This week, legal rights and diabetes have come a long way – but as the technology changes, so have some of the challenges. What happens when a school refuses to use CGM technology? I’m talking to two attorneys this week who have actionable advice and the law on their side. The Dept of Justice has already ruled on this in one state, in a decision that has nationwide impact.
Bonnie Roswig is an attorney with the small non profit Center for Children’s Advocacy which focuses on addressing legal needs of vulnerable children.
Jonathan Chappell lives with type 1 and is a private practice lawyer in Connecticut.
They recently filed an administrative complaint with DOJ in the Eastern district of VA, with more to come. They've also created a template for families, on their own to download, complete, and file on their own: Here's more information for parents
There's also a Facebook group that is following this issue: https://www.facebook.com/groups/followt1ds
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
Don't miss our Diabetes Summer Camp Webinar this week!
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It’s In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: a look at how weight loss might lower cancer risk in people with type 2, a new study that says BG spikes are good(?!), Modular Medical submits a new insulin pump the FDA, another look at COVID-19's effects on people with diabetes, a marathoner with type 1 heads to the last trial for this summer's Olympics, and more!
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Do you know your rights with diabetes? Our guest this week is John Griffin, a trial lawyer with more than 30 years of advocating in and out of the courtroom. He lives with type 2 himself – this is an eye opening and useful conversation.
Griffin served as National Chair of the Board of the American Diabetes Association in 2011, and is the former Chair of the Association’s Legislative and Regulatory Subcommittee.
Also, if you’ve been given a blood glucose meter you probably know how to use it, but do you know how it works? We’ll explain the chemistry going on here
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
More information about how your glucose meter works:
The information explaining Metformin comes from DiaTribe
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It’s In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: Novo Nordisk will discontinue Levemir by the end of 2024, Tandem begins limited launch of software updates that will include Dexcom's G7, Beta Bionics iLet pump will be covered until some pharmacy plans, and lots more!
Links and transcript below
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Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now.
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In the news is brought to you by Edgepark simplify your diabetes journey with Edgepark
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This week was World Diabetes Day so there is a LOT going on..
Our top story is
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Novo Nordisk said on Wednesday it would discontinue its long-acting insulin Levemir in the United States, citing manufacturing constraints, reduced patient access and available alternatives.
The Danish drugmaker said supply disruptions would start in mid-January, followed by discontinuation of the Levemir injection pen in April and of Levemir vials by the end of 2024.
Novo has another long-acting insulin, Tresiba, on the market and says quote - "global manufacturing constraints, significant formulary losses impacting patient access effective in January 2024, and the availability of alternative options in the U.S. market" are key factors in the decision.
The announcement comes eight months after Novo said it would cut U.S. list prices for several of its insulin products next year, including a 65% reduction in the list price of Levemir. Novo, which overtook LVMH (LVMH.PA) as Europe's most valuable listed company this year, posted record operating profit for the third quarter, with sales of its obesity drug Wegovy reaching $1.36 billion, up 28% from the previous quarter.
https://www.reuters.com/business/healthcare-pharmaceuticals/novo-nordisk-discontinue-levemir-insulin-us-market-2023-11-08/
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Big news from Tandem Diabetes this week – first, their Control IQ algorithm gets FDA approval for children as young as two years old. the technology’s original 2019 clearance limited its use to those aged 6 and older.
And.. they are officially rolling out the software update that will allow users to connect to either the Dexcom G6 or G7 CGM. If you’re in the limited launch you got an email this week telling you the next steps – wider release is expected gradually in the first part of 2024. Integration with Abbot’s FreeStyle Libre is expected very soon as well – which would mean Tandem’s tslim x2 and Mobi pumps would be compatible with three CGMs. Full disclosure: there wasn’t a media release that I received on this, but my son is in the limited launch group so we got the email.
https://www.fiercebiotech.com/medtech/tandem-diabetes-care-cruises-fda-ok-toddler-use-automated-insulin-delivery-algorithm
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Beta Bionics iLet pump and its supplies are now covered as part of some pharmacy benefits - Express Scripts added it to its national formulary list. Historically, insulin pumps fall under the durable medical equipment (DME) insurance benefit. Usually pharmacy benefits are more flexible with fewer up front costs.
