New "Smart" Diabetes Software from Medtronic Identifies Trends & Recommends Actions

http://type2diabetestreatment.net/diabetes-mellitus/new-smart-diabetes-software-from-medtronic-identifies-trends-recommends-actions-2/

Today Medtronic announces what is sure to be the first of a whole new generation of diabetes management software: its CareLink® Pro 3.0 Therapy Management Software — the first system to include algorithms capable of analyzing data from a patient"s insulin pump, continuous glucose monitoring (CGM) device, and blood glucose meter "to identify the most important patient information in one easy-to-use dashboard."

Take note that this first 3.0 version is for clinicians only, but similar programs will surely be available to patients directly very soon.

The addition of a smart "Dashboard" does away with the need for your doctor or you to manually pour over stacks of data reports to make sense of trends; it provides "a snapshot of ... key insulin delivery and glucose information on one page, ... pinpoints the exact times the patient experienced a low (hypoglycemic) or high (hyperglycemic) glucose pattern and prioritizes these patterns making it easier to identify what actions/behaviors tend to lead to these events."

(click the images for a closer look)

The part that analyzes high and low events is called the "Episode Summary," and it goes a step further by actually making therapy recommendations "so that clinicians can make the most informed treatment decisions possible."

"By reducing the amount of time it takes to interpret patient data, clinicians may have more time to spend with patients fine tuning and making adjustments to therapy and behavior," the company points out.

On top of that, Medtronic"s announcement quotes its Chief Medical Officer, Dr. Francine Kaufman, as saying: "We believe decision support is a key advancement toward developing an artificial pancreas, which will rely upon automated decisions to make adjustments to patients" therapy, and are excited to bring it to the medical community."

I"d have to agree that from the AP perspective, this is exciting. This summer I wrote a two-part series about how important it is to make our diabetes data speak to us. I stand by what I said then: "Reams of glucose data are only as useful as our ability to interpret them and to understand what to do about what we"ve learned."

I was so heartened to hear manufacturers buzzing about "data interpretation" at the annual ADA conference in June! So it"s no surprise to see that a key feature of next-gen logging software is the ability to automatically alert users to trends. In the consumer version, we hope that takes the form of simple messages ("You were running high the last 4 days between 3-5pm") and straightforward recommendations to combat problems ("Check lunchtime insulin:carb ratio; account for afternoon snack?").

Kudos to Medtronic for being the first to debut smart D-management software; there will surely be bugs to work out.

As I said in summer: It could just make all the difference in the world if our BG data records could be translated into meaningful recommendations for us, and not just weeks after the fact. Obviously, using a built-in algorithm doesn"t guarantee that the system would always suggest the right moves, but the alerts themselves would make all that stored data "come alive." Bring it on.

btw, Medtronic"s CareLink is part of its MiniMed Paradigm Revel System, the only FDA-approved integrated system combining an insulin pump with CGM.

With that whole proprietary system in mind, I must note: I hope vendors are paying equal attention to the 2nd pillar of my "real diabetes management" series: the burning need for interoperability and standardization: There ought to be a standard protocol so that all products storing diabetes data can "talk to each other," and connect to each other and to computers and Smartphones using standard data formats and standard cables.

As a PWD who struggles to juggle multiple devices, I"m just sayin" ...

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn"t adhere to Healthline"s editorial guidelines. For more information about Healthline"s partnership with Diabetes Mine, please click here.

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FDA Adds Boxed Warning to Canagliflozin Due To Increased Leg and Foot Amputation Risk

http://type2diabetestreatment.net/diabetes-type-2/fda-adds-boxed-warning-to-canagliflozin-due-to-increased-leg-and-foot-amputation-risk/
Lauren Biscaldi, Assistant Editor May 16, 2017 FDA Adds Boxed Warning to Canagliflozin Due To Increased Leg and Foot Amputation Risk Share this content:

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Canagliflozin use is associated with increased risk of toe, foot, and leg amputations.

Data from 2 large clinical trials have confirmed that treatment of type 2 diabetes with canagliflozin (Invokana®, Invokamet®, and Invokamet XR®; Janssen Pharmaceuticals, Inc.) may lead to an increased risk of leg and foot amputations, according to a US Food and Drug Administration (FDA) Drug Safety Communication.1

The announcement — an update to a similar communication issued in May 20162 — cites data from CANVAS (Canagliflozin Cardiovascular Assessment Study; ClinicalTrials.gov identifier NCT01032629) and CANVAS-R (A Study of the Effects of Canagliflozin [JNJ-28431754] on Renal Endpoints in Adult Participants With Type 2 Diabetes Mellitus; ClinicalTrials.gov identifier NCT01989754), which found that leg and foot amputations occurred “about twice as often in patients treated with canagliflozin compared to patients treated with placebo,” according to the FDA announcement.

Continue Reading Below

Over one year, amputation risk for patients in CANVAS and CANVAS-R was equivalent to 5.9 and 7.5 out of every 1000 patients treated with canagliflozin, respectively, compared with 2.8 and 4.2 out of every 1000 patients treated with placebo. The most common amputations resulting from canagliflozin therapy were of the toe and middle of the foot, although above-knee and below-knee leg amputations were also reported.

As a result, the FDA will require canagliflozin drug labels to include prominent boxed warnings describing the risk to patients.

Health care professionals and patients are advised to report adverse effects and serious issues resulting from canagliflozin use to the FDA MedWatch program

Related Articles

• Renal Injury Warnings for Canagliflozin, Dapagliflozin Strengthened by FDA
• FDA: Interim Trial Results Link Diabetes Drug to Potential Increased Risk for Amputations
• Incidence of Diabetic Ketoacidosis Low With Canagliflozin in Type 2 Diabetes

Reference

1. FDA Drug Safety Communication: FDA confirms increased risk of leg and foot amputations with the diabetes medicine canagliflozin (Invokana, Invokamet, Invokamet XR). Silver Spring, MD: US Food and Drug Administration. https://www.fda.gov/Drugs/DrugSafety/ucm557507.htm. Published May 16, 2017. Accessed May 16, 2017.
2. FDA Drug Safety Communication: Interim clinical trial results find increased risk of leg and foot amputations, mostly affecting the toes, with the diabetes medicine canagliflozin (Invokana, Invokamet); FDA to investigate. Silver Spring, MD: US Food and Drug Administration. https://www.fda.gov/Drugs/DrugSafety/ucm500965.htm. Published May 18, 2016. Accessed May 16, 2017.

Related Topics

• Diabetes
• Diabetes Complications
• Type 2 Diabetes

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New "Smart" Diabetes Software from Medtronic Identifies Trends & Recommends Actions

http://type2diabetestreatment.net/diabetes-mellitus/new-smart-diabetes-software-from-medtronic-identifies-trends-recommends-actions-2/

Today Medtronic announces what is sure to be the first of a whole new generation of diabetes management software: its CareLink® Pro 3.0 Therapy Management Software — the first system to include algorithms capable of analyzing data from a patient"s insulin pump, continuous glucose monitoring (CGM) device, and blood glucose meter "to identify the most important patient information in one easy-to-use dashboard."

Take note that this first 3.0 version is for clinicians only, but similar programs will surely be available to patients directly very soon.

The addition of a smart "Dashboard" does away with the need for your doctor or you to manually pour over stacks of data reports to make sense of trends; it provides "a snapshot of ... key insulin delivery and glucose information on one page, ... pinpoints the exact times the patient experienced a low (hypoglycemic) or high (hyperglycemic) glucose pattern and prioritizes these patterns making it easier to identify what actions/behaviors tend to lead to these events."

(click the images for a closer look)

The part that analyzes high and low events is called the "Episode Summary," and it goes a step further by actually making therapy recommendations "so that clinicians can make the most informed treatment decisions possible."

"By reducing the amount of time it takes to interpret patient data, clinicians may have more time to spend with patients fine tuning and making adjustments to therapy and behavior," the company points out.

On top of that, Medtronic"s announcement quotes its Chief Medical Officer, Dr. Francine Kaufman, as saying: "We believe decision support is a key advancement toward developing an artificial pancreas, which will rely upon automated decisions to make adjustments to patients" therapy, and are excited to bring it to the medical community."

