2007: Diabetes Year in Review

Happy Holidays, everyone! ‘Tis the season for cocktail parties, and roundups of the closing year, no? I was feeling a little overwhelmed about attempting “the roundup” this year, so I decided to ask you all to get involved. To me, it seems that if 2007 is remembered for anything, it will be as the birth year of Health 2.0, the rise of Social Media and its conjunction with health and healthcare offerings on the web. For diabetes in particular, product design took the spotlight for the first time, while a few drugs were spectacular failures.

LET’S WRITE THIS ONE TOGETHER…

Diabetes_2007

Below are my personal observations about what was Big in Diabetes for 2007. I’m thinking that many of you out there in the Diabetes Community have your own take on what was big in diabetes this year. So how about you share your comments on launches, happenings, treatments, trends, bloopers & outtakes — you name it — below? I’ll continue to update this post with your feedback until we hit 2008. What say?


Making Pharma History.

2007 was a watershed year. At a $2.8 billion loss, Exubera made its mark as one of the most expensive flops in the history of the pharmaceutical industry. Pfizer spent about $370 million this year on promotion alone, financing everything from CDE and doctor training, to prime-time TV spots. Lesson learned: Before you invest billions in a product that will benefit very few people, you’d better do your homework and talk to your customers first!

Avandia came in at a close second, making history as one of the most controversial and potentially harmful blockbuster drugs ever pushed through the system. It’s had an enormous ripple effect, even to the point of potentially contributing to a slow-down in pharma innovation, some observers say.

Byetta continued to take the diabetes world by storm this year, especially with the introduction of its new long-acting release (LAR) version that’s showing unparalleled A1c results in patients. “LAR continues to look like a $3 billion-plus seller in our minds as no other diabetes medication — now or on the horizon — comes close to lowering A1c as effectively combined with the weight loss profile, which likely gets better in longer-term studies,” states Jim Reddoch, an analyst with the high-profile firm Friedman, Billings, Ramsey & Co.

Meanwhile, Merck’s Januvia may take the prize as the most talked-about oral diabetes drug of the year, with both experts and patients duking it out over its relative effectiveness and safety. Hundreds of visitors find their way here to DiabetesMine.com each day by searching the Web for the term “Januvia” (!)


Pushing the Envelope.

Despite some grumblings to the contrary, innovation in diabetes R&D made some great strides this year. A number of studies proved the positive effects of new ultrafast insulins — including Biodel’s Viaject and Sanofi’s Apidra. Microneedle patches for insulin delivery, from companies like Ingenta, also showed very promising results in studies this year.

For Type 1′s in particular, 2007 was all about “the steady growth and implementation” of continuous glucose monitors. As part of the JDRF’s Artificial Pancreas project, Yale researchers have successfully tested an artificial pancreas made by Medtronic in a small group of teens with type 1 disease, according to US News & World Report. Still, some prominent diabetes physicians think the CGM market is “growing too slowly and reimbursement denials are criminal.” Amen. Despite the establishment of official HCPCS codes (insurance codes) for CGM, coverage by your health plan is far from guaranteed.

“The (CGM) systems are far from perfect, but they have saved countless individuals from severe lows and dangerous highs, and gave us all a valuable tool in the quest for glycemic stability,” CDE and author Gary Scheiner remarks to me.

One area where we really pushed the envelope this year was product design. I am proud to report that my “Open Letter to Steve Jobs,” calling on the gurus of consumer design to help update medical product design, echoed off the walls. Before long, the issue was appearing in BusinessWeek and the UK Guardian and BrandWeek, and one design firm in particular decided to take action to get the industry’s creative juices flowing. We, the Patient Community, were finally able to speak out loud and clear on how important product design is in devices that we wear and live with 24/7.


Piercing the Public Consciousness.

Many believe that 2007 was “watershed” for diabetes for this reason alone: “Diabetes is becoming part of the national debate and people are beginning to realize that we have a serious problem and things have to change.”

Certainly Mike Huckabee’s candidacy (like him or not), and national awareness campaigns like the Know Your A1c campaign from the Diabetes Care Coalition have helped to sear diabetes into the American consciousness. The UN Resolution on “Uniting for Diabetes,” along with the 2007 World Diabetes Day events, lighting up iconic landmarks around the globe, captured media attention everywhere to help “bring the world together around diabetes care.” Now it remains to be seen what the Powers That Be will do about it in 2008.


Social Media: Taking Flight.

As noted, 2007 marks the take-off of Health 2.0, where Web 2.0 interactive internet functionality meets health and healthcare. Suddenly, patients who use the web to learn about and/or manage their health are taking center stage.

