Diabetes Connections | 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.

Meet the newest insulin pump: all about “twiist” with Sequel CEO Alan Lotvin 04/16/2024

In the News... Dexcom-to-watch update, Wegovy studies, night time hypo research and more! 04/12/2024

The FDA took down this teen’s free bolus calculator. He needs your help to bring it back. 04/09/2024

Diabetes Technology: Expectation vs Reality with Dr. Stephen Ponder 04/02/2024

In the News... diabetes drug pricing, vial shortage, pump using Tidepool Loop cleared, insulin cows and more! 03/29/2024

Answering your questions about Tandem’s new Mobi pump (and more) with Director of Product Marketing Ben Mar 03/26/2024

"It needs to be easier" - DIY pioneer Dana Lewis turns her attention to exercise and T1D 03/19/2024

In the News... ATTD updates, new CGMs, drops for diabetes eye disease, scholarships and more! 03/15/2024

Behind the Wheel with T1D: Navigating Teen Driving and Diabetes 03/12/2024

Addressing the “shocking” lack of research into T1D & periods - Tidepool's Period Project 03/05/2024

In the News... MicroGlucagon to speed up insulin, SGLT2 & false positive tests, FDA warns about non-invasive glucose monitors and more! 03/01/2024

“It’s the Chaos Lottery & our ticket got pulled” - Sarah Stewart Holland on parenting a child with T1D 02/27/2024

"I needed to take my own advice" - Catching up with advocate Chris Ruden 02/20/2024

In the News.. Tandem Mobi released, surprising outcomes for type 2 surgery, exercise and diabetes studies, T1D at the Super Bowl, and more! 02/16/2024

Dexcom’s Jake Leach on a new CGM for type 2, updates on G6, G7 and more! 02/13/2024

Dexcom’s Jake Leach on a new CGM for type 2, updates on G6, G7 and more! This week, we get an update from Dexcom. Chief Operating Officer Jake Leach talks about their soon to be launched CGM for people with type 2. It's called Stelo and it's front of the FDA right now. We also answer a lot of your questions about G6, G7, interoperability, connectivity and what's next. Some information on Stelo: Find out more about Please visit our Sponsors & Partners - they help make the show possible! Learn more about from extreme temperatures Learn more about Drive The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Here's where to find us: Learn more about everything at our home page Reach out with questions or comments: [email protected] Episode summary (AI generated) A new CGM product for people with type 2 diabetes. Stacey Simms and Jake Leach discuss a new CGM product for people with type 2 diabetes, currently under FDA review. Stello extends sensor wear to 15 days while maintaining accuracy and reliability for CGM users, regardless of insulin titration. Stello aims to help people with diabetes understand how food impacts their glucose levels through a simple and user-friendly CGM device. CGM for type 2 diabetes and payer coverage. Jake Leach explains how the new CGM product will notify users of high glucose levels without alerting them to take insulin, providing valuable insights into food and diet impact on glucose levels. Stacey Simms seeks more detail on the product and its potential for long-term use, expressing interest in education and training for users to fully understand and benefit from the technology. Stacey Simms asks Jake Leach about the continuous use of CGMs, and Jake explains that the product is designed to be engaging and provide value continuously, with users learning and improving their diabetes management over time. Jake also mentions that the company is working with payers to expand coverage for CGMs beyond Medicare, as it can be a challenge for people without insulin use. CGM access, naming, and interoperability. Stello is a cache pay product starting off affordable and competitive, with potential for reimbursement as evidence of benefits grows. Jake Leach: Excited about new brand for Dexcom, with different design for new population, but still with expected performance reliability. Jake Leach: G6 and G7 interoperability is a focus, with Omni pod integration and launch timing controlled by Dexcom. G7 features and enhancements. Jake Leach: Enhancements made to Bluetooth connectivity on G7 device, now available across channels and geographies. Jake Leach discusses the company's focus on improving sensor reliability and user satisfaction through ongoing software development and user feedback. The company prioritizes features based on user feedback and releases them in a timely manner, with a dedicated team working on the Apple Watch feature. Dexcom's CGM technology and its potential for more widespread access. Jake Leach and Stacey Simms discuss the evolution of G7, including its smaller size and reduced environmental footprint. The company is working on a direct-to-watch submission and has validated alerts and alarms on the watch platform. Dexcom aims to provide best CGM for users' pump systems, partnering with multiple companies globally. Jake Leach is passionate about expanding access to CGM technology for people with diabetes worldwide. /episode/index/show/diabetesconnections/id/29913313

CGM is a legal “reasonable accommodation” Why are many schools still fighting it? 02/06/2024

In the News.. weight loss & cancer study for T2D, new pump submitted, Summer Olympic hopeful with T1D and more! 02/02/2024

“It lets us have more fun” - Camp Surefire uses new tech to follow EVERY camper’s CGM in one place 01/30/2024

The Diabetes Community and the Health Care "Rebel Alliance" - with Author Susannah Fox 01/23/2024

In the News... Spray insulin tested, Dexcom T2D sensor submitted, A1C period pads... and more! 01/19/2024

