January 30, 2012

Nominate @Diabetic_Iz_Me for a Shorty Award #dsma

I am a huge fan of #dsma, the weekly twitter festival of all thing diabetes. (Wednesdays. 9:00 pm eastern time follow the tag #dsma) It is wonderful because Cherise is more wonderful.

You can show a little Love Ya Mean It by nominating Cherise too. 

You can go about it a few different ways:

  • Paste @Diabetic_Iz_Me into the form:http://shortyawards.com/category/socialfitness and ad a reason why you nominated her.
  • Send a tweet like this: I nominate @Diabetic_Iz_Me for a Shorty Award in #socialfitness because of weekly #dsma chat 4 living well w/ diabetes.
  • You can also tweet shorter nominations like this: #shortyawards @Diabetic_Iz_Me #socialfitness she runs #dsma which is my weekly lifeline other diabetics and a variety of topic to live well

The contest wants you to be creative with the reason. A tweet without a reason for the nomination will not be counted. So don't forget that part, OK? We want votes to count.

The rules say a nomination must be relevant to the category. There is an easyone, Cherise is about as relevant to social fitness as is possible. Through #DSMA she helps people living with diabetes live health, fit, spiritual, emotional, rational, and irrational lives with all type of diabetes.

Here part of the category definition:
The #SocialFitness Shorty Award, in partnership with Anthem Blue Cross and Blue Shield’s Health. Join In., honors an individual who helps others to make healthy choices in their lives through their influence on social media. More here.
You can vote for Cherise in as many categories as you want, as often as you want, just make #SocialFitness one of those votes.

Only one nominee and one category per tweet.

ReTweets (RTs) are eligible provided the account and nomination meets all the other requirements.

Voting for Cherise in the same category more than once simply replaces the text of your original vote; it does not count as an additional vote. (Bummer.)

Come on DOC - share the love!

#TwoBits on People and Devices

Two great recommendations from around the DOC in case you missed them over the weekend (or maybe 3 from 4). While they are not intended to be variations on a theme I can't help but eeing them that way. Yes they talk about Dexcoms but I see the theme as commentary on supporting the people with diabetes in our lives without being a pain in the ass about it. Not the easiest thing to do, particularly for a parent, but equally true of a partner or co-worker (or even a waiter* but then going there would make this three bits.)

Abby has a piece on SixUntilMe about her first day on the job as an RN, a low during orientation and a new coworkers calmly asking “Are you OK.” A spectacular piece. I particularly love the way she speaks of those three words.
“If you have diabetes, you know why this made me feel so comfortable. There was no stress from her side conveyed to me. She didn't freak out and ask someone for juice. At no point did she have a worried look on her face. She just knew.”
I highly recomend that we parents out here diabetes land read this and think about ways of talking with our kids about diabetes in ways that are: comfortable, not stressed, no freak out, skip the worried look and simply let them know we are there for them.

It ain’t easy. It is a great goal. I'll try. I'll slip up. I'll try again.

Christopher and Dayle write at A Consequence of Hypoglycemia writes about how they would improve the Dexcom CGM. Since I am out there advocating that people talk about what they want from gadgets you may think I like this because Christopher and Dayle write about what they want from their respective gadgets in this post.

OK I do like that, what makes this great is that the gadget are put info the context of how those devices effect the people they care about. They speak of time sensitive alarm volumes and custom alarms, kinda like selecting a ring tone on your phone. What is magic is they do that in consideration of the person next to them. Towards the end Dayle offers up the great idea of the Dexcom having a buddy system with other devices. Devices that play nice, what a concept. It is even more impressive when it is in the context of the devices supporting their loved ones as well as themselves. The idea that customizing devises so that people interact more comfortably, with less stress, fewer freak outs and simply dealing with the diabetes on the 'Are you OK' level seams so simple. In that it is revolutionary.

Great stuff.

*We can leave the waiter out of the equation but Kerri piece is so reminiscent of most of our dinners out with diabetes that I have to smile. Somehow dinner out is a particularly hard time to just ask "Are you OK?"

January 27, 2012

#TwoBits - Scare Tactics, Altered Images and Diabetes Ads

Riva Greenburg has a wonderful piece  (first of two pieces) up on the Huffington Post about Agriculture and Health. I found fascinating the idea of linking farm policy and health. I thought the idea that incentives for health based agricultural goal vs demonizing was a fascinating way of approaching the issues. It’s kinda like the idea of positive emotional behavior as motivation vs scare tactics and shame to get individuals to deal with the diet health and relationship in their individual lives. 

