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Diabetes Connections | Type 1 Diabetes

The T1D news show you've been waiting for! Long-time broadcaster, blogger and diabetes mom Stacey Simms interviews prominent advocates, authors and speakers. Stacey asks hard questions of healthcare companies and tech developers and brings on "everyday' people living with type 1. Great for parents of T1D kids, adults with type 1 and anyone who loves a person with diabetes.
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Now displaying: Page 3
Aug 22, 2023

It's one of the biggest milestones in my family’s experience with diabetes. Our son is off to college! I asked Benny to come on and talk about what’s on his mind, how he’s feeling and to answer your questions, including if he’s going to tell people he has T1D.

We also answer your questions about overnights, how we’ve prepared, our plan for share and follow and much more. I can’t believe this day is here!

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

Our previous episodes with Benny: https://diabetes-connections.com/?s=benny

Don't miss Moms' Night Out - our next stops are in Texas, Rhode Island, & North Carolina

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

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

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Check out Stacey's books!

Learn more about everything at our home page www.diabetes-connections.com 

Reach out with questions or comments: info@diabetes-connections.com

 

 

Aug 15, 2023

This week, figuring out which diabetes devices you want to use is hard enough.. but then you have to navigate insurance. There’s a new effort to streamline the process - a platform called DiabetesWise that’s available – for free - for patients and providers:

Korey Hood is the founder of DiabetesWise and he lives with type 1. We’ve talked about DiabetesWise before – but this insurance option is new. We talk specifics about how it can help, who it’s for and what else Korey has in store for the platform.

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

Our previous episode with DiabetesWise: https://diabetes-connections.com/?s=diabeteswise

Learn more about Moms' Night Out!

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

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:

Facebook (Group)

Facebook (Page)

Instagram

Twitter

Check out Stacey's books!

Learn more about everything at our home page www.diabetes-connections.com 

Reach out with questions or comments: info@diabetes-connections.com

 

 

Aug 8, 2023

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.

Justin's Podcast

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

Don't miss Moms' Night Out - a new event for moms of children with diabetes

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

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:

Facebook (Group)

Facebook (Page)

Instagram

Twitter

Check out Stacey's books!

Learn more about everything at our home page www.diabetes-connections.com 

Reach out with questions or comments: info@diabetes-connections.com

 

 

Aug 4, 2023

It’s In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: a new pilot program will allow some pharmacists to prescribe CGMs, Georgia becomes the latest state to pass a law securing Glucagon for schools, new info about COVID-19 and new cases of T1D, insulin pump infusion set and skin reaction study, does kombucha tea lower blood glucose and more!

Moms' Night Out early bird specials will end soon for Texas and Rhode Island! 

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Find out more about Edgepark

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

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:

Facebook (Group)

Facebook (Page)

Instagram

Twitter

Check out Stacey's books!

Learn more about everything at our home page www.diabetes-connections.com 

Reach out with questions or comments: info@diabetes-connections.com

Transcription:

Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines happening now
XX
In the news is brought to you by AG1. AG1 helps you build your health,
foundation first.
XX
New pilot program to allow pharmacists to prescribe CGMs. This comes from the American Pharmacists Association Foundation, with support from Helmsley Charitable Trust. While many patients with diabetes may not even have access to a primary care physician, the average person interacts with their community pharmacist 12x more often than their primary care provider. The program will launch in 20 community pharmacy practices across the U.S. There will be a 90-day enrollment period followed by 12 months of monitoring and management
https://www.businesswire.com/news/home/20230720044367/en/The-APhA-Foundation-launches-patient-enrollment-for-a-program-to-expand-access-to-pharmacist-provided-continuous-glucose-monitoring-CGM-devices-and-services
XX
We told you recently about Mobi’s approval, that’s Tandem’s tiny pump, billed as the world’s smallest durable automated insulin delivery system. Convatec Group now saying they’ve partnered with Tandem on a new five-inch infusion set for the Mobi. Not a lot more information than that, but interesting because while Convatec makes infusion sets for just about every tubed pump, last year, Tandem acquired another infusion set developer, Capillary Biomedical.
https://www.outsourcing-pharma.com/Article/2023/07/18/Convatec-to-manufacture-new-infusion-set-for-Tandem-Diabetes-Care

XX
New law in Georgia to make sure all schools have emergency glucagon on hand and that it can be used for any student. House Bill 440 took effect on July 1, 2023. It will allow public and private schools in Georgia to acquire and keep a supply of glucagon. It allows prescribers to provide standing orders or prescriptions for ready-to-use glucagon to schools so that this medication can be rapidly administered to students in an emergency. Schools will also be able to work directly with glucagon manufacturers or third-party suppliers to obtain the products for free or at fair market or reduced prices. In 2018 a school nurse in Illinois used another students glucagon on a different study having an emergency, breaking the law. It’s since been changed in Indiana and now, in Georgia. Disclaimer: the state rep who sponsored this bill, Doug Stoner is married to my dear friend Trip Stoner who lives with type 1.
https://www.thegeorgiavirtue.com/georgia-legislature/georgia-bill-to-help-schools-treat-hypoglycemic-emergencies-becomes-law/
XX
I think most of us know this but good to see research on it. A new study shows skin reactions at insulin pump infusion sites are common among people with type 1 diabetes who use the devices and can lead to delivery failure.
researchers at the University of Washington, in Seattle, used biopsies and noninvasive imaging to compare insulin pump sites with control sites in 30 patients. They found
Several differences were found at pump sites in comparison with control sites, including fibrosis, inflammation, eosinophils, a disease-fighting white blood cell which indicated an allergic reaction here.
The inflammatory response, they say, "may result in tissue changes responsible for the infusion site failures seen frequently in clinical practice." Nearly all patients (93.3%) reported itchiness at the site, and 76.7% reported skin redness.

While the researchers think preservatives in the insulin or the makeup of the infusion sets are probably to blame, they admit they don’t really understand it fully yet.

https://www.medscape.com/viewarticle/995068
XX
Very large new study seems to confirm that the COVID-19 pandemic precipitated a jump in cases of type 1 diabetes in children and teenagers. This study pooled data from 17 previous studies and looked at 38-thousand people under the age of 19. They found the incidence of type 1 was about 14-percent higher during 2020, the first year of the pandemic, than in the previous year. The incidence rose higher still in the second year of the pandemic, up 27% from 2019.
Before COVID-19, the incidence of type 1 diabetes in children was rising at a steady rate of around 2–4% a year.
The meta-analysis did reaffirm that children diagnosed with type 1 diabetes tended to present with more severe forms of disease during the pandemic than before. The incidence of diabetic ketoacidosis, a potentially life-threatening complication of new-onset type 1 diabetes, rose by 26% from 2019 to 2020, probably because people were hesitant or unable to seek emergency care when early symptoms appeared.
It’s still unclear what triggered the sudden increase in diabetes and how long the trend might persist. It’s also important to keep in mind that a few researchers have spoken out that they believe the increase sounds implausible. And that Studies from Finland7, Scotland8 and Denmark9 could not directly link coronavirus infections to the increase in type 1 diabetes.
https://www.nature.com/articles/d41586-023-02322-0
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Commercial – AG1
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New research shows the best time to predict childhood type 1 diabetes is ages 2-6, when screening detects 80-percent of future cases. Research shows screening children ages 2-6 best predicts childhood type 1 diabetes, successfully detecting 80% of future cases. Early screening also leads to more timely treatment, better health outcomes, and less diabetes distress. These researchers reviewed findings that screened 90-thousand children under the age of 6 and 32-thousand children under 18. These researchers emphasized the need to work towards the adoption of universal screening at the state government, payer, and healthcare provider levels.
https://diatribe.org/early-diabetes-screening-kids-can-improve-quality-life
XX
Very small pilot study suggesting that kombucha reduces blood glucose levels in adults with type 2. I’m including this because you’ll likely hear a lot about it.. but keep in mind, the sample size was too small for statistical significance. A total of 12 participants with type 2 diabetes were randomly assigned to consume 240 mL of either a kombucha product or placebo daily with dinner for 4 weeks. They then waited 8 weeks and switched to the other product for another 4 weeks.

Kombucha significantly lowered average fasting blood glucose – on average from 164 to 116.
Kombucha tea is a fermented drink made with tea, sugar, bacteria and yeast.
https://www.medscape.com/viewarticle/995035

XX
Afon, a Welsh based company, is working on a non-invasive glucose sensor that has the potential to revolutionize the way blood glucose levels are monitored.

We’ve heard these types of promises before, but are yet to see something materialise into a real-world product. With the development of optical sensors in the early 2010s, the concept of using technology to monitor glucose levels in a non-invasive manner was first brought up. Light is used by these sensors to obtain signals from beneath the skin. For several years, there has been discussion about incorporating such technology for glucose monitoring by smartwatches. Afon adopts an entirely different approach. Its blood glucose sensor is called Glucowear. It is an RF sensor that fits under the base of the wrist. The gizmo uses radio frequencies to obtain signals from beneath the skin. Unlike optical sensors this technology provides real-time monitoring with no time lag.

Hoping for a 2024 launch date
The company stated that they hope to have the device on the market by early 2024. This is an extremely optimistic goal given the stringent requirements imposed by health regulators. There is no information available on how well Afon is progressing with regulatory approval, and the company’s website makes no mention of the regulatory process. So far the Afon Blood Glucose Sensor has undergone three rounds of testing at Profil, a world-renowned diabetes research center in Germany. A multi-phase trial of this technology will be conducted at Swansea University’s Joint Clinical Research Facility (JCRF) later in 2023. There will also be other multi-site trials before the device hits retail in 2024. Glucowear delivers real-time continuous glucose monitoring through its wireless integration with a smart device. Designed to be placed under a user’s smartwatch, the sensor allows the said device to serve as an integral part of the monitoring system. Afon promotes the Glucowear as a comfortable wearable and ensures that the painless CGM has a battery lifespan of up to 14 days when fully charged.
https://gadgetsandwearables.com/2023/07/24/afon-blood-glucose-sensor/
XX
https://www.medpagetoday.com/popmedicine/cultureclinic/105707
XX
On the podcast next week.. talking to Justin, better known as DiabeTech, who was diagnosed with T1D by TikTok! Last week I talked to the author of Sweeite!

That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

 

Aug 1, 2023

It's almost time for back to school! How do you explain type 1 diabetes to students? I asked a preschool teacher whose daughter has t1d to talk about how to get the message through without scaring anyone.

Laura Self also has a great book our for kids called Sweetie. Her daughter, Hannah, was diagnosed at age 8 and is now 20. She spent the spring semester in Europe this year. Laura and I talk about how we tried to help our children find independence, confidence, and responsibility with diabetes.

Moms' Night Out is in three cities! Find out more before our early bird specials end. 

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

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:

Facebook (Group)

Facebook (Page)

Instagram

Twitter

Check out Stacey's books!

Learn more about everything at our home page www.diabetes-connections.com 

Reach out with questions or comments: info@diabetes-connections.com

 

 

Jul 25, 2023

This week, actress Jennifer Stone lives with LADA.. she decided to become a nurse and started her first ER job in March of 2020. I asked her what it was like knowing she had to take care of her own diabetes while also taking care of patients during a pandemic:

You might know Jennifer best from her days on Disney’s Wizards of Waverly Place… I caught up with her to talk about how she manages LADA, why she decided to become a nurse and still continue acting... and what’s next for her dual careers.

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

More about LADA

More about Medtronic's InPen system

Our previous episode with Jennifer Stone

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

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:

Facebook (Group)

Facebook (Page)

Instagram

Twitter

Check out Stacey's books!

Learn more about everything at our home page www.diabetes-connections.com 

Reach out with questions or comments: info@diabetes-connections.com

 

 

Jul 18, 2023

Let's talk about menopause and type 1. It’s hard enough to find information about this part of life for women without diabetes.. so when this week’s guest started looking for research about T1D she wasn’t too surprised to come up short:

Dawnie Adams is a midwife who is determined to use peer support to push medical research forward. We talk about her experience, what she and her group are doing to support each other, how diabetes and menopause can have similar symptoms which just makes everything confusion.. and much more.

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

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:

Facebook (Group)

Facebook (Page)

Instagram

Twitter

Check out Stacey's books!

Learn more about everything at our home page www.diabetes-connections.com 

Reach out with questions or comments: info@diabetes-connections.com

 

 

Jul 14, 2023

It’s In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: a new insulin pump gets FDA approval, once-weekly basal insulin for type 2 gets through another trial, New Jersey caps insulin prices for some, possible link between ability to chew and glucose control, a landmark diabetes study moves on to aging and T1D, JDRF Children's Congress and more!

Learn about Moms' Night Out - a new event for moms of children with diabetes

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

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:

Facebook (Group)

Facebook (Page)

Instagram

Twitter

Check out Stacey's books!

