Podcasts about dka

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 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, 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/

Video Version Only on HCPLive! In this episode of Diabetes Dialogue, 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, sit down with Steven Russell, MD, PhD, Chief Medical Officer at Beta Bionics, to discuss the latest real-world outcomes from the iLet Bionic Pancreas—an autonomous insulin delivery (AID) system cleared by the US Food and Drug Administration (FDA) in 2023. Russell outlines the iLet's fully automated design, which sets it apart from conventional AID systems by requiring no manual settings, carb ratios, or correction factors. The system determines 100% of insulin dosing, adapting continuously to glycemic trends without relying on user engagement. This autonomy makes the iLet particularly effective for individuals with suboptimal diabetes self-management or limited access to endocrinology care. New real-world data, covering 3,300 users from the first year of commercial rollout, reveal a mean baseline A1c of 8.5%—higher than the 7.8% in the pivotal trial and reflective of the broader U.S. type 1 diabetes (T1D) population. The iLet reduced glucose management indicator to 7.3%, yielding an average A1c reduction of 1.2%, more than double that seen in the pivotal study. Outcomes were most pronounced among those with severe hyperglycemia: users starting with A1c >14% saw average reductions of 7%, with low rates of diabetic ketoacidosis (DKA) and minimal increases in hypoglycemia (median time

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.

This past winter, Dr. Rich Griffey, healthcare quality leader from Washington University School of Medicine and Emergency Medicine, came to present grand rounds on a new way to care for patients with mild to moderate DKA, which they call the SQuID protocol. This talk serves to inspire us to look even at some of our well established conditions and see what we could do differently, as well as appreciate the value that healthcare quality improvement integrated with research methods and implementation science thinking can do when they all come together for the improvement of patient care. Come be inspired with us! CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com   WANT TO WORK AT MAYO? EM Physicians: https://jobs.mayoclinic.org/emergencymedicine EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs   Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs  

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.  

In today's episode, taken from live recordings at PREMIER 2024, we dive into an increasingly common treatment for type 1 diabetes: hybrid closed loop insulin pumps. We'll begin with a brief overview of traditional insulin pumps and explain how hybrid closed loops are different. The core of our discussion will be centered around three case studies, illustrating potential scenarios you might encounter in a pediatric emergency department and how to manage them effectively. With NICE's recent technology appraisal advocating for universal access to hybrid closed loop systems for all type 1 diabetes patients, it's crucial to understand these devices. Over the next few years, you'll likely encounter these systems frequently. We'll cover the essentials of how these pumps work, their benefits, and potential issues that might arise, such as connectivity problems, cannula issues, and handling intercurrent illnesses. Join us as we explore the revolutionary impact of hybrid closed-loop systems, which offer better glucose control and significantly improve the quality of life for those with type 1 diabetes. Dr Nicola Trevelyan has been the Clinical Lead for the Paediatric Diabetes Service in Southampton for the last 20 years. During this time, she has seen huge changes in the management of CYP with diabetes.  She has been involved in several large multicentre trials for paediatric diabetes,  helping to better our understanding of how best to use new technologies in diabetes management in children and move forward access to new treatment technologies.  She was one of the founding committee members for the Assoc of Children's Diabetes Clinicians (ACDC) in 2006 and has been on working parties for BSPED helping evidence base and re-write the national DKA guidelines in 2020 and for the National Paediatric Diabetes Audit.  For the last 4 years, she has been on the Clinical Advisory Group for the RCPCH Quality Improvement Programme for Paediatric Diabetes. 

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. 

The JournalFeed podcast for the week of May 6-10, 2024.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Tuesday Spoon Feed:Utilizing oxygen, rather than room air, for patients with intermediate-risk acute PE may be helpful even if patients are not hypoxemic. We'll need a study (but not this one), for further information.Thursday Spoon Feed:Sodium-glucose cotransporter 2 inhibitor (SGLT2i)-associated ketoacidosis (DKA) had delayed resolution compared to type 1 diabetes (T1D)-associated DKA despite often being “milder”. This could be due to significantly lower insulin doses given in the setting of the lower plasma glucose levels often seen in this population.

Welcome to PTBN Pop's Video Jukebox Song of The Day! Every weekday will be featuring a live watch of a great and memorable music video. To celebrate the 75th birthday of the legendary Billy Joel, all of the songs this week are by this iconic singer and songwriter. On today's episode, Steve Riddle is watching, “Why Should I Worry?” from 1988. The YouTube link for the video is below so you can watch along! https://www.youtube.com/watch?v=Jb7kJ-j_dKA

TIME STAMPS: 01:04 INTRO TO KETOACIDOSIS: A state of CONFUSION, FATIGUE, WEAKNESS, & NAUSEA caused by an overproduction of acids resulting from PROTEIN CATABOLISM (very bad, very scary!) 04:04 Who all should be concerned about diabetic keto acidosis (DKA)? 08:08 WARNING SIGNS that you may be headed for DKA. 11:55 INSPIRING LESSONS LEARNED from attending the 2024 NPC Emerald Cup! 13:03 Make-up & hair-style tips for bikini competitors. 14:05 Why competitors should make eye contact with the judges when they are on stage. 15:05 Confidence & stage presence. 17:21 Sarah's go-to “mostly animal-based” NOOTROPIC KETO COFFEE recipe! 23:20 “Take away the dross from the silver and the smith has material for a vessel.” Proverbs 25:4 (one of my favorite proverbs for cutting) 24:00 Does God approve of the CARNIVORE DIET?! https://www.youtube.com/@CarnivoreJosh 27:02 Answering a question on how to GAIN WEIGHT on the CARNIVORE DIET (bulk). 30:49 SUPER SERMON: SUFFERING (1 Peter CH1-5) - 4 KEYS TO SUFFERING FOR CHRIST “The God of all grace, who called you to his eternal glory in Christ, will himself restore, establish, STRENGTHEN, and support you after you have suffered a little while.” (1 Peter 5:10) Do you like RIBEYES? Search Carnivore Coaches Corner (the #1 bodybuilding podcast in England) on any platform for our NUTRITION PODCAST co-hosted with Coach Mark Ennis! SUPERSET Coaching membership inquiries: https://calendly.com/ssyl/meet-greet Information on The Open Natural: https://www.theopennatural.com/Home

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.  

