Podcasts about afrezza

Hey Diabuddy thank you for listening to show, send me some positive vibes with your favorite part of this episode.In today's episode, I sit down with Ginger Vieira, a T1D, freelance Diabetes writer, Mother, and Diabetes author. Many of you have been asking me more about inhaled insulin (Afrezza). So, I thought this would be a great opportunity to do a deep dive into Afrezza and debunk some of the myths behind this incredible fast-acting medication. Ginger Vieira ResourcesWebsiteDiabetes Nerd - YouTube PageType 1 Tea - Podcast  BooksInstagramLinkedinOther Episodes With Ginger#244#144#137Coach Ken's Resources:Website: www.simplifyingdiabetes.comNewsletter Sign Up"More Than A1C" - My Signature Coaching ProgramThe Diabetes Nutrition Master CourseThe 5-Pillars Of Diabetes Success WorksheetDecember (2024) Stronger Together With T1D Get-TogetherSupport & Donate To The PodcastHave a question, send me a DM or email. I'd love to connect and answer any questions you have.You can find the show  on any platform you listen to your podcasts!Don't forget to click on that subscribe button and leave a 5-star review, so you're notified when new episode drop every week.Questions about diabetes, don't hesitate to reach out:Instagram: @CoachK3NInstagram: @thehealthydiabeticpodFacebook: @Simplifying Life With DiabetesEmail: ken@simplifyingdiabetes.comPodcast Disclaimer: Nothing that you hear on The Healthy Diabetic Podcast should be considered medical advice or otherwise; please always consult your medical TEAM before making any changes to your Diabetes management.Support the show

Paul shares his extensive Afrezza knowledge.  JUICE CRUISE 2025 Eversense CGM Learn about the Medtronic Champions Try delicious AG1 - Drink AG1.com/Juicebox I Have Vision Use code JUICEBOX to save 40% at Cozy Earth  CONTOUR NextGen smart meter and CONTOUR DIABETES app Learn about the Dexcom G6 and G7 CGM Go tubeless with Omnipod 5 or Omnipod DASH * Get your supplies from US MED  or call 888-721-1514 Learn about Touched By Type 1 Take the T1DExchange survey *The Pod has an IP28 rating for up to 25 feet for 60 minutes. The Omnipod 5 Controller is not waterproof.  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 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! 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 Apple Podcasts. Thank you! The Juicebox Podcast is not a charitable organization.  

Aisha has lived with type 1 for over 30 years. We talk about coming out, Afrezza and doctors that don't help. JUICE CRUISE 2025 Eat Hungryroot Screen It Like You Mean It Eversense CGM Learn about the Medtronic Champions This BetterHelp link saves 10% on your first month of therapy Try delicious AG1 - Drink AG1.com/Juicebox I Have Vision Use code JUICEBOX to save 40% at Cozy Earth  Get Gvoke HypoPen CONTOUR NextGen smart meter and CONTOUR DIABETES app Learn about the Dexcom G6 and G7 CGM Go tubeless with Omnipod 5 or Omnipod DASH * Get your supplies from US MED  or call 888-721-1514 Learn about Touched By Type 1 Take the T1DExchange survey *The Pod has an IP28 rating for up to 25 feet for 60 minutes. The Omnipod 5 Controller is not waterproof.  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 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 Apple Podcasts. Thank you! The Juicebox Podcast is not a charitable organization.

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: Mannkind releases info about it's Afrezza pediatric studies, Dexcom launches AI tech with Stelo, Health Canada approves Tandem/Dexcom G7, diabetes drug may help sleep apnea, an app in development to help drivers with T1D and more! 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 Episode transcription with links: 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 Mannkid expects to talk to the FDA about Afrezza inhaled insulin for pediatric approval early in 2025. The company just announced six-month results from its Phase 3 INHALE-1 study of kids aged 4-17 with type 1 or type 2 diabetes comparing either inhaled pre-meal insulin or multiple daily injections (MDI) of rapid-acting insulin analog, both in combination with basal insulin. A 26-week extension phase in which all remaining MDI patients were switched to inhaled insulin is ongoing. HbA1c change over 26 weeks exceeded the prespecified non-inferiority margin of 0.4% (0.435%), largely driven by the variability of a single patient who did not adhere to the study protocol. A modified ITT (mITT) analysis, which excluded this subject, did not exceed the predetermined threshold of 0.4% (0.370%), thereby establishing the non-inferiority of Afrezza to MDI, which was the primary endpoint of the study. Over 26 weeks of treatment, there were no differences in lung function parameters between the treatment groups, There were no differences between groups or concerns in other safety measures, including hypoglycemia. https://www.medscape.com/viewarticle/inhaled-insulin-benefits-kids-diabetes-too-2024a1000nex   XX Dexcom announces the use of AI for its Stelo platform. The company says the new Dexcom GenAI platform will analyze individual health data patterns to reveal a direct association between lifestyle choices and glucose levels while providing actionable insights to help improve metabolic health. Stelo users will start seeing the features this week. The AI is modeled after Google Cloud's Vertex AI and Gemini models. We'll hear more about this in January – Dexcom will be part of a panel at the Consumer Electronics Show about AI and healthcare. BTW this press release is the first time I've seen what seems to be a new slogan for Dexcom – Discover What You're Made Of. https://www.businesswire.com/news/home/20241217011997/en/Dexcom-Launches-the-First-Generative-AI-Platform-in-Glucose-Biosensing XX Staying with Dexcom, users report that the geofencing issue we reported on seems to be resolved. Previously, if you had an issue with Dexcom G7 outside of your home country, you couldn't reinstall or use the app without customer support. With the latest iOS and Android G7 apps, this seems to be resolved. This is according to the folks in the DIY community who first brought it to my attention.   XX Interesting insulin development to watch. Egypt approves EVA Pharma's insulin drug products, which is a collbaration between Eli llly and EVA, an Egyptian company. The Egyptian Drug Authority approved the insulin glargine injection manufactured by EVA Pharma through a collaboration with Eli Lilly and Company (NYSE: LLY). Launched in 2022, the collaboration aims to deliver a sustainable supply of high-quality, affordable human and analog insulin to at least one million people annually living with type 1 and type 2 diabetes in low- to middle-income countries (LMICs), most of which are in Africa.   Lilly has been supplying its active pharmaceutical ingredient (API) for insulin to EVA Pharma at a significantly reduced price and providing pro-bono technology transfer to enable EVA Pharma to formulate, fill and finish insulin vials and cartridges. This collaboration is part of the Lilly 30x30 initiative, which aims to improve access to quality health care for 30 million people living in resource-limited settings annually by 2030. https://www.prnewswire.com/news-releases/lilly-and-eva-pharma-announce-regulatory-approval-and-release-of-locally-manufactured-insulin-in-egypt-302333269.html     XX Can we add treating sleep apnea to the list of applications for terzepatide? That's the generic for Zepbound and Mounjaro. Phase 3 study shows that 10- and 15-milligram injections of Zepbound "significantly reduced the apnea-hypopnea index" among those who have obesity and moderate-to-severe obstructive sleep apnea. Eli Lilly said there was nearly a 20% reduction in weight among those in the trials. The company said it plans to submit its findings to the Food and Drug Administration and other global regulatory agencies beginning mid-year. https://www.aol.com/popular-weight-loss-drug-could-131507702.html   XX Health Canada okays Tandem's tslim X2 with Dexcom G7 and G6 making it the first and only insulin pump in Canada that is integrated with both Dexcom sensors. Now, t:slim X2 users in Canada can experience even more choice when it comes to CGM compatibility, along with the option to spend more time in closed loop with Dexcom G7's 30-minute sensor warm-up time, faster than any other CGM on the market.3 In addition, t:slim X2 users who pair Dexcom G7 with an Apple smartwatch4 can see their glucose numbers directly from their watch without having to access their pump or smartphone4. Tandem will email all in-warranty t:slim X2 users in Canada with instructions on how to add the new compatibility feature free of charge via remote software update. t:slim X2 pumps pre-loaded with the updated software will begin shipping to new customers in early January 2025.   To check coverage and start the process of getting a Tandem insulin pump, please visit tandemdiabetes.ca. https://www.businesswire.com/news/home/20241210731189/en/Tandem-tslim-X2-Insulin-Pump-Now-Compatible-with-Dexcom-G7-CGM-in-Canada XX A federal jury on Tuesday awarded Insulet $452 million in its patent skirmish with EOFlow over insulin patch pumps. The jury awarded Insulet $170 million in compensatory damages from EOFlow and an additional $282 million in exemplary damages for willful and malicious misappropriation. A judge has not yet entered a judgment on the decision. Insulet filed a lawsuit in the U.S. District Court for the District of Massachusetts in 2023, claiming EOFlow copied patented components of its Omnipod insulin pumps. In October 2023, the Massachusetts district court issued a preliminary injunction against EOFlow. Following that decision, Medtronic called off plans to buy EOFlow for about $738 million.   A federal appeals court later overturned the preliminary injunction, and EOFlow resumed selling its devices in Europe. The company recently defended against a separate injunction filed by Insulet in Europe's Unified Patent Court, according to Korea Biomedical Review, an online English newspaper based in Seoul, South Korea.   The Massachusetts jury found this week that EOFlow and CEO Jesse Kim, as well as two of three former Insulet employees who were named as defendants in the lawsuit, misappropriated Insulet's trade secrets.   Insulet CEO Jim Hollingshead said the company is “extremely pleased with the jury's verdict.” EOFlow did not immediately respond to a request for comment. https://www.medtechdive.com/news/insulet-eoflow-jury-verdict-patent-lawsuit/734745/ XX A tele-education program for health care providers who treat people with diabetes resulted in significant improvements in patient outcomes, including better blood sugar levels and increased use of medical devices to manage the disease, a University of Florida study finds. Led by researchers in the UF College of Public Health and Health Professions and the UF College of Medicine, the program used the Extension for Community Health Care Outcomes model, which has been adopted worldwide to train clinicians who treat patients with a variety of conditions. Known as Project ECHO, this is one of the first to demonstrate patient benefits for the program in a large, randomized trial. The findings appear in the journal Diabetes Care. https://ufhealth.org/news/2024/clinician-training-program-leads-to-better-outcomes-for-patients-with-diabetes XX New app under development to make driving safer for people with diabetes. Diabetes Driving Pal says it will use CGM data and guide you while you are driving without any annoying alerts. Guidance/suggestions will be on your car dashboard so that you don't have to look at phone and it will be very individualized and actionable. In a study last year, ~70% of people have reported (5% reported accident) to have at least one low blood sugar while driving and most reported that CGM alerts were not enough to protect them. We are hoping to start beta testing in a few months. We are trying to raise the fund to develop this product. We need your support. For more information, please visit: https://lnkd.in/gTDhnDc4 XX I'm also going to link to the top ten most read diabetes and endocrinology stories of 2024 from Medscape. This is almost all GLP-1 related.. and mostly for people with type 2. https://www.medscape.com/viewarticle/icymi-top-10-diabetes-endocrinology-stories-2024-2024a1000n6u?&icd=login_success_email_match_fpf XX That's it for the last In the News of 2024! Don't miss out episode next week with a look ahead to what we're watching in 2025. I'm SS I'll see you back here soon…

Dr. Blevins is back to talk about the inhaled insulin called Afrezza. JUICE CRUISE 2025 Screen It Like You Mean It Eversense CGM Hungryroot eat healthy Learn about the Medtronic Champions This BetterHelp link saves 10% on your first month of therapy Try delicious AG1 - Drink AG1.com/Juicebox I Have Vision Use code JUICEBOX to save 30% at Cozy Earth  Get Gvoke HypoPen CONTOUR NextGen smart meter and CONTOUR DIABETES app Learn about the Dexcom G6 and G7 CGM Go tubeless with Omnipod 5 or Omnipod DASH * Get your supplies from US MED  or call 888-721-1514 Learn about Touched By Type 1 Take the T1DExchange survey *The Pod has an IP28 rating for up to 25 feet for 60 minutes. The Omnipod 5 Controller is not waterproof.  How to listen, disclaimer and more 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 Apple Podcasts. Thank you! The Juicebox Podcast is not a charitable organization.  

In this special edition recorded at the 84th American Diabetes Association Scientific Sessions, Carol Levy, MD, director of the Mount Sinai Diabetes Center and Type 1 Diabetes Clinical Research, joins the podcast for a deep dive into the INHALE-3 trial and how to incorporate individual patient-level factors into the management strategy of patients with type 1 diabetes who could benefit from inhaled insulin (Afrezza). Their second on-site episode focused on the INHALE-3 trial, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, begin the conversation by focusing on the differences in safety and efficacy observed with use of inhaled insulin seen among those using automated insulin delivery systems relative to their counterparts using multiple daily injections. Later in the episode, the focus of discussion shifts to the potential of inhaled insulin in optimizing diabetes management among pregnant patients with type 1 diabetes.

At the 84th American Diabetes Association (ADA) Scientific Sessions, INHALE-3 was among the trials to take center stage. A phase 4 trial comparing the use of inhaled insulin (Afrezza) against standard care, results demonstrated use of inhaled insulin, in addition to insulin degludec, was associated with improved HbA1c in patients with type 1 diabetes, with an improvement of 0.5% or greater observed among 21% of those on inhaled insulin and 5% of those with usual care. At the meeting, study investigator Grazia Aleppo, MD, professor of Medicine and director of the Diabetes Center at Northwestern University, joined hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, for a discussion on the trial, results, considerations for practicing clinicians, and next steps for research. In the latter portion of the episode, Aleppo, who serves on the guideline writing committee for the ADA Standards of Care discusses recent updates in diabetes technology. Chapters 00:47 - Intro 01:15 - INHALE-3 08:00 - Reasons for Participating 10:40 - Results in AID Users 17:01 - Updates in Diabetes Technology

Today we are discussing Afrezza with Michael Castagna, CEO of MannKind. Screen It Like You Mean It Eversense CGM Learn about the Medtronic Champions This BetterHelp link saves 10% on your first month of therapy Try delicious AG1 - Drink AG1.com/Juicebox I Have Vision Use code JUICEBOX to save 30% at Cozy Earth  Get Gvoke HypoPen CONTOUR NextGen smart meter and CONTOUR DIABETES app Learn about the Dexcom G6 and G7 CGM Go tubeless with Omnipod 5 or Omnipod DASH * Get your supplies from US MED  or call 888-721-1514 Learn about Touched By Type 1 Take the T1DExchange survey *The Pod has an IP28 rating for up to 25 feet for 60 minutes. The Omnipod 5 Controller is not waterproof.  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 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! 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 Apple Podcasts. Thank you! The Juicebox Podcast is not a charitable organization.  

There are so many misconceptions out there about inhaled insulin! Most endocrinologists still don't understand it. The misconceptions keep some doctors from even letting their patients try it! But Ginger is obsessed with it. Sami wants to try it. Her mother is worried about her lungs. Sami's struggling to correct highs! Afrezza inhaled insulin is the fastest insulin on the market — shouldn't Sami be able to try it? OH MY! Type 1 diabetes is so tedious, but inhaled insulin is a game-changer. More on inhaled insulin: Video: Using Inhaled Insulin with Type 1 Diabetes Video: Getting Insurance Approval for Inhaled Insulin Articles: Inhaled Insulin Unscripted and hardly edited, join us for another afternoon of spilling the tea of T1D! Get more from Ginger and Sami here: Sami's Instagram  Ginger's Instagram  HoneyHealth: Sweat by Sami & Ginger's T1D D Ginger's Diabetes Books on Amazon Ginger's YouTube: DiabetesNerd Ginger's Diabetes Articles

Join us as we talk about our experience at the 18th Annual Diabetes Technology Meeting in Europe (ATTD 2024). In this podcast, we'll be unpacking our favorite lectures from the event, which hold some very exciting data and insights. From cutting-edge advancements in diabetes technology to the latest developments in medications, we'll cover it all. Tune in as we explore the forefront of diabetes innovation and share our experiences from this meeting!In this episode, we will talk about:What updates are happening in diabetes technology? What are updates in diabetes medications? What is new with CGMs and Type 2 Diabetes? What is the silence all alert on your Dexcom G7? What is a continuous ketone meter and when is it coming? What is the most common cause of DKA in type 1's? What is time in tight range? What is Tzield (data information)? What is the new data on Afrezza? What is new information about SGLT2 inhibitors? What data information came out regarding Mounjaro? Show notes:Diabetes Technology Podcast - https://tcoydthepodcast.transistor.fm/47TCOYD Video Vault - https://tcoyd.org/tcoyd-video-vault/TCOYD Live PLUS Diabetes Technology https://tcoyd.org/live-feb-2024/?  ★ Support this podcast ★

Kelly uses Afrezza, an inhaled insulin. Eversense CGM This BetterHelp link saves 10% on your first month of therapy Try delicious AG1 - Drink AG1.com/Juicebox Use code JUICEBOX to save 40% at Cozy Earth  Get Gvoke HypoPen CONTOUR NextGen smart meter and CONTOUR DIABETES app Learn about the Dexcom G6 and G7 CGM Go tubeless with Omnipod 5 or Omnipod DASH  Get your supplies from US MED  or call 888-721-1514 Learn about Touched By Type 1 Take 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 My type 1 diabetes parenting blog Arden's Day Listen to the Juicebox Podcast online 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! 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 Apple Podcasts. Thank you! The Juicebox Podcast is not a charitable organization.  

The inhalable insulin known as Afrezza begins affecting blood glucose remarkably faster than injected insulin, in just roughly 2 minutes. Ginger Vieira tells us her experience using Afrezza for three years, how she implements it into her treatment and how it works.   Ginger's Website | Ginger's Youtube   DISCLAIMER: This podcast is not medical advice. Always consult with your doctor before making changes to your health care.   Fill out T1D Exchange Registry    Follow for more: Instagram | Tik Tok | YouTube | Facebook   Watch Video Podcast on Youtube 

At Moms' Night Out Providence, I was part of an Ask Us Anything panel that included Moira McCarthy and Kerri Sparling. We had a lot of fun on this panel and a lot of fun at MNO period. If you're wondering what this event is all about, I think this panel will give you a lot of insight. It's serious, and humorous, I hope helpful, and it's all peer to peer – we're not doctors. Moira McCarthy's daughter, Lauren, was marking 26 years with T1D during this event! Moira is a ski, adventure and travel writer. A JDRF International Volunteer of the Year and author of six books including, “Raising Teens with Diabetes.” Her blog Despite Diabetes helped me a lot and she's left it up as a resource. Kerri Sparling is a writer, poet and speaker who has dedicated her life to the power of the patient narrative. Best known for the blog and book, “SixUntilMe,” she is the author of “Balancing Diabetes” and “Rage Bolus and other poems.” Kerri has lived with type 1 for 37 years. Our next MNO is in Charlotte in February 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! 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  

It's been five years since Ryan Reed has been behind the wheel at a NASCAR track. He raced in Vegas earlier this month as part of the Xfinity Cup Series. We talked about what's changed for his T1D management, how he handles diabetes & driving, why he's changed to a pump since we last talked and much more. Reed also explains why he appreciates the diabetes community now more than ever. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Our previous episodes with Ryan Reed (and one with his mom!) 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    

Most of us wouldn't think twice about using someone else's emergency glucagon if our child or another adult needed it. But that's something a school nurse or other health care provider could lose their license over. Now, some states are passing legislation to make it easier for anyone to use any one's rescue glucagon. We talk to Georgia State Rep. Doug Stoner and his wife, Trip Stoner, a long-time diabetes advocate who lives with type 1 about what they were able to get passed in their state, what you can do to take action in yours, and what they're planning next to help people with diabetes. Find your legislators here  Read Georgia's glucagon bill here  Contact Doug here: Rep.DougStoner@gmail.com Moms' Night Out Registration is OPEN 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    

It's one of the biggest milestones in my family's experience with diabetes. Our son is off to college! I asked Benny to come on and talk about what's on his mind, how he's feeling and to answer your questions, including if he's going to tell people he has T1D. We also answer your questions about overnights, how we've prepared, our plan for share and follow and much more. I can't believe this day is here! This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Our previous episodes with Benny: https://diabetes-connections.com/?s=benny Don't miss Moms' Night Out - our next stops are in Texas, Rhode Island, & North Carolina 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    

It's almost time for back to school! How do you explain type 1 diabetes to students? I asked a preschool teacher whose daughter has t1d to talk about how to get the message through without scaring anyone. Laura Self also has a great book our for kids called Sweetie. Her daughter, Hannah, was diagnosed at age 8 and is now 20. She spent the spring semester in Europe this year. Laura and I talk about how we tried to help our children find independence, confidence, and responsibility with diabetes. Moms' Night Out is in three cities! Find out more before our early bird specials end.  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    

This week, actress Jennifer Stone lives with LADA.. she decided to become a nurse and started her first ER job in March of 2020. I asked her what it was like knowing she had to take care of her own diabetes while also taking care of patients during a pandemic: You might know Jennifer best from her days on Disney's Wizards of Waverly Place… I caught up with her to talk about how she manages LADA, why she decided to become a nurse and still continue acting... and what's next for her dual careers. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. More about LADA More about Medtronic's InPen system Our previous episode with Jennifer Stone 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    

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 insulin pump gets FDA approval, once-weekly basal insulin for type 2 gets through another trial, New Jersey caps insulin prices for some, possible link between ability to chew and glucose control, a landmark diabetes study moves on to aging and T1D, JDRF Children's Congress and more! Learn about Moms' Night Out - a new event for moms of children with diabetes 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   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 AG1. AG1 helps you build your health, foundation first. XX Our top story, Tandem's Mobi Pump is approved. The FDA cleared the tiny pump for people with diabetes ages six and up. Tandem says mobie is fully controllable from a mobile app and is the world's smallest durable AID system. It still has a button on the pump to dose and holds 200 units. You use the same infusion set as the current Tandem pumps and Mobi uses Control IQ. Limited release planned for late this year and fully available early 2024. https://www.drugdeliverybusiness.com/fda-clears-tandem-mobi-automated-insulin-pump/ XX Learning more about a newly approved therapy for type 1 diabetes called Lantidra. Two safety and efficacy studies found that 21 participants who took Lantidra did not need to administer themselves insulin for a year or more. Twelve of those participants did not need to take insulin for up to 5 years, and 9 did not need insulin for over 5 years. Lantidra is an allogeneic (donor) pancreatic islet cellular therapy. In other words, Lantidra uses cells taken — or isolated — from human organ donor pancreases. “In [a] subsequent process, the insulin-producing islets are purified from the rest of the pancreatic tissue using a density gradient. Once the islets are isolated, purified, and put for a short time in cell culture, the cell preparation is infused into the liver of the recipient,” he explained. https://www.medicalnewstoday.com/articles/fda-approves-first-cellular-therapy-for-type-1-diabetes-what-does-it-do#How-does-islet-cellular-therapy-work? XX Once weekly basal insulin for type 2 gets through another trial. After 26 weeks of treatment and five weeks of follow-up, patients on weekly insulin icodec had significantly larger improvements in their HbA1C than those using daily insulin. Both groups had an extremely low rate of adverse events. These researches say next step is FDA evaluation. https://www.utsouthwestern.edu/newsroom/articles/year-2023/july-weekly-insulin-found-safe.html XX That's the idea behind Fractyl Health's treatment for type 2 diabetes—which could also be used for weight control. The Lexington, Massachusetts-based biotech company is in the early stages of developing a one-time gene therapy intended to lower blood sugar and body weight using the same mechanism as semaglutide. “You have this problem where you need to stay on therapy for efficacy,” says Harith Rajagopalan, a cardiologist by training and CEO and cofounder of Fractyl Health. “That's the Achilles heel.” The company wants to deliver an artificial gene to the pancreas that continuously produces the GLP-1 hormone so there's no need for weekly injections. The approach, called gene therapy, uses inactivated viruses to carry a therapeutic gene to pancreatic cells. (Viruses are used because of their natural ability to deliver genetic material to cells.) The company is aiming to begin an initial human trial by the end of 2024 https://www.wired.com/story/a-one-time-shot-for-type-2-diabetes-a-biotech-company-is-on-it/ XX Gov. Phil Murphy signed three bills into law Monday aimed at cutting the high cost of prescription drugs in New Jersey. The new laws will cap how much residents will pay for some popular medications such as insulin, prevent pharmacy benefit managers from engaging in practices that make drugs more expensive, and create a panel that will monitor prices set by pharmaceutical companies. One measure (S1614) would cap the cost of insulin, epinephrine auto-injector devices and asthma inhalers for state and local public workers enrolled in the State Health Benefits Program, the School Employees' Health Benefits Program and other state-regulated plans. For a 30-day supply, insulin will cost $35, EpiPens $25 and asthma inhalers would be capped at $50, according to the bill. The law takes effect next year. https://www.nj.com/politics/2023/07/new-laws-to-stem-high-cost-of-prescription-drugs-in-nj-were-just-signed-by-gov-murphy.html XX The European Medicines Agency (EMA) said on Tuesday it has extended its probe into Novo Nordisk's (NOVOb.CO) diabetes drugs Ozempic and weight-loss treatment Saxenda, following two reports of suicidal thoughts, to include other drugs in the same class. The agency began its review on July 3 after Iceland's health regulator flagged the reports of patients thinking about suicide and one case of thoughts of self harm after use of Novo's drugs. https://www.reuters.com/business/healthcare-pharmaceuticals/eu-extends-ozempic-probe-include-other-drugs-2023-07-11/ XX We often hear that diabetes can lead to problems with your teeth.. but one researcher says it might be the other way around. A University at Buffalo researchers says there is a notable correlation between chewing functionality and blood glucose levels in people with type 2. Specifically, he found that patients with T2D who maintain a full chewing ability exhibit significantly lower blood glucose levels compared to those with compromised chewing function. The thinking here is that chewing stimulates the body in all sorts of ways, including releasing hormones that help you feel fuller and help in digestion. More studies are expected. DOI: 10.1371/journal.pone.0284319 https://scitechdaily.com/the-surprising-connection-between-chewing-and-type-2-diabetes/ XX The next step of the landmark Diabetes Control and Complications Trial will focus on aging with type 1 diabetes. The original randomized DCCT clinical trial results, published September 30, 1993, in the New England Journal of Medicine, proved that early intensive glycemic control was the key to preventing or slowing the progression of long-term eye, kidney, and nerve complications of type 1 diabetes. Subsequently, EDIC has yielded many more major findings including that early tight glycemic control also reduces cardiovascular risk and prolongs survival in type 1 diabetes. subsequent EDIC data also have suggested that it is never too late to initiate intensive glycemic control Together, DCCT and EDIC — both funded by the National Institutes of Health at 27 sites in the United States and Canada — have changed the standard of care for people with type 1 diabetes Prior to the DCCT, between 1930 and 1970, about a third of people with type 1 diabetes developed vision loss and one in five experienced kidney failure and/or myocardial infarction. Stroke and amputation were also common, DCCT/EDIC chair David M. Nathan, MD, said while introducing the symposium. "All of the advances in care of type 1 diabetes have developed because this study demonstrated that it was important — continuous glucose monitoring (CGM), new insulins, better [insulin] pumps…I think the most profound finding is that mortality in our intensively treated cohort is the same as in the general population. That says it all," Nathan told Medscape Medical News. https://www.medscape.com/viewarticle/994221 XX Commercial – AG1 XX Today, JDRF, the leading global type 1 diabetes (T1D) research and advocacy organization, urged members of the Senate Appropriations Committee to renew the Special Diabetes Program (SDP) and support policies to ensure insulin is available at an affordable and predictable price. Opened by U.S. Senator Patty Murray (D-WA) and led by U.S. Senators Susan Collins (R-ME) and Jeanne Shaheen (D-NH), the hearing took place during the 2023 JDRF Children's Congress, a biennial event that brings over 160 kids and teens living with T1D face-to-face with lawmakers and top decision-makers. The youth delegates traveled to Washington, D.C. from across the country and JDRF's international affiliates in the United Kingdom, Australia, the Netherlands, and Canada. The SDP has accelerated the pace of T1D research through a long-term investment of funding at the National Institutes of Health. The program has led to significant scientific breakthroughs, including Tzield, the first disease-modifying treatment for T1D, which can delay the onset of the disease by over two years. Without Congressional action, the SDP will expire at the end of September. "The Special Diabetes Program has fundamentally changed what it means to live with diabetes, put new life-changing therapies in our hands, and brought us closer to cures," said Aaron Kowalski, Ph.D., JDRF CEO. "We must keep this momentum going so we can capitalize on the progress to date and realize cures. However, until we have cures, people need access to affordable insulin. JDRF urges Congress to pass the bipartisan INSULIN Act of 2023, which will establish a $35 per month insulin copay cap for people with commercial insurance and includes other provisions that would make insulin more affordable for everyone, regardless of insurance status." Dr. Kowalski was joined at the hearing by Dr. Griffin Rodgers, Director of the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health, who provided testimony on the scientific value of the SDP, and Jimmy Jam, award-winning producer, songwriter, musician, member of the Rock & Roll Hall of Fame, and T1D parent. "My son Max, who is now in his twenties, was just two years old when he was first diagnosed with type 1 diabetes. Late nights working on music became late nights working on music and waking up my son to test and manage his blood sugar levels," said Jimmy Jam. "Type 1 diabetes should be one of those things we can all agree on. Diabetes doesn't care if you're a Democrat or a Republican. We can all agree that there should be research to improve the lives of those with diabetes. We can all agree that insulin should be affordable for all who need it." Two 2023 JDRF Children's Congress delegates shared their T1D experience with the committee: Maria Muayad: 10-year-old Maria is from Maine and is a member of her school's civil rights club and math challenge group. Every November, Maria, and her mother, Golsin, give blue ribbons to the staff at her school in honor of National Diabetes Awareness Month. Elise Cataldo: 15-year-old Elise lives in New Hampshire and is passionate about educating those around her about life with T1D and tries to use things like pump site changes and blood sugar checks as opportunities to help others learn. Following the hearing, the 2023 JDRF Children's Congress delegates continued their advocacy by meeting with lawmakers in their Capitol Hill offices. https://www.prnewswire.com/news-releases/2023-jdrf-childrens-congress-delegates-urge-lawmakers-to-support-type-1-diabetes-research-and-access-to-affordable-insulin-301874927.htmlXX XX A 23-year-old with type 1 diabetes has broken the record for circumnavigating Britain in a kayak after paddling 2,000 miles in 40 days. Dougal Glaisher beat the previous record by 27 days. Glaisher was diagnosed with type 1 diabetes at the age of 19 shortly after winning the Oban Sea Kayak race in Scotland, when he had blurred vision and struggled to recover his energy. The expedition was to raise money for the UK-based charity Action4Diabetes and Glaisher livestreamed his blood sugar On Tuesday he was well stocked with a bunch of bananas and a stash of cereal bars lashed to his boat. But in remote areas it was more challenging. Around the islands off Scotland he ran out of freeze-dried meals and survived on porridge for several days. He also sourced drinking water from streams. . It is the first time anyone has used a surfski – a kayak that you sit on top of – to paddle around the country. XX On the podcast next week.. I sat down with Dexcom's new Chief Commercial officer to talk about their announcements from this week about the type 2 market and other features important to people with type 1. Our last epoisde is all about Kickass Healthy LADA 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, G7 updates – direct to watch announcements – and a lot more about what Dexcom sees as the next frontier in CGM. A conversation – from ADA – with the company's Chief Commercial Officer Teri Lawver. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. 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    

It's In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: FDA approval for a pancreatic islet cell therapy to treat type 1, stem cell research moves ahead, big news from the ADA Scientific Sessions about what's next for medications like Mounjaro and a pill form of semaglutide. Dexcom announces a sensor for people with type 2 who don't use insulin, Libre moves ahead with Ketone monitoring and more.   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   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 the T1D Exchange a nonprofit organization dedicated to improving outcomes for the entire T1D population. XX Big week of news following the 2023 ADA Scientific Sessions conference. What follows is just the tip of the information iceberg, so please follow the links in the show notes to much more. -- XX Top story though isn't from ADA – but a new FDA approval.. for a pancreatic islet cell therapy to treat type 1. It's called donislecel, developed from cadaver donors and giving as a single infusion straight into the liver. Immunosuppression is required to maintain cell viability, just as it is required to support a transplanted kidney or other organ. Approval was based on what seems to be a very small study – 30 people with type 1 who had hypoglycemic unawareness and who received between one and three infusions of donislecel. After one year, 11 people did not need to dose insulin.. 10 stayed that way for more than five years. But five people in the study were not able to stop dosing insulin at all. This method is different from what Vertex and Sernova are trying to do with stem cell therapy. https://www.medscape.com/viewarticle/993854 XX Vertex moves forward on their clinical trial of islet stem cell therapy. All six patients treated with VX-880 had undetectable fasting C-peptide (endogenous insulin secretion) at baseline, a history of recurrent SHEs in the year prior to treatment and required an average of 34.0 units of insulin per day. Following treatment, all six patients demonstrated endogenous insulin secretion, improved glycemic control as measured by HbA1c, improved time-in-range on continuous glucose monitoring, and reduction or elimination of exogenous insulin use. Two patient are completely insulin independent after one year – with an A1C of 5.3 compard to 8.6 at baseline.. the other 6.0 with a 7.6 at baseline – again the ”after” number is without taking insulin. As a result of these safety and efficacy data in Parts A and B, the independent data review committee has recommended moving to Part C of the trial, which allows for concurrent dosing of patients at the full target dose of VX-880. https://www.businesswire.com/news/home/20230623446641/en/Vertex-Presents-Positive-VX-880-Results-From-Ongoing-Phase-12-Study-in-Type-1-Diabetes-at-the-American-Diabetes-Association-83rd-Scientific-Sessions XX Sernova also reports good results with their cell pouch system. Five of the six patients who have completed implantation continue to experience insulin independence for periods ranging from six months to more than three years. The sixth patient only recently completed the protocol-defined islet transplants.. so no results yet. There is a second group testing a larger cell pouch. https://www.drugdeliverybusiness.com/sernova-interim-data-cell-pouch-system/ XX Big news from ADA about all of the type 2 and obesity drugs you've likely heard about.. here are some headlines: SURMOUNT-2 clinical trial evaluating tirzepatide – brand name Mounjaro - for weight loss in adults with obesity or overweight and type 2 diabetes. Average weight loss was 15.7% at the highest dose, with many other health benefits such as lower A1C levels; reduction in waist circumference, and body mass index; and improvements in cardiometabolic disease risk factors such as lipid levels, cholesterol, and blood pressure. That 15 percent weight loss was about 34 pounds and the a1c reduction for half of those in the study went down to 5.7 which is considered nondiabetic. Mounjaro is currently approved for type 2 and the FDA could approve Mounjaro regardless of diabetes status later this year. https://diatribe.org/new-lilly-trial-results-show-big-weight-loss-results-positioning-mounjaro-obesity-drug-approval XX A study called PIONEER looks at oral semaglutides – some calling it the Ozempic pill. When compared to other anti-diabetic medications such as Jardiance, Januvia and Victoza, people taking the oral semaglutide say 1% or or more reduction of HbA1c compared to those treated with other anti-diabetic medicines. They also were more like to achieve a 5% or more reduction of body weight. Note: this was not a study comparing a semaglutide pill with the same type of injection. https://www.news-medical.net/news/20230607/Oral-semaglutide-outperforms-other-medications-in-type-2-diabetes-treatment-significantly-reducing-HbA1c-and-body-weight.aspx XX And look for two additional new drugs to treat obesity in the next few years.. orforglipron, is easier to use and to produce, and it will probably be cheaper than existing treatments. The second, retatrutide, has an unprecedented level of efficacy, and could raise the bar for pharmacological obesity treatment. Orforglipron and retatrutide both mimic hormones produced by the lining of the gut in response to certain nutrients. These hormones help to slow the passage of food through the digestive tract and lower appetite by acting on receptors in the brain — both effects that reduce people's desire to eat and help them to lose weight. Orfoglipron is a non-peptide molecule that researchers say is easy to produce and is a pill.. a lower price is anticipated for this one. Retratritude looks like it could help people lose even more weight than Mounjaro. https://www.nature.com/articles/d41586-023-02092-9 XX Dexcom announces a new product in the US – coming in 2024 – designed for people with type 2 who don't use insulin. This will be built on the G7 hardware, but with different software and a 15 day sensor. CEO Kevin Sayer also announced that the G7 will be able to share data direct to the apple watch https://www.businesswire.com/news/home/20230623025076/en/Global-Continuous-Glucose-Monitoring-Pioneer-Dexcom-Reveals-New-Plans-to-Bring-Sensing-Technology-to-Millions-More XX Abbott will partner with Weight Watchers - people who have been prescribed one of Abbott's FreeStyle Libre 14-Day or FreeStyle Libre 2 sensors and who are using the WeightWatchers diet plan to see their CGM data directly in the WeightWatchers app. This is also a study where Abbott will launch two pilot programs directed at using CGM data to help people with Type 2 diabetes adjust and manage their dietary habits, regardless of whether they're on insulin therapy. XX A little bit more news about Abbott's dual glucose and ketone sensor under development. Announced a last year's ADA, the company says it's moving forward through R&D Separately from the Type 2 CGM push, Taub also offered an update on the dual glucose ketone sensor that's currently under development at Abbott and that the company first announced at last year's ADA conference. The sensor will be aimed at catching rising ketone levels as early as possible to help avoid cases of diabetic ketoacidosis. An Abbot executive says – quote - “There's so much that we stand to learn about ketones because there hasn't been a continuous sensor for them before, so there's really very little we know about the evolution of ketones “ https://www.fiercebiotech.com/medtech/ada-abbott-pushes-widespread-cgm-use-type-2-diabetes-weightwatchers-ada-collabs XX Commercial XX Beta Bionics has received FDA 510(k) clearance for the compatibility of the Fiasp Pumpcart prefilled insulin cartridge with the iLet automated insulin-delivery system. The iLet is a bionic pancreas that fully automates 100% of all user insulin doses, providing users with the choice of three insulins, Novolog; Humalog; and Fiasp Pumpcart. The device eases diabetes management in everyday life and almost eliminates the expertise that has been required in the past to set up and manage a traditional insulin pump. In May 2023, Beta Bionics was awarded FDA approval for the iLet device. The iLet manages glucose levels with just a meal announcement and is paired with a Dexcom G6 Continuous Glucose Monitoring System for glucose readings. All that is required for set-up is the user's weight. While there is a need for carbohydrate awareness, no carb counting is necessary. Bolusing, correction factors, insulin-to-carb ratios, and pre-set basal rates are also unnecessary. Beta Bionics president and CEO Sean Saint said: “Beta Bionics has been working tirelessly to create an insulin delivery system that offers less burden and more convenience for the type 1 community. Since launching last month, the iLet bionic pancreas is now available and clinics and users are being trained on its simple design and easy management features. “When Fiasp Pumpcart prefilled cartridges are available, users will save time not having to manually fill cartridges and will have more choice for their diabetes management.” https://www.medicaldevice-network.com/news/beta-bionics-gains-fda-clearance-for-prefilled-insulin-cartridge/ XX Oura – the ring that tracks your sleep – will start sending info to three CGM info companies.. January, Supersapiens and Veri. All three of these companies provide software based off of the Libre CGM. These companies will now be receiving sleep scores and other biometric data from Oura so they can see how these measurements affect users' glucose levels and overall health. https://www.forbes.com/sites/andrewwilliams/2023/06/27/oura-smart-ring-can-be-used-to-help-monitor-blood-sugar/?sh=2520116c2b10 XX Just a fun fact here – there is a Facebook group called type 1 diabetics for 50 plus years. And it looks like this week they passed over 1500 members. XX On the podcast next week.. I sat down with Dexcom's new Chief Commercial officer to talk about their announcements from this week about the type 2 market and other features important to people with type 1. Our last epoisde is all about Kickass Healthy LADA That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

LADA is a form of diabetes that is often mistaken for type 2 but needs to be treated much more like type 1. As you can imagine, getting the diagnosis wrong is dangerous. This week's guest, Jacqueline Haskins, says she got lucky. A friend said her symptoms sounded more like Latent Auto Immune Diabetes in Adults than like Type 2. Jacqueline is the author of Kick Ass Healthy LADA where she shares research, advice and her own story. She's an aquatic biologist and an award winning author. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Here are our earlier episodes around LADA    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    

Katie Bone is the youngest ever American Ninja Warrior Women's National winner! She is also a nationally ranked rock climber and has her eyes on the Olympics. Katie was diagnosed with type 1 at age eleven and is now seventeen. We talk about her big win, a recent injury and what she's looking forward to next. She also answers a lot of your questions about managing T1D during training and competitions. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. More about Katie here: https://katiebone.com/ Watch Katie's NInja Warrior win: https://www.youtube.com/watch?v=i3Jlvc3OwLw    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    