I"d have to agree that from the AP perspective, this is exciting. This summer I wrote a two-part series about how important it is to make our diabetes data speak to us. I stand by what I said then: "Reams of glucose data are only as useful as our ability to interpret them and to understand what to do about what we"ve learned."

I was so heartened to hear manufacturers buzzing about "data interpretation" at the annual ADA conference in June! So it"s no surprise to see that a key feature of next-gen logging software is the ability to automatically alert users to trends. In the consumer version, we hope that takes the form of simple messages ("You were running high the last 4 days between 3-5pm") and straightforward recommendations to combat problems ("Check lunchtime insulin:carb ratio; account for afternoon snack?").

Kudos to Medtronic for being the first to debut smart D-management software; there will surely be bugs to work out.

As I said in summer: It could just make all the difference in the world if our BG data records could be translated into meaningful recommendations for us, and not just weeks after the fact. Obviously, using a built-in algorithm doesn"t guarantee that the system would always suggest the right moves, but the alerts themselves would make all that stored data "come alive." Bring it on.

btw, Medtronic"s CareLink is part of its MiniMed Paradigm Revel System, the only FDA-approved integrated system combining an insulin pump with CGM.

With that whole proprietary system in mind, I must note: I hope vendors are paying equal attention to the 2nd pillar of my "real diabetes management" series: the burning need for interoperability and standardization: There ought to be a standard protocol so that all products storing diabetes data can "talk to each other," and connect to each other and to computers and Smartphones using standard data formats and standard cables.

As a PWD who struggles to juggle multiple devices, I"m just sayin" ...

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn"t adhere to Healthline"s editorial guidelines. For more information about Healthline"s partnership with Diabetes Mine, please click here.

Type 2 Diabetes Treatment
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New "Smart" Diabetes Software from Medtronic Identifies Trends & Recommends Actions

https://type2diabetestreatment.net/diabetes-mellitus/new-smart-diabetes-software-from-medtronic-identifies-trends-recommends-actions-2/

Today Medtronic announces what is sure to be the first of a whole new generation of diabetes management software: its CareLink® Pro 3.0 Therapy Management Software — the first system to include algorithms capable of analyzing data from a patient"s insulin pump, continuous glucose monitoring (CGM) device, and blood glucose meter "to identify the most important patient information in one easy-to-use dashboard."

Take note that this first 3.0 version is for clinicians only, but similar programs will surely be available to patients directly very soon.

The addition of a smart "Dashboard" does away with the need for your doctor or you to manually pour over stacks of data reports to make sense of trends; it provides "a snapshot of ... key insulin delivery and glucose information on one page, ... pinpoints the exact times the patient experienced a low (hypoglycemic) or high (hyperglycemic) glucose pattern and prioritizes these patterns making it easier to identify what actions/behaviors tend to lead to these events."

(click the images for a closer look)

The part that analyzes high and low events is called the "Episode Summary," and it goes a step further by actually making therapy recommendations "so that clinicians can make the most informed treatment decisions possible."

"By reducing the amount of time it takes to interpret patient data, clinicians may have more time to spend with patients fine tuning and making adjustments to therapy and behavior," the company points out.

On top of that, Medtronic"s announcement quotes its Chief Medical Officer, Dr. Francine Kaufman, as saying: "We believe decision support is a key advancement toward developing an artificial pancreas, which will rely upon automated decisions to make adjustments to patients" therapy, and are excited to bring it to the medical community."

I"d have to agree that from the AP perspective, this is exciting. This summer I wrote a two-part series about how important it is to make our diabetes data speak to us. I stand by what I said then: "Reams of glucose data are only as useful as our ability to interpret them and to understand what to do about what we"ve learned."

I was so heartened to hear manufacturers buzzing about "data interpretation" at the annual ADA conference in June! So it"s no surprise to see that a key feature of next-gen logging software is the ability to automatically alert users to trends. In the consumer version, we hope that takes the form of simple messages ("You were running high the last 4 days between 3-5pm") and straightforward recommendations to combat problems ("Check lunchtime insulin:carb ratio; account for afternoon snack?").

Kudos to Medtronic for being the first to debut smart D-management software; there will surely be bugs to work out.

As I said in summer: It could just make all the difference in the world if our BG data records could be translated into meaningful recommendations for us, and not just weeks after the fact. Obviously, using a built-in algorithm doesn"t guarantee that the system would always suggest the right moves, but the alerts themselves would make all that stored data "come alive." Bring it on.

btw, Medtronic"s CareLink is part of its MiniMed Paradigm Revel System, the only FDA-approved integrated system combining an insulin pump with CGM.

With that whole proprietary system in mind, I must note: I hope vendors are paying equal attention to the 2nd pillar of my "real diabetes management" series: the burning need for interoperability and standardization: There ought to be a standard protocol so that all products storing diabetes data can "talk to each other," and connect to each other and to computers and Smartphones using standard data formats and standard cables.

As a PWD who struggles to juggle multiple devices, I"m just sayin" ...

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn"t adhere to Healthline"s editorial guidelines. For more information about Healthline"s partnership with Diabetes Mine, please click here.

Type 2 Diabetes Treatment
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New "Smart" Diabetes Software from Medtronic Identifies Trends & Recommends Actions

https://type2diabetestreatment.net/diabetes-mellitus/new-smart-diabetes-software-from-medtronic-identifies-trends-recommends-actions-2/

Today Medtronic announces what is sure to be the first of a whole new generation of diabetes management software: its CareLink® Pro 3.0 Therapy Management Software — the first system to include algorithms capable of analyzing data from a patient"s insulin pump, continuous glucose monitoring (CGM) device, and blood glucose meter "to identify the most important patient information in one easy-to-use dashboard."

Take note that this first 3.0 version is for clinicians only, but similar programs will surely be available to patients directly very soon.

The addition of a smart "Dashboard" does away with the need for your doctor or you to manually pour over stacks of data reports to make sense of trends; it provides "a snapshot of ... key insulin delivery and glucose information on one page, ... pinpoints the exact times the patient experienced a low (hypoglycemic) or high (hyperglycemic) glucose pattern and prioritizes these patterns making it easier to identify what actions/behaviors tend to lead to these events."

(click the images for a closer look)

The part that analyzes high and low events is called the "Episode Summary," and it goes a step further by actually making therapy recommendations "so that clinicians can make the most informed treatment decisions possible."

"By reducing the amount of time it takes to interpret patient data, clinicians may have more time to spend with patients fine tuning and making adjustments to therapy and behavior," the company points out.

On top of that, Medtronic"s announcement quotes its Chief Medical Officer, Dr. Francine Kaufman, as saying: "We believe decision support is a key advancement toward developing an artificial pancreas, which will rely upon automated decisions to make adjustments to patients" therapy, and are excited to bring it to the medical community."

I"d have to agree that from the AP perspective, this is exciting. This summer I wrote a two-part series about how important it is to make our diabetes data speak to us. I stand by what I said then: "Reams of glucose data are only as useful as our ability to interpret them and to understand what to do about what we"ve learned."

I was so heartened to hear manufacturers buzzing about "data interpretation" at the annual ADA conference in June! So it"s no surprise to see that a key feature of next-gen logging software is the ability to automatically alert users to trends. In the consumer version, we hope that takes the form of simple messages ("You were running high the last 4 days between 3-5pm") and straightforward recommendations to combat problems ("Check lunchtime insulin:carb ratio; account for afternoon snack?").

Kudos to Medtronic for being the first to debut smart D-management software; there will surely be bugs to work out.

As I said in summer: It could just make all the difference in the world if our BG data records could be translated into meaningful recommendations for us, and not just weeks after the fact. Obviously, using a built-in algorithm doesn"t guarantee that the system would always suggest the right moves, but the alerts themselves would make all that stored data "come alive." Bring it on.

btw, Medtronic"s CareLink is part of its MiniMed Paradigm Revel System, the only FDA-approved integrated system combining an insulin pump with CGM.

With that whole proprietary system in mind, I must note: I hope vendors are paying equal attention to the 2nd pillar of my "real diabetes management" series: the burning need for interoperability and standardization: There ought to be a standard protocol so that all products storing diabetes data can "talk to each other," and connect to each other and to computers and Smartphones using standard data formats and standard cables.

