March 28, 2012

iCo Therapeutics and JDRF Team Up

Links


iCo Therapeutics and JDRF Team Up
to Support Phase II Clinical Trial iDEAL for Diabetic Macular Edema 
--Trial that aims to address the leading cause of blindness
in people with type 1 diabetes and type 2 diabetes being led by Johns Hopkins investigators--

iDEAL Phase II Study Update

March 28, 2012, Vancouver, Canada—iCo Therapeutics (TSX-V: ICO), a Vancouver-based drug reprofiling company and JDRF, the largest charitable funder of type 1 Diabetes (T1D) research have joined forces to investigate a potential new treatment for one of the most common complications of diabetes, diabetic macular edema (DME).  The iDEAL study is a Phase II clinical trial to evaluate whether the drug iCo-007 could help to treat DME in people with either T1D or type 2 diabetes.  The study is being conducted at the Wilmer Eye Institute of the Johns Hopkins University School of Medicine.  

bit.ly/HnGkde via jdrf

March 27, 2012

Who Ya Gonna Call?

Links
Ghostbusters if you have a free floating apparition.


But if you are in the media and are writing about diabetes where are you going to get an informed patient voice?
Diabetes Advocates Offer Assistance in Accurate Reporting in the Media
27 Mar, 2012 17:00 CET
”We want to help get it right,” states diabetes advocacy groupTuesday, March 27, 2012 (BERKELEY, CA) – Did you know there are more than five different types of diabetes? If your knowledge of diabetes is defined by what you hear and see on the news or in movies then you probably don't. Diabetes Advocates, a nonprofit program made up of influential members of the diabetes community has launched a media outreach campaign, designed to assist the media on all things diabetes.  
Kelly Kunik, a member of Diabetes Advocates, stated: “Today is Diabetes Alert Day in the US and we are trying to stress to all media sources that more due diligence is required on everyone’s part when reporting on diabetes. We want to help all sources ‘get it right’ but also stress the importance of explaining the differences among ‘all things’ diabetes.” 
See full press release here: http://www.cisionwire.com/diabetes-advocates-a-program-of-the-diabetes-hands-foundation/r/diabetes-advocates-offer-assistance-in-accurate-reporting-in-the-media,c9236817



Do You Do It?

Links
Download?

I have been to a few diabetes events where a point was made that few folks download there stuff* (* a word that hear means; meter, pumps, CMG, food log, workout schedule and a partridge in a pear tree.) Why is that?

Now that may come as surprise to folks who have read my bits on diabetes technology, DEWY and the data frontier that while I value data, we don't download. So forgive a little Sheldonesque nerdieness and let me suggest that there are reasons we don’t boldly go where no one has gone before.

In our case it is too much of a PITA - pain in the Apple. We use Macs. A program is not Mac compatible if it requires me to run windows on my Mac or even an old version of Mac OS. For that matter a program isn’t PC compatible if it can’t run on the current version of Windows either. All of which is totally irrelevant because the stuff may not be best downloaded into a Mac or Windows computer anyway. Possibly the target device device should be more, dare I say it, in touch with our lives - portable across all the devices we use. It should probably be in the cloud and accessible with any computer or phone with current browser.

I realize that may give a lot of cardiac physicians patients at FDA a heart attack. But the reality is dirt simple: people choose to carry mobile devices. These could be a great conduit to move information relevant to diabetes management into a data cloud. To boldly go where the PWD already are.

Syncing data is a manual process. Why is that? Why do we need to drag out a cable connect it to some legacy port on a computer and jump through hoops to move the data? At one point our the meters and pumps all used cables connecting to the serial port but the Windows XP box I had at the time only had one such port. Naturally the cables were different so to down load the meters and pumps meant swapping cables. Care to guess how often that seemed like a good idea?


Why do we need to manually sync at all? Why not just introduce the stuff* to our cell phone. Like paring a head set and then let the devices do all the work. Isn’t that what the devices are meant to do. Diabetes care is extra work. Why in the name of all things holy do we have to do extra processes to sync the stuff that is already extra work.

I think the prime directive for device manufacturers needs to be to not inter fear with the  lives that they touch. Look we all know Kirk broke the prime directive every other episode but at least there was some token angst before heading off into a romance with some alien babe.  Strive for no extra work.

