August 27, 2009

August 26, 2009

From The News Wire: What's a Rebel?

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Medtronic's earinigs call is on Seeling Alpha

Anyone know what a Rebel insulin pump is? (see bold below)

In diabetes, the business delivered solid double digit results on a constant currency basis despite the economic headwinds. These results also reflect the team’s work in successfully managing the Quick-Set field action. We reached over 158,000 patients with replacement products within the first few days of the recall. Additionally, the continued success of continuous glucose monitoring and solid insulin pump sales in this economic environment further validated the value of our market leading technology. This quarter, we also extended our lead as the only company with a proprietary CGM sensor augmented pump on the market by launching the Veo insulin pump in the UK and Ireland. Veo is a significant step forward as the first semi-closed loop product which features a low glucose suspend function that automatically shuts down insulin delivery when a patient’s glucose levels are trending dangerously low, and we’re planning to launch it most international markets later this quarter.

In the US, we’re also very excited about our pipeline and remain on target with plans to launch our Rebel insulin pump later this quarter and our patch and next generation durable pumps in fiscal 2011. These innovations will extend the most complete and comprehensive line of sensor augmented therapy options available on the market.

August 25, 2009

Happy Brithday from Dexcom

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I got a Happy Birthday call from Dexcom. Connor gets CGM coverage too! I like the present even if they didn’t know my birthday.

Should be an interesting fall diabetes management with technology wise.

My early bet is his A1C may go up a little as I suspect he may have some night time below target range numbers we aren't seeing without CGM. I think he will get zen with trends.

I think Delaney will be beeping like crazy as it helps her pay attention to what is going on. I hope she'll see some better averages and a lot less oops I forgot variability.

August 24, 2009

A Hyper Check

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No no not the blog sugars. The 'bole.

As in Hyperbole.

I am sitting here checking my email and the news has someone in a full blown rant. I wish I had his coverage. He apparently has outstanding health coverage. He going on about “anything that comes between My Doctor and My Health is rationing. Anything the Government does that limits My Doctors options...”

Really? Is that what that is.

I didn’t know to call it that. But now that I know what to call it, I know that private insurance has been rationing continuous glucose monitoring since it was invented. Like many other people with type 1 diabetes we have been denied coverage.

I just figured that we, like a lot of other people, were applying for coverage with the hope of getting what we see as a quantum leap in treatment but with the real expectation that what we were doing was trying to storm at the castle gates. If enough of us banged on the door long enough the gates of our private insurance will open and CGMs will come tumbling. Or something like that.

Waiting is another issue with this guy on TV. Rationing is going to mean waiting for the health care we need now. Grandma may have complications or worse waiting.

We got a letter from our insurer telling us that the ‘formulary’ test strips under our plan were changing. We could get one free meter to switch.

Well we don’t like the formulary strips much. One meter doesn’t make the table ante at the T1 card game. IMHO the minimum to get in the game is four meters; a meter at home, backup at home, meter at school and a meter at the gym at school for potential PE issues. Not that it matters because we are going to use the strips and meters we think work best, not the ones our insurer is rationing

I wonder what the pundit on TV has to say. Nothing I suspect. It would be inconvenient to admit that the insurers do private deals with suppliers and negotiate special deals to make a particular brand of strips the formulary.

I doubt he would have an issue with that. There is practically spit flying in this dudes rant and the real point is he is getting his 15 minutes. If he puts on a really good show he may get picked up for another 15 in another broadcast.

Sadly people with type 1 don't live in 15 minutes of broadcast fame. But we do know our Hyper and Hypo.

At our house our turn for CGM, for at least one of the kids, is has come. We have waited long enough. I heard she was approved for a CGM. I am not sure but I think this is our third full court try for the thing. There have been countless Hypos and Hypers as in hyperglycemia not hyperbole in the intervening time. Some have been south of 40.

South of 40 is what most people who know what serious is would consider serious. There are potential long term issues with hypos, I hope we minimized them by acting fast. 100 to 1 Mr. TV guy has no idea what hyper or hypo mean and doesn't know a 38 from 102. I bet he lives red and blue.

