May 24, 2013

FDA allows A1c test for diagnosing diabetes

This is a Cut and Paste post from the FDA: 
For Immediate Release: May 23, 2013

FDA allows marketing of first A1c test labeled for diagnosing diabetes

Today the U.S. Food and Drug Administration announced that it is allowing marketing of the COBAS INTEGRA 800 Tina-quant HbA1cDx assay (Tina-quant HbA1cDx assay) for the diagnosis of diabetes by health care professionals. This is the first HbA1c test that FDA has allowed to be marketed for this use.

The HbA1c tests, or A1c tests, currently on the market are FDA-cleared for monitoring a patient’s blood glucose (sugar) control, but not for diagnosing diabetes. A1c tests measure the percentage of hemoglobin A1c that is bound to glucose, giving a patient’s average glucose level over a three-month period.

Diabetes is a serious, chronic metabolic condition where the body is unable to convert glucose into the energy needed to carry out daily activities. An estimated 25.8 million people in the United States have diabetes, including seven million people who remain undiagnosed. If left untreated, high blood glucose levels (hyperglycemia) can lead to serious long-term problems such as stroke, heart disease, and damage to the eyes, kidneys, and nerves.

The diagnostic criteria for diabetes have changed over time. Based on the research and recommendations of international diabetes experts, many health care providers have already been using some A1c tests to diagnose diabetes, in addition to the established diagnostic procedures of a fasting blood glucose test and an oral glucose tolerance test to diagnose diabetes. However, before today, A1c tests were not specifically designed or granted permission by FDA to be marketed for diabetes diagnosis, making it difficult to know which A1c tests were accurate enough for this purpose. The Tina-quant HbA1cDx assay, a laboratory-based test, can be used to both accurately diagnose diabetes and monitor blood glucose control.

“Providing health care professionals with another tool to identify undiagnosed cases of diabetes should help them provide patients appropriate guidance on treatment before problems develop,” said Alberto Gutierrez, Ph.D., director of the Office of In Vitro Diagnostics and Radiological Devices at FDA’s Center for Devices and Radiological Health.  “As the Tina-quant HbA1cDx assay was designed for diabetes diagnosis and has been reviewed by the FDA, physicians can have confidence that this test is reasonably safe and effective when used for its intended purposes of monitoring and diagnosing diabetes.”

In support of marketing clearance, investigators analyzed 141 blood samples and found less than six percent difference in the accuracy of test results from the Tina-quant HbA1cDx assay compared to results from the standard reference for hemoglobin analysis.

The Tina-quant HbA1cDX assay is available by prescription for use in clinical laboratories. Over-the-counter HbA1c tests should not be used by patients to diagnose diabetes, and only a qualified health care professional should make a diagnosis of diabetes. Individuals who receive a diabetes diagnosis should discuss with their physician what they need to do to manage their diabetes.

Hemoglobin A1c tests, including the Tina-quant HbA1cDx assay, should not be used to diagnose diabetes during pregnancy and should not be used to monitor diabetes in patients with hemoglobinopathy, hereditary spherocytosis, malignancies, or severe chronic, hepatic and renal disease. This test should not be used to diagnose or monitor diabetes in patients with the hemoglobin variant hemoglobin F.

The Tina-quant HbA1cDx assay is manufactured by Roche, of Basel, Switzerland.  Roche’s North American headquarters are located in Indianapolis, Ind.

May 22, 2013

diaTribe, Get the Newsletter, Enter to win a free book

If you are not reading diaTribe (, you should. It is a monthly newsletter about diabetes research and products with content from who I consider the smartest team in diabetes team, lead by Kelly Close and Adam Brown.  Sign up here:

diaTribe also has just published a book with the ADA, Targeting a Cure for Type 1 Diabetes: How Long Will We Have to Wait? To celebrate publishing Targeting a Cure, diaTribe is giving away 30 eBook copies! You can enter the giveaway here.

Here is their quick outline of the book:
Targeting a Cure covers the latest research directed toward curing type 1 diabetes, presenting both the challenges and the breakthroughs. Targeting a Cure is written from a patient perspective and is rich in detail on all the most recent developments in the field. With a foreword by Dr. Robert Ratner, Chief Scientific & Medical Officer at the ADA, an introduction by Dr. Aaron Kowalski, VP, Treatment Therapies at JDRF, and a conclusion by Kelly Close, Editor-in-Chief of diaTribe, Targeting a Cure is a thorough resource that reveals where we stand in the search for a cure for type 1 diabetes and where we are headed. 

