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Eli Lilly’s diabetes treatment meets main goal in two late-stage studies

I am definitely not going to say that I know enough about clinical trials and what phase 1 or late-stage studies means, but when I see a report, I’m going to report it. This news is a couple of weeks old. Hey, I didn’t say it was breaking news, I just said it was news.

So this article is in regards to Eli Lilly’s Ultra Rapid Lispro insulin which is basically like Humalog, but faster. If I’m not mistaken, it is Eli Lilly’s version of Fiasp, but like I said, I could be wrong.

The good news is that the late-stage studies showed that this insulin “significantly improved post meal blood sugar levels”. That’s the kind of stuff that I like to hear.

I like hearing about new, better insulins.

Obviously, most of that doesn’t matter because majority of us are not going to be able to afford the new insulins, but that’s an ongoing issue (which I’ve been attacked on before from people who don’t know me, so I’m not talking about that in this post.)

I’ve tried Fiasp in the past and I absolutely loved it. Unfortunately, my insurance didn’t cover it, so I couldn’t keep using it. My insurances over the years have switched quite often which means that I’ve switched between Humalog and Novolog.

I haven’t really seen too much of a difference between these two, so I’m hoping that a competitor to Fiasp comes to market and then at least one of the two will be covered by my insurance.

novo nordisk matter incubator digital health competition

Novo Nordisk and Matter a Healthcare Incubator Team Up for Digital Health Competition

Digital health is the new rage. Well, not so much new, but companies are going all in on digital health. Novo Nordisk is teaming up with startups for a diabetes challenge, aiming to create new digital health tools.

matter health incubatorThis will be a competition that Novo Nordisk and Matter, a healthcare incubator, will be putting on. The competition actually started last week on October 9, I’m a bit behind on my news here. The concept of the competition is quite simple,

The competition will ask entrepreneurs, researchers and other healthcare innovators to create new digital tools to help diabetes patients achieve better health

The initial applications are due October 26 where a group of 10-15 semi-finalists will move on to the net round. The next round will include a demo day which will then narrow the competition down to 2-3 finalists who will receive a $25,000 seed funding and also enroll in a 12-week accelerator where they will work with Novo Nordisk and Matter.

So, for those that may not know what an incubator is when it comes to the tech world, it is basically a company that helps startups grow and develop by offering them office space, networking among other startups in the same niche, office management help (for example providing support for their HR, office supplies, etc.). Incubators are important to startups because it allows them to collaborate with other startups and combine resources to grow their business.

The HBO hit show, Silicon Valley, is based around a tech incubator.

Now, why is this important and why am I sharing it on my site?

Great question.

The answer is quite simple.

It is programs and contests like these that will change the healthcare system. Some of the smartest people in the world will be working at these tech companies and they are starving for seed money and will put tremendous effort into these projects and competitions. They will be working with actual patient data that is provided by Novo Nordisk, so they will be able to utilize real life situations.

Digital health used to be the thing of the future, but in my opinion, it is the thing of NOW. So, we must embrace digital health and welcome it into our lives, because it is what is going to help people living with chronic conditions continue to live a happy, healthy and long life.

What are your thoughts on this competition? Do you know any tech companies that would be interested in submitting an application before October 26? Share this post with them.

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FDA generic drugs

FDA Blocking Sneaky Moves from Brand Names to Block Generics

As part of my “educate myself more” attempts, I wanted to dig into an article about the FDA a little deeper. The most confusing part of my coverage of diabetes in the decade that I’ve been doing this has easily been anything to do with the FDA.

It has always been confusing to me.

But, this article is pretty straight forward, the practice being talked about is a bit, well, shady.

Blocking Generics

So, when a company submits a generic drug to the FDA, the brand name pharmaceutical company will help organize citizen petitions to the FDA which will bog down the process of getting said generic approved by the FDA.

generic manufacturingI get it, it makes sense, but it seems like a pretty sketchy move in my book.

The FDA announced last week that it is going to crack down on these practices.

FDA Commission Scott Gottlieb is quoted in the article saying,

while the record shows that citizen petitions have rarely delayed specific generic drug approvals, there’s no doubt that the process requirements associated with … petitions can add to resource burdens on the generic drug review process.”

Another tactic that brand name companies use is to withhold samples from the generic company. According to the Washington Examiner article,

“a generic company needs up to 5,000 samples of a brand name drug to complete approval testing.”

These both seem like old school pharmaceutical tricks that have probably been used for a long time, but I don’t like them and I like the crack down.

Building the Biggest Building

I’ve used this example in the past, but there are two ways to have the biggest building in town.

1. Knock down the current biggest
2. Build the biggest building in town

What does that mean?

You can either become the best by trying to knock down the others and cheat and get ahead by putting them down.

Or

You can become the biggest building by putting in the work, making a better product and just dominating your competitor.

