June 27, 2017

Meter Accuracy Study - DTS

Diabetes self-care is driven by data from glucose meters. The accuracy of meters matters because it is the cornerstone living successfully with diabetes. The Diabetes Technology Society just published a blinded study of meters. Have a look: https://www.diabetestechnology.org/surveillance.shtml

February 9, 2017

Pills better than insulin for t2?

Physicians Briefing reports a Swedish study that shows a lower risk of mortality (I vote that is a better outcome) with oral type 2 medications than with insulin. Good to see the study considered hypos. Given that diabetes is underestimated as a cause of death, it is good to see research looking at the big picture of all-cause mortality.

WEDNESDAY, Feb. 8, 2017 (HealthDay News) -- For patients with type 2 diabetes, novel oral glucose lowering drugs (GLDs) are associated with reduced risks of all-cause mortality, cardiovascular disease (CVD), and hypoglycemia, compared with insulin use, according to a study published online Jan. 24 in Diabetes, Obesity and Metabolism. 

Still - YDMV. The best course of treatment is the one the patient and physician agree meets the individual needs.

I think this "all-cause" approach should be taken when considering access to care beyond medications. One size doesn't fit all. Disrupting access to diabetes tool from strips, to the appropriate pump should be considered on a similar basis. 

February 2, 2017

Diabetes is Underestimated

Sometimes I think diabetes it is the Rodney Dangerfield of health. Unfortunately, it isn't a joke.

A recent study highlighted in this piece at Medscape says diabetes is underestimated as a cause of death in the US. The study puts diabetes, "the third leading cause of death in the United States in 2010, after diseases of the heart and malignant neoplasms and ahead of chronic lower respiratory diseases and cerebrovascular diseases." 

People with diabetes can thrive. By engaging early, we minimize complications, costs, and deaths. We need the appropriate tools and medications to be successful. 

Join me in calling on Congress to maintain the prohibition on pre-existing conditions, like diabetes, being grounds to exclude people from health care coverage. 

It is easy. 
  • The Diabetes Patient Advocacy Coalition has an easy to send letter to Congress. I'm sending it often. You can too.  
  • I'm sending Tweets from their Twitter Scorecard. Join me.
  • Getting through to our Senator's by phone has been iffy recently. So I 'm sending snail mail. 
Not only do we need to work with our doctors to care for diabetes. We need to work with our elected officials to maintain access to coverage. We need respect.




January 25, 2017

My Diabetes May Vary


Variations are inevitable and frustrating. 

Following treatment for cancer, I started medications as part of recovery including an emotional health medication. They seem to help. But the emotional health drug has a side effect - it bumps up my glucose levels. This feeds a feeling of fasting glucose frustration.

My go-to response is to try "to eat better." But when I don't see immediate results, the myth that I can control the rat bastard with diet, makes me feel a temptation to just eat less, to produce less glucose. The risk (and some days the reality) then becomes to eat less AND worse.

I aggravate everything doing that. It is a losing proposition.

So type 2 diabetes becomes more front of mind. I am checking glucose more. (Boy, I would love a sensor that filled in the gaps in my glucose profile. Come on Libre)

I think on balance the numbers are OK-ish. But they show that type 2 diabetes doesn't play well with others health issues, including emotional health.

As it changes, it demands additional adjustments. I know that is the deal. Knowing it doesn't make it less frustrating.


Type 2 is inevitably frustrating.


MDMV


January 16, 2017

CMS Ruling on CGM

The Centers for Medicare & Medicaid Services has concluded that Continuous Glucose Monitor Systems can be covered as durable medical equipment.* Specifically, those with an FDA label for the purpose of adjusting the treatment diabetes.

In practical terms currently, means the Dexcom G5. The CMS finding also established criteria for coverage that is an innovation target for other devices to achieve. Codes and coverage still need to be worked out. Still, this is great news. As one piece on the ruling observed. "Nearly 25% of patients with type I diabetes fall under Medicare."

A lot of effort, by many, contributed to this success. The industry has maintained a rapid pace of innovation. FDA has responded with timely reviews of CGM applications, most recently with a non-adjunctive label for the G5. A majority of both houses of Congress supported legislation in the last Congress supporting coverage. Courts ruled in individual cases for coverage. We, the people with diabetes, advocated in every avenue open to us to ask for coverage.

Positive diabetes health news is great. Savor this.


*You read the CMS Ruling at https://www.cms.gov/Regulations-and-Guidance/Guidance/Rulings/Downloads/CMS1682R.pdf

December 19, 2016

Last Minute Shopper Alert: Stuff the Vegas UnCon into Their Stocking.