The data we downloaded was less than complete. Why doesn’t the information a PWD enter into the bolus wizard come out with the download? Also the limited data downloaded it ends up in different programs. Wouldn’t it be great if the meter, cgm, pump info and maybe user information like ran three miles all showed up on the same report?

What the heck why isn’t that report smart? The rules of diabetes are not that complex. Can’t the devices apply some algorithms and point out trends.  Like, "Dude you are always high at 4:30, seriously look at these numbers." Or how about, "Listen man I love ya but I haven’t seen at lunch time blood check in ages how do you feel about a little reminder?"

Why don’t we download?

  • Not compatible with our computers or devices.
  • Our diabetes varies and at times we vary the meters we use.
  • It is a different manual process for each device and all are pain in the ass.
  • The data ends up in different reports
  • It hard to pull together to figure out how it impacts life.
  • Diabetes is already an intrusion and this is an intrusion we can choose to skip.

That maybe more than enough from me. What about your views on downloading, do you do it? Why or why not and how can it be mage better?




Previous data rants at YDMV:

March 26, 2012

Proud of the Kid

Links
Connor spoke at the American Diabetes Association's Greater Philadelphia Area Chairmans's Reception the other day.

Did a nice job.



Proud of the kid, even if he is not much of a kid any more.


March 22, 2012

Beta Cell Stress Could Trigger Type 1 Diabetes @JDRF

Links

Before T1d Stresses patients, stress on the beta cells may trigger T1D. Which matters because understanding how it works help find cures. So knowing what you don't know helps.

Study provides important clue in type 1 diabetes; could help scientists identify and validate potential drug targets to alleviate ER stress and preserve beta cell mass in T1D
In type 1 diabetes (T1D), pancreatic beta cells die from a misguided autoimmune attack, but how and why that happens is still unclear. Now, JDRF-funded scientists from the Indiana University School of Medicine have found that a specific type of cellular stress takes place in pancreatic beta cells before the onset of T1D, and that this stress response in the beta cell may in fact help ignite the autoimmune attack. These findings shed an entirely new light into the mystery behind how changes in the beta cell may play a role in the earliest stages of T1D, and adds a new perspective to our understanding how T1D progresses, and how to prevent and treat the disease. 
More about the study, published in the March 22 issue of the journal Diabetes, the researchers, led by Sarah Tersey, Ph.D., assistant research professor of pediatrics, and Raghavendra Mirmira, M.D., Ph.D., professor of pediatrics and medicine at the Indiana University School of Medicine is online here: 
http://www.eurekalert.org/pub_releases/2012-03/jdrf-rfb032212.php 

March 20, 2012

Thanks Riva for the Shout Out in @JDRF Research Summit Column

Links
Riva Greenberg has a write up of the JDRF Research Summit in her Huffington Post column. She nicely details the topics covered that day. She also quotes my YDMV write up saying;
What I, and more than 600 attendees with Type 1 diabetes, family members, health care providers and industry representatives, learned in a nutshell is what blogger Bennet Dunlap put so well, "I don't see a magic bullet coming but I do see different approaches to tackling things that will count as a cure. Those will happen like everything does in increments. Along that journey we'll see better care before cures. So prevention may come before restoration of beta cell function, that's cool, steps matter."
Thanks for your kind comment Riva, I am flattered.

If you missed the event please read Riva's piece to get a glimpse of what you missed. Two of the day's presentations are available on theBetesNOW.

Meet the T1D Exchange
Top 10 Things We Don’t Know About Type 1 Diabetes

March 15, 2012

The Best Pump

Links
The question which is the 'best' insulin pump floats up in diabetes conversation regularly. Best is a natural but probably wrong question.

The quality of pumps and their ability to preform the basic insulin deliver functions is so good that these days users have the ability to choose the device and vendor that best fits their unique lifestyle. That is a real wordy way of saying, ‘there is no best pump.’

Happily one size does not fit all.

People with diabetes have different needs because as individual their diabetes varies. So don't look for the absolute best pump but to the device that best accommodates your individual lifestyle. This dude's may love his backpack but it may not be your best choice. (And what is in the giant bottle on the bottom of that thing anyway?)

Design and feature matter. For example the patch, folks seem to have a love / hate relationship with the OmniPod. That is great. If you are drawn to the patch pump, no tubing, PDA driven approach -great. If. like my kids. you think it is too big and uncomfortable and tube are okay a more traditional pump may be better in your life. There are a lot of criteria individuals can consider. Remotes are really great for little kids. Lock the pump down and have mom or dad operate it with a remote control. How much insulin do you use and how much does it hold. Is it a color a young girl is comfortable wearing 24/7.