May 16, 2013

Accomplishments: Serious and Silly

This week I am joining Karen and many others in D-Blog Week.
Today's topic is, "Accomplishments Big and Small"

Our prompt of Today is: 
We don’t always realize it, but each one of us had come a long way since diabetes first came into our life. It doesn’t matter if it’s been 5 weeks, 5 years or 50 years, you’ve done something outstanding diabetes-wise. So today let’s share the greatest accomplishment you've made in terms of dealing with your (or your loved one’s) diabetes. No accomplishment is too big or too small - think about self-acceptance, something you’ve mastered (pump / exercise / diet / etc.), making a tough care decision (finding a new endo or support group / choosing to use or not use a technology / etc.).

I think one accomplishments in which take pride, and I will leave the evaluation of greatness to others, is this post. I am proud where writing it took me. It is fairly serious and I share another link that is spectacularly silly but related in that I shared with with the same friend I have never met other than in the DOC. 

Bad things happen to good people.

I wrote this for another T1 dad who has had some issues with a church preschool. OK y’all may not recognize me as the author here but what the heck here goes:

Bad things happen to good people. It isn’t God’s will that they happen but part of God’s providence. There is a distinction there that is small but significant.

If bad things only happened to bad people we could easily know who’s evil from there rest. It would be like God showing up in a cloud and tossing about lightening bolts. There would be no question of who was in charge and we would be compelled to believe in that all powerful God.

Now think of God as a parent. Parents want their kids to do OK and to love them back. We all kind of get around to the idea that, the kids have to choose to be OK and love us back for themselves.

God being infinite is infinitely more loving and wise is more aware of this truth than we are. So God is infinitely more motivated to let us, his children, choose to love him by NOT forcing us to do so. In short God keeps us in freedom to choose to love God or reject God because that is how love works. (Every one sing the Sting song, “If you love someone, set them free…” OK enough of that sillieness.)

So what does this have to do with the topic at hand? Lots. First we get what we can handle or more precisely what we can handle with God’s help. We didn’t do anything bad, were not being punished, it is just our at bat, our lot, our thing. It is real hard to keep that in mind particularly, when those piling on the crap are wearing religious garb and projecting that they are all wise and speaking for god. Nope they are just human.

Second, we only get what we can handle, if we couldn’t, if it was going to break us for sure, we wouldn’t get it. That ain’t saying it is an easy load. It is saying we have an even shot. No more, no less, we are in freedom.

Third somehow there is a way to be better for all of it, we have to find the up side of the equation that is keeping us in freedom to come out OK. I am not so sure that I know what that is. If I figure it out I’ll let you know but it is there someplace. Our gig is to find it and do it.

I am coming to feel that there is a community here that may be more than it seems. We are here to help each other with the diabetes thing but the fact is the real issue is how the diabetes thing gets into our heads and hearts. That is more than helping with blousing tips.

It may be that we are here to really reach out and say, “That is wrong. I will stand by you to help you not over react but to act in accordance with what is right.” We can’t change the way Fishville or some church board act and think. We can support each other and in doing so help ourselves on a better path.

So let me say that I empathize with every emotion you are feeling, I know them first hand. The real spiritual issue is not to let what we experience as the shallow hollow self interest of others turn us into them.

Stand up for your child, her mom, her grandfather and her brother. You were put on this path because you can come out of it a better stronger man, father, husband and son. I probably can too. It may well be that you sharing your experience is a way to help me see that it is the same for me.

Thanks for the hand.

Stand tall stand and proud stand up for the children you are God’s chosen advocate for. Do so in away that makes us, them and God proud of you. You have done so so far. I have faith you can continue to do so.

In the long run - it is how we react that counts

This was originally posted as:

And now for something completely different

That was a little deeper and really out of character for me. So here is another bit I did for the same guy far more in the public character of us both. I am just about as proud of this which should be proof that I am, at best, an adolescent at heart. Here is an excerpt, the full long link follows:

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...

It go on and on at:

May 15, 2013

Of Independence and Angry Mobs (A YDMV Classic aka rerun)

This week I am joining Karen and many others in D-Blog Week.

