxiety. I find it best not to feel that scare tactics aren't always the best understanding and empathy for diseases hard to manage may be better.” Melinda wrote, “Did you ask her if she could afford her insulin and supplies? If she had a support network to encourage her or did you just decide to be Dr. Judgy Pants?” Melissa wrote, “Do you know if she went to her car and cried from helplessness like I used to after I exams with an ophthalmologist who had This kind of bedside manner? It took some time to find a doctor who could help me create a plan instead of send me off alone and frightened.” And then Mike wrote, “This mentality scared me into doing something better briefly as a teen. Soon enough, it led to hopelessness and years worth of higher A1Cs until love, actual good doctors and peer support inspired me to change how I lived” I wrote “Curious if there are any long term studies showing this is effective, other than the patient saying, Wow, that's a wake up call. What is it like for them? 10 years down the road? Did it help hurt make no difference?” And I actually wrote “not being sarcastic, genuine question” because you know, Twitter, but then the ophthalmologist chimed in back. And during all the time these advocates are saying these things, other doctors and other people are telling us how wrong we are. So the original ophthalmologist chimes in with, “I'm just showing people their own body part. I've never had a patient get upset with me for showing them pictures. I have taken up their own body part. I don't need a study to convince me to keep doing that.” Another doctor said “Patients Like pictures. We do the same with coronary angiograms. In cardiac patients, a picture's worth 1000 words, also puts in their minds the idea of the now and the potential future, good practice.” Another person a medical resident wrote, “I like it, it's hard to convince some patients without symptoms that keeping an A1C down to an arbitrary number is worth the effort of diet, exercise and expensive meds. This could help motivate many patients.” And then he writes “Also, it's not the author's job, the ophthalmologist job to make sure the patient has all of the resources needed to adequately treat the patient's diabetes during their brief eye exam. That's our jobs as PCPs.” So that's what he's going to be or may be already is I can't really tell from his Twitter bio primary care physician. Okay, so, literally, this went on for days, I kept getting notifications, because I kept chiming in, like, Are there studies like, oh, let's talk about this, you know, and, as you can imagine, it got pretty nasty sometimes. I mean, there's jerks in every Twitter thread on every side, so we're not going to talk about that. We're going to talk about the discussion and the disconnect because this is that fascinating. Most of the doctors really believe this is a good thing, I'm so glad that that primary care physician chimed in and said, “well, it's really not your job as an ophthalmologist to give them any resources or do more with them.” And this original doctor kept chiming in and saying, “No, I really do try to support patients.” It was just one tweet, you know, we don't know what he's really doing. So maybe he is, you know, talking to them more. What about your experience? In my experience with those other doctors, right, not the endocrinologist, the eye doctor, the dentist, even the pediatrician with Benny, they have no idea what diabetes takes. That's okay. It's not their specialty. I don't mind that. They don't know. I mind when they try to tell us more than they know. Right? Like, I had an eye doctor once Tell me, Benny was not in the room, he asked, “how long has he been diagnosed?” 12 years. I think at that time. “Well, you know, 20 years is when the complication starts showing up in the eyes.” And I actually said out loud because I'm a pain in the ass patient. And I said, Really? What was the last time you actually read anything in a medical book about diabetes? I tried to be nice, I said it kind of nicer than that. But it's it really, when did you learn about type 1 diabetes? And he said in medical school, and I said, and when was that, right 25 years ago? And really, when were those studies done? Right? If you're looking at a study from 25 years ago, that study probably followed people living with diabetes who had been diagnosed at least 10, if not 20 years before that. So your data is kind of outdated. And we know if you're a longtime listener of the show, you know, from studies like the EDIC trial, and many others, that eye complications, along with many other complications are way down and almost non existent for people with diabetes, who have access to good care and insulin. I mean, we know there's a whole other world out there, but we know these complications when care is given our way down. And whenever I talk about complications, I always want to say complications can happen even with the best care with diabetes. I mean, look at life - complications can happen with anything. So we try to do the best. We can see just other factors, you know, genetics, environmental, what have you. But with eyes in particular, I've talked to two