Lows happen. (Feel free to insert an “s” word for lows there if you feel the need.) That is part of YDMV. It will be nice to have the tools to manage it (I am thinking the other the other word but mean lows.) It is nice that our time has come. I am particularly interested in using CGM to help manage basal setting.

I fully understand what the guy on TV is calling rationing. Like a lot of other people living with type 1 we have some first hand experience with it and the private sector. I don’t know what the end game in DC punditry is going to be. I suspect it will be more hyped up simplistic sound bites.

The conversion is kind of over stimulated and loosing cognitive abilities. Sound the media needs to check it collective blood sugar and take a correction bolus to get back into the sanity range.

What ever the outcome of all the 'debate' (hyper see above) is, we will still have two cases of type 1 in our house. We will still use strips and insulin. In the many homes across the world like ours, we know hyper, hypo, strips and insulin are the daily ante to be in the game.

We just are tired of playing. 24/7/365.

August 23, 2009

I am not Nature Boy - but..

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... even I see this as packaging over kill.












In the front is the pump. The little black thing. That part matters.

The rest is what came with it. Those parts don't matter so much.

In the middle are all the manuals, cables, ezManager program disk and stuff I don't expect the boy will ever use. Most of this will all be stuck on a shelf in case we change our minds and feel the need to reference or otherwise use it.

On the left hand side there is a box with two sets. One each of the two styles of inset sets. This box is twice the size as a box of ten sets. Two sets in the space of 20. Inspired packaging.

In this kid's particular case, "I don't expect the boy will ever use" includes the One Touch Ping meter / remote. Being a boy and having a male wardrobe I don't see him feeling the need to hide the pump. Pants have front pockets and there is where his pump lives. He doesn't have much call for a remote. I checked the case the meter came with. I was looking to see if it said "Goodyear" on the side. I am not saying it is big. I am just saying I figure if I filled it with helium it would be able to fly cameras over football games in the fall.

YDMV. I do think there are those who will make great use of the remote. Our daughter being one. When she can stash the pump and use a remote she, having a female wardrobe, will have more dress options. Specifically more dresses. I also can see parents of toddlers being huge fans. Lock the pump. Deliver via remote control.

All that stuff in the back of the picture? That is packaging. Lots and lots of packaging. It seems almost laughably excessive, except that we are paying for that excess upfront in the purchase price and out the door as trash or recycling to be picked up at the curb.

This could have all fit in a a box 1/4 the size. Even if this is a big box it is a small thing. I guess I can ad this to the list of things that J&J does that make no sense to me at all. It's a long list. It is kind of thing I Should Shut Up about because it isn't all that important in the Diabetes Big Picture but then again maybe little stuff matters too.

August 21, 2009

I Should Shut Up

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I get caught up in minor stuff. Technology that doesn't play nice together - minor. Indifferent CGM sales people - minor. Software - minor. Silly pumps that are not what they could be - minor. Moronic practices to pick yet another another dollar a day out of type 1 families' pockets - annoying but not big picture.

The boy is 15. His A1C is 6.4. He is 100% self managed. That is the Big Picture Show. It is a damn good show.

The girl is 12. She is growing like a weed yet her A1C is 7.6. She learned new locations to wear her set and became a little more Zen with the Art of Pre-bolusing at camp. She has rock solid age appropriate D skills (in no small part from watching her brother.) That’s all huge.

That stuff is what matters. That is what will lead to long lives. Maybe even long enough to see a cure.

So I should shut up about the stuff that doesn't matter.
I probably won't but I probably should.

August 17, 2009

Why Not Me Too

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I just left a comment over at Chris Bishop's.

He writes a nice bit about Why No Me and I encourage you to go read it.

I feel it is worth re-running my reply there, here if only in the hope it helps share and amplify his message.


I go to church early. I help get the band set up and eat the donuts. I guess that makes me a roadie. (It’s a very good rock band – they make church a lot more fun for me and there are donuts for the crew.)

