Tag Archives: diabetes

Choice Is Necessary.

May 4, 2016 – 9:08 am

United Healthcare has decided that, as of July 1, adult patients with diabetes on certain UHC insurance plans who want insulin pump therapy should only be allowed to choose a Medtronic insulin pump. Hat tip to DiabetesMine for breaking the news.

There’s a lot more to it than just that one sentence, and obviously, people have a lot of questions.

Let me first say this: people who work for medical device makers and insurance companies are actual people, and they have families and concerns of their own, so I don’t think it’s fair to equate companies and their practices with the people who work hard for them every day.

That said, it’s really hard to find anything good in this discovery. Let’s be honest, okay? There is nothing good in this discovery. It is only benefitting those implementing the rule, and only harming those affected by the rule.

There was some explanation from United Healthcare about why they’re going down this road, and it’s a ridiculously weak argument. You can come to your own conclusions about it after you read what they have to say about it. But my take is that they’re not even trying to give a good explanation for this. Medtronic, for their part, has remained silent.

Did UHC get something for making Medtronic an exclusive provider? Or are they just being lazy, deciding they don’t want to keep up on all of the insulin pump manufacturers out there? Is Medtronic out there trying to cut similar deals with other insurance companies? Does this put pressure on other device makers to try and secure their own piece of the pie? Most of all: What if an actual artificial pancreas solution is approved by the U.S. Food and Drug Administration, and it’s not a Medtronic solution? Does that leave UHC patients out in the cold?

I’m not even going to try to answer those questions. They’re not important. They just don’t matter.

Because any way you slice it, this is bad news for People With Diabetes.

United Health Group, parent company of United Healthcare, has this as their mission statement:
 
 
“We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities.”

“We work with health care professionals and other key partners to expand access to quality health care so people get the care they need at an affordable price.”

“We support the physician/patient relationship and empower people with the information, guidance, and tools they need to make personal health choices and decisions.”
 
 
It appears that the latest about this exclusivity arrangement shows UHC’s mission statement to be rather disingenuous. In fact, it looks like they just took a giant shit all over it and its claims to “expand access to quality health care so people get the care they need at an affordable price”.

Reducing Eliminating choice for patients is wrong, it reduces innovation, and in no way does it “improve the overall health and well-being” of People With Diabetes, or even save them money.

I’m going to start saying something, and I’m going to repeat it any time someone asks me why something like this is a big deal.

Choice isn’t just important… choice is necessary.

Companies love to talk about how competition is good for the marketplace, good for consumers. Apparently, it’s not good enough for United Healthcare, because they just turned a fire hose on the idea of competition. You know, there are studies that show People With Diabetes do better when they have more information, more tools, and yes, better tools to help them manage their condition. I can’t find a single shred of evidence anywhere that says removing choices for patients with a chronic condition helps them live better lives.

You are wrong, United Healthcare. You’ve made a decision that only benefits you, and does not ensure even one better outcome for any of your patients. You are wrong, and I will keep telling your rotten story to as many people as I can. Including my elected officials, and news agencies.

For my part, I wish I would have had access to this information when I visited Medtronic a couple of weeks ago. The upper echelons of Medtronic Diabetes management was there that day, and someone must have known that this decision was imminent. But they didn’t share it with any of the advocates in the room. I would have liked to have asked questions and share my view directly with Medtronic brass that day.

Just as there are actual people working for these two organizations, there are actual People With Diabetes insured by UHC. And those people deserve and are entitled to choices when it comes to how they manage their diabetes. Patient trumps proprietary. And it always will.
 

By StephenS | Posted in Healthcare | Also tagged , | Comments (9)

Liquid Splenda? A little goes a long way.

May 3, 2016 – 9:08 am

I was contacted recently regarding by a PR person asking if I’d like to try a sample of a new Splenda product: Splenda® Zero™ Liquid Sweetener.
Splenda_LiquidZero
This is liquid Splenda. In case you didn’t know, I’m a Splenda fan, and when approached, I thought it would be fun to try this out. The idea is that this is Splenda’s formula, just in liquid form.

