Main

July 19, 2012

J&J Enters the Patch Pump Market.

J&J is adding a patch pump to their arsenal. Actually, it's a patch pen, used to deliver mealtime insulin. Wicked!  I just received this info from their communications team:

"On Friday, July 13, LifeScan, acquired Calibra Medical, Inc. of Redwood City, CA. Calibra Medical is the developer of a unique, wearable three-day insulin patch designed to offer a convenient and discrete mealtime insulin dosing option for people with diabetes who take multiple daily injections (MDI) of insulin. While not yet available, this new insulin patch is intended to make it easier for patients to adhere to their prescribed mealtime insulin therapy and help them achieve and maintain good diabetes control.

We’re committed to providing patients with innovations that help improve their lives at every stage of their diabetes management.  The acquisition of Calibra Medical represents an important addition to our portfolio of insulin delivery offerings that include the Animas family of insulin pumps.
 
Calibra was a privately held venture and this is an early stage acquisition.  The terms of the acquisition are not being disclosed and we are not commenting on when we expect the product will be available.  There are a number of milestones that must be met before the product can launch."

The info I found for Calibra Medical Inc.'s patch pump looks a little generic, but I'm excited to see where this goes.  I love seeing more options on the insulin delivery table.  I'll definitely be following up with more details as I scout them out. 

Edit:  Bernard had a great post a few years back about this pump, with more detail.  :)

July 14, 2011

Coco, Disney, Lilly, and Nick Jonas's ... Mom.

At Friends for Life, several members of the DOC had a chance to meet up with representatives from Lilly (one being the same guy who rode over on the Magical Disney Bus with me from the airport, and he had the most impossibly teeny carry-on bag.  Only a guy could pack business clothes for a week into one, single carry-on.  /digression and also, hi, Adam) to discuss a very cool partnership between Disney and Eli Lilly.

Oh yes, that's right:  Disney has it's own PWD. Her name is Coco.  She's a monkey. (Or "MWD," as Leighann so aptly put it.)  

Others have written about Ms. Coco and her diabetes bracelet of animated glory, but I wanted to chime in and add my excitement.  I grew up with images of Mickey Mouse and Donald Duck as parts of my childhood, and I knew plenty of kids who went to Disney World on vacation.  But I didn't know anyone else who had diabetes.  Now, diabetes has infiltrated the mainstays of childhood memories by becoming part of the Disney gang.  Coco, a monkey who clearly has the same affinity for bows as my daughter, is right there in the thick of the Disney mainstream, and sporting a busted pancreas.  This is awesome, because it gives little kids with diabetes a cartoon character they can identify with, and feel cool about. (And I'm secretly thankful that Mickey or Minnie weren't 'chosen' to have diabetes, since mice are always managing to get cured randomly.)

Part of this collaboration between Lilly and Disney is an update to the Disney Family.com website, featuring editorial and information specific to families with type 1 diabetes.  This, to me, is just as cool as that crazy MWD.  Disney is extremely well-known (see also: understatement of the year) and to have type 1 diabetes featured prominently in their space is nothing short of remarkable.  This is mainstream attention to a disease that was once sorely misunderstood and ignored.  (Now we're just slightly misunderstood and social media'd.)   Now you can visit www.Family.com and check out their diabetes offerings, anchored by the tagline, "Everyday challenges; everyday magic." 

And lastly, as part of this Disney/Lilly partnership (henceforth referred to here as "Dilly," because I can't type those two words over and over again without getting distracted), there's a contest.  "Once Upon a Time" is all about sharing the real stories of life with diabetes, and bringing more families into the magic of Friends For Life.  From the website

"Lilly Diabetes and Disney Online have joined forces to help families with children who have type 1 diabetes see the magic that exists in everyday moments.  It's all part of a new initiative designed to provide understanding and support to families affected by type 1 diabetes."

What happens next is an essay contest where parents of kids with diabetes are encouraged to submit an essay inspired by their child's experience with type 1 diabetes.  These entries will be judged, and the winning entry will score air fare, hotel, and conference registration for a family of four to attend the 2012 Friends for Life conference.  

To top it off, Disney and Lilly have added some celebrities to help raise awareness of their Once Upon a Time contest.  One of these celebrities is the mother of OMG NICK JONAS himself, Denise Jonas.  I'll be speaking with her this afternoon, and will share her take on all of this with you later today!

I am impressed.  This isn't just a drop-in-the-bucket kind of advocacy effort so a company can check their "We did our diabetes advocacy due diligence" box.  This is real.  A real Disney character with type 1 diabetes.  A real chance for a family to enjoy the magic of both Disney and Friends for Life.  I love this.

Obligatory disclosure:  I attended an information session hosted by some members of the Lilly team, and they filled me and some of my fellow PWDs in on this partnership information.  Per usual, my opinions are my own.  As are my typos.  

August 05, 2010

BSparl and Her Mommy in Diabetes Forecast.

We both love purple.   Can you tell?Babies, babies, everywhere!  In particular, there are babies in this month's issue of Diabetes Forecast, with a focus on pre-existing diabetes and pregnancy.  I'm very proud that BSparl and I had the opportunity to share our story with the Forecast readers, and that the photographer who visited our home wasn't too bothered by the cat hair.

(One quick note after reading through the "Guide to Pregnancy" article in the magazine:  Diabetes is tough. We know that.  Diabetes and pregnancy is tough, amplified.  But don't let the long article about "what could happen" sway you if you are planning to pursue a pregnancy and you have diabetes.  The information in that article is important, accurate, but can admittedly be overwhelming.  Not all diabetic pregnancies encounter the same kinds of complications that mine did - everyone's experiences vary.  Just know that information overload comes with any pregnancy, and diabetic ones are no exception.  We may get some added bonus worries, but the end result of our pregnancies can be just the same as the pregnancies of non-diabetic women:  a healthy baby.  Take all of the information you read online in stride, including the stuff I've posted here.  It's a lot of hard work, but like they say, it's so, so worth it.)

And with that, I'm off to give the BSparl a snuggle.

February 15, 2010

Disclosure: I've Got One.

Disclosure is the responsibility of the blogger, and we’re under more scrutiny these days than ever before.   But I’ve never had an issue with transparency here – actually, I think I tell you guys way more than you probably want to know.  You knew when I started and stopped working for dLife, you know what publications I’m contributing to regularly, and you know about my relationship with Dexcom.  This blog is about my life with diabetes, and even though I know this is my life that I’ve decided to share, it’s important to me that people know my professional relationships with diabetes companies.  I’d want to know that information if I were reading this blog, too.

So (long winded intro to this post, eh?), I wanted to continue to keep you guys in the loop.  I’ve decided to sign a sponsorship agreement with the Animas Corporation. This whole thing started a few months ago, when I was exploring the idea of a new insulin pump and was excited about the Animas/Dexcom integration (no, I don’t have a CLUE when that’s happening, but I’m mighty hopeful it does go through in 2010).  But I’m still under my current pump warranty, so my hands were tied.  Reps from Animas reached out, one thing lead to another, and now I’m working with Animas, not as an employee, but as part of their outreach program that includes country singer George Canyon, LPGA Golfers Kelli Kuehne and Michelle McGann, and former Miss America Nicole Johnson (to name a few).  The program tries to spread the Animas name by working with people who have diabetes who are doing cool things (pregnancy is cool, right?), can inspire others to consider pump therapy, and want to talk honestly about how diabetes impacts their lives.  Bless their hearts for daring to partner with a – gasp! - blogger.  As part of this program, I’ve switched insulin pumps from my Minimed 722 to an Animas OneTouch Ping and am receiving my pump and pump supplies from the company gratis.  (Don’t worry, my doctor is in the loop and my supplies and pump are still a prescribed item.  This agreement doesn’t replace my medical team – just my method of insulin delivery.)

My new insuiln pump.  With my new, mega-basal rates.  Holy pregnancy!
My new insulin pump, showcasing my new mega-basal rates.  :)

This agreement is similar to the Dexcom one from last year (which is still in effect), in that I’m still going to be business as usual here on SUM.  Like with Dexcom, during the course of drafting this agreement, I spoke at length with many of the folks at Animas and they're well aware that everything I write about won't always be favorable (nothing is perfect, and we’re still talking about needles and diseases here), but what I say about their product will always be honest.  That means that when the pump is behaving itself and working smoothly, I'll say that.  And when I’m frustrated by pump fashion challenges and tangled infusion sets, I’ll say that, too.  This agreement isn’t a filter, but I think it’s important that you, as readers who trust me to be straightforward and honest at all times, know what kind of lens my perspective is seen through.  Just like with anything else.  Like when I tell you that Buried is the greatest film EVER.  (It is.)  Or that my baby is the cutest fetus EVER.  (She does make me smile.)  Or that my cats are the most annoying animals ever.  (I can't stand that gray one.) 

Every blogger is biased, but not every blogger discloses their biases.  I’m trying to do right by you guys, as best I can.

So that’s the latest.  As always, if you have concerns about this, please let me know.  I’m happy to answer any questions (but, just like before, my answer might be “Honestly, I have no idea.”).  And, just like before, if Nikon calls, I’m answering without hesitation. 

January 13, 2010

JDRF, Animas, and Dexcom Walk Into a Bar: Not a Diabetes Joke - An Artificial Pancreas.

Okay, so it's not a joke.  And it's not a bar.  But the JDRF, Animas, and DexCom have walked into a momumental agreement in efforts to create an artificial pancreas.

According to the press release, "The Juvenile Diabetes Research Foundation today announced an innovative partnership with Animas Corporation to develop an automated system to help people with type 1 diabetes better control their disease – the first step on the path to what would be among the most revolutionary advancements in treating type 1 diabetes: the development of an artificial pancreas, a fully automated system to dispense insulin to patients based on real-time changes in blood sugar levels."  

Alan Lewis, PhD, President and Chief Executive Officer of JDRF, is quoted in the release as saying, "JDRF will provide $8 million in funding over the next three years for this project, with a target of having a first-generation system ready for regulatory review within the next four or so years.” 

So what exactly would it mean to have an artificial pancreas?  More from the release:  “If successful, the development of this first-generation system would begin the process of automating how people with diabetes manage their blood sugar,” said Alan Lewis, PhD, President and Chief Executive Officer of JDRF.  'Ultimately, an artificial pancreas will deliver insulin as needed, minute-by-minute, throughout the day to maintain blood sugars within a target range.  But even this early system could bring dramatic changes in the quality of life for the 3 million people in the U.S. with type 1 diabetes, beginning to free kids and adults from testing, calculating and treating themselves throughout the day.'”  

Also, "DexCom, Inc., a leading manufacturer of CGM devices, will supply the CGM technology for the system to be developed by JDRF and Animas." 

