It’s always a privilege to talk to one of the Joslin Medalists. This week you’ll hear from Laurie Harper. She was diagnosed as a toddler in 1955 and will mark 67 years with type 1 later this year. She shares what she remembers about her early years with diabetes, how her family adjusted, the technology she started with and what she uses now.
The Joslin Medalist program recognizes and studies people who’ve lived with type 1 for at least 50 years. Laurie tells us more about the medalist program, about aging with diabetes and she takes a look back at how different the management was almost 70 years ago.
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
Learn more about the Joslin Medalist Program
Check out Stacey's book: The World's Worst Diabetes Mom!
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Episode Transcription Below (or coming soon!)
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It’s “In the News…” Got a few minutes? Get caught up! Our top stories this week include new information about the temperature at which insulin can be safely stored, a warning about men taking Metformin, news about sexual health and women with diabetes, and a heads up about a virtual mental health conference coming up for people with diabetes.
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
Sign up for our newsletter here
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Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners!
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Episode Transcription Below (or coming soon!)
Please visit our Sponsors & Partners - they help make the show possible!
Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast.
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The news is brought to you by The World's Worst Diabetes Mom: Real Life Stories of Parenting a Child With Type 1 Diabetes. Winner of best new non-fiction at the American Book Fest and named a Book Authority best parenting book. Available in paperback, eBook or audio book at amazon.
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Our top story.. a look at how insulin holds up under real-world and often hotter conditions than is recommended. Doctors without Borders found that a range of insulins can be stored at warmer temperatures than previously recommended. They showed it’s okay above 77-degrees all the way up to 99 degrees for four weeks. This is really important not just for emergency settings like refugee camps but for people who live in areas without refrigeration. They often have to travel to health clinics which may be far away and which can’t send them home with the insulin. The group now says pharmaceutical corporations should urgently submit to regulatory authorities for use of insulin under expanded temperature ranges. This came out a few weeks back, but I haven’t seen it anywhere.
https://www.doctorswithoutborders.org/latest/msf-study-shows-some-insulin-can-be-stored-warmer-temperatures
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Big headlines this week about Metformin and the risk of of birth defects in the babies of men who take it. Metformin is a very common diabetes drug, taken by tens of millions of people around the world. Sons born to men taking it were more than three times as likely to have a genital birth defect as unexposed babies. These problems were relatively rare, occurring in fewer than 1-percent of all babies with dads who took Metformin but it’s significant because tens of millions of people worldwide take metformin. These researchers say the paper’s findings are preliminary and observational only.. and that men with diabetes should NOT abruptly stop metformin before trying to conceive. Reassuringly, the researches saw no effect for men who took the drug earlier in life or even a year before. Expect a lot more research to come on this one.
https://www.science.org/content/article/rare-genital-defects-seen-sons-men-taking-major-diabetes-drug
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Grain of salt needed here, but new research may show that people with type 1 are more likely to manage better if they have high levels of psychological resilience. This was a British study that followed 18-hundred people with type 1 or type 2 diabetes. They used a questionnaire to determine how they adapted to change and focused under pressure. The researchers found that people with type 1 diabetes who had low psychological resilience also had poorer blood sugar control after two years. The idea is that something like this would offer the opportunity to identify those who might benefit most from additional support when they are first diagnosed.
https://medicalxpress.com/news/2022-03-psychological-resilience-future-high-blood.html
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Among patients with diabetes, women are just as likely as men to suffer from sexual dysfunction, but their issues are overlooked. Big session on this at the Diabetes UK Professional Conference this week. Reserachers say women with diabetes can experience reduced sexual desire, painful sex, and other issues which can increase the risk of depression. But these issues are usually untreated despite help being available. They talked about the embarrassment factor and the idea that many women with sexual dysfunction don’t realize diabetes could be a factor.
They encourage health care professionals to go beyond conversations about contraception, pregnancy and menstruation. A recent study led by Belgian researchers found that among more than 750 adults with diabetes 36% of men and 33% of women reported sexual dysfunction.
https://www.medscape.com/viewarticle/971208
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Concerning new trend about pre-diabetes.. it’s doubled among children over the last 20 years. The increase was seen over almost all subpopulations of young Americans, regardless of income, ethnicity and education. The study in the journal JAMA Pedatirics included kids 12 to 19 years old from 1999 to 2018. The rate of presdiabetes went from 11.6-percent to 28.2-percent. Pre-diabetes means blood glucose levels are higher than normal but not yet at the diabetes threshold. These researchers are quick to point out, they don’t know the reason why this is happening.. while diet and exercise are usually what’s pointed to.. it’s not entirely clear that’s the reason behind this rise.
https://www.cnn.com/2022/03/28/health/prediabetes-children-study-wellness/index.html
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Huge new study of more than 3-million people says people with type 2 have a higher risk of 57 other health conditions. Experts described the findings as stark and alarming and said it underlined the urgent need to reduce the risk of more people developing type 2 diabetes. The study, which is yet to be peer-reviewed, focused on people over 30. These researchers say the higher risks occurred when people were diagnosed with type 2 diabetes under the age of 50.
https://www.theguardian.com/society/2022/mar/29/type-2-diabetes-results-higher-risk-57-other-conditions-study
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Want to let you know about the Diabetes plus Mental Health virtual conference coming up in May. This two-day event will highlight ways in which living with diabetes affects mental health. There will be 2 tracks - one for patients and one for caregivers and providers. I’m excited to take part – just in a light hearted way. I’ll be hosting a game show type session where you can meet some of the presenters and participants. Lots more information lined up.. registration is open now and early bird pricing ends April 3rd.
https://dmhconference.vfairs.com/?fbclid=IwAR2BiuxasHL0bBGe_6JpDzMnhY__kr6HptYFGpfdwEO0ftDL7pTbMyFycIY
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On this week’s long format episode we’re talking to JDRF about the new non-profit insulin they’ve backed. Why will this effort from Civica RX be different? We’ll talk about it. Next week we’ll have a conversation with one woman in the Joslin Medalist Study. Diagnosed nearly 70 years ago she shares her story and why she’s excited about part of this incredible group.
Listen wherever you get your podcasts
That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
There's a new plan to manufacture and sell insulin at a much lower list price. The company behind it is non-profit Civica RX, which has support from JDRF.
Stacey talks to JDRF CEO Aaron Kowalski about what their role is here, how realistic this plan is, who it may help and a lot more. They also spend some time talking about the reorganization of JDRF and what the future after COVID 19 looks like for them.
More about Civica's Plan (we'll talk to them in a future episode)
Here's the episode Stacey references with Thom Scher and Aaron Kowalski
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
Sign up for our newsletter here
-----
Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners!
-----
Episode Transcription Below (or coming soon!)
Please visit our Sponsors & Partners - they help make the show possible!
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
Sign up for our newsletter here
-----
Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners!
-----
Episode Transcription Below (or coming soon!)
Please visit our Sponsors & Partners - they help make the show possible!
Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast.
XX
The news is brought to you by The World's Worst Diabetes Mom: Real Life Stories of Parenting a Child With Type 1 Diabetes. Winner of best new non-fiction at the American Book Fest and named a Book Authority best parenting book. Available in paperback, eBook or audio book at amazon.
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People who recover from a mild case of COVID-19 appear to have an increased risk for subsequent new-onset type 2 diabetes… but not other types of diabetes. This is from a big new study in Germany. It lines up with previous studies of more seriously ill patients with COVID 19 who had increased rates of type 2 in the months following. This was more than 35-thousand patients – no prior history of diabetes. The risk of developing type 2 increased by 28-percent if the person had COVID, again even a mild case. The researchers say anyone who tested positive for COVID should be aware and get screened for diabetes in the months and years following.
https://www.medscape.com/viewarticle/970600
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Big new study that – interestingly – talks about the CGM as a telehealth device. It looked at how doctors continued to care for children with type 1 before and after the first year of the COVID pandemic. The use of CGMs increased significantly among those with non-commercial insurance… from 24 percent in 2019 to 35 percent by the end of 2020.
Another finding in this same study.. those with higher A1Cs, racial minorities, and those with non-commercial insurance were more likely to have high rates of DKA. But the implementation of telehealth and CGMs increased parental oversight which resulted in better care at home and lower than expected hospitalization rates. I want to dig a little deeper here because a lower hospitalization rate during the first year of the COVID pandemic overall.. was found to be tied to a lot of fear about going to a hospital during that time.
https://mhealthintelligence.com/news/telehealth-helped-maintain-type-1-diabetes-care-among-kids-during-pandemic
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Swiss pump maker Ypsomed announces the software they’ll use for their automated insulin delivery. Ypsomed will partner with CamDiab’s CamAPS app. The launch will start in select major countries in Europe, with other territories to follow over the course of 2022. This includes a hybrid closed loop – like Omnipod 5 and Control IQ - as well as smartphone control.. it’s compatible with Dexcom’s G6. It’ll start on Android then roll out on iOS.. Ypsomed is partnering with Lilly to come to the US – we’ve had them on the show before talking about this. They hope to submit to the FDA this year.
https://www.drugdeliverybusiness.com/ypsomed-partners-with-camdiab-on-smartphone-based-automated-insulin-delivery/
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The FDA is due to make a decision on Teplizumab by August 17th. This is a drug that has been shown to delay type 1 diabetes. Last year the FDA turned down Provention Bio, asking for a resubmission with more information. The company is also running the phase 3 PROTECT trial of teplizumab. That’s in newly-diagnosed type 1 diabetes patients. They hope to expanding the indications for the drug.
https://pharmaphorum.com/news/fda-sets-august-decision-date-for-proventions-type-1-diabetes-drug/
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More study underway into the tuberculosis vaccine as a treatment for type 1. This is Dr. Denise Faustman’s lab – they’re recruiting 150 teen with type 1 for pediatric clinical trials of the shots. Faustman’s work is controversial because her studies have been very small and many experts say they don’t show significant improvement. But Faustman says the vaccine appears to help patients with Type 1 diabetes by altering their immune system and that even though no one in her trials is off of insulin, there is improvement.
https://www.bostonglobe.com/2022/03/21/metro/could-100-year-old-vaccine-treat-type-1-diabetes-mgh-researchers-are-working-find-out/
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If you’re watching live, today is the last day to back the Kickstarter for Type 1 The Movie. We talked about this on last week’s podcast episode – Noah Averbach Katz is an actor who lives with type 1 and is making a movie where diabetes is front and center. Since Noah and his wife are on Star Trek Discovery, that community has jumped in to really amplify this. It’s been great to see and he’s well over his goal. If you’re watching or hearing this after March 23rd, you can follow the link anyway to stay up to date on the project. I gave and I’m excited to see how it all turns out!
https://www.kickstarter.com/projects/noahak/type-1?ref=thanks-tweet
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On this week’s long format episode we’re going on a deep dive about stem cell research with the folks at Viactye. They’re working on two fronts now.. encapsulation AND gene editing with the people at CRISPR. Next week you’ll hear from JDRF about the new non-profit insulin they’ve backed. Why will this effort from Civica RX be different? We’ll talk about it.
Listen wherever you get your podcasts
That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
There’s been a lot of excitement recently about stem cell transplants and progress toward using this as a functional cure for type 1. There are a few separate groups working on this, this week we're talking to ViaCyte to get past the hype and look at the real progress here.
You'll hear from ViaCyte’s Head of Clinical Development Dr. Manasi Jaiman. ViaCyte has been studying stem cell transplants for several years – and recently started working with the gene editing technology CRISPR. We’re going to talk about what this is all about, how close they really are, and who would even be in line to benefit.
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
Sign up for our newsletter here
-----
Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners!
-----
Episode Transcription Below (or coming soon!)
Please visit our Sponsors & Partners - they help make the show possible!
It’s “In the News…” Got a few minutes? Get caught up! Top stories this week: Dexcom G7 approved in Europe, JDRF speaks out on non-profit insulin plan, Ukraine diabetes aid progress, texting for T2D, Reaction to Pixar's Turning Red
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Join us LIVE every Wednesday at 4:30pm ET
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
Sign up for our newsletter here
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Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners!
-----
Episode Transcription Below (or coming soon!)
Please visit our Sponsors & Partners - they help make the show possible!
Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast.
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The news is brought to you by The World's Worst Diabetes Mom: Real Life Stories of Parenting a Child With Type 1 Diabetes. Winner of best new non-fiction at the American Book Fest and named a Book Authority best parenting book. Available in paperback, eBook or audio book at amazon.
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Our top story this week.. Dexcom gets the CE Mark for it’s new G7 system, which means it’s approved in Europe. The approval is for people ages 2 and up, including pregnant women. I’m putting the full screen photo up here and I’ll post this on the website and in the FB group for those listening.. interesting to finally get a good look at the much smaller applicator – as expected looks a lot like the Libre. Also interesting, all the PR for this has said, developed in partnership with Verily.. remember them? That was part of google, probably best known for saying they were going to develop a contact lens that would monitor glucose. I’ve reached out to Verily, love to know more about this partnership. Anyway, we’ve done a ton on G7, I’ll link up some of our recent conversations with the folks at Dexcom. They submitted to the US FDA at the end of 2021, no firm timeline on US approval.
https://www.medicaldevice-network.com/news/dexcom-ce-mark-g7-cgm-system/
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Some good news about living longer with chronic conditions, including diabetes. This was a 20-year British study that ended in 2011, so one caveat here, it doesn’t include COVID. Men gained 4-point-6 years of life expectancy; women gained 2-point-1. When it comes to disability-free life expectancy, men gained about a year less and women stayed the same. This included people with chronic conditions including those with diabetes. These researchers do point out that while they’d expect to see the same increase in the US – the lack of health and social safety net programs could make a negative difference here. But they point to CGM technology and better medication as making a big difference for those with diabetes.
https://www.healthline.com/health-news/why-people-with-chronic-conditions-such-as-diabetes-are-living-longer-without-disability#Cognitive-impairment-is-the-exception
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Children who develop type 1 diabetes show epi-genetic changes in the cells of their immune system long before the antibodies of the disease are detected in their blood. An epigenetic change affects how our genes work. Outside factors such as environmental, viral infections, are usually the cause. These researchers say these are previously unknown changes that signal the increased risk of developing type 1 and could give an even earlier indication than the anti-body marker tests available now.
https://www.news-medical.net/news/20220316/Epigenetic-changes-could-be-a-biomarker-for-early-detection-of-type-1-diabetes.aspx
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Could text-messaging with their doctors help people with type 2? A new team in Chicago is looking at text-based intervention in underserved communities. The intervention will deliver personalized information directly to patients through text messages, including reminders about self-monitoring and prescription refills, interactive office hours and general information about diabetes, motivational support and answers to frequently asked questions. These doctors say the idea is to create more opportunities for patients to meaningfully engage and reduce barriers by employing technology already in people’s hands.
https://today.uic.edu/an-sms-solution-for-type-2-diabetes
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Last week we told you about the effort by Civica RX to make affordable insulin. Civica, is a nonprofit generic pharmaceutical company. JDRF directed funds to this effort and CEO Aaron Kowalski wrote an op ed that I’ll link up. In it, he talks about the success Civica has had lowering the costs of other medications. We’ll have Kowalski on the show soon and I’ve reached out to Civica as well. This would lower the price to $35 a vial no matter your insurance. Congress still hung on a $35 co-pay cap for those with insurance.
https://www.healthline.com/diabetesmine/op-ed-jdrf-leader-on-insulin-affordability-for-all-americans
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Over in the UK they keep moving forward – covering all 400-thousand Britons with type 1 for the Libre CGM. Former guest of the podcast, Dr. Partha Kar, says everyone with type 1 will be able to get a CGM if they want one by the end of March. It will no longer be restricted by who doctors think need it the most. By the way, Briton means someone from England, Scotland or Wales. It’s the first time I’m using that word so UK friends.. let me know if I’ve got it right!
https://www.dailymail.co.uk/health/article-10606335/All-400-000-type-1-diabetic-Britons-offered-high-tech-implant.html
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Still a big need for diabetes help to Ukraine. A lot of the efforts are paying off – Insulin for Life showing that the supplies are on their way or have arrived. Spare a Rose reports that individual donations so far have totaled more than 115-thousand-dollars. I’ll keep linking up places to donate
https://www.jdrf.org/blog/2022/03/02/helping-the-diabetes-community-in-ukraine/
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Reaction to Pixar’s Turning Red. I loved this. I put out a call for photos of people seeing themselves in the movie’s tiny little moments of diabetes representation. Thanks to all who sent those in – you can see them on Diabetes Connections on Facebook and Twitter. And my Stacey Simms account on Instagram. It’s all just one account there.
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While Turning Red had diabetes in the background.. this week on the long format episode we’re talking about a movie that wants to put type 1 front and center. And it’s got the Star Trek community excited as well! Meet the Star Trek Discovery actor with type 1 who’s leading this effort.
Next week, we’re going on a deep dive about stem cell research with the folks at Viactye. They’re working on two fronts now.. encapsulation AND gene editing with the people at CRISPR.
Listen wherever you get your podcasts
That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
What happens when the diabetes community and the Star Trek fandom collide? The actor who brought these groups together spent time as a blue-skinned alien on Star Trek Discovery. Now Noah Averbach-Katz wants to make a movie where T1D is front and center. He shares more about the Kickstarter campaign to fund it, and about his time in the Star Trek world
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
Sign up for our newsletter here
-----
Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners!
-----
Episode Transcription Below (or coming soon!)
Please visit our Sponsors & Partners - they help make the show possible!
Stacey Simms 0:00
Diabetes Connections is brought to you by Omnipod take Omnipod dash out for a spin with a no commitment free 30 Day Trial, by Dexcom. Take control of your diabetes and live life to the fullest with Dexcom and by club 1921, where Diabetes Connections are made.
This is Diabetes Connections with Stacey Simms.
This week when the diabetes community and the Star Trek fandom collide! The actor who brought these groups together spent time as a blue skinned alien with a lot of prosthetics on Star Trek Discovery, but he had to find a way to reach his fingers for blood sugar checks.
Noah Averbach-Katz 0:45
I sort of explained that to him. And they said, Well, it's fine. We'll just put you in gloves the whole time. So the entire time of my sort of run of the show, I am wearing like black leather gloves. Regardless of what I'm doing. I'm eating breakfast, I'm wearing black leather gloves, I'm flying a spaceship, I'm I'm wearing black leather gloves. And that was just so I can have easy access to my fingers. So I could test.
Stacey Simms 1:10
That's Noah Averbach-Katz . And while we talk a lot about Star Trek, he's really here to share the news about a movie he's making called type one. We've got all the info about the Kickstarter campaign to fund it, and other ways you can help.
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 along. You know, we aim to educate and inspire about diabetes with a focus on people who use insulin. I didn't plan it this way. But it's interesting. This is the second week in a row that we're doing more of a pop culture or media type episode about diabetes. Right? We talked about turning red last week, if you missed that episode, that is the new Pixar movie on Disney plus, that features two characters with diabetes in the background. And I talked to Susan Fogg from Pixar, who made that happen with her whole team, of course, and one of the things that Susan talked about was why it was just fine to have diabetes in the background, right? That's about what isn't her life. That's how it is for many people with diabetes. It's not always front and center. It's not always what you want to talk about.
But this week's guest looked at things a little differently. And she'll hear Noah Averbach-Katz wanted to put diabetes front and center and make a movie that didn't feature it in the background. So while I didn't plan, as I said, you know, back to back here, I think it's an interesting contrast. Of course, the other big contrast is that Noah's movie is self-funded, it is on Kickstarter, I am going to link that up right here in the show notes. It'll be at diabetes connections.com. Very easy to get to, as we are taping the Kickstarter is still going on. But if you're listening to this after it is ending, the deadline is March 24 2022. And as you'll hear, he's already exceeded his goal. And we'll talk about how that happened. But it doesn't mean that he still doesn't need the money. This movie is expensive, all movies are expensive, and he shares about where the money will go, even as he has exceeded the goal. So if you are so inclined, I will link that up. You can head over there. There's a preview of the movie and more information.
Noah was diagnosed with type one as a teenager, he will share that story. He's an actor, he has been featured in Star Trek Discovery. That's just one of the parts that he has had. And as he mentioned, he is married to Mary Wiseman, who has a starring role in Star Trek Discovery. When they got married in 2019. The New York Times did a write up and I will include that because it's a beautiful story. It's really well written. It's a lot of fun, but I will just share the headline here a life frequently apart, but an enterprise they'll boldly take on. There's a lot of Star Trek in this family. I do need to warn you know what is pretty blunt about diabetes. We all talk about this in different ways. But I would want a heads up if I were listening to this episode with kids. It's not that he's not factual or that he's overly morbid, but when he talks about what can happen, he doesn't pull any punches. So just go into the interview knowing that he's a dry wit and I didn't want to edit what he had to say. So he's blunt. I talked a little bit about my Star Trek fandom during the interview. I'm going to come back and share some stories about that afterwards.
Okay, our conversation in just a moment but first Diabetes Connections is brought to you by Omnipod. And I remember years ago when Benny first started on the Animas insulin pump Yeah, this was a long time ago and upgrade came out but we had to wait years to be eligible for it because of insurance requirements out frustrating is that I'm so glad things are changing. For example, the Omnipod promise takes those worries away with the Omnipod promise you can upgrade to Omnipod five s When it's available to you and covered by insurance, all for no additional upfront cost Omnipod is available through the pharmacy, which means you won't be tied to a long term contract, you're free to upgrade at any time. Not to mention, you can pick your pods up right where you pick up your insulin, go to diabetes dash connections.com and click on the Omnipod logo for full safety risk information and Omnipod promise terms and conditions, visit omnipod.com/diabetes connections.
Noah, thank you so much for joining me, I think this is going to be a lot of
Noah Averbach-Katz 5:35
fun. My pleasure. Thank you so much for having me.
Stacey Simms 5:38
Let's just jump in and start off the bat. Tell me about this movie. Before I ask you why you wanted to do something like that. Tell me what type one what is it?
Noah Averbach-Katz 5:48
So type one is essentially a short film about a type one diabetic and his wife who in the wake of some sort of societal disaster, I mean, really take your pick these days, they sort of go on a journey to kind of find what they hope as a cache of insulin to keep the guy alive as long as possible. And that's pretty much the thrust of the film.
Stacey Simms 6:14
Is it written?
Noah Averbach-Katz 6:14
I mean, you've this is all you right? Yes, yes, I of course wrote myself in the starring role as diabetic man. So yes, it's, it's all written. I haven't read it in a really long time. So I'm wondering if it's any good. But I probably should have dipped back in on it before I started the Kickstarter, but it's too late. Now.
Stacey Simms 6:34
It's one of those things, be careful what you wish for. Because it's been so successful.
Noah Averbach-Katz 6:38
There's a saying that if you really want to freak an actor out, give them the role. I definitely feel that these days.
Stacey Simms 6:45
So it doesn't sound like you wrote this to recently tell me the story of how it kind of came to you the idea and your how you started putting it together? Sure,
Noah Averbach-Katz 6:53
I was actually doing a play in Baltimore. And in that play, there was a very talented deaf actor named Michelle Edmonds, and she was gracious enough to sort of lead me into the deaf community in a small way, kind of give me some insight on what it means how important it is all the intricacies there were and there were also, you know, translators and other deaf consultants on this show as well. And it just really got me thinking about the diabetes community, and how different it was from the deaf community. In the deaf community. There's so much that is shared between people, there's so much like common, not language, but like common understandings of etiquette and stuff like that. And there are these huge community hubs like Gallaudet University and stuff like that. And in the diabetes community, especially in the type one community, for a lot of reasons, it isn't quite like that. Part of that is, you know, at some would say this is debatable, but I genuinely consider if you choose to be diabetes can be an invisible illness. So you know, you're not sort of having to survive in the same way that people with other non invisible disabilities have to do. I felt at the time, there was a real lack of media of things that people in the diabetic community could sort of rally around and have a common thing to talk about, other than how they handle their care. Pretty much all of the diabetes representation in the current landscape right now, you know, obviously, there's this long list and some are better than others, and some are like iconically bad and some are really trying to be hard. But all of them are really for the abled community. They're not really for the disabled community. And there's nothing really wrong with that, especially when the creators or whoever's writing or producing a movie tries really hard to get things right. There's nothing wrong with that. But I think you'd be hard pressed for any other diabetics to to point to something and say, oh, yeah, that is really represents something about my experience. And I can talk about this, this is a launching point for a conversation with other people. And I was sort of in that headspace. And in this play I was doing, I was playing a dog. And I had these long stretches where I just laid on the floor for like, 45 minutes, and I would just sit there thinking blahdy blah, just random thoughts going through my head. And I sort of thought about this idea, which is, you know, basically the pitch for the movie, and I thought that could be a good idea. That's not a bad idea for a script and like, it's something that is both narratively exciting, and something that I think is a universal experience for type one diabetics, the fear of not being able to get your insulin whether that's through a natural disaster or whether that's through an institutionally caused lack of access. And that was in February, late February of 2020. And then like five weeks later, I was sitting in my house in New York being like, Well, I think I need to write this down. So for the first four or five weeks of quarantine in New York, when we were just completely locked inside, I would wake up early write for an hour. And at the end of that little section, the script was was finished pretty much.
Stacey Simms 10:20
I'm curious, when you talk about diabetes in media, I think we all have a story, or a movie, a TV show a book, something that we look at and say, Gosh, really, like, sometimes they get it right. But it's so minor. And sometimes they get it wrong. And it's major. Does there anything that you have seen that you're just like, why?
Noah Averbach-Katz 10:37
Well, you know, the one that really has stuck with me over the years is a episode of The Walking Dead. And it's so relevant to this film. It's almost embarrassing, but it's an episode of The Walking Dead, where it's a type one diabetic and his sister. I mean, I don't actually really remember so don't know what I'm sorry. Yeah. And he's dragging this cooler of insulin, and the good guy steals it and gives it back. And then I think they all get eaten by zombies. Yeah, but I just think she goes low, and they give her a shot. Yeah, something like that. And I just remember thinking, I'm sorry, what you This is year four of the zombie apocalypse, and you're just dragging around a cooler of insulin. These efforts are dead, you're dead, you're dead. And I think everybody has this conference, or a lot of people have this conversation, which, you know, what would you do in the zombie apocalypse? I get in my car, do this type of blah. And my answer is, I'm dying. I'm out. And people hate that answer that really drives them. No, no, no. And I'm like, no, no, no, I'm the guy who's going to buy you another five minutes by holding them off in the corridor, you know what I mean? Because I'm not surviving this stuff. And that sort of is sort of this other element of this whole movie is, is that experience, you know, of, of really feeling like in media, like so often, disabilities type one, but plenty of other disabilities are used as this sort of plot point where the person who is abled saves the disabled person, and they're the hero, and everything works out. And in reality, it's not that way, because people with disabilities have to fight for themselves, right? You know, in every single case, it's not abled people stepping up to the plate and saying, we're going to change this for you, we're going to do this for you. It's it's people with disabilities, absolutely fighting tooth and nail for whatever they need to make their lives livable with the help of abled allies, right. Of course, they're not doing it on their own, there are people who are assisting them. But it really is the people with disabilities front and center. And so part of this film is also putting that in the middle of it as well. So it it's not necessarily about somebody who is abled, dragging a cooler of insulin through the forest. It's teamwork, it's two people working together to try and accomplish a goal. And the person with the disability is really in the center of the story.
Stacey Simms 13:09
So tell us about the Kickstarter, this launched, I think I saw you and you and I started talking, when you were just shy of the goal in the time it took us to set up this interview and talk to each other, you have exceeded the goal by more than I think twice. You're like 200% above it. Can you talk to me a little bit about what you actually are raising money for. For those of us maybe who don't understand what needs to go into a movie, we know it costs a ton of money,
Noah Averbach-Katz 13:34
you know, I've never made a movie before. So I'm learning as I go, just how expensive everything is, you know, you have to pay for all this really expensive specialized equipment, you have to pay for the use of a space, you know, we're going to be shooting, like outside of the city center where we live. So we have to rent hotel rooms and rent an Airbnb and very people in and out and pay for everybody's food. You know, we have to compensate to the best of our ability, everybody who's working on the film. And that's not to, you know, include, like professional actors, like my wife, or, you know, a director who could really commend a fee, like Anthony is doing all this for free and helping out with the Kickstarter on top of that. So it's an expensive process. And part of it is I feel such a massive responsibility to make this movie feel as polished and professional as possible, so that everyone has to take it seriously. It doesn't just sort of get pegged as a disability piece. You know what I mean? Because it's maybe because of it as an excuse. Yeah. Oh, well, it looks a little under production value. So I definitely feel a big responsibility to make it feel and look and read like a real professional films and that is is, unfortunately very expensive.
Stacey Simms 15:03
All right. One of the things that really got my attention was you did not only get the attention of the diabetes community with your social media campaign and the Kickstarter here, but of course, you got the attention of the Star Trek community and it looks like they have been really generous. I got it. I mean, this is so embarrassing, because all right, I'll show my age. I'm a huge Star Trek fan, but I am a next generation fan. And it never kind of went from there. I started watching the next generation. Mostly I just watched in high school. Then I watched it was in syndication. I don't know if you know what that is. I do.
Noah Averbach-Katz 15:33
I'm not that young. Okay. I watched it in syndication to Alright, so Washington syndication I know that Netflix used to send out DVDs It's okay.
Stacey Simms 15:43
And then I got busy with life and kids and I missed all the other ones
Noah Averbach-Katz 15:47
Miss DS nine, you missed Voyager? No, first contact. My goodness, you've got a lot of catching up to do.
Stacey Simms 15:54
I did. I watched all the movies. In fact, we did. We did a rewatch of all of them, including the original movies like with Kirk, we did have during COVID. We'll come back to that because I have some specific Star Trek questions. But let's talk about you and your wife. No, you did not meet on Star Trek. Right? You guys knew each other before it didn't she she was cast. Tell me the story. Well, first
Noah Averbach-Katz 16:14
off, let me say this, which is that? You know, our director Anthony Rapp, who is also on Star Trek Discovery, basically has been mentored by Jonathan Frakes, aka Riker. So there is a very strong connection to the next generation in this film. As Anthony sort of has been doing directing on Discovery is Anthony Rapp the same Anthony Rapp from rent. That's correct. The very same. Oh, yes. Yes, we've got all of your favorite nostalgia pics. All in one movie.
Stacey Simms 16:47
90s. Rewind.
Noah Averbach-Katz 16:50
Yeah, yeah. So Anthony, you would, of course know him is Mark from rent, but he's been in dazed and confused, and eventually babysitting either as a direct connection to the next generation here. So it's not so far out of the realm to bring that up. But Mary and I met at Julliard, we were both classmates there. And I was a big Star Trek fan. And she hadn't really, you know, she, like everybody who grew up in the 90s. In the early aughts had like, watch the next generation, but that's kind of it. And she got an audition for Star Trek. And I was so excited. And I read the lines with her. And that was kind of it. She was supposed to do a slate, which is essentially like, just like a full body shot to see how tall you are. And she came in wearing this flowery flowing dress, sort of a hippie dress. So I would normally never say anything. But this one time, I said, Look, sweetie, you look amazing. But you need to wear something with shoulder pads. And so she came back in, and it's sort of military style jacket. And she got the parts. So that's what I liked. I liked to say that she got the part because of that. Oh, that's so funny. And that was in 2016 17 2017. And then she's just been working on the show. And I got a chance to work on the show as well. And yeah, it's just been a lot of fun for me. I hope she's having as much fun as I am. But I'm certainly having a good time. But
Stacey Simms 18:14
what is it but your mother is the biggest Star Trek, right?
Noah Averbach-Katz 18:17
This is true. Yes. My mother is of course having the most fun of all. Yes, she's gotten to go to conventions with me when I've been at conventions. She got to go on set and sit in the captain's chair. She really has. Yeah, she really has lived this this wild Star Trek fan dream that she's very, very pleased with herself. And we're all very happy for her. She's having the time of her life.
Stacey Simms 18:44
We haven't actually talked about your diabetes. Well, how old were you when you were diagnosed?
Noah Averbach-Katz 18:49
I was 13. It was the summer between eighth grade and my freshman year of high school. So that was about 20 years ago.
Stacey Simms 18:57
What do you remember about it?
Noah Averbach-Katz 18:59
I remember just like feeling kind of, I just remember all the classic symptoms, you know, going to the bathroom all the time being so thirsty, losing a ton of weight. And then my family doctor came in to the office and said something to me, and my mom looked upset. So I was like, well, this isn't good. I don't know what he's talking about. You know, this was sort of before diabetes was in the consciousness for everyone. You know, it's like phase one, phase two diabetes. Yeah. And then, you know, I'm old enough to remember using NPH and having to eat on this crazy schedule when my long acting would kick in. And you know, it's funny because I stopped using a pump in 2011 but that pump that I had been using was pretty much the same pump since 2005. And so I'm like, I'm done with pumps. I'm out. I don't want to use them anymore. But then I'm like, Oh man, like I'm still thinking about pumps like people think about the ice Phone five like Blackberry. Yeah, I'm like I'm stuck in 2005 when it comes to a lot of that technology, so it's been a similar journey to many others.
Stacey Simms 20:13
Did you go on a pump? Or do you still use pens? No, I
Noah Averbach-Katz 20:16
still use pens. But I have graduated to using a Dexcom G six. So at least I'm not completely stuck in the past. Well,
Stacey Simms 20:25
the reason I'm asking is mostly because when I ask actors, I always like to know how or if they try to hide the technology. Because some of these outfits are pretty form fitting.
Noah Averbach-Katz 20:36
When I was on Star Trek, I wasn't on the G six yet, I was still using finger sticks. And for those who don't know, I was playing an alien, a blue alien called an Andorian. It was it was a full prosthetic face, right? So my entire face is covered in this thick layer of rubber. And one of my classmates kind of the king of prosthetics. His name is Doug Jones, you would know him as the fish from the shape of water. Oh, yeah, he also wears prosthetics. And I had been on set with him a lot. And I'd see they put him in prosthetic hands. He's kind of like goofy looking gloves, but that you couldn't take them on and off, they were super fitted. So he would just sit there, you know, not being able to poke at his phone or do anything. And when I got cast, I was so you know, so excited. Thinking about the prosthetics and I thought, Oh, crap, you know, if they put me in these prosthetic gloves that I can't take on and off, I'm screwed, you know, I'm gonna have to have somebody take my blood sugar, maybe on my forearm. But if I'm wearing clothing that I can't roll up and down like this is going to be a disaster. So I asked Mary, and she said, well just bring it up to the costume people and see what they can do for you. And the costume people, oh, I sort of explained that to them. And they sort of Nan said, Well, it's fine. We'll just put you in gloves the whole time. So the entire time of my sort of run of the show, I am wearing like black leather gloves. Regardless of what I'm doing. I'm eating breakfast, I'm wearing black leather gloves, I'm flying a spaceship, I'm wearing black leather gloves. And that was just so I could have easy access to my fingers. So I could test. So that's kind of a fun, diabetes Insider.
Stacey Simms 22:20
Because you know, it's after stories, if we were talking to small children, or people who were wondering about how they're going to work at work or school, you can use an accommodation to be made even this blue alien. found a way. Exactly, exactly. But that's great. So I've already asked about your mom and Star Trek. And I hesitate. But I'm just always curious as being a parent of a child with type 1 diabetes. I'm most curious about other parents. And I know that when you're 13 or 14, you're not really paying attention to how your parents are going through something like that. But is there anything that they did when you were a teenager that helped?
Noah Averbach-Katz 22:55
Hmm, when you're 13, you're still really a kid, you know what I mean? So it's hard to say like what they did that helped, you know, they, they took me when I got diagnosed, we were gonna go to London. And instead, we went to a diabetes summer camp, which I absolutely loathe. And I was utterly miserable. I was so unhappy. But I think it was very good for them. So I think that really helped them because they were, you know, they were totally freaked out. It was this huge job, there wasn't the resources available online, right, you know, so it was just like, you kind of get thrown to the wolves back then. And it's sort of sink or swim. So I think that really helped them. And then the first semester or two of high school, I was just sort of like in and out of school, I would just like not go to school. And they were just sort of fine with that. And I think that was helpful just to take a couple of months to just get my bearings understand what was going on. And I think for them just having me around so that they also weren't worrying all the time. Yeah. And then I think it was also very helpful at some point. And of course, this changes person to person, everybody, when it comes to this stuff really needs different forms of help. But I think at some point, I just said, I am so sick of having you guys around. I'm so sick of being around you. I'm tired of you. I'm tired of you. And I'm 14, you know, yeah. So I'm taking control of this, and I'm taking control of my life, and I'll see you suckers later. And being okay, with handing me the reins, you know, is not an easy thing for any parent to do. And I think they just sort of let me go for it. You know, and I think that was really useful and very smart. Because at the end of the day, it really is it is on the diabetic to take care of it as much as the parent would love to movie with only ever leave your site. Exactly. And, you know, of course it's not the same for younger kids who really do need that different level of attention. But yeah, you know, once you hit 14, you're going to hit some problems if you're really trying to not control but have some control over your child's life, even if it is in the diabetes fear. You're the one who's who's out there alone, you have to be able to handle it yourself. So feeling like your parents trusted you to be able to not die is a good vote of confidence.
Stacey Simms 25:24
You sound like my son. That's so blunt.
Noah Averbach-Katz 25:27
Yeah. Well, you know, diabetes makes you kind of blunt, because it is black and white, right? You get this stuff and you live where you don't, and you die. And that's sort of what the movie is about. As much as it is about disaster or access to infant. It is also a very universal thing for diabetics, which can make some non-diabetics a little uncomfortable, which is a constant confrontation with mortality, right? You have the stuff you live, you don't have the stuff you die, there's not really wiggle room in there, and you kind of have to get comfortable with it. Because otherwise, you're just kind of woken up by it in the middle of the night and you start to panic. So you have to kind of make peace with it and look it in the eyes and just say alright, your this fact is coming with me, and I can handle it.
Stacey Simms 26:13
Let's talk a little bit more about Star Trek. You know, Gene Roddenberry's vision was very optimistic. Sure. Does that optimism hold up in this crazy time that we're living in? I mean, I'll answer I'll say yes, because I think that's why people are still drawn to it and still love all the shows. But I'm curious what you think about this very optimistic.
Noah Averbach-Katz 26:33
Here, my experience interacting with most people, and I think this Kickstarter is a reflection of that is that people want to be the best version of themselves, they want to be helpful. They want to lend aid where they can. And when asked to step up to the plate, most people do their best. I think that's my experience is that there is a lot of stuff that gets in the way of that. But I just really think that most people want to help. And there aren't a lot of opportunities to help. Because the world is huge. And our communities have sort of fractured and for all sorts of reasons. But when I watch different shows, or think about different shows, I actually think that the reason why Star Trek has stuck with so many people is it is a real reflection of how people try to be the best version of themselves how they would like to interact with people, which is leading with a from a sense of, of cooperation, leading from wanting to be helpful, leading to problem solving. And just those simple things cooperating with other people, anybody who's worked at a job knows this cooperating is really challenging. Working alongside other people who come from a different background have different ideas than you is really challenging, working together to solve a problem that doesn't have a clear answer, that people have different ideas about how to go about solving is really, really challenging. And I think Star Trek is about, like, how do you navigate that right? How do you navigate people who are trying to work together, but are very, very different. I think that has been the most one to one reflection of my sort of adult experience, which is that people want to help they want to be involved. They want to make the world a better place. But it's really, really hard to do. I don't know, I just think people don't want to live in a dark, gritty reality. It's cool to watch. Don't get me wrong. But I think people really do strive to live in a community orientated, bonded, connected society. And that is sort of the example that Star Trek offers less than a utopia. I don't think it's a utopia, because there are so many issues, you know, otherwise there wouldn't be any problems. And I don't think that Star Trek is offering a world where there are no problems. I think it's offering a world where the opportunity to solve conflicts to solve interpersonal problems with quality communication, where a lot of the societal barriers have been removed. So it makes the focus less about how you're going to survive and more about how you can aid your community. I think that's sort of what people would really, really like most people I interact with anyway.
Stacey Simms 29:37
Yeah. Well said very well said. So what's next for type one, the movie? I mean, as I said, you've already hit the Kickstarter goal. It'll wrap up pretty soon. What comes next in the process?
Noah Averbach-Katz 29:49
Well, you know, like, once we sort of realized, okay, we're going to have enough money to make this movie. We've sort of kicked our pre production into gear, hiring everybody who's not already on The team finding the right location, getting all the logistics in order. And that will continue basically up until we shoot sometime in May. And then after May it goes into post production, and then a post production goes smoothly will go into the festival circuit. So yeah, it's really just trying to get the machine running for this project, which seems like a small little movie, but to do it right really does take a lot of it takes all hands on deck, and you're saying May of this year just start shooting? Yeah, we got to move fast because people have to make other television shows holy
Stacey Simms 30:35
cow. Well, Noah, thank you so much for joining me for sharing so much information. I'm thrilled that the Kickstarter has gone so well. And I hope that when you can breathe again, it sounds like you're running nonstop for several months, come back and tell us how it went and how we can continue to help.
Noah Averbach-Katz 30:53
Absolutely, I would love to be back. Thank you so much for having me.
Stacey Simms 31:02
You're listening to Diabetes Connections with Stacey Simms. More information and that Kickstarter link, of course, over at diabetes connections.com. If you're listening in a podcast app like Apple or Spotify, the links should be there too. Sometimes they don't work so well in those apps. So please head on over to the episode homepage every week to get the information at diabetes dash connections.com. It's really interesting with podcast apps, how they're so easy to use, but the links don't often show up, especially with Apple, which is the top way people listen to the show as to the Apple podcast app. But you know, the links are not so hot. So I always put it out there that you can head back to the homepage, I am going to tell you a little bit more about my Star Trek stuff. I alluded to a little bit in the interview there. But how I how it ties into my former career in television. No, I was never on a Star Trek episode.
But first, Diabetes Connections is brought to you by Dexcom. And when we first started with Dexcom, back in December of 2013, the share and follow apps were not an option. They just hadn't come out with the technology yet. So trust me when I say using share and follow makes a big difference. I do think it's really important. I say this a lot. Talk to the person you're following or sharing with and get comfortable with how you want everyone to use the system. Even if you're following your young child. These are great conversations to have at what numbers are you going to get in touch? How long will you wait before you call that sort of thing. And that way, the whole system gives everyone real peace of mind. And I'll tell you what I love about Dexcom share, and that is helping Benny with any issues using the data from the whole day and night, not just one moment, internet connectivity is required to access the separate Dexcom follow app. To learn more, go to diabetes connections.com and click on the Dexcom logo.
So I mentioned a little bit of the interview with Noah about how I love Star Trek The Next Generation and how that's really where my fandom stop. If you just kind of embarrassing. I meant to watch Discovery before he talked to him. But I ran out of time. And I've got to get Paramount or whatever the channel it's on. So we did watch season one of Picard. We did it with the free special right the free trial of that channel. Since the second season has just come out, I'll probably get paramount and watch Discovery.