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
XX
In the news is brought to you by AG1. AG1 helps you build your health,
foundation first.
XX
Our top story, Tandem’s Mobi Pump is approved. The FDA cleared the tiny pump for people with diabetes ages six and up. Tandem says mobie is fully controllable from a mobile app and is the world’s smallest durable AID system. It still has a button on the pump to dose and holds 200 units. You use the same infusion set as the current Tandem pumps and Mobi uses Control IQ. Limited release planned for late this year and fully available early 2024.
https://www.drugdeliverybusiness.com/fda-clears-tandem-mobi-automated-insulin-pump/
XX
Learning more about a newly approved therapy for type 1 diabetes called Lantidra. Two safety and efficacy studies found that 21 participants who took Lantidra did not need to administer themselves insulin for a year or more. Twelve of those participants did not need to take insulin for up to 5 years, and 9 did not need insulin for over 5 years.
Lantidra is an allogeneic (donor) pancreatic islet cellular therapy. In other words, Lantidra uses cells taken — or isolated — from human organ donor pancreases. “In [a] subsequent process, the insulin-producing islets are purified from the rest of the pancreatic tissue using a density gradient. Once the islets are isolated, purified, and put for a short time in cell culture, the cell preparation is infused into the liver of the recipient,” he explained.

https://www.medicalnewstoday.com/articles/fda-approves-first-cellular-therapy-for-type-1-diabetes-what-does-it-do#How-does-islet-cellular-therapy-work?
XX
Once weekly basal insulin for type 2 gets through another trial. After 26 weeks of treatment and five weeks of follow-up, patients on weekly insulin icodec had significantly larger improvements in their HbA1C than those using daily insulin. Both groups had an extremely low rate of adverse events. These researches say next step is FDA evaluation.

https://www.utsouthwestern.edu/newsroom/articles/year-2023/july-weekly-insulin-found-safe.html
XX
That’s the idea behind Fractyl Health’s treatment for type 2 diabetes—which could also be used for weight control. The Lexington, Massachusetts-based biotech company is in the early stages of developing a one-time gene therapy intended to lower blood sugar and body weight using the same mechanism as semaglutide. “You have this problem where you need to stay on therapy for efficacy,” says Harith Rajagopalan, a cardiologist by training and CEO and cofounder of Fractyl Health. “That’s the Achilles heel.” The company wants to deliver an artificial gene to the pancreas that continuously produces the GLP-1 hormone so there’s no need for weekly injections. The approach, called gene therapy, uses inactivated viruses to carry a therapeutic gene to pancreatic cells. (Viruses are used because of their natural ability to deliver genetic material to cells.) The company is aiming to begin an initial human trial by the end of 2024
https://www.wired.com/story/a-one-time-shot-for-type-2-diabetes-a-biotech-company-is-on-it/
XX
Gov. Phil Murphy signed three bills into law Monday aimed at cutting the high cost of prescription drugs in New Jersey.

The new laws will cap how much residents will pay for some popular medications such as insulin, prevent pharmacy benefit managers from engaging in practices that make drugs more expensive, and create a panel that will monitor prices set by pharmaceutical companies. One measure (S1614) would cap the cost of insulin, epinephrine auto-injector devices and asthma inhalers for state and local public workers enrolled in the State Health Benefits Program, the School Employees’ Health Benefits Program and other state-regulated plans. For a 30-day supply, insulin will cost $35, EpiPens $25 and asthma inhalers would be capped at $50, according to the bill. The law takes effect next year.
https://www.nj.com/politics/2023/07/new-laws-to-stem-high-cost-of-prescription-drugs-in-nj-were-just-signed-by-gov-murphy.html
XX
The European Medicines Agency (EMA) said on Tuesday it has extended its probe into Novo Nordisk's (NOVOb.CO) diabetes drugs Ozempic and weight-loss treatment Saxenda, following two reports of suicidal thoughts, to include other drugs in the same class.

The agency began its review on July 3 after Iceland's health regulator flagged the reports of patients thinking about suicide and one case of thoughts of self harm after use of Novo's drugs.
https://www.reuters.com/business/healthcare-pharmaceuticals/eu-extends-ozempic-probe-include-other-drugs-2023-07-11/
XX
We often hear that diabetes can lead to problems with your teeth.. but one researcher says it might be the other way around. A University at Buffalo researchers says there is a notable correlation between chewing functionality and blood glucose levels in people with type 2.
Specifically, he found that patients with T2D who maintain a full chewing ability exhibit significantly lower blood glucose levels compared to those with compromised chewing function. The thinking here is that chewing stimulates the body in all sorts of ways, including releasing hormones that help you feel fuller and help in digestion. More studies are expected.
DOI: 10.1371/journal.pone.0284319
https://scitechdaily.com/the-surprising-connection-between-chewing-and-type-2-diabetes/
XX
The next step of the landmark Diabetes Control and Complications Trial will focus on aging with type 1 diabetes.
The original randomized DCCT clinical trial results, published September 30, 1993, in the New England Journal of Medicine, proved that early intensive glycemic control was the key to preventing or slowing the progression of long-term eye, kidney, and nerve complications of type 1 diabetes. Subsequently, EDIC has yielded many more major findings including that early tight glycemic control also reduces cardiovascular risk and prolongs survival in type 1 diabetes.
subsequent EDIC data also have suggested that it is never too late to initiate intensive glycemic control

Together, DCCT and EDIC — both funded by the National Institutes of Health at 27 sites in the United States and Canada — have changed the standard of care for people with type 1 diabetes Prior to the DCCT, between 1930 and 1970, about a third of people with type 1 diabetes developed vision loss and one in five experienced kidney failure and/or myocardial infarction. Stroke and amputation were also common, DCCT/EDIC chair David M. Nathan, MD, said while introducing the symposium.

"All of the advances in care of type 1 diabetes have developed because this study demonstrated that it was important — continuous glucose monitoring (CGM), new insulins, better [insulin] pumps…I think the most profound finding is that mortality in our intensively treated cohort is the same as in the general population. That says it all," Nathan told Medscape Medical News.

https://www.medscape.com/viewarticle/994221
XX
Commercial – AG1
XX
Today, JDRF, the leading global type 1 diabetes (T1D) research and advocacy organization, urged members of the Senate Appropriations Committee to renew the Special Diabetes Program (SDP) and support policies to ensure insulin is available at an affordable and predictable price. Opened by U.S. Senator Patty Murray (D-WA) and led by U.S. Senators Susan Collins (R-ME) and Jeanne Shaheen (D-NH), the hearing took place during the 2023 JDRF Children's Congress, a biennial event that brings over 160 kids and teens living with T1D face-to-face with lawmakers and top decision-makers. The youth delegates traveled to Washington, D.C. from across the country and JDRF's international affiliates in the United Kingdom, Australia, the Netherlands, and Canada.

The SDP has accelerated the pace of T1D research through a long-term investment of funding at the National Institutes of Health. The program has led to significant scientific breakthroughs, including Tzield, the first disease-modifying treatment for T1D, which can delay the onset of the disease by over two years. Without Congressional action, the SDP will expire at the end of September.

"The Special Diabetes Program has fundamentally changed what it means to live with diabetes, put new life-changing therapies in our hands, and brought us closer to cures," said Aaron Kowalski, Ph.D., JDRF CEO. "We must keep this momentum going so we can capitalize on the progress to date and realize cures. However, until we have cures, people need access to affordable insulin. JDRF urges Congress to pass the bipartisan INSULIN Act of 2023, which will establish a $35 per month insulin copay cap for people with commercial insurance and includes other provisions that would make insulin more affordable for everyone, regardless of insurance status."

Dr. Kowalski was joined at the hearing by Dr. Griffin Rodgers, Director of the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health, who provided testimony on the scientific value of the SDP, and Jimmy Jam, award-winning producer, songwriter, musician, member of the Rock & Roll Hall of Fame, and T1D parent.

"My son Max, who is now in his twenties, was just two years old when he was first diagnosed with type 1 diabetes. Late nights working on music became late nights working on music and waking up my son to test and manage his blood sugar levels," said Jimmy Jam. "Type 1 diabetes should be one of those things we can all agree on. Diabetes doesn't care if you're a Democrat or a Republican. We can all agree that there should be research to improve the lives of those with diabetes. We can all agree that insulin should be affordable for all who need it."

Two 2023 JDRF Children's Congress delegates shared their T1D experience with the committee:

Maria Muayad: 10-year-old Maria is from Maine and is a member of her school's civil rights club and math challenge group. Every November, Maria, and her mother, Golsin, give blue ribbons to the staff at her school in honor of National Diabetes Awareness Month.

Elise Cataldo: 15-year-old Elise lives in New Hampshire and is passionate about educating those around her about life with T1D and tries to use things like pump site changes and blood sugar checks as opportunities to help others learn.

Following the hearing, the 2023 JDRF Children's Congress delegates continued their advocacy by meeting with lawmakers in their Capitol Hill offices.
https://www.prnewswire.com/news-releases/2023-jdrf-childrens-congress-delegates-urge-lawmakers-to-support-type-1-diabetes-research-and-access-to-affordable-insulin-301874927.htmlXX
XX
A 23-year-old with type 1 diabetes has broken the record for circumnavigating Britain in a kayak after paddling 2,000 miles in 40 days. Dougal Glaisher beat the previous record by 27 days.

Glaisher was diagnosed with type 1 diabetes at the age of 19 shortly after winning the Oban Sea Kayak race in Scotland, when he had blurred vision and struggled to recover his energy.

The expedition was to raise money for the UK-based charity Action4Diabetes and Glaisher livestreamed his blood sugar
On Tuesday he was well stocked with a bunch of bananas and a stash of cereal bars lashed to his boat. But in remote areas it was more challenging. Around the islands off Scotland he ran out of freeze-dried meals and survived on porridge for several days. He also sourced drinking water from streams.
. It is the first time anyone has used a surfski – a kayak that you sit on top of – to paddle around the country.
XX
On the podcast next week.. I sat down with Dexcom’s new Chief Commercial officer to talk about their announcements from this week about the type 2 market and other features important to people with type 1. Our last epoisde is all about Kickass Healthy LADA

That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

Jul 12, 2023

My son Benny is back from a four week trip halfway around the world with a non-diabetes camp program. He says it was amazing! To be honest, I had a really hard time with it. This week, we share how we prepared, what went wrong, how Benny deals with feeling different on these types of trips and a lot more.

This episode first aired in August of 2021

Previous episodes with Benny:

14 years of T1D

Benny & Stacey talk untethered and more on their way to the endo

Talking about Control IQ & addressing kids' questions about diabetes

Our 12 year diaversary

Ten years of T1D - our whole family speaks up

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

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Jul 4, 2023

This week, G7 updates – direct to watch announcements – and a lot more about what Dexcom sees as the next frontier in CGM. A conversation – from ADA – with the company’s Chief Commercial Officer Teri Lawver.

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

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:

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Learn more about everything at our home page www.diabetes-connections.com 

Reach out with questions or comments: info@diabetes-connections.com

 

 

Jun 30, 2023

It’s In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: FDA approval for a pancreatic islet cell therapy to treat type 1, stem cell research moves ahead, big news from the ADA Scientific Sessions about what's next for medications like Mounjaro and a pill form of semaglutide. Dexcom announces a sensor for people with type 2 who don't use insulin, Libre moves ahead with Ketone monitoring and more.

 

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

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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 the T1D Exchange a nonprofit organization dedicated to improving outcomes for the entire T1D population.
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Big week of news following the 2023 ADA Scientific Sessions conference. What follows is just the tip of the information iceberg, so please follow the links in the show notes to much more.
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Top story though isn’t from ADA – but a new FDA approval.. for a pancreatic islet cell therapy to treat type 1. It’s called donislecel, developed from cadaver donors and giving as a single infusion straight into the liver. Immunosuppression is required to maintain cell viability, just as it is required to support a transplanted kidney or other organ.
Approval was based on what seems to be a very small study – 30 people with type 1 who had hypoglycemic unawareness and who received between one and three infusions of donislecel. After one year, 11 people did not need to dose insulin.. 10 stayed that way for more than five years. But five people in the study were not able to stop dosing insulin at all. This method is different from what Vertex and Sernova are trying to do with stem cell therapy.
https://www.medscape.com/viewarticle/993854
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Vertex moves forward on their clinical trial of islet stem cell therapy. All six patients treated with VX-880 had undetectable fasting C-peptide (endogenous insulin secretion) at baseline, a history of recurrent SHEs in the year prior to treatment and required an average of 34.0 units of insulin per day. Following treatment, all six patients demonstrated endogenous insulin secretion, improved glycemic control as measured by HbA1c, improved time-in-range on continuous glucose monitoring, and reduction or elimination of exogenous insulin use. Two patient are completely insulin independent after one year – with an A1C of 5.3 compard to 8.6 at baseline.. the other 6.0 with a 7.6 at baseline – again the ”after” number is without taking insulin.
As a result of these safety and efficacy data in Parts A and B, the independent data review committee has recommended moving to Part C of the trial, which allows for concurrent dosing of patients at the full target dose of VX-880.

https://www.businesswire.com/news/home/20230623446641/en/Vertex-Presents-Positive-VX-880-Results-From-Ongoing-Phase-12-Study-in-Type-1-Diabetes-at-the-American-Diabetes-Association-83rd-Scientific-Sessions
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Sernova also reports good results with their cell pouch system. Five of the six patients who have completed implantation continue to experience insulin independence for periods ranging from six months to more than three years. The sixth patient only recently completed the protocol-defined islet transplants.. so no results yet. There is a second group testing a larger cell pouch.
https://www.drugdeliverybusiness.com/sernova-interim-data-cell-pouch-system/
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Big news from ADA about all of the type 2 and obesity drugs you’ve likely heard about.. here are some headlines:
SURMOUNT-2 clinical trial evaluating tirzepatide – brand name Mounjaro - for weight loss in adults with obesity or overweight and type 2 diabetes.
Average weight loss was 15.7% at the highest dose, with many other health benefits such as lower A1C levels; reduction in waist circumference, and body mass index; and improvements in cardiometabolic disease risk factors such as lipid levels, cholesterol, and blood pressure.
That 15 percent weight loss was about 34 pounds and the a1c reduction for half of those in the study went down to 5.7 which is considered nondiabetic. Mounjaro is currently approved for type 2 and the FDA could approve Mounjaro regardless of diabetes status later this year.
https://diatribe.org/new-lilly-trial-results-show-big-weight-loss-results-positioning-mounjaro-obesity-drug-approval
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A study called PIONEER looks at oral semaglutides – some calling it the Ozempic pill. When compared to other anti-diabetic medications such as Jardiance, Januvia and Victoza, people taking the oral semaglutide say 1% or or more reduction of HbA1c compared to those treated with other anti-diabetic medicines. They also were more like to achieve a 5% or more reduction of body weight. Note: this was not a study comparing a semaglutide pill with the same type of injection.
https://www.news-medical.net/news/20230607/Oral-semaglutide-outperforms-other-medications-in-type-2-diabetes-treatment-significantly-reducing-HbA1c-and-body-weight.aspx
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And look for two additional new drugs to treat obesity in the next few years.. orforglipron, is easier to use and to produce, and it will probably be cheaper than existing treatments. The second, retatrutide, has an unprecedented level of efficacy, and could raise the bar for pharmacological obesity treatment.

