Mounting Evidence Shows Diet Soda May Be Hurting Your Diet — Here's How
New Diabetes Monitors Require Fewer Pricks, Less Guessing
Coming Soon: Continuous Glucose Monitoring, With No Finger Pricks
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Also called non-nutritive sweeteners, these can be synthetic – such as saccharin and aspartame – or naturally derived, such as steviol, which comes from the Stevia plant. To date, the U.S. Food and Drug Administration has approved \u003ca href=\"https://www.fda.gov/Food/IngredientsPackagingLabeling/FoodAdditivesIngredients/ucm397725.htm\" target=\"_blank\" rel=\"noopener\">six types of artificial and two types of natural non-nutritive sweeteners\u003c/a> for use in food.[contextly_sidebar id=\"9cHOWFJBVWEQQfvraluyBJ45Elnnkn5i\"]\u003c/p>\n\u003cp>That’s been great news for those working hard to curb their sugar consumption. \u003ca href=\"https://doi.org/10.3945/ajcn.111.030833\" target=\"_blank\" rel=\"noopener\">Aspartame\u003c/a>, for example, is found in more than 6,000 foods worldwide, and about 5,000-5,500 tons are consumed every year in the United States alone.\u003c/p>\n\u003cp>The American Diabetes Association – the most well-respected professional group focusing on diabetes – \u003ca href=\"http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices/what-can-i-drink.html\" target=\"_blank\" rel=\"noopener\">officially recommends diet soda as an alternative\u003c/a> to sugar-sweetened beverages. To date, seven U.S. municipalities have imposed a sugary beverage tax to discourage consumption.\u003c/p>\n\u003cp>However, recent medical studies suggest that policymakers eager to implement a soda tax may also want to include diet drinks because these sweeteners may be contributing to chronic diabetes and cardiovascular diseases as well.\u003c/p>\n\u003cp>\u003cstrong>Why Are These Sweeteners Calorie-Free?\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The key to these virtually calorie-free sweeteners is that they are not broken down during digestion into natural sugars like glucose, fructose and galactose, which are then either used for energy or converted into fat.\u003c/p>\n\u003cp>Non-nutritive sweeteners have different byproducts that are not converted into calories. Aspartame, for example, undergoes a different metabolic process that doesn’t yield simple sugars. Others such as saccharin and sucralose are not broken down at all, but instead are absorbed directly into the bloodstream and excreted in the urine.\u003c/p>\n\u003cp>Theoretically, these sweeteners should be a “better” choice than sugar for diabetics. Glucose stimulates release of insulin, a hormone that regulates blood sugar levels. Type 2 diabetes occurs when the body no longer responds as well to insulin as it should, leading to higher levels of glucose in the blood that damages the nerves, kidneys, blood vessels and heart. Since non-nutritive sweeteners aren’t actually sugar, they should sidestep this problem.\u003c/p>\n\u003cp>\u003cstrong>Artificial Sweeteners, Your Brain and Your Microbiome\u003c/strong>\u003c/p>\n\u003cp>However, there is growing evidence over the last decade that these sweeteners can alter healthy metabolic processes in other ways, specifically in the gut.\u003c/p>\n\u003cp>Long-term use of these sweeteners has \u003ca href=\"https://doi.org/10.2337/dc08-1799\" target=\"_blank\" rel=\"noopener\">been associated with a higher risk of Type 2 diabetes\u003c/a>. Sweeteners, such as saccharin, have been shown to \u003ca href=\"http://doi.org/10.1038/nature13793\" target=\"_blank\" rel=\"noopener\">change the type and function of the gut microbiome\u003c/a>, the community of microorganisms that live in the intestine. Aspartame \u003ca href=\"https://doi.org/10.1139/apnm-2016-0346\" target=\"_blank\" rel=\"noopener\">decreases the activity of a gut enzyme\u003c/a> that is normally protective against Type 2 diabetes. Furthermore, this response may be exacerbated by the “mismatch” between the body perceiving something as tasting sweet and the expected associated calories. The greater the discrepancy between the sweetness and actual caloric content, the \u003ca href=\"http://doi.org/10.1016/j.cub.2017.07.018\" target=\"_blank\" rel=\"noopener\">greater the metabolic dysregulation\u003c/a>.[contextly_sidebar id=\"1WiRRvjeXSgRFmENuLBZhCvtglNEvId8\"]\u003c/p>\n\u003cp>Sweeteners have also been shown to change brain activity associated with eating sweet foods. A functional MRI exam, which studies brain activity by measuring blood flow, has shown that sucralose, compared to regular sugar, \u003ca href=\"https://doi.org/10.1016/j.appet.2011.12.001\">decreases activity in the amygdala\u003c/a>, a part of the brain involved with taste perception and the experience of eating.\u003c/p>\n\u003cp>Another study revealed that longer-term and higher diet soda consumption are linked to \u003ca href=\"https://doi.org/10.1016/j.physbeh.2012.05.006\">lower activity in the brain’s “caudate head,”\u003c/a> a region that mediates the reward pathway and is necessary for generating a feeling of satisfaction. Researchers have hypothesized that this decreased activity could lead a diet soda drinker to compensate for the lack of pleasure they now derive from the food by increasing their consumption of all foods, not just soda.\u003c/p>\n\u003cp>Together these cellular and brain studies may explain why people who consume sweeteners still have a \u003ca href=\"https://doi.org/10.1371/journal.pone.0167241\">higher risk of obesity\u003c/a> than individuals who don’t consume these products.\u003c/p>\n\u003cp>\u003ca href=\"https://doi.org/10.1503/cmaj.161390\">As this debate on the pros and cons of these sugar substitutes rages on\u003c/a>, we must view these behavioral studies with a grain of salt (or sugar) because many diet soda drinkers – or any health-conscious individual who consumes zero-calorie sweeteners – already has the risk factors for obesity, diabetes, hypertension or heart disease. Those who are already overweight or obese may turn toward low-calorie drinks, making it look as though the diet sodas are causing their weight gain.\u003c/p>\n\u003cp>This same group may also be less likely to moderate their consumption. For example, those people may think that having a diet soda multiple times a week is much healthier than drinking one case of soda with sugar.[contextly_sidebar id=\"nPADPRMuF9gHM8AprlV1Wgo1Jciefs8f\"]\u003c/p>\n\u003cp>These findings signal that consumers and health practitioners all need to check our assumptions about the health benefits of these products. Sweeteners are everywhere, from beverages to salad dressing, from cookies to yogurt, and we must recognize that there is no guarantee that these chemicals won’t increase the burden of metabolic diseases in the future.\u003c/p>\n\u003cp>As a physician of internal medicine specializing in general prevention and public health, I would like to be able to tell my patients what the true risks and benefits are if they drink diet soda instead of water.\u003c/p>\n\u003cp>Legislators considering soda taxes to encourage better dietary habits perhaps should think about including foods with non-nutritive sweeteners. Of course, there is an argument to be made for being realistic and pursuing the lesser of two evils. But even if the negative consequences of sugar substitutes doesn’t sway our tax policy – for now – at least the medical community should be honest with the public about what they stand to lose or gain, consuming these foods.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan class=\"fn author-name\">Eunice Zhang is a c\u003c/span>linical fellow of preventive medicine at the University of Michigan. This article was originally published on \u003ca href=\"https://theconversation.com/diet-soda-may-be-hurting-your-diet-96181\" target=\"_blank\" rel=\"noopener\">The Conversation\u003c/a>.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"There is growing evidence that artificial sweeteners can alter healthy metabolic processes, specifically in the gut.","status":"publish","parent":0,"modified":1526664530,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":993},"headData":{"title":"Mounting Evidence Shows Diet Soda May Be Hurting Your Diet — Here's How | KQED","description":"There is growing evidence that artificial sweeteners can alter healthy metabolic processes, specifically in the gut.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Mounting Evidence Shows Diet Soda May Be Hurting Your Diet — Here's How","datePublished":"2018-05-18T17:21:53.000Z","dateModified":"2018-05-18T17:28:50.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"441680 https://ww2.kqed.org/futureofyou/?p=441680","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/05/18/diet-soda-may-be-hurting-your-diet/","disqusTitle":"Mounting Evidence Shows Diet Soda May Be Hurting Your Diet — Here's How","source":"Health","nprByline":"Eunice Zhang, University of Michigan, For\u003cbr />The Conversation\u003cimg src=\"https://counter.theconversation.com/content/91452/count.gif?distributor=republish-lightbox-advanced\" alt=\"The Conversation\" width=\"1\" height=\"1\" />","path":"/futureofyou/441680/diet-soda-may-be-hurting-your-diet","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Artificial sweeteners are everywhere, but the jury is still out on whether these chemicals are harmless. Also called non-nutritive sweeteners, these can be synthetic – such as saccharin and aspartame – or naturally derived, such as steviol, which comes from the Stevia plant. To date, the U.S. Food and Drug Administration has approved \u003ca href=\"https://www.fda.gov/Food/IngredientsPackagingLabeling/FoodAdditivesIngredients/ucm397725.htm\" target=\"_blank\" rel=\"noopener\">six types of artificial and two types of natural non-nutritive sweeteners\u003c/a> for use in food.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>That’s been great news for those working hard to curb their sugar consumption. \u003ca href=\"https://doi.org/10.3945/ajcn.111.030833\" target=\"_blank\" rel=\"noopener\">Aspartame\u003c/a>, for example, is found in more than 6,000 foods worldwide, and about 5,000-5,500 tons are consumed every year in the United States alone.\u003c/p>\n\u003cp>The American Diabetes Association – the most well-respected professional group focusing on diabetes – \u003ca href=\"http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices/what-can-i-drink.html\" target=\"_blank\" rel=\"noopener\">officially recommends diet soda as an alternative\u003c/a> to sugar-sweetened beverages. To date, seven U.S. municipalities have imposed a sugary beverage tax to discourage consumption.\u003c/p>\n\u003cp>However, recent medical studies suggest that policymakers eager to implement a soda tax may also want to include diet drinks because these sweeteners may be contributing to chronic diabetes and cardiovascular diseases as well.\u003c/p>\n\u003cp>\u003cstrong>Why Are These Sweeteners Calorie-Free?\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The key to these virtually calorie-free sweeteners is that they are not broken down during digestion into natural sugars like glucose, fructose and galactose, which are then either used for energy or converted into fat.\u003c/p>\n\u003cp>Non-nutritive sweeteners have different byproducts that are not converted into calories. Aspartame, for example, undergoes a different metabolic process that doesn’t yield simple sugars. Others such as saccharin and sucralose are not broken down at all, but instead are absorbed directly into the bloodstream and excreted in the urine.