July 29, 2008

Watching Reflections of Earth EPCOT fireworks. Son says on of the images on the globe is soup. Like food soup.

Should he be drug tested

July 28, 2008

Ok I will post a story by cell phone. Short bits. 160 characters per post. In reverser order. This should be fun.

Delaney hi. Connor ate my app

1/1

Out to dinner. Our reservation was messed up. Wrong day. Alex & Erica helped me out. I gave them a BadShoe pin. Then Delaney's set failed.

2/3

I went to the front desk. Now it was a good thing I gave them a pin the were busy but they like me and made a quick call for help.

3/4

Alex & Erica called 1st aid. They had a needle for me so I hiked over.

We had just ordered appitizers. The family could work out were I was

4/4

Jo and Terry gave me a needle. We had a short chat. I gave them a pin and husseled back to give laney a shot.

The boy ate my appitizer.

What Slump?

FFL was great. I was worried about a sophomore slump. I shouldn't have. Even the presentations I choose to see again had new value. I went to see Joe and Paul knowing the rough outlines of what they were going to say and even some of the jokes. The jokes were still funny and what they had to say still reliant.

Not wearing a first timers ribbon I saw from the other side that it challenges me to engage those new people just a little more than others.

We have to come all the way to Florida to hang out with Willie and Patti. That is probably a good thing for Philly. If we got together much more the pandemonium could be potentially catastrophic for the 5 county area. It was great to see Mark, Larry, Theresa, Kerri, Ellen, Sara, Shelby, Manny, Jim, Laura, Monique (congratulations), Natalie, Jeff, Bob and meet Tom, Vincent, Craig & co. and oh so many more.

Friends for Life isn't about diabetes it is about the vast network of people who make living with diabetes possibility.

Much more to say but the kids are waking up and it is time to do vacation stuff.

July 27, 2008

FFL UPDATE

Connor: conference was good

Me: yeah we will be back. Maybe not every year

Con: I am coming every year if I have to pay

Priceles

July 24, 2008

Live-ish from FFL

Kerri thinks I am terrifying. It may be a compliment but it doesn't sound that way. That is OK she reminds me of my sisters when they were her age. That may be a compliment but it will not sound that way in a second. I was the kid brother. I have 4 older sisters. My mom says I had 5 moms and she didn't bother disciplining me because the other 4 did.

Kerri you don't know terror.

I am wearing a ping and a Cosmo named Wanda for all of you with kids who watch Nickelodeon.

I will try to collect my thoughts on the pumps and post them when we get back to the land of the working people. We're going to Disney next week and well blog posting will not be as important as being Goofy. Yeah I know how can y'all tell the difference between being Goofy and my blogging.....

More later.

July 23, 2008

Live from FFL
Blogging from my phone!
Met manny and Kerri
Amimas' hit man hasn't found me yet.
Delany saw Joe - Joe rocks
More later

July 22, 2008

Should restaurants have to disclose nutritional info?

That is the question being asked by the LA Times. Check it out:

http://www.dailynews.com/opinions/ci_9953544

From The News Wire: Tuesday Three-for

We are off for FFL tomorrow and a side trip to Disney after. YDMV postings maybe strange. I have figured out how to post from my cell phone but thanks to the modern marvel that is Sprint can't post picture from the cell phone because my Sprint picture mail doesn't work right. I called customer service. Somehow after a bunch of transfers I got disconnected. Funny you would think a phone company would figure out how to do telephone customer service....

Anyway

Three stories caught my eye today.

JDRFis funding work at Harvard, encapsulated porcine islets do small human test and an article on Stem Cells.

$3M award from the Juvenile Diabetes Research Foundation funds interdisciplinary research that bridges chemical biology and genomics

Researchers at the Broad Institute of Harvard and MIT have received a grant to support novel, integrative research aimed at finding ways to encourage the human body to replenish the cells that are missing in type 1 diabetes. Awarded by the Juvenile Diabetes Research Foundation (JDRF), the $3M grant will fund work that knits together two interdisciplinary fields, genome biology and chemical biology, to address a fundamental question in human biology: can existing cells be coaxed to regenerate ones that are lost or damaged by disease?
http://www.eurekalert.org/pub_releases/2008-07/biom-bie072108.php

Living Cell Technologies Reports Clinical Benefit for All Patients in Diabetes Trial MELBOURNE, AUSTRALIA and AUCKLAND, NEW ZEALAND
Jul 21, 2008 (MARKET WIRE via COMTEX) -- Living Cell Technologies Limited today released further interim results describing clinical benefit in all patients who have received implants of DiabeCell(R), the Company's encapsulated porcine islet cells for the treatment of type 1 diabetes

http://www.marketwatch.com/news/story/living-cell-technologies-reports-clinical/story.aspx?guid=%7B3860642C-44C4-4620-A9E7-838D5206A9E1%7D&dist=hppr


Novocell Looks to Stem Cells for Diabetes Cure
Monday, July 21, 2008 Ed Baetge and the team of scientists he has led for seven years have had setbacks and disappointing days, but the prospect of finding the cure for Type I diabetes makes their research too tantalizing to give up. Especially now that Baetge believes that they’re on the brink of a medical breakthrough that could stave off the disease in humans. "I’m convinced we’re going to do it," Baetge said. "It’s going to take some time, but we can do this."