As a PWD who struggles to juggle multiple devices, I"m just sayin" ...

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn"t adhere to Healthline"s editorial guidelines. For more information about Healthline"s partnership with Diabetes Mine, please click here.

Type 2 Diabetes Treatment
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Original Article
#Diabetes_Mellitus
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New "Smart" Diabetes Software from Medtronic Identifies Trends & Recommends Actions

http://type2diabetestreatment.net/diabetes-mellitus/new-smart-diabetes-software-from-medtronic-identifies-trends-recommends-actions-2/

Today Medtronic announces what is sure to be the first of a whole new generation of diabetes management software: its CareLink® Pro 3.0 Therapy Management Software — the first system to include algorithms capable of analyzing data from a patient"s insulin pump, continuous glucose monitoring (CGM) device, and blood glucose meter "to identify the most important patient information in one easy-to-use dashboard."

Take note that this first 3.0 version is for clinicians only, but similar programs will surely be available to patients directly very soon.

The addition of a smart "Dashboard" does away with the need for your doctor or you to manually pour over stacks of data reports to make sense of trends; it provides "a snapshot of ... key insulin delivery and glucose information on one page, ... pinpoints the exact times the patient experienced a low (hypoglycemic) or high (hyperglycemic) glucose pattern and prioritizes these patterns making it easier to identify what actions/behaviors tend to lead to these events."

(click the images for a closer look)

The part that analyzes high and low events is called the "Episode Summary," and it goes a step further by actually making therapy recommendations "so that clinicians can make the most informed treatment decisions possible."

"By reducing the amount of time it takes to interpret patient data, clinicians may have more time to spend with patients fine tuning and making adjustments to therapy and behavior," the company points out.

On top of that, Medtronic"s announcement quotes its Chief Medical Officer, Dr. Francine Kaufman, as saying: "We believe decision support is a key advancement toward developing an artificial pancreas, which will rely upon automated decisions to make adjustments to patients" therapy, and are excited to bring it to the medical community."

I"d have to agree that from the AP perspective, this is exciting. This summer I wrote a two-part series about how important it is to make our diabetes data speak to us. I stand by what I said then: "Reams of glucose data are only as useful as our ability to interpret them and to understand what to do about what we"ve learned."

I was so heartened to hear manufacturers buzzing about "data interpretation" at the annual ADA conference in June! So it"s no surprise to see that a key feature of next-gen logging software is the ability to automatically alert users to trends. In the consumer version, we hope that takes the form of simple messages ("You were running high the last 4 days between 3-5pm") and straightforward recommendations to combat problems ("Check lunchtime insulin:carb ratio; account for afternoon snack?").

Kudos to Medtronic for being the first to debut smart D-management software; there will surely be bugs to work out.

As I said in summer: It could just make all the difference in the world if our BG data records could be translated into meaningful recommendations for us, and not just weeks after the fact. Obviously, using a built-in algorithm doesn"t guarantee that the system would always suggest the right moves, but the alerts themselves would make all that stored data "come alive." Bring it on.

btw, Medtronic"s CareLink is part of its MiniMed Paradigm Revel System, the only FDA-approved integrated system combining an insulin pump with CGM.

With that whole proprietary system in mind, I must note: I hope vendors are paying equal attention to the 2nd pillar of my "real diabetes management" series: the burning need for interoperability and standardization: There ought to be a standard protocol so that all products storing diabetes data can "talk to each other," and connect to each other and to computers and Smartphones using standard data formats and standard cables.

As a PWD who struggles to juggle multiple devices, I"m just sayin" ...

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn"t adhere to Healthline"s editorial guidelines. For more information about Healthline"s partnership with Diabetes Mine, please click here.

Type 2 Diabetes Treatment
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Original Article
#Diabetes_Mellitus
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New "Smart" Diabetes Software from Medtronic Identifies Trends & Recommends Actions

http://type2diabetestreatment.net/diabetes-mellitus/new-smart-diabetes-software-from-medtronic-identifies-trends-recommends-actions-2/

Today Medtronic announces what is sure to be the first of a whole new generation of diabetes management software: its CareLink® Pro 3.0 Therapy Management Software — the first system to include algorithms capable of analyzing data from a patient"s insulin pump, continuous glucose monitoring (CGM) device, and blood glucose meter "to identify the most important patient information in one easy-to-use dashboard."

Take note that this first 3.0 version is for clinicians only, but similar programs will surely be available to patients directly very soon.

The addition of a smart "Dashboard" does away with the need for your doctor or you to manually pour over stacks of data reports to make sense of trends; it provides "a snapshot of ... key insulin delivery and glucose information on one page, ... pinpoints the exact times the patient experienced a low (hypoglycemic) or high (hyperglycemic) glucose pattern and prioritizes these patterns making it easier to identify what actions/behaviors tend to lead to these events."

(click the images for a closer look)

The part that analyzes high and low events is called the "Episode Summary," and it goes a step further by actually making therapy recommendations "so that clinicians can make the most informed treatment decisions possible."

"By reducing the amount of time it takes to interpret patient data, clinicians may have more time to spend with patients fine tuning and making adjustments to therapy and behavior," the company points out.

On top of that, Medtronic"s announcement quotes its Chief Medical Officer, Dr. Francine Kaufman, as saying: "We believe decision support is a key advancement toward developing an artificial pancreas, which will rely upon automated decisions to make adjustments to patients" therapy, and are excited to bring it to the medical community."

I"d have to agree that from the AP perspective, this is exciting. This summer I wrote a two-part series about how important it is to make our diabetes data speak to us. I stand by what I said then: "Reams of glucose data are only as useful as our ability to interpret them and to understand what to do about what we"ve learned."

I was so heartened to hear manufacturers buzzing about "data interpretation" at the annual ADA conference in June! So it"s no surprise to see that a key feature of next-gen logging software is the ability to automatically alert users to trends. In the consumer version, we hope that takes the form of simple messages ("You were running high the last 4 days between 3-5pm") and straightforward recommendations to combat problems ("Check lunchtime insulin:carb ratio; account for afternoon snack?").

Kudos to Medtronic for being the first to debut smart D-management software; there will surely be bugs to work out.

As I said in summer: It could just make all the difference in the world if our BG data records could be translated into meaningful recommendations for us, and not just weeks after the fact. Obviously, using a built-in algorithm doesn"t guarantee that the system would always suggest the right moves, but the alerts themselves would make all that stored data "come alive." Bring it on.

btw, Medtronic"s CareLink is part of its MiniMed Paradigm Revel System, the only FDA-approved integrated system combining an insulin pump with CGM.

With that whole proprietary system in mind, I must note: I hope vendors are paying equal attention to the 2nd pillar of my "real diabetes management" series: the burning need for interoperability and standardization: There ought to be a standard protocol so that all products storing diabetes data can "talk to each other," and connect to each other and to computers and Smartphones using standard data formats and standard cables.

As a PWD who struggles to juggle multiple devices, I"m just sayin" ...

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn"t adhere to Healthline"s editorial guidelines. For more information about Healthline"s partnership with Diabetes Mine, please click here.

Type 2 Diabetes Treatment
Type 2 Diabetes Diet
Diabetes Destroyer Reviews
Original Article
#Diabetes_Mellitus
#obesity_help

As Temps Rise, Risk of Pregnancy Complication May Too

http://type2diabetestreatment.net/diabetes-and-pregnancy/as-temps-rise-risk-of-pregnancy-complication-may-too/
(*this news item will not be available after 08/13/2017) Monday, May 15, 2017

MONDAY, May 15, 2017 (HealthDay News) -- Outdoor air temperature may influence a pregnant woman"s risk of developing gestational diabetes, a new study suggests.

Mothers-to-be in very cold climes are less likely to develop diabetes during pregnancy than women exposed to hotter temperatures, researchers say.

If borne out in other studies, these findings could have important implications for the prevention and management of gestational diabetes, said study lead author Dr. Gillian Booth.

Changes in temperature may only lead to a small increase in the risk of gestational diabetes, but the number of women affected may be substantial, said Booth. She is a scientist at the Li Ka Shing Knowledge Institute at St. Michael"s Hospital in Toronto.