I think that's where it is Fingers crossed. I've got it right. There's so much streaming. But back in the day before streaming, and just syndication. I used to watch Star Trek The Next Generation and I started watching it in high school. And I believe it was always in syndication, right wasn't one of those weird shows that didn't really have a network home. It was just syndicated. And it stayed in syndication forever, even after the series finished its run. So when I worked at WSTM, the NBC affiliate in Syracuse, New York, I used to go to bed very early because I had to be up I had to be on the air at five o'clock in the morning. I didn't remember what time I got up to it was even worse than radio because I had to put makeup on and you know, get dressed to look cute. I mean, that was got dressed to radio too. But you don't I mean, it's all different. So I used to go to bed at 730 or eight o'clock. And to Star Trek The Next Generation came on at seven. So I used to watch that most nights. And then when that was over, it was bedtime. And I got into that habit for ever. And then I moved jobs and move cities and you know, it just didn't last and I never picked up on any of the other shows.
I loved Picard as if they did a great job of kind of updating it and giving a lot of nods to the fans but also having a really good time and my husband is not as much of a Star Trek fan as I am and he really liked Picard. And we also watched as long as I'm giving you sci fi recommendation just we watched the Expanse this year too. We started watching that last year and that's on Amazon Prime. The Expanse is fabulous. The first season is pretty slow. I know get through it. Don't skip it though. You need it for later on. But the first season is not the best. But it's a great show. It's six seasons. I've loved it so much that when I was finished I went back and read all the books and the books are fantastic too. Good stuff Although, all right now that I'm recommending pop culture stuff, I will say that the expanse, especially in the early seasons, that early books is very male centered. It's written by a couple of guys. So no surprise there. When you watch the next generation, when you go back now with my now, those skirts are pretty short and the female crew doesn't exactly get the best storylines. So if you're looking for sci fi or fantasy, that is just incredible, and also happens to be a little bit more female centered, and Kay Jemison, Broken Earth series. I read that last year, absolutely phenomenal. Probably the best sci fi or fantasy series I've read in ages. And I'm into that too. So I'll link I'll link all this up. If you're interested. Join me for my new pop culture podcast. Stacey talks about sci fi. You know what, that sounds kind of fun. All right. But that is not what this podcast is all about. Go check out Noah's Kickstarter.
Next week, I am getting right back into the technology and tools of diabetes. We're talking with the folks from via site. This is the encapsulation of stem cells. This is the quote, functional cure. We know way down the road for type one, they were really interesting. There's a lot of new stuff that's been happening since I last talked about via site on the show. It's kind of beyond encapsulation, that what they're doing very much sci fi feeling, if I could tie it back into that, but it really is interesting stuff. And I hope you can join me. All right, thank you, as always, to my editor, John Bueknas from audio editing solutions. Thank you so much for listening. I really appreciate it. I'm Stacey Simms. I'll see you back here soon. Until then. Are any of you expecting me to say live long and prosper? Alright, be kind to yourself. Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged
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Episode Transcription Below (or coming soon!)
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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 of the past seven days. we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast.
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The news is brought to you by The World's Worst Diabetes Mom: Real Life Stories of Parenting a Child With Type 1 Diabetes. Winner of best new non-fiction at the American Book Fest and named a Book Authority best parenting book. Available in paperback, eBook or audio book at amazon.
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Non-profit drugmaker Civica expects to launch lower-cost versions of insulin in the United States. Civica said it would produce three copycat versions of insulin, and make them available at roughly the same price for all customers, once approved by U.S. health regulators.
The company's products, which would be available as both vials and pre-filled pens, are biosimilars to Sanofi Lantus, Eli Lilly's Humalog and Novo Nordisk's Novolog. The maximum price would be no more than $30 per vial and no more than $55 for a box of five pen cartridges. Civica, which was launched by seven health groups to make essential medicines available at affordable prices, expects to file for regulatory approval in 2023 with products available in 2024.
https://www.saltwire.com/atlantic-canada/news/civica-aims-to-launch-low-cost-insulin-in-us-by-2024-100701260/
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Tandem has issued an urgent field safety notice. This in Europe ONLY and is for the t-slim X2 pumps with Basil IQ technology. According to the notice, a user could inadvertently program and confirm a basal rate with an incorrectly placed decimal point. That could mean giving too much or too little insulin. Tandem says you can continue to use the pump after confirming basal rates are correct. A software update is coming. Again, this is Europe only and this is NOT an issue for any pumps on Control IQ
https://www.drugdeliverybusiness.com/tandem-diabetes-warns-on-some-tslim-x2-insulin-pumps/?fbclid=IwAR0dV04W49iQ1LavAIQMkpleif77XiVqKq7ZrhUiFTrpylem-ZHIByRN8nw
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Interesting new potential treatment for diabetic retinopathy. Retinopathy happens when the disease damages tiny blood vessels in the eye, reducing blood flow to nerve cells in the retina. Treatment can be injections or laser surgery. These scientists are looking at photo-bio-modulation – which involves irradiating the eye with far-red to near-infrared light. This increases oxygen-rich blood flow to the retinal cells. They use an LED contact lens to get the light exactly where its needed. No human tests yet.. so it’s a far way off.
https://newatlas.com/medical/led-contact-lens-diabetes-blindness/
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I don’t have much of an update about diabetes aid to Ukraine except that it’s still very much needed. If you’re so inclined, we’ll link up where you can donate. One partnership I didn’t mention last week is one between the Ministry of Health of Ukraine, a group called Direct Relief, and the International Diabetes Federation. They are working closely together to understand where supplies are short, secure donations within and deliver them quickly to where they’re needed. Lots of links to vetted organizations in the show notes and here on our fb page.
https://sparearose.org/
https://www.jdrf.org/blog/2022/03/02/helping-the-diabetes-community-in-ukraine/
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The ordinary blood pressure medication verapamil continues to show benefits in treating type 1 diabetes. Patients taking verapamil required less insulin two years after their type 1 diagnosis and also showed evidence of other surprising benefits. These researchers caution that their study is small and needs to be confirmed by larger clinical studies. There are a few other going on right now.. but the preservation of some beta cell function is very promising.
https://www.uab.edu/news/research/item/12670-an-oral-medication-shows-benefits-treating-type-1-diabetes-for-at-least-two-years-after-diagnosis
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Two pieces of good news about insurance coverage. Our friends in Ontario, Canada will finally get CGM coverage. Starting March 14th the Assistive Deices Program will cover funding for a CGM and related supplies for people with type 1 .
https://www.baytoday.ca/local-news/people-with-type-1-diabetes-to-get-government-funding-for-real-time-continuous-glucose-monitors-5126997
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And in the US military families will have pharmacy coverage for Abbott’s Free Style Libre 2 under Tricare Health. This should make the Flash Glucose Monitor available with zero copay to Tricare members. It begins next month.
https://www.pharmacytimes.com/view/military-members-families-and-retirees-get-simplified-access-to-abbott-s-freestyle-libre-2-system-through-tricare-
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Bringing some awareness of how common a misdiagnosis is when an adult has type 1 diabetes.. professional golfer JJ Spaun is speaking up. He was diagnosed with type 2 but after a couple of years of struggling he found the right doctor and the right diagnosis. He next plays in the Players Championship this weekend we’ll see if we can spot the Libre on his arm.
https://www.golfchannel.com/news/after-diabetes-misdiagnosis-jj-spaun-feeling-new-person
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Our long format episode this week is all about Pixar’s Turning Red. There are two background characters in the movie with diabetes and we’ve got the behind the scenes story why.
Next week: why the star trek community pushed a T1D kickstarter campaign over the top.
Listen wherever you get your podcasts
That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
When Pixar’s new movie, Turning Red premieres, the diabetes community will probably enjoy the story, but we’ll be looking very closely at a couple of background characters. There are two with diabetes technology on their arms Diabetes isn’t part of the plot here, but it's very visible.
We can thank Susan Fong for that. She’s what’s called the Dailies and Rendering Supervisor for Turning Red. Fong lives with type 1 and she’s the one who asked to put diabetes into the movie. We talk about the team effort to get these characters on screen, the balance of math and art that is both diabetes and movie-making and a lot more.
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
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Episode Transcription Below (or coming soon!)
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Stacey Simms 0:00
Diabetes Connections is brought to you by Omnipod. Simplify life with diabetes. by Dexcom. Take control of your diabetes and live life to the fullest and by Club 1921, where Diabetes Connections are made.
This is Diabetes Connections with Stacey Simms.
This week when Pixar’s new movie Turning Red premieres, the diabetes community will probably enjoy the story. But we'll be looking very closely at a couple of background characters. There are too with visible diabetes technology. Diabetes is not part of the plot here, which is kind of the point.
Susan Fong 0:45
And sometimes I think that's important. I know a lot of folks get frustrated by the number of questions. They're asked about diabetes, or can you eat that? Should you be eating that? What's that thing on your arm, and sometimes it's just nice to be who you are, and have it not be a part of.
Stacey Simms 1:01
That's Pixar’s, Susan Fung. She lives with type one. And she is the person who asked to put diabetes into Turning Red . We talk about the team effort to get these characters on screen, the balance of math and art that is both diabetes and moviemaking, and a lot more. 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. If you are new, we aim to educate and inspire about diabetes with a focus on people who use insulin. And how cool was it to see people who use insulin in the Turning Red trailer when this came out a couple of months ago, and you know, there was that first trailer, the little teaser, where we saw one child with what looked like a pump infusion set maybe on her arm. We all went bananas. But then the second trailer came out and we saw another kid with diabetes technology. It looked like a Dexcom CGM on her arm. And that prompted 1000s of posts and tons of questions. Well, we've got the answers for you this week.
My guest is Susan Fung and she is what is called the dailies and rendering supervisor for Turning Red . She'll explain what that means and how this whole process came together. Susan lives with type one she was diagnosed at age five. Her sister also has type one she was diagnosed a few years later. Susan was Pixar as sequence lead on Seoul, the rendering Supervisor of Coco and she's worked on Brave Toy Story three Wally Up Ratatouille, the list goes on and on. I am really grateful that she spent some time talking to me about diabetes and animation and a lot more.
But first Diabetes Connections is brought to you by Omni pod. You know, I'm a big fan of choice when it comes to diabetes technology. I get so excited when there's something new. Because if you live with diabetes, whatever type whatever age, you deserve to find the best fit for you. That's just one reason I'm working with Omnipod to help spread the word about their program that makes it so easy to test their system out. It's the Omnipod dash free trial. If you want to try an insulin pump or see what life without tubes is all about, you can now try Omnipod dash free for 30 days. The trial comes with no commitment or obligation, not right for you. No problem, go to diabetes connections.com and click on the Omnipod logo or go to omnipod.com/diabetes connections for details, Terms and Conditions apply for full safety risk information and free trial Terms and Conditions. Visit omnipod.com/diabetes connections.
Susan, thank you so much for joining me. I think the whole community just went bananas when we saw the trailers of the teasers for Turning Red . So to talk to you about how this all happened is just a thrill. Thanks for being here.
Susan Fong 3:55
Definitely. Yeah, thanks for having me.
Stacey Simms 3:56
Let's just jump right in. Why are there depictions of diabetes in this movie? How does this happen?
Susan Fong 4:03
We have a long history of Pixar, of trying to increase diversity and representation on screen. It's largely been motivated by folks in our characters and crowds departments who on each film have made suggestions on what we could incorporate. And I happened to be on read very early. When your supervisor you're one of the first folks to start on the film. And so given that I was on early, which is the best time to make a suggestion. I asked the crowd supervisor like hey, can we get a representation of insulin pump in this movie? And he said, Heck yeah. And then he took that back to our director, our soup tech and kind of what we can consider our production pod and the producer. They made some suggestions about what we could incorporate to increase representation on screen and everyone loved the suggestion of insulin pump. And that's how we got it in the film.
Stacey Simms 4:45
Just before we go any further sop tech.
Susan Fong 4:48
Is that a sup tech is it the supervising technical director is the supervisor of all the supervisors.
Stacey Simms 4:54
Okay. So when you were asking about an insulin pump What did you have in mind kind of to maybe sneak it in, or make it part of the story or just have it somewhere on the on the screen?
Susan Fong 5:08
Really, for me, it was just about representation. I think, you know, given that it was a kids movie, or were in middle school, we see a bunch of children on screen. It's something that I don't see, I don't see representation of myself in that way. And so even if it's not a central element of the story, to me, is just still holds value saying like, Hey, kids all look different. We all have something different about us. And this happens to represent how I'm different, at least visibly.
Stacey Simms 5:34
When I saw the trailer for Turning Red , I just thought I you know, I don't know the story. As you and I are talking, I haven't seen it yet. It has not yet been released. But even without the depiction of diabetes, you see this pre teen or tween, and then she turns into a panda. It's just such a crazy, fun representation of the madness of puberty. I mean, I assume that's what the movie really is about. And that's a time where you feel so different, whether you have diabetes or not. But having that extra stuff on you has got to be even more of a burden. So I know you were gonna talk about your story. But is that part of what you were thinking about with this kind of movie?
Susan Fong 6:11
Yes, I think that is a strong central theme is kind of that challenge of those middle school years. And what happens when you go through puberty. And it is true, that's kind of the phase when a lot of young diabetics become more self conscious, I actually did not get an insulin pump until I graduated from college, I have now had diabetes for have to do some math, I think 38 years. And so it wasn't, you know, available for me when I was that age, which meant it was a little less visible. You know, for me, the way it manifested was a blood glucose meter, always getting eat a snack maybe whenever when other folks didn't. But it did make you always stand out.
Stacey Simms 6:45
So let's talk about you. You were diagnosed when you were five years old, in the early 80s. Do you remember any of your own diagnosis?
Susan Fong 6:52
I do. And some of it I think when I describe it is likely my interpretation as an adult looking back. I you know, I did listen to one of your podcast episodes a few weeks ago, you were surprised that both folks on the show had misdiagnosis stories, well add me to that list. I came down with some sort of virus kind of standard sore throat kind of thing. We went and saw the doctor says this just a virus sent me home went back a week later, because I wasn't improving. They gave us antibiotics sent me home. Third week, when we come back, my mom was basically frantic at that point, because she could barely keep me awake. And when they tested my blood sugar, actually, the doctor took one look at me and said, Oh God, we got to get her straight to the ER, Mom rushes me to the ER. And then I'm like, basically in an attic consciousness. So I have flashes of like, remembering my mom running and screaming for help beat her up a little bit. Because my mother's amazing. Such a fighter for me, my sister is diabetic too, by the way. And so you know, I was the first to be diagnosed of the two of us. And the doctor just really kind of missed all the signs, you know, massive weight loss, massive thirst, increasing somnolence, you know, couldn't stay awake. And so when they tested my blood sugar, they couldn't, you know, return a value, it was too high to return a value. I was in about a week, I was not sent home with a blood glucose meter, which is crazy. And we were in the middle of a move, which, of course. And so shortly after diagnosis, we moved to Raleigh, North Carolina, and I was lucky to be seen at Duke University. And they were much more forward thinking in that day and age of having, you know, everyone have a blood glucose meter. And also using sliding scales for insulin, really deciding on your insulin dose based on what you were eating instead of the other way around. Right. And I remember the horror, when we moved to Atlanta, endocrinologist was like you set your own doses. But I am grateful for that foundation, you know, that Duke gave us so I think I was probably without a meter for maybe four weeks. And that thing of those first blood glucose meters back then it's like three minutes that had a wash bottle. You know, it was Yeah,
Stacey Simms 8:56
yeah. Many, many people at that time didn't have a home meter in the early 80s. Is my understanding, at least Yes. Wow. When was your sister diagnosed,
Susan Fong 9:04
she was diagnosed, right? In the preteen years, bless her heart. And you know, in our case, we recognize the signs. My sister was complaining about something to my mom, my mom said, Hey, we should check your blood sugar, and it was high. And that's always one of those things where you're testing it. But you're not really thinking about what that next moment is like, if that number pops up. And it's not what you expect.
Stacey Simms 9:26
I've talked to parents who have multiple children with type one, but very few siblings. Would you mind talking for a minute of what is that? Like? I'm sure she wanted some support from you, but you're the little sister. And then after a while you do have each other to lean on, but it still had to be devastating.
Susan Fong 9:42
I think diabetes was less intensively managed back in that day. And when I think about you know, it is a constant thought woven through every moment of my day as an adult and I think as a child, honestly, I didn't think that way. You know, it was something that you tested your blood at breakfast and dinner You took a shot at breakfast and at dinner, and there was very little thinking in between, because often what they had was you running high enough to avoid the lows, you know, so I had a few critical lows as a child, you know, one of wishes the first day that pool opens and summer. Too many hours in the pool. Yeah, Dad was flying solo that weekend, I'm sure. You know, that was part of the challenge. But it just wasn't as present in my mind. And I think, you know, as we got older, and the technologies improved, and the diabetes complications and control trial results came out. That's really when the shift happened, where we tried to become more intensively managed. And so when I look back at the diagnosis that my sister, while it's devastating, and I'm sure she was devastated, we actually didn't talk about it that much. You know, I think that's just part of the innocence of childhood.
Stacey Simms 10:47
Yeah, that makes sense. For sure. One of the things that I found when I was doing some of the research for this episode was a video of you, I think it's three years old, it might be longer, it might be older than that was Khan Academy. And you're kind of explaining your job and explaining things about, you know, how it works at Pixar. And then you talked about diabetes, and you held up the Animas vibe, which I just said off such fond memories of animals. But do you mind if I ask what technology you're using now?
Susan Fong 11:15
I'm on the Tandem T slim with Dexcom.
Stacey Simms 11:17
If you're not familiar as you listen, it went under business a few years ago. But in that video, you talk a little bit about math and diabetes and math and art and your job. I thought that was fascinating. Could you speak a little bit about how all that goes together.
Susan Fong 11:32
And again, our technology has improved. But as a diabetic, I measure almost everything I eat on a food scale. And so there's a constant exercise of math of I read the package, and it says there's 20 grams of carbohydrates for 30 grams of weight. And now on my scale, I have 60 grams of weight than how many carbs do I have. So there's constant calculations like that, that you're doing. And I've also mentioned, both in my job and in diabetes, the importance of kind of gut instinct, that the longer you're diabetic, the more comfortable you are operating on gut instinct. As I know, I should take this amount of insulin for 40 grams. But because I did this intensive fitness class this morning, I'm going to lie and take a little less. And so there's a kind of a math fine, you know, is your foundation, and it helps validate your gut instincts, but you're still going to modify things from there, it's not the end all be all. And in my job, so much of what I do is predicting the amount of farm meaning render farm cores or number of CPUs or computers, you can think of it that we need to make our film on any given day. And I start doing this forecast about three years before the film comes out. And so I am constantly playing with math, you know, figuring out if this department has this many shots to do, and this is the average cost per shot, how much farm do they need on a given day. And all of that is graphed and plotted over time. And it just reminds me so much of when I look at now my Dexcom graph on my MIT swim or on my phone, and I'm looking at these graphs, and I'm looking for anomalies like, Hey, this looks a little high, Hey, that looks a little off, hey, this is going up faster than I expect. And it's all of the same things that I'm doing at work. When I'm looking at the validation of the data, I have that gut instinct of you begin to recognize the patterns over time. And then your gut kicks in and says this pattern looks wrong to me. And that's when you dive in and figure out what you know how to
Stacey Simms 13:24
fix it. I remember when my son was diagnosed, our endocrinologist said, you know, you have to understand diabetes is just as much art as science. And I understand that kind of in theory, but the way you're talking about it really makes sense is your your work must be just as much science as art and artists science as well.
Susan Fong 13:42
Definitely. I mean, I think, you know, there's so much more art, I would say in my job, then definitely than in the world of diabetes, there's the art of gut instinct, for sure. You know, working at Pixar, I'm so lucky that the math I do, ultimately results in a pretty picture at the end of the day. And I and that is how I got interested in working for a company like Pixar is I was in undergraduate school at Georgia Tech. And I took a class that was intro to graphics. And one of the things they have you do is write a math program that draws a single pixel at a time. The technology back then that we used was called ray tracing. So I wrote a ray tracer, that first time you generate a photorealistic image, just from writing text in a text editor. It's magic, you can't believe that you can do it. And that's really what the art of rendering is. There's a lot of complex math that goes into it, some of which I am familiar with, but it's more handled by our engineers. But that math is all based on the laws of physics. And the laws of physics dictate how lighting bounces around the room, or how you know, skin is slightly translucent, if it has a light source behind it. And so those kinds of things. We have a physical measurements of real world data that inform equations that we use to replicate that on screen. So it's really kind of a fascinating place to be with math and One pence to the accountants of the world. But no. When I think of what's a career in math as a kid, that's kind of what I would think of as something like, you know, being an accountant. And that did not hold enough interest for me. For me, it was more about what can I do with math that does tie back into some of my core passions, for things like art, photography, just the beauty of the world.
Stacey Simms 15:22
It's interesting. I always wanted to be a journalist, you know, I spent my career in broadcasting. And when I was a freshman in college, one of my first assignments was, I was so lucky, they did a press tour for The Little Mermaid, the movie, it wasn't finished. But they showed a lot of the unfinished animation to us. And they talked about how difficult it was to get her hair to swirl around underwater. And I always think about that, when I watch you laughing at that.
Susan Fong 15:47
I'm not, I just I've spent I've done a lot of work on hair over the years. Okay, that is a challenge. Okay,
Stacey Simms 15:53
so when I remember they took her hair, I think about that almost every time I watch an animated movie, and I cannot believe how realistic it's getting. I cannot believe how far it's common. And you know, I know it's just the beginning is that realism that we're seeing? Is it all the computers animation getting better is it people knowing how to manipulate it better, isn't just so much, or the computer so much more powerful,
Susan Fong 16:15
it's all three. So see anything about simulation simulation of something like hair or cloth, we start with a physical space solution that our director of software engineering who has a PhD from UC Berkeley, she has written along with her team, a simulator, and that kind of is the first thing that our simulation team will will run. But there are many cases that kind of physically accurate, isn't what the director is looking for. And that's where the art of simulation comes in. Of if the director is saying they want a different shape, try to think of a good example, like in the movie Brave, when Maratha has a hood up and then pulls it back over her long curly hair. That was a very art directed shot. If you just ran a physics simulator, that's not what it would look like. And so you know, you have to learn to incorporate, you know, ways of tweaking that that base foundation to kind of give the look that you're looking for. It's really one of those things where it marries everything you've said, there's better software that you know, is based on the laws of physics, there's faster computers that can run more complex calculations. And then we evolve our artistry over time, and our simulation artists have gotten better at better at the art side of simulation, you know, sculpting the shape of a blanket or sculpting the way the shower curtain silhouette is. These are things that are more art than science.
Stacey Simms 17:33
So let's go back then to Turning Red does the diabetes that we saw depicted on the two characters does that come up in the movie at all is it in the background isn't mentioned or explained,
Susan Fong 17:44
it does not come up in the movie. It is not mentioned or explained more than one character is diabetic. One of my favorite characters that happens to be a diabetic. And you may have seen this on our second trailer is a blonde girl, her hair in a ponytail in the girls bathroom. But when Mei turns into a panda in the bathroom, she's there, and she has her infusion set on her arm. Her name Stacy Frick, you know, she's the the popular friendly girl. She accepts me for who she is, despite all her differences. And she also happens to be a diabetic. And so it's just kind of she is a more central character than we often have. When we think about different efforts, we've had that increasing representation. A lot of times it's just you know, kind of in the background on a crowds character, but species a reoccurring character, but it's not part of the story. And sometimes I think that's important. I know a lot of folks get frustrated by the number of questions. They're asked about diabetes, or you know, can you eat that? Should you be eating that? What's that thing on your arm? And sometimes it's just nice to be who you are, and have it not be a part of the story.
Stacey Simms 18:46
Okay, I'm gonna let the fact that she's named Stacy slide right by because I do not want the illusion ruined that I somehow influence that. I know I didn't. But you mentioned a couple of minutes ago that you would listen to a podcast episode where two of the women were misdiagnosed. And I'm pretty sure that was one where we talked about this movie. And we talked about representation. And specifically one of the guests was concerned about talking about this as though it was only inclusive of type one, which we all know diabetes technology is worn by people with different types of diabetes. Did that occur to you at all? And is that? Well, I'll just leave it there. Did that occur to you at all? Is that something that you had thought about?
Susan Fong 19:26
I mean, I 100% agree with Dr. Walker. I think I'm lucky that I've had exposure through my friends to type two diabetics that do read the same technology that I do. You know, one of my my good childhood friends, her mom crashed out her car when she was low, and she had never heard of a Dexcom and granted back then they were a little bit newer. But when I found out what happened, you know, I said you know about this technology. And one of the problems that we've been having over the years is having endocrinologist be open to fighting for that technology for a type two diabetic let's say to come into dependent. So I 100% agree with Dr. Walker, that it's extremely important to have that just be diabetes, and not necessarily about the type. We all have different pieces of technology that we need to use to manage ourselves. And this is just one of the tools.
Stacey Simms 20:14
I was struck to when you mentioned that you brought it up, hey, we'd like to have somebody with diabetes, visible technology in this movie. And the person next to you said, Heck yeah, let's do it. Pixar seems to really be making this push to show so many more different kinds of people, different types of people, I guess you could have a big company meeting and talk about it is it's kind of something in the air. How is that happening? And it just seems like they're doing it right.
Susan Fong 20:38
I think this goes back to the importance of having a diverse workforce. If you have diverse voices in the room, they're more likely to advocate for different things about the stories that stand out to them, where representation is lacking, or something as misrepresented. In general, in the tech industry, we've seen a groundswell of support for different diversity inclusion efforts. And we have had several talks and summits at Pixar, where we talk about different strategies to both increase our presentation, but also improve the hiring process, improve the support that folks are lent once they do start. And I think it was around that area that folks started saying, Hey, can we and crowds was our easiest place to start, because we build a giant library of different people. And so you know, over the years, we've added crutches and canes and wheelchairs, a cochlear implant on one movie. And I remember, I think it was added a few films back, but there's a shot of someone just sitting in a waiting room, you know, it's pretty large on the screen that you definitely see it. And we had a similar response to that. People just want to see the presentation of the real world. And I think given that this film, in particular, was set in toronto, toronto is an incredibly diverse city. And it gave us so many opportunities to represent represent that diversity on screen. It's a little difficult
Stacey Simms 21:55
to see in the trailer, what type of diabetes technology the characters are wearing, is that on purpose, is it supposed to be a depiction of a Dexcom or a tubed pump site? You know, my listeners are really wanting to dig deep and find this. More general, it's
Susan Fong 22:10
okay either way, unroll response on social media was overwhelming. And I took all my willpower in the world to not hop in and be like, it's not that. I appreciate everyone's curiosity. So I think one of the things that was really important to our director is being accurate to the time period in which the film was was set. And so this is the early 2000s, I was an early adopter of Dexcom. It did not look like that in the early 2000s, I think was 2004 when the Dexcom, seven first came out, they weren't widespread. And so what we see is more of our presentation of a tube pump. And one of the challenges when we we said heck yeah, and that was our crowd supervisor, Paul Candiac. And are one of our folks and characters Mara. They were both on board. But then the question and the challenge became, how often do you shoot characters waist, which is where more most people wear a pump, in film and TV, if you've watched, you know, an episode tonight, pay attention to it. We're always framing character spaces. If we put the insulin pump on the waist, I think it was going to be more challenging to actually see it. And so that kind of led to some strategizing by Mara of like, well, hey, can we put the infusion set on the arms? You know, how common is that. And I definitely had friends that did that. And it seems like a great way to make sure that even if we're shooting from the waist up, or kind of, you know, torso up, that you would still have an opportunity to see a representation of it. So it's intended to kind of be representative of a pump of that era, kind of pre CGM being quite popular.
Stacey Simms 23:41
Yeah, I had growing emotions and growing up when my son was growing up, we saw lots of kids wearing two big pump on their arms. He would never ever do that. He just drives me bonkers, like, just try it. No, but I remember we saw lots of kids doing it. I'm curious to you know, as a mom of a child with type 1 diabetes now, older teenager, my goodness, I am curious. And maybe I should ask your mom, but I'm gonna assume that your mom sees all of your movies. Yeah. And when she goes to this one, she's got two kids with type one. She seen you guys through lots of ups and downs. Not only is she got to be just so incredibly proud of you. And I'm sure if your sister, what do you think something like this means to her?
Susan Fong 24:21
That's a great question. I remember one story and I'm trying to pull it out of the recesses of my brain where my mom was explaining to someone that she had to give me a shot twice a day, and the other mother responded with I would rather die. And oh my god, no. I'm sorry. I think increasing representation helps even our parents, you know, who are fielding the same questions of just normalizing it. And I think there's a lot of misconceptions about diabetes. If you're well manage, and you know that someone is going to have birthday cake. Generally, you can figure out a way to manage that with insulin. And so there's a lot of missing conceptions that parents are often having to fight, you know about what their children with diabetes can do? And the answer is they can do everything they can to everything that kid without diabetes can, it might be a little bit harder. It might take, you know, some strategizing some trial and error, but they can do everything. A person without diabetes can. And so I think, you know, just that normalization of kids are all the same. Some of them were diabetes, tech, some of them are diabetic, some of them are not, I think could be powerful.
Stacey Simms 25:29
When I asked my listeners, what kinds of questions they wanted me to ask you, the only actual question and I'll share the thought is, was we say goodbye in a moment, but the only actual question was, will they make stuffed animals or merchandise featuring these characters? I understand. But I'm guessing the answer is probably not if they're not main characters in the movie?
Susan Fong 25:51
Probably not. I'm not a part of our kind of, I can't remember the name of the group consumer products are not a part of consumer products to know what is coming as a part of bread. But yes, I would imagine that
Stacey Simms 26:02
follow up and get the skinny on that one. And then the last question I want today, it's really wasn't about diabetes. But I'm just curious, you said you started working on this years ago, can't imagine you know, I talk into a microphone, we put the podcast episode out next week or whatever, I can't imagine the process here. What is it like for you all, when you know that people are going to finally see this movie?
Susan Fong 26:22
Oh, it's it is the moment of joy that we all wait for. It's been challenging and COVID times because we're used to being able to go out to a theater and watch it with a fresh audience. And sometimes, after you've seen a film for, for many times, through many iterations, you don't laugh at the jokes anymore, because she's kind of have absorbed them and are used to them and you're more focused on the visuals on screen and getting them approved. And so when you see with a fresh audience, it's the first time you get to see that, that reaction, it really does make your heart sing. There was an absolutely incredible moment, when the crew was watching the film. At the end of the film, when the credits come up, the band in the film named for town is singing a song, and the audience was singing back. And it was amazing. And it's yeah, it's those moments that are really, really powerful. Just, I can't even put words to what it feels like. But it's a highlight for sure.
Stacey Simms 27:22
Get not really understanding how not only animation works, but all the computer stuff you were talking about. You kind of mentioned that many people had a role in this. Can you talk about what you meant there?
Susan Fong 27:33
Yeah, so my only contribution on the insulin pump was the spark of an idea. And from that point forward, many, many artists had their hands on this. There's a process in the art department where they're pulling reference, and they're coming up with what they think that design should be. There's a process of approval, where it goes in front of the director, and approving the design, the art director approving the design, it moves into characters to actually be physically modeled as a 3d model, into shading to be shaded, to look representative of insulin pump. And then you know, the tubing and the infusion set itself are also a particular challenge, because our stimulation department had to make sure that the tube moved as the cursor moves, they had to make sure that the infusion set laid flat against the skin. And a lot of those tweaks ended up being done by both animation and our characters department who do shot sculpts, which is when you just need to tweak something to make it flush, just a tiny little, you know, adjustment. So it actually required a number of requirements to have their hands on it, to make it work. So I just really want to thank everyone that put effort into it. And I think also, you know, artists also say when they work on something like this about how much they learn, and how rewarding it is to learn about how these different pieces of assistance, topology work.
Stacey Simms 28:47
Did they call you down sometimes, like, can we look at your pump? Can we look at your CGI?
Susan Fong 28:53
You know, I helped recall the shader packet repo reference and, you know, put it up on a board to kind of decide, you know, how you're going to take the reference you see and turn it into something that is our own. And yes, I pulled a lot of the reference for for fire characters department and fielded constant questions. And I love that. One of the little things under the scenes is the infusion set was not named infusion set, because it got lost in the game of telephone. So it's called insulin injector as the name of the model.
Stacey Simms 29:22
Oh, gosh. Gosh, I really appreciate this. It was so much fun. And I'm so excited to see the movie now. I mean, we're so funny, because we're like, yeah, yeah, the plot looks great. Tell us about this five second scene.
Susan Fong 29:37
I still am very overwhelmed by social media response. And I knew it was important to me. I didn't know it would be the same for everyone.
Stacey Simms 29:46
Oh, well. It was quite the big deal. And it will continue to be so well, I said that my listeners didn't have a lot of questions. But one thing they said over and over again was to please thank Pixar. They're doing such a good job at making everyone feel rested. sent it. And everybody just said, please say thank you for doing this. And I wanted to pass those thoughts along as well. Because it really, as you saw on social media, I guess you saw the posts, it's so meaningful to people. And we really do appreciate that not only you did it, but you came on to talk about it. So Susan, thank you so much for joining me and sharing your story and for sharing your story in the movie.
Susan Fong 30:21
Of course, I appreciate it.
Stacey Simms 30:28
You're listening to Diabetes Connections with Stacey Simms.
More information as always, at diabetes connections.com. If you're new, and you're listening, maybe on a podcast app, like Apple or Spotify or something, the show notes also have a transcription and links can be kind of difficult to see in some of those players even in some of the top and most used podcast players. So if you can't find it, or it looks weird, you could always go back to diabetes connections.com. And we have a very robust search as well. If you are new, and you'd like to take a spin through all of our episodes.
I got to give a big thanks to Jim Hill. He is the host of the Disney dish podcast and fine tuning to podcasts. I really recommend if you're Disney fan, he connected me with the right people at Pixar and helped make this happen a little bit more to share about Turning Red in just a moment.
But first Diabetes Connections is brought to you by Dexcom. So my husband and I were watching a movie the other night, and we got a Dexcom alert, then he was upstairs in his room. And for some reason it took me back to the days when we basically had blood sugar checks on a timer. This was a long time ago, my son has lived with diabetes for 15 years. And we would check doing a finger stick the same time every day at home and at school. And whenever extra we needed to. It really is amazing to think about how much our diabetes management has changed with share and follow. I didn't stop the movie to get up and check on him. I knew what was going on, I could decide whether to text him or go up and help out using the shared follow apps have really helped us talk less about diabetes, which I never thought would happen with my teenager. And he loves that part too. Trust me, that is what is so great about the Dexcom system, I think for the caregiver or the spouse or the friend, you can help the person with diabetes manage in the way that works for your individual situation. Internet connectivity is required to access Dexcom, follow separate follow up required, go to diabetes connections.com and click on the Dexcom logo.
Just a little bit more before I let you go about Turning Red in the community response and vape a little bit more from Pixar. I'm releasing this episode a little early, which means I'm taping it a little bit early. At this point, I have submitted an op ed to a couple of national outlets. So hopefully they will be picked up. And I'll be telling you about that. But the Op Ed was about a lot of what Susan and I talked about in that interview in that Turning Red shows but doesn't tell about diabetes, how it is not a plot point, and how that's actually a bit of a breakthrough. And in the Op Ed I go on to talk about how it avoids what so many other even children's shows run into, which is a depiction of media diabetes depiction of media. That's wrong. And we talked about that a lot in the episode that Susan falling mentioned there with Dr. Heather Walker, and Dr. Phyllis duros, who was also in that episode as well had contributed a chapter to Dr. Walker's book. So I will link that episode up you can go back and hear our whole conversation about diabetes and media. Her particular take on Turning Red s depiction you just showing telling about diabetes. And that will keep you posted. If the Op Ed pops up anywhere. We also talk in the op ed a little bit more about the type how the type is not mentioned either. And I think that is important. So as you're sharing this story, remember, you know not everybody who wears an insulin pump or a CGM lives with type one diabetes, let's include people with lots of other types. There are lots of other types of diabetes. I am one and I get pushback on this a lot. And we're all entitled to our opinion. But I am one who thinks our community is much stronger together. And that means not throwing people with other types of diabetes under the bus. And all of that to say I haven't even seen the movie yet. Right? The movie hasn't been released as I'm taping this, I cannot wait. I'm sure it's going to be terrific. And you know, I'll be watching it as soon as it is released. Let me know what you think I would love to hear from you. I have a feeling we'll be talking about this for quite some time to come.
Thanks as always to my editor John Bukenas from audio editing solutions. Thank you so much for listening. We've got in the news in just a couple of days. I do that every Wednesday live on social media and then we turn that around for a podcast episode on Fridays. These episodes are usually released these long format interview episodes every week on Tuesday. This one's snuck out a little bit early, but usually we are on Tuesdays so you can find out more on the homepage or on social media. Of course you can always follow me. I'm Stacey Simms. I'll see you back here in a couple of days until then be kind to yourself.
Benny 34:50
Diabetes Connections is a production of Stacey Simms media All Rights Reserved all wrongs avenged
It’s “In the News…” Got a few minutes? Get caught up! Top stories this week include: where to donate if you want to help people with diabetes in Ukraine, a look at cases of COVID-induced diabetes that seem to be temporary, Dexcom gets FDA breakthrough status for use in hospitals, insulin prices mentioned in the State of the Union, T1D college scholarships and learning more about a non-invasive glucose monitoring system called SugarBeat.
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Episode Transcription Below (or coming soon!)
Please visit our Sponsors & Partners - they help make the show possible!
Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast.
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The news is brought to you by The World's Worst Diabetes Mom: Real Life Stories of Parenting a Child With Type 1 Diabetes. Winner of best new non-fiction at the American Book Fest and named a Book Authority best parenting book. Available in paperback, eBook or audio book at amazon.
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Our top story.. a lot of you were asking about help for people with diabetes in Ukraine. I didn’t jump right into this last week because I get very concerned about scams. We hate to think anything about diabetes isn’t on the up and up.. but we need to be careful. I was really glad to see Insulin for Life, which is very well known and well-run, stepping in here. And easy way to donate to them is through Spare a Rose for Ukraine. This is the annual campaign centered around valentine’s day that usually runs through February.. they’re extending it through March. All donations will be directed to Insulin for Life, a registered charity with over two decades of experience providing insulin and diabetes supplies to under-resourced countries, and responding to emergencies. Their international consortium and network in Europe, with partners in Ukraine and neighboring countries, has supplies ready to go if, when and where needed.
https://sparearose.org/
https://www.jdrf.org/blog/2022/03/02/helping-the-diabetes-community-in-ukraine/
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As doctors learn more about people who develop COVID-related diabetes they’re finding blood sugar returns to normal a few months later. Researchers studied 600 patients who showed signs of diabetes while hospitalized for COVID-19, including 78 with no previous diagnosis of diabetes. Compared to patients with pre-existing diabetes, many of the newly diagnosed patients had less severe blood sugar issues but more serious COVID-19. Roughly a year after leaving the hospital, 40% of the newly diagnosed patients had gone back to blood sugar levels considered non-diabetic.
https://www.reuters.com/business/healthcare-pharmaceuticals/covid-related-diabetes-may-be-temporary-racial-disparities-widen-with-omicron-2022-02-25/
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Scotland has nearly 2-million people in a huge ongoing COVID study. The latest info from that shows no association with a COVID infection causing type 1 diabetes in children less than 16 years old. Type 1 in children increased to about 1.2 times the average during the pandemic but it doesn’t seem to have been caused by COVID. The US CDC has said otherwise, that there does seem to be a causal link between COVID and type 1. In all the studies so far, getting a COVID vaccine was not associated with incidence of type 1 diabetes
https://www.medscape.com/viewarticle/969166
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Good news about using the Dexcom CGM in the hospital. The FDA has granted Breakthrough Device Designation for Dexcom for healthcare professionals to monitor and manage glucose levels… in adults who use insulin while in the hospital. We first talked about this in 2020 when the FDA temporarily allowed hospital CGM use because of COVID. Dexcom created a special page on their website to provide resources to clinicians.. I’ll link that up.
https://www.dexcom.com/hospitalcovid-19
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Researchers say they’re making progress into amyloid, a key molecule in the pancreas that contributes to type 2. For the first time, scientists say they’ve uncovered the step-by-step changes that take place in a molecule known as human islet amyloid polypeptide. It’s helpful in the body until it changes into a more damaging form. The researchers said their findings, raise the possibility of new treatments for type 2 diabetes and other amyloid-related diseases such as Alzheimer’s
https://www.medscape.com/viewarticle/969265
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There is a huge psychological barrier against starting insulin for those with type 2. A new web-based resource is hoping to help with that. One in four adults with type 2 report being unwilling to start insulin once it’s recommended. These Australian researchers designed an online resource called “Is insulin right for me?” They went through eight psychological barriers like “does insulin mean my diabetes is more serious?” Then they went through the educational process around each. This was a very small study – fewer than 40 people- but the response was positive enough to continue toward a broader roll out. Editorial here – I speak to people all the time who feel like starting insulin is a failure of will power. I get it, we should all eat better and exercise more.. but no one feels the same shame about blood pressure medication. I’m glad to see this getting some attention.
https://www.healio.com/news/endocrinology/20220228/online-education-may-ease-insulin-fears-of-adults-with-type-2-diabetes
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The price of insulin came up in the State of the Union speech this week. President Biden talking about lowering prescription drugs and capping the price of insulin for the insured. He singled out 7th grader Joshua Davis from Virginia, who was diagnosed with Type 1 diabetes when he was 11 months old. Joshua’s father also lives with type 1 and the family were guests of the first lady during the state of the union. It’s not clear if any of the measures to lower prescription drugs will actually get through congress.
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We’re keeping up the non-invasive glucose monitoring news.. and the latest contender is sort of an old one. The My Sugar Watch is said to be moving forward and could be available this year. MySugarWatch is a licensee of the BEAT sensor, also known as SugarBEAT, from Nemaura Medical.
The SugarBEAT CGM has been around for a while, getting its CE Mark European approval in 2019. It’s a small patch that sticks onto your skin for 24 hours, then you replace it. The transmitter sends wireless readings to a smartphone app via Bluetooth every 5 minutes. They submitted to the FDA in early 2020.. with what looks like an updated submission last year. No word on a timeline or US rollout.
https://www.notebookcheck.net/MySugarWatch-needle-free-continuous-glucose-monitor-for-type-2-diabetes-on-the-cards-as-award-winning-Nemaura-posts-encouraging-financials.605046.0.html
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If you’ve got a high school senior with type 1 – you may want to check out Diabetes Scholars. Applications are open now. There is one application to be considered for any and all of the scholarships.. it closes March 27th. You must be a high school senior with Type 1 diabetes seeking a higher education at an accredited two or four year university, college, technical or trade school in the United States. And you must be a US citizen or permanent resident.
https://diabetesscholars.org/
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Our long format episode this week is all about Eversense – we take a deep dive into this implanted CGM system. The FDA just approved the E3 which lasts 180 days – six months – with no sensor changes. Next week? The real story behind the character with diabetes in Pixar’s turning red.
Listen wherever you get your podcasts.
That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
In February, the FDA approved the Eversense E3 for 180 day wear. That means you could have a CGM working – with no sensor changes needed – for up to six months. That’s been available in Europe for a while, but in the US it’s been a maximum of three months. As you’ll hear, the people at Eversense have even bigger goals.
This week, you'll hear from Senseonics Chief Medical Officer, Dr. Fran Kaufman. We get the basic info about the device, the plan for working with pump companies, a look ahead and much more. Imagine one year without a sensor change!
Dr. Kaufman is also a practicing endocrinologist and she’s been seeing patients for more than 40 years. She has a passion for this community and a lot to say about what truly helps patients thrive with diabetes.
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
..