\u003c/p>\n\u003cp>Theoretically, these sweeteners should be a “better” choice than sugar for diabetics. Glucose stimulates release of insulin, a hormone that regulates blood sugar levels. Type 2 diabetes occurs when the body no longer responds as well to insulin as it should, leading to higher levels of glucose in the blood that damages the nerves, kidneys, blood vessels and heart. Since non-nutritive sweeteners aren’t actually sugar, they should sidestep this problem.\u003c/p>\n\u003cp>\u003cstrong>Artificial Sweeteners, Your Brain and Your Microbiome\u003c/strong>\u003c/p>\n\u003cp>However, there is growing evidence over the last decade that these sweeteners can alter healthy metabolic processes in other ways, specifically in the gut.\u003c/p>\n\u003cp>Long-term use of these sweeteners has \u003ca href=\"https://doi.org/10.2337/dc08-1799\" target=\"_blank\" rel=\"noopener\">been associated with a higher risk of Type 2 diabetes\u003c/a>. Sweeteners, such as saccharin, have been shown to \u003ca href=\"http://doi.org/10.1038/nature13793\" target=\"_blank\" rel=\"noopener\">change the type and function of the gut microbiome\u003c/a>, the community of microorganisms that live in the intestine. Aspartame \u003ca href=\"https://doi.org/10.1139/apnm-2016-0346\" target=\"_blank\" rel=\"noopener\">decreases the activity of a gut enzyme\u003c/a> that is normally protective against Type 2 diabetes. Furthermore, this response may be exacerbated by the “mismatch” between the body perceiving something as tasting sweet and the expected associated calories. The greater the discrepancy between the sweetness and actual caloric content, the \u003ca href=\"http://doi.org/10.1016/j.cub.2017.07.018\" target=\"_blank\" rel=\"noopener\">greater the metabolic dysregulation\u003c/a>.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Sweeteners have also been shown to change brain activity associated with eating sweet foods. A functional MRI exam, which studies brain activity by measuring blood flow, has shown that sucralose, compared to regular sugar, \u003ca href=\"https://doi.org/10.1016/j.appet.2011.12.001\">decreases activity in the amygdala\u003c/a>, a part of the brain involved with taste perception and the experience of eating.\u003c/p>\n\u003cp>Another study revealed that longer-term and higher diet soda consumption are linked to \u003ca href=\"https://doi.org/10.1016/j.physbeh.2012.05.006\">lower activity in the brain’s “caudate head,”\u003c/a> a region that mediates the reward pathway and is necessary for generating a feeling of satisfaction. Researchers have hypothesized that this decreased activity could lead a diet soda drinker to compensate for the lack of pleasure they now derive from the food by increasing their consumption of all foods, not just soda.\u003c/p>\n\u003cp>Together these cellular and brain studies may explain why people who consume sweeteners still have a \u003ca href=\"https://doi.org/10.1371/journal.pone.0167241\">higher risk of obesity\u003c/a> than individuals who don’t consume these products.\u003c/p>\n\u003cp>\u003ca href=\"https://doi.org/10.1503/cmaj.161390\">As this debate on the pros and cons of these sugar substitutes rages on\u003c/a>, we must view these behavioral studies with a grain of salt (or sugar) because many diet soda drinkers – or any health-conscious individual who consumes zero-calorie sweeteners – already has the risk factors for obesity, diabetes, hypertension or heart disease. Those who are already overweight or obese may turn toward low-calorie drinks, making it look as though the diet sodas are causing their weight gain.\u003c/p>\n\u003cp>This same group may also be less likely to moderate their consumption. For example, those people may think that having a diet soda multiple times a week is much healthier than drinking one case of soda with sugar.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>These findings signal that consumers and health practitioners all need to check our assumptions about the health benefits of these products. Sweeteners are everywhere, from beverages to salad dressing, from cookies to yogurt, and we must recognize that there is no guarantee that these chemicals won’t increase the burden of metabolic diseases in the future.\u003c/p>\n\u003cp>As a physician of internal medicine specializing in general prevention and public health, I would like to be able to tell my patients what the true risks and benefits are if they drink diet soda instead of water.\u003c/p>\n\u003cp>Legislators considering soda taxes to encourage better dietary habits perhaps should think about including foods with non-nutritive sweeteners. Of course, there is an argument to be made for being realistic and pursuing the lesser of two evils. But even if the negative consequences of sugar substitutes doesn’t sway our tax policy – for now – at least the medical community should be honest with the public about what they stand to lose or gain, consuming these foods.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan class=\"fn author-name\">Eunice Zhang is a c\u003c/span>linical fellow of preventive medicine at the University of Michigan. This article was originally published on \u003ca href=\"https://theconversation.com/diet-soda-may-be-hurting-your-diet-96181\" target=\"_blank\" rel=\"noopener\">The Conversation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/441680/diet-soda-may-be-hurting-your-diet","authors":["byline_futureofyou_441680"],"categories":["futureofyou_1060","futureofyou_1","futureofyou_73"],"tags":["futureofyou_312","futureofyou_309","futureofyou_38","futureofyou_426","futureofyou_61","futureofyou_1071"],"collections":["futureofyou_1093"],"featImg":"futureofyou_441686","label":"source_futureofyou_441680"},"futureofyou_440094":{"type":"posts","id":"futureofyou_440094","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440094","score":null,"sort":[1521469806000]},"guestAuthors":[],"slug":"new-diabetes-monitors-require-fewer-pricks-less-guessing","title":"New Diabetes Monitors Require Fewer Pricks, Less Guessing","publishDate":1521469806,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003ch3>\u003cem>Continuous glucose monitors have been around for over a decade, but reductions in cost and improvements in quality have enticed more patients and doctors to try them out.\u003c/em>\u003c/h3>\n\u003cp>For Melissa Lee, the worst part of diabetes isn’t pricking her finger to check her glucose level or changing her diet to keep her blood sugar in check. Rather, it’s the constant worry and mental calculations.\u003c/p>\n\u003caside class=\"pullquote alignright\">'In a perfect world, everybody with diabetes would benefit from some form of this technology.'\u003ccite>Kathleen Dungan, Ohio State University\u003c/cite>\u003c/aside>\n\u003cp>“You have to think about what did I eat last, how much insulin did I take for that, where is my blood sugar now, which direction is it trending, and then based on that, what am I going to eat?” she says. “You’re making these educated guesses about how much of a really volatile hormone [insulin] to take, and that is mentally exhausting.”\u003c/p>\n\u003cp>Lee, 38, who was diagnosed with Type 1 diabetes when she was 10, recounts ruined dates, missed flights and abandoned excursions, all because she was worried about her glucose level or forgot to bring a replacement for her insulin pump.\u003c/p>\n\u003cp>“You can go from being okay to being really not okay in a moment’s notice,” says Lee, who lives in Milpitas, California and works as the director of community relations at Bigfoot Biomedical.\u003c/p>\n\u003cp>To relieve some of the burden for the estimated 9.3 million people who use insulin to regulate diabetes, medical device makers have introduced new ways to monitor glucose and administer insulin.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Better Glucose Management\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_440097\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"wp-image-440097 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi.jpg\" alt=\"FreeStyle Libre\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">Melissa Lee displays the components of the FreeStyle Libre, her blood glucose monitor. \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Continuous glucose monitors, or CGMs, have been around for over a decade, but poor quality and high costs have been barriers to use, says Irl Hirsch, who holds the Diabetes Treatment and Teaching Chair at the University of Washington School of Medicine. But improvements on both fronts lead him to believe that CGMs will soon become the standard of care. At his own clinic, 60 percent of patients use one.\u003c/p>\n\u003cp>“The financial impact and the insurance coverage is not the barrier that it used to be,” Hirsch says. What’s more, “The quality and the accuracy of these things have just gotten better.”\u003c/p>\n\u003cp>CGMs measure glucose levels not in blood but in the interstitial fluid, which surrounds the cells just underneath the skin. A sensor sticks onto the body, typically on the upper arm or abdomen, with a small, flexible needle that penetrates the skin. The sensor takes a reading every 5 to 15 minutes and transmits that information to a separate receiver or a smartphone app, which patients can check at any time. The reading shows their current glucose level and a trend graph for the last eight hours. If the number is high and rising, the patient can bring their glucose down using insulin; if it’s low and dropping, they need to eat some sugar, fast.\u003c/p>\n\u003cp>“It's very exciting technology. I think it's really revolutionizing diabetes care,” says Kathleen Dungan, an associate professor of medicine at Ohio State University who runs the school’s endocrine clinical trials unit. “In a perfect world, everybody with diabetes would benefit from some form of this technology.”\u003c/p>\n\u003cp>\u003cstrong>Too Little Insulin\u003c/strong>\u003c/p>\n\u003cp>Every time you eat, your pancreas pumps out insulin to help your cells extract glucose from the blood and use it for fuel. In Type I diabetes, the pancreas stops producing insulin, while in Type II the cells can’t utilize the hormone properly. In either case, too little insulin causes excessive blood glucose levels. Chronic high blood sugar, or hyperglycemia, can lead to heart disease, kidney disease, stroke, nerve damage, blindness and loss of limbs.\u003c/p>\n\u003cfigure id=\"attachment_440099\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"size-full wp-image-440099\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi.jpg\" alt=\"Melissa Lee, who was diagnosed with type one diabetes at 10 years old, models the FreeStyle Libre in Hayward, Calif.\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">Melissa Lee, who was diagnosed with Type 1 diabetes at 10 years old, models the FreeStyle Libre, \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In contrast, too much insulin results in low blood sugar, or hypoglycemia, which can cause weakness, dizzy spells, seizures, shaking, fainting and even death.\u003c/p>\n\u003cp>Patients typically use blood glucose meters that measure sugar levels in a drop of blood to determine if they need to take more insulin or not. However, having to prick your finger and draw blood to check your glucose level can be a major hurdle for maintaining normal blood sugar. Some patients may have aversions to needles, while others may have difficulty creating a sterile environment in which to take a reading.