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Arden's Day Blog

Arden's Day is a type I diabetes care giver blog written by author Scott Benner. Scott has been a stay-at-home dad since 2000, he is the author of the award winning parenting memoir, 'Life Is Short, Laundry Is Eternal'. Arden's Day is an honest and transparent look at life with diabetes - since 2007.

type I diabetes, parent of type I child, diabetes Blog, OmniPod, DexCom, insulin pump, CGM, continuous glucose monitor, Arden, Arden's Day, Scott Benner, JDRF, diabetes, juvenile diabetes, daddy blog, blog, stay at home parent, DOC, twitter, Facebook, @ardensday, 504 plan, Life Is Short, Laundry Is Eternal, Dexcom SHARE, 生命是短暂的,洗衣是永恒的, Shēngmìng shì duǎnzàn de, xǐyī shì yǒnghéng de

Amazon Buys Online Pharmacy

Scott Benner

This could have a huge and positive impact on insulin pricing... Watch this space


Amazon could start selling discounted meds to cash payers as soon as the PillPack deal closes

  • Amazon bought internet pharmacy start-up PillPack last week for around $1 billion.
  • Consumers could get access to prescription meds sooner than you might expect.
  • Drug supply chain experts suggest that the company could target the growing niche of people who pay out-of-pocket for their meds.

Now that Amazon has snapped up internet pharmacy PillPack for around $1 billion in cash, how long will it take before consumers can rely on the e-commerce giant for their medicines, as they do for groceries, clothing, books and pretty much everything else?

And what will Amazon's strategy be once the deal closes this year?

CNBC spoke to a half-dozen drug supply chain experts to find out.

It'll happen faster than you think

When Amazon bought Whole Foods, shoppers were able to access discounts the day the deal closed. It all started with a few items, but expanded to a much broader array of groceries.

Some experts believe Amazon will take a similar approach with prescription medicines to show value right off the bat. The companies said the deal would close in the second half of the year, which means it could happen any time.

"Amazon could rename PillPack as 'Amazon Pharmacy,' and start right away," said Talha Sattar, CEO of internet pharmacy start-up Nimble. "The bigger question is about the form that the offering will take."

Amazon could start by targeting those who pay cash for their meds, either for generic drugs or branded drugs with coupons from companies like GoodRx.

“Day 1, Amazon will likely focus on cash purchases of both generic and brand medicines — all they need to do so is [get] a board of pharmacy license in all 50 states, and dispensing capacity," said Jonathan Schwartz, CEO of another internet pharmacy start-up, CareZone.

story reposted from CNBC 
Christina Farr@chrissyfarr
Published 9:25 AM ET Tue, 3 July 2018  Updated 12:31 PM ET Tue, 3 July 2018

That's a chunk of a $450 billion market, or about 6 percent of the U.S. population, which includes the noninsured and those with high-deductible plans. It also doesn't require working with the largest pharmacy benefits managers, like Express Scripts, which are gatekeepers of sorts for those who opt to use their health insurance.

Amazon's biggest rival, Walmart, already offers a service like this. It's essentially a list of generic medicines with a $4 price for 30-day prescriptions — no insurance required. Some experts believe Amazon could do its own version of this quickly, and with even lower prices to attract users away from its competitor.

"A company like Amazon could capture $10 [billion] or $20 billion in revenue by doing that well," said Sattar.

But not a complete offering

Pharmacy experts disagree on whether Amazon will have success forging relationships with pharmacy benefits managers.

An Express Scripts spokesperson said Friday that its agreement with PillPack is expiring in July and that the two companies haven't yet reached an agreement on rates. The company did not say whether a change in ownership would affect the discussions.

Other pharmacy benefits managers might shy away from maintaining an agreement with PillPack if they see it as a threat.

For that reason, it might take some time before the company is able to offer cheaper, in-network prices on prescription medicines.

Stephen Buck, who previously worked at drug distributor McKesson, suspects that it would be more than a year before that happens because he believes Amazon will be slow and deliberate with its rollout. Amazon might pick a small market, like a single state, to pilot the offering before expanding to others. PillPack operates in 49 states.

The ABC factor

Amazon is also a partner with J.P. Morgan and Berkshire Hathaway in a program to fix heath care for their employees.

The PillPack offering might come in handy as the partners look to distribute affordable medicines to their 1.2 million combined workforce. Atul Gawande, the group's recently named CEO, recently spoke about his plans to target waste in the health-care system, including high prices associated with things like administrative costs and prescription medicines.

But it's possible that Amazon will work more quickly on its own. Gawande has made clear that disrupting the health industry could take decades — and Amazon typically works far more quickly than that. "Amazon is not known for doing things slowly," Sattar said.


Dexcom G6 Restart

Scott Benner

How to Extend the Dexcom G6 Sensor Beyond the Ten Day Hard Stop...

Reposted with permission from Diabetes Daily's David Edelman.

Some clever technologists have discovered how to restart a Dexcom sensor to extend its life beyond ten days. The process works by exploiting a bug in the sensor pairing process.

Katie DiSimon walked us through the process. Katies is involved in the community of people who are building homemade automated insulin delivery systems using current insulin pumps and continuous glucose meters.