The system uses an adaptive, closed-loop algorithm that initializes with the user’s body weight and requires no additional insulin dosing parameters. The algorithm removes the need to manually adjust insulin pump therapy settings and variables.
iLet simplifies mealtime use by replacing conventional carb counting with its meal announcement feature. This enables users to estimate the amount of carbs in their meal, categorized as “small,” “medium” or “large.” Over time, the algorithm learns to respond to users’ individual insulin needs.
https://www.drugdeliverybusiness.com/beta-bionics-pharmacy-benefit-bionic-pancreas/
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The UK has launched a pioneering study to explore the development of type 1 diabetes in adults which aims to screen 20,000 individuals. Research will enable earlier and safer diagnosis of type 1 diabetes through blood tests. This makes the UK the first country to implement general population screening for type 1 diabetes in both children and adults. The Type 1 Diabetes Risk in Adults (T1DRA) study, launched on World Diabetes Day, seeks to enroll 20,000 adults aged 18 to 70.
Supported by The Leona M. and Harry B. Helmsley Charitable Trust and building on the Diabetes UK-funded Bart’s Oxford Family study (BOX), T1DRA aims to unravel the mysteries of adult-onset type 1 diabetes.
https://www.diabetes.co.uk/news/2023/nov/groundbreaking-study-to-screen-20000-adults-for-type-1-diabetes.html
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The National Institute for Health and Care Excellence (NICE), England’s cost-effectiveness watchdog, has finalized a draft guidance regarding hybrid closed-loop systems, concluding that the technology should be made broadly affordable and accessible to help people with Type 1 diabetes better manage the condition.
In this month’s final draft guidance (PDF), NICE recommended that hybrid closed-loop technology be offered to all people with Type 1 diabetes who are having trouble controlling the condition using their existing devices.
NICE said that it has already devised a five-year rollout plan with the NHS to bring the technology to people with Type 1 diabetes. Hybrid closed-loop systems will be offered first to children, young people, existing insulin pump users and women who are pregnant or planning to become pregnant, after which they’ll be issued to adults who have an average HbA1c reading of at least 7.5%.
https://www.fiercebiotech.com/medtech/nice-recommends-hybrid-closed-loop-systems-type-1-diabetes-prompting-praise-medtronic
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Commercial
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Kyle Banks was diagnosed with type 1 diabetes on November 1, 2015 while performing with the traveling production of Disney’s The Lion King. Performing nightly for sold out audiences across the country was a dream come true, but after experiencing symptoms of the onset of type 1 diabetes, the dream temporarily turned into a nightmare. The symptoms he experienced were typical for the onset of this chronic illness. but with limited knowledge of type 1 diabetes, he had no idea what was occurring or the drastic life change that would soon follow. In 2020, he founded Kyler Cares in partnership with Children’s Hospital New Orleans and has since connected with families from across the country that are living with this disease. Kyler Cares seeks to improve health outcomes for people of color living with diabetes and ensuring families can access the resources and technology available for better management is the route the organization is taking to achieve that goal.
At Kyler Cares we’re working to improve health outcomes for people of color living with diabetes by improving access to diabetes technology, creating connections to education and resources, and fostering community as an added system of support on our journeys.
Kyler Bear & Friends’ T1 Diaries is an eight-part animated series for kids, dedicated to storytelling about life with Type 1 Diabetes. Our series is more than just an educational tool; it’s a reflection of real-life stories and an avenue to strengthen community ties. It’s a vehicle for us to inspire young people to begin laying a foundation of knowledge and self-confidence with management of T1D that will resonate throughout their lives until a cure for the disease is discovered.
By supporting this series with a donation, you will be contributing to a project that not only educates and informs but also offers comfort and a sense of belonging to kids navigating life with T1D. ‘Kyler Bear’s T1 Diaries’ isn’t just a series; it’s a beacon of hope, a source of information, and a testament to the strength found in our amazing T1D community. Join us in bringing these stories to life
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Married At First Sight UK ends this week, but one bride says viewers haven't seen her whole story.
Fans will find out if Tasha Jay, 25, decides to stay with partner Paul Liba on the Channel 4 show.
But Tasha, who has type 1 diabetes, has spoken out about how footage about her condition didn't make the final cut.
While she's "really sad" that it was left out, Tasha's pleased that people are now realising why she behaved in a certain way on the show at times.