\u003c/p>\n\u003cp>\u003cstrong>Popular CGMs\u003c/strong>\u003c/p>\n\u003cp>CGMs aim to ease that pain and inconvenience. Dexcom and Abbott are two of the largest producers of CGMs, with Abbott’s FreeStyle Libre the newest device approved by the FDA, in September 2017.\u003c/p>\n\u003cp>The Libre sensors last for 10 days and cost $59 each. Sensors for Dexcom’s G4 or G5 system are $350 for a pack of four and have to be replaced every seven days. Patients also have to purchase a receiver, about $60 for the Libre versus $465 for the Dexcom G5. Finally, Dexcom requires a separate transmitter to send the glucose information to the receiver, another $595. Both companies’ devices are covered by major insurance providers and Medicare, so the actual cost to patients varies.\u003c/p>\n\u003cfigure id=\"attachment_440100\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-440100\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/IMG_0829-1020x680.jpg\" alt=\"Ken Reutell of Petaluma, Calif. displays his MiniMed 670G\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-520x347.jpg 520w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Ken Reutell of Petaluma, Calif. displays his MiniMed 670G. \u003ccite>(Danielle Venton/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Libre is the only monitor that doesn’t have to be calibrated daily with a traditional blood glucose reading, meaning patients never have to prick their fingers.\u003c/p>\n\u003cp>Studies show that patients who use a CGM have \u003ca href=\"http://care.diabetesjournals.org/content/40/Supplement_1/S48\" target=\"_blank\" rel=\"noopener\">better control over their diabetes\u003c/a> than patients who use traditional blood glucose tests. Doctors recommend patients check their glucose between \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/blood-sugar/art-20046628\" target=\"_blank\" rel=\"noopener\">4 and 10 times per day\u003c/a>, but in reality, only \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/14999899\" target=\"_blank\" rel=\"noopener\">one-third of patients\u003c/a> test themselves as often as they should. Abbott says patients using its device easily exceed this standard, checking on average 16 times a day.\u003c/p>\n\u003cp>Lee, who uses the FreeStyle Libre, says being able to easily check her blood glucose helps her know how it's affected by her diet. “You suddenly have this insight into how actions you took actually affected some kind of diabetes outcome,” she says.\u003c/p>\n\u003cp>Another Type 1 diabetes patient, Lisa Trahan, 33, yses the Dexcom G4 and says it’s “terrific.” Trahan, a clinical psychologist based in San Marcos, Texas, says the frequent readings provide her with more peace of mind, especially before exercising or eating. However, she still doesn’t trust the device enough to forego pricking her finger to double check the numbers.\u003c/p>\n\u003cfigure id=\"attachment_440101\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-440101\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/IMG_0816-800x533.jpg\" alt=\"A man's hand holds a small gaget.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ken Reutell's MiniMed 670G means he spends less time pricking himself to monitor his blood glucose levels. \u003ccite>(Danielle Venton/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I can trust the CGM reading of my Dexcom G4 to be within 20 percent in either direction of my actual blood sugar reading,” she explains. But, she says, that range can make a big difference when tinkering with blood sugar or insulin. “I use the alert as a suggestion to check my blood sugar and go from there.”\u003c/p>\n\u003cp>\u003cstrong>Smarter Insulin Pumps\u003c/strong>\u003c/p>\n\u003cp>Besides checking blood sugar, the other part of managing diabetes is taking insulin, either with an injection or an insulin pump.\u003c/p>\n\u003cp>Traditional insulin pumps are preset to deliver different doses at certain times of the day. However, it can be difficult to match the correct dose to fluctuations in glucose levels that occur naturally throughout the day or because of diet or exercise. A patient or doctor can adjust the levels manually, but it requires complex calculations and typically isn’t done every day.\u003c/p>\n\u003cp>Medtronic’s MiniMed 670G, the first integrated CGM-insulin pump system approved by the FDA in 2016, aims to solve that problem. The 670G can vary the amount of insulin it delivers as often as every five minutes, in response to input from an integrated glucose monitor.\u003c/p>\n\u003cp>The only calculation patients have to make is to manually deliver a boost of insulin every time they eat that is proportionate to the number of carbohydrates in the meal. They also need to prick their fingers three times a day to calibrate the system.\u003c/p>\n\u003cp>Despite the excitement over the 670G, the price can be prohibitive, running between $6,000 and $9,000. Medtronic says some of the cost is covered by insurance.\u003c/p>\n\u003cp>\u003cstrong>A Debate Over Alarms\u003c/strong>\u003c/p>\n\u003cp>Because low glucose levels can be so dangerous, most monitors have built-in alarms that go off when a patient’s glucose has dropped too low. However, Abbott’s FreeStyle Libre does not. Hirsch, the diabetes expert from the University of Washington, says because of this he recommends Dexcom’s CGM, even though the Libre is less expensive and easier to use.\u003c/p>\n\u003cp>The MiniMed 670G also has an alarm, and to patient Ken Reutell, 67, from Petaluma, California, this is a great feature. In the past he’s had to call 911 and has even passed out because his blood sugar had dropped so low. He's used the 670G for six months and says the alarm alerts him well before he gets to that point. Other users, however, have \u003ca href=\"https://www.reddit.com/r/diabetes_t1/comments/7sjpsi/just_placed_on_order_for_the_medtronic_790/dt5oh0l/\" target=\"_blank\" rel=\"noopener\">complained\u003c/a> that the 670G’s alarm is loud and goes off too frequently.\u003c/p>\n\u003cp>And while the device can alert a patient to a dangerously low glucose level, it can’t do anything about it because it doesn’t administer glucose.\u003c/p>\n\u003cp>“(W)hen you get too low, your liver starts pumping out more glucose. That’s something that insulin pumps don’t do yet,” Reutell laments.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Something for the next generation of devices, perhaps.\u003c/p>\n\n","blocks":[],"excerpt":"Continuous glucose monitors have been around for over a decade, but reductions in cost and improvements in quality have enticed more patients and doctors to try them out.","status":"publish","parent":0,"modified":1521487176,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":36,"wordCount":1621},"headData":{"title":"New Diabetes Monitors Require Fewer Pricks, Less Guessing | KQED","description":"Continuous glucose monitors have been around for over a decade, but reductions in cost and improvements in quality have enticed more patients and doctors to try them out.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"New Diabetes Monitors Require Fewer Pricks, Less Guessing","datePublished":"2018-03-19T14:30:06.000Z","dateModified":"2018-03-19T19:19:36.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440094 https://ww2.kqed.org/futureofyou/?p=440094","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/03/19/new-diabetes-monitors-require-fewer-pricks-less-guessing/","disqusTitle":"New Diabetes Monitors Require Fewer Pricks, Less Guessing","sourceUrl":"DIY Health","nprByline":"Dana Smith","path":"/futureofyou/440094/new-diabetes-monitors-require-fewer-pricks-less-guessing","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003ch3>\u003cem>Continuous glucose monitors have been around for over a decade, but reductions in cost and improvements in quality have enticed more patients and doctors to try them out.\u003c/em>\u003c/h3>\n\u003cp>For Melissa Lee, the worst part of diabetes isn’t pricking her finger to check her glucose level or changing her diet to keep her blood sugar in check. Rather, it’s the constant worry and mental calculations.\u003c/p>\n\u003caside class=\"pullquote alignright\">'In a perfect world, everybody with diabetes would benefit from some form of this technology.'\u003ccite>Kathleen Dungan, Ohio State University\u003c/cite>\u003c/aside>\n\u003cp>“You have to think about what did I eat last, how much insulin did I take for that, where is my blood sugar now, which direction is it trending, and then based on that, what am I going to eat?” she says. “You’re making these educated guesses about how much of a really volatile hormone [insulin] to take, and that is mentally exhausting.”\u003c/p>\n\u003cp>Lee, 38, who was diagnosed with Type 1 diabetes when she was 10, recounts ruined dates, missed flights and abandoned excursions, all because she was worried about her glucose level or forgot to bring a replacement for her insulin pump.\u003c/p>\n\u003cp>“You can go from being okay to being really not okay in a moment’s notice,” says Lee, who lives in Milpitas, California and works as the director of community relations at Bigfoot Biomedical.\u003c/p>\n\u003cp>To relieve some of the burden for the estimated 9.3 million people who use insulin to regulate diabetes, medical device makers have introduced new ways to monitor glucose and administer insulin.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Better Glucose Management\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_440097\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"wp-image-440097 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi.jpg\" alt=\"FreeStyle Libre\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">Melissa Lee displays the components of the FreeStyle Libre, her blood glucose monitor. \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Continuous glucose monitors, or CGMs, have been around for over a decade, but poor quality and high costs have been barriers to use, says Irl Hirsch, who holds the Diabetes Treatment and Teaching Chair at the University of Washington School of Medicine. But improvements on both fronts lead him to believe that CGMs will soon become the standard of care. At his own clinic, 60 percent of patients use one.\u003c/p>\n\u003cp>“The financial impact and the insurance coverage is not the barrier that it used to be,” Hirsch says. What’s more, “The quality and the accuracy of these things have just gotten better.”\u003c/p>\n\u003cp>CGMs measure glucose levels not in blood but in the interstitial fluid, which surrounds the cells just underneath the skin. A sensor sticks onto the body, typically on the upper arm or abdomen, with a small, flexible needle that penetrates the skin. The sensor takes a reading every 5 to 15 minutes and transmits that information to a separate receiver or a smartphone app, which patients can check at any time. The reading shows their current glucose level and a trend graph for the last eight hours. If the number is high and rising, the patient can bring their glucose down using insulin; if it’s low and dropping, they need to eat some sugar, fast.\u003c/p>\n\u003cp>“It's very exciting technology. I think it's really revolutionizing diabetes care,” says Kathleen Dungan, an associate professor of medicine at Ohio State University who runs the school’s endocrine clinical trials unit. “In a perfect world, everybody with diabetes would benefit from some form of this technology.”