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Novolog is not 'medically necessary' or the letter that made my head almost come off my body

Happy New Year everyone!

Ok, now sit down. I mean it. Sit. Down.
Then read this:


Did your head almost come off your body? Steam from your ears? Or is your jaw still on the floor?

Yep, Grace's insurance, Keystone Mercy,  the flippin' Medicaid that the state put her on on December 1st, denied her Novolog and said that she needs to use the 'formulary' insulin. That is Humalog.
If I wanted her on Humalog, I would have had her on Humalog.
If her doctor wanted her on Humalog, she would have placed her on Humalog.
If her endo thought Humalog would do better by her, she would have prescribed it.
As it turns out, gee, she is on NOVOLOG - for TWO YEARS now!

And you know the sole reason that Keystone Mercy decided this???
You guessed it folks.

GREED.


Money was the sole reason they made this decision. Novolog costs more than their formulary.

Not for one minute do I believe that they have Grace's best interests and healthcare at heart.
They didn't consult her endo.
They didn't consult her primary doctor.
They didn't call me.
They didn't read her files or ask for her history.
They didn't call her CDE.
They didn't look at how long and how successful she has been on Novolog.
They didn't look at her A1C or her blood sugars.
They didn't look at the difference reported between Novolog and Humalog.

They even go so far as to say that she has not tried 'formulary alternatives' which means she didn't try what they have rostered as the lowest-costing insulin they can get.
Oh, poor Keystone Mercy.

Monday morning - a complaint AND a grievance are being filed against Keystone Mercy.
Monday morning, the 'BitchSwitch' that my dear friend Kelly coined, is being flipped!
Monday morning, I am calling a lawyer at the PA Health Law Project.

It's so ON.

1-3-11 update:
* Complaint/grievance sent certified mail to KMHP
* Complaint/grievance filed over the phone
* Left case manager at KMHP left a scalding message on their voicemail
* Endo on board and sending letter in support of Novolog
* BitchSwitch flipped
* Head still on body, surprisingly



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Scientists uncover new mechanism that reduces risk of type 2 diabetes, cardiovascular disease (II)

Pointing the Way

In 2007, Griffin and his colleagues published a study in the journal Structure (October 16, 2007, Volume 15, Number 10, pp.1258-1271) that explained the difference between how full and partial agonists interacted with PPARγ. Full agonists interacted strongly with a region of the receptor known to be important for the classical fat generation program. On the other hand, partial agonists, which are poor agonists of the receptor, did not interact with this region at all but interacted more strongly with a potentially critical region of the receptor. From a drug development point of view, these results offered a new area of the protein to focus on to optimize therapeutic molecules that would be potent insulin sensitizers without driving fat generation.

"Bruce Spiegelman at Dana-Farber was starting to uncover the fact that the phosphorylation of PPARγ takes place in the very region where MRL-24, one of the partial agonists interacted," Griffin said. "I suggested that compounds like MRL24 might be better at antagonizing the cdk5 site given their strong interaction in this region of the receptor. For the new study, we provided significant amounts of compound to support the animal studies and provided an plausible mechanism for how partial agonists might recruit co-activator proteins to the cdk5 surface of PPARg."

While the team found that PPARγ phosphorylation effects were reversed by both full and partial agonists, partial agonists indeed accomplished this as well or better than the full agonists. Mimicking the effects of just blocking the phosphorylation event by mutation of the site on the receptor showed improvements in the production of adiponectin.

The new study also suggests a unified framework for understanding the relationship between fat cell dysfunction in obesity and anti-diabetic therapies based on PPARγ. In animal studies, high fat diets activate the cdk5 kinase, initiating phosphorylation, disrupting a number of key metabolic regulators including adiponectin and adipsin, a fat cell-selective gene whose expression is altered in obesity.

"The great paradox of this whole effort is we're targeting a receptor critical for fat production to offset the problem of fat overproduction," Griffin said. "Unfortunately, current drugs that target PPARg increase fat as one of their unwanted long-term side effects."

While the study is a big step forward, important questions still remain such as does a high fat diet and obesity lead to activation of cdk5 in non-fat tissues, Griffin said, since the negative effects of obesity extend far beyond metabolic syndrome to diseases like cancer and neurodegeneration.

The first authors of the study, "Anti-diabetic drugs inhibit obesity-linked phosphorylation of PPARγ by Cdk5," are Jang Hyun Choi, Alexander S. Banks Jennifer L. Estall, and Shingo Kajimura of the Dana-Farber Cancer Institute and Department of Cell Biology, Harvard Medical School. Other authors include Pontus Bostrom, Dina Laznik, Bruce M. Spiegelman and Jorge L. Ruas of the Dana-Farber Cancer Institute and Department of Cell Biology, Harvard Medical School; Michael J. Chalmers, Theodore M. Kamenecka of The Scripps Research Institute; and Matthias Bluher of the University of Leipzig, Germany.

Labels: diabetes general, type 2 diabetes symptoms

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By Writing About It, I Will Most Surely Cause The Infusion Set Nirvana To Cease.....

By writing about it, I will most surely cause the Infusion Set Nirvana to cease; yet I must.

I placed the infusion set in my right thigh late Thursday night, and since that time it's done it's job quite nicely.

I don't even realize it's there most of the time. It's hasn't gotten caught in my jeans or my underwear (and you all KNOW what I'm talking about) and my numbers have been quite good.

The infusion site doesn't hurt at all when my jean slide against my skin or when I brush my fingers over the infusion site without even realizing that I'm doing it.