endocrinologists in the past year, who say when they see a patient with any kind of eye issue under the age of 40, with Type 1 diabetes, they call everybody who's nearby, because they never see it. They want everybody to come in and identify it and look at it and see what the poor patient, but see what it really is all about, because they never see it anymore. So my little conversation with that eye doctor, hopefully made him rethink a little bit about how he talks to other people with diabetes. I've had the same conversation with my pediatricians when I feel like educating because sometimes it is absolutely exhausting. And I had to back away from the Twitter thread because of that, that it is exhausting to keep educating and educating. You don't know everything about type 1 diabetes, you're not a specialist. Thank you for pointing this out. But what can we do about it? What's the point? Why would you say you're going to be in trouble? I'm going to give you a wake up call. I'm going to scare you straight. Why would you say all those things Thinking the outcome is going to be positive? If you're aware of a study that talks about these things, and I was pilloried on Twitter for suggesting there could be a study, what would the control group look like? people who never get good health information, people who are never shown their bad eyes, or that they're going to lose a limb or blah, blah, blah, right? No, look, I don't create scientific studies. But you don't have to be a genius here. But why couldn't you something really short, that just gives you a taste of what we're talking about here? Do a six month study, right? Pick an age group to a six month study your 25 year olds with Type 1 diabetes, everybody gets the same exams, but your feedback is - you're doing terrible. You have to be nervous. We're scaring you straight, kiddo. It's a wake up call. Now go get better. And the other one is, Hey, I really feel like we could do more together. Well, how can I support you? What are the challenges you're seeing that are creating these issues with Type 1 diabetes, there may not be anything I can do to help but I understand that you're probably doing the best you can because type one is really difficult. And then the other one, the third part of the study would People who are told here are your test results. See you next, right with no emotional kind of feedback. Why couldn't you do a quick study of that and see what happens in just six months? My guess is you would see really interesting results. So better minds than me, thank goodness picked up on this and actually put it in a presentation at ATTD, at the international conference for advanced technologies and treatments for diabetes. This is the conference that I just talked to Kevin Sayer. That episode just aired a couple days ago. This is where he was in Madrid, Spain. So this is a huge international conference and this Twitter thread made it to a presentation, which shocked me. What shouldn't have shocked me is who was doing the presentation. This was the hashtag talk about complications presentation by Renza Scibilia and grumpy pumper Chris, who we've had them both on the show separately to talk about this and other issues. But this talk about complications slide that made its way to the presentation showed the original a tweet from the doctor, the ophthalmologist comedian, and they actually blacked out his name, which I didn't do here, because Twitter is public. And they showed the original tweet, you know, very effective wake up call. And then they put another tweet next to it. And I think that this is a hope that physicians might consider saying this instead. So let me read you the original tweet again. And then the one that they suggest. So the original tweet, “Why are diabetic eye exams are so important? I can take a 28 year old with an A1C of 14 show her a  picture of a normal retina, then a picture of her diseased retina then a picture of what her retina could look like in 10 years with an A1C of 14. Very effective wake up call.” Here's an alternative to saying that “Diabetes is really tough, and you're managing as you can right now. Thank you for coming to see me eye screening is really important. We know having a higher A1C increases the risk of diabetes related conditions. Let's work together to try to reduce the risks.” Now I know some of you and maybe hopefully if you got your physician or not Doctor or dentist or somebody else to listen to this episode, it might sound very, you know, Kumbaya and woo woo. And, you know, let's work together. But I'm telling you, as the mom of a kid with type one, as a person who sees doctors for her own conditions, it is so much more helpful to hear this than to hear the other scary, effective wake up call. I mean, you know, when I go to my doctor, and I say, I'm really upset, I've been trying hard and gaining weight, you know, what I don't want to hear is “You're really fat. And we know that being obese can help lead to health complications, and higher increase of cancer. Because you know, you really want to watch out what happens, you have this risk and your family and blah, blah, blah. So just stop eating desserts.” What would be