It's In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: FDA warning about compounded versions of semaglutides like Wegovy and Ozempic, new research on what people with diabetes who start Go Fund Me campaigns are asking for, Tandem's CEO gives an update on Dexcom G7 and Libre integration, follow-up on the French Open player denied insulin on the court, and more! Here's more info about Mom's Night Out: https://bit.ly/DMomsNightOut 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   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 Moms Night Out! Treat yourself to some time away with other moms who get it! XX The U.S. Food and Drug Administration is warning consumers not to use off-brand versions of the popular weight-loss drugs Ozempic and Wegovy because they might not contain the same ingredients as the prescription products and may not be safe or effective. Agency officials said this week that they have received reports of problems after patients used versions of semaglutide, the active ingredient in the brand-name medications, which have been compounded, or mixed in pharmacies. Officials didn't say what the problems were. The trouble is that those versions, often sold online, contain a version of semaglutide that is used in lab research and has not been approved for use in people. As of May, Ozempic and Wegovy remain on the FDA's list of drug shortages. When drugs are in short supply, compounding pharmacies are permitted to produce versions of those medications. Consumers should only use drugs containing semaglutide with a prescription from a licensed health care provider and obtained from a state-licensed pharmacy or other facilities registered with the FDA, the agency said. https://time.com/6284497/fda-warning-ozempic-wegovy/ XX ZVHER-ehv pronounce https://www.youtube.com/watch?v=u8spdvgpIzs French Open organizers reversed their initial decision denying Alexander Zverev access to insulin injections on the court. Initially they said he'd have to do his injections during off-court bathroom breaks, something players are limited to only two of. Zverev has lived with type 1 since he was three years old? And apparently there were complaints after he injected himself during his fourth-round match. Zverev said he was told it didn't look right when he injected himself on the court. “This is not a clever take because if I don't do it, my life will be in danger. But they said it looks weird,” he said. And it prompted a response from type 1 diabetes research charity JDRF. In an open letter, the charity said: “We would like to emphasise that insulin administration is an essential aspect of type 1 diabetes management, and it should be treated with the same respect and understanding as any other medical intervention. “It is critical that athletes with diabetes, like Mr. Zverev, are given the necessary accommodations and support to effectively manage their condition while competing. This includes the ability to administer insulin when required, as recommended by their healthcare professionals.” XX Many people with diabetes in the United States have turned to crowdfunding to pay their medical bills, even though a quarter of patients sampled had insurance, according a new study by Duke University researchers. In the United States, more than 40% of patients with diabetes struggle to pay their medical bills. Among those patients, more than half — 56% — have either delayed or foregone care entirely, Caroline E. Sloan, MD, MPH, a primary care physician at Duke University School of Medicine, and colleagues wrote. One estimate suggested that the average patient who is dependent on insulin and has insurance spends about $4,800 every year on physician visits, supplies, medications, hospitalizations and lost wages — the equivalent to 15% of the median U.S. per capita income. They evaluated 313 GoFundMe campaigns describing patients' medical situations, expenses and fundraising goals. The researchers included an oversampling of type 1 diabetes campaigns so they could have roughly even proportions of type 1 and non-type 1 diabetes campaigns “and ensure a wide breadth of experiences.” Sloan and colleagues found that the median fundraising goal was $10,000, the median amount raised was $2,600, and just 14% of campaigns reached their goal. Additionally, 25% of fundraisers had insurance, but 49% of those who did have insurance said their out-of-pocket costs were still too high. Fewer than 10% requested money specifically for insulin; 48% of direct medical expenses were not directly related to glucose control. When it came to characteristics of campaigns for types of diabetes, they found that 21% of total campaigns — almost all of which were campaigns for type 1 diabetes — requested money for diabetic alert dogs. Campaigns not for type 1 diabetes mentioned indirect medical expenses more often than campaigns for type 1 diabetes: 63% vs. 34%. “Thirty-five percent of patients with type 1 diabetes started fundraising campaigns for diabetic alert dogs, which cost about $15,000 and are not covered by insurance because of high variability in effectiveness,” the researchers wrote. “Clinicians who learn of a patient's intent to purchase a dog could redirect them toward proven management strategies, such as continuous glucose monitors.” https://www.healio.com/news/primary-care/20230613/patients-with-diabetes-are-increasingly-turning-to-gofundme-to-pay-medical-bills XX XX United Healthcare will now cover the Eversense E3 CGM System for people with type 1 diabetes and people with type 2 who use insulin. That's as of July 1. The Eversense E3 CGM is inserted just under the skin and stays there for six months. UnitedHealthcare is the largest health insurance company in the United States https://finance.yahoo.com/news/senseonics-announces-unitedhealthcare-coverage-eversense-110000925.html XX operational and commercial goals we set for this year,” CEO John Sheridan said in a call with investors on Wednesday afternoon. That confidence is helped along in particular by the company's plans for a spate of product expansions and launches later this year. “Overall, there's an enthusiasm at Tandem as we approach being able to offer another wave of innovative products to the diabetes community,” Sheridan said. “With these launches, we'll be building upon our reputation for offering high-quality products and services that reduce the burden of diabetes management.” Among those launches will be the integration of Dexcom's G7 continuous glucose monitor sensor and Abbott's FreeStyle Libre 2 and 3 into Tandem's t:slim X2 insulin pump system, which Sheridan said would make Tandem's device “the first FDA-cleared insulin pump integrated with multiple CGM sensors.” Those additions will come in the form of free, remote software updates, per the CEO, with the first updates slated to begin rolling out in the coming quarters. For each of the three integrated CGMs, Tandem will perform “internal walkabout testing” before adding them to its t:slim system in scaled launches first in the U.S. and then internationally; the process has already begun for Dexcom's G7 and Abbott's Libre 2 sensors, with the Libre 3 on track to be a “fast follow-up” after the previous model's U.S. launch this fall. Sheridan suggested that a “meaningful number of customers” could be using a G7-connected t:slim pump by the third quarter, while the FreeStyle Libre version of the tech should reach that same nebulous milestone in the fourth quarter Alongside the upgrades to its t:slim X2 pump, Tandem is also eyeing an upcoming launch for its new Mobi pump, which is still under FDA review. The pump is about half the size of the t:slim models and can be completely operated via a smartphone app. “Our dialogue with the agency remains constructive as we work through the process of FDA review and responding to questions,” Sheridan said. “In the meantime, we continue to prepare for its launch in the second half of the year.” https://www.fiercebiotech.com/medtech/tandem-plots-h2-launch-slimmed-down-insulin-pump-dexcom-and-abbott-cgm-integration XX XX Researchers at Washington University School of Medicine in St. Louis have identified a process in immune cells that links vitamin D deficiency during pregnancy to an increased risk of Type 2 diabetes in those born from those pregnancies. The research is published June 13 in the journal Nature Communications. Some theories of disease suggest that conditions in utero may have irreversible, lifelong consequences in offspring. The new study's principal investigator, Carlos Bernal-Mizrachi, MD, said that could be happening to the children of mothers who don't have adequate levels of vitamin D during pregnancy. https://www.news-medical.net/news/20230613/Vitamin-D-deficiency-during-pregnancy-linked-to-an-increased-risk-of-Type-2-diabetes-in-offspring.aspx XX In the 16+ years since my son was diagnosed with type 1, I have attended dozens of diabetes conferences and events. Now I've taken the best elements from those events and created a brand new experience. We're going to have lots of diabetes technology for you to see and learn about, stress-relieving social time where you can meet other moms just like you, and speakers who will leave you feeling energized and ready to face the challenges of parenting a child with T1D. XX Update on non invasive glucose monitoring.. Know Labs says they're in the next stage of their Bio-RFID sensor. Lots of behind the scenes and lab advancements here from what I can tell. But they release says: For 2023, Know Labs remains focused on external validation of its technology and contributing to its growing body of peer-reviewed evidence, which can be found at www.knowlabs.co/research-and-validation. The company will make further refinements to the Gen 1 Device as it works toward realizing its vision for the KnowU and UBand and bringing an FDA-cleared product to the marketplace. https://www.businesswire.com/news/home/20230607005237/en/Know-Labs-Completes-Build-of-Portable-Generation-1-Prototype-for-Non-Invasive-Glucose-Monitoring XX Dexcom focuses on mental heath during the UK Diabetes Awareness Week. They've released a new study showing 84% of people surveyed agree having diabetes can negatively impact mental health. Their news release goes on.. To honor the strength and resilience of the diabetes community, and to promote mental health and connection, Dexcom is encouraging people with diabetes - and their friends and family - to strike a #DexcomWarriorPose by hosting a day of free puppy yoga classes at Puppy Yoga London in Hoxton, London this Saturday 17 June. https://www.businesswire.com/news/home/20230612005039/en/New-Study-Shows-That-84-of-People-With-Diabetes-Struggle-With-Mental-Health1 XX On the podcast next week.. 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, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: Lilly becomes the first of the big three insulin makers to settle a class action lawsuit over pricing, the FDA approved Beta Bionics' iLet system, oral meds trialed for T2D seem to work as well as Ozempic injectable, Lego adds a T1D "friend" to their line and a big win for an American Ninja Warrior competitor with T1D. 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 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 VIVI Cap Keeps your insulin at the exact right temperature, even in extreme heat or cold. XX Our top story, Eli Lilly has agreed to pay $13.5 million to end a six-year, class-action lawsuit accusing the company of overpriced its insulin. As part of the settlement, Lilly has agreed to cap out-of-pocket costs for its insulin at $35 per month for four years. That's three months after Lilly said it would cut insulin prices to that level. The lawsuit was filed in 2017, against insulin makers Lilly, Novo Nordisk and Sanofi. Plaintiffs claimed the companies joined in an “arms race” to raise list prices of their meds while the “real” price to pharmacy benefit managers remained constant or in some cases dipped. Price increases of insulins that previously cost $25 per prescription were pushed up to $450, the suit said. The increases, taken in “lockstep,” were “astounding and inexplicable,” according to the class action lawsuit. Novo and Sanofi have yet to settle this case. https://www.fiercepharma.com/pharma/eli-lilly-inks-settlement-long-running-insulin-pricing-lawsuit XX The FDA is changing its draft guidance for industry regarding Antidiabetic Drugs and Biological Products. It's been 15 years since an update. Topics covered in the draft guidance include: Hemoglobin A1c (A1C), a measure of average blood sugar, remaining an acceptable primary efficacy endpoint The FDA now considering a reduction in the risk of hypoglycemia (low blood sugar) to be a clinically relevant outcome measure for diabetes drug clinical trials, when accompanied by either a reduction or maintenance of an acceptable A1C. The use of data collected by continuous glucose monitoring (CGM) systems, which allow for nonstop, passive glucose monitoring, in clinical trials to potentially support hypoglycemia labeling claims. Recent advancements in CGM technology have led the agency to recognize the advantages of data collected from these systems in clinical drug development. The FDA will be accepting comments on the guidance until August 24, 2023. https://www.appliedclinicaltrialsonline.com/view/fda-on-track-to-updates-diabetes-efficacy-endpoints-guidance XX The iLet bionic pancreas from Beta Bionics gets FDA approval for people with type 1 age 6 and up. This is a unique system in that it starts with only the user's weight and requires meal announcements – no carb counting – to automate blood sugar. It will launch with the Dexcom G6 CGM. You'll hear from the company CEO this Tuesday in our next episode where we do a deep dive into the system. https://www.medicaldevice-network.com/news/beta-bionics-fda-insulin-pump/ XX Researchers had observed an increased incidence of type-1 diabetes cases during the COVID-19 pandemic. Now, a new study has confirmed the link and established a temporal association between the development of type-1 diabetes in children and infection with the SARS-CoV-2 virus. The new study published in Jama Network was the first research that used data, which indicated if the type-1 diagnosed children previously had COVID-19 infection. The researchers found the likelihood to develop type-1 diabetes increased by 57% in children who had a confirmed COVID-19 infection, compared to those who did not have the infection. https://www.medicaldaily.com/covid-19-infection-increases-incidence-type-1-diabetes-children-study-469854 XX New oral medication from Pfizer seems to stack up well next to Ozempic for weight loss. New study looked at people with type 2 found danuglipron when given twice a day, lowered blood sugar in patients at all doses and reduced body weight at the highest dose after 16 weeks. The weight loss with danuglipron is of a similar magnitude to that observed in the mid-stage data for Novo Nordisk's semaglutide, known as Ozempic when used for diabetes and Wegovy for obesity. The treatments, including Pfizer's danuglipron, belong to a class of drugs that mimic the gut hormone glucagon-like peptide-1 (GLP-1), which works by suppressing appetite and were initially developed to treat type 2 diabetes. Pfizer is also testing another oral diabetes drug, lotiglipron, which is given once daily and has said it plans to initiate late-stage development of only one of the two candidates. The company believes an oral therapy could appeal to patients who want to avoid injections. https://www.reuters.com/business/healthcare-pharmaceuticals/pfizer-diabetes-drug-reduces-weight-similar-novos-ozempic-2023-05-22/ XX Artificial intelligence (AI) algorithms used to screen for and predict type 2 diabetes may be racially biased, which could perpetuate health disparities, according to a study published last week in PLOS Global Public Health. Risk prediction models for type 2 diabetes have shown promise in bolstering early detection and clinical decision-making, but the researchers pointed out that these models can bias the decision-making process if risk is miscalibrated across patient populations. The research team found that the Framingham Offspring Risk Score underestimated type 2 diabetes risk for non-Hispanic Black patients, but overestimated risk for their white counterparts. The ARIC Model and PRT overestimated risk for both groups, but to a greater extent for white patients. Research like this highlights that while data analytics and AI approaches may help find gaps in chronic disease management and care, racial disparities are still a major obstacle to achieving health equity for diabetes patients. A 2021 study of city-level data revealed significant disparities in diabetes mortality rates across the United States. The analysis sourced data from the 30 largest cities in the US and demonstrated that mortality rates were higher for Black individuals than for white individuals. Disparities were also found to be up to four times larger in some cities compared to others, with Washington, DC experiencing the highest rates of diabetes mortality inequities. https://healthitanalytics.com/news/potential-racial-bias-found-in-type-2-diabetes-risk-prediction-models XX 1 in 3 adults with Type 2 diabetes may have undetected cardiovascular disease. Elevated levels However, mildly elevated concentrations of of two protein biomarkers that indicate heart damage may be an early warning sign of changes in the structure and function of the heart, which may increase the risk for future heart failure, coronary heart disease or death. Researchers analyzed health information and blood samples for more than 10,300 adults collected as part of the U.S. National Health and Nutrition Examination Survey from 1999 to 2004. Study participants had reported no history of cardiovascular disease when they enrolled in the study. One-third (33.4%) of adults with Type 2 diabetes had signs of undetected cardiovascular disease, as indicated by elevated levels of the two protein markers, compared to only 16.1% of those without diabetes. https://medicalxpress.com/news/2023-05-adults-diabetes-undetected-cardiovascular-disease.html XX VIVI CAP XX MTV Documentary Films has acquired worldwide rights to Pay or Die, a film about Americans living with diabetes who face a cruel choice: pay the “extortionate” cost of insulin charged by pharmaceutical companies or risk death. Scott Alexander Ruderman and Rachael Dyer directed and produced the documentary, which premiered in March at SXSW. MTV Documentary Films plans a theatrical release later this year, followed by a debut on streaming platform Paramount+. Those personal stories in the film stretch across the country. “From a mother-and-daughter struggling to rebuild their lives after spending their rent money on insulin, to a young adult diagnosed with Type 1 diabetes during the COVID-19 pandemic, to a Minnesota family thrust into the national spotlight when their 26-year-old son dies from rationing his insulin, Pay or Die highlights this devastating struggle to survive while living with diabetes.” https://deadline.com/2023/05/pay-or-die-mtv-documentary-films-acquisition-directors-scott-alexander-ruderman-rachael-dyer-news-1235382566/ XX Katie Bone win the “American Ninja Warrior Women's Championship” — not only claiming the title but a cash prize of $50,000. She donated $5,000 to the Juvenile Diabetes Research Foundation and Pumped NM. Bone has not only appeared on three iterations of the competition series, but is also a nationally-ranked rock climber. While not the youngest competitor anymore, she was the shortest standing at 5 foot, 2 inches. She's been making waves since competing in “American Ninja Warrior Jr.” in 2020. To train for the event during the pandemic, her father built a ninja course in their backyard. During that competition, Bone, who was diagnosed with Type 1 diabetes at 11 years old, competed with both her insulin pump and glucose monitor on her arms. Being on the show also presents Bone with the opportunity to be an ambassador for Type 1 diabetes awareness and representation. Bone says Type 1 diabetes didn't end her life, it just changed it. “I hope I inspire a little kid to wear their pump on their arm,” Bone said. “It makes everything that you do that more amazing.” In February, Bone competed at the USA National Women's Team Climbing trials in Austin, Texas. During her fourth climb, she fell. “Katie heard four pops,” Tammy Bone said. “She tore her ACL and both sides of her meniscus. This was a moment she was preparing for all her life and it got put on pause.” Bone had surgery and has been getting physical therapy in Colorado. The family returned Monday night to New Mexico after being away for three months. Bone still has her eyes on the Olympics, though the road to recovery may take some more time. “I don't need easy, I just need possible,” she said. https://www.abqjournal.com/2602750/17-year-old-new-mexico-ninja-warrior-katie-bone-takes-the-title-in-womens-championship-competition.html XX Today LEGO has revealed the first wave of Friends sets for 2023, bringing in a new cast of characters and an update to the branding with a new logo. A new LEGO Friends television series will also accompany the new sets. LEGO's annual Play Well study revealed that 3 out of 4 children felt there were not enough toys with characters that represent them, so LEGO is aiming to bring more diverse representation to Heartlake City that's inclusive of not just various ethnicities and genders, but also disabilities and neurodivergence. LEGO says the 2023 sets and series will feature characters with limb difference, Downs Syndrome, anxiety, vitiligo, and even pets with disabilities, including a blind dog and a dog with a wheelchair. She has a CGM printed on her arm and even has a printed phone tile showing her blood sugar. Her name is Hannah and she's in 41744 Sports Center https://www.brothers-brick.com/2022/10/27/lego-friends-reveals-5-sets-for-2023-with-diverse-characters-to-better-represent-children-news/ XX XX On the podcast next week.. Beta Bionics CEO Sean Saint. Last week I MedT 780G 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 long-awaited Medtronic 780G is now FDA approved. It's been out for two years in Europe and has features that are a bit different from other commercially available automated insulin delivery systems in the US, including a target range down to 100. This week you'll hear from Heather Lackey, global medical education director for Medtronic Diabetes who also lives with type 1 and has used the 780G. We talk about what else this system can do – remember this is the one with the 7-day infusion set – and Stacey asks a lot of your questions. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. More info here: https://diatribe.org/medtronic-minimed-780g-approved-fda Lackey mentions a study where even with no meal boluses for three months, people stayed mostly in range. Here's that study: The Official Journal of ATTD Advanced Technologies & Treatments for Diabetes Conference Madrid, Spain—February 19–22, 2020.  Diabetes Technology & Therapeutics. Feb 2020.A-1-A-250.http://doi.org/10.1089/dia.2020.2525.abstracts 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 Rough Transcription: Stacey Simms  0:00 Diabetes Connections is brought to you by The only Ultra rapid acting inhaled insulin by Omni pod five, the only tubeless pump that integrates with Dexcom G six mi Dexcom G seven powerful simple diabetes management. This is Diabetes Connections with Stacey Simms. This week, the long awaited Medtronic 780 G is now FDA approved. It's been out for two years in Europe and its features that are a bit different from other commercially available systems in the US, including a target range down to 100.   Heather Lackey  0:44 And it's just been proven to do so successfully without really increasing a lot of time below range. You know, what will the next system lead up? Will it be below 100? I don't know. But it's so nice to be waking up with glucose levels that are so much closer to someone without type 1 diabetes with this lower target.   Stacey Simms  1:05 That's Heather Lackey, global medical education director for Medtronic. She also lives with type one, we talk about what else the system can do remember if this is the one with the seven day infusion set, and I ask a lot of your questions. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show. Always so glad to have you here. You know, we aim to educate and inspire about diabetes with a focus on people who use insulin. I'm your host, Stacey Simms, and we are getting some big FDA approvals. Along with the Medtronic 780 G, we got word that beta bionics islet will soon be commercially available. As I am recording this I do have an interview set up with the beta bionics CEO. If all goes to plan that will be our show next week. Real quick, while the original islet dual chambered pump was not what was in front of the FDA, the pump that has been approved has some really interesting features. It's unique in that there are no steps to the programming. When you get your pump, you're not putting in basal rates or insulin sensitivity factors or anything like that. All you do is put your weight in. But that is for next week. You can follow me on social media. We've already shared some information about the islet and I've done many episodes in the past if you want to listen to those to get an idea of what was approved, but this week, we're talking about the Medtronic 780 G, as you likely remember Medtronic at the very first of what we now call a ID systems automated insulin delivery systems with their mini med 670 G and that was approved in 2017. We've been hearing about the 780 G for a long time. It was submitted in 2021. I've talked a lot about the delays in the in the news episodes. It has been approved in Canada since last year. It was approved in Europe in 2020. We're gonna go through lots of features of the pump, but you should also know that the sensor used with this system The Guardian four is approved with no finger sticks for dosing, which to me is one of the most significant changes. My guest to talk about all this is Heather lackey. She has been with Medtronic for more than 19 years. She delivers medical education strategy for insulin pump systems. She trains Medtronic education teams around the world. She lives with type one she was diagnosed at age 16. She was also a consultant on the movie Purple Hearts. She also popped up in a scene in that movie and yes, I asked her about that. Lots to get through. But first Diabetes Connections is brought to you by Afrezza. Afrezza is the only FDA approved mealtime insulin that comes in a powder you inhale through your lungs. So why should you consider this unique alternative to mealtime injections. Afrezzais another option if you want to lower your use of needles or if you're experiencing skin reactions at your injection sites, and it is ultra rapid acting so you can take it right when your food arrives. Even unexpectedly. Find out more see if Afrezza is right for you go to diabetes dash connections.com and click on the Afrezza logo. Afrezza can cause serious side effects including sudden lung problems low potassium and it's not for patients with chronic lung disease such as asthma or COPD or for patients allergic to insulin. Tell your doctor if you ever smoked ever had kidney or liver problems history of lung cancer or if you're pregnant or breastfeeding. Most common side effects are low blood sugar cough and sore throat severe low blood sugar can be fatal. Do not replace long acting insulin with Afrezza, Afrezza is not for us to treat diabetic ketoacidosis please see full prescribing information including box warning medication guide and instructions for use on our frezza.com/safety. Heather, thank you so much for joining me. I have a lot of questions for you about the new system but first welcome. I'm glad to have you here.   Heather Lackey  4:52 Oh thank you Stacey. It's my pleasure to be here and so nice to get to meet you. I listen to your podcast and just excited Good to be a part of this one.   Stacey Simms  5:00 Oh, well, I'm thrilled to have you. And I'm sure you don't mind if I say it has been a long time coming. Lots of people very excited about this improvement. Can we start by just talking about the seven EDG? What makes this different from the Medtronic pumps that have come before?   Heather Lackey  5:16 Yeah, well, the mini med seven add system is different in the fact of course, it let's say what it Phil has right still has automated basal insulin, and that insulin ID based on the sensor glucose values, but this system is set apart because it delivers does auto correction boluses, like every five minutes is needed. So we know that life with type 1 diabetes, as you well know, as a mom, someone with type one and be living with it, we know that life does not go as we expect all the time and as planned. And so many things affect our glucose outside of the three things that we've always tried to juggle for years, right? Food and insulin and exercise. But now that we really kind of identify that there's so many other things that are impacting our glucose, it really brings to light the fact that we don't get it right 100% of the time, when we dose insulin, we adjust food. And so that's where those auto corrections that are coming in real time, every five minutes, if needed, can really help. And what I love about the system is the auto corrections, you don't have to be sky high to get an auto correction. As a matter of fact, you don't even have to be high. before they begin. They're really kind of thinking like a pancreas than as soon as your glucose rises over 120 milligrams, as the basal is working as hard as it can and saying, Hey, I need help, then the auto corrections come into play. And they can start dosing a correction bolus every five minutes if needed.   Stacey Simms  6:59 So what is the difference between the auto basil and that bolus that you're talking about? Because you know, the automated systems that are out right now already adjusted basal every five minutes? What is actually happening when you say oh, and it's also giving a bolus?   Heather Lackey  7:14 Yeah, so the bolus happens every five minutes on top of the date. Right, facie, so let's say, again, the goal for many meds seven ad G, there were kind of two goals in play, right, we wanted to further improve time and range, you know, compared like with the mini med 670 G system without compromising any safety, because we all know we can drive down glucose, right, but you don't want to have a lot of lows. And we wanted to reduce the daily interactions with the system. And those daily interactions, right, the the alerts and the alarms and all of the safety pieces that were were added to mini med seven, add, those have all been now relaxed, and so less than erection and improvement in time and range without sacrificing hypoglycemia. So what's nice about the system is you not only are delivering the auto basil, like you said, right, we have auto basil and other systems that now if the auto basal cannot keep the glucose level in the target range, it predicts that the glucose level is going to go higher than it would like then that's when those auto corrections come. And they don't come once an hour, they come every five minutes. As soon as that since your glucose rises over 120 milligrams per deciliter. If the system says, Hey, I'm working as hard as I can with your basal, and I'm not able to keep your glucose at the target range that we want, right. And we'll talk about targets and here in just a minute, hopefully. But if we can keep your glucose at that target range, then I'm going to ask for some help. And that's where those auto corrections. And those are boluses. Right? boluses that happen every five minutes without the patient having to agree to them, or take any action on their part. They just happen automatically.   Stacey Simms  9:14 Alright, I have a few more questions about that. But I'll get back to that in a couple of minutes. Because I feel like most people will just see the results. And they they may not have too many questions about exactly what's going on there. But I want to get back to that bullets in a minute. But you mentioned range, and the seven EDG has a lower range than Tandem and Omnipod. Five have currently right it's correcting down to 100. Or that's a choice. You can adjust that.   Heather Lackey  9:37 Yeah, there's a couple of things that are different and new about this. And Minimates seven add definitely treats to a target, not a range. But you're right though the target is the lowest target at this moment that's available and so the auto basal target, you can set three settings Three different targets are available to where the person was diabetes , their healthcare provider can can really identify which target is best for them. But the three targets are 100 milligrams per deciliter, 110, and 120. Now 100 comes as kind of the default auto basal target. And that's because we know that this system was all of the copious data that we have. And all of the simulations that were done before this system was even launched, was using that 100 target. And that's what this system is built around to be the best target to you.   Stacey Simms  10:36 We should note that tide pool type pool loop, which was approved by the FDA a few months ago, can correct down to 87. But it is not available in any insulin pump, yet. It's a software program that was approved. So 100 for Medtronic is the lowest that you can actually use right now. But it's interesting, that's 101 10 and 120, where some other systems have, you know, an exercise mode that is a higher range, do you have any insight as to why those were chosen?   Heather Lackey  11:02 Well, those are that close to target to mirror a normal functioning, you know, system a system without diabetes . And the interesting thing is, is the 100 target is very much achievable without sacrificing time below range, right? So we're able to drive with the auto basal target being set at 100. And with having the auto corrections that are even delivering up to every five minutes, this is the system, you know, determined that those were needed. We have the algorithm that built to drive the system to 100. And it's just been proven to do so successfully without really increasing a lot of time below rage. You know, what will the next system lead us? Will it be below 100? I don't know. But it's so nice to be waking up with glucose levels that are so much closer to someone without type 1 diabetes. With this lower target.   Stacey Simms  12:03 Let's talk about the sensor because there are changes here too. Right. Tell me about the sensor that goes along with the 780G? Yeah, well,   Heather Lackey  12:10 the Guardian four sensor is the center that it works with the mini med 780G system. And the Guardian Force center was designed really to reduce the burden as daily finger sticks. That was the whole goal. Let's remove calibration from the system. And let's try to develop a system that doesn't require finger sticks. As we know, sometimes finger sticks still are needed with really with any of the systems and sensors. But the majority of the time when our patients are in the mark guard feature is they are using the SR glucose to bolus off that, you know, there's no real need for a fingerstick glucose. And interestingly enough, most patients bend upwards of you know, 95% or so in that smart guard feature. And so many patients will tell me, I am forgetting my glucose meter at home. And I had one patient that went on a trip, he went out of the country and he said, Look, I totally left insulin and glucose at home because I had kind of forgotten to take my meter bag with me. Wow, learning for sure.   Stacey Simms  13:27 Oh my gosh, yeah, my son goes without a meter quite often. Since you know his we use the Dexcom in the control IQ system from Tandem. But yeah, you don't want to forget your bag entire. That's not good   Heather Lackey  13:38 news. Okay, that's if that's now a burden that is taken off of you. And that's lovely. Yeah, no doubt. No need to be prepared, right?   Stacey Simms  13:47 Yep, absolutely. And I think it's worth pointing out that this is the only automated insulin system in the United States. That is one system, right? It's a glucose monitor infusions that insulin pump. That's all Medtronic and this system has that extended infusion set right so you're talking to sensor you were for seven days, and an infusion set for seven days, right. We'll get right back to my conversation with Heather but vs Diabetes Connections is brought to you by Omni pod. And when you're deciding that a random insulin pump, you got a lot to think about, especially if you've never used a pump before. It really can seem overwhelming. I remember that there are a lot of choices, and you want to make the right decision. And that's why I'm so excited to tell you about Omni pod five. Curious about trying an insulin pump or seeing what life without tubes is all about. Unlike traditional tube pumps, you can try Omni pod without being locked into a four year contract. You might even be eligible for a free trial, go to diabetes dash connections.com and click on the Omnipod logo for full safety risk information and free trial Terms and Conditions. Also visit omnipod.com/diabetes connections. Now back to Heather answering my question about this seven day infusion set   Heather Lackey  15:03 That's exactly right. One kind of new feature of the mini med seven add system is the extended infusion set. And that extended infusion set. It's been launched for a few months in a few different countries. But it comes now with de minimis 780G system, and really allowing people to just kind of have to think about changing a center and changing their infusions that just one day out of the week versus anymore. And so that system, you know, I have so many people that will go have our youth told us for years, you know, that we have to change our infusion set every three days. And why are we able to start to use that system now, and just been using that now for seven days. And the the, it's really simple to explain without getting into a lot of engineering details, but that infusions that is made with this advanced material. And what it does is it helps to reduce the insulin preservative, you know, kind of the loss that we would typically have, it helps to maintain the insulin flow. And it helps to maintain the stability of the unfolding. And so there's such a reduced risk of any kind of blockage or occlusions, with your infusion set whenever you use this new extended infusion set. And I always have to remind patients and people with that need us and their families, make sure you're only using the extended infusion set for seven days, and you're not using your current infusions that are that long, because the materials are different.   Stacey Simms  16:41 Yeah, good point. Can you use any insulin in those extended infusion sets?   Heather Lackey  16:47 So well, in the mini med 780G system, the insolence that are approved and on label are human log and Nova logs. So both of those are available to us with that set.   Stacey Simms  16:59 So no, Lusia if I ask, just checking, those are not approved at this time. Got it? Got it. I had a listener ask if the duration of insulin is adjustable, you know, is that a setting that people can kind of go in and tinker with?   Heather Lackey  17:13 Yeah, so active insulin kind of talks about the or is our duration and insulin kind of tuning knob that is in the programmable settings on the mini med 780G pump, the active insulin Time is of the two settings that are critical is one of the two, right the first setting is the auto label target, you know, looking at that 100 glucose target for most people with diabetes, but then also setting the active insulin time to two hours. And a lot of people will say, Look, I have never had active insulin or insulin on board. I've never thought that human log or Nova log was out of my body in just a couple of hours. And so it's interesting that Medtronic is recommending a two hour active insulin time. Why is that? And the real answer is this is what the algorithm was designed around, right, it's fine to have the ability to, you know, the algorithm is asking the patient, if you set the active insulin time to two hours, then that gives me the ability to calculate insulin, if I think it's needed, right, that doesn't always mean that you're just gonna get insulin stacked on top of, you know, each other dose on top of a dose every two hours. It just means that gives the algorithm the ability to give correction sooner. And whenever you're giving those auto correction. as frequently as every five minutes, it makes sense to be able to just kind of give the algorithm the freedom to make the decision if it's needed. And anytime I have someone that really wants to debate this, and understand how the algorithm works, I just always have to say, let's just look at the data. And you know, we're not stalking we're not having hypoglycemia in the 10s of 1000s of patients that we have data on.   Stacey Simms  19:06 Yeah, it's actually I wish I had a diabetes educator. Maybe this will be for another episode. You are obviously a diabetes educator. But it'd be fun to have somebody else from a different pump company because other pump companies will say no, no, no, exactly. As you're saying like you're stacking insulin. We set it this way for a reason. It's not adjustable for a reason. Is this two hour duration. A different setting from previous Medtronic pumps forgive me? I'm not as familiar with them.   Heather Lackey  19:29 You don't know. That's a great question. They see it the same accident one time. Honestly that has been a part of the bolus calculator settings, the bolus wizard and now the smartcard bolus feature that even since the paradigm days, right, when the bolus calculator was first presented, we're now looking at decades ago with the active insulin time. So it's the same setting we've had, but now it's kind of viewed in a different way than Then it has been in the past, right? In the past, it was very traditional, like you're saying and, and kind of how patients will think of it with, you know, whenever I'm in conversation with them, they're like, How can this be. And the simple fact is, with setting the accidents one time, as low as two hours, which is what we see the best control, the best time and range and the lowest time below range, right? So the fueler lows is actually set at two hours. And what that does is it just is a tuning algorithm knob. And it says, Hey, algorithm I'm going to allow you to give, if you determine that it's necessary, meet Insulet. And because you're looking at my rate of change, you're looking at how much insulin is on board, you know, how many grams of carbohydrate that I've entered, it takes all of this information into account and decide if action should be taken. And what lovely is the patient, the person with diabetes that mom, dad, the family, they don't have to make any of those decision, the system is doing it for them.   Stacey Simms  21:05 It should have probably started with this question. But what does the algorithm use as a starting base? You know, we're used to traditional insulin pumps where you sit with your educator or your doctor and you say, Here's my basal rate, here's my sensitivity factor or correction factor, or, as we're talking about here, duration, there is a pump in front of the FDA right now that just uses body weight. What is the 780? G use?   Heather Lackey  21:26 Yeah, that's a great question as well, algorithm really start with total daily dose of insulin, kind of as it is its starting point, right, the calculation. And that's why whenever you are new on the mini meds 780G system, people have to stay in manual mode. So the kind of the non auto basal in auto correction kind of piece of it. So they stay in manual mode for 224 hour days, right. So it's two days in manual mode. And then there's enough data as a starting point for this system to be able to, to say, Okay, this is a safe basal amount for you to begin with. In addition, if there's sensor glucose tracings, in that 48 hours of kind of that warmup period, to the smart guard feature, then those fasting sensor glucose level pump is looking to see like, how much insulin Do you require, whenever you're not announcing meals and, and so it see, okay, this is your center, glucose is in a fasting state. Now, how much auto Basil is being delivered. And that is kind of the two main pieces of information of how the system decides how much auto basil to begin with, and to deliver,   Stacey Simms  22:49 got it, can the user switch back to manual mode,   Heather Lackey  22:53 yet, they can, at any time, they can stop the smart guard feature, we know that the data is so overwhelmingly heavy weights heavy on the smart guard side. So we definitely see a major difference in time and range being improved. Whenever people are in this barcard feature versus in manual mode, right? They're always encouraged to say and   Stacey Simms  23:16 got it but the system doesn't like. And I hesitate to say it this way. But you'll know exactly what I mean, the system isn't kicking people out as much as one of the very early automated systems for Medtronic, right? That was a big complaint with the 670 was I got kicked out of auto mode.   Heather Lackey  23:30 That was a complaint. And we know that whenever the mini med six, seven ad system, the first hybrid closed loop system of its time was a pretty conservative algorithm, right? Because it was first of its kind, Medtronic really had to build on a number of safety precautions. And in many cases that led to those unwanted alerts and alarms and interactions with the pump to keep the system kind of in that auto mode, smart guard auto mode feature. And so with this, we the exits on mini med 780 G system. I mean, they're just not happening, right. And again, though, the number one of two goals of this system was to reduce the daily interactions with the system. So we can't have beats and alerts and alarms. And hey, you have to enter a BG all the time in order to stay in to the automation mode. This is a big difference that people especially those that have been on previous hybrid closed loop systems of all kinds, they're like this is really a pretty big change right? exits at night, exit in the daytime alerts at night. Those are some of the things that are really different from a user lens. Whenever I hear anyone asked my husband, you know, like what kind of from your standpoint In a view, what's the biggest change with you seeing your wife were the minimis 780G system for a while. And he just says, look, it just doesn't wake us up at night. And he just seems to be a little bit more pleased. A lot of surveys that have been conducted all throughout, you know, the countries where people are using and wearing many hats, 7080 G system, you know, it's like 94 95% of people are saying that they're satisfied with the impact on the their quality of life, they're happier with the quality sleep, that's one that's pretty high, ranked and desired by many. So for us to get a good night's rest and to feel confident to go to bed, lay our head down, not have lows or highs not have alerts and alarms. That's the system that we need. And that that's what people are enjoying.   Stacey Simms  25:54 One more question about manual mode, a listener had asked me is manual mode usable during the auto mode? In other words, if somebody really feels like they need to do an additional bolus, can they do it?   Heather Lackey  26:05 It can be done, but I would kind of ask why do they feel like it needs to be done? Right? Why would you need to go out to manual mode if you need to give an additional bolus. So carbs can be entered at any time that those are consumed? Right, we definitely want to announce our mills. And at any time in the smartguard feature, a patient can always look to see if if they what we kind of say a user initiated correction dose is needed. So you don't you know, I don't ever want people to feel like once I'm in the smart guard feature, guy can't take action. If I see glucose, where I don't want it to be or if I've eaten something that I didn't tell it, you know, go ahead and deliverable list, at least check to see if a bolus should be given. And maybe some of the feedback that patients had on mini med 670 G system where they felt like they had to enter in perhaps kind of ghost carbs or fake carbs when they weren't actually eating them to kind of trick the algorithm to giving more insulin, I think you'll find with now that control that we have able to control on this system like that active insulin times and the auto basal. I don't see that people at all are having to what we say automate the automation? Well,   Stacey Simms  27:27 yeah, we let me ask you a follow up on that. Because I don't know anybody who uses an AI D system who just puts in meal boluses and says, Great, I'm always in the range I want to be are you saying that's what's happening with the 780?   Heather Lackey  27:39 Well, I'm saying that anytime that you eat in any of the AIP systems, right, you can you can enter those grams of carbohydrate. But because many meds 780G system gives the autocorrection doses starting at anytime, and glucose is over 120 systems. If the auto basal can't handle that glucose response, then they're gonna get it. So because you start you intervene the system intervene early and intervene often, there's less of the need to take matters in your own hand. Right. So it's a different mindset. Really it?   Stacey Simms  28:18 Yeah, no, it's absolutely it sounds great. Well, we'll see. When you said meal announcements, to be clear, you're talking about carb counting and putting in the numbers of carbs you're eating, you're You're not just saying I am eating?   Heather Lackey  28:31 You're saying I Yes. You're you're entering grams of carbohydrate. Thank you for clarifying going   Stacey Simms  28:36 no, I'm just you know, I know it's coming. It's amazing to see how these things are changing. I just want to be clear as we go. Yeah. Well,   Heather Lackey  28:42 you know, that's kind of a segue Stacey to a lot of the different thoughts on do people have to now with autocorrection? Do people have to be so precise on the grams of carbohydrate that they're entering into those bits? Okay. Well,   Stacey Simms  28:59 let me give you Yeah, let me let's segue into that. Let me give you the best case use that I can make in my house or something like this. I have an 18 year old, he's a great kid. He's very responsible with diabetes. He is terrible about bowling before he eats. It's just it's just not happening. And so we have a lot of, you know, excursions that perhaps don't necessarily need to be happening. I would be thrilled at a more aggressive post meal bolused system. So talk me through what happens to scenarios for you. Somebody has an AD of just throw 85 carbs out there because this happened recently. So somebody has an 85 carb dinner, they bolus five minutes after they finish it. Or somebody has an 85 carb dinner and completely forgets to bolus how does the system handle those things? Oh, yeah.   Heather Lackey  29:45 Well, I'd love to show you my report. Because not only does it happen with an 18 year old, it happens with me more than I would like oh my goodness. I plan for 33 years. How am I forgetting to push the button,   Stacey Simms  30:01 I love it, you're human, you're human. I'm totally   Heather Lackey  30:04 human. So the 85 gram carb dinner, and they bill it five minutes later, right? We know that if you are not giving insulin before the meal, right, you're gonna have food most likely showing up to the party before the insulin arrives, right, so you're gonna have food, their glucose is gonna rise because of the food digest. And then here comes insulin. In that case, we would say, Look, if then, you know, if you're really bolusing, after the meal, you probably are going to need to reduce your meal Bolin, than we have some exact parameters for healthcare providers to kind of discuss with their patients. But you know, on average, it's like, look, probably just dose for, you know, maybe that path in your case, maybe it's not, because as you know, as those is that sensor, glucose starts to rise, the auto basal start to increase, it gets to the maximum, let's say, and then here comes the auto correction. And then you've got insulin, you know, from the bolus still showing up to the party at that point. So what's so great about this system is it knows like, okay, auto Basil is increasing, then there's some, you know, potential auto corrections, as soon as the bullet is given, the system goes, Okay, let's just, let's back off, right, let's see, what's gonna happen with the system before we really just push the pedal to the metal and start giving more correction. Right? So everything is done with the total safety in mind, right, which is something that's so great. Now for the 85 grams of carbohydrate, and they don't bolus at all, well, then that's really what are the auto corrections and the auto basil can shine, that's really where you're going to see sensor glucose is rising. And am I going to say they're never going to go high with an 85 gram carbon bill, I would say that wouldn't be, you know, really unlikely, depending on what what the nutrients are in that food, I would think it was going to be unlikely. And so glucose is going to rise, the system is going to to handle it as as well as it can. But what I can see time and time again, with when mills are skipped, that patients don't go as high and they don't say as high as long. But we have a study that actually support that patient who did zero pole was seeing for a period of time. So this is every single meal for this length of time. And I'd have to look at the report to know exactly the days, but their time and range was just right under that 70% of time and rain. Yeah. And so that's not at all what we are recommending, because we know that if you bolus and you're using the recommended settings, it doesn't matter if you're eight year old, or if you are a 18 year old, or if you're a 58 year old or if you're a 78 year old, we know that for everyone, you can have an upward time and range of 80% plus, right. So we know it's better. And we absolutely want to provide the charge that we should be announcing mil but it's so nice, whenever the occasional I forgot to bolus to you know,   Stacey Simms  33:29 sort of occasional   Unknown Speaker  33:32 got your back for some more than   Stacey Simms  33:36 excellent. I did get this question about the bolusing system, how much of a correction is given? Because on some of these other systems, it's a partial correction. I don't know if you can share that, you know, it's it may be part of the algorithm that you can't share. And then also, how does the system differentiate? Or does it between a missed meal and a random high? You know, a high that may come for another reason?   Heather Lackey  33:57 Yeah. Thank you good questions. Okay. So for the repeat the first one, if you don't mind, sure   Stacey Simms  34:03 how much of a correction is given, you know, like on the T slim, I think I may not be correct here, but it's something like, you know, once an hour can give 60% of the program to bolus. So is that something that the Medtronic keep some good and maybe proprietary? Well,   Heather Lackey  34:16 I can tell you this is the difference with the mini med 780G system is it gives a full correction, you know, if needed every five minutes and every correction bolus, right? It's like if you were giving a correction yourself with a pump, you're going to enter your glucose. The system does the same. It says look, this is where the glucose is. This is where I want it to be. And it's targeting 120 Whenever it's giving a correction dose of insulin, right. That's why after 120 it can start to deliver a correction dose and it looks at the difference and it sees how much insulin is going to be needed. And then it also applies other metrics as well like how much insulin is circulating in the body and And then it determine the safe amount that is going to be needed every five minutes. Got it?   Stacey Simms  35:06 Got it. Okay, great. And then the other question is about does the system differentiate between, you know, missing a meal or a high for another reason? And I could think of highs, you know, and teenagers for, you know, hormones or exercise, things like that, does the system differentiate? And I guess the follow up is, does it need to, or is a high, just a high,   Heather Lackey  35:24 you know, really high is the high and and that's what's so great about the the system anytime there is a rising rate of change, and you know, parameters are met, that the pump says, Wait a second, this is a rising rate. Oftentimes, it's a meal that's missed right? To meet the parameters. When the system sees that this is Matt, what it does is it allows a correction dose to be delivered even a little bit more aggressively. Right. So you know, it does have a mill detection module built in. It has mill detection technology built in, but it doesn't so much say, Oh, this is your sensor, glucose is rising now because of the meal. So I'm going to act this way. Versus your since your glucose is rising, because you have hormone releasing in the middle of the night and you're sleeping, right. Either way, this system is looking at the sensor glucose response. And if it's corrections need to be delivered in a more aggressive manner, or larger corrections need to be delivered either way, then the system is able to do that. You know,   Stacey Simms  36:40 we've mentioned several times that you live with type 1 diabetes. I mean, I know I can talk to you about the pump for probably another two hours. And I hope you'll come back on and we can talk more about it. But I want to ask you about your your journey. You were diagnosed as a teenager, what did you use what was the first diabetes technology, I assume it was a blood sugar meter. coming right back to Heather in just a second. But first Diabetes Connections is brought to you by Dexcom. And Benny has been using the Dexcom CGM for almost 10 years now, that first insertion was in 2013, just before he turned nine. I mean, it was great. Then if you've done finger sticks for a while you know how amazing it is to go from that to continuous glucose monitoring. But it is even better. Now. The Dexcom CGM systems just keep improving, continuing to get more and more accurate with no finger sticks or scanning required. The easy push button insertion has made it easy for Benny to do it himself. He has done every one since we switched to the GS six in 2018, which is really great for his independence back then, as a younger teen. Of course, we still love the alerts and alarms, and that we can set them how we want if your glucose alerts and readings for the G six do not match symptoms or expectations. Use a blood glucose meter to make diabetes treatment decisions. To learn more, go to diabetes connections.com and click on the Dexcom logo. Now back to Heather talking about what things were like she was diagnosed at age 16.   Heather Lackey  38:10 Yeah, you know, I was diagnosed in 1990. And of course, I had a meter. The old lancing device that I had was the one that you lay on the table and it's spring loaded and it like warm around like a hammerhead, and it would poke your finger. Right. So that was my first one. And you know, I was just on conventional insulin therapy, right, at least had disposable syringes. I wasn't sharpening a needle or have a glass of orange or anything like that. And you know, for me, Stacy, my parents were so great. My dad worked internationally. And they were just constantly talking to people like what, there's got to be something that right because I was doing everything I could, I mean, I really tried hard. And I have for, you know, three decades, tried hard to really kind of manage things. And they said, you know, there's got to be something better. And that was right at the end was actually before the end of the DCCT trial, when my parents were told, Hey, there's, we've got to get her on something better. We're starting to notice that these multiple daily injections are going to be a lot better. So went to went and started multiple daily injections. And at that point, this was in 1992. At that point, they they the healthcare team said you ought to consider a tump you're you're young your parents have insurance. You guys are certainly kind of wanting to have the best control you should consider a pump and Stacy for cash for seven years. The first seven years after I was diagnosed I did not want an insulin pump to save my life. I wouldn't even think about it until someone said hey, I had gained some weight in college, as many females and male do and I was trying to lose weight exercising to on the elliptical and or the treadmill, either one. And every time I would exercise, I would go low. And every time I would go low, I would have to have juice and peanut butter crackers, or whatever the case was, and I was having more calories than I had exercised off, you know, you can see the counter of your calories that you're burning. And I'm like, This is ridiculous, I'm going to continue to go low, and not be able to trim down my weight some, and I didn't have the right tools. And so that's the reason I started on a pump and then have been on a pump. For the last, I don't know, 2026 27 years, maybe when you   Stacey Simms  40:37 used to do a lot of patient training on insulin pumps, I know you still do some now, I'm even in your role here. What are their biggest concerns? You know, there's a lot of mechanical learning if you've never used an insulin pump before. But there's also as you mentioned, there's a reluctance sometimes. Can you share a little bit about what patients tell you?   Heather Lackey  40:54 I think the unknown is the biggest thing for patients, right? They don't know if it's surgical, they don't know if it how this goes in how you disconnect, how you're going to get live. The five emphases as I call it, you know, how do you sleep? How do you shower? How do you swim? How do you go in, you know, with exercise and do sports, what happens with intimacy and things like that, you know, those are unknown if you haven't met with a an educator or you haven't had a friend or even a health care provider that's kind of talked to you through that. So I think once people understand how insulin pumps and continuous glucose sensors kind of work inside of our life, and really how easy they are. The trainings are so much more simplified today, because the therapy is so much easier, right? And so I think once they start to see they're starting to put the pieces together, like the technology is working in the background, I don't have to work as hard. Here's the the, you know, two or three things that I have to do change my infusion set once a week, change the sensor once a week, and then I have to enter some grams of carbohydrate, however those grams of carbohydrate are calculated, then they start to understand this is not as big of a deal.   Stacey Simms  42:09 All right, I have to go back. You said the five S's and then I kind of heard you editing as you went, you can say six on this podcast. But what were the other ones we had sleep swim.   Heather Lackey  42:18 So fleet that were when boarding and zek?   Stacey Simms  42:22 That's great. I love that list. That's a great list. All right, before I let you go, I can't let you leave without talking about Purple Hearts, this Netflix movie that you were a consultant on, right? Tell me a little bit about what happened there. This is a character that has type one. And she marries a marine to get benefits health benefits. And it's a very romantic story. How did you come to be a consultant on that? And what was it like? Well, what was so interesting   Heather Lackey  42:46 about this, I mean, it was I mean, what a one and a life champ or V I mean, it was really great. The director, or producer, I think it was the director, she had reached out to Medtronic, specifically, because she was, you know, obviously going to be doing this movie, and the hurt. So her team had reached out to Medtronic. And she really wanted to one US product in the movie. But I guess her colleagues and friends and and others that he had talked to whenever she mentioned that this character was going to have type 1 diabetes. They were all like, Yeah, well, we, you know, we've learned that Medtronic pump for, you know, years and years. And so that's why she reached out, right, so reached out to our communications team and our marketing team. And those teams were so great to say, hey, look, they're going to be using a pump and sensor on the set, they might need to have some help. Just making sure that everything is used correctly. And you know, you're always in film, in movies, etc. Whenever I see things being used in an incorrect way. So yeah, so anyway, I was able to go out on the set. And then, you know, one thing just kind of led to another and they were like, well, you know, we're gonna need someone to train. You know, Sophia Carson is the actress. I mean, like, what an amazing thing to be able to beat her and all the other dudes amazing talent on that, that and they were like, Why don't you I mean that you do this? So why don't you just do this in the movie. And I was so happy that that tiny little piece was not cut it, it was such an important thing for my friends and family to be able to see so. And it really does kind of make people with type one I've heard over and over it was kind of cool for the film to kind of walk through people without type 1 diabetes. Like there's a trainee, you know, like, we have to get to understand how to use this equipment. And it's kind of the big day whenever you go on an insulin pump. The coolest thing about the scene that I was in with Sophia Carson, whenever she we finished the scene and she got on the system and we had everything is moving and working at and it was it was there. She was like, Heather, this is amazing that people go through this. And then she was like, gonna give you a hug like this is like I feel empowered having this system on me whenever I'm playing a character that has type 1 diabetes, so it was very organic and natural. And that wasn't anywhere in the script, you know. So it was just a true testament to how powerful technology is and people with diabetes. Five,   Stacey Simms  45:31 is there going to be a second one?   Heather Lackey  45:32 I have pushed. I have said, I hope that there is everybody wants to know what happened to those two characters. I don't know about it, but I would I would love to see a second movie as well.   Stacey Simms  45:45 That'd be great. Well, we will leave it there. Thank you so much for sharing so much of your time with me. I would love to have you back on to talk more about this system. We still have a lot of questions. I'm sure we just scratched the surface. But I really appreciate your time. Thanks so much for sharing so much information.   Unknown Speaker  45:59 Thank you Stacey. Have a great day.   Stacey Simms  46:05 You're listening to Diabetes Connections with Stacey Simms. Lutz where information with diabetes dash connections.com. I know we didn't get to all of your questions. I will definitely talk to the folks from Medtronic. Again, I thought Heather was really terrific. And she laid everything out. I loved her five S's. But you should also know that the 780 G she mentioned this. It's currently approved for users seven years old and above with type one, they have started taking pre orders that happened in the middle of May, and they will be shipping later this summer. throughout the US. If you have a 770 G, you will be eligible for a free upgrade through remote software. If you want to be notified more, you can go there's a link in the show notes and get their upgrade notification newsletter. So just go to diabetes connections.com Click on this episode's homepage. It'll give you all the information that you need. I'm taking a deep breath because as I have been telling you, my May was bananas. It was wonderful. It was busy and all the best ways. But I mean, I went to Ireland at the beginning of the month. Then I went to New Orleans for my daughter's graduation. Then we had a giant family reunion at my house. So hopefully as you're hearing this, nothing that busy has popped up for the month of June. What I do have on the calendar is the ADA Scientific Sessions conference toward the end of this month. I have never been to this. I've always tried to make it but it's never worked out. So I have immediate pass. I have my microphones packed Well, not yet, really. But I am going to be going and talking to all of these companies. I'll be putting stuff in the Facebook group. So please join Diabetes Connections, the group or sign up for our newsletter. And you can do that at diabetes dash connections.com Because I'm gonna be asking what you want here, who do you want me to talk to what questions you want me to ask. I'm going to try to do a whole bunch of interviews while I'm there and set up a whole bunch more. You can always email me Stacey at diabetes connections.com. I'm super excited about going to this event and really hoping to bring your questions to more of these folks. As I mentioned at the beginning of the show, I am scheduled to talk to beta bionics about the eyelet so that should be next week's episode. And of course we have in the news this Friday to fill you in if there are any more FDA approvals a there's more stuff in front of them. This has been a really interesting year so far, and we're not halfway through. Thank you to my editor John Buchanan, audio editing solutions. Thank you so much for listening. I'm Stacey Simms. I'll see you back here soon until the end. Be kind to yourself.  