I think this is a huge step forward for a new way of treating type 1 diabetes.  I've clocked over 204,360 hours with type 1 diabetes since my diagnosis over two decades ago, I've seen so many tremendous technological steps forward in treatment options for type 1.  Home glucose testing machines were "all the rage" when I was diagnosed, and there were only two or three insulin options for injection therapy.  Now, home meters are the norm, there are more insulin options and more insulin delivery options now than ever before, and continuous glucose monitors are part of my regular routine (versus before, if you had mentioned them to me as a kid, I would have thought you were from the moon). 

And now we're talking about an artificial pancreas?  A real one?  One that actually could be used in my lifetime, before I'm too old to care or too sick to benefit from it?  I believe this can happen, and I am so hopeful that these organizations and companies can make this a reality.

A cure is something I don't think much about.  It's something my heart has protectively hardened me against hoping for.  I know that reversing my body's inclination to attack its own islet cells could be a long time in coming.  What I do know is that I've been living with type 1 diabetes for almost my entire life, and I've battled hard to keep my body healthy and strong.  And now, I'm expecting a baby and have even more incentive to stay healthy for my child, so that I can be part of her life for a long, long time.  

If an artificial pancreas can help me minimize highs and lows in my blood sugars, that could help to protect my body from diabetes-related complications.  I could be safer.  My body could feel more "normal."  And my baby has a better chance of having me see her children born some day.

This press release has given me a reason to grin today.  And I'm excited to see how far these organizations can bring us all towards a better life with type 1 diabetes.

July 28, 2009

Charlie and the Twitter Factory.

I have a lot to catch up on, including a post about Lee Ann and I braving the Indiana highways and then the BlogHer conference, but let me just say this first:  I like Charlie Kimball.  I like him as a person, as a fellow diabetes advocate, and as a race car driver because, really, that is just damn cool.  So there's my big disclaimer:  I like Charlie.  (I even have a post ready to write about meeting up with him at Friends for Life a few weeks ago.)

So I do not like to see Charlie, the guy, under such attack for the @racewithinsulin Twitter account.  Plenty of bloggers are up in arms about the Novo/Kimball union and its steps into social media, like John Mack from the Pharma Marketing Blog.  I felt a little protective of my fellow PWD, which prompted me to do a little investigating.  I wanted to know how Novo, the company, feels about this whole Twitter/marketing/Pharma thing.

So I asked them.

Charlie Kimball and Kerri Sparling.  Dressed almost identically.  Weird.

Ambre Morley, Associate Director of Product Communications at Novo Nordisk and I met at the Friends for Life conference, and I told her that I was concerned about the backlash towards Charlie and the branded Twitter account.  "I have a ton of questions, and I know some of the PR people who are questioning the account might do well to hear the answers.  Like why the account doesn't follow anyone.  And what's the deal with those blatantly branded Tweets?"

She agreed to answer my questions.  And since Novo is the first I can think of to jump in with a pharma-branded Twitter account with a "real face," I wanted to hear the answers.  (Note:  All links to pages within the answers were added by me.)

Kerri:   Charlie is a valued member of the diabetes community, so I can understand why you guys chose to partner with him. But what made you decide to start a Twitter acct?  

Novo:  When we decided to partner with Charlie, we explored a number of different opportunities. He was already "tweeting" personally, however, when he asked about tweeting about our partnership, which includes the insulin he takes everyday, Levemir and NovoLog, we knew had to figure out a way to do it right. We didn't think it was right to ask him to put the prescribing information on his page and monitor every time he tweeted about diabetes. So we created a new account that we could ensure met all regulatory guidelines. Why Twitter? He was already doing it, so we wanted to create something that would easily fit into Charlie's lifestyle.
 
Kerri:  Why are Charlie's personal Tweets and his Levemir Tweets exactly the same?  
 
Novo:  It's important to understand that Charlie does all of the tweeting, both on his personal page and on the Novo Nordisk Race with Insulin page. It's up to him. They aren't always exactly the same, but where convenient and appropriate, he uses the same tweets, as it's probably easier to copy and paste. There are times when the tweets are different.
 
Kerri:  Does Charlie write the Levemir Tweets or is there an editorial vetting proces? Can you explain the thoughts behind the "branded" Tweets?  
 
Novo:  Charlie writes all of the tweets, including the Levemir and NovoLog branded tweets.  We provided him with instruction for how to tweet about the brands and comply with pharmaceutical regulations. So, anytime he tweets the words Levemir or NovoLog, a link to the product prescribing information has to be included.
 
The reason? Take a look at the page from your computer. You see the patient safety information on the left, along with a link to novonordiskcare.com on the right, which contains all of the prescribing and other important information. The challenge is, because the majority of Twitter users read and update their accounts from mobile devices, we knew most people would not see that information if Charlie wrote a tweet. That's why the prescribing information is there. It's required. It's similar to when a company does any stand-alone promotion of a product, that information has to be there.
 
More importantly, it's important to understand that the branded tweets aren't random. Charlie takes Levemir and NovoLog, so when he decides to tweet that he just took his insulin, he really just did. We don't believe a pharmaceutical company has tried to do branded tweets before, much less with a spokesperson who takes the insulin. But we're still learning and trying to figure it out. It's been a fun and definitely interesting time.  
 
Kerri:  Why doesn't the @racewithinsulin Twitter acct follow or reply to anyone? What kind of regulations must be in place for a Twitter acct of this kind?  
 
Novo:  While Charlie is the face of Race with Insulin, it is a corporate account for Novo Nordisk.  At this time, we aren't able to follow anyone, as pharmaceutical usage of social media is very regulated and we want to ensure we do it right. This is just the first phase and as we grow and learn, hopefully we will be able to follow people in the future. We are also open to suggestion.

After speaking to you, we took your advice and set up an e-mail address for the page. (Editor's Note:  I suggested that the account would seem a bit more accessible if they, at the very least, had some contact information.)  You should see an image update in the next week with the new address. But as I know you know, social media moves in real time and we haven't quite caught up to that speed in pharma. We're making baby steps but we're trying to stay in the race.
 
Kerri:  We know you guys are breaking new ground with this Twitter account, so what should we expect as part of your growing pains?  
 
Novo:  We're still learning. We want to do a lot, but we also understand that the pharmaceutical industry is the most heavily regulated in this country. We won't be able to do things as easily as say computer or food companies, but you have our commitment that we do plan to try to engage. Stay tuned.  
 
Kerri:  How has Novo felt about the blog backlash to @racewithinsulin, and how has Novo moved to protect themselves and Charlie?  
 
Novo:  If no one talks about what you do, you probably haven't made much of an impact. That said, it would be nice if the talk was all positive and more importantly, true. We encourage people to ask questions and give us an opportunity answer. We're pretty transparent about our challenges and open to discussion about any ideas to make it better. There were some false assumptions gaining traction, but that's also the nature of this business. You can never please everyone, but you can only hope that social media will adopt some of the principals [sic] of traditional journalism and report the facts, before making assumptions. We're working to move quicker to respond but also encouraging anyone to just ask. As for Charlie, he has been great. He's in a profession where he already has a lot of attention on him and is working with us to help make the page a success.

Kerri:  What do you want the Twitter community to understand about the aims of @racewithinsulin?
 
Novo:  We are very happy to be working with Charlie and wanted to reach as many people as possible. Twitter was an application that Charlie was already using and we wanted to find a way where he could continue to do so and incorporate our relationship.

It's still new and we're just getting started, but we hope to continue to find new, innovative ways to continue to reach everyone with his powerful message that diabetes does NOT slow him down!

*   *   *

I'm glad Novo went out on a limb and dove into the social media space, and I'm also glad that they agreed to answer my questions.  Thanks, Ambre!  What are your thoughts about Pharma in the social networking space?  Don't just say "Hey, they're doing it wrong!"  If you think it's so wrong, what would make it right? 

July 08, 2009

Diabetes ... is a Game?

The idea of creating a game about diabetes both intrigues me and creeps me out a little bit.  Diabetes is a game? I guess after an evening of "WHY 200?  WHY?!!" I'm not feeling so light and fluffy about diabetes.  But I see the potential for kids to learn about diabetes and its management through the use of games, so I'm all so for whatever gets good information out there.  And over the last few days, I've come across two particularly interesting games, thanks to reader alerts, aimed at kids who either have diabetes or have friends with diabetes.

The first game is on the Nobel Prize educational games site and it's cleverly called The Diabetic Dog game.  (Wee bit short on imagination once they got to the naming part, I suppose.)  I will admit - I played this game for at least 15 minutes and I appreciated the cuteness of the doggy. 

The Diabetic Dog Game

As a "caretaker," I was instructed to keep my diabetic doggy (named, in my profile, "DoggyPants") happy (by petting him), well-fed (by purchasing food for him), getting him to exercise (by walking him), and keeping his blood sugar in check by giving him insulin injections.  Keeping an eye on the bar at the bottom left of my screen let me know what DoggyPants's blood sugar was, and I could feed and dose him accordingly.

(Sidenote:  Having that bar gauge with his blood sugar in it sure helped me figure out what I was doing, and I wondered if the developers of this Diabetic Dog Game realized how they're helping further the case for continuous glucose monitors.) 

Overall, I liked how this game showed the importance of insulin, food choices, and exercise as the cornerstones for good diabetes management, and it didn't tout insulin as "a cure."  Basically, all you do is chase this little puppy around and feed him or dose him or walk him.  Constant cycle of redundancy, only the results aren't predictable.  Kind of like real life.  :)  

The other game I have been receiving reader alerts on is the Didget from Bayer.  I haven't seen this game in person, but according to the word on the street (read: their website), "The Didget blood glucose meter from Bayer is the only meter that plugs into a Nintendo DS or Nintendo DS Lite gaming system to reward children for consistent testing."  

The DIDGET.  IN ALL CAPS!

So it's an actual meter that snaps into the Nintendo system.  (It appears to be, or be completely identical to, the former "GlucoBoy" from a bit ago.)  Honestly, that is pretty darn cool, and I wish that kind of "fun" was available when I was testing my blood sugar as a kid.  Hell, I'd like to have that kind of positive reinforcement NOW, thank you very much.  

"This unique meter helps encourage consistent testing with reward points that children can use to buy items within the game and unlock new game levels. And, since the DIDGET meter is based on Bayer’s trusted CONTOUR™ system, you know you’re getting a meter that’s reliable." They are also building a community for kids to "hang out in" virtually, comparing notes.  Of course, since it's Bayer, they need to slide in their personal product endorsement, but they have the right idea.  Test often, get rewarded for keeping tabs on your numbers, and maybe Nick Jonas will show up at your house and give you a hug.

That last part?  A lie.  But Bayer is working its way into the hearts of kids with diabetes, and as a former kid with diabetes myself, I would have appreciated that kind of innovation as part of my childhood with this disease.  From what I can tell so far, this meter is being marketed towards diabetics in the UK, but hopefully there will be a United States counterpart.  With mg/dl readings.  Because doing conversions when low?  Not so easy.

So there you have it. We've come a long way from that game with the elephants or the other one about the Escape from Diab, and hopefully more efforts will be made to engage kids - and adults! - with diabetes.  Positive reinforcement is hard to come by in this whole diabetes mess, so every little bit helps.