Baetge is the chief scientific officer for Novocell, Inc., a San Diego biotechnology company. Earlier this year, Novocell researchers were able to convert human embryonic stem cells into insulin-making cells that stopped diabetes when implanted in mice.

http://www.voiceofsandiego.org/articles/2008/07/21/economics/892novocell072108.txt


Edited - make it a four-for.

Insulin-producing Cells Can Give Rise To Stem-like Cells In-vitro
ScienceDaily (July 22, 2008) — The question of whether insulin-producing cells of the pancreas can regenerate is key to our understanding of diabetes, and to the further development of regenerative therapies against the disease. Dr Rosenberg from the McGill University Health Centre (MUHC) and McGill University together with Dr Bernard Massie from the Centre hospitalier de l'Université de Montréal (CHUM) have just concluded that they can.
http://www.sciencedaily.com/releases/2008/07/080721152008.htm



July 18, 2008

From the News Wire: Lantus vs NPH: Safer not better control

Long-Acting Insulins in Type 1 Diabetes Safer Than Traditional Agents

For type 1 diabetes, long-acting insulins such as glargine (Lantus) reduce severe hypoglycemic episodes but don't offer clinically significant improved glycemic control, according to a meta-analysis.

July 17, 2008

From The News Wire: CGM and Insurance

Reuters in Forbes and other places has a story on CGM and insurance. Nothing real new there but good to see We Hold These Truths to be Self Evident getting some press play.

http://www.forbes.com/reuters/feeds/reuters/2008/07/17/2008-07-17T154512Z_01_N17296380_RTRIDST_0_DEVICES-DIABETES-ANALYSIS.html

http://economictimes.indiatimes.com/News/International_Business/Insurers_hold_key_to_diabetes_device_sales/articleshow/3246833.cms

T1 at the Olympics

I'll miss Gary Hall Jr. but the USA will have a T1 athlete at the games.

From http://www.hoinews.com/sports/sports_story.aspx?id=160373


Heart of Illinios fans got a real Olympic thrill this past weekend cheering on Team USA to a pair of volleyball wins over Spain. The American volleyball team put on a high-flying highlight show in front of red,white and blue fans at U.S. Cellular Coliseum in 3-0 and 3-1 wins over Spain. While area fans were wowed by powerful spikes and precision passes, few of the fans realized one of the American players has type 1 Diabetes.

Kevin Hansen is headed to his first Olympics as a 26 year-old setter from Newport Beach, California. The former Stanford star was diagnosed with type 1 diabetes as a ten year-old. His status now as an Olympic athlete makes him a great role model for others with juvenile diabetes. A role model Heart of Illinois fans are hoping will soon be wearing a gold medal!

From The News Wire: Biodel Trials

DANBURY, Conn., July 16 /PRNewswire-FirstCall/ -- Biodel Inc. NASDAQ: BIOD today announced that its two pivotal Phase III VIAject(TM) clinical trials are now complete, with the last study patient visit on July 14, 2008. Results of the full trial will be released either at Biodel's poster presentation at the European Association for the Study of Diabetes (EASD) on Tuesday, September 9, 2008, or at a later appropriate scientific forum.

More at:
http://sev.prnewswire.com/health-care-hospitals/20080716/NYW13316072008-1.html

July 16, 2008

Caveat Lector

"Let the reader beware."

I am warming you up with a little Latin on purpose. Not to make me look smart, although if it does that is awesome, because I usually don’t look all that smart. I figure you know that.

I assume everyone reading anything I write knows to beware because I wrote it, but I am not talking about just my silly stuff. Get this: You can’t believe everything you read, in a book, in the newspaper or even on the Internet. That is good advice, particularly for the science-like stuff. I am not saying don’t read it. On the contrary I think it is very important to read stuff if for no other reason than so that you learn to get a feel for the good, the bad and the ugly.

I post a lot of stuff under the tag “From the Newswire.” I post stuff that I find interesting. A lot of it, as some of my fellow bloggers are kind enough to point out is pie in the sky small study stuff . I think it good to stay current and staying current is how one develops an appropriate BS sensor.

A lot of reporting and reporting based on other reporters reports no what they read and maybe didn't really understand falls into a trap of over simplification. Sadly folks can buy into that over simplification and hold it dear. I think the best way of avoiding that trap is reading a lot and being both curious and skeptical.

“Diabetes” is a trap. The press doesn’t know the difference between T1 and T2 any better than most of us did before diagnosis. There is lots of reporting that would be a lot better if it made the distinction. In point of fact we can all benefit from more accuracy.

Not that I am all that accurate myself. This site isn’t YT1DMV. Mostly because it sounds stupid and isn't a ridiculously simple play on the ever popular Your Mileage May Vary. So here I am ranting about what the press calls diabetes and I am guilty of the same at my own site.

We all know the T1 T2 particular lack of accuracy but what about the others. Say a book on how a low to no carb diet is really the key in diabetes (pick a type) control or the study of say vitamin D.

Here is a wonderful article that goes into great detail on study from which all those vitamin D articles sprung. (By the way the articles uses actual Latin to look smart.) Hopefully we were all taking them with a grain of salt to start with.

So what is the Latin for: Look out for simple answers to a complex problems?

July 15, 2008

Scott's got a good read

Well I spent the time I should have writing, reading Scott's blog. It is on the topic of T1 and T2. Very good. Good links.