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

In this podcast, Dr Charlie Brower PGY-3 at the University of Cincinnati leads a discussion of a recent journal club article looking at the impact of a subcutaneous insulin treatment pathway for mild and moderate DKA. We explore the financial and operational impacts of this pathway as compared to traditional treatment with IV insulin

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

In this episode, Stephanie and Suzanne discuss DKA pathophysiology, causes, signs and symptoms, diagnosis, and management.  The critical care management aspects outlined include:1.  Replace fluids2. Supply insulin3. Replace potassium4. Supply glucose

We're talking about raising kids with type 1, the journey to diabetes independence, and educating around the use of emergency glucagon. We're bringing you a panel discussion from Moms' Night Out Frisco! We have terrific speakers at our Moms' Night Out events but we also have some panel discussions. This time around it's Stacey and Cami DiRoberto. Cami's daughter, Maci, was diagnosed with type 1 at age 7 in 2017. She and turned 13 just after our conference back in October. Couple of quick housekeeping notes: this was presented and recorded as a hybrid Zoom and in person presentation – Cami broke her arm and was unable to attend in person. Her audio is fine, but Stacey's recorded through the computer mic and isn't up to our usual standards. We're providing the transcript below. Cami is a Gvoke ambassador and this panel was sponsored by Xeris Pharmaceuticals, the company that makes Gvoke. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Note: Gvoke is a prescription injection for the treatment of very low blood sugar in adults and kids with diabetes ages 2 and above. Do not use if you have a specific type of adrenal or pancreatic tumor, starvation, chronic low blood sugar, or allergy to GVOKE. High blood pressure, hypoglycemia, and serious skin rash can occur. Call your doctor or get medical help right away of you have a serious allergic reaction including rash, difficulty breathing, or low blood pressure. Visit www.gvokeglucagon.com/risk for more information. Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Take Control with Afrezza  Omnipod - Simplify Life Learn about Dexcom  Edgepark Medical Supplies Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription:  Stacey Simms  0:05 This is Diabetes Connections with Stacey Simms. This week talking about raising kids with type one, the journey to diabetes independence and educating around the use of emergency glucagon. I'm bringing you a panel discussion from moms Night Out Frisco. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show. You know, we aim to educate and inspire about diabetes with a focus on people who use insulin. I'm your host, Stacey Simms and my son was diagnosed with type 117 years ago this week right before he turned to he's almost 19 years old. He's a freshman in college and he's far from perfect. I'm far from perfect but cannot believe how far we have come at our moms night out events. We always have terrific speakers. Coming up for our Charlotte event. In February we have Sarah Stewart Holland. She is the co host of pantsuit politics, and her son was diagnosed really not too long ago. She went through that very publicly, and just going to be sharing her story. Our other speaker is Madison Carter. She is a local TV news anchor who lives with type one herself. But we also have some panel discussions at these events. This time around you're going to hear me and Cami de Roberto hammies daughter Macy was diagnosed with type one at age seven in 2017. She had her birthday just after our conference, which was back in October a couple of quick housekeeping notes. This was presented and recorded as a hybrid zoom and in person presentation, kami broke her arm and was unable to attend in person. Her audio is great, but mine recorded through the zoom. And it is pretty rough. My amazing editor John has worked his magic the best that he can. But I'll be honest with you my side of the conversation is not up to what I think our usual standards are around here. I will tell you though, I'm putting a transcription in with this episode. Wherever you're listening, you should be able to scroll down on the podcast app and see and read what you're listening to. If there's any confusion about my side of the conversation, you can always head over to diabetes connections.com and click on the episode homepage to read it as well. Also, Cami is a Gvoke ambassador and this panel was sponsored by Xeris pharmaceuticals, the company that makes Gvoke you know I like my full disclosures around here. But they made this really easy. This is a genuine Parent to Parent conversation. And it's mostly about independence. You know how you get from a kid who's totally dependent on you to a young adult that you you can send off on their own. And one more thing about mom's night out the early bird special for our next event in Charlotte has ended but I'm gonna give you a promo code right here just use m n o mom's night out m n o 30 to save $30 off Charlotte registration. Alright, that is a long enough introduction. The panel is up next and since I just told you about CAMI I took out the introduction that I gave at the event and the big lead up so we're going to just jump directly in right after this important message. Gvokeis a prescription injection for the treatment of very low blood sugar in adults and kids with diabetes ages two and above. Do not use if you have a specific type of adrenal or pancreatic tumor starvation, chronic low blood sugar or allergy to Gvoke High Blood Pressure hypoglycemia and serious skin rash can occur. Call your doctor or get medical help right away. If you have a serious allergic reaction, including rash, difficulty breathing or low blood pressure visit Gvokeglucagon.com/risk. For more information. I think everybody has heard my family's diagnosis story. My son was going to the strip before he turned to one can tell us a little bit about Macy's diagnosis.   