June 11, 2009

An Open Letter to Brett Michaels.

Idiot.Dear Brett Michaels,

Really?  Really?  I'm going to hope that you were misquoted.  I'm going to hope that maybe the reporter took your comments out of context and made you sound like an idiot, instead of you actually saying the following:

"Brett Michaels:  The only time it [diabetes] will ever affect you in bed is if you have extremely low blood sugar and you go into insulin shock, at which point you won't be standing up, let alone performing sex. However, I will sometimes hold off on the insulin, which will jack my blood sugar level up to the low 200 range. It's like how a prizefighter will want to go into the ring with his blood sugar levels high. It gives you the stamina of a bull. So, yes, sometimes I will endanger my own life to pleasure a woman."

(source:  Huffington Post

You dumb shit.  Brett, going low during sex is a pain.  I know.  I've had to stop for snacks, and I've had to stop entirely.  I've had discomfort and the inability to perform due to high blood sugars, too.  I've had sex while connected to my insulin pump, and I've also had to find ways to feel comfortable with sharing my diabetes with sexual partners.

But you, saying that you purposely run high "like how a prizefighter will go into the ring?"  Gives you "the stamina of a bull," you say?  You don't sound cool - you sound like a toolshed.  I was under the impression that high blood sugars are among the main reasons for sexual complications for diabetic men.  Are you hearing me, Mr. Michaels?  If you run purposely high, your manhood runs the risk of malfunction.  And stamina of a bull?  Pffft.

High blood sugars aren't steroids.  They're toxic and cause lethargy.  They are dangerous for a diabetic.  They make your breath smell like airplane glue, and telling a reporter that running high makes you shag like a rock star is a bit of a misleading statement.  (Are sure you're rocking these women as passionately as you claim?)

Dude, you are in the public eye.  You are among the very few celebrities who are living with type 1 diabetes.  I'm not saying you have to be Johnny Advocate, but don't spread misinformation.  Don't encourage some young guy to skip his injection in pursuit of being good in bed.  You know as well as I do that good diabetes control is what leads to strength and stamina.

You know better.

Or maybe you don't.

Best,
Kerri.

May 26, 2009

Sotomayor and Diabetes Get All Media'd Out.

I can't pretend to have all the information on Judge Sotomayor and her Supreme Court appointment.  But I do know that my first day back here at work has been one email after the other about Sonia Sotomayor and the effects of her type 1 diabetes on her potential new gig. 

Total media deluge.  Here are some of the highlights:

  • Time Magazine provided an article that made me wonder if I'll make it to 40 years old, never mind to tomorrow, complete with heroin-esque photo to represent an "insulin injection."  They unfortunately paint diabetes as a disease that will rot you in a month's timeframe and leave nothing but your shoes.  (Hey Time, why don't you visit the Diabetes365 project to get a feel for what real diabetes photos look like?  Sorry for that digression but mainstream media needs to get their hands on some better, more accurate stock photography!)

  • The Wall Street Journal asks the question, "Should Sotomayor's diabetes be considered in the nominiation process?", citing the ADA's press release applauding Obama's selection.  Apparently, Sotomayor's weight is under attack as well as her diabetes status.  Are only the uber-healthy capable of just rulings?  The news, she is going berserk.

  • The Newsweek "Human Condition" blog comes right out and says not to worry about Sotomayor's diabetes, stating, "And while Sotomayor's condition may lead to complications that force her to retire after twenty years of hard work on the court, there's also the chance that if appointed, she could be hit by a bus on her second day and be forced to retire then."  (Morbid, but good point.)

  • The Huffington Post is in on the action, too, calling out a few Twitterers for running their 140 characters:  "Glenn Beck's Twitter - wondered if Obama, the 'messiah,' has healed Sotomayor's diabetes yet. Michelle Malkin proved that Twitter's 140 character cap isn't too strict to include both a vague sexist and racist remark."  And the Wonkette takes sarcasm and snark to a new level with their "Sotomayor has diabetes - good or bad?" column.

  • Yet this article from the New York Times doesn't even mention her diabetes at all.

  • Of course, this topic hasn't escaped us, the diabetes community, either.  Amy wrote about Judge Sotomayor last week, David posted on Diabetes Daily, the dLife Today blog has a piece, and TuDiabetes members are sharing their perspectives, too, like Jenny's post and Ann's discussion.  The JDRF also issued a statement regarding Sotomayor.  And I'm sure there are others who weigh in.

Holy media overload.  The Internet is exploding, it seems. 

I admittedly do not know much about Judge Sotomayor or her background other than what I've read over the last week or two about her potential appointment.  But I do know quite a bit about type 1 diabetes after 22 years with it.  And in my opinion, her diabetes shouldn't play a role in this consideration process - at all.

A "defective pancreas" does not mean a defective mind. 

May 01, 2009

The Friday Six: May Day!

I must thankfully admit - blood sugars have settled down a wee bit (thanks to a 150% basal rate increase that I'm not changing until I'm sure the cortisone is out of my system) and my wrist might be feeling a little better, so things are looking much sunnier in my corner of the Internet today.  About damn time. 

It's time for a little Friday Six action:

1.  Last night I had the opportunity to attend the JDRF Spring for a Cure event at the Metropolitan Pavillion in NYC.  I haven't been into the city in a few weeks, so it was kind of fun to ride the train in and get a little "aaaah" over Grand Central again.  I met up with Gina Capone and we spent a few hours checking out all the trappings, from cheesecake to white wine.  We ran into my former coworker Jon and his wife Lindsey, fellow blogger Allison Blass, and some of JDRF's finest.

Kerri and Aida - chilin'.

The JDRF knows how to throw an event, as the place was packed with people all passionate about diabetes research and a cure.  Including Soprano's star Aida Tuturro, who I spent some time talking to.  (She's a hot ticket!)  Aida has type 2 diabetes and was featured on dLifeTV a few seasons ago.   

2.  Also, best-selling author Brenda Novak is a friend of the diabetes community, thanks to her Novak’s 5th Annual Online Auction for Diabetes Research.  According to the press release, "The auction is held each May is a labor of love for her son who has lived with the disease for most of his life. It is also a month-long online event featuring lunches, dinners and one-on-one meetings with celebrity authors, world-class getaway vacations and state-of-the-art gizmos and gadgets."  And this year, my friends at the Diabetes Research Institute are the sole beneficiaries.  Pretty darn cool.  Visit the auction site and start bidding.  It all benefits a cure!

3.  Today is the last day to enter the Diabetes Mine 2009 Design Challenge, so if you're still thinking about entering to win $10,000, you'd better get cracking!   Submissions can be sent in until 11:59 Pacific time, so there's still time to enter. 

4.  The new issue of diaTribe is out with an all-new SUM Musings - complete with cameos from my mother and my brother talking about diabetes awareness for those who aren't diabetic themselves.  If you aren't a subscriber already to diaTribe, sign up.  Seriously.  I know I'm a columnist there and am very biased, but Kelly and Co. do a fantastic job andThe Friday Six:  May 1, 2009 edition I'm a proud supporter of their work.

5.  In a little plug for my office, the production team at dLifeTV is looking for a few good diabetes stories to potentially feature on the show.  Currently, they're seeking college students with diabetes, married couples dealing with diabetes in their relationship, and diabetics struggling with alcoholism.  Check out the call for submissions and see if we're looking for YOU.

6.  And in a little plug for yetis, I think I may have spied one from the train last night.  We were just about to pull into Harlem 125th when I looked down and saw a person sitting on a bench outside.  Wearing a full fur suit.  Like a real fur suit - no joke.  I am not unconvinced it wasn't a yeti.  Which leads me to SkyMall.  Which leads me to this video.  Then this one.  Which leads me into a brain tangent I wasn't prepared for. 

Holy digression.

I'm off to buy a yeti.  Or maybe just take a nap.  :)  Either way, have a good weekend!

March 25, 2009

Smiths Medical Pulls Out from Diabetes Market.

Farewell, Cozmo.Wow - this surprised me. 

The company that makes the Deltec Cozmo pump issued a statement today, saying that they are stopping the sale of their insulin pump.  According to the press release

“The continued health of the thousands of people who use the Deltec Cozmo® insulin pump is our primary concern, and they should be reassured that their pump remains an excellent choice to help them manage their diabetes,” said Srini Seshadri, president of Smiths Medical. “Our customers also should be reassured that Smiths Medical will meet all of its warranty obligations; provide customer and clinical support for the lifetime of the warranty of all pumps; ensure that Deltec Cozmo® insulin pump cartridges and Cleo® and Comfort® infusion sets are available; and make any necessary transitions as simple as possible.”

Why did they pull out? Looks like the pump "biggies" - Medtronic and Johnson & Johnson - have cornered the market share.  More from the release:

"In addition, as its only direct-to-consumer enterprise, the Diabetes business has little synergy with the rest of Smiths Medical’s businesses. For this reason, Diabetes requires its own extensive sales, marketing, reimbursement, insurance and clinical support infrastructure in the United States, which has resulted in it becoming uneconomical as sales and profits for the business have decreased. Without a strong, profitable Diabetes business in the United States, the world's largest medical market, it would also be impossible to sustain the business internationally.

Looks like the full transition out will take about four years, which corresponds to the warranty on new insulin pumps.  Cozmo pumpers, at that time, will need to chat up their medical team to get information on switching to a new insulin pump.  They have a whole website dedicated to answering questions, so if you need more information, check out the site.

Personally, I'm sad to see this happening.  I think having more pump manufacturers contributes to more innovation, offering diversity to insulin pumpers.  I'm a Medtronic pumper, but I considered the Cozmo back when I was shopping for a pump.  I hate seeing options removed from us.

Sorry to see you go, Cozmo.   

March 09, 2009

Diabetes + Stem Cell Research = Hope.

Go Bama!  Go Bama!Chris and I were talking the other day about something completely random, when he turns to me and says, "Oh, wait.  Did you hear that Obama is signing that bill to reverse the ban on stem cell research?"

"I did."  

"So?  Are you excited?"

And I thought about the last two decades.  How the veiled promise of "five more years and then ..." and still nothing. 

"I'm hopeful.  You know me, baby.  I'm almost always hopeful, but until it's actually real ..."

He gave me a grin.  "We just keep you healthy and hoping, right?  Well, this is a huge leap forward."

And today, we leapt as President Obama reversed the ban.

We'll keep hoping.  With the JDRF actively leading (and Tweeting!) the charge, and with diabetes on the national stage, progress could actually be made.  Not just a product redesign or another clever device, not just another type of insulin or another pill - real progress.   

I'd love to go from "type 1" to "type: cured." 

(I've been itching to use the past tense for a long time now.)

January 05, 2009

Dexcom Disclosure.