Last week church started a three week series about listening for the message where your specific talents are being called. Or at least that is what I got out of it. Not to subtly on the providence scale, one of the signers pulls me aside to tell me one of his day job employees’ 6 year old was just diagnosed T1. The mom was overwhelmed.

Mom needed to know there is a future.

It seems like I am hearing similar tunes on my life’s radio’s preset stations:

Someone needs help: Why not me?

August 14, 2009

Is that the Winds of Change or Smoke Blowning Up My Shorts?

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Conitnua Health Care announced 3 new product certifications earlier this month.

Here is part of the press release:

BEAVERTON, Ore.--(BUSINESS WIRE)--Continua Health Alliance, the non-profit, open industry alliance of more than 200 leading health care and technology organizations, today announced the availability of three new Continua Certified™ devices from member companies. These certified products mark an important milestone in the group’s mission to establish a system of interoperable personal connected health solutions.


Later they add:

For the millions of people worldwide coping with diabetes, personal connected health solutions such as the Continua compliant blood glucose meter device reader offer a convenient way to transmit vital information to their care teams. With easy access to accurate, ongoing trend data, care teams can make more informed treatment decisions and intervene more quickly to address potential problems.


What does that mean?

I hope to find someone who can answer some questions about that last bit. I want them to explain it in small simple words a simpleton like me I can understand:

First, What is the plan for diabetes care? That is beyond the two sentence of smoke you are blowing up our collective skirts quoted above. If you are going to address “millions of people world wide” someone should be able to explain what it is you think you going to do for us and have some reasonable details on how it is going to work. You should be reachable by the few of us who will take time to listen to your PR and call your hand. If you not ready to put some cards on the table we can only assume you don't even have a pair of deuces.

Second, does your alliance actually of over 200 do anything for the diabetes community other than issue press releases? As I understand the Continua “ecosystem” it is expected there will be a bunch of gadgets in our homes checking our weight, oxygen levels, blood pressure, glucose and number of partridges in our pear tree (It is one per tree. We get stuck with a dozen of the things every year and it is a measure of our true love that we put up with the dang birds squawking all the time but I digress.) All the happy little sensors will report data to a hub. That hub will then shoot the data off to where ever we choose to send it. Continua has shared a vision that clearly sees sending data to Google and/or Microsoft’s electronic health records. Here the rub, as far as I can tell there is no hub yet. Without a hub it isn’t clear how any of these devices do any thing useful other than allow your 200 companies to pretend they are working towards standards while marketing only proprietary data systems.

Third, try not to make a mountain out of a mole hill. An open industry alliance of more than 200 leading health care and technology organizations that has produced, a scale, a blood pressure cuff, a proprietary IR to USB glucose monitor dongle and two oxygen sensor (apparently without the aforementioned hub) is hardly diorama let alone an ecosystem.

Here is the simple deal. We understand you are trying to make a living - we can respect that. Is it asking too much of you to keep in mind that in our families lives depend on the information our diabetes tool produce?

Maybe some of the 200 of you can start acting like you understand and respect. At least the ones who see our lives as their livelihood.

August 12, 2009

When Pigs Can Fly

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What would you wish for if you found Aladdin’s Magical Diabetes Lamp?

My three wishes are below but first it being Aladdin’s lamp, it comes with some rules, provisos as it were; no wishing for more wishes and no wishing for true love which in the type 1 universe is a cure. Oh and for fun and to stay with the general silliness of my guest post on SUM movie themes get bonus points.

(Full disclosure: This is a rerun of an April 08 YDMV post.)

So this my little list. I switched movie themes from Aladdin to Star Wars just for kicks.

1) Insurance coverage for continuous glucose monitoring, the pediatric edition. We are in the trials of basal rate change purgatory and right now it's closer to hell than the angelic alternative. Actionable information on real trends as opposed to spot checks and guessing when the numbers move seem more like a fantasy than a technological tool without insurance coverage. Yeah I know I’m asking for insurance companies to turn away from the Dark Side.