\u003c/p>\n\u003cp>\u003cstrong>Too Little Insulin\u003c/strong>\u003c/p>\n\u003cp>Every time you eat, your pancreas pumps out insulin to help your cells extract glucose from the blood and use it for fuel. In Type I diabetes, the pancreas stops producing insulin, while in Type II the cells can’t utilize the hormone properly. In either case, too little insulin causes excessive blood glucose levels. Chronic high blood sugar, or hyperglycemia, can lead to heart disease, kidney disease, stroke, nerve damage, blindness and loss of limbs.\u003c/p>\n\u003cfigure id=\"attachment_440099\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"size-full wp-image-440099\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi.jpg\" alt=\"Melissa Lee, who was diagnosed with type one diabetes at 10 years old, models the FreeStyle Libre in Hayward, Calif.\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">Melissa Lee, who was diagnosed with Type 1 diabetes at 10 years old, models the FreeStyle Libre, \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In contrast, too much insulin results in low blood sugar, or hypoglycemia, which can cause weakness, dizzy spells, seizures, shaking, fainting and even death.\u003c/p>\n\u003cp>Patients typically use blood glucose meters that measure sugar levels in a drop of blood to determine if they need to take more insulin or not. However, having to prick your finger and draw blood to check your glucose level can be a major hurdle for maintaining normal blood sugar. Some patients may have aversions to needles, while others may have difficulty creating a sterile environment in which to take a reading.\u003c/p>\n\u003cp>\u003cstrong>Popular CGMs\u003c/strong>\u003c/p>\n\u003cp>CGMs aim to ease that pain and inconvenience. Dexcom and Abbott are two of the largest producers of CGMs, with Abbott’s FreeStyle Libre the newest device approved by the FDA, in September 2017.\u003c/p>\n\u003cp>The Libre sensors last for 10 days and cost $59 each. Sensors for Dexcom’s G4 or G5 system are $350 for a pack of four and have to be replaced every seven days. Patients also have to purchase a receiver, about $60 for the Libre versus $465 for the Dexcom G5. Finally, Dexcom requires a separate transmitter to send the glucose information to the receiver, another $595. Both companies’ devices are covered by major insurance providers and Medicare, so the actual cost to patients varies.\u003c/p>\n\u003cfigure id=\"attachment_440100\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-440100\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/IMG_0829-1020x680.jpg\" alt=\"Ken Reutell of Petaluma, Calif. displays his MiniMed 670G\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-520x347.jpg 520w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Ken Reutell of Petaluma, Calif. displays his MiniMed 670G. \u003ccite>(Danielle Venton/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Libre is the only monitor that doesn’t have to be calibrated daily with a traditional blood glucose reading, meaning patients never have to prick their fingers.\u003c/p>\n\u003cp>Studies show that patients who use a CGM have \u003ca href=\"http://care.diabetesjournals.org/content/40/Supplement_1/S48\" target=\"_blank\" rel=\"noopener\">better control over their diabetes\u003c/a> than patients who use traditional blood glucose tests. Doctors recommend patients check their glucose between \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/blood-sugar/art-20046628\" target=\"_blank\" rel=\"noopener\">4 and 10 times per day\u003c/a>, but in reality, only \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/14999899\" target=\"_blank\" rel=\"noopener\">one-third of patients\u003c/a> test themselves as often as they should. Abbott says patients using its device easily exceed this standard, checking on average 16 times a day.\u003c/p>\n\u003cp>Lee, who uses the FreeStyle Libre, says being able to easily check her blood glucose helps her know how it's affected by her diet. “You suddenly have this insight into how actions you took actually affected some kind of diabetes outcome,” she says.\u003c/p>\n\u003cp>Another Type 1 diabetes patient, Lisa Trahan, 33, yses the Dexcom G4 and says it’s “terrific.” Trahan, a clinical psychologist based in San Marcos, Texas, says the frequent readings provide her with more peace of mind, especially before exercising or eating. However, she still doesn’t trust the device enough to forego pricking her finger to double check the numbers.\u003c/p>\n\u003cfigure id=\"attachment_440101\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-440101\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/IMG_0816-800x533.jpg\" alt=\"A man's hand holds a small gaget.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ken Reutell's MiniMed 670G means he spends less time pricking himself to monitor his blood glucose levels. \u003ccite>(Danielle Venton/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I can trust the CGM reading of my Dexcom G4 to be within 20 percent in either direction of my actual blood sugar reading,” she explains. But, she says, that range can make a big difference when tinkering with blood sugar or insulin. “I use the alert as a suggestion to check my blood sugar and go from there.”\u003c/p>\n\u003cp>\u003cstrong>Smarter Insulin Pumps\u003c/strong>\u003c/p>\n\u003cp>Besides checking blood sugar, the other part of managing diabetes is taking insulin, either with an injection or an insulin pump.\u003c/p>\n\u003cp>Traditional insulin pumps are preset to deliver different doses at certain times of the day. However, it can be difficult to match the correct dose to fluctuations in glucose levels that occur naturally throughout the day or because of diet or exercise. A patient or doctor can adjust the levels manually, but it requires complex calculations and typically isn’t done every day.\u003c/p>\n\u003cp>Medtronic’s MiniMed 670G, the first integrated CGM-insulin pump system approved by the FDA in 2016, aims to solve that problem. The 670G can vary the amount of insulin it delivers as often as every five minutes, in response to input from an integrated glucose monitor.\u003c/p>\n\u003cp>The only calculation patients have to make is to manually deliver a boost of insulin every time they eat that is proportionate to the number of carbohydrates in the meal. They also need to prick their fingers three times a day to calibrate the system.\u003c/p>\n\u003cp>Despite the excitement over the 670G, the price can be prohibitive, running between $6,000 and $9,000. Medtronic says some of the cost is covered by insurance.\u003c/p>\n\u003cp>\u003cstrong>A Debate Over Alarms\u003c/strong>\u003c/p>\n\u003cp>Because low glucose levels can be so dangerous, most monitors have built-in alarms that go off when a patient’s glucose has dropped too low. However, Abbott’s FreeStyle Libre does not. Hirsch, the diabetes expert from the University of Washington, says because of this he recommends Dexcom’s CGM, even though the Libre is less expensive and easier to use.\u003c/p>\n\u003cp>The MiniMed 670G also has an alarm, and to patient Ken Reutell, 67, from Petaluma, California, this is a great feature. In the past he’s had to call 911 and has even passed out because his blood sugar had dropped so low. He's used the 670G for six months and says the alarm alerts him well before he gets to that point. Other users, however, have \u003ca href=\"https://www.reddit.com/r/diabetes_t1/comments/7sjpsi/just_placed_on_order_for_the_medtronic_790/dt5oh0l/\" target=\"_blank\" rel=\"noopener\">complained\u003c/a> that the 670G’s alarm is loud and goes off too frequently.\u003c/p>\n\u003cp>And while the device can alert a patient to a dangerously low glucose level, it can’t do anything about it because it doesn’t administer glucose.\u003c/p>\n\u003cp>“(W)hen you get too low, your liver starts pumping out more glucose. That’s something that insulin pumps don’t do yet,” Reutell laments.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Something for the next generation of devices, perhaps.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440094/new-diabetes-monitors-require-fewer-pricks-less-guessing","authors":["byline_futureofyou_440094"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_309","futureofyou_26","futureofyou_128","futureofyou_80"],"featImg":"futureofyou_440096","label":"futureofyou"},"futureofyou_435719":{"type":"posts","id":"futureofyou_435719","meta":{"index":"posts_1591205157","site":"futureofyou","id":"435719","score":null,"sort":[1506702749000]},"guestAuthors":[],"slug":"coming-soon-continuous-glucose-monitoring-and-no-finger-pricks","title":"Coming Soon: Continuous Glucose Monitoring, With No Finger Pricks","publishDate":1506702749,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>U.S. regulators have approved the first continuous blood sugar monitor for diabetics that doesn't need backup finger prick tests.\u003c/p>\n\u003cp>Current models require users to test a drop of blood twice daily to calibrate, or adjust, the monitor.\u003c/p>\n\u003cp>The pain of finger sticks and the cost of testing supplies discourage many people from keeping close tabs on their blood sugar, which is needed to manage insulin use and adjust what they eat.\u003c/p>\n\u003cp>Abbott's new FreeStyle Libre Flash Glucose Monitoring System, approved Wednesday by the Food and Drug Administration, uses a small sensor attached to the upper arm. Patients wave a reader device over it to see the current blood sugar level and changes over the past eight hours.\u003c/p>\n\u003cp>Most of the 30 million Americans with diabetes use standard glucose meters, which require multiple finger pricks each day and only show current sugar level. More-accurate continuous glucose monitoring devices are used by about 345,000 Americans.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But most don't do the finger pricks to calibrate them and may get inaccurate readings, said Dr. Timothy Bailey, who helped test FreeStyle Libre.\u003c/p>\n\u003cp>\"We're able to lower blood sugar safely\" with this technology, said Bailey, director of the Advanced Metabolic Care and Research Institute in California. He receives consulting fees from various diabetes device makers.\u003c/p>\n\u003cp>Too-high blood sugar levels can damage organs and lead to heart attacks, strokes, blindness and amputations. Very low blood sugar can cause seizures, confusion and loss of consciousness.\u003c/p>\n\u003cp>Abbott's device was approved for adults with Type 1 or Type 2 diabetes and should be available in pharmacies within months. The company, based near Chicago, did not disclose the price of the reader or the sensors.\u003c/p>\n\u003cp>Abbott's system can't be used with an insulin pump, a device worn against the skin that allows users to inject insulin as needed, but the company is planning improvements to eventually enable that.\u003c/p>\n\u003cp>Rival Medtronic this spring launched a device in which the insulin pump automatically responds to blood sugar changes recorded by the sensor and either withholds or injects insulin as needed.\u003c/p>\n\u003cp>The pain of finger sticks and the cost of testing supplies discourage many people from keeping close tabs on their blood sugar, which is needed to manage insulin use and adjust what they eat.\u003c/p>\n\u003cp>Abbott's new FreeStyle Libre Flash Glucose Monitoring System, approved Wednesday by the Food and Drug Administration, uses a small sensor attached to the upper arm. Patients wave a reader device over it to see the current blood sugar level and changes over the past eight hours.