Looking for one more brilliant gift?

Your Diabetes May Vary but the gift may not. What's better thanVegas UnConference?

Don't know about the UnConference? Learn here, it is perfect for People with Diabetes (PWDs) and the People who Love Us (PLUs). Find your people. Have fun in the process.

Winter is coming. With it the winter doldrums and the need for a Valentine's Day celebration. Give the Unconference now as a stocking and join the fun in Vegas.

Book the UnConferece here. Then with Amazon Prime you can have these socks to hang from the bed post in time for a visit from Naughty Santa's Helper.

Wink Wink, Nudge Nudge.

December 14, 2016

I had prostate cancer. It’s been a blessing.


I've been out of circulation.

Turns out I’m fortunate; I had prostate cancer. It’s been a blessing.

Fortunate first because, I’m using the past tense - HAD. OK, it is still early, but all the information so far points to success. Score. I’m saying had.

From the first concerns to the diagnosis, and surgery, I had a lot of fun riding hundreds of miles on my bike. They had me in better condition than I have been in for a decade or more. Being in better shape helped. Rides were my meditation and were the space where I could get emotionally ready for the surgery.

I’m lucky it was detected while it was localized. What matters is I had, and still have a stunning level of support from family, friends and health care team.

I wince when people say they are sorry for what I have been through. While I greatly appreciate that sentiment, sorry isn't the lens I see my experience through.
I’m not at all sorry for it.

I am thrilled that, if cancer was in my life’s path, it was slow growing, highly treatable type.

I greatly appreciate that my family doctor of 30+ years connected me with a second opinion. That second opinion proved to be the star of my team. I benefited from the personal relationship between these two professionals. It is such that a phone call from my primary was all it took to get me a personal phone call and appointment from a surgeon whose staff said his calendar was booked for months. That took less than a day.

I could not work with better people. Family first isn't what they say; it is how they live. It was never about picking up the slack; it was always about being proactively supportive.

My family is wonderful. They showed that even when I didn’t. They supported my both contradictory fierce independence charting a path through the process and rants at the myriad of SNAFUs that come from the spectacularly non-systematic health process, incorrectly called the healthcare system. I am sure my vacillating between being noncommutative or a ranting loon was not fun.

I’m not sorry. I’m blessed.

I much more clearly see the many blessings who are the people in my life.

Love Ya Mean It

September 8, 2016

Glycemic Index' May Be Too Unreliable to Manage Diabetes: 
Wide variability seen after eating same food at different times

The opening: Glycemic index values of the same foods can vary widely and may be an unreliable indicator of blood sugar response, according to a new study.

No kidding?!

YDMV

June 27, 2016

Sugar Surfing comes to Minneapolis

From Scott's Diabetes

Sugar Surfing comes to Minneapolis

Dr. Stephen Ponder is a pediatric endocrinologist and certified diabetes educator with Scott and White Healthcare in Temple, Tx. He’s lived with type 1 diabetes since March of 1966 and has been a pioneering force in diabetes telehealth and remote care for many years.
Dr. Stephen Ponder
One of his latest projects is Sugar Surfing, a modern approach to managing diabetes.
Sugar Surfing Book
“You can’t stop the waves, but you can learn to surf.”
It’s happening on September 24th, 2016, 12:30 pm (workshop runs from 1:00 pm to 4:00 pm, at Open Book.
If you’re nearby and interested, please register and share! Space is limited, so don’t delay!
More at Scott's
https://scottsdiabetes.com/2016/06/26/sugar-surfing-minneapolis/

June 15, 2016

Wanted: Teen Athletes with Diabetes (Girls and Boys) Team Novo Nordisk Camps

From their release:

Team Novo Nordisk Seeks Young Athletes with Type 1 Diabetes

Tuesday, June 14, 2016 — ATLANTA, Ga. – Team Novo Nordisk, a global team of athletes with diabetes, spearheaded by the world’s first all-diabetes professional cycling team, kicks off the first of two talent identification camps today in Athens, Ga. The talent identification camps serve as a key recruiting tool for Team Novo Nordisk to develop athletes for the men’s professional squad and help fulfill the team’s ultimate goal of racing in the Tour de France by 2021. Currently, 48 young athletes with type 1 diabetes from 18 different countries are slated to attend. Applications are open for a limited amount of remaining spots at the second camp, which begins July 12, at www.teamnovonordisk.com.