Podcasts about dka

Dr. Nicole Glaser is the Chief of Pediatric Endocrinology and a professor of Pediatrics at UC Davis Children's Hospital. She is recognized as an international expert in pediatric diabetic ketoacidosis (DKA), an important complication of diabetes in children. She has led many of the key multi-center studies that guide DKA management. She has also been involved in the development of several national and international guidelines for DKA management in children that guide current practice worldwide.Learning Objectives:By the end of this podcast, listeners should be able to:Describe best practices for triaging patients with DKAExplain the pathophysiology of acute cerebral edema in DKADescribe the evidence and physiologic basis for fluid selection and rate in DKA Describe the evidence supporting insulin infusion rates in pediatric DKA List best practices for lab monitoring in DKA, and how to define when a patient is ready for transition to subcutaneous insulin References: Abramo TJ, Szlam S, Hargrave H, Harris ZL, Williams A, Meredith M, Hedrick M, Hu Z, Nick T, Gonzalez CV. Bihemispheric Cerebral Oximetry Monitoring's Functionality in Suspected Cerebral Edema Diabetic Ketoacidosis With Therapeutic 3% Hyperosmolar Therapy in a Pediatric Emergency Department. Pediatr Emerg Care. 2022 Feb 1;38(2):e511-e518. doi: 10.1097/PEC.0000000000001774. PMID: 30964851.Kuppermann N, Ghetti S, Schunk J, et al. Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis. N Engl J Med. 2018;378:2275-2287.Glaser N, Barnett P, McCaslin I, et al. Risk factors for cerebral edema in children with diabetic ketoacidosis. N Engl J Med. 2001;344:264-269.Bergmann KR, Abuzzahab MJ, Perepelista V, Udeogu J, Qiu L, Lammers S, Nickel A, Watson D, Kharbanda A. Improving Emergency Department Care for Children With Medium- and High-Risk Diabetic Ketoacidosis. Pediatrics. 2025 Oct 1;156(4):e2024068959. doi: 10.1542/peds.2024-068959. PMID: 40907982.UC-Davis-Health-Magazine-Fall-2019.pdfQuestions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Scott talks with Marley, mom to one-year-old Bane, diagnosed after DKA and a life flight. From ICU to CGM and Mobi, she shares hard-won reality, faith, and growing TikTok advocacy. Free Juicebox Community (non Facebook) Type 1 Diabetes Pro Tips - THE PODCAST Eversense CGM Medtronic Diabetes Tandem Mobi ** twiist AID System Drink AG1.com/Juicebox Use code JUICEBOX to save 40% at Cozy Earth  CONTOUR NextGen smart meter and CONTOUR DIABETES app Dexcom G7 Go tubeless with Omnipod 5 or Omnipod DASH * Get your supplies from US MED  or call 888-721-1514 Touched By Type 1 Take the T1DExchange survey 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! *The Pod has an IP28 rating for up to 25 feet for 60 minutes. The Omnipod 5 Controller is not waterproof.  ** t:slim X2 or Tandem Mobi w/ Control-IQ+ technology (7.9 or newer). RX ONLY. Indicated for patients with type 1 diabetes, 2 years and older. BOXED WARNING:Control-IQ+ technology should not be used by people under age 2, or who use less than 5 units of insulin/day, or who weigh less than 20 lbs. Safety info: tandemdiabetes.com/safetyinfo 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 it!  

Scott talks with Marley, mom to one-year-old Bane, diagnosed after DKA and a life flight. From ICU to CGM and Mobi, she shares hard-won reality, faith, and growing TikTok advocacy. Go tubeless with Omnipod 5 or Omnipod DASH * Dexcom G7 CONTOUR NextGen smart meter and CONTOUR DIABETES app Get your supplies from US MED  or call 888-721-1514 Tandem Mobi  twiist AID System Free Juicebox Community (non Facebook) Type 1 Diabetes Pro Tips - THE PODCAST Eversense CGM Medtronic Diabetes Drink AG1.com/Juicebox Touched By Type 1 Take the T1DExchange survey Use code JUICEBOX to save 40% at Cozy Earth  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! The Pod has an IP28 rating for up to 25 feet for 60 minutes. The PDM is not waterproof. Brown et al. Diabetes Care (2021). Sherr et al. Diabetes Care (2022). Pasquel FJ, et al. JAMA Network Open (2025). Single-arm studies comparing 3 months of Omnipod 5 use to standard therapy in 240 people aged 6-70 years and 80 people aged 2-5.9 years with type 1 diabetes and 305 people aged 18-75 years with type 2 diabetes. 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 it!

Crystal, 33, T1D since 12, recounts DKA, insulin restriction for weight, congenital health challenges, and her turnaround—prebolusing, diet tweaks, and pursuing an insulin pump—with community support and hope. Free Juicebox Community (non Facebook) Type 1 Diabetes Pro Tips - THE PODCAST Eversense CGM Medtronic Diabetes Tandem Mobi ** twiist AID System Drink AG1.com/Juicebox Use code JUICEBOX to save 40% at Cozy Earth  CONTOUR NextGen smart meter and CONTOUR DIABETES app Dexcom G7 Go tubeless with Omnipod 5 or Omnipod DASH * Get your supplies from US MED  or call 888-721-1514 Touched By Type 1 Take the T1DExchange survey 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! *The Pod has an IP28 rating for up to 25 feet for 60 minutes. The Omnipod 5 Controller is not waterproof.  ** t:slim X2 or Tandem Mobi w/ Control-IQ+ technology (7.9 or newer). RX ONLY. Indicated for patients with type 1 diabetes, 2 years and older. BOXED WARNING:Control-IQ+ technology should not be used by people under age 2, or who use less than 5 units of insulin/day, or who weigh less than 20 lbs. Safety info: tandemdiabetes.com/safetyinfo 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 it!

An ICU nurse mom recounts her child's type 1 diabetes DKA diagnosis, winning school CGM monitoring, juggling celiac, and data-driven management with pump/CGM—practical advocacy and tactics parents can replicate. Go tubeless with Omnipod 5 or Omnipod DASH * Dexcom G7 CONTOUR NextGen smart meter and CONTOUR DIABETES app Get your supplies from US MED  or call 888-721-1514 Tandem Mobi  twiist AID System Free Juicebox Community (non Facebook) Type 1 Diabetes Pro Tips - THE PODCAST Eversense CGM Medtronic Diabetes Drink AG1.com/Juicebox Touched By Type 1 Take the T1DExchange survey Use code JUICEBOX to save 40% at Cozy Earth  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! * The Pod has an IP28 rating for up to 25 feet for 60 minutes. The PDM is not waterproof. Among all paid Omnipod 5 G6G7 Pods Commercial and Medicare claims in 2024. Actual co-pay amount depends on patient's health plan and coverage, they may be higher or lower than the advertised amount. Source IQVIA OPC Library. 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 it.

Leslie shares her teen's type 1 diabetes diagnosis and DKA, rapid self-management with Dexcom G7 and Tandem t:slim Control-IQ, ADHD challenges, camp chaos, and parenting tactics that build independence. Free Juicebox Community (non Facebook) Type 1 Diabetes Pro Tips - THE PODCAST Eversense CGM Medtronic Diabetes Tandem Mobi ** twiist AID System Drink AG1.com/Juicebox Use code JUICEBOX to save 40% at Cozy Earth  CONTOUR NextGen smart meter and CONTOUR DIABETES app Dexcom G7 Go tubeless with Omnipod 5 or Omnipod DASH * Get your supplies from US MED  or call 888-721-1514 Touched By Type 1 Take the T1DExchange survey 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! *The Pod has an IP28 rating for up to 25 feet for 60 minutes. The Omnipod 5 Controller is not waterproof.  ** t:slim X2 or Tandem Mobi w/ Control-IQ+ technology (7.9 or newer). RX ONLY. Indicated for patients with type 1 diabetes, 2 years and older. BOXED WARNING:Control-IQ+ technology should not be used by people under age 2, or who use less than 5 units of insulin/day, or who weigh less than 20 lbs. Safety info: tandemdiabetes.com/safetyinfo 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 it!

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: Sanofi lowers prices, oral pill for T1D prevention studied, updates from Medtronic, Tandem, and Sequel Med Tech, falsely lower A1Cs (and why that happens), Biolinq gets FDA okay for micro-needle CGM 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   Check out VIVI Cap to protect your insulin from extreme temperatures 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 French drugmaker Sanofi says it would offer a month's supply of any of its insulin products for $35 to all patients in the U.S. with a valid prescription, regardless of insurance status. The program, originally meant for uninsured diabetes patients, would now include those with commercial insurance or Medicare, the drugmaker said. Patients will be able to purchase any combination, type, and quantity of Sanofi insulins with a valid prescription for the fixed monthly price of $35, starting January 1. Lilly and Novo also have similar programs through which they offer insulin products for $35 a month for U.S. patients regardless of whether the patients have insurance. There is no law at work here – the only legislation that has changed the price of insulin came with the Inflation Reduction Act in 2022 with the Medicare cap. Helping lower the cost here, biosimilars hitting the market and the huge profitability for GLP-1 drugs for Novo and Lilly https://www.reuters.com/business/healthcare-pharmaceuticals/sanofi-offer-all-insulin-products-35-per-month-us-2025-09-26/ XX A pill typically prescribed for rheumatoid arthritis and alopecia might help slow the progression of type 1 diabetes, a new study says. Baricitinib (bare-uh-SIT-nib) safely preserved the body's own insulin production in people newly diagnosed with type 1 diabetes.. and their diabetes started progressing once they stopped taking baricitinib, results show. They produced less insulin and had less stable blood sugar levels.   Baricitinib works by quelling signals in the body that spur on the immune system, and is already approved for treating autoimmune conditions such as rheumatoid arthritis, ulcerative colitis and alopecia, researchers said.   “Among the promising agents shown to preserve beta cell function in type 1 diabetes, baricitinib stands out because it can be taken orally, is well tolerated, including by young children, and is clearly efficacious,” Waibel said. “We are hopeful that larger phase III trials with baricitinib are going to commence soon, in people with recently diagnosed type 1 diabetes as well as in earlier stages to delay insulin dependence,” she added. “If these trials are successful, the drug could be approved for type 1 diabetes treatment within five years.”   Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.   https://www.usnews.com/news/health-news/articles/2025-09-23/pill-effective-in-slowing-type-1-diabetes-progression XX An existing transplant drug has shown promise in slowing the progression of type 1 diabetes in newly diagnosed young people, potentially paving the way for the first therapy that modifies the disease after diagnosis. The Drug, called ATG, is currently used together with other medicines to prevent and treat the body from rejecting a kidney transplant. It can also be used to treat rejection following transplantation of other organs, such as hearts, gastrointestinal organs, or lungs. The researchers studied 117 people aged five to 25, who'd been diagnosed with type 1 diabetes within the past three to nine weeks. The participants were from 14 centers across eight European countries and were randomized to be given different doses of ATG (0.1, 0.5, 1.5, or 2.5 mg/kg) or a placebo. ATG was given as a two-day intravenous (IV) infusion. The main goal was to see how well the pancreas could still make insulin after 12 months, measured by C-peptide levels during a special meal test. C-peptide is released into the blood along with insulin by the pancreas.   The findings are promising, showing that ATG, even at a relatively low dose, can slow the loss of insulin-producing cells in young people newly diagnosed with type 1 diabetes. The lower dose also caused fewer side effects, making it a more practical option. https://newatlas.com/disease/antithymocyte-globulin-newly-diagnosed-type-1-diabetes/     XX The FDA has delayed its feedback on Lexicon Pharmaceuticals' application to bring Zynquista (sotagliflozin) to people with type 1 diabetes. The agency had planned to respond this month but will now wait until the fourth quarter after reviewing new data from ongoing studies. Zynquista, an oral drug meant to be used with insulin, has already been approved for heart failure (marketed as Inpefa). But in type 1 diabetes, it faces safety concerns: last year an FDA advisory committee voted 11–3 that its benefits don't outweigh the increased risk of diabetic ketoacidosis (DKA). The FDA later issued a complete response letter rejecting the drug. Lexicon is still pushing forward, hoping its additional submissions will strengthen Zynquista's case for type 1 diabetes approval. https://www.biospace.com/fda/after-fda-rejection-lexicons-type-1-diabetes-drug-hit-with-another-regulatory-delay     XX A common but often undiagnosed genetic condition may be causing delays in type 2 diabetes diagnoses and increasing the risk of serious complications for thousands of Black and South Asian men in the UK—and potentially millions worldwide. A new study found around one in seven Black and one in 63 South Asian men in the UK carry a genetic variant known as G6PD deficiency. Men with G6PD deficiency are, on average, diagnosed with type 2 diabetes four years later than those without the gene variant. But despite this, fewer than one in 50 have been diagnosed with the condition.   G6PD deficiency does not cause diabetes, but it makes the widely used HbA1c blood test—which diagnoses and monitors diabetes—appear artificially low. This can mislead doctors and patients, resulting in delayed diabetes diagnosis and treatment.   The study found men with G6PD deficiency are at a 37% higher risk of developing diabetes-related microvascular complications, such as eye, kidney, and nerve damage, compared to other men with diabetes.   "This study highlights important evidence that must be used to tackle these health inequalities and improve outcomes for Black communities. Preventative measures are now needed to ensure that Black people, especially men, are not underdiagnosed or diagnosed too late." https://medicalxpress.com/news/2025-09-hidden-genetic-delay-diabetes-diagnosis.html XX Novo Nordisk today announced the resubmission of its Biologics License Application (BLA) to the US Food and Drug Administration (FDA) for Awiqli® (insulin icodec) injection, a once-weekly basal insulin treatment for adults living with type 2 diabetes. If approved, Awiqli® would become the first once-weekly basal insulin available in the United States, providing an alternative to daily basal insulin injections for adults living with type 2 diabetes.   The resubmission is based on results from the ONWARDS type 2 diabetes phase 3a program for once-weekly Awiqli® which is comprised of five randomized, active-controlled, treat-to-target clinical trials in approximately 4,000 adults with type 2 diabetes. The clinical program evaluated Awiqli® vs. daily basal insulin and the primary endpoint in these trials was change in A1C from baseline.1-5 Awiqli® is approved in the EU, along with 12 additional countries. In addition, regulatory filings have been completed in several other countries, with further regulatory decisions expected in 2025. XX Interesting news from Sequel Med Tech – they've signed an agreement with Arecor to pair the twiist pump with AT278 an ultra-concentrated (500U/mL), ultra-rapid insulin in development. They also have a deal with Medtronic to develop insulin for new pumps. This insulin isn't yet approved, it's 5 times stronger than standard fast acting  it's hoped that a clinical study will begin next year. Arecor says its insulin could potentially be the only option capable of enabling and catalyzing the next generation of longer-wear and miniaturized automated insulin delivery systems.   https://www.drugdeliverybusiness.com/sequel-arecor-develop-rapid-insulin-twiist/ XX Tandem Diabetes Care announes its t:slim X2™ insulin pump with Control-IQ+ automated insulin delivery (AID) technology is now cleared for use with Eli Lilly and Company's Lyumjev® (insulin lispro-aabc injection) ultra-rapid acting insulin in the United States (U.S.).   – The t:slim X2 insulin pump with Control-IQ+ technology is now cleared for use with Lyumjev for people with type 1 diabetes ages 2 and above and all adults with type 2 diabetes. The companies are continuing to work toward securing Lyumjev compatibility for the Tandem Mobi pump. https://hitconsultant.net/2025/09/29/tandem-diabetes-cares-tslim-x2-pump-cleared-for-use-with-lillys-ultra-rapid-lyumjev-insulin/ XX You can now place your order for the MiniMed™ 780G system with the Instinct sensor, made by Abbott. And if you are already a MiniMed 780G user, you can place an upgrade order today. ​This is a 15 day wear sensor, with no transmitter or overtape required. It looks the same at other Abbot sensors such as the Libre but is proprietary to Medtronic. Shipments are scheduled to start in November.   ​ https://www.drugdeliverybusiness.com/medtronic-launches-minimed-780g-instinct-abbott/   XX The global type 1 diabetes (T1D) burden continues to increase rapidly driven by rising cases, ageing populations, improved diagnosis and falling death rates. ,   The study estimates that T1D will affect 9.5 million people globally in 2025 (up by 13% since 2021), and this number is predicted to rise to 14.7 million in 2040. However, due to lack of diagnosis and challenges in collecting sufficient data, the actual number of individuals living with T1D is likely much higher, researchers say.   In fact, they estimate that there are an additional 4.1 million 'missing people' who would have been alive in 2025 if they hadn't died prematurely from poor T1D care, including an estimated 669,000 who were not diagnosed. This is particularly true in India, where an estimated 159,000 people thought to have died from missed diagnoses. The study predicts that 513,000 new cases of T1D will be diagnosed worldwide in 2025, of which 43% (222,000) will be people younger than 20 years old. Finland is projected to have the highest incidence of T1D in children aged 0-14 years in 2025 at around 64 cases per 100,000. The substantial increases in T1D forecasts between 2025 and 2040 underscore the urgent need for action. As co-author Renza Scibilia from Breakthrough T1D explains, "Early diagnosis, access to insulin and diabetes supplies, and proper healthcare can bring enormous benefits, with the potential to save millions of lives in the coming decades by ensuring universal access to insulin and improving the rate of diagnosis in all countries."   The authors note some important limitations to their estimates, including that while the analysis uses the best available data, predictions are constrained by the lack of accurate data in most countries-highlighting the urgent need for increased surveillance and research. They also note that data on misdiagnosis and adult populations remain limited, and the analysis assumes constant age-specific incidence and mortality over time. Furthermore, incidence data from the COVID-19 period were excluded from part of the modelling to avoid bias. Future updates are expected to improve as new data become available and applied. https://www.news-medical.net/news/20250919/New-study-warns-of-millions-of-undiagnosed-and-missing-people-with-type-1-diabetes.aspx XX A new study has found that semaglutide — the active ingredient found in some GLP-1 medications prescribed for diabetes and to aid weight loss — may help protect the eyes from diabetic retinopathy. Researchers estimate that as much as 40% of all people with diabetes also have diabetic retinopathy — a potentially blinding eye condition caused by blood vessel damage in the eye's retina. There is currently no cure for diabetic retinopathy. The condition is often managed through injections of anti-VEGF medications into the eye, surgery, and blood sugar monitoring and control. For this lab-based study, researchers used samples of human retinal endothelial cells that were treated with different concentrations of semaglutide. The cells were then placed in a solution with both a high glucose level and high level of oxidative stress — where there is an imbalance of antioxidants and free radicals — for 24 hours.   Past studies show that oxidative stress plays a role in the formation of diabetic retinopathy.   At the study's conclusion, researchers found that the retinal cells treated with semaglutide were twice as likely to survive than cells that were untreated. Additionally, the treated cells were found to have larger stores of energy.   Scientists also found that three markers of diabetic retinopathy were decreased in the semaglutide-treated retinal cells. First, the levels of apoptosis — a form of cell death — decreased from about 50% in untreated cells to about 10% in semaglutide-treated cells. The production of the free radical mitochondrial superoxide decreased from about 90% to about 10% in the treated retinal cells.   Researchers also found the amount of advanced glycation end-products — harmful compounds that can collect in people with diabetes and are known to cause oxidative stress — also decreased substantially.   Lastly, scientists reported that the genes involved in the production of antioxidants were more active in the semaglutide-treated cells when compared to untreated cells. Researchers believe this is a sign that semaglutide may help repair damage to the retinal cells.   “Our study did not find that these drugs harmed the retinal cells in any way — instead, it suggests that GLP1-receptor agonists protect against diabetic retinopathy, particularly in the early stages,” Ioanna Anastasiou, PhD, molecular biologist and postdoctoral researcher at the National and Kapodistrian University in Greece, and lead author of this study, said in a press release.   “Excitingly, these drugs may be able to repair damage that has already been done and so improve sight. Clinical trials are now needed to confirm these protective effects in patients and explore whether GLP-1 receptor agonists can slow, or even halt, the progression of this vision-robbing condition.” https://www.medicalnewstoday.com/articles/ozempic-semaglutide-may-help-protect-against-diabetes-related-blindness-retinopathy   XX Biolinq has received De Novo Classification from the U.S. Food and Drug Administration for its lead product, Biolinq Shine, a patch on the forearm that provides real-time glucose feedback through a primary color-coded LED display, visible with or without a phone. This one is tricky – it's called a needle free CGM but it also says it uses micro needles. By the way, De Novo isn't exactly the same as what we think of for FDA approval for medical devices. It's not as rigorous but it's a streamlined route for novel, low to moderate risk devices with no existing equivalent. We'll see how this one turns out. https://www.hmenews.com/article/biolinq-s-multi-function-biosensor-receives-fda-de-novo-classification