Dexcom is now a sponsor of SUM.I use a Dexcom CGM.  (This isn't new news, but bear with me.)  During the course of the last year, the folks at Dexcom took notice of my bloggish ramblings.  And thanks to my honest feedback (yes, I told them that their device is the most comfortable for me, but the adhesive still needs work) and their support of the diabetes community, they've decided to sponsor me here at Six Until Me and provide my Dexcom products gratis.

I am very, very proud to be part of this agreement, and I'm also very grateful.  Even though my sensors are now covered by insurance, copays and deductibles are still what they are, and I'm thankful for any financial assistance that can come my way during these tough economic times.

However, I wanted to let you guys know what the deal is because I don't want there to be any questions about my relationship with different companies.  Disclosure is the responsibility of the blogger, and I wanted you guys to know about this agreement as soon as the proverbial ink was dry on the contract.  To be clear, yes, Dexcom is giving me my sensors for free.  They are now a sponsor of this blog.  They are going to be placing an ad here in the coming weeks, and you also may see me in their ad campaigns.  And I am using their product.

But it's important to note that my decision to use their product did not stem from a sponsorship agreement.  As I've written before, I tested the CGM models that were made available to me and made my decision to move forward with Dexcom based on my actual user experience, and prior to any agreements between myself and the company.  During the course of drafting this sponsorship agreement, I spoke at length with many of the folks at Dexcom and they're well aware that everything I write about Dexcom won't always be favorable (nothing is completely awesome - these technologies are still in development across the board), but what I say about their product will always be honest.  And unedited.  (And hopefully spelled correctly.) This is the disclaimer that has been provided by the Dexcom legal team and is now living in the disclosure section of my site:

"DexCom is a sponsor of www.sixuntilme.com and provides DexCom products to Kerri.  All content is that of the author and not reviewed or approved by DexCom."

So I'll continue to discuss the pros and cons of Dexcom'ing, with honest feedback about its accuracy, the BEEEEEEP!s, how it makes me feel emotionally, the flipping adhesive problems, and the moments when it bails me out of a potentially difficult diabetes situation.  The one things I'm now biased on are the financial implications of using a CGM.  I will not be paying for my sensors during the course of this sponsorship, so when a sensor comes loose after just a day or when the accuracy is spazzing out, I can't properly convey that feeling of "Arghhhh, frigging expensive sensor waste!"  But I do know what it's like to use this device and to fight for its coverage.  And I also know what managing diabetes has been like for the past 22 years, so I'm no stranger to the expense of this disease.

There's my moment of disclosure.  If you have any questions about this, or concerns about anything, please let me know.  I'm doing my best to give a true and honest perspective to you guys, and I want to make sure everyone knows where I stand here at SUM.  I work for dLife.  I'm sponsored by Dexcom.  And, if given the option, I would sell my soul to Nikon for making such a stellar camera.  But I want to be honest with you guys and I also wanted to share this exciting (at least to me) news, so now you know.  :)

November 17, 2008

He Said "Cure."

I don't believe everything I hear, and I'm very, very skeptical when it comes to news sources touting the new "cure" for diabetes.  

But Brian Williams said there was a breakthrough in a cure for type 1 diabetes.  He specified type 1.  He said it was an autoimmune disease.  He said developments could be made within a year.

He said "cure."

I watched the video.  My thoughts started running absolutely wild, with hope boiling up in me like the soup on the stove.  It's already been over two decades, but there's still so much of my life left.  Will I spend any of my future without diabetes?

I got up quietly and went into the bathroom.  I shut the door and turned on the fan and ran the faucet and cried, hard.  I didn't want anyone to hear me.  I just wanted to be by myself and just take a minute to feel.  

The newswire article stated, "Two popular leukemia drugs, Gleevec and Sutent, kept lab mice from developing type 1 diabetes and put 80 percent of diabetic mice in remission, an international team said on Monday."  For those of you who are working with these two cancer drugs that can help us, Gleevec (made my Novartis) and Sutent (made by Pfizer), please keep working on this research.  To Dr. Arthur Weiss of University of California, San Francisco, we need you to help find a cure for this disease. 

He said "cure." 

I said it, too, just to see what it would be like.  And it tasted so beautiful, so bitter, so foreign in my mouth.

I feel hope.

World Diabetes Day in NYC.

Last Friday, on World Diabetes Day, I had the pleasure of spending the day with Fran Carpentier at the Young Voices event in NYC.   Discovery Health showcased the video submissions from people with diabetes and they had a talented panel of guest speakers and ambassadors, including Lee Fine from FiveHumans, the adorable Charlie Kimball of racing fame, and Miss Black USA Kalilah Allen-Harris

I had some great interviews with these folks that I'll be posting over the next few weeks, but in meantime, I wanted to share some photos from the event.

World Diabetes Day in NYC 

Former Mets player Todd Zeile, Fran Carpentier, Kerri Sparling, ESPN report Brian Kenny, and country star Steve Wariner 

Fran, Kerri, and Kalilah. 

Fran, me, and Kalilah Harris

Charlie Kimball and Kerri Sparling 

Charlie Kimball and me.  :) 

A big part of what was discussed at this event was the DAWN Youth Initiative, which is dedicated to improving the level and conditions of psychological support for kids and young adults with diabetes.  The DAWN Youth WebTalk survey was conducted in partnership with Novo Nordisk, the International Diabetes Federation (IDF) and the International Society for Pediatric and Adolescent Diabetes (ISPAD).  I had a chance to speak with Dr. Barbara Anderson, DAWN Youth Advisor (and a former part of my own personal diabetes care team at Joslin!) about diabetes, depression, and how we deal with diabetes.  "It's important to be in touch with other young people with diabetes," she said, and I thought of all of us here in the diabetes blogosphere.  Our interactions with one another are crucial to our diabetes management.  We keep one another sane!

World Diabetes Day was recognized across the world and the outpouring of support was tremendous.  Over 1,000 landmarks were lit in blue.  Those of us in the blogosphere wrote about our diabetes lives, created videos, and even expressed ourselves in song.  But there is still a lot of work to be done (check out the comments on my YouTube video for examples of miseducation and ignorance).  And every day, we all help to raise awareness in our own ways.

How did you celebrate World Diabetes Day?  Feel free to post your link in the comments section.  And with almost two weeks left in Diabetes Awareness Month, how will you close it out?  (Should I dye Siah blue?  Somehow, I think she'd find a way to thwart me.) 

(And, for the record, I wore a bright blue scarf on Friday to show my support.  But it was muggy as hell in the city, so the scarf ended up crumpled up in my purse instead of around my neck.  I tried, I swear!)

(One more post script:  Today is my brother's birthday, so wish him a happy one!) 

November 07, 2008

Listen to the diaBeat.

The Friday Six:  November 7, 2008 editionWell that title gets the prize for Worst Pun on the Planet.  It's Friday, I was up way too late last night trying to find a stupid purse, and I woke up this morning with Siah trying to faceplant into my collar bone.  Foolish Sausage ... but at least there's a Friday Six.

1.  ReliOn has issued a recall on some of their insulin syringes.  (Thanks to all of the readers who sent me a head's up on this one.)  According to the press release, ReliOn is "recalling one lot of ReliOn sterile, single-use, disposable, hypodermic syringes with permanently affixed hypodermic needles due to possible mislabeling. The use of these syringes may lead to patients receiving an overdose of as much as 2.5 times the intended dose, which may lead to hypoglycemia, serious health consequences, and even death."  Check the release to see if this development affects you.

2.  Last week, I wrote about the Hannah Montana and diabetes episode that the parents at CWD, and other folks as well, were fighting to have pulled by Disney.  And holy power of the diabetes community - it was pulled off the air!  Parents are pleased, some fans are disgruntled, and Miley Cyrus is now encouraging people to ... Drink Water, Not Sugar?  Not sure where she's going with this, but I'm curious to see.

3.  And because I haven't had a chance to mention it yet, I wanted to thank everyone who came out for the JDRF walk in RI on October 26th.  The day was absolutely gorgeous, and there were about 6,000 people at this year's walk in Roger Williams Park.  My mom, stepfather, brother, nephew, niece, sister- and brother-in-law, Chris's best friend, and my ever-supportive husband walked as part of Team Six Until Me.  I had a chance to meet a few RI readers, chat up some parents, and enjoy a nice lunch out joined by Chris's mother and grandmother.  Diabetes awareness has become a family affair, and I'm so honored and proud to have their support.

4.  This Sunday, November 9, marks the fourth annual D-Blogger Day.  The details are on Gina's Talkfest blog, but the general gist is this:  If you are a diabetes blogger, November 9th is the day we collectively come together and post about diabetes.  Sure, there are other things going on in our lives, and who wants to blog on a Sunday?  But D-Blogger day has been a tradition in this here blogosphere and I've been a proud participant for three years, so be sure to raise your voice on Sunday.

5.  And next Friday is World Diabetes Day - are you ready to mark the occasion?  There are events taking place all over the blogosphere and in the "real world," as well.  Will you dress in blue to show your spirit?  Will you blog about diabetes and educate others?  Are you helping to light a building in blue?  I'll be in NYC marking the day - where will you be?  Do you love questions?  Does it sound like I have upspeak?

6.  Wow, five very diabetes-centric things.  I think I need a little levity.  So I'll consult Le Sausweege.  I went to grab my work bag this morning and it turns out that Siah wanted to visit dLife.  She was sitting patiently in my bag, her little paws pressing the buttons on my cell phone.

Bring Siah to Work Day

Thanks, Sausage.  You aren't annoying at all.

Have a great weekend, and since it's NaBloPoMo all month long (ahhhhh!), I'll see you tomorrow.  And Sunday.  And all next week.  :)

October 22, 2008

Diabetes Goodie Bag.

Le Goodie Bag.  Le French.  Fronch?  Fronch fries.Over the past few weeks, I've received some terrific diabetes-related products and information from people out there who are aiming to make a difference.  Ranging from support groups to bracelets, it's time to help spread the word.  (Note:  I received all of these products as samples and have not paid for these items, nor have I been paid to talk about these items.)

This is a green dot.First off, some bracelets from Lauren's Hope came in the mail.  I had a bit of an addiction to beaded medical alert bracelets a few years ago, and this care package seems to have reignited my love for something diabetes-related and delicate.  The beaded samples were beautiful (pictures coming on Flickr later today) and there was also a very cool waterproof/adjustable/washable bracelet that would be great for active little kids ... or active grown ups.  :)  If you are looking for some medical alert jewelry options that are a little different and fun, check out Lauren's Hope.

This is a green dot.I also received a sample from Stephanie Cion at WellAlarm, and she was kind enough to answer a few questions about their unique service (interview will be posted later next week).  The charm itself is sleek and classy looking, and has a sophisticated look, considering it's intended for medical use.  There is a PIN on the back of the charm that, if someone called the number and punched in the code, they'd have access to my medical information. I think this is a unique service and has some potentially life-saving benefits, but I have to admit - the idea that dropping this charm on the ground leaves my information potentially vulnerable.   (Important note:  "regular medical information" can also be engraved on the charm, so it's not just a PIN code.)  WellAlarm has received some good press this morning already, being featured in this morning's HARO newsletter.  I'm curious to see where this product lines goes.