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
Sign up for our newsletter here
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Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners!
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Episode Transcription Below (or coming soon!)
Please visit our Sponsors & Partners - they help make the show possible!
Stacey Simms 0:00
Diabetes Connections is brought to you by Dexcom. Take control of your diabetes and live life to the fullest with Dexcom and by Club 1921, where Diabetes Connections are made.
This is Diabetes Connections with Stacey Simms
This week Eversense is an implantable continuous glucose monitor. It just got FDA approval for a 180 day where that's six months with the dose sensor changes. Something else that makes it different. It can vibrate to let you know if you're low or high.
Dr. Fran Kaufman 0:39
And then people really, really enjoy that long term concept, as well as vibratory alerts. We've got people who work on the tarmac at the airport and they can't hear anything. So the only way they can actually do this is with the vibratory alerts.
Stacey Simms 0:52
That's the company's chief medical officer, Dr. Fran Kaufman, we go in depth on the Eversense system talking about how it all works, accuracy, and looking ahead to whether they'll partner with any insulin pumps for a closed loop. And they have big plans to make the system last even longer. 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. Oh, we so glad to have you here. We aim to educate and inspire about diabetes with a focus on people who use insulin. If you are new, my son was diagnosed with type one right before he turned two that was back in 2006. He is now 17 years old. My husband lives with type two diabetes. I don't have diabetes, I have a background in broadcasting. And that is how you get the podcast.
And I have been doing this podcast since June of 2015. I looked back in the show archives. They're all on the website. You can use a search box to find what you're looking for. But I looked back and we first talked to Eversense in October of 2018. We actually talked about Eversense at that time, not with the company. I talked to Darryl Greene. He was one of the first people in the US to get the sensor implanted. He is a news anchor. And he did it for his show, he showed the video of the implant the whole thing. I will link that up in the show notes so you can hear what Darrell had to say at the time and see an early version of Eversenseit has changed a bit since then.
But as you will hear this week, it is subcutaneous it's just under the skin. And that is where the Dexcom or libre or Medtronic Guardian sensor lies, but you can't insert it yourself. It is a quick outpatient procedure. It's minor but it is still a procedure. The flip side that's it for six months, no supply orders, no changing sensors. My guest here to talk about it and answer a bunch of your questions is Dr. Fred Kaufman. She is the Chief Medical Officer of sin psionics. The company that makes Eversense she is a pediatric endocrinologist who still sees patients and I could take the whole episode to read off her accomplishments. She's been in practice for 40 years, director of the comprehensive childhood Diabetes Center and head of the Center for endocrinology, diabetes and metabolism at Children's Hospital Los Angeles, former president of the American Diabetes Association, chair of the National Diabetes Education Program, on and on. And she has authored over 250 Scientific manuscripts and numerous books. I love talking to people like Dr. Kaufman, because yes, she's a very accomplished woman. She obviously knows her stuff. But you will hear her passion for this community. She is really in it to help all patients living with diabetes.
Quick note, I realized, as I was listening back, I do that a lot with these interviews for editing and you know, editorial reasons, I didn't ask about the capacity to share the sensor data in real time, right share and follow for something like this, Eversense has had that for a while. They don't use the same terms. They call it Eversense Now. And that doesn't change with the three the latest iteration of Eversense does have the capacity for other people to follow the user’s numbers. And I know that's important to a lot of you. I didn't want to imply that it isn't available by leaving it out of this interview. So you don't hear about it. That's on me. But it is there.
Here's my interview with Dr. Kaufman.
Dr. Kaufman, thank you so much for joining me. There's so much to learn about this system. My listeners are very interested. Thanks for spending some time with us.
Dr. Fran Kaufman 4:30
Well, thanks for having me.
Stacey Simms 4:31
I would usually start by asking you to talk about the latest and greatest this FDA approval that came through. But let's back up just for a minute. For people who are not familiar. Can you take us through what the system consists of here kind of set the table of what we're talking about when we say ever since? Well, I'd
Dr. Fran Kaufman 4:48
love to because I think understanding the system really enables you to understand this new innovation we have with our Eversense three system, the overall Eversense CGM Is three components. It is a fully implanted sensor very small, it's about three millimeters by 13 millimeters, and it's placed under the skin in the subcutaneous space, which is where all the sensors are working. They're all measuring the same glucose values in that interstitial space in what we call the interstitial fluid. But this is placed minor office procedure done by healthcare providers that we train and certify, we also give them the tools to be able to do both the insertion. And then when the time comes the removal of the sensor and the insertion of the next sensor. That's the center. It is a fluorescent technology, all the other CGM systems are enzymatic. So that is another distinguishing feature for us, and then placed over the sensor with a very mild silicone-based adhesive is a transmitter and the transmitter through near field energy powers the center, and that enables the sensor to read the interstitial glucose, give it back to the transmitter, the transmitter then sends it to the app on your smartphone. And that's where you can visualize your glucose value. But our transmitter held in place, again with a very mild silicone-based adhesive. So there are fewer skin reactions, also has a very unique capability of on body vibratory alerts. So if you don't have to have your smartphone sitting in your lap, you want to run upstairs for something you want to run outside, you want to take a bike ride without your cell phone, then you will get the alerts right on body, the transmitter itself will vibrate. And you'll know whether you're going high or low with your glucose values. And that's a feature that many many people truly enjoy and appreciate. And then the app is pretty much like all the apps, you can view your glucose every five minutes, the arrows for the directional change of your glucose-to-glucose curve for the last three hours, six hours, whatever you'd like. And it also, of course, has alert both auditory as well as visual on the cell phone itself. So those are the three major components and lots that differentiate us.
Stacey Simms 7:16
Yeah, I let me go through a little bit of what you said kind of break it down even further, you mentioned that the sensor uses something different to measure glucose level this is based on light or fluorescence, can you kind of explain that a little bit more or as much as you can, some of its proprietary,
Dr. Fran Kaufman 7:34
you well, and then lay terms so that I can understand it. I am a physician at OSI you know not a an engineer. But essentially, this sensor is composed of a sensing surface where glucose attaches reversibly dependent on how much glucose the sensor is exposed to at that point in time. And of course, this interstitial fluid is moving. So you know it's bringing glucose continuously to the sensing surface. And then the power is to turn on little LEDs that light up that sensing surface in a full arrest by how much glucose is attached. And that fluorescence n is equal to the concentration of glucose.
Stacey Simms 8:18
Can you see that under your skin? Can you see that happening? Do like is there like a little light show going on?
Dr. Fran Kaufman 8:23
No. Other Yep. Could it be cool?
Stacey Simms 8:29
Maybe that's an add on feature for the future. I'd also heard this was a while ago. So this may have changed. I had heard that earlier iteration of this technology made it that it was sensitive to light. In other words, if you were exposing that site to sunlight a lot, it didn't work as well. Well. So
Dr. Fran Kaufman 8:45
there it rarely occurs. But there is something called an ambient light alert, if there is a lot of sun exposure. And this is mainly because that tape is peeling. So the sides of the transmitter are a little bit more exposed. It will pick up in ambient light tell you what can't reliably read the glucose and ask you to you know, either cover it or you know, get out of the sunlight.
Stacey Simms 9:09
Also, if, as I said, kind of going through it step by step of what you mentioned, let's talk a little bit more about how the transmitter connects. I saw someone on Instagram recently showing how it is, for lack of a better word seems very easy to Ristic she was kind of taking it on and off on and off quickly showing how easy and how different it is. Does that sound accurate? In other words, I think we're used to these devices staying on and we want to stick them as tight as humanly possible and then we rip them off like a really tight bandage. This is very different.
Dr. Fran Kaufman 9:40
Well this is very different so it's not holding the sensor in place right the sensor is fully implanted. So if this falls off, you do not lose a sensor. You just place it back on so the adhesive tape you know obviously sticks on one side to you on the other side to the transmitter and a few hit a door way or Your reference tumbling with your kids and a falls off, you can just place it right back on to that same adhesive. Or if you need a new adhesive, you know, there, you're just carrying a one little piece of adhesive in your purse or in your pocket. And that's all you really need to carry around with you.
Stacey Simms 10:16
I don't know if this will ring a bell with you. But it seems to me like your color forms, which were like kind of stickers, but kind of not you could take them on and off a few times. That's what this reminds me of.
Dr. Fran Kaufman 10:27
I'm not sure exactly know what you mean. But what what this is, is something that's very mild on the skin, we do ask you to replace it every day, take it off, clean the skin, let it breathe for a little bit while you're taking your shower, drying off and then place it right back on. So it's not that you have a piece of tape on for now what will be six months, you're changing that tape and letting the skin breathe. And of course, the tape is breathable as well.
Stacey Simms 10:55
That's a great point. I didn't want to imply that when I say take it on and off a bunch of times that it's more than a day. What changed recently, what did the FDA approve, that got everybody so excited?
Dr. Fran Kaufman 11:05
Well, we're like everybody, right? We are continuously innovating listening to the voice of our customer who is the person with diabetes healthcare provider. And one of the things we continuously heard was people want a sensor that lasts even longer. I mean, we're lasting 90 days in the US, it was already 180 days outside of the US. But for both, this is the next iteration for both. So this is our really, we call it a three because it's really our third sensor iteration. So some chemistry changed is you can imagine some of the other little minor things also changed. But the major change was in that sensing surface, allowing it to have a chemistry change that enables it to last really reliably for the six month time period. You know, whenever we put something in the body, the body reacts, and the way the body reacts to our sensor and the other sensors is it kind of oxidizes it, it surrounds it, it does a lot of other things to it. This chemistry change enables that reaction to be less significant over time, so that the sensing capability remains really excellent for a much longer period of time before we can get the six month indication. Talk to me a little
Stacey Simms 12:23
bit about the clinical trials that I'm sure were done for this when you're talking about six months. The questions my listeners had mostly about this was like, well, what could go wrong? Right? What if I want to get this taken out? Or what if it irritates me, it tell me a little bit about the people who've already done this.
Dr. Fran Kaufman 12:39
So there's our clinical trial, the promise trial that involved 181 individuals wearing actually more than one sensor for the most part. And then there's our vast really commercial experience both outside the US as well as the inside of the US where 1000s of patients have used the sensors. worse, worse, worst worst case scenario, you decide you don't want to have a CGM at all you can get it removed, or you could actually leave it in place till the time duration is up and get it removed, then there's really no compelling indication that you have to get it removed right away. If you don't want it or if it stops working. It actually is kind of okay as a permanent implant. Although that is not what we're asking people to do. We are asking them, as well as the FDA asking them to get it removed when the time comes. So that would be worst case scenario. For the most part, once it's placed in the skin, the skin is healed. Again, the mild adhesive on the scan, really, people enjoy it want it needed if but our system, rather than have no sensor at all, if you decide for a period of time, you don't want to wear the transmitter. Maybe you're getting married, maybe you're going to Hawaii and you willing to go without your CGM, which of course, for me and my patients, that would be a big no, no, then you can just take the transmitter off, charge it, then put it in a drawer and put it back on when you come back home. So it gives you that option. If you don't want to wear the transmitter to take it off for a period of time, or take it off, you know, an hour a day or two hours a day, whatever you'd like to do. There's a lot more flexibility because you're not losing the sensor at that point.
Stacey Simms 14:23
Yeah, talk to me about that, because I'm imagining and I've shared this on the show before my son is very interested in this, especially because of sports and wrestling in particular, he thought it would be so great to be able to take the transmitter on and off. Well, you haven't off. You've already mentioned the sensor will still alert you you know it'll vibrate.
Dr. Fran Kaufman 14:39
As soon as that transmitter is off. You do not get any sensor readings at all. So
Stacey Simms 14:45
my mistake. Yeah, my mistake. I thought for some reason it vibrated under the skin even without it.
Dr. Fran Kaufman 14:49
No, no, it's not the sensors not vibrating in your body. It's a transmitter on top of your skin that's vibrating.
Stacey Simms 14:55
Got it. Okay, talk to us a little bit about accuracy. What you found commercially as you mentioned clinical trials. I think my listeners are pretty familiar with Mark. But can you speak to that?
Dr. Fran Kaufman 15:04
Absolutely. I have been in the field of diabetes since 1978. So I'm old. And I'm really proud of it. And I've seen so much what I started with animal insulin and urine testing. And obviously, what I've seen in my own career a lifetime is awe inspiring. Unfortunately, it hasn't gotten us all where we want to be, which is done with this disease all together. But it has made obviously management. So much more important, easier, better, difficult, whatever you want to say. But we do now have a lot of tools and technology that can improve people's management. One of them is CGM. And those early CGM, which I was involved with, when I was in academic medicine, as an investigator were wonderful, you couldn't rely on them to make a dose adjustment, for sure. But you could get patterns and trends and see what was kind of happening overnight, it was really an amazing advancement, then as the accuracy continued to get better for these devices, we were able to look at a point in time and say, That's what my glucose value is, I can dose off that glucose value, which of course is what you're able to do with our sensor. And then you got more and more accuracy. And now, that's what you know, really, your value is. So our accuracy is measured by Maher during our promise trial. And one of the issues we have to face is, the longer the duration the sensor last, the longer our clinical trials have to last. So if you got a sensor that last seven days, your trial seven days, if it last 14 days, your trials, 14 days, in the last 180 days, your trials, 180 days, and one day, we'll get up to 365. So we'll have these really long trials that will be arduous for the patient and our clinical investigators, and a long time to get the results. But so for the six month trial, people came in 10 times about 10 hours each time, we drove them high and low, so that we could get across the sensor life as well as across all the glucose values from 40 to 400. To see the accuracy of our EversenseII three system and the MAR turnout overall to be 8.5, which is excellent. We're really happy with that Mart, it's you know, it's among best in class for CGM center available. And as always, the mart is leased. On the first day, of course, we only have one first day every six months, whereas sensors it's every week or every 10 days or every 14 days. And then it really settles down and all the way till the end of sensor life. 180 days they are busy was at that point still below eight, below eight below eight. Wow, you know, you have to put all the seven days first. So we did first day seven, day 14, day 21, day 30, day 60, day 90 day 120 150 and 180 day evaluation. So when you put all those together, it turns out to be a mark of 8.5. And then of course it's in the hypo range, we had an excellent mark, also a little bit less than eight in the hyper we had an excellent Mark less than eight. So it really is a pretty excellent system.
Stacey Simms 18:24
Is it simplistic to assume that gets better as it goes? Or does it get better for a certain point, and then it gets a little higher? Well, actually,
Dr. Fran Kaufman 18:32
we could have assumed that. But it turns out it's highest at the beginning and then pretty much stayed around the low aids, high sevens the rest of the time period.
Stacey Simms 18:42
I'll confirm this. But I don't believe any other CGM in the US has a mark that is under eight. I don't know that you can talk about it like that, as you said it's 8.5 for the whole life of the sensor. But that's really interesting.
Dr. Fran Kaufman 18:54
Well, there are depending on the conditions and other things. There are some marks that are under eight as well. And does Mark need to be five is marking to be six, we're probably pretty close to good enough, or excellent enough in that eight range. You know, when we started March, the first month was I think 25. Yeah,
Stacey Simms 19:16
yeah, it's come a long way. Yeah. Talk to us about calibration. The system does need to be calibrated, but the E three less than before.
Dr. Fran Kaufman 19:24
Absolutely. So as you can imagine a sensor lasting 180 days and when we get to the year long sensor, we'll likely not ever be able to get away from any kind of calibration. Now we're hoping with 108 with a 365 Our year long sensor, which will be a real Mark change to some of the platform configurations that we might be able to only have to calibrate once a week. But right now we're at a calibration of for the first 21 days it's twice a day. So the first calibration is really easy. You wake up in the morning, you take the transmitter off, it does need to be charged. It takes about 10 to 15 minutes charge to take your shower, you clean your skin, it put the transmitter back on, and you do your calibration. And then 12 hours later, you need another calibration for the first 21 days. And then after that it's mainly one calibration a day.
Stacey Simms 20:20
I'm pausing because I'm intrigued. We'll have to come back later to the 365. Okay, we talked about what's next is the goal, ultimately, no calibration, or you've already kind of hinted that as it gets longer and longer where you don't anticipate with a year long sensor you anticipate continuing to have to have some kind but but once a month is the goal. Yeah, hello,
Dr. Fran Kaufman 20:38
once we start once a week, we're not exactly sure. But it's hard to imagine that we would have something that long, that would not require some calibration.
Stacey Simms 20:50
Let's talk a little bit about one of the biggest questions that my listeners sent in, which was, when will this work with my pump? Do you have any plan? I mean, I'm assuming you have plans in place. But I let you jump in, you already started to answer
Dr. Fran Kaufman 21:02
it. Yeah, well, that's obviously our goal, as well. And so we're working towards that I can't really give a timeframe because it's not just dependent on us. And as you can imagine, some of the companies coming out or are just trying to get their first product out that first iteration. So they'll be a bit of a lag, but we're doing everything we can to facilitate it. I do have
Stacey Simms 21:25
to be nosy I understand if you can answer this, any of the existing pump companies in the US on the table with you? Well, we help
Dr. Fran Kaufman 21:31
every pump come and he's going to be on the table with us when you know when the time comes.
Stacey Simms 21:35
And what would have to happen. Is there another designation? Is it IC GM that you all need to get?
Dr. Fran Kaufman 21:40
It's pretty much IC GM. And then of course, even once you get that you've got to do some coordination with the pump companies open the API, how do they talk to each other, it is a bit away. But we're working on it, trust me.
Stacey Simms 21:55
My husband was joking last night, when I was telling him we were going to speak and he was like, gosh, all then they need to implant the pump. Because I put it all under the skin. I was like, you know what you're getting ahead of yourself. Like let's,
Dr. Fran Kaufman 22:05
you know, it is interesting, when you talk to cardiologists, you know, everything they have is implanted. When you talk to endocrinologist, they're not quite as familiar with the concept of implanting things. And the reason the implant makes so much sense is is one is you can't knock it off, it's obviously easy to put in and to retrieve, and it takes some of the burden. You may have to calibrate. But you don't have to change sensors every week or every other week. And it takes you don't have to order things anymore. So there's a trade off on our goal, which is to make life easier, more simple for people with diabetes. So that implant does in and of itself make things in a different framework, where I just don't have to, I travel, I don't have take anything but my little adhesive patches, versus somebody otherwise has to take a half their suitcase full of sensors.
Stacey Simms 22:59
Yeah. You mentioned endocrinologist and the implant? How is the physician training going? And Pardon my ignorance? Is it an endocrinologist that you trained to do this? Is it another kind of Doctor Who puts it in?
Dr. Fran Kaufman 23:09
Well, if the answer is yes to all of that, so endocrinologists have come forth and been interested in learning how to do it, you were not the only implantable drug or the you know, system that they have. They've got the implantable birth control. So some that are very, very interested love during the procedure kind of gets back to why they wanted to be physicians. And then others of course, who don't feel they want to really do it. So they're, they refer their patients to somebody who is doing it. So it mainly endocrinologist, we've got dermatologists, primary care, you name it, and they are there, as well as not just physicians and osteopathic doctors, but also nurse practitioners and physician's assistants do it as well.
Stacey Simms 23:53
I remember when we first started talking about this a few years ago, there were very few doctors who did it. I remember talking to our endo here, he was like, I don't know anybody in Charlotte, I'm imagining that that is changed. Do you have any numbers? Or how people would find out if it's done in their area?
Dr. Fran Kaufman 24:07
Well, absolutely, we can help them find out if it's done in their area if their own physician isn't doing it. But we certainly have picked up more and more physicians when a patient comes to the doctor and says, you know, hey, you know about this, I saw it, I'm really captivated by some of its qualities and differentiators. And the doc says, I don't know much let me contact and they contact us. We talked about, you know what it would be like to become a procedure list. And many of them say yes, so we have been able to increase the number of people learning how to do the procedure, particularly in some of the large groups and the large practices. A lot of them just really enjoy that aspect of medicine that they hadn't done maybe for a while and certainly the new endocrinologists coming out they're much more technology based than people my generation. What Chris wants to be my generation of retired do not intend to do. They want to have a procedure, they want to be able to break up the day, and many of them in their practices, you know, do it like Wednesday afternoons or Friday mornings, to accommodate their patients. And of course, they get reimbursed for that part of their time part of their, you know, they need to be trained, it's a way to be a little closer to your patients in some way. A couple of that clinicians have told me, it's enhanced my relationship with some of my patients, when you know, we have that opportunity for me to really impact in this significant way. Yeah,
Stacey Simms 25:33
that makes sense. You mentioned supplies, I was also thinking about costs when you said that, because write anything with a surgical procedure, even though it's very minor is going to have a cost associated with it. But I was assumed that's balanced out by as you said, you're not ordering supplies, you're not getting new stuff. Every couple of weeks. Can you talk a little bit about the insurance side of this is this well covered,
Dr. Fran Kaufman 25:53
it is well covered, we'd like it to be universally covered. We're working towards that as well. As you can imagine, we have a whole group of people, some insights, and CX mainly with our partner associate diabetes care, who is our partner in the sales and marketing of the Eversense CGM systems. And now of course, very, very excited about having Eversensethe three, so they're, they're working hard with the payers as well. Medicare pays for it. I think we have over 200 million covered lives. And we're hoping to be able to continue to have every insurance company cover this. Now if your insurance company doesn't cover it, there's appeals that can occur. And for the most part, those appeals work because the insurance company realizes the benefit of patients having CGM and we're, you know, really differentiated. So who's a patient who wants to use an implanted CGM, somebody who you know just travels a lot and doesn't want to worry about reordering, just want to put something in themselves, for whatever reason, dexterity cognitive, just don't like taking out all those needles and looking at them and putting things in themselves. And then people really, really enjoy that long term concept, as well as vibratory alerts, we've got people who work on the tarmac at the airport, and they can't hear anything. So the only way they can actually do this is with the vibratory alerts, do you really have somebody
Stacey Simms 27:18
who's works at an airport like that? We do. That's just fabulous.
Dr. Fran Kaufman 27:23
And these are some of the people who have come forth. And you know, they're our ambassadors. Somebody works in an elevator shaft and can't have anything big on their body. And this enables them to be down there and still feel the vibratory alert,
Stacey Simms 27:38
I have a bunch of questions that are more forward looking. But before we kind of move on to that, I'd be curious what you have learned. I mean, the system has been around in a shorter wear form since 2016, in Europe, and I'm curious, what has changed? or what have you learned from the people who have used it?
Dr. Fran Kaufman 27:56
Well, what's been really interesting is once somebody gets their second sensor, they're hooked for life. You know, there are some who use it, and then meal wasn't right for them. The same with other CGM, the same with pumps the same with any kind of technology. But once somebody said, I like my first one, let me get a second one, then they're pretty much hooked for life. And what are they want, they want longer duration, with the same level of accuracy, people really appreciate the accuracy of our system. As a result, they continue to use it. We've got patients on their 10th 15th I don't even know how many sensors, some of them I've had they've were on early and have never left.
Stacey Simms 28:36
Does it always go in the same place? Is it always on the arm and then they just kind of switch back and forth to either arm? They do.
Dr. Fran Kaufman 28:42
And I'm probably the only one who can say this and say I'm a physician. There are of course as always off label use of things.
Stacey Simms 28:51
Okay, we will leave that there. But very interesting. This might be a very dumb question. Can you go through airport sensors with this, you know, the the different devices, metal detectors, all that kind of stuff?
Dr. Fran Kaufman 29:02
You can you can even have a MRI, you know, the other sensors need to be removed for an MRI, but you must remove the transmitter.
Stacey Simms 29:09
Got it? That's interesting, and MRI and X rays and all that. Yep. Without the transmitter on, you've already mentioned that the the goal here is longer were one whole year. That's something that you all are working toward. I'm curious to, again, not to bring this personal or anything. My son is not yet 18. And he's been talking about this for a while, are you looking into pediatrics,
Dr. Fran Kaufman 29:31
we are looking to be there too. So we're hoping to have our 365 Day sensor in clinical trial in 2022. It's our hope we're working towards it. And that will have a pediatric component.
Stacey Simms 29:46
You've already alluded to the fact that you've been in diabetes for a while, you know, you worked directly with patients. I'm curious, could you give us some perspective on this? I mean, there are some people that look at a device like Eversenseand say yes, give me I want that, you know, for my child for myself. This is terrific. There are others who are squeamish about it can't possibly think about it just aren't interested. I'm curious when you were thinking about your patients, you know, how do you talk to them about things like this? Do you see patients anymore?
Dr. Fran Kaufman 30:12
I do see patients, I couldn't imagine not seeing patients. And I have, I will admit, I've been very unusual and that I've been out of my academic practice since 2009. And I'm still seeing my same patients and picking up some new ones here and there. You know, everybody has what they think is going to work for them. They try things, maybe it does work, maybe it doesn't work. But what I think what kind of captivates somebody about Eversenseis that it is long term, no longer does the patient have to worry about reordering and where they're going to be on Saturday, because they've got to change their sensor. And what happens if the sensor comes out early, where's the, you know, all those kinds of issues. So with a fully implantable sensor, it's there, and it's in there, lots of people like that as kind of really reducing some of the burden of diabetes for them. You know, once they hear about that, and they hear about, you know, if I want to I can take off the transmitter without sacrificing I like the idea, I don't have to have my phone with me all the time. I mean, just all these advantages kind of Captivate many, many people. And as a result, they want that opportunity. And once they have it and they see those advantages, they stick with it, for the most part, it has to be the right person I you know, we are by no means saying that 90% of people who are on intensive insulin management should be using ever since. But probably 1015 20% should be. And when you look at really kind of what the recommendations are now as a healthcare provider for me to manage my patients on intensive insulin, it's hard to imagine doing it without a CGM. That means you know, there's 1.6 million type ones they all likely need to CGM. 3 million type twos likely need a CGM, with all that number of patients, there need to be choices, there need to be differentiators, not just the same over and over again, whether it's seven days, or 10 days or 14 days. And that's really where we're kind of captivating the healthcare provider, as well as captivating the patient, I'd love for
Stacey Simms 32:17
you to come back on perhaps without, with maybe half the Eversensehat on and what I'm getting at is to talk to somebody like yourself, who has been in this world for so long, who has seen a lot of changes, who has adapted with and help their patients take advantage of all of the changes that have come through, I feel like it's an opportunity to really kind of dig into more about diabetes. So hope you don't mind if I call you again in the future.
Dr. Fran Kaufman 32:39
I'd love to I'll probably have a little bit of a bonnet on for what we
Stacey Simms 32:45
can make that that's fine. We can go with that. But before I let you go here, let me ask you about it. I don't know if you've seen new patients anymore. But when you talk to your patients, you know, I assume I'm just picturing. Gosh, I know I'm not trying to butter you up, I promise but lucky patients, right, they've got an endo, who's passionate, who really cares about this, who's really you know, we were lucky to have one as well like that, when you're talking to your patients these days. So much technology has changed in just the last five years and so much more cool stuff is coming. I assume you don't just focus on that tech, right? You're not just hey, here's a CGM go home. Can you give us kind of a peek into what you think makes a really good start or really good continuation? Or I guess it's a really good plan for people living with type one right now?
Dr. Fran Kaufman 33:29
Yeah, well, I mean, yeah, probably the most important thing is to find support. Nobody can do this alone, ever. I don't care how old you are. I don't care how independent you think you are. And whether that support is with your healthcare team, with your family members. I mean, it's all the better when it's multi faceted. I'm very involved with my patients, they all have my home phone number call me whenever they want text me all day long, mainly because it's such a burden that we transfer over to them on a we teach them we do this diabetes education, you know, stay in this lane, don't go too high. Don't go too low. Don't eat that. Don't you know, don't do this. And it's hard. And they really need support. So you know, camps, groups, your podcast. I mean, what a difference all this makes. And I really had to say what's the biggest difference I've seen over my career, it's that we've gotten diabetes into the open, people aren't hiding it anymore. And as a result, it's part of normal life. And it's trials and tribulations, the time it takes isn't as difficult when people can see the benefit and feel that support in their community, their parents, their friends, their spouse, their co workers. And I think for the most part, people are fascinated by the technology when you show it to them when I patient show it to them very interested in helping out however they can. And that's to me the biggest change when I First of my career, we spend so much time trying to tell people not to hide diabetes. When I patient told me the other day, she's just got a new job, she brought her co workers together, show them her sensor, her meter her glucagon. And, you know, kind of felt it was a badge of honor that they offered to learn about, uh, to help her if need be. And she felt, you know, kind of automatically brought into a community of people who care and I think the vast, vast, vast majority of people do care. And then of course, the technology is just the advances have been monumental, since I've been met, began my career patients being involved in their care doing what needs to be done, looking towards the future, understanding their own lab tests, coming with questions. I mean, that's that's where the fun is. I was in clinic yesterday, I saw a relatively new patient, he's about nine. And you know, the father is the fact what he's has learned. These two parents have learned in a short period of time, I rivals what my fellows can learn.
Stacey Simms 36:07
You know, I said, I was going to ask you this one question and let you go. But I have to follow up with Why are you still working? You said, I'm never going to retire. You already said that. You're like, that's it? Why are you so passionate about this?
Dr. Fran Kaufman 36:18
Well, first of all, I'm in my early 70s, which is the new 40s I think, I feel great. And I have spent so much of my career getting to where I am and the understanding, I personally have that, what would I do all day? Why wouldn't I want to continue to do whatever I can. And that's just how I am, I guess, and what my friends have retired, and they're happy, and they're doing what they need to be doing. I mean, the beauty of my end of the age spectrum is that you can do what you want. There's no I have to go to school, or I should get married, and I got to get a job. I mean, by this time, you get to do what you want. Finally,
Stacey Simms 36:58
where are we lucky? This is what you want to do. Gosh, thank you so much for joining me. I'd love to have you back. You can bring your bonnet, and we'll work
Dr. Fran Kaufman 37:05
it out. Okay,
Stacey Simms 37:06
thank you so much.
You're listening to Diabetes Connections with Stacey Simms.
More information about Eversense three at diabetes connections.com. Wherever you are listening, there should be extensive show notes. If not, you can always go back to diabetes connections.com. And check out the episode homepage,
I reached out to Darryl Greene, the gentleman that I spoke to a couple of years ago to get his thoughts on what he thinks of the system now. So I'm going to report back and let you know what he thinks if he's still using it. And if you are using EversenseI'd love to hear from you as well, I will also link up a couple of reviews that were in the community a couple of years ago for an earlier version. But if you are in Europe, perhaps you've been using the 180 day for a while or you're newer, you want to use the E three in the US as it rolls out. Let me know I'd love to follow up because there's so much curiosity about this system. And for so many people, it comes down to the actual procedure. Right, once it's in, people seem to love it. The questions people have are about how does the procedure go is easy to find a doctor is it easy to get it removed. So I'd love to hear from you if you have experience in that way.
All right. Coming up, I want to give you a sneak peek into what we're talking about next week. And that is all about Pixar is Turning Red. And boy, I'm so excited about the show I have for you. But first Diabetes Connections is brought to you by Dexcom. And when we first started with Dexcom, and that was in December of 2013, long time ago now, shared follow ups were not an option. They hadn't released that technology yet. I know that using sharing follow makes a big difference. I think it's really important though, to talk to the person you're following or sharing with and get comfortable with how you want to use the system. Even if you're following your young child. I mean, Benny was nine when we started with that. These are great conversations to have and they change over time. What number are you going to text your kid at how long you're going to wait to call your spouse that sort of thing. And that way the whole system gives everybody real peace of mind. I have loved helping Benny with any blood glucose issues using the data from the whole day and night. And not just one moment. Internet connectivity is required to access separate Dexcom follow app to learn more, go to diabetes connections.com and click on the Dexcom logo.
Next week's episode is one I cannot wait to share with you it is all about Pixar’s Turning Red. If you're not familiar, the plot of this movie has nothing to do with diabetes. It's all about adolescents. You know there's a girl she turns into a giant panda red panda when she gets excited and then she has to become to turn back unto herself. I don't know any more than that because I haven't seen the movie yet. But I do know is as you've seen if you see the trailers that there are two what they call background characters with diabetes technology. And as soon as we saw that trailer, there were two of them that were released. Actually, the diabetes community went bananas. And I used some of my contacts to reach out to Pixar. So I have an interview with the person at Pixar who is responsible for this.
I've seen a lot of interesting rumors online. It is not John Lasseter, he is no longer with Pixar. He is the former CEO there and he has a child with type blenders probably an adult now, he was responsible for developing Elsa in Frozen from a bad guy. She was supposed to be real villain in that movie to a much more sympathetic character with powers she could control because Lasseter saw a parallel to diabetes in that character. His son has diabetes. It's something that he didn't choose, right didn't want, but it's a part of him. And it doesn't make them bad. And he saw that parallel and Elsa and it helped guide the character. And I'll link that up. He's talked about that publicly before if you're not familiar with that story, but it wasn't him. And it wasn't a person on set or a voice actor who had a child with type one. I can't tell you more because it is embargoed until a little bit closer to the movies release. But I am going to put the episode out early.
So here's how the schedule is gonna go. We're gonna have in the news that will be Wednesday live on social media, I do it you can watch it on Facebook, LinkedIn, YouTube and Instagram. And that becomes an audio only episode that will be released on Friday. And then on Sunday, March 6, I will be releasing the following weeks long format interview episode in advance of the march 11th release of turning red. If you follow or subscribe to the show different podcast apps use different terminology, you will get it no problem it'll automatically come to you if you follow me on social media. You'll see it if you subscribe to the newsletter. If you don't, that's the best way really to keep in touch with me off of social media, you can subscribe just by going to diabetes connections.com and scrolling all the way down or the pop up will come up but the the newsletter will go out to remind you so I'm really excited about that. I'm thrilled to have had this interview and to get more insight and I hope we've made a new friend for the show. I know she listens I'm rubbish even say that but I hope she sticks around.
Alright, that'll do it. Thanks as always to my editor John Bukenas from audio editing solutions. And thank you so much for listening. A lot coming by we'll see you back here soon Until then be kind to yourself.
Benny 42:23
Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged
It’s “In the News…” Got a few minutes? Get caught up! Top stories this week include: a look at Vitamin D in newly diagnosed kids with type 1, new study about bariatric surgery, type 2 and COVID, endos are the top specialty adopting telehealth and a look at a new movie about type 1 - find out why it also has backing from the Star Trek community!
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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 of the past seven days. If you’re new we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast.
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Looking to get organized? Diabetes supplies can really add up and all that pump and CGM stuff or even shots and wipes and strips can clutter everything up. I’ve got a great new guide to help you out. It’ll get you started and keep you organized. That’s totally free and it’s over on the podcast homepage.
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A new study adds to the idea that Vitamin D might help with type 1 diabetes in kids. These researchers look at young people ages 10-21 and found that a supplement of Vitamin D2 may improve insulin sensitivity and slow the increase of A1C for those newly diagnosed. This was over the course of a year. Very small study, fewer than 40 kids and teens, and all of them diagnosed for three months or less. A lot more to learn here.. but the study is in the Journal of the Endocrine Society.
https://www.healio.com/news/endocrinology/20220221/vitamin-d2-supplement-may-slow-progression-of-newonset-type-1-diabetes-in-children
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This is more business news.. but something to keep an eye on.. RosVivo has signed with Eli Lilly for commercial development. Rosvivo has a drug said to be a game changer to treat diabetes and obesity. Lilly will now review and move it forward. The drug is said to restore the function of beta cells that secrete insulin, the cause of diabetes, and at the same time lowering insulin resistance. Animal studies only but we’re keeping an eye on this one.
https://finance.yahoo.com/news/rosvivo-therapeutics-inc-signed-material-125200372.html
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Provention Bio has resubmitted the Biologics License Application (BLA) for teplizumab. This is the drug that shows a delay of clinical type 1 diabetes for three years. The FDA said “no” last year.. but it did so in a way that left the door open, so Provention has done what’s been asked and is now resubmitting. The CEO says quote - “We continue to proceed with a sense of urgency, recognizing that significant unmet need exists for patients and their caregivers.”
https://www.empr.com/home/news/drugs-in-the-pipeline/provention-bio-resubmits-bla-for-teplizumab-to-delay-type-1-diabetes/
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The link between high blood pressure and diabetes seems to come down to a small protein cell. An international team shows this glucagon like peptide called GLP-1 pairs up the body’s control of blood sugar and blood pressure. Doctors have known for a long time that high blood pressure and diabetes go together, but this is the first time the reason for that has been found in the body. GLP-1 is released from the wall of the gut after eating. It also stimulates a small sensory organ in the neck. These researchers say GLP-1 is just the start for more study.
https://scitechdaily.com/long-standing-enigma-finally-cracked-link-discovered-between-high-blood-pressure-and-diabetes/
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More support for bariatric surgery as a treatment for type 2 diabetes. A study found that adults with obesity who had weight loss surgery and achieved “substantial weight loss” before contracting COVID reduced their risk for severe infection by 60% compared to those who didn’t have surgery. The study was conducted by researchers at the Cleveland Clinic. Previous studies have found that in obese patients with type 2, bariatric surgery sends it into remission more than 75% percent of cases.
https://blogs.bcm.edu/2022/02/21/bariatric-surgery-helps-with-diabetes-leads-to-better-covid-outcomes-study-finds/
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Throughout the COVID 19 pandemic, endocrinologists have had the highest rates of… telehealth adoption. This study released by Doximity – we’ve spoken to them on the show – looked at telehealth claims from January 2020 to June of 2021. As expected, younger physicians used telehealth more than their older counterparts. And they say the research shows that telehealth can successfully help manage diabetes – and that it even lowers A1C in people with type 2. They don’t say why.. but I’d think it’s because it’s easier to get a visit in remotely. Interestingly they also did a top five for metro areas with the highest telehealth adoption. They were: Boston, Baltimore, Charlotte, Philly and San Francisco.
https://mhealthintelligence.com/news/telehealth-adoption-highest-among-diabetes-gi-care-providers
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The World Health Organization is looking for people living with diabetes for an international focus group. They say they hope to foster solidarity and policy action between people living with diabetes, while acknowledging and highlighting differences in treatment and management needs between different types of diabetes. The focus group will be held March 9 and 10 live and online. We’ve linked up the survey you need to fill out to be considered.
https://extranet.who.int/dataformv3/index.php/257838?lang=en
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An ambitious project to make a movie about type 1 diabetes in a dystopian world is moving along via kickstarter. Noah Averbach-Katz is an actor and writer and has lived with type 1 for more than 20 years. He says too often a disabled person is reduced to a plot point - a problem that gives the abled hero an opportunity to save the day. He wants to tell a story that captures the fears, trials, and experiences of a Type 1 diabetic. The Star Trek community is rallying behind this – Averback Katz and his wife Mary Wiseman are both part of the Star Trek Discovery series. The kickstarter goes until March 24th.
https://www.kickstarter.com/projects/noahak/type-1
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As we hinted last week, Omnipod has a fun crossover with Nintendo. The very popular Switch game, Animal Crossing now has a new diabetes-themed designed by Insulet. It’s known as Omnipod Bay, you add it to the game with a special code. Omnipod Bay features booths from selected diabetes charities as well outfits, diabetes supply bags and diabetes-themed areas and activities. I asked – no little podcast headphone as of this time! The game add-on comes just two weeks after Insulet’s Omnipod 5, was cleared by the FDA.
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Our long format episode this week is with the Lauren Bongiorno, a diabetes health coach who is a terrific example of why it’s not a great idea to aim for perfect with diabetes. She shares how her A1C was basically perfect during college but that she… was miserable. And next week.. all about Eversense, the 6 month CGM.
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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.
Lauren Bongiorno was diagnosed with type 1 as a child and growing up, she showed every sign of success. She was a division one athlete, playing soccer in college and achieved the lowest A1C her endo had seen in a college student.. but while her care team celebrated that 5.7, she was miserable.
Lauren shares how she took control and got that happiness back. She’s now a Diabetes Coach at her company, Risely. We talk about some common pitfalls, the pressure to be perfect and what coaching really means.
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
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Episode Transcription Below (or coming soon!)
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Stacey Simms 0:00
Diabetes Connections is brought to you by Dexcom. Take control of your diabetes and live life to the fullest with Dexcom and by Club 1921 Where Diabetes Connections are made.
This is Diabetes Connections with Stacey Simms.
This week, Lauren Bongiorno was diagnosed with type one as a child and growing up she showed every sign of success. She was a division one athlete playing soccer in college and achieved the lowest A1C her endo had ever seen in a college kid. But while her care team celebrated, she was miserable.
Lauren Bongiorno 0:41
And I was sitting there and it was like literally an out of body experience because I'm watching like the doctor, high five, my mom and my five each other and I was like, I'm not happy, I'm not happy.
Stacey Simms 0:52
Lauren shares how she took control and got that happiness back. She's now a diabetes coach. We talk about some common pitfalls, the pressure to be perfect and what coaching really means. 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. I am 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. As I'm taping the intro to this episode. I am like you sifting through some FDA approvals these seem to be coming in fast and furious now or at least as fast and furious as the FDA does anything. But after a very long logjam, you know, this is all stopped up by COVID. It really seems like things are moving along. So to that end, this episode will not focus on tandems mobile bolus, which was just approved, you know, bolus by phone or the ever since CGM 180 day where approval. Those were the two biggies over the last week. And I am going to focus on them in upcoming episodes ever since should actually be next week. And Tandem a couple of weeks after that. As always, if you'd like to get your questions asked please join us in the Facebook group Diabetes Connections, the group if you're not on Facebook, no problem. Shoot me an email Stacey at diabetes connections.com. I have my own set of questions. But I always want to hear from you. And your questions are always fantastic. So please send them in.
But there is a lot more to diabetes than technology. You all know that. And I wanted to share Lauren Bongiorno’s story, because I think this really resonates for parents of kids with type one. And for adults with diabetes, nobody's harder on us than we are on ourselves, right and the pursuit of perfection. It's just gonna mess you up. I'll let Lauren share her story. But just for background, She is the CEO and head coach at a company she founded called Risely that's a bit of a play on how in diabetes arise isn't a good thing. You know, an arrow up on your CGM, a higher A1C , their website says type 1 diabetes has given rise a bad reputation. But we think it's time we reclaim it. I think that's really clever. And I think this is the first time I've spoken with a health coach on the show. So we talk about what exactly that is, and why somebody would choose to work with a coach along with a medical provider. Here's my talk with Lauren Bongiorno.
Lauren, thanks for spending some time with me and my listeners. I'm so excited to talk to you.
Lauren Bongiorno 3:33
Oh, thank you so much for having me on. Stacey. I'm so looking forward to this conversation. Yeah, I
Stacey Simms 3:38
feel like I've we've connected and I've seen you, you know, all over social media. So I'm, I'm really excited to kind of hear more of your story and share your experiences. Because just the little bit that I know, I feel like you're kind of the embodiment of why perfect doesn't always work out with diabetes, if I could say that.
Lauren Bongiorno 3:56
Yeah, I think you can say that. And it's so interesting, because I think that if there's one thread of my entire life that I can really look at, it's this striving for perfection, and then getting too close to perfect and realizing, Oh, wait, this is not what I wanted. So definitely applies to diabetes, for sure.
Stacey Simms 4:17
Well, let's back up and explain what we're talking about here. Let's start closer to the beginning. You were diagnosed at age seven. Do you remember any of that?