Today's topic is, "Share and Don’t Share"
Our prompt of Today is: 
Today we’re going to share our most memorable diabetes day. You can take this anywhere.... your or your loved one's diagnosis, a bad low, a bad high, a big success, any day that you’d like to share.

I wrote this in July 27, 2007, still true and and a lot of software, devices and industry attitude  I still am looking for.

Of Independence and Angry Mobs

When in the course of human events at the CDW Friends For Life Conference I was in a discussion about data and how to get it to the care team people who needed it. The moderator asked about care teams and who were the key players we rely on to care for diabetes, specifically the endo, the CDE etc..

So everyone around the room was talking about how often they have a doctor visit and how much time was spent with the Dr. verses the nurse at a visit and so on. Folks talked about doctors they love and other told horror stories of doctors they bailed out on.

After a while of this the guy next to me, Mark, said something so brilliant it stopped me cold. He said, and this is a close as I can get to a quote;

‘My wife and I are our daughter’s primary care team.”

That may have been the single best sentence of the week. (Editors note: OK my past 9+ years with a CWD) I would say we hold these truths to be self evident but it obviously wasn’t evident to anyone else in the room until he said it. Then there was unanimous support for the idea.

Now I must be an idiot. (OK I know many of you are likely to have come to this conclusion yourself.) Our doctor has been making this point to us for years. He has no interest in us printing out charts and data just for him to see. Now if we use software to help us manage the care we give our kid and we want to work through an issue with him, he is more than happy to have a look at some printouts.

The next day at the CWD conference in one of the CGM meeting we were directed into talking about how CGM data could be sprung free from the little receiver and shot out to other devices and or members of the team. (2007) Specifically we were instructed to talk about how we would feel about it if the doctor could get be alerted to the data in near real time.

So off we go about getting information to the doctor. The device makers were read hot on getting data to the doctor, like doctors around the nation are sitting in the office with nothing to do but wait for the red phone to ring or something. That must be the way to getting stuff sold and or paid for, “get the doctor the data.”

Well in this second session, we the people staged a little uprising and were insisting we needed the data ‘cause we are the care givers when the manufacturer’s rep said something along the lines of, ‘Well, you know, only the doctor can make a change in therapy…”

This was followed by laughs and shouts to the contrary from the crowd. I did a healthy business in selling pitchforks, torches and other angry mob supplies.

The same doctor centered imagery was prominent in the displays around display booths in the trade show. Concerned looking older male models dressed as doctors pointing at some point on a graph on a computer screen so some younger female model could pose as a mom in a admiring nod while the picture was take.

So here is a problem. The gadget manufacturers don’t get the big idea that families are the primary care givers. I guess they can be forgiven if only one in twenty of us has the presence of mind to say the family is the primary care team in a focus group meeting the day before.

We all need to get a grip! Software, IF it is going to be used in T1 households, is going to be used by primary care givers mom and dad or by the T1 patients themselves.

Before we got our first diabetic kid out of Children’s Hospital at age 9 Children’s was talking to us about looking to independence. Our goal was to raise a kid to independently manage his, then her when the second dx happened, own diabetes.

Someplace along that path to independence has to be for families to manage the freaking condition without an umbilical cord back to the doctor’s office. Yeah the doctor knows how to manage diabetes, our job was to learn it and teach it without that care becoming a teenage rebellion issue. Sounds easy enough right?

So all you manufacturers out there, make tools that support independence. Tying us tighter to a doctor electronically isn’t the goal. It is the opposite of the goal.

Independence is the goal.

May 14, 2013

Hang Together, Not a Check Box

This week I am joining Karen and many others in D-Blog Week.

Today's topic is, "We the Undersigned." 

Our prompt of Today is: 
Recently various petitions have been circulating the Diabetes Online Community, so today let’s pretend to write our own. Tell us who you would write the petition to – a person, an organization, even an object (animate or inanimate) - get creative!! What are you trying to change and what have you experienced that makes you want this change?

Hang Together.

Petitions need to be a call to action not a check box. 

Consider the most prominent of all American petitions the Declaration of Independence. The people who signed that were committed to action. It was an act of treason against mother England. We all know Ben Franklin’s, “We must all hang together, or assuredly we shall all hang separately.” Think about that, this wasn't a casual thing, clearly it was outside the signors comfort zone. 