When many diabetes tech companies are turning their attention to CGMs or closed loop systems, Josh Pittman has his eye on the basics: lancets. His company PIP, makes a new kind of smaller and thinner device for fingersticks. This week, we talk about why he thinks this is still necessary, why he's passionate about helping people overcome fingerstick fear and what his mother with type 2 taught him about why the basics are so important to long term care. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.   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    

On social media, Neil Greathouse is better known as “The Betes.” He posts daily about diabetes on social media. It's a lot of work – and not his real job. I wanted to know why this is important to him. What is he hoping to accomplish? There is so much to Neil's story – he's become a diabetes educator – and he's an open book – he'll share about going into DKA not too long ago, a failed marketing effort with a big diabetes company and much more. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. My first conversation with Neil, from 2017: https://diabetes-connections.com/neil-greathouse-t1d-instagram-inspiration/ 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    

It's In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: The US Senate grills insulin makers about keeping the price where it is, two studies look at the impact of faster-acting insulins, a new study looks out temperature and insulin storage, researchers examine CGM access and health outcomes, and more Check out Moms' Night Out with three new dates on the calendar! 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   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 Moms Night Out - Treat yourself to some time away with other moms who get it. Our next stops this fall in Providence, RI and Frisco TX. XX Our top story this week, big Senate hearing on insulin.. The three insulin makers recently cut their list prices by around 70%. The Senate Committee on Health, Education, Labor and Pensions pressed industry leaders and all three – Lilly, Novo Nordisk and Sanofi - committed to “keeping their drugs affordable,” But asked whether the companies would no longer raise prices on their existing insulins, only Lilly sai yes. The Sanofi and Novo Nordisk chiefs did not. Sen. Markwayne Mullin, R-Oklahoma, called PBMs “the fox guarding the henhouse,” going after the executives for essentially “rebating themselves." He said the situation “isn't working for America.” “This committee is going to stay on this issue," Senator Bernie Sanders said Wednesday. "We need profound change in the industry and in PBMs." https://www.fiercepharma.com/pharma/bernie-sanders-led-senate-committee-holds-pharma-chiefs-and-pbm-execs-feet-fire-insulin XX Not a big difference between fast-acting insulin aspart and standard insulin. New study using hybrid closed-loop insulin delivery system found that faster acting Fiasp did not offer any additional glycemic benefits compared with standard insulin aspart – Novolog - and participants had more cases of hyperglycemia with ketosis with the Fiasp. The study cohort had a baseline HbA1c of 7.2% and a time in range of 63.9% at the start of the trial. Of the cohort, 76% was using a hybrid closed-loop insulin delivery system at enrollment. There were no cases of severe hypoglycemia or DKA during either intervention. https://www.healio.com/news/endocrinology/20230508/time-in-range-similar-with-fastacting-vs-standard-insulin-for-young-kids-with-diabetes XX On the other hand, people with type 2 diabetes saw more time in range with faster acting insulin. These were adults with type 2 on basal bolus MDI along with CGM. The insulins here with Lyumjev and humalog. https://link.springer.com/article/10.1007/s13300-023-01400-w XX New study confirming that insulin doesn't have to be refrigerated as strictly at package instructions. These researchers took 6 different bands and types of insulins and stored them – quote - unopened for 1–4 months in non-refrigerated conditions in a real-world setting during the summer in India, all compared with control samples of each insulin, which remained refrigerated. Insulin vials were stored in watertight bags. Bags were placed in either an open plastic container stored on a high shelf or in a cupboard, or in clay pots with a separate water compartment. All storage containers were placed in shaded areas The temperature was measured every 15 min by electronic data loggers. The mean maximum temperatures were between 86 and 94 degrees. Most of the insulin stayed fine for two months and much of it for four months. Every study I talk about is linked up at this episode's homepage at d-c dot com with more specifics. https://www.thelancet.com/journals/landia/article/PIIS2213-8587(23)00028-1/fulltext?fbclid=IwAR1J2Y2JLZNHTvlPwtCo7t-wA60zhFMRvx2DEc7sujaFOX1pKc_-RbjhnL0 XX Not so shocking conclusion that increasing access to CGMs – regardless of ethnicity and insurance status – can improve outcomes. Despite higher rates of complications among T1D youths from lower-income backgrounds, diabetes technology is 50% lower among this group. Youths with public insurance have frequent interruptions to CGM access, which are associated with worsening HbA1C trends. Implicit biases and willingness to recommend diabetes technology to youths from underrepresented backgrounds are likely additional contributors to these disparities, according to authors. Authors concluded the results demonstrated in the study suggest equitable access to CGM soon after T1D diagnosis could be a first step to improve HbA1C for all youths, but acknowledge this access alone is, “unlikely to eliminate disparities entirely.” The authors add broader societal strategies to address structural drivers of disparities in diabetes care are required. https://www.contemporarypediatrics.com/view/equitable-access-to-glucose-monitoring-improves-hba1c-levels XX Interesting reminder that the seemingly obvious answer isn't always the right one comes from cataract research.. Cataracts—the clouding of the lens of the eye—are the number one cause of blindness worldwide and are a common complication of type 2 diabetes. The current hypothesis behind diabetic cataract development is coined “the sugar hypothesis” and suggests that high blood sugar—a hallmark of diabetes—precedes cataract development. The working assumptions underlying the sugar hypothesis describe higher levels of glucose in the lenses of people with diabetes convert to a sugar alcohol molecule called sorbitol, which induces structural changes to the lens of the eye that precede cataract development. While unproven, researchers rarely investigate this theory further due to cataracts' treatable nature. Now, after some animal studies, it looks like the damage actually starts before blood glucose rises above normal. The reseahres say it's still too early to tell what's going on but they hope ore study will bring the medical community a step closer to understanding the cellular mechanisms underlying the origins of diabetic complications during the pre-diabetic stage of the disease. Then, they say, they can search for ways to better prevent them. https://scitechdaily.com/sweet-deception-sugar-hypothesis-of-diabetic-cataract-development-gets-an-eye-opening-reality-check/ XX Very large study shows that GLP1 receptor agonists—a class of diabetes medications that include Trulicy and Ozempic —are associated with fewer major adverse cardiovascular events than another type of diabetes drug older veterans with no prior heart disease. The second drug type is DPP4 inhibitors with brand names like Januvia and Nesina. Apparently, the clinical trials showing cardiovascular benefits for these drugs were conducted in people who already had heart disease, so these researchers wanted to see if it would help those who did not. 100-thousand US veterans were included in this study. The median patient age was 67 years, and the median diabetes duration was 8.5 years. The researchers included variables such as age, sex, race, body mass index, blood pressure, laboratory values like hemoglobin A1c, and history of prior illnesses in the statistical analysis. https://medicalxpress.com/news/2023-05-diabetes-drugs-adverse-cardiac-events.html XX Ascensia expands it's Eversense PASS, a Payment Assistance and Simple Savings program designed to enhance affordability and access to the Eversense E3 CGM System. Under the new and improved program, more people with diabetes will be eligible for assistance paying for the system, which now includes increased savings for eligible first time users. Eligibility for the program has now been extended to all commercially insured people with diabetes across the country, including those who do not have coverage for the Eversense E3 system from their insurance provider. Eversense is an implanted CGM that lasts six months and has a removable smart transmitter. https://www.prnewswire.com/news-releases/ascensia-diabetes-care-expands-payment-assistance-and-simple-savings-program-for-eversense-e3-cgm-system-301818639.html XX Right back to the news, but first, I want to tell you about Moms Night Out! In the 16+ years since my son was diagnosed with type 1, I have attended dozens of diabetes conferences and events. Now I've taken the best elements from those events and created a brand new experience. We're going to have lots of diabetes technology for you to see and learn about, stress-relieving social time where you can meet other moms just like you, and speakers who will leave you feeling energized and ready to face the challenges of parenting a child with T1D. We had the first of these in January – I didn't realize it was the first I actually expect it to be a one and done – but it went to so well and the reaction was so good from moms around the country that I deided to keep going. Our next stops are Frisco TX and Providence RI, back to Charlotte in Feb and more cities to come in 2024. Join us – check out the very top of diabetes-connections dot com or click on the event tab. XX XX Garmin today announced expanded region availability of the Dexcom Connect IQ apps. Available for a wide range of Garmin smartwatches, the Dexcom Connect IQ app3 provides people with diabetes with a secondary way to view their glucose levels, right from their wrist. Connect IQ is the app platform for Garmin wearables, bike computers, and outdoor handhelds https://www.garmin.com/en-US/newsroom/press-release/wearables-health/people-with-diabetes-can-now-view-dexcom-cgm-data-on-their-garmin-smartwatch-or-cycling-computer/ XX XX On the podcast next week.. Neil Greathouse is a familiar face on social media – posting every day as “The Betes.” I'll catch up with Neil to talk about what motivated this every day connection – he has a real job not in diabetes – and more. Last week I spoke with The Marvelous Mrs Maisel's Austin Basis about managing T1D on set and off. That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

Medicare has now expanded coverage for CGM use among people with type 2, in part because of studies by companies like Dexcom. We'll talk about those findings and learn more about the US release of the G7. Dexcom Chief Operating Officer Jake Leach gives us information on app updates, talks about CGM for people with type 2 and gestational diabetes, pump integration for the G7, smoothing – and what that means – and a lot more. More info about CGM and Medicare: From ADCES: http://www.radiomiw.com/press.html Dexcom Medicare coverage info: https://www.dexcom.com/en-us/g6-g7-medicare This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Moms' Night Out is back! Three cities are on the schedule:  Learn more  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    

It's In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: after a long wait, the FDA approves Medtronics 780G and lifts their warning letter, Omnipod GO for people with type 2 gets approved, a look at insulin in pill form, a new way to treat overnight low blood sugars and lots more! 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   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 the T1D Exchange, make your voice heard and drive research that matters XX Buckle up there is a LOT going on XX Medtronic's Minimed 780G AID system gets FDA approval. This is for people aged 7 years and older who have type 1 diabetes. Medtronic will begin taking preorders on May 15, 2023. Users of the current MiniMed 770G will be eligible for free remote software upgrades. The 780G is currently available in 105 countries. It has been available in Europe since 2020 and in the UK since 2021. The biggest difference from other systems is that it can automatically administer bolus correction insulin doses every 5 minutes. It will also automatically adjust basal insulin The insulin pump's infusion set can be worn for 7 days, rather than 3 days as with the older system, and the glucose target level can be set as low as 100 mg/dL. In the pivotal US trial, overall, patients who used the 780G spent 75% of the time in ideal glucose range (70-180 mg/dL) and 1.8% of the time below that range. Overnight, the figures were 82% and 1.5%, respectively. With the glucose target set at 100 mg/dL and active insulin time set to 2 hours, patients spent 78.8% of time in range without increased hyperglycemia. https://www.medscape.com/viewarticle/991091 XX U.S. Food and Drug Administration (FDA) lifted Medtronic's warning letter sent in December 2021. The resolution of the warning letter follows ongoing remediation actions from the company and proactive actions to continue to strengthen its quality systems. All regulatory restrictions associated with the warning letter have been resolved. https://finance.yahoo.com/news/medtronic-diabetes-resolves-warning-letter-203000188.html XX FDA also approved Omipod GO, for people with type 2 who take daily injections of long acting insulin. Insulet says “Omnipod GO was designed to serve the more than three million people using basal insulin or transitioning to insulin therapy to treat their type 2 diabetes” Omnipod GO is a standalone system that provides a fixed rate of continuous rapid-acting insulin for 72 hours. It's tubeless and waterproof just like a regular Omnipod but it's offered in seven different pre-programmed daily rates, ranging from 10 to 40 units per day, and operates without the need for a handheld device to control the Pod. It has been cleared for use with the following U-100 insulins: NovoLog®, Fiasp®, Humalog®, Admelog®, and Lyumjev®. The product was developed to serve people with type 2 diabetes earlier in their treatment journey by starting them on Pod therapy for their insulin delivery, rather than daily injections. If a patient becomes insulin-intensive, meaning they require both basal and bolus insulin, the transition to another Omnipod product would be seamless. Omnipod GO will have its US launch sometime next year. https://www.businesswire.com/news/home/20230424006026/en/Insulet-Announces-FDA-Clearance-of-Omnipod-GO%E2%84%A2-a-First-of-its-Kind-Basal-Only-Insulin-Pod-Further-Simplifying-Life-for-People-with-Type-2-Diabetes XX Senseonics says the first pediatric study participant has received an Eversense 365-day CGM insertion. The E3 180 day implantable CGM got FDA approval in February last year. Dr. Francine Kaufman, Senseonics CMO, said expanding to a pediatric population represents a “priority” for the company. Positive results could further extend the company's reach across the global diabetes community, she added. The company also intends to utilize study data to submit for an integrated CGM (iCGM) designation in 2023. Senseonics holds an FDA investigational device exemption (IDE) to expand the trial to pediatric patients. These patients — between 14 and 18 years old — first enrolled in the second quarter of 2023. https://www.drugdeliverybusiness.com/senseonics-first-pediatric-cgm-insertions/ XX Baqsimi gets a new home. Amphastar Pharmaceuticals is buying the Glucagon nasal spray from Lilly in a deal worth up to $1.08 billion dollars. Launched in 2019, Baqsimi saw worldwide sales worth $139.3 million in 2022, the companies said. You may remember that Lilly had acquired Baqsimi from Locemia Solutions in 2015. The drug has an active compound glucagon, a form of a hormone produced in the pancreas that stimulates glucose production https://www.reuters.com/markets/deals/eli-lilly-sell-low-blood-sugar-drug-amphastar-2023-04-24/ XX The FDA recently cleared a new experimental drug for type 1 diabetes to begin a phase 2 clinical trial. If approved, the drug would be the first therapy to specifically address low blood sugar at night. We've talked about this.. Zucara Therapeutics is testing an oral medication currently known as ZT-01 will attempt to restore the body's natural ability to respond to low blood sugar levels. Researchers will evaluate the ability of the drug to blunt hypoglycemia caused by insulin in type 1 diabetes. This phase 2 clinical trial follows positive results from the company's earlier phase 1 study which included 18 participants with type 1 diabetes who received the treatment. Of these 18, 16 (89%) had a meaningful increase in glucagon production after being given ZT-01, with no serious health events during the trial. https://diatribe.org/drug-prevent-nighttime-lows-approved-enter-clinical-trials XX The T1D Exchange Registry is a research study conducted online over time, designed to foster innovation and improve the lives of people with T1D. The platform is open to both adults and children with T1D living in the U.S. 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. The registry aims to improve knowledge of T1D, accelerate the discovery and development of new treatments and technologies, and generate evidence to support policy or insurance changes that help the T1D community. By sharing opinions, experiences and data, patients can help advance meaningful T1D treatment, care and policy. XX Australian scientists have designed a new way to swallow insulin, in a pill form. The design also has potential uses for delivering other protein drugs, such as antibiotics and cancer treatments. Insulin is made of smaller versions of proteins called peptides. Previous attempts to develop an orally administered insulin have found that the severe pH levels in the gastrointestinal tract degrade the peptides, causing the drug to lose its function. To get around this problem, the scientists encapsulated the insulin in a lipid-based nanomaterial placed inside an enteric capsule. In animal studies, long acting insulin was absorbed better than fast acting. They say long way to go, but an interesting start. https://newatlas.com/medical/new-insulin-capsule-game-changing-diabetics/ XX A new proof of principle study demonstrates the accuracy of Know Labs' proprietary Bio-RFID™ sensor in quantifying different analytes in vitro, proving a 100% accuracy rate in these tests. The full study is currently undergoing the peer-review publishing process. “Proof-of-principle studies are critical in demonstrating Bio-RFID's accuracy for non-invasive methods of medical diagnostics. This was an essential step toward achieving our goal of delivering the first FDA-cleared, truly non-invasive glucose monitoring device to the market” Know Labs' technology platform, Bio-RFID, uses electromagnetic energy in the form of radio waves to non-invasively capture molecular signatures, which can be converted into physiologically meaningful information and insights. While the technology is proven to accurately measure several analytes inside and outside the body, the first application of this technology is aimed at non-invasive glucose monitoring. This study did not include people but researchers say it's an important step on the way. https://www.businesswire.com/news/home/20230421005095/en/Know-Labs-Demonstrates-Accuracy-of-Non-Invasive-Bio-RFID-Technology-with-Proof-of-Principle-Study XX Moms Night Out – new cities include Providence, RI, Frisco, TX and Charlotte NC. more info here XX On the podcast next week.. Dexom's Jake Leach brings us up to date on some G7 updates as well as new Medicare coverage for people with type 2. Last week's episode was with the first US commercial pilot with type 1, Pietro Marsala. . That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

Jisel Parra had a rocky start with diabetes – as a teen her type 1 was initially misdiagnosed and she struggled with support and mental health. But she found ways to find community and gradually started to thrive with T1D. These days, Jisel runs A Tad Too Sweet, which makes trendy medical bracelets. She has a career outside of diabetes and has two children. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. 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    

It's In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: Abbott recalls Freestyle Libre readers (not the sensors, see below for more information), Medicare expands CGM coverage for  more people with type 2, a new study looks at the transition for children with T1D to adults and why patients aren't being served well during that time, and much more! 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   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 Athletic Greens AG1 by Athletic Greens is daily nutrition made really simple. XX If you've got an Abbott Libre reader – check it for a huge recall. The company is issuing a class one – that's the most serious -recall of all readers distributed in the U.S. from November 2017 to February 2023, totaling more than 4 million devices. The recall is due to the potential overheating, sparking, or fire that may occur when the readers are charged with non-Abbott adapters or USB cables, or when they are damaged or exposed to liquids. Abbott-provided USB cables and power adapters limit the current to safely charge the battery, whereas third-party cables and adapters may allow much higher power, increasing the risk of fire. Abbott has reported 206 incidents related to this issue, including at least seven fires and one injury, but no deaths. I've got the phone number to call and more information in the show notes at d-c dot com. This recall only applies to those using the external reader device, not those using their smartphone. Contact Information Users with questions about this recall should contact Abbott Customer Service at 1-855-632-8658, available 7 days a week from 8AM to 8PM Eastern Time, excluding major holidays. https://www.fda.gov/medical-devices/medical-device-recalls/abbott-recalls-readers-used-freestyle-libre-freestyle-libre-14-day-and-freestyle-libre-2-flash XX A big policy change coming next week - The Centers for Medicare and Medicaid Services will expand continuous glucose monitor coverage to more people with type 2 diabetes. That starts April 16th, this Sunday if you're listening as the episode first drops. The expanded coverage applies to people using a basal only routine, as well as others who have a history of what has been classified as “problematic hypoglycemia.” Bottom line for those with type 2 – check with your doctor to see if a CGM is now covered October.https://diatribe.org/medicare-expands-cgm-continuous-glucose-monitor-coverage-type-2-diabetes XX Montana lawmakers are considering a bill that would require insurance companies to cover CGMs for people with Type 1 and Type 2 diabetes. House Bill 758 has broad support from lawmakers, but it faces opposition from insurance companies and some providers. That opposition focuses on the cost, whether a CGM is medically necessary at all stages of diabetes, and the possibility that CGM manufacturers will raise their prices if there is an insurance mandate. Blue Cross and Blue Shield of Montana, the state's largest insurer, estimates the bill, if passed, would cost the organization nearly $5 million a year. The BCBS spokesperson also says ““These things are a convenience,” https://khn.org/news/article/montana-potential-bill-insurance-covering-continuous-glucose-monitor/ XX Short-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with an increased risk for heart failure hospitalization among patients with type 2 diabetes (T2D), according to a Danish registry study. Among over 300,000 patients with T2D, short-term use of NSAIDs was associated with a relative 43% increased risk of a first-time heart failure hospitalization in the subsequent 28 days. NSAIDs increased the risk of heart failure even more in type 2 diabetics who were 80 or older (78%) or who had high blood sugar levels (68%), the results showed. Those who'd never used an NSAID before had the worst reaction, with their heart failure risk nearly tripling. However, heart failure was not associated with using NSAIDs in people with well-controlled diabetes and normal blood sugar levels. https://www.medpagetoday.com/cardiology/chf/103936 XX New study from Boston Children's Hospital shows the transition from child to young adult managing type 1 is a pretty fraught time. routine outpatient care for type 1 diabetes decreased between ages 16 and 24. At the same time, emergency room visits to treat the condition increased for that age group. The study raises the concern that young adults lack a “medical home” with an endocrinologist and instead may be seeking routine care such as insulin prescription refills from an emergency department (ED), Garvey says. If anything, the research supports the idea that endocrinologists should have an integral role in diabetes management for young adults, she says, and illustrates how specialized care may prevent the need for acute care in hospitals. The data here showed that annual endocrinologist visits declined from 2.3 per year at age 16 to 1.5 per year by age 24. This data stands out, Garvey says, because previous research has shown endocrinologists are the main providers of type 1 diabetes care for most young adults with the condition. These researchers hope the study can serve as a launching point for endocrinologists to assess how they can help young adults better manage type 1 diabetes https://answers.childrenshospital.org/self-care-of-diabetes/ XX XX The past few years have seen numerous advances in the understanding of how type 1 diabetes develops and how to manage it, yet the global disease burden remains high, according to a review article published April 5 in The Lancet. The authors cite data related to diabetes control in youth and adults from the T1D Exchange demonstrating that only 21% of adults with type 1 diabetes have an A1c (a blood test that reflects a 90-day sugar average) of 7.0 or lower. While type 1 diabetes is the third most common disease of childhood, there should be greater awareness of adult onset of the disease. The paper references data from the UK Biobank indicating that up to 40% of type 1 diabetes diagnoses occur in people over age 30. , the paper notes that racial and ethnic disparities persist and insulin pump usage is lowest at 18% among non-Latinx Black populations compared with 72% among non-Hispanic white people and 40% among Hispanic populations. The paper also reports that inhaled insulin – brand name Afrezza - has demonstrated a fast onset of action, improving the ability to control glucose after meals. https://medicalxpress.com/news/2023-04-global-diabetes-burden-high-advances.html XX A research team led by the University of Michigan Health Department of Neurology followed more than 120 patients who underwent bariatric surgery for obesity over two years after the procedure. They found that all metabolic risk factors for developing diabetes, such as high glucose and lipid levels, improved outside of blood pressure and total cholesterol, according to results published in Diabetologia. Investigators also found that patients two years removed from bariatric surgery showed improvements in peripheral neuropathy, a condition marked by damage to the nerves that go from the spinal cord all the way to the hands and feet. . Obesity is the second leading risk factor for peripheral neuropathy after diabetes, which affects more than 30 million Americans. https://medicalxpress.com/news/2023-04-bariatric-surgery-reverse-diabetes-complications.html - XX Athletic Greens XX As of April 12, 2023, Panbela Therapeutics has officially begun their Phase II double-blind, randomized study to assess the effectiveness and safety of CPP-1X-T for recent onset type 1 diabetes (T1D). The study will involve enrolling 70 patients across six different centers in the United States, with Indiana University leading the trial. The first patient has already been enrolled, which has led to a boost in the company's stock prices. Panbela Therapeutics is a clinical-stage biopharmaceutical company that specializes in developing innovative therapies for cancer patients and those with other urgent medical needs. They have recently completed a clinical trial of ivospemin, a treatment for locally advanced or metastatic pancreatic cancer. The company also acquired Cancer Prevention Pharmaceuticals in June 2022, a clinical-stage biopharmaceutical company that focuses on developing therapies to prevent cancer and rare diseases. CPP-1X-T is one of the drugs that Panbela Therapeutics is currently developing. This drug has shown potential complementary activity with the FDA-approved treatment for pancreatic cancer and is being evaluated for the treatment of T1D in the Phase II clinical trial. The company's shares have been fluctuating in recent months due to various factors, including the progress and results of their clinical trials. https://beststocks.com/panbela-therapeutics-begins-phase-ii-clinical/ XX Type 1 Diabetes Conference & Community For people living with type 1 diabetes of all ages where they can find: Information, Motivation, And Inspiration To Thrive With Type 1 Diabetes XX The book! XX On the podcast next week.. Jisel Parra was diagnosed as a teenager and it couldn't have gone worse – they didn't prescribe insulin initially, she struggled with getting the right and with her mental health.. but now she makes medical jewelry and tags with her company A Tad Too Sweet. I'm excited for you to hear her story. Last week, Dr. Bryce Nelson on Tzield. . That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

Dr. Bryce Nelson is one of the first doctors in the country to administer the new Tzield to delay the onset of type 1. He's been involved with TrialNet, identifying those who have the genetic markets for T1D and says that research was exciting but frustrating because they had no treatment. Now, they're looking at a possibly new way of talking about T1D. Dr. Nelson is the Chief of Endocrinology at Children's Hospital of Richmond at VCU Dr. Nelson takes us through the process of using Tzield – which was researched under the name teplizumab – from identifying the patient, to treatment to what happens next. His first patient, William Troutman, is a North Carolina teenager. William's mom joined me a few weeks ago to tell their side of the story. Listen to our episode with Amanda Troutman: https://diabetes-connections.com/delaying-a-t1d-diagnosis-with-tzield-a-deep-sigh-of-relief-for-a-little-while/ This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.   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    

When the FDA cleared the 3 FreeStyle Libre 2 and FreeStyle Libre 3 (iCGM) system sensors for integration it meant a big leap forward to interoperability. For the first time in the US, insulin pumps can work with two different sensors.. Libre and Dexcom. This week, Stacey talks to Dr. Jordan Pinsker, medical director for Tandem Diabetes Care, about the upcoming Libre integration, the Mobi pump that's in front of the FDA right now, and much more. Dr. Pinsker has extensive experience with automated systems – he's been there since close to the beginning and we talk about the long process to bring them to market, how they're changing lives and what is still yet to come. More about the Libre approval: https://beyondtype1.org/freestyle-libre-aid-clearance/ More about Dr. Pinsker: https://www.tandemdiabetes.com/providers/bio/jordan-pinsker This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. 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    

Ginger Vieira is here to talk about her new book – she's written on everything from pregnancy with diabetes to exercise to her new series of children's books. But she's such a well-versed advocate, I had to ask her about her work at the T1D Exchange and all about her use of Afrezza. Why does she love it so much and what does she want you to know about using inhaled insulin? This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. More about Ginger: https://www.gingervieira.com/ Diabetes Doodles: https://diabetesdoodles.com/ 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    

Infusion sets have always seems like the weak link of pumping for us. What good is the best algorithm and state of the art pump and CGM if the way it all attaches to the body is no good? New information shows infusion failures happen more than you may think. John Wilcox's company, DiaTech Diabetes, has an infusion set failure detection system. He's going to explains what that is, how it works and what you can do with the sets you have right now to make them more effective More here: https://diatechdiabetes.com/ This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. 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    

It's In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: Dexcom G7 is now available in the United States, Insulet buys assets from Bigfoot and another California company, new studies about cannabis and type 1 and COVID and diabetes, different predictors of type 2 in women and men, plus scholarships for T1D students. 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 Episode Transcription:  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 T1D Exchange dedicated to improving outcomes for the entire T1D population XX Our top story. Today's the day. February 17th is the day Dexcom's G7 becomes available in the United States. Now.. whether you can get it still depends on your insurance, your doctor – a new prescription is needed – and the availability at your pharmacy. Whether you want to get it may depend on if you use a compatible pump system – the G7 will NOT work with Tandem's CIQ or Omnipod 5 for several more months. The G7 will be accessible to all Medicare patients with diabetes who meet the eligibility criteria as of today.. so no wait there. Much more to come on the launch I'm sure.. https://investors.dexcom.com/news/news-details/2023/Dexcom-G7-Continuous-Glucose-Monitoring-System-Will-Be-Available-to-Medicare-Beneficiaries-at-Launch/default.aspx?fbclid=IwAR0cKhAv5C8TMZ8v8f98rlhnvBQ0JkFj3SLRyc7RdMeOAO3_Tpl95cKNX20 XX People who've had Covid-19 have a higher risk of developing diabetes, and that link seems to have persisted into the Omicron era, a new study finds. Mounting evidence suggests Covid-19 infections are tied to a new diagnosis of diabetes, though it's not clear whether this relationship is a coincidence or cause-and-effect. Big study here, 23,000 adults who'd had Covid-19 at least once. The raw data showed that people who'd had Covid-19 had higher risks of being diagnosed with diabetes, high cholesterol and high blood pressure after their infections. But when the researchers adjusted those numbers to account for the benchmark diagnosis, only the risk of diabetes remained significantly elevated. Covid-19 increased the odds of a new diabetes diagnosis by an average of about 58%. The new study is notable because it adds recent data, said Wander, who was not involved in the research. It also used strategies to try to address shifts in health care during the pandemic. Another strength of the study was that it included people who were diagnosed between March 2020 and June 2022, so it was able to estimate the risk even after the Omicron variant swept through the US. https://www.cnn.com/2023/02/14/health/covid-diabetes-risk-study/index.html XX Insulet making a couple of interesting acquisitions.. $25 million in assets from Automated Glucose Control LLC in California. And the same amount $25 million of assets from Bigfoot Biomedical. AGC and Insulet have had a partnership since 2016 which mostly involved the algorithm that led to Omnipod 5. Bigfoot has also claimed patents regarding more hands-off insulin delivery, The acquisition effectively doubles Insulet's IP portfolio, Eric Benjamin, the company's executive VP of innovation, strategy and digital products, said in a press release. XX Dr. Halis Akturk and colleagues began noticing patterns among people with T1D in Colorado hospital emergency departments (ED) after cannabis was legalized in the state. They have since conducted several nationwide retrospective studies on those living with T1D that also use cannabis, including hospitalization records and T1D Exchange Registry participant surveys. They found that T1D participants had repeated return visits to the ED in the following weeks, and DKA was frequently misdiagnosed. Based on that research, Dr. Akturk's team has recently developed a key to differentiating between DKA and a new syndrome that mimics DKA, one they've named HK-CHS: Hyperglycemic Ketosis-Cannabis Hyperemesis Syndrome. To treat HK-CHS, your care team will typically increase fluids, treat the high blood glucose with insulin, and balance your electrolytes, or anion gap. You will be advised to stop using cannabis until the symptoms resolve. These treatments will bring your blood glucose levels back into target range and get your gut moving again, which will ease the nausea and vomiting. Depending on your dose, frequency, and duration of use, symptoms may take several days to several weeks to resolve. https://t1dexchange.org/cannabis-t1d-risks/ XX About two thirds of people with type 1 diabetes in the United States have overweight or obesity, nearly the same proportion as Americans without diabetes, new nationwide survey data suggest. What's more, among people with overweight or obesity, those with type 1 diabetes are less likely to receive lifestyle recommendations from healthcare professionals than those with type 2 diabetes, and are less likely to actually engage in lifestyle weight management activities than others with overweight or obesity, with or without type 2 diabetes. "the lack of evidence for safe, effective methods of diet- and exercise-based weight control in people with type 1 diabetes may be keeping doctors from recommending such methods," these researchers say. "Large clinical trials have been done in type 2 diabetes patients to establish guidelines for diet- and exercise-based weight management, and we now need something similar for type 1 diabetes patients." https://www.medscape.com/viewarticle/988199 XX New research showing men and women have different risk factors when it comes to type 2 diabetes. In healthy women, low serum level of the adipose tissue protein adiponectin was an independent strong predictor of type 2 diabetes and prediabetes in the future. In healthy men, instead, low serum level of the liver protein IGFBP-1, was an independent strong predictor of type 2 diabetes and prediabetes This means that these proteins, which are measures of insulin sensitivity in adipose tissue (adiponectin) and liver and muscle (IGFBP-1), can predict whether one has a high risk of getting type 2 diabetes in 10 years. A previous study performed in Shanghai in 2016 showed gender differences in the same direction. In men with prediabetes the risk of future type 2 diabetes was significantly reduced if they increased their physical activity and muscle mass . In contrast, the same study showed that women with prediabetes must avoid increasing waist circumference and abdominal obesity or reducing large waist circumference to prevent type 2 diabetes. https://medicalxpress.com/news/2023-02-women-men-shown-factors-diabetes.html XX Tempramed/ VIVI Cap XX XX 2023 Diabetes Scholars applications are now open! If you're a high school senior living with type 1 diabetes in the US, you can apply to get money for college. https://diabetesscholars.org/apply-now/?fbclid=IwAR2txFmkmxp9qoMf5ZkKX0f83oxj3aOr69rCXeqozRDxq7Dt94e9QdBQrjg XX On the podcast next week.. Diatech Diabetes is a medical device company based out of Memphis, TN committed to changing the way infusion set failure detection is done with our infusion set failure detection system, SmartFusion. The last episode is with Dr Phyllisa Deroze all about explaining to your child when you, the parent, have diabetes. 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 T1D Exchange Registry is a research study conducted online over time, designed to foster innovation and improve the lives of people with T1D. The platform is open to both adults and children with T1D living in the U.S. 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. The registry aims to improve knowledge of T1D, accelerate the discovery and development of new treatments and technologies, and generate evidence to support policy or insurance changes that help the T1D community. By sharing opinions, experiences and data, patients can help advance meaningful T1D treatment, care and policy.