Cami  4:01 Yeah, so Macy was diagnosed in second grade. It was the tail end of her second grade year. I'm sure like many of you, I was completely ignorant about type 1 diabetes. I knew there was a type one I knew there was type two, I really didn't know the difference. I knew one kind of struck children, but I was completely ignorant. So it was like the last week of her second grade year at school and we had just moved back to California from Arizona actually. So we were kind of transitioning and all in all areas of life. And she had three bedwetting accidents in a matter of three weeks. First time she was at my mom's house, like having a little sleepover with me. And my mom called me the next morning and I called and checked in. Hey, how was everything? You guys have fun last night? She said yeah. She said we're just we're cleaning up to today. Macy had a little accident and I was like, well that's really weird. She hasn't done that in years. But that's so weird because it's not totally outside of the norm for a seven year old little girl you know it could happen so that was weird, but a week later happened again and I was like, Okay, are we drinking too much water before we go to bed? What's happening? Let's let's really so I started to pay more attention happened one more time a week later on, I was like, something's wrong. The red flags, you know, we're going off. And so it was a party it was because it was the last week of school. It was a party at school. And I woke her up and saw that she had had an accident and it kind of laid some towels down and changed your sheets. And I said, Oh, honey, I said, You had another accident. I said, I think we probably need to get in and see a doctor now. I said, Do you feel okay, you know, in my mind, I was hoping like bladder infection or something like that. But somewhere in the depths of my mother's instinct, diabetes flashed across my brain. And i i To this day, I don't know why. So I was sort of praying that it wasn't gonna be that, but I didn't really even know why I was thinking that it was all very blurry and confusing. But she said she felt fine. She wanted to go to school. So I said, okay, and I made an appointment with her pediatrician that afternoon. So I picked all three of my kids up from school that afternoon, and the four of us had at the end of the pediatrics office, and she checked it out and you know, took her vitals and sort of a physical exam. And she said, I think she'll show your daughter fine. She said, I think she's growing. It's hot outside, you know, but she's fine. And I said, Okay, I said, we'll upgrade nose and I said, Can you just indulge me? And could you check for diabetes. And I swear to you, I still don't know why I felt so convicted to request that. But I did. And she did sort of begrudgingly. And our blood sugar came back at 323. I'll never forget time kind of stopped in that moment. Doctor came back after the nurse came in and prick Macy's finger, you know, she left when three, the four of us were playing I Spy in the room. And like 1015 minutes later, so kind of like now that I look back and inordinately long time, the doctor kind of knocked on the door and up and said, Hey, Mom, can you come out in the hallway for a second? So I walked out. And she had the landline kind of cradled her shoulder and she she was clearly on hold when she said I am so sorry, I don't really know how to tell you this. But you're right, your your daughter has diabetes, and you're going to be heading to the hospital for a couple days. And you know, here's my office, if you want to make arrangements for your other kids, and just the world just kind of stops for a second. And in that moment, I didn't even know what I didn't know. I mean, I'm sure many of you can share that sentiment. It's just confusing. You don't even really know what you're about to deal with. But that was how she was diagnosed. And then off we went to children's Fortunately, she was, you know, we avoided DKA, which I'm so grateful for, like I said her blood sugar was 323. So they actually sent us home and called us when a bed was ready for her. So we were able to go home and pack a bag and kind of try to be positive and find some sanity for us. But also,   Stacey Simms  7:34 we were so lucky, our pediatrician, I called them similar symptoms. And she said, You have never seen diabetes, can anybody under the age of two to provide your program and so we can move on out. And we had such a incredible start to the families today because of that very smart pediatrician didn't let it get to be a routine thing. Can you talk a little bit of you mentioned your other children. This could be a whole separate discussion unto itself. But to talk about the impact to your to your family,   Cami  8:03 if you can believe this, at the time she was diagnosed, we were literally living through a kitchen remodel, my whole dining room was set up I had like a hot plate and we had moved our refrigerator was like an all the way by the front door. Our house was an absolute disaster. And of course, we needed to figure out our new sort of diet plan as well after all this. So kitchen remodel and type 1 diabetes diagnosis were not ideal at the same time. So my husband Tori and I were in the hospital for two nights. And fortunately, we have a big family here. And so we had my sisters in law and my brothers and I mean, we had all kinds of family that came and stayed with my kids. But those first nine to 12 months were really particularly rough on Macy's, little sister Emma, they're they're really close in age, but 14 months apart. I think it's so confusing. She was six at the time. And I think she was terrified. And so much attention goes to managing it's in those early weeks, months, gosh, even the first year who you're still trying to figure out what your cadence for management is, you know, how often are you going to prick your finger and where and when and how do you leave the house and make sure you have everything that you need. I mean, there's so much it's like everything else stops and all you can do is focus on how to make sure this child of yours stay safe. And so I think there there definitely was an impact on my two younger children because all the focus was on me so we worked really hard on my husband and I like taking turns to like take the other two and do kind of go do special things and get them out of the house. But that was tricky for a while. That was definitely tricky, but we encouraged my other two kids to like prick their fingers and hey, let's all check our blood sugar. So we did a lot of that in the first couple months, which was kind of fun. My Anna Macy sister was not not a fan of the prep but my son was like all about it. He was doing it to my sister so that was super cute.   Stacey Simms  9:53 It is hard it still works to this day. I don't want to seem genuine so like self promotion machine like I did talk to my daughter went off tests. It is one of my favorite episodes. It was just last year. It's part of the sequence and it's okay to acknowledge that what helped me was just really honest. Aisha Nina, she's 22 She is really got an interesting perspective. It's been a while to see she was fine with me was diagnosed and she's very honest. And she still has some hard feelings about it. But she's an adult to, to acknowledge why it was the way it was. And she's also it was a lot of fun to talk about that damn Calgary, Kimball. Because my son was diagnosed who for the first time all that disrupted Alright, so I'm gonna ask him, I'm gonna put my own two cents in real quick. So we're gonna talk about that what was going through your head when Macy was diagnosed? Right and talking about your concerns and views for the future? Here's how. I don't want to say dumb. Here's what I didn't know about diabetes. So my little 23 months old. My first question for the endocrinologist was, don't I have to be shuffling his feet and put his toenails differently? I was like   something is like, okay, no, it's got to be like that. I mean, we're talking about bigger fears. But you know, that's where I started out.   