  1. In phone’s Bluetooth list, “forget” the Dexcom transmitter from the list.
  2. Go to G6 app and stop sensor session. Click yes to end it despite all the warnings.
  3. Then choose to start a new session. Choose the “no code” sensor session.
  4. Wait 2 hours and 5 min. If any pairing messages come up for the transmitter during the wait, say no.
  5. After the wait, restart the phone and open G6 app.  This will trigger the phone to try to re-pair with the transmitter. Accept the pairing request.
  6. You may need to restart the phone one more time, but then you’ll be greeted with two calibration requests and a new sensor session.

The directions above are for how to restart the sensor without using the receiver. During the restart process’ 2-hour wait, you will not be receiving current glucose readings, similar to any new session start-up process.

If you have the G6 receiver, you have the opportunity to use the receiver for the restart and continue to still receive current glucose values throughout the 2-hour wait. Here are the instructions in the video below.

 

You must start and finish the restart process prior to your existing sensor session expiration. Katie recommended setting an alarm on your phone for day #9 of your G6 session, so you can avoid rushing at the last minute. If you do miss the window and your session expires before you restart it, and the ten-day hard stop happens, you can still restart the sensor. This would just mean that you have to first reset the transmitter.

Instructions for all the options can be found on this page.

The Caveat to the Hack

The Dexcom G6 has not been tested or approved by the FDA for restarting sensors. There is no guarantee of sensor accuracy. Extend the sensor life only at your own risk.

A previous version of this post was updated to remove incorrect information. 

The text is from Diabetes Daily. The art is my doing. I have not tried this process with Arden's G6 and I'm currently not planning on trying. I am sharing the article with confidence as I have never know Diabetes Daily to share inferior content. Let me know if it works!


Omnipod® Horizon™ System Significantly Improves Glycemic Control in Patients with Type 1 Diabetes

Scott Benner

Good news for the future from Omnipod!

BILLERICA, Mass.--(BUSINESS WIRE)--Jun. 24, 2018-- Insulet Corporation (NASDAQ:PODD) (Insulet or the Company), the leader in tubeless insulin pump technology with its Omnipod® Insulin Management System (Omnipod System), today announced that positive results from the most recent clinical trial of the Omnipod® Horizon™ Automated Glucose Control System (Omnipod Horizon System) were presented during the American Diabetes Association (ADA) 78th Scientific Sessions in Orlando.

The study demonstrated that the Omnipod Horizon System performed well and was safe for over five days of use in adults, adolescents, and children with type 1 diabetes.

In the era of personalized medicine, Insulet is committed to bringing our innovative technology to the global diabetes community and our clinical data give us confidence that the Omnipod Horizon System will be a significant advancement in diabetes management.
— Dr. Trang Ly, Senior Vice President and Medical Director

The study was conducted in a supervised hotel setting under free-living conditions with unrestricted meals and moderate-intensity exercise and included patients who use multiple daily injections or traditional tubed insulin pumps as their standard therapy. Study participants spent significantly less time in hypoglycemia, more time in the target glucose range and had better overnight glycemic control compared to their standard therapy. The investigational device includes features that allowed study participants to customize their diabetes management by adjusting their target blood glucose levels and insulin delivery.

“We recognize that everyone’s treatment needs are different, and the Omnipod Horizon System provides individualized diabetes management to address real world challenges,” said Dr. Jennifer L. Sherr, MD, PhD, of Yale University School of Medicine. “One of the important features is the ability for users to tailor the system for exercise and high fat meals to maintain good glycemic control.”

During the study, glucose control was maintained in the target range (70 to 180 mg/dL) between 69% and 79% of the time overall, and between 74% and 85% of the time during the overnight period, across all age groups. Hypoglycemia was very low overnight, ranging from 0.7% and 1.3% of the time, across age groups.

“In the era of personalized medicine, Insulet is committed to bringing our innovative technology to the global diabetes community and our clinical data give us confidence that the Omnipod Horizon System will be a significant advancement in diabetes management,” said Dr. Trang Ly, Senior Vice President and Medical Director. “We are very pleased that for the second consecutive year, Omnipod Horizon System research was highlighted in the official ADA Press Program based upon its overall excellence in furthering research and advancing treatment for people with diabetes.”

The rest of the article is here


Quincy the Koala uses Dexcom G6 (with video)

Scott Benner

Koala with Diabetes at San Diego Zoo Receives Help from Dexcom G6

A group of San Diego based experts came together June 1, 2018 to help a koala with diabetes at the San Diego Zoo. The koala, a male named Quincy, has been diagnosed with type 1 diabetes.

Media release from the San Diego Zoo, Dexcom and Scripps Health

The experts, representing veterinarians, endocrinologists from Scripps Health, biotechnology professionals from Dexcom and San Diego Zoo animal care specialists took a course of action designed to better manage Quincy’s blood sugar levels through the application of a glucose monitor.