Orforglipron and retatrutide both mimic hormones produced by the lining of the gut in response to certain nutrients. These hormones help to slow the passage of food through the digestive tract and lower appetite by acting on receptors in the brain — both effects that reduce people’s desire to eat and help them to lose weight. Orfoglipron is a non-peptide molecule that researchers say is easy to produce and is a pill.. a lower price is anticipated for this one. Retratritude looks like it could help people lose even more weight than Mounjaro.
https://www.nature.com/articles/d41586-023-02092-9

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Dexcom announces a new product in the US – coming in 2024 – designed for people with type 2 who don’t use insulin. This will be built on the G7 hardware, but with different software and a 15 day sensor.
CEO Kevin Sayer also announced that the G7 will be able to share data direct to the apple watch
https://www.businesswire.com/news/home/20230623025076/en/Global-Continuous-Glucose-Monitoring-Pioneer-Dexcom-Reveals-New-Plans-to-Bring-Sensing-Technology-to-Millions-More
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Abbott will partner with Weight Watchers - people who have been prescribed one of Abbott’s FreeStyle Libre 14-Day or FreeStyle Libre 2 sensors and who are using the WeightWatchers diet plan to see their CGM data directly in the WeightWatchers app.
This is also a study where Abbott will launch two pilot programs directed at using CGM data to help people with Type 2 diabetes adjust and manage their dietary habits, regardless of whether they’re on insulin therapy.
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A little bit more news about Abbott’s dual glucose and ketone sensor under development. Announced a last year’s ADA, the company says it’s moving forward through R&D
Separately from the Type 2 CGM push, Taub also offered an update on the dual glucose ketone sensor that’s currently under development at Abbott and that the company first announced at last year’s ADA conference. The sensor will be aimed at catching rising ketone levels as early as possible to help avoid cases of diabetic ketoacidosis. An Abbot executive says – quote - “There’s so much that we stand to learn about ketones because there hasn’t been a continuous sensor for them before, so there’s really very little we know about the evolution of ketones “
https://www.fiercebiotech.com/medtech/ada-abbott-pushes-widespread-cgm-use-type-2-diabetes-weightwatchers-ada-collabs

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Commercial
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Beta Bionics has received FDA 510(k) clearance for the compatibility of the Fiasp Pumpcart prefilled insulin cartridge with the iLet automated insulin-delivery system.

The iLet is a bionic pancreas that fully automates 100% of all user insulin doses, providing users with the choice of three insulins, Novolog; Humalog; and Fiasp Pumpcart.

The device eases diabetes management in everyday life and almost eliminates the expertise that has been required in the past to set up and manage a traditional insulin pump. In May 2023, Beta Bionics was awarded FDA approval for the iLet device.

The iLet manages glucose levels with just a meal announcement and is paired with a Dexcom G6 Continuous Glucose Monitoring System for glucose readings.

All that is required for set-up is the user’s weight. While there is a need for carbohydrate awareness, no carb counting is necessary. Bolusing, correction factors, insulin-to-carb ratios, and pre-set basal rates are also unnecessary.

Beta Bionics president and CEO Sean Saint said: “Beta Bionics has been working tirelessly to create an insulin delivery system that offers less burden and more convenience for the type 1 community. Since launching last month, the iLet bionic pancreas is now available and clinics and users are being trained on its simple design and easy management features.

“When Fiasp Pumpcart prefilled cartridges are available, users will save time not having to manually fill cartridges and will have more choice for their diabetes management.”
https://www.medicaldevice-network.com/news/beta-bionics-gains-fda-clearance-for-prefilled-insulin-cartridge/
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Oura – the ring that tracks your sleep – will start sending info to three CGM info companies.. January, Supersapiens and Veri. All three of these companies provide software based off of the Libre CGM. These companies will now be receiving sleep scores and other biometric data from Oura so they can see how these measurements affect users’ glucose levels and overall health.

https://www.forbes.com/sites/andrewwilliams/2023/06/27/oura-smart-ring-can-be-used-to-help-monitor-blood-sugar/?sh=2520116c2b10
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Just a fun fact here – there is a Facebook group called type 1 diabetics for 50 plus years. And it looks like this week they passed over 1500 members.
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On the podcast next week.. I sat down with Dexcom’s new Chief Commercial officer to talk about their announcements from this week about the type 2 market and other features important to people with type 1. Our last epoisde is all about Kickass Healthy LADA

That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

Jun 27, 2023

LADA is a form of diabetes that is often mistaken for type 2 but needs to be treated much more like type 1. As you can imagine, getting the diagnosis wrong is dangerous. This week's guest, Jacqueline Haskins, says she got lucky. A friend said her symptoms sounded more like Latent Auto Immune Diabetes in Adults than like Type 2.

Jacqueline is the author of Kick Ass Healthy LADA where she shares research, advice and her own story. She’s an aquatic biologist and an award winning author.

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

Here are our earlier episodes around LADA 

 

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

The best way to keep up with Stacey and the show is by signing up for our weekly newsletter:

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Reach out with questions or comments: info@diabetes-connections.com

 

 

Jun 20, 2023

Katie Bone is the youngest ever American Ninja Warrior Women’s National winner! She is also a nationally ranked rock climber and has her eyes on the Olympics. Katie was diagnosed with type 1 at age eleven and is now seventeen. We talk about her big win, a recent injury and what she’s looking forward to next. She also answers a lot of your questions about managing T1D during training and competitions.

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

More about Katie here: https://katiebone.com/

Watch Katie's NInja Warrior win: https://www.youtube.com/watch?v=i3Jlvc3OwLw 

 

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

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Jun 16, 2023

It’s In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: FDA warning about compounded versions of semaglutides like Wegovy and Ozempic, new research on what people with diabetes who start Go Fund Me campaigns are asking for, Tandem's CEO gives an update on Dexcom G7 and Libre integration, follow-up on the French Open player denied insulin on the court, and more!

Here's more info about Mom's Night Out: https://bit.ly/DMomsNightOut

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

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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 Moms Night Out! Treat yourself to some time away with other moms who get it!
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The U.S. Food and Drug Administration is warning consumers not to use off-brand versions of the popular weight-loss drugs Ozempic and Wegovy because they might not contain the same ingredients as the prescription products and may not be safe or effective.

Agency officials said this week that they have received reports of problems after patients used versions of semaglutide, the active ingredient in the brand-name medications, which have been compounded, or mixed in pharmacies. Officials didn’t say what the problems were. The trouble is that those versions, often sold online, contain a version of semaglutide that is used in lab research and has not been approved for use in people.
As of May, Ozempic and Wegovy remain on the FDA’s list of drug shortages. When drugs are in short supply, compounding pharmacies are permitted to produce versions of those medications.
Consumers should only use drugs containing semaglutide with a prescription from a licensed health care provider and obtained from a state-licensed pharmacy or other facilities registered with the FDA, the agency said.
https://time.com/6284497/fda-warning-ozempic-wegovy/

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ZVHER-ehv pronounce https://www.youtube.com/watch?v=u8spdvgpIzs
French Open organizers reversed their initial decision denying Alexander Zverev access to insulin injections on the court. Initially they said he’d have to do his injections during off-court bathroom breaks, something players are limited to only two of. Zverev has lived with type 1 since he was three years old? And apparently there were complaints after he injected himself during his fourth-round match. Zverev said he was told it didn’t look right when he injected himself on the court. “This is not a clever take because if I don’t do it, my life will be in danger. But they said it looks weird,” he said.
And it prompted a response from type 1 diabetes research charity JDRF. In an open letter, the charity said: “We would like to emphasise that insulin administration is an essential aspect of type 1 diabetes management, and it should be treated with the same respect and understanding as any other medical intervention.

“It is critical that athletes with diabetes, like Mr. Zverev, are given the necessary accommodations and support to effectively manage their condition while competing. This includes the ability to administer insulin when required, as recommended by their healthcare professionals.”
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Many people with diabetes in the United States have turned to crowdfunding to pay their medical bills, even though a quarter of patients sampled had insurance, according a new study by Duke University researchers.

In the United States, more than 40% of patients with diabetes struggle to pay their medical bills. Among those patients, more than half — 56% — have either delayed or foregone care entirely, Caroline E. Sloan, MD, MPH, a primary care physician at Duke University School of Medicine, and colleagues wrote. One estimate suggested that the average patient who is dependent on insulin and has insurance spends about $4,800 every year on physician visits, supplies, medications, hospitalizations and lost wages — the equivalent to 15% of the median U.S. per capita income.
They evaluated 313 GoFundMe campaigns describing patients’ medical situations, expenses and fundraising goals. The researchers included an oversampling of type 1 diabetes campaigns so they could have roughly even proportions of type 1 and non-type 1 diabetes campaigns “and ensure a wide breadth of experiences.”

Sloan and colleagues found that the median fundraising goal was $10,000, the median amount raised was $2,600, and just 14% of campaigns reached their goal.

Additionally, 25% of fundraisers had insurance, but 49% of those who did have insurance said their out-of-pocket costs were still too high. Fewer than 10% requested money specifically for insulin; 48% of direct medical expenses were not directly related to glucose control.

When it came to characteristics of campaigns for types of diabetes, they found that 21% of total campaigns — almost all of which were campaigns for type 1 diabetes — requested money for diabetic alert dogs. Campaigns not for type 1 diabetes mentioned indirect medical expenses more often than campaigns for type 1 diabetes: 63% vs. 34%.

“Thirty-five percent of patients with type 1 diabetes started fundraising campaigns for diabetic alert dogs, which cost about $15,000 and are not covered by insurance because of high variability in effectiveness,” the researchers wrote. “Clinicians who learn of a patient’s intent to purchase a dog could redirect them toward proven management strategies, such as continuous glucose monitors.”
https://www.healio.com/news/primary-care/20230613/patients-with-diabetes-are-increasingly-turning-to-gofundme-to-pay-medical-bills
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United Healthcare will now cover the Eversense E3 CGM System for people with type 1 diabetes and people with type 2 who use insulin. That’s as of July 1. The Eversense E3 CGM is inserted just under the skin and stays there for six months.
UnitedHealthcare is the largest health insurance company in the United States
https://finance.yahoo.com/news/senseonics-announces-unitedhealthcare-coverage-eversense-110000925.html
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operational and commercial goals we set for this year,” CEO John Sheridan said in a call with investors on Wednesday afternoon.

That confidence is helped along in particular by the company’s plans for a spate of product expansions and launches later this year.

“Overall, there’s an enthusiasm at Tandem as we approach being able to offer another wave of innovative products to the diabetes community,” Sheridan said. “With these launches, we’ll be building upon our reputation for offering high-quality products and services that reduce the burden of diabetes management.”

Among those launches will be the integration of Dexcom’s G7 continuous glucose monitor sensor and Abbott’s FreeStyle Libre 2 and 3 into Tandem’s t:slim X2 insulin pump system, which Sheridan said would make Tandem’s device “the first FDA-cleared insulin pump integrated with multiple CGM sensors.”

Those additions will come in the form of free, remote software updates, per the CEO, with the first updates slated to begin rolling out in the coming quarters. For each of the three integrated CGMs, Tandem will perform “internal walkabout testing” before adding them to its t:slim system in scaled launches first in the U.S. and then internationally; the process has already begun for Dexcom's G7 and Abbott's Libre 2 sensors, with the Libre 3 on track to be a “fast follow-up” after the previous model’s U.S. launch this fall.

Sheridan suggested that a “meaningful number of customers” could be using a G7-connected t:slim pump by the third quarter, while the FreeStyle Libre version of the tech should reach that same nebulous milestone in the fourth quarter

Alongside the upgrades to its t:slim X2 pump, Tandem is also eyeing an upcoming launch for its new Mobi pump, which is still under FDA review. The pump is about half the size of the t:slim models and can be completely operated via a smartphone app.

“Our dialogue with the agency remains constructive as we work through the process of FDA review and responding to questions,” Sheridan said. “In the meantime, we continue to prepare for its launch in the second half of the year.”
https://www.fiercebiotech.com/medtech/tandem-plots-h2-launch-slimmed-down-insulin-pump-dexcom-and-abbott-cgm-integration
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Researchers at Washington University School of Medicine in St. Louis have identified a process in immune cells that links vitamin D deficiency during pregnancy to an increased risk of Type 2 diabetes in those born from those pregnancies. The research is published June 13 in the journal Nature Communications. Some theories of disease suggest that conditions in utero may have irreversible, lifelong consequences in offspring. The new study's principal investigator, Carlos Bernal-Mizrachi, MD, said that could be happening to the children of mothers who don't have adequate levels of vitamin D during pregnancy.
https://www.news-medical.net/news/20230613/Vitamin-D-deficiency-during-pregnancy-linked-to-an-increased-risk-of-Type-2-diabetes-in-offspring.aspx

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In the 16+ years since my son was diagnosed with type 1, I have attended dozens of diabetes conferences and events. Now I’ve taken the best elements from those events and created a brand new experience. We’re going to have lots of diabetes technology for you to see and learn about, stress-relieving social time where you can meet other moms just like you, and speakers who will leave you feeling energized and ready to face the challenges of parenting a child with T1D.
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Update on non invasive glucose monitoring.. Know Labs says they’re in the next stage of their Bio-RFID sensor. Lots of behind the scenes and lab advancements here from what I can tell. But they release says:
For 2023, Know Labs remains focused on external validation of its technology and contributing to its growing body of peer-reviewed evidence, which can be found at www.knowlabs.co/research-and-validation. The company will make further refinements to the Gen 1 Device as it works toward realizing its vision for the KnowU and UBand and bringing an FDA-cleared product to the marketplace.
https://www.businesswire.com/news/home/20230607005237/en/Know-Labs-Completes-Build-of-Portable-Generation-1-Prototype-for-Non-Invasive-Glucose-Monitoring
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Dexcom focuses on mental heath during the UK Diabetes Awareness Week. They’ve released a new study showing 84% of people surveyed agree having diabetes can negatively impact mental health. Their news release goes on..
To honor the strength and resilience of the diabetes community, and to promote mental health and connection, Dexcom is encouraging people with diabetes - and their friends and family - to strike a #DexcomWarriorPose by hosting a day of free puppy yoga classes at Puppy Yoga London in Hoxton, London this Saturday 17 June.

https://www.businesswire.com/news/home/20230612005039/en/New-Study-Shows-That-84-of-People-With-Diabetes-Struggle-With-Mental-Health1

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On the podcast next week..