Cami  11:27 Yeah, I'm not too far off. My first question was, was she going to have to like wear on her body because I didn't want her tiny little frail body like Mark with devices. I was like, am I Heartland my, my mind went immediately, like pacemaker I'm like, can we get this stuff inside, so we don't have to, like be visible about the so my first little vanity, which is a concern, you know, I didn't want her to have to wear stuff. And they were like, now there's, there's no pacemaker type machine. That's gonna. I mean, it's amazing how quickly I got past that. I mean, we were we had we used to call it a power packs. And so you know, the more visible we could be the better. So we got past that. And thankfully, I think we might even touch on this a little later. But she's super open about her devices. And when people ask her and said that, so that was great. But yeah, my initial thought was, oh, my God, oh, my gosh, and and it really wasn't until I got home, Stacy that I realized the 24/7 hour nature just and actually, I remember, I think it was day two, and we were on lunch of day two. So we had checked in like late afternoon on I think, a Thursday. And so we had dinner at the hospital. And then we had breakfast at the hospital. And so we were working on lunch at the hospitals for our third meal. And the nurse comes in and says, okay, so it's time to, you know, let's do our carb counts and let dial up our insulin, we know what our ratio is. And we were like, Yeah, we got this and I looked at when I went, hey, just to like, be clear, I go, we're not this isn't like, Bro. This is like, like, while we're in LA, oh, we're gonna, this is gonna level out. We're not gonna have to do this all the time. Right? And she was like, yeah, no, this is basically, this is how we have to do meals. Wow. So that was a moment to   Stacey Simms  13:05 Yeah, we're here in order to talk about dealing with loans preparing for loans. Do you remember when you realize, because when you and I were talking, I'm gonna ask you to some of these things I have the answer to so Don't be coy. I didn't think about this for a while but used to think about this in the hospital already. When they started applying with us. Right. It   Cami  13:24 was discharged day. And it was our last meeting with the diabetes educators who were fabulous. By the way. They were wonderful contents. Yeah, it was our last day. And so we like our final meeting. And you know, Macy stayed in a row and just touring and I went into the diabetes education room. And they kind of did like an overview. And then they said, Okay, and there's, you know, there's one more thing that we need to make sure we go over with you. And that's, you know, what we call severe lows, and they pulled out the red glucagon emergency kit. And they said, You know, sometimes you can have too much insulin or too much activity. And, and it doesn't happen very often. But, you know, sometimes it can happen, and you need to be prepared to use this kit. And I was like, what? Can you pause for a moment? And let's just rewind a minute. What do you mean, and that was a massive moment in time where I realized, so this medicine that you're telling us, we have to give her, and we have to decide how much to give her to keep her alive, if we give too much, could also be fatal. And, boy, that was a poignant moment. And I'm sure one we could all share and pause on because that is the reality. But yes, that was when we left the hospital and I was absolutely terrified, terrified about severe lows.   Stacey Simms  14:42 I want to just get to the other question before the one in terms of like, do you have those fears, but you you still want him to lose their life? You still want them to be independent? I mean, your seven year old so you're going to immediately send her off to be super independent. But how did you Once the engine, you know, I hesitate to see how did you get the cast that but how did you move forward with that?   Cami  15:05 It was difficult, um, you know, that was sort of the age, you know. So we're now heading into third grade and I remember I had this like special lunchbox for her that whenever she ever we would leave the house, we go anywhere and had all of our staff had had her with an emergency kit and had her sugar it had her testing all the stuff. We all we all have that. And I remember there were a couple of times where Macy got invited to have playdates at some friends house. And again, we kind of knew what the school kind of knew newly back in California, so I didn't know everyone yet. And she had a couple playdates. And so I sent mom would text me and say, Hey, Mom, you know, so and so wants to know if Macy can come over after school and play. And so I would respond and say, yes, she would love to however, I just need to make sure you understand BCS type 1 diabetes, and this can mean this and you know, she's, she's on it, but I really need you to just have your phone with you all the time. And I will tell you, it was challenging because we didn't get a lot of repeat invites. And then and then I would go over how to use that glucagon emergency kit, because I was scared. I mean, what if, what if they're out jumping on a trampoline? And God forbid, that's her first low. I mean, so I felt like, I had to do that. But it was really tough because I didn't want to and I think her social life. So you know, then I I tried to include an invite over to our house. So I did you know, slumber parties. That was a whole nother chapter to get through. But we did them in our house. You know, we didn't have in our house for a long time. But as long as I had a willing person on the other end, I allowed me to go do those things. As long as I had a mom or a trusted, you know, dad or trusted caregiver. On the other end, I really tried to give her that opportunity to go and be away from me. Like frankly,   Stacey Simms  16:38 it was interesting. He was a two year old, my son. We taught him some things. And I know we're gonna talk about that a little bit later. But did you start teaching Macy to do her own care with like with supervision, pretty much   Cami  16:51 immediately, immediately. I have videos of her coming home, like five days after the hospital and going okay, here's Macy, she's gonna give herself her insulin injection, and I'm videoing her and she's smiling on the couch. And so immediately, I mean, we really, and I don't know why I certainly could not have possibly had the foresight to know that that was important at the moment. I don't know why we did that. But I'm glad we did. I mean, Stacy for you. I mean, he was so young. How, at what age? Did you start giving him independence? Or or? Yes.   