CGM may matter. If CGM integration is mission critical only Medtronic has int on the market in the USA. Animas, Roche, OmniPod and Tandem are in the on deck circle with Dexcom. Remember that deck circle is a baseball term. There is no clock in baseball and Animas and Omni pod have been next in the line up for years waiting to come to bat. Some of the fans in the stands are getting rowdy and jeering the Ump wanting to see them come to bat. Food databases are touted as a key feature. If they are to your look carefully at the implementation and ease of building realistic meals. Can you customize the food database to your needs.

Service matters. Check it out by calling the service in the middle of the visit by the sales team. Like everything else service varies. We have had great service from Animas other say they have had issues. Read up on TuDiabetes and CWD and keep in mind that when the device is as integral a part of life as an insulin pump individual service expectations will be very high.

Sets matter. People talk about pump features but the set and how it feels going in are where the rubber meets the road. Well the insulin meets the subcutaneous tissue. Try on sets as part of the sales process. Sets plural not set.

Instead of which is best maybe the question should be what features best adapt to my lifestyle. That the art and science of insulin pumping has progressed from that back pack size prototype, in the black and white pictures above, to diverse miniature devices is great.

What is best is we get to choose based on our individual preference.


Related posts from the YDMV archives:
Why Pump
What would be Really Cool

#TwoBits - Research Videos on Faustman and T1D Exchange

Links
Meet the T1D Exchange from the DC JDRF Research Summit on theBetesNOW
http://thebetesnow.com/?p=201

Manny has a fascinating video interview with Dr Faustman on TuDiabetes.
http://www.tudiabetes.org/video/an-interview-with-dr-faustman-2012

March 14, 2012

Body of Proof - Type 1 Diabetes Stops Nothing

Links

In last night’s episode of the coroner crime drama Body of Proof, the character of the  daughter of the lead was diagnosed with type 1 diabetes. It was done very well.

Life is going on and nobody seems to see anything coming. Grandma is at home with the teen while mom is at a business function. The teen is rushed to the hospital but nobody is sure why. Test show it is DKA associated with T1D.

Later we see mom and daughter in a hospital room. The girl has a bunch of IV tubes hanging. She is scared. Mom is scared. The girl doesn’t understand how she can have diabetes if she isn’t over weight diabetes.

Mom tells her that is type two and it is acquired but her diabetes is different.

The girl knows diabetes is incurable. She is afraid she will loose her legs or go blind.

Mom says, “You forget everything you have ever heard about diabetes. Okay? Those are misconceptions. It is a completely manageable condition...  and I am going to be with you every step of the way. Okay.”

So many things right here:

  • Diabetes sneaks up on you - you don’t see it coming. 
  • It is scary, for everyone in the family. 
  • There are different types of diabetes. 
  • Type 2 and type 1 are not the same thing.
  • There is no cure.
  • Forget the misconceptions. 
  • I am going to be there with you every step of the way. 


There was more.

After the broadcast ABC ran a little PSA with the actresses Dana Delany and Mary Mouser on the set. They mention JDRF and speak of the kids and adults diagnosed by type 1 everyday, “like me” says the teen actress.

Wait! kid and adults... like me!

Yes. Mary Mouser, teen actress has T1D.

On the her twitter feed @MaryMMouser she wrote her goal “was to prove that Diabetes stops nothing! :)”

As the father of an aspiring young actor who also happens to be T1D the message that diabetes stops nothing is particularly poignant.

Thanks ABC.
Thank Body of Proof.
Mostly, thanks Mary.

Diabetes stops nothing!


(You can watch the episode here: http://abc.go.com/watch/body-of-proof/SH5580165/VD55179081/identity. The scene with the mom and daughter is at the end time at 40:30. Sadly the Public service announcement at the end of the broadcast is not included.)

Update: Scott posted a link the PSA in the comments, thanks Scott, here it is:

March 12, 2012

Damn Mice.