Not the usual why are the called the same thing but rather a good look at how they are not the same. I can't recommend it enough.

http://sstrumello.blogspot.com/2008/07/new-research-clarifies-distinction.html

July 13, 2008

LYMI Kel

I like branding. Who else has a brand like BadShoe for their family? It’s on polo shirts, luggage, messenger bags, pins etc. Given that it seems odd that I hadn’t come up with anything for YDMV.

Kelley, our oldest DD and resident media critic, and I had played around with some ideas but none really took hold. Kelley is pretty good. She made our walk graphics and she did the Disney With Diabetes castle of diabetes stuff for us last year. She didn’t like it but we love it and had fun with it at FFL last year.

She and I played with pumps and meters with YDMV on the display, various font based ideas and a bunch of others.

Yesterday I dusted off a few of the logo attempts and more or less settled on the idea but I was struggling with how to manipulate stuff on the screen. She took about 5 minutes to rebuild the thing.

Anyway we both liked the idea that there is a center line that runs though YDMV. At first you may not see that center line. Like a life with diabetes stuff bounces around it. The lower case d provided better visual balance kind of points out that a d low is a different thing all together.

Kelley left for a month of summer film school at NYU today. We are all very excited for her. The film school at NYU’s Tisch School of Art is her dream. She is up there living her dream.

Miss ya already Kelley – LYMI.

July 10, 2008

Dex on Ping / Pod

Some of the questions in To Ping or not to Ping had to do with how the integration of the Dexcom CGM will work with Animas’ future pump. While Animas is not offering up any particulars the other side of the relationship is. And they are also talking about how it will work with the Pod.

Thanks to the good folks at Thomson Financial and Voxant we can see what DexCom, Inc. had to say at the Citigroup Healthcare Conference this year.


Technology integration partnerships -- in January of this year, we announced two separate partnerships, one with Animas Corporation, a J&J subsidiary, and one with Insulet Corporation. In each of these arrangements, we would seek to develop an integrated insulin pump CGM system. What that will entail embedding our proprietary software and hardware design into the Animas pump in the case of Animas, or into the Insulet PDA in the case of Insulet. That will allow the user to display CGM data on the screen of their pump or their PDA. This results in the elimination of the patient having to carry a separate DexCom receiver, but it will retain all of the same functionality within those devices.


The full transcript is here.


Well that sort of sheds some light. Maybe what is what is in the slightly larger Ping case is the DexCom stuff.

But that was before the Ping introduced the idea of a controller like meter / remote like the Omni Pods with a traditional pump. So maybe it doesn’t shed much light other than we shouldn't expect to carry a DexCom receiver.

July 9, 2008

Go Read CWD, It's Shorter There

There is an interesting thread over on the Children with Diabetes forums, well OK there are often many interesting threads at CWD, but this one in particular got me thinking.

I tend to get long winded when thinking. - You probably know that.


Anyway the tread is titled The child or parents choice. It is about who chooses to go on the pump particularly for 8 and younger kids. I recommend you go read it and join in.

Naturally it got me to thinking about why we put our 8 year old on a pump and how that decision happened. It was really quite simple. We put an 8 year old on a pump because her brother was on one and she wanted too.

A lot of her experiences with diabetes have kind of been monkey see monkey do. I mean that in a loving way - honest.

I often feel a little like if she was destined for diabetes Connor had to get it first to show her the ropes. He is that good of an influence. (Don't worry he is at camp and won't read this and get a swelled head.)

For the first few days after she was diagnosed (by us in Disney World) she was into it. She was doing blood test and she doing her own shot in no time. She was, in her words, “in the diabetes club.” That didn’t last too long, reality hit home but it sure helped us get past our shock of a second diagnosis.

I can say first hand from that experience that a second diagnosis is no less emotionally devastating than the first. You just know what to do about it.

Where was I? Oh yeah pumps.


The kids didn’t start pumping at the same time. Yet once he choose to pump, the die was cast for her as well.

We felt that Connor’s transition to pumping was an important opportunity to help him take a step toward independence. Independent diabetes care has been our goal since the first days of Connor’s diabetes. Melissa and others beat it into us.

Interestingly the same internet friend helped us at the points of diagnosis and choosing to pump. This is the kind of friend who knows you need a laugh around about the second day after diagnosis. So he wrote us about his type 1 and making shooters from needles as a kid, you know an irresponsible influence.

We met this internet friend face to face at a fireworks party in Epcot a few days after diagnosing Delaney. It was an Ice Cream party. He had on pump. He sat down with Connor and talked at length about both ice cream and pumps.

Connor was sold. “All the Ice Cream you want dad, you just push a button!”

So my deal with Connor was that he had to learn how the pump worked and pass the written test at Children’s Hospital. That is a lot to ask of a fifth grader but remember we are talking about “All the Ice Cream you want!”


A year later, Delaney was ready to pump. Monkey see Monkey do. She choose to pump too. She was in the second grade and I didn’t make her take the CHOP test. She had lived it watching Connor. She picked it up as fast as she picked up testing and shots.

Just like with self testing and self injecting there were bumps in the road. Reality set in - in the form of set changes. Fortunately there was numbing cream.

I wrote that pumps are not about insulin infusion. They are about holistically improving the quality of life for families dealing with type 1 diabetes. Oddly that thread ended up talking about basal rates. OK I think I had a (big) Gin and Tonic that night. Good start, lousy ending.

In retrospect the single most useful part of out experience in moving to pumps wasn’t pumping. What was most significant was helping Connor and Delaney see that they could make diabetes life choices and they would be a big part of making those choices happen.