really helpful is, “Yeah, boy, it's really tough. I can see that your whole life, you've been a healthy weight. You're an active person who knows how to eat well. What's changed in your life in the last couple of years? How old are you? What is your metabolism doing? Let's sit down and talk about how things are changing maybe so that you can find a plan that might help you change” I mean, I just came up with that at the spur the moment, but it's so much different to here. Let me help you. And let's figure out what you can do to make this better rather than let me blame you and shame you and scare you. A lot of people tune that out. And if they're scared, they don't want to do anything to make it better because they lose hope. I really hope that some healthcare professionals who saw this on Twitter took a moment to stop and think about it. I know a lot of them responded. And remember kind of insulting frankly, calling the diabetes advocates, trolls and one person called the bats. I don't know if that's a UK thing, or I don't know what that was all about. And there were some people who got kind of nasty, as I said earlier, but I really hope that people who saw this conversation, maybe had a different conversation with the next patient that came into their office, maybe a person with diabetes, who saw the conversation had the words now to tell one of their health care providers. Look, this isn't helping me. I need you to speak to me in this way. Which is really, really hard to do. I will say before I let you go here that a lot of the physicians piped in with Well, my patients never react poorly when I give them this news, they all seem to appreciate it. Do the doctors not know that we talk to them differently than other people? Do doctors not know that some people like get dressed up to go to the doctor will really make sure that they are well groomed. I mean, it sounds silly, but you know exactly what I'm talking about. Right? doctors don't realize that we go to our cars. And as Melissa said, in that tweet, sometimes we cry, we call the friend and say you won't believe what happened to me. Or some people will tell a nurse things that they won't tell a doctor or they'll tell the front receptionist and they'll get the anger and so the doctor, people don't tell their doctor unless you're me and you're a pain in the butt. Very few people tell their doctor, hey, you're wrong. Or I don't like this. Or even Can we try something different? People don't talk back to doctors. And the fact that they don't know this… Come on, guys. You got to be better. You got to think about it. What do you think my way off base here? Were you part of that? Twitter chat, did it make you mad? Did it make you think? Let me know. You can always email me Stacey at Diabetes Connections. com. I'll put this in our Facebook group as well Diabetes Connections of the group on Facebook. I'd love to keep the conversation going. If you're a physician who has listened to this long oh my gosh, thank you so much. I cannot tell you how much we appreciate it when you take a moment to consider the other side of the stethoscope for lack of a better word. Let's keep this conversation going. Of course, if you think I'm wrong, I am the world's worst diabetes mom, I can live with that. And you can find out much more at the website diabetes dash connections.com. Please subscribe to the show on any podcast app or just keep listening through social media or however you found us. We appreciate that we're not going to tell you where to listen. We just hope you keep on tuning in. I'm Stacey Simms, and I'll see you back here next week.   Unknown Speaker  15:57 Diabetes Connections is a production of social Stacey Simms media All rights reserved all wrongs avenged   Transcribed by https://otter.ai

  As we all wait for the release of the newest hybrid closed loop software, Stacey has some thoughts about what she hopes it'll bring to her family's experience. Transcription below! Check out Stacey's new 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 This episode of Diabetes Connections is brought to you by “The World's Worst Diabetes Mom, Real Life Stories of Parenting a Child With Type One Diabetes,” available now as a paperback eBook and audiobook, Learn more at Diabetes dash connections.com Welcome to one of the minisodes of diabetes connections. I'm your host, Stacey Simms. And I started these shorter episodes this year, just so I could talk a little bit about stuff that interests me. We still have our weekly episodes every week that are longer and more interview based. But these are just little bits of topics one at a time, where I want to kind of share what's on my mind and then hear back from you whether it's in the Facebook group or elsewhere on social media. If you are new, we have a terrific Facebook group. It's diabetes connections, the group, please reach out and join and you can always reach out via email. or other social media I am Stacey at diabetes dash connections calm. And today I want to talk to you about some thoughts on Control IQ, the new hybrid closed loop system from Tandem.   