When you're a parent with diabetes, your kids often learn about diabetes before they can read or write. They know you might beep or take shots or wear a CGM and they often become diabetes helpers in serious circumstances. This week, Dr. Phyllisa Deroze talks about why she wrote a new book “Diabetes Helpers.” Dr. Deroze began blogging at DiagnosedNOTdefeated.com almost immediately after being diagnosed with diabetes in 2011. The following year she founded Black Diabetic Info; a website dedicated to helping close gaps of cultural incompetence around diabetes information. Amazon link to Diabetes Helpers This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Our previous episode with Dr. Deroze about how diabetes is misrepresented in media:  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    

Today's episode is all about Afrezza, the inhaled insulin! My Guest today is Ginger Vieira. Ginger is the Senior Content Manager at Beyond Type 1 and Beyond Type 2 and has been living with T1D since she was in middle school.  She is a WEALTH of diabetes knowledge. Be sure to check below for links to all her diabetes resources including all of the books she has written! At the moment, Afrezza is only FDA approved for people who are 18 years and older BUT, AS WE SPEAK, there is a clinical research trial being done to see if it is safe and effective in the pediatric population. After listening to this episode you are going to want them to hurry and and get that study DONE so our kids will have access to this amazing drug. I will put a link below to the trial as well. Enjoy! HELP SUPPORT THE SHOWFollow the show on Instagram @sugarmamaspodcastCome join the Facebook Group!Visit the Sugar Mama's Podcast WebsiteWrite a Review and help other type 1 families find the show!Donate to the show through Buy Me a Coffee!**Buy me a Coffee is a no strings attached way to support the show! Every donation given, whether it is a one time gift or a monthly membership, goes to making this podcast come to life each and every week. It helps fund things like the physical and virtual equipment needed to produce a podcast such as a website (I use Podpage), a recording platform (I use Squadcast), a podcast hosting platform (I use Buzzsprout) and editing software ( I use Descript). I truly appreciate support from listeners like you so, from the very bottom of my insulin cartridge, thank you!OTHER INFO MENTIONED IN THE SHOWGinger on Instagram   Find all of Ginger's books and resources HEREThe Pediatric Afrezza Clinical Research TrialSupport the show

REMINDER: This podcast should not be considered medical advice. Please speak to your doctor to determine whether Afrezza is right for you.I am thrilled to release this episode with Michael Castagna PharmD, CEO of MannKind. MannKind is the maker of Afrezza, the inhaled insulin. Listen back to Episode 25 released on May 18, 2022 (link below) if you want my initial impressions of Afrezza. As you may have gathered from listening to this podcast, I'm a huge fan of Afrezza. It has completely changed how I manage my diabetes and it has greatly simplified my daily routine. Afrezza is a game changer for people that take insulin (both Type 1 and Type 2 diabetics).Michael provides tons of useful information about what Afrezza is, how dosing works, who Afrezza is appropriate for, how to get a prescription, how to pay for it, etc. We go in-depth on some really important topics and I think you will find this episode to be extremely useful.If you are interested in Afrezza, please reach out to Afrezza Assist to get the process started. They are extremely helpful and will let you know what to expect as you speak to your doctor, insurance company, and pharmacy. https://afrezzaassist.comEpisode Links:Episode 25 - my initial thoughts on Afrezza https://stream.redcircle.com/episodes/a48ce257-6477-4472-a7b2-3ecebeab6c00/stream.mp3Afrezza FAQs: https://afrezza.com/faqs/Prescribing doctors: https://afrezza.com/find-a-doctor/Afrezza Assist: https://afrezzaassist.com

I am so excited for you to hear this episode with Ginger! Ginger has a wealth of knowledge pertaining to all things diabetes. She's been T1D since 1999 and has been writing about diabetes related topics for 15 years. Ginger has authored or co-authored 5 books relating to diabetes and she's currently a full-time writer and Content Manager for Beyond Type 1 and Beyond Type 2. Ginger has been doing intermittent fasting for 8 years and has a learned quite a bit about how fasting affects her body. Also, Ginger has spent a lot of time figuring out how to exercise while maintaining stable BGs (spoiler alert: fasting plays a major part in this!)Ginger was a fascinating guest!*Check out her website for links to her books and the articles she has written.https://www.gingervieira.com*Find her on Twitter at @GingerVieira*Links to Ginger's articles on Beyond Type 1: https://beyondtype1.org/leadership/ginger-vieira/*The articles referenced in the episode are as follows:Intermittent Fasting with T1D: https://diabetesstrong.com/intermittent-fasting-type-1-diabetes/Afrezza: https://beyondtype1.org/inhaled-insulin-type-1-diabetes/

Kim returns with more trial news. 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, iHeartRadioRadio 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: new research that keeps beta cells safer after transplant, a new drug for type 2 also shows weight loss success, the makers of Afrezza buy a simple patch pump, Beyond Type 1 tackles mental health and diabetes and lots more! 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 Our top story, another approach to beta cell encapsulation. There are a few methods being tested to protect the transplanted cells from the body's immune system. A new and promising one seems to be a new biomaterial in the form of microgel beads. This study was in mice only but after three months the beta cells survived and maintained blood sugar levels with no rejection drugs. Interestingly, this study put the cells into the omentum, not the liver as is apparently the usual spot. I never heard of the omentum.. in case you haven't, it's a layer of tissue connecting the stomach with the other abdominal organs. It's non-vital so it's safer if any complications take place. No word on when human trials might begin here. https://newatlas.com/medical/microgel-beads-safer-path-cell-transplants-treat-diabetes/ XX FDA approval for a new injection for type 2 diabetes called Mounjaro. It's made by Eli Illy and is shown to lower blood sugar and can help patients lose weight. Existing medicines target a hormone called the glucagon-like peptide-1 that is involved in the control of blood sugar. But Mounjaro targets a second hormone, the glucose-dependent insulinotropic polypeptide, as well. It is the first medicine to target both. While not yet approved as an obesity treatment, it's performed very well in clinical trials for weight loss. One study showed it helped patients lose an average of 16 to 22 percent of their weight: That's on par with bariatric surgery https://www.statnews.com/2022/05/13/fda-approves-lilly-diabetes-drug-that-analysts-expect-to-be-a-big-seller/ XX Big deal for MannKind, the makers of Afrezza inhalable insulin. They're acquiring Zealand Pharma's wearable V-Go Insulin Delivery Device. The V-Go is a patch pump that's meant for people with type 2 – it delivers basal insulin at a set rate all day long and can give boluses only in increments of 2 units of insulin at a time, up to 36 units in 24 hours. The deal is expected to close by the end of the month. https://www.mddionline.com/diabetes/mannkind-acquires-wearable-insulin-device-zealand-pharma XX Young adults who were at risk of food insecurity had an increased incidence of diabetes 10 years later, according to the results of a study from Washington State University. Although previous research has associated food insecurity with a range of health issues, this study showed a connection over time, which could indicate a causal relationship. The investigators could not identify the exact reason for this connection, previous research has shown that food-insecure households often have diets with lower nutritional values. The study results did not indicate differences among ethnicities or races, but they also said that a limitation of the study was the number of minorities in the sample, which could be too low to show a pattern, according to investigators. The investigators plan to evaluate food insecurity risk and health issues within American Indian and Alaska Native and American Indian populations, which they said are often left out of annual reports on food insecurity. XX Beyond Type 1 has a new mental health portal.. announced as part of this Mental Health Awareness Month. The global nonprofit is partnering with BetterHelp to provide affordable mental health resources and services to its online community with two weeks of free, professional online therapy. Beyond Type 1 will continue to expand the resources available on the site.. it's not just for this month. https://beyondtype1.org/mental-health/. XX Another entry into the quest to find a non-invasive way to monitor glucose. Movano Inc reports they have – quote - successfully validated the functionality of its proprietary and patented system-on-a-chip. They say this is designed specifically for blood pressure or glucose monitoring systems. It's very early here.. they are also creating a prototype for clinical studies. But this tech got them a new patent. We're keeping an eye on these non-invasive devices – it remains to be seen if any will be accurate enough to use to dose insulin. https://www.prnewswire.com/news-releases/movano-successfully-completes-functional-testing-of-smallest-ever-custom-mmwave-sensor-designed-for-non-invasive-glucose-and-cuffless-blood-pressure-monitoring-301545710.html 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 Back to the news.. Big candy recall, so heads up if you use any of these for lows. It includes specific varieties of SKITTLES® Gummies, STARBURST® Gummies, and LIFE SAVERS® Gummies due to the potential presence of a very thin metal strand embedded in the gummies or loose in the bag. No illness or injuries have been reported. I'll link up the specific lot and manufacturer information. https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/mars-wrigley-confectionery-us-llc-issues-voluntary-recall-specific-varieties-skittlesr-gummies XX A college fashion design major has a unique senior project. Naomi Kinnamon spent her senior year working on a collection titled “Type 1 Of A Kind.” This series draws on her experiences as a woman with type 1 diabetes who struggles to find clothing that fits comfortably with her insulin pump. She's lived with type 1 since 6th grade and says the most difficult clothing to find were dresses and jumpsuits. So she designed her own. Kinnamon showed off her designs at SCAD – the Savannah College of Art and Design and I'll link that up in the show notes. https://www.wsav.com/now/scad-senior-designs-clothing-for-women-with-type-1-diabetes/ XX On this week's long format episode, you'll hear about the latest on the iLet Bionic Pancreas. Next week.. Mike Joyce is set to complete an incredible long-distance hiking trail. It's actually three trails – the longest in the US – he'll talk about how he does this with type 1. 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.

REMINDER: This podcast should not be considered medical advice. Please speak to your doctor to determine whether Afrezza is right for you.In my opinion, Afrezza is one of the best insulins out there. Unfortunately, not many people - both patients and doctors- know much about it. Afrezza is an inhaled insulin that is very fast acting and it works without the need to pre-bolus. In this episode, I highlight the pros and cons of Afrezza and how I use it in conjunction with intermittent fasting. If you decide that you are interested in learning more about Afrezza, I highly recommend that you call Afrezza directly at 1-844-323-7399 to get started. If you start with your insurance company, expect to encounter road blocks.

It's "In the News..." the only LIVE diabetes newscast! Top stories this week: Medtronic expands its insulin pump recall, Afrezza inhaled insulin pediatric studies to begin, new report says adults w/T1D are a "Forgotten population," new research into type 2 diabetes and statins and more! Join us each Wednesday at 4:30pm EDT live at https://www.facebook.com/diabetesconnections   Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode transcript below: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I'm going to link up my sources in the Facebook comments – where we are live – and in the show notes at d-c dot com when this airs as a podcast.. so you can read more if you want, on your own schedule. XX In the News is brought to you by Real Good Foods! Find their Entrée Bowls and all of their great products in your local grocery store, Target or Costco. XX Our top story this week.. Medtronic has expanded a recall of its MiniMed 600 series insulin pumps to include nearly half a million devices. This is an FDA Class One recall – the most serious type – because the pumps may deliver incorrect insulin doses. The recall was first announced in 2019 for just two models. Medtronic now says it will replace any MiniMed 600 series insulin pump that has a clear retainer ring with one that has the updated black retainer ring at no charge. That's even if there is no damaged and regardless of the warranty status of the pump. There's more to this – including directions on how to check if your pump may be affected and who to call. I'll put all of that here in the FB comments and in the show notes. https://www.usnews.com/news/health-news/articles/2021-10-05/medtronic-expands-recall-to-include-more-than-463-000-insulin-pumps XX Enrollment is under way for the first pediatric trials for Afrezza inhalable insulin. This will involve children ages 4 to 17 living with type 1 or type 2 diabetes. It's called the INHALE-1 phase three trial. They're going to look at changes in A1C after 26 weeks.. and then changes in fasting glucose after another 26 weeks. If you're interested, we've got the link for more info to this study and to learn about enrollment. Afrezza was approved for adults back in 2014. https://clinicaltrials.gov/ct2/show/NCT04974528. https://investors.mannkindcorp.com/news-releases/news-release-details/mannkind-announces-first-patient-enrolled-inhale-1-study XX Last week we told you about the Glucagon emergency kit recall from Lilly. Reuters is reporting that the kits were made in a factory previously cited for quality-control violations, including several involving the glucagon product. Lilly had received a report of a patient who experienced seizures even after being injected with the drug, a sign that glucagon was not potent enough to work. The company said the product failure might be related to its manufacturing process, without elaborating. A spokesperson declined to say whether Lilly has received other reports of adverse events related to the Glucagon kits. Separately, Lilly is facing a federal criminal investigation into alleged manufacturing irregularities involving another of its U.S. factories in New Jersey. Reuters is following both stories and of course, we will too. https://www.reuters.com/business/healthcare-pharmaceuticals/exclusive-eli-lillys-recalled-emergency-diabetes-drug-came-plant-cited-by-fda-2021-10-04/ XX Big new report on adults with type 1.. called a forgotten population in this write up. The consensus statement covers diagnosis, goals and targets, schedule of care, self-management education and lifestyle, glucose monitoring, insulin therapy, hypoglycemia, psychosocial care and much more. This is a joint statement from the American Diabetes Association and the European Association for the Study of Diabetes Their last consensus report on type 2 diabetes has been "highly influential," these researchers say.. so they recognize the need to develop a comparable report specifically addressing type 1 diabetes in adults. https://www.medscape.com/viewarticle/960158 XX Adults with Type 2 diabetes on statin therapy may see worsening diabetes symptoms. Important caution: the researchers are quick to say that association does not prove causation, no patient should just stop taking their statins based on this study. These are cholesterol lowering medications with brand names like Lipitor and Crestor.. Statin users had a 37% higher risk for diabetes progression, including extremely high blood sugar levels and elevated rates of disease complications. Nearly half of adults with Type 2 diabetes also have high cholesterol and many of them stop taking statins due to this kind of thing. But that may increase the risk for heart attack or stroke. So definitely talk to your doctor before making any changes. https://www.upi.com/Health_News/2021/10/04/statins-diabetes-progression-risk-study/7261633358483/ XX More to come, But first, I want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Real Good Foods. Where the mission is Be Real Good They make nutritious foods— grain free, high in protein, never added sugar and from real ingredients—the new Entrée bowls are great. They have a chicken burrito, a cauliflower mash and braised beef bowl.. the lemon chicken I've told you about and more! They keep adding to the menu line! You can buy online or find a store near you with their locator right on the website. I'll put a link in the FB comments and as always at d-c dot com. Back to the news… -- DreaMed Diabetes gets FDA approval to expand their platform to people with type 1 and type 2 diabetes. Called Advisor Pro, it's the first decision support system that has been cleared to assist healthcare providers in the management of diabetes patients who use insulin as well as CGMs and meters. We spoke to these folks on the podcast last year. They say Advisor Pro aims to solve the massive worldwide shortage of endocrinologists by empowering primary care clinicians, to be able to provide expert level endocrinological care to diabetes patients. The company's founder says the next step is to develop and extend the technology to cover all injectable or oral medications for diabetes. https://www.businesswire.com/news/home/20211006005640/en/ https://diabetes-connections.com/we-treat-the-data-lifting-the-burden-of-diabetes-with-dreamed/ -- Really interesting look at who's adopting newer diabetes technology. This is from an article over at Dia Tribe where they feature a research study showing that roughly 55% of people with diabetes had positive, open attitudes toward technology. However, another 20% had negative attitudes and did not trust technology, while the remaining 25% either did not want additional data, did not want to wear a device on their body or had a very high level of diabetes distress related to using devices. When they focused on people with type 2.. it turns out the uptake of technology was actually lowest among people aged 18 to 25. This group also had the highest levels of diabetes distress and the highest A1C levels, and many reported that they did not like having a device on their body as their main reason for refusing the devices. Others reported the frequency of alerts and alarms, feeling physically uncomfortable, and cost as reasons for rejecting devices. These researchers say providers need to find ways to avoid making patients feel guilty about their choice of technology as well as watching out for negative judgements for those who use devices but don't achieve near perfect glucose control. https://diatribe.org/new-tech-and-psychological-toll-diabetes-management Please join me wherever you get podcasts for our next episode - The episode out right now is all about the film Pay or Die an upcoming documentary about insulin access and affordability. – That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

This week "In the News...." Did wearing a CGM in the water disqualify a high school swimmer? What his family says happened and why they're suing. The ADA wants to start using the word "remission" instead of "reversed" for type 2 diabetes - we'll talk about why. Dexcom says they are no long smoothing data, new migraine and diabetes research and T1Interntioanl is out with their latest survey results about the price and use of insulin. 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 transcript below   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days.  As always, I'm going to link up my sources in the Facebook comments – where we are live – and in the show notes at d-c dot com when this airs as a podcast.. so you can read more if you want, whenever you want. XX In the News is brought to you by Real Good Foods! Find them in your local grocery store, Target or Costco. Real Food You Feel Good About Eating. XX Top story this week.. A discrimination complaint against the Colorado High School Activities Association has been filed with the U.S. Department of Justice. At issue? A student was disqualified for wearing his continuous glucose monitor.  Ethan Orr is a 16-year-old swimmer whose team qualified for the state championships. According to his attorney Orr wore a blood glucose monitor taped to his arm during seven prior matches, including the one in which his team qualified for the state championships, with no issue. But at this meet, the ref said Orr would not be allowed to swim in his last race because of his glucose monitor and tape. They didn't have a sub so the whole team was disqualified. The attorney says, “This is simply blatant discrimination against a kid with a disability, and it led to unnecessary and unfair consequences to him, his teammates, and the school,” According to the lawsuit, Orr is protected under two federal laws – the Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973. I've reached out to the local reporter on this story and hope to talk to the family soon XX People with type 2 diabetes should be considered in remission after sustaining normal blood glucose levels for three months or more without medication. That's a new consensus statement from the American Diabetes Association® and several other international groups. They recommend testing every year to determine long term maintenance. The real news here – as I see it – is trying to get people to stop saying “Reversal” or “cure” when it comes to diabetes. The statement here doesn't seem to be about the science, but says the word remission “strikes an appropriate balance” between the diabetes not being active and progressive, but also recognizing improvement may not be permanent. https://www.diabetes.org/newsroom/press-releases/2021/international-experts-outline-diabetes-remission-diagnosis-criteria XX Got lots of comments and questions about some changes noticed on the Dexcom G6 app recently. Turns out, Dexcom has removed what's called data smoothing from its most recent update. As of August 9th they say “The Dexcom G6 app used to smooth all but your current reading on your trend graph. With data smoothing, there can be some differences between the G6 reading you see in real time (the white circle) and the G6 readings you see in the past on your graph (black dots). I'm showing a photo here – I'll post this with the podcast episode for those listening.   To avoid these differences, we removed data smoothing from the Dexcom G6 app in the 1.9 release, but the Follow app and Receiver continue to smooth past CGM data. We will remove smoothing in an upcoming Follow app release to match the G6 app, but we don't plan to remove data smoothing from the Receiver.”   These differences don't affect the real-time glucose data, alarm, or alerts. Honestly, I'm not sure why they're doing this or why they smoothed in the first place.. but we'll follow up and try to find out more XX Not a lot of answers here, but this is interesting.. apparently, people with type 2 diabetes are unlikely to develop migraines and people who get regular migraines are less likely to develop diabetes. To find out why.. scientists are looking at two small proteins that are linked to migraine and drive production of insulin. This team from the University of Tennessee says some of the newer treatments for migraines could increase the risk of diabetes because of the use of these proteins. They want to figure out how to prevent that.   https://www.fiercebiotech.com/research/mouse-study-shows-how-causes-behind-migraine-pain-can-improve-diabetes-treatment XX T1International is out with results of their 2020 global out of pocket cost survey for people with type 1 diabetes. Worldwide, one out of every four respondents reported having under-used their insulin at least once within the last year due to high cost. 63.2% of participants reported disruption of insulin supplies and 25.3% reported an increase of insulin prices related to the COVID-19 pandemic. They've conducted this survey every two years since 2016, adding additional questions each year. This time, the Results were published as a research paper in the Journal of Diabetes Research and Clinical Practice, linked in the show notes. https://www.t1international.com/access-survey/ XX More to come, including news about a rare form of diabetes, 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… XX This is from the UK but I think it's an important reminder that there are more than 2 types of diabetes. It's new plan to discover and treat mono-genetic diabetes. That's caused by a single gene mutation – although the specific gene affected can differ. The condition occurs in two types, neonatal – which can occur within the first six months of life – and MODY that develops later, often before the age of 25. About 2% of all diabetes cases are thought to be monogenetic… the National Health System in England is forming a new training and treatment program to make sure these patients received the correct treatment sooner. https://www.theguardian.com/society/2021/aug/30/nhs-england-to-train-staff-in-all-trusts-to-spot-rare-type-of-diabetes XX And finally, thousands of people in the path of Hurricane Ida are still without power and possibly need help getting their medication. I want to make you aware of the Diabetes Disaster Response Coalition (DDRC). This is a coalition of lots of diabetes groups – if you need immediate help or want to plan for an emergency, they have the resources. Physicians and health care providers can call 1-314-INSULIN to report diabetes supply shortages and request support.  People with diabetes and their loved ones can call 1-800-DIABETES (800.342.2383) is available to support people with diabetes and their loved ones for more information. https://diabetesdisasterresponse.org XX Please join me wherever you get podcasts for our next episode -Tuesday –  we're talking to the folks from Walmart about their deal with Novo to sell their own brand of Novolog Insulin.. The episode out right now is with MannKind, makers of Afrezza inhalable insulin. That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.      