Speaking of scare tactics, there is an ad running by NYC that shown an amputee than links diabetes, soda and amputations. In an interesting twist to the scary ad in question - it is photoshopped. Boston.com reports that photo is digitally altered and not of an amputee or even diabetic. The poll in the Boston.com piece is running in favor of the altered ad. Apparently photoshopping images to make models skinny on magazine covers is bad but faking amputations is OK. 

What is your view of digital manipulation to make a point? How about scare tactics - think they work? 
Sysy has a piece up on The Girls’d Guid to Diabetes about scare tactics and this adRiva also has some great words about the campaign in her back issues. 

January 16, 2012

The Brits Crack Me Up.

#TwoBits A Great #DSMA Live Replay and #TuDiabetes Live

Here’s a quick #TwoBits* around the DOC this week.
Replay the DSMA Live show from week guest Lane Desborough.  Lane shares his career, passion & glimpse inside of his life as a Parent of a child w/ diabetes. In addition to being a T1D Dad Lane is a key part of the Medtronic brain trust helping shape T1D care. I have met the guy and listening to him is a great investment of time.  http://dsmalive.com/2012/01/13/after-thoughts-lane-desborough/
Friday January 20, Join the TuDiabetes for a live video chat with C.C. King, Ph.D., Associate Research Scientist at the UC, San Diego Pediatric Diabetes Research Center. Dr. King will begin by presenting a brief overview of his research into stem cell therapy for type 1 diabetes, followed by a live Question & Answer session with the TuDiabetes community!
* 1/20/12 1 pm Pacific Standard Time (GMT -8)
* 1/20/12 4 pm Eastern Standard Time (GMT -5)
*If you see an interesting pair of posts around the Diabetes Online Community (DOC) how about sharing them with the rest of us with the hash tag #TwoBits in case others missed them?

January 14, 2012

Stem Cell Reports and Asking questions.

There are a number of headlines about stem cells as a cure for type 1 that have been written in the past few days. They are based on a study out of China the reports to have reeducated lymphocytes aka T cells. I read this article and am left with far more questions than I am comfortable with. Josh Levy has a sound write up, I recommend his write up
In part here why I have questions. In other news this week identified CD8 T cells as the source of the autoimmune response that causes type 1.1 There is a quote from ViaCyte on Diabetes Mine that spoke  to the difficulty of  getting stem cells to differentiate into beta cells.2 For that I presume that getting a stem cell to differentiate into any specific cell is an involved proposition. 
The lymphocytes reportedly reprogramed in the China study are already differentiated cells.  If the autoimmune process is stopped it is due to a modification or reeducation of these CD8 T cells. There are a myriad of CD8 cells and they are created in the lymph nodes to recognize specific antigens on the cells the are programmed to kill. 

Differentiated means a stem cell became a specific cell in the body. That is they started off as a stem cell and became a specific type of t cell. Very loosely hematopoietic stem cel in bone marrow become a common lymphoid projenitor that becomes a T cell.
This study suggests that exposure to stem cells changes the existing antigen receptors. If that is true then why don’t the stem cell that become to the lymphocytes in our bone marrow have the same effect? I also fail to see a mechanism to explain how this erase the memory of the adaptive immune system. Why is it the type 1 autoimmune T cells that are reeducated and not say the one that provide immunity to chickenpox.  
All that said I would love to see a cure. I get excited by headlines just like everyone else. I hope this is repeatable. I have come to be suspicious of reports of apparatus that seem to good to be true. 

I would hope that the news agencies that report this kind of study know enough to ask some basic questions. Among them should be how does it work, is it peer reviewed and has the study been repeated? 
1 La Jolla Institute researchers identify pivotal immune cell in Type 1 diabetes in humans, http://www.eurekalert.org/pub_releases/2012-01/ljif-lji011112.php
2 http://www.diabetesmine.com/2012/01/whats-up-with-diabetes-stem-cell-research-firm-viacyte.html

January 13, 2012

#TwoBits on Cure Research. One Guy: Joshua Levy

Here’s a quick #TwoBits* from around the DOC.
We of us living with T1D want a cure. A lot of us also want an easy way to keep track of progress towards cure. My Go To Guy is Joshua Levy. In late December he wrote two essays well worth reading for those looking for cures. 
Of Mice and Men: Joshua also started a new blog. One dedicated to all the NOD Mice that get cured. The freaking mice get cured all the time and each time starts a cycle of a cure is coming headlines. It is nice then to have a resource that knows the difference between curing mice and people while still keeping an informed eye on what is going one with the rodents. 