That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
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Jun 13, 2023

Medications like Ozempic, Wegovy and Mounjaro are getting a lot of attention. What are they? How can they help people with type 1 and type 2? Should you think about taking one? After all, the weight loss component alone sounds amazing.

This week, Stacey talks with Dr. Steve Edelman, who lives with type 1 and heads up Take Control of Your Diabetes – TCOYD – a not-for-profit organization with the goal of teaching and motivating patients in diabetes self-care. We go through the science behind these medications, who might think about taking them, and whether they live up to the hype.

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

TCOYD ONE retreat info here

More info about GLP-1 medications here 

Dr. Edelman's "Buongiorno" Mounjaro video here 

 

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

The best way to keep up with Stacey and the show is by signing up for our weekly newsletter:

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Reach out with questions or comments: info@diabetes-connections.com

 

 

Jun 6, 2023

The newly FDA-approved iLet Bionic Pancreas is the most hands-off automated insulin delivery system to be commercially available. At set up, all you enter is your weight and the only interaction with the pump is to announce meal size, no carb counting.

Stacey talks with Beta Bionics CEO Sean Saint. We go through this pump system in lots of detail, talk about future plans – yes we’ll talk dual chambered pump which is the original design here - and get a little philosophical about the idea behind a hands off system.. especially for those of us used to being much more in the driver’s seat.

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

More about Beta Bionics: https://www.betabionics.com/

Our previous episodes about the iLet here: https://diabetes-connections.com/?s=ilet

One of many write ups of clinical trials with the iLet system: https://www.nejm.org/doi/full/10.1056/NEJMoa2205225

Stacey mentioned our episode with ConvaTec about infusion sets: https://diabetes-connections.com/the-seven-day-infusion-set-is-here-whats-next-from-convatec-infusion-care/

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

The best way to keep up with Stacey and the show is by signing up for our weekly newsletter:

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Jun 2, 2023

It’s In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: Lilly becomes the first of the big three insulin makers to settle a class action lawsuit over pricing, the FDA approved Beta Bionics' iLet system, oral meds trialed for T2D seem to work as well as Ozempic injectable, Lego adds a T1D "friend" to their line and a big win for an American Ninja Warrior competitor with T1D.

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

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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 VIVI Cap Keeps your insulin at the exact right temperature, even in extreme heat or cold.
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Our top story,
Eli Lilly has agreed to pay $13.5 million to end a six-year, class-action lawsuit accusing the company of overpriced its insulin. As part of the settlement, Lilly has agreed to cap out-of-pocket costs for its insulin at $35 per month for four years. That’s three months after Lilly said it would cut insulin prices to that level.
The lawsuit was filed in 2017, against insulin makers Lilly, Novo Nordisk and Sanofi. Plaintiffs claimed the companies joined in an “arms race” to raise list prices of their meds while the “real” price to pharmacy benefit managers remained constant or in some cases dipped.
Price increases of insulins that previously cost $25 per prescription were pushed up to $450, the suit said. The increases, taken in “lockstep,” were “astounding and inexplicable,” according to the class action lawsuit. Novo and Sanofi have yet to settle this case.

https://www.fiercepharma.com/pharma/eli-lilly-inks-settlement-long-running-insulin-pricing-lawsuit
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The FDA is changing its draft guidance for industry regarding Antidiabetic Drugs and Biological Products. It’s been 15 years since an update. Topics covered in the draft guidance include:
Hemoglobin A1c (A1C), a measure of average blood sugar, remaining an acceptable primary efficacy endpoint
The FDA now considering a reduction in the risk of hypoglycemia (low blood sugar) to be a clinically relevant outcome measure for diabetes drug clinical trials, when accompanied by either a reduction or maintenance of an acceptable A1C.
The use of data collected by continuous glucose monitoring (CGM) systems, which allow for nonstop, passive glucose monitoring, in clinical trials to potentially support hypoglycemia labeling claims. Recent advancements in CGM technology have led the agency to recognize the advantages of data collected from these systems in clinical drug development. The FDA will be accepting comments on the guidance until August 24, 2023.
https://www.appliedclinicaltrialsonline.com/view/fda-on-track-to-updates-diabetes-efficacy-endpoints-guidance
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The iLet bionic pancreas from Beta Bionics gets FDA approval for people with type 1 age 6 and up. This is a unique system in that it starts with only the user’s weight and requires meal announcements – no carb counting – to automate blood sugar. It will launch with the Dexcom G6 CGM. You’ll hear from the company CEO this Tuesday in our next episode where we do a deep dive into the system.
https://www.medicaldevice-network.com/news/beta-bionics-fda-insulin-pump/
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Researchers had observed an increased incidence of type-1 diabetes cases during the COVID-19 pandemic. Now, a new study has confirmed the link and established a temporal association between the development of type-1 diabetes in children and infection with the SARS-CoV-2 virus.
The new study published in Jama Network was the first research that used data, which indicated if the type-1 diagnosed children previously had COVID-19 infection.

The researchers found the likelihood to develop type-1 diabetes increased by 57% in children who had a confirmed COVID-19 infection, compared to those who did not have the infection.
https://www.medicaldaily.com/covid-19-infection-increases-incidence-type-1-diabetes-children-study-469854
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New oral medication from Pfizer seems to stack up well next to Ozempic for weight loss. New study looked at people with type 2 found danuglipron when given twice a day, lowered blood sugar in patients at all doses and reduced body weight at the highest dose after 16 weeks.

The weight loss with danuglipron is of a similar magnitude to that observed in the mid-stage data for Novo Nordisk's semaglutide, known as Ozempic when used for diabetes and Wegovy for obesity.
The treatments, including Pfizer's danuglipron, belong to a class of drugs that mimic the gut hormone glucagon-like peptide-1 (GLP-1), which works by suppressing appetite and were initially developed to treat type 2 diabetes.
Pfizer is also testing another oral diabetes drug, lotiglipron, which is given once daily and has said it plans to initiate late-stage development of only one of the two candidates.
The company believes an oral therapy could appeal to patients who want to avoid injections.
https://www.reuters.com/business/healthcare-pharmaceuticals/pfizer-diabetes-drug-reduces-weight-similar-novos-ozempic-2023-05-22/

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Artificial intelligence (AI) algorithms used to screen for and predict type 2 diabetes may be racially biased, which could perpetuate health disparities, according to a study published last week in PLOS Global Public Health.

Risk prediction models for type 2 diabetes have shown promise in bolstering early detection and clinical decision-making, but the researchers pointed out that these models can bias the decision-making process if risk is miscalibrated across patient populations.

The research team found that the Framingham Offspring Risk Score underestimated type 2 diabetes risk for non-Hispanic Black patients, but overestimated risk for their white counterparts.

The ARIC Model and PRT overestimated risk for both groups, but to a greater extent for white patients.

Research like this highlights that while data analytics and AI approaches may help find gaps in chronic disease management and care, racial disparities are still a major obstacle to achieving health equity for diabetes patients.

A 2021 study of city-level data revealed significant disparities in diabetes mortality rates across the United States.

The analysis sourced data from the 30 largest cities in the US and demonstrated that mortality rates were higher for Black individuals than for white individuals. Disparities were also found to be up to four times larger in some cities compared to others, with Washington, DC experiencing the highest rates of diabetes mortality inequities.

https://healthitanalytics.com/news/potential-racial-bias-found-in-type-2-diabetes-risk-prediction-models
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1 in 3 adults with Type 2 diabetes may have undetected cardiovascular disease. Elevated levels
However, mildly elevated concentrations of of two protein biomarkers that indicate heart damage may be an early warning sign of changes in the structure and function of the heart, which may increase the risk for future heart failure, coronary heart disease or death.

Researchers analyzed health information and blood samples for more than 10,300 adults collected as part of the U.S. National Health and Nutrition Examination Survey from 1999 to 2004. Study participants had reported no history of cardiovascular disease when they enrolled in the study.
One-third (33.4%) of adults with Type 2 diabetes had signs of undetected cardiovascular disease, as indicated by elevated levels of the two protein markers, compared to only 16.1% of those without diabetes.
https://medicalxpress.com/news/2023-05-adults-diabetes-undetected-cardiovascular-disease.html
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MTV Documentary Films has acquired worldwide rights to Pay or Die, a film about Americans living with diabetes who face a cruel choice: pay the “extortionate” cost of insulin charged by pharmaceutical companies or risk death.

Scott Alexander Ruderman and Rachael Dyer directed and produced the documentary, which premiered in March at SXSW. MTV Documentary Films plans a theatrical release later this year, followed by a debut on streaming platform Paramount+.
Those personal stories in the film stretch across the country. “From a mother-and-daughter struggling to rebuild their lives after spending their rent money on insulin, to a young adult diagnosed with Type 1 diabetes during the COVID-19 pandemic, to a Minnesota family thrust into the national spotlight when their 26-year-old son dies from rationing his insulin, Pay or Die highlights this devastating struggle to survive while living with diabetes.”

https://deadline.com/2023/05/pay-or-die-mtv-documentary-films-acquisition-directors-scott-alexander-ruderman-rachael-dyer-news-1235382566/
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Katie Bone win the “American Ninja Warrior Women’s Championship” — not only claiming the title but a cash prize of $50,000. She donated $5,000 to the Juvenile Diabetes Research Foundation and Pumped NM.

Bone has not only appeared on three iterations of the competition series, but is also a nationally-ranked rock climber.

While not the youngest competitor anymore, she was the shortest standing at 5 foot, 2 inches. She’s been making waves since competing in “American Ninja Warrior Jr.” in 2020.

To train for the event during the pandemic, her father built a ninja course in their backyard.

During that competition, Bone, who was diagnosed with Type 1 diabetes at 11 years old, competed with both her insulin pump and glucose monitor on her arms.

Being on the show also presents Bone with the opportunity to be an ambassador for Type 1 diabetes awareness and representation.

Bone says Type 1 diabetes didn’t end her life, it just changed it.

“I hope I inspire a little kid to wear their pump on their arm,” Bone said. “It makes everything that you do that more amazing.”

In February, Bone competed at the USA National Women’s Team Climbing trials in Austin, Texas.

During her fourth climb, she fell.

“Katie heard four pops,” Tammy Bone said. “She tore her ACL and both sides of her meniscus. This was a moment she was preparing for all her life and it got put on pause.”

Bone had surgery and has been getting physical therapy in Colorado. The family returned Monday night to New Mexico after being away for three months.

Bone still has her eyes on the Olympics, though the road to recovery may take some more time.

“I don’t need easy, I just need possible,” she said.
https://www.abqjournal.com/2602750/17-year-old-new-mexico-ninja-warrior-katie-bone-takes-the-title-in-womens-championship-competition.html
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Today LEGO has revealed the first wave of Friends sets for 2023, bringing in a new cast of characters and an update to the branding with a new logo. A new LEGO Friends television series will also accompany the new sets. LEGO’s annual Play Well study revealed that 3 out of 4 children felt there were not enough toys with characters that represent them, so LEGO is aiming to bring more diverse representation to Heartlake City that’s inclusive of not just various ethnicities and genders, but also disabilities and neurodivergence. LEGO says the 2023 sets and series will feature characters with limb difference, Downs Syndrome, anxiety, vitiligo, and even pets with disabilities, including a blind dog and a dog with a wheelchair. She has a CGM printed on her arm and even has a printed phone tile showing her blood sugar. Her name is Hannah and she’s in 41744 Sports Center
https://www.brothers-brick.com/2022/10/27/lego-friends-reveals-5-sets-for-2023-with-diverse-characters-to-better-represent-children-news/
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On the podcast next week.. Beta Bionics CEO Sean Saint. Last week I MedT 780G

That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

 

May 30, 2023

This long-awaited Medtronic 780G is now FDA approved. It’s been out for two years in Europe and has features that are a bit different from other commercially available automated insulin delivery systems in the US, including a target range down to 100.

This week you'll hear from Heather Lackey, global medical education director for Medtronic Diabetes who also lives with type 1 and has used the 780G. We talk about what else this system can do – remember this is the one with the 7-day infusion set – and Stacey asks a lot of your questions.

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

More info here: https://diatribe.org/medtronic-minimed-780g-approved-fda

Lackey mentions a study where even with no meal boluses for three months, people stayed mostly in range. Here's that study: The Official Journal of ATTD Advanced Technologies & Treatments for Diabetes Conference Madrid, Spain—February 19–22, 2020.  Diabetes Technology & Therapeutics. Feb 2020.A-1-A-250.http://doi.org/10.1089/dia.2020.2525.abstracts

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Rough Transcription:

Stacey Simms  0:00

Diabetes Connections is brought to you by The only Ultra rapid acting inhaled insulin by Omni pod five, the only tubeless pump that integrates with Dexcom G six mi Dexcom G seven powerful simple diabetes management.

This is Diabetes Connections with Stacey Simms.

This week, the long awaited Medtronic 780 G is now FDA approved. It's been out for two years in Europe and its features that are a bit different from other commercially available systems in the US, including a target range down to 100.