Married at First Sight - or MAFS - is a social experiment where experts match complete strangers who try to live as a couple.
Tasha says her wedding day with Paul on the show was a "really beautiful moment" that included her telling Paul about her diabetes and his reaction.
"I got filmed taking my insulin and checking my blood sugar," she tells BBC Newsbeat..
Tasha was diagnosed at aged two and half and says people have asked why that part of her was hidden in the show.
"And I'm like I didn't hide it," she says.
"For whatever reason they haven't shown it, which really upsets me because diabetes is a part of my story."
Tasha believes that, if people had known about her diabetes, it would have changed their perception of certain moments in the show.
At Moms' Night Out Providence, I was part of an Ask Us Anything panel that included Moira McCarthy and Kerri Sparling. We had a lot of fun on this panel and a lot of fun at MNO period. If you’re wondering what this event is all about, I think this panel will give you a lot of insight. It’s serious, and humorous, I hope helpful, and it’s all peer to peer – we’re not doctors.
Moira McCarthy’s daughter, Lauren, was marking 26 years with T1D during this event! Moira is a ski, adventure and travel writer. A JDRF International Volunteer of the Year and author of six books including, “Raising Teens with Diabetes.” Her blog Despite Diabetes helped me a lot and she’s left it up as a resource.
Kerri Sparling is a writer, poet and speaker who has dedicated her life to the power of the patient narrative. Best known for the blog and book, “SixUntilMe,” she is the author of “Balancing Diabetes” and “Rage Bolus and other poems.” Kerri has lived with type 1 for 37 years.
Our next MNO is in Charlotte in February
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
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Learn more about everything at our home page www.diabetes-connections.com
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This is the first episode of our new show, Diabetes Connections TYPE 2.
Here's what we're talking about:
What IS an A1C? What you need to know about this all-important number.
My guest is a sports photographer and journalist. We’re going to talk about what it takes to do that job and how he was diagnosed with diabetes after a tough run in with the Texas heat..
And hey this is our first episode – we’ll get to know each other a little bit.
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
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A1C information from:
and the American Diabetes Assocation
More about the history of Diabetes Awareness Month & World Diabetes Day
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It’s In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: new studies on the safety and efficacy of what's called the pill form of drugs like Ozempic and Mounjaro, a new study says it may be possible to diagnose a person with type 2 just by recoding their voice, the latest on Tzield, the only drug shown to stave off type 1 for any length of time, how a vegan diet impacts people with T1D, one of the team who discovered insulin gets a long-due honor, and more!
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Sign up for our newsletter here
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Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines happening now
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In the news is brought to you by Edgepark simplify your diabetes journey with Edgepark
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The next step in GLP-1 research is focusing on oral medications. new study looking at two different versions danuglipron dag-NEW-la-pron and orforglipron ah-for-GLOO-pron
The primary examined outcome consisted of how different the absolute changes in the percentage of glycated hemoglobin (HbA1c) from baseline were between the treatment and control groups. Secondary outcomes included endpoint differences in body weight, fasting plasma glucose (FPG), systolic and diastolic blood pressure, body mass index (BMI), and heart rate between the treatment and control groups when absolute changes from baseline values were measured.
The preliminary findings indicated that the orally administered small molecule GLP-1RAs danuglipron twice daily from Pfizer and orforglipron once a day from Lilly were effective in weight reduction and glycemic control in individuals with type 1 diabetes, obesity, or both. As compared to the controls, the novel small molecule GLP-1RAs not only resulted in a significant lowering of HbA1c levels in patients with type 2 diabetes mellitus but in patients with obesity and type 2 diabetes, danuglipron and orforglipron also brought about significant weight reduction.
While the safety profiles indicated that the orally administered danuglipron and orforglipron did not increase the odds of serious adverse reactions or hypoglycemic events, the odds of adverse gastrointestinal events such as diarrhea, nausea, constipation, and vomiting were higher. These adverse gastrointestinal events were also linked to higher odds of treatment discontinuation.
