Category Archives: Diabetes

What’s the ETA?

June 29, 2015 – 9:18 am

ETA… Estimated Time of Arrival. It’s almost an antiquated term in today’s english, often passed by in favor of terms like “When can I expect that?” and “What’s your hard deadline?”.

When it comes to diabetes, we’ve almost been conditioned at this point to stop asking when a cure will happen. Many don’t believe there will ever be a cure, and many more believe, but aren’t holding their breath for it.

In fact, hearing phrases like “We’re so close to a cure” or “It could happen in your lifetime” (to someone of my age), or the previously ubiquitous “Within five years” is one of the easiest ways to identify someone not in the know on such things.

Many organizations have, while championing a cure, backed off of anything that might even possibly be construed as a promise of a cure for diabetes couched within a specific time frame.

I’ll admit that this is good, because it keeps people from becoming overwhelmingly disappointed when a cure doesn’t happen within the window in which we might have expected it. Often, it allows us to say that a cure is not imminent, so let’s work on making diabetes easier to manage in the meantime. I am all for that.

But since I’m a both-sides-of-the-coin type of person, I will also admit that not expecting a “just around the corner” cure for diabetes, sometimes, feels like an excuse to hold off finding a cure for even longer. Sometimes, just to develop more products. Things that will keep us paying through the nose, that will make things easier for People With Diabetes, but will siphon off money for other things that family members of People With Diabetes could really use.

It’s the skeptic in me that asks: How many People With Diabetes can’t afford to send their kids to college due to the fact that their out-of-pocket medical expenses range in the thousands of dollars each year? How many can’t afford to keep up with repairs to their homes? I’ve been one of those people.

I don’t really sit on either side of this question. How could I? I mean, hell yes… I want a cure. I want it yesterday. But in the absence of a cure, I also think that an artificial pancreas system is a remarkable development, and should continue to be funded through to completion. And then improved upon after that.

That’s where I’m going with this post… how do I justify championing improvements in therapy, drugs, and devices, without losing sight of, even a little bit, of the need for a cure? I’m torn when I think about it. I get that little twinge in my gut that has always been a benchmark for me to look at a situation with a fresh set of eyes.

I also have a fresh sense of respect for those who are both working on ways to improve our lives with diabetes, and are still passionate about a cure for this awful disease. I think that’s a tougher tightrope to walk than I’ve been giving people credit for up to now.

My goal from this point forward? Right now, I think it’s to remember that a cure is still incredibly important, and it should be worked on and funded, and should not take a back seat to CGM In The Cloud or Inhalable Insulin or any of the latest developments. It’s important to keep asking: What’s the ETA on my cure? Yet both sides of the equation are important. In many ways, equally important right now.

When we talk about a cure, let’s remember the amazing steps in improving diabetes management that have happened, and are still happening. Likewise, when talking about improvements in diabetes management, let’s not lose sight of the ultimate goal:

The Cure.
 
 
 

By StephenS | Tagged , , , | Comments (0)

Market forces in the insulin pump space.

May 21, 2015 – 10:31 am

It’s no secret that the number of people diagnosed with diabetes is growing, here in the United States and elsewhere. Yet, with the end of the Snap insulin pump last Friday, insulin pump options just got smaller. Does that mean we’ll start to see less innovation in pumping? Less options to upgrade? Possibly a higher cost?

I fear the answer may be Yes.

It’s all tied to a little thing I don’t like to call supply and demand. But I guess I have to.

There are roughly 300,000 insulin pumpers in the USA, give or take 50,000, depending on who you get your data from. As of this time last week, there were six insulin pump options available. That’s about 50,000 pumpers per maker, though obviously, some companies have more market share than others. Today, there are five pumps available to People With Diabetes in this country. If we divide the math evenly, that’s immediately 10,000 more users per pump.

Of course, if you’re a maker of one of these (still available) pumps, you might want to make a deal with previous Snap users to get them under your umbrella before another company does. That’s also supply and demand. So Insulet, makers of the OmniPod, and Animas, makers of the Vibe, are offering deals for Snap pumpers to move to their respective offerings.

Once this transition is complete (I’m guessing in about four months or so), the offers will probably end. At that point, who knows? Well, we do know this: With fewer competitors, pump makers will be less inclined to compete for our business. They will all see a spike in their revenue as a result of Asante’s demise, and they will all believe they have the best pump on the market. So if they don’t want to offer an upgrade pathway for existing users (as Tandem’s t:slim has declined to do recently), they won’t. Especially if you’ve still got some time under warranty left.

And what about price? The retail cost of an insulin pump has been right around $5,000 to $6,500 per unit for some years now. We know that the cost of everything goes up at some point, but that’s especially troubling when it comes to our diabetes, which costs a great deal of my disposable income already, even though I have good insurance coverage. The thought of having to pay even more for something I rely on so heavily is scary indeed. If I finally decide on a new pump in six months, will I have to pay a higher price?