How much do you really know about the only inhalable insulin? This week, Stacey interviews the CEO of MannKind, makers of Afrezza. Mike Castagna talks about how Afrezza works, misconceptions about the product, the worldwide market, pediatric studies and lots more. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. More about Afrezza Tim Street's blog Diabettech  Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode transcription below: Stacey Simms  0:00 Diabetes Connections is brought to you by Dario health manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first premixed auto injector for very low blood sugar and by Dexcom take control of your diabetes and live life to the fullest with Dexcom This is Diabetes Connections with Stacey Simms. This week all about Afrezza How much do you really know about the inhalable Insulet. I had a great conversation with the people who make it   Mike Castagna  0:34 For me, it's about using the right product to meet your needs to get you in control. And if you're doing well, great, we're going to avoid the long term complications. But if you're not doing your health, and you gotta really try to find the best set of tools, they're gonna make you successful and fit your lifestyle.   Stacey Simms  0:47 That's mankind CEO Mike Castagna. We talked about how Afrezza works misconceptions the worldwide market pediatric studies and lots more. 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. We so glad to have you here we aim to educate and inspire about diabetes with a focus on people who use insulin. And this week, we're talking about the use of the only inhalable insulin, my son was diagnosed with type one right before he turned two, he is 16. My husband has type two diabetes, I don't have diabetes at all. But I have a background in broadcasting. And that is how you get the podcast, I have to say that personally, my family is very interested in Afrezza Benny really would like to try this seat. Of course, as I mentioned in that tease up there, they're looking at pediatrics, he is still under 18. So it's not proof for his age group. But we're watching it really closely. And I have a lot of friends. A lot of bloggers and people in the diabetes community have talked about this for years. And some things have changed. So I wanted to have them on the show and find out more. So a little bit of background for you. If you are brand new to all this, Afrezza was approved in the United States in 2014. And the company that makes it is mankind. For a while it was sold by Santa Fe, but then mankind took it back. It's one of those things where sometimes the business side seems to have gotten more attention than the product itself. So what is Afrezza it is a powder, it comes in cartridges, and you suck it in you inhale it with a special inhaler device. To me, it looks more like a whistle than a traditional inhaler like an asthma inhaler. It's not like a big tube. I'll link up some photos in the show notes. I'll also link up the Afrezza website so you can learn more and see their information. And my guest this week is Dr. Mike Castagna, the CEO of mankind now he has a Doctorate of pharmacy, he worked as a pharmacist behind the counter for CVS at the start of his career. But then he went back to school and he got an MBA from the Wharton School of Business. He's fun to talk to he doesn't mince words, and he truly believes in this product, I do have to tell you that Mike mentions monomeric insulin a couple of times, I'm going to come back after the interview and explain more about that give you a better definition. All you really need to know is that it's faster than how liquid insulin is made. And all of that in just a moment. But first Diabetes Connections is brought to you by Daario. And over the years I find we manage diabetes better when we're thinking less about all the stuff of diabetes tasks. That's why I love partnering with people who take the load off on things like ordering supplies, so I can really focus on Benny, the Dario diabetes success plan is all about you all the strips and lancets you need delivered to your door, one on one coaching so you can meet your milestones, weekly insights into your trends with suggestions on how to succeed, get the diabetes management plan that works with you and for you, Daria is published Studies demonstrate high impact clinical results, find out more go to my dario.com forward slash Diabetes Connections. Mike, thanks for joining me, I'm really excited to catch up. And look, I'm stuttering because I can't believe this is the first time we're talking to you. But thanks for coming on. Oh, thank you, Rodney. I'm super excited before we jump in and start talking about Afrezza Can you give us some perspective kind of dial back because mankind is not. It's not a name that came out of nowhere? There's really important history. Can you kind of talk about that a little bit first?   Mike Castagna  4:14 Sure. Mankind comes from our founder named after Al Mann and Al Mann was a true innovator. He started I think 17 companies and everything from the cochlear implant to the pacemaker to insulin pumps that many of us know today as Medtronic used to be called mini med. And Al Mann built the insulin pumps over the 80s and 90s and was very successful and sold that company to Medtronic. And then he took literally $1 billion of his own money and invested in mankind. And he had put this company together through three companies he owned the technology to make Afrezza was really a combination of companies and the reason he was so dedicated as he saw in the pump market, which we now see today on CGM was that the variability in mealtime control was so high and the fluctuations you see that the influence takes about an hour and a half to kick in. And it's hard to get real time control if you can't get a faster acting insulin. And so he set out to make a real time acting insulin, so phrases and hailed as monomeric. And that was really what the magic was in our technology making a dry powder was was free dryness, if you heard of dippin dots ice cream, we have basically large dipping machines in our factory, but we free dry the particles to make a freezer and under stabilize the monomeric form. So when you're inhaling, you're inhaling influenza, as soon as it's in your blood is active, or when you inject it has to hold hexamer and has to break down there were about 45 minutes. And that's how you can make it stabilize an injectable form. But it has to break down and then it starts working. And that's why there's always this lag effect between we see injectable and foam in and help us is very different products were categorized with real time rapid acting, but the name mankind comes from elmen and the guy who probably 60% of people on pumps have their own pumps that he created. So amazing gentlemen, huge contributions to diabetes and millions of people were alive today because of his work and his generosity and roven to take that forward here and kids and frozen inhaled insulin.   Stacey Simms  6:06 I mean, never look at dippin dots the same again.   Mike Castagna  6:10 I see a large factory of they don't like it, you know, we can always make different types of things don't go well.   Stacey Simms  6:15 I love it. Let me ask you to go into a little bit more detail about how someone who uses Afrezza would actually use it. Can you talk a little bit about like a daily routine?   Mike Castagna  6:25 Yeah, I mean, I know, you know, well, you're in this disease. I mean, people sometimes graze all day, and they just kind of ride their sugars and take a little bit some along the way or many boluses. And some people you know, eat once or twice a day, or some people, you know, carb restricted and everyone has a different way. And I think that you know, the big thing difference was for the patients that I see is, it's in the moment, meaning you don't have to time your meal and your insulin, when you're going to take it and where you're going to be. As soon as your food arrives. You take your first dose.   Stacey Simms  6:50 Most people I know who use Afrezza take a long acting insulin with it. Is that pretty standard for people with type one?   Mike Castagna  6:57 Yeah, I'll take one year, right? Yeah, you need a basal insulin of some sort, you know, and, and a meal time was held, we do have some patients on pumps where they will use their punches for their basil, for example, and use a phrase for real time corrections. So you know, the average patient is very different. We have some patients that are type twos, you know not not on any basil, you'll need to be on basil for if you're type two. But if you're type one, you need to basil, long acting insulin, and you need your meal time. And we know the biggest problem in this country is still mealtime control is the number one thing people with diabetes struggle with. And it's a big reason why, you know, six, or seven or eight, you know, eight out of 10 people basically are not a goal on insulin because of the mealtime control. So it's a daily challenge for everybody.   Stacey Simms  7:39 Can you talk a little bit about how Afrezza is kind of measured out? Because when we think of mealtime, insulin, everything's a carb ratios. And especially as I mentioned, if you're on an insulin pump, you're you're putting in the carbs that you eat. So how does that work?   Mike Castagna  7:51 Yeah, it's funny, I get into many debates with people because, you know, I'm a pharmacist by training, but I'm not the smartest guy. But I couldn't do all the work people do every day to influence sensitivity ratios and carb counting and timing. And all I can tell you is everyone's masks off by 50%, one direction or another. And so we have this false pretense that we're that accurate. And dosing are influenced by down to the half a unit or one unit. And the reality is your angle of injection can decrease, you know, change your absorption by 25%, your site of injection can change absorption, your your stress level can change your impact with your insulin, there's so many things that go into your daily dosing of insulin, that, you know, being that precise, down to the unit is not as accurate as we all think. And I think that's that's one of the misnomers of, you know, the timing is what you really struggle with when you're using injectable insulin, and you just don't know what's going to happen. You know, when people I guess doctors often you know, you don't have to carb count with Afrezza . And they give me funny looks. And the reality is, you know, we've never done a study where you're carb counting to get your dose of insulin, that's, you know, so becomes a four 812 dose linear all the way up to 48 units, it's additive, and you just got to be close enough. And so it's about a two to one ratio, you know, there's no direct pulmonary equivalent to injectable insulin, unfortunately, but, you know, people are taking five units of injectable insulin per meal, they're gonna need about eight units of Afrezza and maybe even 12. And you're gonna figure that out, it's your first meal or two what what the right dose is for you. But you just got to be close enough. And that's a big misunderstanding for people of how accurate the dose has to be. This is the sixth dose cartridge is a big problem. I know plenty of type one patients who take for a 1224 meal, especially they haven't Chinese food or sushi, they just they dose a lot. So I think that's something people have been comfortable, so dramatically different than anything they've ever been trained or taught in their history of living with diabetes.   Stacey Simms  9:36 I would assume that a prescription for Afrezza comes with a doctor's visit where someone whether it's someone who works for Afrezza, or the endocrinologist talks to you about how to do this dosing. You said you figure it out, but I've got to assume that you're not just sending people home with this inhalable and say, just test it, I mean, right somebody, you're at a ratio   Mike Castagna  9:59 and I think That's the key thing is, you know, having patients understand because it's odorless and tasteless. So you inhale, and you're like, what did I get it? And I'm like, yeah, if you inhaled, and I have the second, it's in your blood, it's in your lungs, it's breath activated. So you can't really, of course, you can try to mess up something. But we have something called Blue Hill, where we can show proper inhalation technique in the office on an iPhone app or an Android. And so you know, we hope that patients are being trained either by our trainers or the doctors offices, and will propagation technique looks like that's number one. And then number two is the right dosing. And as you know, individualized dosing is important and fun. And, again, that's why I say we take a lot of the math out because it's either gonna be a four or an eight, and all of a sudden, you're like, Oh my god, I'm gonna take an eight units, it's a lot it's really not when you're taking inhalation units versus injectable units and that's what people got to get comfortable with if their first or second dose so they really do figure out this meal did this or pizza is going to take longer so pick another dose and now our people do figure it out pretty much within the first week. And then there's one thing actually I want to mention because I often forget this is because injectable insulin is such a long tail it's in your body for four to six hours before it's out and that feeds into your basal rate your long acting and so when people switch over presence pretty much out of your body in a net roughly an hour and a half. Sometimes people need to adjust their basil and that's something to watch out for if you do switch to Afrezza enter you're struggling with with some of the basil rates. Some patients you know I hear people anecdotally you know, we don't want to study their the bump up their basil 10 15% on Lantus. And I've heard patients on to see that because it does have that long tail of down there in front sometimes on the basil. So there are the other metrics patients have to watch out for when they are switching to the product. It's not just the uptime, it's also something that basil where you look at   Stacey Simms  11:38 I have a question and I i apologize because it's a it's a bit ridiculous. I'm gonna ask it anyway. Right back to the interview in just a moment. But first Diabetes Connections is brought to you by Gvoke Hypopen. And our endo always told us that if you use insulin, you need to have emergency glucagon on hand as well. Low blood sugars are one thing we're usually able to treat those with fast acting glucose tabs or juice. But a very low blood sugar can be very frightening. Which is why I'm so glad there's a different option for emergency glucagon, it's Gvoke Hypopen. Gvoke Hypopen is pre mixed and ready to go with no visible needle, you pull off the red cap, 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. Now back to my interview with Mike, where I will ask that ridiculous question.   You had mentioned it's tasteless, odorless, I recall hearing and I'll have to fact check this. But I recall hearing that years ago dandruff shampoo, they had to add like that tingly feeling because people didn't think it was working like it's totally fake. But people just didn't believe it was a medicated shampoo because it didn't have an unpleasant sensation. Have you thought or talked at all about adding like a flavor or a feeling to so people really know that they got it? Or is that just really bananas?   Mike Castagna  13:12 If somebody might company come and talk to you ahead of time? There's somebody internally who wants us to look at like cherry flavor Afrezza especially as they go into pediatrics? And the answer is, look, there's blueberry Metformin because the metformin smells awful and tastes awful, probably. So you know, those things are possible. We've never done them. And to my knowledge in this industry with dry powders, it is a question that came up recently. Is that should we be thinking about the cherry flavor Afrezza or some other flavor? And I think the answer is TBD. We I don't know what the date is on inhaling the food coloring dye or whatever. Yeah. But that's some of the stuff we have to justify that it's safe and effective. And along with FDA would want us to test but they come up recently and another internal discussion. And since you're asking, I think we'll look at it, even if maybe there's a way to even show a placebo, that's a cherry flavor or something right a one time dose to see what it's like. So I don't know. But now, but people like I said, it's sometimes you get a call, like you know, when you take a phrase of one out of four people will get a cough initially. And generally there were the first four weeks that cough goes away 97% of the people. So I always tell people, you're having a cough, like as long as not interrupting your life, it should slowly get to your first refill. And it should be mostly resolved by that your body's getting used to putting a powder in your lungs. But that's uh, you know, when people ask, what's the difference between injectable and inhaled in terms of safety, you know, you're putting a drug powder in for the first time in your body and your body could choose that. And the number one thing that's different, were injectable insulin. You know, you have other other things. You're dealing with injection sites and pump sites and scar tissue and things like that.   Stacey Simms  14:48 Does the body actually acclimate to the powder or is it just a question of someone gets better and used to the inhalation sensation?   Mike Castagna  14:55 You know, it's it's a good question. I don't know if I have a black and white answer here. bodies give. Yeah, my guess is the body's getting used to putting a dry powder in and just exit and you get used to like weed. You can drink a glass of water before and after and help you minimize it. But it's generally like that's what it feels like it's not a productive call frightening, there's not a call to happens 10 minutes later, it usually happens. We have to inhale.   Stacey Simms  15:17 You mentioned BlueHale , can you tell us a little bit more about what that is?   Mike Castagna  15:21 Yeah, so BlueHale  is to two different things. The first one that we're looking at is with the patient training device. So we can show you whether you had a good emulation or not a good emulation and show you that technique. The second version, actually, you can detect with those you put in the cartridge and hilar. So it has a proprietary software there that we can see what cartridge you put in for the adapter. And it'll tell you on your app, if you took a for a 12 or 16, how much you took in that session. And then we hooked integrate that with the CGM data. So now you can show those response curves on CGM one day and eventually I want to get into AI and predictive analytics. But we're not there yet. But we think that's the magic of what people really want, which is one that I use the thing when you live with diabetes, you just must remember and be that perfect to know exactly what those you did with them. You took it, what meal you were and then I simulated being a patient for a week. And I realized I could remember if I took a four and eight, I take a six or 620 is that 30 minutes or one hour like it was it was amazing. When you just think about life and people are human. They're there. They're human. So they're not keeping track. And they're not that accurate. They're just estimating. And that's when I talked about the dosing of insulin, like we're always estimating everything, we're estimating the time our food is going to come and how long it's going to work. You know, what the carbs are? How much am I gonna eat or drink? Like, it's all accurate? It's all off. None of it's that accurate. That to me is the thing I realized when I was thinking of doing one of those a disease, you don't you think they're perfect. They're not. They're human beings. And that's when I see one out of five doses of injectable insulin are intentionally missed. And the predominant one that's missed is actually lunchtime, which makes sense to wear out in a social environment. They don't want to inject. And by the time they get back, they forget it's probably too late. Or you're already high.   Stacey Simms  17:00 What do you mean by intentionally Miss? You mean? Like they people just forget?   Mike Castagna  17:03 No, no, they intentionally knew they should take a dose of insulin, but they're in a lunch conversation, or they forgot their insulin in the office. Or they'll have their CGM receiver on the bike, or they essentially don't they miss one of the five doses. So if you're missing 20% of your doses, it's really hard to get in control. And there's all kinds of reasons, but that's intentional omission versus unintentional. Which is I forgotten.   Stacey Simms  17:23 I'm curious what the sources on that that's, I mean, I don't doubt it. I'm just curious.   Mike Castagna  17:27 Yeah, I couldn't find it. follow up on that. I have your email, I'll look for it. Yeah, no, because I didn't believe it. And then there was a study done with one of the pens coming out that has digital connectivity. And I looked at it and I looked at the data and like, wait, if a person needs three times a day, seven days a week, that's at least 1721 doses, right? And I think the average person is taking like 1212 shots a week. And I'm like, Well, that doesn't make sense. But you realize, you know, again, we're human, people aren't always as compliant as we want, or they don't eat three times a day perfectly are the two big meals, you know, everyone does something different. So having insulin that meets your needs, and your lifestyle, I think is really important in the world. And you know, look, we like our products, obviously, we're here, we love the Afrezza. But But I also just for me, it's about using the right product that meets your needs to get you in control. And if you're doing well, great, you're gonna avoid the long term complications. But if you're not, you own your health, and you got to really try to find the best set of tools that are going to make you successful and fit your lifestyle. And, you know, obviously, we're not doing well when 80% of people on insulin on a boat. I mean, that's that, to me is the number one thing, I look at this country and say, well, despite all the adoption of pumps, and technology and CGM, we still have not made a meaningful difference in percent of people to go. And that's frustrating.   Stacey Simms  18:35 Way back in the beginning of this interview, we talked about Chinese food and pizza. And I'm just curious, you know, these are things that are hard to dos for, because they they kind of they come later, you know, what most people listening are very familiar with, and I think probably have their own system for dosing, whether it's an extended bolus or injecting more than once. How would you do something like that on a Friday? Is it a question of you would take what you think when you're eating, and then again, in a bit later, like, how do you account for those high fat foods?   Mike Castagna  19:02 Yeah, you know, I'm going to pick on Anthony Hightower, who I know you interviewed before. So I actually met Anthony on a bed over social media. And he had showed me your servers where he ate pizza. So I'll pick on him because I want the public discussion here, sir. He pizza and his sugars are basically flat over the two, three hours post meal. And I said, I'm like, shocked. He's like, this is something people cannot do naturally on the history of injectable insulin, they they always struggle. And when you eat pizza, you're going to struggle not just for hours, but potentially for the next day because just throws everything off. I think in his case, right? I've watched him he took a big dose up front, you know, let's say he's gonna take 12 units of injectable he took 24 units of Afrezza. And then he washed her wasn't an hour, and then an hour she was above where he started. He took another dose, maybe took a four and he has to tap it off. And then an hour later, just thought was too high or not right. But you can always keep your sugars in that kind of control. That's one of the studies we did back in 2018, called this test study was showing that you could do as soon as one hour with no more hyper risk. And that was a big concern of people, how can I do that one hour, well, pretty much hit its peak effect in one hour. So if your servers are still moving in the wrong direction, you can correct them at that point. And so that's where someone on pizza or Chinese food, like, yeah, it's a high dose up front and may manage it through the whole system. Or they may see an hour or two later, they're still high and to take another dose, that they can bring it down at some point.   Stacey Simms  20:20 Alright, let's talk about the big questions that people generally have. And that the one I hear the most is, Is it safe? Right? Is it? Is it okay to inhale this stuff into my lungs? Can you talk about the studies that you've done?   Mike Castagna  20:32 Yeah, I think if we were able to make inhaled insulin 100 years ago, we'd be scratching our heads those who would inject themselves three times a day. So I think it's just an unfortunate matter of 100 years of difference. But we studied a phrase that probably over 3000 patients 70, some trials $3 billion over 20 years, like, that's how much money time and energy is going into prove the safety and effectiveness of this product. And you know, and I tell people like you know, there is no data to say that it's not safe. We have all the rodent studies, all the CT scans that along looking for fibrosis looking for pulmonary issues, we found nothing. So it doesn't sit in the lung. There's an old product called exubera on the market years ago. And exubera was a sugar based manatal formulation which got absorbed over time into your lungs in a friend this case, the it's got water and human influence. So when we ask about what ingredients are you worried about the human influence, human influence, it's the whole AI base, but it's human influence characteristic, and water is purified. So we know that safe and the other only other carrier in our products SDK p which is a excluded product that is not metabolized in the body, it's just 100% extruded. So you know, there's three ingredients in our product. One is human insulin, one is water, and one is tkp. And SDK p comes out of the system. So I don't I don't think the body is afraid of human insulin. And what are so I think, you know, I always struggle with this topic. Because, you know, what happened is there was some lung cancer cases and Newser, were they there was a couple of our data. But you know, in the seven years since FDA approval, we've seen no safety signals come up in the postmarketing. We have almost 10,000 patients on the presidency. I know people in the drug for 1012 years. And so, you know, we don't see anything that gives us concern. And we're going into kids now, who would have to take the drug for 40 5060 years. So I think it's hard to prove something that you've never seen. But safety comes with time. And I think the good news is product has been approved by the FDA for seven years now. And we've not seeing any safety signals in our database, which we look every year, our rems program ended early by the FDA and and we've continued to show good data and all the studies we've done, we've not seen anything new come up in our anywhere safety issues. So if you're, you know, the populations, I would say if you have COPD, and asthma, this is not the right drug for you.   Stacey Simms  22:41 So a dumb question, though. If you have diabetes, and you smoke, can you get an Afrezza? prescription?   Mike Castagna  22:48 We would say you should not? Yes, we have a warning for that.   Stacey Simms  22:52 Well, I just wanted to be clear that there was an actual warning, it wasn't just a please don't because it's bad for   Mike Castagna  22:57 warning. Don't   Stacey Simms  23:00 tell me about the study with kids. Because I've got one, I've got a 16 year old who was quite interested in this product.   Mike Castagna  23:06 Yeah, no, I just found out Unfortunately, the dagga three year old cousin in the family have just come down with type one. And she will, she'll be four and our studies gonna go down to four years old to 17 years old, when we launch it. So I'm excited, we had to do a study to show that the pharmacokinetics and dynamics of inhaled insulin are similar in kids as it as adults. And so once that study was complete, we we wrote a protocol down to the FDA and said, We'd like to go into the next phase, and now run a larger study head to head against the standard of care. And the FDA has pretty much signed off on that protocol at this point. And we have contracted with a third party to now run that trial. And we'll be having our investigator meeting here in next month. And so hopefully, we'll see our first patient in the four to 17 year old range, probably here in September, October time frame. So super excited, long time to get here took too long from my perspective, but can't wait to help kids. But our founder Outman invested, he became very wealthy when he sold the insulin pump company. And he took $1 billion of his own money and made Afrezza inhaled insulin because he felt the problem with the injectable subcutaneous delivered insulin was it just took too long to work. And you know, somebody has an hour lag effects from food. That's real timing, it's always hard to catch those two even. And so he really wanted to make an inhaled insulin that really mimic a physiologic insulin that you see in the body. And he felt the only way you could get there was through a dry powder, lung delivered instantaneous insulin, you can also get there through an implantable pump. But that didn't work out when they tried that back in the 90s. I recall. So people got infections and things like that. So that would that didn't work. So they really were going to get a in my mind that physiologic inform that's gonna be monomeric stabilized is probably going to happen only through the inhaled route. So we have we have to get comfortable with this from overall efficacy and safety. Otherwise, you're not going to really ever get this control that people are looking for real time.   Stacey Simms  24:55 No man, he lived long enough to see Afrezza approved, didn't he?   Mike Castagna  24:59 He's All approved. And unfortunately, I'm here because he died on my daughter's birthday. So I was debating whether to come to mankind or not. And I'm very superstitious, the Al Mann pick the day he died. And he died February 25 2016. And then they made decision to join and help save the company and save a frozen kick on the market. Because I think, you know, I saw all these wonderful patients stories online. And I said, these patients like Anthony Hightower is one of them, what they did something that no one else did, they did something we never did in our clinical trials. And so I got to talk to them. And I realized we just didn't dose it properly. So you go back to the development of the product, a lot of the challenges were under dosing because everybody's trying to compare one to one to injectable insulin, and therefore one of underdosing patients, and therefore, they got equal outcomes didn't do any worse than injectable insulin per se. But could they have gotten better outcomes if we dosed improperly? Right? And I think that's, that's the state of we're now trying to generate to show that the kids buddy now be head to head, or if he knows him properly, what happens? Right, and that's we're really focused on right now.   Stacey Simms  26:01 Is there anything that you wanted to talk about that I haven't answered?   Mike Castagna  26:04 No. I mean, we're only available in the US, we're in the process of going to Europe. So I don't know if you have any. Yeah, we do. Though, so I know, we have patients on a name patient basis in Germany, and UK and Italy. So you know, their governments are actually important a president and pay for it. We're in the middle of filing for Australia. We were approved in Brazil, and we're going to India so so you'll see this more and more around the world. You have listeners in those markets. There's not gonna happen this year. And hopefully, the next year or the following year in some of these markets, we'll be looking at bringing it to more patients in those markets.   Stacey Simms  26:37 Well, and just got a big approval here in the United States for Medicare patients. Right.   Mike Castagna  26:42 Yeah. So that one, I, you know, we get a lot of questions on that one. And so you know, this market CGM patients were told you need to be injecting yourself, I think four times a day, we couldn't get your CGM. So then doctors were not getting patients Afrezza. And so we were able to ask CMS to change that, and they did to the year but rather haven't done they're not done. And so here we are a year later that that policy is now being updated. I want to thank CMS and all that you're helped make that happen. And I think it helps in people in CGN, because I understand that removes some of the other requirements to get CGM, even an injectable these patients so little mankind was the one who started that process. And then we're able to help a lot more people. So it's great. And we're trying to get Medicare $30 a month insulin. So we have Medicare listeners. And you know, we're trying to make sure we help get patients access that are on Medicare. I think that's important.   Stacey Simms  27:33 That doesn't stack up in terms of cost in the United States.   Mike Castagna  27:36 Yeah, I mean, you know, fortunately, the billion dollar debacle in this country is drug pricing, as we all know, and as a pharmacist, I know firsthand when people go through an LMS they're on how many co pays are on. And so we really have tried hard to make sure that no patients pay no more than $15. So we have copay card programs, we actually have a free drug programs, they really can't afford it, we'll give it to you for free. If you're going through the prior authorization process, we give it to you for free while you're going through that. So we all want payers and reimbursement to be the excuse of why a patient can't get access to our product, we think that people will do well on our product, we're willing to take that bet that they'll see good results. And if they see good results, the payers will usually pay for it. And it says you may or may not know that there's a monopoly in diabetes between two insulin players, and three payers, who are all working together to make sure there's no competition. You know, that's unfortunate, but they pay to make sure that patients have a difficult time getting Afrezza . And that's always one of my frustrations of competition or diseases. You know, 400 years, we've seen the precise the dispensing from 20 hours a while 95 and let's say miles, hundreds of dollars. You know, for me on the payer side, we want to make sure patients we try to bring it down to about $15 on commercial and Medicare, you know, they generally pay comparable to what they would and some Medicare plans a little bit higher I can you know, that's a hit or miss when you when you go to submit for reimbursement, but we try to do everything we can to make sure people will have access to our product   Stacey Simms  28:57 $15 for $15 for commercial patients, no, no, but what is it? What is it for? What do you get for $15? Is it a month? Is it a   Mike Castagna  29:05 my week? Yeah, whatever, whatever. You gave two boxes, three boxes, whatever is on that prescription for that month,   Stacey Simms  29:10 for the month. Okay, I didn't mean to interrupt you.   Mike Castagna  29:12 I don't think I know, I was gonna say I forgot we actually have a cash pay program. And people are paying cash for their insulin. And we do see several 1000 people a month paying cash for injectable insulin, we have influenced savings comm where it's $99 a month for frezza. And you know, can you a bigger box or more doses, you might pay 199 but we tried to make the cash price, you know, roughly $100 a month. If we if you had no insurance, for example.   Stacey Simms  29:37 I'm not sure you can answer this question. But I will ask it anyway, is the biggest challenge for you all the failure of exubera? Is it just people not knowing what this is? You know, as you move forward, you know, what is the big challenge to get more people to adopt us?   Mike Castagna  29:51 I mean, for me, the biggest challenge are the doctors. We created a program we basically gave it for free to patients for two years for 15 bucks. Like no no priority. Nothing, we just charge you $15. And that didn't change a lot of doctors from jumping on board. And doctors just don't know our data. And so they think this product doesn't have a lot of data behind it. And they don't know our data, they don't know. Like when I would ask a doctor, how fast from the time you inject your bolus, your pump to the time you look on a CGM, that your institute sugars are coming down, and I get in these endocrinologist, I'll get five minutes and mediate and 20 minutes an hour, the answers, I need 90 minutes, 220 minutes, that's the answer. And so they don't even know the pharmacokinetics and pharmacodynamics differences between injectable insulin inhaled, and then you have doctors, right, you know, calling some of these ultra acting drugs faster, we'll look at the package inserts, they're no faster than their old products. And there's a lot of misperceptions out there some of these newer launches of old tracking insulin, and to me they're, they're really not that much different than the predecessor and look at the data, you know, there's not a faster, there's not dramatically faster onset or offset or, you know, a one c lowering or weight gains on very much the same. So, no, I think it's just a matter of doctors trying to really understand the data.   Stacey Simms  31:02 Before I let you go, are there any plans in the future to change anything about the way it looks? or different colors? I mean, I know it sounds kind of silly, when you're just trying to get people to adopt the new technology, but from a user standpoint, and look, I know, you've heard all the jokes of my friends who use this will make you can't comment on designers. They don't say anything, they'll make comments like, you know, taking a hit or whatever, right? I mean, it's it's inhaling, it's this little thing that you're, you're inhaling, it looks a certain way. I'm curious if the cosmetics of it are anything that are on your radar, or needs to be improved even?   Mike Castagna  31:36 No, I mean, I think when you spend, you know, $3,000,000,000.20 years doing a new drug development or taking 100 year old product and reinventing it, you had to get that right in terms of device design and airflow dynamics and consistency. And those. And I think all that's really important because, you know, misperception that oh, my God, it's going to be less can be more variable than injectable insulin. And the data just doesn't support that statement. And so for us, we have one of the world's most unique installation platforms across the entire pharmaceutical industry, we deliver more power to the lung, the most technologies out there. So that's why you can get consistency, those two those, and you don't have a lot of variabilities, because our technology and our device is called a low velocity inhaler. And what that means is there's a resistor that helps slow the powders as they're coming out of the inhaler. So they get deep into the lungs. And that's why you get that nice absorption curves that we see. And we're most inhalers or high gloss inhalers. So it's just enough sucking air as hard as you can, and hoping you get you know, 20 30% of lung drug into your lungs, and mostly stuck in your teeth to device in the back of your throat. That's most dry powder inhaler technologies out there today. And so that's something unique to us and our technology and our device, they all work really well together, you couldn't just take our powder and put into another inhaler, and or just as well would not work. So yeah, we're pretty happy with the device I we are going to other diseases. So you know, we're we're going down to the FDA with our partner for an approval in October for pulmonary hypertension patients. And we have several other orphan lung areas we're going into to help more patients with lung disorders. So you know, I think that's important, like our, our technology, our inhaler, our platform is gonna be used in more and more patients over the next decade than just diabetes.   Stacey Simms  33:13 Well, that's what I was gonna ask is, if it works, so well, you know, will you partner with other medications? That's great to hear.   Mike Castagna  33:18 Yeah, you know, we're really busy, we probably have about 10 to 12 formulations of products working on this year and five marone products in the pipeline. And so it's it's a really good time of mankind, we're super excited to be here. And it was a turnaround, the company struggled for many, many years. And we're on our way to success. And I think, firstly, you'll be you'll be hearing more about it. So I know it's been a long time. And maybe you didn't talk to us yet. But hopefully you'll talk to us more and more as we continue to generate new data and more more patients start using it.   Stacey Simms  33:45 I'd love to, I'd love to, especially with the kids programs. And like I said, I've got a 16 year old who is very curious about this. And, you know, once once safe and effective. Once we get all that safety stuff in here. It's mom says, you know, I'll definitely I know, I would like to check it out. So I really appreciate you coming on and spending so much time with me and my listeners and explaining all this and we'll definitely talk again. Thanks, Mike.   You're listening to Diabetes Connections with Stacey Simms. More information at Diabetes connections.com. Always on the episode homepage. I also have a transcription as well, sometimes those podcast players don't display the show notes and the links. So if you have any trouble, just go back to Diabetes connections.com. And I just want to say that I did reach out to have Mike or somebody from Afrezza on the show. And you heard him say, you know, it's been a while, um, you know, it just took a while to connect to the right person. Let's just say that, and I will have them back on because lots of good stuff is happening. As you heard. I want to take a second and kind of explain Monomeric insulin and, you know, I'll be honest with you. The scientific points here are really not my strong suit. I'm a communications major, right. So I did what I always do, and I am People who know a lot more than I do to help me explain it. I went to the Facebook group Diabetes Connections as a group. And you know, I said, How do you explain monomeric insulin I know it's faster. And Tim Street, who is just wonderful and runs the diabettech.com page that's like diabetes tech diabetic, and I'll link that up as well. He provided this explanation, which really brought it home for me, and boy, I hope I'm pronouncing everything correctly. So Tim wrote, insulin naturally links its chains together to form stable molecules. Typically it connects two together and then links three of those two chains together. Additionally, to create six This is highly stable and described as hexameric. In order to use these chains, you have to break the molecules apart to single chains, which are monomers. Typically fast acting insulins are stored as dimers, two monomers connected, which are easier to split, then hexamers. by storing the insulin as a single chain, a monomer, the body doesn't have to break the chains to instantly use the insulin molecule it receives. And that is why Afreeza wraps the monomeric form in the capsules, to make it ultra fast. Thank you, Tim, that actually made a lot of sense. I gotta tell you, we have the smartest people and the kindest people in this Facebook group. If you're not there yet, and you want to join, come on in, I highly recommend it. You don't have to be a Tim Street. You don't have to be able to explain these concepts. You do have to be nice. And you do have to not post a lot of drama. I'm very tough on my diabetes groups. I run two of them. They're very nice and friendly places for a reason. But Tim, seriously, thank you so much. That was a great explanation. And I really appreciate it. Diabetes Connections is brought to you by Dexcom. If you're a veteran, the Dexcom g six continuous glucose monitoring system is now available at VA pharmacies in the United States. Qualified veterans with type one and type two diabetes may be covered. Picking up your Dexcom supplies at the pharmacy may save you a lot of time to connect with your doctor for more info Dexcom even has a discussion guide you can bring with you get that guide and find out more about eligibility. It's all@dexcom.com backslash veterans, and all the information is always at Diabetes connections.com. Before I let you go, just a quick note about back to school, I have never done less. I packed up a bag for Benny to bring to the nurse. He brings his daily supplies with him every day in his backpack. But of course, like most people, our nurse has backup supplies for him. So I put those together. He brought them in along with our plan or orders, you know from our endo. And that was it. I haven't set foot in the building. I'm not sure when I will go in or if I will go in probably when you forget something or they run out there. But I've never done less work. You know, I did a lot of work over the years to go to school and meet with people and he's got it. So not much to report. It feels very strange. All right. Please join me this Wednesday when we have our in the news live on Facebook every Wednesday at 430 and then we turn that into a podcast episode. I love doing that. It's been a lot of fun. I hope you're enjoying it. Give me your news tips. If you've got any from this week, just email me Stacey at Diabetes connections.com thanks as always to my editor John Bukenas from audio editing solutions. Thank you so much for listening. I'm Stacey Simms. I'll see you back here in a couple of days until then be kind to yourself.   Benny  38:27 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged

It's "In the News..." the only LIVE diabetes newscast! -- Top stories this week: T2D screening guidelines to change New Gvoke Kit approved Gestational Diabetes cases up in younger women Are magnets & radio waves coming to T1D care? Update on #DiversityInDiabetes -- Links and sources in the transcript 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 on Wednesday August 25th 2021 – and in the show notes at d-c dot com when this airs as a podcast.. so you can read more if you want, whenever you want. XX In the News is brought to you by Real Good Foods! Find them in your local grocery store, Target or Costco. Real Food You Feel Good About Eating. XX Top story this week.. the number of young people with type 2 nearly doubled in the United States from 2001 to 2017. These researchers found significant increases in all types of diabetes among both sexes and across racial and ethnic groups. Type 1 diabetes remains more common among white youth. The highest rates of type 2 diabetes were seen in youth who are Black or Native American. It's interesting that these CDC and NIH researchers say they don't know the cause of the huge increase in type 2. They talk about rising obesity, but wonder what's behind that? They also wonder if it's because of increased screenings, environment or something else. https://www.reuters.com/business/healthcare-pharmaceuticals/diabetes-surges-among-american-youth-study-shows-2021-08-24/ XX Big change recommended in screening for adults with type 2. The U.S. Preventive Services Task Force now recommends screening for people who are overweight starting at age 35… five years earlier than recommended right now. That would include 40% of the US adult population. This task force recommends screenings that insurance companies must completely cover, without out of pocket costs to the insured, under the Affordable Care Act. XX FDA approval for Gvoke Kit to treat severe hypoglycemia. Xeris pharmaceuticals already provides Gvoke glucagon as an autoinjector and a prefilled syringe.. this Kit is for patients who prefer to draw up their own doses of glucagon using a vial and syringe. You don't have to mix anything, it's still a ready-to-use liquid glucagon. Could be helpful to those who prefer mini-glucagon doses – which are NOT FDA approved – but are sometimes used during illness. Note that's my comment, Xeris and the FDA is not talking about mini glucagon dosing at all.   https://www.fiercepharma.com/drug-delivery/xeris-a-rival-to-lilly-and-novo-gets-fda-nod-for-glucagon-kit   XX Growing numbers of pregnant women are developing gestational diabetes. Between 2011 and 2019, rates of gestational diabetes in the United States jumped 30%, according to a large nationwide study of first-time mothers. The cause? Not clear. Every age group saw an increase – from 15 to 44 – so it's not just moms getting older, which is happening. These researchers want to look at non -traditional risk factors like stress. This was a huge study – 13 million moms in the US. https://www.upi.com/Health_News/2021/08/18/diabetes-pregnancy/7401629306285/ XX In the – no thank you – department – researchers say they've got an implanted pump you'd refill just by swallowing a capsule. The catch? First, they have to implant the pump – which is described as the size of flip phone - along the abdominal wall, interfaced with the small intestine.   That refill capsule is magnetic, so the implant draws the capsule toward it. It then punches the capsule with a retractable needle and pumps the insulin into its reservoir. The needle must also punch through a thin layer of intestinal tissue to reach the capsule. These Italian developers testing it all out in pigs – they say it controlled blood glucose successfully… for several hours. https://spectrum.ieee.org/implantable-medical-devices https://www.newscientist.com/article/2287225-diabetes-implant-is-restocked-by-swallowing-magnetic-insulin-capsules/ XX Another maybe it'll work item… Israeli startup Hagar has something called G-Wave technology that measures blood sugar levels using noninvasive radio waves. The prototype puts the tech into a ceramic bracelet. Uses Bluetooth to transmit readings to an a mobile app with display and alert functions. A proof-of-concept study found the company's radio frequency technology was able to continuously measure glucose levels with at least 90% accuracy, compared to the estimated 70% rate for traditional continuous glucose monitors. They claim that's because it measures glucose in real time. Hagar now plans to launch clinical trials to pursue FDA approval https://www.fiercebiotech.com/medtech/hagar-brews-up-11m-after-a-serendipitous-spill-led-to-creation-new-cgm-tech 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— 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… XX Big grant goes to Scripps Whittier Diabetes Institute to study the use of CGMs in hospitalized patients with type 2. This is a $3.1 million dollar grant from The National Institutes of Health. It's to build on research going on now – during the COVID-19 pandemic. CGM devices have been approved for outpatient use since 1999, but their use in the hospital setting remains limited to research efforts and the special conditions allowed during the pandemic. https://timesofsandiego.com/tech/2021/08/10/scripps-whittier-diabetes-institute-gets-3-1m-for-glucose-device-study/-- XX Congrats to Diversity in Diabetes for their newly minted 501c3 status. The group was founded last summer and is dedicated to creating awareness and providing solutions to end health disparities and the lack of representation in the diabetes space. Their big event – People of Color Living with Diabetes Virtual Summit kicks off Sept 16 – more info and how to register in the show notes. XX Please join me wherever you get podcasts for our next episode -Tuesday –  we're talking to the folks from MannKind, makers of Afrezza inhalable insulin. You had a lot of questions for them.. looking forward to that episode! The episode out right now is with Kyle Banks – a Broadway performer diagnosed with type 1 while acting in the Lion King. That's In the News for this week.. if you like it, please share it! If you're watching this replay on YouTube please subscribe, if you're listening via the audio podcast please follow. Whatever it's called – I appreciate you being here. Thanks for joining me!  

Kyle Banks is a Broadway performer – singer, dancer, actor – he was diagnosed with type 1  while in a production of the Lion King and had to figure out – pretty much on his own – how to  manage on stage. Kyle explains how he learned what he needed to do to perform at his best and shares stories about his time on stage with T1D. Now Kyle has started a foundation to help get diabetes technology into the hands of more people who need it. Learn more about KylerCares Plus, some feedback about our last episode.. and a little bit about back to school. Visit our YouTube channel & subscribe! 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 Stacey Simms  0:00 Diabetes Connections is brought to you by Dario health. Manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first premixed auto injector for very low blood sugar and by Dexcom take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:22 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:27 This week, Kyle Banks is a Broadway performer, singer dancer actor who's diagnosed with type one while in a production of The Lion King and had to figure out pretty much zone how to manage on stage,   Kyle Banks  0:41 I would have to go into work with my glucose hovering around 33 50. And by either intermission or the end of the show, my glucose would crash and I would experience these crazy hypoglycemic episodes. And it was really scary for a while.   Stacey Simms  0:58 He's come a long way, Kyle explains how he learned what he needed to do to perform at his best. And now Kyle has started a foundation to help get diabetes technology into the hands of more people who need it. Plus, I got some feedback from you about our last episode. I'll share that and a little bit about back to school. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show. Always so glad to have you here. You know, we aim to educate and inspire about diabetes with a focus on people who use insulin. so much great feedback from our last episode where I interviewed my son Benny diagnosed before he was two now he's 16. And he went away for a month this summer to Israel without us with a non-diabetes camp program. So if you've listened, and you send me feedback, I really appreciate it. As I shared during that episode, I was nervous because we are far from perfect. There was funny bits too. I'll share a few of those after the interview. But guys, really, thank you so much. It is amazing to have that kind of support. I really appreciate you. I met Kyle banks at friends for life this summer lucky enough to travel to that in person conference, Kyle gave a welcome speech to new families that were there for the first time. And I knew I had to talk to him. But I heard from a bunch of families who came up to me later, instead of you that interview, Kyle, you know what a great voice. And boy does he have a great voice and what a terrific story. He was diagnosed with type one, nearly six years ago in November of 2015. And as you'll hear the story he was performing, he had made his career on Broadway. And if To me, it just seems like performing in that kind of venue on with that kind of energy you need to put in. It's like being a professional athlete. So I was very interested to talk to him. And I was really surprised, and you may be too as you listen, to hear how he started off with truly very little guidance. Of course, he has come a long way. And he shares how he did it, where he turned for advice, what he's using now. And he also talks about his foundation, and that is Kyler cares. We're going to talk about the benefit concert that helped that foundation from Broadway with love. It's called I'll link that up at Diabetes connections.com and you could watch really the incredible performances very entertaining. I am gonna play a clip of Kyle singing from that in just a moment and then we're gonna go right into the interview. But first Diabetes Connections is brought to you by Gvoke Hypopen, you know, low blood sugar feels horrible. You can get shaky and sweaty or even feel like you're going to pass out there are a lot of symptoms they can be different for everybody. I'm so glad we have a different option to treat very low blood sugar Gvoke Hypopen it's the first auto injector to treat very low blood sugar Gvoke Hypopen is pre mixed ready to go with no visible needle before Gvoke people needed to go through a lot of steps to get glucagon treatments ready to be used. This made emergency situations even more challenging and stressful. This is so much better. I'm grateful we have it on hand. 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   (Kyle sings “Summer Time”)   Stacey Simms  5:04 Kyle, thank you so much for joining me. I'm really excited to talk to you. Your story is so unique. Thanks for coming on the show.   Kyle Banks  5:12 Thanks for having me. I'm excited to be a part of the show for sure.   Stacey Simms  5:15 That's great. We have so much to talk about. Let me just start if I could, at the beginning, your diagnosis story happened. While you were you were living your dream, right you were performing on on Broadway, you were touring, tell me about when you were diagnosed with diabetes.   Kyle Banks  5:32 Well, I was diagnosed in November of 2015. And I'm an actor, vocalist. And so I usually between like the Broadway cast and the touring company of The Lion King, and I was on tour at the time, and we were touring like Canada and California. And I just begin feeling having these crazy symptoms, like exhaustion and constant the need the urge to constantly urinate in, I would really scared me to death was the fact that I lost 30 pounds over the course of like three weeks. And so that was the trigger that made me go to the doctor to see what was going on with me. And that's when I was told that spective that I was diabetic based on my glucose test that that yet administered in the urgent care office, unfortunately, was on steroids at the time. So the physician that was treating me suspected that maybe steroid induced type two diabetes Oh, wow. So he prescribed, prescribed Metformin for me and told me, he suggested I go to the emergency room, but my response was, but have showed a knife so as possible, like what can we do to get through this. So I picked up my prescription and Metformin and went to the show to the theater, still feeling awful. And over the course of the next three weeks, of course, the Metformin did absolutely nothing to help with the symptoms that I was experiencing. And that landed me in the hospital for three days. And that's when I was properly diagnosed with Type One Diabetes. But still, up until being hospitalized, I was working and doing the show, which was looking back on it, which was really crazy, because it shows the intense at high intensity shows a lot of a lot of energy, most of which I did not have   Stacey Simms  7:40 let me just jump in. Because we're going to talk about performing on Broadway and what that does to your body in the energy you need. The Lion King, which we've been fortunate enough to see is nonstop What was it like during that time? Do you can you share I mean, I can't even imagine you must have slept all day, and just performed the best you could have been gone right back to bed.   Kyle Banks  8:01 Yeah, that was my life. Literally in bed all day, wow. Up until the time I would go to work, strike myself into the theater. And usually we're running around during the entire show, just acting. Crazy. You know, the cast is so much the show so much fun to be a part of being in the cast. And then the Quraan camaraderie backstage during the show, the energy is always high and festive. And so of course that's participated in none of that when I wasn't on stage, I was like in my dressing room trying to just replenish any amount of strength that I could or sitting in my station where we get stressed. While the show was happening, it was definitely a huge struggle pushing through just that time. Even after my diagnosis, it took a while for my energy to return. Because my glucose levels was so all over the place. When I was diagnosed one of the crate I you shared with me a bit about your son's experience and the fact that he had amazing doctors that he had access to the same thing with me. But you know, my doctors were not able to tell me once they prescribed insulin for me and showed me how to incorporate that into like the management of diabetes, that they did not share with me the struggles that I would have taken insulin and being so active. That was something that I had to figure out on my own. So   Stacey Simms  9:36 to give you a prescription for insulin, I assume they put you on shots and send you back out to perform it sounds like with very little instruction of, you know, exercise is going to bring you down and eating is going to kind of level you out or I don't even know. So when you got back to your first weeks or months of performances. Do you mind sharing a little of the trial and error I can't imagine as you've already said it, it wasn't a smooth transition back.   Kyle Banks  10:03 Oh, God, no, you know, it's crazy because I actually went to New Orleans to travel to New Orleans to visit my mom's doctor. And she told me to go to the emergency room. And that's when I was hospitalized for three days. So then once I was released, I flew to Denver where the show and jumped right back into the show with now my new regimen for diabetes management, which included finger pricks, which I would do like sometimes 12 or 12 finger prints during the show. And this insulin regimen, that immediately after the first show, I remember my glucose crashed to like the low 20s. And this became a pretty consistent situation where I would have to go into work with my glucose hovering around 303 50. by either intermission or the end of the show, my glucose would crash and I would experienced these crazy hypoglycemic episodes. And it was really scary for a while and this went on for months. And I knew that I just could not continue in this route, because I was reading that, you know, the fluctuations really dangerous, and not only could you know, pass out and have a seizure, if one's glucose goes too low, but you know, could also bring about complications as well. So I knew I had to figure out a better system for my lifestyle, and this new diagnosis that I was now living with. So after about nine months after, actually a full year after my diagnosis, the show just happened to travel to New Orleans. And we were there for a month at the end that I decided to take some time off from work to figure out how to better care for myself and to figure out if I would even be able to continue on performing at this level, and just really figure out a plan for my career.   Stacey Simms  12:05 Well, we know how the story ends that you are still performing and you can. So what made the difference? How did you figure it out?   Right back to Kyle answering that question. But first, Diabetes Connections is brought to you by Dario. And one of the things that makes diabetes management difficult for us that really annoys me and Benny, it isn't actually the big picture stuff. It's all those little tasks that add up. I mean, are you sick of running out of strips? Do you need some direction or encouragement going forward with your diabetes management? Would visibility into your trends help you on your wellness journey? The Daario diabetes success plan offers all of that and more No more waiting in line at the pharmacy no more searching online for answers number wondering about how you're doing with your blood sugar levels, find out more, go to my dario.com forward slash diabetes dash connections. Now back to Kyle talking about how he figured out how to thrive on stage and avoid those huge lows.   Kyle Banks  13:09 Just having that time to the Lion King can be all consuming when you're doing the show between rehearsals and the actual show and the adrenaline that comes in being getting prepared for it. And once once the curtain comes down, so it doesn't really leave much time for other activities. But having the time off, I was able to just really do a lot of research digging online and social media. I discovered beyond type one and children with diabetes. And since a lot of various resources that could different podcasts, such as you or I listened to a lot of shows which people just talking about how they care for themselves. And this is such a varied cast of people talking about their experiences, athletes, teachers and a varied cast. So I was able to really just dig in and hear what other people were doing and take certain things that I could apply to to my situation and really helped me by when I went back to work. I now have a plan of action, I could test it out and discovered that it actually worked. I could go into work with my glucose hovering around 120. I make sure I had lots of snacks with me and a small meal that I would eat without insulin during intermission, and then another small meal after the show without insulin. And I was so shocked that I was able to I didn't experience the crashes anymore, and I'm able to just maintain my level of activity in a safe way and I'm just so thrilled that this information was available to me. I just had to go a little digging to find it.   Stacey Simms  15:03 So yeah, I mean, it sounds like if I'm hearing you correctly, that you went outside the traditional medical sphere, right, it sounds like you got all of your information from the community,   Kyle Banks  15:14 pretty much, pretty much, I knew that my situation is very different than the other patients that my physicians were treating. Initially, I thought, well, the way Kyla cares came about was, when I was in New Orleans, with the time off from work, I reached out also reached out to children's hospital because I figured that would be a great route to find out how they were basically, you know, in the theater with basically big kids running around, running around the theater. So I figured that it would be a lot of insight that maybe the kids or the kids would be able to give me as it relates to how they manage. And so I connected with Children's Hospital is already connected with them, because we do a lot of outreach through Disney. And with Shriners Hospital Children's Hospital, so it's rather easy to connect with them. And that's when I discovered that the kids were having horrific outcomes as well as it relates to glucose management. And I was really moved by the fact that the endocrinology team, stressing to me just the effects that this disease is having on communities of color, specifically kids of color, and how they were having different outcomes in their Caucasian patients. It really struck me and months after that initial meeting, I was just harping on the information that I was given. And that's how eventually, that's how coworkers came to be as a result of that meeting at Children's Hospital with the endocrinology team,   Stacey Simms  16:50 we're going to talk about Kyle cares. And we're going to come back to these disparities that are just, they're heartbreaking, and they are real, just to finish kind of on your experience, you're able to go back and perform. And as you said, you you kind of bounce on, if that's the right word, you kind of go back and forth between the Broadway cast the touring cast. I know, everything's messed up now because of COVID. But from from the time you went back, were you able to go back to the roles that you had been performing and loving before your diagnosis?   Kyle Banks  17:22 Yeah, I was, I'm just so happy to have been able to figure out how to do that safely. Because I did it for so many months. Luckily, without any horrific events happening, like me passing out on stage, or even behind the stage, for that matter, I was able to make it through that very scary time period, without any of that happening. And I'm very lucky to have that had a seizure with my glucose being so low so often. But yeah, I was able to figure out how to do it and how to continue doing all of the things that I love. And like I said it was the community making the information that so many people are just so eager to share online that really helped me push through   Stacey Simms  18:11 what technology Do you use now?   Kyle Banks  18:15 You Economy pod influence, and the Dexcom ci six, continuous glucose monitor?   Stacey Simms  18:22 Are you able to I think I know the answer to this, but are you able to kind of hide that stuff under your costumes? Or is it shown I'm curious what that looks like.   Kyle Banks  18:32 Um, you know, the wardrobe department at lion kings so supportive in just just extremely loving and nurturing through this whole period gluinos first outfit with my Omni pod, I was so concerned that it will cause problems for wardrobe. And when I brought it in and sold it to them on my own. It's like, Oh, that's no problem. So they made me flesh tone bands for my arm and for my abdomen that I could wear deserve scenes in the show where we repair on top. And it was pretty simple fix. Wow, that's great. Yeah, I think they made my slipcovers in like two minutes, like maybe like five minutes before the first show when I was wearing the really simple thing. That's cool. All right,   Stacey Simms  19:20 let's talk about Kyle cares. I am going to come back and ask you a lot of Broadway questions later. But let's talk about hierarchies. Right now. This is your nonprofit. As you mentioned, this provides grants you do a lot of work to get technology for children for young adults with type one. And I've done a little bit of reporting over the years, frankly, not as much as maybe we all need to be thinking about but some reporting on the racial and ethnic disparities, because it's really incredible when you dig into it. When you look at use of insulin pump technology. It's something where, you know, 1/5 of black children compared to white children use comes from my understanding of how Craig if I'm wrong, it's not only Because of income or education or insurance, you know, it's a question of, I don't know, you tell me I shouldn't be talking to you about this. Tell me what you have found out, what should we be thinking about?   Kyle Banks  20:11 Yeah, you know, that's that was my thought as well, when I, when we first began, like digging into Kyla cares and figuring out, you know how we wanted to help. providing grants that can go towards the technology would be the most beneficial route. And we soon discovered that, you know, the complicated the situation is, is much more complicated the financial barriers that keep people from accessing the technology, especially with kids, the stigma surrounding diabetes, specifically type 1 diabetes is really high. And a lot of kids, even the ones that have insurance and have their parents have the financial means to access to technologies, they still don't want to wear them because they don't want to feel different than their peers or don't want the attention that wearing these medical devices on their bodies brings into their lives, we've discovered that a lot of what is needed is one diabetes education, just making sure that families of color have like the basic information needed to care for themselves for a loved one living with the disease. You know, things like, you know, reinforcing the latest glucose management practices and why CG ins and pumps are beneficial and know ways to avoid hyperglycemia and hypoglycemia, pre bolusing movement like walking after meals and using incorporating more water into one's daily water intake as a way to flush excess glucose out simple things like this, we're finding that many parents and people living with the disease aren't aware of them, especially those that have been living with the disease for an extended period of time. It's sort of like they spaced out all of the latest information as it relates to care or management of this disease. So yeah, there's there's a lot of confidence building that needs to happen. Because we live in communities of color.   Stacey Simms  22:21 Do you think that and listen, I don't mean to put you on the spot, I know that you are not in you know, you're not an endocrinologist, you are not a perhaps an anthropologist, you know, as I said, these questions. But, you know, I think it's so important that we could try to talk about these things openly. And I wonder if, as you talk about better education for the patients and trying to get these kids and their families to, you know, be more accepting or look at different, you know, technology, not worry about fitting in. What about the endocrinologists themselves? Do you think that there is a problem or a situation here where, without meaning to even right, I mean, I'm not quite sure how to phrase this, Kyle. But I guess what I'm asking is, do you think they treat patients of color differently? They don't say, Hey, here's a CGM, or here's a pump, or here's, are you finding that sometimes the endos are not trusting their patients, I'm not even sure how to phrase it, but they're not, they're not giving them the opportunities to use the technology.   Kyle Banks  23:18 This is indeed true. I'm discovering that a lot of patients living with type one, especially people of color, are not even being offered the latest technology or technology in general, to help them with, with management. And I mean, there's so many things that goes into that there's a shortage of endocrinologist, so it's really hard to get an appointment, a lot of these endocrinologist worked. The cultural differences that many endocrinologist face when dealing with patients can be intense. In those moments, we only have 30 minutes or hours with someone to try and figure out why they're having so many problems, and just not being able to relate to the human being that's sitting in front of you and their lived experiences. It does create these situations that eventually lead to horrible outcomes for the patient. So and I'm not saying that, you know, all endocrinologists are approaching these situations with ill intent. I just think it's just the way things are set up right now or the way the way the system is set up. It's not serving the patients, especially specifically patients of color, well, those issues are, do exist and we need more endocrinologist of color, or more doctors to go into endocrinology into the field. And we need need some culturally sensitive training before in the cringe for occasion and in the prints that are treating people of color as well.   Stacey Simms  24:58 While these are tough issues. To talk about you made an interesting point earlier about the way you found the care that has helped you through the most, and that was through the community. And I think that that's a story that I've heard over and over and over again, by people who belong to all different types of racial, ethnic, socio economic, you know, different groups. We come when I've done this, I've said, Hey, I have something I want to try, I bring it to our endocrinologist. And he says, oh, great idea. Sure. He didn't suggest it, it doesn't mean that he's holding back something or trying to keep it from me. He just was, you know, for whatever reason, we have a fabulous endo, you know, that wasn't something that was on his radar. And I wonder, too, just in the last couple of years, we finally had these discussions about getting more people of color at conferences represented in the community, you know, jdrf, beyond type one, friends for life, as you mentioned, children with diabetes, you went to the children with diabetes friends for life conference in July, we met for about three seconds. So thanks for for that I really ran up. Kyle as he was trying to start speaking and I was like, you have to come on the show. It's great to meet you. But just being there, I always say we were so lucky, because I saw people in the community that looked just like my son. And my family, from the very beginning didn't even occur to me that we weren't presented a long way of saying, Kyle, going to friends for life this summer, I've got to assume that you met some families of color, that you felt that you were there to have these kinds of conversations, not just for that, I mean, you have so many great stories to tell. But let's start there. What was that like for you this summer,   Kyle Banks  26:31 it was an amazing experience. And children with diabetes is actually one of the organizations that were Kyla cares is partnered with, to expose more families of color to that experience. And we actually brought a few families from New Orleans to friends who live with me as well. So it was really great to see the process of opening up to being more engaged with management happened in real time. Like the kids that came with me, I watched them a little bit apprehensive at first going into like this very white space. And not knowing what was going to happen or what the experience would be like or, or even I tried my best to just explain the benefits of being there. But I think it's something that you have to experience firsthand to really get the gist of what it's about. So it was great to see the kids just open up and make other friends. Because many of these kids, they don't know any, they're the only person they know living with type 1 diabetes. So to see them make up a friends that living with type 1 diabetes or at dinner, you know, to hear them discuss, you know, pre bolusing. And you know how many carbs are in their meal and just for them to be able to have those companies have stations in this setting freely and not feel judged or not feel different. And by the end of it, you know, they're exchanging numbers they've made friends know, they're definitely more engaged in their care, checked in on a few of them. And they're just a lot more excited about being healthy and doing the things that they've learned that the takeaways from the conference, and I was excited to see them incorporating some of those lessons into their own self care. So because lets me know that no, this can work if we expose the kids, specifically kids of color if we expose them to these types of experiences that can have a positive effect in their lives and in their care.   Stacey Simms  28:42 Can I ask some Broadway type questions? Oh, cool. All right. Okay. Love it. Alright, so we were fortunate enough to see the Lion King on Broadway. And you know, what an exceptional show. I think most people are familiar with the incredible costumes, the staging, the dancing. I mean, it's just an incredible show. Tell us a little bit. You've played so many different parts in that as I'm looking through your biography, right? What have you played in that show?   Kyle Banks  29:06 Oh, my God, I played. I'm in the ensemble, or a lion king, but I've also understudied and fossa. And just being in the cast of liking has been just an amazing experience. It's been like a dream come true. And it's also it's one of it was one of my favorite cartoons outdoors, or Animated Movies of the child. So to be a part of the cast. It's just been a dream and being on Broadway and touring the country. I mean, I've been able to see. I mean, there aren't many cities that I haven't been to Wow. And Lion King is such a popular show that when we traveled to the city, we get to sit for three and four weeks at a time. So really get to golf ourselves in the communities in which we visit and that's actually been the best Part.   Stacey Simms  30:00 What's it like when you as the cast members come down the aisle, because that is a breathtaking moment for the audience. And we're looking at these incredible costumes and the carrot they never break character roll. Ooh, and on, there's got to be little kids backing you. Like what is that, like for you all   Kyle Banks  30:18 the excitement in the faces of people. I mean, the kids are one thing, but as the adults are adjusted to experience the show, I mean, I've had chrome men come to me to come up to me after the show with tears. And now it's just talking about how move they were by what they experienced on the from the stage. And it's really cool to be part of a show that is so engrained in, in our culture and so loved. So meaning it means so much to so many people. It's just been amazing experience being connected to the show,   Stacey Simms  30:55 unfortunately, I'm gonna guess you haven't performed in a while, what's the latest with COVID and performances?   Kyle Banks  31:01 Well, Lion King is opening on Broadway, September 14, and then the tour in October. But we made the decision that transitioning into like this, some of them new ventures in my life, one of which is Kyla cares, now over the pandemic. And having time off really allowed me to just dig into the work we're doing here at COVID cares in the partnerships that we've been able to establish with other organizations. And this work is so meaningful to me. Because I know personally, just the difficulties living with type 1 diabetes, but also, I personally experienced the triumphs of figuring out how to care for myself and still be a part of the things that bring me joy, and how to do that safely. want other kids who I want kids to know specifically that, you know, they can still do all of the things that they want to do in life and really just give them the tools they need to, to lead a healthy life and to be normal kids, you know, and for the adults that are that are living with this disease to know that know, if you engage in your care, things will begin to turn around. And it doesn't have to be this horrific experience where it's just a steady decline in health, you can still lead a healthy life with type 1 diabetes.   Stacey Simms  32:37 Kyle, before we wrap it up here, I know your funds for like an A die. Let me just throw a few rapid fire questions. Sorry, okay. All right. Has your Omni pod ever gone off on stage? Like, have you ever had an alarm or Dexcom alarm during a performance?   Kyle Banks  32:56 Oh, my God. Yeah. I mean, I, I've had my podcast on stage. So like standing there, and it's going off? And and I mean, what can I do? I try to do my best to try to avoid those moments. But I'm even one time is a funny Omnipod story, my Omni pod, expire it in my PBM was in my dressing room, so I didn't have time to run to get it. So I took the Omni pod off when it's still blaring and just put it in the trash, which was near the stage. But you know, far enough where it could be heard from the stage? Well, after about two scenes, I come off stage and I see all of this commotion stage managers and security for the theater of him around this trashcan trying to find out what's this loud, glaring noise? And is it dangerous? Like do we need to stop the show? And I'm like, No, I'm so sorry. But it's my part. I explained it all. And it turned into a funny moment. But it was not. It did security was not induced.   Stacey Simms  34:11 That's funny. Oh my goodness. Yeah, that can happen. For sure. I'm sure people are gonna ask me to ask you just you know, you've talked about how you kind of learned to figure your blood sugar to figure out your eating and you figured out, you've been able to figure out what works for you on stage. And I'm curious if you had any advice for kids who are doing school plays or adults who are performers?   Kyle Banks  34:33 Well, they, you know, the thing that really helped me out, honestly, was really learning how to incorporate the technology into my care, and leaning heavily on my CGM, and all of the information that it was delivering to me and which allowed me in turn to respond to what my glucose was doing or any fluctuations that I was having. you're experiencing, it really just helped me to not not having to finger prick and wait for that information, which is limited because it doesn't let you know doesn't inform you if your glucose is rising or falling. So just having that information just made a world of difference, and allow me to really just care for myself when I was performing. And it also allowed me to focus on what I was doing, as opposed to just being so concerned with my glucose.   Stacey Simms  35:31 Before let you go, how can we help Kyler cares? What do you need from us?   Kyle Banks  35:36 Unfortunately, because of COVID, a, we've had a really difficult time with fundraising, all of the fun ways in which we would go about raising funds have sort of been snatched from us, we did a fundraiser called from Broadway with where I incorporated a concert of love songs performed by artists that are currently on Broadway, from shows like Book of Mormon and Hamilton Lion King, of course. So during the shutdown, we produced that and presented it virtually, we were going to present the live version of that in New Orleans at the singer theatre, which is a theater that houses most of the Broadway shows that visit the city. But unfortunately, New Orleans is like one of the hotspots for this fourth, this fourth way the pandemic, so a children's hospital and other health care facilities that were parking within the cities. And neither did we felt comfortable with a live gathering of 2800 people with all that's going on. So, um, we're just trying to figure out, you know, the best ways to raise funds and how to continue connecting with our community, because it COVID is making it really difficult to gather. And it's something that that's something that's really important, as it relates to sharing this information with one another, helping with donations would be great. Also just more people of color, just sharing their stories as well. We find that the more visible we are, the more people can see themselves, the more it helps with feeling that you're part of and helps with confidence building and the reduction of stigmas and just knowing that you're not alone, so it's a two ways people can really help.   Stacey Simms  37:39 Well, Kyle, thank you so much for coming on for sharing your story. I hope this the break, I'm gonna call it from performing isn't the end of your performing. So   Kyle Banks  37:55 not at all. Well keep us posted. I most definitely will. I'll let you know. And I'm looking forward to you know, again, producing one of the things you know, feeding my artistic muscle is really excited about producing the shows from Broadway with love. And I hope I can get back to that because the first one was a lot of fun. So if people haven't seen it, you can go to our YouTube channel and check it out. But yeah, I want to get back into that when things when COVID allows us to do so. Excellent. We look forward to it.   Stacey Simms  38:30 Thanks so much for joining me.   Announcer  38:36 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  38:42 A lot more information on Kyle on Kyler cares. You can find it all at Diabetes connections.com. At the episode homepage, there's a transcription there as well as there is for every episode, I was so excited to talk to Kyle. Some of you may know I'm just such a real Broadway fan. I love musicals. I highly recommend Schmigadoon on Apple TV, if you haven't watched that yet. It's very entertaining and fun. I had actually talked about starting a Broadway type podcast during COVID. I still may do that I have in the back of my head how I want to do it, but it's gonna be so much work the way I want to do it. So we'll see maybe next year. I don't know. I'll keep that in my back pocket for a while. A lright, Big thanks to Kyle for coming on. And coming up. I'm going to talk a little bit about back to school what it looks like in my house this year. And also some feedback about our last episode. Benn's big trip to Israel, but first Diabetes Connections is brought to you by Dexcom. And you know, I do get a lot of questions about Dexcom coverage for people on Medicare. And why not? It's not like you stop needing a CGM, the minute you turn 65 The good news is that the Dexcom g six continuous glucose monitoring system is covered for Medicare for patients who meet the coverage criteria. If you have type one or type two diabetes and intensively managed Insulin, you may be covered. To find out more about what that means. And if you qualify, go to Dexcom.com/G6-Medicare, I will link that up this episode, don't worry about writing it down, you're gonna want to talk to your doctor and you may even be able to get your Dexcom supplies at the pharmacy saving time and money. Learn more. Here's the link but it's over at the homepage dexcom.com.com/G6-Medicare.   Alright, I was very worried, as you know about the episode with Benny, because as you heard if you heard, he was far from perfect when he went by himself to Israel, which I didn't expect it and expected to be perfect. But you know, I see a lot of parents who post on Facebook and want their kids to stay under six for their agencies and never go above 130 on the Dexcom. And you know, we don't live like that at all. I wanted Benny to be honest and open and boy was he ever. It was interesting to hear him talk about what it was like and talk about diabetes camp and you know, gosh, I'm so thankful knock on wood wherever I can knock here, you know, he's a confident happy kid. He's got strong opinions, and I really feel like he's gonna be okay, right after a trip like that. So the feedback I got was just fun. A lot of people reached out with their own stories. Corinna wrote, thank you so much to both of you for sharing this experience. It's so valuable to see how a parent can continue to support their son or daughter in an age appropriate manner. Lee wrote, I love that he's so transparent and genuine. I'm betting on Benny, several emails and direct messages saying thank you for being honest, it's really nice to know that we don't have to be perfect balancing independence and could quote diabetes, health and numbers can be difficult. A lot of acknowledgment about that. But my favorite came from Joan, who emailed me and said, This reminded me of my 16 year old adventure on a cross country bus tour. We were still using urine testing. This is 1974. No CGM is no pumps, no cell phones or texting. I have a similar well adjusted attitude as your son which has served me well through my 50 plus years. With T1D. What I learned from this podcast was what a challenge it must have been for my parents, I have traveled the world had my share of health issues, enjoyed my life. And I'm not eating celery crying in the corner. Thanks for sharing this story. Joan, thank you for sharing that email. And the funniest thing about it, I read it to Benny, he did not know what your urine testing was, he had no idea that finger sticks weren't a thing at some point in in pretty recent history. 1974. So you know, I got to talk to him and explain it's so funny. And he was diagnosed so little. And he's not a diabetes podcast or a researcher. And I see what he doesn't know. It's so interesting. So Joan, thank you so much for that. If I get any interesting stories or funny emails, I'll definitely share them as we go forward. But I want to just quickly bring up back to school, which is still looking so difficult in so many places across the country. And I wish you all well, especially those of you with younger children. Oh my goodness. So I've got to going back to school, my daughter is a junior in college, she is back. And my husband drove with her all the way to New Orleans or she goes to school because she's got a car this year. Thanks for giving me something else to worry about. Yay. But she's doing great. And Benny is a junior in high school, and he's driving to school, our school will start the day after this episode goes live. We're in the south. So they go to school before Labor Day growing up. I always went back to school right after Labor Day, but he's driving to school this year. I don't know when I'm going to see him. He's so busy. And right now, his school does have a mask order with a very large public school system in North Carolina. And he's vaccinated. I assume that we'll get the booster shots as they roll those out. But it's going to be interesting to me. I mean, he goes to an enormous High School. It is I want to say there are 650 kids in his class in his grade. So it's a very big school. It's a crowded school. So we'll see how this works out. He expects to be back virtually in school very soon. I don't know. But I will share that I realized just today. I have to get all his diabetes stuff back and bring it to the nurse. And I know you're thinking well, Stacy, you've done this every year since he was in preschool. How could you forget? We know with COVID we haven't even been in the school. I went back. I don't even know when last year a couple months ago could have been last week. I have no sense of time anymore. I went back and got all the stuff that we left there from 2019 2019 2020 that school year, and I haven't been back to see the nurse since so we're getting the school form signed. I got to put his stuff together and make a new kit. I um, so we'll be doing that. And then you know, he's you know, Benny, he's super casual. He'll take his backpack everywhere. So he'll have supplies, but I like to have stuff at the nurse's office for him. As well, and hopefully it's the same nurse, because man, she was great. And she totally got that he's super casual and just wants her to be there when he needs her and doesn't need her checking on him. And, you know, really terrific person. There are, at least at the time when he was a freshman, there were 21 kids at that school was type one. And I'm going to assume there are more, because I don't know about your town. But we're having more and more cases here. And it's not anecdotally I just talked to the end of the other day, and he said they have many more. And we'll we'll talk about that in a future episode. You know, many people think COVID is sparking more cases of all types of diabetes. Before I let you go, take a moment to check out our YouTube channel. We are getting a lot of engagement there. I've got the in the news episodes over there. So if you don't know that we have a YouTube channel, it's just Diabetes Connections on YouTube. And all the episodes are there. If you prefer to listen to podcasts on YouTube, which many do they're most of them are not video podcasts. It's just audio, but a lot of people like that platform. Also the newscasts, though, are video so if you want to see me play an anchor lady, you can head on over there and I'll link that up in the episode as well please subscribe if you head over there you know very simple just click Subscribe on the on the YouTube channel. Thank you as always to my editor John Buckenas from audio editing solutions. Thank you so much as you listen next week, we are likely going to air the Afrezza interview that I did over the summer. Still working on a few things but it looks like that one is going to come through for next week very excited to get an update from them. They've been around for a while. But man are they making a push ahead as they have more studies, more studies with children coming up and lots of interesting stuff, Afrezza and of course the newscast Wednesdays at 430 Eastern Time live on Facebook. I'm Stacey Simms. I'll see you back here in just a couple of days until then be kind to yourself. Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged

Any level of exercise can be more challenging when you live with diabetes. When Eoin Costello was diagnosed with type 1 at age 19, he was worried that his love for fitness and sports would have to be put aside. Instead, he found a way to not only stay active but to coach other people with diabetes to do the same. Whatever level of fitness you're looking for, Eoin is all about having fun and making it work. He's also the host of The Insuleoin Podcast. Stacey appears on a recent episode talking about her parenting experience. Also this week, In Tell Me Something Good – type 1 diabetes and space force? Did we just see a big barrier – military service – come down? Link to the article here.  This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode Transcription Below:  Stacey Simms  0:00 Diabetes Connections is brought to you by Dario health manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first premixed auto injector for very low blood sugar and by Dexcom help make knowledge your superpower with the Dexcom G6 continuous glucose monitoring system. This is Diabetes Connections with Stacey Simms. This week exercise with type one can be a challenge. You know there are a lot of variables Eoin Costello was determined to make it work when he was diagnosed and says the key is don't expect perfection.   Eoin Costello  0:41 When I start something new, I'm probably gonna see some highs and I'm probably gonna see some lows. And I think being aware of that, first of all is very important because you're not going to be as frustrated or discouraged when you do inevitably see these highs and lows   Stacey Simms  0:57 Eoin was diagnosed as a young adult. He has his own podcast and we talk about managing different kinds of workouts, treating lows at 3am. And lots more in Tell me something good type 1 diabetes, and space force. Did we just see a big barrier US military service come down? This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.   Welcome to another week of the show. Always so glad to have you here. You know, we aim to educate and inspire about diabetes with a focus on people who use insulin. I'm your host, Stacey Simms, my son was diagnosed with type one back in 2006, at the age of almost two, and he is now 16. My husband lives with type two diabetes, I don't have diabetes, I have a background in broadcasting. And that is how you get this podcast. I am just back from podcast movement, which is a really big podcasting conference. I've gotten to it in years past, but I haven't been in a while it was really fun to catch up just like diabetes conferences, you know, you see all your friends and you do learn stuff. And I was there in a different sort of capacity, not just learning about my own show. But I'm working a little bit with a group called sheep podcasts, which is of course, podcasting for women. And I bring all this up just to say, it was really interesting to see the difference between travel at the beginning of July, which was the first time I really went to any kind of conference or in person gathering that wasn't, you know, immediate family. And in July, we were certainly very cautious. And friends for life, the organization there did a great job at being smart about COVID and doing everything they needed to do. But the difference this time was just the attitude and the feeling because of the Delta variant. You know, it was very interesting. Many more people were masking indoors than in July, many more people were expressing concerns about traveling back and forth. And I don't bring this up to say anything other than it was an interesting observation. You all know as you listen, you know, this is a very educated audience What's going on? I don't have to tell you anything. If you follow me on social media, you might have seen that I was wearing a mask outdoors in downtown Nashville, I was kind of reluctant to go to downtown Nashville at all, but I'd never been there. And I wanted to see all the bridesmaid stuff myself. Because it is like the National Capital now in the US for bachelorette parties. And yes, it lives up to that hype. It was amazing. But I was wearing my mask outdoors. If you followed me on social you saw that. And I haven't done that before but it was crowded and a lot of young people and you know in the US the younger the less likely to be vaccinated. So we took more precautions than we know I say we then me than I normally would have also was so much fun to meet some diabetes friends just as an odd coincidence in Nashville last Wednesday. As you listen children with diabetes, the group that puts on friends for life had a very cool event with mankind, the people behind Afrezza inhaled insulin, and they sponsored a fun time at a go kart track with Conor Daly. He is an IndyCar driver who lives with type one. And he was in town because Nashville had their very first Music City Grand Prix. I will link that up. It was a very cool, very different kind of race. But Connor was very cool himself. He was super engaging with the kids. I will link up some coverage. There was a new story come up some of the local news stations came out and made some videos which was really nice. I got to meet Rachel Mayo, who is a very cool lady who lives in Nashville. And you know, we're we've connected on social media for years. She lives with type one. She works with the JDRF chapter there. And Ernie Prado who's been on the show before he works at NASA. I saw him with friends for life. And he told me if I was going to Nashville, I had to look her up. So Rachel, it was so great to meet you. And maybe next time we will get in the go karts. I don't know. It was really fun though. you know, one of the things I mentioned podcast movement, but one of the things that's really fun about going there is meeting other podcasters you know, we already have fabulous other shows in the diabetes community. There are lots of podcasts and more of them. keep popping up all All the time, I did sort of a swap with this week's guest, but we did it kind of backwards. I taped the interview you're about to hear with Eoin first. And then he interviewed me about a week later. But he has already aired the interview that he did with me. His turnaround time was quicker. So I'll put the link in the show notes to that Eoin Castillo's show is the Insuleoin podcast, it is great. Oh, and you can hear the name in the title there Eoin was diagnosed almost 10 years ago at the age of 19. And he was very active very much to sports at the time. And as you can imagine, very worried about whether he'd be able to continue. It's a bit hard to imagine now. But even 10 years ago, there wasn't the social media there was in the communication we have now in the diabetes community. I mean, it's taken off for sure. But when you think about it, 2011 was still at the very beginning. So there wasn't a lot of information out there for somebody who wants to run marathons or lift weights competitively, you know, that sort of thing. We had a great conversation about how Eoin you know, kind of found his way and he is now helping many, many other people. And he is Yes, he's from Ireland. I think his accent is much nicer than my my New York accent which occasionally comes out I know you hear it here and there. But first Diabetes Connections is brought to you by Gvoke Hypopen. Our endo always told us that if you use insulin, you need to have emergency glucagon on hand as well. Low blood sugars are one thing we're usually able to treat those with fast acting glucose tabs or juice but a very low blood sugar can be frightening. Which is why I'm so glad there's a different option for emergency glucagon it is Gvoke Hypopen. Gvoke Hypopen is pre mixed and ready to go with no visible needle. You pull off the red cap and push the yellow end on to 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 via chromosoma or insulinoma. Visit Gvoke glucagon comm slash risk.   Eoin Welcome to the show. It's great to talk to you today.   Eoin Costello  6:59 Thank you, Stacey. Thanks for having me on. I'm actually a longtime listener of the podcast. I was a pleasure. So I appreciate it.   Stacey Simms  7:05 Thank you so much. I was just about to say I really enjoy your podcast. It's kind of funny talking to a fellow podcaster. This will be nice.   Eoin Costello  7:14 Absolutely. At least we were both used to speaking on a mic.   Stacey Simms  7:17 Oh, we see now you set it up. Now we have to like up the game. We really have to be good today. I want to talk about your show and what led you there. But let's just start at your story's beginning. You were diagnosed with type one at at 19. What's going on in your life during that time?   Eoin Costello  7:35 Yeah, so I was kind of transitioning from high school, we just call it regular school in Ireland into college. So I had done a year of like a portfolio course I was actually going to art college for animation. It was around Christmas time. And I had noticed some differences in terms of how I was feeling. Obviously, I was very tired. I had lost about a stone and a half in the space of a month. I was really thirsty all the time. I just didn't have any energy. And I suppose because I was 19. And I was kind of into fitness and train and and keep myself healthy. I had this I had this naive attitude of I'm 19 I'm invincible. How could there be anything wrong with me, therefore, I'll just brush it off to the side. And it was around Christmas time and and in Ireland, we like to go to bars, we like to have a good time around that. Obviously, in France, I was having a few drinks. And if I was tired during the day, I would say it's only because I was out last night or if I was thirsty. It's because I've had a few drinks the previous night. And it wasn't until my parents were kind of quietly concerned. What they had mentioned that I should probably go dEoin to the GP get a blood test and just to see if everything's okay. And I reluctantly agreed because I was kind of saying, Look, I'm fine. I'm fine. I'm fine. There's nothing wrong with me. But I I gave in, because I just wanted to keep my parents happy.   Stacey Simms  8:59 Let me just interrupt you real quick. Just to translate over here. A stone is 14 pounds. So you lost 21 pounds.   Eoin Costello  9:06 Yeah, it flew off me. Right? Yeah. And in a very, very short space of time was about a month, a month and a half. But the thing about it was because you kind of see yourself every day, I didn't notice it as much. And it wasn't until I'd seen a friend who I hadn't seen and maybe six months or so I just bumped into her in the street. And she said to me, You look really different. And I said how would you mean and she goes I don't know you just look different. And she she kind of blurted it out and was embarrassed nearly but from saying it, but it was obviously because I had lost so much weight in such a short space of time. So basically I went down to the GP got a blood test. And a couple days later I got a phone call saying this is all I said it is blood test come back. You have type 1 diabetes, you need to go to the hospital right now. And I went in and my bloods were like six 40 640 so very high. And then that led me to my new life.   Stacey Simms  10:05 Was there any confusion about which type it was? Because sometimes, as a young adult, they don't go type one initially,   Eoin Costello  10:11 no, straightaway, they they had told me it was type one. But I had barely even heard the word diabetes before. I obviously knew that it was a condition that people lived with. But I had no idea of the complexities of it, or just the, the detail that you have to now live your life by. But no, there was no confusion. It was type one straightaway.   Stacey Simms  10:31 And while I'm sure your parents were supportive, but very worried, I heard your brothers gave you an interesting well, while you were in the hospital, is that true?   Eoin Costello  10:40 Yeah, it is true. So I was I was in hospital. I think I stayed there for about three nights while I was on an IV and obviously getting the crash course and diabetes management. And my family, in a good way have a dark sense of humor. We're nice people we like to think what around difficult times like that sometimes it can be nice to try and keep things light hearted. So my two brothers got a cough my brother and or my my dad. And we're obviously informed that Eoin has been diagnosed type 1 diabetes is in hospital. And on their way to the hospital. They picked up bottles of CO sweet jellies, these kinds of things to bring in as a joke. It kind of sounds weird. If you don't if you don't know. It came, it came from a good place.   Stacey Simms  11:30 That's funny. Yeah, I think sometimes dark humor has its place for sure if you know it's coming with love. That's really funny. Exactly, of course. So you're already very involved, as you said in fitness. I assume you played sports all growing up. What were you thinking at the time about what was to come next?   Eoin Costello  11:47 Yeah, there was a lot racing through my mind, obviously. But one of the big things that stood out to me and one of my main concerns was, can I continue to play sport, can I continue to be active, and for my whole life, I, I played a lot of different sports. But at the time, I was playing football, or I was playing soccer at a very high level. And I wanted to continue doing that. And because I didn't know anything about diabetes, I had almost automatically assumed that this would prevent me from being as active or playing sport. So it was obviously a big adjustment in terms of how to manage blood sugar around exercises, as we all know. But as time went on, I kind of quickly realized that look, you can of course, still play sport, you can be active, as long as you're still prioritizing your diabetes health. But the first while I was I was very concerned.   Stacey Simms  12:41 It's interesting, when you were diagnosed, you know, almost 10 years ago. Now, this is a time before a lot of social media. I mean, it's kind of just starting. But I guess what I'm asking is, you have a huge Instagram following, and other social media following and you post advice, and you talk very openly about how to do what you do with type 1 diabetes, I've got to assume that wasn't available for you. When you were diagnosed? How did you figure it out? How did you know what to do?   Eoin Costello  13:07 Very, very good question. It reminds me of when I kind of first got back to college. Because when I was in class, obviously, I had just been recently diagnosed. And as you say, Stacy, there was no social media, there wasn't really any, any sort of community based support groups that I could kind of connect with online and learn from other diabetics. And as we know, it can be very isolating to live with diabetes, because it's sometimes are consuming in your life. So at times, I was thinking I only person in the world left with this thing. And obviously I wasn't, but sometimes you can feel like that because it is so just on your mind all the time I was in college, I remember, some days, I was supposed to be doing work, but I might be behind the computer or laptop, just researching diabetes, because I became obsessed with in a really good way. Because I knew that. Okay, this is a very, very serious condition. It's something that is out of my control. Now I have it, there's nothing I could have done to bring it on. There's nothing I could have done to prevent us. But it's in my best interest now to know as much as possible. And for any diabetic out there, the more that we know, inevitably the easier things can be. I kind of just became obsessed with obsessed with trying to understand how different exercise would affect me how stress would affect me how lack of sleep would affect me, how hydration, different foods, these kinds of things. And it was it was almost like a guilty pleasure. I was just constantly constantly looking at open research and   Stacey Simms  14:42 we're going to talk about what works and I'd love to get some advice for everybody from you know, the very casual athlete to somebody who's really, really more involved in fitness. But I got to ask, did you have any mishaps in the beginning? Did you try anything that you said that's not going to work?   All right back to Eoin answering that question. But first bottom line, you need a plan of action with diabetes. We've been lucky that Benny's endo has helped us a lot with that and that he understands the plan has to change. It's been he 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 rage percentage within three months reduction of a win see within three months and a 58% decrease in occurrences of severe hypoglycemic events, try Dario's diabetes success plan and make a difference in your diabetes management. Go to my dario.com forward slash diabetes dash connections for more proven results and for information about the plan. Now back to Eoin answering my question about whether he's tried something in his workout or his diet routine that just didn't work.   Eoin Costello  15:59 Thankfully, I didn't have anything dramatic. Thankfully, I highlight. But yeah, of course, there's so much trial and error with diabetes and from throughout throughout the last 10 years, I have just had thousands of highs, maybe not 1000s of lows, hopefully keep them keep them less. But the more that I tried different things, the more that I tried to get out there the more exercise that I did on a test and different foods with different amount of amounts of insulin. There's just so much trial and error. But hopefully, I didn't have anything like decay or I wasn't kind of rushed into hospital board. Well, fingers crossed. Yeah, let's keep let's keep it. So it was more so just the highs and lows as they call them rather than anything too serious. Thankfully,   Stacey Simms  16:47 well, and I'll be I'll be clear on I was thinking more like you ate a banana before a workout. And it was not the right idea or wasn't so much like DK. Okay, I'm not too worried about, you know, that kind of mistake. I was just thinking about something smaller. But that's up to you.   Eoin Costello  17:03 Yeah, of course, there's times where I remember when I, I think it was been a few weeks after I was diagnosed and I was kind of getting back into the gym. But I was also kind of coming into a honeymoon phase quite quickly after I was diagnosed. And I was taught and I was learning to carb count for one unit of insulin for 10 grams carbohydrates. And I remember, I finished the workout in the gym, I went down to the changing room to get changed up shower, and I had a banana. I weighed out the banana. It totaled 50 grams of carbs. So I thought, Okay, perfect. I've waited out I've done everything I'm supposed to do. I took five units of insulin and ate a banana. But I hadn't fully realized the impact of a potential honeymoon phase. So I quite quickly plummeted. And I now have to get two liters orange juice in quite quickly. But I'm just mistakes like that. Just where you think you're on the right track with an insulin dose of carb count or something as diabetes does. It sometimes surprises you?   Stacey Simms  18:06 No doubt. I hate bananas. That's funny. That's why I gave that as an example. I'm not surprised that you had an incident with a banana. No, no, don't. Not one of my favorites. What kind of technology do you use? Do you use a CGM? Do you use an insulin pump?   Eoin Costello  18:24 So I've always used MDI, my mom, Nova rapid and Lantus. But only this year, I've got a Dexcom G6. And as you can imagine, that's completely opened up my eyes to a 24 hour period with my blood sugar rather than just that snapshot in time with a finger prick.   Stacey Simms  18:41 What motivated you What led you to start using a CGM,   Eoin Costello  18:45 it was more so they had become available in Ireland. So thankfully, in Ireland, we are with something called the long term illness scheme. So if you're diagnosed with Type 1 diabetes in Ireland, all of your supplies are covered, which is unbelievable. But only recently they had included the Dexcom G6, so it was actually only offered to me almost a year to today. It's been a game changer. It's just and particularly with exercise, it gives you so much more freedoms or much more confidence when you are to go to the gym or you are to go for a run or whatever it might be. It's so   Stacey Simms  19:19 interesting with exercise because my son who lives with type one has played lots of different sports. And it's always amazing to see those rises in blood sugar that comes not from food, but from exercise and the different types of exercise you have to learn what to leave alone with treat for. Did any of that take you by surprise? Did you see those? I call them adrenaline highs?   Eoin Costello  19:43 Absolutely. Yeah, I suppose what really surprises me and still to the day What surprised me so much is the drastic difference between and this is obviously from my own experience, the drastic difference between heavy weight training and something like a rant So to give you an example, if I was to actually, only this morning, I was in the gym, and I was doing relatively heavy squats. And when I work with heavier weights, my blood sugar skyrockets. So I've now gotten to the stage where more often than not, I will have to pre bolus for a heavy leg workout, because I'm anticipating that big spike. Whereas if I'm to go for a run, I'll know that after, say, 2030 minutes, my blood sugar's are inclined to trend lower. So ideally, I always try and go for a run with little to no insulin on board. That's why I like to run first thing in the morning. And then we're training in terms of weights, depending on what it is. I'm training. Like, if I'm doing heavy squats, I may need to pre bolus as if I'm having a meal, which is strange.   Stacey Simms  20:52 Yeah, yeah. But you have to figure all that out. I mean, it's it's incredible. And I always feel like just when we have one sport figured out, he decides to change. keep you guessing, right. You can't quit baseball. We figured it out. Now. He's done baseball, and basketball, football, a little bit of lacrosse, and now he's really enjoying wrestling. So I think wrestling is going to take us through high school, we are still figuring it out. Because it is you know, practice is super intense with lots of cardio and then sometimes wait on alternate days. And then the meats are just a lot of standing around and then these bursts of energy. So you know, it's   Eoin Costello  21:27 what would Benny's blood sugar? How would it react if he was saved on an intense wrestling session?   Stacey Simms  21:34 Well, the practices are to the point where we have the example, the very first wrestling practice he ever went to he ate 85 uncovered carbs during the two hours, he just liked having to stop No way. It was real. It was unreal. He was he's an active kid. But at the time, this is two and a half years ago. Now. He wasn't as fit as he is. Now to be quite honest with you, he had taken himself on as kind of a project and between eighth grade, and now he's about to be a junior. So two and a half, three years, he's really transformed his body. He's gotten a lot more fit. He's lost weight, he's muscled up. It's been it's been fun to watch, and kind of inspiring as the mom who just like walks the dog and works out a couple times a week. But he's really done well. So that first practice, though, was amazing. So we knew we had to make some changes. So we you know, we adjusted insulin. And as he exercised and became more sensitive, right, he responded better to the insulin, we were able to make a lot of adjustments. So if we knew it was a heavy cardio day, he would change his basal rates going in, in having control like you with Tandem has kind of changed that. But still, if it was a heavier weight day, he actually he kind of wait, no pun intended, he waits out the high, he doesn't like to dose for it too much because he will drop. And then during a meet, he just tried to kind of ride it. But he's 16 on. So sometimes that means ignoring it. To be quite honest with you, I can imagine and just getting through. So as his mom, I'm like, you know, if you just gave yourself a little bit you could He's like, it's fine. It's fine. It's fine. And it's fine. He's doing very well. He's very healthy. Our endocrinologist is pleased. So I can't really criticize him. But I but I'd like to   Eoin Costello  23:23 as mother's ward. Well, I'm sure look, he's he's in fantastic hands, obviously. But it's it's amazing to hear that he has stayed so active. And as you say he changed his body and seeing the difference with even the insulin requirements. Oh, yeah. Amazing.   Stacey Simms  23:37 Yeah, it's been great. So let me get I don't want to talk all let us let me get back to you. Sorry. When you talk to people about diabetes and fitness, and let's be honest, you are you know, fitness seems to be kind of your job. This is something that you are really passionate about. I'll share some videos and some photos if you haven't seen Eoin he's he? Are you a model? You're a fitness model in some ways, right? Terrible question. You're   Eoin Costello  24:03 gonna laugh at regression? Well, yeah, I'm with a model agency in Dublin, but it's not my my full time job.   Stacey Simms  24:09 Okay, so you can imagine how fit he is to have that as even a part time job. So let's start though by talking about people who are moderately active with diabetes, right? They may not they may not expect to be on the cover of, you know, a Fitness magazine, but they want to get in better shape. What kind of advice do you have for somebody who is worried about going low? Or is hearing us talk about these highs and isn't quite sure what to do? Where do you start?   Eoin Costello  24:35 Yeah, absolutely. Good question. And it's, it's something that I always touch on too. I make it quite clear that because I am so into fitness, I would never expect anybody to, you know, go to the gym five or six days a week and go out for runs multiple times a week. It's what I do with what I love. It's not for everybody else. But it's important that as a diabetic, we have some sort of activity in our life. Whether that be Going for a short walk a day, whether that be playing tennis, whether it be going for a swim, anything that you enjoy is the first piece of advice. It's important that if you want to exercise or if you're trying to introduce a new sort of regime or routine into your into your life, it's important that you enjoy it. Because if you do, you're a lot more inclined to continue to do and continue to see the benefits from it. So if somebody is concerned about the highs that I was speaking about, or the lows that I mentioned, what Ron's there is so much trial and error. And it's important that people always remind themselves of when I'm starting something new. And this can be with any aspect of your life. But particularly with diabetes, when I start something new, I'm probably gonna see some highs, and I'm probably gonna see some lows. And I think being aware of that, first of all, is very important, because you're not going to be as frustrated or discouraged when you do inevitably see these highs and lows. But if I was to offer somebody advice, who is trying to start walking or trying to start, say, even a light jog a couple times a week, the first thing is always be prepared for a high or low blood sugar, particularly low blood sugar, because the impacts of a low can obviously affect you quite quickly. So the first thing is always have your low treatment and start small, you don't need to aim to run a marathon quite quickly, you can think, Okay, I'm going to start this week, walk around the block, see how my blood sugar react, I might do to walk around the block, see how my blood sugar reacts to that. So instead of that kind of all or nothing mentality, you really need to ease your way into it. Because when you ease your way into things, you can steadily see any patterns or trends which approach, it might not be the best idea for somebody to say, Okay, I haven't gone to the gym ever before, but I want to start going, therefore, I'm gonna go to the gym six days a week, yeah, it's gonna be very, very, very difficult to understand how your body and how your blood sugar reacts to that. It could be I'm gonna go to the gym one day a week, and I'm gonna see what my blood sugar's like before, I'm gonna see what my blood sugar is like, during, and after. And if you're aware of the trends and patterns, like I said, with your blood sugar, it gives you more confidence over time. And the more confidence you have with your blood sugar, the easier it is to continue to do more.   Stacey Simms  27:27 And then for the people who want to do more, because we have quite a few people who listen to this show who are very much dedicated to fitness activity, athletics, you know, for those high achievers, any tips to kind of stay at that high level or get there,   Eoin Costello  27:43 I think a lot of that would depend on what that specific person's goal is. But if it is, say, to change your body composition, for example, and you really enjoy going to the gym, you like lifting weights, you can see your body changing over time, and you want to continue doing that, because it's it's what you love. Again, it's about enjoying it. But the priority will always be your blood. And I think no matter who you are what you do in terms of your exercise, whether it be intense, or just kind of casual each day, the priority is always blood sugar. Always, always always, for me anyway, that's how I feel about. And I think if you have a good understanding of how you're reacting to these certain things, then again, it gives you the confidence to push further and further and further and further, if that's what you want to do. So, to give another example from from my own experience, since the lockdown in Ireland, the gyms high close now, they're opened back up, thanks, thankfully. But when the gyms closed, I got big into running. And the first few rounds that I went on, it was again, a lot of trial and error, I would see a few lows, I would see my bloods dropping at a certain distance or a certain time. But the more I did it, the more my confidence grew. And then the more you do, you can kind of see yourself setting yourself goals. So I did a running challenge, which was 48 miles over 48 hours. So you'd you'd run for miles, every Yeah. So it was four miles, every four hours for 48 hours. And before I started running, I was thinking arc like could I could I do that, like with my butcher we get in the way is that realistic foot The more that you do, you can kind of see yourself getting closer and closer and closer and closer to doing these things. So if there is somebody who, as you say Stacey is a high achiever, or really enjoys their training, if you have that goal that you want to work towards, you can tweak your training or, or even tweak your diabetes management towards that, if that makes sense.   Stacey Simms  29:50 Yeah, I'm curious though you said you know the blood sugar is your top priority. What do you mean by that? Do you mean staying in range just knowing where it is? You know? When you say your blood sugar is the most important part of your workout, can you just talk a little bit about what you mean by that?   Eoin Costello  30:05 Yeah, of course. So I mean, not even specifically with training just in general, I always went out obsessing about it too much, I always like to prioritize my diabetes health. And for me, that is trying to keep my time and range in range as much as possible. Because I know that if I'm fluctuating high and low, and my time and range isn't where I would like it to be, that can almost immediately affect my quality of life for that for that day. Because I know that my clothes are up and down, not gonna feel the best and gonna feel as if I'm on the backfoot to my blood sugar kind of chasing them. So I always like to be as prepared as possible, so that I can almost look ahead those 2345 hours into a time where I'm working out to see, okay, I've eaten I've eaten this meal, I've taken this insulin. How can I expect that to react when I say I prioritize as I prioritize it, because I know that I won't be in the best form or I won't be able to train as much as I would like, if I'm having difficulties with my blood sugar.   Stacey Simms  31:12 What do you like to use to treat Lowe's Do you have a go to   Eoin Costello  31:16 when I'm disciplined with Lowe's, my go twos are these lift glucose drinks, or else dextrose tablets was easier said than done. When you when you're not having low blood sugar, but it's a whole different story, when you're waking up at 3am with a low blood sugar. And if I wake up at 3am, with a low blood sugar, the kitchen is just raided. And it's I always say I'm like a bear going into a picnic sometimes just can't be stopped.   Stacey Simms  31:44 Let's you know, it's nice to know you're human. I mean, that's that that takes a lot of discipline to just go for the tabs.   Eoin Costello  31:51 It depends on how low I am. If I'm dipping just underneath the time and range, it's easy enough just to stick to the glucose. But if I know I'm going lower, it's game over in terms of the treatment. And I know that then I'm going to inevitably see that kind of rebound. Hi, yeah,   Stacey Simms  32:09 do you have any foods that you really like to indulge in every once in a while   Eoin Costello  32:15 there is chips or crisps? We call them over here. And they're like, we thought they're beautiful things really crunchy. You're making me think about them. They're just these really crunchy salt and vinegar chips, as you call them. And they do these massive bags in Ireland. So I always have a few of them in the house. Just I probably eat them too often. Maybe that's why I train so much.   Stacey Simms  32:42 You know, I did want to ask you about your podcast. I'm curious. You know, I mean, I was in broadcasting. I know why I started my show, gosh, many moons ago. Why did you start your podcast? How did that come about?   Eoin Costello  32:55 I had never planned on us to be honest. And I think when I initially set up an Instagram page two, as you said earlier, Stacey to kind of help give people advice that I might be able to offer or what just experiences from my own life, it was almost like a snowball effect where the more that I shared, I felt as if the more I had to say. And then it almost came from a sort of selfish standpoint because I really wanted to interview other diabetics. And like throughout the past 10 ish years, I've always learned more from other diabetics than I have anybody else. So I felt that having a podcast gave me an opportunity to speak to as many diabetics as I could and to hear from their experiences. So it was to get other people on to share their experiences. And some of the guests that I've had on have been amazing. And I know you're going to be on shortly, which I can't wait for, for as well. I call this the insulin podcast redefining diabetes. I call it that because, well, for two reasons. Number one is I feel that diabetes is so globally well known. Everybody knows that it exists. But it's so widely unknown, and people don't truly understand the the intricacies that you're just a normal day entails. So I call that redefining diabetes, because I want to hopefully redefine what society see diabetes as and also, more importantly, what a diabetic sees that IBS is, it's really important for me that any diabetic out there realizes that look, it's not an ideal situation to be in as we know, it's a difficult condition to live with. What if we can learn to redefine that in our own head and kind of scratch on the surface to see what positives can we take from this, it doesn't have to just be a negative impact on our life. There can be positives from it, and I feel from sharing some of my own experiences and more, I suppose particularly more with the guests. It helps get that point Cross I've had people who've climbed Mount Everest ran across Canada, Chris Rutan, who was a motivational speaker who has obviously been on your podcast too. And I just think it can offer a lot of people value as your podcast those you've, you've been going for years now. And I know there's obviously 1000s of people that get such a massive benefit from this. So I'm hoping that they do too from my podcast.   Stacey Simms  35:23 I'm sure they do. It's a great show. But before I let you go, I'm curious, you know, you want to redefine diabetes. So if you look back at Oakland, 10 years ago, right, in the hospital, your brothers are bringing you soda and candy. And, you know, giving you a hard time, would you say that, at least to yourself, the definition of diabetes that you got that day, that in these 10 years? Since that you, you've redefined that for you?   Eoin Costello  35:51 I would like to think so. Yeah, I think if I was to put myself back in that hospital bed that was that 10 years ago, and to see how far I've come even just in terms of my own management and how I view my own diabetes? Yeah, I think I've redefined it for myself, which I'm proud of, I have to say,   Stacey Simms  36:09 yeah, you shouldn't be It's okay. That's great. Eointhank you so much for joining me, it was a pleasure to talk to you. I'm looking forward to talking to you for your show. I'm always it's a little weird to flip the microphone around and be interviewed. But I'll try to behave myself. Thanks. Great. Thanks so much for joining me today.   Eoin Costello  36:27 Thanks, Stacey. I can I just quickly say, I just want to thank anybody who's listening. I know that anyone who listens to the podcast is obviously looking for value. And I know that your time is an important asset. So I hope you've been able to get something from this episode. And Stacey, I'd like to thank you because this podcast for me personally has has brought me a lot of value. And it's offering people 1000s of people out there huge support and reassurance around their diabetes. So from a type one diabetic. Thank you, and I appreciate you.   Announcer  37:03 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  37:08 For more information about Eoin in my show notes, you can always find out everything at Diabetes, Connections comm if you're listening in the podcast player, it may be a little difficult to see everything. Some of them don't support the links or the transcript I put in you can always come on home to Diabetes connections.com I so appreciate talking to Eoin. It was so kind of him to say what he said there at the end. I never know what to say. But what a nice comment. And I really do appreciate that I do highly recommend his podcast, the insuleion podcast. It's a lot of fun. He's so engaging, as you heard, and it really is terrific. Please check it out. Up next, we're gonna talk about space force. Did you hear about this guy with type one made it in? What does that mean for military service in the US? We'll talk about it. But first Diabetes Connections is brought to you by Dexcom. Dexcom has a diabetes management software called clarity. Do you use this because for a very long time, longer than I'd like to admit, I thought it was just something our endo could see. But it's really helpful. Now I have it on my phone, you can use it on both a desktop or as an app. And it's an easy way to keep track of the big picture. I find I use it a lot when we're adjusting things you know, which felt for a long time like it was non stop at age 16. Any kind of seems to be leveling out on growth and basil rates, at least for now. But clarity really helps us see longer term trends and helps us not you know over react, the overlay reports help put context his glucose levels and patterns. And when you share the reports with your care team, it's easy for them to get a great idea of what's going on and then they can better help. managing diabetes is not easy. But I feel like we have one of the very best CGM systems working for us find out more Diabetes connections.com and click on the Dexcom logo. And an article from Stars and Stripes was making the rounds. This is a military publication. And you may have seen this really interesting. Tanner Johnson was due to graduate from the US Air Force Academy in Colorado. When he was diagnosed with type one. They allowed him to return but they referred him for counseling and they told him this is going to be the end of your military career. But he told the counselor, I want to stay in what if we could demonstrate that I could do it. He was able to get in front of the academy superintendent and talk to him. And apparently that personal meeting made a big difference because the 10 General Richard Clarke reportedly went to bat for Johnson. There's not a lot of detail in the article about the process here. But Johnson was allowed to graduate in 2021 and he was accepted into the space force. If you are not familiar. This is I don't blame you because it's very, very, very new. Us space force is the sixth independent US military service branch. Of course it is tasked with missions and operations. In the space domain, it was signed into law at the end of 2019. And honestly, I know a lot of people think that this is something that former President Donald Trump just kind of made up and put into existence. But the idea has been around since the 50s. And it was seriously considered in the early 80s by Reagan. So I only say that to say, this is part of the US military. I saw a couple of Facebook comments about Tanner Johnson questioning whether this was really a military service assignment for somebody with type 1 diabetes, I believe it is, is it combat? Ready, right? Because Can you be deployed when you have type 1 diabetes is still the question. And that certainly doesn't seem to be something that is being planned for with space for so I obviously have a lot of questions, as I'm sure you all do, as well. So I reached out to the reporter who wrote the story and said, you know, can you connect us I'd really like to talk to Tanner, and she reached back immediately. It was fabulous. I was so grateful for that. Thank you, Karen. And she said, I will ask him, I will reach out but he just started training with space force. And he will need authorization from leadership to talk to you she said quote, they tend to say no. So we'll see what happens. If you know, Tanner Johnson, or you could get me an interview with him. Please reach out. Let me know how to be connected. Because I have a lot of questions as I know you do, too. But what an inspirational story, what a big first step for the US military. We've talked to other people who have been diagnosed while they are already in the military, and they've been able to stay active. But I don't know anybody who was diagnosed during training, who was able to stay in. So we'll keep following this one. But I'm putting this under Tell me something good because man, that's the last big barrier. We've got, you know, airline pilots in last couple of years can be type one now. Military service is the one that we still, you know, after that it'll be astronaut. So I think it's fantastic.  If you have a Tell me something good story, please reach out Stacey at Diabetes connections.com or post in our Facebook group. I ask there periodically. I love sharing good news. Okay, before I let you go, just a reminder, join me on Wednesday, every Wednesday on Facebook Live. I do a very quick five to six minute newscast give you the headlines in diabetes of the last week all types of diabetes, not just type one. And then I turn that around. We make it a podcast episode on Fridays. But if you want to watch that Facebook Live, then it's on YouTube. And I you know I put it all out on social this week. If you're listening as this episode goes live on August 10, the Facebook Live is going to be earlier. I'm still actually making my schedule because Wednesday just is some kind of bananas day. And I have to do the newscast earlier. So watch the Facebook space. It'll probably be three o'clock in the afternoon 330 something like that. It's usually 430 and I am getting a great response. So I'm so glad you all seem to enjoy it. Thank you very much. If you have news tips, send them my way too. And that's it. Thank you so much to my editor John Bukenas from audio editing solutions. Thank you so much for listening. I'm Stacey Simms. I'll see you back here in just a couple of days until then, be kind to yourself.   Benny  43:11 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged

Anticipation just keeps growing for the new Omnipod system, still waiting for FDA approval. This week, we talk to Dr. Trang Ly, Senior Vice President & Medical Director at Insulet Corporation. We'll get an in-depth run through of the features of Omnipod 5 with Horizon, what makes it different from the other hybrid closed loops already on the market, and many other questions you all had. Our previous interview with Insulet CEO Shacey Petrovic  This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode Transcription Below Stacey Simms  0:00 Diabetes Connections is brought to you by Dario health manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first premixed auto injector for very low blood sugar, and by Dexcom take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:21 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:26 This week anticipation growing for the new Omnipod 5 system still waiting for FDA approval. Many of the people behind it have waited a long time to knowing the promise of closed loop systems for people with diabetes and their families.   Dr. Trang Ly  0:42 I still remember the very first time the very first patient that I put the system on and, and I was watching that insulin being delivered. And I remember just like hugging the participants, Mom, because we just both knew how incredible this was going to be if, if this could reach masses of people.   Stacey Simms  1:04 That's Dr. Trang Ly, Senior Vice President and medical director at insulin Corporation, we'll get an in depth run through of the features of Omnipod 5 with horizon. What makes it different from the other hybrid closed loops already on the market and many other questions you all sent in. 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. You know I'm always so glad to have you here. We aim to educate and inspire about diabetes with a focus on people who use insulin. As you listen to this particular episode couple of things to keep in mind, Omnipod 5 with Horizon the full name of the system we are talking about today is not out yet it is not commercially available as of this taping. This episode is live on August 3 2021. The FDA is still mulling it over. If you are looking for even more information and some of the history of this, it may be worth going back to our first episode about this system that was almost exactly two years ago with the company CEO Shacey Petrovic. And I will link that interview up in the show notes at Diabetes connections.com COVID, really through this submission for a loop with the delays. And I didn't mean upon there with the word loop. But I know there has been frustration in the community. And there's frustration with an Insulet as well. But it really is close. Now, if you are not familiar and I know we have a lot of new listeners who've joined the show more recently. I know some of you have been hearing about this for years. But bear with me for just a moment as I explain it very quickly. You've got your Omnipod pod. That's the thing that holds and infuses the insulin, it's an all in one. It sits on the body, there's no buttons, there's no display, there's nothing to read, you've got your separate handheld controller, the thing with the display on it and the buttons are the touchscreen of how you actually control the pod when it comes to giving insulin for meals or for correction doses, that sort of thing. And for Omnipod five with horizon, you also have the Dexcom G6, the continuous glucose monitor, the pod and the CGM work together to give less or give more insulin to try to keep you in range. Now that is very, very simple. But Dr. Ly will explain it in much better detail. And I will also link up more information as always in the show notes. If you haven't ever seen what this looks like if you're curious, we'll link you up to all of the information. Dr. Trang Ly, my guest is the Senior Vice President and medical director at Insulet. Corporation, she leads their Omnipod five automated insulin delivery system clinical program before her time at Insulet. Dr. Ly was a pediatric endocrinologist in Australia. And toward the end of the interview, we talk about how personally knowing families that will benefit from this system and systems like it, you know what that is like for her. So my interview with Dr. Ly in just a moment, but first Diabetes Connections is brought to you buy Daario health and over the years, I finally managed diabetes better when we're thinking less about all the stuff of diabetes tasks, and that's why I love partnering with people who take the load off on things like ordering supplies, so I can really focus on Benny, the Dario diabetes success plan is all about you all the strips and lancets you need delivered to your door, one on one coaching so you can meet your milestones, weekly insights into your trends with suggestions on how to succeed get the diabetes management plan that works with you and for you, Dario is published Studies demonstrate high impact clinical results, find out more go to my dario.com forward slash diabetes dash connections. Dr. Ly, thank you so much for spending some time with me. My listeners are very excited to get all the information that they can about this. So thanks for being with me today.   Dr. Trang Ly  4:58 Yeah, great to be program. Thanks, Stacey   Stacey Simms  5:01 you got it. Let's start with an overview. I know that most people listening are probably very familiar with what we think Omnipod 5 with horizon will be. But can you start by just giving us an update and taking us through what is in front of the FDA for approval as you and I are speaking today?   Dr. Trang Ly  5:17 Yeah, so happy to do so the Omnipod five system that you're referring to is Omnipod, or Insulet, first automated insulin delivery system. So this system, he has previously known as horizon or the Omnipod, five algorithm on the pod itself. And it talks directly with the ICGM, which is the Dexcom G6 sensor, and also has a separate controller device as well to be able to remotely deliver boluses and stop and start automated mode, the system that some kind of FDA just requires you to wear a pod and a CGM to stay in automated delivery, because the algorithm is on the pod itself. And I think that is the key feature of the Omnipod five system,   Stacey Simms  6:14 a lot to break down there. And we'll get to each of the components. But let's start there with the kind of the brains of the operation being on the pod. What does that mean, in a practical sense when someone is wearing the system that they don't have to worry about it stopping that sort of thing?   Dr. Trang Ly  6:27 Yeah. So the The key difference between previous products is that with our current Omnipod dash and earlier versions of Omnipod, the pod delivers the basil programs and the bolus delivery that the user has initiated. And so insulin is not under automated delivery. But in our future system with Omnipod. Five watch the pod does is that takes the CGM value which you wear on body and so that value directly communicate with the pod itself. And then the system and the algorithm on the pod takes that CGM value and determines how much insulin you need every five minutes. If you're running high, and you need a little bit more influence, the pod will automatically increase insulin delivery. And if you're at your target or dropping low, it will augment insulin delivery, so it might suspend or it might reduce the insulin that you need. That is the key difference between the product that is available today. And the future with Omnipod. Five,   Stacey Simms  7:38 you would still use the PDM or the phone and we'll get to that to give yourself a meal bolus or a correction bolus.   Dr. Trang Ly  7:47 That's right. For those instances where you're about to have a meal. Or if you're running high for whatever reason, like you underestimated carbs earlier, and you want to give a manual bolus, you can do that any time. And you would do that by using the controller device or PDM, to enter in your carbs, and use our bolus calculator to deliver that insulin. So all of those features are very similar to the current production on the pod dash, which again, is very similar to our earlier version. So that's on the pod.   Stacey Simms  8:24 Let's talk about the algorithm a little bit. I know there's a lot that's proprietary here. But I'm curious, we've seen over the last couple of years, Medtronic come out with a you know, an automated device. Tandem has control IQ, I believe my listeners are pretty familiar with the workings of those, what would be the biggest differences between how those systems work and how Omnipod 5 with horizon will work.   Dr. Trang Ly  8:49 I'm very familiar with those algorithms. Because I, you know, in my previous life, I worked very quickly with those systems as they were being developed. And so I say, you know, having been in this role for the last five years and been running the clinical trials. For them, I can tell you that the main difference I'd say would be that our algorithm, you can set the target glucose for whatever time of day. And the range we have is between 110 to 150, in 10 milligram per deciliter increments. And you might have a family where you want to go overnight, you want to run out and 20 because you feel more comfortable at 120 overnight, and then but during the day you want to run at 110 you can set up a profile so that the algorithm augments insulin delivery to your preferred target glucose level. And, you know, we we knew when we were coming to market that we were not going we certainly weren't the first and not the second product market. So we knew that we had to deliver a level of personalization for our users. So we really listened to what people wanted. And people do want that level of personalization and customization. And so we implemented that design feature into our clinical trial to demonstrate that our system performs very safely across those different target glucose level. Until our clinical studies which show we'll get into Dude, what was tested across a very wide range of patients, for initially, we did a beam study, which was for patients aged six to 70 years of age. And then most recently, just a couple weeks ago, we were reported on our preschool age participants who were between two to six years of age, and they see I'm sure you'll appreciate that they're young. glucose control is just very variable, very unpredictable. And, you know, I think strength of our algorithm is that it works very well, even if you, you know, Miss or skip a bolus, occasionally, you know, that algorithm is going to kick in, it's going to deliver, you know, a decent amount of insulin to get you back in range, it's going to happen immediately, but it's calling to do its best to keep you in the range as much as possible. And similar, I'd say to the other systems, especially, I'd say more second generation systems is that we are getting, you know, excellent timing range, especially in the overnight period.   Stacey Simms  11:32 It was I laughed a little when you said preschool, as you know, My son was diagnosed before he was two. And whenever I see studies with little kids that work so well, it's so exciting, because you know, that age group, they can't even tell you when they're feeling weird. They can't stomach my son couldn't even pronounce the word diabetes. So it's a different age group altogether. So I was thrilled to see those results.   Dr. Trang Ly  11:53 I know, well, I have two kids under five right now, and they don't have diabetes. And I have no idea how much they're going to ace or whether or not you know how much activity they're going to do. And I just can't even fathom how challenging it would be to have a child with diabetes. And are they low? Or are they or as I just grumpy? asleep,   Stacey Simms  12:18 I didn't have enough. Oh, my goodness, I should have said this towards the beginning. And I know, I know Dr. Like that, you know, this, we use control IQ. We're very happy with the Tandem, but we're not rooting for any system here. I think that the and I say we I mean me, I it's so exciting to see all of these systems beginning to come to market beginning to really have an impact to have differences in their algorithms so that people can pick and choose exactly what they want. And we're just at the beginning of it. So I am so excited to see the study's going so well, I have a couple of questions about what you've already mentioned, on that target of 110 to 150, just to be crystal clear about it, you're talking about not just putting the pump into say using Tandem, for example, exercise mode or sleep mode, you're seeing in you know, my weekday profile, for example, I know my son plays basketball every day from three to seven so we're going to create a profile that changes his blood glucose target for that period of time, perhaps starting you know, before he plays a little bit and then extending after and that's an actual profile in the pump that you then could change. Okay, perfect. All right, that's really interesting. Is there an Is there a and I hate to use Tandem is word sorry, is there an exercise mode or a sleep mode? Or is it just the user sets it as they want?   Right back to Dr. Ly answering that question. But first Diabetes Connections is brought to you by tchibo hypo pin and you know, low blood sugar feels horrible. You can get shaky and sweaty or even feel like you're gonna pass out there are a lot of symptoms and they can be different for everyone. I'm so glad we have a different option to treat very low blood sugar Jeeva hypo pen, it's the first auto injector to treat very low blood sugar chivo Kibo pen is premixed and are ready to go with no visible needle before Jeeva people needed to go through a lot of steps to get glucagon treatments ready to be used. This made emergency situations even more challenging and stressful. This is so much better. I'm grateful we have it on hand find out more go to Diabetes connections.com and click on the G book logo g book shouldn't be used in patients with pheochromocytoma or insulinoma visit Jeeva glucagon comm slash risk. Now back to Dr. Ly. Going into more detail about how the Omnipod 5with horizon system works.   Dr. Trang Ly  14:36 Separate but yes, what you describe is exactly how our product works or during the day. It might be that you want your son to run out 110 through the day but maybe between the hours of three and seven you'd run at 140 that is an option. And you can set that up pre programmed so that he doesn't have to remember to do that every day or you can run in what we call a hyper protect mode, which is work similarly to like attempt days or that you you'll be familiar with. So that's more of an ad hoc, oh, I feel like exercising for the next two hours, I'm going to set my program in hyper protect mode. And hyper protect, what the system does is it adjusts your target glucose to 150. And it actually gives you less insulin than your basal insulin. So you're running essentially with less insulin on board than you would normally would during that period. And so we we did a lot of studies to kind of land on that design. And we feel that he does a good job of preventing hyperglycemia for, for people without problems asked afterwards. So it has worked well, because it doesn't, you know, sometimes, when you're preparing for exercise, you might take a snack, and that drives your blood glucose up. And then if you have a really robust algorithm that might kick in and give you a fair amount of insulin. So that's what we were trying to avoid with our design was that not just that the setpoint is elevated, but also that the system can't give too much insulin during that time. So that's sort of our equivalent exercise mode. We don't have anything called sleep mode. But as I said, our set point of 110, you know, once were created will be the lowest available in the United States.   Stacey Simms  16:30 One of the things I've learned recently, and I I feel like I haven't seen this reported very widely, is that, unlike Tandem control IQ, the Omnipod system, the Omnipod, five with horizon, learns the user it changes, it has a little bit of I guess I call it artificial intelligence. Is that correct? And can you walk me through what I'm saying? What I mean by that? Yeah.   Dr. Trang Ly  16:56 Yes, yeah, I think I think you're I'm getting to a really key difference between our, our system and others. So with, with our system, when we, when we were developing it, we wanted to reduce the work that comes with diabetes, as well. And so you know, a lot of the work that comes with that is adjusting those or rate adjusting, you know, all the settings and things like that. And so our system, initially, when you, when you have it out of the box, it does rely on your basal rate to start off, automated insulin delivery. But over time, the system learns through the turtle Gary informed that is delivered by the system. So the system knows about this, and can rely on this information, because it's reliable come through the system to augment insulin delivery. So you might have a small child who only has 10 units of insulin per day. Now system is not going to give too much insulin, based upon the fact that it knows that in the last few days, it's never given more than 10 units a day. And so the safety constraints are personalized for that user. And on the opposite end of the spectrum, know, we have users that use 100 units a day. And in that case, the algorithm knows that it can give a lot more insulin, and this person will tolerate it quite fine. Because you know, when you have insulin is unlikely to make much difference for this person who takes 100 units a day. And so as it accrues that information over time, the algorithm does adapt the ability to know how much insulin it delivers based on that information. So what it means is that, in order to get the results we got, you know, you're not having to tweak basil rates on an hourly basis. Sometimes I've seen, you know, people have different basil rates every hour. And what we're really striving to do here at Insulet is create products that reduce burden for people. And that includes including, you know, optimizing settings, so that people can get, you know, so that everybody can get good glucose control and, and not have to rely on perhaps educators and clinicians at the academic centers who are familiar with these devices to really get those good results.   Stacey Simms  19:38 So I'm just trying to understand the the automatic adjustment that you're talking about there based on the total daily insulin. So if after a few weeks of using Omnipod five with Horizon, a person should expect to not adjust basil rates should like what should they be seeing because if like let's say as someone has six different basil, right When they start on the system, what what's happening? Right? What's going on? Are they Is it like the other systems where it's adjusting every five minutes, it's giving you boluses. If needed you How is the smartness of the of the pump working there?   Dr. Trang Ly  20:12 Yes, if you had six different rates running for 24 hours, initially, the algorithm would take that information and would have bent in front of every every five minutes based upon the inputs that were provided to the system, as well as how your CGM is tracking how much insulin on board, you have all of those things. So at all times, the system makes a influence decision every five minutes. So that occurs, as soon as you put the system into automated mode. That happens all the time. And when people ask me about order corrections, I say, yes, this system automates and make some adjustments every five minutes to drive you towards your target glucose. So corrections are incorporated within the system, we don't consider any difference between basil modulation and what was modulation of insulin is insulin. So every five minutes, you're getting a essentially order correction if you need it. But that works very similarly to, you know, the systems that are currently on the market. And over time, the those six basil programs that you have really not utilized in the system at all beyond that first part. And so if you are running high for whatever reason, and you know, you you tweak other things, but not your basal rate. And so I'd say in in that way, you know, our system is more similar to the Medtronic system. And in that way that the basil rates do not directly inform automated insulin delivery. But things that are still under your control at all times is influence coverage, share your correction factor, target glucose, correct above all those settings that have always been within on the pod, and also very similar across many bolus calculators all stay the same. So you're always going to be sort of always going to be directly in control of all those fat. And so if you're running high, it might might be that you need more corrections over time before your system adjusts to that higher insulin requirement. But   Stacey Simms  22:34 you're in control, oh, wait, target number, but only only down to 110? That's right. Gosh, I have so many questions with the automated systems. I think you mentioned this, but I'm not sure. What about insulin duration, is that something that the user can change? Or is that something that is set,   Dr. Trang Ly  22:50 so there, so the Dow system, the user can change that, and how it manifests itself is that it will inform the duration of insulin action for all those manual boluses that you deliver. So if you're someone who's very sensitive to insulin, and it hangs around for a really long time in your body, and you have a six hour early insulin action, then you can program that until you know your bolus of insulin that you deliver at 6am in the morning, that's going to take till midday before it disappears from the system, as it knows that all of those will still be accounted in the same way with the duration of insulin action that you provide to the system. In terms of the automated insulin delivery, we have the intellects, proprietary duration of insulin delivery, that is the input to the insulin model from which we deliver that insulin that is consistent, and is just one value. And it's the same value and the algorithm that's been tested across the board from in all of our clinical trials. So that does not change, and is within the algorithm that dictates that five minutes away insulin delivery.   Stacey Simms  24:11 To me, that was one of the big surprises of using an automated system. We have, you know, My son is 16. And we started using an automated system when he was what 14. So you're in the middle of those fabulous teenage years, and he's using tons and tons of insulin. And it seemed to me that we needed an insulin duration of like two to three hours. And when they switched it on Tandem. It's it's five, I really fought on that thinking this is going to be a disaster, and it was fine. It worked really well. So it's one of those interesting things once you get an automated system and realize this is my opinion, once you realize how much work you were doing to try to stay in range. It's kind of nice to let that system take over once you trust it. And I would assume that that's what you found in these studies. I mean, you mentioned that people spent more time in range, but let me give you the floor. Take a minute or two to talk about. I've seen the study You know, you've been kind of putting them out with different age groups over the last couple of weeks and months, take a moment to brag about the studies.   Dr. Trang Ly  25:08 Yeah, we're so grateful to the diabetes community who really gave this product life through our clinical studies. So I'm just deeply grateful for every patient and family who took part in it. Because without them, you know, be a product, but it wouldn't be Omnipod. Five. And so it was really a ton of work that we I feel like has been many years in the making. Yeah, we've worked really hard on this algorithm to get it pretty much as good as it could be. And, you know, back in 2019, as we were preparing to do these clinical studies, I really wasn't sure about how our results would stack up. But I have to say that I'm completely blown away by how well our algorithm has performed. So in the talk first about our six to 70 year old age group. So the first lot of results that came out came out in March of this year, we had essentially two groups. So we had the children, which were six to 14 years of age, and then the 14 to 17 years of age, which is the adolescent and adult group. So I was just covered the adult group there. So we saw and time in range improvement to 74% in the adult Group, a once the reduction down to 6.8%. And then very minimal hyperglycemia. If you look at our hypo compared to other published data out there, it's the lowest hypo, which we measured by time under 70, compared to all the other groups. And in terms of the children, there's six to 13.9 years of age group, we got to a timing range of 68%. And this was equivalent to 3.7 hours per day improvement. So really remarkable improvement in timing range. And in terms of a one see improvement, we got that down from 7.7%, down to 6.99%. So really remarkable reduction in a one C. And what's super, super exciting is that just recently at Ada to see or wishes a couple of weeks ago, we showed that in the extension faces after the main three month pivotal study, everyone could continue using it if they chose to. And we saw a further reduction in a one C, which is just incredible. So in both the adults and children, we saw a continued decline in a one C. So just really super exciting to see that, you know, our product continues to be helpful for these patients with diabetes.   Stacey Simms  28:05 Let's talk a little bit about the the setup of the system. You know, when in the very beginning of the interview, I asked you to kind of describe it. And it's Omnipod Dexcom, G6, and then a controller of some kind. Let's talk about the controller. Last I had heard this was going to be the PDM. If needed, the more traditional I guess you'd call it but you'll expLyn it to me or an Android phone. Tell me about the controller in the short term. And then we can talk about what you're planning.   Dr. Trang Ly  28:32 Yeah, that's right. So we will have the controller device. So we have an Insulet provided controller, which our were choosing to use that word over PDM. Because not everyone knows what a PDM is that yes, that controller device, we will always ship with our product. And so you will be able to use that in a locked down device which can only communicate with pods and can't really do much else with it. And but users will have the option to download an app from their from selected android phone to also have that same experience. So it's the exact same app that would be that would exist on the controller. And you would be able to essentially control your parts and replace that controller with the Android app.   Stacey Simms  29:25 I should have said the PDM stands for what personal diabetes manager. That's right. Okay. So that's an antiquated term now, though, so we'll put that aside. But to be clear, so if I have the right Android phone, you're seeing this is not a lockdown Android phone, I can get this the app and I can use my personal phone to control my Omnipod five with horizon system.   Dr. Trang Ly  29:47 Yes, that's right. That's what's currently in front of FDA right now.   Stacey Simms  29:51 Do you know and again, if it's up to them, or you can say I know we're limited sometimes what models or is there a list somewhere?   Dr. Trang Ly  29:57 Yeah, we haven't. I don't think We have indicators or phone models that will be available at any time. But we'll do that soon after launch will list those out that they will be as the first offering selected Android phones.   Stacey Simms  30:14 And I would assume the plan is to eventually go to all types of phones, including apple. That's right. My question for Omnipod is always what I'm about to ask you. But phone control makes it a little bit obsolete. And that is why no button on the pod why not even like a one dose one unit or something on the pod?   Dr. Trang Ly  30:34 I've been asking this, since I've had the podcast. Yeah, I think he just originated with the original design. And I think perhaps, because it really started originally with the idea of children using our device, and having that separate controller to track all the information. I think just at that time, because it was primarily a product for children, we wanted to make sure that infant delivery was always, you know, very intentional, and not unintentional. And so would always to have that remote control potential and and not have any, you know, button on the pod, which could lead to accidental or insulin deliveries, unintended,   Stacey Simms  31:21 or just a couple of laundry list type questions. Dexcom has already announced that they're going to seek FDA approval for the g7. Soon, I would assume that Omnipod will eventually, you know, work with the g7, which should users should be concerned at all about that kind of compatibility?   Dr. Trang Ly  31:38 Yeah, I think eventually, you can expect that, you know, systems that are integrated with G6 Today, we'll be working towards g seven in future. You know, I think the whole idea of interoperability reach was beheaded by the FDA really enables companies to work faster to integrate with future versions of systems. So you know, we we want to be at the leading edge of that innovation. And I think that will come with time. We I don't think we've announced any times or dates regarding that. But it is something that, you know, we fully intend to support.   Stacey Simms  32:17 And this may be another business type question. But everyone who's using Omnipod right now, what's the plan for current customers? We're getting ahead of ourselves, I know the system's not approved. But can people using arrow so dash expect to kind of be seamlessly switched over to Omnipod? Five with horizon?   Dr. Trang Ly  32:35 Yeah, I don't think we have released all the information regarding how we're going to transition our current customers. Yes, I don't think that that is publicly available yet. But we, you know, one thing we do strongly believe in is supporting our current customers. And what we have said is that Omnipod five will be available via the pharmacy channel at price parity kadesh. And so what that means that if you are already receiving cash today that you're going to be in a very good position to have coverage for Omnipod. fi. And but we haven't detailed the information regarding you know, how we're specifically transitioning every single patient at this, at this point,   Stacey Simms  33:25 separately from the pod. tide pool loop is also in front of the FDA, as you and I are speaking, I'm not even quite sure really what to ask you about this doctor, like because I know it's coming from tide pool. But can you share anything about the relationship from Omnipod to Tandem? And how the loop project is going? It's kind of a it's a different animal kind of out there. But I don't want to leave without asking you about it.   Dr. Trang Ly  33:51 Yeah, you just said Omnipod to Tandem, but I'm   Stacey Simms  33:54 so sorry. Yes.   Dr. Trang Ly  33:58 Yes, yeah. Well, that is title program. So it's best that you speak to Howard about that. But it is a program that we support. And and we certainly, you know, believe in interoperability and supporting points for our users. And yes, you're right. I believe the last update is that it is currently under review with FDA wouldn't use the dash parts, or does it use it with Omnipod? Five. So it's, it's not it's not going to be backwards compatible with dash pod   Stacey Simms  34:35 guidance. My next question was, so if Omnipod five with horizon is approved, Omnipod is manufacturing the same pods for both systems. That's right. I know you know, I'm not sure we're supposed to talk about it. But I know you know, because you've spoken to the loopers groups and you speak to people all the time that there's a bunch of people using the older pods, the arrows, pods, I believe for a nod FDA approved system, they're looping with the separate from title loop, they're looping with those pods is only going to keep making those pods once this new system is approved,   Dr. Trang Ly  35:10 we haven't said exactly when we will stop making those pods. But I think the community should expect which and I know that they already do that at some point in time in the near future, we would need to stop making those pods. And that's for a variety of reasons. But as you will know, Stacy, and many of your audience will know, you know, that is much older technology. And you know, we prioritize innovation that is going to work well and be safe for our users. You know, that's partly why we moved to dash to integrate Bluetooth technology. And then which has enabled us with Omnipod, five to talk via Bluetooth to CGM. So that type of safe integration is really important to us in our future offerings of product. And so at some point in time, that will, we will need to start making that and also, you know, that is with all the technology, all the components, and etc. So, once that happens, though, we will let the community know with sufficient time so that people can prepare for alternative methods of therapy. And hopefully that will be Omnipod. Five,   Stacey Simms  36:25 you've been so generous with your time, I just have a couple of more questions. I really appreciate it. One of the questions that was asked in the podcast Facebook group was when approved, how will the training for this go? In other words, with control IQ, I sat down, I took a course I took a quiz. And once I passed it, my doctor had written a prescription. And we got the downloadable, you know, into the pump. And we were off and running did not meet with a diabetes educator or an endocrinologist to learn how to use control IQ. What will the system be for teaching people and getting Omnipod? Five to them?   Dr. Trang Ly  36:58 Yeah, so for people who are already using Omnipod dash, you can expect that the experience will be similar to what you just described for control IQ. So you will not have to meet someone in person in order for you to start that system up. So it will be similar in a training quiz, number of steps. But you can do it all self directed and be often running on Omnipod. Five, or you can choose to speak to someone or meet in person with an educator if you wanted more information about for instance, how the algorithm works or whatever question you had on your mind. But for brand new users who've never used a pump before, then it will there will always be in person training, or virtual training. You know, there's some things that you we still feel that is necessary to cover, you know, basics of pump therapy that will require meeting with their certified trainer to go through. But yes, we're current on the Pog dashes as you can expect the transition to be fairly seamless.   Stacey Simms  38:08 Another question that came up was about insurance coverage, but particularly Medicare. Can you speak to that? Yeah. So   Dr. Trang Ly  38:15 currently, we have Medicare coverage under Part D, which allows for pharmacy coverage of the pod. So we do have that. And they only came in recently in the last I'd say three years or so. So once that came through CMS, we worked with many plans to get Omnipod covered under that peptides for Medicare. So one of the things that, you know, we're working on well, FDA clearances, is still under review, we are working on making sure that we get as many people covered as possible. When Lord, they come. So yeah, it's a major priority for us to make sure that our patients get covered for this product.   Stacey Simms  39:06 You referred back a couple times to your days as a pediatric endocrinologist. How exciting is this for you? You know, the people that use this product, you know, the people that use other automated pumps. Can you speak a little bit just from your personal side about the excitement because you know, this is going to help people?   Dr. Trang Ly  39:25 Yeah, it's just incredibly exciting. And maybe not everyone knows about this. But yes, Stacy, as you mentioned, I am a pediatric endocrinologist. And it's actually about 10 years ago now, but I did my very first study in automated insulin delivery and that was back in Perth in Western Australia. And in that study, we use a Medtronic pump add to Medtronic sensors and a blackberry phone and the algorithm was on a blackberry phone and it was I haven't mentioned this to many people. But those those sensors were, you know, were challenging at times to deliver insulin from. But it was such important studies, in terms of proof of concept to show that, you know, we could augment insulin delivery and, and making that decision every five minutes gets you in better glucose control. And it was really extraordinary. And I still remember the very first time, the very first patient that I put the system on, and, you know, and I was watching that insulin being delivered. And I remember just like hugging the participants, Mom, because, you know, we just both knew how incredible this was going to be if, if this could reach masses of people, it's always been for me, something that will be realized. And, you know, it has been through really great products like control IQ. And you know, soon Omnipod five will be out with a great algorithm. And because we just know that this type of technology is what is going to allow parents to sleep at night and let people be comfortable with their diabetes and be more confident about it so that they can focus their brains on other life decisions and not be so consumed by their diabetes. And so it is really incredible for me to be able to see the results of our algorithm just works so well in such a huge population of patients, even in just in clinical trials today. And I just know that there's going to be incredible impact from this product in future when we launched.   Stacey Simms  41:47 Well, thank you so much for coming on and sharing so much information. We're all excited to see what happens next. And I hope that you are you know, other folks or Insulet will come on and share more information, you know, fingers crossed as the rollout happens. So thanks so much for joining me.   Dr. Trang Ly  42:02 Thank you so much. So happy to be on.   Announcer  42:09 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  42:15 Lots more information at Diabetes connections.com. I know the one question everybody asks that we cannot answer is when will this be available, it will be available when the FDA approves it. And you know, that could come any minute it could come in a few months, you know, we are not privy to that information. But once it is available, it will take a little while to roll out. So Omnipod I'm sure we'll make a lot more information available as we move forward. We'll talk to them again. And we will answer as many questions as possible. Also got a lot of questions about insurers, that's going to depend as well, quite often, insurers will not initially cover new products. I know Omnipod is talking with everybody. But it may take a little bit of time. So we'll circle back on all of that it is difficult to pick and choose the listener questions that I asked but I really try to focus on what I know the person that I'm talking to can answer and I thought Dr. Ly was was really fabulous and spoke to me frankly, for longer than I expected. So I really appreciate her sharing so much information with us. And I hope you found that helpful. All right. Diabetes Connections is brought to you by Dexcom. And I do want to talk for a moment about control IQ. You heard me mention that several times during the interview. That is the Dexcom G6 Tandem pump software integration. When it comes to Benny's numbers, you know, I hardly expect perfection I want I'm happy I'm healthy. I have to say control IQ has exceeded my expectations, Vinny is able to do less checking and bolusing and is spending more time in range. His last couple of Awan C's were his lowest ever and 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 really so grateful for this. Of course individual results may vary. To learn more, go to Diabetes connections.com and click on the Dexcom logo. Before I let you go, we're actually traveling this week. So the interview with Benny about Israel is coming up and thank you so much for all of the questions that you have sent in. There was a Facebook group posted Diabetes Connections of the group. If you want to chime in and ask me some questions to ask my son who recently got home from one month overseas. He is 16 and he was with a camp group but it was not a diabetes camp. He's home safe and I've done some debriefing with him. It was really interesting. And Gosh, teenage boys. So interesting. I can't wait to share some of his stuff with you. And some things I'm not sure I will share. No I mean we're pretty much an open book but he right he doesn't really handle diabetes exactly the same as I would but home safe and sound and really did very, very well. reminder that on Wednesdays I do in the news live On Facebook on Diabetes Connections, the Facebook page, and that becomes a podcast episode on Fridays I, as I said, I'm traveling, so hopefully technically all will go well, we shall see. But that in the news episode has become a lot of fun, frankly, and people really enjoy that still short, so I'll put that out as well. And then in the weeks to come, I have some great interviews for you. We have interviews about sports and being very active. I have an interview with the folks that have Afrezza that I'm really excited to bring to you. It's been a while since we spoke to them. And of course, that interview with Benny, so lots to come. thank you as always to my editor John Bukenas from audio editing solutions. I thank you so much for listening. I'm Stacey Simms. I'll see you back here in just a couple of days until then, be kind to yourself.   Benny  45:46 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged

It's time to give patients a chance to do something different to gain control of their disease. Michael Castagna is the CEO of MannKind, the company on the - “cutting edge of helping transform the care of diabetes where people can really get real-time control.” Michael is an entrepreneurial executive with more than 20 years of experience in the strategic development in Fortune 500 companies as well as privately held biotech start-ups. His innovation is driven by a mission to develop the products and therapies that can help people take control of their health and experience the best of what life has to offer. Let's dive right into this episode where you'll learn how Afrezza hit the market, how it's changing the speed of the ‘in and out' of insulin, how it all works, and how it may just be the future of insulin. [00:01 - 05:36] Opening Segment I introduce Michael Castagna Michael shares his background and story Journey and success in the pharmaceutical world  The approval of Afrezza  [05:37 - 13:53] The Fastest Acting Insulin on the Market Michael shares the touch and go process of Afrezza  Mistake made along the way Investing his own money  Getting back on track Explaining the inner workings of Afrezza  Human insulin  Fast acting  How it gets out of the body Following the pediatrics  Green light to phase 3 [13:54 - 25:16] Impacting Mankind with MannKind Partnerships with doctors The ones who understand take it on board  Michael talks about the transition process of MannKind Royalties  Pipeline  Technology  Current numbers Michael looks out to the next 5 years of MannKind and Afrezza Thoughts on acquisitions  Organic growth and shareholder value  Afrezza as a global product  Launching the next drugs [25:17 - 29:02] Closing Segment The future of Insulin Michaels final message to listeners  You have nothing to lose  Try a new tool and get to know it Think about your patients  Final Words  Tweetable Quotes: “I liked running into the fires and fixing things…” - Michael Castagna “It works fast, it works completely different from injectable insulin… It's in and out of the body quickly.” - Michael Castagna “Why not try a whole new tool…? We're going to be here for the next 20 years. Your patients want to try this. Give them a chance to do something different to gain control of their disease.” - Michael Castagna Resources Mentioned:  https://afrezza.com/ (Afrezza) Connect with Michael on https://twitter.com/mannkindcorp/status/983794225039880192?lang=en (Twitter), https://www.linkedin.com/in/michael-castagna-a15770/ (LinkedIn), and https://www.facebook.com/MannKindCorp/posts/michael-castagna-ceo-of-mannkind-believes-were-on-the-cutting-edge-of-helping-tr/10156426077168629/ (Facebook). Go check out https://mannkindcorp.com/ (https://mannkindcorp.com/) a learn more about how they are making life more human! To know more, you can connect with me, David Kliff onhttps://www.linkedin.com/in/ephraim-glick-8403a465/ ( )https://www.facebook.com/DiabeticInvestor/ (Facebook), https://twitter.com/diabetic_invstr?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor (Twitter), and https://www.linkedin.com/in/david-kliff-78b669b/ (LinkedIn), or email me at dkliff@diabeticinvestor.com. Be sure to visit https://diabeticinvestor.com (https://diabeticinvestor.com) for more insights and real-time analyses on the evolving business of diabetes. Don't be shy, I'd love to hear from you! You can also reach me at 224-715-3761. NOTE*: We are in no way a replacement for real medical professionals. All information in this podcast is obtained through reliable sources. Please be aware of our https://diabeticinvestor.com/investment-newsletter-disclaimer/ (Disclaimer). LEAVE, SUBSCRIBE, REVIEW + help someone who wants to learn more about the wacky world of...