Further, longitudinal studies are required to understand these treatment options' long-term efficacy, tolerability, and safety.
https://www.news-medical.net/news/20231017/Oral-diabetes-and-obesity-meds-danuglipron-and-orforglipron-show-promise-but-have-gastrointestinal-drawbacks.aspx
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More news about Tzield to slow type 1 progression in newly diagnosed children and adolescents. Data from the Phase III PROTECT clinical trial, presented at the 2023 Annual ISPAD Conference, showed that superior beta cell preservation was observed compared to placebo.
On average, patients administered with TZIELD required numerically fewer insulin units and had numerically higher time in range, compared to those on placebo. HbA1c reductions and the overall rates of clinically important hypoglycemic events were similar among both study groups.
TZIELD is the first and only disease modifying therapy in type 1 diabetes
An observational extension study following participants for a further 42 months is ongoing.
Release of the PROTECT trial data follows the company’s acquisition of Provention Bio (a Sanofi Company) in April 2023 and therefore represents a key milestone for Sanofi.
https://www.europeanpharmaceuticalreview.com/news/187735/sanofi-treatment-could-slow-type-1-diabetes-progression/
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Lots of speculation about what the growing popularity of new diabetes drugs will do to the device market. Abbott says they’re doing just fine.. and that the treatments could end up boosting sales of the medical device maker. Shares have dropped with concerns that GLP-1 drugs like Ozempic and Mounjaro could hurt CGM sales. Abbott says their sales are actually up this year.
Now, grain of salt, because this is press release info.. but it’s worth noting that the device market is very important to people who use pump systems of course. Most diabetes device analysts do seem to agree with Abbott here.
https://www.reuters.com/business/healthcare-pharmaceuticals/abbott-beats-profit-estimates-strong-sales-devices-diagnostics-2023-10-18/XX
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Could a 10-second smartphone voice recording diagnose type 2? This is something else.. biotech firm Klick Labs testing 267 people who had already been diagnosed as being either non-diabetic (192 people) or type 2 diabetic (75 people).
Each person was asked to record a specific spoken phrase on their own smartphone via an app, up to six times a day for two weeks. Depending on the speed at which each individual spoke, those recordings were six to 10 seconds long.
When 14 acoustic features of the resulting 18,465 recordings were analyzed, it was found that several of those features – such as pitch and intensity – differed in a consistent manner between the diabetic and non-diabetic participants. Although these differences couldn't be detected by the human ear, they could be picked up by signal processing software.
This finding suggests that developing type 2 diabetes causes subtle changes in a person's voice.
With that theory in mind, the scientists created an AI-based program that analyzes voice recordings along with patient information such as age, sex, height and weight. When tested on the volunteers, that program proved to be 89% accurate at identifying type 2 diabetic women and 86% accurate at spotting diabetic men.
Those numbers should improve as the technology is refined. For reference, the team found that traditional fasting blood glucose tests were 85% accurate for both sexes, while glycated hemoglobin and oral glucose tolerance tests were 91% and 92% accurate, respectively.
https://newatlas.com/medical/10-second-voice-test-type-2-diabetes/
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Ultrasound may prove a new treatment for type 2 diabetes.. GE HealthCare Technologies is teaming up with Novo Nordisk on peripheral focused ultrasound, a new technology with potential to regulate metabolic function–without drugs, GE HealthCare said in a release. Early-stage clinical research suggests this type of ultrasound can affect diabetes patients’ glucose metabolism by stimulating nerve pathways, the company said.
https://www.marketwatch.com/story/ge-healthcare-teams-up-with-novo-nordisk-to-treat-diabetes-without-drugs-7b679c3e
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New research on diet and type 1 diabetes.. looking at plant based & moderate carb diets. I’ll link up the full results but the upshot here is that portion control, moderate carb, and vegan all worked very well – when you’ve got a dietitian helping you make individual choices. The Vegan diet in particular is interesting, but it was not low carb – some people actually ate more carbs than usual – up to 300 a day – but the fat levels were very low. This group’s insulin sensitivity went was up, and they lost on average 11 pounds. A1C decrease was about the same in all the groups.
“It’s important to have different types of diets that fit with different individuals
https://diatribe.org/type-1-diabetes-new-studies-vegan-and-moderate-carbohydrate-diets-type-1-diabetes
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Improving health insurance coverage is not enough to address existing racial and ethnic disparities in glycemic control among US adults with diabetes. This was a large study by researchers at Columbia University Irving Medical Center. A cross-sectional analysis of more than 4000 US adults with elevated HbA1c, results of the study suggest Hispanic or Latino and non-Hispanic Black individuals were more likely to have poor glycemic control relative to their non-Hispanic White counterparts despite access to care, with investigators noting social, health care, and behavioral or health factors did little to attenuate these apparent disparities.
