Your Google May Vary

One of the fun things about having a web site is seeing where the traffic comes from. I see a few regulars here, I get used to seeing your ISP showing up (you know who you are and I know your at work). I kinda wonder who you regulars are what is it that keeps you coming back, but your here and that's cool. I write to see what will come out, I usually don't know what to expect when I start. I figure you feel the same way. I find it amusing and flattering that you enjoy it enough to come back.

The most fun is seeing the Google searches that end up here. I thought some of you regulars might enjoy some Google searches that have landed folks here ay YDMV in the last few days, so here we go the searches are bold, my two cents follows:

diabetes newbie
Hi, Welcome! Being a newbie to diabetes is tough. I hope you get that you should laugh and I hope the site helps you do that. I know it hard to laugh as a newbie. No you're not going to end up as goofy as I am, I was silly before my kids were diagnosed.

I'm a type 1 diabetic have a hypo every week
Congratulations. A few lows a week means you are aggressively trying to be in range. As long as you can feel the lows, and you are not going real low, you are just fine. If you don't see any lows in a week my bet is your average is too high. That said - YDMV.
Talk to your doctor for real medical advice. Don't trust your health to web pages, particularly mine. I'm a nut case.

Sea World San Antonio employees write a blog
Oh crap, Sea World is tracking me down! I hope it isn't about the letter I sent to Mr. Bud.

Hey Brensdad - love ya man, and your dad too. Here's to both of you and to your health! Cheers.
(I'm toasting with a nice Victory Hop Devil)

Diabetes and the Arabic culture
Dude you are way lost. I barely understand American Culture.

I have a lot of respect for everyone who is working to manage diabetes. I was particularly impressed with the folks who came over from UAE to attend Children With Diabetes, Friends For Life. They came to Florida, out of their care for diabetes management, where they ran smack into a bunch of goofy Americans like me. Talk about a shock.

I found they were wonderful, dedicated, caring people. I hope they found the same about us. Maybe it isn't such a culture shock after all.

What was that song I heard in Orlando? Oh yeah "Its a Small World After All. It a Small World After All It a Small Small World...." (Try getting that song out of your head for the next few days! LOL)

kissing + diabetics
Now it is getting interesting!

This leads to my all time favorite, very specific and not from the same IP address or even same hemisphere as that last one but maybe we need to get you kids together:

if you kiss a guy that has diabetes can you get diabetes
No

Have fun.
(Let's just keep it at kissing for now shall we?)

Update: So much for kissing, check out DiabetesMine.

Newbie Advice II: Pain in the Alliteration

All those years ago when we had our first diagnosis I remember thinking, (well OK I said it right out loud) “Did they intentionally make these words up to be confusing?”

The answer is YES. (Well it is my answer anyway.)

So my newbie friends, I thought a little vocabulary rant would help. There a books full of confusing diabetes terms. I’ll just mock, errr... elaborate on a few:

Hypoglycemic and Hyperglycemic. I don’t know about the rest of the world but speaking from my personal experience I was way too much in a daze of sleep deprivation, caffeine and commuting back and forth to Children’s Hospital to have brain capacity or attention span to make out anything other than Hypblurglycimic when ever I heard or read theses words. They were indistinguishable and interchangeable as far as I could tell. Both meant bad. I could get high and low but not from these words.

Yeah I get the whole Hypo = Low. I also get sleep deprived and over caffeinated = hyped up. Using what little functional brain power I had to parse out the o or er mid word was asking too much. It took 10 to 15 months to have those words mean anything to me without a dictionary.

In point of fact I didn’t master them until I needed to be able to reliably confuse people who were being a pain in the butt by spitting them out real fast. I knew just exactly how mind warping that could be.

Speaking of mind warp, I think the folks who named insulin must have been up watching the Rocky Horror Picture Show and sampling the pharmaceutical company’s rejects all night. Humalog, Humulin, Novalog it’s inhumane. Seriously, there you are trying like hell to sort this stuff out and not make a mistake. Not only because you are holding a needle to your kid with their life on the line but you don’t want to sound like a moron while you’re at it. 

No such luck the good folks at Big Pharmamarketing bought into the whole Transylvania Transsexual alliteration too much. Who cares if patients can figure out which is which, they are laughing their butt off.

Just in case you crack the insulin code they use the same tactic on what the insulins are used for; Bolus / Basal. I kept wondering why I needed a bowl of basal, was pesto meant to be a big part of the new healthy eating program? Nope Basal and Bolus are just part of the babble. Like the hypo / er, I didn’t master them until I found they were effective offensive verbal weapons when use rapidly against the food police and other such pains in the derrière.

So yes they intentionally make these words up to be confusing, learn them use them, they will empower you. They are the first lines of defense in the war against the food police and practitioners of 504 obfuscation.


Click here for the YDMV Newbie Post Index.