The emails for Control IQ were set to go out this week. So I'm sure there was a lot of online chatter and you know, scrambling for this and did you get your email and that kind of stuff? Did you get your prescription? And do you have it yet? And have you downloaded it? And I thought it would be fun to just take a moment before you know we start sharing our thoughts about Control IQ and trying it you know, just for the record, kind of to get this down. What are my hopes, what are your hopes for Control IQ and really for a lot of these hybrid closed loop systems and before I get into that, for the Hybrid closed loop systems systems. I think that your perspective on this has to depend on when you entered the diabetes community. I know we have people listening who have been diagnosed for years and years, you know, 50 plus years, 60 plus years. And their perspective is going to be very different than someone whose child perhaps was diagnosed six months ago. So just as a reminder, my perspective is that of a parent whose child was diagnosed 13 years ago, at 23 months, who went seven years with no CGM, because frankly, we didn't we didn't really feel like it was accurate enough to put a second sight on my kid's body. And by age nine, it really became his choice. And then when he chose to do it, I don't think he's taken it off for more than two days. You know, Maybe a beach trip here and there. But we really are huge fans of CGM. And he's had a pump since he was two and a half. So that's my perspective. Look, I know this is not going to be perfect, right? I mean, all this technology has issues. But what I really hope but I am hoping for is not, you know, perfect numbers, right? I don't think Benny's A1C is going to suddenly go down to 5.8. And that's not my goal. What I'm really hoping from Control IQ. What I'm really hoping we get from Control IQ is less stress, less of a mental burden on both of us, and more freedom for Benny. And let me just talk a little bit about that. Because I if you know me, and you listen to the show, we give him a lot of freedom. But a perfect example is he was at a wrestling tournament. I mean, he's just off crutches recently, but the kid hasn't missed a practice or a meet. He just really likes to go and be part of the team and they put him to work. He's been Great, but he went to a trip where he was catching the bus at school at 6am. They took the kids, this was a Saturday, they took the kids about 45 minutes away. He didn't get home until eight o'clock that night. They feed them on the road. It's a lot of potluck. It's a little bit of fast food, but it's really nice. A lot of parents get together and make homemade stuff. And I pack lunches for Benny too, just because he likes to eat certain things. It's not about diabetes really. and then you know, I try not to hover and check in all day. Obviously, I can see his blood sugar on the Dexcom and he's responsible for remembering and taking care of himself. And on a lot of these days, and this is this happens really just about every weekend during wrestling season, and usually once during the week they have a match after school to what generally has been happening is he's bolusing after, because he's not sure exactly what he's going to eat, or he forgets, right, and that he's kind of correcting a little bit late. So we haven't had any really crazy highs. I mean, there's one inset issue we had, but he's been kind of floating up to like 210 to 215. And then I'm debating when do I text him because we do have an agreement, we, you know, that is well within my rights to text him, but at the same time, you know, I want to leave him alone. I don't want I don't want to burden him. So it's been a little bit of a struggle and I'm really hoping for his Control IQ evens those numbers out, right, I don't really expect it to take care of you know, if he forgets to bolus and spikes up to 400, which happens every once in a while and he come on, I don't expect it to fix that. But if he's bolusing as he's eating or a little bit after, or he miscalculates carbs, right? I'm really hoping it helps with that. I'm hoping it helps with the excitement spikes and some of the adrenaline spikes from athletics. I don't know what it'll do with that. I'm optimistic but You know, we'll have to see, What I hear about all the time from people who have done the DIY loops is that they, they don't necessarily have, quote, better control or more in range numbers, because a lot of people who do DIY frankly, I mean, they had really low A1Cs to begin with many of them. I know as you're listening, you're saying not me, okay, I'm just making a generalization stay with me. The point is that they may not see a huge difference in A1C or time in range, but they are seeing better sleep, they are seeing less work, right, more freedom. For Benny, with Control IQ and for everybody with Control IQ, I hope it means less work and less upstairs less mental burden. And for people who do have higher A1Cs, who maybe are newer to pumping or newer to CGM or maybe this is an opportunity for better education. I really hope that those people do see better health and do see better outcomes and do see better outcomes. I mean, as you listen to this podcast, again, making a generalization