This is a green dot.Bob Hawkins sent me a copy of his terrific book, The Joy Of Diabetes.  I'm a huge fan of anything that helps to raise awareness for diabetes in a way that's easy for people to understand and identify with.  Bob writes about his 45+ years with type 1 diabetes in a way that isn't intimidating.  His little cartoon avatar explores everything from alcohol to exercise to aiming for the joy in life.  I definitely recommend his book, and you can order a copy from his website.

This is a green dot.And I heard from Katie, one of my readers in NYC, that she's starting a support group which is meeting fro the first time on November 18th at the Friendman Diabetes Institute.  According to the flyer, "This group is open to members of the public who are young women living with diabetes. There is no cost for participation. The group will be self-led however there will always be a staff member from Friedman Diabetes Institute available during the meetings. We are creating a place to talk with others about living with diabetes, particularly as young adult women. If you think this group is for you, it probably is. Please get in touch and let us know that you are interested and if you can make it to the first meeting."  For more details, check out this flyer and email Katie at DiabetesNYC [at] gmail [dot] com.

This is a green dot.One other thing, for all your vloggers out there: The JDRF, Discovery Health, and Novo Nordisk are calling for video submissions for their Young Voices: Life With Diabetes program. Videos are being accepted until November 1st, so get cracking!  The videos should be "highlighting your attitudes, wishes, and needs for how the next U.S. president can help defeat this disease."  Okay, easy enough.  The website states:  "For video submissions, Novo Nordisk will donate $10 to the Juvenile Diabetes Research Foundation to help fund research leading to a cure for type 1 diabetes. For teams, group entries, or multiple videos submitted by an individual, a single donation of $10 will be made. Novo Nordisk will make a total donation of up to $25,000."  For more information, visit the Young Voices website and raise your voice!  :)

That's all for the goodie bag today, aside from piles of tissue paper that Siah is already dancing around in.  

Oh, one last thing:  I bet I'm the last person on the whole damn internet to see this video clip, but have you caught the drunken Orsen Wells commercial?  The moment at 0:51 made me laugh so hard that I watched it several times over.  "MmWaaaHaaa ... the Frensh!"

October 14, 2008

Fran's Diabetes Parade.

A cup of coffee with a fellow diabetic.  :)There's that instant connection between people who have diabetes, because we really know.  We know what it's like to test blood sugars, count carbs, wrangle in pump tubing, battle numbers, fear complications, and live life with this disease every single day.  We get it, physically and emotionally.

And then there are the people with diabetes who you connect with, regardless of the disease bond.  When I heard Fran Carpentier take the microphone at the Women's Empowerment, Diabetes, and Development event (sponsored by Novo Nordisk, World Diabetes Foundation, the MDG3 Global Call to Action, and the Global Alliance for Women's Health), I knew this lady was on my wavelength.

"I didn't cry when I was diagnosed because my mother was too busy fainting," she said with a loud laugh, filling the room with her warmth and charismatic spirit.  Type 1 for over 39 years and a Senior Editor at Parade.com, Fran looks healthy, sounds healthy, and has a seemingly unbreakable spirit.  And she's passionate about diabetes.  Diagnosed in 1969 and "Patient No. 2" of the landmark DCCT trial, Fran stated confidently, "You not only survive, but you also prevail!"

After the speakers finished their presentations, I made my way over to Fran to introduce myself.  Instant connection - we started comparing diagnosis dates, insulin pumps (we're both Medtronic users these days), questions about CGMs, and talking about those moments that only another diabetic woman can understand. 

"So my pump is here," she reached into her shirt and pulled out her insulin pump.  

I laughed.  "Mine, too.  In the bra is the best place to hide it in a dress!"  

We sat at one of the tables in the conference room and chatted without effort.  Life as a diabetic, life as an editor, growing up in RI versus growing up in NYC, insurance battles (at that time, I was mid-stream in my war with Oxford for the CGM), and diabetes blogs.

"I've been a diabetes blogger since May 2005.  It's a fantastic way to connect with other diabetics, and to help me feel like I'm not the only one out there who is dealing with this."  I grinned at her.  "It's what connected me to dLife in the first place." 

"I know!  I've read your stuff!  I'm starting my own diabetes blog next month at Parade.com."

The conference ended, yet we found ourselves at a diner down the street, sharing stories over many cups of coffee (don't worry - we switched to decaf to prevent off-the-wallishness).  Diabetes brought us together and gave us "war stories" to share, and we spent several hours chatting each other up.  It was like connecting with an old friend, even though we'd never met before.  

I sat across from Fran, a powerful career woman with a laugh that caused heads to turn at the diner and with her pump casually hanging out of the front of her dress, and I saw what I hoped would be my future.  Thank you, Fran, for being someone I can relate to, respect, and hope to be just like.

Editor's Note (read:  more from Kerri):  Fran's blog is live!  Check out Diabetes, Day-By-Day over at Parade.com!

October 10, 2008

Vroooom!

The Friday Six:  October 10, 2008 editionToday has been condensed into just a few little hours of productivity.  But I had a few things I wanted to share.  (Six things, to be precise.)

1.  Is anyone out there going to the BlogHer Reach Out conference in Boston tomorrow?  I will be there, proudly attending my first BlogHer event and helping raise the visibility of patient bloggers.  If you're in Boston for the conference, please email me and let me know - I'd love to say hello in person.

2.  Speaking of blogger ladies, my friend Dr. Val (formerly of Revolution Health) has launched her new site:  Getting Better with Dr. Val.  The site has an accessible tone, a great look, and is definitely going to be one of my regular Internet stops.  Val also offers up some seriously funny medical-themed cartoons, which I'm so happy to see because I feel that humor is a HUGE part of disease management.  A little laughter goes a long way.  Be sure to check out Dr. Val's new site!

3.  Dates and times for another Fairfield County Dinner are being tossed around - any new takers?  Looking to do something in the first or second week of November.  Meet-ups are happening more and more around the blogosphere (check out Scott's Second Annual one!) and it's a great way to put a face and a voice with the blogger's we're reading.  Email me if you are available, and interested!

4.  Just a reminder:  Have you signed your name to the Google Doodle petition?  As of this morning, we have 3,097 signatures.  Let's see if we can crack 4,000 by the end of the day!  So coworkers, friends, family members, random people reading this blog, and cats across the world (use those paws and claws for good), sign it and raise your voice!

5.  In completely unrelated-to-diabetes stuff, this link (found on Twitter - imagine my shock) made me giggle.  Actually, it made me laugh out loud, so loud that I think I startled co-workers.  Nothing like the relationship battles between what appear to be overgrown Dots candies

6.  And in just a few hours, I'll be making the worst financial decision of the year and heading off to RI to pick up my new car.  (THANK GOD - the Jetta and I have not even been speaking for the last month.)  I'm excited and terrified, all at once.  And I know I'm going to be a lunatic about keeping it pristine because, well, it's part of my OCD charm.

Have a good weekend!!! 

October 03, 2008

Approved!!!

I have been approved!!!!!!!

YAY!!!!!!

They're covering my sensors.  I cannot believe it.  And from what I've been told, I'm one of the first on Connecticut's Oxford Health Plans to be approved for CGM use. 

Also from what I've been told, it takes an external appeal to make it happen.  So if you are fighting for CGM coverage, DO NOT GIVE UP.  Keep fighting!  Appeal every denial.  Make sure you don't miss any appeal deadlines!  It seems like insurance companies deny everything at first and only approve once you battle back.  So keep fighting, and do not give up!  (And use exclamation points!  Ahhh!  I'm so excited!!)

The tools to live well with diabetes should not just be for the people who can afford them.  Fight for your right for coverage.

October 02, 2008

A Unified Front.

United by diabetesTmana wrote a post on TuDiabetes today that hit home and hit hard. An excerpt:

"I am concerned that these different outlooks and interests could, rather than unite us in the common cause of improved quality of life and life expectancy for people with diabetes, cause public conflicts that could rob all of our communities of the resources needed to assist diabetics, both within our online communities and outside of them."

I agree with this whole-heartedly.  While I'm an in-house editor at dLife, a member of several online communities like TuDiabetes, Diabetes Daily, a diabetes blogger here at SUM, and an active supporter of organizations like the JDRF, ADA, CWD, and DRI, these things all come second to why I'm doing this in the first place:  I am a person with diabetes, a diabetic, a type 1, pancreatically-challenged ... whatever you want to call me, I have diabetes, first and foremost.

What I care about is improving my life, and our collective lives, as we live with diabetes.  I want to see support communities do just that - SUPPORT.  The very concept of different online groups pitting against one another is ridiculous.  Aren't we all working towards the same common goal?  To live long, healthy, and well-supported lives with diabetes?  To see technological improvements?  To see a cure, maybe in our lifetimes? 

Everyone has different agendas and different goals - I understand that.  But I also understand that diabetes is not a business to me.  It's my life - our lives.  And anything that can improve that life should be supported and encouraged, despite whether or not I'm a member or if I participate in a fundraising walk. 

And while I understand the business aspect of different companies and organizations, I don't like the idea of division.  I don't like the idea that three different places are working their tails off to cure this disease, but not sharing the data.  I am not sure who crosses what communication lines, but I want to know that the JDRF, DRI, and other research hubs are sharing their theories on curing this disease.  That is happening, right?  We're all working together to cure this, right?  There are so many different diabetes organizations, but where is our unified front? 

In her post, tmana said that she didn't want different communities to assimilate in efforts to "merely to present a united front to the high-priced resources and partners," and I agree with that completely.  This disease is unique to each diabetic and their loved ones, and the various communities and organizations reflect that.  But I want the diabetes communities to mature and embrace one another instead of ostracizing and battling.  It sounds altruistic, but we're not talking about t-shirts here.  This is about a disease, a serious one, that we live with every day.  And while we rally behind all these different organizations, we need to remember - never, ever forget this - that we are really rallying behind one another as a community of diabetics, regardless of whose newsletter we receive or whose network we have a username in.

The "industry" of diabetes continues to grow, especially as more and more people are diagnosed every day.  But we can't lose sight of the most important aspect of these communities and organizations:  Support.   And I value the support I get from you guys here on the blog, outside in your blogs, in-person at dinners and events, and all over the internet and the Real World as a whole.

We are all living with diabetes.  Standing together does far more than walking alone. 

September 25, 2008

When At First You Aren't Approved - Appeal, Appeal, Appeal.

There's a lot of buzz in the blogosphere today about insurance denials and appeals, starting with an article in the Wall Street Journal about "Pushing Back When Insurers Deny Coverage For Treatment."  Scott Strumello brought this article to my attention this morning via his comprehensive blog post about it, and Bernard sent me there again with his perspective.  And after reading everyone's take, in addition to having experienced three denials for CGM coverage from my insurance company (Oxford Health), I realize that I have gone at this problem the wrong way.

