2020 American Diabetes Association (ADA) guidelines recommend that after a trial of metformin, doctors add additional drugs based on the presence of cardiovascular and kidney-related comorbidities, risk of weight gain and hypoglycemia, and cost. In this video, Irl B. Hirsch, MD, of the University of Washington in Seattle, explains the rationale for starting insulin next for patients with persistent HbA1c elevation above 9-9.5% despite lifestyle changes and metformin.
Technology is finally innovating diabetes management. With the advancement in technologies like continuous glucose monitors, traditional insulin pumps are evolving into smarter devices that can automate insulin delivery.
Medtronic and Tandem Diabetes are the only two companies to offer hybrid closed loop systems. A community of diabetics are also hacking pumps to do the same thing. CNBC’s Erin Black just switched from the hacked system to Tandem’s Control-IQ and takes a look at how insulin pumps are getting smarter.
…It seems fasting triggers a dramatic switch in the body’s metabolism, according to a paper Mattson and colleagues published in February in the experimental biology journal FASEB. In humans, fasting for 12 hours or more drops the levels of glycogen, a form of cellular glucose. Like changing to a backup gas tank, the body switches from glucose to fatty acids, a more efficient fuel. The switch generates the production of ketones, which are energy molecules that are made in the liver. “When the fats are mobilized and used to produce ketones, we think that is a key factor in accruing the health benefits,” says Mattson.
In people with Type 1 diabetes, the pancreas can’t make insulin. Those with the condition require several doses of insulin a day and spent $5,705 per person on it in 2016, an increase of $2,841, or 99%, per person since 2012, according to the nonprofit Health Care Cost Institute.
(Podcast interview “This Weekend With Gordon Deal”, 12-14-19)
Costs continue to rise, so much so that almost half of people with diabetes have temporarily skipped taking their insulin, according to a 2018 survey by UpWell Health, a Salt Lake City company that provides home delivery of medications and supplies for chronic conditions.
“Insulin prices doubled in a four-year period,” said Cathy Paessun, the director of the Central Ohio Diabetes Association. “They continue to go up, and the infuriating thing is that there is no change in the process for creating the product.”
Imagine a smart insulin port attached to your skin, delivering the right dose, and at the right time. At the same moment, getting all information regarding your sugar levels, meds timings and health data, managed and analyzed with the accompanying app.
Kite replaces the need to pump yourself with over 30 injections a week, thanks to the soft cannula insertion. It turns any device into a ‘smart’ device, and automatically dispenses the accurate insulin dose. Designed to be affordable, a device like this can be very helpful in the lifestyle management of diabetics.
The functions of the port include: dispensing the dose, capturing data and sending to the diabetes management app. The app integrates blood sugar levels, carb intake and activity. Kate also has wireless connectivity.