Signing meant the risking being hanging by the British if captured. That is not an understatement . The signors had more than a little skin in the game. These days signing a petition often is little more than a Facebook like. I am not sure there is any lower common denominator of approval than that a Facebook like and that many petitions are at best only tiny bit more than that. 

I think we need skin in the game. A willingness to give some kind of effort towards the change that petitions seek. To do so means we have given a little more than a quick glance at the matter and are willing to actually be involved in what ever revolution we are signing up for. 

So I am all for a petition that is not so much signed as a movement that is joined. Here is a cause to think about joining: Look at the amounts invested in research per patient for AIDS, Breast Cancer and Diabetes. This chart is from my friend Manny who got the numbers here

Sure it is fun to click away to petition for funding a Death Star. If we are going to petition let it be more than a silly click and be about something meaningful. Research is something for which the diabetes community should “petition the government for a redress of grievance.”  If that last bit sound familiar, it come from Franklin’s day. Written by people that know what a petition was, it is the last line of the First Amendment to the Constitution. 

Let do something not just click something. 

May 13, 2013

Oil Change and Tune Up.

This week I am joining Karen and many others in D-Blog Week.

Today's topic is, "Share and Don’t Share"
Our prompt of Today is: 
Often our health care team only sees us for about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Today, let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one's daily life with diabetes? On the other hand, what do you hope they don't see?

Oil Change and Tune Up.

We see our diabetes healthcare team four times a year (15 minutes a vista per each). Kind of like an oil change for the kids. The care team changes the insulin cartridge and rotate the sets and we are good for another 3,000 miles. We have a good relationship but our conversations are fairly low key.

I honestly don’t think there is much I wish they were aware of, that they are not, and I don’t think there is anything I hope they don’t see. That said I don’t think we have a typical patient / endo relationship.

Early on I printed out numbers and BG reports. The Dr. asked if I printed them for him or me. “Well. You.” I said, “I thought you needed them.” His response was if I had questions bring them in otherwise don’t bother.  I liked that a lot. I took it as an indication that he trusted us to make the adjustments that were needed to as they were needed and trusted us to decide what he needed to see. (Hint: not much).

I think that is the how our relationship works. They offer suggestions as needed answer questions and we go about our respective business. We at time differ one stuff. For example they are not big CGM fans because most of their patients who have gone on them, come off fairly quickly. That didn’t keep me from asking and getting scripts to try them.

Like others our kids didn't love carrying around the extra CGM stuff. We didn't use them all the time but occasional CGM use still made finding basal patters easier.

Like everyone's, our diabetes has varied. What has been consistent is that our care team is there for us, when we need them, they offer suggestions and trust us to do what we can to manage. That trust was very apparent when our second diagnosis happened. We were on vacation and they trusted us to start care with daily phone calls checking in. They put normal life, in this case the vacation, first and work diabetes into that normal life. That perspective is a great gift and they consistently share that with us. Each visit is an chance to tune up that perspective.

If they read this I hope they know I can’t imaging a better relationship, and even if they don't I feel the same way. LOL.

May 10, 2013

Of Beer and Insulin

I was pretty psyched to see Lilly’s insulin factory. I had no idea how the stuff got into those little bottles. I had seen the picture of pork pancreas stacked 10,000 pounds high that was used in the old days to make one pound of insulin crystals. It is in Breakthrough, the book about the discovery of insulin by Thea Copper and Arthur Ainsberg. I knew that pork piles aren’t the means of making insulin now. I did not know much more.

Much to my delight I found making insulin is a lot like brewing beer. The folks at Lilly may not have been delighted by my comparison but they were good sports about it. While I can brew an acceptable ale at home, I am sure I can't cook up a batch of insulin.

Some of the finer Belgian beers are crafted by Trappists Monks and fermented with wild yeast that happens to float into the brewery. Wild bugs may be great for a Belgian Lambic but are not so great for insulin. A multitude of little microorganism would love to grow up in a big old vat of glucose. So Lilly goes to great lengths to keep them out. Just like home brewing (only more so) sterilization is a big deal for insulin production.