Stacey Simms  17:25 Everybody curates differently.   Unknown Speaker  17:27 I noticed, you know, I   Stacey Simms  17:28 jokingly call myself the world's worst diabetes mom, but slight. And I, we always wanted to raise our kids to leave home. And if it's about them, and you know, everybody, everybody's different. But when he when we both worked full time, so my kids were both in daycare, and we're, we're the luckiest people, I think when it comes to the type one things that happen. And so when I brought him back to daycare, the manager was like, oh, yeah, I used to be a minute, I can get injections. And I was like, Can you sleep here because I don't want to give you the money. And then go, actually, the whole team here started learning how to do it. And once he got an Insulet, on six months later, everybody was like, Yeah, I'll check that out, you know, and two of the ladies there became nursing students, not because of him, but like he was just cool. He didn't have a desk calm because this was 2006. He didn't get a desk until he was nine. And so we decided that when he was going into kindergarten, which honestly was one of the most terrifying things for me, like that was a hard, hard transition. Because we've had it so good at daycare, we told preschoolers, as we called that, like, hey, we want Benny to know how to check his blood glucose and muses, champions to kindergarten. And so we're going to teach him that at home. And can you help us out a daycare? And if your kids have ever been in daycare, like that's where they are independent, they come home, they would do anything for being going to calculus and the dude helping us a four steps. So let's do one. He talked to him, like, boys took their own leadership when kindergarten things like demonstrated I was able to do it so that once you could do that, and he always knew, officially, I have to show my there was always a responsible adult, he wasn't just doing that. So that helped us because in our neighborhood, first grade is when people start going playdates pretty much by themselves. And so we would line up, no Dexcom. But people have to call me and be like, Here's what a meeting person and I'm going to be helping from the dose and I want everybody in my neighborhood a person, which is really fun. And that's what I believe is really good friends with London because we get the case. Every evening on the counter for the kids, I don't know it's like after school.   I could go on and my answer to that question is very gradually, every year he did something else that is more leading more and more towards independence. Was the blood sugar perfect? Absolutely not. But that's the trade off I think sometimes. Alright, so we come back to our stuff we're talking about. Do you have any lessons you learned that can help other moms with, you know, similar aged kids just starting out?   Cami  20:14 I think probably, and again, not not because I did this, because I knew what I was doing. But as it turns out, we gave me see the confidence or Macey develop the confidence to be really open about her diabetes. Um, there's actually an influencer, who she's now a PA, some of you may follow her. But she's, she's a PA, she has type 1 diabetes, and she just had chant twins a couple years ago. But anyway, she did this whole post online, maybe three years ago, something like that, about the importance of teaching your kids to be confident about this, and to talk about it enough to be embarrassed about it. Don't go into the corner and trick your finger. Don't try to hide all your stuff. Because what she found she was talking about her own experience when she was younger, she said, there was so much curiosity among kids about what you know what, what is going on? What are you doing over there? And why are you freaking out? You know what's happening? And she said, When I tried to hide it, that's when people really got curious. And it became kind of this big thing. And she said, as soon as I was like, Oh, I'm pricking my finger, because I have type 1 diabetes, and I just need to know my blood sugar. They were like, oh, okay, no big deal. And when she said that, it resonated with me, because I feel like we did that, again, by the grace of God, not because we knew what we were doing. But, you know, we really encouraged me see, to talk about it. And to educate people, I said, you know, you have this for better or for worse. And it's kind of your responsibility to talk about it and to educate and to kind of be an ambassador for this. And if you see someone else who has come on, welcome and introduce yourself and say, Hey, like, like your next column. And so to be open about it, and to embrace it, I really think it's helped or to just be confident and to accept it. And I, you know, it's easy for me to say, because my daughter was seven at the time, I think if you have a diagnosis, when you're you know, on stage, it may be for you to a little bit like that, if you have a diagnosis with a 16 year old boy, man, I think that would be really, really challenging, because you just might not have that same response from him or, you know, 15 year old girl. So I think that's difficult, but to the extent possible, I really think that's invaluable. Probably one of the most valuable components of Macy's type 1 diabetes life is that she's not embarrassed about it. It is what it is that she wished she didn't have it. Of course she did. But it is what it is. I would say that's probably my number one piece of advice,   Stacey Simms  22:21 I think to you, you kind of as I said, we were very lucky. Betty is extremely outgoing, don't know where to get stuff from. And she nearly it was never shy about diabetes, daughters Natori introverted. And I would worry, I think it would be different, but I worried about her in middle school in high school, it would have been a different experience. I think, overall, they're just different kids. Yeah,   Cami  22:43 I mean, I think as they get older, you know, Macy's in eighth grade, right for 14, and college scares the heck out of me. I mean, when she goes spent the night at a friend's house, where I know the mom very, very well. And five minutes away from me, that's one thing, but I'm terrified of college, and her leaving the house, we're doing everything we can to prepare her. But I'd love to hear a little from you. Well,   Stacey Simms  23:08 you know, I'm gonna start by my mother gave me advice a long time ago, especially when he was really little, which is don't borrow trouble. Like there's enough to worry we have in front of us. So when he was two, she was like, don't think about college yet, but you'll get there. So I won't say don't think about just obviously, your top two. But that kind of helped prove a little bit. But I will