I get it, once a generic comes out, you’re not going to make as much money as you will if there’s not a generic, but you know this going into launching a new medication.

What are your thoughts on this? Are there any other sneaky little tricks played on the FDA that are worth discussing?

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ai-machine-learning-diabetes

AI and Machine Learning in Diabetes: Reality or Hype?

If you know about me, you know that I love technology. I haven’t talked too much about AI (artificial intelligence) a lot here, but I do talk a lot about it in person.

I think that AI, AR (augmented reality) and VR (virtual reality) are going to be huge game changers in all aspect of life, but definitely in the healthcare landscape.

A recent article, Hype vs. reality in health care AI: Real-world approaches that are working today goes into much more depth than I can. I love technology, but I don’t know enough about the details.

The article touches on a few areas that AI is already being utilized and where it can be taken further in the future. One of these areas is something that I think is important.

Machine Learning

Machine learning is already being used to take data from a patient and identify early indicators of diseases.

In the non-diabetes space machine learning is being used by Google to help identify cancerous tumors and Stanford is using it to identify skin cancer.

ibm-watson-diabetesRecently I wrote about an article talking about using digital health in all four stages of the patient journey, this is very similar. Using machine learning, or AI, during all 4 of these stages is where healthcare can be more predictive and maybe we can save more lives because of it.

During the diagnosis process, partnerships like the one IBM Watson Genomics and Quest Diagnostics made, could

 

identify potential disease or blood disorders simply from looking at blood sample results.

Imagine going to get your blood drawn and then within 24 hours knowing you need further tests because the data from IBM Watson was able to predict or detect something happening inside your body. Some may have issues with the patient privacy in this case, but I know I wouldn’t.

Predicting Health Results

Once some one is diagnoses, machine learning can still help that person manage their disease. Think about predictive low systems within the Medtronic 670G and the Tandem t:slim X2 Basal-IQ Technology Predictive Low Glucose Suspend. Both of these are using machine learning to help predict lows in the future.

Using AI and machine learning is so important because diabetes can go undiagnosed, even from a primary care physician. Don’t believe me? Well, it happened to me.

Lab results can be uploaded and then thats when the machine learning “stuff” happens. It can spit out possible diseases, recommendations of prescriptions and medications, meal plans, etc. that a doctor may miss initially.

Remember that data I talked about yesterday from, well it can be used to help diagnose, alert, or even help you manage your disease better.

What are your thoughts on AI? Do you think that it is indeed just all hype or do you look forward to it? A lot of companies are already using it.

The future looks bright in my opinion.

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patient privacy from using wearables

Despite Patient Privacy Risks, More People Use Wearables for Health

A recent Deloitte Survey of US Health Care Consumers found overwhelming numbers of people who utilize wearables in their health management despite the patient privacy risks.

I am one of those people. I wasn’t surveyed, but I wear a CGM and an Apple Watch at all times. There is a lot of things that I give up some privacy for in order to have the convenience of what that product gives me.

The interesting part of this study is that:

Sixty percent of the 4,530 respondents said they are willing to share PHI generated from wearable devices with their doctor to improve their health.

I’d think that number would be higher. If you’re going to use wearables, why wouldn’t you want to share the data with your doctor?

I’d assume the main reason is because you don’t want the doctor to judge you from an unhealthy or for being a “bad” patient.

I use wearables because I want the real-time data to make short term decisions and then when I visit my doctor, that’s usually when I discuss long-term decisions and strategies.

diabetes heart rateWearing an Apple Watch and seeing that my heart rate is way too high tells me right away that I need to calm down and get my heart rate back to an ideal level.

Then, I will share this data with my doctor because if there is a pattern of high heart rates, we can figure out what that pattern is and how I can try and avoid whatever is causing that.

The main issue of the study and article that I am writing about is that once the data from a wearable is uploaded to your healthcare professionals system (EHR), HIPPA regulations now apply and this is where their could be privacy issues.

There are a lot of numbers and stats in this report that I found interesting, so I recommend checking it out.

Another one is that 31% are interested in connecting with a live health coach.

That’s one feature that I love about mySugr. Live health coaching.

What are your thoughts on all of this?

Do you use wearables?

Would you share your data with your doctor or keep it for yourself?

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novo nordisk connected pens mysugr

Novo Nordisk Connected Pens – mySugr Updates

This post is almost a double-header if you will. Partially about Novo Nordisk and part about mySugr.

The first part is about the connected pens that Novo Nordisk is planning on releasing in 2019. These connected insulin pens will be “connected” to data systems, which currently seem to be Dexcom, Glooko and Roche (mySugr).

I am excited about this because I switched over to insulin pens earlier this year and I NEVER track my insulin intake now. I think I have maybe 10 times in the past 6 months of using Dexcom and mySugr. These connected pens will help me with tracking my insulin dosing.