In the News... Spray insulin tested, Dexcom T2D sensor submitted, A1C period pads... and more! It’s In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: Vertex pauses their stem cell transplantation trials after a patient death, spray insulin is tested, learning more about Dexcom's sensor for type 2, measuring A1C through menstrual blood and more! Find out more about Please visit our Sponsors & Partners - they help make the show possible! Learn more about from extreme temperatures Learn more about Drive The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Here's where to find us: Learn more about everything at our home page Reach out with questions or comments: [email protected] Episode transcript: Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX In the news is brought to you by Edgepark simplify your diabetes journey with Edgepark XX Our top story this week… XX Vertex Pharmaceuticals, Inc. has paused a study of stem cell–derived, fully pancreatic islet cell replacement therapy (VX-880) following two patient deaths. Neither death is related to the therapy itself - called VX-880 – according to the company. Vertex says they plan to share full data soon. In the study that was paused, 14 patients with type 1 received infusions of VX-880 and standard immunosuppression. After 90 days, 13 of the patients have an A1C under 7 without using exogenous insulin. This was the study that made a big splash in the New York Times in late 2021 with the headline “A Cure for Type 1 Diabetes?” and featuring Brian Shelton among others. Shelton is one of the two patients who have died. https://www.medscape.com/viewarticle/vertex-pauses-islet-cell-study-after-patient-deaths-2024a10000oe XX Early days but researchers in Norway are testing an insulin body spray. Patients squirt the insulin directly on to their inner forearm, where skin tends to be thinner, allowing easier absorption. Within minutes, it gets absorbed into the bloodstream. This joins other research on skin patches packed with micro-needles that punch tiny and reportedly painless holes in the skin to let insulin seep through. The spray contains insulin and propylene carbonate, a chemical often used in cosmetic skin creams to help them penetrate the outer layers of the skin. In this case, it’s hoped the chemical — attached to insulin in the spray droplets — will help the hormone seep as far as the tiny blood vessels that lie beneath the surface of the skin, where the hormone will then get absorbed into the bloodstream. InsuLife, the Norwegian company developing the body spray, is setting up a trial involving 12 patients with type 1 diabetes to see how different doses of the spray compare with injected insulin in controlling blood-sugar levels. It is used just before a meal, like injected insulin. The clinical trial was set up after a study involving five people found the spray reduced blood sugar levels by about 20 per cent after a meal. https://www.dailymail.co.uk/health/article-12965203/insulin-spray-arm-diabetes-jab-Hope-sight-millions.html XX The FDA clears the Qvin’s Q-Pad™ A1c Test System which uses menstrual blood to get an A1C result. The kit is intended for the collection of menstrual blood samples by individuals 18 years of age and older using the Q-Pad, a pad with an embedded blood collection strip (Q-Strip). Each kit includes 2 Q-Pads, a return sample container, and a stamped mailing pouch. The FDA clearance was based on data from a clinical validation study that included 198 participants. Samples were collected using the Q-Pad Kit and were returned to the laboratory by mail. To provide the reference sample, a venous blood draw was performed on participants by a phlebotomist. An analysis of both samples demonstrated that the clinical performance of the Q-Pad test system in measuring HBA1c was equivalent to the traditional method of blood testing. https://www.empr.com/home/news/fda-approved-q-pad-test-system-uses-menstrual-blood-to-measure-hba1c/ XX Learning more about Dexcom’s upcoming CGM designed for people with type 2 who don’t use insulin. It’s to be called Stelo and they’ve submitted to the FDA with an eye on a late summer launch. I was at the announced last June – this is a system that will have very few alerts and alarms.. Stelo looks a lot like the G7 but will have different software and will last for about 15 days per sensor. https://www.theverge.com/2024/1/11/24034098/dexcom-stelo-cgm-diabetes-health-tech-ces-2024 XX Tandem Diabetes Care's t:slim X2 Insulin Pump Automated Insulin Delivery System is now the first to incorporate the Abbott FreeStyle Libre 2 Plus Sensor for users in the United States. The FreeStyle Libre 2 Plus sensor is a modified version of the FreeStyle Libre 2 sensor cleared in 2023 by the US Food & Drug Administration for use with automated insulin delivery (AID) systems. The move follows Tandem's December announcement of integration with the recently available 10-day Dexcom G7 sensor. https://www.medscape.com/viewarticle/tandem-insulin-pump-system-integrates-libre-sensor-2024a10000iq?form=fpf XX If you use Omnipod 5 with an Android, there’s a software update you need to do. The FDA has issued a Class one correction recall. due to a software error that occurs when the user enters a bolus amount less than 1 unit without putting a leading zero before the decimal point. This recall is not a product removal and users should have already received an alert that won’t let them use the app until they do the software update. . XX Embecta continues to move ahead with its insulin patch pump.. submitting a 510(k) premarket filing to the FDA for its proprietary insulin patch pump. This is a disposable pump for people with type 2 diabetes. It also has a closed-loop version under development to follow. That version features an embedded algorithm that requires Embecta to run a clinical study. Henry Anhalt, chief medical officer, says nine out of 10 people with diabetes live with type 2 diabetes. However, Anhalt says the majority of automated insulin delivery systems cater to those with type 1 diabetes. Embecta aims to offer more options and tools to the broader diabetes care community, he says. https://www.drugdeliverybusiness.com/embecta-submits-insulin-patch-pump-fda/ XX Update on insulin prices.. as a few prices changes went into affect at the beginning of the year. So, what took effect this month was that Sanofi followed suit with Eli Lilly and Novo Nordisk to implement this cap on insulin co-pays at $35 that took effect January 1. And that comes after the provisions of the Inflation Reduction Act capped insulin for people on Medicare at $35. The Medicare cap is automatic and part of policy. For everyone with commercial insurance, the cap is voluntary from the companies. For those without government or private insurance, the picture is more complicated. If your insulin is still more than $35 per month, ask your pharmacist for coupons or check out getinsulin dot org. https://www.pbs.org/newshour/show/new-law-caps-insulin-prices-for-some-with-diabetes-but-cost-remains-high-for-millions XX Commercial XX XX Young adults who reported higher stress during their teenage years to adulthood were more likely to have high blood pressure, obesity and other cardiometabolic risk factors than their peers who reported less stress, according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association. Cardiometabolic risk factors often occur together and are a significant cause of cardiovascular disease. These include obesity, Type 2 diabetes or prediabetes, high cholesterol and high blood pressure, researchers noted. In 2020, cardiometabolic diseases, including cardiovascular diseases and Type 2 diabetes, were the most prevalent chronic health conditions and collectively accounted for nearly a quarter of all deaths in the U.S., according to the American Heart Association statistics. In 2023, the American Heart Association noted the strong connections among cardiovascular disease, kidney disease, Type 2 diabetes and obesity, and suggested redefining cardiovascular risk, prevention and management. https://finance.yahoo.com/news/childhood-stress-linked-higher-risk-100000670.html XX Shout out to NBC News for a great story they did recently on LADA – featuring two women who have both been on this podcast. Dr. Phyllisa DeRoze and Mila Clark were both first misdiagnosed with type 2 before they got a correct diagnosis of LADA. I’ll link up the NBC story along with our chats with both women.. thanks to Mila for giving me a mention as one of the voices in the diabetes community who made her think was she had might not be type 2.. but could be LADA. https://www.nbcnews.com/health/diabetes/diagnosed-type-2-diabetes-may-different-form-disease-rcna132571 XX Join us again soon! /episode/index/show/diabetesconnections/id/29552108

Should glucose be considered a vital sign? Molly McElwee Malloy makes the case 01/16/2024

Is Sernova’s Cell Pouch System a Functional Cure for T1D? An update from CEO Cynthia Pussinen 01/09/2024

“What are you most looking forward to?” A T1D New Year conversation with Gary Scheiner, MS, CDCES 01/02/2024

In the News... Does food-as-medicine work for T2D? Fake Ozempic warning, new Tzield research, My Cause My Cleats and more! 12/29/2023

