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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

Filtering by Category: Type I News

Rule change for T1Ds and operating commercial motor vehicles

Scott Benner

Federal motor carrier safety administration (FMCSA), DOT rule change…

FMCSA revises its regulations to permit individuals with a stable insulin regimen and properly controlled insulin-treated diabetes mellitus to be qualified to operate commercial motor vehicles (CMVs) in interstate commerce!

from the American Diabetes Association:

The American Diabetes Association (ADA) applauds the U.S. Department of Transportation, Federal Motor Carrier Safety Administration (FMCSA) for its new rule permitting individuals with insulin-treated diabetes to be certified to operate commercial motor vehicles in interstate commerce. The new rule, published in the Federal Register yesterday, is the culmination of more than two decades of advocacy by the ADA to change the rules that govern commercial drivers with diabetes.

Since the 1990s, when Congress and FMCSA began studying the feasibility of licensing people who use insulin through waiver and exemption programs, ADA has been pushing for a medically-appropriate system to individually assess people with diabetes. Recognizing the discrimination that results when people are deemed unsafe simply because of how they treat their diabetes, ADA insisted on better, more fair rules. ADA celebrates the achievement of that goal today with FMCSA’s final rule.

FMCSA rules apply to most people who operate commercial motor vehicles – trucks, buses, construction vehicles, delivery vehicles, airport shuttles, etc. – in interstate commerce. In addition, many employers adopted the rule for their own use in evaluating workers, even if those workers were not directly subject to the rule itself. As a result, a rule that categorically excludes people who use insulin means people with diabetes are kept out of many jobs they are otherwise qualified to perform. The old rule contained a blanket exclusion against insulin use regardless of how well a person managed his or her diabetes. In 2003, FMCSA began granting exemptions to individuals who could satisfy safety criteria and wait out a long and cumbersome application process. The application process involved a period of many months during which the individual could not drive a commercial vehicle, often resulting in loss of income.

The new rule allows individuals on a stable insulin regimen to operate commercial vehicles without needing to obtain an exemption from the government. It provides for an appropriate assessment of diabetes by the individual’s treating clinician, followed by examination and certification from a certified medical examiner. “This rule eliminates a longstanding barrier that prevented people with diabetes from fully realizing their potential in the workforce,” said Katie Hathaway, JD, Vice President of Legal Advocacy for the American Diabetes Association. “I’m proud of ADA’s commitment to this issue and to leading the fight for what’s right for people with diabetes. We are so pleased to celebrate this victory alongside those affected by the outdated rule.”

Read the rest of the ADA’s statement here


Dancing For Diabetes

Scott Benner

I'm proud to introduce Dancing for Diabetes as the newest sponsor of the Juicebox Podcast and I am absolutely thrilled to have the opportunity to tell you about this amazing diabetes charity. 


Dancing for Diabetes has been spreading awareness through the art of dance to better educate the community, raise funds to find a cure, and inspire those with diabetes to live healthy and active lives for the past 18 years and will continue to do so until a cure is found! 

Diagnosed with type 1 diabetes at 10 years old in 1999, Elizabeth Forrest was determined to not let diabetes negatively impact her life. As a direct result, Elizabeth created nonprofit organization, “Dancing for Diabetes.”

As a student in a middle school dance program in Sanford, Florida, Elizabeth was inspired to host a show to raise funds but more importantly, spread awareness. What started as a small neighborhood event quickly transformed into a large annual production and then further into a year round 501c3 nonprofit organization. In the fall of 2018, Dancing for Diabetes will produce its 18th annual show.

Year round, Dancing for Diabetes provides free dance class for kids and teens with type 1 diabetes, hosts several outreach events and programs for kids, teens and adults, and produces Touched by Type 1 – an educational and empowering conference in Orlando, Florida. To learn more, please visit: www.dancing4diabetes.com


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.


UPDATED: Dexcom G6 Restart

Scott Benner

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

I’ve used this method multiple times using the code and once without the code, all with success. Original method is below.


Original post below. Updated method above this text.

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.

Use your G5 or G6 receiver to bypass the 2 hour warmup (note: technically I filmed these from a couple different restart sessions, and then edited them in the correct order for a single video...so ignore timestamps on my phone in the video if you are nit-picking. LOL.)

 

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