Lauren Bongiorno 4:24
Yeah, I definitely remember it. I remember it was the day after Halloween. I remember my mom being on the phone with my dad in the kitchen and I had just had a tantrum and I think she was trying to figure out if it was a seven year old tantrum or if it was a something's wrong tantrum. And I had been losing a lot of weight and when you're seven years old, and I was really like skinny as a child and you lose, you know, 20 pounds, there's definitely some signs that something else may be going on and I was drinking so much water and I remember hearing my mom, you know, talk to my dad and have them deciding To take you to the doctor, so I went to my regular pediatricians office, and I was sitting there. And the distinct memory I have is of my mom and the doctor on the other side of the door and my mom hysterical crying. And if you know, my mom, she's like the strongest woman, she is a like, so independent, so strong. And I don't think that was the first time I ever heard her cry, or at least I remember her ever crying. So I was like, Oh, something is wrong. And then I ended up in the hospital, stay there for a few days. And when you're a kid, and you have everybody around you crying and saying, it's going to be okay, and you're so strong. And you also at the same time, don't really understand what that means. It sets you up for an interesting and interesting path and an interesting life. And definitely now looking back a lot of things that I think I didn't realize was going on in my mindset, and in my own personal development and relationship with diabetes.
Stacey Simms 5:53
And so fast forward to a story that you tell on your website, which is when you were in college, and kind of realized that this was not sustainable. But I'm curious between seven and 19. Were you that model diabetes kid?
Lauren Bongiorno 6:05
Yeah, that's actually the phase I don't talk about as much. And it's interesting, because I think it's the phase that most people and most of our clients that rise they relate to. And so that stage from seven to 18 really was, it was me just being in a very reactionary mode with my diabetes. So it was like, Oh, your blood sugar is high. Shoot, let's correct it and get it down. Oh, shoot, it's low. Alright, let's drink some juice really fast. So you can get back on the soccer field. And it was very kind of ping pong lead. And I never fully felt like I had the energy or the mood that I think that I could have in hindsight now, because I didn't realize like how much that Ping Pong was impacting me. And I also really didn't care. Like for me what was most important and for my parents, and what they instilled in me was a, you're gonna do anything you want in life, diabetes isn't going to stop you. And B, as long as when you go to the doctor, your a one C is in a good place, then you're good and you're in you're healthy. And my a one C was never crazy. It was always in the high sixes, low sevens. And that was before CGM. Right? I was diagnosed 21 years ago. And so there was no really concept of time and range being more important than a one C and and things like that. I think that during that time, it was a lot of because I didn't want diabetes to stop me. I took that as don't slow down to pay attention to your diabetes, it was very much do the bare minimal to keep your numbers not from being crazy, but just in a healthy range or healthy to your doctor standards or to your parents standards. And that time of ping pong up and down. When I eventually got to college, I realized that wait a second, I'm playing I was recruited to play division one soccer in college, it was the first time that I really started to connect my mind and my body and my numbers. And really realizing that I was not taught a lot about my whole body like this whole body approach of food and nutrition and glycemic index and eating for energy and eating for better blood sugars and exercise for specifically insulin sensitivity and what happens with weight training. And we're working out you know, two times a day when you're playing soccer in college. And those exercises are impacting my blood sugars in different ways than I had seen in the past. And I was trying to compete with a lot of other players for spots. And now my blood sugar's 300. And now I have a disadvantage. And I didn't like that because I was a very competitive person. And I took this as an opportunity to become more independent and tuned in to my diabetes and crafted in a way that would make me feel successful and would make me feel in control. And as an effect of that, what I did was I became obsessed, I became obsessed with my numbers obsessed with the food that I was putting in my body, obsessed with exercising, like over exercising all of this to the point where I actually lost my menstrual cycle for four years because my body fat percentage was so low, and it wasn't like I wasn't eating it wasn't like I was suffering from an eating disorder. In that sense. It was literally just a disorder of almost like perfection, in the name of wanting to control my diabetes in my numbers so badly. And when you start to see the results of that you're like, Okay, I'm doing this right. And that is a story I tell a lot and a lot of people know is I came home from college I think I was a sophomore junior in college. I had my endocrinologist checkup and you know, when you're a teenager your parents still come to the endocrinologist with you sometimes the doctor and so I remember sitting on the chair and my mom next to me and the doctor coming in who is my pediatrician kind of doctor from my dad. The doctor from a from childhood. And she was like her hands were in the air. And she was like Lauren, I have never seen a college student with a 5.7 a one. See, this is A1C you've ever had this is incredible. How did you do it? She like calls the nurse and the nurse comes in. She's like, can you talk to my other patient like in the UK, this other girl in the other room who's in who's in college and her agency is in great. And I was sitting there and it was like, literally an out of body experience. Because I'm watching like the doctor, high five, my mom and my five each other. And I was like, I'm not happy. I'm not happy. And you often think that your blood sugar's being perfect, or your agency being perfect. That is the sign of happiness, it's a sign of hell, that's a sign of perfection. I know you've made it. And I would never ever want to put my body through what it went through and go back to that place. And it was really because of my mindset. It was my mindset, it had nothing to do with a 5.7 a one C because my last day one C most recently was a 5.6.
Totally different plays, I eat pizza, I have doughnuts, I have, you know, I want to have a fabulous relationship with exercise and with food. So it's all about the intention behind what you're doing. And that's what I realize most in that moment.
Stacey Simms 11:21
I have so many questions, Lauren. How did you get them from I mean, you're still very young at 19. I'm thinking my daughter is 20. My son is almost 17 at 19. How did you get from I have this great agency. And I'm not happy to now. And I'm sure it was a journey I'm sure didn't happen overnight to I have a great agency. And I'm happy with I mean even pizza and I'm exercising the way I want to.
Right back to Lauren, but first Diabetes Connections is brought to you by Dexcom. It's really hard to remember what things were like for us before we started using the Dexcom. I mean, I haven't forgotten at what I mean is it is so different. Now, when it was a toddler, we were doing something like 10 finger sticks a day. Even when he got older, we still did at least six to eight every day and you know more when he wasn't feeling well or when something was off. But with each iteration of Dexcom, we've done fewer and fewer sticks. The Dexcom G six eliminates finger sticks for calibration and diabetes treatment decisions. I think all the time about Betty's little worn out fingertips. And it makes me so glad that Dexcom has helped us come so far, his fingertips are now healthy and smooth, which I never thought would happen when he was in preschool. If your glucose alerts and readings from the G six do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions, learn more, go to diabetes connections.com and click on the Dexcom logo. Now back to Lauren. She's talking about how she found her way to being more kind to her body and to herself.
Lauren Bongiorno 12:58
I would say that it was definitely a culmination of a few different things. The first thing was the real that moment really was a defining moment for me. But it also just opened up more ways of thinking about my life. And my just understanding of myself. I had started doing yoga around that time in college and Yoga does this incredible thing of giving you space to really watch your body and watch your patterns and watch your thoughts without judgment that's like at the root of the philosophy of yoga, or at least one of them. And what I realized was I wasn't happy with myself and with my identity, that diabetes was something that my whole life I kind of pushed away and it was always in the background, but I never fully accepted it. And if you don't accept the body that you're in, in my experience, you try to overcompensate in other areas. So you try to overcompensate in being perfect with food being perfect with exercise being perfect with your blood sugars. And ultimately, I had this like moment at the doctor's office where I just looked it's almost like a flashback in a movie where I looked back in my time so far in college and I'm like everybody is going out and having fun and I'm like saying no to going out to dinner with friends so I can make my organic broccoli and fish or whatever it was because I was didn't want to be tempted by having bread or pasta at this like restaurant they were going to or I would you know not want to stay out late or even like drinking college I didn't drink a lot like barely drank in college because I wanted to go to a 6am yoga class next day because I know that that really benefited my mind and my body in the way that I thought it needed to. And I just realized that I didn't want to live a life that a wasn't sustainable and be I wasn't happy. Like I think that it's important to understand your core values and I think my values were shifting away from perfection and approval of others or approval. Have my doctor my family and like more of being a little bit of a renegade and being like, well what do I want my life to look like? What do I want my relationship to food look like what I want my relationship to just everything that I do look like and what came out of that was this realization that what I was doing didn't match up and so what I was doing it wasn't sustainable if I wanted to lead a healthy and happy life and so I wanted to find a way of how could I have a healthy diabetes you know journey with my blood sugar's and not have complications later on in life and not have be in that phase in my life where I was from seven to 18, where I was just paying palming all over the place and not being aware of my blood sugar's not having predictability and those types of things. And how could I also not be on the other end of the spectrum where I was super restrictive, obsessive over health, there had to be a happy medium, there had to be a better way. And I had tried so many different diets at that point, high carb, low fat keto, high fat, low carb, like don't eat bread, don't eat process, this so many packaged food, but I realized that it was just exhausting. It was exhausting to try to apply it an outer rulebook to my life, and I wanted to start looking at my inner knowledge and creating that rulebook for myself.
Stacey Simms 16:17
Let's talk a little bit about coaching. Can you explain a little bit about what coaching is because I'm, as a parent of a kid with type one we have only ever, like, seen the endocrinologist. And then I've relied on our educator, and, frankly, the diabetes online community. What's a coach,
Lauren Bongiorno 16:34
of course, so a coach really is somebody who is helping you with accountability is helping support you in getting to the vision that you have for yourself, and is there to reflect back patterns and observations and help you with behavior change. So for example, a lot of parents of kids that we work with in our programs, they're coming because they realize, okay, we see our endocrinologist or a doctor a few times a year, and there's so much time in between that we want to be able to understand how to get our child's numbers better overnight, or in the morning time or when they're going to play sports. And we know that it's really about like the day to day things and not so much the let's go to the doctor and just depend on on them to tell us everything, we want to essentially take ownership over this and understand what's happening with their hormones with their insulin sensitivity with their, you know, time of the month, if they're females who are going through that phase that can be really challenging or just growth spurts in general, with nutrition and all this knowledge. So I really Riselywe focus on a behavior change, be published research, and then see our client data that we've had since 2015. And it's a lot of of work of a combination of mindset, and the blood sugars and the emotional impact that diabetes has on you. So you can think of it as a supplement to your endocrinologist, your CDE. And you're an a therapist or a mental health provider. If you have that.
Stacey Simms 18:05
I get a little nervous when people who don't have a medical degree are helping but at the same time, I understand that. Like I said, I got most of our information from the community right when I started a Dexcom on my son at age nine. I didn't call the Endo. I mean, I literally put it on Twitter, and was like, I don't understand this. Can you help me? What am I looking for? So I'm kind of speaking out of both sides of my mouth, Lauren. But I guess the Frank question is, talk to me about helping people with type one as a coach, when you are not a diabetes educator when you know you do not have a medical degree?
Lauren Bongiorno 18:39
Hmm, I absolutely love this question. All the coaches on our team are nationally board certified health coaches with that at the root health coaching is about helping you get unstuck by helping you develop the tools and the strategies to become aware of your blocks and your patterns so that you can move toward that vision that you have for yourself or for your child. A lot of times people know what they should be doing. Right? They know, when you slow down you take time what's happening with your blood sugar's what we're doing is we provide a space for you that is a dedicated space and dedicated time to slow down and hold you accountable for looking at your Dexcom clarity and looking through the patterns of your blood sugar. Your child's blood sugar's for the past two weeks and saying, Oh, wow, we didn't even realize that at 8am Every morning or 7am when they get on the school bus that their blood sugar is is really spiking and we're rushing, right, we're rushing to get out at the door. So we're not giving them a pre bolus. We're not doing drinking water in the morning or we're having, you know, just a waffle instead of maybe adding a little bit of protein in that and let's get curious what would happen if you did X, Y and Z Right? Or putting them in the driver's seat most of the time and saying what do you think would change the outcomes for these numbers? Like what are the things things that you've noticed have worked for you that you want to be doing more. It's identifying the gaps in your knowledge, giving them the accountability and the relatability, to somebody living with diabetes, as all our coaches do that they need, and helping them with the implementation and creating sustainable change. We've coached over 350 clients over the past six years now. And if you look at all that client data, it speaks, and it says something. And what it says is that there is a need for coaching, because diabetes is a condition where it is impacting you 24/7. And depending on seeing your doctor, which the health care system in America specifically is very much a top down model approach, where you're sitting there and you're waiting to receive, receive your next move, receive what your basal changes receive what you should do next, it doesn't set you up for success, the education that diagnosis doesn't set you up for success, the touch base with your doctor doesn't set you up for independence. And we have a choice to either follow that or to create a new system and create a new way. And that's essentially what we're doing.
Stacey Simms 21:09
So let me ask you some specific questions. If I could like kind of pick your coaching brain here. This time of year, without diabetes, many of us are thinking about changing what we eat. I'm going to diet this year, I'm going to lose that weight I gained I'm going to and it never works. Because I think we all know that that kind of FAD dieting or that short term stuff doesn't work, but we do it anyway. Can you speak a little bit? Because you've been successful with this, you know, you mentioned you wouldn't go out to eat with your friends, because you had to eat a certain way at home? How do you get there? How do you create those changes that really do make a long term difference,
Lauren Bongiorno 21:45
I think that we have to stop thinking that there's this next one thing, this next diet, this next outer rule book or whatnot, that is going to be the solution to all of our problems with our methodology and coaching specifically, and in my own personal life, what has made the biggest difference is really holistically looking at the areas of your life that impact your health, from your relationships to your self worth and your self love to your with diabetes, it's nutrition and relationship with food. It's stress management, it's your sleep, it's your hormones and your understanding of all of that it's a holistic approach, and a holistic approach. It can't happen overnight. And so diets and things like that with food, if you've tried to do it in the past, and you've gotten through, like, you know, up to Wednesday, and then you're like, shoot falling down. More is like, Alright, we're gonna go over like on Monday, which like we've all been there, it's so fascinating that we keep going back to doing that same thing instead of realizing, wow, that doesn't work, right. And so what I like to say is, don't set a goal that has anything to do with a metric, whether it's weight, or even with a one C and like, specifically, set the vision that you have for yourself. And if you set the vision that you have for yourself, like how do they feel? How do they what do they look like? What how are they operating from day to day? What are they thinking like, who are they at their core, then you start making decisions on a day to day basis that support that vision and there's less pressure and when there's less pressure of like, oh, shoot my a one C or my you know, blood sugar isn't better than it was yesterday, when I woke up or the weight, the scale is a second today than it was yesterday, there's more chance of actually lasting longer, because you're not going to feel as defeated. So if you want to feel somebody who is energized, and who is, you know, really fitting good in their clothes, or just confident set that as your vision of yourself, and then on a day to day basis focus on doing things that support that vision.
Stacey Simms 23:54
Let me ask you if I could, and this will be for people who live with type one, you know, adults, young adults, older adults, but not parents yet, like we'll get to them later. Can you give us some advice, perhaps or a couple of tips to have, you know, like more confidence with type one. And as you said, like not necessarily how to get your agency down or more time in range, but just like some good stuff for this year.
Lauren Bongiorno 24:14
Yeah, I love that. So I would say the first thing is to lean into your diabetes. So many of us often think that the diabetes part is the shadow part of us and it's the part that we have to hide and we have to push away and if that is your underlying belief that I can't be loved if people know that I have diabetes, or if I'm showing my insulin pump or I won't be accepted onto the soccer team or football team or whatever it is. If that is your like subconscious root belief, then you're going to operate from that place and you're not going to want to be checking your blood sugar in public you're going to wait until after you're done eating with your friends or drinking to the bathroom and give yourself you know a shot or give yourself your insulin and setting yourself up for you know higher blood triggers all night long. So there are so many benefits of just leaning in. And coming from a place of me for years hiding my pump, not letting people know that I had diabetes and not telling my now fiance until three months in that I had diabetes, it is so freeing, and such a relief when you can just show up as your full self. And it has benefits of obviously your mindset, and how confident you are and of your numbers as well. So I say I would think that that's the first tip I would have because it's a more of a mindset, emotional tip that will take you so far. And then on a number standpoint, I would say to focus on 1/4 of the day. Diabetes is like a Rubik's cube where there's 1000 different is that there's at any one given time, I described it recently as being interviewed for an article and they were asking me to describe but a day in the life of diabetes. And I essentially said it's like a seesaw with 50 Different factors piling up on either side at any given time, and you trying to find the centerpiece, right. So there are so many different factors. And the idea is is to not get overwhelmed by all those factors. Because if you're overwhelmed, you're going to be paralyzed, and you're not going to do anything, and you're not going to want to move forward and you're going to feel defeated. So try to look at 1/4, the day that maybe it's your most out of range section, whether it's overnight, morning, afternoon or evening, and just commit to working on that. Just commit to maybe pre bolusing at dinner time or commit to actually putting your CGM alarm on or on a different ringtone. So you wake up in the middle of the night, if it's high, since that's like the longest amount of time you want, you want to be arranged essentially, for your overall health, choose that 1/4 of the day, and then once you nail that, then move on to the next piece. But diabetes is always this thing that it's continuous learning, and you want to be able to have the energy to sustain until there is a cure. And we don't have to lower your agency five points, or three points, or even two points in the next 30 days or 90 days we can work rather on building the habits that support that a one C.
Stacey Simms 27:13
What is your advice to parents of kids with type one in the new year? Like what should we be thinking? How can we help our kids like grow up? This is a big challenge. Happy, Healthy, independent, not too worried about diabetes, but worried about
Lauren Bongiorno 27:26
oh my gosh, yes. And we were talking about this off air. See where it's interesting, because we've coached so many people who are in their 20s 30s 40s 50s and beyond who have had diabetes since they were kids. And we've seen a lot of their challenges that they're coming to us with today that a lot of it is rooted in their childhood and how their maybe parents kind of or their their caregivers or their doctors spoke about diabetes to them or how they were trained to relate to their diabetes. And so when we see the parents of T Wendy kids in our group coaching program, or in our one on one programs, we're watching and we're we're seeing how they're relating to their child's diabetes and what their child is how they're related to their diabetes, and we're able to help shape them in a better direction, so that they're not ending up where the kid is, you know, 30 years old coming back to us being like my, you know, my mom, did you when I was coaching with you guys when I was younger, and I've been and I feel like I need to come back. Right? Like it's, it's helping them now. And still, those things that we wish as coaches and the older people in our programs wish that they had when they were children. So I think there's a few different messages that I would share. One is your goal as a parent is not to help your child avoid suffering, and avoid all the highs and all the lows and all those things all the time, your goal and your job is to be there for them in a way where they feel like they can talk to you, they can come to you. And you could observe maybe what you're seeing in their blood sugars or in their behavior in a teammate kind of way. So kids are going through so much with their hormones and with development, and especially in their preteen and teenage years just fitting in, in general. And then when you add diabetes on top of it, it's there's this extra layer that just comes with it. And so one of my least favorite things is when you hear a parent or a doctor say off that child, they're just being so non compliant, right? They're just they're not testing their sugar, they're not doing this, they're they're just not being responsible. We have to put stricter rules on them or we can't let them go out or we can't do that. That isn't going to help. Right what they you really need to do is to help them get to the root of why they're feeling that way and why they're behaving that way. So one thing that I we work a lot with on with parents is on helping them understand what their child's goals are, which for a lot of them it's to have the cupcake at school with their friends or to be able to go out and have a sleepover with their friends and not have their mom call them 26 times, right? Which I always joke about, because I'm like, now there's Dexcom share, when I was a child trying to have a sleepover, my mom didn't even have Dexcom to like, look at, I'm pretty sure she sat in the car outside the person's house for like, the whole entire night. It's valid, right and those in the kids and what they want, it's this balance between wanting to keep your kids safe, and also wanting them to just be a kid. So I think that a lot of the time, it's about you as a parent wanting to protect them by not burdening them. And just by taking away you know, all of the jobs that they're doing with their diabetes or their task or making it simple with like carb counting for them, we're only putting quote unquote, healthy food or low glycemic foods on their plate. But that might not actually be what's going to help them for the long run. So really, I think for any parent listening, this, to me is one of the hardest jobs, you guys are all heroes, I can't imagine I look at my mom now and my dad, and I'm like, Thank you, like, I had no idea what you were really going through. And that that job that you that extra job you had when I was diagnosed, and you're doing great. And I think that you can do quote unquote, all the perfect parenting in the world and your child, there's going to still have, they're still going to have challenges later on. So the goal is really to set them up with to be independent, to care about how they feel, to care about their numbers, but also to not be limited by their diabetes and and to find that balance.
Stacey Simms 31:32
I'm just curious. Did you ever go back to your endocrinologist who was like, Yes, this is amazing, like the high fiving. Doctor like does that doctor know about it this way?
Lauren Bongiorno 31:43
So the funniest thing about it is I adored that doctor, I love her. She we follow each other on Facebook. Sometimes when I do local, I speak at local JDRF event. She's there love her. And I think that she's probably seen me talk about it a little bit on social media for sure. We've never like address it specifically. But I don't it's not about her. That wasn't her fault. She was celebrating me like I think a parent would celebrate a child to achieve who had an agency like that. And I think the bigger issue is really the lack of emphasis on mindset. And on mental the mental and emotional impact diabetes has on children and teenagers and adults for that matter with diabetes.
Stacey Simms 32:27
Hey, I'm just curious. And I always ask guests this, you don't have to answer. What kind of tech do you wear? What are your diabetes devices if you don't mind sharing?
Lauren Bongiorno 32:34
Yeah, so I wear an omni pod and the Dexcom G six, I was on charts for my first two years living with diabetes. And then I went to a Medtronic wired pump for about, I would say, 14 years. And then the last six years, I'm not sure if this math, somebody can add this math, drag, but it should all equals 21, less five or six years I've been on an omni pod. And I just love, love love that it doesn't have a wire. And that's that works for me personally,
Stacey Simms 33:02
before I let you go. It talked to me a little bit about your partnership with a couple of nonprofits. You know, I know that you would rightly want to make more of a difference than just with coaching. So who are you working with? What are these about?
Lauren Bongiorno 33:16
Yes, so we are here to help create the short term change for individuals impacted by type 1 diabetes and families and the long term change with diabetes care. So our approach is community based it's collaboration, it's how can we all take our the best of our missions and lift each other up. And so ways in which we collaborate with the community. Number one, we have Kyler Keres, which is a nonprofit organization that provides grants for continuous glucose monitors and insulin pumps for children and young adults living with type one diabetes. And Kyle banks is the founder, he actually played Mufasa on Broadway in The Lion King. And he is an incredible human being we actually found out recently when we were together that we have the same diabetes anniversary November 1, so that was fireworks were going off. Because we already love each other so much, but we're thrilled to partner with them. Because we just have, I think, because I was diagnosed as a kid and so many people on our team are also diagnosis kids, we have a special space place in our heart for young adults and children who don't have access to those things. And there's a direct correlation between your household income and your agency and your diabetes control. And so we really want to be able to give back in that way and to help support those people. And then secondary to that we have our together to one D Impact Fund which partnerships that we you know, work with in the community. They're able to donate to that fun to help give coaching scholarships to people who face significant barriers to health care to our coaching programs. And all the people who come through our programs through the scholarship They're carefully selected and you know, have an in depth review process, but it really allows us to be able to impact the community on that intimate level.
Stacey Simms 35:05
It's so interesting to hear, like how much I noticed didn't happen overnight, but like how much you are doing, when you look back at that 19 year old with that amazing a one C, but that not so amazing life? What do you think you've come so far?
Lauren Bongiorno 35:21
You know, in a way, I feel like I had so many years of struggling with my diabetes, that it was a blessing in a way it was such a blessing because it brought me here and we've impacted so many people's lives with diabetes. And you know, women who weren't able to have babies, they've had miscarriages after miscarriage because you know, maybe it's related to diabetes. And then finally bring a healthy baby baby into this role because their agency is down or to the parent who their child is diagnosed. And they feel like there is no possible way and they don't understand how they can, you know, go to a soccer game and not completely tanked their blood sugar's and then they're able to and they feel that their child has that sense of freedom back and confidence that all these little things, it's really, it's why we do what we do. We are there's so much passion behind what we do so much intention, so much integrity, and so much, so much hope that what we're doing can continue to be a ripple effect and impact people on an even larger level than we're doing now. And that's what keeps us going every single day. So I think 19 year old me or even seven year old niece who is standing in front of my gym class, my mom recently found a video I was sending for my gym class after getting diagnosed, doing a fundraiser at my school with my little pigtails and limited t shirt on it was so cute. And that girl was I feel like meant to do this all along. And it doesn't mean that there's not challenges, it doesn't mean that there's not Robox but it means that that those things are just there to push me to keep going and push me to realize how worth it this is.
Stacey Simms 37:00
That's great. Oh my gosh. I love that. Lauren, thank you so much for joining me.
Lauren Bongiorno 37:04
Thank you so much for having me, Stacy.
Stacey Simms 37:11
You're listening to Diabetes Connections with Stacey Simms.
More information about Lauren and coaching and Risely and you can read her story. And she's been on some national media, she's got great videos, all of that is linked up at diabetes connections.com. As we do every week, every episode has its own page.
If you head on over there and click on episodes, you will find them all. There's also a very robust search. And I say that because we are up to this is episode 455. So if there's a topic that you're interested in, we have likely covered it. Obviously, we haven't covered everything. And please send me your suggestions. But if you just type it into the search box, it really is. I'm really thrilled with my web folks, I'm stuttering around because I had nothing to do with it. But I asked them to make me a great search. And they did. And you could also search by topic by date, whatever suits your needs. So please check that out.
We have some great shows coming up. Boy, there's so much going on these days every Wednesday I do in the News Live and that's on social media. And then I turn that into a podcast episode. That's every Friday five or six minutes of just headlines and in the news stuff for the diabetes community. Next week, you should be hearing from ever since I'm working on that episode right now we're going to talk about their longer where and you know, a lot of you already have commented in the Facebook group about you know, worries about this device. And who was it for? I gotta tell you, Benny is super eager for this because of wrestling and his sports. Think about a CGM that you can't knock off, right. So I'm not here to endorse them. But I am here to say let's talk to them and find out more about this option. We're also going to talk about Tandem and waiting because while they just got FDA approval, they have an earnings call later this month that I want to wait until after that because some interesting things may come out. So we'll be speaking to them. And that episode will probably air in early March.
But in between those two, I have an interview with the folks at Pixar and I have a great story about why there is diabetes technology featured in turning red. This is the newest Pixar movie debuting on Disney plus in March. And so look for that episode, probably right before the movie comes out. We've taped it, I have to hold it sometimes these things are embargoed, and this was one of those cases. So really excited to bring that to you. All right, thank you as always to my editor John Bukenas from audio editing solutions. Thank you so much for listening. I'm Stacey Simms. I'll see you back here soon Until then be kind to yourself.
Benny 39:43
Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged
It's "In the News..." Got a few minutes? Get caught up!
Top stories this week include two big FDA approvals! Tandem's Mobile Bolus and Eversense 180 day sensor both get the okay, we're looking at earlier detection of T1D in kids, there's a new discovery around a protein that might help T2D, info about Spare a Rose and Omnipod drops a hint about a crossover with a popular Nintendo game.
Join us LIVE every Wednesday at 4:30pm EST
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
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Episode Transcription Below (or coming soon!)
Please visit our Sponsors & Partners - they help make the show possible!
FB LIVE:
Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. If you’re new we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast.
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Looking to get organized? Diabetes supplies can really add up and all that pump and CGM stuff or even shots and wipes and strips can clutter everything up. I’ve got a great new guide to help you out. It’ll get you started and keep you organized. That’s totally free and it’s over on the podcast homepage.
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Our top story this week – big movement from the US FDA, two approvals we’ve been waiting for. The first, Tandem Mobile bolus – what I’ve been calling bolus by phone. As expected, company says when released, this will be no additional cost for in-warranty customers through a remote software update. Limited launch in the spring, followed by expanded launch this summer. It’s compatible with both iOS and Android, although limited to just a couple of models right now. This is a very important step not just for customer convenicen but as Tandem moves forward with it’s new hardware line including Mobi will need an external device for full control.
https://www.tandemdiabetes.com/landing-pages/remote-bolus
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The second FDA approval came through for The Eversense E3 continuous glucose monitor. This 180-day implantable sensor will be available later in 2022. If you’re not familiar, you have the sensor, inserted under the skin of the upper arm (and removed) every six months by a trained healthcare provider. There is a rechargeable transmitter which vibrates on the body for highs and lows.. and a mobile app. The sensor requires two calibrations per day for the first 21 days of wear. After that it requires one calibration. Lots of questions here and I’m talking to these folks for an upcoming episode.. look for that in about two weeks.
https://diatribe.org/180-day-implantable-cgm-eversense-e3-approved-fda
XX
Saw an interesting post from Omnipod this week on IG.. All about Pat Podder® - the caption says she “is a long-time member of the Pod Squad who loves a good DIY project, going swimming, and to explore new places.” Take a look at this animation, along with the hashtag they used.. Animal Crossing.. are we about to see a gaming crossover? Insulet says an announcement is coming Thursday of this week, so if you’re listening to the podcast it may have already happened.. I’ll follow up.
https://www.instagram.com/p/CaA_5rEsyMH/
XX
Big push in Germany to get doctors to screen very young kids for type 1. This group conducted the world’s largest population based screening for type 1 diabetes in children so far. Since 2015, any child aged 2–5 years in Bavaria, Germany, could have their blood tested for islet autoantibodies. These show early stage type 1 diabetes years before high blood sugars and other symptoms. More than 90-thousand kids have been tested and point 31 percent (.31%) have been diagnosed. Next up is to take a deep dive into the potential cost savings and increased quality of life compared to what happens without these early screenings.
https://medicalxpress.com/news/2022-02-early-diabetes-children.html
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It’s a mouse study.. but good potential here for a drug to treat type 2 diabetes. It works by amplifying a protein that has a positive effect on insulin. The protein is called Swell-1 and it’s vital for normal insulin secretion from pancreatic cells. And, SWELL-1 activity seems to be significantly disrupted in people with type 2. Fixing that seems to restore both insulin sensitivity and insulin secretion. And it does this without lowering blood glucose when that’s not needed. Long way to go but promising..
https://newatlas.com/medical/new-drug-target-diabetes-metabolic-disease-swell1/
XX
The Spare a Rose campaign was back – focusing on Valentine's Day but continuing through February. The idea here is that instead of buying a dozen roses.. you buy 11 and donate the value of that last flower to help someone with diabetes. Since starting in 2013 Spare a Rose has raised almost 400-thousand dollars.. most of that has gone to Life for A Child. Now, these donations are going to the Insulin For Life Global organization. It provides insulin, supplies, education, and advocacy to children and adults. With that the name has changed from Spare a Rose, save a child to Spare a Rose save a life.
https://sparearose.org/
XX
More type 1 at the Olympics! Last week we told you about Snow Boarder Kamilla Kozuback who was diagnosed at age 13. Czech skeleton athlete Anna Fernstädtová came in 7th a couple of days ago. A MONTH ago she was in the hospital, newly diagnosed with diabetes. She wrote on Instagram: “7th place at the Olympic Games. Not the runs I wanted, not the result I wanted. But these are happy tears. Not even a month ago I was in hospital, without knowing what would happen. But we made it happen. Thank you everyone who got me here And to everyone who is also dealing with type 1 diabetes: everything is possible! You got this!!”
https://www.facebook.com/annafernstaedt
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Our long format episode this week is with the folks at Sigi pump.. a new tubeless rechargeable pump that got breakthrough device designation last fall.
Listen wherever you get your podcasts
That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
Last fall, Sigi pump received Breakthrough Device Designation from the US FDA. Although it's still a long way from being released, Sigi is very intriguing; it uses some of the best parts of existing pump systems.
Pim Von Wesel is Co-CEO of AMF Medical, the company that makes the Sigi Pump. We’ll talk about what makes this system unique, which partners they're eying for collaboration and the timeline for submitting to the FDA really looks like.
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
Sign up for our newsletter here
-----
Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners!
-----
Episode Transcription Below (or coming soon!)
Please visit our Sponsors & Partners - they help make the show possible!
Stacey Simms 0:00
Diabetes Connections is brought to you by Dexcom. Take control of your diabetes and live life to the fullest with Dexcom and by Club 1921, where Diabetes Connections are made.
This is Diabetes Connections with Stacey Simms.
This week, it's called Sigi pump. And last fall it received breakthrough device designation from the US FDA, there's still a long way to go before this tubeless rechargeable pump could be on the market. And company leaders say that's okay by them.
Pim van Wesel 0:37
We're biding our time to make it short is excellent in every respect, technically, from a usability point of view, of course, which has a huge focus to us lowering therapy burden, and also just being able to produce it in sufficient quantities.
Stacey Simms 0:51
Pim van Wesel is Co-CEO of AMF Medical, the company that makes the Sigi pump, we'll talk about what makes this system unique, which partners they're eyeing for collaboration, and what the timeline for submitting to the FDA really looks like,
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. Before we jump in, I want to give a big shout out to the amazing people in our Facebook group. If you're not there, it's Diabetes Connections, the group and I just want to single them out, because I think that it is the smartest diabetes Facebook group that's out there. I know I'm a little biased. But you know, it's not the kind of group that's going to tell you how to eat or how to dose or you must do this, or how dare you do that. As you know, if you listen to the show, that's not our deal at all. And I just want to take a moment because I've been asking the folks in there many of whom have lived with diabetes for 50, 60 years, many of whom work for technology companies, many of whom have been blogging about diabetes for many, many years. And I've been bringing them questions that have come up in my local group, things like cannula length, making a difference, some questions I had about summer camps for this year. And they all also have fabulous conversations. So I know we're all if you're on Facebook, you're in a ton of groups already. I do think that it's a really good one. If you'd like to hear from people who have lived with this condition for a long time who are very knowledgeable and frankly, very opinionated, which I like a lot. I do run a very tight ship. I do this in my local group as well as this one, you're not going to get away with any nonsense. Any weird stuff, a snake oil. Yeah, we will have none of them. But it's a great group. And I just was given them a shout out because they've been very, very helpful, especially lately.
Okay. Sigi pump caught my attention when it received that breakthrough designation that I mentioned. And to be clear, that means the FDA will try to speed it through the process. It does not mean it's approved for that it's guaranteed approval. And Sigi by the way is S-i-g-i. I did share some photos of it in the Facebook group. And my guest is Pim van Wesel , the CO CEO of AMF medical, that is the Swiss company behind Sigi pump. They are very early on here. Clinical trials have not yet started, but they do plan that when they get through the process to launch in the US first while it looks a bit like an omnipod, but the pod part is reusable. You recharge it as needed, and they give you two so you don't have to stop pumping while you're recharging. One of them. The only disposable part is the infusion set, although they call it something else, the part that connects to the body. Lots more information about Sigi in my interview with Pim van Wesel
Pim thanks for joining me. I am excited to find out more about this product in this company. Thanks for coming on the show.
Pim van Wesel 3:54
Thanks for having me. Stacey. Very excited to share what we have.
Stacey Simms 3:57
Yeah, I have so many questions for you. But let me just start by asking, just tell you a little bit about the company that makes Sigi what is A M F medical? What do you all do?
Pim van Wesel 4:08
Well, AMF medical was really spun out as a standalone company in 2021. But the history of the company goes back to 2014 when the founders hit upon a technology which they initially started using in some high end components for laboratory equipment. But a number of the founders had a history from a previous startup in insulin delivery. It didn't work so well then. But when they analyze this particular technology, they said, Wait a minute, we can probably make a insulin pump with this technology that would work that would not destroy insulin and being a large, fragile hormone. And they started a project in 2015. Over time, the project got big enough that they decided what we decided I joined since then to make it a separate company just because the investment story is very big. Different for insulin technology versus, you know, high end led components. So, company started in 2014, on off separately in 2021. Around the time we kind of came out of stealth. And, you know, I joined a little over a year ago, basically to help build a business after the founders started with a technology hired a great r&d leader pair who turn it into a product and then meet to help make it a business.
Stacey Simms 5:27
Or you mentioned coming out of stealth mode. The first time I heard about this was when the US FDA gave what they call breakthrough device designation. What does that mean? And why is that important?
Pim van Wesel 5:40
Well, it's important to us because we feel we have a few capabilities, particularly around usability and lowering the therapy burden that we wanted to test with the FDA, if it deserves to some recognition. Practically, it means that that puts us a little bit earlier and faster into the approval process. But we have an ongoing conversation with the FDA that started with a pre submission conversation there. And we decided to that we would try for this designation to get some recognition for some of the capabilities that we have, they picked up on a number of them, which got everybody very excited. You know, in a way, it's, you know, recognition that we're addressing unmet patient's needs.
Stacey Simms 6:18
Okay, so I got a little bit ahead of myself there by starting by asking about the FDA, let's just back up and talk about what the product is. Tell me about the Sigi pump. What makes this different,
Pim van Wesel 6:28
it is a patch pump, we have designed it for interoperability with multiple systems, so multiple third party glucose monitors and multiple algorithms. And I think one of the novelties that we'd like to bring is just tremendous ease of use. So we use standard prefilled insulin cartridges, I think that's in a nutshell, the product, it is a semi reusable product, the pump itself is reusable, you would have to as a user, with a dedicated charger, and whenever you need to switch it out. Because your cartridge is empty, you take your second pump, pump, pump into cartridge, use a new sterile cap to close it and then put it back onto your pad. The pad is a or tray, but we call it a pad is basically placed on your skin. And you can clip your palm on and off as needed.
Stacey Simms 7:17
I'm going to describe this probably pretty poorly. But in my mind's eye using existing technology, this seems to me like you use sort of a pump infusion set. So you would insert the tray the base as you called it onto the skin. And then that's temporary, right, you would take that off every couple of days like you do right now. But the patch pump is more like a more durable pump like a Medtronic or a Tandem, but you physically clip it flat, it connects to that infusion, well, I'm calling an infusion set. And is that close to accurate?
Pim van Wesel 7:52
That is I think that is a very good description with the one caveat that we have the ambition for the pads to last a little bit longer than a couple of days. Which basically means that once the pad is on the skin, let's just say for a moment that it lasts a week, as you run out of insulin you your take your pump off, you put in a new cartridge, and you clip your pump back on as long as the pad lasts, or what you could imagine somebody who has a very high use in need of insulin, they might for instance less in people that are in type two, not that that's our primary focus. But if they were to go through 160 units in less than two days, they wouldn't have to change the insertion of the pad or to disposable if you will. So that's the idea. Absolutely.
Stacey Simms 8:38
Got it. We're going to talk about more features, and you know a lot more about what the system is about. But before we go any further is what we're talking about in existence yet. In other words, is somebody wearing this? Is this in clinical trials? Where are you in the process?
Pim van Wesel 8:53
So we have functioning prototypes? We have not, and we've tested the usability of those we published something at ATDD last year. And we'll we'll have some more information at ATDD coming up in March sort of product exists. But formally speaking, we have not done the first human yet and as planned for later this year towards the end of 2022.
Stacey Simms 9:16
Got it? Well, the next question I know my listeners are going to have is can they take part in that are those are those first people in Europe or in the United States?
Pim van Wesel 9:24
There? I'll be very honest W in Europe. And that is primarily just to you know, we're startups. So we're trying to keep it manageable and coordination effort. So to do this in the US is probably a little bit beyond what we can can do at the moment. But clearly, I mean, just to answer the following question. Our intent is to first go in marketing United States and that's why we have these conversations with the FDA.
Stacey Simms 9:48
Got it. Got it. Well, we have lots of listeners in Europe too. So we'll put all the information out is as you're able to send to us. Alright, so let's talk a little bit more about the product itself, or the system itself, I should say the public Um, you mentioned you know, refilling insulin, this is prefilled pump cartridges as designed, right? This is not, you don't have to draw it out and fill it correct.
Pim van Wesel 10:09
There's no, if the term here fiddling to fill it, you basically take it out of the, you know, insulin caps in the refrigerator, and you pop it in straightaway you you don't have to wait 20 minutes for it to warm up, the system is compensating for that. So there's no air bubbles. And these cartridges, they already exist, they're already on the market. They're just being used today, with, you know, the Tethered pumps, or, you know, the pumps you were in a belt or in a pocket. So, you you mentioned the Medtronic pumps. Actually, there's other products out there that use this exact same existing cartridge. And I think you've spoken about some of these pumps in other podcasts.
Stacey Simms 10:46
Yeah, it's interesting. You know, we're so US centric sometimes that I certainly tend to forget, I believe what, Ypsomed uses the cartridges?
Pim van Wesel 10:54
Yes, Ypsomed uses that cartridge here in Europe And they have their agreement with Lily in United States. And there's a Roche product as well that uses this. But to our knowledge, this is the only patch pump that's designed around this cartridge. And it's actually a big part of why the pump has the size that it has, we couldn't make it much smaller and, and still fit the cartridge in
Stacey Simms 11:16
tiny a little bit more about the pump design itself. As I'm reading through, it looks like it is controlled from a phone or controlled by a separate controller. Are there any buttons on the pump itself,
Pim van Wesel 11:27
there are no buttons on the pump itself. And it is operated via your own smartphone. That's definitely the ID that we're working towards. We don't think people need another personal device manager in their pocket. So keep it simple.
Stacey Simms 11:40
And now I've talked about system a few times. Let's talk about that. So Bluetooth unable to go to a smartphone to go to an AI Controller talk about that a little bit.
Pim van Wesel 11:49
It is in no technical parlance. It's it's designed in the discussions with FDA RS ultimate controller enabled pumps. So nice pump, and it has everything that you could, you know design to so we're not trying to backwards integrate an algorithm and interoperability with third party CGM is designed to be able to do that. And when we say designed to be able to do that it has the communication capabilities with Bluetooth, it has the processing power to have an algorithm on board, and it has the battery life to deal with it as well. It's a rechargeable battery, of course, all of that is designed to be able to communicate and to calculate in, you know, work with dosing algorithms, if you will, that would be onboard. There's some systems that have the dosing algorithm on a personal device manager or in the future on the phone. We can accommodate that as well. We think that there's some advantages to having the algorithm actually embedded on the pump. And we've designed it to be able to do that.
Stacey Simms 12:46
I may have missed this point. You're not creating an algorithm for the pump?
Pim van Wesel 12:52
No, I think when we initially I think the ambitions were for the company were quite large. But if we really look at the core competencies, the core capabilities that his team has is around fluidics management and is around miniaturization. So over time, we also realized that, you know, we should better stick to what we do well, and is just make an excellent pump a truly excellent pump. Otherwise, we don't think we have any right to be on the market. And we have this open ID, you know, collaborating with, as far as we're concerned with any algorithm that's approved with any CGM, that is that is available. So we really have an open protocol or an open system mindset there. I think that's a little bit. You know, if we read the documentation, what the what the FDA is doing with the creation of these new product categories, such as ace pump, an IC, GM and I control, or we read a little bit with the JDRF has as a position statement around your artificial pancreas. We're fully subscribed to that philosophy, because we're open. Yeah,
Stacey Simms 13:59
it's really interesting, because ideally, and we've been talking with this for a couple of years now ideally, right, you'd get your pump, you get your CGM, you'd be able to pick and choose and then say, Okay, I want this algorithm I you know, I want my, I mean, I'll put the blue sky thing I want to Sigi I want my libre, and I want to use the control IQ. Correct? Is that something you think is a real possibility here?