In the News... Does food-as-medicine work for T2D? Fake Ozempic warning, new Tzield research, My Cause My Cleats and more! It’s In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: a new study looks at food-as-medicine for type 2, another FDA warning about fake Ozempic, new research says gut markers may help predict who Tzield will work best for, JDRF partners with NFL and more... Happy New Year - we'll see you in 2024! Find out more about Please visit our Sponsors & Partners - they help make the show possible! Edgepark Medical Supplies from extreme temperatures Learn more about Drive The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Here's where to find us: Learn more about everything at our home page Reach out with questions or comments: [email protected] Episode transcription: Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX In the news is brought to you by Edgepark simplify your diabetes journey with Edgepark XX Our top story this week… XX You often hear people say food is medicine.. but an intensive program trying to show that’s the case did NOT improve glycemic control in adults with type 2 diabetes any better than usual care. This was a randomized clinical trial. After 6 months, both groups had a similar drop in HbA1c -- 1.5 percentage points among program enrollees and 1.3 percentage points with usual care, with no significant differences in other metabolic lab values between the groups either, the researchers wrote in JAMA the food-as-medicine participants even gained some weight compared with the usual care group over 6 months (adjusted mean difference 1.95 kg, P=0.04). "I was surprised by the findings because the program is so intensive," Doyle told MedPage Today. "The health system built brick-and-mortar clinics, staffed them with a dietitian, nurse, and community health worker, had weekly food pick-up for 10 meals per week for the entire family, and participants spend a year in the program." Costing an estimated $2,000 annually per participant, the food-as-medicine program allowed participants to choose from a variety of vegetables, fruits, and entrees each week -- enough food for two meals a day, 5 days a week. They were also provided recipes and cooking instructions and met with dietitians to track goals. On the other hand, the control group was only provided usual care, a list of local food bank locations, and the option to join the program after 6 months. The trial was conducted at two sites, one rural and one urban, in the mid-Atlantic region. It recruited 465 adults with type 2 diabetes who completed the study, all of whom started with an HbA1c of 8% or higher. All participants were also self-reported as food insecure. The average age was 54.6 years, 54.8% of participants were female, 81.3% were white, and most resided in the urban location. Of note, all participants also resided in the program's service area and were affiliated with the health system that ran it. "One study should not be over-interpreted," said Doyle. "It is possible that such a program could work in other contexts, among patients less connected to a health system, or in other formats. The main alternative to providing healthy groceries and education is to provide pre-made 'medically tailored meals.'" "I hope the study raises awareness of the potential for food-as-medicine programs to increase healthcare engagement and to push researchers and policymakers to generate more evidence on ways such programs can improve health." It’s worth noting that there is very little study – much less clinical trial level study on this type of thing. The researchers say they hope it spurs more research to find methods that will have a large impact. https://www.medpagetoday.com/primarycare/dietnutrition/107998 XX New information about moderate low carb diets for people with type 1. The study published in The Lancet Regional Health - Europe is the largest of its kind to date. Participants were for different periods randomly assigned in a crossover manner to eat a traditional diet with 50% of the energy from carbohydrates, or a moderate low-carbohydrate diet with 30% of the energy from carbohydrates. The 50 participants all had type 1 diabetes with elevated mean glucose, long-term blood sugar, and injection therapy with insulin or an insulin pump. Half were women, half men. The average age was 48 years. Participants on a moderate low-carbohydrate diet were found to spend more time in what is known as the target range, the range within which people with type 1 diabetes should be in terms of glucose levels. The increase in time within the target range was an average of 68 minutes per day compared to the traditional diet, while the time with elevated values was reduced by 85 minutes per day. The researchers saw no evidence of adverse effects. https://www.news-medical.net/news/20231220/Moderate-low-carb-diet-safe-and-effective-for-adults-with-type-1-diabetes.aspx XX Researchers at Case Western Reserve University and University Hospitals have identified an enzyme that blocks insulin produced in the body—a discovery that could provide a new target to treat diabetes. Their study, published Dec. 5 in the journal Cell, focuses on nitric oxide, a compound that dilates blood vessels, improves memory, fights infection and stimulates the release of hormones, among other functions. How nitric oxide performs these activities had long been a mystery. The researchers discovered a novel “carrier” enzyme (called SNO-CoA-assisted nitrosylase, or SCAN) that attaches nitric oxide to proteins, including the receptor for insulin action. Given the discovery, next steps could be to develop medications against the enzyme, he said. https://thedaily.case.edu/new-cause-of-diabetes-discovered-offering-potential-target-for-new-classes-of-drugs-to-treat-the-disease/ XX The Food and Drug Administration on Thursday warned consumers not to use counterfeit versions of Novo Nordisk's diabetes drug Ozempic that have been found in the country's drug supply chain. The FDA said it will continue to investigate counterfeit Ozempic 1 milligram injections and has seized thousands of units, but flagged that some may still be available for purchase. The agency said the needles from the seized injections are counterfeit and their sterility cannot be confirmed, which presents an additional risk of infection for patients. Other confirmed counterfeit components from the seized products include the pen label and accompanying information about the healthcare professional and patient, as well as the carton. The FDA urged drug distributors, retail pharmacies, healthcare practitioners and patients to check the drug they have received and to not distribute, use or sell the units labeled with lot number NAR0074 and serial number 430834149057. People who have Ozempic injections with the above lot number and serial number can report it directly to the FDA Office of Criminal Investigations. https://www.nbcnews.com/health/health-news/fda-warns-ozempic-counterfeit-diabetes-weight-loss-rcna130871 XX New research indicates that information in the gut may predict how well a person responds to Tzield. That’s the medication approved earlier this year to delay the onset of type 1. These findings reported in the journal Science Translational Medicine, casts a new spotlight on the immune system's relationship with the microbiome, revealing how gut microbes can shape the progression of type 1 diabetes. With this new knowledge in hand, clinicians may better pinpoint patients who are most likely to respond to teplizumab. https://medicalxpress.com/news/2023-12-gut-microbes-patients-response-drug.html XX Experts are advocating for universal screening for type 1 diabetes. With the availability of Tzield and other medications on the horizon, there's a stronger push for screening earlier in life. At least 85% of people who are newly diagnosed do not have a family history of diabetes. Testing for autoantibodies can be completed at home through the TrialNet clinical trial program, or at a doctor’s office or lab. For instance, JDRF’s T1Detect program provides at-home testing for $55, with lower-cost options for people in financial need. The 2024 American Diabetes Association (ADA) Standards of Care recommend more intensive monitoring for the progression of preclinical type 1 diabetes. The Standards of Care also recommend using Tzield to delay the onset of diabetes in people at least 8 years old with stage 2 type 1 diabetes. https://diatribe.org/type-1-diabetes-it%E2%80%99s-time-population-wide-screening XX Commercial XX https://www.healthline.com/health-news/the-years-biggest-medical-advancements-in-diabetes-treatment XX DRF, the leading global funder of type 1 diabetes (T1D) research, is recognizing the NFL stars who showcased their creativity and a remarkable show of support as part of the highly anticipated annual "My Cause My Cleats" (MCMC) campaign. The My Cause My Cleats initiative allows NFL players to wear custom-painted cleats during selected games to raise awareness and funds for the charitable causes closest to their hearts. The unofficial start of the campaign begins on Giving Tuesday with unboxing day events showcasing the players' cleats and the stories behind them. It continues through weeks 13 and 14 of the season, culminating with the players donning their cleats on game day. After the games, some players donate their cleats to their chosen charities or the NFL auction, with all proceeds going toward their selected causes. Type 1 Diabetes is a life-threatening autoimmune condition that affects people of all ages, regardless of family history or lifestyle choices. To live, people with T1D must carefully balance injecting or infusing insulin with their carbohydrate intake throughout the day and night. T1D impacts approximately 1.6 million people in the U.S. It is unpreventable, and there is currently no cure. This year, JDRF is thankful for the support of several players who have T1D or are advocating for their loved ones with T1D, including Mark Andrews of the Baltimore Ravens, Orlando Brown, Jr. of the Cincinnati Bengals, Blake Ferguson of the Miami Dolphins, Collin Johnson of the Chicago Bears, Chad Muma of the Jacksonville Jaguars, Nate Peterman of the Chicago Bears, and Kevin Radar of the Tennessee Titans. "The NFL players who support JDRF through the My Cause My Cleats exemplify the passion and determination at the heart of the type 1 diabetes community," said Kenya Felton, JDRF Director of PR and Celebrity Engagement. "They serve as inspirations for many adults and children affected by T1D, demonstrating that with an understanding of T1D, effective management, and a good support system, you can overcome the challenges of the disease. Their support helps to increase awareness and is significant in helping JDRF advance life-changing breakthroughs in T1D research and advocacy initiatives." Since its inception in 2016, the MCMC campaign has provided a platform for many NFL players and affiliates to support JDRF's mission, including Beau Benzschawel, David Carr, Will Clarke, Keion Crossen, DeAndre Carter, Reid Ferguson, Jaedan Graham, Jarvis Jenkins, Collin Johnson, Henry Mondeaux, Jaelan Phillips, Adam Schefter, Brandon Wilds, and Jonah Williams. XX Join us again soon! /episode/index/show/diabetesconnections/id/29259028

"How do you start giving them independence?" A Moms' Night Out T1D panel discussion 12/19/2023