Navigating Communication in Pediatrics and Public Health Policy ChallengesIn this episode of The Pediatric Lounge, the hosts discuss the recent passing of Resolution 29 at the Leadership Conference, emphasizing its significance in preventing 11,000 cases of diabetic ketoacidosis (DKA) through finger-prick testing. The show also delves into upcoming pediatric conferences and events, with special mention of notable guests. The main discussion focuses on effective communication strategies in pediatric care, especially in the context of public health policy and vaccine advocacy. Dr. David Hill joins the conversation, sharing insights on the importance of transparent and empathetic communication with patients and the challenges posed by misinformation and political influences in public health.00:00 Welcome to The Pediatric Lounge00:28 Exciting News from the Leadership Conference01:43 Upcoming Events and ConferencesMIAAP 75TH ANNUAL CONFERENCEPreventing the Crisis- Mini Fellowship03:12 Introducing Dr. David Hill03:27 The Importance of Effective Communication04:56 Personal Stories and Reflections16:46 The Power of Storytelling in Medicine18:43 The Role of Pediatricians in Public Health19:05 Challenges in Medical Messaging33:08 The Importance of Vaccination Messaging35:21 Challenges in Communicating Vaccine Benefits35:59 Flu Vaccine Efficacy and Public Perception36:21 Impact of Misinformation and AI on Vaccine Decisions37:24 Understanding Vaccine Effectiveness39:08 The Need for Better Flu Vaccines45:17 Political Influence on Public Health Policy49:33 Balancing Science, Politics, and Public Health01:00:01 Effective Communication Strategies in Pediatrics01:02:21 Conclusion and Final ThoughtsSupport the show

Disclaimer: The views expressed in this video should not be used for medical diagnosis or treatment or as a substitute for professional medical advice. Individual symptoms, situations and circumstances may vary. Sponsored by Abbott Summary In this conversation, Leigh Fickling shares her journey as a diabetes mom after her daughter Ava was diagnosed with type 1 diabetes at the age of three. She reflects on the signs and symptoms of diabetes and DKA that were overlooked initially, the importance of education and awareness in managing diabetes, and her role as a caregiver and advocate for others with diabetes. Leigh discusses the challenges of navigating workplace accommodations for diabetes and emphasizes the need for community support and preparedness in managing diabetes effectively. Chapters 00:00 The Diagnosis Journey Begins 08:02 Understanding DKA and Its Symptoms 17:03 Navigating Diabetes Management as a Caregiver 22:06 Workplace Accommodations for Diabetes 33:56 Empowering Others Through Shared Experiences Resources: https://childrenwithdiabetes.com/ https://www.linkedin.com/in/leighfickling

Disclaimer: The views expressed in this video should not be used for medical diagnosis or treatment or as a substitute for professional medical advice. Individual symptoms, situations and circumstances may vary. Sponsored by Abbott Summary In this episode, Rob Howe interviews Danica Collins, a long-time type 1 diabetes advocate, about her personal journey with diabetes and a recent experience with diabetic ketoacidosis (DKA). Danica shares her story of living with diabetes for nearly 20 years, the importance of community support, and the challenges she faced during a severe DKA episode while traveling. The conversation emphasizes the need for self-advocacy, understanding DKA, and the emotional aftermath of such experiences. Danica's insights aim to educate and empower others in the diabetes community. Chapters 00:00 Introduction to the Journey of Diabetes Advocacy 02:53 Reflecting on 19 Years with Type 1 Diabetes 05:50 The Importance of Community in Diabetes Management 08:47 Experiencing DKA: A Personal Story 11:35 Navigating the Hospital Experience 14:57 The Role of Self-Advocacy in Healthcare 17:55 Understanding DKA and Its Implications 20:42 The Aftermath of DKA: Recovery and Reflection 23:32 Sharing Stories to Raise Awareness 26:37 The Emotional Impact of Diabetes and DKA 29:49 Final Thoughts on Living with Diabetes Resources https://www.instagram.com/danicathediabetic/?hl=en https://www.dia-log.co/

Disclaimer: The views expressed in this video should not be used for medical diagnosis or treatment or as a substitute for professional medical advice. Individual symptoms, situations and circumstances may vary. Sponsored by Abbott Summary In this episode, Dr. Eden Miller discusses the concept of Euglycemic DKA, a condition that can occur even when blood sugar levels are normal. The conversation covers the importance of understanding the symptoms, the role of medications like SGLT2 and GLP1 in increasing the risk of DKA, and the necessity of regular ketone checks. Dr. Miller emphasizes the need for education and empowerment in managing diabetes, especially in unique situations like pregnancy and prolonged fasting. The episode concludes with strategies for preventing Euglycemic DKA. Chapters 00:00 Introduction to Euglycemic DKA 02:00 Understanding Euglycemic DKA 04:08 Impact of Medications on DKA 07:10 Symptoms and Confirmation of DKA 09:20 The Importance of Regular Ketone Checks 11:07 Exploring GLP-1 Medications 12:30 Other Causes of DKA 16:22 Preventing Euglycemic DKA Resources: https://diabetesandobesity-care.com/ https://www.linkedin.com/in/eden-miller-b02a5a178

Disclaimer: The views expressed in this video should not be used for medical diagnosis or treatment or as a substitute for professional medical advice. Individual symptoms, situations and circumstances may vary. Sponsored by Abbott Summary In this episode of Diabetics Doing Things, Dr. Eden Miller discusses the prevention and treatment of diabetic ketoacidosis (DKA). The conversation emphasizes the importance of knowledge and awareness in managing diabetes, particularly in understanding one's own ketone levels. Dr. Miller uses analogies to make the topic more accessible and encourages patients to develop a personalized action plan for monitoring ketones. The discussion also highlights the significance of communication with healthcare providers and the role of support systems in managing diabetes effectively. Chapters 00:00 Introduction to DKA Awareness Series 01:13 Knowledge is Power: Understanding DKA 05:24 Communicating DKA Risks Effectively 08:08 Using Analogies to Understand DKA 10:02 Developing a Personal Ketone Action Plan 12:54 Monitoring and Troubleshooting Ketones 16:01 Empowering Yourself and Your Support System Resources: https://diabetesandobesity-care.com/ https://www.linkedin.com/in/eden-miller-b02a5a178

Disclaimer: The views expressed in this video should not be used for medical diagnosis or treatment or as a substitute for professional medical advice. Individual symptoms, situations and circumstances may vary. Sponsored by Abbott Summary In this episode, Dr. Eden Miller discusses diabetic ketoacidosis (DKA), a serious complication of diabetes. She explains the basics of DKA, its signs and symptoms, and the importance of monitoring ketones. The conversation also covers the causes of DKA, personalizing awareness and management strategies, and the significance of de-emotionalizing diabetes management. Dr. Miller emphasizes the need for proactive measures and open communication with healthcare providers to prevent and manage DKA effectively. Chapters 00:00 Introduction to Diabetic Ketoacidosis (DKA) 02:00 Understanding DKA: The Basics 05:07 Signs and Symptoms of DKA 10:02 Monitoring Ketones: Tools and Techniques 14:45 Causes of DKA: Understanding Triggers 19:57 Personalizing DKA Awareness and Management 24:45 De-emotionalizing Diabetes Management 30:11 Conclusion and Next Steps Resources: https://diabetesandobesity-care.com/ https://www.linkedin.com/in/eden-miller-b02a5a178

L'épisode 20 de SOFRESH est consacré à JUNKY TJS aka DJ JUNKAZ LOU, une série en 6 parties.Partie 02 « Je préfère taguer »Fin des années 80, JUNKY remarque des tags en bas de chez lui. C'est le tagueur BAUL DCM qui l'impressionne par son style.Au sein de la Maison des Jeunes des Agnettes il rencontre MASE ONE (NGB), passionnés de graffiti, les deux ne se lâcheront plus.C'est aussi la période des tags dans les dépôts de métro à Porte de Clichy avec SANK, la rencontre de PSEDO, les murs de BANGA, le vol à l'étalage, la rivalité entre DCM et les 93MC, les TBA, les peintures de MEO…JUNKY (qui pose ALERT à l'époque) crée avec MASE ONE (SHOET) le crew TJS, les membres sont de Gennevilliers. S'en suit une connexion avec les DKA de Nanterre puis la rencontre avec DEZER.. Bonne ÉCOUTE !On a besoin de votre soutien : likez, partagez et commentez sur votre plateforme d'écoute car cela nous aide pour le référencement !SOFRESH (Robin Master & Somy DUC). SOFRESH

Laura, 55, was diagnosed with type 1 in March 2024 after months of missed signs, DKA, septic shock, and necrotizing fasciitis. Now on a GLP, she's honeymooning without insulin. Part 2 of 2 Free Juicebox Community (non Facebook) Type 1 Diabetes Pro Tips - THE PODCAST Eversense CGM Medtronic Diabetes Tandem Mobi ** twiist AID System Drink AG1.com/Juicebox Use code JUICEBOX to save 40% at Cozy Earth  CONTOUR NextGen smart meter and CONTOUR DIABETES app Dexcom G7 Go tubeless with Omnipod 5 or Omnipod DASH * Get your supplies from US MED  or call 888-721-1514 Touched By Type 1 Take the T1DExchange survey 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! *The Pod has an IP28 rating for up to 25 feet for 60 minutes. The Omnipod 5 Controller is not waterproof.  ** t:slim X2 or Tandem Mobi w/ Control-IQ+ technology (7.9 or newer). RX ONLY. Indicated for patients with type 1 diabetes, 2 years and older. BOXED WARNING:Control-IQ+ technology should not be used by people under age 2, or who use less than 5 units of insulin/day, or who weigh less than 20 lbs. Safety info: tandemdiabetes.com/safetyinfo 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 it!

Laura, 55, was diagnosed with type 1 in March 2024 after months of missed signs, DKA, septic shock, and necrotizing fasciitis. Now on a GLP, she's honeymooning without insulin. Part 1 of 2 Go tubeless with Omnipod 5 or Omnipod DASH * Dexcom G7 CONTOUR NextGen smart meter and CONTOUR DIABETES app Get your supplies from US MED  or call 888-721-1514 Tandem Mobi  twiist AID System Free Juicebox Community (non Facebook) Type 1 Diabetes Pro Tips - THE PODCAST Eversense CGM Medtronic Diabetes Drink AG1.com/Juicebox Touched By Type 1 Take the T1DExchange survey Use code JUICEBOX to save 40% at Cozy Earth  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! The Pod has an IP28 rating for up to 25 feet for 60 minutes. The PDM is not waterproof. Brown et al. Diabetes Care (2021). Sherr et al. Diabetes Care (2022). Pasquel FJ, et al. JAMA Network Open (2025). Single-arm studies comparing 3 months of Omnipod 5 use to standard therapy in 240 people aged 6-70 years and 80 people aged 2-5.9 years with type 1 diabetes and 305 people aged 18-75 years with type 2 diabetes. 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 it!  