Insurance companies don't care about my future baby.  They don't care about my A1c.  Unfortunately, insurance companies are watching dollars and cents, not good sense.  A passionate letter from a patient doesn't even come close to moving an insurance company to provide coverage or overturn an appeal.  They seem to respond to "the facts" only, and I should have attacked them with facts to begin with.  Instead, I took the personal approach, which left me denied three times.  And it's partially my fault because I expect them to care, even when I know they won't.  My approach was arrogant, thinking they'd respond to actual emotion.

But this time?  No emotion at all.  This appeal was just the facts, ma'am.

I sent the Connecticut Department of Insurance a packet of information this morning, in hopes of having my Dexcom CGM system denial overturned.   I included the following:

  • Request for External Appeal form (my insurance information, healthcare provider information, detailed description of disagreement with healthcare plan)
  • The denial letter from Oxford Health Plans, stating that their decision is final
  • Proof that the service in question is a covered benefit (this was in the form of my insurance policy benefit handbook)
  • Executed medical release form
  • Photocopy of my insurance card
  • Documentation supporting my appeal, including a letter from me, my endocrinologist, and Dexcom
  • Oh, and a check for $25.  They specify that this is non-refundable. 
Insurance appeal packet - heavy.

Under the guidance of the Region Managed Care Director at Dexcom, the supporting documentation I included was very factual and devoid of almost any emotion.  My personal letter, which was written with the help of the Dexcom rep and is so stoic and so dry that it doesn't even sound close to anything I would say is supposedly an example of what "will work."  The letter from my endocrinologist cited my elevated A1c, the ADA A1c standard for pregnancy, the Factor V issue, 22 years of IDDM, and various complications I've experienced (including the cotton wool spot, high blood pressure, etc).

Dexcom also provided a packet, which included the recent NEJM study results and other studies supporting the use of CGM technology to better control diabetes.  The letter from my Dexcom rep included a demonstration of the proven benefits of CGM technology on health outcomes, and also outlined the appeal-denied-appeal-denied cycle that I've been in for the last few months.

So it's in the FedEx box now and waiting to be sent off to the Connecticut Department of Insurance.  Each item is tabbed and in the order requested by the appeal form.  It's on time, comprehensive, and fact-filled.  I hope this appeal gets my CGM approved.

The only frustrating part of this process was that I couldn't really lash out.  I couldn't tell these insurance companies what I was really thinking, which was along the lines of "WHAT THE FUCK IS WRONG WITH YOU?  CAN'T YOU SEE THAT THIS TECHNOLOGY WORKS AND I WANT A HEALTHY PREGNANCY AND WHO ARE YOU TO TELL ME I'M NOT APPROVED?!!"  (Ahem.  Sorry.)  It's infuriating to play by their rules, but I'll do whatever it takes to obtain approval.  It makes me absolutely crazy that this technology exists and it has worked for me and it's still not covered.  Don't insurance companies want people to remain healthy?  Isn't there a cost-benefit to them for acting proactively instead of reactively? What is wrong with this healthcare system?!

I'll wait patiently.  I'll hope that this fact-driven approach gets me somewhere.  And I'm very thankful for the assistance and support I've received from Dexcom, dLife, and my friends and family.

But I had to get my digs in somewhere - the memo line of the check is "ridiculous fee for appeal."  Jerkface insurance company.  They're messing with the wrong girl.

(I hope.) 

September 19, 2008

Arghhhh, Me Hearties.

The Friday Six:  September 19, 2008 edition

Holy late post, but better late than never, right, me hearties?  (Oh, this pirate crap will be the very death of me.)  Jumping right into this week's Friday Six!

1.  Yes, it's Talk Like a Pirate Day.  In celebration of this silliness, I offer you the Pirate Translator, some pirate jokes, and a Twitter avatar, courtesy of my extremely silly brother:  Kerri the pirate.

2.  The JDRF is still taking applications for the 2009 Children's Congress - but not for long!  The deadline for application is October 6, 2008, so if you and your child are interested in applying and representing the diabetes community before Congress, now is the time to apply.  Visit the JDRF website for more information.

3.  Another D-related event is the First Annual Diabetes Rockstar Cruise, brought to you by the folks at Diabetic Rockstar.  According to Sara, a SUM reader and a member of the Diabetic Rockstar crew, "The most exciting part about the cruise is that Carnival has a program called Cruising for Charity, where we will be receiving a portion of the proceeds for Fight It! our charity arm at Diabetic Rockstar.  Our funding goes to uninsured, in-need and newly diagnosed diabetics who need supplies and additional help."  Unfortunately, I won't be attending this event, but if you're interested in learning more about this cruise, taking place next May, visit the Diabetic Rockstar website

4.  And in my own personal diabetes news, I've been embroiled in the battle with Oxford Health of Connecticut for CGM coverage.  Fun.  (Sarcasm.)  I have a solid insurance representative at Dexcom who is helping me get all the paperwork together for my external appeal - yes, this is the one I have to send them a CHECK for, greedy bastards - and I'm working with my endocrinologist on a letter highlighting pre-pregnancy planning and the need for tighter diabetes control.  This is a paperwork nightmare, and now I understand why lots of people never get to this stage of the appeal, because it's so damn complicated.  BUT I am moving forward and will file this external appeal by the end of next week.  Hopefully this will overturn my previous three denials.  In any event, I'm almost positive they won't refund the $25 filing fee.  Pricks.  ;) 

5.  On the Children With Diabetes site, there's a short video about Friends For Life 2008, and you'll find a smattering of diabetes bloggers in there, including Sara, Heidi, Bennet, and me!  (And I look seeeeerious, since they caught me in the pregnancy seminar and I was all panicked ears.)  Check out the video!

6.  And I'm still woefully behind on vlogging, but I'm hoping to get a clip up here by Monday or Tuesday.  Next week is pretty nuts - I have plans for dinner in the city, I'll be at a seminar at the UN midweek, and I'm gearing up the dLife crew for our JDRF walk next weekend - but I need a little face-time.  I'm sort of short on vlog topics - any ideas from you guys?  For now, all I have is this sort of crummy quality clip from The Swell Season show on Wednesday.  I have another one, of one of their new songs, that I can post this weekend after I pull it from my KerriBerry

For now, I'm off to RI for yet ANOTHER wedding this weekend (btw, Chris and I have been married for four months as of yesterday - holy cow!) and to spend time with the family.  You guys have a great weekend!!!

September 08, 2008

CGM Study Shows This Stuff Works!!!

My insurance company still says NO to my request for approval of a continuous glucose monitoring system.  But - a ha! - a study conducted by the JDRF has given me something to print out and mail along with my third appeal.  Thanks to several dozen emails this morning directing me to the study and special thanks to Cynthia Rice, Director of New Technology Access in Washington, DC, I now have the inside scoop on why insurance companies should listen up and listen good:

Kerri:  This study quantifies the value of a continuous glucose monitoring device for people with type 1 diabetes, in particular, for adults aged 25 and over.  How did individuals over the age of 25 fare using this device?

Cynthia:  The study found patients with type 1 diabetes who used continuous glucose monitoring (CGM) devices to help manage their disease experienced significant improvements in blood sugar control. Overall, adults 25 and over lowered their A1c by .53%; were more likely to lower their A1c by 10%; and were more likely to reach target below 7.0.

Kerri:  In regards to the younger group, the kids under 15, how were their results similar or different?

Cynthia:  Children under age 15 using CGM were more likely to lower their HbA1c by at least 10% and achieve HbA1c levels below 7% compared with non-CGM users.  At the same time, the average decrease in HbA1c was not significantly different in the CGM and non-CGM groups.  Although the study was not specifically designed to assess the effect of frequency of CGM use on A1c, an initial analysis of the data suggests that patients under 15 who used CGM at least six days a week or more lowered their A1cs just as much as adults.  On average, only 50% of children under 15 who used CGM used it six days a week or more.

Kerri:  What is the assumption about the 15 - 24 age group?  Why didn't the use of a CGM make a bigger impact on their A1c values?

Cynthia: 
Fifteen to twenty-four-year-old CGM users as a group did not experience significant improvements in glucose control compared with the control group.  Although it’s clear from a preliminary analysis of the data that teenagers were the least likely group to wear the CGM near daily (30%), the study was not geared to answer this question -- however, many families with teenagers will not be terribly surprised with the result.

Kerri:  At a session at CWD in Orlando this year, Bruce Buckingham discussed how CGMs work best for people who wear them at least six days a week.  Your study appeared to confirm this statement, at least for the 25 and older group.  How does duration of use affect results?

Cynthia:  In the study, CGM use varied with age, averaging at least six days a week over the course of the trial in 83% of the patients 25 years and older, but dropping off to 30% of the 15 to 24 year olds and 50% of the 8 to 14 year olds. Although the study was not specifically designed to assess the effect of frequency of CGM use on HbA1c, an analysis presented this week at a scientific conference suggested that patients within all three age groups, including teens and young adults, who used the device at least six days a week had substantially lower HbA1c levels after six months compared with patients who used CGM less than six days a week.

Kerri:  Many people with diabetes are fighting with their insurance companies to get their CGM systems approved.  How can this study help move patients towards approval?

Cynthia:  By showing that CGM use improves glucose control, this study, published in the prestigious, peer-reviewed New England Journal of Medicine, gives justification for expanded health plan coverage of CGM.  JDRF will be briefing health plans on these results and encouraging people with type 1 diabetes and their loved ones advocate to their own health plans to cover CGM.  You can help secure coverage for CGM by clicking here.

Kerri:  And lastly, how can we, as the diabetes community, get more involved and help move research forward?

Cynthia:  When you click on this link, you can not only help secure coverage for CGM, but sign up to receive emails from JDRF on how you can advocate for federal research funding and get involved in your local community to help move research forward.  

I am Kerri and I approve this CGM.  I wish you would, too!

Thanks for your time, Cynthia!  And for more information on CGM insurance coverage, you can visit the JDRF website, sign the CGM Anti-Denial Petition, and check for more CGM updates here on SUM.

August 27, 2008

You Gotta Fight ... For Your Site.

I am pretty crap with site rotations.  This is a fact, evidenced by the same pad of callous on my fingertips from testing and the smudge of dots on my thighs from infusion sets.  Back when I was taking injections, I favored my arms for a few years, then my stomach, then my legs, building up layers of scartissue and absorption issues with every prick.

I know site rotation is important, but it's never been my strong point.  Until I'm forced to do it.  Change is something I'm reluctant to make sometimes, especially when it comes to managing pain.  I have to be honest - most of the time I prefer using the same site locations because they sting less.  I test on the tips of my fingers because those nerves aren't as responsive and the lancet doesn't sting, for the most part.  Same for my thighs - the infusion sets don't sting as much when they are nested in an already-broken in area.  