Also, areas that are getting hotter because of climate change could see more cases of gestational diabetes, the study authors theorized.

Others are less certain of this link, however.

"Temperature and risk of diabetes is a hot topic," said Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York City.

However, the study doesn"t show a direct cause-and-effect relationship, and Zonszein cautioned that it"s too soon to consider the findings definitive.

"Pregnant women or those wanting to become pregnant should not pay attention to this finding at this time, as more studies are needed to show a true causal effect," said Zonszein, who wasn"t involved in the study.

Moreover, "the findings of this study do not support that climate change, a rise in global temperatures, increases the incidence of diabetes in Canada or worldwide," he said.

Booth explained that gestational diabetes in women develops in the second trimester of pregnancy and is usually temporary. Women are screened for it at 24 to 28 weeks of pregnancy.

If there is a connection between temperature and gestational diabetes risk, cells called brown fat might help explain it.

According to Zonszein, "Brown fat cells are cells that -- instead of storing energy -- burn energy."

Booth speculated that extreme cold triggers activity of brown fat, thus controlling weight gain. It might even lead to weight loss, improving blood-sugar levels, she noted.

However, Zonszein said that many environmental factors -- such as excessive food intake, sugary drinks, inactivity, stress and lack of sleep -- can cause gestational diabetes in women genetically susceptible to the disease.

"Genetic factors are very important," he said, "and they are affected by many environmental factors, probably temperature is one more."

For this study, the researchers analyzed about 500,000 births in the Toronto area over 12 years. The researchers also looked at the average temperature for 30 days before diabetes testing, then compared temperature readings with results of the diabetes testing.

In women exposed to extreme cold -- 14 degrees Fahrenheit or lower -- in the month before the test, gestational diabetes was less than 5 percent. But it was about 8 percent for women when temperatures averaged 75 degrees Fahrenheit or higher, the findings showed.

Moreover, the odds of developing gestational diabetes rose slightly with every 18-degree rise in temperature, Booth said.

The association held up whether women were born in hot climates or colder regions, she added.

"Furthermore, the same association was seen when we looked at consecutive pregnancies in the same woman," Booth said.

Besides a healthy diet and physical activity to avoid excess weight, controlling temperature might be something women can do for a healthier pregnancy, Booth suggested.

"For example, turning down the thermostat and getting outside in the winter, or using air conditioning in summer, and avoiding excess layers in hot weather may help to lower the risk of gestational diabetes," she said.

An association between temperature and gestational diabetes was also reported last September in a Swedish study. In that paper, researchers found that gestational diabetes was more common in the summer than in other seasons.

Booth said the findings of the new study might also pertain to developing type 2 diabetes.

"The risk factors for gestational diabetes and type 2 diabetes are virtually the same," she said.

The report was published online May 15 in the CMAJ (Canadian Medical Association Journal).

SOURCES: Gillian Booth, M.D., scientist, Li Ka Shing Knowledge Institute, St. Michael"s Hospital, Toronto, Canada; Joel Zonszein, M.D., director, Clinical Diabetes Center, Montefiore Medical Center, New York City; May 15, 2017, CMAJ (Canadian Medical Association Journal), online

HealthDay Copyright (c) 2017 HealthDay. All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services.

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When Paying for Insurance Makes Paying for Diabetes Supplies Impossible

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The Cost of a Chronic Illness – Tuesday 5/16
Insulin and other diabetes medications and supplies can be costly. Here in the US, insurance status and age (as in Medicare eligibility) can impact both the cost and coverage. So today, let’s discuss how cost impacts our diabetes care. Do you have advice to share? For those outside the US, is cost a concern? Are there other factors such as accessibility or education that cause barriers to your diabetes care? (This topic was inspired by suggestions from Rick and Jen.)

Diabetes is one of the most costly conditions in the US. For many of us who depend on life-saving insulin, the cost can be astronomical every month. With insulin ranging from $200-300 per vial (depending on what type and where you get it) to over $500 per pack of insulin pens, it’s hard to understand how any family can make it when they have to not only pay for the insulin but other supplies like test strips.

I have good insurance now through my husband’s employer, however, it wasn’t always that way for me. I worked a job where there were only 5 employees, and my boss was not required to offer benefits. The plan that was offered was group health insurance through the parent company we worked for, but I paid 100% of the cost. The only thing I could afford on my just-above-minimum-wage paycheck was a premium that was $450 (and this was 10 years ago too), but it also carried a deductible of $2500 – and one that absolutely nothing was covered, not even prescriptions – until this deductible was met. So, if I had even paid for the deductible to even get to the 70% co-insurance by December, I I would have paid $7,900 total. So I did the only thing I could do.

I bought my insulin bottle by bottle, and rationed my insulin – running my sugars in the 200-400 range. I can even remember the pharmacy technician asking me if I had insurance to cover any part of the cost. (And what is mindblowing is that the very same insulin I bought then has tripled in price since then.)

I also had an insulin pump, and I would wear the sites for a week or longer if I could – most of which would become infected.

I rarely checked my blood sugar because I couldn’t afford the $80 per box for test strips that I needed.

I didn’t even go to a doctor, let alone an endocrinologist, for an entire year.

So, how does cost affect diabetes care? It affects it directly. If a person is too strapped to afford to even pay for medical coverage, how can they also be expected to pay the exorbitant costs of the supplies that they also need?

It’s not enough for people to have coverage – they need coverage that is both affordable and helps pay for the medications and supplies they need. Otherwise, more and more people will be in the same boat as I was — and so many are now — due to catastrophic plans being the only thing that is remotely affordable: skipping appointments and rationing medications and supplies just to pay for the healthcare they may never be able to use. And with insulin being the highest of all yet most necessary, it’s certainly not something anyone should ever have to ration.

People with diabetes and other costly conditions need better access to the medications and supplies they need, without it costing a literal arm, leg, or eye to get it.

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How to Safely Use Glucose Meters and Test Strips for Diabetes

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NHS provides outpatients updates following cyber attack

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The NHS has provided an update about planned treatment and outpatient appointments following the ransomware attack on its IT systems.
It has posted advice for patients after a small number of hospitals had to cancel patient appointments due to a cyber attack which affected 150 countries worldwide.
The update says: "If you have a planned operation, procedure or outpatient appointment at a hospital affected by this incident, please visit the hospital website for further advice and information about routine services at this time. If you are still unsure what to do, contact the hospital directly.
"Patients already in hospital at this time will continue to receive normal care. Inpatients will be told if any changes to their planned treatment are needed because of this incident."
The NHS announced on Monday that it was "open for business" but acknowledged that some hospitals and GP surgeries are still suffering disruption.
Home Secretary Amber Rudd said that a million people were treated on Monday, with GP surgeries working hard to ensure as few patients as possible are affected.
People with diabetes who have blood tests or other appointments with their GP are urged to attend unless they are contacted by their surgery and told otherwise.
"All GPs surgeries did open, though some of them had to use pen and paper," said Ms Rudd. "The vast majority of patients have noticed no difference. It has been a very strong response."
Dr Anne Rainsberry, national incident director at NHS England, added: "There are encouraging signs that the situation is improving, with fewer hospitals having to divert patients from their A&E units.
"The message to patients is clear: the NHS is open for business. Staff are working hard to ensure that the small number of organisations still affected return to normal shortly."
The NHS has warned the appointments at hospitals and GP may be slower than normal while the disruption caused by the ransomware attack subsides.
The update continued: "You can help the NHS cope by choosing the right service for your needs, and attending A&E only if it is essential.
"Apart from your hospital, there"s a range of other primary care services that can offer help, such as your GP, pharmacist, dentist or optician."Type 2 Diabetes Treatment
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Smartphone app set to help people with type 2 diabetes and high blood pressure