So my conclusion after all this long windedness is this: There is more long term value in letting the child choose to pump, to help them learn to start the mastery of their diabetes lives, to move to independence, than the huge value of pumping alone.

July 8, 2008

Transitions - Lemonade Life

Alison has a good topic over at Lemonade Life about transitioning from home to college. She is going to be on chat at Diabetes Talk Fest on the topics of Transitioning to Independence: Driving, Drinking and Dorms. That promises to be a good one for parents and maybe better for teens. Check it out.

Why Buy into Pumping

Not the idea of pumping Better is Better makes that case brilliantly.

Why buy them?


In the next 4 years there will be a wholesale change in the insulin pump world. We have to be excited that the rate of change is accelerating. (See calculus geeks, we can love that second derivative too.) There is a lot of talk of more pod like products coming down the road. Amy has written about two, the nano pump and the behind the glass (you can't take a picture of it Amy!) MiniMed wearable pump prototype. MM would like us to believe that it is coming by 2010. NIH is sponsoring talks on the closed loop. The CGM market is expected by some to exceed the pump market in the coming years.


OK! OK! I know it isn't all roses, there were those who thought the Bong was a good idea too. Cool as it all may be it isn't Really Cool.


So why do we buy the actual pump? Is ownership the best financial model and if so who is it best for, patients, vendors or insurance companies?


Maybe we should lease them. It works for cars and office equipment.


Maybe we should rent pumps or as in the Omni Pod model throw them out with every set change. In the current buy-for-a-four-year-commitment we get stuck in a technological time-warp for 4 years. Unless we upgrade and upgrades are not typically covered by insurance. Even with insurance diabetes isn't cheap.


Anyone keep a cell phone for four years? I didn't think so. And no matter what any teen says, a cell phone isn't life saving technology.


About that insurance, the insurance company pays a large up front fee for a product it is betting will work for the patient. It may it may not. If the pump doesn’t work in a patients life style, it sits on a shelf un-used for years. The insurance company has already paid for all 4 years.


Renting or leasing would get rid of that big bump up front for the insurance company (OMG I just made a suggestion to save an insurance company money - hell must have frozen over.) If the lease term was less than 4 years pump patients could benefit from advancing technology faster.


The Pod people have an interesting model going. Every time you toss out a pod it is an opportunity to upgrade the functionality of the product. They have a lower up front cost but as I understand it have higher cost of consumables. This lowers the cost of entry that is good for expanding the market even with insurance. (Can you say lower co-pay?)


Lowering the barrier for entry also raises the need for customer service because changing becomes cheaper. If you read their conversations with the financial press (I do - so I must have no life) you will see that the Pod People are very aware of the importance of customer service. I have to think that people with diabetes can only benefit from increasing the priority of service.


Don't get me wrong, I am not saying service is bad in the pump business. Animas has provided great service from day 1. Yet regular YDMV readers know I still beat the heck out of them. We're talking about two of my kids' lives here - no good deed goes unpunished, sorry Audrey.


New business models would give the traditional pump users the opportunity to take advantage of new products faster. I would expect that there would higher consumable cost or possibly recognition (a word that here means benefit to the consumer) of the annuity value of consumables as part of the user / manufacturer relationship.


Hello? Insurance dudes? You can innovate and be creative - life isn't all actuarial calculations and denial letters.You can be part of a brave new world! Step up and create a pump rental payment plan.


If we are moving to more pod-like experiences where the technology is the consumable, why root the traditional pump in a different, traditional 4 year user cycle? In a YDMV world some folks are gonna like traditional pumps. Why can't they benefit from innovative business models as well as innovative technology too? Why do we have to wait for more pod people to land before overhauling the sales and service space?


So my YDMV friends, which is more innovative, the wear the pod pump or the business model that shortens the technology cycle for pump patients?

ps. Amy had a post on renting here. Thanks for pointing that out Amy.

July 6, 2008

Ping or not to Ping that is the Question.

When our internet goes down, I ping a known address. When I get a reply back, I know everything is OK.

Hoping for a analogs response, I figured I would put out some queries for Ping the new Animas One Touch Pump (or is it a system?)


The Big Questions
(by big I mean without answers there is no point in even considering a 4 year commitment to Ping.)

  • When do you expect Dexcom integration?
  • Will Ping need an upgrade to talk with Dexcom, if an upgrade is required for a Dexcom why should I buy a Ping now?

It is public information that Dexcom integration is in the works. Asking for answers about how it will be handled is only a fair and proper action for an informed consumer.

Further it sadly appears that since the Johnson and Johnson acquisition of Animas the upgrade policy has changed to a practice of increasingly substantially fees. The more so the longer a user has been loyal to the Animas brand. It seems that the policy now is to create incremental product cycles to insure users pay out of pocket upgrade fees. Given that appearance, one can logically assume that Dexcom integration is at least as far down the road as to generate upgrade fees for Johnson and Johnson. Given this appearance of a J&J policy of maximizing out of pocket fees by users, why would anyone consider Ping without a commitment to know pricing for the Dexcom integration?

Here are some suggested fair and honestly acceptable answers.

At Animas we are working diligently to integrate the Dexcom CGM capability into our Ping product. We can not speculate on FDA actions and can not comment on time frames.
(That is a fair an honest answer and I would take it as such.)

Since we do not know what the FDA may require we can not commit to not needing and upgrade.
(again fair and honest answer.)