Very few koalas have been diagnosed with and treated for diabetes. Quincy currently requires insulin injections, which are based on his blood sugar level.With a continuous glucose monitor, we may beable to monitor Quincy’s glucose levels throughout the day without having to disturb him. We are hopeful that thistechnology will work as well in koalas as it does in people, thus allowingus to optimize his insulin therapy while promoting his welfare during his illness.
— Cora Singleton, DVM, senior veterinarian, San Diego Zoo Veterinary Services.

Learn more about Dexcom today!

 

The Dexcom G6 Continuous Glucose Monitoring System that Quincy is wearing is the latest innovation in diabetes management technology, which started shipping to people with diabetes earlier this month. The sensor and transmitter placed on Quincy sends his blood glucose levels in real time to a smart device monitored by his caretakers. With the new G6 technology, his veterinarians will no longer need to prick his skin multiple times per day to test his blood glucose levels. The Dexcom CGM also has built in alerts and alarms that will proactively notify Quincy’s caretakers before his blood glucose reaches dangerous levels.

You can imagine what this technology means for Quincy,and any person trying to manage this challenging disease. Just like Quincy’s veterinarian, people with diabetes and their family or friends can monitor their glucose levels from a mobile device, providing around-the-clock safety and peace of mind.
— Peter Simpson, vice president of advanced technology at Dexcom

Koalas normally sleep during the day and are solitary animals. Animal care staff at the San Diego Zoo hope the new sensor will allow them to get more detail about Quincy’s glucose levels while also reducing the number of times they need to disturb him. "Quincy has an insulin deficiency type of diabetes, and needs insulin to control his blood sugar levels and ensure he gets the energy needed to help him build muscle, gain weight and stay healthy much like our human patients," said Athena Philis Tsimikas, M.D., corporate vice president of the Scripps Whittier Diabetes Institute. "Hypoglycemia abnormally low blood sugar is a safety concern, and the limiting factor to using the right doses of insulin, especially in an animal that can’t tell us their symptoms. The continuous glucose monitoring now allows optimal dosing to best manage Quincy’s diabetes." The application of the monitor went smoothly, and animal care staff said they look forward to having information that will help them develop a treatment plan to improve Quincy’s condition. Quincy’s diabetic condition was initially diagnosed by veterinarians at the Los Angeles Zoo, where Quincy was living at the time. He was transferred to the San Diego Zoo for continued advanced diagnosis and treatment. Diabetes has rarely been documented in koalas, and animal care experts do not know what may have triggered this condition in Quincy.


Sugar Rush

Scott Benner

Erin was my guest on episode 170 of the Juicebox Podcast. Check out her episode and her blog, 'Sugar Rush Survivors'. 

After my son’s diagnosis in 2013 at the age of 21 months old I did what a lot of parents do when faced with a life altering diagnosis. I searched online for anyone sharing their experiences with type 1 diabetes (T1D). I joined Facebook groups, read blogs and listened to podcasts. One source I found was Arden’s Day by Scott Benner.

A few months ago on one of the T1D Facebook pages I follow I saw a post by a familiar name. Scott asked for input from fellow parents of children with T1D for his Juicebox Podcast. I thanked him for his podcast with Dr. Denise Faustman and offered to talk with him for the podcast. We connected on Skype and recorded an episode titled, 'Just another Tuesday with Type 1 Diabetes'.

I have experienced the instant bond among T1D parents many times now and it just never gets old. Being able to look another person in the eyes, knowing that they understand the triumphs and fears of this daily life is incredibly reassuring. To hear compassion in another person’s voice in answer to my questions and frustrations makes it easier to continue with the hundreds of decisions I make to keep my son’s blood sugar in range as much as I possibly can.

Scott has brought that compassion and understanding to listeners all over the world and is continuing to make the diabetic online community (DOC) a landing pad of understanding and education. When we spoke for the podcast he encouraged me to lower my son’s Dexcom high alert from 170 to 130. I had been nervous to lower it prior to talking to him but I tried it. It has helped us keep his blood sugar in range by alerting us of rising blood sugar so we can act on it sooner than we had previously.

I found another powerful connection when I met my friend and blog partner Alese. When my son was diagnosed a few months shy of his second birthday we were in the hospital for four days of intense education before we were allowed to be discharged. We had so much information crammed into our heads in such a short time but my son was still so young that he couldn’t tell us how he felt with highs, lows, or the in-betweens. When I met Alese I was grateful that she could translate how highs and lows feel for her. But I was shocked and dismayed to find how little information she was given upon diagnosis as an adult.

As we realized how powerful this connection and exchange was for the two of us, we decided we couldn’t keep it to ourselves, and the idea of jointly writing a blog was born. Sugar Rush Survivors is our attempt to share with others what has worked for us, what still frustrates us, and what lifts us up in our daily management of T1D. In addition to the blog page we manage the Sugar Rush Survivors presence on Facebook, Instagram, and Twitter.

I am grateful for the opportunity to speak on Juicebox Podcast and write on Sugar Rush Survivors adding my voice to the many others in the DOC to say, “You are not alone!”

Blogwww.sugarrushsurvivors.com
Facebookhttps://m.facebook.com/SugarRushSurvivors/
Instagramhttps://www.instagram.com/sugarrushsurvivors/
Twitterhttps://mobile.twitter.com/contact_srs