“Future studies should apply causal frameworks to evaluate the role of other structural barriers contributing to the high burden of poor control among insured Hispanic or Latino and non-Hispanic Black individuals to develop effective interventions,” investigators concluded.1
https://www.hcplive.com/view/racial-disparities-in-diabetes-management-go-beyond-insurance-status-study-finds
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Commercial – Edgepark
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A scientist who helped discover insulin a century ago has been honoured with a memorial in Aberdeen.
John JR Macleod was awarded the Nobel prize for his part in the ground-breaking project – one of the most significant advancements in medical science.
However, the physiologist’s achievements were largely unknown.
Now he has been celebrated in his home city with the unveiling of a new life-sized bronze sculpture.
https://news.stv.tv/north/aberdeen-memorial-for-scientist-john-jr-macleod-who-co-discovered-insulin-unveiled-at-duthie-park
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If you watch the Food Network’s Halloween Cookie Challenge – you can root for the diabetes mom. Chelsea Fullmer’s son lives with type 1. The Food Network says she is a mother, entrepreneur, and passionate baker with her own Central Texas baking business, “Pink Lemon Cookies.” Tune in Monday evening
https://shoptherock.com/round-rock-baker-rises-to-the-occasion-on-food-networks-halloween-cookie-challenge/?fbclid=IwAR3S8vA8JkbtUkVhjg1L6L9CFBIP4v_Nf-p9hWn0VUvFh5RHjDlIy8-YvYo
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Next week I’m talking to Ryan Reed, NASCAR Xfinity driver with type 1 about what got him back behind the wheel. And our last long format episode was all about Dexcom U and student athletes with T1D.
Join us again soon!
It’s In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: lots of news from the EASD conference, including info from Dexcom, Vertex, and more, the ADA issues new guidelines for CGM use at school around caregivers' ability to follow, a new study says women should be screened at a younger age for type 2 diabetes, and congrats to Lauren Dahlin, who lives with type 1, for qualifying for the Ironman race in Hawaii.
Find out more about Moms' Night Out
Please visit our Sponsors & Partners - they help make the show possible!
Edgepark Medical Supplies
Check out VIVI Cap to protect your insulin from extreme temperatures
Learn more about AG1 from Athletic Greens
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The best way to keep up with Stacey and the show is by signing up for our weekly newsletter:
Sign up for our newsletter here
Here's where to find us:
Learn more about everything at our home page www.diabetes-connections.com
Reach out with questions or comments: info@diabetes-connections.com
Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines happening now
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In the news is brought to you by Edgepark simplify your diabetes journey with Edgepark
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Lots of news out of EASD – the European Association for the Study of Diabetes happening this week. Including, a new trial finds that antiviral medications, when given soon after a child is diagnosed with type 1 diabetes, might help preserve those vital beta cells.
The team followed 96 children aged 6 to 15 who were all diagnosed with type 1 diabetes within three weeks prior to their enrollment in the study. The children were randomly selected to receive either the two antiviral medicines or a placebo for six months.
After one year of follow-up, the researchers found that C-peptide levels remained "significantly higher" in kids who'd gotten the antiviral treatment compared to those who hadn't. That suggests the treatment helped shield the child's pancreatic beta cells from destruction.
While C-peptide levels dropped a full 24% in children who received the placebo, it fell by just 11% in those who got the antivirals, the investigators found.
On top of that, 86% of kids who'd gotten the antivirals still produced their own insulin at a level that makes treatment with supplementary insulin easier, the team said, and is also known to be linked to lowered risks for diabetes complications.
The treatment appeared to be safe, with no severe side effects noted.
According to Mynarek's team, their research supports the notion "that a low-grade persistent virus infection is an underlying disease mechanism, and that type 1 diabetes may be prevented by development of new vaccines."