Diabetic ketoacidosis can be life-threatening but there's some variability in the way it's managed between health settings. Intervention involves intravenous insulin administration, hydration, electrolyte replacement and treatment of the underlying precipitant. In a survey of practitioners from 31 different hospitals in Australia there was an even split between those organisations which followed a fixed rate insulin infusion protocol, usually based on bodyweight, or a variable rate infusion protocol, titrated against blood glucose concentration. Three quarters of survey respondents had worked at another hospital that had different DKA management protocols raising concerns about the cognitive load on junior health staff moving between institutions. In Europe there has been some normalisation towards fixed rate protocols, despite there being no good quality evidence for superiority. In this podcast we hear some theories from two of the authors of the study published recently in the Internal Medicine Journal.12:40 SGLT2 inhbitor-associated ketoacidosis17:26 The cognitive burden of variation across settings25:11 the challenges of researching this questionsGuestsDr Lisa Raven FRACP PhD (St Vincent's Hospital, Sydney)Dr Mahesh Umapathysivam FRACP DPhil (Southern Adelaide Diabetes and Endocrine Service; Royal Adelaide Hospital) Guest HostDr Mervyn Kyi FRACP PhD (Royal Melbourne Hospital; Northern Hospital)ProductionProduced by Dr Mervyn Kyi and Mic Cavazzini DPhil. Music licenced from Epidemic Sound ‘Tree Tops' by Autohacker and ‘Fugent' by Lupus Nocte. Image created and copyrighted by RACP. Editorial feedback kindly provided by RACP physicians Aidan Tan, Hugh Murray, Stephen Bacchi and Aafreen Khalid. Key Reference“Heterogeneity in the management of diabetic ketoacidosis in Australia: a national survey”  [IMJ. 2025]Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.

Join Kate, Mark, Gary and Henry as they discuss 4 great new POEMs (studies with the potential to change practice): a digital mental health intervention, the risk of DKA in patients using SGLT2 inhibitors, esketamine's effects on suicidal ideation and unresponsive depression, and whether “one-size-fits-all” thyroid reference ranges misleading.Links:Essential Evidence Plus: www.essentialevidenceplus.comDigital mental health app for depression: https://pubmed.ncbi.nlm.nih.gov/40227715/RIsk of DKA with SGLT2s: pubmed.ncbi.nlm.nih.gov/40070044/Esketamine and resistant depression or suicidality: pubmed.ncbi.nlm.nih.gov/39790081/ What is a normal TSH: https://pubmed.ncbi.nlm.nih.gov/40324200/ Joseph O'Connor and the Escape Line Trilogy (2 great novels): https://www.amazon.com/The-Rome-Escape-Line-Trilogy-2-book-series/dp/B0BSNX3C89 

In this episode, I'm joined by Carly Piehl, a 35-year-old mom and wife who was diagnosed with type 1 diabetes in late 2024 while in DKA, with no family history and no warning signs. Carley opens up about what those first overwhelming months were really like, from being sent home from the ER with a 13 A1C to navigating both the emotional and blood sugar rollercoaster. Despite early progress, she still felt stuck and frustrated until she found our signature group coaching program and discovered a new way to live with T1D. We talk about what it looks like to build confidence with food, technology, and mindset, especially while managing the daily demands of motherhood and marriage + the secret to her FIVE POINT A1C DROP. This episode is dedicated to anyone out there who has ever thought: Will I ever make peace with T1D? Quick Takeaways: The #1 thing that helped Carley make this transformation of lowering A1C from 13 to below 8.0 How to build confidence with food, technology, and mindset–especially while managing the daily demands of motherhood and marriage Advice AND treatment everyone should receive at diagnosis“That's when I realized, I was going to need to find other people who had diabetes to learn…”

Nicole from Perth shares her 25-year type 1 diabetes journey — from pancreatitis at 13 to DKA, loss, GLP-1s, and thriving with CGM, Omnipod, and hard-won perspective. Free Juicebox Community (non Facebook) Type 1 Diabetes Pro Tips - THE PODCAST Juice Cruise 2026 - Come Sail Away Eversense CGM Medtronic Diabetes Tandem Mobi ** twiist AID System Drink AG1.com/Juicebox Use code JUICEBOX to save 40% at Cozy Earth  CONTOUR NextGen smart meter and CONTOUR DIABETES app Dexcom G7 Go tubeless with Omnipod 5 or Omnipod DASH * Get your supplies from US MED  or call 888-721-1514 Touched By Type 1 Take the T1DExchange survey 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! *The Pod has an IP28 rating for up to 25 feet for 60 minutes. The Omnipod 5 Controller is not waterproof.  ** t:slim X2 or Tandem Mobi w/ Control-IQ+ technology (7.9 or newer). RX ONLY. Indicated for patients with type 1 diabetes, 2 years and older. BOXED WARNING:Control-IQ+ technology should not be used by people under age 2, or who use less than 5 units of insulin/day, or who weigh less than 20 lbs. Safety info: tandemdiabetes.com/safetyinfo 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 it!  

Contributor: Taylor Lynch, MD Educational Pearls: Dilutional Hyponatremia: Occurs when there is an excess of free water relative to sodium in the body. Causes a falsely low sodium concentration without a true change in total body sodium. Commonly seen in DKA: Hyperglycemia raises plasma osmolality. Water shifts from the intracellular to extracellular space. This dilutes serum sodium, creating apparent hyponatremia. Corrected sodium calculation: Use tools like MDCALC, or apply this formula: Add 1.6 mEq/L to the measured sodium for every 100 mg/dL increase in glucose above 100. Clinical relevance: Considering corrected sodium in DKA is crucial, as the lab value may not be reflective of actual sodium depletion. True severe hyponatremia can lead to complications like seizures May require treatment with hypertonic saline. References: Fulop M. Acid–base problems in diabetic ketoacidosis. Am J Med Sci. 2008;336(4):274-276. doi:10.1097/MAJ.0b013e318180f478 Palmer BF, Clegg DJ. Electrolyte and Acid–Base Disturbances in Patients with Diabetes Mellitus. N Engl J Med. 2015;373(6):548-559. doi:10.1056/NEJMra1503102 Spasovski G, Vanholder R, Allolio B, et al. Diagnosis and management of hyponatremia: a review. JAMA. 2014;312(24):2640–2650. doi:10.1001/jama.2014.13773 Summarized by Ashley Lyons, OMS3 | Edited by Ashley Lyons & Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/  

Screening has moved front and center in the conversation around type 1 diabetes. But we're just at the very beginning of this – what do we really need to know? I'm talking to Dr. Shara Bialo – she's a pediatric endocrinologist who lives with type 1. She was diagnosed as a kid while in DKA. She's working with Sanofi to push for screening, but this is personal – we talk about wanting better guidelines, and more mental health support. And how do we move this research into the general population, where it can have the greatest impact? More about screening here  This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Previous episodes with Ben Mar here Join us at an upcoming Moms' Night Out event! 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  Check out VIVI Cap to protect your insulin from extreme temperatures 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 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.

Noor's sudden DKA diagnosis sparks battle to survive, learn carb counting, and embrace tech while raising two young kids. Free Juicebox Community (non Facebook) Eversense CGM Medtronic Diabetes Tandem Mobi ** twiist AID System Drink AG1.com/Juicebox Use code JUICEBOX to save 40% at Cozy Earth  CONTOUR NextGen smart meter and CONTOUR DIABETES app Dexcom G7 Go tubeless with Omnipod 5 or Omnipod DASH * Get your supplies from US MED  or call 888-721-1514 Touched By Type 1 Take the T1DExchange survey 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! *The Pod has an IP28 rating for up to 25 feet for 60 minutes. The Omnipod 5 Controller is not waterproof.  ** t:slim X2 or Tandem Mobi w/ Control-IQ+ technology (7.9 or newer). RX ONLY. Indicated for patients with type 1 diabetes, 2 years and older. BOXED WARNING:Control-IQ+ technology should not be used by people under age 2, or who use less than 5 units of insulin/day, or who weigh less than 20 lbs. Safety info: tandemdiabetes.com/safetyinfo 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 it!  

In this episode of Diabetes Dialogue, co-hosts hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and co-director 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, discuss significant developments in diabetes care from May 2025, including Medtronic's restructured business model, Sequel Twiist's technological collaboration with Abbott, and Breakthrough T1D's efforts to advance early detection of type 1 diabetes (T1D) through national screening initiatives. The discussion opens with news of Medtronic's decision to spin off its diabetes division into a standalone entity, currently referred to as “New Diabetes Company.” While the final name is forthcoming, the move is intended to streamline operations and accelerate innovation within the diabetes space. The hosts highlight the company's promising technology pipeline, including the forthcoming 800 series insulin pump with full smartphone control and plans for a tubeless insulin delivery system. Both experts express optimism that the independence may foster greater agility in product development, enhance accessibility, and maintain a focus on user-centered design, including for populations with visual impairments. Next, Isaacs and Bellini examine the announcement of the Sequel Twiist partnership with Abbott to integrate continuous ketone monitoring (CKM) into a hybrid sensor, which is expected to function similarly to the FreeStyle Libre 3. This device, still in development, will provide real-time data on both glucose and ketone levels—a critical advance for people with type 1 diabetes using insulin pumps, who are at elevated risk for diabetic ketoacidosis (DKA). While excited about the potential for earlier DKA detection, Bellini emphasizes the importance of cost-effective implementation and integration with existing pump platforms. The episode concludes with coverage of Breakthrough T1D's advocacy before the US Preventive Services Task Force to support routine screening for T1D autoantibodies. The goal is to identify individuals in early stages of the disease to prevent DKA and misdiagnosis. The hosts note that despite advancements in understanding T1D progression, many patients remain undiagnosed until presenting with DKA or are mistakenly classified as having type 2 diabetes. References: Medtronic plc. Medtronic announces intent to separate Diabetes business. Medtronic News. Published May 21, 2025. Accessed June 2, 2025. https://news.medtronic.com/2025-05-21-Medtronic-announces-intent-to-separate-Diabetes-business Sequel Med Tech. Sequel Med Tech to Integrate twiist Automated Insulin Delivery (AID) System with Abbott's Future Dual Glucose-Ketone Sensor. GlobeNewswire News Room. Published May 22, 2025. Accessed June 2, 2025. https://www.globenewswire.com/news-release/2025/05/22/3086535/0/en/Sequel-Med-Tech-to-Integrate-twiist-Automated-Insulin-Delivery-AID-System-with-Abbott-s-Future-Dual-Glucose-Ketone-Sensor.html Breakthrough T1D. Breakthrough T1D Submits Application to Make Screening for Type 1 Diabetes Part of Recommended Preventive Services in the US - Breakthrough T1D. Breakthrough T1D. Published May 21, 2025. Accessed June 2, 2025. https://www.breakthrought1d.org/for-the-media/press-releases/breakthrough-t1d-submits-application-to-make-screening-for-type-1-diabetes-part-of-recommended-preventive-services-in-the-us/

Podcast summary of articles from the April 2025 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include ECGs in cardiac arrest, strep toxic shock syndrome, diabetic ketoacidosis, chest pain work ups, exertional heat stroke, and pulmonary embolism controversies.  Guest speaker is Dr. Matthew Carvey.

In this powerful episode, Risely coaching graduate Mary McCauley shares her story of being misdiagnosed with Type 2 diabetes when she was actually living with adult-onset Type 1 (LADA). From being dismissed by doctors to ending up in DKA and sent home with no insulin, her story highlights just how dangerous misdiagnosis can be. Mary opens up about the emotional toll, the turning point of finally receiving the correct diagnosis, and the journey of reclaiming confidence and ownership over her health. If you've ever felt dismissed, unsure of your diagnosis, or like something just isn't adding up, this episode will empower you to ask the hard questions and trust your gut. You deserve to be heard, supported, and correctly diagnosed. Quick Takeaways:Navigating misdiagnosis  The damage of stereotypes & importance of diabetes education throughout the entire world: medical bias is real  Impact of the gaps in our healthcare system on people living with type 1 diabetes How the right support can change everything Timestamps:[03:11] Mary's journey begins: The first signs that something wasn't right [04:00] “I will never know actually when this journey started or how long my honeymoon phase really has been.”[08:22] "I was labeled as non-compliant during that time." [10:05] “I still had never talked to an endocrinologist, like an actual endocrinologist, nobody had ever explained to me what all of this meant.” [10:44] “I went home and I didn't ever test my blood sugar again. Because that's what I was told.”[17:10] The ER experience: Misdiagnosis & dismissal[19:00] "I was losing my vision, what's happening?"[27:09] Finally receiving the correct diagnosis [29:53] “Being a LADA type one, it can feel a lot like you're in limbo.”[42:55] Advice for someone who thinks they have been misdiagnosed [48:09] "You don't have to suffer more to be valid." [50:58] “When we know better, we do better.” What to do now: Follow me @lauren_bongiorno and @riselyhealth on Instagram to stay in the loop when new episodes drop. Apply for coaching and talk to our team so you can reclaim the life you deserve. 

This week on the Inside EMS podcast, hosts Chris Cebollero and Kelly Grayson tackle a metabolic monster that every EMS provider needs to master: diabetic ketoacidosis (DKA). They kick off with a common (but critical) 911 scenario: a 19-year-old with a history of Type 1 diabetes, confusion, vomiting and a blood sugar of 500. Sound familiar? Kelly dives into the physiology of DKA, explaining how glucose can be sky-high while cells starve, triggering fat breakdown and ketone production that spirals into life-threatening acidosis. The hosts hit the must-know pathophysiology, signs and symptoms (hello, Kussmaul breathing!), and what providers often miss — like dehydration, vomiting and abdominal pain. They break down how to spot DKA with capnography and EKG changes, especially when hyperkalemia mimics a STEMI. From EMS management tips (don't shut down those fast respirations!) to fluid resuscitation caveats, this is a crash course in saving DKA patients before they crash. Whether you're running calls or managing chronic patients, this episode arms you with the clinical know-how and common-sense insight to handle DKA with confidence. Memorable quotes  “We're starting to see more increasing calls for type one diabetes, insulin-dependent type two diabetes ... and we need to be able to understand what we're doing. — Chris Cebollero “One of the big clues in the scenario is the vomiting. Lots of DKA patients will have vomiting and abdominal pain.” — Kelly Grayson “A lot of times, these hyperkalemia patients and these acidotic patients are going to be handled just fine by correcting their fluid deficits and correcting their glucose with an insulin drip. Just getting their glucose back down to normal level is going to manage the lion's share of the hyperkalemia.” — Kelly Grayson Enjoying the show? Email theshow@ems1.com to suggest episode ideas or to pitch someone as a guest!