Health on the Net is so hot, in fact, that VC (venture capitalist) money is flowing almost like back in the old days of the Internet bubble — but with better business plans behind the sites this time, presumably. For a sampling, see these 38 new health web sites. Specifically for diabetes, just a few of the new online tools include:

What’s really changing the landscape, of course, are new Social Media sites for patients — blogs, wikis, podcasts, and full-featured networks such as TuDiabetes that give people a place to congregate and share their knowledge and concerns. These sites give the patient community a collective voice they never could have dreamed of before. And our collective voice is making waves. Witness the call for improved product design, mentioned above, and also the hypoglycemia case of Mr. Universe, Doug Burns. An outraged patient community spoke out, and the trumped-up charges were suddenly dropped. Lesson learned: Social media on the Net really CAN make a difference in “real life.”


Here At Home.

As you all know, I became an insulin pumper this year. And never-say-never, but I am feeling like I’ll never to go back to injections if can avoid it. Insulet’s OmniPod really has succeeded in “making diabetes a smaller part of life” for me. Of course, it’s not perfect, as I am not perfect. Managing diabetes remains a $#%@! frustrating challenge, thus I continue to write :)

In fact, I penned my 30th Straight Up column for dLife this month. I also a spent a good part of 2007 researching the field of Diabetes Education, and what can be done to remedy the crisis it is facing. I learned a ton — and made a few people mad along the way — but “blowing the whistle” was never a popular job.

DiabetesMine.com hit the Top 10 in the World’s Best Blogs in Health & Medicine on the Healthcare 100 Index. We started an online newsletter service so readers can follow the site directly from their own inboxes if they so desire. I even hosted the first-ever T-shirt giveaway contest, and had a little fun with a new category called Monday Madness. Share yours ;)

* * * *

Now it’s your turn…

D_roundup_2007

*** UPDATE 12/25 ***

Thank you, everyone, for your excellent input on the highlights of 2007. To summarize briefly, not to be missed this year:

* The Photo Projects: Diabetes Made Visible, Manny’s Word in the Hand contest, and the Diabetes365 Project started by Beth, all bringing life with diabetes “to life” on the web, with about 1,500 pictures posted on the latter to date.

* On the CGM front, duly noted that Dexcom, the first continuous monitor to gain FDA approval, now has its 2nd generation product on the market, and the 3rd generation rendition is already in clinical trials.

* Offline, several leadings CDE’s brought my attention to the increased recognition of the importance of
a patient-centered approach to diabetes care by the Powers That Be. “This is evidenced by the
articles in Diabetes Forecast, the development of the Conversation Maps teaching system by the American Diabetes Association, the new Standards for Diabetes Self-Management Education published by the ADA and AADE,” educator Martha Funnell writes to me. In any case, we’ve turned the spotlight on improving diabetes education across the board.

* Keep your eyes peeled for Scott S’s year-end roundup, including what he considers important steps toward a cure — “Teva’s Diapep 277 drug, Eli Lilly’s deal with MacroGenics, Inc. to commercialize teplizumab, a humanized anti-CD3 monoclonal antibody, and other potential next generation anti-CD3 molecules for use in the treatment of autoimmune diseases, including Type 1 diabetes.”

Got more to add? Feel free to post your input below.

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19 Responses

  1. Nick
    Nick December 17, 2007 at 10:21 pm | | Reply

    You know, I tried Symlin, and I just didn’t like it. Being type 1.5, I found it to be exceptionally difficult to avoid a low 15 minutes after taking the stuff, then managing basal rates to compensate for the slower rate of stomach-emptying. My endo even suggested taking it in lieu of bolusing at all. May still try that.

  2. Bernard Farrell
    Bernard Farrell December 18, 2007 at 3:52 am | | Reply

    Amy

    Thanks for a great roundup, it’s been a good year in terms of progress on diabetes and health issues.

    In your list of online tools, you should also include http://SweetSpot.dm.

    And please don’t forget about the Diabetes365 Project started by beth. Our official site is http://projectdiabetes365.com and we have about 1500 pictures that illustrate a little of what it’s like to live with diabetes.

    On the CGM front, you should mention that Dexcom now has their 2nd generation CGM product on the market and they are already trialing their 3rd generation product.

    That’s all I can think of for now.

  3. Rachel
    Rachel December 18, 2007 at 5:03 am | | Reply

    I think you covered everything pretty well. :)

    On a personal level, I was glad to join you as a Viewpoints columnist at dLife. Now that I am taking medication for type 2, I am finding that I can empathize more with those reluctant to go on medication or insulin. Growing more comfortable with my weight has become a priority because I’m not overweight and I’m doing just fine with my numbers.