 

Heather Lackey  0:44

And it's just been proven to do so successfully without really increasing a lot of time below range. You know, what will the next system lead up? Will it be below 100? I don't know. But it's so nice to be waking up with glucose levels that are so much closer to someone without type 1 diabetes with this lower target.

 

Stacey Simms  1:05

That's Heather Lackey, global medical education director for Medtronic. She also lives with type one, we talk about what else the system can do remember if this is the one with the seven day infusion set, and I ask a lot of your questions. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

Welcome to another week of the show. Always so glad to have you here. You know, we aim to educate and inspire about diabetes with a focus on people who use insulin. I'm your host, Stacey Simms, and we are getting some big FDA approvals. Along with the Medtronic 780 G, we got word that beta bionics islet will soon be commercially available. As I am recording this I do have an interview set up with the beta bionics CEO. If all goes to plan that will be our show next week. Real quick, while the original islet dual chambered pump was not what was in front of the FDA, the pump that has been approved has some really interesting features. It's unique in that there are no steps to the programming. When you get your pump, you're not putting in basal rates or insulin sensitivity factors or anything like that. All you do is put your weight in. But that is for next week. You can follow me on social media. We've already shared some information about the islet and I've done many episodes in the past if you want to listen to those to get an idea of what was approved, but this week, we're talking about the Medtronic 780 G, as you likely remember Medtronic at the very first of what we now call a ID systems automated insulin delivery systems with their mini med 670 G and that was approved in 2017. We've been hearing about the 780 G for a long time. It was submitted in 2021. I've talked a lot about the delays in the in the news episodes. It has been approved in Canada since last year. It was approved in Europe in 2020. We're gonna go through lots of features of the pump, but you should also know that the sensor used with this system The Guardian four is approved with no finger sticks for dosing, which to me is one of the most significant changes.

My guest to talk about all this is Heather lackey. She has been with Medtronic for more than 19 years. She delivers medical education strategy for insulin pump systems. She trains Medtronic education teams around the world. She lives with type one she was diagnosed at age 16. She was also a consultant on the movie Purple Hearts. She also popped up in a scene in that movie and yes, I asked her about that. Lots to get through.

But first Diabetes Connections is brought to you by Afrezza. Afrezza is the only FDA approved mealtime insulin that comes in a powder you inhale through your lungs. So why should you consider this unique alternative to mealtime injections. Afrezzais another option if you want to lower your use of needles or if you're experiencing skin reactions at your injection sites, and it is ultra rapid acting so you can take it right when your food arrives. Even unexpectedly. Find out more see if Afrezza is right for you go to diabetes dash connections.com and click on the Afrezza logo. Afrezza can cause serious side effects including sudden lung problems low potassium and it's not for patients with chronic lung disease such as asthma or COPD or for patients allergic to insulin. Tell your doctor if you ever smoked ever had kidney or liver problems history of lung cancer or if you're pregnant or breastfeeding. Most common side effects are low blood sugar cough and sore throat severe low blood sugar can be fatal. Do not replace long acting insulin with Afrezza, Afrezza is not for us to treat diabetic ketoacidosis please see full prescribing information including box warning medication guide and instructions for use on our frezza.com/safety.

Heather, thank you so much for joining me. I have a lot of questions for you about the new system but first welcome. I'm glad to have you here.

 

Heather Lackey  4:52

Oh thank you Stacey. It's my pleasure to be here and so nice to get to meet you. I listen to your podcast and just excited Good to be a part of this one.

 

Stacey Simms  5:00

Oh, well, I'm thrilled to have you. And I'm sure you don't mind if I say it has been a long time coming. Lots of people very excited about this improvement. Can we start by just talking about the seven EDG? What makes this different from the Medtronic pumps that have come before?

 

Heather Lackey  5:16

Yeah, well, the mini med seven add system is different in the fact of course, it let's say what it Phil has right still has automated basal insulin, and that insulin ID based on the sensor glucose values, but this system is set apart because it delivers does auto correction boluses, like every five minutes is needed. So we know that life with type 1 diabetes, as you well know, as a mom, someone with type one and be living with it, we know that life does not go as we expect all the time and as planned. And so many things affect our glucose outside of the three things that we've always tried to juggle for years, right? Food and insulin and exercise. But now that we really kind of identify that there's so many other things that are impacting our glucose, it really brings to light the fact that we don't get it right 100% of the time, when we dose insulin, we adjust food. And so that's where those auto corrections that are coming in real time, every five minutes, if needed, can really help. And what I love about the system is the auto corrections, you don't have to be sky high to get an auto correction. As a matter of fact, you don't even have to be high. before they begin. They're really kind of thinking like a pancreas than as soon as your glucose rises over 120 milligrams, as the basal is working as hard as it can and saying, Hey, I need help, then the auto corrections come into play. And they can start dosing a correction bolus every five minutes if needed.

 

Stacey Simms  6:59

So what is the difference between the auto basil and that bolus that you're talking about? Because you know, the automated systems that are out right now already adjusted basal every five minutes? What is actually happening when you say oh, and it's also giving a bolus?

 

Heather Lackey  7:14

Yeah, so the bolus happens every five minutes on top of the date. Right, facie, so let's say, again, the goal for many meds seven ad G, there were kind of two goals in play, right, we wanted to further improve time and range, you know, compared like with the mini med 670 G system without compromising any safety, because we all know we can drive down glucose, right, but you don't want to have a lot of lows. And we wanted to reduce the daily interactions with the system. And those daily interactions, right, the the alerts and the alarms and all of the safety pieces that were were added to mini med seven, add, those have all been now relaxed, and so less than erection and improvement in time and range without sacrificing hypoglycemia. So what's nice about the system is you not only are delivering the auto basil, like you said, right, we have auto basil and other systems that now if the auto basal cannot keep the glucose level in the target range, it predicts that the glucose level is going to go higher than it would like then that's when those auto corrections come. And they don't come once an hour, they come every five minutes. As soon as that since your glucose rises over 120 milligrams per deciliter. If the system says, Hey, I'm working as hard as I can with your basal, and I'm not able to keep your glucose at the target range that we want, right. And we'll talk about targets and here in just a minute, hopefully. But if we can keep your glucose at that target range, then I'm going to ask for some help. And that's where those auto corrections. And those are boluses. Right? boluses that happen every five minutes without the patient having to agree to them, or take any action on their part. They just happen automatically.

 

Stacey Simms  9:14

Alright, I have a few more questions about that. But I'll get back to that in a couple of minutes. Because I feel like most people will just see the results. And they they may not have too many questions about exactly what's going on there. But I want to get back to that bullets in a minute. But you mentioned range, and the seven EDG has a lower range than Tandem and Omnipod. Five have currently right it's correcting down to 100. Or that's a choice. You can adjust that.

 

Heather Lackey  9:37

Yeah, there's a couple of things that are different and new about this. And Minimates seven add definitely treats to a target, not a range. But you're right though the target is the lowest target at this moment that's available and so the auto basal target, you can set three settings Three different targets are available to where the person was diabetes , their healthcare provider can can really identify which target is best for them. But the three targets are 100 milligrams per deciliter, 110, and 120. Now 100 comes as kind of the default auto basal target. And that's because we know that this system was all of the copious data that we have. And all of the simulations that were done before this system was even launched, was using that 100 target. And that's what this system is built around to be the best target to you.

 

Stacey Simms  10:36

We should note that tide pool type pool loop, which was approved by the FDA a few months ago, can correct down to 87. But it is not available in any insulin pump, yet. It's a software program that was approved. So 100 for Medtronic is the lowest that you can actually use right now. But it's interesting, that's 101 10 and 120, where some other systems have, you know, an exercise mode that is a higher range, do you have any insight as to why those were chosen?

 

Heather Lackey  11:02

Well, those are that close to target to mirror a normal functioning, you know, system a system without diabetes . And the interesting thing is, is the 100 target is very much achievable without sacrificing time below range, right? So we're able to drive with the auto basal target being set at 100. And with having the auto corrections that are even delivering up to every five minutes, this is the system, you know, determined that those were needed. We have the algorithm that built to drive the system to 100. And it's just been proven to do so successfully without really increasing a lot of time below rage. You know, what will the next system lead us? Will it be below 100? I don't know. But it's so nice to be waking up with glucose levels that are so much closer to someone without type 1 diabetes. With this lower target.

 

Stacey Simms  12:03

Let's talk about the sensor because there are changes here too. Right. Tell me about the sensor that goes along with the 780G? Yeah, well,

 

Heather Lackey  12:10

the Guardian four sensor is the center that it works with the mini med 780G system. And the Guardian Force center was designed really to reduce the burden as daily finger sticks. That was the whole goal. Let's remove calibration from the system. And let's try to develop a system that doesn't require finger sticks. As we know, sometimes finger sticks still are needed with really with any of the systems and sensors. But the majority of the time when our patients are in the mark guard feature is they are using the SR glucose to bolus off that, you know, there's no real need for a fingerstick glucose. And interestingly enough, most patients bend upwards of you know, 95% or so in that smart guard feature. And so many patients will tell me, I am forgetting my glucose meter at home. And I had one patient that went on a trip, he went out of the country and he said, Look, I totally left insulin and glucose at home because I had kind of forgotten to take my meter bag with me. Wow, learning for sure.

 

Stacey Simms  13:27

Oh my gosh, yeah, my son goes without a meter quite often. Since you know his we use the Dexcom in the control IQ system from Tandem. But yeah, you don't want to forget your bag entire. That's not good

 

Heather Lackey  13:38

news. Okay, that's if that's now a burden that is taken off of you. And that's lovely. Yeah, no doubt. No need to be prepared, right?

 

Stacey Simms  13:47

Yep, absolutely. And I think it's worth pointing out that this is the only automated insulin system in the United States. That is one system, right? It's a glucose monitor infusions that insulin pump. That's all Medtronic and this system has that extended infusion set right so you're talking to sensor you were for seven days, and an infusion set for seven days, right. We'll get right back to my conversation with Heather but vs Diabetes Connections is brought to you by Omni pod. And when you're deciding that a random insulin pump, you got a lot to think about, especially if you've never used a pump before. It really can seem overwhelming. I remember that there are a lot of choices, and you want to make the right decision. And that's why I'm so excited to tell you about Omni pod five. Curious about trying an insulin pump or seeing what life without tubes is all about. Unlike traditional tube pumps, you can try Omni pod without being locked into a four year contract. You might even be eligible for a free trial, go to diabetes dash connections.com and click on the Omnipod logo for full safety risk information and free trial Terms and Conditions. Also visit omnipod.com/diabetes connections. Now back to Heather answering my question about this seven day infusion set

 

Heather Lackey  15:03

That's exactly right. One kind of new feature of the mini med seven add system is the extended infusion set. And that extended infusion set. It's been launched for a few months in a few different countries. But it comes now with de minimis 780G system, and really allowing people to just kind of have to think about changing a center and changing their infusions that just one day out of the week versus anymore. And so that system, you know, I have so many people that will go have our youth told us for years, you know, that we have to change our infusion set every three days. And why are we able to start to use that system now, and just been using that now for seven days. And the the, it's really simple to explain without getting into a lot of engineering details, but that infusions that is made with this advanced material. And what it does is it helps to reduce the insulin preservative, you know, kind of the loss that we would typically have, it helps to maintain the insulin flow. And it helps to maintain the stability of the unfolding. And so there's such a reduced risk of any kind of blockage or occlusions, with your infusion set whenever you use this new extended infusion set. And I always have to remind patients and people with that need us and their families, make sure you're only using the extended infusion set for seven days, and you're not using your current infusions that are that long, because the materials are different.

 

Stacey Simms  16:41

Yeah, good point. Can you use any insulin in those extended infusion sets?

 

Heather Lackey  16:47

So well, in the mini med 780G system, the insolence that are approved and on label are human log and Nova logs. So both of those are available to us with that set.

 

Stacey Simms  16:59

So no, Lusia if I ask, just checking, those are not approved at this time. Got it? Got it. I had a listener ask if the duration of insulin is adjustable, you know, is that a setting that people can kind of go in and tinker with?

 

Heather Lackey  17:13

Yeah, so active insulin kind of talks about the or is our duration and insulin kind of tuning knob that is in the programmable settings on the mini med 780G pump, the active insulin Time is of the two settings that are critical is one of the two, right the first setting is the auto label target, you know, looking at that 100 glucose target for most people with diabetes, but then also setting the active insulin time to two hours. And a lot of people will say, Look, I have never had active insulin or insulin on board. I've never thought that human log or Nova log was out of my body in just a couple of hours. And so it's interesting that Medtronic is recommending a two hour active insulin time. Why is that? And the real answer is this is what the algorithm was designed around, right, it's fine to have the ability to, you know, the algorithm is asking the patient, if you set the active insulin time to two hours, then that gives me the ability to calculate insulin, if I think it's needed, right, that doesn't always mean that you're just gonna get insulin stacked on top of, you know, each other dose on top of a dose every two hours. It just means that gives the algorithm the ability to give correction sooner. And whenever you're giving those auto correction. as frequently as every five minutes, it makes sense to be able to just kind of give the algorithm the freedom to make the decision if it's needed. And anytime I have someone that really wants to debate this, and understand how the algorithm works, I just always have to say, let's just look at the data. And you know, we're not stalking we're not having hypoglycemia in the 10s of 1000s of patients that we have data on.

 

Stacey Simms  19:06

Yeah, it's actually I wish I had a diabetes educator. Maybe this will be for another episode. You are obviously a diabetes educator. But it'd be fun to have somebody else from a different pump company because other pump companies will say no, no, no, exactly. As you're saying like you're stacking insulin. We set it this way for a reason. It's not adjustable for a reason. Is this two hour duration. A different setting from previous Medtronic pumps forgive me? I'm not as familiar with them.