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An augmented reality app to help people with type 2 diabetes and high blood pressure manage their medication in Australia is to be developed.
Augmented reality (AR) comprises technology that generates real world data and then provides digital information to overlay new data on top of it.
Dr Alireza Ahmadvand, who is a research scholar from the Queensland University of Technology (QUT), and colleagues are investigating how best to use augmented reality to help people who require a variety of medication, including people with diabetes.
Ahmadvand said: "A person with diabetes sometimes has to take, on average, eight medications at the same time including blood sugar-lowering medications, cholesterol-lowering medications, aspirin, anti-depressants/anxiolytics or medications for weight management.
"Keeping track of all the advice, understanding it, and being able to ask the right questions are major challenges. AR brings the possibility of using smartphones to give information on specific medications in a form appropriate to each person"s level of understanding in a convenient and timely way."
Ahmadvand added that compliance is often low and medications may not be taken on time among people who are required to take multiple drugs, but the use of smartphones enables new ways to deliver healthcare and help people manage health conditions.
The smartphone app will also give people the opportunity to call or message diabetes helplines, should they have a question about their medication.
"[Patients] receive a lot of high-level professional advice but at the point of having to take the medication they are alone, it is then that our solution will step in.
"The app can give the possibility of calling, messaging or direct contact to credible diabetes helplines, if they are in doubt as to what to do if they have forgotten something about their medication or its side effects.
"We hope this will decrease the complexity and increase compliance with medications for people managing both type 2 diabetes and hypertension by improving understanding of their conditions."Type 2 Diabetes Treatment
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Mother says teenage daughter barred from school trip due to her type 1 diabetes

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A teenager with type 1 diabetes has been left "devastated" after she was barred from a school trip because of her condition, says her mother.
Aaliyah Thomson, from Scotland, was due to travel to Highlands Holiday Park with students from Elgin High School, but her mum says the school stopped her going at the last minute.
Speaking to the Press and Journal newspaper, Jaye Thomson said: "She was really looking forward to it, but then spent all of Friday evening [upset] when she found out she couldn"t go, she was really devastated.
"Diabetes is classed as a disability and it’s the only reason she"s not been allowed to go."
According to Ms Thomson, the plans for the trip were made in January and she even met with teachers about her daughter"s condition.
Ms Thomson says she had informed the school about Aaliyah"s diabetes in advance of the trip, but received a recent email asking about medical problems affecting any of the children going on the trip.
She said: "I went to a meeting at the school earlier this month just to go over things and to make sure Aaliyah would be safe. At that point, I got the impression that the teachers didn’t want her to go because it would be a hassle for them."
A Moray Council spokesman said: "The school did everything possible to get the necessary information from Ms Thomson about Aaliyah"s condition and medication but, despite repeated efforts over a number of weeks, this was not forthcoming.
"In the absence of that information and following consultation with professionals from other sectors, the school decided that it could not take the risk of allowing Aaliyah to join the class trip to what is a relatively remote area. We can understand her disappointment but we"re satisfied that no fault lies with the school."
But Ms Thomson has insisted she had provided school with the necessary information in relation to her daughter"s type 1 diabetes.
She said: "I had adjusted Aaliyah"s insulin so that she would be fine for all the activities, but she was on a similar trip last year with New Elgin Primary School and had no problems.
"It"s the way the school went about this that hurts the most, they made it so hard for her and I do consider it discrimination."Type 2 Diabetes Treatment
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New research links lack of sleep with heightened risk for type 2 diabetes in youth

http://type2diabetestreatment.net/diabetes-news/new-research-links-lack-of-sleep-with-heightened-risk-for-type-2-diabetes-in-youth/

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A new review of scientific literature on the importance of sleep in youth suggests that a lack of sleep can lead to decreased appetite control and body weight regulation, all of which can raise risks for the development of type 2 diabetes.
The largest decline in sleep duration and poor sleep quality over the past decades has been seen in children and adolescents, a trend that earlier studies say may contribute to weight gain, increased risks for cardiovascular disease and poor mental health.
This new review of evidence, published in the journal Nutrition and Diabetes, has looked at 23 studies on the topic of risk factors for type 2 diabetes and sleep variables to try and elucidate the mechanisms that may explain the association between the two.
Researchers from Children’s Hospital of Eastern Ontario Research Institute, in Canada, reviewed studies that not only assessed risks from inadequate sleep, described as sleeping less than six hours per night - a two-hour or so sleep deficit compared to standard advice for children - but also sleep architecture.
A healthy sleep architecture refers to having the right number of restorative sleep cycles and rapid eye movement phases to feel sufficiently well-rested. An out of whack sleep architecture has been associated in past studies with insulin resistance.
In terms of sleep duration, researchers have found that the lowest risk for type 2 diabetes is observed, similar to the figure given for adults, at a minimum sleep duration of seven to eight hours per day.
Drawing from the findings of the different studies evaluated, they have identified a number of mechanisms by which the lack of sleep can elevate risks for type 2 diabetes among children.
One of them, perhaps the most prominent one, is the increased exposure to the stress hormone cortisol due to short sleep duration. This may contribute to the accumulation of visceral fat and subsequent increased insulin resistance.
The reason for this is that the authors also noted that the association between sleep quality and insulin resistance was not independent of the level of adiposity - the increase in the number of fat cells.
There may also be another phenomenon implicated that has to do with the nervous system which, in response to the stress of not sleeping, negatively influences the hormone leptin.
While we sleep, leptin usually rise to control appetite. However, when sleep is restricted, leptin gets inhibited. The inhibition of leptin leads to an increase in hunger and a decrease in satiety. These effects can translate into progressive weight gain.
Sleep is a modifiable lifestyle habit associated with the prevention of type 2 diabetes. One randomised trial that was part of the review conducted among children aged 8 to 11 years showed that increasing sleep duration by just 1.5 hour per night over a week resulted in lower food intake and lower body weight.
Although more studies are needed to shed light on the mechanisms linking insufficient sleep with type 2 diabetes risk, there"s no possible risk in children and teens improving their sleep and getting enough of it on a regular schedule each night.Type 2 Diabetes Treatment
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There is a debt of service due from every man to his country, proportioned to the bounties which nature and fortune have measured to him.

http://type2diabetestreatment.net/diabetes-research/there-is-a-debt-of-service-due-from-every-man-to-his-country-proportioned-to-the-bounties-which-nature-and-fortune-have-measured-to-him/
Skip to main content There is a debt of service due from every man to his country, proportioned to the bounties which nature and fortune have measured to him. 5/16/2017

– Thomas Jefferson,
third US president

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Nonrenewal of CHIP could raise costs for low-income families

http://type2diabetestreatment.net/diabetes-research/nonrenewal-of-chip-could-raise-costs-for-low-income-families/

Failure to renew the Children"s Health Insurance Program, which would transfer families to marketplace plans, could cause out-of-pocket health care costs for low-income families with children with chronic conditions to rise by $233 to $2,472 at the lowest and highest income levels, respectively, researchers reported in Health Affairs. The findings also showed that out-of-pocket treatment costs may be highest among those with diabetes, epilepsy or mood disorders due to increased cost sharing for hospitalizations and prescription drugs.

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Pediatric chronic illness tied to increased mental health risks in adulthood

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UK researchers found that children with chronic physical illnesses such as asthma, arthritis, cancer, chronic renal failure, congenital heart disease, cystic fibrosis, epilepsy and type 1 diabetes were more likely to develop anxiety and depression that persisted until adulthood, compared with those without such conditions. The findings in the Journal of Child Psychology and Psychiatry were based on a review of 37 studies involving more than 45,000 youths.

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Temperature increases tied to higher gestational diabetes risk

http://type2diabetestreatment.net/diabetes-research/temperature-increases-tied-to-higher-gestational-diabetes-risk/

A Canadian study in the Canadian Medical Association Journal found increases in average outdoor air temperature were associated with higher risks of gestational diabetes mellitus. Researchers said the results were consistent with earlier studies.

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Study: Pharmacist-involved collaborative care improves outcomes in diabetes

http://type2diabetestreatment.net/diabetes-research/study-pharmacist-involved-collaborative-care-improves-outcomes-in-diabetes/

Asian patients with uncontrolled type 2 diabetes had a mean A1C reduction from 8.6 ± 1.5% at baseline to 8.1 ± 1.3% at six months after participating in a multidisciplinary collaborative care with regular follow-up from pharmacists and usual care, compared with the usual care group, according to a study in the Journal of Clinical Pharmacy and Therapeutics. Singaporean researchers used a cohort of 411 diabetes patients and found those in the intervention group also showed improvements in Problem Areas in Diabetes and the Diabetes Treatment Satisfaction Questionnaires and an average cost reduction of $91.01 per patient.