\u003c/p>\n\u003cp>Most of the 30 million Americans with diabetes use standard glucose meters, which require multiple finger pricks each day and only show current sugar level. More-accurate continuous glucose monitoring devices are used by about 345,000 Americans.\u003c/p>\n\u003cp>But most don't do the finger pricks to calibrate them and may get inaccurate readings, said\u003cbr>\nDr. Timothy Bailey, who helped test FreeStyle Libre.\u003c/p>\n\u003cp>\"We're able to lower blood sugar safely\" with this technology, said Bailey, director of the Advanced Metabolic Care and Research Institute in California. He receives consulting fees from various diabetes device makers.\u003c/p>\n\u003cp>Too-high blood sugar levels can damage organs and lead to heart attacks, strokes, blindness and amputations. Very low blood sugar can cause seizures, confusion and loss of consciousness.\u003c/p>\n\u003cp>Abbott's device was approved for adults with Type 1 or Type 2 diabetes and should be available in pharmacies within months. The company, based near Chicago, did not disclose the price of the reader or the sensors.\u003c/p>\n\u003cp>Abbott's system can't be used with an insulin pump, a device worn against the skin that allows users to inject insulin as needed, but the company is planning improvements to eventually enable that.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Rival Medtronic this spring launched a device in which the insulin pump automatically responds to blood sugar changes recorded by the sensor and either withholds or injects insulin as needed.\u003c/p>\n\n","blocks":[],"excerpt":"U.S. regulators have approved the first continuous blood sugar monitor for diabetics that doesn't need backup finger prick tests.\r\n","status":"publish","parent":0,"modified":1506714872,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":659},"headData":{"title":"Coming Soon: Continuous Glucose Monitoring, With No Finger Pricks | KQED","description":"U.S. regulators have approved the first continuous blood sugar monitor for diabetics that doesn't need backup finger prick tests.\r\n","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Coming Soon: Continuous Glucose Monitoring, With No Finger Pricks","datePublished":"2017-09-29T16:32:29.000Z","dateModified":"2017-09-29T19:54:32.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"435719 https://ww2.kqed.org/futureofyou/?p=435719","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/09/29/coming-soon-continuous-glucose-monitoring-and-no-finger-pricks/","disqusTitle":"Coming Soon: Continuous Glucose Monitoring, With No Finger Pricks","nprByline":"Linda A. Johnson\u003cbr />Associated Press","path":"/futureofyou/435719/coming-soon-continuous-glucose-monitoring-and-no-finger-pricks","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>U.S. regulators have approved the first continuous blood sugar monitor for diabetics that doesn't need backup finger prick tests.\u003c/p>\n\u003cp>Current models require users to test a drop of blood twice daily to calibrate, or adjust, the monitor.\u003c/p>\n\u003cp>The pain of finger sticks and the cost of testing supplies discourage many people from keeping close tabs on their blood sugar, which is needed to manage insulin use and adjust what they eat.\u003c/p>\n\u003cp>Abbott's new FreeStyle Libre Flash Glucose Monitoring System, approved Wednesday by the Food and Drug Administration, uses a small sensor attached to the upper arm. Patients wave a reader device over it to see the current blood sugar level and changes over the past eight hours.\u003c/p>\n\u003cp>Most of the 30 million Americans with diabetes use standard glucose meters, which require multiple finger pricks each day and only show current sugar level. More-accurate continuous glucose monitoring devices are used by about 345,000 Americans.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But most don't do the finger pricks to calibrate them and may get inaccurate readings, said Dr. Timothy Bailey, who helped test FreeStyle Libre.\u003c/p>\n\u003cp>\"We're able to lower blood sugar safely\" with this technology, said Bailey, director of the Advanced Metabolic Care and Research Institute in California. He receives consulting fees from various diabetes device makers.\u003c/p>\n\u003cp>Too-high blood sugar levels can damage organs and lead to heart attacks, strokes, blindness and amputations. Very low blood sugar can cause seizures, confusion and loss of consciousness.\u003c/p>\n\u003cp>Abbott's device was approved for adults with Type 1 or Type 2 diabetes and should be available in pharmacies within months. The company, based near Chicago, did not disclose the price of the reader or the sensors.\u003c/p>\n\u003cp>Abbott's system can't be used with an insulin pump, a device worn against the skin that allows users to inject insulin as needed, but the company is planning improvements to eventually enable that.\u003c/p>\n\u003cp>Rival Medtronic this spring launched a device in which the insulin pump automatically responds to blood sugar changes recorded by the sensor and either withholds or injects insulin as needed.\u003c/p>\n\u003cp>The pain of finger sticks and the cost of testing supplies discourage many people from keeping close tabs on their blood sugar, which is needed to manage insulin use and adjust what they eat.\u003c/p>\n\u003cp>Abbott's new FreeStyle Libre Flash Glucose Monitoring System, approved Wednesday by the Food and Drug Administration, uses a small sensor attached to the upper arm. Patients wave a reader device over it to see the current blood sugar level and changes over the past eight hours.\u003c/p>\n\u003cp>Most of the 30 million Americans with diabetes use standard glucose meters, which require multiple finger pricks each day and only show current sugar level. More-accurate continuous glucose monitoring devices are used by about 345,000 Americans.\u003c/p>\n\u003cp>But most don't do the finger pricks to calibrate them and may get inaccurate readings, said\u003cbr>\nDr. Timothy Bailey, who helped test FreeStyle Libre.\u003c/p>\n\u003cp>\"We're able to lower blood sugar safely\" with this technology, said Bailey, director of the Advanced Metabolic Care and Research Institute in California. He receives consulting fees from various diabetes device makers.\u003c/p>\n\u003cp>Too-high blood sugar levels can damage organs and lead to heart attacks, strokes, blindness and amputations. Very low blood sugar can cause seizures, confusion and loss of consciousness.\u003c/p>\n\u003cp>Abbott's device was approved for adults with Type 1 or Type 2 diabetes and should be available in pharmacies within months. The company, based near Chicago, did not disclose the price of the reader or the sensors.\u003c/p>\n\u003cp>Abbott's system can't be used with an insulin pump, a device worn against the skin that allows users to inject insulin as needed, but the company is planning improvements to eventually enable that.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Rival Medtronic this spring launched a device in which the insulin pump automatically responds to blood sugar changes recorded by the sensor and either withholds or injects insulin as needed.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/435719/coming-soon-continuous-glucose-monitoring-and-no-finger-pricks","authors":["byline_futureofyou_435719"],"categories":["futureofyou_1062"],"tags":["futureofyou_309","futureofyou_1366","futureofyou_128"],"featImg":"futureofyou_435721","label":"futureofyou"},"futureofyou_434678":{"type":"posts","id":"futureofyou_434678","meta":{"index":"posts_1591205157","site":"futureofyou","id":"434678","score":null,"sort":[1502373602000]},"guestAuthors":[],"slug":"when-wounds-wont-heal-therapies-spread-to-the-tune-of-5-billion","title":"When Wounds Won’t Heal, Therapies Spread — To The Tune Of $5 Billion","publishDate":1502373602,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>PHILADELPHIA — Carol Emanuele beat cancer. But for the past two years, she has been fighting her toughest battle yet. She has an open wound on the bottom of her foot that leaves her unable to walk and prone to deadly infection.\u003c/p>\n\u003cp>In an effort to treat her diabetic wound, doctors at a Philadelphia clinic have prescribed a dizzying array of treatments. Freeze-dried placenta. Penis foreskin cells. High doses of pressurized oxygen. And those are just a few of the treatment options patients face.\u003c/p>\n\u003cp>“I do everything, but nothing seems to work,” said Emanuele, 59, who survived stage 4 melanoma in her 30s. “I beat cancer, but this is worse.”\u003c/p>\n\u003cp>The doctors who care for the 6.5 million patients with chronic wounds know the depths of their struggles. Their open, festering wounds don’t heal for months and sometimes years, leaving bare bones and tendons that evoke disgust even among their closest relatives.\u003c/p>\n\u003cfigure class=\"related\">\u003c/figure>\n\u003cp>Many patients end up immobilized, unable to work and dependent on Medicare and Medicaid. In their quest to heal, they turn to expensive and sometimes painful procedures, and products that often don’t work\u003cstrong>.\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s an amazingly crappy area in terms of the quality of research. I don’t think they have anything that involves singing to wounds, but it wouldn’t shock me.”\u003ccite>Sean Tunis, chief medical officer for Medicare from 2002 to 2005\u003c/cite>\u003c/aside>\n\u003cp>According to some estimates, Medicare alone spends at least $25 billion a year treating these wounds. But many widely used treatments aren’t supported by credible research. The $5 billion-a-year wound care business booms while some products might prove little more effective than the proverbial snake oil. The vast majority of the studies are funded or conducted by companies who manufacture these products. At the same time, independent academic research is scant for a growing problem.\u003c/p>\n\u003cfigure id=\"attachment_434681\" class=\"wp-caption aligncenter\" style=\"max-width: 770px\">\u003cimg class=\"size-full wp-image-434681\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/08/chronic-wounds-3.jpg\" alt=\"\" width=\"770\" height=\"513\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-3.jpg 770w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-3-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-3-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-3-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-3-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-3-520x346.jpg 520w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003cfigcaption class=\"wp-caption-text\">Carol Emanuele sits at home in Philadelphia. Emanuele was diagnosed with diabetes in 2015 and also survived stage 4 melanoma when she was 38. \u003ccite>(Eileen Blass for Kaiser Health News)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It’s an amazingly crappy area in terms of the quality of research,” said \u003ca href=\"http://www.cmtpnet.org/about/team/\">Sean Tunis\u003c/a>, who as chief medical officer for Medicare from 2002 to 2005 grappled with coverage decisions on wound care. “I don’t think they have anything that involves singing to wounds, but it wouldn’t shock me.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"http://journals.lww.com/plasreconsurg/Abstract/2016/09001/Dressing_and_Diabetic_Foot_Ulcers___A_Current.21.