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Comparative Effectiveness And Costs Of Insulin Pump Therapy For Diabetes

Comparative Effectiveness and Costs of Insulin Pump Therapy for Diabetes

Comparative Effectiveness and Costs of Insulin Pump Therapy for Diabetes

Ronald T. Ackermann, MD, MPH; Amisha Wallia, MD, MS; Raymond Kang, MA; Andrew Cooper, MPH; Theodore A. Prospect, FSA, MAAA; Lewis G. Sandy, MD, MBA; and Deneen Vojta, MD
Evaluation of healthcare utilization and costs over 3 years for adults with insulin-requiring diabetes who transition from multiple daily insulin injections to insulin infusion pumps.
ABSTRACT
Objectives: Continuous subcutaneous insulin infusion (CSII), or “insulin pump” therapy, is an alternative to multiple daily insulin injections (MDII) for management of diabetes. This study evaluates patterns of healthcare utilization, costs, and blood glucose control for patients with diabetes who initiate CSII.
Study Design: Pre-post with propensity-matched comparison design involving commercially insured US adults (aged 18-64 years) with insulin-requiring diabetes who transitioned from MDII to CSII between July 1, 2009, and June 30, 2012 (“CSII initiators”; n = 2539), or who continued using MDI (n = 2539).
Methods: Medical claims and laboratory results files obtained from a large US-wide health payer were used to construct direct medical expenditures, hospital use, healthcare encounters for hypoglycemia, and mean concentration of glycated hemoglobin (A1C). We fit difference-in-differences regression models to compare healthcare expenditures for 3 years following the switch to CSII. Stratified analyses were performed for prespecified patient subgroups.
Results: Over 3 years, mean per-person total healthcare expenditures were $1714 (95% confidence interval [CI], $1184-$2244) higher per quarter for CSII initiat Continue reading

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A BBC News Anchor Describes What It Was Like to Have a Hypoglycemic Attack Live On Air

A BBC News Anchor Describes What It Was Like to Have a Hypoglycemic Attack Live On Air

A diabetes nightmare recently became a reality for BBC news anchor Alex Ritson. On December 1, the radio announcer, who has type 1 diabetes, suffered a severe hypoglycemic attack on-air.
“As I was trying to read the script, my eyes started operating independently of each other, creating two swirling pages of words, neither of which would stay still,” he wrote about his recent experience. “And I had a strange sensation which I can only describe as my subconscious, for reasons of survival, independently trying to wrestle my life controls away from my failing conscious mind.”
Fortunately, Ritson’s colleagues were aware of his medical condition and promptly helped him consume more than a dozen packets of sugar. Within minutes, he returned to his anchor seat and shared the harrowing incident with his audience. “If someone you know has type 1 diabetes and you see them sweating, yawning or looking incredibly tired—or being uncharacteristically drunk or moody—ask them to check their sugar level,” he wrote.
Diabetes is a condition in which the body has trouble processing glucose (sugar) because the effects of insulin have been reduced.
In people with type 1 diabetes, that's because the pancreas isn't making enough insulin. In people with type 2 diabetes, that's because the body's cells have become resistant to insulin. Both types cause more glucose to end up in your blood than normal. As a result, patients—especially those with type 1—may be prescribed medicine to regulate their blood glucose levels. This can, unfortunately, cause your blood sugar level to beco Continue reading

Diabetes Insipidus (DI) vs SIADH Syndrome of Inappropriate Antidiuretic Hormone NCLEX Review

Diabetes Insipidus (DI) vs SIADH Syndrome of Inappropriate Antidiuretic Hormone NCLEX Review

SIADH vs Diabetes Insipdius! Are you studying diabetes insipidus and SIADH and find it very confusing discerning between the two disease processes? You are not alone!
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In this article, I am going to easily break down the differences between diabetes insipidus (DI) and SIADH (Syndrome of Inappropriate Anti-diuretic Hormone). I addition, I provide a lecture on how to remember the differences between the two!
Don’t forget to take the SIADH vs Diabetes Insipidus Quiz.
What is Diabetes Insipidus and SIADH?
This is where the body has a problem producing ADH (either too much or not enough). What is ADH? It is anti-diuretic hormone. This hormone is produced in the hypothalamus, and stored and eventually released in the posterior pituitary gland. In order to understand diabetes insipidus and SIADH, you MUST understand how ADH works because ADH plays an important role in both DI an SIADH.
Lecture on SIADH and DI
Key Points to Remember about SIADH and DI
Each condition is related the secretion of ADH (anti-diuretic hormone also called vasopressin) which plays a major role in how the body RETAINS water.
Each condition presents oppositely of each other (ex: in SIADH the patient retains water vs. DI where the patient loses water)—-Remember they are opposite of each other!
Diabetes Insipidus and Diabetes Mel Continue reading

New Diabetes Products for 2017: Glucometers and CGMs

New Diabetes Products for 2017: Glucometers and CGMs

For the last year, Diabetes Self-Management has been following all the new innovations and products aimed at helping to improve the lives of those living with diabetes. From the latest glucometers and monitoring systems to insulin pumps, pens, and treatments, several major advancements made their impact on the diabetes community in 2016.
When selecting some of the new products, we first talked to Gary Scheiner, MS, CDE, clinical director of Integrated Diabetes Services of Wynnewood, Pennsylvania. Scheiner, known as the MacGyver of diabetes products, has lived with Type 1 diabetes for more than 30 years. He tries out new products before recommending them to patients. “It’s important to see new products from the user’s point of view, not just from the [health-care practitioner’s] side of things,” said Scheiner.
In 2016, the pace of innovation continued to race ahead with unbelievable technology right out of a Star Trek episode. The growing use of smartphone technology and mobile applications has led to better access to blood glucose readings, general health information, and much more. Read on to learn about the newest products. We guarantee you there’s something here for everyone, whether you live with Type 1 or Type 2 diabetes.
In this installment, we look at glucometers and CGMs that have recently hit the market.
Glucometers and CGMs
With the FDA’s approval of Medtronic’s MiniMed 670G, people with Type 1 diabetes will have the option of the first hybrid closed-loop insulin pump and continuous glucose monitoring system. According to study results, the MiniMed Continue reading

Cancer Drug Gleevec Might Slow Type-1 Diabetes

Cancer Drug Gleevec Might Slow Type-1 Diabetes

Gleevec, the daily pill that turned a killer type of leukemia into a manageable disease, may also help slow the worsening of diabetes, researchers reported Monday.
In a follow up to a 2008 study in which diabetic mice were cured by the drug, a team reports “modest” effects in adults with type-1 diabetes. This is the type of diabetes often called juvenile diabetes and it’s caused when the immune system mistakenly destroys insulin-producing cells called beta cells.
Tests done in 67 adults with type-1 diabetes showed the drug appeared to boost their body's own production of insulin, Dr. Stephen Gitelman of the University of California San Francisco School of Medicine told a meeting of the American Diabetes Association.
“On average the people that got the medicine used less insulin,” Gitelman told NBC News.
He stressed that it is a small trial meant to show the drug can safely do in people what it did in mice.
“We just wanted to get a sense if this showed some benefit in adults so we could get to the target population in kids,” Gitelman said.
“The conservative estimate is that beta cell function was maybe 19 percent better at one year. So it’s not a slam-dunk home run.”
The team will have to get Food and Drug Administration permission to test the drug in children.
About 5 percent of the 29 million Americans with diabetes have Type-1 diabetes.
It’s an autoimmune disease, caused when the body mistakenly destroys pancreatic cells that produce hormones like insulin and glucagon that control blood sugar. High glucose levels damage tiny blood vessels, which in t Continue reading

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