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Brain Function Abnormalities With Overweight/Obesity in Type 2 Diabetes

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Jeff Craven May 16, 2017 Brain Function Abnormalities With Overweight/Obesity in Type 2 Diabetes Share this content:

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In addition to brain imaging, patients underwent cognitive tests to assess memory, executive function, and psychomotor speed.

Patients with type 2 diabetes mellitus (T2DM) with overweight or obesity were more likely to show severe and progressive brain function and cognition abnormalities compared with patients at a normal weight, according to recent research published in Diabetologia.

"This study showed that the concurrent presence of overweight/obesity was associated with cortical atrophy, disrupted white matter integrity and cognitive dysfunction in early stage [T2DM]," In Kyoon Lyoo, MD, PhD, from the Ewha Brain Institute and the Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea, and fellow researchers wrote.

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"An increased awareness of overweight/obesity-related risk is necessary to prevent and manage [T2DM]-related brain atrophy and cognitive dysfunction from early stage [T2DM] onward."

The researchers studied 50 patients with overweight or obesity who had been diagnosed with T2DM for fewer than 5 years and compared them with an age-, sex-, and disease duration-matched cohort of 50 patients at a normal weight with T2DM and 50 individuals in a control group who were at a normal weight.

Patients were between 30 and 60 years of age, with body mass index (BMI) cut-offs for overweight and obesity at 25 to 29.9 kg/m2 and ≥30 kg/m2, respectively.

All patient groups underwent brain imaging that included global mean cortical thickness measurements and global mean fractional anisotropy of the whole brain white matter skeleton. Cognitive tests were also administered to assess memory, executive function, and psychomotor speed.

The researchers found a lower global mean cortical thickness in patients in the overweight and obese T2DM group (z, −2.96) compared with patients in the normal weight T2DM group (P for group effect =.003). There was a negative association between disease duration and global white matter integrity in the overweight and obese T2DM group (z, 2.42) compared with the normal weight T2DM group (P for interaction =.02), as well as a decrease in psychomotor speed in the overweight and obese T2DM group (z, −2.12) not seen in the T2DM group at a normal weight (P for interaction =.03).

The researchers recommended longitudinal follow-up for patients with overweight or obesity with T2DM to determine any long-term effects of impaired glucose tolerance on brain function and cognition.

"Our results suggest that a relationship exists between disease duration and metabolic measures in each diabetic group (classified according to BMI)," the researchers wrote. "However, as there was no information on fasting insulin and C-peptide levels in the normal-weight control group, differences in metabolic measures between the type 2 [diabetes] and control groups could not be determined in the present study."

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Reference

Yoon S, Cho H, Kim J, et al. Brain changes in overweight/obese and normal-weight adults with type 2 diabetes mellitus [published online April 27, 2017]. Diabetologia. doi:10.1007/s00125-017-4266-7

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New Type 1 Diabetes Treatment and Prevention Options on the Horizon

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There’s new hope on the horizon for those with type 1 diabetes (T1D). Biopharmaceutical company TetraGenetics is working on an innovative drug therapy that can stop or prevent the body’s immune system from attacking its own pancreas.

How T1D Develops

Most people who develop T1D do so as a result of a particular virus that triggers an exaggerated autoimmune response.

In the pancreas, the cells that produce insulin are called beta cells. In people that have a particular type of gene associated with T1D, the beta cells have a quality (an antigen) that closely resembles the antigens found in the virus.

When you are exposed to the virus, your immune system activates its T cells to start combating the infection by creating antibodies. However, these antibodies can’t distinguish between the beta cells and the virus cells. They look too similar, so the antibodies destroy them all in an attempt to protect against the viral infection.

Unfortunately, by killing off your beta cells, your immune system has also eliminated your body’s ability to produce insulin. You are now diabetic.

Both Genes and Virus Necessary for T1D to Develop

There are four viruses that can cause the autoimmune cascade that results in T1D: German measles, mumps, rotavirus, and the B4 strain of the coxsackie B virus. These viruses all possess antigens that are similar to the antigens in the beta cells of the pancreas.

It’s important to note that not everyone who is exposed to these viruses will develop T1D. You have to already possess the genetic makeup associated with T1D.

If you do carry the T1D genes but don’t get any of these viruses, you may never actually develop the disease. You have to have both.

In other words, if you do have these genes and you contract one of the viruses, then you will likely have to inject insulin for the rest of your life…unless a treatment or cure is found.

New Drug Therapy Could Interrupt the Autoimmune Attack

That’s what TetraGenetics is working on. They have found a way to block the destruction of the beta cells during an immune response. Their approach involves a drug that creates a different type of antibody, one that inhibits the activity of the immune system’s antibodies.

The company has discovered several drugs that create different antibodies that appear to have similar effects on the immune system’s antibodies. Now they need to determine which has the greatest likelihood of success with the fewest negative side effects. Once they’ve decided on the best drug, then they can seek approval to begin testing on humans.

Funding for this Research is Essential

Unfortunately, research is expensive and every step of this process requires funding. Thankfully, TetraGenetics just received an investment from JDRF T1D Fund that will allow them to continue this line of research. JDRF T1D Fund is a venture philanthropy that partners with private commercial research facilities and foundations to bring to market drugs, devices, diagnostic tools, and vaccines to help those living with T1D.

The chairman and CEO of TetraGenetics, Douglas Kahn, said, “Support from the JDRF T1D Fund couldn’t have come at a better time, enabling us to select the best of our antibodies and advance our lead drug candidate in preparation for clinical trials. The investment funding and access to JDRF experts will significantly accelerate our T1D drug development program.”

This approach, if successful, will help doctors stop the development of T1D. Since the autoimmune process can take years to kill off all the pancreas’ beta cells, there’s a chance it could be interrupted. This would allow some beta cells to be saved, thereby preventing the development of type 1 diabetes.

The company’s press release also said that this therapy “may contribute, in combination with other therapies, to an eventual cure.” This is definitely something to feel hopeful about, but remember, too, this research is still in a very early stage.

Stay tuned for more developments as this research continues.

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New "Smart" Diabetes Software from Medtronic Identifies Trends & Recommends Actions

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Today Medtronic announces what is sure to be the first of a whole new generation of diabetes management software: its CareLink® Pro 3.0 Therapy Management Software — the first system to include algorithms capable of analyzing data from a patient"s insulin pump, continuous glucose monitoring (CGM) device, and blood glucose meter "to identify the most important patient information in one easy-to-use dashboard."

Take note that this first 3.0 version is for clinicians only, but similar programs will surely be available to patients directly very soon.

The addition of a smart "Dashboard" does away with the need for your doctor or you to manually pour over stacks of data reports to make sense of trends; it provides "a snapshot of ... key insulin delivery and glucose information on one page, ... pinpoints the exact times the patient experienced a low (hypoglycemic) or high (hyperglycemic) glucose pattern and prioritizes these patterns making it easier to identify what actions/behaviors tend to lead to these events."

(click the images for a closer look)

The part that analyzes high and low events is called the "Episode Summary," and it goes a step further by actually making therapy recommendations "so that clinicians can make the most informed treatment decisions possible."

"By reducing the amount of time it takes to interpret patient data, clinicians may have more time to spend with patients fine tuning and making adjustments to therapy and behavior," the company points out.

On top of that, Medtronic"s announcement quotes its Chief Medical Officer, Dr. Francine Kaufman, as saying: "We believe decision support is a key advancement toward developing an artificial pancreas, which will rely upon automated decisions to make adjustments to patients" therapy, and are excited to bring it to the medical community."

I"d have to agree that from the AP perspective, this is exciting. This summer I wrote a two-part series about how important it is to make our diabetes data speak to us. I stand by what I said then: "Reams of glucose data are only as useful as our ability to interpret them and to understand what to do about what we"ve learned."

I was so heartened to hear manufacturers buzzing about "data interpretation" at the annual ADA conference in June! So it"s no surprise to see that a key feature of next-gen logging software is the ability to automatically alert users to trends. In the consumer version, we hope that takes the form of simple messages ("You were running high the last 4 days between 3-5pm") and straightforward recommendations to combat problems ("Check lunchtime insulin:carb ratio; account for afternoon snack?").