"How do you start giving them independence?" A Moms' Night Out T1D panel discussion We're talking about raising kids with type 1, the journey to diabetes independence, and educating around the use of emergency glucagon. We're bringing you a panel discussion from Moms’ Night Out Frisco! We have terrific speakers at our Moms' Night Out events but we also have some panel discussions. This time around it’s Stacey and Cami DiRoberto. Cami’s daughter, Maci, was diagnosed with type 1 at age 7 in 2017. She and turned 13 just after our conference back in October. Couple of quick housekeeping notes: this was presented and recorded as a hybrid Zoom and in person presentation – Cami broke her arm and was unable to attend in person. Her audio is fine, but Stacey's recorded through the computer mic and isn't up to our usual standards. We're providing the transcript below. Cami is a Gvoke ambassador and this panel was sponsored by Xeris Pharmaceuticals, the company that makes Gvoke. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Note: Gvoke is a prescription injection for the treatment of very low blood sugar in adults and kids with diabetes ages 2 and above. Do not use if you have a specific type of adrenal or pancreatic tumor, starvation, chronic low blood sugar, or allergy to GVOKE. High blood pressure, hypoglycemia, and serious skin rash can occur. Call your doctor or get medical help right away of you have a serious allergic reaction including rash, difficulty breathing, or low blood pressure. Visit for more information. Find out more about Please visit our Sponsors & Partners - they help make the show possible! Edgepark Medical Supplies from extreme temperatures Learn more about Drive The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Here's where to find us: Learn more about everything at our home page Reach out with questions or comments: [email protected] Episode transcription: Stacey Simms 0:05 This is Diabetes Connections with Stacey Simms. This week talking about raising kids with type one, the journey to diabetes independence and educating around the use of emergency glucagon. I'm bringing you a panel discussion from moms Night Out Frisco. 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. You know, we aim to educate and inspire about diabetes with a focus on people who use insulin. I'm your host, Stacey Simms and my son was diagnosed with type 117 years ago this week right before he turned to he's almost 19 years old. He's a freshman in college and he's far from perfect. I'm far from perfect but cannot believe how far we have come at our moms night out events. We always have terrific speakers. Coming up for our Charlotte event. In February we have Sarah Stewart Holland. She is the co host of pantsuit politics, and her son was diagnosed really not too long ago. She went through that very publicly, and just going to be sharing her story. Our other speaker is Madison Carter. She is a local TV news anchor who lives with type one herself. But we also have some panel discussions at these events. This time around you're going to hear me and Cami de Roberto hammies daughter Macy was diagnosed with type one at age seven in 2017. She had her birthday just after our conference, which was back in October a couple of quick housekeeping notes. This was presented and recorded as a hybrid zoom and in person presentation, kami broke her arm and was unable to attend in person. Her audio is great, but mine recorded through the zoom. And it is pretty rough. My amazing editor John has worked his magic the best that he can. But I'll be honest with you my side of the conversation is not up to what I think our usual standards are around here. I will tell you though, I'm putting a transcription in with this episode. Wherever you're listening, you should be able to scroll down on the podcast app and see and read what you're listening to. If there's any confusion about my side of the conversation, you can always head over to diabetes connections.com and click on the episode homepage to read it as well. Also, Cami is a Gvoke ambassador and this panel was sponsored by Xeris pharmaceuticals, the company that makes Gvoke you know I like my full disclosures around here. But they made this really easy. This is a genuine Parent to Parent conversation. And it's mostly about independence. You know how you get from a kid who's totally dependent on you to a young adult that you you can send off on their own. And one more thing about mom's night out the early bird special for our next event in Charlotte has ended but I'm gonna give you a promo code right here just use m n o mom's night out m n o 30 to save $30 off Charlotte registration. Alright, that is a long enough introduction. The panel is up next and since I just told you about CAMI I took out the introduction that I gave at the event and the big lead up so we're going to just jump directly in right after this important message. Gvokeis a prescription injection for the treatment of very low blood sugar in adults and kids with diabetes ages two and above. Do not use if you have a specific type of adrenal or pancreatic tumor starvation, chronic low blood sugar or allergy to Gvoke High Blood Pressure hypoglycemia and serious skin rash can occur. Call your doctor or get medical help right away. If you have a serious allergic reaction, including rash, difficulty breathing or low blood pressure visit Gvokeglucagon.com/risk. For more information. I think everybody has heard my family's diagnosis story. My son was going to the strip before he turned to one can tell us a little bit about Macy's diagnosis. Cami 4:01 Yeah, so Macy was diagnosed in second grade. It was the tail end of her second grade year. I'm sure like many of you, I was completely ignorant about type 1 diabetes. I knew there was a type one I knew there was type two, I really didn't know the difference. I knew one kind of struck children, but I was completely ignorant. So it was like the last week of her second grade year at school and we had just moved back to California from Arizona actually. So we were kind of transitioning and all in all areas of life. And she had three bedwetting accidents in a matter of three weeks. First time she was at my mom's house, like having a little sleepover with me. And my mom called me the next morning and I called and checked in. Hey, how was everything? You guys have fun last night? She said yeah. She said we're just we're cleaning up to today. Macy had a little accident and I was like, well that's really weird. She hasn't done that in years. But that's so weird because it's not totally outside of the norm for a seven year old little girl you know it could happen so that was weird, but a week later happened again and I was like, Okay, are we drinking too much water before we go to bed? What's happening? Let's let's really so I started to pay more attention happened one more time a week later on, I was like, something's wrong. The red flags, you know, we're going off. And so it was a party it was because it was the last week of school. It was a party at school. And I woke her up and saw that she had had an accident and it kind of laid some towels down and changed your sheets. And I said, Oh, honey, I said, You had another accident. I said, I think we probably need to get in and see a doctor now. I said, Do you feel okay, you know, in my mind, I was hoping like bladder infection or something like that. But somewhere in the depths of my mother's instinct, diabetes flashed across my brain. And i i To this day, I don't know why. So I was sort of praying that it wasn't gonna be that, but I didn't really even know why I was thinking that it was all very blurry and confusing. But she said she felt fine. She wanted to go to school. So I said, okay, and I made an appointment with her pediatrician that afternoon. So I picked all three of my kids up from school that afternoon, and the four of us had at the end of the pediatrics office, and she checked it out and you know, took her vitals and sort of a physical exam. And she said, I think she'll show your daughter fine. She said, I think she's growing. It's hot outside, you know, but she's fine. And I said, Okay, I said, we'll upgrade nose and I said, Can you just indulge me? And could you check for diabetes. And I swear to you, I still don't know why I felt so convicted to request that. But I did. And she did sort of begrudgingly. And our blood sugar came back at 323. I'll never forget time kind of stopped in that moment. Doctor came back after the nurse came in and prick Macy's finger, you know, she left when three, the four of us were playing I Spy in the room. And like 1015 minutes later, so kind of like now that I look back and inordinately long time, the doctor kind of knocked on the door and up and said, Hey, Mom, can you come out in the hallway for a second? So I walked out. And she had the landline kind of cradled her shoulder and she she was clearly on hold when she said I am so sorry, I don't really know how to tell you this. But you're right, your your daughter has diabetes, and you're going to be heading to the hospital for a couple days. And you know, here's my office, if you want to make arrangements for your other kids, and just the world just kind of stops for a second. And in that moment, I didn't even know what I didn't know. I mean, I'm sure many of you can share that sentiment. It's just confusing. You don't even really know what you're about to deal with. But that was how she was diagnosed. And then off we went to children's Fortunately, she was, you know, we avoided DKA, which I'm so grateful for, like I said her blood sugar was 323. So they actually sent us home and called us when a bed was ready for her. So we were able to go home and pack a bag and kind of try to be positive and find some sanity