Unrealistic CGM Expectations

Med Student with Diabetes Cautions Against Unrealistic Expectations for Continuous Glucose Systems

Zachariah Kramer a med student, class of 2010, says the media coverage of the value of a CGM without equal reporting to the down side is a problem. “I believe this will lead to unrealistic hopes among diabetics eagerly searching for more effective ways to manage their disease.”

http://www.diabeteshealth.com/read/2008/05/16/5757.html

The good some-day-to-be-a doctor however wears a pump and CGM. Some how he understands but we don’t.

Is the message here do as I say not as I do?

The information a CGM provides he says is valuable. I have to wonder if the implication of the articles isn’t that the value is there only because he’s a medical student and we the unwashed masses shouldn’t expect trending information to be valuable because we aren't doctors (or doctors in training.)

Now me, I think it is an unrealistic expectation that the Medical Community, including soon to be newbie doctors, will manage our day to day diabetes care. I am willing to bet that author knows more about diabetes care form ten years of experience practicing type 1 care than from med school. Practice makes perfect, even medical practice.

Are CGMs a panacea, a cure? Heck No. Would the information be valuable for managing basal rates in growing kids? Heck Yeah! (Probably more so than in managing BS in an adult medical student who isn’t going through growth spurts and puberty.)

CGMs have issues. We hold these truths to be self evident. We also know that to secure Life, Liberty and the pursuit of Happiness we, not our physicians are the front line of diabetes care.

Pappa

I’m a T1 parent. I blog. So do a lot of other T1 parents, some of who are T1 themselves. Of course we all know and love the T1 bloggers.

How about the wisdom of the ages – a T1 grandparent’s blog?

Well now there is that too. For a starter on the wisdom path how is this little gem?

In order to have a normal, helpful and caring relationship with a T1 child, extended family and friends MUST accept the seriousness of this disease at face value… They must also examine themselves and the distinction between being afraid of the child and being afraid for the child. A little knowledge and education will go a long way toward understanding that you can help keep that child safe and secure and lessen your own fears.

Enjoy

http://dotinggrandparents.blogspot.com/

The Artificial Pancreas, Unteathered.

The Artificial Pancreas making you loopy?

Lots of folks are working hard to close the loop of Pump, CGM and Software to make an artificial pancreas. JDRF has made it a high profile mission. NIH and FDA have a workshop coming up.

It is interesting to read about people who have a different perspective. Outside the loop as it were. A University of Akron professor is teaming up with the Northeastern Ohio Universities College of Medicine to taking a biological approach. His group is, if you will forgive the over simplification, making a small tube with holes in it that may do the job.

So if you missed it here is an article on their work:
http://pubs.acs.org/cen/science/86/8618sci4.html

It is your turn to walk the CGM.

There is a great article about a Diabetes Dog in the Argus Courier, from scenic Petaluma, California. I had absolutely no clue where Petaluma California may be but Google maps did. It is north of San Francisco, south of Santa Rosa. I assume it is scenic.

It was you typical hypo dog story - which is to say very cool. Who needs a CGM if Muttly can sniff out problems? Well OK I can see value in CGM for basal testing but a smart hypo dog would be cool none the less.

Our beagle has occasionally woken us up when Delaney was low. Not that she is reliable at it. The only thing our dogs are reliable at are eating and barking when one of the neighbors walk by with their dogs. We have a lot of neighbors with dogs. Ours reliably bark a lot. We have the K9 equivalent of morons.

Anyway the thing that really got me interested in this article is the family has THREE kids with type 1. I thought we had it tough with two. Actually I think anyone with a toddler with type 1 has it tougher than we do. At least our kids can talk.

Anyway back in scenic Petaluma, the dog, Lawton, can sniff out lows in all the kids and like a groovy new CGM can predict lows and know to get help. That is way cool. That is smarter about diabetes than a lot of people I know.

Quote:

With three young boys to monitor, Lawton has been a life-saver for the Schumacher family. “He’s a super hero,” said (Meri) Schumacher. “He’s the greatest thing. He even wakes me up at night when the kids levels are low. I used to not be able to sleep at night because I was so worried about them. Now I can go to sleep and Lawton will come lick my face to wake me up if something changes. He really is our miracle.”

I tried reading the story to my beagles. They were not impressed but they barked when the Lab from down the street walked by.

Morons – Yeah I know that moron is synonymous with beagle and for that matter when it comes to Type 1 a lot of the people I know too. Not that I want a lot of people licking my face...

From the News Wire: Leukophoresis

Phase 1 Study Shows Promising Results In Type 1 Diabetes

Guess what? It works for Mice!

http://www.thepittsburghchannel.com/health/16265215/detail.html

From the News Wire: Omni Pod Earnings Call

Insulet Corporation Q1 2008 Earnings Call Transcript is on line at :
http://seekingalpha.com/article/77146-insulet-corporation-q1-2008-earnings-call-transcript?source=homepage_transcripts_sidebar&page=1

Ten pages, mostly business stuff relating to sales, sales taskforce, volumes income etc… Go read it if you are into that stuff. I pulled out a few parts that were potentially of interest to families dealing with type 1

On CGM integration:

Mimi Pham - JMP Securities
Can you talk about the time line for the Abbott or DexCom integration? Last week, DexCom had mentioned December 2009 time frame for seven to be integrated with your J&Js pump?

Duane DeSisto
Our goal with both partners is basically to be into the FDA in the first half of 2009. Then both of our partners are significantly more familiar with that whole regulatory path, but our goal with both partners is in the first half of ’09 to be into the FDA.

On Quality Control and service:

Benjamin Andrew - William Blair & Company
Somebody asked before about product quality issues and you talked about seeing a little bit of a bump in issues. Are you catching those at the manufacturing level or are those coming back out of the field?

Duane DeSisto
I’d love to tell you we catch them all at the manufacturing, but we have seen a slight blip of probably 1% to 2% out in the field in terms of phone calls. We’ve reacted to them. I think our customer service is doing a great job, I think it gets pretty high marks when people talk to them and I think what we’ve seen we’ve been able to deal with so far.

Benjamin Andrew - William Blair & Company
Do you credit back a Pod or two and try to make nice to the patient, or do you lose people from that? Has it become recurring with any individual?

Duane DeSisto
It is. I would tell you it takes a lot of time and effort to get the patients, so we will do whatever it takes to keep the patient.

On using the Omni pod for something other than insulin:

William Plovanic - Canaccord Adams, Inc.
You had previously mentioned on other calls that you would be partnering with a pharmaceutical company. Is the Micromet portion of the press release is that the partnership you had mentioned, or is there something else?
Duane DeSisto
That is not the partnership that we are alluding to, no.
William Plovanic - Canaccord Adams, Inc.
Are you still expecting something by the end of the year?
Duane DeSisto
We would be disappointed if we don’t get something by the end of the year, correct.

Scott's a Good Read

Scott has an interesting interview / conversation with Dr. Norma Sue Kenyon on his blog. The good doc is both a professor of surgery, medicine, microbiology and immunology at the University of Miami and the mom of a T1 daughter. This makes for an interesting set of skills IMHO. Scott's writing is informative and approachable. Hop over if you haven't seen it yet.

http://sstrumello.blogspot.com/2008/05/interview-with-immunologist.html