In this jam-packed episode, Dr. Jeremy Pettus and Dr. Steve Edelman team up with special guest Dr. David Ahn to break down the latest and greatest in diabetes technology for 2025. From extended-wear CGMs to fully automatic hybrid closed-loop pumps and dual-hormonal systems, this episode is your complete guide to what's available now and what's coming soon. Whether you're on MDI, using a pump, or considering a tech upgrade, this conversation will help you navigate the expanding world of devices—and find the right setup for you.Key Topics:Extended-Wear CGMs: The Dexcom G7 now lasts over 15 days—and the Eversense implantable sensor lasts a full year.Over-the-Counter CGMs: Learn about Dexcom Stelo and Abbott Lingo, designed for people without diabetes.New Pump Launches: Including Tandem Mobi, Beta Bionics iLet, Sequel Twist, and Medtronic's MiniMed™ 780G with Simplera Sync sensor.Medtronic Simplera Sync: What to know about its U.S. launch, wear time, and integration with the 780G system.Dual-Hormone Systems: Explore how glucagon is being used alongside insulin to prevent lows and simplify diabetes management.Ketone Monitoring: Continuous ketone sensors are on the horizon, and they could change how we detect and prevent DKA.Improved App Integration: Discover updates in CGM and pump interfaces for iPhone and Android, including Libre 3+ and universal app platforms.Customizing Your Combo: Why matching the right CGM with the right pump (or sticking with MDI) is more doable—and more important—than ever. ★ Support this podcast ★

Behind the Scenes of Pediatric Critical Care with Dr. Rana ShamiIn this episode of The Pediatric Lounge, hosts Herb and George bring on Dr. Rana Shami, the medical director of the pediatric intensive care unit at Inova Children's Hospital. Dr. Shami discusses her journey from the American University of Beirut to leading a premier PICU in Fairfax, Virginia. She shares insights into the challenges and innovations in pediatric critical care, such as the use of high-flow oxygen and bedside ultrasound, as well as the critical importance of multidisciplinary teamwork. Dr. Shami also talks about the growth of their PICU fellowship program and her advocacy for early diabetes screening to prevent DKA. The episode illuminates how pediatric ICU care has evolved and the ongoing efforts to improve patient outcomes through simulation education and data-driven approaches.00:00 Introduction to The Pediatric Lounge00:28 Sponsor Message: Hippo Education01:08 Meet Dr. Rana Shami: From Beirut to Fairfax01:30 Dr. Rana Shami's Journey in Pediatric Critical Care05:46 Legacy of Dr. Steve Keller in Pediatric Critical Care11:26 Advancements in Pediatric Intensive Care15:36 Challenges and Innovations in Pediatric Care21:42 The Role of Technology in Modern Pediatric Care30:06 Personal Stories and Reflections in Pediatric Care31:48 Using Data to Improve Healthcare33:25 The Power of Tableau in Data Visualization35:48 Leadership Style in the PICU39:25 The Role of Simulation in Medical Training42:35 Launching a PICU Fellowship Program47:18 Telehealth and Remote ICU Work51:16 Advocating for Pediatric Health56:27 The Parent Wise NGO59:19 Concluding Thoughts and FarewellSupport the show

In this episode, Dr. Mark talks with Kristen, who was diagnosed with type 1 diabetes at age 17—just months before graduating high school. The adjustment was rocky. Fear of lows led Kristen to stop taking insulin entirely during her honeymoon phase, and eventually, she ended up in the hospital again with DKA. That second hospital stay marked a turning point. Kristen began to accept her diagnosis, change her mindset, and reframe how she saw insulin—not as something to fear, but as something that keeps her alive and thriving. Now 19, Kristen is learning to trust technology, navigate new challenges with her Medtronic 780G pump, and even planning to get SCUBA certified—without letting fear get in the way. Her story is one of resilience, reflection, and reclaiming freedom with T1D. Grab your FREE copy of the Diabetes Sucks and You Can Handle It audiobook HERE.

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: Eli Lilly will start a lcinical trial for tirzepatide for people with type 1 diabetes, more details on Dexcom's 15 day G7 sensor, Ozepmic pill form tested, type 5 diabetes identified 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   Check out VIVI Cap to protect your insulin from extreme temperatures 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 Our top story this week.. Eli Lilly takes the first steps toward getting tirzepatide approved for people with type 1 diabetes. Tirzepatide is sold under the brand names Mounjaro for type 2 and Zepbound for obesity. The main purpose of this study is to find out how well and how safely tirzepatide works in adults who have type 1 diabetes and obesity or are overweight. Participation in the study will last about 49 weeks. Official Title A Phase 3, Multicenter, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study Evaluating the Efficacy and Safety of Tirzepatide Once Weekly Compared to Placebo in Adult Participants With Type 1 Diabetes and Obesity or Overweight This is a big deal because, even though many people with type 1 are able to get a prescription for tirzepatide, it's not approved for T1D and so insurers won't usually cover it.   https://clinicaltrials.gov/study/NCT06914895 XX The use of drugs like Ozempic, Wegovy and Zepbound in people with type 1 diabetes has risen sharply over the past decade, a new study finds, even though there's little information on the drugs' safety and effectiveness for the condition. The family of medications called GLP-1 receptor agonists includes drugs like Wegovy, Zepbound, Ozempic, Mounjaro and Victoza. But the clinical trials of these medications specifically excluded people with type 1 diabetes, who are dependent on the hormone insulin to survive because they can't make enough of their own. Drugmakers feared that using the GLP-1 medications with insulin might raise the chance of dangerously low blood sugar events, or hypoglycemia, and were unwilling to take the risk of studying them in people with type 1.   For the study, which was published last month in the journal Diabetes, Obesity, and Metabolism, researchers at Johns Hopkins University reviewed the medical records of more than 200,000 people with type 1 diabetes from 2008 to 2023. They grouped the data in three-year periods, starting with October 2008 to September 2011 and ending with October 2020 to September 2023. GLP-1 medication use spiked, as well. Among adults with the highest category of obesity, about 4% used GLP-1 medications in 2008, and 33% did by 2023 – an 800% increase. But these are anecdotal reports and may not reflect instances in which people have side effects or complications like low blood sugar, which can be life-threatening. But Shin says what's really needed is information from randomized, double-blinded studies, in which participants are followed forward in time and given either a drug or a placebo. https://www.cnn.com/2025/04/09/health/glp-1-type-1-diabetes-study/index.html   XX Later this month the FDA will conduct a final meeting regarding a new, investigational compound (sotagliflozin) soda-GLIFF-a-zin that has been shown to Improve QoL and Reduce Long-term Complications for people with type 1 diabetes (T1D). The patient advocacy group Taking Control of Your Diabetes (TCOYD.org) is working to inform the T1D community about sotagliflozin - and to encourage people to sign a Change.org petition directed towards FDA.  Last fall, the FDA declined to approve sotagliflozin due to concerns about a potential increased risk of diabetic ketoacidosis (DKA), despite this being a condition that people with T1D on insulin face and manage daily. While TCOYD respects FDA's caution, the group stands by T1D patients and their physicians who, as a team, balance risks and benefits every day. https://tcoyd.org/petition/ XX Dexcom receives FDA approval for it's G7 with 15 day wear. We have an interview with Chief Operating Officer Jake Leach coming up on Tuesday – we talk about the planned roll out of this sensor, what else has changed, and the fine print in the press release – it says    “A study was conducted to assess the sensor life where 73.9% of sensors lasted the full 15 days. When using the product per package labeling, approximately 26% of sensors may not last for the full 15 days.   https://investors.dexcom.com/news/news-details/2025/Dexcom-G7-15-Day-Receives-FDA-Clearance-the-Longest-Lasting-Wearable-and-Most-Accurate-CGM-System/default.aspx?utm_source=www.diabetech.info&utm_medium=referral&utm_campaign=dexcom-g7-15-day-sensor-gets-fda-cleared-but-will-it-actually-last-that-long   XX Glucotrack is joining something called  FORGETDIABETES bionic pancreas initiative, - this is an European Union project that aims to develop a long-term automated insulin delivery system for type 1 diabetes patients. Glucotrack's Continuous Blood Glucose Monitor (CBGM) will be integrated into the system to provide real-time glucose readings. The initiative's goal is to create a bionic invisible pancreas that eliminates the need for therapeutic actions and reduces psychological burden.   The architecture of BIP encompasses a ground-breaking, lifelong lasting implanted ip glucose nanosensor; a radically novel ip hormone delivery pump, with unique non-invasive hormone refill with a magnetic docking pill and non-invasive wireless battery recharge; an intelligent closed-loop hormone dosing algorithm, optimized for ip sensing and delivery, individualized, adaptive and equipped with advanced self-diagnostic algorithms.     Pump refilling through a weekly oral recyclable drug pill will free T1D subjects from the burden of pain and awkward daily measurement and treatment actions. Wireless power transfer and data transmission to cloud-based data management system round-up to a revolutionary treatment device for this incurable chronic disease. key feature of BIP is to be fully-implantable and life-long lasting thanks to novel biocompatible and immune-optimized coatings guaranteeing long-term safety and stability https://www.stocktitan.net/news/GCTK/glucotrack-to-participate-in-forgetdiabetes-a-prominent-european-cjjldjb0dq7h.html XX A newly recognised form of diabetes, called Type 5, was announced this week at the World Congress of Diabetes 2025. A global task force will investigate this less-understood condition, which differs from Type 1 and Type 2 diabetes. Type 5 diabetes affects people who are underweight, lack a family history of diabetes and do not show the typical symptoms of Type 1 or Type 2 diabetes. The condition was first observed in the 1960s and referred to as J-type diabetes, after being detected in Jamaica. It was classified by the World Health Organisation in 1985, but removed in 1998 due to lack of physiological evidence. At the time, experts believed it to be a misdiagnosed case of Type 1 or 2 diabetes. New research has since confirmed that Type 5 is different. https://economictimes.indiatimes.com/news/new-updates/a-new-type-of-diabetes-has-been-found-by-scientists-and-it-doesnt-show-the-typical-symptoms-of-type-1-or-type-2/articleshow/120276658.cms?from=mdr   XX Oral semaglutide cuts major heart risks in people with type 2 diabetes by 14%, offering a powerful pill-based option. A new clinical trial, co-led by endocrinologist and diabetes specialist John Buse, MD, PhD, and interventional cardiologist Matthew Cavender, MD, MPH, at the UNC School of Medicine, has demonstrated that the oral form of semaglutide significantly lowers the risk of cardiovascular events in individuals with type 2 diabetes, atherosclerotic cardiovascular disease, and/or chronic kidney disease. Results from the rather large, international trial were published in the New England Journal of Medicine and presented at the American College of Cardiology's Annual Scientific Session & Expo in Chicago, Illinois.     The effect of oral semaglutide on cardiovascular outcomes was consistent with other clinical trials involving injectable semaglutide, but more trials are needed to determine if one method may be more effective than the other at reducing major cardiovascular events. https://scitechdaily.com/new-pill-form-of-semaglutide-shows-major-benefits-for-people-with-diabetes/ XX April 14 (UPI) -- The U.S. Food and Drug Administration on Monday warned consumers and pharmacies that fake versions of Ozempic, a drug to treat Type 2 diabetes, have been found in the United States. Novo Nordisk, the Danish-headquartered manufacturer, informed the FDA on April 3 that counterfeit 1-milligram injections of semaglutide were being distributed outside its authorized supply chain. The FDA and Novo Nordisk are testing the fake products to identify whether they're safe. Patients are asked to obtain Ozempic with a valid prescription through state-licensed pharmacies and check the product for any signs of counterfeiting. People in possession of the fake product are urged to call Novo Nordisk customer care at 800-727-6500 Monday through Friday from 8:30 a.m. to 6 p.m. EDT and report it to the FDA's criminal activity division's website. Side effects can be reported to FDA's MedWatch Safety Information and Adverse Event Reporting Program (800-FDA-1088 or www.fda.gov/medwatch) as well as to Novo Nordisk, at 800-727-6500. https://www.upi.com/Health_News/2025/04/14/FDA-fake-Ozempic-drugs-Novo-Nordisk/6841744666854/ XX Can a digital lifestyle modification program reduce diabetes risk? A new study shows that the lifestyle intervention significantly reduced 10-year diabetes risk among prediabetics by nearly 46% and increased the diabetes remission rate, highlighting the importance of lifestyle changes. However, the study was not a randomized trial, and participation in the lifestyle intervention was voluntary, which may introduce selection bias. The study evaluated 133,764 adults, categorizing them as diabetic (7.5%), prediabetic (36.2%), and healthy (56.3%), based on fasting glucose and HbA1c levels. https://www.news-medical.net/news/20250414/Digital-lifestyle-program-cuts-diabetes-risk-by-4625-in-prediabetics-study-of-130k2b-adults-reveals.aspx XX Chrissy Teigan is speaking out about her son's type 1 diagnosis – teaming up with Sanofi to encourage people to screen early for Type 1 diabetes.   Teigen got a crash course in the risks of undiagnosed Type 1 diabetes when her 6-year-old son, Miles, was hospitalized with complications of the autoimmune disease last year. The family knew nothing about Type 1 diabetes when Miles was diagnosed during an unexpected medical emergency, Teigen said in a Tuesday announcement. “We were confused and scared when Miles was first diagnosed,” she said in a statement. “There is no doubt in my mind that knowing in advance would have made a positive impact for Miles, me, and our entire family. I want everyone to hear me when I say: stay proactive and talk to your doctor about getting yourself or your loved ones screened for type 1 diabetes today!”   Teigen shared her family's story in a two-minute video on ScreenForType1.com, a Sanofi website that discusses how to get screened for the condition. Miles' diagnosis made Teigen feel like she “went from a mom to a doctor overnight,” she said. That experience is why Teigen said she is “begging you: Do this one thing, and screen yourself and your family for Type 1 diabetes.” https://www.fiercepharma.com/marketing/sanofi-signs-chrissy-teigen-diabetes-screening-campaign XX Dr. Richard Bernstein – best known for his advocacy around low carb diets for people with diabetes – died this week at the age of 90. Born in 1934 in Brooklyn, New York, he was diagnosed with type 1 at age 12. In the 1970s he adapted a blood glucose monitor for home use and helped pioneer home glucose monitoring. He published multiple books on Diabetes including the #1 selling Diabetes book on Amazon.Com “Dr. Bernstein's Diabetes Solution: A Complete Guide to Achieving Normal Blood Sugars” and “Diabetes Type II: Living a Long, Healthy Life Through Blood Sugar Normalization”.  He practiced and saw patients right up until his death.