for us. But also, Stacey Simms 7:34 we were so lucky, our pediatrician, I called them similar symptoms. And she said, You have never seen diabetes, can anybody under the age of two to provide your program and so we can move on out. And we had such a incredible start to the families today because of that very smart pediatrician didn't let it get to be a routine thing. Can you talk a little bit of you mentioned your other children. This could be a whole separate discussion unto itself. But to talk about the impact to your to your family, Cami 8:03 if you can believe this, at the time she was diagnosed, we were literally living through a kitchen remodel, my whole dining room was set up I had like a hot plate and we had moved our refrigerator was like an all the way by the front door. Our house was an absolute disaster. And of course, we needed to figure out our new sort of diet plan as well after all this. So kitchen remodel and type 1 diabetes diagnosis were not ideal at the same time. So my husband Tori and I were in the hospital for two nights. And fortunately, we have a big family here. And so we had my sisters in law and my brothers and I mean, we had all kinds of family that came and stayed with my kids. But those first nine to 12 months were really particularly rough on Macy's, little sister Emma, they're they're really close in age, but 14 months apart. I think it's so confusing. She was six at the time. And I think she was terrified. And so much attention goes to managing it's in those early weeks, months, gosh, even the first year who you're still trying to figure out what your cadence for management is, you know, how often are you going to prick your finger and where and when and how do you leave the house and make sure you have everything that you need. I mean, there's so much it's like everything else stops and all you can do is focus on how to make sure this child of yours stay safe. And so I think there there definitely was an impact on my two younger children because all the focus was on me so we worked really hard on my husband and I like taking turns to like take the other two and do kind of go do special things and get them out of the house. But that was tricky for a while. That was definitely tricky, but we encouraged my other two kids to like prick their fingers and hey, let's all check our blood sugar. So we did a lot of that in the first couple months, which was kind of fun. My Anna Macy sister was not not a fan of the prep but my son was like all about it. He was doing it to my sister so that was super cute. Stacey Simms 9:53 It is hard it still works to this day. I don't want to seem genuine so like self promotion machine like I did talk to my daughter went off tests. It is one of my favorite episodes. It was just last year. It's part of the sequence and it's okay to acknowledge that what helped me was just really honest. Aisha Nina, she's 22 She is really got an interesting perspective. It's been a while to see she was fine with me was diagnosed and she's very honest. And she still has some hard feelings about it. But she's an adult to, to acknowledge why it was the way it was. And she's also it was a lot of fun to talk about that damn Calgary, Kimball. Because my son was diagnosed who for the first time all that disrupted Alright, so I'm gonna ask him, I'm gonna put my own two cents in real quick. So we're gonna talk about that what was going through your head when Macy was diagnosed? Right and talking about your concerns and views for the future? Here's how. I don't want to say dumb. Here's what I didn't know about diabetes. So my little 23 months old. My first question for the endocrinologist was, don't I have to be shuffling his feet and put his toenails differently? I was like something is like, okay, no, it's got to be like that. I mean, we're talking about bigger fears. But you know, that's where I started out. Cami 11:27 Yeah, I'm not too far off. My first question was, was she going to have to like wear on her body because I didn't want her tiny little frail body like Mark with devices. I was like, am I Heartland my, my mind went immediately, like pacemaker I'm like, can we get this stuff inside, so we don't have to, like be visible about the so my first little vanity, which is a concern, you know, I didn't want her to have to wear stuff. And they were like, now there's, there's no pacemaker type machine. That's gonna. I mean, it's amazing how quickly I got past that. I mean, we were we had we used to call it a power packs. And so you know, the more visible we could be the better. So we got past that. And thankfully, I think we might even touch on this a little later. But she's super open about her devices. And when people ask her and said that, so that was great. But yeah, my initial thought was, oh, my God, oh, my gosh, and and it really wasn't until I got home, Stacy that I realized the 24/7 hour nature just and actually, I remember, I think it was day two, and we were on lunch of day two. So we had checked in like late afternoon on I think, a Thursday. And so we had dinner at the hospital. And then we had breakfast at the hospital. And so we were working on lunch at the hospitals for our third meal. And the nurse comes in and says, okay, so it's time to, you know, let's do our carb counts and let dial up our insulin, we know what our ratio is. And we were like, Yeah, we got this and I looked at when I went, hey, just to like, be clear, I go, we're not this isn't like, Bro. This is like, like, while we're in LA, oh, we're gonna, this is gonna level out. We're not gonna have to do this all the time. Right? And she was like, yeah, no, this is basically, this is how we have to do meals. Wow. So that was a moment to Stacey Simms 13:05 Yeah, we're here in order to talk about dealing with loans preparing for loans. Do you remember when you realize, because when you and I were talking, I'm gonna ask you to some of these things I have the answer to so Don't be coy. I didn't think about this for a while but used to think about this in the hospital already. When they started applying with us. Right. It Cami 13:24 was discharged day. And it was our last meeting with the diabetes educators who were fabulous. By the way. They were wonderful contents. Yeah, it was our last day. And so we like our final meeting. And you know, Macy stayed in a row and just touring and I went into the diabetes education room. And they kind of did like an overview. And then they said, Okay, and there's, you know, there's one more thing that we need to make sure we go over with you. And that's, you know, what we call severe lows, and they pulled out the red glucagon emergency kit. And they said, You know, sometimes you can have too much insulin or too much activity. And, and it doesn't happen very often. But, you know, sometimes it can happen, and you need to be prepared to use this kit. And I was like, what? Can you pause for a moment? And let's just rewind a minute. What do you mean, and that was a massive moment in time where I realized, so this medicine that you're telling us, we have to give her, and we have to decide how much to give her to keep her alive, if we give too much, could also be fatal. And, boy, that was a poignant moment. And I'm sure one we could all share and pause on because that is the reality. But yes, that was when we left the hospital and I was absolutely terrified, terrified about severe lows. Stacey Simms 14:42 I want to just get to the other question before the one in terms of like, do you have those fears, but you you still want him to lose their life? You still want them to be independent? I mean, your seven year old so you're going to immediately send her off to be super independent. But how did you Once the engine, you know, I hesitate to see how did you get the cast that but how did you move forward with that? Cami 15:05 It was difficult, um, you know, that was sort of the age, you know. So we're now heading into third grade and I remember I had this like special lunchbox for her that whenever she ever we would leave the house, we go anywhere and had all of our staff had had her with an emergency kit and had her sugar it had her testing all the stuff. We all we all have that. And I remember there were a couple of times where Macy got invited to have playdates at some friends house. And again, we kind of knew what the school kind of knew newly back in California, so I didn't know everyone yet. And she had a couple playdates. And so I sent mom would text me and say, Hey, Mom, you know, so and so wants to know if Macy can come over after school and play. And so I would respond and say, yes, she would love to however, I just need to make sure you understand BCS type 1 diabetes, and this can mean this and you know, she's, she's on it, but I really need you to just have your phone with you all the time. And I will tell you, it was challenging because we didn't get a lot of repeat invites. And then and then I would go over how to use that glucagon emergency kit, because I was scared. I mean, what if, what if they're out jumping on a trampoline? And God forbid, that's her first low. I mean, so I felt like, I had to do that. But it was really tough because I didn't want to and I think her social life. So you know, then I I tried to include an invite over to our house. So I did you know, slumber parties. That was a whole nother chapter to get through. But we did them in our house. You know, we didn't have in our house for a long time. But as long as I had a willing person on the other end, I allowed me to go do those things. As long as I had a mom or a trusted, you know, dad or trusted caregiver. On the other end, I really tried to give her that opportunity to go and be away from me. Like frankly, ... /episode/index/show/diabetesconnections/id/29114223

