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Archive for June, 2005

Lantus/Travel Strategies

Klinkkk-kruunch! Another Lantus vial bites the dust! Now that sticky sort of aura of it all over the bathroom counter… and tomorrow the argument with the insurance folks about why I need to renew the prescription again already. Gotta have at least two vials in the house!

June 30th, 2005 | Categories: Diabetes Essentials, Self-Disclosure | Comments: (15)

Experimenting with Antibodies

Exciting news on experimental treatments! A new study on Type 1 diabetics showed that injecting the antibody anti-CD3 may help “stop this autoimmune disease in its tracks,” according to JDRF executive VP for research Dr. Richard Insel.

June 26th, 2005 | Categories: D-News Examined | Comments: (3)

Conference Wrap-Up

I’m back home now (you knew that!), up to my eyeballs in the end of school/start of summer camp mayhem, and am also coming to an end of the immediate observations drawn from my trip to the recent ADA Conference. A very enriching experience: I met such fabulous people! Including Dr. Bill Quick and his wife Steph of DiabetesMonitor, who are the sweetest and most knowledeable pair a diabetic could ever hope to meet. And an invigorating getaway, too, save for the Southern California June Gloom. Oh well.

June 23rd, 2005 | Categories: D-News Examined | Comments: (4)

Technical Upgrade Complete

Hello Again — looks like the technical tweak was a success here! Which means:

All posts are now permalinked under the URL www.diabetesmine.com.

In case you had linked to the original Typepad URL, it is officially changed to http://amytenderich.typepad.com (WITHOUT THE UNDERSCORE in my name), so you’ll want to update, preferably to the main URL above.

June 21st, 2005 | Categories: Miscellaneous | Comments: (4)

Closing the Loop

One of the terms most-oft overheard at the recent ADA Conference was the “closed-loop system” for diabetes: when will we have it? is it really viable?

June 21st, 2005 | Categories: Diabetes Essentials | Comments: (8)

The Case of the Pump Case

The Deltec people (henceforth to be known under the name of their parent company, Smiths Medical), who make the highly appealing CozMore pump/monitoring system, hosted a series of intimate dinners at the ADA Conference last weekend to present a “state of the technology” address to their valued contacts. I was lucky enough to attend one. (What? I’m a prime prospect for them!)

June 17th, 2005 | Categories: Diabetes Product Parade | Comments: (9)

Breaking Ground with “The Self-Managed Disease”

(Sort of an addendum to my last post)

With the shifting focus to official recognition that successful diabetes management lies in the hands of the patient rather than the medical provider, there’s a whole lot of flurry of late about “behavioral issues.”

The guru of diabetes behavior is of course Dr.
William Polonsky, author of Diabetes Burnout and founder of the new Behavioral Diabetes
Institute (and also a really nice guy!)

Between moderating panel sessions at this weekend’s
ADA Conference, Dr. Polonsky was kind enough to give me a moment to ask him
about this phenomenon.

“So, diabetes is really unique this way, isn’t it?
Being the only disease that is managed more by
the patient than by the doctor?” I asked (thinking myself quite clever).

“No, actually, it isn’t,” he said. “What about
cancer? And heart disease? Patients have to be
diligent about testing their blood pressure, and about their diet –
avoiding salt, for example. Actually, we’re
breaking ground here for other diseases by focusing on the behavioral side.”

“Oh, I get it,” I said (in another fit of
articulation).

But I do get it! It’s the old notion of
“compliant” versus “non-compliant” patients turned inside-out. No matter what drugs and treatment plans are
available, they will only work if the patient
takes charge and uses them proactively.

This simple fact has had an immeasurable effect on
countless clinical studies attempting to gauge
the success of medical therapies. For example, if you send a bunch of patients off with capsules they’re supposed to
swallow and a meal plan to follow, and then
measure their blood pressure levels (or whatever’s being studied) weeks or months later, how do you really know anything for
sure? Did they really follow instructions? They
may say so, but everybody likes to get an “A,” right?

On the flipside, patients involved in studies where
they’re closely monitored tend to overachieve for
the period while they’re in the limelight. This well-documented occurrence is called the Hawthorne Effect.

The point is (yes, I’m getting to it!) that
patients aren’t just abstract “subjects” at which
doctors can throw new drugs and devices. Rather, they are the key people who
will make the medicine work. Like
so many “new” concepts in medical science, common sense is finally coming to the surface here: patients’ behavior matters
at least as much as the treatments
available!

(Anyone with brilliant ideas on how to motivate
people to take better care of themselves can
contact Dr. Polonsky’s institute here.
Make sure to cc me at amy@diabetesmine.com as well!)

Permanent link to this post (426 words, 1 image, estimated 1:42 mins reading time)

June 15th, 2005 | Categories: Diabetes Essentials | Comments: (7)

Surprising Interview with a Joslin Researcher

At this weekend’s annual ADA Conference, I had the
privilege to sit for an hour just chewing the fat (or, um, chatting…)
about the state of diabetes care with Dr. Richard Jackson of the Joslin Diabetes Center.

Dr. Jackson has the dubious title of “Director of
Field Outreach, Strategic Initiatives,” but his personal passion is talking
with patients about how diabetes affects their life.

For new patients, his biggest edict is, “You are
not doomed. People with diabetes are doing better and better all the
time.”

“When patients come in I ask, ‘How are you doing?’
Often they slump down in their seats and say, ‘I don’t know.’ So I say, ‘NO,
how are you doing?’” he told me.

The point is: How do you feel? Physically?
Mentally? The only way to achieve well-being is
to be in touch with your own state of affairs, this doctor says.

Here are Dr. Jackson’s top tips for getting a
handle on your own diabetes and getting the most out of your doctor/educator visits, as he
related them to me this week:

* Find Out Where You Are
Start
out by getting your numbers: your A1C (at least every 3 months), and your blood pressure, cholesterol, and microalbumin test
results (all annually). Also, make sure you see an opthamologist annually to be armed with
the data on your eye health. Never go in to see your diabetes doctor without knowing
what your health starting point is, Jackson says, or the visit will be unproductive.

And don’t get caught up on some stringent number-goals. Some people do quite well with A1C’s of 7+, or even up to 9, he says.

* Decide What to Focus On
It is
ridiculous to think you have to tackle everything at once. Look at your health records, and decide which ONE or TWO things you
will work on in the coming months.

Instead of making vague resolutions like, “I’ll eat
better,” focus on very specific things like lowering your A1C by checking more
often so that you can react immediately to highs.

Or maybe you’ll focus on blood pressure instead of
the diabetes-specific stuff. “If a Type 2 gets his/her blood pressure down from 150 to
140, they can gain as much health-wise as by lowering their A1C,” the doctor
says.

* Think
of Your Diabetes as a Small Business, and Your Care Team as Your
Consultants
Go in to your appointments with information on where
your “business” stands, and clear goals and/or questions. Have them advise you on
these specifics to get the most “bang for your buck.” And remember that these people work
for you. Sometimes you might want an A1C more often than every 3 months. If they
push back, insist.

“If you ask, your doctor will likely do it. You
just have to ask!” Jackson says. (He also notes that Metrika’s home A1C testing kit for under $20 at the drugstore is a good
option.)

* Make Sure You See the
Results
This is why you need regular testing. Get your older and
newer test results side-by-side and compare your numbers. You can see
that you have made a difference!

Reward yourself in some positive way, and then set
new goals for your next triumph. The ability to see the difference you have made is
key. It’s a rush, like improving your SAT scores or video game scores — whatever
turns you on.

If you do all this, there’s no way for nasty
complications to sneak up on you, Jackson says. You’ll be on top of it and won’t allow
problems to progress. “Remember, nothing ever happens suddenly with
diabetes.”

Thank you, Dr. Jack, I feel better
already!

Permanent link to this post (615 words, 1 image, estimated 2:28 mins reading time)

June 13th, 2005 | Categories: Diabetes Essentials | Comments: (5)

Product Roundup: Continuous Monitors (in the Holding Pen), Convenience Enhancers

*ADA Conference News*

With over 150 companies going all out to showcase the latest and greatest here, I was surprised to hear many conference attendees expressing disappointment not to see anything “earth-shattering” on the new technology front this year. Nevertheless, three continuous monitoring products, currently in the holding pen awaiting FDA approval, look promising:

June 13th, 2005 | Categories: Diabetes Product Parade | Comments: (15)

Jim Turner, Party Animal

*Still live from the ADA Conference in San Diego*

To pick up where I left off, the dLife cocktail party last night was a blast. They premiered the new season of shows, which looks to be getting better all the time. The new idea is to do a “group intro,” and then split up the hosts, so that each has a chance to shine with his or her guest. A welcome improvement, I’m sure you’d agree!

June 12th, 2005 | Categories: Fun Stuff | Comments: (4)