*If you see an interesting pair of posts around the Diabetes Online Community (DOC) how about sharing them with the rest of us with the hash tag #TwoBits in case others missed them?

January 12, 2012

#TwoBits Diabetes Sisters & Stem Cells at the Mine.

Here’s a quick #TwoBits* from around the DOC.
1: Registration for Diabetes Sisters annual conference open January 1st. I hear they are already about half way booked. For more information see: http://www.diabetessisters.org/events/nationalconference
2: Diabetes Mine has an interesting piece on encapsulated stem cells research. An outstanding read. http://www.diabetesmine.com/2012/01/whats-up-with-diabetes-stem-cell-research-firm-viacyte.html
*If you see an interesting pair of posts around the Diabetes Online Community (DOC) how about sharing them with the rest of us with the hash tag #TwoBits in case others missed them?

January 11, 2012

Of Fantasy Diabetes Devices, Sheldon & Dewy

Victoria’s Secrets holiday runway special has past, football is winding down so maybe we need some new fantasy league to talk about. How about insulin pumps? 
I had a fascinating conversation with Greg from Medtronic at CWD’s Friends For Life last summer on the topic of what would be my fantasy pump. A plausible device, that is one based on current technology, insulins etc.. I would say that a full artificial pancreas is beyond that scope but only a little. 
Yes it takes a particular lack of a real life to have fascinating conversations about fantasy pumps. You can call me Sheldon if you must. It turns out for me the fantasy isn’t a pump, and so the talk expanded out to a fantasy diabetes management system. Greg asked if I thought FDA would approve my fantasy devices. I allowed as how they  probably wouldn’t but industry would probably wouldn't make it either.
Meet DEWY, he's a winner. 
I think the tools available to manage diabetes are fairly good. I think there is a significant opportunity for better diabetes care through breaking down the technological towers of Babble that separate devices from each other and our lives. My fantasy device would be a common collection point for diabetes information in a way that would facilitate managing lives with diabetes not just adjusting parts of those lives. 
Our meters, pumps, CGMs need to talk together and work through a common Diabetes User Interface. A D.U.I. 
WAIT! We can’t call it D.U.I.! That’s been used. 
How about DEWY for ah.. um.. er.. Diabetes Equipment Works for You.   
Dewy’s job is to listen for information from devices and lives. Then to integrate that into a possible responses. Dewy should work for us, patients, in our lives. Dewy should try to accommodate our individual life styles not define them. 
Dewy should help out with the basics. If we are low or high Dewy needs the wizard logic already in pumps to help calculate corrections or carbs based on our particular insulin and carb sensitivity. Dewy should have access to food databases with the ability to create a meal list in a way that approaches the ease of use of making play lists in iTunes. Drop and drag foods into a meal, easily adjust quantities of food in a meal, calculate carbs and even make note of fat, fiber and protein. Parents will want to be able to store these 'cause kids eat the same meal over and over again, by choice. Dewy should be able to help adjust boluses based on all of that but like any good friend of a diabetic not be too pushy about it. 
Dewy could even help out tracking trends. He could gently mention times of the day that he sees spikes. He could pay attention to our post workout BGs and see if there are trends worthy of note. Along the same lines Dewy could even try to pay attention to two hour post meal BGs and make suggestions about I:C rates. He could look for between bolus times when basals are responsible for what happening with BG and point out trends. 
Dewy would scream bloody murder if he ever sees serious overnight lows. He would turn off basals and wake up everyone and anyone we say with phone calls and text messages and keep at it until we tell him it is OK. That is just the kinda guy Dewy is.
Some folks like patch pumps, some traditional pumps and some folks like shots. To accommodate those life styles choices Dewy should be independent of device manufacturers. That is Dewy should be able to accommodate what ever meter, pump or cgm an individual chooses. Dewy should be smart and tag along with us patients where  we do our living, so he will need to reside on the smart phone or device of our choice. 
Dewy isn’t an artificial pancreas, not that he wouldn't be willing to work with one. An AP tries to be a pancreas. AP wouldn't care what you ate or if you worked out. Dewy being a really good diabetes assistant would, if we wanted him to, track what we eat or how our workouts impact our lives. 
Dewy would talk wirelessly to devices; pumps, meters, CGMs. He would do this securely and let us know if he is in touch or lost connection to devices. He would be the universal remote to the show that is our diabetes lives. When we change to a device that woks better in our life, Dewy could cope. He would have simple friendly ways to enter shots, exercise, and daily, weekly and monthly cycles. He would let us invent variables of our own because, well, our diabetes many vary. 
Until there are artificial pancreases, smart insulins, encapsulated implantable functioning beta cells and the cure that reverses the autoimmune glitch that causes type 1 diabetes families will need to manage diabetes. Managing diabetes will requires multiple devices to measure and adjust blood glucose but wouldn’t be cool if they all played nice? 
Well that’s my crazed fantasy pump. This got me wondering what others would see as a fantasy diabetes device? What is yours?