In the News.. Arthritis drug studied for T1D, calls to poison control over Ozempic, Tandem Source released, and more! 12/15/2023

In the News.. Arthritis drug studied for T1D, calls to poison control over Ozempic, Tandem Source released, and more! It’s In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: an existing drug for arthritis is being studied for treatment of T1D, poison control centers report a big increase in calls about misdosing of Ozmepic and semaglutides, Tandem releases it's Tandem Source software, we've got an update on a possible non invasive glucose monitoring system, ADA releases it's standards of care and more! Find out more about Please visit our Sponsors & Partners - they help make the show possible! Edgepark Medical Supplies from extreme temperatures Learn more about Drive The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Here's where to find us: Learn more about everything at our home page Reach out with questions or comments: [email protected] Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX In the news is brought to you by Edgepark simplify your diabetes journey with Edgepark XX Our top story this week… XX A world-first clinical trial has found a common drug used to treat rheumatoid arthritis can suppress the progression of type 1 diabetes in recently diagnosed patients. Australian reserachers say they’ve discovered that baricitinib *bare-uh-sit-en-ub* can preserve the body's own insulin production. The scientists recruited 91 people, aged between 10 and 30 years old, to take part in the double-blind randomised trial. All patients had been diagnosed with type 1 diabetes within the last 100 days and continued with their prescribed insulin therapy throughout the study. The results showed those in the baricitinib group were able safely and effectively to preserve their body's own insulin production and suppress the progression of type 1 diabetes. "Our trial showed that, if started early enough after diagnosis, and while the participants remained on the medication, their production of insulin was maintained. "People with type 1 diabetes in the trial who were given the drug required significantly less insulin for treatment." Dr Faye Riley, research communications manager at Diabetes UK, said of the latest trial: "These findings show by tackling the root of type 1 diabetes - an immune system attack - an existing drug can help to shield the pancreas, in people recently diagnosed with type 1, so they can continue making more insulin for longer. "This can give people with type 1 diabetes much steadier blood sugar levels and help to protect against serious diabetes complications down the line. "Immunotherapies are edging us towards a new era in type 1 diabetes treatment, and could help us overcome a major hurdle en route to finding a cure for the condition. "This trial takes us another step closer." The study was funded by JDRF, a non-profit organization which focuses on type 1 diabetes research. The research has been published in the New England Journal of Medicine. https://news.sky.com/story/world-first-trial-finds-arthritis-drug-may-help-treat-type-1-diabetes-13024706 XX Earlier this month, Dexcom’s G7 became compatible with two pump systems: Beta Bionic’s ilet pump and Tandem Diabetes tslim X2. Current customers should have received instructions on how to download the updated software – new pumps will be shipped with G7 software already loaded. Tandem has also announced their new Tandem Source platform – full launch in the US with international rollout slated for next year. Anyone in the U.S. who uses a Tandem pump—as well as their respective healthcare providers—will now have access to the Source platform. On the patient side, insulin dosage data will automatically transfer from the pump to the platform, by way of the t:connect mobile app, where it’ll be compiled into three reports for your doctor. Patients will also be able to use the platform to access new software updates for their pumps and to reorder supplies as needed. Long term, the company hopes to use the data from users – which would be blinded- to update automated insulin dosing algorithms. https://www.fiercebiotech.com/medtech/tandem-begins-full-us-rollout-source-diabetes-management-platform XX New look at benefits from a plant based diet – this research says it can reduce the risk of type 2 diabetes by 24%. It’s not just about weight loss. They reviewed data on more than 113,000 participants in a large-scale British observational study, gathered over 12 years. They found that normal values for cholesterol, blood sugar, inflammation, and insulin are associated with a low risk of diabetes. They also found that good liver and kidney function is important in diabetes prevention. A plant based diet helped with all of those factors. The researchers do point out that there is such a thing as an unhealthy plant-based diet. Those that are still high in sweets, refined grains and sugary drinks are associated with an increased risk of type 2 diabetes, researchers found. https://www.usnews.com/news/health-news/articles/2023-12-13/plant-based-diets-cut-diabetes-risk-by-24 XX Reports of more patients with type 2 diabetes having trouble getting coverage for medication like Ozempic and Mounjaro – because health insurance companies are putting new restrictions in place. Most U.S. health plans cover GLP-1s for type 2 diabetes but many providers will prescribe it off label for weight loss. There is another medication – Wegovy – approved for weight loss, it’s the same drug as Ozempic just packaged in a difference dose and name. The average number of weekly Ozempic prescriptions rose 33% between the first and third quarters of this year, but has since dropped more than 6% to about 431,000, according to Iqvia Institute for Data Science. Doctors and patients are bracing for changes in January, when individual health plans often set new coverage terms. "It may be that January 1, all of a sudden something that was covered is no longer," said Dr. Robert Gabbay, chief science officer at the American Diabetes Association. https://www.reuters.com/business/healthcare-pharmaceuticals/us-diabetes-patients-face-delays-insurers-tighten-ozempic-coverage-2023-12-12/ XX Poison control centers across the US say they are seeing a steep increase in calls related to semaglutide, with some people reporting symptoms related to accidental overdoses. From January through November, the America’s Poison Centers reports nearly 3,000 calls involving semaglutide, an increase of more than 15-fold since 2019. In 94% of calls, this medication was the only substance reported. The compounded versions of semaglutide are often different from the patented drug. Many contain semaglutide salts called semaglutide sodium and semaglutide acetate. The FDA says the salt forms of the drug have not been tested and approved to be safe and effective the way the patented form of the medication has, and thus they don’t qualify for the compounding exemption in the law for drugs in shortage. In other cases, the compounded versions are sold in unapproved dosages. But these compounded versions are popular because they may cost less out-of-pocket, especially if the treatment isn’t covered by insurance. The name-brand drugs are sold in pre-filled pens, which come with some safeguards. Patients dial to the correct dose and click to inject, so it’s harder to make mistakes. Compounded versions, however, typically come in multidose glass vials, and patients draw their own doses into syringes. It’s easy to get confused. https://www.cnn.com/2023/12/13/health/semaglutide-overdoses-wellness/index.html XX XX Type 2 diabetes patients who received endocrinology care through telehealth alone had poor glycemic outcomes compared with those who received in-person or hybrid care, which contrasts with prior research findings, according to a new study. Previous research has shown that telehealth is effective in improving glycemic control, but there has not been enough data on utilization and outcomes linked to routine telehealth care for type 2 diabetes since 2020, especially in the endocrinology setting, the researchers wrote. One reason may be that the strategies to support glycemic improvement deployed during in-person appointments, like self-management education and sharing home blood glucose data, have not been consistently translated to telehealth. “Implementation of approaches to overcome these differences, such as team-based virtual care and technological tools to automate blood glucose data sharing, are needed to ensure all patients receive high-quality diabetes care regardless of care modality,” they wrote. These study findings contrast with previous research, including a study published in early 2022 that revealed that telehealth maintained quality of care and led to better health outcomes for patients with type 2 diabetes during the COVID-19 pandemic. The study included 16,588 with type 2 diabetes who received care before or during the pandemic, with 7,581 having a telehealth visit with either a primary care physician or an endocrinologist. https://mhealthintelligence.com/news/telehealth-only-care-fails-to-improve-type-2-diabetes-outcomes XX Medtronic’s deal to buy a South Korea based insulin patch pump maker is off. Back in May Medtrnoic announced a 738-million dollar deal to buy EOFlow, which makes EOPatch, a tubeless, wearable and fully disposable insulin delivery device. EOFlow already launched its EOPatch insulin delivery system in Korea and Europe. The company submitted the insulin delivery device for U.S. FDA clearance in January. https://www.massdevice.com/medtronic-nixes-738m-deal-for-insulin-patch-pump-maker-eoflow/ XX Commercial XX Update on non invasive continuous glucose monitoring. The most recent validation of the technology’s accuracy has been released as a preprint. In an experiment, researchers fed thousands of radio frequency glucose readings into a machine learning model to translate them into blood sugar values and compared the results against those from a Dexcom G6. CGM accuracy is judged by mean absolute relative difference, or MARD. The statistic is reported as a percentage: a MARD of 10 percent, for example, means that the CGM is on average within 10 percent of the reference value. The Bio-RFID system scored a MARD of 11.27 percent. In truth, this result is difficult to interpret. Though Bio-RFID’s MARD is not yet in the same neighborhood as its competitors’ (the Freestyle Libre 3 and the Dexcom G7 report MARDs of 7.9 percent and 8.7 percent, respectively), the experiment wasn’t a true test of the device’s capabilities, because it didn’t use a lab-drawn glucose measurement as its reference value. The volunteers also did not have diabetes, which meant that their blood sugar levels were likely more stable than those of most future customers. The FDA has specific accuracy standards that it expects CGM manufacturers to meet for devices intended for “nonadjunctive” use and for use in a closed-loop insulin pump system. Know Labs’s product will need to meet these objective standards to be validated as a truly reliable CGM. The Path to Approval “Our expectation is that we’ll be in front of the FDA as we move into the second half of 2024,” says Erickson. Much larger trials will be needed to show that the device works and meets FDA standards. Erickson says, “We expect to have an FDA-cleared device in 2025.” Though the business is still finalizing the form of the next generation, it expects that it can navigate the FDA approval process quickly. The FDA has already confirmed that RFID is quite safe and there should be little worry about side effects (though there could be a hazard of interference for patients already using electronic medical devices such as pacemakers). https://www.diabetesdaily.com/blog/this-company-is-racing-to-create-the-worlds-first-non-invasive-cgm-718069/ XX Today, the American Diabetes Association® (ADA) released the Standards of Care in Diabetes—2024 (Standards of Care), a set of comprehensive and evidence-based guidelines for managing type 1, type 2, gestational diabetes, and prediabetes based on the latest scientific research and clinical trials. It includes strategies for diagnosing and treating diabetes in both youth and adults, methods to prevent or delay type 2 diabetes and its associated comorbidities like cardiovascular disease (CVD) and obesity, and therapeutic approaches aimed at minimizing complications and enhancing health outcomes. "The latest ADA guidelines present pivotal updates for health care professionals, ensuring comprehensive, evidence-based care for diabetes management. These changes reflect our ongoing commitment to optimizing patient outcomes through informed, adaptable, and patient-centered health care practices,” said Robert Gabbay, MD, PhD, the ADA’s chief scientific and medical officer. “The ADA’s Standards of Care ensures health care professionals, especially our primary care workforce, provide the best possible care to those living with diabetes.” Notable updates to the Standards of Care in Diabetes─2024 include: New updates in managing obesity in people with diabetes, including approaches to reduce therapeutic inertia, support more personalization, and incorporate additional obesity measurements beyond body mass index (i.e., waist circumference, waist-to-hip ratio, and/or waist-to-height ratio). New screening recommendations for heart failure in people with diabetes. Updated recommendations for peripheral arterial disease (PAD) screening in people with diabetes. Guidance on screening and the use of teplizumab, approved to delay the onset of type 1 diabetes. More guidance on the use of new obesity medications, glucagon-like peptide 1 (GLP-1) agonists or dual glucose-dependent insulinotropic polypeptide (GIP) receptor agonists, to reach sustained weight management goals. Updates in guidance on the diagnosis and classification of diabetes. A focus on hypoglycemia prevention and management. Emphasis on screening people with diabetes for nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis at primary care and diabetes clinics. New emphasis on the evaluation and treatment of bone health and added attention to diabetes-specific risk factors for fracture. A focus on screening and management of people with diabetes and disability. Emphasis on enabling health care providers to master diabetes technology, using artificial intelligence for retinal screenings with necessary referrals, and embracing telehealth and digital tools for diabetes self-management education. New information on the possible association between COVID-19 infections and new onset of type 1 diabetes. "As the ADA's chair of professional practice committee, I'm excited to share our latest updates to advance diabetes care through new scientific insights and technological innovation, all aimed at enhancing experience for people with diabetes and health care professionals in managing this complex condition," said Nuha A. El Sayed, MD, MM Sc, the ADA’s senior vice president of health care improvement. Other noteworthy changes to the 2024 Standards of Care include: Updated immunization guidance to include newly approved RSV vaccines in adults over 60 years of age with diabetes. New emphasis on cultural sensitivity in diabetes self-management education, with considerations for changing reimbursement policies. More detail and emphasis on psychosocial screening protocols to better identify diabetes distress. The importance of diabetes technology, with an emphasis on continuous glucose monitors (CGMs) and automated insulin delivery (AID) systems. Continued emphasis on inclusion and person-centered care. “At the ADA, we are focused on improving the quality of care for anyone who lives with diabetes, prediabetes, or who is at risk of developing diabetes. The Standards of Care is critical to ensuring the improved treatment of diabetes, a chronic disease that requires continuous care through a well-informed and coordinated health care team. These standards equip health care professionals with the gold standard in diabetes care, ensuring the highest level of service and knowledge in the field,” said Chuck Henderson, the ADA’s chief executive officer. The ADA annually updates its Standards of Care through the efforts of its Professional Practice Committee (PPC). Comprising 21 global experts from diverse professional backgrounds, the PPC includes physicians, nurse practitioners, certified diabetes care and education specialists, registered dietitians, pharmacists, and methodologists. Its members hold expertise in areas like adult and pediatric endocrinology, epidemiology, public health, cardiovascular risk management, kidney disease, microvascular complications, preconception and pregnancy care, weight management, diabetes prevention, behavioral and mental health, inpatient care, and technology in diabetes management. Additionally, the committee collaborates with 19 specialized content experts. The 2024 Standards of Care has garnered endorsements from the American College of Cardiology (Section 10), the American Society of Bone and Mineral Research (Bone section in Section 4), and the Obesity Society (Section 8). Today, the Standards of Care in Diabetes—2024 is available online and is published as a supplement to the January 2024 issue of Diabetes Care®. A shortened version of the guidelines, known as the Abridged Standards of Care, will be made available for primary care providers in the journal Clinical Diabetes®, along with a convenient Standards of Care app as well as a Standards of Care pocket chart. The online version will be annotated in real-time with necessary updates if new evidence or regulatory changes merit immediate incorporation through the “living” Standards of Care process. Other Standards of Care resources, including a webcast with continuing education (CE) credit and a full slide deck, can be found on the ADA’s professional website, DiabetesPro®. https://diabetes.org/newsroom/press-releases/american-diabetes-association-releases-standards-care-diabetes-2024 XX Join us again soon! /episode/index/show/diabetesconnections/id/29097458