Will I be paying a higher price for what is essentially the same pump? I’m thrilled that Medtronic has their threshold suspend technology, and I’ve seen and heard lots of positive news about the Vibe, but… the pumps themselves, on the outside, appear to be pretty much the same pumps as the previous generation from these companies. At this point, manufacturing these for a number of years (remember, only the software is different) should make the cost to the manufacturer far less than it was at the beginning of their run. But will it still be the same cost? Without any significant innovation other than software, which should also get less expensive over time?

I wish I had we had the chance to try out every pump on the market. Then I’d we’d be able to decide for ourselves if there is something special about a pump that is worth paying the same, or an extra, price for. Or something about a pump that makes it not worth paying the same, or an extra, price for.

Not that we’d be allowed to do that.

More choice, at least steady improvement, and a chance to upgrade for a fair price. Is that all we get, if we’re lucky? How about more innovation, more choices, and less cost as a product gets older? They even do that with mobile phones, for heaven’s sake. Is someone saying we’re not as worthy of innovation, choice, and affordability as the average cell phone user?

That’s the message I’m hearing, and I fear we may not be at the end of this cycle yet.
 
 
 

By StephenS | Tagged , , | Comments (1)

Choose something new? Or go with the existing standard?

May 4, 2015 – 9:57 am

I’m thinking it might be time… time to find a new piece of alert jewelry.

The only medical alert jewelry I've ever owned.

The only medical alert jewelry I’ve ever owned.

I am incredibly awed and fascinated by people who have diabetes ink on their bodies. Those people don’t have to worry about wearing a bracelet or a necklace that details the fact that they have diabetes. It’s right there on their arms (it’s on everybody’s arms, right?) for everyone to see. But… while I may admire someone else’s tatoo, the thought of getting one of my own just doesn’t appeal to me.

I’ve had the same Medic Alert necklace for all of the 24 years I’ve been living with diabetes. I updated it after I was diagnosed with high blood pressure, but it’s been the same model all this time. I got it originally because 1) I was told I must get a medical alert something because I had diabeeeteees; and 2) Because I didn’t want to be too flashy about advertising my diabetes to the world. Geez, and now I write a blog and engage in advocacy. How the world changes.

The thing is, I actually like my necklace. It has the basic information. It allows someone who finds me to make a collect call (why they don’t have an 800 number after all these years is beyond me) if they want to find out my endocrinologist’s name, etc. It has all of the most important medical information on it:

DIABETES
INSULIN DEPENDENT.
HYPERTENSION
ALLERGIC TO SULFA.

After wearing it 24/7/365 for so long (except while swimming and… sex), it really feels like another part of my body. It feels weird when I’m not wearing it. And I know of at least one instance when emergency medical technicians looked at it and made the call, getting valuable information that helped me.

But… I don’t like to stick with the same thing all the time. I’m thinking it might be nice to have something else I could wear now and then. But what? I’ve seen a lot of ads for different medical alert bracelets and such. Should I get something new? Even if it’s just so I could have an alternative? First world problems, yes?

I don’t know the answers to those questions yet. But I’m going to do a little research. I’m going to look into what’s available on the market, and decide if something new might be good for me.

I’m thinking it might do you some good to look into alternatives too. Unless you’re wearing something you really like already. If you are, please leave me a comment to let me know what it is so I can check it out. If you’re living with diabetes… and you don’t have something like this that you’re wearing already… even though it might seem strange and uncomfortable at first (because it was for me too)… get one now.

As strange as it may seem to be wearing an advertisement for your own diabetes, that advertisement may prove amazingly invaluable to you today, or tomorrow, or fifteen years down the road. If you want people to take your diabetes seriously, take it seriously yourself and get your own alert bling. Then leave me a comment below.
 
 
 

By StephenS | Tagged , | Comments (5)

Medtronic Acquires Diabeter: Hopefully, the beginning of something great.

April 27, 2015 – 11:35 am

A couple of weeks ago, Medtronic, the maker of the insulin pump I’m wearing, made a few waves with its acquisition of the Diabeter clinic in the Netherlands. Diatribe has some of the details, and they were able to speak with Medtronic Diabetes President Hooman Hakami. To read the full story, CLICK HERE.

Diabeter has clinics in four different locations in the Netherlands, specifically designed to help children manage their diabetes. They do a lot to work on a continual basis with patients, employing technology where possible to help patients make updates and manage their care in between visits to the clinic. And they’re pretty successful too: Eighty-five percent of their Type 1 patients who wear insulin pumps carry an A1c under 7.5, and half of their patients on MDI (multiple daily injections) do the same. Notable is how involved they are in their patient’s care. In short, they and their patients are sharing data, and making updates to therapy where necessary, a lot more often than the every 90 days model that most of us here in the States work with.

What does this deal do for Medtronic? I think it probably means a lot of things, not all of them bad.

First, they’ll be able to get real up-to-date information on patients, allowing them to see where they, as a company, might be able to step in and make a positive impact. If one particular product or plan works better than another for a patient, they’ll be able to see that and then bring their vast resources to bear on helping bring that to a wider group of patients. Likewise, Diabeter should be able to continue helping patients without worrying about who is going to pay the rent every month.

Let’s make no mistake though. Medtronic would not have made this investment without wanting to profit from it. Initially, we know they would like to expand the Diabeter model to others in the Netherlands and throughout Europe. What would that look like? Do patients get charged every time data is shared back and forth with a healthcare professional? If patients are considering an insulin pump or CGM for the first time, will they be able to choose between a Medtronic pump/CGM and other offerings on the market in Europe? We don’t know how it’s going to work… it’s still too early. But I don’t think it would thrill Med-T if most of the patients at Diabeter clinics were wearing an Animas Vibe system.

And finally… since it’s so successful, could the Diabeter model work here in the USA? I certainly think it could. But I don’t think it would have a chance here. That’s because of restrictions that insurance companies would make on constant feedback to and input from your doctor. There’s a reason why we go to the endocrinologist only every 90 days, and it’s not just about A1c. I also think it would tax endos and CDEs, especially, to be that involved in a patient’s care. There aren’t enough of them to go around as it is.

I don’t know. Maybe I’m too pessimistic about all of that. I know this sort of system would work for People With Diabetes here. The real issues around making it happen would be resources and payment.

I must admit that I find this acquisition by Metronic interesting. I’m going to want to see how this works for everyone involved: Medtronic, Diabeter, healthcare professionals, and most of all, patients. Over the next few years, I’m hoping we see the expansion of proven techniques that help PWDs be as successful managing their diabetes as possible, with the least amount of work involved to get there. And I don’t care where the great ideas come from, as long as they keep coming.
 
 
 

By StephenS | Tagged , , , | Comments (1)

So Worthy: Diabetes Community Advocacy Foundation.

December 31, 2014 – 9:16 am

With the end of the year approaching, I wanted to write a few blog posts with the idea of pointing you toward some important (to me, anyway) diabetes organizations.

I recognize that JDRF and the American Diabetes Association are important non-profits that deserve your support as well. But I want to dedicate these posts to other organizations that are doing important work to further the cause and improve the lives of everyone living with diabetes.

If you have a few dollars left at the end of the year, consider making a donation to these worthy organizations.

One other thing: I was not asked to write nor am I getting anything for writing about these groups.
DCAF_Logo

Diabetes Community Advocacy Foundation

Originally started as Diabetes Social Media Advocacy (hence the #DSMA hashtag), the Diabetes Community Advocacy Foundation officially became a non-profit organization in 2012.

Founded by Cherise Shockley, DCAF is meant to connect people living with and affected by diabetes, both through social media and in real life. It is everything its name suggests, but it is so much more than that too. Its outreach is many and varied, encompassing initiatives that are well known and not so well known, including:

– DSMA Twitter Chats: Every Wednesday night at 9:00 eastern time here in the USA, friends from around the world get together via Twitter and discuss diabetes. Actually, they discuss their lives, with diabetes as a common thread. But of course, it’s way more than that. There are usually questions and answers surrounding a common topic, and there are questions (and answers) from individuals logging on. With a ton of laughter and encouragement thrown in for good measure. For many, this is the gateway to the rest of the Diabetes Online Community, and for that alone, it’s worth a contribution to DCAF. It always leaves me feeling so happy that I stayed up for it. If you haven’t already, you’re encouraged to join the conversation by following the @DiabetesSocMed Twitter account or the #DSMA hashtag.

– DSMA Live, DSMA Live En Vivo, and DSMA ‘Rents Podcasts: Using a various lineup of amazing hosts, DSMA Live (Thursdays at 9:00 ET), DSMA En Vivo (in Spanish every other Tuesday at 9:00 ET), and DSMA ‘Rents (every other Monday at 9:00 ET) take an hour to focus on one topic or one person. Whether it’s diabetes research, a new D initiative, managing your diabetes, diabetes and exercise, or special and unique events in the diabetes world, these three podcasts will keep you informed and educated. And of course, you’re encouraged to phone in and be part of the talk too. Find out more on any of these and connect to the podcasts by going to the DCAF page on Blog Talk Radio.

– Blue Fridays: A simple way to spread awareness and show support for those living with diabetes, DCAF has been the leader of the Blue Fridays initiative. You’re encouraged to Think Blue – Wear Blue every Friday and on World Diabetes Day. There’s even a Facebook page. It’s an easy way to get your advocacy on each and every week.

Those are just some of the unique ideas that have come from this passionate organization. The recently retired DSMA Blog Carnival and some in-person DSMA Live events are a couple of additional highlights. DCAF is an organization that is not afraid to try something new, not afraid to look toward the next horizon if there’s a way to support and uplift People With Diabetes. If there’s a way to connect people living with and affected by diabetes, Cherise is interested in making it happen.

Would you like to help make it happen? To make a donation to Diabetes Community Advocacy Foundation, simply go here and click on the Donate button:
http://diabetescaf.org/2012/11/supporting-dsma-through-dcaf/
 
 
Disclosure: In the past, I’ve written Blog Carnival posts for DCAF, and more recently, I’ve been honored to moderate a few installments of the weekly DSMA Twitter chat. Strictly pro bono… I am not compensated in any way for doing so.
 
 
 

By StephenS | Also posted in Advocacy | Tagged , , | Comments (1)