Shocking news have circulated the internet that Casey Johnson has died from Diabetes Ketoasidosis, a complication often associated with poor diabetes management. “Dr. Michael Baden, former chief medical examiner in New York City, said Johnson probably slipped into a diabetic coma, but people can usually be resuscitated from that in the first 24 hours.”
Johnson, the daughter of New York Jets owner Robert “Woody” is also the heir to the Johnson & Johnson health care products fortune. Of course, Johnson & Johnson is the owner of Animas corporation, one of the biggest makers of Insulin pumps.
One can only begin to imagine the effect this unfortunate event will have on Animas. Johnson lived a party life. In December, she announced her engagement to bisexual reality TV star Tila Tequila. Its very sad that someone with all the resources to have great control of the condition has ended this way.
I’m just back from a fairly long international trip, and thought I would share some of my experiences traveling with an insulin pump.
As I had an incredible number of connections during my flight, I had to go through Airport security a number of times. As I went through security the first time, I though I would save myself the inconvenience and take the pump off and put it through the metal detector. Despite the fear of some people that X-Rays may damage the device, the reality is that there is nothing magnetic in tha X-Ray machine, and I’ve been assured that puting the pump through it will not damage it.
After my second connection in San Francisco, I was told that taking the pump off was completely unnecesary. The officer said: “Is that an insulin pump?”… “you don’t need to take it off, the machine will not beep for it so you can go straight through with it”. So I decided to do that, after all, taking the pump off was a (very small) inconvenience and great if I could avoid it.
I left it on as I went through security in Newark. Given the temperature outside was welll bellow freezing, we had a significant amount of clothing on. We were asked to put coats and other outerware through the Xray machine. As I ended up with my Jeans and T-shirt I was asked by an officer again if that thing in my belt was an insulin pump. “Yep” I replied and then I proceeded to go through the metal detector, which as promised, did not alarm.
But thing had not ended just yet. I was then instructed to step into a flexyglass cabin for a manual inspection. As I asked what prompted the different process I was told that “We need to do an extra check because you are wearing an insulin pump”. Ten minutes later we where in our way, a bit disappointed that things did not go as smoothly as I expected.
So I made a decision. For the rest of the trip (another 6 or 7 flights) I disconnected my pump and put it in the little tray with the rest of my electronics. After all, pumps can be disconnected for up to a couple of hours, and pumps consumables don’t even show-up on the X-rays
Baseball player Dave Hollins is shares his story of being diagnosed with Type 1 during his professional career. He shares his first experience with going on insulin and how the earlier versions of a pump where not right for him. Today, Dave is in great health and uses an insulin pump to manage his diabetes.
Yesterday I was packing my diabetes supplies for an upcoming international trip, and though it may be useful to share some insights about what I’m packing. This is my first big trip since I’m on the pump, and must admit that my first impression is that there us a lot more “stuff” I need to carry with me compared with my last trip on injections. My kit looks like this:
Here is the list of what I’m bringing with me:
2 boxes of Paradigm Quicksets (20 sets total)
2 boxes of Paradigm reservoirs (20 in total)
4 boxes of test strips for my Freestyle Lite(400 strips total)
Spare Medtronic pump
Portable sharps container
3 vials of NovoRapid/Novolog (10ml each)
A few lancets
5 syringes (in case things o wrong)
3 AAA bateries + coin (for the pump)
Spare Freestyle Lite
Alcohol swabs
Ketone strips
Quickserter
Frio bag (to keep the insulin
Overall, my diabetes supplies will take about half of the space on my carry-on, and believe me, I want this stuff with me at all times. The last thing I want is for my diabetes supplies to be lost in one of the many connections I need to take, so puting it in checked luggage is not going to be an option.
It’s probably also worth mentioning (you probably noticed in the list above) that I’m taking a second insulin pump with me. Medtronic has a program where you can get a spare pump when you are traveling. It’s probably not necesary if your destination is in a country where Medtronic has a significant presence. However if your trip includes more obscure places I highly recommend you consider borrowing a backup. My backup pump is Medtronic 515, a bit older than my current Medtronic 522, but considering is just a backup, it should be more than adequate. Kudos to Medtronic for puting this program in in place here in Australia.
Today I received a press release from Lilly about their latest innovation on insulin… 3ml vials… yep… I’m not kidding…
Over the last few years, Lilly has fell behind in the area of type 1 diabetes care. After the introduction of Humalog in 1996 we are yet to see any new significant advancements from the American giant.
The last few attempts have been really disappointing. First, the introduction of the Kwikpen, which although interetsing, only replicates what NovoNordisk and Sanofi-Aventis had already done with their isulins.
And then there was the issue with the discontinuation of Ultralente. Lilly discontinued four of their very old products because there was not enough demand for them anymore. However, they did not replace them with newer products. One can only speculate on whether this was triggered by the success of what is possibly the biggest insulin seller of all times… Lantus.
It’s always sad to see reduction of competition on the diabetes market, because competition is a key driver for innovation, better products and ultimately better care. Lilly’s position is only a confirmation of the sad reality of diabetes drugs… it’s about business.
A couple of days ago I bumped into a video produced by the guys at Tu Diabetes, and I thought it was too good not to give it a plug. The video is a compilation of submissions by members of the Tu Diabetes community, and while humorous, shows the serious ways in which type 1 diabetes affects each of us.
According to DHF, the video was made “to raise diabetes awareness and in preparation for World Diabetes Day”. “We held the Making Sense of Diabetes video contest during October 2009. We sought video entries about the impact diabetes has on our lives through one of the five senses: sight, hearing, taste, touch and smell. We produced compilation video, showcasing footage from some of the videos for each of the senses.”
Here is the final compilation
Thanks to Manny and his team for organizing the contest and to all contributing members for their submissions.
Yesterday I received a letter from Medtronic, informing me of a new approval after some recent changes to their CGMS products. Medtronic has completed a study titled “An Inpatient Evaluation of Six-Day Subcutaneous Glucose Sensor Performance” which proved that sensors can be used for 6 days instead of 3. Additionally, sensors where also tested in alternate sites, instead of just the abdomen.
According to the study “The Medtronic MiniMed Subcutaneous Glucose Sensor was originally approved by the FDA for commercialization as part of the Continuous Glucose Monitoring System (CGMS) on June 15, 1999 (PMA 980022). The Sensor is composed of a microelectrode with a thin coating of glucose oxidase beneath several layers of biocompatible membrane. This same sensor is used as part of the Guardian REAL-Time System, the latest advance in continuous glucose monitoring, which is based on the CGMS. Similar to the CGMS, the Guardian REAL-Time System has been developed for use in conjunction with a standard home blood glucose meter. The Guardian REAL-Time received regulatory approval from the FDA in 2006. As currently used, the Subcutaneous Glucose Sensor is labeled for a maximum use duration of 72 hours, using only the abdomen area as an insertion site. Recent studies have shown that the useful sensor life could extend beyond three days, and it is reasonable to expect a significant percentage of sensors to last six days. It is the goal of this study to confirm sensor performance accuracy data from one of these recent studies. The sensor is also commonly worn in body areas other than the abdomen (such as the buttock). This study will also demonstrate sensor accuracy when used in an alternate site.”
This is a very positive piece of news that means that people here in Australia can now get Continuous Monitoring for about half the cost of what was possible previously. This is particularly important since insurance coverage for CGMS is not available here in Australia and patients wanting to use it have to pay out of pocket.
Now, a lot of people where reusing the sensors to achieve the 6 day mark, even if it was not officially approved. It would be interested if that same people will now try to get it to work even longer than 6 days…
Over Christmas and New year I’m going to be traveling overseas to the US and Latinamerica. As part of the preparations I’ve started to do some research on a few of our destinations and have decided to share my findings.
I plan to share some of the resources I’ve found, some general and some more specific to the destination. And speaking of destitation, what better place to start than the most magic place on earth… Walt Disney World.
My first surprise when I searched the internet was the sheer amount of information specifically on Type 1 diabetes and Disney Parks. There are quite a few sites either dedicated or with significant sections on visiting Disney with D. On close inspection, however, it looks like some of the sites have not been updated in the last few years. Maybe this is just a signal that nothing has changed.
The first mention in my resource list goes to AllEars. Not only do they have an incredible section on D but also plenty of information about Disney parks in general. It is also worth visiting the old but still online content of the original Disney with Diabetes blog site.
Dlife also has a section on Disney travel. While less comprehensive, also gave me a few interesting tips, specially around hydration and the effects of adrenaline.
Overall I feel well prepared for the 3 or 4 days I’ll spend at the parks, and I’m sure to post here my experiences. Needless to say, I plan to test very often and pack at least twice as much supplies as I need (including a second pump, but more about that in another post).
This week I had the opportunity to attend the Insulin Pump Expo 2009. This event is organized by The local chapter of Diabetes Australia, and brings together the diabetes community interested in Insulin Pumps. There were two presentaton tracks on the day, one for prospective pumpers and an advanced one for those of us who have been pumping for a while.
In the introductory session they introduce the basic concepts of pumping, with the objective of helping people decide whether they may be interested in an insulin pump. There is also presentations by most pump manufacturers and it’s an interesting to see them competing with each other for patients attention.
I’m already on a pump and pretty much locked to it for the next 3 1/2 years, so for me, the advanced session was where the real value was. Cheryl Steele from the Diabetes Department at Western Health, presented a very comprehensive presentation on bolus options, handling tricky food and continuous glucose monitoring.
Particularly interesting for m was the section on takeaway foods. I’ve always had issues with some foods and had assumed that there was not much you could do… Naughty eating gets naughty BGLs…. It turns out that what I’ve been doing wrong is using the wrong type of bolus. I’ve been using normal bolus for everything while in reallity the fat content of the foods slows down the absortion rate.
Some of the recommendations were quite impresive… for a Big Mac, for example… 50% of the insulin immedicately and 50% over 3 or 4 hours… Pizza, 30-40% now and the rest over 6-7 hours. We were also told to include part of the fat content in the carb count as the liver will eventually turn it into glucose.
Overall was a great night and look forward to see whether I can used what I learned to get better control.
Many people with chronic conditions successfully manage them with pills. This, however, is not the case for those of us living with Type 1 diabetes.
When first diagnosed I remember being told that the main issue with insulin is that it was a protein, and that as a consequence, it would be digested if taken in oral form. While there has been a number of attempts at alternative methods of delivery, we are still ultimately stuck with shots (or variations like a pump).
This may now be about to change. A group of scientists have combined nanotechnology and magnetism to create a delivery system that is simple, but extremely durable and accurate.
According to an article published in Diabetes Health, “The Boston researchers’ solution is a small implantable device, less than a half inch in diameter, that is placed in a patient’s body. The device contains a drug-filled membrane that is also embedded with nanoparticles of magnetite, a naturally magnetic mineral. The nanoparticles are about 1/100,000th the width of a human hair.”
“The amount of the drug that a patient receives can be controlled by how long the magnetic field is applied. Longer pulses produce higher doses. Theoretically, diabetes patients using such a system would be able to self-administer insulin simply by passing a magnetic field near their implanted drug delivery devices for a set amount of time.”
Shocking news have circulated the internet that Casey Johnson has died from Diabetes Ketoasidosis, a complication often associated with poor diabetes management. “Dr. Michael Baden, former chief medical examiner in New York City, said Johnson probably slipped into a diabetic coma, but people can usually be resuscitated from that in the first 24 hours.”
Posted by Henry 
According to the study “The Medtronic MiniMed Subcutaneous Glucose Sensor was originally approved by the FDA for commercialization as part of the Continuous Glucose Monitoring System (CGMS) on June 15, 1999 (PMA 980022). The Sensor is composed of a microelectrode with a thin coating of glucose oxidase beneath several layers of biocompatible membrane. This same sensor is used as part of the Guardian REAL-Time System, the latest advance in continuous glucose monitoring, which is based on the CGMS. Similar to the CGMS, the Guardian REAL-Time System has been developed for use in conjunction with a standard home blood glucose meter. The Guardian REAL-Time received regulatory approval from the FDA in 2006. As currently used, the Subcutaneous Glucose Sensor is labeled for a maximum use duration of 72 hours, using only the abdomen area as an insertion site. Recent studies have shown that the useful sensor life could extend beyond three days, and it is reasonable to expect a significant percentage of sensors to last six days. It is the goal of this study to confirm sensor performance accuracy data from one of these recent studies. The sensor is also commonly worn in body areas other than the abdomen (such as the buttock). This study will also demonstrate sensor accuracy when used in an alternate site.”
I plan to share some of the resources I’ve found, some general and some more specific to the destination. And speaking of destitation, what better place to start than the most magic place on earth… Walt Disney World.
This week I had the opportunity to attend the Insulin Pump Expo 2009. This event is organized by The local chapter of Diabetes Australia, and brings together the diabetes community interested in Insulin Pumps. There were two presentaton tracks on the day, one for prospective pumpers and an advanced one for those of us who have been pumping for a while.
Many people with chronic conditions successfully manage them with pills. This, however, is not the case for those of us living with Type 1 diabetes.