Here’s a quote from Novo Nordisk on the partnerships from a recent press release:

“Our non-exclusive partnership strategy allows us to integrate with the various digital platforms that people are already using to help manage their diabetes,” said Camilla Sylvest, executive vice president of Commercial Strategy & Corporate Affairs at Novo Nordisk. “We firmly believe that this will help more people realise the full benefit of our innovative medicines and begin to ease the mental burden of diabetes treatment for those individuals.”

When the news broke that mySugr will be part of this integration, I was ecstatic. I test my sugar and then I correct based off of that. My blood sugar levels are automatically sent to the mySugr app, but I have to manually input how much insulin I am taking, which I am just not good at. Same goes with the Dexcom Clarity app, I don’t typically open up the app and input my insulin dosage. Hmm…I’m starting to hear a new 2019 goal!

If you would like to read more about this, check out the press release here.

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virtual clinics for diabetics

Virtual Clinics for People with Type 2 Diabetes

In a recent article from press release from Blue Cross and Blue Shield of Georgia, they announced virtual clinics for people with type 2 diabetes.

I am sharing this and expanding on this because I think that this is a great opportunity for insurance companies across the country.

The press release states that:

Participants in Onduo’s virtual diabetes clinic will learn more about their body’s response to meals, medication and exercise by tracking their glucose readings in almost real time and seeing patterns that could explain the spikes and dips in their reading numbers. Consumers also will have ongoing access to a care team — including coaches, diabetes educators and doctors — for support in managing their diabetes.

People can participate in this virtual diabetes clinic if they are enrolled in certain BCBSGa plans. In the long run, offering these types of virtual clinics for people living with type 2 diabetes can help lower costs for the insurance companies.

People who are more educated and knowledgable about a disease can make better decisions towards a healthier lifestyle.

Virtual Clinics

I’d like to say bravo to BCBSGa for doing this.

Do you know of other insurance companies around the country that are doing this?

I’d love to hear more about other insurance companies that are also doing this.

Taking this one step further, I think these virtual clinics should be offered to anyone who is enrolled in the insurance program.

Why?

Maybe someone doesn’t know that they have diabetes, like the millions and millions of Americans who currently don’t even know they have diabetes. This virtual clinic could help them understand signs and symptoms and figure out that they may just have diabetes.

Going even further, open the clinic up to educate people on heart disease and other common diseases in America.

These virtual clinics can be opened up by people outside of the insurance industry too.

Do you think that a pharmaceutical company wouldn’t want to fund these type of clinics? Knowing that if any of these people actually do have Type 2 that they aren’t going to end up on one of their drugs?

Virtual clinics are so important because people can’t always just get up and go to an in-person clinic or educational meet up. Maybe they don’t have a ride, are sick, immobile, whatever the case is, but they can’t make it to the clinic to receive the education they need, so now they have to lose out?

Absolutely not!

That’s why virtual clinics like these need to be around.

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digital health patient journey

Using Digital Health Throughout the Patient Journey

In a Brand article from Forbes.com Digital Health Offers Disruptive Potential for Diabetes the author touches on a lot of great points of how digital health can benefit the diabetes industry.

I think that digital health can help just about any disease state, but since diabetes is my thing, we will stick with that.

The primary part of this article that I found intriguing was breaking down the Diabetes Patient Journey, as they call it in this article.

journey of a diabetes patient

This journey consists of the following stages:

1. Awareness
2. Diagnosis
3. Treatment
4. Self-Management

There are not many examples given as to how digital health can help in all four of these stages, but I have a few ideas to add to it.

Awareness

As much as I want to think that digital health can really help the awareness aspect, I’m not 100% sure how it can. I mean, let’s be real, it obviously can help because digital health is just where the future is.

I think that one area digital health can help with the awareness is with a quick questionnaire on an iPad. Depending on what answers you provide, the AI (artificial intelligence) can prompt the next set of questions. If this occurs in every appointment, then it can be brought up to the doctor’s attention.

Why the iPad instead of just the normal papers that are filled out? Sometimes, I mark things on questionnaire sheets, just to see if I’m asked about it. When I’m not, then I know it wasn’t even looked at, which is obviously not good.

With the iPad, then it can alert you to bring up to the doctor and also be sent to your EHR (electronic health record)

Diagnosis

Diagnosis is an extremely difficult time for the person being diagnosed and the family. There are so many questions flying around. Can I eat this? Can I do this? How do I do this? What does this mean? A needle in my stomach? By myself? What?

Self-Management / Treatment

I think that the Self-Management and Treatment are basically the same thing. Treatment, I believe, means treatment in the hospital or inside the doctor’s office. I personally feel that ties in directly to self-management. Your care mixed with your doctor’s care is your overall treatment.

This is the area that I think there is already a lot of digital health companies playing. In fact, there may be too many apps. Which, there can’t be too many because each person may like a different feature of all the apps.