But those wild highs forced me to change my stubborn ways.  (Yes, wicked stubborn.  Ask Chris.  Or my mom.  Or ... anyone, I guess.)  And now, after over two weeks of using expanded body real estate, my numbers are faring a bit better.  I'm seeing much better absorption using lower back sites and even though the infusion sets sting like hell for a few minutes after going in, my postprandials are more in range.  I feel like a bit of a stooge for being so stubborn and letting a little sting or a smidge of fear keep me from taking control of this crap. 

This has nothing to do with being stubborn, but I liked the photo.

Ruts - I get in them.  I'll do the same thing, every day, expecting something to change.  And I get all moody when it doesn't.  I frustrate myself because I let complacency or comfort or sometimes fear keep me from making even the tiniest of changes.  I'm now accustomed to having my infusion set on my lower back and I feel comfortable using it.  And my body seems to be enjoying the change, too, because my thighs are starting to heal up and the speckled red dots of old sets are disappearing (helped along by some high octane moisturizers, exfoliation, and some good old fashioned neosporin). 

It's not all awesome, though.  With this new site location on my lower back, the tubing is a bit more exposed and I've found myself forgetting to tuck it back into the waist of my skirt.  It's also less-than-cozy on the first site night, because I sleep on my back and I can feel the infusion set.  But these discomforts are worth it when I'm seeing my blood sugar at 147 mg/dl an hour and a half after lunch.  I'll freaking take that. 

Stubborn Kerri ... she needs to shake things up now and again!  (Only in first person, not in third person.  Third person is not as effective.)

August 01, 2008

Flaking Out Friday Six.

The Friday Six:  August 1, 2008 editionWhirlwind doesn't even begin to describe the last two weeks, but I'm trying to recap bit by teeny bit.  From adventures with web-camming (There you go, Google. Just for you.) to Manny Ramirez being traded, it's time for The Friday Six.

1.  A few months ago, I mentioned a Fairfield County D-Dinner meet-up, and several people emailed.  Then, because I am hopelessly disorganized and was in the middle of planning my wedding, I lost track of planning that event.  I'm very sorry, and still hopelessly disorganized.  :)  But I'm trying to set it up again, and am looking at having the dinner sometime in late August or early September.  If you are still interested, would you please drop me (another) line at kerri at sixuntilme dot com?  If it's okay with the potential attendees, I can create an email list so we can figure out the details via email.  Thanks!

2.  Also, adding a little Canadian flair to the diabetes-theme, have you heard of Team Diabetes?  Skip off to Orlando this coming January and join Buzz Bishop and the 95 Crave Team Diabetes Crew to raise funds and awareness for the Canadian Diabetes Association.  For more information, check out the Canadian Diabetes Association and throw some support to our neighbors to the north.

3.  I'm very eh about this:  Manny Rameriz?  To the Dodgers?  Granted, he's one of the best ballplayers on paper, but boy is he a "wicked pissah" (thanks, Julia).  For the real-deal details, without even a smidge of bias, check out Boston Dirt Dogs.  (And keeping with the Boston news, do you want to see what your site looks like written in the ol' Boston accent?  Here's how SUM readsDo yours!  Valley Girl may make you laugh out loud for real.)

4.  Total side note:  On my way to lunch, I heard "Crazy In Love" on the radio.  As I was leaving lunch, I heard "Ring The Alarm."  I love Beyonce.  She is my musical guilty pleasure.  Please share yours, so I'm not forced to have my face burning in shame all alone.  I also like Yanni.  Help!!!

5.  In some TuDiabetes news, there's a new video about seeing diabetes through the eyes of children.  As a former child with diabetes (now a pseudo-adult with diabetes), this video helps me remember how I saw diabetes, and how I saw myself as a result, when I was small.  Click here to watch the video on YouTube, and click here to get involved with the inititative

6.  Lastly, because I bought a webcam and have nothing but time on my hands (What? Lies, Kerri - lies!), I'm debating starting to vlog (video blog) here on SUM.  Only - here's the problem - I have no CLUE what to talk about.  I'm much more the wordsmithy-type than the talk-to-the-camera type.  But I love meeting other diabetics and am always so surprised when I hear their voices or see their faces.  Words are just one dimension to our personalities - the way someone sounds or the way they laugh really tells you alot.  I'm curious to hear what you guys would be interested in (or should I just give the camera to Siah and let her do her thing?).  In any event, forgive me for talking too fast, moving too much, and using lions for my own personal gain.  (The password is "sixuntilme")

Chris and I are excited to host Batman and her boyfriend this weekend - yay for friends who will drive all the way out here! - so have a good weekend and I'll see you Monday!  :)
 

SUM Tags: , , , , ,

July 31, 2008

CWD: Lancet Devices.

At the CWD conference, there was a big ol' expo going on while the focus groups were taking place.  Every company from Omnipod to Dex4 to my friends at diaTribe were interacting with the CWD Friends for Life attendees. 

Before the expo, I was talking with Sara about lancing devices.  (My life is a thrill a minute, no?)  She swears by the Muliticlix, while I had never used one before.

"You NEVER have?  We need to fix that."   

So when the expo opened that morning, we went off to find the folks at Accu-Chek, so I could try out one of their Multiclixes.  (Multiclixes?  Multiclixi?  How do you make that one plural?)  After a demonstration, some questions, and wrangling them to hand over a demo device, I also checked out the Renew booth and convinced them to hand over a sample, too.

So now that the dust has settled from CWD, I finally had a minute to try out these devices.  

First, the Renew.  I'll admit it:  It looked like a spaceship, so I was intrigued.  I liked the color choices (mine is the old lime green one they first marketed, but they have a whole new selection of colors now) and it's reasonably small.  However, I needed to read the manual before I could get the cartridge in there.  I'm not sure if it was the lack of coffee in my system or my overblown KerriBerry technojoy, but I couldn't figure out how to unhinge the thing to get the lancing cartridge in there.

Kerri and the Renew

The manual was clear, thankfully, so within a few seconds, I had the cartridge loaded up and ready to roll.  Thanks to decades of diabetes and an unquenchable desire to prick the center of my fingers instead of the sides, I have some serious calluses to work through.  I used the "3" setting at first, but that barely made a dent and produced the teeniest drop of blood ever.  Cranking it up to the "4" setting procured a good drop. 

The device is less painful (admittedly) than the One Touch lancing device I used every day, but here's the big drawback:  every new test uses a new lancet.  Yes, this is best for finger health and to avoid infection, but it's also a big, fat waste of a lancet if you aren't able to draw blood with the first prick.  Testing my blood sugar once used two lancets, and there are only 20 in the cartridge.  I'm hoping that a future generation of this product allows lancet reuse (for us old-timers who only change lancets with our clocks). And I'm also hoping that the future generation is a little smaller because while I was intrigued by the round design, it doesn't fit neatly into any of my factory meter cases.

Kerri tried out the Multiclix, too.

I also tried out the Muliticlix and Sara is right:  this thing is pretty pain-free.  The woman at the Accu-Chek booth was telling us about the patented technology they have for their devices, keeping the lancet on a track so it doesn't spiral into your finger and rip up your skin any more than necessary.  I've used it a few times already in the last day or two and the results have been pretty good.  Once I figured out how to insert the drum (I'm fumbly-clumsy these days, and it took me a few seconds to load this one, too), it was all systems go.  The shape of this device is the familiar cylindrical one, and it fits into my meter case.

Pros for this device are that you can reuse the same lancet as many times as you'd like.  Economical, in my eyes, because I'm not wasting lancets.  It also, as I said before, fits in my meter case, which makes it easier to integrate into my current routine.  The cons on the Multiclix are that the depth settings just aren't deep enough for a veteran tester like me.  On one of my least-calloused fingers, I'm using the "4" setting.  Maybe with continued use, the calluses would ease up a bit, but from my perspective now, it would be good if the settings went up another notch.  Or two.  ;)

Have you guys used any of these devices?  What was your experience - good or bad?  

(And I'm also waiting for my Pelikan Sun device to be mailed to me - more on that once it arrives!)


SUM Tags: , , , , ,

July 29, 2008

CWD Meets CGM.

"The problems are that they aren't accurate all the time and they don't replace fingersticks."  She adjusted her shirt collar.  "It's tough for insurance companies to get on board with that."

It's no surprise that I attended every CGM focus group offered at CWD.  From discussions about government viewpoints with Arleen Pinkus of the FDA to debates about accuracy with Dr. Bruce Buckingham, I was tuned in and looking for ammo against my insurance company's repeated denials.  (Acknowledgment of my second appeal arrived in the mail while I was away.) 

When the group (which included Manny, Sara, and the man himself - Bennet) asked about insurance coverage, the FDA lady told us that there just wasn't enough data from the Medicare crowd.  

"So you're telling us that we just need to slap a few sensors on some 65 plus diabetics and that will help turn the tide?" I asked.

She actually said, "Yes.  That would do it."

Fight for your right to monitor!

Fortunately, the CGM session with Bruce Buckingham was far more informative and armed me with enough information for my third appeal letter.  He was a warm and soft-spoken man who lead a 90 minute session about CGMs and how they can benefit the life of someone with diabetes. 

"When I worked at the diabetes camps, they called me a pancreas, because my pancreas worked," he quipped to us, talking about the history of diabetes and explaining how physicians used to taste the urine of their patients to make a diagnosis.  "The first pump was in 1978.  The first common place meter was in 1980.  I know - the pump was before the meter!"  

Dr. Buckingham talked about how CGMs don't measure blood glucose, but instead measure the interstitial fluid.  He told us that it takes about six minutes for the blood glucose to affect the interstitial fluid measurements, which helps explain how CGMs and glucose meters don't always match up with precision.  He cited that the delay is more realistically a full eight minutes.

There was a lot of discussion about accuracy.  From my almost 22 years of experience with type 1 diabetes, I'm convinced that every mg/dl result is a concrete one.  It's been a tough mental hurdle, leaping from snapshots to trending.  But Dr. Buckingham confirmed yet again that a CGM is a trending, and not a treatment, device.  Any CGM result should be confirmed on a glucose meter before treating with food or insulin. 

Another point he touched upon was that of sensor calibration.  I test upwards of 15 times per day, so I was inclined to calibrate my sensor whenever I tested my blood sugar.  "Calibrating when unsteady can cause the sensor to be biased," Dr. Buckingham said.  If I test and my numbers are rapidly rising, I'm calibrating my sensor on the climb.  That's going to throw off the accuracy for sure.  Calibrating when steady (or at least steady-ish ... diabetes is never completely precise) helps retain the integrity of the sensor.  But there is always a lag time with subcutaneous sensors, i.e. recovery from a low blood sugar may not be apparent on a sensor in a timely fashion.