More YDMV musings on data here:
Do You Do It? (Download?)

Accu-Chek Nano FDA Approved.

Roche announced that they have FDA approval for the NANO in the US.
Innovative, small, no code device will be available to people with diabetes in the U.S. in first half of 2012
Roche (SIX: RO, ROG; OTCQX: RHHBY) announced today that it has received clearance from the U.S. Food and Drug Administration (FDA) for its Accu-Chek® Nano SmartView blood glucose monitoring system. The new Accu-Chek Nano meter, which is smaller than a standard credit card, employs a large brilliant backlit display and does not require any manual coding or code key for enhanced ease of use. It also offers improved functions such as customizable test reminders, pre- and postmeal markers and average glucose calculation. The Accu-Chek Nano meter uses Accu-Chek® SmartView test strips and will be available to customers in the first half of 2012. 
Our pals across the pond did a review of the Nano a while back: http://www.shootuporputup.co.uk/2009/06/review-roche-accu-chek-aviva-nano/

January 10, 2012

Required Reading - JDRF on GRI in Countdown

Back in September JDRF Launched a prize to encourage people outside of diabetes research to join the hunt for a Glucose Responsive Insulin (GRI.) I wrote briefly about it in the post Know a Smart Chemist? JDRF's current edition of Countdown, their online magazine has a great story with more information about GRI and the JDRF initiative.

This is a fascinating approach to living with type 1. It is not a cure in the pure sense but if they can find ways to make Glucose Responsive Insulin work it is a Game Changer. In fact The Game Changer is the title of the piece and because of that potential, years down the way, the articles gets my vote for this weeks reading assignment.

The Game Changer: Treating type 1 diabetes with glucose-responsive insulins.

January 9, 2012

JDRF IDDP with KalVista Pharmaceuticals

From the News Wire:

KalVista Pharmaceuticals and JDRF form research partnership focused on novel approach for treating diabetic eye disease 
Southampton, UK and New York, USA 09 January 2012 - KalVista Pharmaceuticals ("KalVista") and JDRF have formed a research partnership focused on a novel approach being developed by KalVista to preserve vision and slow the progression of diabetic eye disease. Diabetic eye disease is one of the most common and most serious complications in people with type 1 diabetes (T1D). JDRF will provide up to $2.2 million in milestone-based financial support and research expertise to KalVista. The goal of this partnership is to advance KalVista's lead pre-clinical candidate, a plasma kallikrein inhibitor, into human proof-of-concept clinical trials and to generate clinical data that would highlight its potential as an entirely new approach to treat diabetic macular edema (DME). DME is a leading cause of visual loss for people with T1D that involves swelling of the retina, which can lead to blurred vision and blindness.  More: http://www.jdrf.org/index.cfm?page_id=116775

#DSMA Makeover & an Easy Resloution #TwoBits

Here is a quick #TwoBits* from around the DOC.
#DSMA’s New Years New Look: The web site has been overhauled and sports a more user friendly interface. Included in the more friendly part is a menu link to the weekly Wednesday night party that is #dsma chat. More on how to join that party can be found in this post.

Carey Potash my favorite blogger at dLife writes about the Medtronic mySentry, its costs and dreaming of a lost poodle. If Carey isn’t in your RSS feed adding him is a great New Years resolution. You will thank me I’m sure. 