I think that where digital health companies can improve is first speaking with the patients and figuring out exactly what they need an app or VR/AR to solve. Too many times companies create apps that just don’t do anything much more special than the other 99 apps. So we have another app that just does the same ole thing as the others.

Where would you like to see advancements in digital health?

I think that utilizing digital health to help educate patients and to allow doctors to have virtual visits with their patients would be a great step in the right direction. I know this is currently happening, but it’s not the norm and it’s definitely a small amount of physicians who are offering this service.

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patients cant afford doctor visits featured image

Why Patients in Some States Can’t Afford to Visit Their Doctors

A recent study from the Kaiser Family Foundation reported in Becker’s Hospital Review breaks down how many patients in each state skip a physician visit due to cost.

I always like to look at these lists to see the top states and bottom states on these lists and think about maybe why these particular states are where they are.

In this particular case, my mind went a different way with this. My mind went to the idea of what happens when these patients skip visits.

Something that Victor Montori writes about in his book, Why We Revolt is that some times patients can’t afford a visit or just can’t make a visit for a specific reason and then that patient is deemed to be non-compliant.


The word non-compliant is a whole other issue and people like Renza can go into more detail on why language matters, but for this post, I will use that phrase.

Let’s say that I might be the most compliant, best patient out there and eager to do what I need to do in order to have a better doctor visit than the last one. So, that means I ate better, I exercised, I got better sleep and I took all the meds I was supposed to take.

But, unfortunately, I had a client become late on a payment and I had to fork out some money for some other non-health related emergency and next thing you know, I can’t afford my co-pay or other out of pocket expenses to go see my doctor.

Now, I look like a bad patient. My health potentially gets worse because I’m not able to review the lab results until I can afford to go see my doctor. But now, I have even more medications and tests that need to be done the next time, causing me to have even less and less money to afford future appointments.

Next thing you know, I’m being admitted to the hospital for poor health all because I couldn’t afford to go see a doctor.

Now, this exact situation hasn’t happened to me, per say, but it happens every single day.

Why These States?

united states can't afford doctor visitsWhat are the reasons behind why people in Texas, Mississippi, Louisiana, Georgie and Nevada to round out the top 5 can’t afford to visit their doctor?

Is it due to just overall struggling economies in those states?

Is it because of poor insurance coverage from Marketplace plans in those states?

Why do people in Iowa, North Dakota, Hawaii, Vermont and Massachusetts all have a far less harder time affording to go see their doctors?

These are questions that I always wonder when I see these lists.

I, for one, am glad to see that PA is 9th from the bottom of the list.

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scared into more sleep

I’ve Been Scared into Wanting to Sleep More

In an article published in MedicalNewsToday titled Why a Regular Bedtime May Benefit Your Heart and Metabolism there is some news from a Scientific Reports study that makes me rethink my sleeping habits.

Well, I can’t even really call them habits, but it’s not much of a habit. It’s a, go to bed at 10 tonight, then maybe 11 tomorrow, but then 2:30 the next night, then back to midnight type of thing.

social jet lag

I’ve talked about my horrible sleeping patterns in the past and why I switched to a Nectar mattress in order to get better sleep and how it actually helped with my blood sugars. But then every time I read an article like this, I’m just reminded of all of the risks that come from sleep deprivation.

What I found interesting in this study is that it talks about “social jet lag” which is the difference in sleep and waking times between the weekend and weekdays and that people who sleep in on the weekends could be at a higher risk for things like heart disease, obesity and of course (like everything else it seems), diabetes.

Here is a quote from the article that really stood out to me:

Overall, volunteers with irregular bedtimes had a higher body mass index (BMI), higher levels of blood sugar, higher blood pressure, and higher levels of hemoglobin A1C, and they were more likely to have a heart attack or stroke in the following decade than individuals with regular sleeping patterns.

Sleep is something that over the past couple of years has scared me. And, it has nothing to do with having a low in the middle of the night and not waking up. That is actually not a big fear of mine at all.

My biggest fear about sleep is just that I’m going to stop breathing one night. I also now fear that all of these nights of bad sleep will catch up to me.

I used to always say, “I don’t need sleep, I’ll sleep when I’m dead”

Well, maybe all of that lack of sleep will get me there a lot earlier than what I previous thought it would.

I have feared for several years that I have sleep apnea, but I’ve never wanted to go and get tested because I know what the outcome and answer is going to be. But, I’m at a point in my life where I am willing to accept everything that may be wrong with me and do what I need to do in order to take care of it.

Losing weight is obviously at the very top of that.

I also know how sleep and my weight have a direct correlation to each other. On night’s that I don’t get great sleep, I tend to eat like crap the next day. I drink much more coffee and I don’t get exercise.

It’s a viscous cycle that must be broken.

What tips do you have for better sleep habits?

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