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">A 2016 review\u003c/a> of treatment for diabetic foot ulcers found “few published studies were of high quality, and the majority were susceptible to bias.” The review team included William Jeffcoate, a professor with the Department of Diabetes and Endocrinology at Nottingham University Hospitals Trust. Jeffcoate has overseen several reviews of the same treatment since 2006 and concluded that “the evidence to support many of the therapies that are in routine use is poor.”\u003c/p>\n\u003cp>A separate \u003ca href=\"https://www.effectivehealthcare.ahrq.gov/ehc/products/367/1737/venous-ulcers-treatment-report-erratum-140127.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Health and Human Services review of 10,000 studies\u003c/a> examining treatment of leg wounds known as venous ulcers found that only 60 of them met basic scientific standards. Of the 60, most were so shoddy that their results were unreliable.\u003c/p>\n\u003cp>While scientists struggle to come up with treatments that are more effective, patients with chronic wounds are dying.\u003c/p>\n\u003cp>The five-year mortality rate for patients with some types of diabetic wounds is more than 50 percent higher than breast and colon cancers, according to an analysis led by \u003ca href=\"http://medicine.arizona.edu/person/david-g-armstrong-dpm-md-phd\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. David Armstrong\u003c/a>, a professor of surgery and director of the Southern Arizona Limb Salvage Alliance.\u003c/p>\n\u003cp>Open wounds are a particular problem for people with diabetes because a small cut may turn into an open crater that grows despite conservative treatment, such as removal of dead tissue to stimulate new cell growth.\u003c/p>\n\u003cp>More than half of diabetic ulcers become infected, 20 percent lead to amputation, and, according to Armstrong, about 40 percent of patients with diabetic foot ulcers have a \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMra1615439\" target=\"_blank\" rel=\"noopener noreferrer\">recurrence\u003c/a> within one year after healing.\u003c/p>\n\u003cp>“It’s true that we may be paying for treatments that don’t work,” said Tunis, now CEO of the nonprofit Center for Medical Technology Policy, which has worked with the federal government to improve research. “But it’s just as tragic that we could be missing out on treatments that do work by failing to conduct adequate clinical studies.”\u003c/p>\n\u003cfigure id=\"attachment_434682\" class=\"wp-caption aligncenter\" style=\"max-width: 770px\">\u003cimg class=\"size-full wp-image-434682\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/08/chronic-wounds-7.jpg\" alt=\"\" width=\"770\" height=\"513\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-7.jpg 770w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-7-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-7-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-7-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-7-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-7-520x346.jpg 520w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003cfigcaption class=\"wp-caption-text\">Navy surgeon Capt. Pat McKay examines the healing progress of skin grafts on Navy Cmdr. Peter Snyder at Walter Reed National Military Medical Center. \u003ccite>(H. Darr Beiser for Kaiser Health News)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Although doctors and researchers have been calling on the federal government to step in for at least a decade, the National Institutes of Health and the Veterans Affairs and Defense departments haven’t responded with any significant research initiative.\u003c/p>\n\u003cp>“The bottom line is that there is no pink ribbon to raise awareness for festering, foul-smelling wounds that don’t heal,” said Caroline Fife, a wound care doctor in Texas. “No movie star wants to be the poster child for this, and the patients … are old, sick, paralyzed and, in many cases, malnourished.”\u003c/p>\n\u003cp>The NIH estimates that it invests more than $32 billion a year in medical research. But an independent review estimated it spends 0.1 percent studying wound treatment. That’s about the same amount of money NIH spends on Lyme disease, even though the tick-borne infection costs the medical system one-tenth of what wound care does, according to an analysis led by Dr. Robert Kirsner, chair and Harvey Blank professor at the University of Miami Department of Dermatology and Cutaneous Surgery.\u003c/p>\n\u003cp>Emma Wojtowicz, an NIH spokeswoman, said the agency supports chronic wound care, but she said she couldn’t specify how much money is spent on research because it’s not a separate funding category.\u003c/p>\n\u003cp>“Chronic wounds don’t fit neatly into any funding categories,” said Jonathan Zenilman, chief of the division for infectious diseases at Johns Hopkins Bayview Medical Center and a member of the team that analyzed the 10,000 studies. “The other problem is it’s completely unsexy. It’s not appreciated as a major and growing health care problem that needs immediate attention, even though it is.”\u003c/p>\n\u003cp>Commercial manufacturers have stepped in with products that the FDA permits to come to market without the same rigorous clinical evidence as pharmaceuticals. The companies have little incentive to perform useful comparative studies.\u003c/p>\n\u003cp>“There are hundreds and hundreds of these products, but no one knows which is best,” said \u003ca href=\"https://medicine.duke.edu/faculty/robert-m-califf\" target=\"_blank\" rel=\"noopener noreferrer\">Robert Califf\u003c/a>, who stepped down as Food and Drug Administration commissioner for the Obama administration in January. “You can freeze it, you can warm it, you can ultrasound it, and [Medicare] pays for all of this.”\u003c/p>\n\u003cp>When Medicare resisted coverage for a treatment known as electrical stimulation, Medicare beneficiaries sued, and the agency changed course.\u003c/p>\n\u003cp>“The ruling forced Medicare to reverse its decision based on the fact that the evidence was no crappier than other stuff we were paying for,” said Tunis, the former Medicare official.\u003c/p>\n\u003cp>In another case, Medicare decided to cover a method called “noncontact normothermic wound therapy,” despite concerns that it wasn’t any more effective than traditional treatment, Tunis said.\u003c/p>\n\u003cp>[contextly_sidebar id=\"IUOicXLNcvlWAf4KdlNL1vPURGpnGL3B\"]“It’s basically like a Dixie cup you put over a wound so people won’t mess with it,” he said. “It was one of those ‘magically effective’ treatments in whatever studies were done at the time, but it never ended up being part of a good-quality, well-designed study.”\u003c/p>\n\u003cp>The companies that sell the products and academic researchers themselves disagree over the methodology and the merits of existing scientific research.\u003c/p>\n\u003cp>\u003ca href=\"http://www.serenagroups.com/?q=node/39\">Thomas Serena\u003c/a>, one of the most prolific researchers of wound-healing products, said he tries to pick the healthiest patients for inclusion in studies, limiting him to a pool of about 10 percent of his patient population.\u003c/p>\n\u003cp>“We design it so everyone in the trial has a good chance of healing,” he said.\u003c/p>\n\u003cp>“If it works, like, 80 or 90 percent of the time, that’s because I pick those patients,” said Serena, who has received funding from manufacturers.\u003c/p>\n\u003cp>But critics say the approach makes it more difficult to know what works on the sickest patients in need of the most help.\u003c/p>\n\u003cp>\u003ca href=\"https://smhs.gwu.edu/news/gw%E2%80%99s-gerald-lazarus-named-22nd-recipient-david-martin-carter-mentor-award\">Gerald Lazarus\u003c/a>, a dermatologist who led the HHS review as then-director of Johns Hopkins Bayview Medical Center wound care clinic, said Serena’s assertion is “misleading. That’s not a legitimate way to conduct research.” He added that singling out only healthy patients skews the results.\u003c/p>\n\u003cp>The emphasis on healthier patients in clinical trials also creates unrealistic expectations for insurers, said Fife.\u003c/p>\n\u003cp>“The expensive products … brought to market are then not covered by payers for use in sick patients, based on the irrefutable but Kafka-esque logic that we don’t know if they work in sick people,” she said.\u003c/p>\n\u003cp>“Among very sick patients in the real world, it may be hard to find a product that’s clearly superior to the others in terms of its effectiveness, but we will probably never find that out since we will never get the funding to analyze the data,” added Fife, who has struggled to get government funding for a \u003ca href=\"https://www.uswoundregistry.com/Home\" target=\"_blank\" rel=\"noopener noreferrer\">nonprofit wound registry\u003c/a> she heads. Not surprisingly, she said, the registry data demonstrate that most treatments don’t work as well on patients as shown in clinical trials.\u003c/p>\n\u003cp>Patients say they often feel overwhelmed when confronted with countless treatments.\u003c/p>\n\u003cp>“Even though I’m a doctor and my wife is a nurse, we found this to be complicated,” said Navy Cmdr. Peter Snyder, a radiologist who is recovering from necrotizing fasciitis, also known as flesh-eating bacteria. “I can’t imagine how regular patients handle this. I think it would be devastating.”\u003c/p>\n\u003cp>To heal wounds on his arms and foot, Snyder relied on various treatments, including skin-graft surgery, special collagen bandages and a honey-based product. His doctor who treats him at Walter Reed National Military Medical Center predicted he would fully recover.\u003c/p>\n\u003cp>Such treatments aren’t always successful. Although Emanuele’s wound left by an amputation (of her big toe) healed, another wound on the bottom of her foot has not.\u003c/p>\n\u003cp>Recently, she looked back at her calendar and marveled at the dozens of treatments she has received, many covered by Medicare and Medicaid.\u003c/p>\n\u003cp>Some seem promising, like wound coverings made of freeze-dried placenta obtained during births by cesarean section. Others, not — including one plastic bandage that her nurse agreed made her wound worse.\u003c/p>\n\u003cp>Emanuele was told she needed to undergo high doses of oxygen in a hyperbaric chamber, a high-cost treatment hospitals are increasingly relying on for diabetic wounds. The total cost: about $30,000, according to a Medicare invoice.\u003c/p>\n\u003cp>Some research has indicated that \u003ca href=\"http://khn.org/news/hospitals-put-more-stock-in-hyperbaric-therapy-for-diabetics-despite-concerns/\" target=\"_blank\" rel=\"noopener noreferrer\">hyperbaric therapy works\u003c/a>, but last year a major study concluded it wasn’t any more effective than traditional treatment.\u003c/p>\n\u003cp>“Don’t get me wrong, I am grateful for the care I get,” Emanuele said. “It’s just that sometimes I’m not sure they know what they’re using on me works. I feel like a guinea pig.”\u003c/p>\n\u003cp>Confined to a wheelchair because of her wounds, she fell moving from the bathroom to her wheelchair and banged her leg, interrupting the healing process. Days later, she was hospitalized again. This time, she got a blood infection from bacteria entering through an ulcer.\u003c/p>\n\u003cp>She has since recovered and is now back on the wound care routine at her house.\u003c/p>\n\u003cp>“I don’t want to live like this forever,” she said. “Sometimes I feel like I have I no identity. I have become my wound.