Wednesday, November 5, 2014

Afrezza, the Inhalable Insulin

Here is the Joslin Diabetes Center's report on Afrezza, the inhalable
insulin. It is FDA approved, and it appears to be safe. It may prove
to be valuable to people who are hesitant to use insulin injections, but
it is not yet approved for children.
This product is intended to be used as a supplement, so you cannot
stop injections altogether. It does not allow users to fine tune their
insulin doses. Peak activity occurs in 12-15 minutes, and it leaves the system rather quickly.
"Afrezza is not recommended for patients who smoke, have asthma or chronic lung disease. If you’re at high risk for Diabetic Ketoacidosis, (DKA) you probably shouldn’t start this new inhalable insulin at all. During the clinical trials, there was an increased rate of DKA."

Tuesday, November 4, 2014

Diabetes and Hearing Loss

My only diabetes complications after 69 years of type 1 are related to mild nerve damage. I have hearing loss caused by nerve damage in both ears, and it has gradually progressed for more than 10 years. The kind of hearing aids that are inserted inside the ears did nothing for me. Now I have been fitted for behind the ear hearing aids, and will start using them in a few weeks. My wife talks very loud and I still need for her to repeat sometimes. I turn up my TV and miss out on a lot of what is said. I should not have waited so long to try these newer hearing aids.
I would like to know if any of my online friends have hearing loss, and do you think it is caused by diabetes? I have a type 1 friend who says that doctors have told him that his hearing loss may be caused by a kind of neuropathy.
I am looking forward to my new hearing aids. They are small and not very noticeable. I think my wife is just as anxious as I am. lol

Wednesday, October 22, 2014

Letter to My Senator

Dear Senator Gillibrand,
Medicare CGM Access Act of 2014' (H.R. 5644), as introduced by Representatives Reed, DeGette and Whitfield, that would ensure Medicare coverage of continuous glucose monitors (CGMs). The Senate companion bill, S. 2689, was previously introduced by Senators Collins and Shaheen.
The CGM is an FDA-approved, physician-prescribed device that detects and displays blood glucose levels continuously, and reveals trends in glucose levels that often go unnoticed by using traditional finger-stick measurements alone. The device enables a person with diabetes to react to rising or falling blood glucose levels before they become dangerous. There is extensive clinical evidence that shows the use of a CGM improves diabetes management. Based on this evidence, national diabetes clinical guidelines recommend the use of CGMs and the devices are covered by nearly all private health plans.
Unfortunately, people with diabetes who become Medicare beneficiaries no longer have coverage for their CGM, even if they have been successfully managing their diabetes with the device. With insulin-dependent seniors being at greater risk for hypoglycemia and having higher emergency room use and hospitalization rates, it makes sense for Medicare to cover this technology.
The 'Medicare CGM Access Act of 2014' would resolve this issue and help pave the way for coverage of the next generation of CGM-related technologies, such as artificial pancreas systems.

Thank you
Richard Vaughn

Thursday, October 16, 2014

Type 1 Diabetics Are LIving Longer

"People with type 1 diabetes live almost as long as other Americans, a recent study finds..... Better diabetes care has narrowed the gap, researchers said.....Until recently, no one would have predicted that people with type 1 diabetes could have a nearly normal life span."
The article below was published several years ago. Things are probably even better now. I am 75, with 69 years of T1, and am very healthy. Some T1 people have lived into their 80s, and a few into their 90s. Researchers are busy looking to find out what these people did right.

Saturday, October 11, 2014

Avoiding Diabetes Complications

A few years ago the Diabetes Health magazine published an article stating that diabetics should maintain a good BG average and A1c, and avoid a roller coaster type of control. The roller coaster control involves having many highs and lows, and that would involve data widely scattered above and below the average. Blood sugars that rise and fall on the path of a roller coaster are traumatic to the body. Experiencing this trauma over and over again for a long period of time can lead to diabetes related complications, even if the A1c is good. I will demonstrate with two examples.
Patient A has test results 40, 55, 65, 100, 135, 145, and 160. The average is 100, but there are numbers that indicate unhealthy highs and lows.
Patient B has test results 72, 80, 94, 100, 106, 120 and 128. The average is again 100, but the data is more closely packed, and none of the numbers are undesirable.
Patient B is experiencing much better control, and is much less likely to have diabetes complications. The "standard deviation" (SD) is a measure indicating how closely the data is distributed above and below the blood sugar average. Patient A had much larger deviations from the average of 100. Patient B had smaller deviations, so the SD was much better. I try to keep my SD close to 20, but it is difficult to do. My A1c's have been in the 5.4-6.4 range for almost 15 years, but when I have too many highs and lows, my SD is higher and I can feel the neuropathy symptoms in my left foot. I used to have some spots of retinopathy in both eyes because of a roller coaster control.
The purpose of this discussion is to demonstrate the fact that a very good blood sugar average can still involve diabetes complications if there is a significant number of highs and lows over a long period of time. Don't rely solely on a blood sugar average and A1c. Try your best to avoid so many highs and lows. A good average accompanied by a stable control is the best way to avoid complications. Proper dieting and well chosen exercise routines can help very much in avoiding the highs and lows.
I had A1c's no higher than 6.1 for almost 10 years, but had the beginning stages of neuropathy and retinopathy. My control had been tight, but it was necessary to make it even tighter. I stopped having so many highs and lows and after a few months had passed, the retinopathy disappeared. The neuropathy is still present in one foot, but I rarely experience any pain. If I have high blood sugar for several hours there is sometimes mild pain during the night. I have been a diabetic for 69 years, and have not had any serious complications. I want to keep it that way!!