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: Learning more about the FDA letter sent to Dexcom, news from ATTD including a bihormonal pump from a Dutch company, time in tight range update, more studies about using insulin and GLP-1 medications, eating chili to prevent gestational diabetes (really!) 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   Check out VIVI Cap to protect your insulin from extreme temperatures 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 Our top story this week: Dexcom Dive Brief: A warning letter posted Tuesday by the Food and Drug Administration revealed quality control issues with Dexcom's continuous glucose monitors. The FDA raised concerns with a design change to a component used in the resistance layer of Dexcom's sensors. The sensors with the new component were less accurate than those with the original component, according to the warning letter. Dexcom has ceased distribution of G7 sensors with the component, but the company's response did not address affected G6 sensors. J.P. Morgan analyst Robbie Marcus wrote in a research note Tuesday that the letter concerns a chemical compound that the sensor wire is dipped in. Dexcom began producing the compound internally to add redundancy to its supply chain.   Dive Insight: Dexcom Chief Operating Officer Jake Leach said in an interview with MedTech Dive last week that the company does not expect the warning letter to affect future product approvals, including a 15-day version of its G7 CGM, and there's no need yet to recall products. Dexcom has submitted the device to the FDA and anticipates a launch in the second half of the year.   Marcus, after speaking to company leadership and a quality control expert, wrote that many of the issues outlined in the letter could be addressed quickly. He added that the warning letter could explain minor delays in approval to the 15-day sensor, but Dexcom is still within the 90-day window for a 510(k) submission.   “While there's always a risk this could impede future product approvals,” Marcus wrote, “we do not expect this to materially delay the 15 day G7 sensor approval.”   The warning letter followed an FDA inspection last year of Dexcom's facilities in San Diego and Mesa, Arizona. Marcus wrote that after the FDA requested additional information and a separate 510(k), Dexcom stopped in-sourcing the compound and reverted back to the external supplier.   Dexcom's devices were misbranded because the company did not submit a premarket notification to the FDA before making major changes to the sensors, according to the warning letter. The sensors with the changed coating “cause higher risks for users who rely on the sensors to dose insulin or make other diabetes treatment decisions,” the letter said.     The FDA raised other concerns in the warning letter, including procedures to monitor the glucose and acetaminophen concentrations used in testing of the G6 and G7 CGMs. The FDA also cited problems with Dexcom's handling last year of a deficiency in its G6 sensors with dissolved oxygen content values, a key input for measuring blood glucose levels. https://www.medtechdive.com/news/dexcom-warning-letter-cgm-coating-change/743597/ XX Lots of studies and info out of the recent ATTD conference. One highlight that has been sort of under the radar: a Dutch company has been using a Bihormonal fully closed-loop system for the treatment of type 1 diabetes in the real world. This is a company called Inreda (in-RAY-duh). The Inreda AP® is an automatic system (closed loop) and independently regulates the blood glucose level by administering insulin and glucagon. The AP5 is certified in Europe and is being used in multiple studies and projects. The AP®6 is currently under development. https://www.inredadiabetic.nl/en/discover-the-ap/ https://pubmed.ncbi.nlm.nih.gov/38443309/ XX Let's talk about time in tight range. If you follow me and diabetes connections on social, you likely saw a video I made about this – it blew up last week. If not.. time in range has been a metric for a short while now.. in 2019 there was a consensus report advising a goal of 70% of time in the 70-180 mg/dL range for most people with type 1 diabetes (T1D) and type 2 diabetes (T2D), with modifications for certain subgroups. Recently we've been hearing more about 70-140 mg/dL — for longer periods as “time in tight range (TiTR).” At ATTD there was more talk about calling that range TING, or “time in normal glycemia.     There's a great writeup that I'll link up from the great Miriam Tucker on Medscape about a debate that happened at ATTD. On March 22, 2025, two endocrinologists debated this question at the Advanced Technologies & Treatments for Diabetes (ATTD) 2025. Anders L. Carlson, MD, medical director of the International Diabetes Center (IDC), Minneapolis, took the positive side, while Jeremy Pettus, MD, assistant professor of medicine at the University of California San Diego, who lives with T1D himself, argued that it's too soon.   https://www.medscape.com/viewarticle/should-time-tight-range-be-primary-diabetes-goal-2025a100073q?form=fpf   XX Sequel Med Tech announces its twist pump will be firs paired with Abbott's FreeStyle Libre 3 Plus. The twist has FDA approval for ages 6 and up and is set to begin its commercial launch by the end of June. The pump—designed by inventor Dean Kamen's Deka Research & Development—also incorporates the FDA-cleared Tidepool Loop software program, to record CGM blood sugar readings, make predictions based on trends and adjust its background insulin levels accordingly. https://www.fiercebiotech.com/medtech/sequel-med-tech-connects-twiist-insulin-pump-abbotts-cgm-ahead-market-debut XX Dexcom's longer-lasting CGM sensor looks promising, based on study results presented at the conference. The trial showed that the new 15-day G7 system is slightly more accurate than the current G7. The accuracy of CGM can be measured using MARD (mean absolute relative difference), which shows the average amount a CGM sensor varies from your actual glucose levels (a lower number is better).  The 15-day G7 has a MARD value of 8.0%, about the same as the Abbott Freestyle Libre 3. The Dexcom G7 15 Day is awaiting FDA approval and is not yet available in the U.S.   XX Little bit of news from Modular Medical.. they plan to submit their patch pump to the FDA late summer or fall of this year. The MODD1 product, a 90-day patch pump, features new microfluidics technology to allow for the low-cost pumping of insulin. Its new intuitive design makes the product simple to use and easier to prescribe. It has a reservoir size of 300 units/3mL. Users can monitor the pump activity with their cell phone and do not require an external controller. The pump uses a provided, single-use, disposable battery. Modular Medical picked up FDA clearance for MODD1 in September. The company also raised $8 million to end 2024. Its founder, Paul DiPerna, previously founded leading insulin pump maker Tandem Diabetes Care. DiPerna invented and designed Tandem's t:slim pump. By developing its patented insulin delivery technologies, the company hopes to improve access to glycemic control. Its founder, Paul DiPerna, previously founded leading insulin pump maker Tandem Diabetes Care. DiPerna invented and designed Tandem's t:slim pump. https://www.drugdeliverybusiness.com/modular-medical-announces-12m-private-placement/ XX More from attd – type 2 news? https://www.drugdeliverybusiness.com/biggest-diabetes-tech-news-attd-2025/ XX Another study that says people with type 1 who use a GLP-1 medication get better outcomes. In this study, those who use GLP-1 with insulin are 55% less likely to have a hyperglycemia-related ED visit, 26% less likely to have an amputation-related visit, and 29% less likely to have a diabetic ketoacidosis (DKA)-related ED visit in the following year compared to those on insulin alone. Although they are not approved for T1D, some patients may receive them off-label or for weight control. Pretty big study for an off label drug: compared 7,010 adult patients with T1D who were prescribed GLP-1s and insulin to 304,422 adult patients with T1D who were on insulin alone.  It is important to note that the rates of new diabetic complications in one year for both groups were around 1%, indicating that these are uncommon outcomes regardless of medication use. https://www.epicresearch.org/articles/some-diabetic-complications-less-likely-among-type-1-diabetics-on-glp-1s   XX Early research here but exposure to antibiotics during a key developmental window in infancy may stunt the growth of insulin-producing cells in the pancreas and boost risk of diabetes later in life The study, is published this month in the journal Science, it's a study in mice. These researchers are working off the idea that when while identical twins share DNA that predisposes them to Type 1 diabetes, only one twin usually gets the disease. She explained that human babies are born with a small amount of pancreatic “beta cells,” the only cells in the body that produce insulin.   But some time in a baby's first year, a once-in-a-lifetime surge in beta cell growth occurs.   “If, for whatever reason, we don't undergo this event of expansion and proliferation, that can be a cause of diabetes,” Hill said.   They found that when they gave broad-spectrum antibiotics to mice during a specific window (the human equivalent of about 7 to 12 months of life), the mice developed fewer insulin producing cells, higher blood sugar levels, lower insulin levels and generally worse metabolic function in adulthood.   in other experiments, the scientists gave specific microbes to mice, and found that several they increased their production of beta cells and boosted insulin levels in the blood. When male mice that were genetically predisposed to Type 1 diabetes were colonized with the fungus in infancy, they developed diabetes less than 15% of the time. Males that didn't receive the fungus got diabetes 90% of the time. Even more promising, when researchers gave the fungus to adult mice whose insulin-producing cells had been killed off, those cells regenerated. Hill stresses that she is not “anti-antibiotics.” But she does imagine a day when doctors could give microbe-based drugs or supplements alongside antibiotics to replace the metabolism-supporting bugs they inadvertently kill.   .   “Historically we have interpreted germs as something we want to avoid, but we probably have way more beneficial microbes than pathogens,” she said. “By harnessing their power, we can do a lot to benefit human health.”     https://www.eurekalert.org/news-releases/1078112 XX Future watch for something called BeaGL - created by researchers at the University of California Davis and UC Davis Health who were inspired by their own personal experiences with managing T1D.   BeaGL is designed to work with CGMs and has security-focused machine learning algorithms to make predictive alerts about anticipated glucose changes, which are sent to a device. In this case, a smartwatch. The end goal is for BeaGL to be completely automated to reduce the cognitive load on the patient, particularly for teens. It's still in research phase but six student with T1D have been using it for almost a year.     https://health.ucdavis.edu/news/headlines/with-ai-a-new-metabolic-watchdog-takes-diabetes-care-from-burden-to-balance/2025/02 XX Investigators are searching for a way forward after two long-term diabetes programs were terminated following the cancellation of their National Institutes of Health (NIH) funding, the result of federal allegations that study coordinator Columbia University had inappropriately handled antisemitism on campus. The programs include the three-decades-old Diabetes Prevention Program (DPP) and its offshoot, the Diabetes Prevention Program Outcomes Study (DPPOS). “We are reeling,” said David Nathan, MD, a previous chair of both the DPP and the DPPOS and an original leader of the landmark Diabetes Control and Complications Trial. Nathan is also founder of the Massachusetts General Hospital Diabetes Center in Boston, one of the 30 DPPOS sites in 21 states. On March 7, the Trump administration cancelled $400 million in awards to Columbia University from various federal agencies. While Columbia University agreed on March 21 to changes in policies and procedures to respond to the Trump administration's charges, in the hopes that the funding would be restored, DPPOS Principal Investigator Jose Luchsinger, MD, told Medscape Medical News that as of press time, the study was still cancelled. https://www.medscape.com/viewarticle/diabetes-prevention-program-cancellation-colossal-waste-2025a100076h XX XX Type 2 diabetes may quietly alter the brain in ways that mimic early Alzheimer's. This was only an animal study – but researchers say the high comorbidity of type 2 diabetes (T2D) with psychiatric or neurodegenerative disorders points to a need for understanding what links these diseases.   https://scitechdaily.com/how-diabetes-quietly-rewires-the-brains-reward-and-memory-system/ XX Eating chili once a month when you're pregnant seems to lower the risk of developing gestational diabetes. This is a real study! While chili showed a link to lower gestational diabetes risk, dried beans and bean soup had no significant effect, even among women who ate them more frequently. Some studies suggest that diets high in beans and legumes, including the Mediterranean diet, reduce GDM risk. While studies link beans to lower diabetes risk, their specific impact on GDM remains unclear. This study analyzed data from 1,397 U.S. pregnant women who participated in the Infant Feeding Practices Study II, conducted between 2005 and 2007. Chili consumption varied significantly by race, education, household size, income, supplemental nutrition status, and region. Non-Hispanic Black mothers consumed the most (0.33 cups/week), while those with higher income and education levels consumed less. Regional differences also influenced chili intake. One possible mechanism for chili's effect is capsaicin, a bioactive compound found in chili peppers, which has been linked to metabolic benefits in other studies. However, further research is needed to confirm this potential role in GDM prevention. Dried bean and bean soup consumption had no clear association with GDM. The study highlights limitations due to self-reported dietary data and the need for more detailed dietary measures. https://www.news-medical.net/news/20250317/Could-a-little-spice-in-your-diet-prevent-gestational-diabetes.aspx XX

Harnessing EHRs to Unlock the Cure for Type 1 Diabetes: A Candid Discussion with ExpertsThis episode, sponsored by Hippo Education, explores the potential role of Electronic Health Records (EHRs) in finding a cure for Type 1 Diabetes (T1D). Hosts are joined by Chip Hart from PCC and Dr. Dan Feiten from Office Practicum, both leading experts in pediatric-focused EHRs. They discuss their personal connections to T1D and the importance of identifying potential cases early, even before DKA develops. The conversation delves into the impact of family history and the need for better communication and education among pediatric clinicians. The experts emphasize the importance of integrating care plans, population health management, and the role of technology in achieving better outcomes. The discussion also highlights the challenges in the current healthcare system, including billing, insurance, and the need for more proactive strategies in pediatric care.00:00 Introduction and Sponsor Message00:40 Meet the Guests: Chip Hart and Dr. Dan Feiten01:38 Personal Stories of Type 1 Diabetes06:04 Redefining Type 1 Diabetes09:46 The Role of EHR in Managing Type 1 Diabetes16:38 Challenges and Opportunities in EHR Data38:54 The EHR Guy's Frustration with Inefficient Forms39:39 Pragmatic Approaches to Care Plans and Protocols40:27 Challenges in Managing Type 1 Diabetes in Families41:18 The Role of Pediatricians and Endocrinologists43:17 Communication Gaps in Diabetes Care44:40 Insurance and Accessibility Issues45:25 The Importance of Pediatric Leadership and Collaboration47:44 Advocating for Better Screening and Resolutions at the AAP01:00:30 The Future of Diabetes Monitoring and Technology01:08:00 Closing Thoughts on Pediatric Care and EHR SystemsSupport the show

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: Sana announces beta cell transplantation without the need for immunosuppresion drugs, Modular Medical teams up with Nudge BG for a brand new completely closed-loop system, the FDA moves forward to crack down on compounded Ozempic and Mounjaro, Dexcom and Abbott bury the legal hatchett for a while, 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 Big news from Sana Biotechnology. Their first in human study of islet cells without any immunosuppression appears to be a success. This is very early and hasn't yet been peer reviewed and published.. but after four weeks, there were no safety issues and the transplanted beta cells were producing insulin. Sana's CEO says  “As far as we are aware, this is the first study showing survival of an allogeneic transplant with no immunosuppression or immune-protective device in a fully immune competent individual. Safe cell transplantation without immunosuppression has the potential to transform the treatment of type 1 diabetes and a number of other diseases.”   I've reached out to Sana to get more on this.. love to talk to them soon.   https://www.bakersfield.com/ap/news/sana-biotechnology-announces-positive-clinical-results-from-type-1-diabetes-study-of-islet-cell/article_d0390fd6-99cb-53bd-b04d-9337121e01bf.html XX FDA says no for sotagliflozin as an adjunct to insulin therapy for glycemic control in adults with type 1 diabetes (T1D) and chronic kidney disease (CKD).  Studies showed a meaningful reduction in A1C but a meaningful increase in DKA. The FDA first rejected this in 2019 and was resubmitted last summer. But The advisory committee voted 11 to 3 against the approval of sotagliflozin stating that the benefits of sotagliflozin do not outweight the risks in adults with T1D and CKD. Sotagliflozin is currently approved under the brand name Inpefa to reduce the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visit in adults with 1) heart failure; or 2) type 2 diabetes mellitus, CKD, and other cardiovascular risk factors.  According to Lexicon, Inpefa will continue to be manufactured and made available to patients. https://www.renalandurologynews.com/news/fda-denies-approval-of-zynquista-for-type-1-diabetes-and-ckd/ XX Two companies we've been following are teaming up.. Modular Medical has an FDA clear patch pump and Nudge BG has an adaptive full closed loop. They've announced a new partnership agreement. From the release: Modular Medical's easy-to-use and cost-effective MODD1 insulin pump technology. Our combined system is intended to nudge blood glucose by making small changes to insulin delivery based on estimated glucose inputs from a continuous glucose monitor." Familiar name to some of you, Lane Desborough is the founder of Nudge BG. He says this will be a fully automated system, no mealtime bolusing needed.   https://www.accesswire.com/957703/modular-medical-announces-licensing-and-partnership-agreement-with-nudge-bg XX Beta Bionics filed for an initial public offering on Monday. The company did not disclose the number of shares it will offer or the price range. Beta Bionics plans for shares to be listed on the Nasdaq under the ticker symbol “BBNX.” The Irvine, California-based company makes an insulin pump called the iLet Bionic Pancreas, which was cleared by the Food and Drug Administration in 2023. Beta Bionics plans to use the proceeds to grow its sales and manufacturing infrastructure and develop new features for its device.   https://www.medtechdive.com/news/beta-bionics-insulin-pump-files-ipo/736805/     XX Tandem Diabetes Care, Inc. signed a multi-year collaboration agreement with the University of Virginia Center for Diabetes Technology (UVA) to advance research and development efforts on fully automated closed-loop insulin delivery systems.   There's a long history here – UVA is where the Control IQ algorithm was developed.  This agreement seems to keep the team together for another decade. https://www.businesswire.com/news/home/20250107162995/en/Tandem-Diabetes-Care-Enters-Multi-Year-Research-Collaboration-with-UVA-Center-for-Diabetes-Technology-for-Development-of-Advanced-Insulin-Delivery-Systems XX New study says insulin is still the best treatment for gestational diabetes, compared to oral glucose-lowering medications. Metformin and gluburide are being closely looked at since they're easier to administer, less costly, and have better acceptance among patients. But this study says insulin was a bit better – slight more babies were born larger for the metformin group, and more moms had hypoglycemia. https://www.medpagetoday.com/obgyn/pregnancy/113651 XX In its Citizen Petition to the FDA, Novo Nordisk argued that there is no clinical need to allow compounding for liraglutide, the type 2 diabetes injection it sells as Victoza. Novo Nordisk last month filed a Citizen Petition with the FDA asking the federal agency to exclude its type 2 diabetes injection Victoza (liraglutide) from a proposed list of drugs eligible for compounding. https://www.biospace.com/fda/novo-launches-citizen-petition-to-block-compounded-victoza XX Bit of an update on compounded terzepatide and semaglutide. The FDA is allowing a grace period of 60 days before starting to enforce the end of allowing compounds of Mounjaro. Meanwhile, semaglutide remains on the FDA's shortage list for several dose strengths, though all doses have been reported as “available” since late October 2024. Compounding pharmacies, especially larger 503B “outsourcing facilities,” maintain they provide an essential public service by offering lower-cost versions of medications that can cost over $1,000 per month. Many insurers still refuse to cover brand-name GLP-1 products for weight loss. Yet  the FDA has reported hundreds of adverse event reports allegedly linked to compounded versions of these drugs, which do not undergo the same rigorous manufacturing inspections and clinical testing as approved brands.   https://www.drugdiscoverytrends.com/compounders-and-drugmakers-clash-over-compounded-weight-loss-drugs-with-fda-in-the-middle/ XX Interesting story here.. this study says a fecal transplant can help people with type 1 and severe gastroenteropathy. The researchers say diabetic gastroenteropathy commonly affects individuals with type 1 diabetes, causing debilitating symptoms like nausea, vomiting, bloating, and diarrhea; however, treatment options remain limited. Researchers conducted a novel clinical trial to test the benefits of FMT in adult patients with type 1 diabetes and severe symptoms of gastroenteropathy, who were randomly assigned to receive either FMT or placebo capsules as the first intervention. After four weeks, Compared with placebo, FMT led to significant changes in the diversity of the gut microbiome. https://www.medscape.com/viewarticle/fmt-shows-early-success-type-1-diabetes-bowel-issues-2025a10000bg XX A couple of weeks ago, listeners told me that the Dexcom geofencing issue we reported on seems to be resolved. Dexcom is now confirming this. 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. As of last month, the geofencing issue has now been resolved with the latest Dexcom G7 2.6 app update. Can I travel with my Dexcom G7? | Dexcom XX Abbott and Dexcom settled all patent lawsuits related to continuous glucose monitors (CGMs). The two competitors, who lead the U.S. market for CGMs, agreed on Dec. 20 to resolve all outstanding patent disputes and not sue each other over patents for 10 years.   Dexcom and Abbott previously reached a settlement in 2014 related to their diabetes devices, which included a cross-licensing deal and an agreement not to sue each other until 2021. After that agreement expired, the companies filed a volley of patent lawsuits. https://www.medtechdive.com/news/abbott-dexcom-settle-cgm-patent-lawsuits/736300/  