2) Faster insulin. Insulin that can jump to light speed without the need to get coordinates from the navi-computer. A real live pancreas uses the force respond to blood glucose as food is eaten. It would be cool if the insulin we give our kids could respond fast enough to cover what is actually eaten without pre-bolusing and pre-guessing what they may eat. Wouldn’t it be great to be able to bolus for what they ate after they ate it and not get a huge spike? Oh and no insulin floating around for hours in a long insulin on board tail.

3) Now the last one is tough, if it is just our household it would probably be sets that last more than 47 hours and 7 minutes. Or maybe management software that isn’t total crap. That said I have a type 1 parents community wide third wish. I wish that the world would be to see the NDEP’s Helping the Student with Diabetes Succeed A Guide for School Personnel as having the respect, acceptance and the force in the nation's schools as if it were a unanimous Supreme Court ruling (with a side order of Imperial Storm Troopers enforcing it.)

Parents keep trying to explain what good care looks like but are stuck to trying to rely on Jedi Mind Tricks with school officials. That isn’t getting it done. Countless families would have significantly less stressful lives if all school administrators could simply make an honest effort to implement the guidelines in Helping Students... . It is thorough, clear, and professional. In my opinion so are the schools that work toward implementation of it.


So much for my wishes: I asked our 10 year old what she would wish for. Here goes:

1) A Flying Pig.

It wasn’t clear if this was a real pig or a plush toy pig. I suspect plush. She has more plush than the gift shops at the exit of Disney rides. It was very clear that it had to fly. Not like Buzz Lightyear - falling with style was right out. Actual sustained controlled flight operations were required. It was unclear if Visual Flight Rules were acceptable or if Instrument Flight Rules would apply. Probably IFR. The flying Pig would be able to tell her if she was low or high. (and probably have an on board food carb database that has a workable user interface unlike the one in our pumps.)

2) A Flying Monkey could apply for the Flying Pig's job and it would not be dismissed out of hand. It would need to be more cool and less scary than a Wizard of Oz Flying Monkey. However a porcine aviator was much preferred. (Editors not: I suspect that the Pig would now have to be a Penguin – this was the list a year and a half ago. The hierarchy of plush toys has changed since this was originally written. Your Diabetes Three Wishes May Vary)

3) The pump should play Pong. This game playing ability should link with anyone else in the room that also has a pump. All T1 kids should be able to play Pong on their pumps anytime they get in range of each other. It wasn’t stated outright but I think it safe to assume that the Flying Pig/Monkey/Penguin should also be a possible Pong opponent if no other kid with a pump is around.

If it is not outside her realm of consciousness that a pig could fly and pumps play pong then I guess a cure isn’t either. She’s smart.

So what are your three wishes?

August 11, 2009

Kerri, Larry, Clint & Me

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I am guest blogging over at Six Until Me today. Kerri is away and I get to play. I have no idea what her cat is up to but I assume it is no good either.

So surf on over to Kerri's and enjoy some Clint Eastwood inspired T1 advice and Larry Bird's rebuttal.

Of Mice and Men: Pills & Genes

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More mice news.

For people not familiar with the YMDV series "Of Mice and Men" the Mice bit it is a tool I use to say. "Hey if you hear about this or if a family member of friend hears about this and get all excited that there is a cure, keep in mind the mice get used in the early stages of investigation and there is a very long path from mice to men." It is good to know this stuff an important to keep it in a perspective that the mice stuff is far way from any actual treatment development and human trials. Oh and parents pediatric approval is even father down range.

That said let see what the mice are up to:

Science Daily as a bit on a possible pill for T1. Mice are involved.

The idea is that that a medication that was developed for other uses may help regulate the immune system.

http://www.sciencedaily.com/releases/2009/08/090810162013.htm

In other mice related news Science Daily also reports on studies that may identify identified a gene that may play a role in the development of type 1.

http://www.sciencedaily.com/releases/2009/08/090810122129.htm

It does say hope and might before although "a lot of ifs remain before we will know whether it could be taken to the clinic,"

What it all mean? Science is poking around type 1 and some mice may be seeing positive results. Mow many mice and how long the goodness last isn't clear.