The researchers concluded that "further studies should be done at an earlier stage in the disease process, to evaluate whether antiviral treatment could delay the progression of beta-cell damage leading to clinical type 1 diabetes."
https://consumer.healthday.com/type-1-diabetes-2665779376.html
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Also at EASD, an update on once a week insulin icodec for the treatment of type 1 diabetes. While several other studies have investigated once-weekly insulins in type 2 diabetes, this was the first data to be presented from a large-scale phase 3 study in type 1 diabetes.
The study, ONWARDS 6, included 582 people with type 1 diabetes who received either insulin icodec or insulin degludec. Participants had an average age of 44 years and an average diabetes duration of 20 years. Both the icodec and degludec group received basal insulin in combination with mealtime insulin (insulin aspart, or NovoLog) over a period of 57 weeks.
Overall, participants treated with once-weekly icodec and once-daily icodec had similar reductions in A1C of -0.5%, suggesting that this new insulin may offer another option for treating type 1 diabetes.
What were the key findings?
This study showed that insulin icodec was effective at reducing A1C in people with type 1 diabetes, although icodec did lead to higher rates of hypoglycemia compared to degludec.
Researchers are still investigating some questions related to the hypoglycemia events that occurred in this trial, such as how the time of injection and exercise may affect hypoglycemia.
https://diatribe.org/once-weekly-insulins-type-1-diabetes-latest-research-update
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Vertex Pharmaceuticals says a third type 1 patient no longer needs insulin after it’s investigational stem cell-derived therapy VX-880, being assessed for type 1 diabetes.
Two patients who had been followed for at least 12 months likewise met the study’s endpoint of the elimination of serious hypoglycemic events (SHE) between 90 days and 12 months.
Tuesday’s results follow an earlier data drop in June 2023, detailing the first two patients that achieved insulin independence and met the study’s primary endpoint.
The first patient achieved insulin independence 270 days into treatment, lasting through month 24 of the follow-up. The patient had type 1 diabetes (T1D) for “nearly 42 years,” according to Vertex’s announcement, and was taking 34 units of insulin daily.
Insulin independence came on day 180 for the second patient, persisting through 12 months of follow-up. The patient had T1D for 19 years and was taking 45.1 units of exogenous insulin daily. This patient had to restart insulin treatment at month 15, though at a much lower daily dose of four units.
The third patient stopped needing insulin at 180 days of treatment, which happened after the data cut-off, according to Vertex.
Aside from insulin independence, the new data from the Phase I/II study showed that VX-880 induced islet cell engraftment in all participants in parts A and B of the study at 90 days. In turn, these patients are now capable of endogenous glucose-responsive insulin production and demonstrated better glycemic control across various measures, including HbA1c and time-in-range.
Before receiving VX-880, all enrolled participants had long-standing T1D and showed no signs of endogenous insulin secretion and required 34.0 units of insulin per day on average, according to Vertex’s announcement on Tuesday. All patients also had histories of recurrent severe hypoglycemic events.
An investigational allogeneic stem cell-based therapeutic, VX-880 works by delivering fully differentiated and insulin-producing islet cells, in turn restoring the body’s glucose-responsive insulin production capabilities and boosting glucose control. VX-880 is designed to be delivered via an infusion through the hepatic portal vein. Patients need to be on an immunosuppressive regimen to receive the candidate.
Vertex’s T1D program also includes VX-264, an investigational therapy that encapsulates stem cell-derived islet cells in a protective device to be implanted into the patients’ bodies, according to the company’s website. Because the device is designed to shield the therapeutic cells from the body’s response, VX-264 is being studied without the use of immunosuppressive therapies.
https://www.biospace.com/article/vertex-touts-promising-data-for-stem-cell-based-type-1-diabetes-treatment/
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I mentioned Dexcom’s presentation at EASD in our long format interview earlier this week..
One of the company’s studies, for example, recruited insulin users in the U.K. to test out the Dexcom ONE device, which offers a more simplified interface compared to the company’s flagship G-series sensors. Though both Type 1 and Type 2 patients joined the study, Dexcom specifically singled out its results in the Type 2 population: The group saw their average HbA1c levels drop from a baseline of just over 10% to 8.5% after three months, then down to 8.3% after another three months, according to a company release.
The data marked the first real-world study conducted on the Dexcom ONE CGM, Leach said.
Another study presented at the EASD conference this week verified the use of the G7 sensor in pregnant women with Type 1, Type 2 or gestational diabetes—making Dexcom’s G6 and G7 devices the only commercially available CGMs backed by clinical data for use during pregnancy, the company said.