“Nobody Really Knows How to Help Me" - Allergic to Insulin with Type 1 Diabetes 12/12/2023

“I’m never going to stop speaking up” Mila Clarke turned her diabetes misdiagnosis into her mission 12/09/2023

Know Your Rights! Navigating the Legal Landscape of Diabetes with Lawyer John Griffin 12/09/2023

Our T1Decade - looking back at ten years of T1D with my whole family (replay) 12/05/2023

Our T1Decade - looking back at ten years of T1D with my whole family (replay) This episode title is a bit misleading (sorry!) because Benny is actually marking 17 years with type 1! He's away at college and while I hope to talk to him for the show soon, we just couldn't swing it in time for his actual diaversary. To mark the date, we’re going to replay the first time I talked to Benny for this podcast – which I did along with my husband and my daughter back in 2016. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Find out more about - we have announced FOUR LOCATIONS for 2024! Use promo code MOM30 to save $30 off any city This is a longer episode, so I wanted to break it down a bit - and a full transcription is below. 00:00 2023 Stacey introduction, talks about Benny's 17th diaversary 03:55 2016 Stacey explains how the order of interviews and a few housekeeping notes 05:22 Slade 24:27 Lea 40:42 Slade (part 2) 1:12:15 Benny 1:26:07 2023 Stacey wraps it up Please visit our Sponsors & Partners - they help make the show possible! Edgepark Medical Supplies from extreme temperatures Learn more about Drive The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Here's where to find us: Learn more about everything at our home page Reach out with questions or comments: [email protected] Episode transcription below - our transcription service doesn't speak diabetes perfectly, so please excuse any mistakes. Thanks! Stacey Simms 0:05 This is Diabetes Connections with Stacey Simms. This week is my son's 17th diversity 17 years with type one to mark what's really his entry into being a young adult with T1D. He's almost 19 We're going to take a look back at when he was a lot younger. We've got a replay of the first time I talked to Benny for this podcast back in 2016. It's a conversation that also includes my husband and my daughter. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show. I'm your host, Stacey Simms. And you know, we aim to educate inspire about diabetes with a focus on people who use insulin. I am not great about remembering Benny's exact dye aversary. And most of the reason why is because his diagnosis was very, it was prolonged, I would say it really only took a week, maybe a week or a couple of days from the time that I called our pediatrician and said, I don't like what I'm seeing Something's really wrong to an actual in hospital diagnosis and, and all the education that goes with it. But we had so many bumps along the way. And I've told these stories before, you know, a fasting blood glucose. That was normal, it was 80. And that was on a Monday. And then some subsequent diagnoses of things that we now know were just symptoms, you know, infection, things like that, that they treated, and we thought, yeah, we got it. And then finally, the A1C results, which came back five days after that initial fasting blood glucose, which is when they sent us to the hospital, all of that to say I remember the days of the week, Monday was the pediatrician Saturday was the phone call to go to the hospital. But I never remember the actual dates. Social media memories usually remind me and sure thing they came up this morning. So I'm recording this on Benny's actual 17 year diver serie on December 2, December also means and I need to tell you one quick thing about moms night out that the early bird special for Charlotte is over. I do have a promo code for you that you can use on the regular price to save $30 off. And that promo code is m n o 30. Mom's night out m and o 30. You'll save $30. With that I will put a link in the show notes. You can always go to diabetes dash connections.com. We have a mom's Night Out tab as well there now. If you go there we are announcing our next cities this week, I may have already done so. So follow on social for that announcement or click on over to the website, click on the mom's side out tab. See the new cities registration is not open for them. But you can sign up to be emailed directly when registration does open. And for more information. All right. I am hoping to talk to Benny for a new episode soon. As you know he's away at college. And I cannot wait to get that kid home for winter break. As this episode goes live. I think he's coming home in about 10 days, not that I'm counting diabetes, while he's been away has been fine. But I've tried really hard not to ask him a lot of bout it other than once in a while like you're doing okay. Right? Because we don't follow his Dexcom anymore. And I really don't know much day to day. You know, he's reordered supplies with me. So I know he's he's doing that kind of stuff. I can't wait to talk to him more. I will let you know when we're going to be taking questions for that episode, we'll post to the Facebook group for that. These conversations you're about to hear were recorded in fall of 2016. Benny is in sixth grade, his voice hasn't even changed yet. Oh, my goodness, I left in the original introduction, which gives more context. But I also want you to know, this is a much longer discussion than I remember. So I'm going to do more comprehensive shownotes with some time codes, if you want to kind of jump around on this episode and pick and choose where you want to listen. So here we go. My family's thoughts on one decade. Remember, this is seven years ago with type one. Stacey Simms 03:55 This part of the podcast is usually where I interview somebody else get them to share their story and their thoughts about living with diabetes. This is different. This is my family's story. And let me tell you, this is what I've done my entire career, talk to people interview people since before I even graduated from college. And these are the toughest interviews I've ever done. I was so nervous. But they were they were wonderful. And I was just thrilled that they agreed to even talk to me. My husband and my daughter are really not front and center. Attention people. I don't know how they live that way. But here's how it's going to go. You're going to first hear from me and my husband Slade. And then you'll hear from Leah. We're in the middle of that interview. I'm going to pause the conversation. And then you'll hear Leah's interview, because I had maybe the most Frank, honest and open conversation about our brothers diabetes that we've ever had. And then we'll wrap that up and you'll hear more from me and slay And then finally you'll hear from Benny. Oh my gosh, that kid, if you have a middle school boy, maybe you'll understand that conversation was, let's say it was interesting. There is a bit of overlap in these conversations as you'd expect. I mean, there are some events that we all talk about. So you'll hear about those things more than once, that sort of thing. Okay, here we go. I'm really interested to see what we talked about today because Slade doesn't really talk about Benny's diabetes publicly. I mean, of course, you you're very, very involved, and you talk about it, I'm sure with friends, and things like that. But it's not like you are front and center at functions. And, you know, that kind of thing over the years, I don't Slade 5:41 have a podcast, Stacey Simms 5:43 I could help you set one up. But I've been told in the past, I speak enough for everybody in the family. So I'm really interested to hear what you have to say if your conversation matches mine. Alright, so let's start 10 years ago, Ben, he was diagnosed with type one. He was not yet two years old. And Leo was just had just turned five. What I remember vividly is the month before he was diagnosed, when I was working at WB T, doing morning radio, you got the kids every morning. So you used to text me, like 730 or seven o'clock every morning and say, you know, kids are okay are off to daycare or you know, here's a funny picture. And you texted me one day and said you are not going to believe the amount of pee that came out of this kid. Do you remember that? Like the mattress is soaked in the floor was wet. I Slade 6:35 remember one morning, getting him out of his crib, right? And the entire mattress was soaking wet. Like everything. All the blankets were wet. The pillow was where the entire mattress was. So it was I'm like it didn't make any sense to me. Stacey Simms 6:53 Right. And you know me at work. I was kind of thinking when you trade off like we did because sleep had a restaurant for many years. So I had the kids in the afternoon and in the evening when he was working. And he had the kids every morning because I used to do a morning radio show that started at 5am. And I just remember thinking, not on my shift like you gotta fix Slade 7:14 which I did right away. Of course, drying the mattress out trying to figure out what happened, but we Stacey Simms 7:19 kind of thought it was a one off. Oh, yeah. Because it didn't happen again for a while. Yeah. And then it happened to get about three weeks later. Well, Slade 7:25 we noticed I think from that point on over the next couple of weeks that he was drinking a tremendous amount of liquid for a 18 month old or 20 month old. It was you know, and he would suck down a little 10 ounce sippy cup in like, you know, 15 or 20 seconds. It was absurd. Stacey Simms 7:45 So the the mattress wedding thing was in October, I think late October or something. And then of course, there was Halloween, which I'm sure didn't do him any favors. That was the year the kids dressed up. But it was the only matching costume we ever did. Leo was Ariel and Benny was flounder. And then, at Thanksgiving, we had family photos on the Friday of Thanksgiving that year. And then we went to the lazy five ranch. And I've told this story before one of my brothers was here, right brother David was there, right? And I posted that picture