DexCom(TM) Announces Joint Development Agreement with Animas

So Here is the answer to my question about where is Animas

Partnership Will Focus on Developing a Continuous Glucose Monitoring System
to Work with Animas(R) Insulin Pumps

SAN DIEGO--(BUSINESS WIRE)--DexCom, Inc. (NASDAQ: DXCM - News), a leading provider of
continuous glucose monitoring systems for people with diabetes, today announced
that it has entered into a joint development agreement with Animas Corporation
to integrate DexCom’s continuous glucose monitoring (CGM) technology into
Animas® insulin pumps.

http://biz.yahoo.com/bw/080110/20080110005232.html?.v=1

30 Degrees is Heating Up

Unomedical is coming to market with an all in one 30 degree set and inserter. For folks trying to get a set into a skinny as a rail kids this may help. The set and inseter come in a single unit like Unomedical 90 degree Inset set.

We are big fans of the Inset all in one sets. Our kids are so skinny there isn't a lot of real estate to shoot a set into that has enough fat. (They didn't inherit this condition from me, I have acres of prime plumpage.) The angle may provide more set location opportunities for them or maybe a set will last a little longer.

For more information see the manufacturer's web site.

SYMLIN Pens Available & Other News

Prom the press release wire:

SymlinPen Offers Convenient SYMLIN Administration for Enhanced Glucose Control
SAN DIEGO, Jan. 7 /PRNewswire-FirstCall/

Amylin Pharmaceuticals, Inc.(Nasdaq: AMLN) announced today the availability of the SymlinPen(TM) 120 and the SymlinPen(TM) 60 pen-injector devices for administering SYMLIN(R)(pramlintide acetate) injection. These new pre-filled pen-injector devices feature simple, fixed dosing to improve mealtime glucose control.

http://www.reuters.com/article/pressRelease/idUS115027+07-Jan-2008+PRN20080107


A patent for low dose Glucogon

SAN FRANCISCO, Jan. 8 /PRNewswire/ -- DiObex, Inc., a privately
heldbiotechnology company developing treatments for metabolic diseases, announcedtoday that it has secured a critical patent from the U.S. Patent and TrademarkOffice for the use of very low dose glucagon, or DIO-901, in the prevention ofinsulin-induced hypoglycemia in diabetes patients. The patent grants DiObexexclusive rights to methods of reducing the risk of hypoglycemia in diabetespatients being treated with insulin by administering very low doses ofglucagon. "This patent protection strengthens our commitment to delivering the firstproduct to the market for the prevention of insulin-induced hypoglycemia indiabetes," CEO David Cory said. "DIO-901 is the only therapeutic indevelopment to prevent insulin-induced hypoglycemia, which is known to limitoptimal glycemic control and cause recurring medical
complications in mostpeople with type 1 diabetes, in many with type 2 diabetes, and is sometimesfatal."

http://www.reuters.com/article/pressRelease/idUS124022+08-Jan-2008+PRN20080108

So haven't people been using low doses of glucogon all along? How do you get a patent for what people are alredy doing. I wonder if this has implications for a closed loop artificial pancreaus. I would think that providing glucogon could be part of the program.

Does anyone know more about this?

It’s (almost) a Free Market – So Step Up

Omni Pod’s announcement today with DexCom put some of the bigger players in the looking like slugs category.

Fist Abbott who bought out the Navigator seems stuck in the FDA mud. There has been all kinds of buzz about the Navigator and it being the inevitable winner in the CGM market place. Tomorrow is the New Hampshire primary and I have to think Abbott is looking a lot like Hillary. Crowned the winner by the pundits but not showing up in the polls. I don’t know what the deal with Abbott is but Omni Pod is looking real smart hedging their bets.

“The agreement is non-exclusive and does not impact any of Insulet's existing third party development agreements.” In other words Omni Pod is still going to keep the door open if Abbott ever get off their butts. In the mean time they are working with Dex.

In a free market those of us shopping for a pump would be able to match it with the CGM that suits our needs and visa versa. - not having the choice dictated by big medical companies keeping things in their house (MiniMed.) Kudos to Omni Pod for getting that.

This leaves Animas the wall flower in the pump CGM dance. Hey Animas, I love you guys. Your service is great. Your support a holistic approach to type 1 wins you some additional loyalty.

But the CGM/Pump combination is a ship that is leaving port. A lot of us were hoping that J&J would bring some capital to help promote innovation. It doesn’t seem to be the case. Best thing to come from the J&J take over was a bounce in the share price.

The 2020 is incrementally an improvement. Pink is a winner with my 10 year old. I think more in the features department would be better. The new software is not winning any rave reviews on line. It isn’t web enabled. It isn’t up to a CGM. Diabetes has more statistics than Major League Baseball. J&J seems to have left Animas in the farm team. Color is good, features are better.

So here we have two big company heavy hitters, Abbott and J&J, folks with Yankee resources who seem to be all about their AA team in Toledo. Dudes act like Big Leaguers - step up. You need to be on the field to win.