Beer is made by putting water and sugar from malted grain and some yeast in a clean sealed bucket. The yeast eats the sugar, excretes CO2 and alcohol, while multiplying like crazy. At some point the yeast can’t grow any more and it dies off. The brewer separates the beer from the mass of dead yeast and put the beer in a bottle with a pinch of extra sugar to carbonate it.

Lilly has some little tiny critters that eat glucose, replicate and in the process sequence a DNA string that just happens to be insulin (and by ‘just happens’ I mean is very carefully engineered). They start with a teeny amount of these critters, like about an ounce, and end up with 50 tons of glucose water in bunch of (very clean) vats fermenting the little guys. Unlike beer Lilly are after the bugs and filter out the water. They filter, wash, spin and process and end up with less than 50 pounds of insulin crystals. A pinch of those 50 pounds will be mixed with sterile solution to fill a bottle. All told a batch makes around a half billion ‘units’ of insulin.

   Photo courtesy of Lilly

About clean: To see the bottling room, from the other side of glass, the tour had to put on hair nets, smocks, booties and for the facially haired, beard masks. That was to look though said piece of glass into the clean room. The guys in the room (or girls it was not really clear their gender for all the garb they were wearing) apparently spend a half hour dressed up. Nothing human exposed, breathing through respirators they were more suited up that what you see in a bio scare flick. The room was beyond surgically clean and 8 vials at a time filled as they looked on. Eight at a time, all day, to the tune of more than a million vials week.

So let review: Like beer insulin is fermented filtered processed and bottled. Like brewing beer sterilization really matters. Unlike beer the process of insulin is not so easy you can do it in the kitchen.

My friends Scott and Scott have posts about the tour that dose not involve beer
here:  and

But for those still with me here is a handy graphic to help with my comparison.

Lilly Diabetes invited and paid for me to attend the 2013 summit. Airfare, lodging, food and transportation was all covered by Lilly. They did not ask me to write about my experience. My comments are my own.  I did check the numbers in the info graphic with them. 

Forbes on Joslin's John Brooks III

John Brooks III the CEO of the Joslin Diabetes Center is featured at Forbes saying, “We’re a 115 year-old startup.”  I met John at the Diabetes Mine Innovation Summit and subsequently he agreed to talk with Lorraine and as a guest on DSMA Live 'Rents. It is clear to me form those encounters that John has every bit of the start up mentality that the Forbes piece writes about.

Good read, and gives me confidence in the direction of diabetes care.

May 9, 2013

Little Help?

Very simple. Take 15 minutes to watch this documentary:

Then tell others about it.

When the documentary passes 10,000 views, Diabetes Hands Foundation will receive a second $10,000 donation from Sanofi matching the first $10,000 they gave last year when the casting call for the documentary was announced.

May 8, 2013

Joslin: Challenges and Opportunities in Type 1 Diabetes Research

The Joslin Diabetes Center hosted their first Type 1 Diabetes (T1D) Symposium on May 6 at the Harvard School of Medicine. Titled “Challenges and Opportunities in Type 1 Diabetes Research” there was an impressive group of speakers on a range of Type 1 research. 

The presentations were fascinating. Seeing the eager interchange between speakers was particularly encouraging. I left with a renewed confidence in the quality of work being accomplished and hope for success in taming T1D. Maybe my most significant take away was to recognize the passion that the researches have is akin to what we as parents of Type 1 kids feel. Those passions can come together when those of us living with T1D help support this work directly and through our elected government’s programs.

There were presentations on the autoimmune attack. Obviously understanding the autoimmune process is critical in being creative about how to stop that attack.    I found it amusing that the process was referred to as an “insult” to the beta cells. Makes me want to tell the beta cells to man up and take a little flack. Apparently it isn’t that easy. 

We were shown detailed images of how the macrophages attack beta cells.  One point that stuck with me was that the autoimmune attack may come in waves over a long period. This suggest that a treatment that mitigates the autoimmune process would need to also be in the body for a long period, be effective when there was a periodic attack on the pancreas and the rest of the time not harmful to other immune processes between those rounds of beta cell insults. 