Maybe possibly something comes of this. It good that a variety of work is getting done. People with diabetes can take comfort in the idea that there is a lot of science being done because it is going to take a lot of science to make even modest gain.

Mean while back at the ranch, it is important that we deal with type 1 now with the tools we have now and try to keep what little mental health we have left now.

August 7, 2009

Of Mice and Men: More Insulin-producing Cells, At The Flip Of A 'Switch'

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Key word: Mice.

Science Daily as a story on turning on beta cells in mice and how it may lead to T1 treatments.

It didn’t say how many mice or how long the improved beta production lasted. How many and how long are always good places to go after the big it was in mice asterisk is applied.

It does say hope and might before although "a lot of ifs remain before we will know whether it could be taken to the clinic,"

That said, head on over and have a read if you are so inclined.

August 5, 2009

WaveSense iPhone App - First Impressions

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My first impression was can I buy stock in this company - they get it.
Seriously.

I made a little flickr set of real bad pictures of the app. There are more picture there than here because I am not competent at uploading pictures to the blog.

This is a stand alone logbook application. As such it is just another app. Entering data sucks but this is clearly the first step. When they have Bluetooth working this is gonna be very cool and I will have to buy my kids iPod Touches. (I assume at that point the program no longer is standing alone and they have to go through the FDA. I am officially not holding my breath. Tough luck kids.)

When you open the App and accept the terms (the ones you didn't read) it starts on a little home page. Since you are new it points out two features to try right away - add information or get help. You can push the other buttons too but these two are good places to start, well who starts with help? This is America we don't do instructions. That leaves enter stuff.

You can ad a glucose reading, carbs or insulin. BG and carbs go in similar screens. Insulin has a whole different look and feel. I assume that is so you know you are entering insulin but it seems kinda like 'one of these things is not like the other.' I am sure they thought it through 'cause everything else seems like they thought it through. Go to flickr see more.

When you enter BG or carbs there is a nice big screen and a key pad. It assumes you are entering information for the current date and time but that can be changed with the typical iPod data wiz wheels. The sceen changes color if you are above or below target ranges.

They give you the option of entering a tag for the relationship to meals. Pre or Post Breakfast Lunch & Dinner. Night is also an option. WaveSense has the good sense to not assume it is pre or post meal by the time of day. It is like they get the idea you schedule may vary like your diabetes.

There is a crap load of options to enter a host of notes. There are 5 notes screens, Food, Exercise (including my most common one - Missed Exercise), Insulin, Meds and Notes. Notes includes my favorite "Dirty Finger." What a great and honest note for a test. You can ad you own notes to the predifined options - note the YDMV I added here. This is brilliant and the missing part of every log book I have seen. You want it as a note you can make it. Did I mention they get it and it as used here is a word that means YDMV.

After you cram in a bunch of data you can look at it; Log book style, charts or statistics. In the log and charts all you need to do is touch an entry and the details notes and all pop on to the screen. Hey why was that number out of range? Oh yeah the set failed, I was attacked by a key lime pie that made me miss my exercise and I under bolused but other than that I was good.

Go to flickr see more or maybe just go to the app store. It is free.

Oh and it doesn't look like a publicly traded firm so I don't have shares.


UPDATE: There's a quick video overview of this at theBetesNOW.com

From The News Wire: WaveSense App for iPhone

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From the Press Release:

WaveSense Diabetes App for iPhone(TM) and iPod(R) Touch Now Available on iTunes(R)

SALEM, N.H., Aug. 4 /PRNewswire/ -- Diabetes? There's an app for that. AgaMatrix, Inc., the makers of the WaveSense(TM) line of blood glucose monitoring products, announced today the launch of their latest product, the WaveSense(TM) Diabetes Manager, an electronic diabetes logbook software application (an "app") that runs on the Apple(R) iPhone(TM) and iPod(R) Touch.