 

Heather Lackey  19:29

You don't know. That's a great question. They see it the same accident one time. Honestly that has been a part of the bolus calculator settings, the bolus wizard and now the smartcard bolus feature that even since the paradigm days, right, when the bolus calculator was first presented, we're now looking at decades ago with the active insulin time. So it's the same setting we've had, but now it's kind of viewed in a different way than Then it has been in the past, right? In the past, it was very traditional, like you're saying and, and kind of how patients will think of it with, you know, whenever I'm in conversation with them, they're like, How can this be. And the simple fact is, with setting the accidents one time, as low as two hours, which is what we see the best control, the best time and range and the lowest time below range, right? So the fueler lows is actually set at two hours. And what that does is it just is a tuning algorithm knob. And it says, Hey, algorithm I'm going to allow you to give, if you determine that it's necessary, meet Insulet. And because you're looking at my rate of change, you're looking at how much insulin is on board, you know, how many grams of carbohydrate that I've entered, it takes all of this information into account and decide if action should be taken. And what lovely is the patient, the person with diabetes that mom, dad, the family, they don't have to make any of those decision, the system is doing it for them.

 

Stacey Simms  21:05

It should have probably started with this question. But what does the algorithm use as a starting base? You know, we're used to traditional insulin pumps where you sit with your educator or your doctor and you say, Here's my basal rate, here's my sensitivity factor or correction factor, or, as we're talking about here, duration, there is a pump in front of the FDA right now that just uses body weight. What is the 780? G use?

 

Heather Lackey  21:26

Yeah, that's a great question as well, algorithm really start with total daily dose of insulin, kind of as it is its starting point, right, the calculation. And that's why whenever you are new on the mini meds 780G system, people have to stay in manual mode. So the kind of the non auto basal in auto correction kind of piece of it. So they stay in manual mode for 224 hour days, right. So it's two days in manual mode. And then there's enough data as a starting point for this system to be able to, to say, Okay, this is a safe basal amount for you to begin with. In addition, if there's sensor glucose tracings, in that 48 hours of kind of that warmup period, to the smart guard feature, then those fasting sensor glucose level pump is looking to see like, how much insulin Do you require, whenever you're not announcing meals and, and so it see, okay, this is your center, glucose is in a fasting state. Now, how much auto Basil is being delivered. And that is kind of the two main pieces of information of how the system decides how much auto basil to begin with, and to deliver,

 

Stacey Simms  22:49

got it, can the user switch back to manual mode,

 

Heather Lackey  22:53

yet, they can, at any time, they can stop the smart guard feature, we know that the data is so overwhelmingly heavy weights heavy on the smart guard side. So we definitely see a major difference in time and range being improved. Whenever people are in this barcard feature versus in manual mode, right? They're always encouraged to say and

 

Stacey Simms  23:16

got it but the system doesn't like. And I hesitate to say it this way. But you'll know exactly what I mean, the system isn't kicking people out as much as one of the very early automated systems for Medtronic, right? That was a big complaint with the 670 was I got kicked out of auto mode.

 

Heather Lackey  23:30

That was a complaint. And we know that whenever the mini med six, seven ad system, the first hybrid closed loop system of its time was a pretty conservative algorithm, right? Because it was first of its kind, Medtronic really had to build on a number of safety precautions. And in many cases that led to those unwanted alerts and alarms and interactions with the pump to keep the system kind of in that auto mode, smart guard auto mode feature. And so with this, we the exits on mini med 780 G system. I mean, they're just not happening, right. And again, though, the number one of two goals of this system was to reduce the daily interactions with the system. So we can't have beats and alerts and alarms. And hey, you have to enter a BG all the time in order to stay in to the automation mode. This is a big difference that people especially those that have been on previous hybrid closed loop systems of all kinds, they're like this is really a pretty big change right? exits at night, exit in the daytime alerts at night. Those are some of the things that are really different from a user lens. Whenever I hear anyone asked my husband, you know, like what kind of from your standpoint In a view, what's the biggest change with you seeing your wife were the minimis 780G system for a while. And he just says, look, it just doesn't wake us up at night. And he just seems to be a little bit more pleased. A lot of surveys that have been conducted all throughout, you know, the countries where people are using and wearing many hats, 7080 G system, you know, it's like 94 95% of people are saying that they're satisfied with the impact on the their quality of life, they're happier with the quality sleep, that's one that's pretty high, ranked and desired by many. So for us to get a good night's rest and to feel confident to go to bed, lay our head down, not have lows or highs not have alerts and alarms. That's the system that we need. And that that's what people are enjoying.

 

Stacey Simms  25:54

One more question about manual mode, a listener had asked me is manual mode usable during the auto mode? In other words, if somebody really feels like they need to do an additional bolus, can they do it?

 

Heather Lackey  26:05

It can be done, but I would kind of ask why do they feel like it needs to be done? Right? Why would you need to go out to manual mode if you need to give an additional bolus. So carbs can be entered at any time that those are consumed? Right, we definitely want to announce our mills. And at any time in the smartguard feature, a patient can always look to see if if they what we kind of say a user initiated correction dose is needed. So you don't you know, I don't ever want people to feel like once I'm in the smart guard feature, guy can't take action. If I see glucose, where I don't want it to be or if I've eaten something that I didn't tell it, you know, go ahead and deliverable list, at least check to see if a bolus should be given. And maybe some of the feedback that patients had on mini med 670 G system where they felt like they had to enter in perhaps kind of ghost carbs or fake carbs when they weren't actually eating them to kind of trick the algorithm to giving more insulin, I think you'll find with now that control that we have able to control on this system like that active insulin times and the auto basal. I don't see that people at all are having to what we say automate the automation? Well,

 

Stacey Simms  27:27

yeah, we let me ask you a follow up on that. Because I don't know anybody who uses an AI D system who just puts in meal boluses and says, Great, I'm always in the range I want to be are you saying that's what's happening with the 780?

 

Heather Lackey  27:39

Well, I'm saying that anytime that you eat in any of the AIP systems, right, you can you can enter those grams of carbohydrate. But because many meds 780G system gives the autocorrection doses starting at anytime, and glucose is over 120 systems. If the auto basal can't handle that glucose response, then they're gonna get it. So because you start you intervene the system intervene early and intervene often, there's less of the need to take matters in your own hand. Right. So it's a different mindset. Really it?

 

Stacey Simms  28:18

Yeah, no, it's absolutely it sounds great. Well, we'll see. When you said meal announcements, to be clear, you're talking about carb counting and putting in the numbers of carbs you're eating, you're You're not just saying I am eating?

 

Heather Lackey  28:31

You're saying I Yes. You're you're entering grams of carbohydrate. Thank you for clarifying going

 

Stacey Simms  28:36

no, I'm just you know, I know it's coming. It's amazing to see how these things are changing. I just want to be clear as we go. Yeah. Well,

 

Heather Lackey  28:42

you know, that's kind of a segue Stacey to a lot of the different thoughts on do people have to now with autocorrection? Do people have to be so precise on the grams of carbohydrate that they're entering into those bits? Okay. Well,

 

Stacey Simms  28:59

let me give you Yeah, let me let's segue into that. Let me give you the best case use that I can make in my house or something like this. I have an 18 year old, he's a great kid. He's very responsible with diabetes. He is terrible about bowling before he eats. It's just it's just not happening. And so we have a lot of, you know, excursions that perhaps don't necessarily need to be happening. I would be thrilled at a more aggressive post meal bolused system. So talk me through what happens to scenarios for you. Somebody has an AD of just throw 85 carbs out there because this happened recently. So somebody has an 85 carb dinner, they bolus five minutes after they finish it. Or somebody has an 85 carb dinner and completely forgets to bolus how does the system handle those things? Oh, yeah.

 

Heather Lackey  29:45

Well, I'd love to show you my report. Because not only does it happen with an 18 year old, it happens with me more than I would like oh my goodness. I plan for 33 years. How am I forgetting to push the button,

 

Stacey Simms  30:01

I love it, you're human, you're human. I'm totally

 

Heather Lackey  30:04

human. So the 85 gram carb dinner, and they bill it five minutes later, right? We know that if you are not giving insulin before the meal, right, you're gonna have food most likely showing up to the party before the insulin arrives, right, so you're gonna have food, their glucose is gonna rise because of the food digest. And then here comes insulin. In that case, we would say, Look, if then, you know, if you're really bolusing, after the meal, you probably are going to need to reduce your meal Bolin, than we have some exact parameters for healthcare providers to kind of discuss with their patients. But you know, on average, it's like, look, probably just dose for, you know, maybe that path in your case, maybe it's not, because as you know, as those is that sensor, glucose starts to rise, the auto basal start to increase, it gets to the maximum, let's say, and then here comes the auto correction. And then you've got insulin, you know, from the bolus still showing up to the party at that point. So what's so great about this system is it knows like, okay, auto Basil is increasing, then there's some, you know, potential auto corrections, as soon as the bullet is given, the system goes, Okay, let's just, let's back off, right, let's see, what's gonna happen with the system before we really just push the pedal to the metal and start giving more correction. Right? So everything is done with the total safety in mind, right, which is something that's so great. Now for the 85 grams of carbohydrate, and they don't bolus at all, well, then that's really what are the auto corrections and the auto basil can shine, that's really where you're going to see sensor glucose is rising. And am I going to say they're never going to go high with an 85 gram carbon bill, I would say that wouldn't be, you know, really unlikely, depending on what what the nutrients are in that food, I would think it was going to be unlikely. And so glucose is going to rise, the system is going to to handle it as as well as it can. But what I can see time and time again, with when mills are skipped, that patients don't go as high and they don't say as high as long. But we have a study that actually support that patient who did zero pole was seeing for a period of time. So this is every single meal for this length of time. And I'd have to look at the report to know exactly the days, but their time and range was just right under that 70% of time and rain. Yeah. And so that's not at all what we are recommending, because we know that if you bolus and you're using the recommended settings, it doesn't matter if you're eight year old, or if you are a 18 year old, or if you're a 58 year old or if you're a 78 year old, we know that for everyone, you can have an upward time and range of 80% plus, right. So we know it's better. And we absolutely want to provide the charge that we should be announcing mil but it's so nice, whenever the occasional I forgot to bolus to you know,

 

Stacey Simms  33:29

sort of occasional

 

Unknown Speaker  33:32

got your back for some more than

 

Stacey Simms  33:36

excellent. I did get this question about the bolusing system, how much of a correction is given? Because on some of these other systems, it's a partial correction. I don't know if you can share that, you know, it's it may be part of the algorithm that you can't share. And then also, how does the system differentiate? Or does it between a missed meal and a random high? You know, a high that may come for another reason?

 

Heather Lackey  33:57

Yeah. Thank you good questions. Okay. So for the repeat the first one, if you don't mind, sure

 

Stacey Simms  34:03

how much of a correction is given, you know, like on the T slim, I think I may not be correct here, but it's something like, you know, once an hour can give 60% of the program to bolus. So is that something that the Medtronic keep some good and maybe proprietary? Well,

 

Heather Lackey  34:16

I can tell you this is the difference with the mini med 780G system is it gives a full correction, you know, if needed every five minutes and every correction bolus, right? It's like if you were giving a correction yourself with a pump, you're going to enter your glucose. The system does the same. It says look, this is where the glucose is. This is where I want it to be. And it's targeting 120 Whenever it's giving a correction dose of insulin, right. That's why after 120 it can start to deliver a correction dose and it looks at the difference and it sees how much insulin is going to be needed. And then it also applies other metrics as well like how much insulin is circulating in the body and And then it determine the safe amount that is going to be needed every five minutes. Got it?

 

Stacey Simms  35:06

Got it. Okay, great. And then the other question is about does the system differentiate between, you know, missing a meal or a high for another reason? And I could think of highs, you know, and teenagers for, you know, hormones or exercise, things like that, does the system differentiate? And I guess the follow up is, does it need to, or is a high, just a high,

 

Heather Lackey  35:24

you know, really high is the high and and that's what's so great about the the system anytime there is a rising rate of change, and you know, parameters are met, that the pump says, Wait a second, this is a rising rate. Oftentimes, it's a meal that's missed right? To meet the parameters. When the system sees that this is Matt, what it does is it allows a correction dose to be delivered even a little bit more aggressively. Right. So you know, it does have a mill detection module built in. It has mill detection technology built in, but it doesn't so much say, Oh, this is your sensor, glucose is rising now because of the meal. So I'm going to act this way. Versus your since your glucose is rising, because you have hormone releasing in the middle of the night and you're sleeping, right. Either way, this system is looking at the sensor glucose response. And if it's corrections need to be delivered in a more aggressive manner, or larger corrections need to be delivered either way, then the system is able to do that. You know,

 

Stacey Simms  36:40

we've mentioned several times that you live with type 1 diabetes. I mean, I know I can talk to you about the pump for probably another two hours. And I hope you'll come back on and we can talk more about it. But I want to ask you about your your journey. You were diagnosed as a teenager, what did you use what was the first diabetes technology, I assume it was a blood sugar meter. coming right back to Heather in just a second. But first Diabetes Connections is brought to you by Dexcom. And Benny has been using the Dexcom CGM for almost 10 years now, that first insertion was in 2013, just before he turned nine. I mean, it was great. Then if you've done finger sticks for a while you know how amazing it is to go from that to continuous glucose monitoring. But it is even better. Now. The Dexcom CGM systems just keep improving, continuing to get more and more accurate with no finger sticks or scanning required. The easy push button insertion has made it easy for Benny to do it himself. He has done every one since we switched to the GS six in 2018, which is really great for his independence back then, as a younger teen. Of course, we still love the alerts and alarms, and that we can set them how we want if your glucose alerts and readings for the G six do not match symptoms or expectations. Use a blood glucose meter to make diabetes treatment decisions. To learn more, go to diabetes connections.com and click on the Dexcom logo. Now back to Heather talking about what things were like she was diagnosed at age 16.