Links

Apparently mice can now turn their gut cells into insulin producers. Seriously is it possible to spit on a mouse in a lab without curing diabetes? I think these diabetic mice just spontaneously cure themselves to stay in the media. Kinda like Charlie Sheen. 
Anyway here is the article and I notice the picture they ran is not a mouse. New Approach to Treating Type 1 Diabetes? Transforming Gut Cells Into Insulin Factories 
Not only do mice get cured at the drop of a hat they also have kick ass abs. Only way that is a mouse is if she was one of the dancers who work the Mickey suit at Disney World...
... get to hang out at Disney too. 

Damn mice 

March 10, 2012

#TwoBits on Change by @Strangely_T1 and @1LittlePrick

Links

Two piece from around the DOC that I enjoyed this morning:
Scott Strange as a wonderful essay on change. Riffing on a #DSMA comment about not letting diabetes change us. Scott make a strong case for the idea that change is what we make of it

Katie Peterson show one change for the better. And by better I mean Double Chocolate Cherry Cookies. Gluten free to boot. Check out the recipe at One Little Prick.

I am from the school of diabetes is a catalyst. It makes changes happen. Now if I can just make the cookies happen...

March 9, 2012

Abbott InstaLinx FDA Approved

Links
Abbott received FDA approval for their FreeStyle InsuLinx Blood Glucose Monitoring System.* It is a meter using their FreeStyle band test strips and with touch screen is also an automated logbook with software to analyze and trend data.

Here is what they said in the press release:

March 08, 2012
Alameda, California — Abbott (NYSE: ABT) today announced that it has received U.S. Food and Drug Administration (FDA) clearance for the FreeStyle InsuLinx Blood Glucose Monitoring System,[*] the first from Abbott to include a touch-screen interface, automated logbook and several personalization features designed to improve the diabetes management experience for patients. This unique device is also equipped with built-in FreeStyle Auto-Assist software that enables patients to track progress, analyze trends and easily display data for their health care providers. The FreeStyle InsuLinx System will be available to U.S. consumers within the coming months.
According to the American Diabetes Association (ADA), approximately 25.8 million people in the United States have diabetes,[**] and of those, many require insulin to manage their condition. The FreeStyle InsuLinx System is the newest addition to Abbott’s portfolio of glucose monitoring systems and is designed to use FreeStyle technology to help insulin-using patients monitor their blood glucose levels to allow them to more effectively manage their condition. Specifically, the FreeStyle InsuLinx System offers:
  • Touch screen designed for ease of use
  • Automated logbook that assists with tracking logged insulin doses and blood glucose levels
  • Personalization features, including the ability to upload weekly messages, pre-and post-meal markers and a personal photograph to the home screen
  • FreeStyle Auto-Assist software that can be uploaded to a computer via USB connectivity and is designed to help people with diabetes, health care teams and caregivers manage diabetes with reports, reminders and messages



*FreeStyle and related brand marks are trademarks of Abbott Diabetes Care Inc. in various jurisdictions.
** American Diabetes Association: http://www.diabetes.org/diabetes-basics/diabetes-statistics/

March 8, 2012

Technology #TwoBits: Carb Counting Blues by @CelloBard

Links

Marie Smith aka @CelloBard has a fun post sharing her observations on sensing. She likens her Dexcom to a school hall monitor and a bit of an unwelcome snitch. With good humor Marie shows the value of sensing to improve carb counting. Oh and oatmeal gets outed.

I also love her picture. It is great to see an image that make me hear.


On the topic of technology it stands to reason that some technology is out of date. DiabetesInControl.com makes that point about meters. Some where in this post there is a grain of common sense about meter accuracy and making sure you use supplies that are not expired (even if I don’t love the semi condescending tone of patient blame. Hey who teaches the patient anyway?) Still the post is on point, use a modern meter with test strips that are in date and have been properly stored. It also gives me a chance to suggest that folks never buy a meter.


March 6, 2012

#TwoBits: Starting a dBlog and wisdom from the dBlog that started us all

Links

Starting your own diabetes blog has never been easier with the easy and free ebook from the Girls Guide to Diabetes. No you don’t have to be a girl to read it. 
My two cents in this two bits is read blogs, join the conversation with comments on blogs, as you develop you voice reag teh ebook and start your own. 

I am among those who view David Mendosa as the original and still king of the diabetes blogs. This week he writes about testing in, The Trouble with Glucose Testing. The key is being taught what to do about it, particularly for non insulin using T2Ds. Studies show the BG test don’t do any good and in large part it because the key part of the equation is missing: what to DO with the results. David has some insights on what to do. 