Here you are, you know, the top educated people in the diabetes community, not necessarily because of this podcast, but we've done the research. People who listen to this show are extremely well educated, you're seeking out more information, you're in the Facebook groups, you're reading stuff, right, you kind of know what's going on. And if you tuned in to learn about Control IQ, just the fact that you know what it is called, and what it is, means you're better educated than probably, I'm going to throw out a number that I'm making up 80% of people in the diabetes community, community, and those are the folks that if they have access to this technology, which is a whole other thing, story altogether, the cost the access, oh my goodness, the costs the access. I mean, I we must acknowledge that. But if they can get this, those people are going to see huge decreases I think in A1Cs and that's really exciting stuff. Is this a solution? a cure? Of course not. And as I just touched on there, we have bigger issues, the cost of insulin, access to insulin access to this technology, education, education for endocrinologists access to endocrinologists for mostly for adults with type one diabetes, right? I mean, there's so much going on here. I didn't mean to get off on a tangent, but my expectation for Control IQ is not that we're going to see miracles. We already sleep through the night pretty well. But I'm hoping that he can continue to have the independence that I give him with more time and range with less nagging from me, you know, gosh, in the back of my mind, I'm really thinking about camp later this year. If you're not familiar, Benny goes away to non-diabetes, regular sleepaway camp for a month every year. And he does really well. That's a topic for another time, I probably will do a minisode on camp. But you know, he does run higher for that month. Some of that is our thinking is about safety. But most of that is about he's a kid who's basically responsible. He's a kid. He's basically responsible for his care 24 seven at this camp, and he will often bolus late or forget a correction bolus. I can't wait to see what Control IQ does for him at camp. It's gonna be really exciting. All right. I know a bunch of you listening are thinking I'm not going to go with Control IQ. I've heard from many people who already see they're going to wait and let it roll out. And then when all the bugs are done, they're going to go ahead and take the plunge themselves. We plan to get it the minute it is available to us. Our endocrinologist, we just saw him at the very beginning of January. He said the prescriptions are in we are all set. So it's possible by the time you hear this, that we already have it and we're using it in Benny's pump, although I doubt it will it will see and I'll post in the Facebook group and I will give a review of course as soon as we possibly can. But man, I'm thrilled to think about this. And if you use another type of insulin pump and you're still listening, you know of course insulin has its own system coming out. Medtronic has a new pump coming out there are more CGM is coming to market. There's gonna be a lot more to talk about, of course when it comes to hybrid closed loops, but we've been waiting for this for a long time, you know, Those loops. But we've been waiting for this for a long time, and I'm so excited to see what it does for Benny. And you know, Benny would probably be the first to tell you that I am the world's worst diabetes mom. If you'd like to learn more about the book or about me, you can head on over to diabetes dash connections dot com and be sure if you're new especially to check out our extensive archive of shows. You can search by keyword or by subject. We will be back next week with our regular interview longer episodes and those drop on Tuesdays. Beginning This month we have added transcriptions for every episode, and you can see those over at the homepage, just click on the individual episode homepage and scroll down and you will see the text of the episode. A lot of people have been asking for that I'm really excited to provide it to provide it. Thank you so much for listening. I'm Stacey Simms. I'll see you back here on Tuesday. Until then, be kind to yourself.   Transcribed by https://otter.ai

Do you share your CGM graphs and A1Cs online? Why? Stacey talks about the trend of sharing everything on social media and wonders if what she learned in her radio career might help us all make sense of when and how to better share. Check out Stacey's new book: The World's Worst Diabetes Mom! In 2020 we're adding these mini-episodes to the weekly line up. Each Tuesday you'll hear the regular longer format interview shows. Thursdays will be these Stacey-solo shows. 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 Show transcript (rough copy so please excuse spelling, grammar, punctuation) Stacey Simms  0:00 This episode of diabetes Connections is brought to you by the World's Worst Diabetes Mom: Real Life Stories of Parenting a Child With Type One Diabetes, available as a paperback eBook and audiobook. Learn more at diabetes dash connections.com   This is Diabetes Connections with Stacey Simms.   