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Diabetes Connections with Stacey Simms Type 1 Diabetes

The T1D news show you've been waiting for! Long-time broadcaster, blogger and diabetes mom Stacey Simms interviews prominent advocates, authors and speakers. Stacey asks hard questions of healthcare companies and tech developers and brings on "everyday' people living with type 1. Great for parents of T1D kids, adults with type 1 and anyone who loves a person with diabetes.
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Diabetes Connections with Stacey Simms Type 1 Diabetes
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Now displaying: March, 2022
Mar 29, 2022

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

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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!)

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Mar 25, 2022
It's "In the News..." Got a few minutes? Get caught up! Our top stories this week include increased risk of  type 2 after having COVID-19, CGM gets high marks as a telehealth device, Ypsomed pump picks a new partner, more study on the TB vaccine for type 1 and T1D: The Movie update!
--
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

-----

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!

*Click here to learn more about OMNIPOD*

*Click here to learn more about DEXCOM*

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.
XX
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
XX
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
XX
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/
XX
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/
XX
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/
XX
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
XX
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.

Mar 22, 2022

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!

*Click here to learn more about OMNIPOD*

*Click here to learn more about DEXCOM*

Mar 18, 2022

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
--
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

-----

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!

*Click here to learn more about OMNIPOD*

*Click here to learn more about DEXCOM*

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.
XX
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/
XX
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
XX
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
XX
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
XX
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
XX
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
XX
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/
XX
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.
XX
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.

 

Mar 15, 2022

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!

*Click here to learn more about OMNIPOD*

*Click here to learn more about DEXCOM*

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

Mar 11, 2022
It's "In the News..." Got a few minutes? Get caught up! Top story this week: Non-profit insulin announced, Tandem issues warning on some pumps, a common blood pressure med may help T1D, a potential new treatment for retinopathy and a PGA player misdiagnosed w/T2D speaks out
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Join us LIVE every Wednesday at 4:30pm EST

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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*Click here to learn more about OMNIPOD*

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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.

 

Mar 6, 2022

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.

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!

*Click here to learn more about OMNIPOD*

*Click here to learn more about DEXCOM*

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

Mar 4, 2022

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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Join us LIVE every Wednesday at 4:30pm EST

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Episode Transcription Below (or coming soon!)

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*Click here to learn more about OMNIPOD*

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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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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.

Mar 1, 2022

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!

*Click here to learn more about OMNIPOD*

*Click here to learn more about DEXCOM*

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

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