Right back to Pim in just a moment, but first Diabetes Connections is brought to you by Dexcom. And we've been using the Dexcom system since Benny was nine years old. We started with them back in December of 2013. The system just keeps getting better. The Dexcom G6 is FDA permitted for no finger sticks for calibration and diabetes treatment decisions you can share with up to 10 people from your smart device. The G6 has 10 Day sensor wear and the applicator is so easy. I have not done one insertion since we got it. Benny does them all himself. He's a busy kid, and no way he can just take a quick glance at his blood glucose numbers to make better treatment decisions. is reassuring. Of course, we still love the alerts and alarms and that we can set them how we want it for glucose alerts and readings and 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 Pim talking about interoperability and whether the system will work with other algorithms and devices.
Pim van Wesel 15:27
Well, we're definitely building our product for that to work, and depends a lot, of course, on the collaboration that that you can put in place with some of his companies. And being a startup, you know, a number of these collaborations are actually, you know, very enthusiastic, and other ones are a little bit more and wait and see, because we're still startup at this point in time. And I understand some of the bigger CGM companies, they might say like, well, let's wait and see if these guys actually gonna make it to market before we spend an awful lot of time co developing with them. But a number of areas septic, and we have good conversation. So will it work with all depends? You know, I don't think it's so much a technical question as a question of, you know, is there the will to make it happen. But we're very encouraged by some of the collaborations that that have been put in place, still early days, but we plan to do our first human and fairly soon thereafter have a what we call a hybrid loop trial with with a select number of patients.
Stacey Simms 16:26
Not to belabor the point here, it would be too early to ask you which CGM you would work with because you're, you're still
Pim van Wesel 16:33
Well, let me turned the question around. Which CGM? Would you first like to see on our pump?
Stacey Simms 16:39
I would. But I first like to say, good question here in the US, right, we only have a Dexcom and Libre, and Medtronic, I'd left them out of that, because they're so proprietary, you know, they only work within their system. So you know, if you ask me, I'm going to say Dexcom? Because that's what we use. But I would also say, I mean, I'll speak out of both sides of my mouth, everybody.
Unknown Speaker 17:03
So
Stacey Simms 17:07
in the works, probably two of which will come to market?
Pim van Wesel 17:09
Well, yeah, it's interesting that you mentioned that, Stacy, because the other day, with, you know, we basically had an inventory of the number of CGM projects out there. And I think it was getting to about close to 40. If you kind of all add them up, and we don't have 40 agreements in place, we have some agreements in place, and when I can talk about it, because there's confidentiality there, but you probably won't be disappointed with some of the names that we're talking about. But to your earlier point, you know, there's different form factors, right. Some people are very comfortable with having, you know, every six months or every 12 months, a minor intervention, not to have, you know, not as a wearable other people are actually, you know, preferring a wearable. And I think we want to accommodate that, as you said, different form factors, different dosing algorithms. So that that's our philosophy. And we're sticking to that for an hour and see how much of that we can make happen. But clearly, when we make our selection the same way these big companies do it, right. They say, I'm not going to work with this startup, well, how much do I believe they actually going to exist five years from now? Those same considerations apply to us as well? Yes, we have some conversation with early startups. But if you want to be successful, we'll probably have to partner with one or two of the bigger ones first, just being very pragmatic. And that's what we're doing.
Stacey Simms 18:28
And I left out one apologies to ever since the folks at Sensionics , who I'm sure you're very well familiar with, but I did not mention them as the US CGM company are available here. And they certainly are. I'm always gonna say work with everybody. It's so interesting to think about how it's changed in the last Gosh, even the last five
Pim van Wesel 18:45
years now. Right. But that's despite debts. It's going so fast. We think there's really just only only one really successful patch pump on the market. And we think we have something to offer in that space where we're at. And we're focused on that.
Stacey Simms 19:00
Is it waterproof? Yep. The fast answer. That's easy.
Pim van Wesel 19:05
No, I think, do the way we think about hedge pumps and look, and I've worked at some of the larger companies that have projects or had projects or have projects in the works on it. There have been so many attempts, I think, and there have been so many bridges burned in that space that are we get a lot of pressure from investors and from, you know, people that pick up with us on the websites to go fast and our philosophy and less our product is excellent. We don't have the right to be on the market. And we're biding our time to make sure it's excellent in every respect, technically, from a usability point of view, of course, which has a huge focus to us lowering therapy burden, and also just being able to produce it in sufficient quantities. It's a high hurdle. We don't want to come out unless we're absolutely excellent. And I'll tell you the story what what I discussed with our r&d people. I said look, we'll go to market when we are confident that we can Then pick a handful of influencers in diabetes technology world, and we'll give them flutter for three months. And we say, do what you want, write whatever you want. If we're totally comfortable doing that, then we're ready to go to market.
Stacey Simms 20:13
I had a question from a couple of listeners. And you've answered this a little bit about the differences between Sigi and the Omni pod, which is, you know, pretty much the closest to something like that, that we already have right here. And you've mentioned things that it's, you know, it's smaller, it's lighter, it is rechargeable, so you're not throwing the pump itself away. Are there other differences you'd like to point out?
Pim van Wesel 20:34
Well, I think the other one you pointed out as well, and that we we put a lot of effort in is the fact that it uses a prefilled cartridge, then this is designed upfront for interoperability, and we'll think we'll be very open. But I think you hit on most of them. Plus, of course, the fact that we use this prefilled cartridge, which we think is also looking at, you know, the feedback that we're getting on the website. There's there's an encouraging number of Omnipod users who've picked up on our website and are sending us comments. So we'll keep working at it. From that perspective.
Stacey Simms 21:05
I'm curious, we I've been talking a lot in the last couple of weeks on the show about infusion sets. You know, we had the folks from convatec on talking about the different types that they're looking to make you already mentioned, hopefully longer. Where can you talk a little bit about that part of this system, I know you can't, you know, there's a lot of proprietary and I'm sure information you can't share. But just in terms of he would seems to be that it would be a different type of insertion, just because it to me and it could be wrong, it seems like it might be have to be bigger, I'll let you talk about it.
Pim van Wesel 21:33
Let's talk about the insertion is designed to be very fast and fast in this respect often means, you know, limited, limited pain, right? If you do it very quickly. That's number one, or insertion is intended to be very quiet, particularly with very young patients in mind, this should not be a scary experience. So that's the insertion the cannula itself, we have a number of ideas around it to make it 470. Where and of course, because the pump, and isn't just the the setup itself, but the pump itself is very, very lightweight, we aim to make it you know, very wearable from that perspective, as well. We are doing a number of tests around you, we've done some testing or the wearability, and we've made some changes to the adhesive. And that's, you know, continues to be a big focus, just trying to work with the best adhesive companies out there. And in terms of the cannula, we are doing some tests around making sure that that you know, we don't have clogging and that we actually can get to seven days without, you know, too much inconvenience. Putting for sale is a pretty high hurdle there for seven day use and need to see if we can get there that's still already work. But I do wonder what are the thing I will say compared to some other pumps is we have no tubing at all right? So the the fluid path, if you will, from the cartridge to the skin of the user is actually very, very short. And that of course has the advantage as well, which other patch pumps have as well, not all of them, but some for sure is that it has very little incident wastage involved, of course, we really aim to completely empty the cartridge.
Stacey Simms 23:12
Are you making the infusion set or the connector? Are you all making that yourselves?
Pim van Wesel 23:17
Yeah, we make everything ourselves except the insulin cartridges which are available, but we are doing everything ourselves. We have from our micro fluidics technology background, we have a lot of information on what works. And we've done extensive insulin compatibility testing with insulins that we believe will be available in this cartridge just so we have the data, which is very encouraging that, you know, it lasts and that doesn't create any you know, material interaction issues. For instance,
Stacey Simms 23:45
I mentioned at the beginning of our chat here that you are relatively new to the company. And you also talked about you're already getting input, I'm sure criticism, comments from the diabetes community from the website. What were you doing before this? And what has it been like to move into the diabetes space where well are very, very passionate?
Pim van Wesel 24:06
Absolutely. It's, I've been with the company formally for about a year, I've, you know, been helping the management team, the executive team and the board a little bit before that. I have a longer experience in diabetes. I worked for about five years in diabetes with Medtronic and Europe. So this is not my my first rodeo. It is a very engaged community and very passionate and very vocal. I've also worked in incontinence and I can tell you that the people who have incontinence problems are a lot less vocal than people living with diabetes for sure. And people stay around right. It's been very encouraging to to reconnect with some of the experts, the clinical experts I had the privilege of working with in the past and they're still around and you're still advising and they're still happy to have a discussion and give very solid input. So quite a bit of experience with diabetes been in medical technology for since 2003. if you will, so coming up to almost 20 years, but I must say that working in diabetes is in the diabetes technology field is particularly gratifying you, you're actually much closer to what's happening than in many other areas of medical technology. So it's been good. It's been good to be back. Absolutely.
Stacey Simms 25:17
That's great. Yeah. And then the past few years, as well, there's been this push from the pump is, you know, this clunky medical device to realizing that people, you know, it's such a part of the day to day life of someone with diabetes, and our phones look great, Why can't our pumps look great. And I'm assuming that that is part of the design here to this is kind of silly to ask, but I did get this question. And I like silly. Is there any planning here to make it different colors to have any designs on it, things like that,
Pim van Wesel 25:48
let me Well, a couple of things. Colors is not the high priority, we have a project extension matrix and colors is actually on there. We think it's a fairly low efforts, we're just questioning in terms of user benefits, if there's not other things we need to focus on first.
Stacey Simms 26:06
And also getting it to market probably is the top priority,
Pim van Wesel 26:08
for sure. But you know, when you talk to two people in the diabetes investment community, they want to see some ideas of what else you can think about for the future. And we have a number of ideas in this. But particularly for young, young users and pediatric patients, for instance, we know these things are important to my, in my former life, I've spent a lot of time coming up with cool stickers that worked on a pump, if you will. But we were already worked very hard on the design. If I show you one day, the first prototypes, they looked very different and quite a bit bigger. And we're very fortunate to work with an excellent design company around some of these four factors, things, I didn't fully appreciate that necessarily when I started. But for instance, the applicator has gone through numerous separations, iterations to allow for single hand application at all different body parts so that the angle still works. And one of our investors, you know, said, Oh, I get it. And I'm not sure if this analogy resonates in the United States. I think it does. But one of the investors said, Wait a minute, you're like the Nespresso, of insulin therapy. And I don't know, if you, you know, if you made an espresso in the old fashioned way, you had to get the amount of coffee, right, you had to get the pressure, right, you had to get the temperature, right. It's quite involved, right, and espresso comes around, and kind of makes it, you know, standard and repeatable and very, very easy to use, come and take a little bit further, it's so happens that the design company that we've worked with, on route a form factor, not that technology run the form factor, actually happens to be the same company that designs the Nespresso machines. They liked our project very much. And I wouldn't say they're doing it for free, but I think we're getting a better rate. And then this person is,
Stacey Simms 27:55
you know, a friend of mine makes a t shirt that says I run on coffee and insulin will have to send them one of
Pim van Wesel 28:00
those. Absolutely. And I'll share it with my espresso friends as well.
Stacey Simms 28:05
Hey, I meant to ask you earlier, and this is a question I got from a listener, you have mentioned, you know, we've talked several times about the prefilled insulin cartridges, do you anticipate a certain type of insulin? Will it work with most of the types that are out right now,
Pim van Wesel 28:19
we have tested it for insulin compatibility with for insulins today, we've tested it with Nova rapid, we've tested with fierce, we've tested with Lumia F, and we've tested with Humalog. And we think that we that we cover a very significant portion of the US market, because there are some, you know, various there is a sell Fill option as well for this product, although that's probably not the benefit that we you know, we we kind of put forward that much but we're very interested in working with with multiple intell insolence, particularly if they could be available in in prefilled insulin cartridges. And we have some ideas are as well, particularly for for type two, to work with higher concentrated insolence. And we have some discussions around well, could the pump identify which type of insulin you're actually putting in your pump? You don't want to confuse you 200 or higher. Right? Right, you 100 Of course, the further discussion around that. And this may be a little bit too far ahead. And you know is well wait a minute, you have different types of insulins, our future algorithms going to take different types of insulin rapid, ultra rapid and to take take into account in their calculations. And how could we ccommodate that the some of the discussions we're having with insulin manufacturers around Okay, would you pump be able to tell which insulin type you have actually just loaded your pump with snakes. Interesting.
Stacey Simms 29:50
Yeah. Yeah. It's very interesting to think about that. My goodness. I was just thinking like, could you use Humalog, Novolog? The four you mentioned, I guess Apidra would be the only one I would have a question about but it just doesn't sound like you've tested it.
Pim van Wesel 30:00
You know, we've not tested it yet. And there's no other reason than that. We know that the insolence I just mentioned, they might be available in the cartridge form factor, or Nofal. Rapids. And, and fill us with, that's public information that they're available in pump cart. And we've all learned about the lily project with Ypsomed, and we kind of figure that they will use a similar cartridge, we don't think that it's going to be very different form factor wise. So that's why we focused on those four,
Stacey Simms 30:33
we've already started looking probably further ahead than we should with something like this. But you mentioned the next time there may be more information will be in in March, and then more trials on people starting later this year. Do I have that correct. Anything else that you want to add that's happening in the near future?
Pim van Wesel 30:50
Will will hopefully well, one feature that we haven't discussed and which we are exploring very actively, and we announced this last HDD is that we have very fast Ultra very fast occlusion detection. And we have now independent data, which will hopefully see published at attd, about comparison to comparative data, how fast our occlusion detection is, and we're exploring what are some of the benefits of that, of course, we tried to balance it against alarm fatigue, of course, we don't want everything to become, you know, an alarm and basically drives people crazy. But we think there's some real benefits to having very faster collision detection, particularly if you go to very young patients. And I think we're seeing more and more people with diabetes getting diagnosed earlier and earlier. And here in Europe, at least, they almost instantaneously go on a pump. And then we think we want to accommodate that. So that's going to be some clinical work we need to do, how do we how do we position the ability to, you know, very, very quickly, we're talking minutes, not hours, right? If you have a very low basal rate, you might not see an alarm in days. And we're actually minutes in that respect and that support very encouraging that we, we still need to think about. So maybe that's one feature we haven't talked about, and we're gonna do some clinical work around.
Stacey Simms 32:09
Interesting. Well, thank you so much for joining me. I look forward to learning more. I appreciate you starting the conversation. Tell your folks when they send those pumps for people to try. Certainly espresso machine. We all love espresso, they can handle that. Very good.
Pim van Wesel 32:23
I like the idea. Well, I wanted to thank you Stacey for the opportunity. And we're always available to answer questions.
Stacey Simms 32:29
Fabulous. We'll talk soon. Thank you so much.
You're listening to Diabetes Connections with Stacey Simms.
Lots more information about Sigi at diabetes connections.com. Every episode has its own homepage with a transcription and more information. If you go there, and the transcription isn't there. And it's an episode after January of 2020. It's coming. It just may take a couple of days to get it posted. But I promise it's there. And we are working our way backwards through the other episodes since we started the show in June of 2015.
I did want to add one thing I forgot to ask during the interview and I asked it later, why the heck is it named Sigi. I emailed them after the interview. And they told me that they came up with the name through an internal naming competition. The chairman of the co founder proposed it kind of a little tongue in cheek was tribute to one of his fellow co founders, an older gentleman, he is 84 years old now. And he was at the origin of what they call the system's core a microfluidic pumping technology idea. His name is Siegfried Strassler and Sigi is his nickname. They said everybody liked it. Also, because I love this it evokes a certain friendly, reliable swiftness. And so it was voted. So that's why it's called Sigi. I love names, I just love to find out why these things are called what they are. I mean, sometimes it's just a number like Omnipod. Five is the next one, Dash was number four and back from there, they're keeping it simple. I liked horizon. I like with control IQ. I hope that they keep names like that. So we don't have to just remember numbers, it makes it easier and it gives a little bit more personality. So thanks for the definition of Sigi and congratulation to Mr. Sigi Sigfrid strassler. Although I guess if it's his nickname, I would not call him Mr. Sigi. I'm calling him Mr. Sigi.
Anyway, we will keep you posted on how the Sigi system moves through the pipeline. And of course, I'm following closely on technology and hoping that we're getting more approvals and more movement for the US FDA for stuff that's already in front of them and that is in the pipeline.
What's coming up. I will say that if you are interested in sending your child to diabetes camp, jump on that most of the camps have opened registration, they usually do that in mid February or by mid February. So chances are if you've got a local camp near you or you want to send your kid to a camp that's not local. Go ahead, look that up. I actually thought I remember when Betty was diagnosed because campus such a big part of our lives as the kids got older, I was thinking, Okay, we're going to do like a diabetes camp tour. I'm going to send him for a week to the local one, I'm going to send three weeks to that one, because that goes for three weeks. I'll send him for two weeks to that, like, I was just gonna trick them around the country. But then of course, he said, No, he was going to go to the regular camp where his sister went, and that was the end of that. And I don't know if I've mentioned here before, I think I have, but he's gone for eight weeks this summer to be a CIT. I'm so excited about that. But eight weeks, man, no share, no follow up. I don't have WiFi at this camp. He'll be fine. We're going to talk about how he wants to do it. I mean, he's 17 years old at this point, so I'm really excited for him.
Okay, we have lots coming up. Please join me for in the news we do that live on social media on Wednesdays, and that it becomes an audio only podcast on Fridays. Thank you, as always to my editor John Bukenas from audio editing solutions. Thank you so much for listening. I'm Stacey Simms. I'll see you back here soon. Until then be kind to yourself.
Unknown Speaker 36:01
Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged
Every week “In the News…” brings you the top stories and headlines around the diabetes community. Top stories this week: A new treatment is being studied to help prevent hypos, cannabis use may decrease women's risk of type 2, examining Veterans Affairs claims for T1D & Agent Orange, better prevention for T2D and heart disease and which athlete at the Winter Olympics was diagnosed with type 1 as a teen?
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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 of the past seven days. If you’re new we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast.
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Looking to get organized? Check out my new guide with top tips to clear your diabetes clutter. Everything from how to start to where to donate and how to keep it from taking over your house. Head over to the home page to get organized.
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Our top story.. moving forward to find a daily therapy to slow or prevent low blood glucose in people with type 1. This is from diabetes-focused life sciences company Zucara Therapeutics. They’re calling the drug ZT-01 and in theory it could restore the body's ability to release glucagon. Long way to go here, but reducing hypoglycemia is obviously a great outcome due to the many risks lows can create. Zucara will now move ahead with it’s proof-of-concept clinical trial in people with T1D. The company expects to publish the findings from that study closer to this summer.
https://www.biospace.com/article/zucara-reveals-hopeful-preclinical-data-in-type-1-diabetes-/
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Part of the 2021 National Defense Authorization Act means a close look at type 1 in the VA. It mandates a report on disability compensation claims submitted by Vietnam War veterans who have Type 1 and were exposed to an herbicide agent during their service. The VA recognizes that Vietnam veterans' Type 2 diabetes can be related to Agent Orange. But it requires veterans with type 1 to provide evidence. There are some challenges here: The VA's claims decision data only goes back to 2003 and they track Type 1 and Type 2 with the same diagnostic code, they don’t distinguish between the two conditions. In 2020, diabetes represented roughly 6.5 percent of all service-related conditions for which Vietnam War era veterans received compensation.
gao.gov/products/gao-22-105143
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New study of gestational diabetes shows it recurs for nearly half of women who’ve had it before. These doctors say little is known about the risk factors for recurrent gestational diabetes. Part of the problem is that they just changed criteria for diagnosing it. In this study about 8-percent of women had a history of gestational diabetes. Of those, almost 50-percent had it recur and just over 7-percent developed type 1 or type 2 between those pregnancies.
https://www.healio.com/news/endocrinology/20220208/risk-factors-differ-for-first-time-recurrent-gestational-diabetes
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What’s the link between weed and a lower risk of type 2? First.. this study only showed such a link in women NOT in men and only in heavy users. In this study that means using cannabis at least four time in the previous month. No differences in the prevalence of type 2 in men who were light or heavy cannabis users versus nonusers. These findings come from a large 5 year study that ended in 2018 and in which people self-reported their use. These researchers say the gender difference was also seen in animal models. Expect more study on this one.
https://www.medscape.com/viewarticle/968186
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More good outcomes with SGLT2 inhibitors and GLP-1 receptor agonists. These drugs are a mouthful but new research links them with lower chances of potentially fatal heart problems in people with type 2 without established heart disease. They compared these newer meds to the risks in people using more traditional therapies, such as metformin. The researchers showed the odds of developing heart failure was 51 percent lower for people using SGLT2 inhibitors, 18 percent lower for GLP-1 users and 57 percent lower for people using both drugs. The newer drugs are prescribed less and these researchers say we need to look at why when the newer ones show better outcomes.
https://medicalxpress.com/news/2022-02-diabetes-drugs-thousands.html
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Some tough numbers about depression and diabetes. In the US.. about 30-percent of people with either type 1 or type 2 have depressive symptoms and 11-percent show signs of major depressive disorder. This lines up with studies from other countries as well, so it’s not just about healthcare. There’s some info in this study about how insulin resistance may go hand in hand with depression.. Women with diabetes seem to be at a heightened risk. Emerging research suggests treatment of depression with antidepressants may decrease the risk of developing diabetes-related complications, although other research suggests there may be complications related to their use.
These conflicting findings highlight the need for further research.
https://www.endocrinologyadvisor.com/home/topics/diabetes/diabetes-and-depression-and-distress-and-psychological-and-clinical-and-social-causes-insulin-and-glycemia-and-antidepressants/
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Our friends at DiabetesMine have a good write up about the very attractive and ever elusive state of non-invasive blood glucose monitoring.. One that caught my eye was Scanbo. This technology uses a 60-second noninvasive finger measurement instead of a traditional blood drop required to measure glucose. The company has developed a prototype. You just put your fingers on the flat white sensors and the system uses a set of algorithms to analyze and offer insight on glucose values. Like most of these we’ve reported on.. they present at consumer shows, not medical conferences and no clinical trials. And.. this is my editorial.. what a weird photo. It looks like you have to put both hands on the machine and with the chipped purple nail polish this looks like no thought was put into it.
https://www.healthline.com/diabetesmine/non-invasive-diabetes-technology
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At least one athlete in these Winter Olympics lives with type 1… Kamilla Kozuback was diagnosed at age 13.. and her first question was whether she’d ever be able to snowboard again. That was only four years ago! At the time she told JDRF Canada – quote, “I want to be in the next Olympics. I’m going to keep working hard, and training all I can” She’s competing in Beijing this week.
https://www.instagram.com/kamillakozuback/?hl=en
https://www.jdrf.ca/finding-strength-in-adversity-newly-diagnosed-teen-competes-in-2020-youth-olympics/
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The documentary “Pay or Die” gets some Hollywood star power behind hit. Susan Silverman signs on as an executive producer. We had directors Scott Ruderman and Rachel Dyer on the show last year to talk about what they describe as a look at the health care crisis in America, told through the personal stories of those with Type 1 diabetes who, because of soaring insulin costs, are living on the edge of survival.
Silverman says, “I believe Rachael and Scott might just shame our shameless government enough to move the needle,” “I’m grateful for the chance to help get eyes on this crucial documentary.”
https://www.hollywoodreporter.com/movies/movie-news/sarah-silverman-diabetes-insulin-documentary-1235084792/
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Our long format episode this week is Molly Schreiber who lives with type 1 and rheumatoid arthritis. Medication for the latter made the decision to get a COVID vaccine complicated and she shares her story. Next week we’re talking with the people at SIGI pump.. a new tubeless rechargeable pump that got breakthrough device designation last fall.
Listen wherever you get your podcasts
That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
People with diabetes were encouraged to get a COVID vaccine early on when the shots were released. But what happens when you live with type 1 and another condition where the vaccine recommendation is more complicated?
Molly Schreiber lives with T1D and rheumatoid arthritis. Her doctors told her to absolutely NOT get a COVID vaccine due to treatment she was taking for the second condition. She was able to eventually get vaccinated then, despite taking precautions, she and her entire family got the Omicron variant. They’re fine now and Molly has a lot of good info to share. She also has several family members with type 1 and has a lot to say about how we care for older people with T1D.
Molly works at the Community Manager for Savvy Coop.
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
Type 1 Diabetes with Other Autoimmune Diseases
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
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Episode Transcription Below (or coming soon!)
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Stacey Simms 0:00
Diabetes Connections is brought to you by Dexcom. Take control of your diabetes and live life to the fullest with Dexcom and by Club 1921, where Diabetes Connections are made.
This is Diabetes Connections with Stacey Simms.
This week, people with diabetes were encouraged to get a COVID vaccine early on, when they were released. But what happens when you live with type one and another condition where the vaccine recommendation is… complicated?
Molly Schreiber 0:35
And I messaged my rheumatologist and I said great news. My hospital has the vaccine in I can get an appointment. You know, I was super excited. And she called my cell phone immediately and says You could not get that vaccine and it was a gut punch. What do you mean, I can't get this vaccine,
Stacey Simms 0:52
Molly Schreiber lives with type one and rheumatoid arthritis, she was able to eventually get vaccinated, then despite taking precautions, she and her entire family off the omicron variant, they're fine. And she has a lot of good information to share. 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. And one of those people had a really bad low last night, as most of you know. And if you are new, I will explain my son, Benny was diagnosed with type one right before he turned two, he is now 17. We use the control IQ system with Tandem and Dexcom. And I gotta tell you, it has been a while since that urgent low has gone off on my Dexcom app. And I really don't remember the last time he had an urgent low that he didn't treat pretty quickly. You know, he very rarely asks for my help. We are at the point now where I have turned off all of the Dexcom alerts except that urgent low.
But in the middle of the night, it was like one o'clock in the morning it went off. And I don't know, you know, usually I would have waited and just said maybe he's got it. He always had stuff in his room. But it was It wasn't in 55 It was 42. So I said, you know, I'm gonna just go check on him. And they brought up a juice box like I have done a bajillion times, you know, when he was little, it's so funny. I gotta say, you know, the juice box used to seem like a big deal, a big amount, I should say. But it looks so tiny. He’s now like six feet tall, but I brought it upstairs.
And it was immediately clear that this was a real low. This wasn't a compression low. He wasn't leaning on the Dexcom. He was disoriented, he was sweaty, he was super hungry. So he drank the juice box, I got him some crackers. And then I sat with him for a little bit. And he started to kind of come back to himself. But he was so hungry. And you know what this is like, I don't know about you. But he was sometimes I really try if I'm with him, which isn't the case all the time anymore. I tried to say you know, you've had you've had your 15 or 20 carbs or you know, when he was little you had your four to eight carbs. And let's just sit because you know, you're going to be okay. Now, you know, you're not going to be hungry in 15 to 20 minutes. But man, that urge to eat. I mean, I know his brain is screaming at him. So I was like, you know, forget this. I went downstairs and I got him some more food. I figured I can always give him more insulin for it and who knows. He just really still felt bad. So we overtreated which, again, we haven't done it a long time totally overtreated. And, you know, he finally felt better and was able to go back to bed. But you know, my adrenaline is like, through the roof. I finally did get back to bed. But I'm sure that he felt much worse than I did. I oh my gosh, it's been a long, long time. I'm sure many of you were asking, Well, what happened? The truth is I don't know what happened. I didn't ask him in the moment. I mean, he's 42 he's not gonna have a coherent answer. I don't really care. I just wanted to treat the low and then go back to sleep.
I’ll ask him tonight at dinner but I gotta tell you at this point, 15 years in the answer he has diabetes is good enough for me. My guess is he ate something and gave too much insulin. Or I know we put a new site on. Maybe that was like a super absorbent site. You know, sometimes that happens, you just hit that sweet spot. And it's just the insulin flows somehow a lot better in that place. If it was really interesting or unusual, I will report back but I only bring it up because it has been a long time. Since I've had to treat a low like that in the middle of the night. It made me remember all those times, you know, not just before control IQ but before Dexcom when that would have been you know a finger stick every five minutes while we were waiting for him to come up and you know, very different times. I hope we all get a better night's sleep tonight. And like I said, if it's anything really interesting or if there's a follow up here, I will let you know.
Alright, this week's guest is somebody I've known for a long time through the diabetes online community. She certainly remembers a different type of technology. We did get to meet in person at a healthy voices conference in Chicago nearly six years ago. We talked about that at the very end of the interview. That was so cool. Hold that conference was freezing. But man, I would love to go back to more in person stuff even if it's freezing. Molly Schreiber was diagnosed with type 1 diabetes as a child in 1989. Her father, grandfather and a cousin all lived with type one as well. In 2018, she was also diagnosed with rheumatoid arthritis. I follow Molly on social media, she's been very open about her struggle, not just with these conditions, but with how difficult COVID has been for her. You know, with autoimmune stuff, you want to be more careful. But her art a diagnosis rheumatoid arthritis diagnosis made getting the vaccine a tough decision. And then when her entire family did catch COVID During this omicron search, it made that more difficult to Molly has been a longtime blogger in the diabetes community. And I'll link up some of what she has written. She is currently the community director for savvy cooperative, and she explains more about that as we talk. I do want to say, you know, Molly really is an incredibly positive person, but she's not a Pollyanna. She keeps it real. And it was great to catch up.
Molly, welcome to the show. Thanks for coming on.
Molly Schreiber 6:08
Thanks for having me.
Stacey Simms 6:09
All right. Before we jump in, or talk about anything, I have to ask, how are you? How are you feeling as your family
Molly Schreiber 6:14
were okay, we all, you know, had the pleasure of having COVID Funnily enough, we pulled my daughter from college because it was getting pretty intense down there and gave her COVID When she got home, so really failed there. But no, we're all doing a lot better. It's been almost three weeks now. So
Stacey Simms 6:31
yeah, I'm glad. And um, you know, there's an awful lot to talk about leading up to that diagnosis, but I'm glad everybody's doing okay. Scary stuff. Yeah, this is usually where I asked people to tell us their diagnosis story. And I'd like to start there with one additional question if I could, because you don't live with just and I put that in quotes with just diabetes. Right?
Molly Schreiber 6:50
Right. I was diagnosed with type one diabetes, when I was a kid, when I was back in 1989, I'll date myself, and I knew a lot about the disease. So my father had type one or had type one and his father and then my paternal cousin. So type 1 diabetes was very much in my life, you know, needles were around testing. At that point, testing blood was not as common as urine. But um, you know, it wasn't a shock, I should say, a lifestyle change. We were already kind of living that. But fast forward to about 10 years ago, I was diagnosed with rheumatoid arthritis, which, yeah, the just living with both is definitely a challenge. They don't, you know, unfortunately, autoimmune diseases can come, you know, in pairs or in groups, you tend to be a collector, but they don't necessarily get treated, or even you have similar symptoms to each other diabetes and RA,
Stacey Simms 7:51
would you mind and Pardon my ignorance? Would you mind talking about RA for a moment what that is?
Molly Schreiber 7:56
Yeah, so the easy way to sort of translate it to the diabetes community is instead of attacking I slit cells, my immune system is attacking my joints, and specifically the synovial membrane, which is sort of that lubricating fluid that's in your joints is not immune disease, as well. So comes from the same family. As you know, and most of your listeners, we don't really know why yet, it happened to me very, I would say suddenly, and I had sort of just an elbow pain thought I grabbed a bag, wrong, you know, off of an airplane on on a weekend trip and just thought, I've asked to push that bag too hard or done something and within a month, I couldn't straighten that elbow. So my arm was bad. And I got to have the fun experience of doctors telling me I was favoring it or had tennis elbow or all sorts of fun things. But within a few weeks, I couldn't walk downstairs and I was sitting because my feet and my knees and just did not then did not work. And I quickly went to the doctor and just said something's really wrong. And unlike type one where you get a blood test, and you know, if your blood sugar is a certain number, there's a pretty good chance you know that you're going to be diagnosed with diabetes with RA, there is a blood test. Lucky for me, I tested positive but plenty of your listeners if they have RA they not not everyone test positive. So you could go down a very long treatment of trying to figure out what's wrong. What is the treatment? Is there treatment? There is there's a couple different treatments, so definitely medication. So you would start with what are called disease modifiers and the most common one that people might know of is called methotrexate, it can be used all these drugs can be used for cancer, but these are used in the RA and similar disease spaces in much smaller doses. So yes, you may if you look them up, see them referred to as chemo that they are just given in lesser doses. So we have those drugs. Most of the time. They don't do enough and you need something that's called a biologic and There are quite a few options. To be honest, this was the hardest part for me. All right, is that I went from living with type one, you know, basically my whole life and there's one treatment, right? There's insulin, everybody takes it. You know, we might have the rare person. I'm sure everyone's heard of someone that was maybe allergic but you take it it works. Does it work perfectly? No real? No, that doesn't always work the same. But everybody takes it. But with a biologic. And with other treatments with these arthritis, autoimmune conditions, it's a gamble. You know, what commercial? Did you see that maybe you want to try that one is a literal question from your doctor. Wow, it is a true gamble of what's going to work. They don't know yet. Why some jobs work and some don't for people and what works for me, if you were to be diagnosed with RA, it might not work for you. It's just a complete gamble. And they don't last forever. So some people have had success for a long time. Others have tried multiple drugs because they lose efficacy. We'd like to say that the drug failed the patient. Patients like us are tend to sort of internalize it and say, Oh, I failed that one. But no, we're gonna say that the drug failed that
Stacey Simms 11:11
I'm pausing here, I'm just gonna kind of stuttering because I'm trying to figure out how to ask this. What I'm trying to say is, with type 1 diabetes, and RA, you're mentioning insulin, you're talking about biologics and other medication, any dangerous interactions, anything that you specifically have had to look out for.
Molly Schreiber 11:24
Yeah, so a couple different things. So one of the initial treatments for rheumatoid arthritis, and it can be a treatment that a lot of patients stay on are steroids. And so plenty, you know, if you have diabetes, and you've ever, you know, had even a horrible bronchitis or pneumonia, or maybe you've had to get a steroid injection, you know, that horrible boost, your blood sugar is going to take them after you have started either that steroid pack or you've had that injection, well, a lot of patients are on a long term dose of steroids. For me, that's simply not an option. And I say that for myself, because, to me, the the struggle of managing my blood sugar as well on them. And also just the feeling of being on them is not worth the side effect of the you know, I'm not getting enough bang for my buck, you know, with with a steroid, so it's not worth the added stress. That's not to say you can't manage steroids, you know, our pumps and our different basal rates and everything, do great things. And I even have a steroid profile in my pump. If for when things get bad, yes, I will go on them. I'm not going to be too prideful. But steroids are first line of defense, they make you feel better quick, they get you back to life, you know, and for me, there's that added habit of blood sugars. But then there's also that little piece of how we're susceptible to getting sick, you know, where our cold takes a little longer for us to recover from, you know, and when you're on these additional medications, you want to keep your blood sugar in check, because when it's not, you're feeling worse, and you're more susceptible to those complications. So there's just that added caveat, you know that you want to stay as healthy as possible, but you're on these drugs that are really, they're calming down your immune system, so it stops attacking you. But in that same breath, they're also not preventing you from getting sick.
Stacey Simms 13:17
I'm going to come back to your family's experience with type one as you listen, I don't want you to think that I'm going to skim over that we're definitely going to revisit that. But keeping our conversation about ra here with COVID. You are one of the first people I remember seeing on social media in my circle, certainly that was talking about issues with either being able to take the vaccine or wondering about being able to take a COVID vaccine. Is that because of the biologic or the medications or is because of the RA condition itself?
Molly Schreiber 13:48
Yeah, so it's a little bit more on the medication side, but a lot of patients again, are on a ton of different biologics. And so at the time when vaccines first came out late in December of 2020, as their confer hospital then and with that came with being eligible to get a vaccine early, which is great. Sounds wonderful, right? I was super excited that I was in a drug club or Texan or Texans are really strong line of defense. With Ra. It's used a lot with non Hodgkins lymphoma as well. It's pretty in terms of the drugs you could be on. It's a pretty heavy hitter, but when I went on it three years ago, I needed it. My disease was in a space that needed it and it worked. I just had an infusion. So vertex in isn't infused by logic. Some people get it once a year, the earliest you can get it is every four months to talk to infusions every four months and repeat. So I was on that schedule, and I'd had an infusion in October, and I messaged my rheumatologist and I said great news. My Hospital has the vaccine in I can get an appointment. Yeah, super excited. And she called my cell phone immediately and says You could not get that vaccine and it It was like a gut punch. What do you mean, I can't get this vaccine. And she said, look, the ACR, the American College of Rheumatology, you know, like a lot of us even still, to this day, we don't know everything, still trying to figure it all out right in terms of COVID. But they know that you need to at least be as far away from that biologic infusion injection as possible for the vaccine have a chance to work. And since I had just had it, I wouldn't be due for my next one until March or April. And she said, We got to try to get you to March or April. And there is a little bit of history behind this. So a lot of patients that have been on vertex in the flu vaccine, for example, doesn't work in one dose, sometimes it's recommended that they get two doses to be able to have an immune response. So they at that time, were kind of basing it on that. And so I waited. And it was incredibly frustrating. I'm pretty sure that's probably what you saw on my social channels, was that here's this thing that we've all been waiting for, with the promise of it, getting back to our lives, but also the promise for, you know, auto immunocompromised patients like myself to feel a little bit more safe, you know, we could get this vaccine and finally feel safe. And I just couldn't get it. And so I had to wait. And the only other thing that came with waiting as I went back into our sort of statewide system of trying to get an appointment, which I think everyone probably still have stories, I'm getting an appointment or getting a test and had to wait and get my initial vaccine. I got that in April, when I was earliest I can get an appointment.
Stacey Simms 16:40
I feel like I may have missed something. I'm sure you said it. Did you have to go off your medication and in order to get the shot to get the vaccine?
Molly Schreiber 16:47
Yeah, so with the toxin and retexe intakes, obviously, everything varies, but the the longer you can have it out of your body, the better. So your body can start, you know, kind of revamping and not being so suppressed. And so with vertex and they wanted me to try to wait six months, I sort of made my own compromise of April, it would have been nice. And with that came a discussion with my rheumatologist. And she frankly told me that she wasn't keeping any of her patients on this drug until COVID was sorted. And this was again a past discussion now, right? Right now it's as we know, we're not going to stay on this drug because of how unprotected you can be against these viruses that are popping up. And she and I agreed that since I still had some other options on the table, that I would try something else. And retexe in its place, obviously, if she had patients that truly, you know, it was the difference between walking and not or, you know, work and not she was not going to take the drug away from them. But we had to have a frank discussion and with our eye, again, back to what I said earlier to gamble when you take a medication, so it was another Okay, Let's gamble and see what this next one might do. While I was on one that was working.
Stacey Simms 18:10
And then after all of that, like many who were vaccinated and boosted buzz, you know, being very careful. Masking up. You got film Kron virus got you got omachron. So I hate to say like, what's your reaction? Because I think we would all have the same reaction. But you went through so much.
Right back to Molly in a moment, but first Diabetes Connections is brought to you by Dexcom. And I get a lot of questions about Dexcom coverage for people on Medicare. And why not, it's not just that you stopped needing a CGM, the minute you turn 65. The good news is that the Dexcom G six continuous glucose monitoring system is covered for Medicare for patients who meet the coverage criteria. If you have either type one or type two diabetes and intensively managed insulin you may be covered. To find out more about what that means. And if you qualify, check out dexcom.com/g six dash Medicare and I will link that up for this episode. You don't need to write it down. It will be in the show notes at the homepage at diabetes connections.com You're going to want to talk to your doctor and you may even be able to get your Dexcom supplies at the pharmacy saving time and money learn more again it's dexcom.com/g six dash Medicare. Now back to Molly talking about her family's experience with COVID.
Molly Schreiber 19:37
So I'd had my two doses that are that had the Pfizer vaccine I had an April and May and then I actually got a third dose that they're not calling it a booster but a third dose and August because it wasn't that six months but they offered it to patients that were immunocompromised this is I know there's so much has come out from the FDA and the CDC this probably was a blip But that
Stacey Simms 20:02
now remember, right? Yes,
Molly Schreiber 20:04
it was a blip and but it was a big blip for me. And so I went and got a third dose all along. I had participated in a research study through Johns Hopkins, which I know a lot of patients have done in, they were just trying to see efficacy in the vaccine with patients with different kinds of autoimmune conditions or health conditions. And so they tested your antibodies before and after each of your vaccine doses. So with my first two, I didn't have any antibodies. I got my third dose so quickly, because I was so excited that happens hadn't been ready with their lab slips yet. So my rheumatologist tested me in November, and showed that I still didn't have antibodies. And I found that out the week before Thanksgiving, and she said, you know, you really need to just stay in your bubble. And I'm like, I've been in this bubble for a long time. But like I mentioned, I have a family. You know, my husband works at the airport, my son works, my daughter goes to college. But luckily, everyone, like you said, We're maths, they're all vaccinated and boosted. Everybody was good. We daughter's college was getting a rise in cases, and they switched exams to online. So my husband ran down and grabbed her right, the week and a half before Christmas. And then that Saturday before Christmas, we all thought a little off. And knowing that there are monoclonal antibodies that I could maybe get, if I were to get COVID, I've been instructed multiple times by all of my doctors, you know, you get these if you get COVID, call us, we took a test, my husband was positive, I was positive, my daughter and my son, and I didn't see it coming, like I said, grabbed my daughter and brought her home and gave her COVID. Right. At school, I really missed the mark as a parent on that one. But it's not a cold, it's not a bad cold. It's not what I guess a lot of people are sharing, at least it wasn't for my family. And I know that I mentioned that I didn't have any antibodies, but my family dead, they're healthy. They're my daughter's 18, perfectly healthy, and had the 102 Fever, the vomiting, the cough, the body aches like you couldn't imagine. And I the sounds so awful to say but they actually understand a little bit of what our eye fatigue is now, because it was so intense with with COVID that I just said, you know, when you felt like you didn't have that extra oomph to pull on. That's what it's like. So I did get a little taste of that. But now, you know, we're about three weeks out doing so much better. But I'd be lying if I didn't say it was a little scary, you know, at times, especially with where our health system is right now.
Stacey Simms 22:43
I'm so glad everyone is doing better. I know so little about Ra. So forgive me if this is a dumb question. Are there lingering issues or concerns that now you have to think about in terms of what medication you're able to take or anything like that, because of having COVID?
Molly Schreiber 22:57
There are so with my rheumatologist, we've been kind of you know, going back and forth. I'm incredibly thankful for portals because I could send messages whenever I had energy, it was great. She said that there's a couple things to be concerned about. She said that they've seen that a lot of patients with autoimmune conditions tend to shed the virus longer so that I'm going to say 10 days I know now it's five days, whatever it is, right? When you listen to this podcast, whatever amount of days it is that they're saying you need to quarantine for, they're saying that they're finding that patients like myself can shed it longer. So that is a concern for you know, if I were to say, Hey, I'm good and you know, go to the party I haven't gone to in many years, that's a concern for the public that the other thing is because I could still be shutting it. They're not sure when to start my biologic backup. And so basically, we're kind of going week to week my rheumatologist just wants to make sure I have zero symptoms, just not even a cough or runny nose. Nothing that could you know, taking something to oppress and suppress my immune system, you know, could trigger and so there's there's that but really, it's just the twofold wanting to keep others safe of them still shedding, you know the virus longer because like I said, we missed Christmas and my mom, you know, was like, well, when can I come up? And I'm like, I don't know. I just don't know and I'm never gonna put her at risk. So I think there's still as awful as it is so many unknowns right now.