That group makes up about 10% of all pregnancies, he said, and “whether you’re on insulin therapy or not, just the benefit of having a
Supported by those findings, Dexcom said in the release that it now plans to make the G7 sensor available for use with Tandem’s t:slim X2 insulin pump in the U.S. and “multiple markets across Europe and Asia-Pacific” before the end of 2023.
https://www.fiercebiotech.com/medtech/easd-dexcom-cgms-notch-wins-among-type-2-and-pregnant-users-and-7-year-real-world-data
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Metformin may lengthen the time until insulin initiation, lower fasting glucose and improve neonatal outcomes for pregnant women with gestational diabetes, according to data from a randomized trial.
In findings presented at the European Association for the Study of Diabetes annual meeting and simultaneously published in JAMA, researchers compared glycemic, maternal and neonatal outcomes for women with gestational diabetes randomly assigned up to 2,500 mg metformin daily with those receiving placebo. The metformin group had a lower mean fasting glucose at 32 and 38 weeks of gestation, and the offspring of women receiving metformin had a lower mean birth weight than the offspring of those receiving placebo.
Metformin reduces the likelihood for large for gestational age among offspring of women with gestational diabetes.
Infants from mothers in the metformin group had a lower mean birth weight than offspring of mothers from the placebo group (3,393 g vs. 3,506 g; P = .005). The percentage of infants born large for gestational age was lower in the metformin group vs. placebo (6.5% vs. 14.9%; P = .003). Mean crown-to-heel length was shorter in offspring of mothers from the metformin group compared with placebo (51 cm vs. 51.7 cm; P = .02).
“Caution should continue with metformin and small for gestational age, especially in those where small for gestational age may be more likely, so those with hypertension or nephropathy,” Dunne said during the presentation.
https://www.healio.com/news/endocrinology/20231004/metformin-provides-glycemic-neonatal-benefits-for-women-with-gestational-diabetes
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More voices are calling for more screening for type 1 diabetes. About 85% of people with type have no family history.
Various research programs are going on worldwide to establish the best ways of implementing universal screening, including programs in Germany, the USA, Israel, the UK, and Australia. A new program (Edent1fi) has just been funded that will include multiple new European countries, including the UK, Germany, Poland, Portugal, Italy, and the Czech Republic. "These are all research programs. The next steps before universal screening for type 1 diabetes becomes general policy will require guidelines for monitoring and endorsement of screening and monitoring guidelines by applicable societies," explains Dr. Sims. This will also be helped by broader access to disease-modifying therapies to impact progression and the need to start insulin injections.
Screening for adults, who can also develop T1D, is less well studied. Although optimal approaches have yet to be elucidated, this population will also likely benefit from identifying early-stage disease and the advantages of education, monitoring, and access to therapy.
https://www.news-medical.net/news/20231003/Universal-screening-A-game-changer-in-early-detection-and-management-of-type-1-diabetes.aspx
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As I mentioned briefly in my last episode, one of the winners of this year’s Nobel prize for medicine has lived with type 1 for almost 60 years. Dr. Drew Weissman and Katalin Karikó won the Nobel for their work on the COVID-19 vaccines received a Nobel Prize of Medicine.
Karikó and Weissman met by chance in the 1990s while photocopying research papers, Karikó told The Associated Press. Weissman was diagnosed at age 5 and I’ll link up a great interview that Mike Hoskins posted – he used to write for DiabetesMine.
http://www.thediabeticscornerbooth.com/2021/02/we-can-thank-this-researcher-with-type.html?m=1&fbclid=IwAR254vGL8G0aU3uUnvfHbJa79WCiFgS8ihMgHMf0V2hK2QYJBLaa9zwMn7U
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Should women be screened for type 2 diabetes at a younger age than men? A recent study published in Diabetes Therapy explores this hypothesis – there’s a lot here and I’ll link it up, but they examine the theory that menstruation can throw off an A1C.
Women with diabetes between 16-60 years of age have an increased mortality risk by about 27% as compared to diabetic men of the same age when both are compared to the general population. Women lose an average of 5.3 years from their lifespan with diabetes as compared to 4.5 years for men. The study comprised two cohorts. The first included over 146,000 individuals using a single HbA1c reading at or below 50 mmol/mol obtained between 2012 and 2019. The distribution was replicated using readings from a second cohort of about 940,000 people, whose samples were analyzed in six laboratories between 2019 and 2021.