To set the table (no pun intended), Splenda is sucralose. It’s what goes into Coke Zero, which I really like. Another popular artificial sweetener is aspartame, which is what’s used in Diet Coke. And there’s your difference.

Up to now, we’ve only seen Splenda in granular form in the marketplace, and that’s been okay, because it still works in my morning coffee. How does liquid Splenda perform?

Very well, and very sweet (no pun intended). I mean, a little of this stuff goes a long, long way.

When I received my sample in the mail, I was surprised at how small the bottle was (1.68 fluid ounces), and I reached out to my contact at the PR firm that arranged the review and I asked whether the size I received was the actual retail size, or if it would be bigger. The answer was yes, what I received is the retail size, and it will sell for around $4.99 US.

Tasting it in my coffee, I understand why the bottle is so small. It packs quite the sweet punch. Ordinarily, a semi-heaping teaspoon of granular Splenda is what I’ll use in a typical cup of coffee. Or two packs of the stuff you see in a restaurant. In liquid form, that equates to one squirt of the bottle. More than that, and you really get extra sweetness.

I’m told that the new Splenda will go well in recipes, and I can’t wait to try it in my next batch of cornbread. I know, sweet cornbread. I’m one of those people. It’s the little something extra I go for when I’m enjoying barbeque, especially. Anyway, personal tastes aside, I can see this as something I might have in my cupboard for cooking. Not to replace sugar in things like pies, necessarily, but in things where I just need a little bump of sweetness, without the high glycemic boost that sugar brings. I suspect if you’re used to carrying a purse around every day, you could pack this little thing away and have instant artificial sweetness as close as your handbag.

If I were a thumbs-up or thumbs-down guy, I’d give this a thumbs up. Easy to figure out, still sugar free, the price isn’t crazy high. I hear it should be in your local store soon. Splenda® Zero™ Liquid Sweetener.

I was given a free sample of Splenda® Zero™ Liquid Sweetener to try at home. I not compensated in any way for my take on it, which is absolutely my view and cannot be bought with a little bottle of liquid sweetener. All opinions are my own.
 

By StephenS | Posted in Reviews | Also tagged , | Comments (5)

Customer service woes? Dexcom’s working on it.

April 29, 2016 – 9:08 am

If you’re a User of the most popular CGM on the planet; and if you’ve needed help from Dexcom’s customer support lately; you may have had a less than stellar experience.

I got a chance to speak with Kevin Sayer about that yesterday. Kevin is Chief Executive Officer at Dexcom. He gave me a rundown of how Dexcom is working on solving some of the issues their customers have been facing.

I asked Kevin if the latest customer service initiatives are a function of Dexcom sales growing faster than their customer service function, or if they’re just looking at things with a fresh set of eyes. The answer is yes to both of those. According to Dexcom’s quarterly report released this week, revenues are up 60 percent over this time last year. That’s a lot. He explained it by saying that it’s one thing when Dexcom was growing from 2,500 to 5,000 customers. But Dexcom is still growing fast, and they now have greater than 150,000 customers. That means when you have problems, they become a lot bigger a lot faster than they used to be. So they were forced to take another look at customer service.

As a result, Dexcom has introduced some initiatives designed to reduce the burden on patients who really could use less burden in their lives.

To begin with, they’re rolling out a phone system upgrade. The idea is to reduce wait times and queues. They’ve introduced a new feature where, when phone lines are busy, a customer can opt to have Dexcom call them back without the customer losing their place in the queue. So hopefully, people won’t be on hold forever anymore.

They’re also adding additional customer service reps. Those hires should continue through the month of May.

In addition, Dexcom has made some website upgrades. There are new self service options, and there have been improvements to the online store. Kevin put it this way: “If you’re ordering supplies at 11 o’clock at night, which is what I’d be doing, we want it to work well.”

Finally, there are training and video updates. More descriptive videos, easier access to videos, and the rollout of something brand new for Dexcom: live webinars.

One of the challenges Mr. Sayer relayed to me is the idea that with the Dexcom G5 system, they were no longer answering questions about sensors and receivers. Receivers that Dexcom designed and manufactured. They were now getting inquiries about sensors and phones. Phones that they didn’t design and don’t manufacture. So that slows up customer service a bit, though he feels they’re getting better at it.

At the end of our conversation, we talked about Dexcom at ten years old. How does he feel about shepherding the company into its second decade?

Kevin admitted that there aren’t a lot of examples to go by in the diabetes device world, because so many have gone out of business before reaching the ten year mark. So in a way, Dexcom is blazing its own trail, while still growing its customer base in a big way. And he told me something that I would expect every CEO to say: Dexcom’s patients are the most important part of their business.

Let’s hope that the phone system upgrades, website improvements, and customer service hires help Dexcom come through for their patients for many more years to come.
 

By StephenS | Posted in Reviews | Also tagged , | Comments (1)

Checking In.

April 25, 2016 – 9:08 am

Hi… how are you? I’m doing well now, thanks.

When I started this blog over four years ago, one of my goals was to keep sort of a history of my life with diabetes. So every now and then, I sit down and chronicle what’s been going on in my world. Partly for me (it’s my blog, after all); and partly for any family (and you’re family) that may come by, now or later, to find out what was really on my mind back in the spring of 2016. So here’s the latest:

You probably know I’ve been traveling a lot. Las Vegas in March, Northern Virginia a couple of weeks ago, California a few days after that. On the way home from Las Vegas, I had a cough, but I attributed it to the dry climate, and thought I would be better once I got home. Then, on my flight home, I wound up next to someone with a mask on (or off and on) through the flight, who was coughing a lot. A couple of days later, I was real people sick, which turned out to be bronchitis, which I never had before. It was treated, but apparently not enough, because a couple of weeks after that, I came down with something else I never had before: pneumonia. Long story short, a couple of weeks of antibiotics, and I’m back to my old self. Thank goodness, ’cause I felt pretty awful there for a few days. Pneumonia takes no prisoners.

Traditionally, my blood sugar runs high when I travel. Chalk it up to a mixture of food I don’t always eat (and thus have trouble bolusing for), and the fact that I’d rather be high than dangerously low when I’m in a hotel room by myself.

But lately, travel has been no trouble at all. Except for one weird breakfast occurrence in Los Angeles where, after breakfast, I found myself low, then ate the carbs I intentionally ignored over breakfast, then suspended my pump, then ate candy, then ate Skittles (thanks Karen). That kind of low doesn’t happen very often. It must have been the animated conversation.

At home, it’s been a revolving door of sorts. It seems like just when I get home, The Great Spousal Unit is headed somewhere herself. So there has been a fair amount of time at home alone for both of us, though we did travel together for the Friends for Life Falls Church event (and I’m super grateful she decided to come with me/let me drag her down there).

Here in Maryland, it’s finally spring. The azaleas are blooming, I have to mow the grass once a week, and plans are being made for throwing mulch down in multiple beds around the yard. I also put up a new window box for Maureen. She was ecstatic.
WindowBox
I got the vegetable garden started over the weekend (which is a week or two late for me– blame travel and the weather), so in a couple of months at most I should be feasting on home grown lettuce just about every night. I can’t wait.

The BGs at home have been playing nice too, mostly. I just have the feeling that my basal rates are really good right now. My dietary bolus needs have changed a bit over time… does that happen to you too? I don’t even touch half a bagel anymore, let alone a full one. Requires gobs of insulin to bring me back down into range, no matter how much I pre-bolus. Seriously, I’m finding that a donut requires less insulin than a bagel these days. Potatoes don’t seem to require much for me now. Bread, on the other hand, is a nuisance. Pepperidge Farm makes a low carb bread that I found a couple of weeks back though, and it actually tastes like bread and requires far less insulin to cover, so when I’m eating a sandwich or toast, it’s at least a decent option.

Other than that, I must admit to going primarily low carb in the last five or six months. Not crazy low carb, but… you know how People With Diabetes say that over the years, orange juice starts to taste like medicine instead of juice? Well, for me, mindless carbs are starting to look like poison to me. I still eat a little of the poison here and there, but I’m also okay with a salad for dinner and something like quinoa rather than rice. My BGs and my weight have responded positively.

Okay, so that’s a lot of my life right now. How’s it going with you? I’d really like to know. Let’s talk!
 

By StephenS | Posted in Random Glucose | Also tagged , , | Comments (1)

Medtronic Diabetes Advocate Forum.

April 21, 2016 – 9:08 am

MedtronicDAF
Full disclosure: Medtronic paid for my travel, hotel, and meals so I could attend this event. All thoughts, on all media, are my own and are never for sale.

I was fortunate enough to attend the latest Medtronic Diabetes Advocate Forum last week in Los Angeles, California. To be honest, it was pretty short on advocacy and long on Medtronic.

But I look at it this way: first, we did come up with a couple of good advocacy ideas (and by we, I mean someone other than me). I don’t want to steal anyone’s thunder, so I won’t reveal anything yet. But watch this space for more later. Second, if I was told ahead of time that I would get a chance to interact directly with top leaders at Medtronic Diabetes, I would have said yes anyway.

So, while it wasn’t exactlly what I expected, it was definitely worth the trip.

What did I learn? I learned that Medtronic Diabetes went through a change about a year and a half back. They have some newer people and newer roles, and they are now looking at what they do through a different lens. That includes a new mission statement:

Transforming Diabetes Care Together
for Greater Freedom and Better Health

 
Every presentation from every person we talked to revolved around the tenets of the mission statement. Here are some of the things I heard:

From Louis Dias, Chief Patient Officer: “In order to transform patient lives, it’s important to keep patient stories in mind so we can transform ourselves.”

From Alejandro Galindo, President, Intensive Insulin Management: “No two diabetes journeys are the same, but they could all be a little better.”

From Annette Bruls, President, Diabetes Service and Solutions: “Medtronic’s next generation solutions seek to answer the questions How have I been doing? How will I be doing? What should I be doing?”

From Hiten Chawla, Senior Director of Marketing, Non Intensive Diabetes Therapies: “We’re working on solutions to improve disease understanding, management, and outcomes for Type 2s and those with pre-diabetes.”

From Hooman Hakami, Executive Vice President and President, Medtronic Diabetes: “We plan to add 19 million more patients by 2020.” (side note: I was assured later that this does not mean 19 million more pumpers, but rather 19 million more patients’ lives improved through Medtronic efforts in the next four years)

There was a lot more, including a panel discussion over lunch that included everyone mentioned above, plus Dr. Francine Kaufman.

Throughout the day, I was impressed by all of the attendees, including the ones from outside the USA. I was encouraged that at the times they needed to, people were able to speak in their own languages and be heard and communicated with in their own languages. It wasn’t always loving. There were some difficult questions, but never a dull moment.

There were a few questions I wish I’d have asked. I’ve gone back and asked them since. How much is Medtronic paying IBM to use Watson’s supercomputing power to crunch data? And what kind of data is being crunched? Is it just data uploaded to CareLink? Is it all data uploaded to CareLink, for all pump and CGM configurations, or just some? I’ll let you know what the answers are.

You can probably tell from the statements above that everyone there is drinking the Kool Aid. Which is good, if you want to actually accomplish the goals you set for your company. I’m also jaded enough to know that it’s really rare that everyone is on board with the mission. And I know that regardless of how the mission looks today, changes will be made over the next few years. That’s the way it goes in business. To stay relevant, you adapt. Anyway, I like what I’m hearing so far.

I must give special thank yous to Amanda Sheldon, Senior Director of Global Content Strategy; Karrie Hawbaker, Senior Manager, Social Media; and Naomi Ruperto, Social Media Community Manager. They went out of their way and then some to make attendees feel welcome, answer questions, and take on a couple of tough issues of their own.

So while it wasn’t all-advocacy-all-the-time, the Medtronic Diabetes Advocate Forum packed a lot of information into a short time frame. Let’s watch together to see how they deliver on the message of transforming diabetes care together for greater freedom and better health. If they pull it off, we’ll all be better for it.
 

By StephenS | Posted in Events | Also tagged , | Comments (3)