say and we touched on this a little bit. The gradual independence that we gave Benny really helped us. I mean, it helped him, but it helped us. So our diabetes educator who is just an amazing woman recently retired, she has two adult sons with type one, one of whom was in New chronologist now, and she told me that the first time we met her, I said, like, oh, you know, do you have any advice? So that what can I basically I was like, How can I not mess this up and make him a good person and a healthy adult. She's like, why we can't tell you how, but I can tell you what not to do. She said, I just taught an 18 year old who's had this for a long time how to get insulin shot, because he had never done it. And he's going off to college. And she's like, don't do that. Don't do that. And you know, we all know that families don't want to pass judgment. I don't know what's going on. But I just was like, Okay, we've got a long time to get into the printer. So what we did was at the beginning of every school year, I would say, Hey, how you want to manage diabetes this year? What's your goal? And so I didn't give him that choice in kindergarten because I was ticked like I said, I was terrified. But in first grade, he said he wanted to eat lunch by lunch at the cafeteria once a week, at least. You know, by fifth grade. He was like, I don't want anyone ever checked in with the nurse because we live in North Carolina where they don't have full time school nurses. So we had a nurse at the office maybe two days a week. We had amazing staff who were like very caring individuals but didn't really know who diabetes. So that's another reason why I taught him to check his blood glucose. Because Jeff's calm which was not just been scheduled this time. So don't shut down we got we got Dexcom we had no Sherawat follow. So I mean we do is at the time he was supposed to pick us up and even just look at the steps. So he's your team didn't really change very much. But fifth grade was I don't want anybody looking over my shoulder anymore. I'm just going to Joe's gonna be compromised. Because I don't know about you guys but Middle School fifth, sixth, seventh eighth grade Marines like Whovians. So I do anything that I need a thumbs up to your teacher, that you gave yourself insulin for lunch. And he was like, Cool. Mr. Parker said, we're good to go. Then Middle School, he's like, I'm not checking in with anybody. I'm on my own. But I want you to text me every day before lunch. You're young, you're bolus. Oh, how wonderful. You would think how wonderful and you want to do bolus every day of that we just want to run with it. And we also talk, a little wonder, but we also have the same conversation starting in middle school about how are we going to manage Dexcom share, because I have a very funny Facebook post that I pulled out for the second book. And it's one of the first to share, he went on a field trip. And I was like, how do people do this? This is the worst thing that's ever happened to me. I have to look at these numbers all the time. Oh my god, this is overflowing. I need this. So I sat him down and I'm like, but if you read above this number for this long, I will text you if you're below this evergreens, Islam, I will text you and we went every year we changed that. By the time he was a junior in high school. I turned off the high alarm senior here, which was our independence here. I was like, okay, but the junior senior high school, I am not going to help you. And once you really, I turned off my love. The real turning point for us was that when he was 16, he went to Israel for a month with a kid, not at the biggest scale just because of regular sleepaway camp. And when he didn't Well, and came home, I said, What am I supposed to do now? Like you're done? I'm done. You're cooked. When you say now your customer service. And we went to camp this summer where he was a lifeguard. And he said, we're done. Like off with follow. So I don't follow. Kids, we're doing this before sharing follow up. You're like, right,   Cami  27:12 is to allow anyone to follow him.   Stacey Simms  27:15 Know that he's following him right now. But I know in the heads of the question, I'll ask him. In the past, he's had friends follow him, friends with him without diabetes. And that's fine. He's young. He has a roommate. He's not alone. I'm sure. My concern right now is more about highs than lows, because he's just kind of doing the minimum. I do like index complexity. But you can see the back end look. I'm gonna talk to him about it, because I figured he's a busy freshman figuring it out. Yeah. So again, we all hear differently. And because I feel him in one cameo, and I'll wrap it up in a second. But because we took all those steps to independence, already, we had really bad diabetes experiences. He's been low on sleepovers. He's been high on sleepovers, he has had his infusion sets come out. He's walking on insulin at restaurants. He walked across my neighbor's lawn to our lawn that intersect without telling anybody at four o'clock in the morning because he was low and didn't like the juice selection. Do you realize   Cami  28:19 that follow over   Stacey Simms  28:21 when they're 62. Right? So we've got a lot of time to make a lot of mistakes and realize like he's a tough cookie. So it's really yeah, we've done it all. Okay, so um, but Matt, what's your question for me? I want to ask you to county before we move on, you mentioned the Congress and things and it's tough on their stuff. And I mean, everything stuff. My daughter's maybe like, can you complain to me, too? Am I the guide a little easier, she's older and she doing 13 to 14 is like when they're really pushing you to make them more independent here to them more.   Cami  28:56 You guys. Yes. So for her birthday, last year, her 13th birthday, she had all these friends that did some these like elaborate parties and all these things she could mom, all I want is I want to go to the mall with my friends. I don't want you hiding in a coffee shop down the street. Property, I want you to drop me and my friends off and leave go back home. All you when we're ready to be picked up. So I dropped her off. And that was what she wanted for her birthday. They went out to dinner. And you know, they I think they were there maybe four hours. But she literally asked for independence for her birthday. You know, we also take advantage of this technology. So she she wears an Apple Watch. So even at school like you know, if we see we're on a chain actually, it's my husband and I and Macy and then they have an iPad in the school office, that some chain so we're always watching her numbers. And if she goes really high, you know, we kind of have to kind of have thresholds like if she's too high for too long, then we're like Amy see, are you having insulin? If she goes low, he may see or you know, are you having sugar so we've kind of got this cadence of communication. And I think because we've so to hold her accountable, it's been easier to allow her to be more independent. Because she and we'll talk about this, I think in a few minutes, Didi like, you know with low she communicates mom and having sugar mom I know I'm high I'm gonna give myself three units. So that's great you know she she communicates but back to your point a few minutes ago there Her brain is also gone because she's 13 and this junior high where it's just like, sometimes we'll be on dessert already through a meal and I'm like, oh Macy bullet strike. She's like, Oh, I forgot. I'm like, provide like we've been doing this for seven years every time you put a morsel of food in your mouth?   