We at Animas / One Touch / Johnson and Johnson recognize that continuous glucose monitoring is of the highest importance to our pumping clients. We commit to every Ping client that if upgrades are needed to integrate CGM into the Ping system that we will make those upgrades free of charge during the normal warranty period. Users can take advantage of the wireless benefits of the Ping system now knowing they will be able to take advantage of the additional benefit of integrating the Dexcom CGM capability into the ping system with no out of pocket costs.
(That would be a fair and honest answer too.)

Now when they get those first question answered here are some more about the rest of the Ping product.

Wireless Hand Held BG meter questions:
Does hand held meter communicate BG to Dex for calibration as it communicates BG to the pump?

Can multi user households have more than one meter in house w/o confusing pumps.

How will Ping work with Dexcom?
Will Ping communicate directly with the Dexcom transmitter?
Or will users need to carry a Dexcom receiver around also?
Or will hand held meter be the intermediary or we need to carry all three?



About the Ping Pump
Can pump alarm setting be adjusted by time of day and set real loud at night?

Do menus allow for scrolling “around the horn” that is loop from top to bottom and visa versa?

Does Ping still allow for custom music on alarms so that multi pump households can tell which kid’s pump is alarming from the tone?

Has the food database interface been updated to allow for user customization or are Baby food & Beans still in the high priority spots?

Has the food database been given iPod like “Play List” user control?

Is food database customizable for user defined foods in categories?

Is food database exportable to smart phone?

How does Ping communicate to computer? – Still the IR dongle in the serial port?

How does Ping communicate with the remote meter - Infrared, rf, Bluetooth…

How will Ping communicate with Dexcom? - Infrared, rf, Bluetooth…

How Ping wireless communication effect battery life?

How much is a replacement hand held Meter?

How many events does the Ping system record?

Where are those events recorded? In the pump or in the hand held meter.

What events are recorded and is there a provision for recording memos on exercise activity.

Can the Ping talk to multiple wireless meters, for example a separate one at school?

What if you use another meter can Ping work with manual BG entry and does Ping remember the BG you enter into it for down loading?

Why is it bigger?

Does the meter come in colors so families with more than one T1 can tell whose meter is whose?

About Max
Is the ezManager Max software all new?

Is ezManager Max software stable?

Is ezManager Max built on Access?

Does ezManager Max follow win and Mac conventions?

Can users access their data and make custom reports?

Are the ezManager Max data files open source?

Do Ping / Johnson and Johnson support the idea of and commit to open source user diabetes data files?

Does Ping / ezManager Max allow users to plan changes to basal w/o connecting pump?

How does the ezManager Max software get information from the CGM?

Does ezManager Max download data from other meters and CGMs?

Does ezManager Max software anticipate families with multi pump users?

How does ezManager Max report basals rates?

Does ezManager Max have 24 hour basal, bolus, carb, insulin report? Does it correctly report basal rates in the times they were given or does it incorrectly report basals as ezManager does.

Does ezManager Max calculate and report on standard deviation.

Does ezManager Max have a multi day average basal BG report?

Does ezManager Max have a multi day graphical representation of BG like Cosmo’s.

Does ezManager Max have a report report of blood glucose vs. carbs and bolus for evaluation of meal spikes and insulin on board.

Is there a portable version of ezManager Max? Is it in the wireless meter? Can it be put in a smart phone?

July 4, 2008

An Independence Day Re-Run

Happy 4th!
(Jefferson is probably turning in his grave.)



With Diabetes, July 4, 2008
The unanimous Declaration
of the parents of someone who is no longer thirteen in the United
States of America

When in the Course of human events it becomes necessary for one people to dissolve the medical care bands which have connected them with their offspring and for those offspring to assume among the powers of the earth, the separate and equal station to which the Laws of Nature and of Nature's God entitle them, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the separation.

We hold these truths to be self-evident, that while all kids with type 1 are created equal, their diabetes may vary, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. — That to secure these rights, glucose management is instituted among them, deriving its just powers from the consent of the managed, — That whenever any Form of parental oversight becomes destructive of these ends, it is the Right of the People with Diabetes to alter and in time to abolish it, and to institute new glucose management, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness. Prudence, indeed, will dictate that glucose management long established should not be changed for light and transient causes; and accordingly all experience hath shewn that mankind are more disposed to suffer, while evils are sufferable than to right themselves by abolishing the forms to which they are accustomed. To avoid a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such glucose management, and to provide new Guards for their future security. — Such has been the patient sufferance of these kids; and such is now the necessity which constrains them to alter their former Systems of Glucose Management.

The alterations will be independence free of repeated injuries and usurpations, all having in direct object the preventing the establishment of an absolute Tyranny over those who's blood is being controled. To prove this, let Facts be submitted to a candid world.
  • Independence is for your parents to give Assent to Laws of BG control, the most wholesome and necessary for the public good.
  • Independence is you doing things in the ways that separate but equal.
  • Independence is the recognition that, in transition and after, Your Diabetes May Vary, that doesn't mean you did something wrong, in means you need to adapt and improvise.
  • Independence means it OK if you forget diabetes now and then, that is a Good Thing - it means your are in the pursuit of Life, Liberty and Happiness - fix the BG when you remember.
  • Independence means you manage the blood not us (we may check in from time to time), we still love you none the less.
This and other things which Independent Persons with Diabetes may of right do. — And for the support of this Declaration, with a firm reliance on the protection of Divine Providence, we mutually pledge to each other our Lives, our Fortunes, and our sacred Honor.