The WaveSense App is the first of its kind to be developed by a blood glucose meter manufacturer that is now available on the iTunes(R) App Store (www.itunes.com) by Apple, Inc. The app is available for download at no charge. The company says their app, in development and testing for over a year, lays the foundation for a series of products to come that will take advantage of the iPhone and other mobile technology platforms to assist people with diabetes in the management of their disease.

The WaveSense App combines the latest in user interface design, diabetes data management, and mobile technology to enable people with diabetes to better manage their disease. The app provides users with a number of cutting edge features including:

Easy-to-use data entry
Dynamic graphing of glucose data
Automatic mealtime tagging of results
Integrated food intake, activity, and medication data management
Insulin dosage management
Statistical analysis of glucose results
Integrated emailing of results
On-screen help menus
User-personalizable settings


More information on the WaveSense App is available here: www.wavesense.info/iphone

From The News Wire: OmniPod Earnigs Call

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The Pod People had their earnigs call and the transcript is up at Seeking Alpha

There is a comment about CGM and here it is:
We continue to make progress with our next generation pod and with the version of our PDM which will provide integrated continuous glucose monitoring capabilities. We remain on track to be into the FDA by year end, with an integrated CGM solution.


And later in the call:
Ben Andrew – William Blair

Good. Last quick question, you mentioned you have a CGM going to the FDA by the end of the year, I assume that's with Abbott with DexCom.

Brian Roberts

Yes, one of those two.

Ben Andrew – William Blair

Are you not disclosing or…?

Brian Roberts

Yes, look at the end of the day, we have agreements in place with both and we are charging ahead with both of them.



Here is another interesting comment on Pod for non diabetes use:
We are also advancing our efforts to outside the diabetes. The request for CE Mark approval has been filed ahead of schedule for our first non-diabetes application and partnership with Ferring Pharmaceuticals. We expect to receive approval this quarter.

From The News Wire: Accu-Chek Continua Certified

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MobiHealthNews.com reportes that Roche's Accu Chek Pix Device Reader earned Continua certification. Hopefully this is a step towards data standardization.


Diabetes management tools just got a step closer to medical device interoperability.

A few hours after news broke that A&D Medical’s Bluetooth-enabled blood pressure cuff and Bluetooth-enabled weight scale had received Continua Health Alliance’s stamp of interoperability, the organization announced that Roche Diagnostics’ Accu-Chek Smart Pix Device Reader, which currently interfaces with blood glucose meters and insulin pumps to transfer data from the devices to the user’s computer, gained Continua certification for USB connectivity.

The Smart Pix device connects to the computer with a USB cord but it interacts with the medical devices via infrared. Once the data transfers to the computer a report appears in the user’s default Internet browser to be saved later, printed out or simply viewed on screen. Roche says the system helps diabetics make timely and well-informed decisions about day-to-day self-care.


So what the heck is a Smart Pix? Roche's web store says:

With the ACCU-CHEK Smart Pix Device Reader, you can quickly collect data from your ACCU-CHEK blood glucose meter or insulin pump, create easy-to-understand charts to analyze your diabetes management program and act on self-care goals.
By making the most of the valuable data held within your blood glucose meter and insulin pump, you can make timely, well-informed decisions about your day-to-day self-care. These efforts can pay off today as you have more energy and feel your best, and down the road with a reduced risk of long-term diabetes complications. 1

Just set your meter or insulin pump near the reader, and the ACCU-CHEK Smart Pix system does the rest. It's truly plug and play for greater convenience and faster downloads—there's no software installation or special knowledge required. You can set personal targets, time ranges and preferred report styles, and print out reports and graphs to share with your healthcare team.

Download directly to your PC

The ACCU-CHEK Smart Pix Device Reader is compatible with:

ACCU-CHEK Compact Plus blood glucose meter
ACCU-CHEK Aviva blood glucose me
ACCU-CHEK Spirit insulin pump
ACCU-CHEK Advantage blood glucose meter
ACCU-CHEK Compact blood glucose meter
ACCU-CHEK Active blood glucose me
Disetronic D-TRONplus insulin pump
ACCU-CHEK 3600 data management system


I think that means it is a $125 dongle. What it does and what gets the "standardized data" treatment I don't know. Continua's big shot dude told me that there will not be continua standards for pumps until the Continua 2.0 release some time like next summer. So how does this costly IR to USB dongle deal with their pump and what data gets dealt with how?