Other presenters spoke on growing new beta cells. It seems that people must do so. Almost all of Joslin’s 50 year medalist, those folks with 50+ years of type 1, who donated their pancreas posthumously for research had functioning beta cells. So beta cells either last a lifetime or, more likely, they can regenerate. As one presentation discussed beta cells pretty much suck at reproducing. Ok that isn’t *exactly* how it was said but you get the idea. There is a small host of inhibitors of cell reproduction hanging out in beta cells. The good news is researcher knows they are there and maybe how to inhibit the inhibition. The closing presentation was on betatrophin which may help beta cells suck less at reproducing. 

Ed Damiano gave a presentation on progress towards a dual hormone artificial pancreas. He made a convincing case for the need for both insulin and glucagon as part of the system. He brought both the passion of a researcher and a dad to the table. It is not that he wants his son wearing a bionic pancreas, it is not the final solution. A cure is. Ed was humble, his research may give kids, like his, a better life while the search continues for a cure. 

That humility was clear throughout the symposium. This was not a day of headlines we so often see blazing about cures but humble presentations that were as much about what researchers didn’t know, as what had been discovered. Accompanying that was a clear desire, often expressed from the podium in reply to questions, to work with other and bring separate efforts together to perhaps jointly find what had not yet been found separately. 

It was a privilege to be there and being somewhat overwhelmed by the individuals giving presentations and asking questions. I can think of little that would have improved the day.    Well, other than a cure. 

My thanks to the Joslin Diabetes Center for extending me an invitation to attend as a member of the diabetes online community. Thanks also to Joslin’s co-sponsor, the Leona M. and Harry B. Helmsley Charitable Trust.

Diabetes Blog week.

I am in. 

TrialNet: Now Online Sign Up, Local Blood Screening

TrialNet is an important way people can participate with clinical trials to study Type 1 Diabetes (T1D). Previously participants needed to go to a participating facility. The recently the National Institutes of Heath (NIH) announced expanded ways to participate. You can sign up online and have blood drawn at a Quest lab close to the participant, at no cost.

TrialNet needs at least 20,000 relatives of T1D people each year to support research. So we all can play a part in finding better treatments and cures. The first step is to roll up our collective sleeves and participate. Now that is even easier.

If you are connected to T1D, this is a way to step up and be part of doing something about it.

Adapted from their website:

How Does Screening Work?
  • Step 1:
  •  First TrialNet will ask some eligibility questions.
  • Steps 2-3:
  •  TrialNet will verify they have your permission to screen your blood sample and collect personal information.
  • Step 4:
  •  The Online Screening will ask for some basic family history information and a mailing address.
  • Step 5:
  •  TrialNet will mail you a screening kit. Take your screening kit to your local Quest for your blood test. 

  • Note: Screening at Quest facilities is only available for persons located in the US, If you are located outside of this area, but still want to participate, please click here for more information
See answers to common questions about screening >

Who is eligible?
Anyone between the ages of 1 and 45 years with a sibling, child or parent with type 1 diabetes. 
Anyone between the ages of 1 and 20 with a sibling, child, parent, cousin, uncle, aunt, niece, nephew, grandparent or half-sibling with type 1 diabetes.

May 7, 2013

Nano System for Smart BG Control

Injectable Nano-Network for Glucose-Mediated Insulin Delivery is the name of a paper in ASC NANO that outlines a possible path to a smart insulin. I hope the particles are smaller than the title. Thte paper is by Zhen Gu, Alex A. Aimetti, Qun Wang,  Tram T. Dang,  Yunlong Zhang, Omid Veiseh,  Hao Cheng,  Robert S. Langer,  and Daniel G. Anderson. 

It is also written up in a NC State University article, the ideas is that nano particle would release insulin the presence of glucose. The tile at NC State is just about as long: Injectable Nano-Network Controls Blood Sugar in Diabetics for Days at a Time. Now that is a title. 

The article goes on to say that mouse tests maintained BG for a more that week with one injection. The NC State piece specifically mentions type 1 diabetes. I am real curious about  T2 as well. Time will tell. 

Anyway this is very exciting stuff and here is a little excerpt about how it all works: 
The new, injectable nano-network is composed of a mixture containing nanoparticles with a solid core of insulin, modified dextran and glucose oxidase enzymes. When the enzymes are exposed to high glucose levels they effectively convert glucose into gluconic acid, which breaks down the modified dextran and releases the insulin. The insulin then brings the glucose levels under control. The gluconic acid and dextran are fully biocompatible and dissolve in the body.

Hop over and read more.

I look forward to reading more.