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Pump May Beat Shots For Type 1 Diabetes

Pump May Beat Shots for Type 1 Diabetes

Pump May Beat Shots for Type 1 Diabetes

TUESDAY, Oct. 10, 2017 (HealthDay News) -- In young people with type 1 diabetes, insulin pump therapy may offer better blood sugar control and fewer complications than daily injections of the vital hormone, new German research suggests.
"Insulin pumps work, and they work even somewhat better than multiple daily injections overall," said Dr. Robert Rapaport, chief of the division of pediatric endocrinology at the Icahn School of Medicine at Mount Sinai in New York City.
Dr. Siham Accacha, a pediatric endocrinologist at NYU Winthrop Hospital in Mineola, N.Y., explained why that might be so.
"If the pump is really taken care of, you can micromanage your diabetes," she said. "You can stop the pump if your blood glucose is coming down, or you can give a bit more insulin if it's going up."
Both Rapaport and Accacha prefer pump use, but if patients would rather do multiple daily injections, the doctors said that excellent control can also be maintained with shots. It's really a matter of patient preference, they noted.
One issue with the pump is price. The start-up cost for a pump can be as much as $5,000, according to Accacha. And there are monthly costs for supplies as well. Insurers, especially Medicaid, sometimes hesitate to pay, both experts said. But studies like this latest one help provide more evidence about the importance of pump therapy.
"Pumps are more expensive, but I don't think expense should guide quality of therapy," Rapaport said. "Even though pumps are more expensive, they lead to better results and less complications, so health care costs will even out."
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Why Insulin Costs So Much

Why Insulin Costs So Much

Everyone who has type 1 diabetes has to use insulin, and about 25 percent of the people who have type 2 diabetes rely on it to control their blood sugar. But its costs are skyrocketing and no end is in sight.
At the annual convention of the American Diabetes Association in Boston this June I listened with perhaps 1,000 other diabetes professionals to one of the world’s top experts on diabetes talk about insulin costs. Irl Hirsch, MD, is the professor of medicine at the University of Washington School of Medicine, also treats patients with diabetes, and has type 1 diabetes himself.
For several years, readers of my articles have written me to complain about the rising cost of insulin. Because I know how expensive that insulin has become, I made sure to hear Dr. Hirsch’s presentation. But I was surprised to see that he cited one of my articles in a slide that he presented.
The Patent Problem
Dr. Hirsch reviewed the cost of insulin from 1921 when Drs. Frederick Banting and Charles Best discovered it. “In a generous gesture that unfortunately didn’t start a trend, they sold the patent for $1 so that cheap insulin would quickly become available. It worked like a charm: within two years Eli Lilly had sold 60 million units of its purified extract of pig and cow insulin.”
But after 1977 Genentech began to produce the first genetically-engineered, synthetic human insulin. This led to the first “dramatic increase” in the price of insulin. Since 1982 Eli Lilly has marketing it as Humulin.
In 1996 the development of the first insulin analog, lispro, led to another increase Continue reading

Insulin: The Canadian discovery that has saved millions of lives

Insulin: The Canadian discovery that has saved millions of lives

Insulin forever changed what it meant to be diagnosed with diabetes. André Picard looks at one of medicine's most significant advances, and the researchers – two recognized with a Nobel Prize and two more overlooked – who chose to never make a profit from their miracle drug
As part of the 150th anniversary of Canada's confederation, The Globe and Mail looks at the Canadians, products and discoveries that changed the world.
When he was admitted to Toronto General Hospital in December, 1921, Leonard Thompson, a 14-year-old with juvenile diabetes, was barely clinging to life. He weighed just 65 pounds and despite a starvation diet of 450 calories a day – the only treatment available at the time – his blood glucose was dangerously high.
On Jan. 22, 1922, Leonard was injected with an experimental treatment called isletin. The impact was negligible.
But, 12 days later, researchers tried again. After the injection, Leonard's blood glucose fell dramatically, to 6.7 millimoles per litre from 28.9 mmol/L. He was discharged from hospital and began to eat more and gain weight.
Within days, six other desperately ill Toronto children received a similar injection, with the same miraculous results. As long as they took an injection daily, their symptoms were largely kept in check.
That drug, renamed insulin, forever changed the lives of people with diabetes. It is one of the great medical discoveries of all times, a Canadian innovation that has saved millions of lives.
Before insulin, children with juvenile diabetes (now called Type 1) lived only 1.4 years on average after diagnos Continue reading

Texting Helps Low-Income Diabetes Patients Manage Insulin Dosing

Texting Helps Low-Income Diabetes Patients Manage Insulin Dosing

People whose diabetes requires insulin injections usually have to make a series of visits to the doctor's office to fine-tune their daily dosage. But many low-income patients can't afford to take those few hours off to see the doctor. As a result, they often live with chronically elevated blood sugars for weeks or months until they can find time to get to the clinic.
But mobile technology can help patients with the process of titrating their dosage without them having to see a doctor, according to a study from New York's Bellevue Hospital.
For people with chronic conditions, mobile technology can provide crucial support and lower costs. Doctors have used mobile messaging to prompt hypertensive patients to measure their blood pressure and to remind HIV-positive people to return for regular lab testing. For people tracking their overall health, Apple's new HealthKit makes it easier for different health and fitness apps to exchange data.
So Natalie Levy, an assistant professor at the New York University School of Medicine and head of Bellevue Hospital's Diabetes Program, decided to try mobile technology to help her low-income diabetes patients adjust their insulin doses remotely.
When diabetics initially start taking insulin shots, they need to check their blood sugar at least once a day to make sure their dosage is correct.
Bellevue, which has traditionally served New York's poor, sees about 5,000 diabetes patients a year. In a survey Levy conducted, one patient reported that it often took three to four months to return for each followup visit during the titration phase.
"Man Continue reading

Diabetes an expensive disease for many Canadians, costing on average $2.5K annually

Diabetes an expensive disease for many Canadians, costing on average $2.5K annually

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Days after his Grade 8 graduation, Julie Vanderschot’s 13-year-old son began to have blurry vision and stomach pains. He was rapidly losing weight, had difficulty chewing, was insatiably thirsty and frequently needed to use the bathroom.
At the same time, he was taking medication to treat an infected tendon in his foot, which he’d hurt in a bicycle accident. “We initially mistook some of the symptoms as side effects of the antibiotics,” said Vanderschot, a policy analyst in Ottawa.
Her son was diagnosed with Type 1 diabetes, an autoimmune disease in which the pancreas can’t produce insulin because the immune system attacks and destroys the cells that produce it. Insulin is a crucial hormone that helps shuttle glucose from the blood into the body’s cells where it’s used as an energy source.
In the weeks and months that followed, the family attended training and education sessions at the Children's Hospital of Eastern Ontario (CHEO), learning how to test blood-glucose levels, administer insulin and adjust dosages, count carbohydrates and manage diet. Vanderschot’s son now sees an endocrinologist every three months.
A report from the Canadian Institute of Health released earlier in November, which is National Diabetes Month, noted that Canada has one of the highest rates of diabetes in the world. More than nine million people are living with diabetes or pre-diabetes in this country. It’s a chronic condition that takes a physical toll and has expensive recurring drug fees.For those who are living with the condition, it’s an expensive situation.
Under Th Continue reading

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