Stacey Simms Welcome to something new on diabetes connections. I'm your host, Stacey Simms. And this is a mini sode, a very short mini episode. I'm going to be doing these in the new year. Just me sharing some thoughts, advice and experience. Please keep in mind, everything I'm talking about here is only through my personal experience as a parent of a child with Type One Diabetes. I am not a medical professional. And I am the author of the world's worst diabetes mom. So keep that in mind as well. One of the questions I get All the time is why don't I share Benny's numbers? Why don't I share my son's A1Cs? Why don't I post more graphs? I do occasionally show some CGM action, you know when I'm trying to prove a point or talk about stuff. But why don't I do that more regularly and especially the A1C numbers? Well, I really did share them for a long time. Benny, he was diagnosed right before he turned two and social media wasn't as big a thing in 2006 when he was diagnosed, but a couple years later, it was and I shared them on Twitter and Facebook until he was about seven, I'd say. And then I became friends with Moira McCarthy, who is a very well known author, blogger. She helps me out on diabetes connections as my co host of the Ask the D mom episodes, and she asked me to think about why I was doing that. And it really did did took me back. I took a step back on that. And after I thought about it for a while, I did stop sharing them. And here's what really helped me. It's one way of looking at it. That might sound funny. Radio really helped me make more sense of how I felt about diabetes numbers. If you're not familiar, I worked in radio for a very long time I started my career while I was in college, at a radio station. I worked at WSYR, I was the weekend reporter in Syracuse, New York for the old news station there. And then after college, I was a local TV anchor and reporter for many years, moved to Charlotte, North Carolina, where I live now in that capacity. I work for the CBS affiliate as a TV reporter and anchor for a couple of years. But I went back to radio for a decade and I did mornings at WBT, one of these big heritage radio stations. So my old Program Director, Bill White, used to caution us against putting too much stock into the ratings. You know, you get these Nielsen ratings, at least you used to in radio, and I want to say you got them every quarter. And these were the ratings that would give us I mean, not just bragging rights, which was a lot of fun to say, you know, we're number one in the market or you know, we're number two or whatever. It was, but they would also set the commercial rates, right how much the sales people could charge for a commercial at any given time on the radio station. Now, it changed a lot in the time that I was in radio, because the ratings systems switched from Nielsen ratings, which were you were writing down what you listen to, I don't know if you ever had one of these Nielsen books, but that's what it was, you would get a physical book. Remember those pen paper like a workbook, and you should write down what you listen to. That's why so many radio stations repeat their call letters a billion times, or at least they did back then. Because they wanted you to remember the call letters when you got your little Nielsen book. So if you're listen to radio station, they're always like news, weather, traffic, you're listening to news talk 1110 WBT, you know, why did we say it a million times an hour, we needed it to stick in your head so you would write it down. But then, really just a couple of years before I left radio, the portable people meter, the ppm system took over and changed everything. So ppm, if you're not familiar, is a system that was developed, I want to say by Arbitron, but now part of Nielsen. So it's like a pager almost, and you wear it. And it detects hidden audio tones, I kid you not within the audio stream, so it logs every time it finds a signal. So a ppm basically picks up when you're listening. And when it came through, there was a lot of talk about is it accurate? Is it biased to younger people who are going to walk around with this thing as opposed to older listeners who can't be bothered, you know, will it pick up stuff in gas station stores that play music or restaurants you know, blah, blah, blah, doesn't matter that ship has sailed. The ppm is now how radio stations get their ratings and it changed everything which is a story for a different time. But I will say if your your local fun morning show is talking less than playing music more, or you're hearing some changes, really you would have heard these almost 10 years ago now and the way you listen to radio Do it was because of ppm and you know now it's debatable whether radio podcasts streaming, that's a whole other story. But so ppm for us really changed the numbers. Our radio station WBT never really sold on those numbers strictly though, because we had a very desirable audience. We had an older audience, our audience had more money, they were more loyal. They were really apt to buy what we were selling. So we did not have to live and die by the ratings, thankfully, and that is what Bill warned