I'll try to find out more.

Here is some initial things that make me go Hmmm.
- $125 for a an IR dongle. Ouch
- IR? Hello what is with the dongle in a Bluetooth world.
- PC what about MAC, hell what about iPhone.
- What are the reports coming out of a PC app a browser based app?
- What are the reports?
- - (UPDATE looks like sample reports here)

- How does the data standardization of Continua help us share data between our diabetes toys?

August 4, 2009

From The News Wire: Son of a Bong

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Ok Ok that title was just fun to write.

For those more interested in toking than shooting your insulin: MannKind Corp's August 3 Earnings Call is up on Seeking Alpha. I freely admit I am not a close follower of the inhaled insulin industry.

Here is the bit that grabbed my eye:

Hakan Edstrom

Thank you, Matt, and good afternoon.

During the last quarter the most significant event was certainly the acceptance by the FDA of our NDA submission. The acceptance occurred on May 16th and we actually received our 74-day letter about 10 days early. Thus, our [inaudible] date is now January 16, 2010 and we are now at the stage of fielding questions from the agency. To date, the questions have been very straightforward and consistent with our expectations. We are encouraged by the interactions with the FDA.

We're also preparing to meet with the agency in order to discuss our development plans for the next generation device, which we recently disclosed on our website and in an interview with CNBC. We have already evaluated this next generation device known internally as Dreamboat, in two Phase I clinical studies. The first of these studies showed that the Dreamboat device is quite insensitive to inhalation technique and supported by a simple patient instruction program using a DVD. The studies have shown that inhalation of 20 insulin units with AFRESA administered with the Dreamboat device produced plasma insulin concentrations comparable to the administration of 30 units using the current Medtone device.

We plan to discuss with the FDA the definitive bioequivalent study design and to map out the approval pathway for the Dreamboat inhaler for use with AFRESA. We are very excited about this next generation device and would like to get it into the hands of patients as quickly as possible.


I did skip over to MannKind's web page and this thing looks a lot less like a bong than Exhubra did.

From The News Wire: DexCom and Animas

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3-Aug-2009 - Entry into a Material Definitive Agreement, Results of Operations and Financial Condit

ITEM 1.01. ENTRY INTO A MATERIAL DEFINITIVE AGREEMENT
On July 30, 2009, DexCom, Inc. ("DexCom"), entered into (i) a Letter of Amendment, amending the Amended and Restated Joint Development Agreement dated January 12, 2009, and (ii) Amendment No. 1 to the Commercialization Agreements, amending the OUS Commercialization Agreement dated January 12, 2009 (collectively, the "Amendments"), each with Animas Corporation ("Animas"). Pursuant to the Amendments, DexCom will collaborate with Animas to develop a modified version of DexCom's transmitter to support a single, global CGM-enabled insulin pump launch by Animas. DexCom is entitled to receive a one-time $1 million milestone payment upon the achievement of performance qualification of a manufacturing line for the modified transmitter and is also entitled to receive an additional one-time $4 million payment upon the first regulatory body approval outside the United States for the new system. The Letter of Amendment modifies the original $5.0 million milestone payment that DexCom was entitled to receive upon receipt of a CE Mark for the first commercializable OUS product. Pursuant to Amendment No. 1 to the Commercialization Agreements the initial term of the OUS Commercialization Agreement is three years from the first commercial product launch, but no later than three years after December 31, 2010.


YDMV Full Disclosure: I own shares of Dexcom. I am also trying to get the things for my kids passed insurance approval.