Stacey Simms 24:34
How Okay, nosey question you don't have to answer How were your blood sugars? Was it difficult to manage? Did you do okay during all of this,
Molly Schreiber 24:41
so that is how I knew it was coming honestly, I think a lot of patients would probably identified that they could tell Oh, I should have known I was gonna I was getting sick, my blood sugar's are higher but my family got very sick that weekend. And on that Sunday, kind of boasting that the one with no in bodies just had a runny nose, you know? feeling great. And that night, my blood sugar started going up. And for me, you know, I'm home, I work from home. Like a lot of people, I kind of have a routine, you know, if I eat or drink, you know, that boring stuff that you can do with diabetes for a long time. And so my blood sugars are pretty good. Of course, there's random days for you're like, What in the world is happening, but this was consistent. This was, you know, I'm not eating something. And I'm just high, you know, it is just higher than normal. And the next morning that Monday, I woke up with 102 fever and felt awful. I actually used I mentioned earlier that I had a steroid personal profile in my pump for when I do get infusions, they come with that infuse steroids, and it has a higher basal rate and a little bit more of a carb ratio in there. And I put that on when I was sick. And so that helps with keeping my blood sugar's under control when I just wasn't feeling well enough to even deal with my pump. Honestly, I was very grateful that I already had that setup. Might be a little too aggressive. I'm not sure. But it was nice, because I don't think I would have had the energy to think through a whole new basil program.
Stacey Simms 26:13
Yeah, definitely. I totally understand that. And it's funny, as soon as you said, you look back at those blood sugars. Oh, yeah, I should have seen it coming. I mean, Vinnie said diabetes for 15 years. I can't tell you how many times we still say oh, yeah, three days?
Molly Schreiber 26:26
Oh, I still do. I've had it for over 30. And I'll be like, should I know that was coming? I've only been through this a million times. Right? Oh, it's always after during you're like, why am i Hi? She makes no sense. And then the next day or like,
Stacey Simms 26:42
you know? So, as you said, You've lived with type one for 30 years, you were diagnosed in a family that was familiar, but at a time you said 1989? Where I'm guessing, you know, my recollection, home meters are just being introduced that sort of thing. Tell me a little bit about your Dad's experience with type one, if you don't mind.
Molly Schreiber 27:01
Yeah, my dad. So my dad was diagnosed in the late 1950s. And so my dad was in the time of boiling needles of no blood sugar testing at all, a lot of guessing. He would say just living his life as a teenager without thinking much about diabetes. He got there serious about his diabetes a little bit later. But because he had sort of grown up in this non technology way of managing type one. He thought it was great that I eventually got meters, pumps and everything. But they weren't for him. CGM weren't for him, nothing was for him, he would see the value for me that it was never. But it's funny when I see that funny, but I look at kids now. You know, I remember. And it's still a fear, but it was a strong, you know, fear of my, my own children getting tightwad, you know, I just, you know, you don't want anyone to experience anything that they don't have to. And so looking back, you know, I didn't have a meter at school, because we had a home meter that sat in the bathroom, you know, I had a snack every day, you had to eat your snack at the same time. And I that was my like, big cool thing about having type one in elementary school, but I look back and you almost have a moment of going, how did I survive all that, like, I didn't have this thing beeping on May 24/7, to tell me what my blood sugar was doing. And I went to gym class and I, you know, I, I survived. And so I a lot of that, I'll look back on you know, when technology fails, or you know, a server's down and all this, I just think back to the fact that I would go to school all day, without a meter with a pack of graham crackers, you know. And I'm still here, and I'm okay. And my dad, on the other hand, my dad, he learned sort of a way that I think a lot of people with type one, including myself, you can kind of slip into where you're very regulated, you know, dinner has to be at 630 because your body has to eat it. You know, and our pumps and everything and our short acting insulin have really given us flexibility, but my father was very regimented, because that was how he survived. You know, that was the insulin they had that was knowing how much food to have in his body at certain times. And so even my husband jokes that family dinner time is 630 because when he came into my family, that's what my father did. That's when he had to take insulin.
Stacey Simms 29:34
Did you say your grandfather had type one? Yeah. So
Molly Schreiber 29:37
my, my grandfather, my dad's father had type one as well. He passed away, right? Shortly before I was diagnosed with type one due to complications, but you know, it's so varied. I don't really even know. At that point. He never would have even experienced a glucose meter.
Stacey Simms 29:56
He diagnosed you know, the date or the year.
Molly Schreiber 29:59
So my dad was born in 48, January of 48. And I believe his father was mid 20s, when he was born so early, a long time ago, and so my dad got it. They used to tell him that diabetes always skipped a generation and a sex. Have you heard that I'm sure you have. And so my cousin who's female has it as well. And that really fed into my dad's thinking of that my dad was the oddball that if he hadn't gotten it, it would have fit the, you know, the mold would have followed the program, you know, but he really blamed himself that I got type one, he really, you know, for a long time, it was really hard for him, but he's also the one who knew to test my blood sugar. You know, my mom took me to the doctor 10 times, and I poison ivy that gave me type one of all the things I got poison ivy, and then just stopped eating and got out, went to the bathroom a million times, and my dad got frustrated and tested my blood sugar. So he didn't see it that way that he had saved me, he thought that he gave it to me. So it's a heavy emotional burden.
Stacey Simms 31:14
It's really hard. Yeah, such an emotional experience. And that's, you know, it's so difficult you think about the tools that that generation didn't have, and how they they did the best they could,
Molly Schreiber 31:22
yeah, so my dad, he, you know, had a bad low when he was living on his own. And this was back in 2015. And he fell and hit his head. And, you know, my father had had a onesies bill of five. And when I say that he lived a very regimented life, he did because that fear of, you know, what could happen if you didn't manage your diabetes was very prevalent, you know, for him growing up. And you know, he had laser eye surgery at Hopkins, when they were still testing on monkeys, like he had a very real fear of losing a limb and more, you know, really suffering. And so he managed himself extremely tightly. And that came with a lot of lows, you know, and we'll all say that your agency is only reflective, you know, of the broad range, you know, it doesn't show the 30s, you know, that you had, and even growing up, he had bad lows, I have many recollections of ambulances coming to the house. And so he had a bad low has had and was admitted to a nursing home, because he just wasn't 100% Ready to care for himself. So just rehab sort of the the problem is, and kind of mentioned this with technology. So we have the tech, right, we have glucose meters in every office everywhere. But even the nursing home staff didn't understand what type one was. So he would tell them, I need my insulin transferred from the hospital without any insulin, she would say, you know, be put down as non compliant. One of our favorite words, right, because he wouldn't eat because he knew his blood sugar was high, but they wouldn't test it, they wouldn't give him insulin, they thought he was just like a type two. And if he wasn't going to eat, he didn't need any insulin. And they would reference him and he said, it doesn't matter what type I am, I need insulin. To the point that, you know, he, no matter how much education we tried to provide, no matter how much he tried to provide, on his end, there was even one night he called an ambulance from his nursing home bed for insulin, because he needed insulin. And the true story is he ended up in DKA from this, and he passed away from it simply because nursing home staff and I'm not generalizing, I personally have not been in a nursing home, but I can only go by his his information of what's happened and others have shared, they simply didn't understand that insulin, you know, is, is air and water for us, you know, we need it, we cannot live without it, and ended up in DKA and didn't come back. And that all stemmed from lack of understanding diabetes, which has been around forever. I just mentioned my great career, my grandfather, it's been around a long time. And so it's really important to me and I, I've talked with a lot of fellow diabetics who are, you know, and early 40s. And we've talked and it's a real fear. And that kind of comes into COVID. You know, what if you end up in the hospital, and can't manage your own disease? And so I think that that's a real fear, even today, you know, if you get COVID, if God forbid, you know, need to be on a ventilator or just are unable to care for yourself what happened?
Stacey Simms 34:36
No, it's absolutely terrifying. And I know that sharing that story is not something that you do lightly. You know, it really is amazing to see these concerns. I don't know how well they're being addressed. All we can do is keep talking about them, and keep educating. So thanks for bringing that up. I do appreciate it.
Molly Schreiber 34:54
Yeah, I don't have the answer. Like you said that. I think we'll figure something out of everyone just shares and
Stacey Simms 35:00
Before I let you go, I do want to ask you about your job because you're, you know, we've been talking what we basically talked about for the last few minutes is patient advocacy. And that is something that you are you're doing in your job day to day with savvy, tell me a little bit about what this organization is and what you're doing.
Molly Schreiber 35:15
Yeah. So savvy, cooperative, founded by two patients to Jen is in the juvenile arthritis space. And Ronnie are other co owners, the cystic fibrosis space and like myself, like probably a lot of people you know, and even you to have had the pleasure of being at, you know, the different tables, you know, pharma tables, companies that are trying to make products better for, you know, all types of different health conditions. And eventually, like myself, Ronnie, and Jen found themselves looking around the table and you see the same faces. And I've met some great friends that way. But are, you know, are all the white women at the table really representing the patient voice of rheumatoid arthritis? You know, and we're being asked questions like, well, what does someone do you know, when they can't afford rent or medication, I am privileged enough to not know what that feels like. And a lot of people are in So Jen, and Ronnie just said, What can we do. And so they started this Co Op. And what that means by a co op is a co op is owned by its members. So we're literally a patient owned organization. And what we do is, quite simply, what I just said, is try to bring every voice to the table, try to have, you know, if a product is created for the HIV community within the HIV community to be at that table, creating that project, you know, and that product and medication and treatment. And so that's just like a very nutshell of what we do.
But we basically have people come to us, and they want to know more about a health condition, or they have an ideal treatment, or medication or an app, or a variety of things. And they asked us to find the people and maybe do the research and do the interviews, and at the end products and ideas and medications or treatments are being co created with the patient, rather than the patient at home seeing a commercial and going well, if they'd asked me, I would have told him that doesn't work. benefits, both the company and the patient. And thing I like to share that's a great example of what we do is a lot of people have heard of Amazon, I'm going to go ahead and assume and maybe even Alexa, and they did a study with us where they wanted to improve Alexa so that people would voice impairments, like stutters and different things could communicate better with her. And now they have a patch that anybody can get add into their Alexa. And it lets more people use that technologies here. And so that is just a small example. But I think it's a great one, you know, showing how something that they took to actual patients and had patients use and give feedback now benefits the greater world and all patients. And so that's what we do, I realize I give a very, you know, nutshell, I work in communities and the community director, which means I get to talk with patients and partners organizations all day, which is a great fit for me because as a patient, which is gathered by now, I really wouldn't want any patient to not feel like they're part of the community, and that they're alone in their journey or that their voice isn't important. So if you know one person hears this, and it's like I've already in diabetes, which I'll reference the great Rick Phillips did for me years ago, made me feel like I wasn't the only person that had those conditions. And if that happens because of this will Stacy, you've done a huge job. I haven't been here.
Stacey Simms 38:57
I hope that happens. It's really as we've learned over the years, right? How just knowing that there's somebody else out there going through the same stuff makes a huge difference. Just one more checking if I could with your family. You mentioned you picked up your daughter, you know you wanted to keep from having coverage came home Scott COVID. How's everybody doing now?
Molly Schreiber 39:14
Everyone's doing okay, much, much better. But it's not lost on me that anyone can get this again at any time. So we're staying in a safe and our masked bubble for now.
Stacey Simms 39:25
Gosh, well, thank you so much for joining me it's so much fun to talk to you. I just you know I have to mention I remember when we first met I don't know why this just popped into my head maybe it's cuz I was I just miss traveling so much. Did we meet in Chicago
Molly Schreiber 39:37
at healthy freshmen airport? We I was
Stacey Simms 39:41
Yeah, I was wearing that blanket thing that I wear like really heavy winter coat anymore. Yeah, we met in the airport in Chicago. Geez.
Molly Schreiber 39:50
Yeah, that's where we met and I it was one of those great moments where you're like, I know you but now I actually know you you know like, it's like my honor. Lying knowledge and then by in person, which is the best because you really know people then
Stacey Simms 40:04
isn't that the time when there was this thing going around the internet, the kids probably call it a meme. But there's this thing going round where it was like, the only really good thing about the internet sometimes is when you meet someone in PR person that you know from online, it turns that first meeting from a handshake to a hug.
Molly Schreiber 40:20
Yes. That's what it is. Yeah. And I do now right now, I picture us waiting for our car together. years ago, too many years ago, because we've been traveling so long.
Stacey Simms 40:34
Oh, my gosh. All right. Well, here's to travel in the future. At some point, Molly, we will grab that cape blanket thing out of my deep recesses of my closet and we'll we'll meet again.
Molly Schreiber 40:45
Yes, we well.
Stacey Simms 40:51
You're listening to Diabetes Connections with Stacey Simms. I will link up more information about a lot of what Molly talked about there, including information about savvy cooperative, yes, that is the group that I have linked to in some emails. And in the Facebook group, a bunch of you have signed up to take part in their research studies. So if you're interested in that, be on the lookout, when it's relevant to our group, I will definitely share that with you. And sometimes there are opportunities to get paid, which is always nice.
It was fun to think about travel again, by talking to Molly and I have some things tentatively on the calendar, you know, you're always afraid now to you know, we got to make plans. But who knows. So I'm excited. In March, I should be going to Syracuse, I have an event at Syracuse University. This is an annual or at least it was before COVID and annual alumni event that I always have a lot of fun in. I'm trying to set up some kind of diabetes event as well, maybe for moms, maybe for families. So I'll keep you posted on that. I am talking to some local diabetes people in the Syracuse, Central New York area, and hopefully we can work something out.
Then at the beginning of April, friends for life Indianapolis is on registration is open. I still haven't pulled the trigger on that I haven't committed to going yet. But I'm pretty sure I'm going to maybe you can help me make up my mind. I think I'm going to be there. But regardless of me go if you're in that area, this is a great regional conference. And the hotel has like these train car rooms. It's a train station that's now a hotel. Definitely check that out. And looking down the road. There's gonna be some local events here in the Charlotte area in April and May and then it'll be friends for life in Orlando in July. So I'm hoping that there will be more in person events as the year goes on. Cross your fingers and hope we stay safe. Man, I'm not sure that it's I'm ready to say anything about a return to normalcy, but it would be a lot of fun to just see some people again and make those connections that you can make them online but there is just you know, as you know, something so different about him person, and I missed that. I miss that a lot.
Alright, thank you, as always to my editor John Bukenas from audio editing solutions. Thank you for listening. Wednesday, it is in the news. Don't forget I do this every week. We are live on social media and then it becomes a podcast episode that'll be out on Friday, just five or six minutes of news in our community. And next week's interview. Have you heard about the Sigi pump? This is a brand new insulin pump. It looks like it's going to be a competitor to Omnipod. There's some really cool features. It's not here yet, but I'm talking to this company about why they are trying to bring it to the US as soon as next year. We'll see what happens with the FDA and everything else but man this pump is really cool. And I can't wait to tell you more about it. Alright, that is all I am Stacey Simms. I'll see you back here soon. Until then. Be kind to yourself.
Benny 43:44
Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged
Every week “In the News…” brings you the top stories and headlines around the diabetes community. This week: Omnipod 5 is approved, T1D families win a NYC field trip lawsuit, the first drug to delay type 1 DX gets a second chance and getting glucagon without a prescription
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Join us LIVE every Wednesday at 4:30pm EST on Facebook and 4:45pm on Instagram
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
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Episode Transcription Below (or coming soon!)
Please visit our Sponsors & Partners - they help make the show possible!
Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. If you’re new we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast.
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Looking to get organized? Check out my new guide with top tips to clear your diabetes clutter. Everything from how to start to where to donate and how to keep it from taking over your house. Head over to the home page to get organized.
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Our top story.. Omnipod 5 is approved. The US FDA has okayed the system more than a year after it was submitted – held up like a lot of other diabetes tech due to COVID. This is a hybrid closed loop which means you still to give insulin for meals but it will work hard to keep you in range. It’s the first system approved with phone control and with a bit of A-I.. the system uses what it learns about you to improve dosing. I spoke to the company’s medical director for the podcast this week and I recommend you listen to that episode for tons of detail on how the system works, what makes it different from what’s already on the market and details about insurance, Medicare and a lot more.
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Medtronic is sending out a letter this week to everyone who received one of its new or replacement insulin pumps within the last six months to remind them to make sure they have saved their basal insulin rates on their devices. This is considered an “urgent medical device correction” notice and was prompted by a series of injuries recently due to the use of pumps that had not been properly programmed.. they came out of the box with no basal rates which is normal.. and for whatever reason, users didn’t know to enter them. Moving forward, Medtronic will look into making their pump menus more user-friendly and updating the educational materials that come with the box to be more clear. It’s a good reminder that whatever pump you use, keep track of the programming – we take photos of my son’s pump settings with his phone and back the photos up periodically.
https://diatribe.org/medtronic-issues-urgent-basal-insulin-reminder-pump-users?utm_source=facebook&utm_medium=organic&fbclid=IwAR0Gsn8KugMTcuzvFKXL7xfZeUgSeHJ9BZzqi7lL38bpuG1qyFrp59i3ooE
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Big ruling in favor of kids with diabetes and other disabilities.. federal court has found that New Yrok City’s Department of Education routinely denies students with diabetes access to field trips and bus transportation. Three sets of parents of T1D kids and the American Diabetes Association sued the district after no care was provided for students on field trips and that the policy of “we’ll call 911” was insufficient for bus riders. The court has ordered the district to train bus drivers and attendants in the use of glucagon and will hire nurses to help on field trips. Many states don’t mandate nurses on fields trips, just trained staff, but NYC does and that made it very difficult for them to follow their own rules. Worth noting, these parents did not seek monetary damages, but filed the suit with the hope of policy change.
https://www.diabetes.org/newsroom/press-releases/2022/federal-court-rules-children-with-diabetes-in-nyc-denied-equal-access-to-field-trips-bus-transportation
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For the second year in a row, in 2021 - more than 100,000 Americans died from diabetes. The story, as reported, is that now Congress should overhaul diabetes care and prevention, promoting consumption of healthier foods, ensuring paid maternity leave, put taxes on sugary drinks and expand access to affordable housing, among other areas. But – and this is just my opinion – they could also tackle the price of insulin and other diabetes medications and supplies. That’s mentioned in this report, but well down the list and isn’t what most of the headlines have picked up on. About 37 million Americans, or 11% of the population, have diabetes, and one in three Americans will develop it in their lifetime if current trends continue, according to the commission.
https://www.reuters.com/world/us/exclusive-us-diabetes-deaths-top-100000-second-straight-year-federal-panel-urges-2022-01-31/
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Another chance for teplizumab. The FDA says Provention Bio can resubmit its application for this therapy to delay type 1 diabetes. The drug has been on hold since the agency questioned whether the planned commercial product was comparable to the product used in clinical trials. The resubmission should be ready to go “in the first quarter," the company said. Teplizumab was granted a breakthrough-therapy designation by the FDA but was rejected last year.
https://www.fiercebiotech.com/biotech/provention-s-med-for-delaying-diabetes-granted-go-ahead-for-fda-resubmission
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Michigan’s attorney general is taking a close look at Eli Lilly, accusing the drugmaker of charging excessive prices for insulin. She’s asked a judge to authorize a probe under the state consumer protection law, including the use of subpoenas to get records and to interview company officials. Michigan supreme court rulings have prevented this kind of investigation before.. the attorney general says those decisions were wrongly decided and “have served to end many consumer cases, and have prevented countless others from ever beginning.”
https://www.usnews.com/news/best-states/michigan/articles/2022-01-26/michigan-ag-seeks-to-probe-eli-lilly-for-high-insulin-prices
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North Carolina law goes into effect this week that allows pharmacists to dispense emergency glucagon without a prescription. There’s not a lot of detail on this – I’ve reached out to local pharmacists and they didn’t know about it. My question is.. which glucagon do they mean? The old red box one or the newer Baqsimi or Gvoke Hypopen? My guess is that whichever, the no prescription may mean paying completely out of pocket.. but I’ll find out. Interestingly this was part of a bill that also makes birth control available in NC without a prescription which I’d think would be bigger news.
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A couple of weeks ago, Dr. Heather Walker was a guest on the podcast.. she is the author of (Un)doing Diabetes: Representation, Disability, Culture… and that book is now available for purchase! As we explained during the episode.. this book explores popular media representations of diabetes.. everything from TV, movies, theater, fiction, fanfiction, fashion and more. It’s meant for academia but you can get it on Amazon.. and I’ll link it up.
https://www.amazon.com/doing-Diabetes-Representation-Disability-Palgrave-ebook/dp/B09QYGLB3S/ref=sr_1_2?crid=Y4JJCSJ18KAQ&keywords=%28un%29doing+diabetes&qid=1643724695&s=digital-text&sprefix=undoing+diabetes%2Cdigital-text%2C72&sr=1-2
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As I mentioned, our long format episode this week is with the folks at Insulet, makers of the omnipod. When that device was approved it bumped out the episode I had scheduled so next week we’re talking about what it’s like when type 1 is just one of the auto immune conditions you live with.. and the other one makes it very difficult to get a COVID vaccine.
Listen wherever you get your podcasts
That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
The US FDA has approved Insulet’s Omnipod 5 Automated Insulin Delivery System. This system was submitted more than a year ago but has been delayed due to COVID 19. Stacey talks to Dr. Trang Ly, Senior Vice President & Medical Director at Insulet Corporation who explains what makes this system different from the other AID systems on the market, what phone control means, what the roll out will look like, insurance issues, Medicare and more.
DiabetesMine's write up of Omnipod 5
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
Sign up for our newsletter here
-----
Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners!
-----
Episode Transcription Below (or coming soon!)
Please visit our Sponsors & Partners - they help make the show possible!
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Stacey Simms 0:00
Diabetes Connections is brought to you by Dexcom. Take control of your diabetes and live life to the fullest with Dexcom and by Club 1921 Where Diabetes Connections are made.
This is Diabetes Connections with Stacey Simms.
This week, the US FDA approves Insulet’s Omnipod 5 automated insulin delivery system. This was submitted more than a year ago but has been delayed due to COVID 19. Let's hope this approval signals at least the beginning of the end of that logjam at the FDA.
Welcome to another week of the show. I am always so glad to have you here I am your host, Stacey Simms, and we aim to educate and inspire about diabetes with a focus on people who use insulin. If you are new to the show, my son was diagnosed with type one right before he turned two back in 2006. He is now 17. My husband lives with type two diabetes. I do not have any kind of diabetes. I have background in broadcasting. And that is how you get the podcast. And for this episode, I am so excited to speak to Dr. Trang Ly, Senior Vice President and medical director at Insulet Corporation. Insulet, of course, makers of the Omnipod. I asked for questions within our Facebook group. It's Diabetes Connections, the group and boy to do come through. But because Dr. Ly is part of the medical side of Insulet, I'm sure you understand there are some questions she just can't answer she it's not her realm of expertise. But I promise we will follow up in the weeks and months to come. And I will do a deep dive into what is such a huge story for our community. I am always so excited to see more choice for people with diabetes and automated insulin delivery is a game changer.
Let's go through the basics. Because while many of you just want to get to “when can I get this in my hands. And I've used this product for years. And it's basic forms, I just want to get the loop..” Let me just take a quick second and set the table because there are a lot of people new to pumping and to pods. And I just want to be absolutely clear. And this is going to be very simplistic Dr. Ly we'll get into many more details. But the pod is what sits on the body. That's what holds the insulin and infuses the insulin into the body. There are no buttons, there's no display, there is a separate handheld controller. This could be a phone, we will talk about that. And that is how you control the pod when it comes to giving insulin for meals, you still must give insulin for meals with this system. With Omnipod 5, you also have the Dexcom G6 that is the continuous glucose monitor. The pod and the CGM work together, it very simplistically gives you more or less insulin to try to keep you in range.
There are similar systems on the market already. The Medtronic 670 was the first like this in the United States. Now they have their 770 G system. Tandem has the control IQ system. For the record. That is what my son has used since January of 2020. And Omnipod system is a little different on these systems all have differences from one another. But as you'll hear the Omnipod system is the first in the US that will actually learn from you. And we'll talk about what that means Omnipod 5 is going to launch through the pharmacy channel just like previous products and will still have no contract. And they are offering what they're calling a limited market release. So this is not going to be available tomorrow to most people Insulet has a Frequently Asked Questions section on their website that I got to say it is one of the most robust I have ever seen in my 15 years of diabetes. So please go there. If you don't hear your question answered by Dr. Ly. I'm going to link it up at diabetes connections.com There will be a link in the show notes.
And as I said, we're going to be covering this a lot more this year. And make sure you tune in every week I do a short newscast episode. We do that every Wednesday live at 430 on Facebook and YouTube. And then I turn that into an audio podcast which comes out on Friday. Those are five or six minutes long, and I'm sure we're gonna have Omnipod updates there. Okay, usual disclaimer, this podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
Dr. Trang Ly, welcome back. And congratulations.
Dr. Trang Ly 4:28
Thank you, Stacey. I'm super excited to be here with you.
Stacey Simms 4:31
I feel like we should have a confetti cannon that started this episode.
Dr. Trang Ly 4:36
Just Oh, it's been incredible few days.
Stacey Simms 4:39
I'd like to talk a little bit later, perhaps about more of your personal feelings. You've been involved in this for so long. And when we spoke in August, you were really generous about sharing some more of your experiences, but I know everyone who's listening wants to get into the nuts and bolts. So let's start by just jumping right in. Tell me what was approved by the US FDA. Let's talk about what Omnipod five is.
Dr. Trang Ly 5:02
Yeah, so Omnipod five is our tubeless automated insulin delivery system that we've been working on for quite some time, and that the whole entire community is excited about. I'll talk about it in terms of the components of the system. So we have the tubeless pod that many people will know and love today. And that essentially stays the same that has added features. So it has the smart adjust technology, which is our algorithm inside the pod, and that delivers insulin every five minutes and can increase decrease or pause insulin delivery based upon the CGM value, so the sensor glucose value, so we are connected to a very important part of the system, which is the Dexcom G6 sensor, great sensor accurate. And that is connected wirelessly to the pod, the person wears the pod and the CGM. And they can have on body closed loop control. Another key component is our controller device. So every person who is prescribed Omnipod 5 will have access to our Insulet provided controller, which is basically the remote controller for the system. And on that is our Omnipod 5 app, where they're able to control their pod and do all their settings for the algorithm. And what is really quite unique about what got cleared and announced on Friday is that patients will also have the option to control their pods from compatible smartphones. And so that is really quite a unique advancement in technology in diabetes, for automated insulin delivery systems. You don't have to use the smartphone to control the pods, but that optionality is there for compatible smartphones. So that would in certain cases, replace the need to carry the Insulet provided controller?
Stacey Simms 7:13
Yeah, we'll definitely talk about the smartphone aspect. As you said, this is a first in many ways. So I want to talk about that in more detail a little bit later on. And another component of the system then is the Dexcom G6.
Dr. Trang Ly 7:25
That's right. And I think what is unique about this is that you'll be able to control the G6 from the G6 app. So all of that start stop sensor, all the calibration, all of that, and the Dexcom follow all that functionality that people are familiar with today stays the same in the Omnipod 5 system.
Stacey Simms 7:49
Okay, we know I needed to clear that up. Because you started off by saying you control it from the G6 app, do you control it from the Omnipod 5 app?
Dr. Trang Ly 7:56
No, you actually control it from the G6. Yeah, that is slightly different to other systems that are on the market, the G6 sensor is stopped and stopped through the G6 app. And then you have the functionality of the Dexcom follow with our system with Omnipod. Five, when you set it up, you enter in the transmitter ID for the Dexcom. And what that allows the Omnipod 5 system to do is connect to that transmitter and display that information front and center of the Omnipod 5 system.
Stacey Simms 8:37
You know, it's funny, I'm sure as we're talking, we're gonna get into a lot of the weeds here because they went straight into the weeds. And I know that we'll talk a lot more as this year goes on. And there's more and more people use the system. But I do want to kind of try to stick to some of the nuts and bolts. Yeah, I'll catch myself here. It's definitely it's not you, it's me as we're going through this. Let's talk about how the system tries to keep people in range, because one of the things that many in my audience are watching very closely are the customizable targets. So you can take Omnipod 5 and customize your glucose target from 110 to 150. Is that still the case that that's what was approved?
Dr. Trang Ly 9:14
Yes, that's correct. That was what was approved. So you can set up see during the day, you want to be at 120. And then overnight, you want to be 110, you can set up a profile that would reflect that, you know, if you're someone who is new to AI, D and you generally tend to run a little bit higher, you don't want to be at 110 straightaway and you want to you know, run at 130. For a while you can set that profile, you can set that 24 hour profile with glucose targets. And that is a unique feature of our system. And that's what was tested in our clinical trials and we're really pleased to be able to offer this level of customization for our patients.
Stacey Simms 9:57
Tell me a little bit more about smart adjust, my listeners And I almost hesitate to ask this. But my listeners are incredibly in tuned to their devices. They have already taken so many of these devices and tried to customize them as much as possible. Many people are trying to adjust their glucose many times an hour. I wonder sometimes about the the adjustment, and no, no pun intended with smart adjust. But the adjustment of people who you kind of need to leave these systems alone, I guess is what I'm trying to get at Have you already come up against that? Or is there any advice you tell people to kind of like ease into the system like this when they're used to making a ton of adjustments themselves?
Dr. Trang Ly 10:34
Yeah, I do think there is some adjustment that needs to be made when adapting to an automated insulin delivery system. But I think a lot of your listeners will be fairly familiar with this type of technology. And really, it is the ability for the system to react to the CGM that's coming in and dynamically adjust insulin every five minutes. I mean, that is what is really the value here in within our system. So smart adjust is our algorithm. And the feature that is really going to set Omnipod 5, apart from the other systems out there. And it is what we tested in our clinical trials, which, as I mentioned, you on our last poll, you know really had extraordinary results in terms of timing range, a one seat reduction, and then that hyperglycemia profile, which was very low hypoglycemia. So I'm really proud of the system that we have built, it is something that we, you know, made improved upon, over the years through our clinical trials. And it was really developed from learning from our patients and all of the of the participants who took part in in our trial. So it really is a real love letter to the community who have advocated so hard for this level of innovation.
Stacey Simms 12:00
One of the very unique things about Omnipod 5 is that in reading about it, you always say it learns the user, right? It kind of changes as it goes in, it adapts which is brand new, this is not something that any of the other automated systems on the market commercial systems do. Can you explain what that means? Yes.
Dr. Trang Ly 12:18
What about design philosophies going into this is simplicity for the user. We know diabetes is an incredibly burdensome condition. And it was important for us that we did not, you know, through delivering automated insulin that we didn't make life even more challenging for people and requiring more attention. We really wanted to create more headspace for people to forget about their diabetes and do other things. Omnipod 5 is a real advance on that front. What we talk about in terms of learning and adapting is that our system initially takes the basal rates that are entered by the system as a starting point for the automatic controller, and then the algorithm as more information comes in, which includes the CGM values, and then the total insulin that is delivered by the system. Based upon that information, the algorithm will augment how much insulin the patient needs at baseline, and then with hyperglycemia, and hypoglycemia as well. Perhaps the most stark example of this was when we had a adult patient who came in who had relatively high A1C, starting point, so probably was not getting as much insulin as she needed. And so had a starting insulin program of around 27 units a day. And then over time, it was about two weeks where the insulin delivered by the system actually ramped up to close to 70 units a day. And that's just in basal insulin
Stacey Simms 14:03
from 27 to 70. Seven Zero. That's correct. Wow.
Dr. Trang Ly 14:07
Yeah. And so that that's a fairly extreme example. But what it shows is the capability of the system to take in new information and make adjustments along the way. And the whole point of that is really to reduce the work that people and parents have to make in terms of, you know, tweaking those basal rates, because, you know, we want to add a system that would reduce that type of burden for these. We're doing as much as we can for our users in this first system. But there will still be the ability for, for users to augment the insulin to carb ratio and correction factor. That all works exactly the same. So if your insulin sensitivity changes over time, you may need to make those adjustments, but the ability for the algorithm to adjust that baseline insulin delivery that day Damage Control does adapt based on new information coming in over time.
Stacey Simms 15:04
I said, Wow. And I want to be very clear on why I am. So I want to stand remember the confetti cannon, I said at the beginning, I want to fire it again. I, I fought I mean, I can only speak to my personal experience. I'm not a health care provider, I'm not an endocrinologist. But I talk to so many parents who feel like their kids aren't doing what they're supposed to be doing, quote, unquote. And then the doctor says, Oh, my gosh, you have to double the basal rates. And suddenly, it's working again, because things can change so much. And we don't know exactly. I can just think of my family as an example, when Benny was a tween to teenager, his basal rate doubled within two years, and then doubled again. And he was getting these incredible amounts of insulin. And when I would tell my friends, a few of them would say like, I could never do that, that sounds so dangerous. I can't believe how much he's getting. And I mean, I've shared he was getting 80 units of basal a day of just basal. And he's back down. It's not it's not even close to that anymore. But he needed it. And I just feel like, gosh, I was gonna ask you to give an example. And I'm so glad you gave that one. Because to know that the system can learn that much and safely give that big of a change is remarkable. I'm curious, did you have any changes in the other direction, like people who were really worried about people who were really experiencing? hyperglycemia?
Dr. Trang Ly 16:23
Yeah, Stacey, going down is easy. Going up is hard. It's, you know, and I'll tell you, it takes some courage to do these types of things. And people are scared, and I will share that I was scared in making, you know, some of these decisions. But, you know, I have learned so much from patients, I've taken care of teenage boys, like your soul, you know, who, who need more than 100 units a day who fluctuate between 70 and 120 units a day in a week. And that's what we need to be doing is helping people like that, you know, who who really struggle and have different insulin sensitive Rudy's on a daily basis and different requirements who are at risk of both hyperglycemia and hypo. And honestly, I carry that with me every day, you know, all those learnings and say, you know, we have to create products that can, you know, address this, because this is what we're trying to help here
Stacey Simms 17:39
right back to Dr. Ly, in just a moment, but first Diabetes Connections is brought to you by Dexcom. If you're a veteran, the Dexcom G6 continuous glucose monitoring system is now available at Veterans Affairs, VA pharmacies in the United States, qualified veterans with type one and type two diabetes may be covered. Picking your Dexcom supplies up at the pharmacy may save you a lot of time to connect with your doctor for more information. Dexcom even has a discussion guide you can bring with you get that guide and find out more about eligibility. Here's the link, I'm going to put this in the show notes, it'll be easy to find it's dexcom.com backslash veterans. But if you don't want to write that down again, it'll be in our show notes at diabetes connections.com. And now back to our conversation with Dr. Trang Ly.
This next question may not make sense with the system. But you tell me, I wanted to know about the percentage of correction bolus that Omnipod 5 gives. And you know, my frame of reference is the Tandem control IQ which my son has used, which the system adjusts basal, if you get close to 160, it gives you a partial bolus if you get close to 180. Is there anything like that going on here?
Dr. Trang Ly 18:51
Yeah, for sure. And what I'd say is that rather than having that modular approach that the other system has, you know, als really has that dynamic insulin delivery every five minutes. And it's pretty straightforward. Basically, whatever target you said, the system is always driving towards that target. So, you know, you can be 110 all day and do that. And, you know, when we did our clinical study, the adult and adolescent population, so this is the 14 and older age group, the target that they used most frequently was the 110 target. And in those patients during the time that they were using that lowest target of 110, they were able to achieve 76% time in range, really great to be able to do that. And so I would say it's basically that straightforward. Whatever target you set the insulin, we're going to adjust insulin to try and get you there as quickly and as safely as possible.
Stacey Simms 19:55
If I'm hearing correctly, though, maybe with this system, we don't think about it as Adjusting basal giving a bolus. It's more, there's an algorithm in here. And it's proprietary. But there's an algorithm in here, and it's just giving insulin as needed. Is that what I'm hearing?
Dr. Trang Ly 20:11
That's right. It is a hybrid closed loop systems that people are still expected to bolus for meals. Right. So that's really important for people to do. And you know, to in order to really get good glucose control, it's important that people premium bolus and work with their healthcare providers to really optimize that insulin to carb ratio and correction factor that yes, our pancreas don't think in terms of basal and correction, those are concepts that we made up, you know, as I tell my team insulin is insulin, you know, it's basal correction, whatever, it's really, you know, how much insulin on board there is, what the trajectory is, and you just make the adjustment accordingly. So, yeah, I don't really separate it
Stacey Simms 20:57
out. new way of thinking really interesting. Again, I'm going to get us off topic here. But I am thinking of the people who've never pumped before and jumping into a system like this, and how much different that must be.
Dr. Trang Ly 21:08
Yeah, we always think about those patients, because we think pump therapy is just a much better therapy in terms of the physiology of insulin delivery, and it's just a much safer, and modality there. So, you know, actually, in our clinical trial, we had about 15% of our users who were on multiple daily injections. So they came in, and we put them straight on Omnipod 5, so they didn't have to first use a pump, or first use the CGM, they just came straight in, we put them on Omnipod, five, and they did really, really well. And we've presented that data at various conferences. So they really did, ultimately, just as well as the people who had previously been pumpers, it is very simple and easy to use. And that really, the simplicity of our system is what makes it so great. And it really reduces that burden of you know, having to pull out pens and syringes when you're out and about and, and be able to discreetly deliver insulin from a phone device. I think, really, that is what sets our system apart from other systems is it's the simplicity and ease of use.
Stacey Simms 22:23
I'm gonna give you a couple of specific questions from our listeners, if you can't answer that. We understand. And I actually have worked in a bunch of questions already. As you listen, I'm getting to as many as I can. But one came up that I thought was interesting, which was, is the system robust enough to defeat a 350 blood sugar on its own, you know, I think everybody's been there. They forget to bolus they're eating a big meal, they realize it too late. And then with these automated systems, you have to be very careful about how much you correct. And then there's a second part of this question, which is, if I do want to give an additional shot for any reason, will the system keep track of something like that?
Dr. Trang Ly 22:58
I guess it depends on why your 350 in the first place. So if it's from food and underestimation of carbs, or you forgot to bolus then I will tell you that by the time you are 350, the algorithm has already known that and it has already delivered a bunch of insulin to bring you down, it will bring you down and it will generally do that in two to three hours and get you within range below 180. Within that time. And we know that because the development of Omnipod 5, we specifically gave people these large meals and didn't bolus for them and watch the algorithm and see what it would do. And, and part of the reason why that's so important is because we know this happens to people all the time, and we want to safely bring them down, but not cause rebound hypoglycemia, because that is not good. And people will not trust the system and will stop using it. So that is exactly the type of testing that we do. So I would say that it is very robust and is very specifically targeted for that in terms of the question of if you give a shot not through the pump, then no, the system would not know about that. But what it will detect is, you know, a falling blood glucose level, and it will be able to suspend insulin delivery very quickly. And depending on the rate of change of glucose, it could suspend, you know, even if it's in the two hundreds, it could suspend very quickly. And as far as I'm aware, actually, none of the commercial systems are able to import that information. So you would have to do that very cautiously because the system isn't aware of that external insulin.
Stacey Simms 24:51
It's an interesting question. You know, we've we've done that, you know, sometimes there will be a bad infusion set or things will happen. I mean, obviously the pod it's a little different and you'll want to give them Manual injection. I understand what you're saying. And I think it was, it was a good question, but it's practically speaking, we're not gonna be able to do every circumstance.
Dr. Trang Ly 25:07
That's right. Yeah. Unless we had like this really special insulin detector.
Stacey Simms 25:16
Why don't we have that yet? Special insulin detector get on that?
Dr. Trang Ly 25:21
Well, you know, well, technically, it's very hard to do insulin assays. So, yeah, anyway.
Stacey Simms 25:28
I guess, you know, in layman's terms, what I what I think of a lot is, okay, if my son needs to give an injection, can he just put in Okay, pump. I gave myself this much. Because with the older non smart pumps, or before there were any hyper close loops, you really could do that. You could kind of fake a dose.
Dr. Trang Ly 25:44
Yeah, you can't with our system. Yeah. Yeah.
Stacey Simms 25:50
I don't think you can do that with any of the automated systems. Now, another quick question, before we move on to smartphone, can you extend a bolus, this was something that came up, can you still do that, or if you can't do you even need to, you can
Dr. Trang Ly 26:02
if you're in manual mode. So manual mode is basically on the pod Dash. And that is when you set it up with the settings that, you know, you discuss with your healthcare provider, and they preset basals and bolus settings. So if you're running that mode, or if you happen to, you know, not have a CGM and you don't want to run an automated mode, then you will have that functionality to have extended bolus. And there are a number of reasons. But we actually looked at this in a clinical trial that we did specifically looking at high fat meals and using extended bolus with our algorithm versus just letting the algorithm work. And what the results showed was that with high fat meals, the algorithm was better in terms of figuring out how much insulin you needed, then a person trying to figure out okay, how much do I give up for and how much do I extend? And because of that data, we decided not to include the extended bolus with our algorithm. side. So in automated mode, extended bolus does not work.
Stacey Simms 27:17
Great. And, and you lead me then into the next point, which is, can you expLyn the manual mode? This is not something that the system decides you're in, right? This is the user saying, okay, I'd like to be in manual mode or no, I'm going to be in auto mode. In other words, you can't get kicked out like on the Medtronic system.
Dr. Trang Ly 27:31
Exactly. So the manual mode, as I mentioned, is all the preset settings that are programmed into the system. And then automated mode is when you have a CGM connected to it. And as long as you have CGM transmitter ID entered you are and you know, your targets set up, you can off you go. And so the setup of the system is very similar to Omnipod dash, except there is an additional step where you enter in the transmitter ID so that the pod knows which CGM to search for. And then once that value comes in, and in fact, you don't actually have to wait for that value to come in, you can just start automated mode, and then the system will use the information that it has to augment insulin delivery. Got it?
Stacey Simms 28:25
Let's talk about the phone. Because I think this is incredibly significant. It's a first for the FDA, it's just going to open the door in my opinion to so much other technology. Yes, right. Now, as you and I were talking, there's only two smartphone models that works with that's gonna change. But let's go down and talk about these features. This is full control allowed from a smartphone, right?
Dr. Trang Ly 28:44
Yeah, I was so excited about this feature. I mean, see, it's the number one feature that our patients ask for over ad over automated insulin delivery, which kind of really blows my mind. I will I
Stacey Simms 28:57
was, you know, I've shared with you, I was gonna say I'm actually a little bit more excited about this. And I, I kind of ended high because automated control is so is so incredible. But phone control is also I mean, my son is he cannot wait for this. It's just, we don't even again, we don't use your system. But yeah, wait, it's just such a great thing. So before I start getting all crazy, let's go through some of the features full control from the phone.