us against my program director. If we got so caught up and excited about the really, really good ratings, would we be devastated by the bad, right where we doing a good show where we serving our listeners, my co host, used to say, super serving our listeners, you know, where we doing all we could for our clients, you know, we were doing all this at 5am where we're doing everything we could do, and that's what we were supposed to focus on. Bill's point was Don't let the numbers run your life. Life and a new station. This is really important. Think about when you might listen to your local news station, you might listen when there's a power failure and you need that radio, you might listen when there's a huge news story, you might just listen occasionally. I mean, in the olden days, you'd listen for school closings before the internet. So we'd get these, these spikes that were very attributable to events, right. And then we would get these lows, that maybe were also attributable to events. But if you got emotionally caught up and thought, oh, all these people are listening, because I'm so great. Then you could also get emotionally messed up when you're thinking they're all tuning out because of me. So you can't put the numbers before what you're supposed to be accomplishing. As a news broadcaster. We were there to inform, to entertain a bit sure, but to inform. And I think Bill's advice is really applicable to diabetes. Look, of course, numbers are important. Of course, we need to pay attention to them, but We can't run our lives around them, we can't let them have the emotional power that many seem to want to give them. I mean, I've been guilty of this too. But you have to step back and recognize they are information, they are guidelines, they are not your value. If your self worth is coming from your child's or your A1C,  I'd really encourage you as Moira did to me years ago, step back and think about that, think about why. And then I would encourage you to try to move that good feeling off of those numbers and onto other ways that you're dealing with diabetes. I mean, for very young children. I mean, that can be such a roller coaster. The victories for me, were the smiles with grandparents, you know, bedtime snuggles, milestones like potty training, you know, even when your your little kid learns to share, right? These are all ways of celebrating and as your kids get older, participating in sports or in the school play, getting their drugs permit Ben he just got his somebody come hold my hand. Oh my god. But these are things to celebrate first date, right? Oh my gosh, these are ways to celebrate with diabetes that aren't about the numbers. Just thinking back right? What stands out if you have older kids, or if you're an adult with type one, what stands out for you? Do you remember that excellent doctor's appointment? Or do you remember feeling really good and doing something that you loved? Because you have to be in range have to be taken care of yourself to be feeling good at these times is all is my point. But you're not focusing on the actual number right? If you're calling your endo appointment, mommy's report card, I am talking to you. Because what happens is, so many people share only the so called good numbers, right? But they don't want to share the so called bad ones. Because if you have publicly celebrated, let's just say a 6.5 A1C you may feel really bad about 7.8 or higher? I mean, let's be real here. And something else to keep in mind. And maybe the most important thing is that for parents, you're making these choices for your kids. You're putting their health information online, you're putting it out there adults, this is different for you. I mean, these are your choices. But parents, you're making a decision for your kids and you're really not getting their okay. And I don't think a seven year old can really decide if it's okay, right. Remember, if you're in a private Facebook group, nothing online is private, nothing you're sharing online once you hit send, or put it out there. Nothing online is private. And that's really the biggest reason why I stopped sharing Benny's A1C. I decided there was no reason for me to leave a breadcrumb trail of health information on the internet for someone and employer and insurer, anybody to find when he was an adult, I don't care how good his numbers have been. And trust me they're far from perfect. Sometimes they're No need to share that. One more thing. There is a school of thought that you don't even need to tell younger children what their A1C is. And I wish I had done that. I mean, I don't really think Benny ever knew until he was out of elementary school. But a lot of endocrinologists are now writing it down and showing the parents if you're in the room together, or maybe emailing it to you later through a health portal, which is protected by HIPAA in a way that Facebook obviously is not. And I think that's great, because you can easily find ways to celebrate or mark time with your kids or, you know, hey, we're at the endo and that's always a reason why we do. We go to a movie, we go shopping, we do a special high five, whatever works for you. But you're not celebrating the number per se. And back to Benny for a moment. Here's how I know he didn't know what his A1C was when he was little. He had a nurse asked him once he was a camp so he was in a not normal setting. And the kids were eating ice cream and I don't know why the nurse was involved. Maybe they were doing it at the health center. Who knows But he asked for his ice cream. And she said, Oh, I don't know. Should you be eating this? What's your A1C?  