Stacey Simms  30:34 Yeah, that's a change. Yeah. I do want to talk about, we're gonna change gears a little bit and talk about severe blows. I noticed people very nervous. I do want to say this is meant to be educational and not scary. But CAMI is going to share some stories. But I do need to say that definition realize that severe lows occur when blood sugar gets too low for your body to function optimally, and requires immediate health to recover. It is really important to be prepared for the unpredictable. And I joke around a lot. But we do take this very seriously in the afternoon students of preparation when I think of the Ford Academy, because you had unfortunately not experienced with us.   Cami  31:16 Yeah, so Macy's had three severe love, none of which happened in the first like four years of her diabetes diagnosis, which was, you know, wonderful, because we never had to use the red mix kit. I don't know if I even would have been able to do that in a moment of panic. And as I walked through the story, I think this will make more sense. But initially, when we were informed about severe lows, what they could look like what they were, I was so terrified, it was like this taboo that I almost didn't even want to think about or talk about, I knew it was there. And I acknowledged it but I just wanted to do everything I possibly could to never ever, ever have to even get into that realm of a severe low and say. And things changed for us a little bit, to be honest, when I learned about Gvoke and how it could be used. So let me walk through, you know, our severe lows and kind of how those played out. So the first one was a few years ago, and my husband was traveling, he was out of town. And so it's just me in the kids home and I tried to eat pretty low carb, but for whatever reason, this pasta night, so I made some pasta. And Keith and I were eating and Macy bolused for her entire plate of pasta, and then eat about half. And then when I was jumping, kind of like a trampoline this like Airtrack thing we have in our backyard at the time, my son was really into like learning how to do flips. So he was like, Macy, come on, let's go out. Let's go out jump on the Airtrack. And so they were out and my daughter and I were kind of inside. I think we were watching a movie or something. So all was quiet, everything's fine. Kids were having fun. It was just a regular night. And then I get the alert on the Dexcom. And it's 50 to two arrows down. And right at that moment we see blast through the front door. She's like Mom, I feel really low. So I'm like okay, so I get her some apple juice. I think we actually use the little gunk, she doesn't like apple juice. So we give her some gummies waited a few minutes. And then then the reading said low we prepped and it was extremely, she was really low. And I said Macy. You can keep pounding sugar I said or we can pull out your G book right now. And she was like, let's just do the G book.   Stacey Simms  33:08 Hey, this is Stacy jumping in. Just to give a little bit of an explanation. Here. Hypoglycemia is defined by level one glucose lower than 70 milligrams per deciliter, and greater than or equal to 54 milligrams per deciliter level to glucose lower than 54 milligrams per deciliter. And level three is a severe event characterized by altered mental and or physical status requiring assistance. This level of hypoglycemia is life threatening and requires emergency treatment, typically, with glucagon. Now, back to kami. And   Cami  33:45 so we were in that moment, I gave her a choice because she, in the absence of intervention, she was going to pass out and she was headed down. And so we injected G voc. And within a very few short moments, she started feeling well and recovered. I think she got up to about 180 and then ultimately leveled out. That's it. That was experience. Number one. Tell us about Jimi Hendrix. Number two was a little bit kind of the same, but kind of different. Again, my husband was it was during a period of time where he was working on something and so he was traveling quite a bit. So it was after dinner, I had to open like 839 o'clock at night. We were actually all up in my room. And my when my husband travels or just forgotten early on, all my kids get to have a slumber party in my room. So Macy and I were reading I think I had one on like a blow up mattress on the floor. And we were watching a movie and just kind of his quiet moment. And the Dexcom alarm goes off. And it's super low reading. And so it was we treated it the same way where we tend to treat with sugar first. And we had no we had no idea. She was I think she was 49 Two arrows down and she had like three and a half units of insulin on board. To this day, we still don't even really know what happened. And so she had sugar continued to drop, we pricked her finger, and she actually that time said, Mom, I want to use Gvoke and so We have several of them. And so we opened it, she actually injected it herself into her the first time I did it in her arm. Second time, she gave it to herself right in her thigh. And same recovery scenario. It was amazing. It worked really quickly. And I knew that it was going to give her what she needed, so that we avoided that biggest fear.   Stacey Simms  35:19 Stacy here again, just jumping back into give this disclaimer, it's really important to understand that Individual results may vary. And you've always got to consult your healthcare provider.   