Kudos to Medtronic for being the first to debut smart D-management software; there will surely be bugs to work out.

As I said in summer: It could just make all the difference in the world if our BG data records could be translated into meaningful recommendations for us, and not just weeks after the fact. Obviously, using a built-in algorithm doesn"t guarantee that the system would always suggest the right moves, but the alerts themselves would make all that stored data "come alive." Bring it on.

btw, Medtronic"s CareLink is part of its MiniMed Paradigm Revel System, the only FDA-approved integrated system combining an insulin pump with CGM.

With that whole proprietary system in mind, I must note: I hope vendors are paying equal attention to the 2nd pillar of my "real diabetes management" series: the burning need for interoperability and standardization: There ought to be a standard protocol so that all products storing diabetes data can "talk to each other," and connect to each other and to computers and Smartphones using standard data formats and standard cables.

As a PWD who struggles to juggle multiple devices, I"m just sayin" ...

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn"t adhere to Healthline"s editorial guidelines. For more information about Healthline"s partnership with Diabetes Mine, please click here.

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GPs urged to lobby on legal decision leading to "devastating" indemnity rises

http://type2diabetestreatment.net/uncategorized/gps-urged-to-lobby-on-legal-decision-leading-to-devastating-indemnity-rises/
GPs urged to lobby on legal decision leading to "devastating" indemnity rises MDU launches "Save General Practice" campaign in face of massive rise in negligence claims

Louise Prime

Tuesday, 16 May 2017

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Medical Defence Union officials have called on GPs to lobby parliamentary candidates about the "potentially devastating impact" that a recent legal decision could have on GP clinical negligence costs.
It has launched the Save General Practice campaign to ask for urgent government support.
The MDU wants the new government to prioritise the matter because it says the large increases in indemnity costs are unaffordable at a time of "unprecedented" pressure on general practice.
MDU chief executive Dr Christine Tomkins has written to GP members warning that the Lord Chancellor"s change to the discount rate – the interest rate used by courts to calculate lump sum compensation payments to victims of clinical negligence incidents and other personal injury claims – has added hundreds of millions to the cost of claims payable by medical defence organisations.
She pointed out that, despite strong lobbying, the Lord Chancellor announced a change to the discount rate from 2.5%, which had been the level since 2001, to -0.75%, effective from 20 March.
Under the ruling a claim that would previously have settled for £8.4m would now settle for £17.5m, she said.
The Lord Chancellor"s statement on the issue included a commitment that the Department of Health would work closely with GPs and medical defence organisations to ensure appropriate funding is available to meet additional costs to GPs.
However, the MDU has said it has been in regular discussion with government departments since December 2016, with no announcement of a solution. It added that with the general election now underway no announcement is possible until after the election and that it might not emerge for months.
Dr Tomkins argued that the rising cost of GP indemnity has been a cause of serious concern for some time and prompted an NHS England review of GP indemnity in July 2016. The discount rate change had made matters much worse, she said.
"The MDU… has made clear to the government that GPs should not have to bear these unaffordable costs. We will continue negotiating with government to find a workable solution."
The MDU is urging GPs to get involved in calling on government to shield general practice from a potentially devastating impact of the new charges and to complete an online survey.

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School nurse cuts threaten children"s health

http://type2diabetestreatment.net/uncategorized/school-nurse-cuts-threaten-childrens-health/
School nurse cuts threaten children"s health Cuts to public health funding, health visitors and school nurses put health at risk, warns RCN

Louise Prime

Tuesday, 16 May 2017

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Cuts to public health funding and to the number of health visitors and school nurses are jeopardising the health of children in England, the Royal College of Nursing has warned.
In its latest report, the RCN found that the transfer of public health responsibility from the NHS to local authorities, at the same time as their funds have plummeted, could be allowing vulnerable children to "fall through the cracks".
In The best start: the future of children"s health, the RCN points out that school nurses and health visitors are at the forefront of providing care to children and young people – promoting healthy mental and physical development, safeguarding vulnerable children and providing a critical link between school, home and the community. But the RCN says there has been a significant decline in the number of school nurses and an emerging trend of reductions in the health visiting workforce. It said cuts to these crucial health services are endangering the health of England"s children and young people.
The college found that while the number of school-age pupils rose by more than 450,000 between 2010 and 2017, during that same period there was a 16% drop in full-time school nurses. It also revealed that since 2015, when there were more than 10,000 health visitors in the NHS, their numbers have fallen by 1,000.
The RCN reported that despite the essential role of health visitors and school nurses, the services have borne the brunt of the government"s £200m cuts to public health since being transferred from the NHS to local authorities. It warned: "As a result, many vulnerable children may be falling through the cracks."
It has called on the next government to provide the resources needed for all local authorities to provide strong and effective health visiting and school nursing services for all children. RCN chief executive and general secretary Janet Davies said: "Cuts to these critical services risk not only the health of our children, but also the future of our country.
"There"s a wealth of evidence that ill health in childhood can have a detrimental impact in adulthood. If these cuts continue, we"re heading for more health problems, more inequality and even more pressure on our public services down the line."

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US researchers suggest better way to estimate children"s fat levels

http://type2diabetestreatment.net/uncategorized/us-researchers-suggest-better-way-to-estimate-childrens-fat-levels-2/
US researchers suggest better way to estimate children"s fat levels Alternative method to body mass index could be more accurate screening tool for overweight

Louise Prime

Tuesday, 16 May 2017

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US researchers have compared methods of assessing body fatness in children. In a study* in JAMA Pediatrics they suggest that one method tested would be a more accurate replacement for z Body mass index (BMI) in screening for childhood obesity.
BMI — calculated by dividing body mass in kilograms by the square of height in metres — has long been used worldwide as a screening tool for overweight and obesity. But it was already known not to work as well in children as in adults. Instead, BMI z scores, based on BMI percentile, have been used to classify children and adolescents as normal weight, overweight or obese.
Researchers behind the study point out that being able to determine which children and adolescents are overweight accurately is central to international efforts to reduce the prevalence of childhood obesity.
Their study compared several body fat indices, including the tri-ponderal mass index, or TMI (which is calculated by dividing a person"s mass by the cube of their height), with other body fat indices of the form body mass divided by height in estimating body fat levels in adolescents. They analysed cross-sectional data from the 1999 to 2006 US National Health and Nutrition Examination Survey, covering 2,285 non-Hispanic white participants aged 8-29 years.
They used dual-energy x-ray absorptiometry and anthropometric data to determine changes in body fat levels, body proportions, and the scaling relationships among body mass, height, and percent body fat. To assess the merits of each adiposity index, they used three criteria: stability with age, accuracy in estimating percent body fat, and accuracy in classifying adolescents as overweight vs normal weight.
They reported that for the population they were studying, TMI yielded greater stability with age and estimated percent body fat better than BMI. In addition, TMI misclassified adolescents as overweight vs normal weight less often than BMI z scores — and performed equally as well as updated BMI percentiles derived from the same data set.
The researchers concluded: "The tri-ponderal mass index estimates body fat levels more accurately than BMI in non-Hispanic white adolescents aged 8-17 years. Moreover, TMI diagnoses adolescents as overweight more accurately than BMI z scores and equally as well as updated BMI percentiles but is much simpler to use than either because it does not involve complicated percentiles. Taken together, it is worth considering replacing BMI z scores with TMI to estimate body fat levels in adolescents."

* Peterson CM, Su H, Thomas DM, et al. Tri-ponderal mass index vs body mass index in estimating body fat during adolescence. JAMA Pediatr. Published online May 15, 2017. doi:10.1001/jamapediatrics.2017.0460.Type 2 Diabetes Treatment
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New "Smart" Diabetes Software from Medtronic Identifies Trends & Recommends Actions

http://type2diabetestreatment.net/diabetes-mellitus/new-smart-diabetes-software-from-medtronic-identifies-trends-recommends-actions-2/

Today Medtronic announces what is sure to be the first of a whole new generation of diabetes management software: its CareLink® Pro 3.0 Therapy Management Software — the first system to include algorithms capable of analyzing data from a patient"s insulin pump, continuous glucose monitoring (CGM) device, and blood glucose meter "to identify the most important patient information in one easy-to-use dashboard."