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>KHN’s coverage of end-of-life and serious illness issues is supported by \u003ca href=\"https://www.moore.org/\" target=\"_blank\" rel=\"noopener noreferrer\">The Gordon and Betty Moore Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"The market for wound care products booms among a growing older and diabetic patient pool, but many treatments are untested and funding for research falls short. ","status":"publish","parent":0,"modified":1501787200,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":49,"wordCount":2051},"headData":{"title":"When Wounds Won’t Heal, Therapies Spread — To The Tune Of $5 Billion | KQED","description":"The market for wound care products booms among a growing older and diabetic patient pool, but many treatments are untested and funding for research falls short. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"When Wounds Won’t Heal, Therapies Spread — To The Tune Of $5 Billion","datePublished":"2017-08-10T14:00:02.000Z","dateModified":"2017-08-03T19:06:40.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"434678 https://ww2.kqed.org/futureofyou/?p=434678","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/08/10/when-wounds-wont-heal-therapies-spread-to-the-tune-of-5-billion/","disqusTitle":"When Wounds Won’t Heal, Therapies Spread — To The Tune Of $5 Billion","nprByline":"Marisa Taylor\u003c/br>NPR","path":"/futureofyou/434678/when-wounds-wont-heal-therapies-spread-to-the-tune-of-5-billion","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>PHILADELPHIA — Carol Emanuele beat cancer. But for the past two years, she has been fighting her toughest battle yet. She has an open wound on the bottom of her foot that leaves her unable to walk and prone to deadly infection.\u003c/p>\n\u003cp>In an effort to treat her diabetic wound, doctors at a Philadelphia clinic have prescribed a dizzying array of treatments. Freeze-dried placenta. Penis foreskin cells. High doses of pressurized oxygen. And those are just a few of the treatment options patients face.\u003c/p>\n\u003cp>“I do everything, but nothing seems to work,” said Emanuele, 59, who survived stage 4 melanoma in her 30s. “I beat cancer, but this is worse.”\u003c/p>\n\u003cp>The doctors who care for the 6.5 million patients with chronic wounds know the depths of their struggles. Their open, festering wounds don’t heal for months and sometimes years, leaving bare bones and tendons that evoke disgust even among their closest relatives.\u003c/p>\n\u003cfigure class=\"related\">\u003c/figure>\n\u003cp>Many patients end up immobilized, unable to work and dependent on Medicare and Medicaid. In their quest to heal, they turn to expensive and sometimes painful procedures, and products that often don’t work\u003cstrong>.\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s an amazingly crappy area in terms of the quality of research. I don’t think they have anything that involves singing to wounds, but it wouldn’t shock me.”\u003ccite>Sean Tunis, chief medical officer for Medicare from 2002 to 2005\u003c/cite>\u003c/aside>\n\u003cp>According to some estimates, Medicare alone spends at least $25 billion a year treating these wounds. But many widely used treatments aren’t supported by credible research. The $5 billion-a-year wound care business booms while some products might prove little more effective than the proverbial snake oil. The vast majority of the studies are funded or conducted by companies who manufacture these products. At the same time, independent academic research is scant for a growing problem.\u003c/p>\n\u003cfigure id=\"attachment_434681\" class=\"wp-caption aligncenter\" style=\"max-width: 770px\">\u003cimg class=\"size-full wp-image-434681\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/08/chronic-wounds-3.jpg\" alt=\"\" width=\"770\" height=\"513\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-3.jpg 770w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-3-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-3-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-3-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-3-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-3-520x346.jpg 520w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003cfigcaption class=\"wp-caption-text\">Carol Emanuele sits at home in Philadelphia. Emanuele was diagnosed with diabetes in 2015 and also survived stage 4 melanoma when she was 38. \u003ccite>(Eileen Blass for Kaiser Health News)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It’s an amazingly crappy area in terms of the quality of research,” said \u003ca href=\"http://www.cmtpnet.org/about/team/\">Sean Tunis\u003c/a>, who as chief medical officer for Medicare from 2002 to 2005 grappled with coverage decisions on wound care. “I don’t think they have anything that involves singing to wounds, but it wouldn’t shock me.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://journals.lww.com/plasreconsurg/Abstract/2016/09001/Dressing_and_Diabetic_Foot_Ulcers___A_Current.21.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">A 2016 review\u003c/a> of treatment for diabetic foot ulcers found “few published studies were of high quality, and the majority were susceptible to bias.” The review team included William Jeffcoate, a professor with the Department of Diabetes and Endocrinology at Nottingham University Hospitals Trust. Jeffcoate has overseen several reviews of the same treatment since 2006 and concluded that “the evidence to support many of the therapies that are in routine use is poor.”\u003c/p>\n\u003cp>A separate \u003ca href=\"https://www.effectivehealthcare.ahrq.gov/ehc/products/367/1737/venous-ulcers-treatment-report-erratum-140127.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Health and Human Services review of 10,000 studies\u003c/a> examining treatment of leg wounds known as venous ulcers found that only 60 of them met basic scientific standards. Of the 60, most were so shoddy that their results were unreliable.\u003c/p>\n\u003cp>While scientists struggle to come up with treatments that are more effective, patients with chronic wounds are dying.\u003c/p>\n\u003cp>The five-year mortality rate for patients with some types of diabetic wounds is more than 50 percent higher than breast and colon cancers, according to an analysis led by \u003ca href=\"http://medicine.arizona.edu/person/david-g-armstrong-dpm-md-phd\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. David Armstrong\u003c/a>, a professor of surgery and director of the Southern Arizona Limb Salvage Alliance.\u003c/p>\n\u003cp>Open wounds are a particular problem for people with diabetes because a small cut may turn into an open crater that grows despite conservative treatment, such as removal of dead tissue to stimulate new cell growth.\u003c/p>\n\u003cp>More than half of diabetic ulcers become infected, 20 percent lead to amputation, and, according to Armstrong, about 40 percent of patients with diabetic foot ulcers have a \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMra1615439\" target=\"_blank\" rel=\"noopener noreferrer\">recurrence\u003c/a> within one year after healing.\u003c/p>\n\u003cp>“It’s true that we may be paying for treatments that don’t work,” said Tunis, now CEO of the nonprofit Center for Medical Technology Policy, which has worked with the federal government to improve research. “But it’s just as tragic that we could be missing out on treatments that do work by failing to conduct adequate clinical studies.”\u003c/p>\n\u003cfigure id=\"attachment_434682\" class=\"wp-caption aligncenter\" style=\"max-width: 770px\">\u003cimg class=\"size-full wp-image-434682\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/08/chronic-wounds-7.jpg\" alt=\"\" width=\"770\" height=\"513\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-7.jpg 770w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-7-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-7-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-7-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-7-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/08/chronic-wounds-7-520x346.jpg 520w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003cfigcaption class=\"wp-caption-text\">Navy surgeon Capt. Pat McKay examines the healing progress of skin grafts on Navy Cmdr. Peter Snyder at Walter Reed National Military Medical Center. \u003ccite>(H. Darr Beiser for Kaiser Health News)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Although doctors and researchers have been calling on the federal government to step in for at least a decade, the National Institutes of Health and the Veterans Affairs and Defense departments haven’t responded with any significant research initiative.\u003c/p>\n\u003cp>“The bottom line is that there is no pink ribbon to raise awareness for festering, foul-smelling wounds that don’t heal,” said Caroline Fife, a wound care doctor in Texas. “No movie star wants to be the poster child for this, and the patients … are old, sick, paralyzed and, in many cases, malnourished.”\u003c/p>\n\u003cp>The NIH estimates that it invests more than $32 billion a year in medical research. But an independent review estimated it spends 0.1 percent studying wound treatment. That’s about the same amount of money NIH spends on Lyme disease, even though the tick-borne infection costs the medical system one-tenth of what wound care does, according to an analysis led by Dr. Robert Kirsner, chair and Harvey Blank professor at the University of Miami Department of Dermatology and Cutaneous Surgery.\u003c/p>\n\u003cp>Emma Wojtowicz, an NIH spokeswoman, said the agency supports chronic wound care, but she said she couldn’t specify how much money is spent on research because it’s not a separate funding category.\u003c/p>\n\u003cp>“Chronic wounds don’t fit neatly into any funding categories,” said Jonathan Zenilman, chief of the division for infectious diseases at Johns Hopkins Bayview Medical Center and a member of the team that analyzed the 10,000 studies. “The other problem is it’s completely unsexy. It’s not appreciated as a major and growing health care problem that needs immediate attention, even though it is.”\u003c/p>\n\u003cp>Commercial manufacturers have stepped in with products that the FDA permits to come to market without the same rigorous clinical evidence as pharmaceuticals. The companies have little incentive to perform useful comparative studies.\u003c/p>\n\u003cp>“There are hundreds and hundreds of these products, but no one knows which is best,” said \u003ca href=\"https://medicine.duke.edu/faculty/robert-m-califf\" target=\"_blank\" rel=\"noopener noreferrer\">Robert Califf\u003c/a>, who stepped down as Food and Drug Administration commissioner for the Obama administration in January. “You can freeze it, you can warm it, you can ultrasound it, and [Medicare] pays for all of this.”\u003c/p>\n\u003cp>When Medicare resisted coverage for a treatment known as electrical stimulation, Medicare beneficiaries sued, and the agency changed course.\u003c/p>\n\u003cp>“The ruling forced Medicare to reverse its decision based on the fact that the evidence was no crappier than other stuff we were paying for,” said Tunis, the former Medicare official.\u003c/p>\n\u003cp>In another case, Medicare decided to cover a method called “noncontact normothermic wound therapy,” despite concerns that it wasn’t any more effective than traditional treatment, Tunis said.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>“It’s basically like a Dixie cup you put over a wound so people won’t mess with it,” he said. “It was one of those ‘magically effective’ treatments in whatever studies were done at the time, but it never ended up being part of a good-quality, well-designed study.”