July 3, 2008

Not that Abbott

Now if you are new to diabetes or are new to online forums and blogs, my buddy Brensdad of Diabetes360 and I will try to explain all the different diabetes terms and web quirks. If you know us you know what to expect. If you don’t, think of us as the Diabetes Bloger's Abbott (Not that Abbott) and Costello.


BadShoe: Look Brensdad, if you're a regular here, you gotta know all the people posting on the blogs.

Brensdad: I certainly do.

BadShoe: Well you know I've never met the folks. So you'll have to tell me their names, and then I'll know who's on the web.

Brensdad: Oh, I'll tell you their names, but you know it seems to me web players now-a-days have very peculiar names.

BadShoe: You mean funny names?

Brensdad: Strange names, pet names...like Brensdad.

BadShoe: Your dad?

Brensdad: EmmasPapa...

BadShoe: And your French cousin?

Brensdad: French?

BadShoe: Goofè.

Brensdad: Goofè. Well, let's see, we have, Who's on NPH, What's on ‘log, I Don't Know is on lantus...

BadShoe: That's what I want to find out.

Brensdad: I say Who's on NPH, What's on ‘log, I Don't Know's on Lantus.

BadShoe: Are you on the forums?

Brensdad: Yes.

BadShoe: You gonna be a writer too?

Brensdad: Yes.

BadShoe: And you don't know the peoples’ names?

Brensdad: Well I should.

BadShoe: Well then who's on NPH?

Brensdad: Yes.

BadShoe: I mean the kid’s name.

Brensdad: Who.

BadShoe: The guy on NPH.

Brensdad: Who.

BadShoe: The NPH kid

Brensdad: Who.

BadShoe: The guy using...

Brensdad: Who is on NPH!

BadShoe: I'm asking YOU who's on NPH.

Brensdad: That's the kid’s name.

BadShoe: That's who's name?

Brensdad: Yes.

BadShoe: Well go ahead and tell me.

Brensdad: That's it.

BadShoe: That's who?

Brensdad: Yes.


BadShoe: Look, you gotta NPH user?

Brensdad: Certainly.

BadShoe: Who's using NPH?

Brensdad: That's right.

BadShoe: When insurance coverage pays off the NPH every month, who gets the money?

Brensdad: Every dollar of it.

BadShoe: All I'm trying to find out is the name of the kid on NPH.

Brensdad: Who.

BadShoe: The guy that gets...

Brensdad: That's it.

BadShoe: Who gets the money...

Brensdad: He does, every dollar. Sometimes his mom comes down and collects it.

BadShoe: Who’s mom?

Brensdad: Yes.


Brensdad: What's wrong with that?

BadShoe: Look, all I wanna know is when you sign on the NPH user, how does he log in his name?

Brensdad: Who.

BadShoe: The guy.

Brensdad: Who.

BadShoe: How does he sign...

Brensdad: That's how he signs it.

BadShoe: Who?

Brensdad: Yes.



BadShoe: All I'm trying to find out is what's the guy's name on NPH.

Brensdad: No. What is on ‘log.

BadShoe: I'm not asking you who's on ‘log.

Brensdad: Who's on NPH.

BadShoe: One insulin at a time!

Brensdad: Well, don't change the prescriptions around.

BadShoe: I'm not changing nobody!

Brensdad: Take it easy, buddy.

BadShoe: I'm only asking you, who's the guy on NPH?

Brensdad: That's right.

BadShoe: Ok.

Brensdad: All right.


BadShoe: What's the guy's name on NPH?

Brensdad: No. What is on ‘log.

BadShoe: I'm not asking you who's on ‘log.

Brensdad: Who's on NPH.

BadShoe: I don't know.

Brensdad: He's on Lantus, we're not talking about him.

BadShoe: Now how did I get on Lantus?

Brensdad: Why you mentioned his name.

BadShoe: If I mentioned the Lantus kid’s name, who did I say is using Lantus?

Brensdad: No. Who's using NPH.

BadShoe: What's on NPH?

Brensdad: What's on ‘log.

BadShoe: I don't know.

Brensdad: He's on Lantus.

BadShoe: There I go, back on Lantus again!


BadShoe: Would you just stay on Lantus and don't go off it.

Brensdad: All right, what do you want to know?

BadShoe: Now who's using Lantus ?

Brensdad: Why do you insist on putting Who on Lantus?

BadShoe: What am I putting on Lantus?

Brensdad: No. What is on ‘log.

BadShoe: You don't want who on ‘log?

Brensdad: Who is on NPH.

BadShoe: I don't know.

Brensdad: & BadShoe Together: Lantus!


BadShoe: Look, you gotta pumpers?

Brensdad: Sure.

BadShoe: The Animus pumper’s name?

Brensdad: Why.

BadShoe: I just thought I'd ask you.

Brensdad: Well, I just thought I'd tell ya.

BadShoe: Then tell me who's using Animas.

Brensdad: Who's using NPH.

BadShoe: I'm not... stay out of insulin cabinet! I want to know what's the guy's name using an Animas pump?

Brensdad: No, What is on ‘log.

BadShoe: I'm not asking you who's on ‘log.

Brensdad: Who's on NPH!

BadShoe: I don't know.

Brensdad: & BadShoe Together: Lantus!



BadShoe: The Animus pumper’s name?

Brensdad: Why.

BadShoe: Because!

Brensdad: Oh, he's using a Omni Pod.