recently on Facebook of David and Benny with a giant glass of orange juice. And then we went to the lazy five ranch and of course Benny couldn't he was still in diapers and he was soaked and he was just laying down and he was exhausted. He felt like garbage. And then that Monday, we went to the pediatrician that Monday right after Thanksgiving, right? And Slade 8:37 then I mean, I think they did a fasting glucose and a few other things. And they thought he had a urinary tract infection knew and I already had suspicions that it was something more like it didn't make any sense. Yeah. And then it was a few days into an antibiotic for what they thought was a urinary tract infection and there was no change. And so his outward symptoms continued to be the same right where he drank tremendous amounts of water and liquid and was always going to the bathroom. Stacey Simms 9:08 Well on that Monday when we went to the doctor his as you said his fasting glucose was normal. It was 80. And then they did a blood draw. They must have found something in his urine, right? They must have found sugar in it because I remember they did a urine test to do a urine test on a kidney. They didn't Slade 9:24 remember that we had to kind of push for them to do an A1C like they it took a week or so. Yeah, Stacey Simms 9:30 but we didn't ask for A1C We just asked for a blood test. I didn't know what we were asking for did I remember holding you had to hold him down? Yes, I did have to hold them down Leah was in the hallway Leah remembers that remember some screaming? Slade 9:40 It wasn't exactly pleasant. Stacey Simms 9:44 Yeah, and then he did that they said I had a urinary tract infection. And I remember when we treated it he seemed to feel better once a day right just from the urinary because he did have one but you know job raucous or pediatrician friend down the street said to me Why would a healthy two year old boy have a urinary You're trying to keep keep looking. So I was convinced at this point that he was he had contracted a fatal disease. I was on the internet. I was looking at all sorts of horrible things. I thought he had kidney cancer. I really did. I was so scared. And then he seemed to feel better. And then on Saturday, they called us and David was still here. And they called us on Saturday and said, like it was an emergency get to the hospital. But they wouldn't. They didn't tell me why. Well, they did tell they thought they told me why because they told me his blood sugar was like, you know, 700, or the A1C correlated to, you know, I don't know what it was. But I remember thinking, He's fine. He looks fine. He's doing okay. Why do we have to rush to the hospital? But we did. Slade 10:33 Yeah. But I remember during that week that we kind of, we were guessing that it might have been diabetes? Stacey Simms 10:42 Oh, well, yeah. Because most people and you know, the symptoms matched perfectly. But I think it was the fasting glucose being kind of normal that threw me off. And I of course, went to worst case scenario, Slade 10:51 you went, you definitely went deeper. But you know, still concern. Yeah. Not knowing. And it's, it's a scary thing, when the doctor calls and says, Take your kid to the emergency room. And you go while he's walking around playing with some toys, he's just fine. So and then, of course, it's just a, it's a crash course. Right? You get admitted in two days later, you're out and you have diabetes and have to live with it the rest of your lives. Stacey Simms 11:19 Oh, you know, one thing I forgot is, when we took him to the pediatrician that first time on the Monday after Thanksgiving, when I called, we knew just enough to say he's got the symptoms of type one. We knew that much that the pain and the drinking, because of all the stuff I'd done with JDRF already and in Charlotte, and my pediatrician, Dr. Scott said, I've never seen it in anybody younger than two. Right, bring him in, and we'll rule it out. And thankfully, you know, they took us seriously because I've heard some nightmare stories of people that don't. But what's funny is, here we are 10 years later, almost every time I go to that pediatrician, and it's one of these big practices with like eight doctors, they all look at Benny's chart and we go in, they say, oh, like he was the youngest one we saw at that time, you know, and now of course, there's lots of kids that are diagnosed younger, unfortunately. But for that practice, it was it was unusual. It's pretty unique. Slade 12:07 Yeah, I just I just distinctly remember that we had to push a little bit. Yeah. To get them to think in that direction. Stacey Simms 12:15 Oh, when he walked in with AD, yeah, they tried to figure out something else. So Slade 12:19 I mean, I think all that really says is, doesn't matter what the age or what you're thinking, you have to be your own advocate, you know, in some way, shape or form, if you're not your voice, then there's an opportunity to miss something. Right? Not get a good look at it. So I think that I think that not going down the you know, the rabbit hole right? To something considerably more catastrophic. And trying to rule that stuff out. You have to, you have to ask and you have to instruct and you have to, you know, your medical team, you have to be part of the conversation, right? You can't just tell me what to do. Stacey Simms 13:04 But it's hard to in some ways, because you don't know what you don't know. But you're I agree with you. You have to we've learned this for many years. Now. You got to push you got to be your own advocate, you got to ask questions. But, you know, if I didn't know, peeing and drinking was a sign of type one, I don't think I would have known what to ask the doctor. Right. But Slade 13:19 I also think that that I don't think doctors are offended by that. I think that that helps them do what they're trained to do is help. Help people get better. And if you're not engaged in the conversation, it's a one way street. Yeah. It Stacey Simms 13:32 would help. Alright, so we're in the hospital now. And I remember he had those things. What are those things called all over you with a stick you the sticky things I had like an Slade 13:41 EKG monitor, right, and he kept pulling Stacey Simms 13:43 them off? Slade 13:44 Yeah, that couldn't have felt good. Stacey Simms 13:48 That was like when we first started using the Hulk analogy, because he was like the baby Hulk pulling everything off. Slade 13:54 Well, it's interesting, and he doesn't have any idea what's going on. Stacey Simms 13:57 But that night, we took turns, you know, you went home. I stayed. And they pretty much didn't tell us until the middle of the night that he had type one. They kind of I think everybody thought we knew. And finally I asked if they had a diagnosis. And they said, Yeah, he's got they would like yeah, he's got type 1 diabetes. I mean, they were nasty about it. But I think everybody thought someone else had told us along the way. Slade 14:19 We didn't see Dr. Werner alto second day or the next day. Yes. We Stacey Simms 14:23 went in on Saturday morning or Saturday, mid morning. We saw nurses and hospitalists there was that one horrible woman. She came in and she smelled. She didn't say anything to us, like not Hello, how are you? I'm so and so she came right in and smelled him. And now I know it was for fruity breath. Right? So when she came in, she smelled him. And you know, I am of course very calm. I said, What are you doing to my son? Who were you? She kind of explained but she kind of left us like you're not coming back and just I don't know what I said. I'm sure it was very nice. But yeah, that night we met the hospitalist. And that was when that was when he said to me, who stays home with Benny, not our endocrinologist, but but just a hospitalist, a doctor who sees people in hospital. And I was already panicking because I had my dream job. And I had health insurance. You had a restaurant you owned a restaurant is that like you can untangle from that pretty easily? You know, I'm closing the doors. When Slade 15:21 we tried to untangle from it, it took a long time. Stacey Simms 15:25 And I was terrified because it couldn't really quit. I wanted to quit my job. But I had to health insurance and I really didn't want to quit my job either. So we said who stays home with Benny? I said, nobody really nasty. And then I burst into tears. And you weren't there. And Vinnie, do not remember you were not there. He was another night. And then then he put his kidneys awake. He's 23 months old. He puts his arm around me. He says it's okay, Mommy. I was like, Dude, you better get your stuff together to myself. You bet this is your 10 year old is comforting you this is not how it's supposed to work. And that was a big turning point for me. And like the guy was great. He said, I'm sorry. He said, What I should have said is what's your situation? He's like, I'm just trying to help you acclimate? And he told us even go back to daycare. And he you know, nobody said no to us. They'll try to help us figure out how to make it work. But that moment was a big turning point for me. Slade 16:14 I don't think I had any big turning points. I mean, the only thing that I realized was, you know, when we finally did come home, and you know, I went grocery shopping. Stacey Simms 16:26 Oh my god, wait. So hold on. Let's get there. So we met Dr. V. The next morning on a Sunday. And he came in and I remember him coming in and saying hi to us and being great. But getting right on the floor with Benny. Yeah, Slade 16:39 and what I remember. And and you have a better memory than I do. But what I remember is him saying listen, based on where we are today with treating this. There isn't any reason he shouldn't have the exact same life he would have without diabetes that he has with diabetes. I mean, that was that was that just set the tone? Right? Stacey Simms 17:00 Yeah, it really did. And I remember, thank you. I will anyway, I remember,... /episode/index/show/diabetesconnections/id/28919868

Diabetes Connections | Type 1 Diabetes

TOPICS