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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.

 

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 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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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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BIG BLUE, PART 2

I'm well aware that I have never been without any medical supplies.
Growing up my dad had amazing health insurance coverage and we had closets (yes, plural) filled with supplies.
Now grown up and on my own insurance,
I am again, blessed with everything I need.

* All it took was a phone call from my doctor to get set up with sensors and my continuous glucose monitor.
* My pump just ran out of warranty in August.
* One phone call and I was upgraded to the newest model.
* I even got to choose the color I wanted (pink!), and it was sent to my work just days later.
* My insurance was so good in fact, that after turning in my old pump, I had a credit of money on my account...so essentially, I got paid to go on an upgraded pump.

Not everyone is as fortunate
and some even lack a basic needle and vial of insulin they need to keep them alive!!!

BUT...many people and various organizations have come together to make it possible for children with Diabetes in some of the poorest countries to receive the insulin they need.

And to make it happen, all you need to do is watch this video:

Up until November 14th (World Diabetes Day), money will be donated to this cause.
Read the press release here to find out more info:
Thanks for doing your part.

GO BIG BLUE!!!!   :)

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Eggs,bikes,and Tylenol PM

I have been struggling with some higher blood sugars lately. About 10 days ago, it got suddenly worse. My postprandials had been going higher for awhile, but then my fastings started to hover in the 130s. I became worried enough to contact Janet and then Dr. Bellin about the situation. After some discussion, it was decided to try a lower carb breakfast and to try not to worry about it too much. I know that stress can cause higher BGs, and seeing those high numbers was definitely causing some stress. This all occurred right before Labor Day weekend and it was decided to wait a few days and see if my numbers improved. If not, it might be time to try some insulin. It would break my heart a little to do this, but would bring down my numbers for sure.

When I told Gary about this, he asked if my sleeping problems might have something to do with the higher numbers? I realized that he might be right about that. So I started taking 2 Tylenol PMs at bedtime. I had been taking them before, but only if I really felt that I needed to. Its been almost a week now since I started all of this and my numbers are better. I know its not very scientific to try three things at once, but at that point, I was ready for any good idea.

So now, I'm having higher protein and fewer carb breakfasts, bike rides or long walks during the day, and Tylenol PM at night. My fastings are definitely better. I'm still having some higher postprandials, (200-250) but not as many. The exercise really helps. I'm planning on tapering off of the Tylenol PM and keeping up with the breakfasts and the exercising for awhile. I'm keeping a close watch on my weight during all of this.

The Labor Day weekend was wonderful. I was really hoping that I would be too busy to worry about my BGs too much, and it really worked out that way. We had a wedding on Saturday. We went to Kelly's Island with some friends on Sunday. We had fun playing some horseshoes there. And on Monday, we went kayaking on the Maumee River and then staffed a Donate Life Ohio booth at the Fulton county fair. Blake Shelton was playing in the background.

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Practice, Practice.....

I expected the "I'm free".....I didn't expect the second line. It made me realize how different he must feel all the time. So....I'll have to add another positive to MDI!!:)

This morning I began teaching the rest of the family how to take care of J.J. on MDI. When J.J. was first diagnosed they were all really too shocked and scared to want to learn. We didn't push them, but hoped they would step up. Eventually they did.....to a point of wondering if it was too much!:) Today they jumped in.....no fears(o.k. a few!)......but they have much more confidence now that they could give a shot without really, really messing up.


I had them practice using an old Lantus vial, used syringes and a clementine. Granted they can't pinch the skin of a clementine, but I had them simulate the effect. I also wanted to make sure they understood what calibration was on the syringe. I would throw out a dosage amount and ask them to draw it up for me. Thankfully I did that, because both of the girls thought the first line was "one" not "zero". So they would have been a unit off!!


J.J. even wanted to give it a try. I drew up the dose and let him inject it. Right now he's a little clumsy, being he's only 7 and his dexterity isn't quite what it will be in a few years......but I think he could do it. I don't think I'd let him draw up the insulin yet, but we shall see! For now he's where he should be.......out in the dirt pit......FREE...to be....a REAL BOY!!!!:)

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