BadShoe: Look, You gotta Cosmore user on this web site?

Brensdad: Sure.

BadShoe: The Cosmore user’s name?

Brensdad: Tomorrow.

BadShoe: You don't want to tell me today?

Brensdad: I'm telling you now.

BadShoe: Then go ahead.

Brensdad: Tomorrow!

BadShoe: What time?

Brensdad: What time what?

BadShoe: What time tomorrow are you gonna tell me who's using Cosmore?

Brensdad: Now listen. Who is not using Cosmore.

BadShoe: I'll break your arm, you say who's on NPH! I want to know what's the Cosmore user name?

Brensdad: What's on ‘log.

BadShoe: I don't know.

Brensdad: & BadShoe Together: Lantus!




BadShoe: Gotta a Mini Med user?

Brensdad: Certainly.

BadShoe: The Mini Med user name?

Brensdad: Today.

BadShoe: Today, and tomorrow's using Cosmore.

Brensdad: Now you've got it.

BadShoe: All we got is a couple of days on the team.




BadShoe: You know I'm a Mini Med user myself.

Brensdad: So they tell me.

BadShoe: I get on the forum to do some fancy posting, Tomorrow's starts a thread and a heavy writer gets up. Now the heavy writer starts a medium term insulin thread. When he starts that thread, I being a good Mini Med user, I'm the send guy over to the NPH. So I open up the thread and send a private message to respond to it to who?

Brensdad: Now that's the first thing you've said right.

BadShoe: I don't even know what I'm talking about!


Brensdad: That's all you have to do.

BadShoe: Is to PM the NPH user.

Brensdad: Yes!

BadShoe: Now who's got a Private Message?

Brensdad: Naturally.




BadShoe: Look, if I Private Message about the tread to the NPH user, somebody's gotta get it. Now who has it?

Brensdad: Naturally.

BadShoe: Who?

Brensdad: Naturally.

BadShoe: Naturally?

Brensdad: Naturally.

BadShoe: So I pick up on the tread and I PM Naturally.

Brensdad: No you don't, you PM the thread to Who.

BadShoe: Naturally.

Brensdad: That's different.

BadShoe: That's what I said.

Brensdad: You're not saying it...

BadShoe: I PM the tread to Naturally.

Brensdad: You PM to Who.

BadShoe: Naturally.

Brensdad: That's it.

BadShoe: That's what I said!

Brensdad: You ask me.

BadShoe: I PM the thread to who?

Brensdad: Naturally.

BadShoe: Now you ask me.

Brensdad: You PM the thread to Who?

BadShoe: Naturally.

Brensdad: That's it.

BadShoe: Same as you! Same as YOU! I PM the tread to who. Whoever it is drops the topic and the thread changes to ‘log. Who PMs topic to What. What throws it to I
Don't Know. I Don't Know throws it back to Tomorrow, Everyone posts. Another guy gets up and writes a thread to Because. Why? I don't know! He's on Lantus and I don't give a darn!

Brensdad: What?

BadShoe: I said I don't give a darn!

Brensdad: Oh, I don't give a dam - that's the Health Insurance Company.

From the News Wire: Boys with T1 have higher testosterone

Sex hormone-binding globulin and total testosterone were higher in individuals with childhood-onset diabetes compared with siblings without diabetes, according to results of a new study.

Researchers from the University of Chicago enrolled 48 participants diagnosed with diabetes before age 18 and 47 siblings without diabetes into the Chicago Childhood Diabetes Registry Family Study (age range, 10 to 32; 39% non-Hispanic white; 75% type 1 diabetes; 96% treated with insulin).



http://www.endocrinetoday.com/view.aspx?rid=29321

Maybe there is somthing to calling Dr Freud after all.

July 2, 2008

From The News Wire: MicroIslet Insulin Encapsulation Update

Company Invents New, Enhanced, Encapsulation Formulation

SAN DIEGO--(BUSINESS WIRE)--MicroIslet Inc. (OTCBB: MIIS, http://www.microislet.com), a biotechnology company engaged in the development and commercialization of cell therapies for diabetes, is pleased to report recent safety and efficacy data.

To date, MicroIslet has seen no adverse events attributable to MicroIslet-P™ in its animal models. The Company has tested hundreds of rodents and is currently completing a trial with nineteen non-human primates. Eighteen of the nineteen have been tested, and the last primate has received its final dose. Importantly, the primates have been subjected to one, two, or even three, separate transplant procedures, with no observed ill effects.

MicroIslet also has efficacy data demonstrating that MicroIslet-P™ can produce normoglycemia in both immune comprised and immune competent rodents. Additionally, all primates tested to date, post-implant, have demonstrated decreases in insulin requirements needed to maintain their blood glucose levels at a healthy concentration. Finally, post-implant, the primates have been primarily managed with long-acting insulin as opposed to acute insulin treatment, indicating improved glucose homeostasis (control).

MicroIslet is now in the process of patenting a new, enhanced, encapsulation formulation, which is being used in a current Good Laboratory Practices (GLP) rodent toxicity trial, and is the Company’s intended formulation for use in its planned human trial. The improved capsules appear to be not only more durable, but they also retain, and may increase, the positive functionality characteristics of previous formulations. Accordingly, MicroIslet believes that the new formulation will enable: (a) a greater decrease in insulin requirements, (b) better blood glucose control, and (c) increased capsule longevity.


http://www.businesswire.com/portal/site/google/?ndmViewId=news_view&newsId=20080702005426&newsLang=en

Flying Pigs II

I told Delaney about the new Animas Ping Pump. I expected here to ask if the Pink Pump was Pink.