 

Heather Lackey  38:10

Yeah, you know, I was diagnosed in 1990. And of course, I had a meter. The old lancing device that I had was the one that you lay on the table and it's spring loaded and it like warm around like a hammerhead, and it would poke your finger. Right. So that was my first one. And you know, I was just on conventional insulin therapy, right, at least had disposable syringes. I wasn't sharpening a needle or have a glass of orange or anything like that. And you know, for me, Stacy, my parents were so great. My dad worked internationally. And they were just constantly talking to people like what, there's got to be something that right because I was doing everything I could, I mean, I really tried hard. And I have for, you know, three decades, tried hard to really kind of manage things. And they said, you know, there's got to be something better. And that was right at the end was actually before the end of the DCCT trial, when my parents were told, Hey, there's, we've got to get her on something better. We're starting to notice that these multiple daily injections are going to be a lot better. So went to went and started multiple daily injections. And at that point, this was in 1992. At that point, they they the healthcare team said you ought to consider a tump you're you're young your parents have insurance. You guys are certainly kind of wanting to have the best control you should consider a pump and Stacy for cash for seven years. The first seven years after I was diagnosed I did not want an insulin pump to save my life. I wouldn't even think about it until someone said hey, I had gained some weight in college, as many females and male do and I was trying to lose weight exercising to on the elliptical and or the treadmill, either one. And every time I would exercise, I would go low. And every time I would go low, I would have to have juice and peanut butter crackers, or whatever the case was, and I was having more calories than I had exercised off, you know, you can see the counter of your calories that you're burning. And I'm like, This is ridiculous, I'm going to continue to go low, and not be able to trim down my weight some, and I didn't have the right tools. And so that's the reason I started on a pump and then have been on a pump. For the last, I don't know, 2026 27 years, maybe when you

 

Stacey Simms  40:37

used to do a lot of patient training on insulin pumps, I know you still do some now, I'm even in your role here. What are their biggest concerns? You know, there's a lot of mechanical learning if you've never used an insulin pump before. But there's also as you mentioned, there's a reluctance sometimes. Can you share a little bit about what patients tell you?

 

Heather Lackey  40:54

I think the unknown is the biggest thing for patients, right? They don't know if it's surgical, they don't know if it how this goes in how you disconnect, how you're going to get live. The five emphases as I call it, you know, how do you sleep? How do you shower? How do you swim? How do you go in, you know, with exercise and do sports, what happens with intimacy and things like that, you know, those are unknown if you haven't met with a an educator or you haven't had a friend or even a health care provider that's kind of talked to you through that. So I think once people understand how insulin pumps and continuous glucose sensors kind of work inside of our life, and really how easy they are. The trainings are so much more simplified today, because the therapy is so much easier, right? And so I think once they start to see they're starting to put the pieces together, like the technology is working in the background, I don't have to work as hard. Here's the the, you know, two or three things that I have to do change my infusion set once a week, change the sensor once a week, and then I have to enter some grams of carbohydrate, however those grams of carbohydrate are calculated, then they start to understand this is not as big of a deal.

 

Stacey Simms  42:09

All right, I have to go back. You said the five S's and then I kind of heard you editing as you went, you can say six on this podcast. But what were the other ones we had sleep swim.

 

Heather Lackey  42:18

So fleet that were when boarding and zek?

 

Stacey Simms  42:22

That's great. I love that list. That's a great list. All right, before I let you go, I can't let you leave without talking about Purple Hearts, this Netflix movie that you were a consultant on, right? Tell me a little bit about what happened there. This is a character that has type one. And she marries a marine to get benefits health benefits. And it's a very romantic story. How did you come to be a consultant on that? And what was it like? Well, what was so interesting

 

Heather Lackey  42:46

about this, I mean, it was I mean, what a one and a life champ or V I mean, it was really great. The director, or producer, I think it was the director, she had reached out to Medtronic, specifically, because she was, you know, obviously going to be doing this movie, and the hurt. So her team had reached out to Medtronic. And she really wanted to one US product in the movie. But I guess her colleagues and friends and and others that he had talked to whenever she mentioned that this character was going to have type 1 diabetes. They were all like, Yeah, well, we, you know, we've learned that Medtronic pump for, you know, years and years. And so that's why she reached out, right, so reached out to our communications team and our marketing team. And those teams were so great to say, hey, look, they're going to be using a pump and sensor on the set, they might need to have some help. Just making sure that everything is used correctly. And you know, you're always in film, in movies, etc. Whenever I see things being used in an incorrect way. So yeah, so anyway, I was able to go out on the set. And then, you know, one thing just kind of led to another and they were like, well, you know, we're gonna need someone to train. You know, Sophia Carson is the actress. I mean, like, what an amazing thing to be able to beat her and all the other dudes amazing talent on that, that and they were like, Why don't you I mean that you do this? So why don't you just do this in the movie. And I was so happy that that tiny little piece was not cut it, it was such an important thing for my friends and family to be able to see so. And it really does kind of make people with type one I've heard over and over it was kind of cool for the film to kind of walk through people without type 1 diabetes. Like there's a trainee, you know, like, we have to get to understand how to use this equipment. And it's kind of the big day whenever you go on an insulin pump. The coolest thing about the scene that I was in with Sophia Carson, whenever she we finished the scene and she got on the system and we had everything is moving and working at and it was it was there. She was like, Heather, this is amazing that people go through this. And then she was like, gonna give you a hug like this is like I feel empowered having this system on me whenever I'm playing a character that has type 1 diabetes, so it was very organic and natural. And that wasn't anywhere in the script, you know. So it was just a true testament to how powerful technology is and people with diabetes. Five,

 

Stacey Simms  45:31

is there going to be a second one?

 

Heather Lackey  45:32

I have pushed. I have said, I hope that there is everybody wants to know what happened to those two characters. I don't know about it, but I would I would love to see a second movie as well.

 

Stacey Simms  45:45

That'd be great. Well, we will leave it there. Thank you so much for sharing so much of your time with me. I would love to have you back on to talk more about this system. We still have a lot of questions. I'm sure we just scratched the surface. But I really appreciate your time. Thanks so much for sharing so much information.

 

Unknown Speaker  45:59

Thank you Stacey. Have a great day.

 

Stacey Simms  46:05

You're listening to Diabetes Connections with Stacey Simms. Lutz where information with diabetes dash connections.com. I know we didn't get to all of your questions. I will definitely talk to the folks from Medtronic. Again, I thought Heather was really terrific. And she laid everything out. I loved her five S's. But you should also know that the 780 G she mentioned this. It's currently approved for users seven years old and above with type one, they have started taking pre orders that happened in the middle of May, and they will be shipping later this summer. throughout the US. If you have a 770 G, you will be eligible for a free upgrade through remote software. If you want to be notified more, you can go there's a link in the show notes and get their upgrade notification newsletter. So just go to diabetes connections.com Click on this episode's homepage. It'll give you all the information that you need. I'm taking a deep breath because as I have been telling you, my May was bananas. It was wonderful. It was busy and all the best ways. But I mean, I went to Ireland at the beginning of the month. Then I went to New Orleans for my daughter's graduation. Then we had a giant family reunion at my house. So hopefully as you're hearing this, nothing that busy has popped up for the month of June. What I do have on the calendar is the ADA Scientific Sessions conference toward the end of this month. I have never been to this. I've always tried to make it but it's never worked out. So I have immediate pass. I have my microphones packed Well, not yet, really. But I am going to be going and talking to all of these companies. I'll be putting stuff in the Facebook group. So please join Diabetes Connections, the group or sign up for our newsletter. And you can do that at diabetes dash connections.com Because I'm gonna be asking what you want here, who do you want me to talk to what questions you want me to ask. I'm going to try to do a whole bunch of interviews while I'm there and set up a whole bunch more. You can always email me Stacey at diabetes connections.com. I'm super excited about going to this event and really hoping to bring your questions to more of these folks. As I mentioned at the beginning of the show, I am scheduled to talk to beta bionics about the eyelet so that should be next week's episode. And of course we have in the news this Friday to fill you in if there are any more FDA approvals a there's more stuff in front of them. This has been a really interesting year so far, and we're not halfway through. Thank you to my editor John Buchanan, audio editing solutions. Thank you so much for listening. I'm Stacey Simms. I'll see you back here soon until the end. Be kind to yourself.

 

May 23, 2023

When many diabetes tech companies are turning their attention to CGMs or closed loop systems, Josh Pittman has his eye on the basics: lancets. His company PIP, makes a new kind of smaller and thinner device for fingersticks. This week, we talk about why he thinks this is still necessary, why he's passionate about helping people overcome fingerstick fear and what his mother with type 2 taught him about why the basics are so important to long term care.

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

 

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

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May 16, 2023

On social media, Neil Greathouse is better known as “The Betes.” He posts daily about diabetes on social media. It’s a lot of work – and not his real job. I wanted to know why this is important to him. What is he hoping to accomplish?

There is so much to Neil’s story – he’s become a diabetes educator – and he’s an open book – he’ll share about going into DKA not too long ago, a failed marketing effort with a big diabetes company and much more.

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

My first conversation with Neil, from 2017: https://diabetes-connections.com/neil-greathouse-t1d-instagram-inspiration/

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

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

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Check out Stacey's books!

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Reach out with questions or comments: info@diabetes-connections.com

 

 

May 12, 2023

It’s In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: The US Senate grills insulin makers about keeping the price where it is, two studies look at the impact of faster-acting insulins, a new study looks out temperature and insulin storage, researchers examine CGM access and health outcomes, and more

Check out Moms' Night Out with three new dates on the calendar!

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

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The best way to keep up with Stacey and the show is by signing up for our weekly newsletter:

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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 Moms Night Out - Treat yourself to some time away with other moms who get it. Our next stops this fall in Providence, RI and Frisco TX.
XX
Our top story this week, big Senate hearing on insulin.. The three insulin makers recently cut their list prices by around 70%. The Senate Committee on Health, Education, Labor and Pensions pressed industry leaders and all three – Lilly, Novo Nordisk and Sanofi - committed to “keeping their drugs affordable,”
But asked whether the companies would no longer raise prices on their existing insulins, only Lilly sai yes. The Sanofi and Novo Nordisk chiefs did not.
Sen. Markwayne Mullin, R-Oklahoma, called PBMs “the fox guarding the henhouse,” going after the executives for essentially “rebating themselves." He said the situation “isn’t working for America.”
“This committee is going to stay on this issue," Senator Bernie Sanders said Wednesday. "We need profound change in the industry and in PBMs."
https://www.fiercepharma.com/pharma/bernie-sanders-led-senate-committee-holds-pharma-chiefs-and-pbm-execs-feet-fire-insulin
XX
Not a big difference between fast-acting insulin aspart and standard insulin. New study using hybrid closed-loop insulin delivery system found that faster acting Fiasp did not offer any additional glycemic benefits compared with standard insulin aspart – Novolog - and participants had more cases of hyperglycemia with ketosis with the Fiasp.
The study cohort had a baseline HbA1c of 7.2% and a time in range of 63.9% at the start of the trial. Of the cohort, 76% was using a hybrid closed-loop insulin delivery system at enrollment.
There were no cases of severe hypoglycemia or DKA during either intervention.
https://www.healio.com/news/endocrinology/20230508/time-in-range-similar-with-fastacting-vs-standard-insulin-for-young-kids-with-diabetes
XX
On the other hand, people with type 2 diabetes saw more time in range with faster acting insulin. These were adults with type 2 on basal bolus MDI along with CGM. The insulins here with Lyumjev and humalog.
https://link.springer.com/article/10.1007/s13300-023-01400-w

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New study confirming that insulin doesn’t have to be refrigerated as strictly at package instructions. These researchers took 6 different bands and types of insulins and stored them – quote - unopened for 1–4 months in non-refrigerated conditions in a real-world setting during the summer in India, all compared with control samples of each insulin, which remained refrigerated.
Insulin vials were stored in watertight bags. Bags were placed in either an open plastic container stored on a high shelf or in a cupboard, or in clay pots with a separate water compartment. All storage containers were placed in shaded areas The temperature was measured every 15 min by electronic data loggers. The mean maximum temperatures were between 86 and 94 degrees. Most of the insulin stayed fine for two months and much of it for four months. Every study I talk about is linked up at this episode’s homepage at d-c dot com with more specifics.
https://www.thelancet.com/journals/landia/article/PIIS2213-8587(23)00028-1/fulltext?fbclid=IwAR1J2Y2JLZNHTvlPwtCo7t-wA60zhFMRvx2DEc7sujaFOX1pKc_-RbjhnL0
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Not so shocking conclusion that increasing access to CGMs – regardless of ethnicity and insurance status – can improve outcomes.
Despite higher rates of complications among T1D youths from lower-income backgrounds, diabetes technology is 50% lower among this group. Youths with public insurance have frequent interruptions to CGM access, which are associated with worsening HbA1C trends. Implicit biases and willingness to recommend diabetes technology to youths from underrepresented backgrounds are likely additional contributors to these disparities, according to authors.
Authors concluded the results demonstrated in the study suggest equitable access to CGM soon after T1D diagnosis could be a first step to improve HbA1C for all youths, but acknowledge this access alone is, “unlikely to eliminate disparities entirely.” The authors add broader societal strategies to address structural drivers of disparities in diabetes care are required.