*If you see an interesting pair of posts around the Diabetes Online Community (DOC) how about sharing them with the rest of us with the hash tag #TwoBits in case others missed them?

#dsma Makeover & an Easy resloution #TwoBits

Here is a quick #TwoBits* from around the DOC.
#DSMA’s New Years New Look: The web site has been overhauled and sports a more user friendly interface. Included in the more friendly part is a menu link to the weekly Wednesday night party that is #dsma chat. More on how to join that party can be found in this post.

Carey Potash my favorite blogger at dLife writes about the Medtronic mySentry, its costs and dreaming of a lost poodle. If Carey isn’t in your RSS feed adding him is a great New Years resolution. You will thank me I’m sure. 

*If you see an interesting pair of posts around the Diabetes Online Community (DOC) how about sharing them with the rest of us with the hash tag #TwoBits in case others missed them?

January 7, 2012

Happy New Lancet and Butterfly Pod People #TwoBits

Here is a quick #TwoBits* from around the DOC.

First Happy New Lancet form our pals across the pond at Shoot Up or Put Up who say;
"Happy New Lancet to all our readers, Please join us in cracking open a brand new shiny lancet in celebration of the new year."
Leighann has a post reporting that Butterfly strips are now approved for the OmniPod so Happy New Strips to the Pod People.

*If you see an interesting pair of posts around the Diabetes Online Community (DOC) how about sharing them with the rest of us with the hash tag #TwoBits in case others missed them?

January 4, 2012

Of Diabetes, The Lion King and Paying It Forward

At our most recent Children's Hospital of Philadelphia (CHOP) Parent Network meeting there was a newly diagnosed mom having a tough time. Diabetes is hard. Having a child diagnosed is devastating. Truth be told at every meeting, everywhere, there is almost always a family in the emotional deluge of a recent diagnosis.  
Why us, why now, we don’t know what to do.
Our family has been there. Twice. The second diagnosiwas no easier even with the skills to manage it. Maybe because we had the skills and experience and knew more clearly what a diagnosis meant.
That’s the deal with a diagnosis like diabetes. As I become closer to people living with other chronic conditions I learn that the flood of emotions associated with diabetes isn’t unique. A lot of my e-patient friends with other conditions to manage share similar stories. Many also share the value they have found in patent communities. There is a common theme of receiving much needed support from communities and ultimately providing. 
So climb up on Pride Rock and queue the music, that is part of the circle of support. Sometimes I wonder who is doing more for who in that process. Sure the newbie needs a shoulder to cry on. Still I think there are those with experience also have a deep need to offer that shoulder. The truly gifted turn the circle a little farther. The make their chronic condition valuable and see it as an ability.
I read this on the Facebook page of Glu*, It was written by Jen Block, “I consider diabetes to be an asset. Its presence in my life has brought many challenges, but with each challenge I face, I emerge a little stronger.” She is a 15 year veteran so she isn’t all pollyanna and goes on to add, “Don’t get me wrong this is a challenging disease and I have no idea of the challenges you face in managing diabetes; but I do know you are all incredible people.
In there is a rock solid answer to, why us, why now, we don’t know what to do. Because you can be better for all the challenges you will face. You can be a little stronger and that is incredible. 

*Glu (myglu.org) is a T1D community launching this spring. I have been having fun with the beta.   

Medtronic Remote CGM Monitor Approved

Medtronic announced that the FDA has approved the mySentry(TM) remote CGM monitor. It is a second screen that allows a parent to remotely see CGM data. Here's a picture from the Medtronic Blog where you can also find more information about the thing. The full press release is here.

Version of something like this have been seen and talked about for years. It is great to see that Medtronic and the FDA managed to find a way to make patient information more available. For parents this has significant value. Particularly over night. Imagine checking BG without getting out of bed. 

Here's a Youtube bit by Medtronic about it:

Happy New Year.  

January 2, 2012

#TwoBits - A List and Lyrical Word @Ninjabetic @DMomBlog

Leighann over at D-Mom has a list of words for 2012. While I am a fan of the last item on her list as the word for diabetes in 2012. I think the one I’ll vote for in the DOC caucus this January is one not in the list but in her introduction, Second. It also is part of teh title of her upcoming book Kids First, Diabetes Second.

Meanwhile George is Looking Somewhere and offers up a lyrical reelection on 2011 and anticipation of 2012. The Ninja is should be the DOC's poet laureate.