All these technical details were well and good, but I wanted information on what made someone a good candidate for a CGM (particularly in the eyes of insurance companies).  Dr. Buckingham provided a list of possible candidates:

  • patients at a high A1c
  • patients with a fear of hypoglycemia
  • hypoglycemic unawareness
  • pregnancy/preconception
  • gastroparesis
  • athletes
  • patients on medications like pramlintide (Symlin) and exenatide
  • patients who may wear the sensor intermittently to better understand their own diabetes

I saw myself on that list several times.  Dr. Buckingham told the group about how a CGM can provide fantastic feedback that can really affect diabetes management decisions.  He said that the immediacy of the feedback helps identify causality, meaning that we could see how different foods affect blood glucose levels, and that the data can be use to prevent or detect earlier extremes in glucose levels. 

He did have some warnings, though.  He warned about over-calibrating (as discussed before).  He also warned against insulin stacking (taking small bolus after small bolus in efforts to correct highs). He also acknowledged that some of the alarms weren't effective, and that many PWDs slept through them.  One tip he offered was to keep the CGM receiver in a glass on the bedside table, so that when it vibrates, the rattle in the glass helps wake you up.

"It doesn't work unless you wear it," he offered, adding that the sensor is a behavior modification tool and if you aren't ready to accept diabetes, you may not be ready to wear an extra device.  According to Dr. Buckingham, a CGM can make someone feel vulnerable and defensive, with every number out there on display.   

But then he said this:  "A CGM can help you achieve a better A1C without increasing hypoglycemia."  I thought about the lack of lows I've had in the past few months, and I was happy to not be crashing and burning in the middle of the night.  But an elevated A1C also came along without those lows to tip the curve.  I'm so hopeful that a CGM will help me gain better control of my diabetes without tossing my numbers down the well every few days.  

I thought about how Chris said he feels safer when I wear it.  My mom said the same thing.  And I agree.

Come on, Insurance Companies.  Get on board!!

Editor's Note:  Do you want to join the fight for CGM coverage?  Sign the CGM Denial Petition and Raise Your Voice!! Also, Dr. Bruce Buckingham is leading a chat about Continuous Glucose Monitors on DiabetesTalkFest tonight.  Log in at 9 pm EST!

SUM Tags: , , , , , ,

June 27, 2008

Jeff Vader Runs the Death Star?

The Friday Six:  June 27, 2008 editionIt's hazy.  Hot.  Humid.  Perfect weather for a snitt fart.  Or the Friday Six.

1.  Yesterday, I received my copy of Laurie Edwards' book "Life Disrupted: Getting Real About Chronic Illness in Your Twenties and Thirties."  I'm honored to have been a part of this project as one of the five people with chronic illness that she interviewed.  If you are living with chronic illness, or if you care about someone who is, this book should be on your bedside table. 

2.  So what are you up to on July 12th?  If you're a diabetes blogger and in the New England area, you should meet-up with Bernard and others at the first New England Bloggers Meet-up.  I'm trying my best to be there that weekend, but I know there will be plenty of PWDs peddling around.  Check out the events page at TuDiabetes for more events in your area!

3.  Also, July 1 has been dubbed CGMS Denial Day.  Have you been battling with your insurance companies for continuous glucose monitoring coverage?  I've been writing about my experiences with Dexcom and insurance coverage here on SUM, and I'm definitely not the only diabetic who is trying to gain coverage.  Should insurance companies be covering these CGMs?  Should the manufacturers be charging less for their product?  Share your thoughts on your blog next Tuesday!

4.  With the CWD conference coming up quickly (I am so excited to be attending this year!), it's time to brush up on your Disney with diabetes skills.  Thankfully, Bennet of YDMV has written a terrific tip sheet that's published on dLife.  Check it out - and also find out about how he cooked insulin in a fridge.  (Yes, really.) 

5.  In non-diabetes stuff, we're still doing wedding wrap-up.  This week has been busy - and FAST.  We've just heard from our photographer who won't have our photo disc and album to us until August.  ARGH.  In this digital, instant-info age, that time frame infuriates me.  But in better news, our thank you cards/emails are almost completed, but we received several gifts without cards.  If you sent something to my office and I haven't sent you a card or an email, PLEASE email me!  I want to thank everyone for their tremendous generosity and kindness - you are such an amazingly giving and wonderful community and Chris and I are so grateful for all of your well-wishes.  I want to properly thank everyone who thought of us!  (Especially whoever sent the cat wine topper thing.  I freaking love it and haven't been able to track down who sent it!) 

6.  And this weekend is going to be awesome, for several reasons.  First, we aren't going to be schlepping back to RI and spending hours on end in traffic.  (Boo on not seeing friends and family, but holy YAY for relaxing!)  We're off to see Wall-E tonight - because I am a five year old - and tomorrow night we're going to see Eddie Izzard at Radio City Music Hall.  I.  Cannot.  Wait.  We ordered these tickets MONTHS ago and I've been looking forward to it since.  I have loved Mr. Izzard for quite some time now and am thrilled at the opportunity see him perform - at Radio City, no less!!!

Monday, Monday, Monday ... I'll see you then.  :) 

June 06, 2008

Scampering Paws Friday Six.

The Friday Six:  June 6, 2008 editionThere has been so much work going on this week that we're all in meltdown mode on a Friday afternoon.  Columns are being edited, podcasts are being uploaded, and deadlines are being met.  But there's an air of Friday meltdown in the office, which includes outbursts of laughter, iced coffee, and fun.  Time for a post-wedding Friday Six!

1.  There is a dog here in the office today.  Usually, this dog is extremely chill and very well-mannered.  But for some reason, today Lucy the Dog is training for a marathon.  She's been racing up and down the hallways, occassionally munching on a squeaky toy.  So every few minutes, you hear the frantic scampering of doggy feet, accompanied by squeeeeeeeak squeeeak squeaky. This is what it sounds like in my brain when things get very hectic.  Strange to see it and hear it happening in real life.

2.  We spent a lot of time last night loading up the honeymoon pictures to Flickr.  There are some fun shots of Chris and I horseback riding on the beach, dining on the beach, and enjoying the evening scenery.  We're proofing our wedding album and hoping to receive our photo disk from the photographer next week, so wedding day photos are coming soon.

3.  I received an email from Austin Cooper last night, asking for a mention of his medical ID site, Evasion ID.  He created these bracelets as medical alert jewelry that PWDs would actually want to wear.  Check out his creations - they are pretty cool.  And 10% of all purchases goes towards the JDRF, so there's a little charity involved in this venture as well.

4.  Also, Tandem Diabetes Care in San Diego, CA is launching a new insulin pump soon.  They're also sporting a new, yet almost completely empty, website.  I received an email from their team yesterday, looking to gain some traction in the blogosphere.  I asked them for some information on the product but they didn't have any they were willing to share.  Hmmm ... would've been better to have some product details instead of a "coming soon" website, but hopefully they'll have something to show us in the near future.

5.  Back in the world of diabetes social networking, Lindsey Guerin of dLife's Blogabetes has started her own diaebtes network on Ning - Diabetic Echoes.   According to the site, "Echoes wants to provide an international place for every diabetic to get information, support and ideas. We hope to provide new treatments, physician's information, emotional support and a global community to you."  Will another new network survive?  Only time will tell. 

6.  And Nick over at Diabetes360 is looking for a new name for his insulin pump.  As he is Waldo's godfather (oh just typing that sounds ridiculously silly, as the dog scampers by with the squeaky toy in her mouth one more time), I have a vested interest in the moniker assigned to Nick's pump.  If you're feeling a bit silly this afternoon, offer up some suggestions for Nick. 

This weekend will be filled with thank you notes, a visit to a few local arts fairs, and maybe a trip to the beach.  It's supposed to be 90+ degrees in western CT this weekend, with enough humidity to make Siah as flat and listless as a kitty pancake.  Stay cool this weekend, and for my friends and co-workers at ADA's 68th Scientific Sessions in San Francisco, have fun!! 

May 08, 2008

Pumps Are Good, M'Kay?

Pumps are good, m'kay?The Associated Press has issued an article about the safety of insulin pumps, claiming that deaths have been linked to insulin pump use.  What's that phrase again?  If it bleeds, it leads?  Our own Scott Strumello, research blogger extraordinaire, has provided a very fine synopsis of the article - you should definitely take a read.  I was contacted by Steve Sabicer, a representative at MiniMed, and had the opportunity to get a little feedback from their camp. 

How does Medtronic respond to the claim that "insulin pumps can be risky and have been linked to injuries and even deaths"?

Medtronic stands behind the many years of clinical evidence that support the benefits of insulin pump therapy in patients of all ages

  • Insulin pump therapy is proven to improve patient outcomes versus multiple daily injections (MDI) with long-acting insulin (glargine).
  • Insulin pump therapy has shown strong results in pediatric patients as young as one year old.
  • Insulin pump use in children and adolescents may be associated with improved glycemic control and improved quality of life, and poses no greater, and possibly less, risk than MDI.
Do you feel that this article could keep doctors and insurance companies from approving the use of insulin pump?

We don't think this will significantly impact physician or insurance company practices moving forward.  The clinical data in support of insulin pumps is very strong.  In fact, Medtronic has noticed that many physicians have proactively come out in support of the therapy in response to this article. That said, we anticipate patients may be concerned because of the lack of context provided by the AP story. Medtronic encourages every patient to speak with their physician before making any decision about insulin pump therapy.

It's important to note that the article conceded that insulin pump therapy is beneficial for adolescents. They only suggested vigilant training and attention by parents and physicians. Medtronic encourages significant parental/physician involvement and we have designed a robust product training protocol to ensure our patients receive optimal instruction on the use and functionality of their insulin pump therapy.

  • We have more than 3,000 certified product trainers
  • Comprehensive online tools (Pump School Online, web-based training modules) for general diabetes information and product specific training
  • Paradigm REAL-Time CD-Rom product training
  • Code and PIE classes

How is Medtronic planning to address this issue with the media?

Medtronic is available for comment and interview to any journalist, and we also encourage them to contact pediatric endocrinologists and patients who have experience with insulin pump therapy.

What can pump users do to show insurance companies and doctors alike that insulin pump therapy should be available to any insulin-dependant diabetic?

As I said before, we don't believe this story will significantly impact physicians or insurers regarding insulin pump therapy. The clinical data in support of insulin pumps is strong.  That said, if patients are having difficulty getting coverage for their insulin pump, they can visit our website for claims information and helpful tools to demonstrate the case of their therapy.

(End of interview)

I've made no secret that I'm a fan of Medtronic's insulin pump line and that I believe pumping insulin has been one of the best decisions I've made for my diabetes management. What makes me craziest about this article is this line:  "There were two possible suicide attempts by teens who gave themselves too much insulin, according to the analysis."  This statement makes it seem like an insulin pump holds a substance far more dangerous than what I injected for over 17 years.  Point is, pumps are not for everyone, but that decision should be made by the diabetic and their caregiver.  I'd hate to see an article like the one from the Associated Press be something that keeps an insurance company from approving use of an insulin pump.

Scott summed it up nicely by saying, "But blaming the pump itself for problems that are not clearly tied to these Adverse Events seems to be irresponsible reporting at its worst."  Hear, hear!

Visitors since November 7, 2005