https://www.contemporarypediatrics.com/view/equitable-access-to-glucose-monitoring-improves-hba1c-levels
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Interesting reminder that the seemingly obvious answer isn’t always the right one comes from cataract research..
Cataracts—the clouding of the lens of the eye—are the number one cause of blindness worldwide and are a common complication of type 2 diabetes. The current hypothesis behind diabetic cataract development is coined “the sugar hypothesis” and suggests that high blood sugar—a hallmark of diabetes—precedes cataract development. The working assumptions underlying the sugar hypothesis describe higher levels of glucose in the lenses of people with diabetes convert to a sugar alcohol molecule called sorbitol, which induces structural changes to the lens of the eye that precede cataract development. While unproven, researchers rarely investigate this theory further due to cataracts’ treatable nature.
Now, after some animal studies, it looks like the damage actually starts
before blood glucose rises above normal. The reseahres say it’s still too early to tell what’s going on but they hope ore study will bring the medical community a step closer to understanding the cellular mechanisms underlying the origins of diabetic complications during the pre-diabetic stage of the disease. Then, they say, they can search for ways to better prevent them.
https://scitechdaily.com/sweet-deception-sugar-hypothesis-of-diabetic-cataract-development-gets-an-eye-opening-reality-check/
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Very large study shows that GLP1 receptor agonists—a class of diabetes medications that include Trulicy and Ozempic —are associated with fewer major adverse cardiovascular events than another type of diabetes drug older veterans with no prior heart disease. The second drug type is DPP4 inhibitors with brand names like Januvia and Nesina.
Apparently, the clinical trials showing cardiovascular benefits for these drugs were conducted in people who already had heart disease, so these researchers wanted to see if it would help those who did not. 100-thousand US veterans were included in this study.
The median patient age was 67 years, and the median diabetes duration was 8.5 years. The researchers included variables such as age, sex, race, body mass index, blood pressure, laboratory values like hemoglobin A1c, and history of prior illnesses in the statistical analysis.

https://medicalxpress.com/news/2023-05-diabetes-drugs-adverse-cardiac-events.html
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Ascensia expands it’s Eversense PASS, a Payment Assistance and Simple Savings program designed to enhance affordability and access to the Eversense E3 CGM System. Under the new and improved program, more people with diabetes will be eligible for assistance paying for the system, which now includes increased savings for eligible first time users.
Eligibility for the program has now been extended to all commercially insured people with diabetes across the country, including those who do not have coverage for the Eversense E3 system from their insurance provider.
Eversense is an implanted CGM that lasts six months and has a removable smart transmitter.
https://www.prnewswire.com/news-releases/ascensia-diabetes-care-expands-payment-assistance-and-simple-savings-program-for-eversense-e3-cgm-system-301818639.html
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Right back to the news, but first, I want to tell you about Moms Night Out! In the 16+ years since my son was diagnosed with type 1, I have attended dozens of diabetes conferences and events. Now I’ve taken the best elements from those events and created a brand new experience. We’re going to have lots of diabetes technology for you to see and learn about, stress-relieving social time where you can meet other moms just like you, and speakers who will leave you feeling energized and ready to face the challenges of parenting a child with T1D. We had the first of these in January – I didn’t realize it was the first I actually expect it to be a one and done – but it went to so well and the reaction was so good from moms around the country that I deided to keep going. Our next stops are Frisco TX and Providence RI, back to Charlotte in Feb and more cities to come in 2024. Join us – check out the very top of diabetes-connections dot com or click on the event tab.
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Garmin today announced expanded region availability of the Dexcom Connect IQ apps. Available for a wide range of Garmin smartwatches, the Dexcom Connect IQ app3 provides people with diabetes with a secondary way to view their glucose levels, right from their wrist.
Connect IQ is the app platform for Garmin wearables, bike computers, and outdoor handhelds

https://www.garmin.com/en-US/newsroom/press-release/wearables-health/people-with-diabetes-can-now-view-dexcom-cgm-data-on-their-garmin-smartwatch-or-cycling-computer/
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On the podcast next week.. Neil Greathouse is a familiar face on social media – posting every day as “The Betes.” I’ll catch up with Neil to talk about what motivated this every day connection – he has a real job not in diabetes – and more. Last week I spoke with The Marvelous Mrs Maisel’s Austin Basis about managing T1D on set and off.

That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

May 9, 2023

Actor Austin Basis has a juicy role in this final season of The Marvelous Mrs. Maisel; he plays Alvin, the head writer on the show within the show. Basis was diagnosed with type 1 at age nine back in the 1980s. It was a time before home blood glucose meters, let alone pumps and CGMs.

He shares how he manages T1D during auditions and on the set and of course we talk about Mrs. Maisel! I had questions about the fashion, the plot, all night shoots and how this final season ends.

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

My first episode with Austin Basis from 2018: https://diabetes-connections.com/actor-austin-basis-and-the-kinetix/

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

The best way to keep up with Stacey and the show is by signing up for our weekly newsletter:

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Check out Stacey's books!

Learn more about everything at our home page www.diabetes-connections.com 

Reach out with questions or comments: info@diabetes-connections.com

 

 

May 2, 2023

Medicare has now expanded coverage for CGM use among people with type 2, in part because of studies by companies like Dexcom. We’ll talk about those findings and learn more about the US release of the G7.

Dexcom Chief Operating Officer Jake Leach gives us information on app updates, talks about CGM for people with type 2 and gestational diabetes, pump integration for the G7, smoothing – and what that means – and a lot more.

More info about CGM and Medicare:

From ADCES: http://www.radiomiw.com/press.html

Dexcom Medicare coverage info: https://www.dexcom.com/en-us/g6-g7-medicare

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

Moms' Night Out is back! Three cities are on the schedule:  Learn more 

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

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:

Facebook (Group)

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Check out Stacey's books!

Learn more about everything at our home page www.diabetes-connections.com 

Reach out with questions or comments: info@diabetes-connections.com

 

 

Apr 28, 2023

It’s In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: after a long wait, the FDA approves Medtronics 780G and lifts their warning letter, Omnipod GO for people with type 2 gets approved, a look at insulin in pill form, a new way to treat overnight low blood sugars and lots more!

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

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

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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 the T1D Exchange, make your voice heard and drive research that matters
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Buckle up there is a LOT going on
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Medtronic’s Minimed 780G AID system gets FDA approval. This is for people aged 7 years and older who have type 1 diabetes. Medtronic will begin taking preorders on May 15, 2023. Users of the current MiniMed 770G will be eligible for free remote software upgrades.
The 780G is currently available in 105 countries. It has been available in Europe since 2020 and in the UK since 2021. The biggest difference from other systems is that it can automatically administer bolus correction insulin doses every 5 minutes. It will also automatically adjust basal insulin The insulin pump's infusion set can be worn for 7 days, rather than 3 days as with the older system, and the glucose target level can be set as low as 100 mg/dL.
In the pivotal US trial, overall, patients who used the 780G spent 75% of the time in ideal glucose range (70-180 mg/dL) and 1.8% of the time below that range. Overnight, the figures were 82% and 1.5%, respectively. With the glucose target set at 100 mg/dL and active insulin time set to 2 hours, patients spent 78.8% of time in range without increased hyperglycemia.
https://www.medscape.com/viewarticle/991091
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U.S. Food and Drug Administration (FDA) lifted Medtronic’s warning letter sent in December 2021.
The resolution of the warning letter follows ongoing remediation actions from the company and proactive actions to continue to strengthen its quality systems. All regulatory restrictions associated with the warning letter have been resolved.
https://finance.yahoo.com/news/medtronic-diabetes-resolves-warning-letter-203000188.html
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FDA also approved Omipod GO, for people with type 2 who take daily injections of long acting insulin. Insulet says “Omnipod GO was designed to serve the more than three million people using basal insulin or transitioning to insulin therapy to treat their type 2 diabetes”
Omnipod GO is a standalone system that provides a fixed rate of continuous rapid-acting insulin for 72 hours. It’s tubeless and waterproof just like a regular Omnipod but it’s offered in seven different pre-programmed daily rates, ranging from 10 to 40 units per day, and operates without the need for a handheld device to control the Pod. It has been cleared for use with the following U-100 insulins: NovoLog®, Fiasp®, Humalog®, Admelog®, and Lyumjev®.

The product was developed to serve people with type 2 diabetes earlier in their treatment journey by starting them on Pod therapy for their insulin delivery, rather than daily injections. If a patient becomes insulin-intensive, meaning they require both basal and bolus insulin, the transition to another Omnipod product would be seamless.
Omnipod GO will have its US launch sometime next year.
https://www.businesswire.com/news/home/20230424006026/en/Insulet-Announces-FDA-Clearance-of-Omnipod-GO%E2%84%A2-a-First-of-its-Kind-Basal-Only-Insulin-Pod-Further-Simplifying-Life-for-People-with-Type-2-Diabetes
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Senseonics says the first pediatric study participant has received an Eversense 365-day CGM insertion.
The E3 180 day implantable CGM got FDA approval in February last year.
Dr. Francine Kaufman, Senseonics CMO, said expanding to a pediatric population represents a “priority” for the company. Positive results could further extend the company’s reach across the global diabetes community, she added.
The company also intends to utilize study data to submit for an integrated CGM (iCGM) designation in 2023. Senseonics holds an FDA investigational device exemption (IDE) to expand the trial to pediatric patients. These patients — between 14 and 18 years old — first enrolled in the second quarter of 2023.
https://www.drugdeliverybusiness.com/senseonics-first-pediatric-cgm-insertions/
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Baqsimi gets a new home. Amphastar Pharmaceuticals is buying the Glucagon nasal spray from Lilly in a deal worth up to $1.08 billion dollars. Launched in 2019, Baqsimi saw worldwide sales worth $139.3 million in 2022, the companies said. You may remember that Lilly had acquired Baqsimi from Locemia Solutions in 2015. The drug has an active compound glucagon, a form of a hormone produced in the pancreas that stimulates glucose production
https://www.reuters.com/markets/deals/eli-lilly-sell-low-blood-sugar-drug-amphastar-2023-04-24/
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The FDA recently cleared a new experimental drug for type 1 diabetes to begin a phase 2 clinical trial. If approved, the drug would be the first therapy to specifically address low blood sugar at night. We’ve talked about this.. Zucara Therapeutics is testing an oral medication currently known as ZT-01 will attempt to restore the body’s natural ability to respond to low blood sugar levels. Researchers will evaluate the ability of the drug to blunt hypoglycemia caused by insulin in type 1 diabetes.
This phase 2 clinical trial follows positive results from the company’s earlier phase 1 study which included 18 participants with type 1 diabetes who received the treatment. Of these 18, 16 (89%) had a meaningful increase in glucagon production after being given ZT-01, with no serious health events during the trial.
https://diatribe.org/drug-prevent-nighttime-lows-approved-enter-clinical-trials
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The T1D Exchange Registry is a research study conducted online over time, designed to foster innovation and improve the lives of people with T1D. The platform is open to both adults and children with T1D living in the U.S. Personal information remains confidential and participation is fully voluntary. Once enrolled, participants will complete annual surveys and have the opportunity to sign up for other studies on specific topics related to T1D. The registry aims to improve knowledge of T1D, accelerate the discovery and development of new treatments and technologies, and generate evidence to support policy or insurance changes that help the T1D community. By sharing opinions, experiences and data, patients can help advance meaningful T1D treatment, care and policy.
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Australian scientists have designed a new way to swallow insulin, in a pill form. The design also has potential uses for delivering other protein drugs, such as antibiotics and cancer treatments. Insulin is made of smaller versions of proteins called peptides. Previous attempts to develop an orally administered insulin have found that the severe pH levels in the gastrointestinal tract degrade the peptides, causing the drug to lose its function.
To get around this problem, the scientists encapsulated the insulin in a lipid-based nanomaterial placed inside an enteric capsule. In animal studies, long acting insulin was absorbed better than fast acting. They say long way to go, but an interesting start.
https://newatlas.com/medical/new-insulin-capsule-game-changing-diabetics/
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A new proof of principle study demonstrates the accuracy of Know Labs’ proprietary Bio-RFID™ sensor in quantifying different analytes in vitro, proving a 100% accuracy rate in these tests. The full study is currently undergoing the peer-review publishing process.

“Proof-of-principle studies are critical in demonstrating Bio-RFID’s accuracy for non-invasive methods of medical diagnostics. This was an essential step toward achieving our goal of delivering the first FDA-cleared, truly non-invasive glucose monitoring device to the market”
Know Labs’ technology platform, Bio-RFID, uses electromagnetic energy in the form of radio waves to non-invasively capture molecular signatures, which can be converted into physiologically meaningful information and insights. While the technology is proven to accurately measure several analytes inside and outside the body, the first application of this technology is aimed at non-invasive glucose monitoring.
This study did not include people but researchers say it’s an important step on the way.

https://www.businesswire.com/news/home/20230421005095/en/Know-Labs-Demonstrates-Accuracy-of-Non-Invasive-Bio-RFID-Technology-with-Proof-of-Principle-Study
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Moms Night Out – new cities include Providence, RI, Frisco, TX and Charlotte NC. more info here
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On the podcast next week.. Dexom's Jake Leach brings us up to date on some G7 updates as well as new Medicare coverage for people with type 2. Last week's episode was with the first US commercial pilot with type 1, Pietro Marsala.
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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.

Apr 25, 2023

Long thought an impossible, development people with type 1 diabetes are now working as commercial airline pilots. The very first to be certified in the US , Pietro Marsala says he decided to forge ahead while working as a flight instructor, taking inexperienced student pilots up while he was in control.

Pietro will share what happened next, how a mountain of data gradually won of skeptics, his in flight diabetes routine and what he’s up to now. You might be a passenger on his next flight!

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

Follow Pietro on Instagram: https://www.instagram.com/flytype1/?hl=en

FAA requirements for pilots who dose insulin: https://www.faa.gov/ame_guide/dec_cons/disease_prot/itdm

More about Pietro Marsala: https://www.healthline.com/diabetesmine/first-commercial-pilot-type-1-diabetes

 

Please visit our Sponsors & Partners - they help make the show possible!

Take Control with Afrezza 

Omnipod - Simplify Life

Learn about Dexcom 

Check out VIVI Cap to protect your insulin from extreme temperatures

Learn more about AG1 from Athletic Greens 

Drive research that matters through the T1D Exchange

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:

Facebook (Group)

Facebook (Page)

Instagram

Twitter

Check out Stacey's books!

Learn more about everything at our home page www.diabetes-connections.com 

Reach out with questions or comments: info@diabetes-connections.com

 

 

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