He was about eight, maybe nine. And he said, I don't know. He turned around and found another nurse and said, Can I have the ice cream? She was like, yeah, sure, Benny, no problem. And, you know, he told me that story when he came home from Camp, but I was kind of glad he didn't know. And I was really glad that he was smart enough to find somebody to give him the darn ice cream. I am not trying to be a killjoy here. You know, we all have what works for us. But I urge you try this. You may find it incredibly freeing not to share your numbers not to share your child's numbers. Come on, you are all so much more than the A1C or the last 24 hours on a graph. Right? You're not raising a number. You're raising a child. I hope this gives you something to think about. Agree. disagree. Remember, I am the World's Worst Diabetes mom. And the book is available on Amazon paperback eBook and audio book and it's available at diabetes dash connections. com where you can always find out more. I hope you come back for our regular full length episodes. Every Tuesday, we feature interviews with newsmakers, athletes, artists, celebrities, authors, speakers, and everyday people, quote unquote just living with Type One Diabetes. I’ve been doing the podcast for four and a half years now, and I really hope you find episodes that you love. I'm Stacey Simms. I'll see you back here next week. Until then, be kind to yourself.   Benny  12:34 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All rounds avenged   Transcribed by Otter.ai

Melissa McCool is the co-founder and CEO of Stellicare Corporation. In 2009, Melissa developed Symptom Targeted Intervention (STI), a clinical program used in thousands of US medical clinics to improve the behavioral determinants of health. Since then, she has written and produced numerous articles, videos, and books and has trained thousands of clinicians around the US and Canada on how to implement STI into clinical practice. Melissa is also an EMDR-trained psychotherapist with a specialization in treating trauma. Her degrees are from UCSD and Columbia University. 00:00 Patient Adherence - Why Patients don't adhere. 03:45 Patient fears. 05:45 Normalizing Patient fears. 07:15 Figuring out the more effective and less effective ways of addressing underlying emotions driving patient behavior. 08:30 What else drives Patient Behavior. 10:50 How the 80/20 Rule changes with Value-Based Care. 12:00 Patient Behavior Problems. 15:00 “I didn't focus on what I thought the patient needed to change, I asked the patient what they thought they needed to work on.” 18:00 Reducing Stress and Improving Adherence. 19:00 The domino effect with Patient Behavior. 21:00 Helping Patients in five minute increments. 23:40 Quality Indicators and A1Cs. 26:30 “Moving the needle,” with “the 20%”. 28:00 Messaging according to Patient Engagement. 30:00 “Our instinct is to work with sweet, cooperative patients.”

Keeping your blood sugar levels in a healthy range is challenging to say the least. Everything from stress to diet, an illness and lack of sleep can impact your numbers. Certified Diabetes Expert Amy Hess Fischl, MS, RD, LDN, BC-ADM, CDE, shares her expert advice and go-to strategies on how to get your numbers to where you want them to be. 

Dexcom has released a few new studies about how people use their continuous glucose monotoring systems. Stacey talks about them with Tomas Walker, Dexcom’s Director of Clinical Projects and a certified diabetes educator. The two studies, released at the American Diabetes Association's Scientific Sessions look at how people use a CGM in the real-world, outside of a clinical setting.  For example, the FDA does not currently label Dexcom for use in making insulin dosing decisions; we are supposed to always confirm with a finger-stick. Of course, not everyone does this and Dexcom wanted to learn more about how and why. Another study looks at how setting the threshold alerts (the high and low alerts) within the system affect how people use a CGM and whether their blood sugar outcomes and A1Cs are affected.   In this episode, Stacey also announces the winners of the Pebble Time Smartwatch Giveaway (thanks to all who entered)! She also talks about carrying supplies when in different theme parks, including going over the rules for carrying bags on rides at Disney World and Universal. 

This month, Pediatric Endocrinologist Dr. Stephen Ponder marks 50 years since his own diagnosis with type 1 diabetes. His book and method "Sugar Surfing" use CGM technology to practice dynamic diabetes management, anticipating where blood sugar numbers will be rather than reacting to where they've been. Dr. Ponder also answers questions from parents about independence, A1Cs and fear.