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bookDiabetes articles about daily topics that affect those living with diabetes. There is a lot of information about diabetes and hopefully you find this information useful in your everyday life. Here we have compiled a list of older articles from our previous "The Diabetes Network" along with links to blogs and articles, an extended reading archive. You can use the search in the top-right menu to search for specific articles.

 

School Supplies.

We, at my pump gear, strive to bring quality insulin pump accessories to kids & kids at heart. Our blog has several purposes:

1. To share information surrounding our #1 hope: a cure!
2. To share current & relevant information about insulin pumps and how to manage life with one.
3. To share anything having to do with diabetes awareness.
4. To share in the support system that is the diabetes online community, with empathy, compassion and humor!

Check out our website!

www.mypumpgear.com

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Why I will never get an A in Diabetes Math

Why I will never get an A in Diabetes Math

Simplify.  Solve.  Repeat.


127bg + 20g carbs - 4 units insulin + 3 hours housework = 232bg


232bg + 40g carbs - 3 units insulin + 30 minutes sitting in car = 180bg


180bg + 10g carbs + 5 min waiting to get trail pass = 70bg


70bg + 30g carbs + 15 min cross country skiing = 42bg


42bg + 15g carbs + 60 min skiiing = 82bg


82bg + 30 g carbs + 90 min skiing = 559bg (recheck: 508bg, which is really the same number given meter accuracy)


559bg - 3.2 units insulin + 90 min waiting = 395bg


395bg - 1 unit insulin + 2 hour nap = 120bg


120bg + 10 g carbs + 2 hours loafing and feeling like crap = 187bg


187bg + 3hours sleeping = 51bg


51bg + 15 g carbs + 3 hours sleeping = 237bg

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Islet cell transplants can be cost effective as well as increase the quality of life- a study

I recently found this abstract and thought it was very interesting and exciting. I was able to get a copy of the entire article from a friend, thanks Jason, but can't print all of it due to copyright laws. I am going to attempt to write about the highlights of what this shows. A health economic analysis of clinical islet transplantation

Keywords:

  • cost;
  • cost-effectiveness analysis;
  • economic model;
  • health economics;
  • islet cell transplantation

Beckwith J, Nyman JA, Flanagan B, Schrover R, Schuurman H-J. A health economic analysis of clinical islet transplantation. Clin Transplant 2011 DOI: 10.1111/j.1399-0012.2011.01411.x. © 2011 John Wiley & Sons A/S.

Abstract: Islet cell transplantation is in clinical development for type 1 diabetes. There are no data on the cost in relationship to its benefits. We performed a cost-effectiveness analysis and made a comparison with standard insulin therapy, using Markov modeling and Monte Carlo simulations. The patient population was adults aged 20yr suffering from hypoglycemia unawareness. Data were estimates from literature and clinical trials: costs were based on the situation in the United States. For insulin therapy, cumulative cost per patient during a 20-yr follow-up was $663000, and cumulative effectiveness was 9.3 quality-adjusted life years (QALY), the average cost-effectiveness ratio being $71000 per QALY. Islet transplantation had a cumulative cost of $519000, a cumulative effectiveness of 10.9 QALY, and an average cost-effectiveness ratio of $47800. During the first 10yr, costs for transplantation were higher, but cumulative effectiveness was higher from the start onwards. In sensitivity analyses, the need for one instead of two transplants during the first year did not affect the conclusions, and islet transplantation remained cost-saving up to an initial cost of the procedure of $240000. This exploratory evaluation shows that islet cell transplantation is more effective than standard insulin treatment, and becomes cost-saving at about 9–10yr after transplantation.

This study has attempted to compare the cost of managing Type 1 diabetes by intense insulin therapy to the cost of intervention with an islet cell transplant. Also woven into the design is how both affect the quality of life.

It begins with data on islet cell graft survival. I converted their graph into a chart.

one year results: full function= 93% partial function= 8% no function= 0%

five year results: full function= 47% partial function= 37% no function= 17%

ten year results: full function= 27% partial function= 49% no function= 24%

This shows that most recipients make it to one year, and half make it to five years with no insulin.

And that half make it to ten years with at least partial function.

This is very positive. Its personally disappointing to me because I am behind the curve. I only made it 2 years with no insulin, but it gives me hope that I will remain where I am for awhile which is still at a very good place. This data reflects what I notice from the cast of characters on the islet cell recipient facebook page as well.

The Quality of life variable was very complicated and I am going to simplify it greatly. It was comparing how the hardships of each treatment affected the quality of the patient's life. The values ranged from 0 which is worst to 1 which is best. The values that I thought the most interesting were:

A healthy person aged 25-34 had a quality of life valued at 0.91

A diabetic aged 25-34 had a quality of life valued at 0.81 If this person had hypoglycemic unawareness, which all recipients do, a reduction of 0.06 put this pt at a 0.75 quality of life.

From here, adjustments were made base on diabetes causing complications that the insulin group would face, and side effects and graft failure issues that the transplant group would face. A graph shows a mostly parallel line with the transplant group slightly ahead of the insulin group.

Then came the cost analysis. The numbers themselves were stunning.

Cost of the organ procurement was $25,000.