Are you a newly diagnosed Type 1 Diabetic? Are you the mom or caregiver of a newly diagnosed Type 1 diabetic child? Are you starting over with your T1D management? Then you are in the right place! This is episode FOUR in a 10 week series for the newly diagnosed.The fourth episode in the Newly Diagnosed Series is all about DKA or Diabetic Keto Acidosis. Rachel and I discuss what it is, the signs and symptoms, who's at risk and more. We also take two little side tangents to discuss inhalable insulin, Afrezza, and the Eversense Continuous Glucose Monitor. Check out the links below to learn more about these two awesome T1D tools. Joining me again and for the entire 10 week series is Registered Nurse and Certified Diabetes Care and Education Specialist (CDCES), Rachel Halverson. Rachel is also a T1D herself and has been living with Type 1 for 23 years now.  What's more, she has her very own online coaching business called Give Me Some Sugar where she primarily helps women manage their diabetes. In other words, she a super-human, hard-working lady! Please see below so you can know where to find Rachel and get in contact with her if you'd like!A diagnosis of Type 1 Diabetes is overwhelming to say the very least. The beginning of the journey with T1D is hard, emotional, scary and HEAVY. That's why I wanted to complete this series to help encourage and equip those families who are now facing this new life with T1D. Enjoy!WHERE YOU CAN FIND RACHEL HALVERSON:Instagram: @givemesomesugardiabetesHer website: https://www.givemesomesugar.coach/Her email: rachel@givemesomesugar.coachHer Facebook Page: https://www.facebook.com/gmsscoachArticle on Afrezza, the Inhalable Insulin: https://diatribe.org/switching-afrezza-inhaled-insulin-tips-diabetes-educator Link to Eversense CGM page: https://www.ascensiadiabetes.com/eversense/get-started-today/?utm_source=google&utm_medium=cpc&utm_campaign=eversensecgm&gclid=Cj0KCQjw8vqGBhC_ARIsADMSd1BqvcF1mrOAk7yLMv2AB6IPercvE5sHBNTY4hm3OQmdmBQfTvTNMi8aAoEmEALw_wcBSupport the show (https://www.buymeacoffee.com/sugarmama)

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

It's "In the News..." the only LIVE diabetes newscast! Top stories this week: Maine passes insulin safety net program MS Attorney General vs Insulin Companies Afrezza covered by Medicare D-Data Exchange news Looking ahead to ADA2021 Join Stacey live each Wednesday at 4:30pm EDT at 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 Stacey Simms and each week I'll share the top diabetes stories and headlines of the past seven days.  We do this live on Facebook so whether you're joining me right now 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. As always, I'm going to link up my sources in the Facebook comments and in the show notes at d-c dot com 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 first off.. want to give you a heads up that ADA Scientific Sessions is kicking off this weekend, so expect to hear studies from just about everyone in the space. I've got interviews lined up for the main show. There are usually some breakthroughs and – while you can't really count on it – some FDA approvals seem to come out this time of year as well. Stay tuned and follow the hashtag #2021ADA . XX Legislation news.. the Governor of Maine last night signed a new law creating an insulin safety net program in that state. It allows eligible Mainers to go to a pharmacy to get a 30 day emergency supply of insulin caped at $35. It's modeled after a Minnesota law that was passed last year, the “Alec Smith Insulin Affordability Act.” Exactly what eligible means in this case it tough to find.. although it looks like everyone with type 1 who has less than a seven day supply – and - with some exceptions, can be used once every 12 months. https://www.wmtw.com/article/democrats-propose-bill-that-would-create-insulin-safety-net-program-cap-price-for-one-monthly-supply-at-dollar35/36512006 XX Mississippi's Attorney General Lynn Fitch has filed a lawsuit against drug manufacturers and pharmacy benefit managers she says are working together to manipulate and inflate insulin prices. She says, quote, “ As the mother of a diabetic, I know the emotional, physical, and financial toll the unconscionable price of insulin has on families,” These companies are exploiting the vulnerable. I'm fighting back because you should never have to decide between paying the ever-increasing price of insulin or compromising your care.” The complaint alleges violations of the Mississippi Consumer Protection Act for unfair and deceptive practices as well as unjust enrichment and civil conspiracy. https://khn.org/morning-breakout/mississippi-attorney-general-alleges-insulin-price-fixing-sues-makers/ XX Starting next year, Afrezza inhaled insulin will be covered by Medicare.  It will offer all doses under the 2022 Medicare Part D Senior Savings Model.. capping the co-pay per 30-day supply at 35-dollars. Afrezza is the only inhaled ultra rapid acting mealtime insulin in the US. MannKind – the company that makes it – has other assistance programs. But this is the first time it's covered by Medicare https://www.globenewswire.com/en/news-release/2021/03/15/2192789/29517/en/MannKind-to-Participate-in-2022-Medicare-Part-D-Senior-Savings-Model-to-Make-Insulin-More-Affordable-for-Seniors.html XX Some updates on the The American Diabetes Association's Standards of Medical Care in Diabetes. These include more information on heart and kidney disease in type 2 and the studies we've been talking about for a while about teplizumab. Those show THAT medication can delay onset of type 1 in high risk relatives of people with T1D. https://www.medscape.com/viewarticle/953438 XX DiabetesMine hosted it's D-Data ExChange – a biannual gathering of leaders in diabetes technology and innovation. Organizers say the focus was on increasing access, expanding the market for tools like CGM to non-insulin users and consumers which has been a hot topic lately, and  building out education and support. Couple of interesting presentations.. including Waveform – a new 14-day-wear CGM with a rechargeable transmitter and reusable sensor insertion tool. Levels – which is a consumer CGM product not just for people with diabetes and from Nudge BG – Diabetes inventor Lane Desborough's new algorithm designed to slightly move or “nudge” basal insulin in response to CGM data. https://www.healthline.com/diabetesmine/summer-2021-diabetesmine-d-data-exchange-tackles-acces-education-and-support#Whats-on-the-June-#DData2021-program?   XX 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. 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 actually relates to diabetes! Listen to Inside the Breakthrough wherever you listen to podcasts.. Back to the news… Canada has passed an act to establish a national framework for diabetes. The idea is to improve prevention, management and research. Diabetes Canada developed Diabetes 360° in collaboration with more than 100 groups and individuals from across the country. The World Health Organization recommends every country implement a national diabetes strategy-and since 2013, Canada has been without one https://www.diabetes.ca/media-room/press-releases/legislation-for-national-diabetes-framework-in-canada-becomes-law 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 – it's a bit up on the air right now.. but I am scheduled to take part in a news conference with Nick Jonas, who famously lives with type 1. I hope to bring that to you – and we're sitting down with Dexcom's CEO next week so if you have a question you want to ask, post it for me in Diabetes Connections – The Group. Our current episode out right now is all about the PROTECT trial –hoping to slow down or even stop diabetes in the newly diagnosed. Thanks and I'll see you soon  

This month, Don Muchow became the first person to run from Disneyland in California all the way to Disney World in Florida. It's a pretty amazing story when you consider that when Don was diagnosed with type 1 back in 1972 they told him that exercise was too dangerous. He wasn't even allowed to take part in his school's gym class! Don shares how he made the turn to ultramarathons and beyond and what led him to make this incredible coast to coast journey. He had to contend with COVID delays along the way and got a terrific surprise when he arrived in Orlando. Plus.. what's next? He's already thinking about another incredible goal. Learn more about Don here In our Innovations segment, a seven day pump inset? And some of our favorites have a little fun with a donut demonstration. Stacey mentioned a new link for Dexcom and Medicare this week. Find that here.  This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode Transcription below     Stacey Simms  0:00 Diabetes Connections is brought to you by Dario Health. Manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first premixed auto injector for very low blood sugar and by Dexcom take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:22 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:27 This week Don Muchow just finished an incredible run from California's Disneyland all the way across the country to Disney World in Florida. diagnosed with type one as a child, Don wasn’t an athlete in his early 40s. He decided to try working out but then he got some bad news. His eyes were in trouble.   Don Muchow  0:47 It was like a punch in the gut to get that laser retinopathy treatment after I had made the decision to be healthy. And I made myself a promise that if I could just have a do over, I will do it over and I just kind of not looked back since then.   Stacey Simms  1:06 He’s definitely not done. He’s 59 and he has yet another big goal. I'm so excited to share his story in our innovations segment, a seven day pump inset and some of our favorites. have a little fun with a doughnut demonstration. 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. You know we aim to educate and inspire about diabetes with a focus on people who use insulin. If you are new welcome. My son was diagnosed with type one back in 2006. Right before he turned to my husband lives with type two diabetes. I don't have any type of diabetes. I spent my career in broadcasting and that is how you get the podcast. My guest this week. Oh my goodness is Don Muchow. He made national news last week when he finished a coast-to-coast run. He calls himself a type one diabetic extreme ultra runner and Iron Man boy is he ever I wanted to read you a couple of highlights from Don's website. So here's what he did before the accomplishment we're going to talk about today in 2019, who ran across Texas he holds the fastest known time record for doing that. 2018 he completed relay Iowa which is 339 miles in 2018. Sioux City to Dubuque first ever solo finisher of the longest us relay first ever T one D finisher 2017 capital to coast race 223 miles, Austin, Texas to the Gulf of Mexico first ever to Indy solo finisher, and on and on and on, I will link up Dan's website over at Diabetes connections.com and in the show notes, and do yourself a favor because that wasn't even a quarter of the list of stuff that he has accomplished. And as you heard, he was not always an athlete. His story is even more amazing. When you find out that when Don was diagnosed in 1972, he was told no exercise too dangerous with type one, not even gym class, he was not allowed to take gym class, I will let Don tell you how he overcame that type of thinking to become the incredible athlete that he is now and he has great advice for those of us who want to be more active but are not ever going to run across Texas, let alone across the country. And that is coming up in just a moment. But first Diabetes Connections is brought to you by Dario. Bottom line you need a plan of action with diabetes we have been very 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 A1C within three months and a 58% decrease in occurrences of severe hypoglycemic events, try Dario’s diabetes success plan and make a difference in your diabetes management. Go to my Dario.com forward slash Diabetes Connections for more proven results and for information about the plan. Don, thank you so much for making some time with me. I really appreciate you coming on.   Don Muchow  4:26 Thank you very much. I'm happy to be here.   Stacey Simms  4:28 How are you feeling this morning?   Don Muchow  4:29 Oh, hungry and tired. Oh   Stacey Simms  4:33 my goodness. You know, I'm not sure where to begin because there's so much to your story. But I guess let's start with my biggest question. And I always have this for people who are ultra athletes and do these incredible incredible feats. Can you tell us why you would do something like this? When did the idea enter your brain that this was a thing you wanted to do?   Don Muchow  4:55 We started thinking about the run about three years ago. And our primary objective was to get the word out to other type ones who are living with the disease. That while exercise can be justifiably scary, because low blood sugars can lead to seizures, and consciousness, even death, the long term complications from avoiding it entirely as I had done for the first 30 or so years, since my diagnosis are really pretty awful, I wouldn't compare it to the remote possibility of a trip to the ER for incredibly low blood sugar. And it's a snake in the room that you have to face. You can't ignore it, and you can't freak out about it.   Stacey Simms  5:42 You said we and our there what Tell me about your team. Before we go any further.   Don Muchow  5:47 I often tell people somewhat jokingly that I just do the running. And my wife and crew chief Leslie does everything else. That's actually pretty close to true. I started calling her mission control. Once we got started, we got closer to the Space Coast.   Stacey Simms  6:01 That's great with a run like this. And well, I want to talk about, you know, other feats that you have done. And you already mentioned, you went so long without regular exercise. There's so much to this story with this run. What did you think because you started this mean, COVID really threw you for a loop, we'll get into that. But when you were starting out what was the plan,   Don Muchow  6:22 we had spent probably about a year getting the route laid out so that it was safe enough to do, we were conscious of the fact that some people might want to do that same route again. And the last thing we wanted was for someone to die trying. When we started thinking about sort of putting feet on the ground, we went out and scouted the route in the car and made sure that I was comfortable with a train and with the route that I would be running. And we still run into obstacles, but it sort of helped us get our mind around the idea of what it would be like to run across the country. Wow.   Stacey Simms  6:58 What kind of things do you look for when you're scouting it out? Is it roads? Is it towns to be able to drive on?   Don Muchow  7:05 You're right on all three of those. We wanted a route that I could run that the van could drive as well. Wouldn't be much use, especially with type one, if I ran 100 miles of trail in Arizona, and there's no way to find. So we wanted a route with wide shoulders, relatively low traffic that the van to drive most of when we were in metropolitan areas that had bike trails. That was the one exception where we just kind of let me run on the trails because they had always pop out to CBS or gas station or something like that.   Stacey Simms  7:39 And why Disney to Disney was that geographic? Are you a fan?   Don Muchow  7:43 I am a fan. My wife and I are both big fans. Disney has been credited for saying something about how If you can dream it, you can do it. And that seemed like a sort of an anthemic statement, but really the the actual route from Disney to Disney was a bit of a happy accident. We originally planned to run from basically from LA to the Space Coast. And a friend of mine said, Oh, well, so you're running from Disneyland or Disney World. And I you know, I didn't have that idea. But that is brilliant. We decided to switch it up just a little bit to do the Disney Disney piece inside the transcontinental run.   Stacey Simms  8:18 Very cool. Oh, that's great. So you started out I remember when you put your feet on the ground and got going. And at that time COVID was not really a thought. When did you realize that you were going to have to make some changes   Don Muchow  8:31 that occurred to me in I think it was about end of the second week of March of 2020. When we were making a restock stop, and big spring, Texas, and we stopped at Costco and they were out of water and out of practically everything else we needed. And we began to get Inklings that it was going to be impossible to resupply the van and we were looking at lockdowns in my hometown. And we thought about, okay, well can we make it to Dallas. And if we did, you know, there will be facing an empty refrigerator. So we decided to kind of be planful about how we were going to sort of pause things and pick it up when it got safer to do so. We had to pause on March 22 or 24th. I don't remember exactly what we picked up again on September 24. ran for about a month and had to pause again because the numbers east of Texarkana were looking bad. And then we finally resumed the last third of the run and on March 2 of 2021 and made it to the coast.   Stacey Simms  9:40 Wow. And pardon my ignorance here when you're marking an event like this or a feat like this. Is it days, hours just miles done? Are there differences in how you market and how if somebody's officially marking it   Don Muchow  9:52 mentally I'd look forward to the next big town. Whatever comes actually the next town of any sort. You Usually what that means is, you know, gas stations, lodging, that sort of thing. And when you're out there in the middle of nowhere, that takes on a special significance. In terms of documenting the run, we originally set out to document it more thoroughly when we thought that there would be records that we might bump up against. When we found out that on this particular route that no one had actually done Disney the Disney before we relaxed a little bit, but still kept marking our progress, we have a live GPS tracker that kept track of where I was, every moment, I have two GPS watches that have my workouts recorded. And we also have the recommendation of an organization called fastest known time, timestamp selfies next to unique landmarks. So in terms of marking our progress, very, very hard to cheat on a route like that if you have to be at a certain place at a certain time, and the only way you can get there is to run. So we documented our progress. using those tools. I   Stacey Simms  11:03 guess what I also meant was in terms of the time break that you had to take because of COVID do you count just the time running then for your you know, the way you clocked it,   Don Muchow  11:13 we did taught up the time total time we spent running believe between the two Disney's It was 88 days, and it was 90 coast to coast records organizations, especially fastest known time, care about the entire time it took you especially if there's no starting gun, that's typically where people like fastest, sometimes calm pick up. It's elapsed time. So if you're visiting the bathroom, you're still on the clock. If your technique picking the lunch break, you're on the clock, we realize that while this might be the fastest known time from Disney to Disney, since it's the first, it'll be a record that's easy to break for anyone that serious about it. It really will only take them about three months to do it at my pace, and many people are faster than I am. So we take comfort in the fact that we drew some attention to type one and exercise. And that this was a bit of a bit of a media event because it was the first Yeah, definitely helped us get the word out.   Stacey Simms  12:10 And I don't mean to take anything away from it. I'm just trying to figure out so do you have to count it on February to April? Or do you just count the time running? I guess would you have to count the COVID break?   Right back to Don answering that question. But first Diabetes Connections is brought to you by Gvoke Hypopen  and our endo always told us if you use insulin, you need to have emergency glucagon on hand as well. Full blood sugars are one thing we're usually able to treat those with fast acting glucose tabs or juice very very low blood sugar can be very frightening. Which is why I'm glad there's a different option for emergency glucagon it's Gvoke Hypopen. Gvoke Hypopen is pre mixed and ready to use with no visible needle. 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 g vo glucagon comm slash risk. Now back to Don. And he's talking about how the timing of this amazing run is recorded.   Don Muchow  13:21 Personally, I count the whole time. It is what it is.   Stacey Simms  13:24 I have a few more questions about the run itself. But I want to go back and talk to you about you mentioned the 30 years you spent not really exercising, it's hard to believe but when you were diagnosed, you were told it was too dangerous. Is that really a factor said tell us about that.   Don Muchow  13:41 I was diagnosed in 1972. And people who are considerably younger than me may not realize that glucose meters weren't invented or weren't publicly available until the early 1980s. My first glucometer was this massive brick shaped thing that I got, I think it was either 1982 1983 prior to that, really the only way of telling what your blood sugar was not what it is. But what it was, was with a urine test and all that really told you as past history. It was justifiable given the circumstances, that if there was no way other than a trip to a hospital to have a glucose test done, that if you couldn't tell how low your blood sugar was, and you were feeling awful and faint, and you know, on the verge of passing out that maybe it wasn't so good to do things that cause a drop in blood sugar problem was that, you know, after 30 years, glucose meters had been around for a while at that point. And I didn't change the advice I was following. So that's on me. But I think a lot of people even with glucose meters are justifiably scared that if they can't stay on top of a severe drop in their blood sugar that maybe this is not for me to do. We face challenges during these long runs. And because I'm type one, like a lot of you out there, you know I gotta face the same challenges and Many of them aren't easy, but I just keep thinking about the turn, I almost took down the road to being visually impaired and having circulatory problems. And I'm just so glad that I went ahead and face those risks. Wow.   Stacey Simms  15:15 Do you remember what it was that made you think I've got to move forward with exercise? I've got to change this. Yes, please, please tell me what you answer that the first thing you did wasn't a marathon.   Don Muchow  15:27 Not a marathon. It was in 2004. I had gone to see my retina specialist who had been monitoring proliferative retinopathy and my left eye. And it had come to the point where he recommended a laser retinopathy treatment, I think those are deprecated. These days, I think they use an anti inflammatory injection now. But back then the recommended treatment was laser treatment of the blood vessels in the eye that were leaking. And it left me with a blind spot. And I asked my retina specialist at the time, well, what does the future look like for me? And he basically said, Well, I'll have more blind spots if you don't do anything. And I had already made a decision that year, that after finding out was short of breath going up the stairs, that I wanted to be healthy, signed up for 5k turkey trot, and it was like a punch in the gut. To get that laser retinopathy treatment. After I had made the decision to be healthy. I made myself a promise that if I could just have a do over, I will do it over. And I'm just kind of not looked back since then. I actually have a little bit of a concern that for many years that once I got to the point where I finished a run across the US that I would turn around and go Okay, now watch, and and not run anymore. But I've taken up swimming. So hopefully that'll help.   Stacey Simms  16:51 And I'm trying to do the quick math, you're done. But how old? Were you in 2004?   Don Muchow  16:55 I think I was in my early 40s. I don't know the exact age, I think it was 42. But I'm not sure about that.   Stacey Simms  17:02 I only asked because you didn't change your mind when you were 22. Right, you didn't start exercising at a super young age. I think 42 is still very young. But it's not, you know, you're not a kid, if you're making decisions a little bit later in life. And the results are phenomenal. I mean, I just can't believe that,   Don Muchow  17:18 I actually think it was something of an advantage to start once I had a gray beard because I have lower expectations of myself. And I think as you push the distance, it's good to remember that not everything in life is achieved by going all out. I progressed slowly to longer and longer distances, probably around 2011, I had gotten used to running marathons and I realized that wasn't getting any faster. There was an ultra, I think it was a 50k in Fort Worth that came up on the radar. And I thought to myself, well, that's only five miles longer than a marathon. Let's try it. I did find it. There were only 400 people in that race that signed up. I think it was like 25,000 or something and signed up for the marathon, but only 400 for the ultra. And it was kind of a nice feeling to realize that, you know, the bulk of the work was behind me. And really now it was just seeing how far I could go. And I began to realize that, you know, if I sort of run my own pace, which is relatively slow, that pushing the distance was a more interesting challenge to me than trying to run faster and risk injury.   Stacey Simms  18:27 By the way, as a mom, I have to say, is that a Dexcom? Beep You good? We need to take care of any.   Don Muchow  18:33 We're good. I have lunch just a little while ago. So it's probably complaining about that.   Stacey Simms  18:39 I'm sorry to be if that's a rude thing to say.   Unknown Speaker  18:41 No, no, no, no, it's we're all tribe.   Stacey Simms  18:45 Thank you. So let's talk. I have some questions from my listeners. But let me ask you a couple more Disney questions. There's this great video of you finishing at Disney World. What was that like? And did you know that they knew you were coming and we're going to be celebrating like that?   Don Muchow  19:00 I knew absolutely nothing about it. We actually were talking just before at our last aid stop before we ran up to the Magic Kingdom about what would happen when we got there. We had thought okay, well, you know, we don't want to serve the Disney guys, we, you know, we realized that's private property, not officially part of the run because we had made a rule for ourselves that we would not run on private property. And when we got to the contemporary zero security guard said, Oh, are you the runner? And my first thought was, oh, guy, we're gonna get escorted off the property and they knew we were coming. And I said, Yeah, I'm the runner. And he said, Okay, well, hang tight. We got some friends waiting for you at the gate, ran over to the gate. And there were probably two or 300 Disney cast members waiting, all cheering. There were people lining the run up to the gate. And when we got there, most of aliquot the president of Walt Disney World presented me with a custom Mickey Mouse cat that said Disneyland The Disney World and escorted me into the park and said, have fun, do what you want to do, we'll pay for it. Wow. And I had an ice cream cone. And I wrote, it's a small world. And I had 50 more miles to go. So I went back and finish running. But it was the most magical time in the world. I just can't thank those guys enough. That was this awesome surprise party.   Stacey Simms  20:20 Do you know who told them? I mean, we   Don Muchow  20:22 all knew your guy, some sneaky person, I don't know. Actually, I actually have many, many months ago at contacted Disney media relations to see if anyone had run from Disneyland Disney World. And then they kind of went radio silent for a while. I suspect that what happened was that they waited for a while to see if it looked like it was going to finish. And then when it looked like it was actually going to happen. They're like, Okay, this is something noteworthy, and let's be there, and let's make his dreams come true. It was amazing. Finish the second finish line on the coast and Indialantic was almost as awesome because I really mostly expected my bio dad and his wife to be there, my brother and his wife. And you know, we'd all take some selfies and celebrate the fact that we got there. And there was a bit of a crowd and make the deputy mayor of Indialantic was there and had swag and other things. If somebody brought me a Red Bull. And I needed that. So it was it was pretty awesome. To have the two finish lines was kind of a bonus.   Stacey Simms  21:26 And just to be clear, when you said after Disney World you had 15 miles to go. Is that the same day that you did this? Yes,   Don Muchow  21:33 yes. The same day. Our plan was to stop in Kissimmee. Right at the turn to 192, which has toward the coast. I think we finished that day at 31 miles. You know, originally, when we didn't think there was going to be much of a fuss at Disney, we were hoping to do more like 3436, something like that. But we actually got in about 50k that day, and I was pretty happy about that.   Stacey Simms  21:57 The next question from my facebook group is about how did you manage blood sugar along the way, I know there must have been lots of ups and downs and things like that. But can you give any advice especially for the athletes who are listening in just on you know how you manage such a, an endurance feat?   Don Muchow  22:15 A couple of things. One is that it's important to be aware that while cardio can make you insulin sensitive, pushing it to the point where stress becomes a factor, the stress hormones can actually reverse that effect a little bit and make you a little more insulin resistant. I like to tell people that that's your body pumping you full of hormones and energy so you can run away from the cheetah. So that's an effect to be aware of my wife, Leslie, who managed all the food, made sure I got enough calories every day did a good job of watching my sugars on Dexcom follow. So generally speaking, when I got to the van, she knew what kind of fuel I needed and had it ready. In terms of using the settings on my T slim Tandem pump, I had to run it in sleep mode most of the time, because I was fairly insulin sensitive during the day and unless blisters or heat were bothering me, the biggest challenge was keeping my sugar up. I found that even in exercise mode, it was those teeny little too much. So I would say if you're going to run 100 milers, 200 miles, that sort of thing. Think about sleep mode, and not just exercise mode. That was something we had to do.   Stacey Simms  23:32 The same person wants to know how many pairs of shoes you went through.   Don Muchow  23:37 If you count just the ones that I wore out, it would be seven, I had a custom pair of shoes equipped with velcro all the way around the top and sand Gators. Same with the ones I use in the Mojave that I put put on for the beach. So that would be the eighth pair. So eight pairs of shoes, including the ones for the beach.   Stacey Simms  23:59 Oh my gosh. And if you could briefly and I will I will get you out of 1030 I promise. Just a couple more quick No worries, we   Don Muchow  24:06 can run a minute or two. Okay. Okay, NOT HAVE NOT HAVE NOT a half hour   Stacey Simms  24:09 Oh, no, no, no, no. Um, another question here is what did your training schedule look like? How do you train for something like this,   Don Muchow  24:17 um, I have a hilly 50k route that I typically do training runs on. I borrowed it from some cycling friends of mine who wanted a route with a lot of hills in it. And I typically try to go out and run that in every kind of weather that I could. During training, I would take I would take the rest day in between training days, but every once in a while I would run three or four days in a row, you know, do the same 50k route. Generally speaking, I didn't train above a 50k distance because I didn't expect to do more than 35 miles a day on the transcon I'm for Texas. We train a little bit longer per day. And for Iowa, we were training like 15 miles a day. But there's just no way for me that I could keep that kind of keep up a distance beyond 35 miles a day for 100 days.   Stacey Simms  25:15 When you're doing something like this, do you try to eat the same stuff all the time? Do you? Are you able to bury things? How does that work for you,   Don Muchow  25:23 um, I tend to gravitate towards some things that I liked. We also paid a lot of attention to trying to get things into me that had protein so that my muscles could rebuild a little bit better overnight. So we ate a lot of hummus, a lot of yogurt, chicken salad, that sort of thing. I got to a point where I didn't want hummus. Yeah, we ran out. We ran out, we ran out a chicken salad before I hated it.   Unknown Speaker  25:54 Yogurt   Don Muchow  25:57 with I'll see hydrated attempted to taste kind of pasty to me. But we would start putting those little mandarin orange cups that you can get at the grocery store, we would put those into yogurt to make it a little a little wetter. And it was a great fuel source. I mean, it's protein, fat, a little bit of sugar. So we I had a lot of that. If I needed carbs, we you know we'd throw in a Oreo or another butter or something like that. But we really paid attention to trying to get the calories and to me. I went through about probably 4000 5000 calories a day. Wow, if any less than that I was losing weight.   Stacey Simms  26:39 Did you did you have to treat lows along the way a lot of them or were you able to kind of manage by what you're eating. And with the sleep mode, as you said,   Don Muchow  26:49 I'm most mostly we managed by eating in sleep mode. We didn't run into a lot of lows on this run. And by that I don't mean to suggest that we had a lot of highs. On the days that were upwards of 35 miles. I tended to have more persistent highs until I went to sleep. And then of course my sugar's dropped very rapidly at that point, we had had previously had a run in with a severe low back in 2019. When I ran across Texas, there was a section between Kermit and Odessa that was very stressful to me. And my sugars had run high the whole day as a 41 mile stretch. And I basically kind of burned up my glycogen was under fueling because my sugar was running high from stress. And then that night when I went to sleep, my sugar dropped to 20. And for anyone here who's not from the US, that's probably one millimolar something very close to that, and, and was wavering in and out of consciousness. And my wife had a glucagon rescue kit that she used on me and I God knows how many carbs for my sugar, what came up. We learned to be careful about that and pay a lot of attention to whether the highs were due to over fueling or stress. And if it was stress, we treated that very differently than we did. You know, overeating. Stress, we typically found that dosing Just a little. And actually taking on food even though my sugar was high, was the best way to get my body to sort of calm down. Otherwise, I would just run high until I fell asleep and then I dropped like a rock.   Stacey Simms  28:38 I'm laughing with this question, because we debated in the group. But this question came up. Ask him what he's going to do next. I do have another?   Don Muchow  28:50 That's a good question. Um, I have been, I've had my eye on solo swim around keywest. That's not as amazing as it sounds from a type one perspective. My good friend Karen Lewin was actually the second type one to solo swim around keywest. I don't remember the name of the first one. So but I would be joining a club of people I'd be very happy to be a member of that's a 12 and a half mile swim. During the COVID pause, I switched to swim training because I needed to do something to break up the run training a little bit it was getting monotonous without knowing when I started again. Yeah. So I've got that swimming on my mind to do after this. But at the same time, I think I need to take some time off, recover. Just relax and sort of let my body sort of recalibrate to what normal life is like.   Stacey Simms  29:46 And I have to ask you mentioned they said Disney World. Come on in and do whatever you want. It's on us. He had an ice cream cone and you did small world, small world on why   Don Muchow  29:59 I have some real Very pleasant memories, from my childhood of riding that ride. It's always been there. And it's quiet. And one of the things that I found on the out on the run was that I would get something a friend of mine called it sympathetic nervous system overload, basically being two or three feet from traffic. for hours on end, I got to the point where I was kind of jumping at loud noises. So we really loved It's a small world. And that was one of the reasons we chose that. And it was our favorite ride anyway, so   Stacey Simms  30:38 I love it. Hey, before I let you go, any advice for people listening who are you know, they're running five K's or they're maybe just starting exercise with type one. And, you know, not planning to do what you've done. But a little nervous, but a little excited about exercise. You know, what do you tell people like that.   Don Muchow  30:59 Um, if you have a bad day, it's just a bad day. Don't kick yourself for mistakes. Don't kick yourself for things that don't go the way you expect, um, look at it as a chance to learn something. Even bad blood sugar Day is a chance to alter your plans, change something in the way that you manage your sugars during exercise. But above all, don't give up. I said   Stacey Simms  31:23 that was my last question. But something else just occurred to me, Don, have you ever gone back to the doctor, or anybody from kind of your previous life?   Don Muchow  31:32 I have. And things have been stable so far, we're going to kind of thoroughly check things out to make sure nothing's changed after the run. But we'll see how it goes.   Stacey Simms  31:42 Yeah, but they've got to be so excited to see what you've done.   Don Muchow  31:46 My endocrinologist is pretty excited. I'm hoping to see him here in about a month or so. And we'll check in with each other and see what we can tell from the numbers. Well, Don, thank   Stacey Simms  31:59 you so much for spending so much time with me. I really appreciate you coming on. Congratulations. And I got to tell you, I think what you should do next is is rest stop and put your feet up for a little while. But I know that's not going to happen. But thanks for being here.   Don Muchow  32:11 That sounds like a great idea. I'm happy to be here. And thank you so much for your time.   Unknown Speaker  32:20 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  32:26 More information about Don in the show notes or Diabetes connections.com linked up to all of his amazing accomplishments. I'm still a little speechless. What a thing to do just to think of doing these incredible goals and getting them done. I know that people like Don will say, well, it's just a matter of training, and then you put one foot in front of the other. But my goodness, it's pretty amazing stuff. Innovations coming up in just a moment. We're gonna talk about what looks like a pretty big move from Medtronic in terms of longer where pump in sets. But first Diabetes Connections is brought to you by Dexcom. And I get a lot of questions about Dexcom coverage for people on Medicare. You know, why not? It's not as though you stopped needing a CGM, the minute you turn 65. The good news is that the Dexcom G6 continuous glucose monitoring system is covered for Medicare for patients who meet the coverage criteria. If you have either type one or type two diabetes, and intensively managed insulin, you may be covered. To find out more about what that means. And if you qualify, check out dexcom.com backslash g six dash Medicare, you're going to want to talk to your doctor and you may even be able to get your Dexcom supplies at the pharmacy saving time and money. Learn more again that link I'll put this in the show notes too. It's dexcom.com backslash g six dash Medicare.   Innovations this week, one medical story and one donut story. Let's do the medical one first, interesting news from Medtronic, they have launched a new line of what's been called insulin infusion hardware. They've launched this in Europe, that basically doubles the time you can wear it so you know, if you were an insulin pump, you know, as you listen, you have the inset on your body. It's the way a tube pump will connect to the Omni pod has this too. It's just a little different cuz it's kind of hidden in the mechanism. But they all have this way that you insert a needle the needle comes out and the catalyst is under the skin with the adhesive and the connector part above the skin. I used to describe it looking like a tiny nicotine patch with a bump on it. They last about three days. You're supposed to change them every two to three days to avoid infection and scarring and clogging and that stuff, but Medtronic says that they have one that will last seven days. And we talked about this when I spoke to Medtronic Sean Salmon back in oh I want to say October of last year was the fall of last year. He mentioned this. He said that the tubing set is what he called it would go from two to three days to seven days. And he said the way they were doing that I'll link up the episodes you can listen again, is that it has to do with the way that they filter insulin. Through the inset. He says that the preservatives in insulin are what causes the site reactions and the clogging and that kind of thing. And they found a way, you know, obviously, it's proprietary didn't go into too much detail. But they found a way to work around that. This is really interesting. I'm surprised this didn't make a bigger splash. This is a huge deal. If it works as well as we would hope to be able to where your pump on your body for longer without scarring or issues or that kind of thing. So European friends, if you're using it, you hear about it, talk to your endo about it, let us know how it goes. And we will wait for more information on the Medtronic seven day inset. And the other story I wanted to bring you in innovations is the I don't know if it's a medical innovation, but it sure could be helpful that fabulous people at TCOYD take control of your diabetes released a video that many of you sent to me and it was just fantastic. I wanted to share it, it is how to eat three donuts and stay in range. And this is Dr. Jeremy Pettis, Dr. Steve Edelman, and they basically have a demonstration. But it's really a kind of comparison of how they would each do it. And they show you they eat three donuts they take you through, they're using a Dexcom to kind of show the results. It is a Afrezza the inhaled insulin, kind of versus timing of traditional insulin, I won't spoil the whole thing. It's fun to watch, I think they do an incredible job as always, of breaking down kind of complex thoughts and making them user friendly, I'll call it and they have such a great sense of humor, I really, really enjoy their stuff. So if you haven't ever watched any TCOYD videos, they have a ton of them. And their conferences are always a really good time too. So I will link that up in the show notes. But I would imagine you could Google how to eat three donuts and stay in range. Probably it'll pop up pretty easily. Before I let you go, we did have our quarterly endocrinology visit. I always thought about putting it off because there's really nothing going on. Right now we're kind of in a groove or just re entering some parts of life. Knock on wood is you're listening this my whole family is vaccinated. Benny is two weeks past his I think I'll be past two weeks past my last one when this episode goes live. Yeah, it will be. And Benny has really re entered more of the real world very recently, as I've mentioned before he got a job. He's back with the wrestling team. He's not yet going to school. He's staying virtual, but he's back on the high school team. And you know, we've had some blood sugar issues as you would expect whenever you're going back to a sport after a long time not but he's managing them really well. So that I only share the endo appointment because he of course, we've known this guy for 14 plus years. He's taking his family to Disney World for the first time. And that's later this year. And that's what we spent mostly we've been talking about.   You know, my tips and tricks for Disney World, we'd have that episode last week, but his kids don't have type one. So it wasn't that relevant anything to have to listen to the podcast episode. And I realized I haven't been to Disney, you know, since COVID. Certainly. And I know that there have been some changes. So I'm fascinated to see that apparently, Fastpass plus has been eliminated during COVID, which was like my lifeblood when I go there, you know, I get this well in advance, listen to how excited I'm sounding just talking about it. But I get him in advance and we refresh 600 times a day and get all the rights we want. I mean, it's really, there's a science to it a little bit of madness to it, too. But it sounds like I'm gonna have to relearn everything. Because it sounds like they're gonna make a lot of changes when they you know, they really start opening up more, although disney world has been open really for months and months and months. But you know, when they start letting the bigger crowds back in, so that was fun. I love our endo. I feel really fortunate that we have the relationship with Him that we do. And the visits are now me kind of sitting in the corner. You know, me I stay, I can't stay quiet. But I do very little. It's really just a conversation between him and Benny and I feel really fortunate about that. Alright, classic episode coming up later this week. As always, thank you to my editor, John Bukenas, from audio editing solutions. Thank you very much for listening. Hey, do me a favor, share the show. If you enjoy it. You think this is good information. If it's valuable or helpful to you in any way. Please tell somebody else in the diabetes community about it. Word of mouth is the best way to spread the word about podcasts and I really appreciate that. All right, I'll see you back here in a couple of days. Until then, be kind to yourself.   Benny  39:35 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged.  

Just a quick reminder that this is my user experience with a frezza and not medical advice. Thanks.

In this episode I discuss my user experience with the inhalable insulin, Afrezza. I discuss how I discovered it, what I had to do to get it, what my experience with it was like, and ultimately why I stopped taking it on a regular basis.

Dave Holmes and James Mansfield stop by the studio to discuss the mental gymnastics of living with type 1 diabetes. Plus Dave tries Afrezza while on the air. Support Beta Cell on Patreon. Things that get mentioned: Just Between Us Episode 17 Dave's Beta Cell interview Jerry How to Survive Snake Season, Even if You Get Bitten

Dave Holmes and James Mansfield stop by the studio to discuss the mental gymnastics of living with type 1 diabetes. Plus Dave tries Afrezza while on the air.Things that get mentioned:Just Between Us Episode 17Dave's Beta Cell interviewJerryHow to Survive Snake Season, Even if You Get Bitten See acast.com/privacy for privacy and opt-out information.

Hear how a type 2 patient manages his diabetes with Afrezza Inhalable Insulin.

I have received many questions about insulin costs. The most common concern? The price of insulin and long-term affordability. In this episode, I interviewed Michael Castagna, Chief Executive Officer of MannKind, the makers of the inhaled insulin about their 4 dollar a day insulin program. What do you think about purchasing rapid-acting insulin for 4 dollars a day? It can be done assuming you use The post Afrezza’s Inhaled Insulin – One Solution to High Insulin Prices? appeared first on Diabetes Health.

Today on the Podcast, Tim has a chat to Mike Joyce. Mike has an A1c of 5.0% and uses Afrezza as his main insulin. We talk about 3 key pillars that have helped Mike maintain these great results while making T1 just that bit easier. Mike also shares his diagnosis story.   Mike on Instagram Please don’t forget to subscribe to the podcast to get new episodes early!   Please check out diabetictim.com   You can find me here:   Instagram   Facebook   Twitter   YouTube  

Anthony Hightower has used Afrezza for the past two years. He credits it (along with a Toujeo, a newer basal insuin) with completely changing his T1D management. In addition to excellent numbers, Anthony shares what else Afrezza has to offer. He explains, he liked it so much, he went to work for Mannkind, the company that makes Afrezza. He and Stacey also talk about the challenges Anthony faced since his diagnosis as a teenager. He admits he spent 20 years trying to avoid thinking about diabetes and credits the online community & the Diabetes Unconference with saving his life. Stacey also shares what those little "clips" are that come with some pump insets. Her family learned the hard way at the beach a while back! She shares how her husband McGyver'd a solution when they'd left the clips at home. And, find out how to contribute to our 100th episode coming up soon!

Mannkind Corporation is the first and currently only maker of inhalable insulin. Their CCO Michael Castagna, a PharmD, answers a bunch of questions about Afrezza, including how it works, why users like it, and what the concerns are around long-term side effects. 

Amber and Ryan got together, just to catch up on the diabetic life. The diabetes world is booming with news. Inhaled insulin is on the diabetic radar again, with Afrezza now on the market. New research revealed how diabetes leads to an increased risk of depression. They were not surprised. Mindfulness plays a role here, […] The post Being Mindful, While Drinking Coffee, and Inhaling Insulin | Amber Clour and Ryan Fightmaster | Real Life Diabetes Podcast #3 appeared first on Diabetes Daily Grind | Real Life Diabetes Podcast.

Today in FirstWord:

In this episode, we discuss newly approved agents for diabetes mellitus: Afrezza (inhaled human insulin), SGLT2 inhibitors (Invokana, Farxiga, Jardiance), and long-acting GLP-1 agonists (Bydureon, Tanzeum).

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