Take note that this first 3.0 version is for clinicians only, but similar programs will surely be available to patients directly very soon.

The addition of a smart "Dashboard" does away with the need for your doctor or you to manually pour over stacks of data reports to make sense of trends; it provides "a snapshot of ... key insulin delivery and glucose information on one page, ... pinpoints the exact times the patient experienced a low (hypoglycemic) or high (hyperglycemic) glucose pattern and prioritizes these patterns making it easier to identify what actions/behaviors tend to lead to these events."

(click the images for a closer look)

The part that analyzes high and low events is called the "Episode Summary," and it goes a step further by actually making therapy recommendations "so that clinicians can make the most informed treatment decisions possible."

"By reducing the amount of time it takes to interpret patient data, clinicians may have more time to spend with patients fine tuning and making adjustments to therapy and behavior," the company points out.

On top of that, Medtronic"s announcement quotes its Chief Medical Officer, Dr. Francine Kaufman, as saying: "We believe decision support is a key advancement toward developing an artificial pancreas, which will rely upon automated decisions to make adjustments to patients" therapy, and are excited to bring it to the medical community."

I"d have to agree that from the AP perspective, this is exciting. This summer I wrote a two-part series about how important it is to make our diabetes data speak to us. I stand by what I said then: "Reams of glucose data are only as useful as our ability to interpret them and to understand what to do about what we"ve learned."

I was so heartened to hear manufacturers buzzing about "data interpretation" at the annual ADA conference in June! So it"s no surprise to see that a key feature of next-gen logging software is the ability to automatically alert users to trends. In the consumer version, we hope that takes the form of simple messages ("You were running high the last 4 days between 3-5pm") and straightforward recommendations to combat problems ("Check lunchtime insulin:carb ratio; account for afternoon snack?").

Kudos to Medtronic for being the first to debut smart D-management software; there will surely be bugs to work out.

As I said in summer: It could just make all the difference in the world if our BG data records could be translated into meaningful recommendations for us, and not just weeks after the fact. Obviously, using a built-in algorithm doesn"t guarantee that the system would always suggest the right moves, but the alerts themselves would make all that stored data "come alive." Bring it on.

btw, Medtronic"s CareLink is part of its MiniMed Paradigm Revel System, the only FDA-approved integrated system combining an insulin pump with CGM.

With that whole proprietary system in mind, I must note: I hope vendors are paying equal attention to the 2nd pillar of my "real diabetes management" series: the burning need for interoperability and standardization: There ought to be a standard protocol so that all products storing diabetes data can "talk to each other," and connect to each other and to computers and Smartphones using standard data formats and standard cables.

As a PWD who struggles to juggle multiple devices, I"m just sayin" ...

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn"t adhere to Healthline"s editorial guidelines. For more information about Healthline"s partnership with Diabetes Mine, please click here.

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US researchers suggest better way to estimate children"s fat levels?

http://type2diabetestreatment.net/uncategorized/us-researchers-suggest-better-way-to-estimate-childrens-fat-levels/
US researchers suggest better way to estimate children"s fat levels Alternative method to measure body mass index could be more accurate screening tool for overweight

Louise Prime

Tuesday, 16 May 2017

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US researchers have compared methods of assessing body fatness in children. In a study* in JAMA Pediatrics they suggest that one method tested would be a more accurate replacement for z Body mass index (BMI) in screening for childhood obesity.
BMI — calculated by dividing body mass in kilograms by the square of height in metres — has long been used worldwide as a screening tool for overweight and obesity. But it was already known not to work as well in children as in adults. Instead, BMI z scores, based on BMI percentile, have been used to classify children and adolescents as normal weight, overweight or obese.
Researchers behind the study point out that being able to determine which children and adolescents are overweight accurately is central to international efforts to reduce the prevalence of childhood obesity.
Their study compared several body fat indices, including the tri-ponderal mass index, or TMI (which is calculated by dividing a person"s mass by the cube of their height), with other body fat indices of the form body mass divided by height in estimating body fat levels in adolescents. They analysed cross-sectional data from the 1999 to 2006 US National Health and Nutrition Examination Survey, covering 2,285 non-Hispanic white participants aged 8-29 years.
They used dual-energy x-ray absorptiometry and anthropometric data to determine changes in body fat levels, body proportions, and the scaling relationships among body mass, height, and percent body fat. To assess the merits of each adiposity index, they used three criteria: stability with age, accuracy in estimating percent body fat, and accuracy in classifying adolescents as overweight vs normal weight.
They reported that for the population they were studying, TMI yielded greater stability with age and estimated percent body fat better than BMI. In addition, TMI misclassified adolescents as overweight vs normal weight less often than BMI z scores — and performed equally as well as updated BMI percentiles derived from the same data set.
The researchers concluded: "The tri-ponderal mass index estimates body fat levels more accurately than BMI in non-Hispanic white adolescents aged 8-17 years. Moreover, TMI diagnoses adolescents as overweight more accurately than BMI z scores and equally as well as updated BMI percentiles but is much simpler to use than either because it does not involve complicated percentiles. Taken together, it is worth considering replacing BMI z scores with TMI to estimate body fat levels in adolescents."

* Peterson CM, Su H, Thomas DM, et al. Tri-ponderal mass index vs body mass index in estimating body fat during adolescence. JAMA Pediatr. Published online May 15, 2017. doi:10.1001/jamapediatrics.2017.0460.Type 2 Diabetes Treatment
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Early menopause linked to heart failure risk

https://type2diabetestreatment.net/uncategorized/early-menopause-linked-to-heart-failure-risk/
Early menopause linked to heart failure risk Women who had shorter total reproductive duration or never gave birth at higher risk

Louise Prime

Tuesday, 16 May 2017

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Women who went through menopause early or who have never given birth may be at greater risk of being hospitalised with heart failure than other women, US research has found.
The authors of the study* published in the Journal of the American College of Cardiology said infertility did not explain the association and called for more research into mechanisms behind the potential cardioprotective effect of reproductive hormones in women.
The authors added that earlier research had found that a woman"s risk of heart disease might be influenced by hormones present during the reproductive period, suggesting that women who experience early menopause might be at an elevated risk for heart disease.
The researchers, who were led from the San Francisco School of Medicine, also pointed out that hormone levels during the reproductive period might be affected by menstrual cycling and pregnancy.
They analysed data from the Women"s Health Initiative, including 28,516 postmenopausal women (mean age at baseline 62.7 years) without cardiovascular disease, to identify associations between the women"s risk of incident heart failure and total number of live births, age at first pregnancy lasting at least six months, and total reproductive duration (time from first menstruation to menopause).
They reported that during a mean 13.1 years" follow up, 5.2% of these women were hospitalised for heart failure. Short total reproductive duration was associated with an increased risk of heart failure, which was also more pronounced in women who experienced natural, rather than surgical, menopause.
The researchers also found that women who had never given birth were at an increased risk for diastolic heart failure and that having more children was not associated with heart failure risk.
The study authors concluded: "In post-menopausal women, shorter total reproductive duration was associated with higher risk of incident HF, and nulliparity was associated with higher risk for incident HF with preserved ejection fraction. Whether exposure to endogenous sex hormones underlies this relationship should be investigated in future studies."
The author of an accompanying editorial** wrote that although the mechanisms of these findings are unclear, their importance and potential impact on women"s health is real. She added: "There also remain many unresolved questions including the mechanisms of oestrogen"s cardioprotective effect, making this truly a work in progress. Altogether, these findings raise interesting questions about the cardiometabolic effects of sex hormone exposure over a woman"s lifetime and continue to raise important questions for future research."

* Hall PS, Nah G, Howard BV, et al. Reproductive factors and incidence of heart failure hospitalization in the women"s health initiative. Journal of the American College of Cardiology 2017; 69 (20): doi:10.1016/j.jacc.2017.03.557
** Scott NS. Understanding hormones, menopause, and heart failure. Journal of the American College of Cardiology 2017; 69 (20) doi: 10.1016/j.jacc.2017.03.561

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