She thought about the remote. It was cool she could hide the pump under a dress and use a remote but it was “something else to carry.”

That made me realize for the most part she doesn’t carry meters. We stage them in places for use, school, friend’s homes, different rooms of the house… more often than not she uses the meter that is near by.

Then she said, “You know what would be really cool?”

“No what?” I was expecting flying pigs.

“A cure.”

July 1, 2008

substantially equivalent

From the FDA site re: Animas ezManager Max

Device Description:
The Animas ezManager MAX Diabetes Management Software, installed onto a patient's or healthcare professional's personal computer, allows downloading and uploading of information to and from Animas insulin pumps and specified commercially available blood glucose meters. The software displays downloaded historical data stored in the pump and blood glucose meter such as basal/bolus deliveries and blood glucose measurements. The data can be displayed in reports and logs to facilitate trending and diabetes management.

Indications for Use:
The Animas ezManager MAX Diabetes Management Software is indicated for use as an accessory to Animas insulin pumps and specified commercially available blood glucose meters. The software supports diabetes management by the patient and/or healthcare professional by allowing for the review, analysis and evaluation of insulin delivery and blood glucose history information.

Predicate Device:
K063674 - Animas ezManager® Plus Diabetes Management Software (Animas Corporation)
Substantial Equivalence:
The Animas ezManager MAX is substantially equivalent to the legally marketed predicate, Animas ezManager Plus. Both devices have the same intended use and fundamental scientific technology.

http://www.fda.gov/cdrh/pdf8/K080587.pdf
http://www.fda.gov/cdrh/pdf6/K063674.pdf



I understand it is legal double speak to get an FDA blessing to market the product, but substantially equivalent isn't exactly what I want to hear. Substantially rewritten from the ground up and only similar only in name would be much better.

From The News Wire: Animas Announces "Ping"

http://www.animascorp.com/ViewAnnouncements.aspx?ID=85

Animas Corporation announced today the clearance of its OneTouch ® Ping TM Glucose Management System by the U.S. Food and Drug Administration (FDA). OneTouch Ping is the first full-feature insulin pump that wirelessly communicates with a blood glucose meter-remote. Using the OneTouch Ping meter-remote, a person can calculate insulin doses and opt to wirelessly instruct the pump to deliver them without touching the pump at all, giving patients more freedom and flexibility in using their insulin pump.

“OneTouch Ping provides patients the advanced insulin pump technology from Animas plus the OneTouch blood glucose technology they trust, put together into a system that offers the discretion, convenience and option of remote insulin dosing," said Juan Frias, M.D., Chief Medical Officer and Vice President of Medical Affairs, Animas Corporation. “People using OneTouch Ping will no longer have to access their pump to deliver a bolus, ultimately making life with diabetes a little easier.”


Also and this I am sure is what they weren't talking about when I bent their ear about ezManager (anyone think they will send me a review copy? yeah me neither)

ezManager® MAX Diabetes Management Software The OneTouch Ping system will also work with the recently cleared ezManager® MAX Diabetes Management software designed to allow users to download important diabetes management data from the insulin pump and meter-remote. Integrated blood glucose data from the meter-remote and insulin dosing data may be downloaded for review, analysis and evaluation of insulin delivery and blood glucose history to better inform healthcare decision-making. The ezManager® MAX software is MAC and PC compatible.


I guess this explains the hits to YDMV I saw coming out of J&J on google searches for Animas and Ping recently.

Oh and anyone other than me a Monty Python fan? The Machine that goes "Ping!" LOL

It looks like Ping is a New Pump (see the picture on their web site) It doesn't look like a 2020.

Or look here -

From the News Wire: Medtronic Increases R&D for D Stuff.

Forbes is reporting Medtronic is investing in medical devices for diabetes.


Medtronic, the world's largest stand-alone medical device maker, is increasing its research and development spending on diabetes technology by 35 percent this year to speed development of next-generation diabetes devices that are simpler to use and more effective in managing the disease, said Chris O'Connell, president of Medtronic's diabetes division.

* New insulin pump in Europe this year would shut off insulin if low sugar detected
“an insulin pump that can automatically shut off insulin delivery if it detects blood sugar has fallen too low, a particular danger when a patient is sleeping.”

* Working on a pump in a patch. (Podlike)
"We're optimistic we'll have a patch pump on the market in fewer than two years"

* Sees continuous monitors outselling pumps one day. (Did anyone mention today is CGM Denial Day?)


I am a little shaky on how shutting of basals once you are already low isn’t locking the barn door after the cow got out. I guess it is a good idea and all but insulin is a lagging deal. If you are low now it is from insulin a few hours ago, you need glucose NOW, not just less insulin. I guess it is a step in the right way.

CGM Denied


By the power vested in blogging by Gina Capone of Diabetes Talkfest, today has been pronounce CGM denial day. We tried to get one for Delaney.


Guess What?


We got denied!


To be honest we expected it. In part we tried just so there would be one more family on the big insurance radar screen.


We would love to have one, maybe less for the ever popular hypo unawareness than for basal rate tuning. Yes Delaney at 10 is at times hypo unaware. She is particularly so in school after PE. CGM would be a great back up to trying to teach a child to manage their diabetes in school. What we really want is help with the basal tuning process of Lather Rinse Repeat.