(Full Financial Disclosure: I have a few shares of DexCom – it was the only pure CGM play I could find. I had shares of Animas before J&J bought them out. I thought I had some Abbott too but I looked at my IRA statement and I don’t have any of them or J&J. I would be real psyched if I could move the market but let’s get real - I’m no Oracle of Omaha)

Omni Pod & DexCom Announce Agreement

Hot off the news wire Omni Pod and DexCom toys are going to be talking. Hello Abbott? you are loosing ground:

Insulet Corporation (Nasdaq: PODD - News), the leader in wearable insulin pump technology with its OmniPod® Insulin Management System, and DexCom, Inc. (Nasdaq: DXCM - News), a leading provider of continuous glucose monitoring systems for people with diabetes, announced today they have signed a development agreement to integrate DexCom's continuous glucose monitoring technology into the wireless, handheld OmniPod System Personal Diabetes Manager (PDM). In addition to programming the patient's insulin delivery, the PDM with integrated DexCom technology will receive and display continuous glucose readings from DexCom's wearable sensor transmitter...

...The agreement is non-exclusive and does not impact any of Insulet's existing third party development agreements.

More at:

http://biz.yahoo.com/prnews/080107/nym062.html?.v=96

Newbie Advice

This is the first in what I intend to be a few short bits on tips for newbies. Hopefully I can pass on some mildly useful advice with a bit of humor to help folks new to type 1 or at least give’m a small chuckle. Comments and corrections are appreciated.



Listen up Newbie!
Newbie Advice: The Long Run
Newbie Advice I: Insulin Resistance
Newbie Advice II: Pain in the Alliteration
A Little Help From Your Friends
A Little (More) Help From Your Friends
Newbie Advice III – Why aren’t we in The Caymans?
Newbie Advice IV: Never Buy a Meter
Fatherhood and Trenches
Snickering All the Way
I know one of your fears.
Who Best to Say You Will Be Okay.

Newbie Advice I: Insulin Resistance

If you are new to type 1 I hope you like mind games. Diabetes is all about the mind games.

Welcome to the club! While you master the secret handshake, I’ll spill the beans on one of type 1’s little mind games. It has a lot of mind games so it is not like I am depriving you of a surprise by letting one out of the hat, you will get plenty of them.

I call this one “Maybe the Doctor was Wrong.” The professionals call it insulin resistance. (The professionals call a lot of stuff by funny names but that's another post.)

When that first diagnosis happens, you start taking insulin with a needle. Relatively large amounts. I’ll explain relative to what, here in a few seconds, that’s the whole trick. For now you don’t know jack and don’t know a trick is at hand. If you are like I was mostly you’re working past your needle phobia (I HATE needles,.)

You are doing what the doctor says. Doing what the doctor says is a good plan, I recommend it. You are doing it and in a few days, maybe a week, you start running low. A lot.

You get a little panicky because at Children’s Hospital they beat into you that lows are dangerous. This is all so new.., and you’re worried you doing it wrong... and you tried to do everything right... and your trying to chart trends... and your sister’s cousin’s friend says you can cure diabetes with cinnamon... and you didn’t really believe it but you put a little in the apple sauce... and NOW YOU HAVE LOWS!

WTF!

So you cut back on the insulin. You have talked to the doctors office about this and you’re using less now than before.

You’re still run low. You cut back more.

Next thing you know you are hardly using any insulin compared to what you started with. (See that is the relative I was talking about, well that and your sister’s cousin’s friend) You think, “Maybe it isn’t diabetes. Maybe it is some funny cold like thing that looks like diabetes but goes away in a week or two! Maybe there is something to the cinnamon in the apple sauce. Maybe the Doctor was Wrong!”

Sorry. No such luck. It is Diabetes.

Welcome to the club. Diabetes loves mind games, this is one of its games. Your sister’s cousin’s friend hasn’t got a clue but diabetes is having a huge laugh tricking you into thinking they may.

Here is the deal. Initially people are resistant to injected insulin. They just don’t use it well. Also the poor beleaguered pancreases is still putting out a little insulin of its own and with injected insulin, that the body is becoming less resistant to, the need for injected insulin has declined, to almost nothing. In some cases, just the long term stuff.

It doesn’t last all that long – just long enough for the mind games to really work you over. In time you start seeing the numbers go up and you slowly work more insulin into the program. The net effect may be little more than to help make you crazy.

I didn’t learn this game; really believe it was a mind game, until after the second kid’s diagnosis.

You are brilliant if you come away with from it with the idea that what worked yesterday may not work today - Your Diabetes May Vary.

More YDMV Newbie Tips: http://www.ydmv.net/2008/01/newbie-advice.html

Miscellaneous Chemistry News

Biodel issued a press release stating the have completed enrollment of two phase III trials of their new fast acting insulin. They also announced plans to build and operate a manufacturing facility.
http://biz.yahoo.com/prnews/080103/nyth117.html?.v=101

As I understand it they are making a faster acting insulin. Faster would bolus better and shorten insulin on board times. It sounded interesting enough that when they issued an IPO I bought a few shares not so sure I would be the first person to sign their kids up to use it but time will tell.


Diabetes Health ran an article on c-peptides. Now I am the first to admit I don't know much other than c-peptides are used in diabetes diagnosis to distinguish between T1 and T2. This article is a nice little primer on c-peptides.

The article suggest thinking has been they don't do much. My thought is regardless of your thought on evolution or creation why would either have something being produced that doesn't do anything? More likely we just don't know what it does yet.
http://www.diabeteshealth.com/read/2008/01/03/5612.html