$5 Q-BANK: https://patreon.com/highyieldfamilymedicine Intro 0:30, Diagnostic criteria 2:02, Type 1 vs type 2 diabetes 5:43, Metformin 6:57, Sulfonylureas 8:36, TZDs 9:09, DPP-4 inhibitors 9:54, GLP-1 agonists 10:39, SGLT2 inhibitors 12:39, Insulin 14:08, Diabetic ketoacidosis (DKA) 16:32, Hyperglycemic hyperosmolar syndrome (HHS) 23:07, Microvascular complications 25:06, Macrovascular complications 33:07, Practice questions 34:46

In this special 3-person episode, I'm speaking to Sharon Harrison-Barker and her son Lewis. Lewis's son Marty was just 10 months old when he was rushed to hospital in DKA in 2017, plunging the whole family into crisis and shifting the dynamic of the family forever. Today Marty is a happy, healthy 8-year-old, but those days in the hospital were the some of the worst of dad Lewis and nan Sharon's lives, as well as their respective spouses. The weeks and months after his son's diagnosis remain a blur for Lewis, and it was the concerned words of a stranger that prompted him to seek help for his mental health. In this chat, Lewis opens up about how from the moment he received the initial call about his son's declining health, he completely shut down. ‘It sent me into self-preservation mode. I felt like people didn't need me to be emotional, they needed me to be functional.' In this episode we hear two different perspectives of the same very difficult experience. Nan and dad tell me how Marty's diagnosis has changed them as a family, sharing some of their memories with each other for the very first time. Their relationship is a testament to how clear communication - as well as boundaries - have allowed Marty to thrive through nursery, school and now as a big brother, but have also helped Lewis and his wife Steph to meet the ever-evolving needs of Marty's condition alongside their own as humans, parents, and partners.CONNECT WITH SHARONSharon's Instagram.CONNECT WITH LEWIS Lewis's Instagram.JOIN THE TYPE 1 ON 1 COMMUNITY:We've got an Instagram account! Come and say hi @studiotype1on1.SPONSOR MESSAGE:Thanks to my episode sponsors Dexcom.Pioneer and leader in Real-Time continuous glucose monitors,Dexcom's goal is to simplify and improve diabetes management for every possible person with diabetes.They have a choice of systems, so you can find the right one for your lifestyle at https://www.dexcom.com/

Contributor: Travis Barlock MD Educational Pearls: What is the ST segment? The ST segment on an ECG represents the interval between the end of ventricular depolarization (QRS) and the beginning of ventricular repolarization (T-wave).  It should appear isoelectric (flat) in a normal ECG. What if the ST segment is elevated? This is evidence that there is an injury that goes all the way through the muscular wall of the heart (transmural) This is very concerning for a heart attack (STEMI) but can be occasionally caused by other pathology, such as pericarditis What if the ST segment is depressed? This is evidence that only the innermost part of the muscular wall of the heart is becoming ischemic This has a much broader differential and includes a partial occlusion of a coronary artery but also any other stress on the body that could cause a supply-and-demand mismatch between the oxygen the coronaries can deliver and the oxygen the heart needs This is called subendocardial ischemia What else should you look for in the ECG to identify subendocardial ischemia? The ST-depressions should be at least 1 mm The ST depressions should be present in leads I, II, V4-6 and a variable number of additional leads. There is often reciprocal ST elevation in aVR > 1 mm The most important thing to remember when you see subendocardial ischemia is…history Still, keep all cardiac causes on your differential, such as unstable angina, stable angina, Prinzmetal angina, etc. Also consider a wide array of non-cardiac causes such as severe anemia, severe hypertension, pulmonary embolism, COPD, severe pneumonia, sepsis, shock, thyrotoxicosis, stimulant use, DKA, or any other state that lead to reduced oxygen supply to the subendocardium and/or increased myocardial oxygen demand. References Birnbaum, Y., Wilson, J. M., Fiol, M., de Luna, A. B., Eskola, M., & Nikus, K. (2014). ECG diagnosis and classification of acute coronary syndromes. Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 19(1), 4–14. https://doi.org/10.1111/anec.12130 Buttà, C., Zappia, L., Laterra, G., & Roberto, M. (2020). Diagnostic and prognostic role of electrocardiogram in acute myocarditis: A comprehensive review. Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 25(3), e12726. https://doi.org/10.1111/anec.12726 Cadogan, E. B. a. M. (2024, October 8). Myocardial Ischaemia. Life in the Fast Lane • LITFL. Retrieved December 7, 2024, from https://litfl.com/myocardial-ischaemia-ecg-library/#:~:text=ST%20depression%20due%20to%20subendocardial,left%20main%20coronary%20artery%20occlusion. Summarized by Jeffrey Olson, MS3 | Edited by Meg Joyce & Jorge Chalit, OMS3 Donate: https://emergencymedicalminute.org/donate/  

On this month's EM Quick Hits podcast: Ross Prager on TEE in cardiac arrest, Justin Morgenstern on nebulized ketamine for analgesia in the ED, Hans Rosenberg & Krishin Yadav on standardizing cellulitis management, Mathew McArther on latest studies on subcutaneous insulin protocols in DKA, Jennifer C. Tang on documenting differential diagnoses medicolegal tips...

When you meet Abi Woodliffe-Thomas, you meet a thoughtful, articulate, intelligent and confident 25-year-old. But for more than a decade, Abi carried her type 1 diabetes in secret as her ‘biggest insecurity' - hiding it from everyone in her life.Abi went through a traumatic diagnosis at the age of just 12, and the experience immediately plunged her into intense feelings of shame around the condition. Still in the hospital bed in recovery from DKA, Abi was also told she would have to give up her beloved acrobatic gymnastics, which she was already devoting 25 hours to each week.Determined to prove the nurses wrong, Abi returned to training the very next week, and channeled every emotion into her sport. She went onto compete at an international level, all the while keeping her condition out of sight.Now retired from gymnastics and working as a performance nutritionist, the weight of what she'd been carrying for so long was released when Abi wrote an article about her type 1 diabetes for her friend's website.Since her diagnosis Abi has overcome so much, both professionally and personally, and is tentatively hopeful about walking a different, more open path towards acceptance - one conversation at a time.‘I do still find it difficult to say the words, oh, I'm diabetic or oh, I've got diabetes. But I think it's really helped talking about it and I think life would look very different if I'd spoken about it from the beginning. But it was my way of protecting myself. I know now that anything is possible, even with a pancreas that doesn't work.'CONNECT WITH ABI:Say hi to Abi on Instagram. Take a look at her professional profile, Happetite.JOIN THE TYPE 1 ON 1 COMMUNITY:We've got an Instagram account! Come and say hi @studiotype1on1. SPONSOR MESSAGE:Thanks to my episode sponsors Dexcom.Pioneer and leader in Real-Time continuous glucose monitors, Dexcom's goal is to simplify and improve diabetes management for every possible person with diabetes.They have a choice of systems, so you can find the right one for your lifestyle at https://www.dexcom.com/

Show notes at pharmacyjoe.com/episode964. In this episode, I'll discuss subcutaneous insulin therapy for patients with low to moderate severity DKA. The post 964: The SQuID Protocol for DKA Treatment - Sounds cool but how well does it work? appeared first on Pharmacy Joe.

On this month's EM Quick Hits podcast: Ian Chernoff on the often elusive diagnosis of traumatic coronary artery dissection, Anand Swaminathan on proper use of insulin in DKA and in hyperkalemia, Brit Long and Hans Rosenberg on mesenteric ischemia pearls and pitfalls in diagnosis and management, Dave Jerome on recognition and management exercise-associated hyponatremia and heat illness and Jesse McLaren on the Queen of Hearts AI model in helping identify occlusion MI on ECG... Help Support EM Cases by Giving a Donation here: https://emergencymedicinecases.com/donation/

In this episode, Lisa shares how her son, Hudson, was diagnosed with Type 1 Diabetes at the age of 20 (9 years after her daughter Juniper was diagnosed)  by playing a silly little game at home. We'll see if they ever play that game again.We chat about the the vast difference in catching a diagnosis early versus in DKA, going into a second diagnosis with a solid foundation of knowledge this time, how the hospital barely let them leave with a prescription for insulin, the difference in a toddler and adult diagnosis, the things they wish happened at their very first end appointment with T1D that lasted all of 20 minutes, and all the amazing things Hudson is doing despite living with T1D. Hang out with us on Instagram:Spill the T1D - @spilltheT1DKeary - @graceandsaltLisa - @thepoolgang_

In this episode: Diabetic Ketoacidosis (DKA) is a severe and potentially life-threatening complication of diabetes, yet it is more common than people think, especially upon diagnosis of diabetes. In this episode of the Taking Control of Your Diabetes podcast, hosts Dr. Jeremy Pettus and Dr. Steve Edelman, both endocrinologists living with type 1 diabetes, provide an in-depth exploration of DKA. They discuss the science behind ketones, why the body produces them, and how they can become dangerous in people living with diabetes. The doctors share personal experiences with DKA and offer valuable insights on recognizing early symptoms, the importance of regular ketone testing, and effective at-home treatment strategies. They also delve into the latest advancements in ketone monitoring technology and discuss certain diabetes medications that may increase DKA risk.Key Topics: What are ketones and what purpose do they serve in the body?Ketogenic diet vs diabetes: what's the difference?DKA risk mitigation and the best ways to go about itDo high glucose levels equate to having DKA?How common is DKA among diabetics and who is at risk?What are early signs and symptoms of DKA?When should you check your ketones?How to measure the important ketone that identifies someone in DKA?What are the different types of ketone meters out there?What are the different levels of ketones and what do they mean?What are some ways you can treat yourself at home?What are the cornerstones of DKA prevention and relief? ★ Support this podcast ★

In this episode of the Saving Lives Podcast, Eddy Joe delves into the latest research comparing balanced electrolyte solutions to 0.9% saline for treating diabetic ketoacidosis (DKA). Discover how BES could potentially revolutionize DKA management by speeding up recovery and reducing complications. Tune in for an in-depth analysis of the study and its implications for clinical practice. The Vasopressor & Inotrope Handbook I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy. If you're in the US, you can order A SIGNED & PERSONALIZED COPY for $29.99 or via AMAZON for $32.99 (for orders in or outside the US). Ebook versions are available via AMAZON KINDLE for $9.99, APPLE BOOKS, and GOOGLE PLAY. ¡Excelentes noticias! Mi libro ha sido traducido al español y está disponible a traves de AMAZON. Las versiones electrónicas están disponibles para su compra for solo $9.99 en AMAZON KINDLE, APPLE BOOKS y GOOGLE PLAY. Citation: Szabó GV, Szigetváry C, Turan C, Engh MA, Terebessy T, Fazekas A, Farkas N, Hegyi P, Molnár Z. Fluid resuscitation with balanced electrolyte solutions results in faster resolution of diabetic ketoacidosis than with 0.9% saline in adults - A systematic review and meta-analysis. Diabetes Metab Res Rev. 2024 Jul;40(5):e3831. doi: 10.1002/dmrr.3831. PMID: 38925619. --- Support this podcast: https://podcasters.spotify.com/pod/show/eddyjoemd/support

Show notes at pharmacyjoe.com/episode949. In this episode, I'll discuss subcutaneous insulin for the treatment of diabetic ketoacidosis (DKA). The post 949: How well does subcutaneous insulin work for DKA treatment? appeared first on Pharmacy Joe.

Brianna continues discussing the challenges of managing her son's type 1 diabetes post-DKA and the support systems involved. Learn about the Medtronic Champions JUICE CRUISE 2025 Screen It Like You Mean It Eversense CGM 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 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.  

As Coach Neil says, this is the episode he needed when he was first diagnosed. If you've been diagnosed with type one diabetes, type 1.5, or LADA within the past 12 months, or are a parent of a child with T1D, this is a must listen. But even if you were diagnosed years ago, you will get something out of this conversation! Coach Neil and I are sifting through all the misinformation and information overload to get you EXACTLY what you need to know in order to thrive with diabetes. Time Stamps:  (05:05) Neil's diagnosis story while in the Airforce (07:35) Avoidance mindset vs. perfection mindset(08:34) Lauren's diagnosis story as a child(10:12) “The' fighter mentality' doesn't work either”(11:08) “There's nothing you did wrong”(14:54) “A lot of our success will come from our relationship to T1D”(16:09) Our best mindset advice(17:02) How to find balance and avoid yo-yo-ing(19:36) The honeymoon phase and tests we recommend (21:20) The pancreas and insulin - what you need to know(25:47) Going to the endocrinologist (26:26) DKA(29:54) The role of healthcare & expectations (32:20) Diabetes stats (34:00) The birth of Risely (35:14) Blood sugar, A1C, time in range targets (37:06) Neil's low story(39:10) Lauren's never-before-told juice story (48:55) A1C: what is it?(52:02) Let's talk nutrition (55:45) Bolusing strategies(59:06) Insulin sensitivity (01:00:10) The role of movement(01:03:30) Have grace with yourself in the learning curve (01:06:04) “When you don't feel like you're working with T1D, it drains you”(01:07:03) “The life you deserve is attainable.”(01:08:23) How Risely can support youWhat to do now:Follow me @lauren_bongiorno and @riselyhealth on Instagram to stay in the loop for when new episodes drop.The doors are open for our Decide and Conquer Group Coaching Program for T1D women. Apply now and talk to our team HERE. We are here to support you in your diabetes journey.Learn more about our 1:1 coaching programs HERE. Learn more about TempMonitor HERE  Buy TempMonitor HEREDisclaimer: Nothing you hear on the Reclaim your Rise podcast should be a substitute for personalized professional medical advice. Please always consult your physician or other medical professional before making any changes to your diet, insulin dosages, or healthcare plan. 