The mean HbA1c level in women at any given age corresponded to that observed in men up to ten years earlier. These findings were corroborated with data obtained from the second cohort.
An undermeasurement of approximately 1.6 mmol/mol HbA1c in women may delay their diabetes diagnosis by up to ten years. Ten years in which they weren’t being treated.
https://www.news-medical.net/news/20231004/The-cut-off-for-HbA1c-based-diagnosis-of-diabetes-may-be-too-high-in-women.aspx
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Commercial – Edgepark
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Very recently, the Americans with Diabetes Association released updated CGM guidance for use in schools. The link to the new guidance is below.
This came about after discussions with stakeholders, including myself and Attorney Roswig. Be clear, this was revised because of the discussions and “rallying” of families impacted, where in some cases schools were pointing to certain flaws in the language in the prior guidance.
While this new guidance may address your CGM issue with your particular school, the new guidance, in our opinion, still needs work. Please know that this work will continue.
If you have any more specific questions, please contact me and I will attempt to address the same. Thank you for your patience, thus far, and anticipated trust and patience going forward. https://diabetes.org/sites/default/files/2023-09/cgm-final-9-22-23.pdf?fbclid=IwAR1t4cpPUSmDoitWiH2hSgNnXWdeYQjPW4rlewjWkWHiOYWc65HX8ub74Yo
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have to show everyone and show myself that this doesn’t change anything,” said Lauren Dahlin about her diagnosis with type 1 diabetes (T1D) at 26 years old in 2017. Today, she’s a true athlete who has competed in nine Ironman races — consisting of a 2.4-mile swim, a 112-mile bike ride, and a 26.2-mile run. Completed within about 14 hours!
This past summer, Dahlin competed in the annual Ironman in Lake Placid, NY. The event came with a lot of pressure because placing within the top 24 racers meant qualifying for the biggest Ironman event of all: the World Championship in Kona, HI.
She did it. Dahlin placed 9th amongst about 600 other female competitors — becoming one of the first women with T1D to qualify for the Ironman in Kona, HI. Happening next weekend Oct 14th
Here’s a closer look at Dahlin’s journey from diagnosis to rockstar competitive athlete.
Diagnosed just days before a potential DKA coma
“I couldn’t even walk half a flight of stairs without getting extremely winded because I was so far gone,” explains Dahlin of her pre-diagnosis symptoms. “The clinic gave me an inhaler for asthma and sent me home!”
Dahlin saw six different providers before someone finally gave her the appropriate diagnosis. They even performed a full-blood panel workup and didn’t diagnose her T1D. Eventually, Dahlin went to the emergency room in Boston, where she lived, and the staff told her she was experiencing diabetic ketoacidosis (DKA). She then spent ten days in the intensive care unit learning about her new life living with T1D.
“I was bummed that the doctors hadn’t caught my diagnosis earlier because there were a lot of clinical trials happening in Boston that I could have been a part of.”
Regardless, Dahlin didn’t want to slow down — within one month of her diagnosis, she signed up for her first half-marathon.
https://t1dexchange.org/ironman-world-championship-type-1-diabetes/
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That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
For adults with type 1, an initial misdiagnosis of type 2 diabetes is unfortunately, all too common. What’s perhaps more unusual is what happened to this week’s guest who was correctly diagnosed by TikTok!
Justin Eastzer talks to me about the community support he found even before he was correctly diagnosed, how it led him to creating his own diabetes videos and content – you may know him better as Diabetech, and how his experience with cancer as a very young adult shaped his life.
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
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Dad and daughter, Randall and Emma Barker, were diagnosed at the same age (ten) and have a few other coincidences around their experiences with T1D. They have a close relationship and this week, they share their story.
The Barkers are here to talk about eye health – we get help from the American Diabetes Association's Dr. Laura Hieronymus to talk about treatment and prevention of complications, which Randall has. But we also talk about what it’s been like for Emma to watch her father live with type 1 and then be diagnosed herself and Randall shares his own feelings of guilt.. and pride. This is a good one.
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
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