As always, I carry my spare infusion set in my handbag and have one in my car "just in case."

I know in my head that it's time to change it, but my skin tells me otherwise.

No telltale itchiness around the site letting me knows its time to rotate, or even redness for that matter.

Part of me thinks that if I change the site, my roll of good numbers will stop, but an even bigger part of me knows that’s just crazy talk!

For now, I’ll stick with it and enjoy the moment, because I know it’s a fleeting and quite a temporary thing. Much like a freshly filled insulin reservoir; Blood Sugar Nirvana, my tolerance for all things Kardashian, fresh cooked bacon on a plate or an untouched cupcake calling my name~

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pancakes for breakfast - low carb and perfect for diabetics!

hi everyone! i hope the sun is shining as brightly with you as it is with me :)

i recently created a video on my youtube channel, a pancake recipe that is just so delicious and low in carbohydrates that i couldn't not share it with you all. they are full of good protein and fat, and are just brilliant for diabetics in the morning - especially kids with a healthy appetite!


if you have any other video requests, please do let me know... i'm quite happy to talk about anything to do with diabetes, or insulin pumping, or diet. and if you haven't yet visited my channel, then do, because there's a healthy living series on there worth checking out ♥

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Natural Treatment For Diabetes - 3 Benefits of a Diabetic Cure

by Martha C. Johnson

Diabetes is a disease in which blood glucose levels are above normal. Type 1 diabetes happens when the beta cells of the pancreas no longer makes insulin because the body's immune system has attacked and damaged them. Some symptoms of diabetes are: unusual weight loss, frequent urination, and extreme hunger.

Type 1 diabetes is treated with insulin. The most common form of diabetes is Type 2 where insulin is resisted by the liver, muscle and fat. People who are overweight and inactive are the prime candidates for type 2 diabetes. Some symptoms in addition to those of Type 1 are: tingling lack of sensation in the hands and or feet, cuts and bruises that are slow to heal, and blurred vision.

Here are 3 benefits of naturally curing diabetes:

No painful injections.

With Type 1 diabetes you have to take insulin shots or use an insulin pump. You would need to learn injection techniques. With Type 2 diabetes you maybe taking medications.

No pain and suffering from diabetes.

Diabetes causes a dangerous nerve pain and pain affects your mood. So not only will you be confronted with pain, you also would have to tolerate the mood swings.

No anxiety from high medical bills.

You won't have any peace of mind when you're worrying about high medical bills. Worrying can also interfere with your healing process. Begin to concentrate on reversing this troublesome disease. There are natural ways to reverse your diabetes so that you may live a more happier life.

Worrying has never fixed anything. Did you know that after worrying, you will feel tired. It also brings discouragement. Anytime you begin to feel discouraged just think of an event that you experienced that made you happy. Think about no longer having diabetes.

For help with reversing diabetes, go to this site that has useful information. http://thenaturalhealthsource.blogspot.com

About the Author
Martha C. Johnson is an herbal specialist who has demonstrated the knowledge necessary to teach others about nutrition. http://thenaturalhealthsource.blogspot.com

Labels: diabetes natural treatment

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Put on a Party that Everyone Can Enjoy -- Even Guests with Diabetes


People who have diabetes -- a disorder of the metabolism, in which their body has trouble converting food in to energy -- must pay close attention to everything they eat. Their bodies do not have the mechanisms necessary to properly regulate their blood sugar levels.

Diabetes affects about 17 million Americans so chances are nice anyone who has the illness will attend your next party. Since you don’t require somebody to feel left out, here are some tips to help you plan a party every guest will enjoy:

* For the main meal, offer your guests variety. Have fish, poultry and lean cuts of beef, veal or pork obtainable so there will be something for everyone. Remove the skin -- which is high in fat -- from poultry. This will benefit not only diabetics, but everyone at your party.

* In lieu of creamy mashed potatoes, which are high in carbohydrates, offer a variety of grains and fresh vegetables for side dishes. Those items are all on the Diabetic Food Pyramid and nice for everyone. Keep in mind, basic foods are always the safest. Avoid sauces, and casseroles, those with cheese and cream sauces.

* For dessert, provide your guests with healthy, low-carb options to the sweet holiday treats. Put out platters with bagel chips, pretzels, low fat crackers, raw fruits and vegetables.

“People with diabetes must avoid foods high in carbohydrates because they send the body’s blood sugar levels soaring,” says Gary Janson, president of American Medical Supply, a Florida-based diabetic supplies company that serves clients in all 50 states. “When you eat, your body breaks down all carbohydrates, and some portion of proteins, in to a sugar substance called glucose. The hormone, insulin, directs glucose to enter the cells, generating energy.”

People who have diabetes should regularly check their blood sugar levels. The cost of testing supplies can exceed $1,200 a year for anyone who tests their blood sugar five time a day. While Medicare and most third party insurers cover a number of the cost, patients can incur substantial out-of-pocket expenses while waiting for insurance reimbursement.

In a regular, healthy person, the body carefully monitors the amount of sugar which is circulated in the blood and removes it when high levels are detected. Diabetics’ bodies either produce inadequate levels of insulin or none at all, so their blood sugar level is chronically high. Over time, patients with diabetes can create such complications as blindness, kidney illness, nerve damage, heart illness, stroke, increased risk of infections or even amputations.

To help patients avoid this expense, companies such as American Medical Supplies specialize in taking the hassle out of ordering and paying for supplies by billing insurance providers and Medicare directly, with no upfront cost to the patient.

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