I just love this image. Gotta wear a latex glove on your other hand when you test you blood. I hope this give you as big a smile as it gave me. 

March 5, 2012

AP on CNN

Links
Nice piece of reporting on the AP by CNN.

http://www.cnn.com/2012/03/04/health/artificial-pancreas/index.html

March 2, 2012

Hey DOC! Welcome Maryam #TwoBits

Links

Hello my Diabetes Online Community friends. Meet Maryam or Myrm as my son calls her, all though I have no idea how that nick name is spelled. (Regular YDMV reades will know I have no idea how anything is actually spelled and not be surprised.)
She bring the DOC the much needed sound of young america which is actually the name of a PRI show but you get the point.   
Here is the bio for her blog: 
Maryam Elarbi is an 18-year-old freshman in college who was diagnosed with Type 1 diabetes at the age of 10. Eight months after her diagnosis, Maryam’s family began attending the “Children With Diabetes” conferences, which changed their entire view on Type 1 and how to cope with it. Over the past eight years, Maryam has been actively involved in advocating for people with Type 1 through these conferences, as well as fund-raising for diabetes research through JDRF’s annual “Walk to Cure Diabetes.” In her spare time, Maryam enjoys reading (especially works by Jane Austen and Kurt Vonnegut), writing, spending time in the beautiful city of Philadelphia, and defeating her brothers in the new “Dance Central 2″ game.
She and the brothers she thrashes at Dance Central 2, helped my son feel welcome at CDW years ago. What a great gift. You can see her almost live in theBetesNOW's fashion report form the FFL Red Carpet. So DOC welcome Maryam! Here’s two of her recent posts:
Adventures in Hypoglycemia
The Importance of Consistency




YDMV on the Goal of diabetes management and teens

.

March 1, 2012

Prayers

Links
When it rains and it pours, we need reflect a ray of sunlight.




Bad thing happen to good people. I see that as an essential part of the freedom to choose good. I have written my feeling on that topic before and you are free to go read it. What matters now is simply say the obvious, bad thing happen to good people.

Event’s in life aren’t some silly punishment by a petulantly juvenile deity. They are just life. Some folks get a lot of life and they give back as much or more. Our diabetes online community is blest with Meri and her family. Three kids with type 1 diabetes and yet she finds the time and energy to be a ray of sunshine brightening the lives of all she share with through ourdiabeticlife.com.

More than once she has been the dove that brought a leaf to my drifting lost in the flood of life’s challenges. Life is like that. We get down. We feel alone.

I think God shares His infinite mercy though other like ourselves because through them, we can see the light of His love. At times maybe only through others can we really see that love.

Meri’s family is now facing yet another deluge. Her husband is entering cancer treatments. I pray that they find as much love they have shared coming back to them as they face the flood of doubt, concern and fear that rains down with the diagnosis.

I pray that I can be a small reflection of the love she has shared with me, with us all. I pray that she and her family feel less alone and that we her friends online can bring her small tokens that let her know our love is with her. I pray that though us God’s love is more visible to them.

Please. Share your love. Share your prayer for the Schuhmacher family. A little sun light can do magic when it rains.







You can join Meri’s friends on Facebook here.

YDMV on spirituality.


.

Study Shows: T2Diabetes Varies

Links
Who would have though it? The picture of type 2 is different that what folks may think.



ScienceDaily (Feb. 9, 2012) - The largest genetics study to date of type 2 diabetes (T2D) has identified new gene variants associated with risk for the common metabolic disease. An international scientific consortium, studying multiethnic populations, uncovered genes that may point to biological targets for developing more effective drugs for T2D.Multiple genes and environmental factors interact with T2D, which affects nearly 300 million people worldwide. The majority of the gene variants remain undiscovered.

Study identifies gene variants among multiple ethnic

Scientists have identified only about 10 percent of the genetic variants contributing to T2D, and most previous studies have been based on people of European ancestry," said senior co-author Brendan J. Keating, PhD, of the Center for Applied Genomics at The Children's Hospital of Philadelphia. This international study found that many gene variants associated with T2D overlap across multiple ethnic groups." The current study included subjects with African-American, Hispanic, Asian and European ancestry.
What is important here? What you think you know about diabetes (any type), from late night comedians and snaky comments about weight is probably wrong. Is the image of Type 2 one of cellular biology, no body image maybe. Perhaps that needs rethinking.