Dr. Trang Ly 29:21
Yeah, and I want to say that, you know, as a pediatric endocrinologist, I totally under appreciated the how our patients valued having phone control, and being able to control their devices from their phone. And it wasn't really until I saw the data that where everybody might have this is their number one request that I was like, huh, we better start listening to patients. Because in my mind, you know, if people aren't using their devices, they're not getting any benefit from automated insulin delivery. So it's really important that we address all the pain points. For our patients, I am really proud of the team for getting this through and getting this clear, it is just so meaningful for our patients, I think it's really important to clarify that if we don't have the phones that we currently have available, it doesn't mean you can't use a ID, that you can't use Omnipod 5, you know, our system will always come with an Insulet provided controller, and you know, you can use it as a separate device. But you know, very, very quickly, we're going to have many phones available where you can download an app, it's as simple as that it, it works on your phone, just like any other app, you open it up, and you input your settings, just like you would setting up a brand new controller, and then you start and stop your pods and manage everything just from your phone, and then you're getting rid of that controller device, you know, you're carrying fewer devices. That's what it is. And you know, in future, we will have iOS and Apple devices in future. We haven't set a timing for that. But you know, all of that is in the works. Because, you know, we care a lot about reducing the friction for people to use and access Apple devices. So I'm very excited about it. All right,
Stacey Simms 31:21
I know you can't give me a timeline. But you said very quickly is very quickly this year for Android and next year for Omnipod is very quickly quarter two for Android and end of this year for kind of get any timeline for
Dr. Trang Ly 31:34
I know, I can't provide any timelines. But you know, the team's working on it. And you know, I get to see the prototypes, and I get to test things out. So it's super fun for me, but I am sorry, I can't provide any time timeline
Stacey Simms 31:47
updates. You know, one of the big questions that came up Omnipod, five is going to come out with limited release. What does that actually mean? And how do you decide who gets it first? And who gets it next? Is it geography? Is it when people signed up? How does it work?
Dr. Trang Ly 32:01
I know everyone is super excited about Omnipod. Five, and especially us as a company, I think it's really best practice before we do anything big in life to start small and make sure that you know everything, all systems are working. And you know, we are doing a lot of innovation actually, not just with the product, but also the way we serve patients in terms of our onboarding platform, our self guided training, ordering, product support all of that. So it's quite a large undertaking for our company. So what we're doing here is making sure that everything goes well and, and is smooth for our users before we embark on the full launch. So right now, just in the next few days, we'll be rolling out our limited market release. And then once we have all the information we need, and all the data to make sure that we can handle all the demand that comes in will be then announcing our full locker release. And we expect that to be in terms of timely, just shortly after the limited. Release is complete.
Stacey Simms 33:10
Okay, but I have to ask a follow up on that. But to be clear, then it's a limited release for the people you've decided we'll get it. Yes. And then it goes to everybody. So it's not going to be a rolling limited release? No, it's a so then my next question is the first question. How did you decide the limited release? Who are these people,
Dr. Trang Ly 33:29
we haven't provided details about that. And part of it is really to make sure that we have, as I mentioned, you know, really assessed our full systems and making sure that, you know, we can address the demand that will be coming in. So I think what people what our patients really need to know is, you know, how did they get on products? That's certainly the number one question that I'm getting is, how do I go on Omnipod? Five? And how do I prescribe it? So you know, for that, I would say that today, you know, getting on Omnipod dash is the fastest way to get Omnipod 5, because for those users, that means that they are most likely have access through the pharmacy channel. And then we expect that our Omnipod 5 coverage will be very similar to our Omnipod dash coverage. So if you're already on the dash, it's expected that you know once Omnipod 5 is available and there is insurance coverage which you know, we're ramping and growing every day then that transition should be very very smooth. And also you know in terms of devices you know, if you're already on and only Pradesh and you're on a G6 you can go through our self guided training and so you know already being familiar with our system and devices that makes it a lot easier in terms of training and transition but also it in enables you to get onto our interest list for Omnipod. Five. And what we'll be doing once it's fully available is really going through that list in in order of people's names on it to make sure that they have coverage and getting them Omnipod. Five as quickly as possible. We're really committed to our current dash users. I mean, all of our new pod users were fully committed to
Stacey Simms 35:23
do people need a new prescription to move from Dash to Omnipod 5?
Dr. Trang Ly 35:27
yes, it's a different product, it's an entirely different product. So yes, they will need a new prescription. Okay,
Stacey Simms 35:33
because that was one of the interesting things with when Tandem rolled out control IQ. Sometimes as you listen, you know, you got to get in touch with your endocrinologist once once it starts rolling out. Right. That's one piece of the puzzle we have to make sure to include, um, you mentioned Dexcom, questions came up Dexcom G7, knock on wood could be approved in the United States this year? What will that change over look like when it goes from G6 to G7 for Omnipod 5?
Dr. Trang Ly 35:57
Yeah, so were working on next in terms of integration of the physical integration with G seven. We're working on that and future sensors. So we haven't announced any timing in terms of when Omnipod 5 would be available with G seven. That is something that we're working on. Even if G seven gets cleared this year. We certainly haven't announced any thing in terms of Omnipod 5 compatibility with that, at this point in time
Stacey Simms 36:29
about Medicare, it is the Medicare coverage expected to be seamless, and supplies seamless for that population. Yeah,
Dr. Trang Ly 36:36
so in that population, you know, we have fairly good coverage for that. And again, growing and as well, and Omnipod dash is available through the pharmacy channel. And as I mentioned, we have great coverage. And already today with Omnipod. Five, we actually have more covered lives right now than we had even just, you know, a few months after Dash was launched. So the team has, you know, our team has made extraordinary progress on that front to ensure that you know, when we're at for release, our patients can get access to that as quickly as possible.
Stacey Simms 37:19
And I should ask the clinical trials where ages six to 70, while the lower limit is something that you have talked to your endocrinologist about people over the age of 70 can still use this device, right?
Dr. Trang Ly 37:30
correct way, clade full six and over no problems for our 70 plus population.
Stacey Simms 37:36
Excellent. What about the rest of the world? The question was, has it been submitted for CE marking Europe, my friends in Australia, your friends in Australia are like what's going on?
Dr. Trang Ly 37:45
I know I I'm like really behind in my emails. Because everyone in Australia wants it, it's gonna come, we have to get it cleared. And you know, our first hurdle was getting across the line in the US. So you know, I'm just super, super excited to get it. And it means we have a great product and you know, our clinical trials prove it. And in time, it will get to all of those places.
Stacey Simms 38:16
I know have kept you longer. I have two more quick questions for you. The second last here is will Omnipod and Dexcom work together on the customer service side now that you are linked as a system? Will customers be able to work with both? If you're not familiar, as you listen with Tandem? Sometimes you call Dexcom? Sometimes you call Tandem. When you have issues. The Tandem can send you replacement sensors, things like that. It's not it's not a seamless partnership. They want help with everything. But I'm curious if Omnipod and Dexcom will start working together in that way.
Dr. Trang Ly 38:47
Yeah, we have. We've been working together for years, in fact, to get this right, because we care a lot about customer service and taking care of our patients. So the teams have been working together very, very closely to make sure that there is warm transfer between both companies for our patients. And that means you know, whatever we can address we address and whatever Dexcom addresses they'll be addressing. Yeah, so as you point out, it is different to some other models that are out there, in that these are really two separate devices. And that means that we're not handling Insulet is not handling any of the sensor orders. But we're just really focusing on on the pod. And I think what that allows us to do is you know, allows each company to do what we're really good at and not like try and figure out how to be dispensers of sensors, that allows us to really scale and move quickly in this space. And again, it's a different type of way to serve customers. But at the end of the day, we don't want to be wasting our time. It's time over these things because they got better things to
Stacey Simms 40:03
do. I meant to ask when we talked about the phone control, and the phone display is a follow feature going to be part of Omnipod 5? So caregivers, spouses can look, yes, we
Dr. Trang Ly 40:13
already have that today with Omnipod View app with the Omnipod dash. So, you know, that's really great and really great, especially for our pediatric population. So that capability already exists today. And we will be providing that later in the year.
Stacey Simms 40:30
And then before I let you go, you and I've talked several times during this interview, and when we last spoke about how you have worked with patients for a very long time, you've seen the burden that diabetes puts on people and how systems like this can start to alleviate some of that. I can't imagine that you've had that much time to reflect it just got approved last week. But you know, how are you feeling about this going forward? It's a combination of so many people's work over the last several years. I mean, I guess what I'm saying is, take a second take a victory lap.
Dr. Trang Ly 41:02
Yeah. See, it's been a pretty emotional week for me to be able to bring this to fruition, I think I really carry the spirit of many of my patients, you know, those types of interactions just never leave you. And just a lot of gratitude this week for what we'll be able to do for a lot of families. I love
Stacey Simms 41:28
it. I'd love to have you come back on or maybe when the system has been out for a while we can talk to some folks who've been using it and and kind of dig a little bit more into how it's helping. But thank you so much for being so accessible for answering so many of my questions and congratulations, I it's I know it's been a long time coming. And I'm so excited for my friends who use Omnipod to have this new choice. Thank you so much.
Thanks, Stacey.
You're listening to Diabetes Connections with Stacey Simms.
More information about this I know you probably still have questions, go to diabetes connections.com for a couple of links, including that frequently asked questions section, it really is very robust, and can answer a lot of what Dr. Ly was unable to get to. It's so exciting. Boy, I know. You know, we're not Podder's, we have not used the Omnipod. But oh my gosh, I know the community has been waiting so long for this. I'm so thrilled for more people to get an automated insulin delivery system, it has made a huge difference with my son. And I can't wait to hear what you all think I know some of you. And some of the people in our Facebook group were in the clinical trials. I don't know how much you all can talk about that. But if you want to post about it, if you'd like to tell me more, you can shoot me an email Stacey at diabetes connections.com. I'm just so excited.
Two quick things before I let you go. First, at the top of the show, I briefly mentioned Club 1921. This is our brand new project, it is still in beta. And it is where anyone with any type of diabetes can find events anywhere in the United States. If you have diabetes, or you love someone who does, you are already a member of club in 1921. If you go to the website, club 1920 one.com, you will find that it's very easy to sign up for free. And we will send you the events you're interested in, you never have to come back to the website, you just click a couple of boxes, tell us what you're interested in. And we will send you the events. If you'd like to list events, you can also sign up and this is for everything from big conferences, to educational events at hospitals, to you know, a Hangout moms at a playground, going for coffee, whatever you want for the diabetes community, any type of diabetes, any type of event anywhere in the United States. As I said, we're still in beta, I'd love for you to sign up and let me know what you think. And if you haven't already guessed why Club 1921 I'm sure most of you have guessed that is the year that Banting. And best and the rest of their team are credited with the discovery of insulin.
The second thing I want to address is it's a little selfish, but I want to share the Omnipod story, this kind of breaking news. This kind of stuff is why I started the podcast. Many of you have heard the story before. But if you are new, I started the podcast in 2015. Because there were and there still are a lot of really good diabetes podcasts out there. But most of them were people telling their personal stories. And that's great. And they were mostly adults. And you know, as a parent of a young child at the time with type one I could relate but it wasn't exactly for me. But more to the point. There was nobody doing diabetes news and that's my background. I was a local TV reporter and Radio News host for my entire career for 25 years plus, and I had just left a career in morning radio because I was so tired to get up at three o'clock in the morning. That's I'm sure you can imagine I did that for 13 years. And I was trying to figure out what to do next. And I realized that There was no one covering diabetes news. And it's not just saying, Oh Omnipod 5 is approved. It's asking the questions that you just heard. I mean, I guess it kind of sounds kind of braggy to talk about this. But to be frank, as the parent of a child with type one, and as the spouse of somebody with type two, I want to know this information. I want to hear it from these companies, I want to ask follow up questions, I want to call them on it, when we have questions that they aren't answering, or we have issues that they're not addressing, whether that's a technology company, or more to the point the insulin companies and things like that.
So if you're new, I hope you go back, we have a great search box on diabetes connections.com. It's in the upper right hand corner. And there's if you click on the episode page, you can get there's more than 400 episodes, you can go through the archive, but I urge you to search for what you like whether it's technology or issues, that sort of thing. And you can really see these products, we started talking about them five or six years ago, and follow them through development, see how things have changed to me. It's so interesting. And there are very few places to get our questions answered. Your a lot of these folks will go on the financial channels and talk about the company. And I'm thrilled, as you probably know, Omnipod stock went up, I don't own Omnipod stock or Insulet stock, but it went up last week. Hurray, that's fantastic. But I care less about that than I do about knowing what they mean by you know, the system learns you, right. So thanks for giving me the opportunity to just kind of share why I find this stuff. So exciting. This is why I started the show. And I hope you enjoy listening.
if you have questions, if there's issues you want to hear more about, please let me know you can always reach me through diabetes connections.com or on social media. And boy, what do you think is next has this loosened up the logjam at the FDA are we gonna see other issues that have been waiting? We've got bullets by phone from Tandem. We've got stuff from Medtronic that's out there waiting, we got tide pool loop. Oh my gosh, I hope 2022 proves as exciting as it has started out. Please join me every Wednesday for in the news. I do that live on Facebook, YouTube, LinkedIn, and at 445 on Instagram. And then we turn that into a regular podcast episode that comes out on Fridays. That's just five or six minutes of the top news headlines in our community every week. And then on Tuesdays, I do these longer format interviews. They usually go up at four o'clock in the morning Eastern time. This was a little different if you're listening as it is first released because I did the interview with Dr. Ly today. It did it at one o'clock this afternoon. And then we turned it around and got it out as quickly as possible.
Thank you as always, speaking of those kinds of audio heroics, to my editor, John Bukenas from audio editing solutions, and thank you so much for listening. I'm Stacey Simms. I'll see you back here soon until then, be kind to yourself.
Benny 47:49
Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged
Every week “In the News…” brings you the top stories and headlines around the diabetes community. This week: a new look at access to #diabetes meds, a look at stress in parents of children with type 1, Mark Cuban's new online pharmacy is open, can worry contribute to type 2 risk factors? And Lilly gets another slap from the FDA, this time about an Instagram ad.
Join Stacey live on Facebook every Wednesday at 4:30pm EST and in Instagram at 4:45pm EST
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
Sign up for our newsletter here
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Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners!
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Episode Transcription Below (or coming soon!)
Please visit our Sponsors & Partners - they help make the show possible!
Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. If you’re new we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast.
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Looking to get organized? Check out my new guide with top tips to clear your diabetes clutter. Everything from how to start to where to donate and how to keep it from taking over your house. Head over to the home page to get organized.
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Among people with type 2, minority ethnic groups have more limited access when it comes to newer diabetes medication.. This study used data gathered from 2005 to 2019 in a large clinical trial conducted at Johns Hopkins and other sites across the U.S.
They found that compared with white patients, all minority groups were less likely to start newer diabetes medications. Black patients were 20% less likely to start newer medications, and American Indian or Alaskan Native patients, were 50% less likely. The researchers stress the findings were not driven by the patient’s income – didn’t matter how much money they made. The researchers say the next step is to look at how insurance coverage impacts which diabetes medications get prescribed.
https://medicalxpress.com/news/2022-01-minorities-diabetes-medications.html
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Billionaire Mark Cuban has opened up an online pharmacy offering prescription drugs at cheaper prices. Insulin isn’t included.. yet.. but there are some diabetes medications listed. Mark Cuban Cost Plus Drug Company says they want to – quote - "bypass middlemen and outrageous markups.” Cuban is not the first to enter the market.. it’s a highly competitive one with contenders like GoodRx
https://www.usatoday.com/story/money/2022/01/24/mark-cuban-cheaper-prescription-drugs/6636901001/
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Really good write up about the stress of parenting a child with type 1 diabetes.. and what can be done about it. This is in Endocrinology Advisor – they spoke to pediatric psychologists and endos. Familiar stories of no sleep, fear of hypos and of future complications but also some good information about how the stress changes over time and over the child’s life. Acknowledging different challenges face parents of very children compared to those of teens. Not a lot of solutions here.. but very good reading about supporting a parent’s well being as well as the child’s.
https://www.endocrinologyadvisor.com/home/topics/diabetes/type-1-diabetes/children-with-type-1-diabetes-and-parents-and-psychological-and-impact/
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Obesity is a main risk factor for developing type 2 diabetes, but it has not been previously seen as a major complication in type 1 diabetes. However, a new study shows that obesity rates in adults with type 1 diabetes are increasing and mirror the rates in the general adult population. These researchers, also at Johns Hopkins, say adults with type 1 diabetes also now have a higher risk of kidney disease than those with type 2.
https://scitechdaily.com/obesity-is-more-common-in-people-with-type-1-diabetes-than-previously-thought/
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Middle-aged men who are anxious and worry more may be at greater biological risk for developing heart disease, stroke and type 2 diabetes, also called cardiometabolic disease, as they get older. This study used a long-running research project, started in 1961 and mostly including white men. They followed different groups of men through 2015 and measured worry through questions and surveys. Higher worry levels were associated with a 10% higher likelihood of having six or more cardio-metabolic disease risk factors. These researchers say it would be important to follow up to see if these associations exist among women and people from diverse racial and ethnic groups.
https://medicalxpress.com/news/2022-01-men-heart-disease-diabetes-factors.html
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Big slap for Eli Lilly from the FDA.. they say an Instagram ad for the type 2 diabetes drug Trulicity was “misleading” and “particularly concerning.” Lilly has since deleted the post in question, but the FDA says it failed to adequately communicate the indication and limitations of use associated with Trulicity, FDA says. It was alerted to the post via complaints to its Bad Ad program. The FDA said that this isn’t the first time it’s warned Lilly on Trulicity ads.
https://endpts.com/fda-slams-eli-lillys-misleading-instagram-ad-for-its-type-2-diabetes-injection/
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MIT engineers are working on a couple of devices to streamline some of the daily diabetes tasks – this got a lot of buzz this past week but is in the very early stages. They have one device that takes a photo of your food, calculates the carbs, measures your blood glucose via a finger stick.. then calculates your insulin dose & gives the injection. That’s all in one device. The second device is all of that AND it’s set up so the blood glucose measurement and insulin delivery happen through the same needle. As I understand it this would be like giving an insulin injection through the CGM wire. We’ll see if it gets out of the lab and into clinical trials..
https://scitechdaily.com/mit-all-in-one-approach-to-diabetes-treatment-features-app-that-identifies-and-quantifies-food-content/
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Before I let you go, our long format episode this week is with Tandem Diabetes. They released an ambitious 5-year plan to add a tiny pump they’re calling Mobi and eventually move to a tubeless system. Next week we’re talking about what it’s like when type 1 is just one of the auto immune conditions you live with.. and the other one makes it very difficult to get a COVID vaccine.
Listen wherever you get your podcasts
That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
Take a deep dive into the future of Tandem Diabetes. In December, the company laid out an ambitious 5-year plan to update software, move to a smaller pump and ultimately a tubeless version. Company leaders say they want to think even bigger and we're talking to Chief Strategy Officer Elizabeth Gasser. We’ll go through the short term changes Tandem has in the pipeline like the tiny Mobi pump and talk about philosophy and more.
Tandem R&D Presentation (slides)
Tandem R&D Presentation (replay)
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
Sign up for our newsletter here
-----
Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners!
-----
Episode Transcription Below (or coming soon!)
Please visit our Sponsors & Partners - they help make the show possible!
Stacey Simms 0:00
Diabetes Connections is brought to you by Dexcom. Take control of your diabetes and live life to the fullest with Dexcom and by Club 1921 where Diabetes Connections are made.
This is Diabetes Connections with Stacey Simms.
This week, a deep dive into the future of Tandem diabetes. That company laid out an ambitious five-year plan to update software, move to a smaller pump and ultimately move to a tubeless version. company leaders say they want to think even bigger.
Elizabeth Gasser 0:37
we have thermostats that manage our home temperature for us. We have self-driving cars we have on demand consumption services that you know, help us get our groceries and plan our meals. Come on. We should demand that level of ease of use in what we're doing here as well.
Stacey Simms 0:54
That's Tandem Chief Strategy Officer Elizabeth Gasser. We’ll go through the short term changes Tandem has in the pipeline like the tiny Mobi pump, she'll answer a bunch of your questions. We'll talk about the philosophy of the company moving forward, and more. 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, I am only so glad to have you here. You know, we aim to educate and inspire about diabetes with a focus on people who use insulin. back in December Tandem made a big splash with their very first research and development presentation. If you haven't seen that, I highly recommend that it is rather long, but it's definitely worth checking out. I'll link that up in the show notes. And you can always find out more at diabetes connections.com. But in this R&D presentation, they laid out a very ambitious five-year plan for the company, which we're going to go through and talk about in detail today.
Quick date check for you This interview was taped on January 10 2022. And we're releasing it on January 25 2022. So as of right now, the FDA has not approved anything new for Tandem no Mobile bolus that is in front of the FDA, and we'll talk about that and so much more. There were a few questions I didn't have time to get to or that you sent in after the interview. So I sent those to Tandem and I will come back after the interview. I'll update you and answer what I can also after the interview, if you are a health care provider, a diabetes educator and endocrinologist if you work in those offices. And a very specific question for you. Please come back. I'll make it quick. But I need some information. And I know you will can help me. Okay.
My guest this week is Tandem Chief Strategy Officer Elizabeth Gasser she says Call me Liz. So I do. Her background isn't in diabetes, it is in strategy and corporate development, working at Qualcomm in their internet services division and at open wave systems, the world's leading Mobile browser provider at that time, and we talk about what it's like to come from that world to this one, I think it's really important to kind of get an idea for these individuals, you know who they are, who are making these decisions that affect so many of us. And of course, we go through that 10 to five year plan product by product.
Liz, welcome to Diabetes Connections. Thank you so much for joining me, we have a lot to talk about today. Thanks for being here.
Elizabeth Gasser 3:24
Oh, my pleasure. I'm excited to chat.
Stacey Simms 3:27
There are a lot of items that Tandem announced in December, there's a lot to go through there. But I wonder if we could start kind of by backing up a little bit I've heard that you Tandem is kind of talking about being less of a hardware company, right, the pump, which will always be there in some way, shape, or form. But thinking more about the software, can we step back a little bit from the products here and talk a little bit more about kind of the philosophy or the vision? Oh, happy
Elizabeth Gasser 3:53
to and if you've watched our R&D day, you'll you'll know that I do enjoy expanding on this particular topic. You know, as with any connected device, the minute you take a piece of hardware, and you give it a cellular connection or or a Wi Fi connection or a connection to the Internet, you've opened up the potential way to do an awful lot of creative things with both data but also with software, it really opens up the potential for continuous update functions and capability. And then also the ability to pull and push data back and forth from a device and and once you've done that, you you really crossed into that that world of the Internet of Things which requires you to be both an excellent hardware company, because you're managing the device, the functions of that device. It's touchpoints through connectivity, but it also requires you to be an excellent software company along the way. And if you look at the Tandem journey over the past five to seven years, you really do see the company's products moving down that pathway. Of course, the pump remains front and center for us it you know, the delivery of insulin is what we do. It's how we bring that therapy benefit to our users. But you also see a start to do things like the ability to update the pump software itself that unlocks new features and functionalities, including the algorithms which we can now continuously update, it allows us to update the different types of devices we integrate with, you'll see we've obviously moved from supporting Dexcom, G5, two, G6, and we're moving to G7. That's all done through software updates. And so it's really hard to be in this space and to be talking about connectivity and connected devices without also embracing the fact that you really are a software company and have to be incredibly good at it to deliver the value that you want to deliver to your customer base.
Stacey Simms 5:59
I do remember years ago, our first pump and I say our work has been he was to when he got it. So it was definitely it was a group effort. But it was the Animas pump. And then a few years or months who remembers after he got that there was an update, where you could bolus from the remote meter. But we had to wait until our insurance would cover until we were up for a new pump. We had to wait I think three and a half years before we could get that. And so when we switched over to Tandem, I think we had the pump for a month when we there was a software update. So it really has changed. And to your point it is it is really remarkable to see that. Let's talk about, as you mentioned, the R&D presentation and some of what's in development. And of course, the usual disclaimer, I am sure that a lot of what we're going to talk about here is in development, it is not FDA approved. So there are limitations, I'm sure about what you can and cannot speak about. And if you can't answer something we totally understand. But let's just jump on in and kind of go through a list here. My listeners are extremely interested in getting some kind of update on the bolus by phone, which is in the FDA hands. But I have to ask you about
Elizabeth Gasser 7:07
Stacey Simms 7:39
Can you share with the rollout process may be? In other words, will it be a simple update to the T Connect app? Will there be some kind of required or prescription required online patient training?
Elizabeth Gasser 7:49
Yeah, happy to and this this kind of ties to the conversation we were just having about, you know, being a software company, right? The introduction of this feature will be straightforward software updates. And so what does that mean? In practical terms, that means updating the iOS or Android Android application to the newest version, which will have the Mobile bolus capability. And at the same time, making sure you do a pump software update so that both sides of that dialogue can happen. And as part of the pumps software update, which happens through the Tandem device updater. There will be some online training, music click through to make sure that they understand the capabilities that we're introducing. And many of our users will be familiar with how you do that.
Stacey Simms 8:33
Would there be a prescription needed for that kind of feature? A
Elizabeth Gasser 8:36
Mobile bonus? Yeah, no,
Stacey Simms 8:39
this may be a silly question. But can you share any details of what Mobile bolus actually means? In other words, I visioned this as Benny will take the his phone out and have full functionality controlling the pump from the phone. Is that accurate?
Elizabeth Gasser 8:53
Yes or no, in that the primary goal of Mobile bolus is to allow for the delivery of a bolus from the phone. So in that sense, you're absolutely right, it will become for most of the day, the app will be the vehicle through which you can interact with the pump the piece, it won't do his full control of the pump. Meaning when you need to go in and look at changing settings, for example, that's not going to be in the Mobile bolus release. That's something that you don't have to do all the time, and can reasonably be done by taking the pump out and using the user interface on the device. As we get to the movie launch. Obviously, that will not have a screen. And so those control features, what we call full control will migrate into the app as well, for the movie pump.
Stacey Simms 9:46
Of course, yes, that makes perfect sense. I'm not going to let myself get too far ahead because boy do I want to ask you about but to just stay on on Mobile bolus for one one or two more questions, but with Mobile bolus are there other There are features that will be on the phone, obviously, it
Elizabeth Gasser 10:03
will marry with the app that currently exists today, right. And so that that is predominantly today, a secondary display tool allows you to see all of the things that are going on with the pump allows you to see blood glucose readings allows you to see insulin on board allows you to see the insulin delivery that you've conducted through the day. And so all of those features will remain. And the focus here really is on augmenting it with the ability to deliver a bolus from the phone. And so that sort of feels like it downplays. No. But it's incredibly, it's an incredibly exciting augmentation, and one that we think is an incredibly important first step towards that for control. Because it is the hardest use case, we have to get that absolutely right.
Stacey Simms 10:49
Will that have share and follow? Is that something that you're working on for down the line? Or is that something that may come sooner? So really
Elizabeth Gasser 10:56
good question. And we do recognize that share follow is incredibly important to our users and their families. Were continuing to look at where explicit share and follow capabilities for on our roadmap and what the best path to implementing that is, in large part because there's a diversity of CGM follow options out there, including our own Sugarmate application, which which can be used for blood glucose monitoring in a follow capacity. And so we don't have roadmap dates to share at this point in time, just know that we're sensitive to figuring out what the best possible implementation is for our customers here. And we want to make sure we're getting as much experience as we can, in the meantime, really understanding how to do good follow. And as I say, we're getting some of that through the Sugarmate app that we're operating, which actually just went live with the Dexcom real time API, right. And so there's a little complexity to thinking through what the best implementation model is. We're working on it and watch this space.
Stacey Simms 12:00
Well, since you brought up Sugarmate, I have to ask with Sugarmate, which is if it's not clear, Tandem owns as you said, many people don't realize that is sugar beet, something that people could use, kind of as a bit of a workaround for a Tandem share and follow or Sugarmate only displays Dexcom data right now.
Elizabeth Gasser 12:18
So today, sugar is explicitly a CGM companion application. It displays data from the Dexcom CGM. Over time we're looking at what features need to be added to that to ensure it delivers the best value proposition to our users. Really interesting
Stacey Simms 12:33
stuff. All right, you segwayed beautifully into my question about Dexcom. How soon after Dexcom G7 is FDA approved, do anticipate it being available on the x two and again, is that a simple software update?
Right back to our conversation, but first Diabetes Connections is brought to you by Dexcom. just about to talk about there. And one of the most common questions I get is about helping children become more independent. You know, those transitional times are very tricky elementary school to middle school middle to high school you get but I'm talking about using the Dexcom has made a big difference. For us. It is not all about sharing follow. I mean, that is very helpful. But think about how much easier it is for a middle schooler to just look at their Dexcom rather than do four to five finger sticks at school, or for a second grader to show their care team the number before Jim at one point, but he was up to 10 finger sticks a day and sometimes more and not having to do that makes his management a lot easier for him. It's also a lot easier to spot the trends and use the technology to give your kids more independence. Find out more at diabetes connections.com and click on the Dexcom logo. And now back to Liz I just asked about tandems planned integration of Dexcom G7 when it is approved and released.
Elizabeth Gasser 13:53
We are intending to implement Dexcom G7 With both pump models so that means X2 and that means Mobi, down the road, our current goal, and this remains our goal is to deliver that within a quarter of FDA approval of the G7. And in terms of how they gets rolled out. I mean, it's very consistent with the software conversation we were just having right. The beauty of the software model is you know, as that gets approved, and as the implementation is ready, we'll be making it available to customers through a simple software update.
Stacey Simms 14:26
Let's move on and talk about the December R&D presentation where this large plan, I think very ambitious and exciting was laid out for the next five years. And we've already mentioned a couple of the products. We're going to go through it in some more detail, but I am curious kind of, you know just what it was like that day and if you didn't see it or hear it, I can link up the video. I'm assuming that it's still up there. But I guess I'm asking this is what were you all talking about that day? There were so many people involved in the presentation, kind of doing handoffs and saying, here's the product, here's the software, here's the philosophy, it had to be a big deal. Tandem had to be a lot of relief when all the technology worked. And everybody got their presentations through with it. You were done.
Elizabeth Gasser 15:07
Oh, absolutely. I couldn't agree more with that sense of it was momentous. And certainly at the end of it, we're all pretty tired. But no, it was, it was exhilarating, too. And I think, you know, we spend a lot of time because of because we're in a regulated space, we spend a lot of time talking day to day about the here and now the stuff that's approved, the stuff that's in market, and the reality is a lot of what we shared R&D day we've been working on for a while now. And you know, some of it's been skunkworks. Some of it's been more formal programs, you know, you just ticking along. And it was really exciting to have a vehicle to share a lot of that thinking and a lot of that innovation that we get to see day in day out. But we don't always get to tell the world about because of the rules and regulations in our space.
Stacey Simms 15:59
Alright, let's talk about it as much as we can. You've mentioned Mobi several times, this had been referred to and I had been told this was not gonna be the name. So we didn't know that. But this had been formally referred to as T-Sport. Now, it is Tandem Mobi. Can you go through the features? Can you go through what this product is?
Elizabeth Gasser 16:19
Absolutely. Where to start? First at it. It's the world's smallest durable pump. So if you're familiar with with the X2, it's half the size, that's really small, durable, four year lifespan hardware. So that in and of itself is exciting. In terms of where we go with the software on top of Mobi, it's going to support Control IQ. So same great algorithm that's in market today, it will be deployed on on both pumps in the same way. And so we get to bring that algorithm across the entire portfolio when Mobi launches, it will be controlled by phone as we were talking about earlier. And that means full control at this point in time, obviously, because there's no screen on the device itself. So what does that mean? Everything you need to do to interact with the pump settings, whether it's bolusing, whether it's looking at your statistics throughout the day, that will come from the phone, it will be charged inductively, which that you know, not something you don't really focus on. But that's that's pretty cool. With we're getting used to wireless charging for all of our consumer electronics devices not having to hunt around for a cord to plug it in. That's what we're doing with with Mobi as well. It'll sit on a little charging station, very easy, very straightforward, less pieces to worry about on pump bolus button. And this one we think is a little differentiated. Certainly in the on body arena, I think it will be the only one only pump out there of this size that has the option to fall back to a button push on the pump just to make sure because obviously, when you are interacting with your pump solely through a phone, we need to build in some measure of failsafe fallback, right if you find himself without the phone, and needs to bolus. And then lastly, waterproof. We're going to support waterproof capabilities through IPX8, which I think is pretty competitive. So lots of stuff packed into a really, really tiny device.
Stacey Simms 18:25
I'm sorry, what is IPX? Eight mean?
Elizabeth Gasser 18:28
The best way to articulate it, it's really just the standards we comply with and IPX eight means fully waterproof, you'll be able to swim and shower with it.
Stacey Simms 18:36
One question about Mobi is I'm trying to visualize how it connects. My understanding is that it uses the standard pumping fusion set that like my son's Tslim currently uses, is that correct? It just sits closer to the body.
Elizabeth Gasser 18:51
That is correct. The Mobi pump will work with the Tandem portfolio of infusion sets. And with the Mobi pump launch, we will also be introducing a shorter infusion set that four or five inches long, that allows for greater diversity of wear options.
Stacey Simms 19:09
I'm so fascinated to see how this works because I'm a very visual person. So he could put it on like my son could put it on his arm and it kind of dangles off. Does it also stick to the body in a way? Or does it just kind of hang there on the tubing, the tiny tubing
Elizabeth Gasser 19:24
work, we're working on the accessories to allow for a diversity of wear options, whether the belt clips or sleeves or a body worn adhesive patch through which you can that you can pop the pump into. So there's a variety of places you can push
Stacey Simms 19:39
it interesting, alright. And like I said, I will link up so you can you can really dial down if you want to and see all of the features of everything we're going to talk about. But just for time limitations, we're not able to go through every single thing. Let's move on to the T slim x three that seemed to be next in the pipeline. What is that?
Elizabeth Gasser 19:55
x three. That's the next iteration for the T slim X To pump. And really the focus there is to continue really honing the capabilities of the T slim form factor, right. And so we recognize that over time t slim continues to play a role in the portfolio, many of our users will continue to want a pump with a built in user interface. And so really the x three programs emphasis is on further developing the processor capabilities of that device, looking at battery life, looking at durability, reliability, looking at wireless software update capabilities, really to make sure that the T slim x two kind of line has continued vibrancy as part of the portfolio over time. And we're making the appropriate investments to support the diversity of software and user interfaces that we want to bring to the portfolio at large. So
Stacey Simms 20:54
right now, it sounds like the changes you're talking about aren't something that, you know, I would look at the pump and say that is significantly different, right? Or that works completely did you've changed at all, it's making small improvements and things that the user, frankly, may not notice? Or will they're, you know, things will just run better, like you said battery life, that sort of thing. Are there significant changes that you could think of that would be coming to the pump itself?
Elizabeth Gasser 21:16
Oh, no, that's absolutely right. I think this one's a little fun for me, because I come from the consumer electronics space, originally and spent 20 years you know, working on phones. And as you think about the types of releases, you do with consumer electronics, year to year, a lot of them are under the hood, that it's really focused on making it connect better, giving it more horsepower, making the battery last longer. And those things aren't always visible on the surface to a user, but may manifest through the quality of the user experience they get from interacting with that device.
Stacey Simms 21:50
The next product is Mobi tubeless. We've talked about what Mobi is, I'm assuming this means know to tell me a little bit about Mobile tubeless. This is
Elizabeth Gasser 22:01
a certain creativity and the naming convention there isn't so
Stacey Simms 22:06
we shouldn't laugh. It's a very big deal. It's a very big deal.
Elizabeth Gasser 22:09
No, I say that affectionately. And look, it's back to the conversation we were having on kind of the Mobi, shorter infusion set and different Bodywear options, more ways to air Mobi, right, we recognize that not everyone ultimately wants a pump with a tube. And so we've been pushing ourselves to say, okay, how can we improve the wearability and the wear option, so that we're reaching the broadest possible base of customers here. And, and this one's kind of an example of the things that we've had in the hopper for a while that not everyone gets to see, we took a little trip in the Wayback Machine and dusted off some of our earliest thinking on movie here. And maybe a tubeless infusion site option has been in our minds for a while. And so we felt it was the right time to bring that idea back to look at how to make it a reality as we get closer to the official launch of Mobi. And so this sits in the roadmap for Mobi as additional ways to utilize and engage with the product. And hopefully, it will give users choices, right? Some days, I don't want to wear my pump on my body, I might want to have it in my pocket and connect via a standard infusion site. Other days, I may be a little more active and find a really need to have a have a tubeless wear option, we get rid of the tube, the goal for us is to satisfy all of those use cases.
Stacey Simms 23:34
And then the last one is the completely disposable patch pump that's in the pipeline. Is this a different form factor than Mobi? Is it a different design? Or is it similar?
Elizabeth Gasser 23:44
So this is a different program? I can absolutely share that. I can't say a whole lot. This is one we want to keep fairly tight under wraps for competitive reasons. But the emphasis there is is very much on miniaturization. Got it. Can we really push the design envelope here on form factor for the device?
Stacey Simms 24:06
You know, it's so interesting. We've been in this community as a family for 15 years. So now you're certainly not as long as many other people but in that time, we've seen and heard a lot of products, right? We've heard about new things coming. We've seen some really great advancements, we see things go away. This is a very ambitious portfolio that we're looking at and five years is it doesn't seem like a long time really certainly as I get older, it seems less than less. Seems everything's going more and more quickly. But a lot can happen in five years is the is the plan here that all of these products will exist together. As you said, you know, the movie tubeless you kind of made it sound like I might be able to take out my Tandem movie with the longer tube and then switch to the tubeless another day is the idea that all of these would exist side by side.
Elizabeth Gasser 24:50
That's a great question, Stacey. I think the best way to answer that is to really reflect on the fact that we do fundamentally believe the day Diabetes space and particularly insulin dependent diabetes is a far more segmented market than every industry analysis would lead us to believe. You know, we often talk about type one and type two, as if those are the only segmentations that are relevant, we do actually think there's various needs, that we should appropriately be segmenting around, including, where preference form factor and user and interface size. And so as we look at the portfolio, we're really looking at how we can satisfy the broadest array of user needs. That may mean there is on occasion, some overlap in functionality between different products that sit in the mix. But the goal is really to provide the right device for the right group at the right time. And so as we think about where we go from here, the roadmap as we have sketched it out, for the 22 to 27 period really is very much about a tube pump offering with a screen, that's Tslim X2, a smaller form factor, more discreet phone operated screen, this option in the form of Mobi and there, the goal really is to create as diverse an array of wear options as we can to satisfy the needs of different user groups and their day to day activities, and then pass that as you think about the idea of a passionate disposable patch that exists as a third category that overtime will, we'll have to see how these different offerings play out with the segments that they're serving, and they are likely to coexist.
Stacey Simms 26:39
So interesting. As we begin to kind of wrap this up, I did have a couple of questions from listeners I wanted to get to, and one of them was about control IQ, frankly, and any changes coming. In other words, we had heard a lot about changing the adjustable, changing the target rates lower than 160 and 180, that they are right now not the target rates. That's when the pump takes action, that kind of thing. And I remember hearing that there was something in front of the FDA, I don't know how much you can share. But can you talk to us about changes coming to control like you, yeah, happy to
Elizabeth Gasser 27:09
talk about the design goals. In terms of control IQ today, it's delivering great outcomes. And in its current instantiation, I think one of the things that's helpful to understand about algorithms is that they're all going to work in different ways. It's like chocolate chip cookie recipes. If you think about it, lots of people have them, but it's how you put the pieces together and in what order and it's the secret sauce that affects how it tastes. Similarly, with algorithms, a lot of it comes down to how you put it together. And it's not always practical to compare from one to another. The real test is, you know, are you getting users to where they need to be in terms of, you know, being able to achieve their time and range goals, for example. So I think it's worth wrapping your head around that idea upfront. Now, having said that, for the control IQ roadmap, our next development frontier really is very much around personalization, and usability. While we're not going to get into very specific, you know, roadmap feature intersections at this time, we're exploring quite a bit here. And Jordan alluded to this a little bit in our R&D Day discussion, part of personalization for us does include exploring lower target ranges, and personalized target ranges, and looking at what it would take to deliver on those capabilities.
Stacey Simms 28:32
Here's a real speculative question that I don't expect you to answer. I'm hearing in the DIY space, that more and more people are coming up with algorithms that don't need meal announcements, or don't even need meal boluses. Is that something that Tandem is working on for an algorithm? Or I guess the real personal question is, could you please Liz, help me because my son forgets to bolus for many meals. He's 17. He's very independent. But oh my gosh, when I see people working on things like that, I just feel like that would be life changing.
Elizabeth Gasser 29:05
Yeah, mail handling unannounced meals on lounge consumption. Yeah, it's the hardest thing to confirm it with the algorithm here. It is fair to say that as part of our ongoing roadmap explorations, we are looking at what it means to improve unannounced meal handling.
Stacey Simms 29:24
I'll take it. I'll take it. Thank you. Another question came up about new infusion sets. And you had mentioned this, you touched on this briefly, but we talked to folks at ConvaTec who make many of the infusion sets and they were talking about longer life improvements to the cannulas or those sorts of things coming to Tandem. Yeah, so we
Elizabeth Gasser 29:46
did talk a little bit about our goals here. During R&D day. You know, it is only one piece of the system but we do recognize infusion set issues can be a real pain point for customers and so we have programs IPs that are ongoing. Some of them are internal driven by us. Some of them are in conjunction with our partners working on a diversity of things. Some of it is extended wear time, which we know is important. But we're also looking at insertion, ease and usability there, we're looking at how to reduce infusion site failures, specifically around occlusions, obviously continuing to look at things like adhesives, reduction of material waste. And so this one, it's a pretty diverse view that we're taking. It's not all necessarily anchored solely in the idea of extended wear, I can't give you any specific breaking news in terms of you know, what we're coming up with and the products we'd like to bring to market. But this one we're paying serious attention to, we recognize that our customers want to see progression here.
Stacey Simms 30:57
Yeah, I have been amazed since day one of pumping, I feel like the infusion sets have, at least for us, and everybody is different. And everybody's skin is different. Everybody's insertion technique is different, which is part of the problem. But you know, I've just been amazed to me, that has always been the weakest link of pumping. And the idea that I'm using pretty much the exact same infusion set that I put on my son's body 15 years ago, just with all the advances that we've had to me, that's the one that needs much more attention. So I'm really, really glad to hear you're working on that. Alright, so this is not a question. But this was a thought that ran through many of the comments. Many people wanted to say, thank you for getting this is terrible. Thank you for getting control IQ through the FDA before COVID. Because oh my gosh, nothing has happened since like, this was approved, what December of 2019. And many people started getting it I think the earliest was January of 2020. And the diabetes community it feels like very little, although there have been there have been approvals. But it feels like everything is moving so slowly now. So I'm sure Tandem is happy about that. But I know the community as well. So I'm not sure if I can even ask you to answer. There's no question there. But thank you.
Elizabeth Gasser 32:05
Oh, I'm not sure there's any good answers there either. Stacey, I certainly applaud the the yeoman's work going on at the FDA to manage through this crisis. And certainly while it's frustrating to have extended approval cycles, and yes, in retrospect, a blessing that we secured approval prior to COVID. I can't do anything but feel respect, admiration and a little bit of sympathy for our friends at the FDA. Yeah. And
Stacey Simms 32:35
again, I don't know if you can answer something like this. Have you heard that they are they're kind of making their way through it just seems like there was such a log jam, I understandably so any feeling any word that they are kind of clearing the deck, so
Elizabeth Gasser 32:47
to speak? I don't think it's my place to comment on my workflow there. I
Unknown Speaker 32:50
tried. You can we do have good
Elizabeth Gasser 32:52
back and forth with the FDA, you communicate with them regularly. And so they continue to engage with the industry constructively, productively.
Stacey Simms 33:02
Alright, before I let you go, you don't live with diabetes, as you said at the very beginning, you know, you come from a software background and that sort of thing. But what is it like to come from that and work in in diabetes, where the work that you do I mean, here I am complaining about infusion sets, and, you know, change the bolus, from what you know, before it reaches 180? You know, we're talking about all of these little things add up to such quality of life issues for people, you know, what does it been like for you to work in this space?