Cost of harvesting the islets was $20,000. with a 50% success rate means $40,000.

Cost of immunosuppression was about $1400/month

Cost of transplant was $93,500. Each successive year was $19,000.

Cost of insulin therapy/year was $6,600. The cost of having complications varied from $106,000 for renal failure to $1,400 for neuropathy.

Combining these two variables shows that initially the transplant is more costly. But, over time, as the cost of the transplant stabilizes, the cost of insulin therapy and its long term complications increases. This study covered a span of 20 years. At about 9 years, the costs intersect and the islet cell transplant remains the lower cost option.

Interesting numbers here were:

20 year cost of insulin therapy was $663,000. Quality of life years gained was 9.1.

20 year cost of islet cell transplant was $519,000. Quality of life years gained was 10.9

The article goes into much more detail, but these are the highlights. It also includes a discussion about how the transplant procedure is expected to improve. This has already proven to be true in that due to a change in an enzyme used in the harvesting procedure, more islets are now obtained per pancreas than when I had my transplant in 2008. And there is much more on the horizon............

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Diabetes Awareness Month - ways to help

There are several ways you can get involved in the fight against the bigD this month.

First on my list is watch the video above. If they get 100,000 views (you can watch more than once - I'm at four and counting), Roche will be making a donation to Diabetes Hands Foundation that will be used to support two humanitarian diabetes programs: Life for a Child (run by the International Diabetes Federation) and Insulin For Life. These programs provide people in need (children in the case of the donation that will be given to them this time) with diabetes supplies and insulin that they otherwise cannot afford. Seriously, all you have to do is watch the video.

Team Type 1 is sending six Type 1 professional cyclists to the Tour of Rwanda November 15. In conjunction with the race, TT1 is doing a "Strip-A-Thon." You can donate unused test strips or make a financial donation to help Type 1 kids in Rwanda.

Diabetes Research Institute is a leader in cure-focused research. You can be part of the cure by uploading a photo and making a donation. The first $25,000 raised will be matched by Animas and Lifescan (both Johnson + Johnson companies and the makers of my pump and meter dynamic duo, Gromit and Wallace).

You can join the Pancremaniacs and ride with us in the Twin Cities ADA Tour de Cure June 4.

You can wear blue and/or orange this month. I know, not as clear as pink in October, but we're just getting ourselves pulled together on this aspect of marketing and we're missing the one focused fundraising machine; it's a little more grassroots in the DOC.* Wait 'til next year: you'll be so sick of blue by the end of November, you'll be begging for Christmas red and green.

And, last (for tonight), but not least, send me your questions. I'm thinking this is the perfect time for another bigD Q&A.


*DOC = Diabetes Online Community

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The Big Blue Test

The Big Blue Test is almost here!  On November 14th, at 2:00 pm (local time).Click here to find out more about the Big Blue Test and the Diabetes Hands Foundation.

Here's something you can do right now to, not only help spread awareness, but to give life-saving insulin to children in need.  Just watch the following video.  That's it.  Simple, right?!  It will take a mere minute and 49 seconds of your time but will give a child with diabetes a week supply of insulin!

Then, spread the word by telling your friends and family to do the same.  Post it on facebook.  Tweet about it on twitter.  Email the link to everyone you know.  Let's see how many views we can help make happen between now and November 14th...

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Islet update

I seem to be in a stable place right now.  I'm still taking about 8 units of insulin per day.  The best strategy seems to be to take 6 units of Lantus at supper time and 1 unit of Novolog before breakfast and before lunch.  With the change in the seasons, I have been getting my exercise in after supper instead of immediately before.  I miss my walk, but this way, I can skip my before supper unit of Novolog.

This seems to keep me steady.  I get a few highs and even some lows.  Both seem to be direct effects of exercise or lack thereof.  I can tell when my body is stressed as well.  I had a headache last week that caused an increase.  Emotions have the same effect.  Its surprising how quickly things can get out of range.  I really have to keep my hands on the reins.

I saw my opthomologist last week.  Still no signs of any retinopathy.
I have been lucky with staying healthy too.  I've been around some coughing and sneezing and worse people without catching anything.

I have been sleeping much better lately.  My insomnia stopped abruptly about the time that I started taking insulin.  I rarely have to get up and read anymore to get myself back to sleep.


On the research front, a new treatment that invovles taking stem cells from testicular cells and converting them into insulin producing cells has been making the news. It may be that we have the power to heal ourselves. It sounds very encouraging and it is also noted that for females, the oocyte should be able to accomplish the same thing.

Also, Living Cell Technologies has just been granted the right to administer its Diabecell product in Russia.  This is the encapsulated pig islet cells.  The procedure costs $150,000 now, but should decrease as more people opt to try this.  This is important because it will increase the number of people who can try it and therefore increase our knowledge about the treatment in general.

Other good news is that the Special Diabetes Program has passed in both the House and the Senate.  This is good news because it is a pledge of $150 million dollars for two years.  This provides funding for many cure based research projects.  I'm hoping it will open the door for many more clinical trials.


These are my kids on the Pacific Ocean.  Becky's birthday present was plane tickets to go see Gary and Cassie in CA.

Below is an islet/stem cell that I thought was just beautiful.

 

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