This week, managing type 1 diabetes into your 70s is a bit of uncharted waters.. While thankfully more and more people are living long with T1D, that wasn't always the case. I'm taking to Dianne Mattiace who is in her early 70s and was diagnosed as an adult, 30 years ago. She was the first person in the US to use the Eversense CGM when it was approved in 2018 and she's still using it today. She answers your questions about this implantable CGM, why she's stayed with it and what else she does to manage in retirement and beyond.   This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. More about Eversense here Our previous episodes about Eversense here  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:  Stacey Simms  0:00   Diane Matisse. Thanks so much for joining me. Welcome to Diabetes Connections. It's great to talk to you. Dianne Mattisse  0:04   Thank you so much for having me. Yeah, let's Stacey Simms  0:07   jump right in. Let's start with your diagnosis story, because you were initially misdiagnosed, right? Take me through what happened? Yes, Dianne Mattisse  0:15   I was 40 years old. And my family history was type two diabetes. And they actually, as soon as you say that to a physician, and it was a general practitioner, it was not an endocrinologist, they automatically just put that label on me and said, you know, you're another type two in your family. It went on for about three months. And I actually was in the honeymoon phase, which now was not even recognized back then. But I, it was at the time where you're making enough insulin to keep you from going into DKA into ketoacidosis end up in a hospital, but not enough to make you feel well, so my blood sugar's were still rising, the medication they had me on wasn't working. And finally, after, I think about three or four months, well, during that time, I saw an endocrinologist. And he also was doing a lot of testing, even the C peptide, which is now a diagnosis tool wasn't able to be done where I lived, they had to send it out to a lab in Atlanta. So once that was kind of established, he admitted me, and started me on insulin and, you know, multiple injections per day, Stacey Simms  1:35   why did you What led you to actually seek out an endocrinologist? Dianne Mattisse  1:39   I was not feeling great with the general doctor treating me and I just kept getting worse and worse. And I was taking oral medications, they weren't all these designer meds that they have now for type twos. Back then it was couple pills. So I was I would call them increase the pills. And as I was increasing the pills over the three or four months, so was my blood sugar increasing, and I kept losing weight. And I'm thinking, well, this is a great diet I'm on I was eating better. But my blood sugar's were going into the three hundreds. So finally, I had been in the medical field before that, actually, it was in the medical field at the time, I was a controller for a nursing home company, but it didn't really have access to a lab or anything like that. I was actually the Regional Controller. And I was on the financial side, right? So I actually went to a lab got my blood sugar taken. I didn't even think to buy a meat or anything like that, which I should have, but I did not. And I kept seeing my blood sugar's go up and up and up. And so I finally just on my own said, I'm gonna go to an endocrinologist. And as soon as I went, he told me, I think you're a type two. And type one, I think you are type one, misdiagnosed as a type two. And let's do some testing. He started he did the C peptide, sent it out, did a bunch of other tests. I have no no recollection. Now, it's been 33 years of what else he did. But over that weekend, so that was like a Friday over that weekend, I just be compensated more I started getting muscle cramps, I called him and he said, go to the hospital Monday morning, seven o'clock and bring a bag you're being admitted. So I did. And he said, I was really on the brink of going into diabetic ketoacidosis. So it was really, really just, you know, it's good that I went to the hospital that morning and got on insulin, I think but I think a lot of people when they're diagnosed after 40 or 35, I just talked to somebody the other day who was diagnosed at like 55. And I think the older you get, the less they even think it just automatically think you're a type two. Yeah, yeah, Stacey Simms  3:58   it's something like half of all cases of Type one are occurring and people over the age of 20. But as you say, once you're over 20, many doctors don't know that it could be type one. I hear a lot of stories of Pupil misdiagnoses type two who have type one of a lot of people who have lotta, you know, latent autoimmune diabetes in adults. I don't hear a lot of these stories happening in the late 1990s. Or prior to that time period. Did you ever talk to your endocrinologist? Like, I don't want to say he was cutting edge because it was pretty obvious you were suffering, right at that point. But it is interesting that this was 33 years ago, and somebody finally got it right. Dianne Mattisse  4:41   I think I was just so sick. By the time I actually went to see him and I had lost about 40 pounds. By that point. He looked at the amount of medication oral meds that I was on, and I think it had been about a period of three months and I kind of was keeping track of the blood sugars on a piano And a little notebook back then, that we had. And he looked at that and said, you know, you're you're decompensating, you're not doing well on any of these meds, the amount of weight I had lost. And I was young, younger. So I wasn't. I mean, I was losing muscle mass, but it wasn't as noticeable if I had been 60 or 70 years old. And he said, You're losing muscle mass. And you're just feeling so bad. I mean, I remember going on a trip with my husband. And we went to the Statue of Liberty at that point. It was you were able to go up the stairs and go into the statue. Yeah, well, we actually went with some family members. And this is before I actually was on insulin about a month before. And I remember going up three steps, and turning around and telling my husband, I can't do this. Oh, wow. And we had always, I had always been going to the gym be doing aerobics. Back then more of a runner than walking. Walking is more popular. Now. Of course, you know, less on the joints and everything. But I was a runner back then I was into aerobics. I was very athletic skier and, you know, snow ski or water skier. And he looked at me and said, What do you mean? And I said, I can't do it. I'm out of breath on step number three, I need to turn around. So that kind of pushed me to figure out. And now when I look back at those pictures of what I look like, I'm like, I actually looked very, very sick. I mean, that weight for me was not a normal weight ever in my life. Maybe when I was 10. Stacey Simms  6:45   For a lot of weight, I Dianne Mattisse  6:48   think I weighed 103. And I mean, I think I weighed more than that. Honestly, in fourth grade. Yeah. Stacey Simms  6:53   Wow. Especially for somebody athletic. That's really tiny. Right? Right. Um, Dianne Mattisse  6:59   you know what it is? It's it's denial. Oh, because nobody in my family. I mean, my family thought I look great. You're, you're on a diet, you're doing great, everything's good. But they didn't know how I was really feeling you know, health wise, I felt horrible. And weak and, and constantly thirsty, and constantly urinating and, you know, in the bathroom all the time and starving me, you actually are starving your body. And it's just the worst, it was a thirst. When I describe it to people, it was a thirst that no matter how much you drank, you could never make it go away. It was just something that was there all the time. So I mean, it was very, I was very lucky to find the right endocrinologist that, like you said, was a little bit of ahead of time, and kind of just said, You're a type one. You're not a type two, there's just no way and immediately hospitalized me and got me on track. So Stacey Simms  8:00   I'm imagining that you did go home with a meter this time. Do you mind taking us through your technology journey because we're here to talk about you know what, you're one of the first people to use the ever since Dianne Mattisse  8:12   I was first I was the first person implanted in the United States with the ever since and my doctor who is in Opelika, Alabama was the for about Columbus, Georgia. And he has an office in OPA Leica. He was the first person to be sort of the first physician to be certified. Wow, the technology. Let me tell you technology now. I always say this if you have to have a disease and a chronic disease. I'm so happy now that I have all of the help and see GMs I had actually left the hospital with a meter. And it was like, I think he had to wait two minutes for it to actually read. You know, your drop of blood. It had to be a much bigger drop of blood and all that. My doctor at the time would not there were pumps, but they were obviously much larger. And the CGM, the first CGM that I had was I had to go to the hospital and have it put on and I wore it it was a big box and I had to wear it for seven days. Then go back to the hospital. They would take the recording out they would review and and print everything, send it to my endocrinologist and then I had to go back to the endocrinologist for a report. So it only took a week of my life and of course, like anybody else I was sure that I was doing everything right and trying to have good read, you know a good recording done. So I would get a good report when I went there. Now I had changed my my original endocrinologist had a family tragedy with his son, so I had to change endocrinologist. And I thought I had a really good endocrinologist. But for some reason, she didn't really push me with the CGM. So I really pushed that. And I have been on all of them. I've been on all of the 10 to 14 day ones I've been on. Like I said, the original one that had to wear for seven days. And honestly, the last one, not the last few years before I went on, ever since I did not, they didn't get along with my body. I mean, I had too many alarms. I had too many failures. I had skinny rotations, I had just inaccuracies. And I finally said to myself, I'm not being compliant because of it. So I just started doing more meter checks. And I tried to manage my diabetes, which I could not I mean, to be honest, I was thinking I was compliant when I when I moved to Alabama and got with my physician now, my endocrinologist. I was not I was not being compliant, because I didn't have a CGM. So I mean, it's almost impossible to stick your finger every five minutes. I was gonna say do Stacey Simms  11:19   you think the right word is compliant, though? I mean, you were trying, right? It's not like you were in your like, I hit that non compliant page. I Dianne Mattisse  11:27   was right. You're right. I was trying. But now that I look back, I'm like, I should have. Well, there was nothing like ever since before I got it. So it was funny thing. My husband heard about it. I actually moved to Alabama a year earlier than my husband he was working down there want to do is finish his job for another year. And so I moved to Alabama, because we bought a house on the spur of the moment. We're on a visit up here. And so yeah, we weren't it wasn't a plan. It was not a plan. We just did it. So when I came up here, I did not have a physician here. I didn't even have a primary. But I did have a pump and I needed to get my supplies. So I I actually called there's only two endocrinologist in Auburn, Alabama. And that's about a half hour from where I live. So one of them wanted me to have a referral. But I didn't even have a primary yet. So I called the other one. Because I needed to get my insulin and my supplies. And they gave me an appointment. And it was funny. I went in on a Thursday to see Dr. Baliga. And he looked at me and said, This is my you know, I'm a new patient started talking to me about the ever since. Have you ever seen it? Have you ever heard about it? And I said, you know, it's funny. My husband saw something on the news about it a few months ago, and he mentioned it to me, but I hadn't seen anything else about it. So he started telling me about it that it was something that was placed under the skin. You wore it for at that time, it was 90 days now it's 180 days. And I said well, let's let's do it today, because he made it sound so wonderful that you wouldn't have to be doing, you know, I would know something every five minutes, I would know if you know and I was familiar with other products that gave you arrows, whether you're going up whether you're going down so you can kind of fix things as you're going along. I didn't have that right now. When I went to see him so I'm like, Ah, it sounds great. He goes well wait, we we haven't got he was at the FDA had certified it. He was certified, but they had to bring the team from Atlanta at the time. So he says but we can do a Tuesday. And I'm like, Okay, I can't wait. I mean, I was so excited. So I had it placed on Tuesday four days after I saw him and I'm now on number 24th sensor and it has been actually so life changing for me i One of the main reasons I was so anxious and happy to hear about something like that is because I was having severe low blood sugars at night and nothing not to wake me up. I mean I My husband actually would call me every morning at 839 o'clock to make sure I had made it through the night that I was still alive. So it was a horrible really way to live and I was having multiple sometimes multiple low blood sugars during the day and or blood glucose during the day. And then I would treat them and then I would go up and down you know so it was it was just up and down cycle and you don't feel well with that at I don't anyway most people don't because you you know you now you have to fix this and you know hope that it fixes that. So once the I got on ever since that disappeared, basically disappeared from my life, I maybe have one, low blood sugar, maybe once every two months now, I have a very, very low percentage less than 1%, every 90 days. So it's amazing to me how technology has changed my life and made me feel like I can actually live kind of like a normal life. I need it. And I also was never really addicted to looking at my phone all the time, like a lot of younger people do. And you know, I don't do a lot of selfies and but now, I mean, I do sit at the table and have my phone there because I want to see what's going on. And if I'm out to dinner, I put it there. And I want to see if it's going down, is it going up? And it gives me that you know that that safety net of, I'm not going to go high, and I'm not going to go low. Do you mind if I ask Stacey Simms  15:57   what other technology you're using because the CGM alone isn't going to prevent lows. Dianne Mattisse  16:02   I have an insulin pump. I don't have the loops. I don't use that because I have the CGM that I 100% believe in and, and love it. I do have a meter. And I do have to calibrate the Eversense once a day, which to me, gives me that feeling of security and safety that I am getting good numbers throughout the day. And if something's really off, you know if it feels like it's off, I will check with my meter. But I use the meter a lot less to be honest, I you know, I really trust you ever since. And I mean, it's been it's proven to me because many times the meter and the ever since will have exactly the same number, or within a few a few numbers. And that makes me feel so much better. Right. Stacey Simms  16:53   But you use you use a pump. That's just I wouldn't call it a dumb pump. But you don't use an automated system. I Dianne Mattisse  16:59   don't use the loop. I don't use the automated system. It has the capability. Okay, but but I don't I just that's not an important factor for me, right? Stacey Simms  17:10   I mean, I'm just trying to be clear for folks that you know, we're listening, you know what you're using in right with, I mean, my son, it's funny to look at technology because he was diagnosed in 2006. So we went, you know, shots and meter, and then DME pump and meter for forever. And then CGM pump your meter to calibrate like you say, and now in 2020, he went closed loop. So he's got a pump that communicates with the CGM. So it's just wild to see how it all works. All right, all the questions people have about ever since tell us about the insertion and the removal, because a lot of that makes a lot of people uncomfortable to think about. Dianne Mattisse  17:49   Right, right. I think the placement of the ever sense has, I think a lot of people think about it as a surgery and as this and that, it really is such a tiny little, maybe just a tiny little incision, not even as big as your pinky fingernail. And they actually, you know, they numb you, of course, and then they put the little the little sensor right under the skin. I mean, you can actually kind of feel it through the skin, you know, which is helpful when you're placing the transmitter. And it doesn't. I mean, honestly, it doesn't hurt at all, I'd rather have that done and then have my teeth cleaned, to be honest. I mean, it's it's really that simple. And I've had, like I said, I'm on number 24. And it's really nothing the removal is the same thing. It takes maybe the insertion the longest part of the insertion or the placement is getting the Lidocaine to numb the area, you know, they actually do it in a very sterile way comes with a big sterile cape. And you know, you're laying on the table and they clean the area very well. I've never had an infection I've never had any what I would call any bleeding I mean it might bleed a little tiny bit, but they cover it with steri strips, there's no stitching, there's no you know, there's nothing like you have to go back and have surgery looked at it or anything like that there's no stitches or anything like that. So the removal my physician has always used an ultrasound for removal. So I think that has become very popular because I belong some a lot of these pages that people talk about it and I can actually feel mine because it really is right under the skin and but I think the ultrasound kind of helps them know exactly where the end is. Because listen, there's you're putting it under the skin, it could move a little bit it could you know turn or whatever, right so I've never really had any issues. I mean, you hear horror stories from people who have never even had it, which really is quite annoying, because I think it's just like slamming a restaurant, if you've never eaten there, you know, just and I think the greatest thing is that we have a choice. Now, it might not be for everyone. But it is something that for people who get these severe irritations or allergies to certain products, you know, with some of the 10, the 14, ones, 14, day 10 to 14 day CGMS. And also, I think a lot of people worry about getting it knocked off. And the cost of it, were this the transmitter, which where you were on the outside, if it comes off, you know, you just stick a new adhesive on it and stick it back on. The other great thing is, you know, we live by a lake and we have a boat. And if I want to go swimming, I take my transmitter off, I get into the water. And I don't have to worry about anything, I don't have like a permanent thing going into my body a permanent or fish going in, you know, which always kind of bothered me going into a pool or going into a lake or something like that. This is once that heals up after a couple of days, there's nothing really on the outside plus it you know, the great thing about ever since also is it uses a different kind of technology. It's not the same technology as other CGMS use. So I believe and this is personally my opinion, I believe that it's much more accurate because of the type of technology that they're using. It's very advanced, Stacey Simms  21:47   you being the way the sensor reads. Yes, the way the sensor reads. And you said you had a lot of irritation from the other CGM. You don't have any irritation with the adhesive that the transmitter sticks Dianne Mattisse  21:59   on at all. None at all. None at all. The little adhesive ups the little adhesive that we put on the back of the transmitter is very very skin friendly. Very skin friendly i and I'm fair and I have blue fair skin blue wise, so I have had pretty severe irritations with other CGM said I had to move them around and try different things and try different products under it. Also products to keep them on, which haven't had to do that either. You know, this kind of stays on? And I don't really think about it. I mean, I think more about checking my phone now than I do thinking about having the sensor. So tell me again, Stacey Simms  22:47   this is your 24th Yes, sir. How long will this one stay in? Dianne Mattisse  22:54   Six months, not? Well, it stays now up to 180 days or up to six months. beginning it was up to three months. And I do know that the FDA is working on the approval for the what 365 Day, which we're all looking forward to that. What I mean, I love going to my doctor so I'm like, you know, I we always kid around. So you know, we have to stop meeting like this. But yes, I mean, it's a it's going to be quite awesome for a lot of people to get it for one year because I do go to my doctor every three months to get prescriptions for the other supplies I need and insulin and things like that. But some people only go to see their endocrinologist or their primary doctor only once a year to manage your diabetes. Stacey Simms  23:49   In the six months, I'm just trying to you know, I'm trying to picture that you think that all the different the CGM changes that would happen within six months. Have you had any issues any reason to go back to your endo and say take a look at this get out the ultrasound machine or is it smooth sailing for you? Dianne Mattisse  24:05   I haven't had any issues for several years. I mean, we're going on six years this July that I've had it the greatest thing is which I've never used the most recent products I'm not sure but but the ever since has an online or on your phone whole picture of what's going on. So I'll tell you how long you're you know how much time you're in. It will tell you exactly the percentage time and range and it also will tell you seven days, 14 days, 30 days, 60 days, 90 days so you can actually see and it will also tell you what your estimated A1C will be it will tell you what percentage is low you're in the low area what percentage you're in high so it gives you all kinds of information. The greatest thing is my doctor has that information also. So if I make a call to him, and I say, you know, I'm not doing well, something's not right, I can't get the sugars down and, and it's not the pump I, you know, I've moved it, I've changed insulin, all that thing, all those things, then he will go on there and say this is what you need to do. But this is what we need to change around, you know, because it's all based on the insulin that you're getting and the activity. It's nothing really I don't feel to do with the CGM. Right? So with the sensor, so I haven't ever had to call him and say, I think it's a sensor. I think most of the time, it's just been the amount of insulin. Or maybe I'm sick. You know, maybe if I have an illness that's not, you know, I had or I made a couple months ago, I had take a steroid shot my wrist. And that just blew me out of the water. So I called him and he was like, Okay, this is what we need to do for two days, you know, so the CGM? No, I mean, I find no fault with that. I mean, I think if the built in protection there is if your meter reading when you put in your calibration in the morning, which I do mine in the morning, you can kind of set it up to do whenever, but I always want to do it first thing in the morning, because I want to know where I'm starting anyway, my day, is it going to be good, bad or ugly that day? So I put my calibration number in there. And if it's, let's say it's off, it's off by 30 or 40 points, you know, you, the sensor itself will tell you something's not right. And it will actually ask you to do another calibration in another hour or so. So, to me, it's, it's kind of a safety check. So that I don't worry about it going off, and being kind of crazy on its own. Because, you know, if something like that happens, and I'm sure with technology, everything has, you know, kinks in it. They you would call the customer service, they have great customer service. And they can actually do a lot with Reese not resetting it actually totally, but figuring out if it really is the sensor really is you. I've had to do a reset on the sensor maybe? Stacey Simms  27:20   Sure. Um, I'm curious, you had mentioned you're in some groups, and I'm sure you know, people who also were there ever since and a lot of people who are interested in it. What's the first question people ask you about it? Like diabetes people? Dianne Mattisse  27:35   How about how is the insertion? How is the placement? Does it hurt? Does it scar does it? How is the surgery? You know, they all like to think it's surgery and everything? Because listen, when you're thinking about that you're thinking about, I don't know, maybe they're thinking of a transplant or something. But it's a very simple thing. And there's a lot of other medical procedures now that use these placements under the skin. There's hormonal ones. I know there's a testosterone one, I think there's an there's one for birth control now. So it's it's, you know, very upfront technology that's being used a lot in medical treatment. So it's not anything, you know, that people should be afraid of. I mean, this is an advanced, very advanced product, I think, and simple life is so much simpler with this, you know, just, I mean, once every six months now you go in, I mean, you're it's 15 minutes, and you know, I mean, the 10 minutes, I'm waiting for the Lidocaine to work. That's, that's the biggest thing. Stacey Simms  28:44   Do you have scoring? Do you have a scar on other very Dianne Mattisse  28:46   fair, like I said before, and I don't scar and usually the FDA requires that they switch arm to arm every six months. So like, they'll do the left arm and then they do the right arm. So in that meantime, I can't even like when I go back to have the removal. If if the sensor has already expired, like but I usually try to go a couple days before. If it's expired, of course, it's not going to have a reading. And then, you know, I have to really figure out where it is because I don't see the scar anymore. There is actually I think it's so tiny that it heals up. I mean, you're supposed to leave the bandaging and everything on instructions or five days. Usually, it's healed up in about two or three days completely healed. You can't even really see anything. So I mean, some people would scar I would imagine, but I mean, I think you have that's the trade off or having a totally accurate CGM. That's easier. That's less expensive than things that are failing and you have to replace all the time I mean, for me, it's, it was never I never thought twice about that. I may be by my age, I have a lot of scars anyway, from falling, and it's like, you know, I'm not worried about having perfect skin anymore. So, but no, actually, because I'm fair. I, I did think about that, but but only for about two seconds. Stacey Simms  30:25   Well, you know, and if you don't mind, um, you know, I'd love to talk about aging with type one. I mean, you know, it's different. Life is different from 20 to 50. Certainly, you've mentioned like, you don't run so much anymore, you know, so I don't want to make a whole Pash of like we all know we're getting older. For lucky, we know we're getting older as like, but you know, years and years ago, people weren't living past 50 type 1 diabetes, let alone 70. And I have listeners in their 80s. And we know people in their 90s with type one. So it's a pretty wild. So I Dianne Mattisse  30:58   73. It's changed 73. My A1C is 6.6. I'm so proud of that. Because when I first got the Eversense inserted, it was in the mid nines or a little bit higher. It wasn't 10, but it was in the night. So I've made tremendous strides in getting it down being healthier. And I'm just very proud of that. Because you know, I would like to be in the fives but I, you know, I'm fine. My physician is fine with it being in the sixes, getting rid of the low blood sugars was a huge thing for me because many, many people die in the middle of the night from having a low blood sugar. And that still happens to people and really with CGM and all these choices, it shouldn't happen. And the fact that the CGM gives me this vibration, I know all anywhere, anytime, if I'm out eating, if I'm in bed sleeping, I know I'm going to get a vibration that's going to tell me what's going on. So that has really helped me be happier in my life. I think I worked 25 years in health care as administrator and then 25 years is real estate. Now I'm retired but I do a lot. I have a charity I'm treasurer for up here in Alabama, that does art. We provide art classes and projects for kids in the schools here, elementary schools and some high schools. I have a little word working business with my sister here, we make maps of the lake and we sell to all the little stores around here and everything. And I keep very busy, I also do a transaction. I'm a transaction broker for my son who's a broker in Florida. So I do a lot of paperwork online for him. So I keep very busy. But the fact that I'm getting older, you know, and I know people will say this, you talk to anybody old, your mind is still young, you still look you know, when you look in the mirror, you go Who is that old lady, but when you when you when you feel good, and I feel so much better with a normal blood sugar. I don't feel like I'm that age, you know, I mean, I I enjoy traveling, I traveled to Florida quite a bit because of a lot of relatives and friends still down there having been there for a long living there my entire life basically. And I feel comfortable traveling by myself, which is a huge thing. Because I can tell you 10 years ago, I did not I mean, I always wanted to have my husband or my son or somebody with me. So that getting old and having diabetes. And I've been very lucky because I don't have any side effects. I don't have any complications from having diabetes for so long. I mean, on one hand, I was very lucky, I didn't have to go through puberty or childbearing. So I got it when all that was done, had my children and everything. But on the other hand, you know, 33 years when I think back 33 years is a long time to be dealing with a chronic disease 24/7 And I don't think anybody really understands that it is a full time job. It is something that is with you 24/7 You cannot forget about it even for a day. I mean, it's dangerous if you think you can, but you just can't. But getting older. I just like to I'm so excited to see all the things that have have come from diabetic technology, all the opportunities that we have now. I love being part of the ever since group of people because honestly I never knew anybody growing up, you know, during when I was diagnosed at 40 I never knew another type one. I felt very isolated and kind of depressed about it because I'm like, even in my family, they didn't really acknowledge it because Nobody had the knowledge about it, they knew a lot about type twos and you should lose weight, eat better and exercise, but they didn't really know much about why I was a type one or how I was managing it or how encompassing it was to your life. So I think just having better communities, among us is has helped tremendously for me. And the ever since has just been, like I said, before, life changing for me, no matter what age I would have gotten it, I think it's just the best product because it's the easiest product to use. And I've used them all, I mean, you can't name one that I haven't used and, and I've gone through the progression from when they had to put it on the hospital until the very newest ones. And nothing really, my body didn't like them for whatever reason. But getting old is great. I just look at it and go, I have friends from first grade still, that I see when I go down. And I'm like, you know, and they, you know, most of my close friends know when everything and they, they are very supportive, but they don't really understand it. So now that I understand it better. I'm okay with that. I mean, I think age has just made me feel like, Hey, I am so lucky to be here and feel as good as I do can be as active as I want to be. No, I don't run anymore, and I don't ski anymore. I last skied when I was 65 And I'm like, hey, that's it. I'm done. I'm not doing that anymore. I you know, I got away without ever having a broken bone or anything. Or last time we went, you know, I went with a bunch of younger girls and, and family, bunch of family. And and I'm like, Hey, I'm skiing is good as he's 40 year olds, but I'm not risking it anymore. Yeah. Stacey Simms  36:45   So I meant to ask Do you know is ever since covered by Medicare? I can look that. Yes, I Dianne Mattisse  36:49   did. Absolutely. Now the first couple years, it was not. And my husband I made that decision to pay out of pocket. But yes, it is covered now. That's great. Yes, right. covered. And it covers the insertion and the removal for the physician also, which I think some of the other insurances don't but but yeah, that was not the deciding factor for me. I mean, we paid out of pocket, and and we just knew it was going to be the best thing for me. Stacey Simms  37:18   Good to know, though. I mean, it's really interesting, again, with a lot of my older listeners, you know, and as we are so excited that people with type one are living to Medicare year and beyond, right, it's really important to look at these things. It is it's a deciding factor for a lot of people. Yes. Okay, before I let you go, Diane, how did you get hooked up as an ambassador? I mean, it makes sense. You're the very first patient in America. So I guess it's kind of a dumb question that everybody wants to speak out, you know, right? Dianne Mattisse  37:42   Well, I never Well, okay. So like I said, I never really was in a group of people, I didn't really even have anybody. You know, nobody in my family, nobody to talk to. So the team came from Atlanta, when I had my first insertion, placement, they'd like you to lose placement. So when I had my first placement, the team from Atlanta came, and that was six years ago, this July. So the person who is head of the sales now I believe, she was on that team, and she came in, and we kind of hit it off. And then I think it went on for about, I think six months later, they decided to get a group together, and call them the patient ambassadors. And that's when that is before a Sensia actually got began, began to be involved in the marketing. So that was when Sen. psionics was doing it. So this person picked eight or nine people. And we still have, I believe, four or five of the original ambassadors, and now it's more demographically varied. You know, we have young, I obviously, I'm the older person, you know, but it is good, because I think it's, you know, it shows that it's for everyone. I mean, there's not an age barrier. And there's not a weight barrier. There's not any kind of barrier, except you have to be a type one and you have to want this device. And it's just but that's how are we got hooked up and we kind of it kind of slacked off a little bit when we became the marketing went over to a Sensia. And they had that agreement with a Sensia. And then they picked four or five of the original people and and you know, we're still very close, we have our own little group chats and things like that. So and it's good because now I know if I have a question or if they have a question we can get with each other. It's it that is the greatest thing. I think younger people or anybody now, Facebook has pages, you know, people like you who are spreading the word. I mean, if there had been This, I think I would have felt so much better. I mean it I'm almost getting teary here. But I think I would have felt so much more inclusive, then than I felt for many, many, many years. So I think that you're doing a wonderful thing by spreading the word and helping people and sharing. And I think you know, somebody like your son, who's 19 is going to have a whole different experience with this than I did. And, you know, because you just by 40, you've gone through all those teenage angst and everything but and I was done having children everything, but then it's like, what the heck now? i What is this, you know, coming on, and I was healthy at that time. And I'm like, What did I ever do? Never did drugs, never smoked. Never, you know, there wasn't all the information about immune system, autoimmune and it runs in my family. We have so much autoimmune disease, but not type one. Yeah. So but the patient ambassador, it's a greatest group, we have a blast when we get together. That's awesome. Well, Stacey Simms  41:10   doing the show is truly a privilege for me, you know, getting to talk to people like you and learning so much. I really appreciate it. Diane, thank you so much for joining me. I hope we connect again soon. So Dianne Mattisse  41:21   and I hope you are very good at that editing.  