Elizabeth Gasser 33:28
That's a great question. It's one that I think you're the first person to ask me to reflect on. You know, I think it is both sobering and invigorating, sobering because, you know, when you come from a world that's, you know, focusing on clicks and engagement and eyeballs, and consumption of media, you can get lost in the little things, and really stepping back and recognizing just the enormity of what type 1 diabetes is, and the burden it places on people's lives, day to day, and feeling like I can show up to work and even in a little way, help with that. That's sobering and profoundly rewarding. It's also invigorating, because, you know, coming from a consumer electronics environment, you see what's possible with the technology as it exists today, and many of those technologies have not yet come to medical devices in a very fulsome way. And so I certainly get out of bed day in day out wondering how we can help therapy benefit from all of the innovation that is going on, in the consumer electronics world, right. You know, we have thermostats that manage our home temperature for us. We have self driving cars we have on demand consumption services that you know, help us get our groceries and plan our meals. I don't mean to trivialize the differences that are involved in translate I think that to medical devices, but I also think as you look at that and say, Come on, we should demand that level of ease of use in what we're doing here as well. And so that that's profoundly motivating.
Stacey Simms 35:13
That's great. Well, thank you so much for sharing so much information for answering what you could answer. And I hope we talk again soon. My pleasure.
Elizabeth Gasser 35:21
Thank you, Stacey.
Stacey Simms 35:27
You're listening to Diabetes Connections with Stacey Simms
more information at diabetes connections.com, including the link to the research and development presentation. If you'd like to watch that or just listen to it, I will link that up over on the website along with the transcription. I really appreciate your patience with the transcriptions. I think we do a great job. But my transcription software doesn't speak diabetes, I try to teach it but it is a little unreliable. That way we go through and try to catch the big stuff. But if you do see anything egregious, or very confusing, please let me know. And I can pretty easily fix that.
I want to take a moment and address a couple of the questions that we ran out of time with Tandem or your questions came in late. I'm going to do that in just a moment. But first, I mentioned at the beginning of the show that I had a question for healthcare providers, I have a question for you, I have a favor to ask of you. You may have heard me talk about Club 1921. I mentioned it right at the beginning of the show, I'm only talking about if you're at the end of some of the podcast episodes, and in the Facebook group, we are in beta. It is my new project. It's all about events in the diabetes community nationwide, any type of diabetes anywhere in the United States.
I need your help, because it's very easy for me to find the big events, right friends for life, JDRF, even ADA stuff online. What I would like to add to the website, and what I think will be vital to its success are all of the events going on in your hospitals. Almost every hospital has a nutrition program for people with type two, an education program for gestational diabetes, things like that. They can be virtual, they can be in person, but I need to find those programs, I need to get into those hospitals, I need to reach the people who want to add those events. This is not a community calendar, where I hope a couple of groups post their events. And we all go from there. I want this to grow into a site where 1000s of people with diabetes, any type of diabetes, find their community find help find what's being offered. And I know that these hospitals want to connect with these folks. So if you could help me do that point me in the right directions to meet with the association's it doesn't have to be one on one with hospital systems, although that would be great, too. But whatever you think might be a help, I would really appreciate it, you can email me Stacey at diabetes connections.com, you can message me on social media, thank you so much, because this will only succeed if we reach out beyond the community that we are already talking to. So thanks.
Okay, let's get to the kind of leftover questions from Tandem, the most common one had to do with international rollout. And I unfortunately, I don't really have any good answers for you. I'll tell you what Tandem said I asked specifically about Australia, I had two people who emailed me asking about what is going on in Australia with the rollout of Control, IQ, nevermind all these other features. And they just said we do not have an update at this time. And then asking about other international markets. So let me read that response in full Tandem says we have launched in a large majority of the international markets, and we're near to medium term focuses on ensuring we work to make our technology broadly available to these customers. We don't have anything to disclose with regard to additional markets at this time. So I know not the answer you were hoping for. I will keep asking on this one. And I do apologize, we are a very US centric podcast because I am US centric. But I appreciate the reminder. And I will try to keep that focused and you know on my list of questions as we move forward with lots of different technology this year.
And then I had also asked them about changes to the current controller queue algorithm. I had asked during the interview if it could take action at a lower number than 160, which is where it jumps up to basil and 180 where it gives an auto bolus at 60% of the bolus rate that the person programs in and Liz did answer that question in the abstract, but I wish I had pushed on it. So I followed up because I thought I had heard that Tandem had already submitted a change on that to the FDA. They responded quote, as Liz mentioned in the interview, we are working on personalization features which include lower targets and thresholds. We've begun to engage the FDA and started our design work, but we're not currently providing any of the feature details and quote, I will add this editorial comment. Every pump company I talked to has started out saying we're going to have lower ranges, we're going to have tighter ranges, we're going to have customizable ranges and every time it hits the FDA that kind of starts to change set You know, Omnipod, if you'll go back and listen to the interviews from two or three years ago, they were going to submit with I think it was 80 to 100 as one of their ranges. And that didn't happen they've submitted with higher ranges, just like Tandem did. I think, again, this is my speculation, I think these will all gradually come down. But if you are looking now for tighter control with these hybrid closed loops, you might want to go the DIY route. Although if you keep your pump in sleep mode, you know you're sleeping beauties with Tandem it's trying to keep you at like one 12.5 The whole time you just have to remember to bolus which works beautifully for some people, and not at all for the person in my house.
Okay, before I let you go quick look ahead. Of course in the news is every Wednesday we do that live on Facebook, and YouTube and I added LinkedIn this week. My goodness, we're also live on Instagram a little bit later, still can't do all of that at once we're working on it. And then I turned that into an audio podcast episode that is released on Fridays, upcoming longer format shows we'll cover more technology including a new pump called Sigi. We've also got some really interesting community interviews. What is it like right now when you live with type one, but you also live with another autoimmune condition that makes it very difficult to get a COVID vaccine. And I'm going to be talking to some of the Joslin medalists who are this is a theme right living longer with type one and the issues that have cropped up for them that nobody really far, we would have to think about so I'm excited about that and so much more.
Thank you as always to my editor John Bukenas from audio editing solutions. Thank you so much for listening. I'm Stacey Simms. I'll see you back here soon until then, be kind to yourself.
Benny 41:48
Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged
Every week “In the News…” brings you the top stories and headlines around the diabetes community. Top stories this week include: how new nanotechnology might help make stem cell transplants a reality (without immuosuppresive drugs), a worldwide A1C survey, the FDA releases more info about issues with Medtronic, lung function and type 2 and some info about diabetes camp.
Join Stacey live on Facebook every Wednesday at 4:30pm EST and in Instagram at 4:45pm EST
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
Sign up for our newsletter here
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Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners!
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Episode Transcription Below (or coming soon!)
Please visit our Sponsors & Partners - they help make the show possible!
Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. If you’re new we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast.
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Looking to get organized? Check out my new guide with top tips to clear your diabetes clutter. Everything from how to start to where to donate and how to keep it from taking over your house. Head over to the home page to get organized.
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Lots of news in the last few months about stem cells and type 1.. but transplantation still means rejection without immune-suppressive drugs. Researchers at Northwestern University say they may have a way around those problems. They’re using nano-carriers to generate a new form of immune-suppression that can target specific cells related to the transplant.. without suppressing wider immune responses. This paper was published in the journal Nature Nanotechnology. one of the researchers, Jacqueline Burke, was diagnosed with type 1 at age nine. She’s one of the study authors and hopes it has a major impact on the future of diabetes research.
https://news.northwestern.edu/stories/2022/01/nanotherapy-type-1-diabetes/
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Possible new link between lung function and the onset of diabetes. This is a big study out of South Korea.. almost 20-thousand healthy adults followed over almost four years. At the beginning of the study none of them had diabetes. After adjusting for other factors, the team found that the group with the best lung function had a lower risk of developing diabetes. More study is needed, but these researchers think that managing lung health – which isn’t really ever looked at as a risk factor - could help prevent diabetes.
http://www.koreabiomed.com/news/articleView.html?idxno=12981
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Big study of people with type 1 from 22 different countries showing that most don’t have an A1C under 7.5%. As you’d imagine, that varies widely by country and by age. This was info from more than 500-thousand people gathered over 4 years. Highest A1Cs were generally in people aged 15-24
There’s a lot of data here and I’ll link it up. But the researchers don’t seem to try to delve into what’s going on or why this is the case.
https://www.healio.com/news/endocrinology/20220119/hba1c-remains-suboptimal-for-most-people-with-type-1-diabetes
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It’s not a surprise that hotter weather could mean more health issues for some.. but a new study from Brazil is closely watching heat and diabetes. Every 5-degree Celsius increase in daily temperature correlated with a 6-percent increase in hospitalizations due to diabetes.. this was between 2000 and 2015. The oldest patients were at an increased risk for diabetes-related hospitalization when exposed to heat. The study authors say it’s the first nationwide study to look at this issue.
https://www.healio.com/news/nephrology/20220118/increase-in-heat-exposure-correlates-with-increase-in-hospitalization-due-to-diabetes
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Medtronic still in a bit of hot water with the US FDA.. Medtronic took more than three years to replace and start recalling insulin pumps with defective retainer rings after first becoming aware of the problem.. this according to an FDA warning letter sent to the company in December and recently made public. The company also failed to investigate more than 800 complaints about defective updated retainer rings and failed to promptly notify the FDA within 30 days after discovering that issues with the device could lead to serious injury or death. Medtronic says, quote “We take these issues very seriously and hold ourselves to the highest standards of quality and patient safety,"
https://www.startribune.com/fda-medtronic-slow-to-update-recall-defective-insulin-pumps-for-diabetes-patients/600136525/
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Medical write up of what might be the oldest person to be newly diagnosed with type 1. This was a 93-year-old woman. Her A1C was 12.9 but I didn’t see in the write up why they had a high clinical suspicion of type 1. They checked her diabetes auto antibodies and confirmed the diagnosis. On recovery, she was discharged home on once daily insulin with aim to self-manage with support. I was only able to find a summary of this.. maybe we’ll learn more soon.. but just another reminder than type 1 can be diagnosed at any age.
https://pubmed.ncbi.nlm.nih.gov/35027384/
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It’s that time of year.. diabetes camp registration is opening up! Our local sleepaway camp announced they’ll start signups in February and your camp may have already done so. Please check soon – a lot of these camps have strict limits and are met pretty quickly. I’m a huge fan of diabetes camp – Benny isn’t going this year because he’s been accepted by his regular camp as a CIT and he’ll be gone for … 8 weeks.
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Before I let you go, our long format episode this week is with Joanne Milo.. diagnosed almost 60 years ago, she was told like a lot of people with type 1 that she wouldn’t live to see 40. What happens now that that group is reaching 70, 80 or 90?! Joanne is also a leader in Loop and Learn and we talk about embracing that DIY tech. Next week we’re talking to Tandem about their newly announced 5 year plan leading to a tubeless patch pump.
Listen wherever you get your podcasts or if you’re listening to this as on a podcast app, just go back an episode.
That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
Diagnosed almost 60 years ago, Joanne Milo loves technology and helped start the popular Loop and Learn group. She’s also passionate about diabetes and aging.
It's hard to believe now, but many people diagnosed in the 1960s and 70s were told they wouldn’t live to age 40. Thankfully, that wasn’t true. But the medical world wasn’t prepared for them to actually live long and healthy lives. There is very little research or support for people with type 1 over the age of 50. Imagine when you get to 80 or beyond!
Joanne Milo is also the author of the book and blog “The Savvy Diabetic” and she has a lot to say about how we can all prepare better for emergencies or hospital stays.
Joanne's website - The Savvy Diabetic
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
Sign up for our newsletter here
-----
Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners!
-----
Episode Transcription Below (or coming soon!)
Check out Stacey's book: The World's Worst Diabetes Mom!
Join the Diabetes Connections Facebook Group!
Sign up for our newsletter here
-----
Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners!
-----
Episode Transcription Below
Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines of the past seven days. All sources linked up where you’re watching and at Diabetes-Connections dot com when this airs as a podcast.
XX
Looking to get organized? Check out my new guide with top tips to clear your diabetes clutter. Everything from how to start to where to donate and how to keep it from taking over your house. Head over to diabetes-connections dot com to organize your diabetes supplies!
XX
Some new information about Dexcom’s upcoming G7, which has been submitted to the US FDA and in Europe. Latest clinical study show the MARD of the G7 is 8.2 for adults, compared to 9 for the G6. MARD is the Mean absolute relative difference and the lower the better here. G7 was even lower, 8.1 for kids. This is close to the same results they talked about last summer, but the group in the trial was bigger. G7 is expected to get approval in Europe this quarter and likely in the US much later this year. Our last longer format interview episode is with Dexcom’s CEO and we go in depth on this.
https://www.drugdeliverybusiness.com/dexcom-ceo-touts-unprecedented-performance-of-g7-in-clinical-trial-awaits-fda-decision/?fbclid=IwAR3G5_Fu9fhPfR0M3FzgCNCsFYmo4gDRDy5nJySgxt56mMVJgrpUsVQedis
https://investors.dexcom.com/static-files/0c3012e2-40f4-4046-a962-85e6b421d490
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Two COVID and diabetes studies I want to talk about.. the first showing that more children are being diagnosed with type 1 and type 2 diabetes after getting COVID. This study looked at databases of people under 18 starting in March 2020 and going for 18 months. There are a LOT of questions here.. including whether post-COVID type 2 diabetes will actual be a temporary or chronic condition.
Which leads us to the other study.. this one of adults, in almost 4-thousand covid patients, just under half developed high blood sugar levels, including many who were not previously diabetic. These researchers say a lot of the patients here were in their 30s and 40s, no sign of diabetes before COVID.. and the levels of glucose in their blood were incredibly high, sometimes more than twice the level that indicates diabetes.
These patients still had high levels of C-peptide, which shows that they were still producing insulin. The theory here is that something is disrupting the fat cells. But the researchers admit they are just at the beginning of figuring this out.
It’s this latter study and others like it that seem to be showing that there really is something different about COVID and blood glucose. I saw a lot of people dismissing the children’s study with, well, any virus can cause T1D. I’m glad these researchers are digging into what’s going on.
https://www.sciencenews.org/article/coronavirus-covid-diabetes-fat-cells-blood-sugar
https://www.nytimes.com/2022/01/07/health/kids-covid-diabetes-cdc.html
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Abbott unveils plans for a new line of consumer bio-wearable sensors that will collect a broader range of biological readings to help users optimize their exercise and nutrition regimens and overall health. Called “Lingo”- which are still under development and aren’t intended for medical use— they are based on the existing Freestyle Libre diabetes monitoring technology. We’re talking about glucose, ketones, lactate and alcohol. Interesting to me that these were shown at the Consumer Electronics Show and not a medical conference, but Abbott is up front that these are basically for athletes and not for people with diabetes or those who need to make medical decisions based on the sensors. We’ll see which of these makes it off the drawing board.
https://www.fiercebiotech.com/medtech/abbott-ceo-ford-unveils-lingo-line-sports-biosensors-based-diabetes-monitoring-tech
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Another divestment for Lilly Diabetes – last week we told you they were doing away with their Journey Medals for diaversaries.. they have since announced that T1D everyday magic is no more. This was a partnership between Lilly and Disney that was a blog and a place for recipes and the home of those Coco books, the cute monkey with diabetes who hangs out with Mickey & Minnie Mouse. As of today you can still get digital versions of the books via the website but we’ll see how long that lasts. Full disclosure: I wrote for them a couple of times – and was paid by them – glad I saved those columns.
https://www.t1everydaymagic.com/thank-you-for-sharing-the-magic/
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Interesting news from an amazing athlete with type 1. We told you that Sebastien Sasseville biked across Canada this summer. He previously went up Mt Everest and did a brutal race across the Sahara. Now, all the data on his blood sugar during that recent ride has been published. It’s in the Journal of Diabetes, Obesity & Metabolism. Sasseville wore the Tandem and Dexcom Control IQ system during the ride.. the article is about how using that kind of automated insulin delivery system can help ultra athletes with diabetes.
https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.14629?fbclid=IwAR2JLTn9dGJu43have5EMqXkWlENuDgPFDQq6RrsbY7TJyRJV0aERsDxYbo
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This week marks 100 years since the first person received a shot of insulin. Canadian teenager Leonard Thompson got that life saving injection on January 11, 1922. Of course, this was via Dr. Frederick Banting and his team.. Thompson was drifting in and out of a diabetic coma and weighed only 65 pounds. He was 14 years old. The first shot was found to be impure and didn’t work. But they were able to fix the problem and administer a second purer shot. Thompson only lived to age 27 but his actions helped save so many lives.
https://www.healthline.com/diabetesmine/diabetes-care-joslin-100-years-first-human-insulin-shot#A-century-of-Joslin
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Before I let you go, as I mentioned earlier, the podcast this week is an update from Dexcom. CEO Kevin Sayer answers your questions about the G7 and lots more. Listen wherever you get your podcasts or if you’re listening to this as on a podcast app, just go back an episode.
That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
This week, Dexcom CEO Kevin Sayer spoke to the JP Morgan Healthcare Conference about the G7 and beyond. We talk about information from that presentation and get to as many of your questions as time allows.
This interview took place on Tuesday Jan 11 and much of what we discussed isn't FDA approved.
Our usual disclaimer: Dexcom is a sponsor of this podcast, but they don’t dictate content and they don’t tell me what to ask their executives.
Recent Dexcom episodes:
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CEO Kevin Sayer talks about G7, Direct to Watch, Adhesive and more
CEO Kevin Sayer talks about Dexcom in Hospital, G7, VA program and more
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Episode Transcription Below
Stacey Simms 0:00
Diabetes Connections is brought to you by Dexcom. Take control of your diabetes and live life to the fullest with Dexcom and by Club 1921. Where Diabetes Connections are made
This is Diabetes Connections with Stacey Simms.
Welcome to another week of the show. You know I'm always so glad to have you here. We aim to educate and inspire about diabetes with a focus on people who use insulin. And I'm talking with Dexcom CEO this week, it's Kevin Sayer, he is back to check in with us again. And in the interest of getting this episode out to you as soon as I could. It might sound a little different right here at the beginning. But Dexcom episodes are always so high interest that it really merits a quick turnaround. I didn't want to sit on this interview for a week. So here's the setup. Dexcom CEO Kevin Sayer gave a presentation to the JP Morgan healthcare conference, if you're listening as this episode goes live, that was just Monday of this week, January 10, the interview you're about to hear took place on Tuesday, January 11.
My usual disclaimer Dexcom is a sponsor of this podcast, but they don't dictate content and they don't tell me what to ask their executives. I asked the Diabetes Connections podcast Facebook group for questions. And Whoa, boy, did you have a lot as always not a surprise. And I really appreciate you sending those in, I got to as many as I could, while also trying to include what the folks at Dexcom had really asked me to bring up there are some topics that they wanted Kevin to make sure to address. And I think we do a pretty good job of trying to reach a balance here.
Kevin, welcome and Happy New Year,
Kevin Sayer 1:46
and Happy New Year to you.
Stacey Simms 1:48
Thank you. Well, this seems to have started out in pretty happy way on the headline, just from this week. Dexcom CEO touts unprecedented performance of G7 in clinical trial. This is after your talk at the annual JP Morgan healthcare conference. Tell me a little bit about that unprecedented performance data.
Kevin Sayer 2:08
I'm happy to. And I just have to qualify it by saying no, I can't send it to all your listeners at the end of the call yet. We're still waiting for approval in Europe. And we have filed this with the FDA, I'm going to take you back a little bit, we made a decision when we were going through the G7 development process that we wanted to answer that performed better than G6. And all of our scientists looked at us and they go oh, really, you're sure because this is really good. And so we spent a lot of time new algorithms and new manufacturing techniques, there's a lot of things in G7 that make it different. We also wanted to validate that performance with a study that was so large, nobody could refute it. So as you look at the data that I presented at the conference yesterday, over 300 patients 39,000 Match pairs all across since one ranges and on the I CGM standard side, but with the 5% 95% lower bound, and even the absolute points, you can see we are well within all of the iCGM standards, which are very technical and actually are a very good measure of how a sensor actually performs in reality. And they were very thoughtful in developing these standards to try and pick the centers that don't work to put you statistically in a bind to whereby if you really aren't performing in the low range or wherever, you're not going to get that iCGM designation. We're very comfortably there.
And the overall MARD in the study, Stacey is eight point, you know I it's in the low eight for adults and pediatrics. And if you start looking at the data, we gather the data sets in three periods, you know, days one and two, the middle days, four, or five and six, and the last days nine and 10. It's pretty low, I think it's below 10. In the first group a day, the first days, which are always a little bit higher, traditionally in our centers than the other days. But in those middle and end days, it's it's near seven, and strips for six. I mean, we have done something that I've been in this business for since 1994. I didn't think we'd ever do this when I started. As far as being this good. This is really, really good data. And we're going to continue to deliver the experience to our customers that they demand from us. So as you can as you think about an iCGM that's driving an automated insulin delivery system. And not only is the performance great, the user where it's 60% smaller, it's a 30 minute warm up. It's a new app. From our perspective, we've got a lot of the clarity data, your listeners will know about clarity. We've got a lot of your clarity data right on the app. There's new alarm configurations.
Stacey Simms 4:48
I'm gonna just jump in with a couple of quick clarifications before we go on. You mentioned a number of there that went by quickly I apologize when you talked about the 300 people in this trial 39,000 match what I missed that one
Kevin Sayer 5:00
matched pairs. That's where you compare the CGM value to the blood glucose value from the laboratory instrument. So the way our studies work is literally we draw blood samples from the individuals in the study at intervals, and then we actually match the CGM data to that laboratory blood instrument. So 39,000 points from these 300 people in this study were matched. Got it?
Stacey Simms 5:27
And you mentioned the MARD mean absolute relative difference. Most of you, as you listen are very familiar with this, the lower the better for CGM G6, I, my understanding was G6 was in the low nines. This is 8.1 for peds. 8.2 for adults, as I'm reading it, that's right. I know you can't tell me I'll ask you anyway, why? What made the difference here? Is it sighs is it algorithm? Do you have anything you can point to? Or is that a trade secret
Kevin Sayer 5:49
it's combination, I think the algorithm has been the most, the algorithm changes were really extensive here. And, you know, we always have manufacturing processes to get better, the way we build the G7 centers different in every step of the way. Literally, our G6 manufacturing processes go away and the G7 ones take over the summer, we're a little similar on the actual sensor wire itself, and that manufacturing, but everything else is different. We just think it it's smaller, it's a lot shorter than G6 was. And so it is it's going to be a completely different experience for everybody.
Stacey Simms 6:28
So to go back to what you were talking about, before I jumped in there, you were starting to talk about alarms, is there something different for the alarm,
Kevin Sayer 6:35
the app is different. And so access to them, and, and just how you use them, if we try to get to be more consumer, thoughtful, as we configured the alarms, we'll see how everybody loves him. It'll be interesting. The alarms are one of the things we get the most comments on when we launch a product initially, we try and please everyone, but we never please everyone. And then you get you know, the agency at one time. I don't know if your call. I think one of our other discussions, we had to make the mute override not work on the low end. Boy, we got a lot of people mad at us about that one. So we've tried to comply with what our users want, and also comply with what the FDA has asked us to do. But I think users will find the alarm experience. Good as well. I like I think it's just gonna be a home run. Yeah, well, I
Stacey Simms 7:24
mean, my son would be happy if an alarm never made a noise again. And I know other people who put like it to alarm every time there's any movement. So I hear where you're coming from, can you give any insight into the G7 app in terms of what the differences that we may see as users? And I guess especially one of the questions I always get is about follow any changes of significance coming that you can share follows
Kevin Sayer 7:47
on a separate software track. And so the G7 system, the app is just we tried to get more data in the app itself, versus what we have with G6. So a lot of the clarity data, or at least summary query data is sitting there right in your app. And that will be i we think people will like that just to see how they're doing over time you got your time in range data for, you know, three 714, you know, a month, 90 days, see how you're doing time in range wise and the app is other than that it's relatively similar. The startup is different and you know, in the interface is going to be different. I think over time, what you'll see with us is that app is now going to get more sophisticated, we changed the entire software platform for G7 and started over again, and we developed a software platform, we can now really change and add on to a lot easier than we could in the past. And so we're hoping to have more frequent software releases.
But we've also learned that CGM is not like Battlestar Galactica game, a game where you want to get a new release every two weeks to fire everybody up. We can't do a release every two weeks, because people depend on this for their, you know, for their lives. And if you do too frequent releases, and you botch a release, you do some wrong, you remember what happened, if we ever make a mistake on the software, the data side, we can't do that. But we do want to add more features more quickly in this platform will enable us to do that. I think one of the things you'll see going forward on the software side, we really want to automate a lot of the tech support features.
We've added some, you know, you can get FAQs right from the app now with respect to your sensor, but there are other things we think we can do tech support wise in the app that will you know, reduce everybody's burden. Nobody likes making a phone call and nobody likes picking up the phone. And when we have a sensor fail, and we do have sensors fail, it just doesn't make any sense that you have to call us if we've got data on a phone, it'd be much easier. For example, if we could diagnose that failure right on the app and go through a very quick process to why but where you could get one. I can't give a timeframe when all those things are going to come but the platform is robust enough that over time, we can add features like that. One of the other nice things about G7, since it's fully disposable, you know, every sensor has its own unique serial number. Whereas with G6, that same transmitters used with three months’ worth of sensors. So it will be, it will be fun to be able to follow things like that and see how the sensors go through the channel where everybody gets attract things of that nature. So what we're really looking forward to the change in our business that G7 affords us.
Stacey Simms 10:28
As usual, I have listener questions, I'm going to try to not repeat because you've been really accessible in the last year, we've talked to a couple of folks from Dexcom, besides yourself. So as you listen, if I didn't get to your question, or if you have a question, good chance, we actually answered it in the last year, year and a half. But given let me ask you about compression lows, because that's one of the things we had talked about, about testing the G7. Any update on that in these trials, if you lay on it, you know, circulation slows, and you can get a false reading any better with the G7
Kevin Sayer 10:54
part of the clinical study is in the compression, because you're pretty much sitting in a chair with a needle in your arm drawing blood. So I'm sorry, we can't really test that we'll learn more about compression when it gets in the field. My hope is that it isn't as much but I can't promise that because I don't know, we're not enough people. I think there are ways over time where we can manage compression better, I'm not going to get into all the science on the phone, believe it or not, I do spend a lot of time with the engineers on this specific issue. Because I have it happened to me from time to time too. So I will call them up say Hey, can we do X, Y or Z? And I think there are some some answers, but I can't give them away because I don't want to give away the playbook. So let's let's just see what we can do overtime on that one.
Stacey Simms 11:42
Okay. All right. But you know, the next clinical trial just have them lean against the side of their bed.
Kevin Sayer 11:46
We will we'll have to do well. Diffic very scientific.
Stacey Simms 11:50
Another question came up, and I think I'm gonna knock wood. I think we've been very lucky on this. It's about new iOS launches from Apple. And I'll read the question and it'll tell you, briefly our experience. This person said Dexcom is part of the Apple Developer Network developers have access to new release such as iOS months before launch, why does Dexcom lag behind Apple iOS launches by months in terms of quote, approved use. And our experience, frankly, is that we have not had any issues Benny and I both have, we just got but as a 13. Plus, we both had very old phones. And we have a latest software and no glitches for us. But that's not everyone's experience, can you talk a little bit about that,
Kevin Sayer 12:30
we do get the iOS versions in advance, and we do our best to comply with them, I would I would tell you that it isn't as simple as it's made out to be. And the iOS version that's launched isn't always exactly what we've worked on as they as they make tweaks, not big ones. But you also test for everything that you know about the new iOS versions, and sometimes are things that you don't know, that are in there that come back and may affect the app later on, which is why we delay a little bit, we try and go through every bit of testing that you can imagine. And I'll be honest with your users, Apple's made iOS changes, because of us, we have called up and said, Look, you got to do XY and Z here we have a problem. And they're very good to work with, they've not been difficult at all, you know, when you think about iOS and Android operating system and all the things that they impact. And it's very hard not to impact somebody adversely when you do a new iOS launch.
And you know, the perfect example with us is the home you'd override journey that I brought up earlier. In the beginning, I believe the only app that can overcome the mute override within iOS is authorized manna in the beginning was Apple's alarm clock, but other people would go around it with their apps was a medical device, we can't do a go around, we have to make sure what we do is in compliance and known so they work with us very well to make sure we could do what the FDA wanted with respect to the mute button. And the same thing with Android on that, and that was a very difficult exercise. So if there's a delay, it's because we're taking time to see what might have been put into iOS that would change our app. And it just one more thing that will stop. new operating systems are often designed to minimize power usage to extend battery life. Oftentimes, minimizing power usage affects an app that has to be running continuously. And those are the types of battles that we fight are things that we have to make sure we test as a new iOS minimizes power usage. Just does that turn us off? Does it does that stop Dexcom? And we've had, we've discovered things of that nature where it could affect our app. So there you go. Long answers. All right.
Stacey Simms 14:44
No, no, that's great. And you mentioned you've asked iOS you've asked Apple to make changes. I assume the alarm was one any others that you can share.
Kevin Sayer 14:52
I know that nothing I could share. Nothing major that I like you said they're very cognizant of the Dexcom community there we are. You know, we're we're a very large part of the iOS, you know, we're pretty, it's pretty vocal group when it comes to iOS,
Stacey Simms 15:06
pretty vocal group period, the whole community. Alright, we say that with love. So another question came from my group, which was about Sugarmate. This is a, I would describe it as a third party app that uses the Dexcom information. And now the real time API to display and and act on data in its own way, my understanding is that Tandem owns Sugarmate, just from way of background here. And you know, Dexcom owns a little bit of Tandem. So there's a relationship there. Can you speak a little bit about data sources, but the bottom line question here was using Sugarmate and the situation to ask you, does Dexcom feel like they own the patient data? Or do the patients still own their data, even when going through the Dexcom web API's, we believe
Kevin Sayer 15:49
the patient's own their data, not us, let me rephrase that we believe the patient's control the use of their data, we are the stewards of that data sitting on our servers. And so we have a responsibility to maintain it and to keep it but where that data goes and where that data is used. We do believe, particularly if it's identified data, that the patient absolutely has complete control over that there's vector sugar made, it's interesting, it was not using API's before it was a like many and non authorized use of the data to display it in a different format that people quite candidly, mess, like better than looking at the Dexcom app. And that's fine. That's why we built the live API's, we made a server change to upgrade our server platform, again, more capacity, more safety, more redundancy. It's a project that's been going on for years. And we've come to the end of that project this year. And when doing so there were some technical issues with Sugarmate, they very quickly switched over to the live API's. And now this is an authorized use of the data based on platform and data pipes that we built. So we're willing to share the data with people when they want it. I think that's an attitude of Dexcom. That changed very much over the years, when we first started, we had a hard time with that concept. Because we worked so hard to invent this technology and gather this data, why would we share it with anybody and say, See, you remember the early days and Nightscout, they were mad at us, we were mad at that. Now, we're not mad at anybody anymore. I think it's important that the data sharing be structured and be used for good purposes. But you know, all in all, it's a, it's a good use of the data that we have, because these are still Dexcom customers. If you want to, you're still buying sensors and using them. It's not a bad thing.
Stacey Simms 17:35
Let me ask you a question about the sensors. And this came up in the fall. I've seen it less since but it's still out there. And I don't know if this is something you can answer. But it seems that we have not received this. But it seems that some customers are getting the G6 sensors, the inserters brand new in the original packaging, but a new label on it that says this product meets shelf-life extension requirements. I'm your people I reached out to them in the fall, they told me the stickers, oh, you know, it's all legit. There are updated expiration dates. But I'm curious why this is happening. And you know, what is the shelf life of the G6,
Kevin Sayer 18:10
I can tell you exactly what's going on, you do shelf-life testing for product as selling your product will last. And over the course of our product lifecycle, you trying to extend that shelf life through more testing to make sure the product still works for the same amount of time period, if you manufactured product with 12 months shelf life, and then extend that shelf life to 18 months. And it's still the same product and still same manufacturing process rather than unbox it, put it in a new box or throw it away, we put a sticker on the outside because it's same products been tested, it's been proven that it works for 18 months, that's not a problem. That doesn't mean that it's 18 months old, we never have inventory that sits around that long to my knowledge, but we do extend shelf lives, it's important for us to do that, with respect to the distribution channel, particularly as we go to the pharmacy, you know, in the drugstore and and our distributors, the longer they have, you know that they can keep product, the better. We don't want people throwing product away if they don't have to. So all that means is we've extended our testing and shown that the product still works for a longer period of time and wanted to to label the product accordingly. That's all
Stacey Simms 19:17
Yeah, I think because it came at a time when there is nervousness just in general not just in diabetes about supply chain and, you know, scarcity concerns. It just seemed unexpected, if that makes sense.
Kevin Sayer 19:30
Well I one of the reasons to extend life is in fact supply chain we don't have inventory issues with G6 you know G6 is a very very well running process right now and still, you know, the premier sensor on the market. In fact, we launched a G6 derivation product in Europe, these past three months called Dexcom. One a it's a cash pay product sold on the E commerce platform in four European countries say See now and it's a lower price and geographies. But we did a feature that we took away, share and follow. We're not connecting any devices. It's it's a simpler technology. And again, we have d six supply to be able to go and do things like that. And we are planning to have G7 capacity to do similar things. We are not shooting small on either front will have capacity on both sides. And, you know, listeners on a supply chain perspective, we have been extremely diligent with respect to components for our products. And right now we see things very good today. We my operations team has just been outstanding on this front. So knock on wood, no, no Dexcom problems today.
Stacey Simms 20:40
All right, two more questions for you. As always, we're going to run out of time. And as you're listening, I would refer you again, we did have a conversation about Dexcom. One in a previous show. So I will link that up. This one is more of I've asked this, you answered it, but I still continue to get questions to please ask you please make sure when GS seven comes out that Medicare is taken care of?
Kevin Sayer 21:00
Well, that is a great question. And I think we've learned from our mistakes in the past. So we will when we get G7 done, what we will do is we will file with CMS to get G7 reimbursement. That's a process that I've heard anecdotally takes three to six months. So if we can get it done in three months, we can't file with CMS until it's approved. But we'll file after approval, and then we'll go and it is our plans to have capacity for all of our US users. When we go it is not that Medicare delay for G6 was one of the most emotionally gut-wrenching things I've dealt with here, because you can't imagine how many emails I got. But we didn't have capacity, and we didn't have everything ready. We've learned from our mistakes. And we'll hopefully be ready to go to everybody. That's our plan right now.
Stacey Simms 21:49
That's great. Okay, and my last question is, and I hate doing this to you, but I'm doing it anyways, look into the chapter, we're gonna look, we're gonna come at it sideways, because I did have one listeners and ask him what's planned for the g8? And I said, Come on, let's let him get the G7. Oh, you know what? I'm happy? You can answer that. Let's go for it?
Kevin Sayer 22:07
Well, well, I'll give you two because we did lose some time in the beginning because my computer wasn't functioning properly. As we look to the future, we want performance to continue to be better. And then we ask ourselves, but we're getting to the point where as you get to an eight, Mar D, we're getting close to finger six, I don't know how much more of a gap there's going to be, as we look to the future, and even G7 derivatives, we want to go to a longer life, we want to go to 15 days rather than 10. We'll be running studies doing that over the next couple of years. We've got a couple of plans there. We're always looking to upgrade the electronics, and how much better electronics, you know, I know one of your bigger user complaints is connectivity and loss of data, how do we improve that experience for our customers to make that better over time? Because we can always be better. And phones change faster than medical devices? So what why do we put there, we're looking at ways how we can help the environment for future product launches again, and changes in the next platforms, G6 has a lot more materials than G7 does as far as just raw plastic. So how do we make an impact there? On the cost side, there's some form factor things that are pretty far out there that we look at that I won't go into that are really, really fun. We'll see if we had done that. And if they're feasible from a cost of manufacturing perspective, but again, we're now very much focused on customer preference, rather than can't we make this work well enough, you know, in my early days here, it's Can we can we just get this thing working well enough to whereby people can rely on it. Whereas now it's one of those features that are going to make it a more engaging experience. And the last one will be software and analytics and things like that, as I look out over time, do we end up with analytics to whereby we can offer our users a menu of choices on the software side to whereby they can get more if you want Dexcom when don't want to connect or talk to anybody? You can have that if you want something that literally literally analyzes every glucose measurement that you take and does something scientifically. How do you get there, I think there's a number of experiences we can develop over time for future product generations without changing the form factor. So I don't see any slowdown in investment on the r&d side. And on the product side, G6 is the best product out there now and G7 will just be better in every way. And then we just keep going from there.
Stacey Simms 24:27
And I appreciate you answering that. Thank you. So if you keep going from there, this is the sideways kind of question I wanted to ask. Okay, go ahead. Okay. A couple of days ago, Abbott announced the idea of what they're calling Lingo, which is bio wearables that will track not only glucose, but ketones and lactate and alcohol. And they say these are not medical devices. You know, this is for people who want to be you know, ultra-marathoners and things like that. We're already seeing sensors used in that way right now. Any plans to do something like this?
Kevin Sayer 24:56
You know what our electronics platform for G7 We could put any, if we could develop a sensor wire with membranes and analytes and such for to measure something else, it would fit right into G7. And we design G7. With that in mind, we have advanced technology work going on with the other analytes. But it's still an advanced technology phase, we have to answer a couple of questions. First, have we done all we're supposed to do on the glucose side? Before we run there, and we got a lot to do right now, Stacy, you've heard me talk on this call. And so we need to get done what we started, we need to get G7 launched, we need to scale it up and manufacture it in the 10s. And ultimately, hundreds of millions of products as we stand up a factory in Malaysia and get our Arizona facility built out even more. So we've got to get that work done. The second piece, I'm going to answer this in three pieces. The second piece is what is the commercial opportunity for each of those things. They did announce this line of sensors, but they're all individual sensors.
So I've worn a lactate sensor, I'll be completely honest with you from the lab and seeing what it does to my workouts and it's very cool, I can see which workout is better than another one. But I'm not ultra-marathoner, I probably wouldn't change my life. But it was very interesting to look at. There are other scientific uses of black data, particularly in a hospital setting. But what is the market for those, and so we're gonna kind of take an approach, we'll continue to develop the science and if Abbott wants to go develop a market, I am happy to follow this time rather than create it, like we've done with glucose. The third piece of this is there are a lot of biosensors out there. Now, you have your Apple Watch, and Apple is continuing to gather more and more data or ranks, whoop bands, Fitbits, they're advertised on television all the time, I would love to incorporate data from these other sensing technologies into into Dexcom. And vice versa, share our data with those people, particularly as you head down the health and wellness path. And let's get some other people's sensors into our platform. In all honesty, if Abbott's really good at sensing these other things, we'll take that data on our platform and analyze it to if they want to, I guarantee you, that probably isn't gonna, gonna happen. But we would, you know, let's be open about this. We're going to get our glucose work done to because we've not seen an opportunity that exceeds this.
Stacey Simms 27:13
Got it? Excellent. Well, thank you so much for answering that it really is so interesting to watch and to see if, as you say, if any of this really, really makes a difference commercially, if people do want to adopt it widely. You know, I think the jury's still out, so we shall follow.
Kevin Sayer 27:26
Hey, thanks for having me again.
Stacey Simms 27:27
Thank you so much. Have a great day.
You're listening to Diabetes Connections with Stacey Simms.
More information at the episode homepage, diabetes, Dash connections.com. I'll have the transcription up as soon as I can. But again, quick turnaround on this episode. Thank you so much, again, for sending in the questions. Obviously, I didn't get to all of them. And if you're not in the Facebook group, that's generally where I asked for questions for this kind of thing. It's Diabetes Connections of the group. I'll link it up in the show notes. As always, I know not everybody's on Facebook, please feel free to always email me if you email me now about Dexcom. I'll save those questions until the next time we talk to them. It's Stacey at diabetes connections.com. Again, it's in the show notes and it's on the website. But I get it not everybody is on Facebook these days.
To that point, at the very beginning of the show, in that little sponsor tease before things even begin, I mentioned club 1921. So let me tell you a little bit more might be an update for some of you. Maybe some of you are hearing about this for the very first time. Briefly, club 1921 is a website. It's a project I've been working on for a long time. And it is a place where anyone with any type of diabetes can find events anywhere in the United States. We are in beta right now. I invite you to go to the website club 1920 one.com. Until around, check it out. Let me know what you think we've immediately identified we went into beta, late last fall several things mostly about the signup that need to be fixed, those could be fixed by the time you log in, my guess is closer to the end of January. There's a little bit of confusion there. I'll explain in a moment. But other than that, it's pretty well set.
The idea here is that instead of a Google Calendar or something like that, this would be a website where you go, you sign up, you tell us what kind of events you're looking for, and then you never have to come back, we'll email you automatically. When events that meet your criteria are edit, very easy. So you pick your type of diabetes, you pick your location, you pick which type of events you want, you pick your age, I mean, you can just say I want everything in every category you can kind of go through, but whatever you pick, and you can change those if you want to come back and change your filters, but whatever you pick, we will email you when those events are added.
If you want to add events. There are two types of events you can add one we're very creatively calling events. This is your JDRF walk. This is your friends for life conference. This is your hospital education for people with type two. It's an event by an organization a was a staff an event where they expect lots of people or it's regularly scheduled, or there's a fee, that kind of thing. The other kind of events we're calling Hangouts. These are my favorite types of events. I love what we're calling Hangouts. This is your mom, coffee, your kid play date at a playground, you know, you're going out to a bar, post COVID, with your adult friends with type one, hang outs are not put on by an established organization. They're put on by people like you and me, we don't have a staff, we just want to meet people in our area. When you're adding those. That's where a lot of the confusion came up in the registration process. Because if you want to add events or Hangouts, you actually have to sign up in a different way.
So I'm going to talk more about that as the weeks go on. We're fixing that part of the website. But if you try to sign up and you see some confusion, it may be because you are trying to add an event or a Hangout. If you want to just sign up to learn about the events and Hangouts, it should be pretty simple. But if it's not, if you have any questions, any suggestions, please let me know. Email me Stacey at diabetes connections.com. Pretty soon you'll email me Stacey at Club 1920 one.com You're going to be hearing a lot more about this because I'm so excited about it. Yes, I know, we might not have a lot of events this year, that's fine. We're going to have events, eventually, in the diabetes space. Again, we're gonna have lots of events, and social media, Facebook, even things like Eventbrite are a terrible way to get the word out about them. And it shouldn't be work to find them, you should be able to just raise your hand and say, I want to know about this stuff. And it should automatically come to you. And that's what I'm hoping to do here.
Okay, back to our regular schedule with the podcast. We will have our Wednesday in the news that's live at 430. Eastern on Wednesday on YouTube and Facebook, and then 445 on Instagram. And then that turns into an audio podcast episode for Fridays. And hopefully next week, we're back to Tuesday and Friday. And we won't do any of this nonsense of pushing episodes around. But I do appreciate your patience. Again, I didn't want you to wait a week for this interview. All right, thank you as always to my editor, the very flexible and understanding John Bukenas from audio editing solutions. And thank you so much for listening. I'm Stacey Simms. I'll see you back here in just a couple of days until then, be kind to yourself. Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged