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A 'Gray Market' For Diabetes Supplies Highlights The Cost Of Care

A 'Gray Market' For Diabetes Supplies Highlights The Cost of Care

A 'Gray Market' For Diabetes Supplies Highlights The Cost of Care


A 'Gray Market' For Diabetes Supplies Highlights The Cost of Care
Bram Sable-Smith / KBIA/Side Effects Public Media
When Tim Rushing turned 50 last year, his doctor called him in for a check-up. They did a physical, ran some tests, and found out that Rushing had Type 2 diabetes.
No surprises there, Rushing says. Both my parents are Type 2 diabetics.
He knew from watching his parents that monitoring his blood sugar would be essential to managing the disease. What Rushing didnt realize was how much that monitoring would cost.
Depending on the type of diabetes, diabetics check their blood sugar anywhere from one to eight times a day. Its a ritual they know well: prick your finger, draw a little blood and place it on a disposable plastic test strip that gets read by a meter. One test, one strip.
Americas 21 million diabetics spend close to $4 billion dollars every year on test strips. Because of their price, though a single strip can cost over $1 an informal, gray market has emerged where diabetics like Rushing can buy the strips more cheaply, but without oversight from the Food and Drug Administration.
Rushing wanted to test frequently, hoping to manage his blood sugars that way. But his insurance only covered one test a day. Additional strips would cost him $1 each, cash. At the rate he used them, that would add up to $180 a month.
So I started looking online and found I could get a box of 50 test strips on Amazon for 12 bucks, Rushing says. That comes out to about 25 cents a strip, a fraction of the price.
Thats what Ive been doing ever since. Ive never even fil Continue reading

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South African Women and Diabetes our right to a healthy future

South African Women and Diabetes our right to a healthy future


South African Women and Diabetes our right to a healthy future
We observe World Diabetes Day on 14 November with the theme Women and diabetes our right to a healthy future.
World Diabetes Day is observed on 14 November and the theme for 2017 is Women and diabetes our right to a healthy future.
Women are generally the primary caretakers in the family and play a central role in the long-term health status of children and other household members. The increase in lifestyle diseases, such as obesity, diabetes and heart disease, calls for a greater awareness of the importance of healthy food and drink choices to help attain and maintain a healthy body weight.
Pregnant women are also at risk of developing a specific type of diabetes, called gestational diabetes mellitus (GDM). This condition occurs during pregnancy and can lead to serious complications, placing both mother and child at risk of developing diabetes later in life.
Insulin resistance and increased blood sugar levels are common during pregnancy, and predispose some women to develop GDM. Poor blood glucose control in pregnancy can be detrimental to the mothers health, cause birth complications and put the baby at an increased risk of developing obesity and diabetes.
Women who have developed GDM in previous pregnancies;
Pregnancies that follow closely on one another;
Women who have had a previous unexplained stillbirth;
Women who have had a previous baby with a very high birth weight (4,5 kg or more);
Women with an immediate family member (parent or sibling) with diabetes.
Most cases of hyperglycaemia (hi Continue reading

Mastery of Medicine in Diabetes Management: A Video Roundtable

Mastery of Medicine in Diabetes Management: A Video Roundtable

Mastery of Medicine in Diabetes Management ADA roundtable
Mastery of Medicine in Diabetes Management was recorded during the American Diabetes Association, 77th Annual Scientific Sessions, June 9-13, in San Diego.
Moderator:
David Nathan, MD, Harvard Medical School; Massachusetts General Hospital
Panelists:
Carol J. Levy, MD, CDE, Icahn School of Medicine at Mount Sinai Hospital
Anne Peters, MD, Keck Medical Center of USC
Part I: Cardiovascular Disease and Diabetes
David Nathan: Hello, my name is David Nathan. I'm a Professor of Medicine at the Harvard Medical School and at the Massachusetts General Hospital, both in Boston, and I'm delighted to welcome you to this educational program today. I'm delighted that we have two experts in diabetes in clinical medicine as well as in clinical investigation: Dr. Carol Levy, from the Icahn School of Medicine at Mount Sinai and Dr. Anne Peters, Professor of Medicine at the University of Southern California.
Today we're going to talk about issues that have come up at the American Diabetes Association annual meeting, and in particular in this session, we're going to discuss cardiovascular disease and diabetes. I've selected a number of abstracts that I think are relatively important in the area, and I'm going to use these as a jumping off point for these two experts to discuss issues regarding cardiovascular disease and diabetes.
So, Carol, Anne, delighted to have you both here. The first abstract I'd like to discuss is one that comes out of a number of places -- Raleigh, Boston, Massachusetts -- and in it, these investigators looked at Continue reading

Diabetes medication associates with DNA methylation of metformin transporter genes in the human liver

Diabetes medication associates with DNA methylation of metformin transporter genes in the human liver


Diabetes medication associates with DNA methylation of metformin transporter genes in the human liver
Clinical Epigenetics volume9, Articlenumber:102 (2017) Cite this article
Given that metformin is the most common pharmacological therapy for type 2 diabetes, understanding the function of this drug is of great importance. Hepatic metformin transporters are responsible for the pharmacologic action of metformin. However, epigenetics in genes encoding metformin transporters has not been fully elucidated. We examined the DNA methylation of these genes in the liver of subjects with type 2 diabetes and tested whether epigenetic alterations associate with diabetes medication, i.e., metformin or insulin plus metformin treatment.
DNA methylation in OCT1 encoded by SLC22A1, OCT3 encoded by SLC22A3, and MATE1 encoded by SLC47A1 was assessed in the human liver. Lower average and promoter DNA methylation of SLC22A1, SLC22A3, and SLC47A1 was found in diabetic subjects receiving just metformin, compared to those who took insulin plus metformin or no diabetes medication. Moreover, diabetic subjects receiving just metformin had a similar DNA methylation pattern in these genes compared to non-diabetic subjects. Notably, DNA methylation was also associated with gene expression, glucose levels, and body mass index, i.e., higher SLC22A3 methylation was related to lower SLC22A3 expression and to insulin plus metformintreatment, higher fasting glucose levels and higher body mass index. Importantly, metformin treatment did also directly decrease DNA methylation of SLC22A1 in hepatocytes cultu Continue reading

Work to Do Before Medicare's Diabetes Prevention Program Is Set in Place

Work to Do Before Medicare's Diabetes Prevention Program Is Set in Place


Work to Do Before Medicare's Diabetes Prevention Program Is Set in Place
Nina C. Brown-Ashford, MPH, CHES, remembers when the Center for Medicare and Medicaid Innovation (CMMI) received the first field reports from the pilot of the National Diabetes Prevention Program (DPP) with the Y-USA. The results were so positive that another agency veteran said, I think there might be something here.
That set in motion calls to CDCs Ann Albright, PhD, RD, the director of the Division of Diabetes Translation, and a process that would lead CMS actuary to certify that pilot participants saved Medicare $2650 a piece over 15 months. Ultimately, 83% of the participants would take part in at least 4 sessions, and the average weight loss was 9 pounds.
Back in March 2016, it was official: DPP would go national in Medicare, come January 1, 2018. That felt really far away, said Brown-Ashford, now the acting director of the Division of Health Care Delivery at CMMI.
On Saturday, she described Medicare DPP as starting on or after that January 1, 2018, target date. While no one is arguing the benefits DPP will ultimately offer, starting a government program from scratchwith features no one has ever used beforeis proving a daunting task. Brown-Ashford led off a symposium at the 77thScientific Sessions of the American Diabetes Association on success stories about the DPP, which has been shown in clinical trials to help those with prediabetes reduce their risk of progressing to type 2 diabetes by 58%.
Recent evidence published in Diabetes Care from 4 years of experience with DPP found major prog Continue reading

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