Contributor: Ricky Dhaliwal, MD Educational Pearls: What are DKA and HHS? DKA (Diabetic Ketoacidosis) and HHS (Hyperosmolar Hyperglycemic State) are both acute hyperglycemic states. DKA More common in type 1 diabetes. Triggered by decreased circulating insulin. The body needs energy but cannot use glucose because it can't get it into the cells. This leads to increased metabolism of free fatty acids and the increased production of ketones. The buildup of ketones causes acidosis. The kidneys attempt to compensate for the acidosis by increasing diuresis. These patients present as dry and altered, with sweet-smelling breath and Kussmaul (fast and deep) respirations. HSS More common in type 2 diabetes. In this condition there is still enough circulating insulin to avoid the breakdown of fats for energy but not enough insulin to prevent hyperglycemia. Serum glucose levels are very high – around 600 to 1200 mg/dl. Also presents similarly to DKA with the patient being dry and altered. Important labs to monitor Serum glucose Potassium Phosphorus Magnesium Anion gap (Na - Cl - HCO3) Renal function (Creatinine and BUN) ABG/VBG for pH Urinalysis and urine ketones by dipstick Treatment Identify the cause, i.e. Has the patient stopped taking their insulin? Aggressive hydration with isotonic fluids. Normal Saline (NS) vs Lactated Ringers (LR)? LR might resolve the DKA/HHS faster with less risk of hypernatremia. Should you bolus with insulin? No, just start a drip. 0.1-0.14 units per kg of insulin. Make sure you have your potassium back before starting insulin as the insulin can shift the potassium into the cells and lead to dangerous hypokalemia. Should you treat hyponatremia? Make sure to correct for hyperglycemia before treating. This artificially depresses the sodium. Should you give bicarb? Replace if the pH < 6.9. Otherwise, it won't do anything to help. Don't intubate, if the patient is breathing fast it is because they are compensating for their acidosis. References Andrade-Castellanos, C. A., Colunga-Lozano, L. E., Delgado-Figueroa, N., & Gonzalez-Padilla, D. A. (2016). Subcutaneous rapid-acting insulin analogues for diabetic ketoacidosis. The Cochrane database of systematic reviews, 2016(1), CD011281. https://doi.org/10.1002/14651858.CD011281.pub2 Chaithongdi, N., Subauste, J. S., Koch, C. A., & Geraci, S. A. (2011). Diagnosis and management of hyperglycemic emergencies. Hormones (Athens, Greece), 10(4), 250–260. https://doi.org/10.14310/horm.2002.1316 Dhatariya, K. K., Glaser, N. S., Codner, E., & Umpierrez, G. E. (2020). Diabetic ketoacidosis. Nature reviews. Disease primers, 6(1), 40. https://doi.org/10.1038/s41572-020-0165-1 Duhon, B., Attridge, R. L., Franco-Martinez, A. C., Maxwell, P. R., & Hughes, D. W. (2013). Intravenous sodium bicarbonate therapy in severely acidotic diabetic ketoacidosis. The Annals of pharmacotherapy, 47(7-8), 970–975. https://doi.org/10.1345/aph.1S014 Modi, A., Agrawal, A., & Morgan, F. (2017). Euglycemic Diabetic Ketoacidosis: A Review. Current diabetes reviews, 13(3), 315–321. https://doi.org/10.2174/1573399812666160421121307 Self, W. H., Evans, C. S., Jenkins, C. A., Brown, R. M., Casey, J. D., Collins, S. P., Coston, T. D., Felbinger, M., Flemmons, L. N., Hellervik, S. M., Lindsell, C. J., Liu, D., McCoin, N. S., Niswender, K. D., Slovis, C. M., Stollings, J. L., Wang, L., Rice, T. W., Semler, M. W., & Pragmatic Critical Care Research Group (2020). Clinical Effects of Balanced Crystalloids vs Saline in Adults With Diabetic Ketoacidosis: A Subgroup Analysis of Cluster Randomized Clinical Trials. JAMA network open, 3(11), e2024596. https://doi.org/10.1001/jamanetworkopen.2020.24596 Summarized by Jeffrey Olson MS2 | Edited by Meg Joyce & Jorge Chalit, OMSII