  4. Dan Fahey
    Dan Fahey December 18, 2007 at 6:47 am | | Reply

    Regarding continuous BG monitoring, I’d remain skeptical of a tool that isn’t accurate enough to receive official sign-off as a REPLACEMENT for traditional BG monitors. Why WOULD insurers cover this yet, when one still needs both systems? [Has anyone yet reviewed the Minimed combined insulin pump/continuous BG monitor?] That combine might help get beyond the issue of insurance coverage, since insulin pumps are often covered.

  5. Allie Beatty
    Allie Beatty December 18, 2007 at 8:17 am | | Reply

    Fantastic roundup! Congratulations for the Top 10 placement in the World’s Best Blogs in the Healthcare 100 Index. You do a fantastic job of reporting the stuff that impacts our lives. Drugs, research, monitoring, politically, socially and technically — you’ve got it covered, Amy! Thanks for everything you do to keep us informed!! Best to you and all yours in 2008!! And thanks for mentioning TuDiabetes – it’s one of my favorite D-social networks, too!

  6. Trusted.MD Network
    Trusted.MD Network December 18, 2007 at 9:51 am | | Reply

    2007 Diabetes Year in Review

    Diabetes Mine sums up an eventful year. Exubera, Avandia, and Januvia are just a sample of diabetes drugs in the news.

  7. Scott
    Scott December 18, 2007 at 12:09 pm | | Reply

    As you may be well aware, for the past 3 years, I have done my own “year in review” so I’ll save my most noteworthy observations for that. However, one element that was visibly absent from your review was any mention on progress towards a cure, which struck me as curious. To be sure, there isn’t a cure yet, but there were several notable investments during 2007, particularly from the pharmaceutical industry, with an eye towards a cure. Notably, Teva’s Diapep 277 will go to trial, also Lilly’s deal with MacroGenics, Inc. to commercialize teplizumab, a humanized anti-CD3 monoclonal antibody, as well as other potential next generation anti-CD3 molecules for use in the treatment of autoimmune diseases, including type 1 diabetes.

  8. Albert
    Albert December 18, 2007 at 12:29 pm | | Reply

    there seems to be an overall empowerment of PWDs through the development of new diabetes technology.

    interestingly enough, I found that on of the most effective instances of “diabetes awareness” happened as a result of the crash of Exubera. I found that many of my consulting friends were knowledgeable about the Exubera flop even though they knew very little about diabetes. They even understood that the long-term effects of inhaled insulin were not known. It strangely enough established a platform for me to educate them on diabetes.

  9. Leah
    Leah December 18, 2007 at 1:27 pm | | Reply

    2007 for me was the year of diagnosis and thus entry into this very strange world of diabetes. Welcome to the jungle!!

  10. Jamie
    Jamie December 18, 2007 at 3:19 pm | | Reply

    I second the motion for CGMS, as it’s easily been the biggest improvement in my diabetic life – I started using the Minimed Real Time with Mini-Link, and it’s helped me trim my A1c to 5.8 – an all time BEST!

  11. Manny Hernandez
    Manny Hernandez December 18, 2007 at 8:10 pm | | Reply

    Awesome roundup, Amy!

    For TuDiabetes, I would say one of the biggest highlights was the “Word in your Hand” Project that resulted in this gorgeous video.

    Check it out if you haven’t:
    http://tudiabetes.com/video/video/show?id=583967:Video:67944

  12. Lauren
    Lauren December 18, 2007 at 9:26 pm | | Reply

    2007 was also the year of my type 1 dx. At this time last year, I was feeling awful — my sugars were starting to soar, but I didn’t realize what was going on until mid-January. Now I feel good, and I’m so thankful for my health and my A1c under 5.5!

    Thanks, Amy, for sharing your Omnipod experience. That’s what encouraged me to research it and find out when it would become available to Bay Area residents. (I have yet to meet a doctor who knows what the Omnipod is.) I may try it starting in January (even though I’m meeting with serious criticism — my friends and family are trying hard to change my mind, because they think wearing a pod will mark me as a “sick person”). Anyway, I am motivated to move forward with the pod in part because of Amy’s enthusiastic posts. So, thanks!

  13. Sunil S Chiplunkar
    Sunil S Chiplunkar December 19, 2007 at 4:48 am | | Reply

    Greetings to Amy and readers of this blog. Amy has done a lot for diabetes management through her thoughts, writings, and actions. Her dedication and passion for the cause of diabetes management is inspiring and rightly so, Amy’s blog is one of the top 10.

    Right now, it would be interesting to expand the geographic coverage of this blog. India is home to largest no. of diabetics in any country. Blogposts and conversations on diabetes related issues touching on the Indian situation will add to the strength of this blog. 2008 should be the year of geographic expansion of this blog (in terms of blogposts). This is one point for the wish list of this blog.

    Another point is that CAM product usage and benefits finds less focus on this blog. Another entry for the 2008 wishlist is to increase the conversations on CAM products.

    Congrats to Amy and God bless her. Merry Christmas to all readers and to AMY.

  14. Sheri Colberg, Ph.D.
    Sheri Colberg, Ph.D. December 19, 2007 at 11:35 am | | Reply

    Amy,
    Your blog is great, and I enjoy finding out from you what’s the latest news in the diabetes world. From my perspective, the most important research in 2007 was the finding that doing any exercise is beneficial for lowering your risk of dying. You don’t necessarily have to meet all of the exercise guidelines set up by the American College of Sports Medicine and the Am. Heart Assoc. Certainly, more exercise is better, but you’ll get some benefit from any movement that you do, and as far as your health and diabetes control are concerned, it’s better to be fit, regardless of your weight. I write an exercise blog for anyone who needs help getting started being more active. Exercise to stay healthy!
    Dr. Sheri Colberg

  15. Scott K. Johnson
    Scott K. Johnson December 20, 2007 at 12:01 am | | Reply

    Great roundup Amy.

    I think what has hit home for me most this year was the photo projects (Diabetes Made Visible, Diabetes365, Word in your hand project, etc.).

    Kind of touching on and agreeing with Scott Strumello’s point above.

    It really drives home just how hard diabetes hits, and just how primitive our treatments still are. Thank God for the tools we have, but we’re a long way from home free.

    It’s just no way to live. I do it because I have to, but damn. We sure do put up with a lot of crap just to make it through each day.

  16. Stu Davidson
    Stu Davidson December 20, 2007 at 11:43 am | | Reply

    Most certainly one of the diabetic highlights for 2007 has to be the honoring and dedication in Canada of Drs. Banting & Best for thier development of insulin in the 1920′s so we may live.

  17. Greg
    Greg December 20, 2007 at 8:59 pm | | Reply

    Well, 2007 has not been a good year for me with diabetes. I went from being able to get off of meds to needing 4 shots of insulin a day in a 6 month period. I am hoping 2008 will be better.

  18. James
    James January 3, 2008 at 5:36 pm | | Reply

    Symlin, for me, has been amazing. When I started on it, my A1C was at 6.8 and creeping upwards. Since starting Symlin, it’s been dead on 6.0 for the last 9 months. I use Lantus but no other insulin at all. The best thing about it is it pretty much avoids the daytime hassles that fast-acting insulin creates – I take it immediatley befor eating, not 30 minutes before, I take the same dose every time, so no carb counting and adjusted dosing, and I never get post-prandial lows. Very occasionally I do get lows, after extended periods of aerobic exercise, but I’d get those with or without Symlin from the Lantus. Ok, it does tend to make you feel a bit bloated, but you get used to that. If you eat way too much, it will make you feel downright nauseous, but that’s a pretty effective weight control tool in itself. My own experience with it has been so good, and deals so well with what seem to be some key hassles of living with diabetes, it just surprises me it isn’t more popular. I haven’t had any trouble getting insurance to pay for it either. Both my endos at USCF have independently recommended it, but it doesn’t seem to have much take up. Maybe I’m still producing enough natural insulin that this works for me and won’t for others (I’m a 1.5) but I’m going to stick with it for as long as it continues to work, and avoid fast-acting insulin which seems to be the cause of so much stress.

  19. IAA Research
    IAA Research November 18, 2008 at 10:54 am | | Reply

    Interface Analysis, a consumer research firm in the Bay Area, is conducting a study on a new diabetes product. We are currently in need of individuals with experience/or currently use Insulet’s Omnipod and we would really appreciate your help in our recruiting efforts.

    This study is completely noninvasive. We are simply looking to get feedback about how to make this diabetes product easier and more satisfying to use.

    The study sessions are 90 minutes long and will take place during December (2008). We pay $150 for an individual session at our facility in Cupertino.

    This is a great opportunity to give feedback on a new diabetes product that may positively impact your life or others living with diabetes!

    If you are interested, please contact Jamie at (408) 834-8443 or email us at iaa_research@yahoo.com

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