August 2, 2009

Stupid Meter Tricks - The Series

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Here are some games we have played with our T1 kids and their meters. I find making a game out of learning is a lot more fun and a more effective way of getting kids to learn than talking in one of their ears and seeing it fly out the other. I am of the school of thought that playing with the diabetes and diabetes stuff helps put diabetes in its place and that place is in line behind normal parent kids give and take.

The Meter Isn’t Important; The Child Is.
Show your kids that he meter is part of life and life is fun. Demystify the meter by playing with it.

Coding Games
Practice some Math to find out what coding or mis-coding your meter does to blood numbers.

Learning How You React to Stuff
Shhh don't tell'm you calculating ISF, tell'm just watching cartoons all morning.

Whack-a-Meter - Show it Who's Boss!
Hammer Time! One swing to better mental health.

August 1, 2009

D Summit - The Untrue Story Scene VI

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Happy Cat Post

The face was a picture of knowing superiority, smug in is clam self confidence. The gray cat look regal too, eyes shut purring as it ears were gently scratched.

“Look at the fools, they think in a generation of Twittering Blackberries the only camera I have access to is the Hotel security?”

Tapping a few manicures fingers on the Blackberry get a quiet, “I see the prices on the NYMEX spot market are continuing to rise.” However these few key strokes meant a few less ear strokes and the cat is not happy. It slowly flicks it's tail in irritation at loosing the center of attention. “Yes, Yes, my Sausage. Don’t let cornering a commodities market interrupt your pressing schedule." Na as she reaches back to the cat she looks at her screen,"...but who is this Ms Siah?”



Somewhat shaken and stirred the Summiteers find themselves climbing into a black and silver shuttle bus. Chris is about to fire up the 455 when he notices M has slid into the driver seat.

“Oh no you don’t,” she says. “Do have any idea how high our insurance premiums have gone with you behind the wheel? Hell we are way passed the assigned risk pool.”

The van slowly moves through the mall parking lot and stops just on the other side of Nordstrom’s.

Chris thinks, ‘I would have been quicker to walk.’

They all roll out and into a fairly typical suburban mall free standing pad watering hole. The bloggers enter the grand hall and move to various gaming tables.

From Casino Royal (1954) to Quantum of Solace there have been 25 films in this series. We all know the canon.

So when the dude with the European accent says a few smooth words it is clear who is who. Chris reaches for the PPK. The assemble masses start collecting their pitchforks, torches and other angry mob supplies.

But there is a twist. Like a breath of new air in the room.

Who would think it? Bought off a by a free drink and some adequate if uninspiring catering the mob is swayed from the things they hold dear. With their Dexcom’s beeping warnings they abandon all they have ever know and felt about diabetes by a cute story about a 7th grade dance. Yeah I know I wouldn’t have believed it either but it says so on a bog on the internet so it must be true.

Dazed and confused they sheepishly file back out and into another bus for the long ride back across the parking lot. Chris, yet anothrer one of the Scott’s and BadShoe look up and see the businessman’s special hotel across the parking lot and decide to walk.

Chris seizes the opportunity to have a smoke. In earlier films this would happen in more significant scenes. These days he has a hard time feeding the habit that started as a device to make him look debonair in those earlier days. He has to walk in the rain with Stadler and Waldorf just to get his nicotine fix. As the Muppet curmudgeons argue about how to navigate 100 yards across the parking stalls, Chris notices his head clearing.

A gray commercial sausage purveyor’s delivery truck flies out of the loading dock of the restaurant. Thinking quickly Chris shove the two old farts one way and dives the other, narrowly saving all their lives. The back of the truck is open and Chris sees commercial compressed gas tanks.

“Odd sausages” 007 quips as he helps the feeble old men to their feet. Looking around he notices there is a compressed gas tank on the back of the van too. A sign proudly states the van is, “Going Green - A Natural Gas Vehicle!” Yet the line from the gray tank runs into the passenger compartment.

“What do you call that? They are trying to kill us!” says curmudgeon 1 shaking his frail old fist at the fleeing truck.

“An act of Mercy!” replies curmudgeon 2.

“N2O” say 007, “It’s a laugh.”