Cami  35:28 Right? I mean, think of severe hypoglycemia, you think of someone on the floor on that worst case scenario? I mean, really, that's what you're thinking, think of incapacitation? And I mean, is my child going to lose his or her life, I mean, that that's really what we've kind of been trained to think about severe low, and there was sort of this paradigm shift for me in my mind about using glucagon, not to say that you use glucagon every time you have a low, not at all, you know, always, of course, treat with sugar. But there are scenarios given the way technology has progressed, we know when someone is headed for disaster, we can prick a finger, we can look on it next time, we can look at their symptoms. And we know that in the absence of intervention, something bad's gonna happen. And with G voc, you can use that to ward off that unimaginable moment of someone passing out. Actually, that's a perfect time to bring up the last time she's just a little over a year ago. She was at a slumber party. That was a birthday party 13th birthday party. I know the mom quite well. She's one of those very supportive moms that you just want to hug and say thank you for understanding and for taking this on and sleeping with one eye open when my daughter spent the night at your house, they had gone out to dinner, they went to PF Changs. And so she had shared a bunch of food with our friends. And they've gone back to the house and they were all getting ready to go swimming. And Macy got a LOW Alert ello w. And I was like, oh, okay, and so we stayed on the phone. And she said, Yep, she just administered it, and she feels fine. And, you know, call you back in a few minutes. She knew she needed it, she was afraid she was gonna pass out. And she administered her Gvoke, her blood sugar popped up within a few short moments. And she never had to experience the full blown incapacitation, that gives me such comfort, knowing that she knows how and when to use that. Because you don't know when it could happen. as vigilant as we all want to be they happen. And so knowing that she has the confidence to pull that out and know when she needs to use it is a massive source of comfort for me. And we're   Stacey Simms  37:20 going to start wrapping up in just a couple of minutes. And I have another quick question for you can we but I want to share, we need to set the amount of comfort, we'd have not had to administer anything that wouldn't have gone. I would have liked it in a few places. We've been to some external markers, that red box here. But one of my proudest parenting moments, wasn't even there for freshman year of high school being wrestled in high school for a couple of years. And we didn't do this in high school, but the sports teams to travel now love them. And they fundraise and they say right hotels and I, I had an instance where I was, you know, still following me as a freshman, and I couldn't reach him. So I called the teen mom. And she was like, Oh, he's actually my son tonight. Like, I'll ping them. And of course, he just wasn't looking at his phone. And he was like, I was laying on me. That's kind of mine. Fine. But he came home though. I said, What would you have done? Like, let's talk this through more, because now I am thinking about more. You know, how do you manage that he's like, Oh, my gosh, luck is anytime I'm with new people overnight between summer camp and wrestling and sleepovers. Anytime when we meet people, I take out the G book United type 1 diabetes I'm going to be and this is the other thing I'm not drinking, if I'm passed out or I'm slurring my orders or anything like that, I'm actually Lucky's like, call the coach then use this and he shows them how to use it as well. Like I really don't want another 15 years of administering. Yeah. But at the same time, I was really proud. And then I said, Well, do you ever like Does anybody ever gets to change rooms? Because of the hammer because of the BB? And he's like, Oh, my God, Mom, I already see what works, you know. But I was really so my one of my last questions who can be here as I don't have a child who has used this? You would like you said, you were there the first time there was another adult there the second time she used it, but have you been talked about? Like, how is it helping? The chief? She fearful? What is she doing? She think about it? You   Cami  39:11 know, I've asked her? And she said she just feel safer? Because she knows that there. She's not scared of it. And to me that's everything because there's a lot of fear involved in this disease, fear of your client, my blood sugar is too high. What's that going to cause in the in the future? I mean, we're we're constantly you know, trying to mimic them an organ, a human organs. You know, there there's a lot involved in that. So just knowing that that component, that fear factor part of it, she's got a plan. She believes she's covered. If she gets to that point, and we do everything possible to avoid it, of course, like all of us do. But if God forbid it happened again, she'll know what to do. And that's amazing that Benny educate other people. I think that that's huge because sort of like wearing your seatbelt right? We we don't put our seatbelts on every day when we get in the car because we think we have a high probability of getting a new car accident but what if we put our seatbelts on? It's the same kind of concept   Stacey Simms  40:09 you're listening to Diabetes Connections with Stacey Simms. Big thanks again to CAMI for zooming on in again, she broke her arm just before the event. And I give her so much credit. I had a crowd to talk to. But she was basically just looking at herself. You know how Zoom is. So I really appreciate that. Kami. Thank you so much. We did take some questions after that last comment of camis. I know it ended a little bit abruptly, but the audio really fell off. After that. There's only so much that John can do with his editing magic. If you liked what you heard, please share the episode. And please join us for mom's Night Out Charlotte in February. And for our other three stops in 2024. I am scheduled to share those locations this week. As you're listening I may have already done it. So please be sure that you're following me on social media. You can always reach out though Stacy at diabetes dash connections.com I will say there was one city that we heard the most comments from and that is on our list. So definitely let me know if your city or a place you cannot get to is on the list. Definitely ping me for 2025 We are listening to you. And we are I mean I'm going forward with this full steam ahead in probably four events a year until I don't know until people stop coming. Thanks again to jump you Candace, my editor and a big thanks again to Xeris for all of their support. I'm gonna read that important safety information one more time. Gvoke is a prescription injection for the treatment of very low blood sugar in adults and kids with diabetes age two and above. Do not use if you have a specific type of adrenal or pancreatic tumor starvation chronic low blood sugar or allergy to Gvoke High Blood Pressure hyperglycemia and serious skin rash can occur while your doctor or get medical help right away. If you have a serious allergic reaction including rash difficulty breathing or low blood pressure, visit Gvoke glucagon.com/risk For more information, I'm gonna link all of that up and the link in the show notes. And Stacey Simms. Thanks so much for joining me. I'll see you back here soon. Until then be kind to yourself.   Benny  42:14 Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged.