Diabetes Health in The News Podcast

By Nadia Al-Samarrie

IndyCar racer Charlie Kimball is back on the racing track now with AJ Foyt as a full-time driver (No. 4 Chevrolet) in the 2020 NTT 17th IndyCar Series.

Diagnosed with type 1 diabetes at the age of 22, four years into his professional racing career, Kimball did not let that stop him from following his passion. “Diabetes is a team sport,” says Charlie. He has partnered up with Novo Nordisk for ten years with the message never to let your diagnosis get in your way.

Charlie has integrated his Dexcom G6 in his car system. When checking his gauges, he can read the speed of his lap time, body temperature, and blood sugar. The pit lane engineers also watch the electronics to keep an eye on his blood sugar levels. By education, his crew – they have learned how to understand the meaning of his blood sugar readings. Although he has a liquid hypoglycemia device built into his helmet, Charlie has yet to use it in competition. Dr. Peters, a well-known celebrity physician, keeps close tabs on Charlie with her smartphone through the Dexcom technology.

Listen to my interview with Charlie to hear how he prepares for a physically demanding race that requires him to drive 200 miles an hour without power steering or power brakes.

You can follow Charlie’s racing schedule on Twitter @racewithinsulin.

You may also be interested in Do What You Love, and It Will Never Be Work, my 2011 interview with Charlie Kimball.

The post Diabetes Health Type 1 : Catching Up with IndyCar Racer Charlie Kimball appeared first on Diabetes Health.

Say the word “ticks” to people you know and it is highly likely that you will see a look of disgust—even dread—on their faces. We all know that getting bitten and blood-sucked by a tick can lead to the painful, hard-to-diagnose Lyme disease.

In many ways, because it can present confusing and hard-to-diagnose symptoms, Lyme disease is much like fibromyalgia—a disease that can have confusing symptoms and is hard to diagnose.

I recently spoke with Dr. William (“Bill”) Rawls,* an OB-GYN who over the years has spent much of his time studying the best way to diagnose various ailments, including Lyme disease. He had some interesting things to say about the humble tick, much of it the first time I’d ever heard detailed observations about spiders’ little cousins.   

When it comes to their eating habits, says Dr. Rawls, “Ticks feed and then drop off. They need a ‘blood meal’ to survive, and over the course of their lives will consume many such meals. There’s also something called a partial feeding where they’ll latch on to host for a while to top off a recent blood meal—a behavior that makes even better for spreading Lyme disease. Then a tick will enter a quiescent period and then come back a year later.”  

In all, says Dr. Rawls, ticks go through three stages of life and need a blood meal to complete each one. “When they come back, they come back a little bigger and a little stronger to complete each stage.”

He explains that each of us has somewhere between 20,000 to 40,000 species of microbes in our body. “Every part of our bodies are colonized by microbes.” That immense number, an approximation at best, tells us much about the complex biology of mammals in general and human beings in particular.

But even the tiny tick carries many microbes, some of which it can inject into humans. So there is ample room to gain new knowledge about them.

As an example of finding unexpected insights about ticks, Dr. Rawls observes that a couple of years ago researchers went out to track one tick species in China. “Instead they found 237 tick families—genera—each with a distinct set of microbes that could be carried by those ticks with the ability to infect vertebrates. Those numbers were a lot higher than most people thought.”

Ticks set out as very small larvae that hatch. “They need to start out with a blood meal by attaching themselves to something small, usually rats. They feed a couple of times then they drop off and molt. They tend to stay under leaf litter where it’s moist.

“For the next blood meal they make a crazy dash out on a limb and hang out and wait until something comes along. A lot of ticks just dry up and die because nothing ever comes along. Next for those that survive, is the nymph stage, where they about the size of the head of a pin—which means people can’t see them. This stage is where ticks spread the majority of diseases. A tick at this stage can be on a person for days without the human host realizing it.

“Eventually you wind up either removing it yourself or it just drops off. If it’s in the out of doors it goes back to leaf litter where it goes through another cycle then comes back as an adult tick—the bigger ticks we find on our dogs or ourselves. These are the ones we can see and because of that they are less likely to cause the illnesses that a smaller nymph tick can. But at the adult stage they can still spread disease.”

He explains that bugs have different ways of detecting their victims. “For insects like mosquitoes it’s probably the CO2 we give off. For arachnids like ticks, it’s probably vibrations.”

Dr. Rawls’ knowledge about tick behavior is derived comes from his years-long study of how our current healthcare system goes about making diagnoses. It’s a system he finds wanting.

“Our system of diagnosis is really dysfunctional. We ask how someone is ill not why they are ill—an approach that really makes for very dysfunctional  treatment pathways. What I mean by that is what we’re looking for to reach a diagnosis is to define the processes that have gone wrong. What’s the immune process? What’s the hormonal process? And we then try to treat those abnormal processes with drugs.

 “That’s how our system is designed. It’s really complex and really expensive, and it leaves a lot of people very, very frustrated. I think there’s value in the concept of diagnosis, but I don’t use it like other physicians do. I go down a list, that list of six things to look for before making a diagnosis: poor nutrition, emotional stress, oxidative stress, toxic stress, physical stress, and level of energy.

“So I’m trying to determine why these persons are ill and why those processes in their bodies are dysfunctional.  And when I do that, you come around to a whole different direction. I can take the guy you’re talking about and redefine the stress factors in his life that led up to his illness and propelled it. Then we get to work on alleviating those stress factors.”

*Dr. Rawls is located in Wilmington, NC., where he operates an herbal supplement company, VitalPlan.com 

The post Diabetes Health Type 1 & 2 Podcast: Lyme Disease Tick Talk appeared first on Diabetes Health.

The A1c is the best known and most reliable measure diabetes patients have for tracking their blood glucose levels over a somewhat extended (three-months) period. The A1c is about to be superseded by a measure called GMI* (Glucose Management Indicator), says Kevin Sayer, President and CEO of Dexcom. Dexcom’s continuous glucose monitoring (CGM) devices have dramatically changed how type 1, and now type2, diabetics manage their blood sugar levels.

*(GMI analyzes CGM-generated data from 14+ days’ worth of blood sugar monitoring to show what a patient’s current A1c percentage would be now versus a three-month wait for the average shown by an A1c.)

“What Dexcom has learned over the years is that the A1c leaves a few things out. For example, you have three diabetes patients, each with the same A1c percentage. But that number alone doesn’t tell you that much about the state of each patient’s diabetes management. It doesn’t tell you whether they’re in a healthy range. One patient’s A1c may show the same result as the other two, but may be averaging blood glucose numbers that vary only between extremely high and extremely low, with little time in a healthy range, and still come out as a reasonable A1c.

“You have to avoid those highs and lows. How the GMI works is to show time and range very quickly, which allows for much greater insight into a patient’s diabetes management than the A1c, which is simply an average.”

Sayer says GMI can be targeted at everyone, type 1s and type 2s. “In our work with type 2s we’ve seen numbers all over the board. From the feedback we’ve received from type 2 patients, one common observation is that ‘this is the first time I’ve been truly educated about my condition.’

“When they read a Dexcom Clarity printout, and see what their average day is like, and see how much time they spend either high or low, it’s a big help. Even though their 90-day A1c might be fine, if they can see day-to-day numbers it’s easier for them to make changes in their management. ‘Should I avoid that late-night snack?’ ‘Should I change what I eat or drink at breakfast?’

“Since CGM can tell how certain foods affect daily changes, patients can use that information to change their habits as necessary. Many type 2s will say they want to avoid shots or going on insulin. So if you have a way of tracking your numbers and what causes them to go high or low, you can manage them in such a way that you could successfully delay starting on insulin.”

Increasing Patient Demand for CGM

Sayer says there is a new wave of patients who want to use CGM and are approaching their doctors to prescribe them. “They see CGM as a good way to monitor and manage their health. “I want to see what my diet does to me during the day.”

It’s still mainly type 1s who are current main users of CGM technology. “That’s where it’s reimbursed now,” says Sayer, “but we can change that dynamic and get CGM to everybody. It will take time. The health system first has to see that CGM is improving outcomes for diabetics. And we’re going to have to do work to build some plausible models for CGM use—daily? Weekly? Quarterly? Annually? —so that payers come to support its general use.”

Pharmacy Distribution

Can patients get Dexcom’s CGM at a pharmacy? “We’ve been pushing pharmacy distribution really hard. Over half of the payers have a pharmacy benefit for patients. I think it’s important for patients to go ask their drugstore if they can get their CGM through the pharmacy benefit.

“We would love to have it work out over time for patients to get our product at the pharmacy. We think it would be ideal for both us and them. We want to be where patients want to be in the distribution scheme. They want to be able to go to their drugstores for products like this.”

The post Dexcom CEO Says CGM Data Will Soon Make the A1c Obsolete appeared first on Diabetes Health.

Diabetes Health Insulin Charts

By Nadia Al-Samarrie

If you have been one of the voices demanding change because having to choose between household expenses, medical supplies and insulin- has infuriated you, then you will be excited to know that your voice has been heard, easing the high cost of your insulin medication.

As of yesterday, all the insulin pharmaceutical companies offer discounted insulin . For your convenience, I have briefly described the cost and provided you with the links and phone numbers so you may read the qualifying criteria to receive your insulin at a lower rate. These discounted medications are limited to U.S. residents only.

Afrezza 

Afrezza offers several discounts for their inhaled insulin that range from $150 to 250 a month. The program is implemented by Eagle Pharmacy. You must contact the pharmacy directly to complete their qualifying form. The offer is limited to 3 packs of 4, 8 or 12 Units of Afrezza cartridges a month.

Offer expires on 12/31/2019

Call Eagle Pharmacy at  1 (855) 748-2663

Eli Lilly

Eli Lilly offers up to a 40% discount on their insulins. The program is implemented by Blink Health.

Offer expires on 12/31/2019

Call Blink Health at 1 (833) 794 – 1293

Sanofi

Sanofi-Aventis offers insulin for $99 a month through their Valyou program for 12 months. The offer is limited to 3 vials of insulin or two packs of insulin cartridge pens.

Call Sanofi at 1- 833-813-0190

Novo Nordisk

Novo Nordisk will start offering a generic version of their NovoLog for $99 a month. The offer is limited to 3 vials of insulin or two packs of insulin cartridge pens.

Offer starts 1/2/2020

Call Novo at 1 (609) 987-5800

I hope you find this helpful. If you are signed up on TheDiabetesHealth Facebook feed, make sure to like this article and pass it along to friends and family.

Wishing you the best in health!

Nadia

The post Diabetes Health in The News: Insulin Companies That Now Offer Discounts for Their Medications appeared first on Diabetes Health.

Summer is here, but has your child’s daily medication fled with the April showers?

According to a study conducted by the Women’s and Children’s Hospital in North Adelaide, Australia, children’s adherence to their medication tends to taper off during the holidays and over the weekend. This can pose a number of difficulties for those who require daily doses to help manage chronic conditions like type 1 diabetes. Researchers found that this lowered adherence was true regardless of gender, age, diabetes dose, or body mass index.

The takeaway? Managing diabetes isn’t easy, and it’s important to ensure that your children take the necessary medication even over their holidays. Consider working directly with your clinician to develop a strategy to keep them on track regardless of the season.

These findings were published by Physician Briefing on June 18th 2019

The post Diabetes Health in The News Podcast: Children with Type 1 Diabetes Taper Adherence on Weekends and Holidays appeared first on Diabetes Health.

Nick Jonas, our podcast guest, will be joining us, to talk about a new diabetes site for people living with type 1 diabetes. He is a singer/songwriter, patient advocate and a person living with Type 1 diabetes. He is one of 4 founders for BeyondType1; a nonprofit committed to donating 100% of your contributions to education, advocacy and curing type 1 diabetes.

If you would like to support and donate to BeyondType1 after you listen to the podcast; know that 100 % of your contribution will support their mission in educating the diabetes community while looking for a cure for type 1 diabetes.

Your tax deductable donation will in no way go to their marketing efforts to raise funds for their organization. All marketing and administrative expenses for BeyondType1, will be absorbed by the founders and the founders friends.

Nick Jonas ‏@nickjonas Jun 30

Nick Jonas Retweeted CrossFit

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