\u003c/p>\n\u003cp>The companies that sell the products and academic researchers themselves disagree over the methodology and the merits of existing scientific research.\u003c/p>\n\u003cp>\u003ca href=\"http://www.serenagroups.com/?q=node/39\">Thomas Serena\u003c/a>, one of the most prolific researchers of wound-healing products, said he tries to pick the healthiest patients for inclusion in studies, limiting him to a pool of about 10 percent of his patient population.\u003c/p>\n\u003cp>“We design it so everyone in the trial has a good chance of healing,” he said.\u003c/p>\n\u003cp>“If it works, like, 80 or 90 percent of the time, that’s because I pick those patients,” said Serena, who has received funding from manufacturers.\u003c/p>\n\u003cp>But critics say the approach makes it more difficult to know what works on the sickest patients in need of the most help.\u003c/p>\n\u003cp>\u003ca href=\"https://smhs.gwu.edu/news/gw%E2%80%99s-gerald-lazarus-named-22nd-recipient-david-martin-carter-mentor-award\">Gerald Lazarus\u003c/a>, a dermatologist who led the HHS review as then-director of Johns Hopkins Bayview Medical Center wound care clinic, said Serena’s assertion is “misleading. That’s not a legitimate way to conduct research.” He added that singling out only healthy patients skews the results.\u003c/p>\n\u003cp>The emphasis on healthier patients in clinical trials also creates unrealistic expectations for insurers, said Fife.\u003c/p>\n\u003cp>“The expensive products … brought to market are then not covered by payers for use in sick patients, based on the irrefutable but Kafka-esque logic that we don’t know if they work in sick people,” she said.\u003c/p>\n\u003cp>“Among very sick patients in the real world, it may be hard to find a product that’s clearly superior to the others in terms of its effectiveness, but we will probably never find that out since we will never get the funding to analyze the data,” added Fife, who has struggled to get government funding for a \u003ca href=\"https://www.uswoundregistry.com/Home\" target=\"_blank\" rel=\"noopener noreferrer\">nonprofit wound registry\u003c/a> she heads. Not surprisingly, she said, the registry data demonstrate that most treatments don’t work as well on patients as shown in clinical trials.\u003c/p>\n\u003cp>Patients say they often feel overwhelmed when confronted with countless treatments.\u003c/p>\n\u003cp>“Even though I’m a doctor and my wife is a nurse, we found this to be complicated,” said Navy Cmdr. Peter Snyder, a radiologist who is recovering from necrotizing fasciitis, also known as flesh-eating bacteria. “I can’t imagine how regular patients handle this. I think it would be devastating.”\u003c/p>\n\u003cp>To heal wounds on his arms and foot, Snyder relied on various treatments, including skin-graft surgery, special collagen bandages and a honey-based product. His doctor who treats him at Walter Reed National Military Medical Center predicted he would fully recover.\u003c/p>\n\u003cp>Such treatments aren’t always successful. Although Emanuele’s wound left by an amputation (of her big toe) healed, another wound on the bottom of her foot has not.\u003c/p>\n\u003cp>Recently, she looked back at her calendar and marveled at the dozens of treatments she has received, many covered by Medicare and Medicaid.\u003c/p>\n\u003cp>Some seem promising, like wound coverings made of freeze-dried placenta obtained during births by cesarean section. Others, not — including one plastic bandage that her nurse agreed made her wound worse.\u003c/p>\n\u003cp>Emanuele was told she needed to undergo high doses of oxygen in a hyperbaric chamber, a high-cost treatment hospitals are increasingly relying on for diabetic wounds. The total cost: about $30,000, according to a Medicare invoice.\u003c/p>\n\u003cp>Some research has indicated that \u003ca href=\"http://khn.org/news/hospitals-put-more-stock-in-hyperbaric-therapy-for-diabetics-despite-concerns/\" target=\"_blank\" rel=\"noopener noreferrer\">hyperbaric therapy works\u003c/a>, but last year a major study concluded it wasn’t any more effective than traditional treatment.\u003c/p>\n\u003cp>“Don’t get me wrong, I am grateful for the care I get,” Emanuele said. “It’s just that sometimes I’m not sure they know what they’re using on me works. I feel like a guinea pig.”\u003c/p>\n\u003cp>Confined to a wheelchair because of her wounds, she fell moving from the bathroom to her wheelchair and banged her leg, interrupting the healing process. Days later, she was hospitalized again. This time, she got a blood infection from bacteria entering through an ulcer.\u003c/p>\n\u003cp>She has since recovered and is now back on the wound care routine at her house.\u003c/p>\n\u003cp>“I don’t want to live like this forever,” she said. “Sometimes I feel like I have I no identity. I have become my wound.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>KHN’s coverage of end-of-life and serious illness issues is supported by \u003ca href=\"https://www.moore.org/\" target=\"_blank\" rel=\"noopener noreferrer\">The Gordon and Betty Moore Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/434678/when-wounds-wont-heal-therapies-spread-to-the-tune-of-5-billion","authors":["byline_futureofyou_434678"],"categories":["futureofyou_1"],"tags":["futureofyou_309","futureofyou_1275","futureofyou_1334"],"featImg":"futureofyou_434679","label":"futureofyou"},"futureofyou_254629":{"type":"posts","id":"futureofyou_254629","meta":{"index":"posts_1591205157","site":"futureofyou","id":"254629","score":null,"sort":[1475256233000]},"guestAuthors":[],"slug":"first-automated-insulin-system-approved-for-type-1-diabetes","title":"First Automated Insulin System Approved For Type 1 Diabetes","publishDate":1475256233,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>The Food and Drug Administration's approval of a new insulin delivery system for people with Type 1 diabetes is a big deal.\u003c/p>\n\u003cp>With Type 1 diabetes, the pancreas makes little or no insulin so people have to replace it with either multiple daily injections or a pump. In either case, that process involves constant error-prone adjustments, particularly around food and exercise. Over the long term, high blood sugar levels can lead to organ damage, but over-correcting by giving more insulin can cause dangerous low blood sugars that can lead to unconsciousness.\u003c/p>\n\u003cp>The device, Medtronic's MiniMed 670G hybrid closed loop system, is made up of an insulin pump and continuous glucose monitor (CGM), both of which are already on the market separately. The new part involves the communication between the two devices.\u003c/p>\n\u003cp>Medtronic's \u003ca href=\"http://www.npr.org/sections/health-shots/2015/01/30/382172052/diabetes-technology-inches-closer-to-an-artificial-pancreas\">previous system \u003c/a>already had a feature that would shut down the insulin pump if the wearer's blood sugar dropped too low. But the 670G predicts when a person's blood sugar is dropping and prevents the low in the first place, and also corrects high blood sugars.\u003c/p>\n\u003cp>This is the first such machine in the world with that level of automation, and thus it is informally being called the first \"artificial pancreas\" system.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>However, it's called a hybrid rather than a fully closed-loop system because users will still need to signal that they're about to eat and estimate the carbohydrate count of the food so the device can calculate the additional amount of insulin needed. That means there's still the possibility of mistakes. But now if that count is off, the 670G will correct the error automatically.\u003c/p>\n\u003cp>For people with Type 1 diabetes, the new capabilities mean they can both sleep through the night without worrying about their blood sugars dropping too low and can go through their day without having to think about their diabetes all the time, according to Aaron Kowalski, chief mission officer for the JDRF, the organization that funds much of the \"artificial pancreas\" research.\u003c/p>\n\u003cp>\"You get almost normalized overnight blood glucose. For people with Type 1 diabetes, that's massively important,\" he said, adding that the overall 24/7 burden reduction means better quality of life. \"The diabetes isn't gone, but [wearers] can think about it less ...This is a historic milestone.\"\u003c/p>\n\u003cp>And more systems like this are coming.\u003c/p>\n\u003cp>Medtronic, via the Minimed division that it acquired in 2001, was the first to market because it's still the only company that manufactures both the insulin pump and CGM technology. But at least five other partnerships between other manufacturers are now developing closed-loop systems, some using already-available pumps and CGMs, others creating new devices. The systems will likely differ from one another in form, user interface, and in the algorithmic approaches embedded in the communication software, \"so people with diabetes will have more choices,\" Kowalski says, noting that JDRF is \"celebrating Medtronic because it's the first commercial system, but we're supporting the entire field.\"\u003c/p>\n\u003cp>Of course, the field still faces challenges. One of the major technological problems is that insulin deposited just under the skin takes too long to begin working; that's why people still need to signal ahead that they're about to eat. The JDRF is currently funding several initiatives working on making faster-acting insulins.\u003c/p>\n\u003cp>\"The faster the insulin works, the more closed the loop will be,\" Kowalski notes. \"It's not easy, but there's a lot of work going on.\"\u003c/p>\n\u003cp>Wearability is another issue. Some people simply don't want to be strapped to devices, even if it means better diabetes control. So, the JDRF has recently announced new funding for miniaturization of the devices.\u003c/p>\n\u003cp>And of course, there's the problem of access. While insurance coverage for insulin pumps is widely established, this is not the case for the CGM component. Medicare doesn't cover CGM technology, meaning that people now must give up those devices or pay out of pocket when they reach age 65. The JDRF is one of several organizations lobbying to change that, as well as to make sure that all payers recognize both the health and economic advantages of new diabetes technologies.\u003c/p>\n\u003cp>\"This is a priority for us,\" Kowalski says. \"We need to make sure people have access. Not just rich people, but anybody who will benefit.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For now, the 670G, which the FDA gave the nod on Wednesday, is only \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/UCM522974.htm\">approved\u003c/a> for people aged 14 years and older. But Medtronic is studying it in children ages 7-13 with the aim of making it available for them, too.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=FDA+Approves+The+First+Automated+Insulin+System+For+Type+1+Diabetes&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"The new system joins a continuous glucose monitor with an insulin pump, which work together to keep blood sugar from going too high or too low. That will make it safer to sleep through the night.","status":"publish","parent":0,"modified":1475595446,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":786},"headData":{"title":"First Automated Insulin System Approved For Type 1 Diabetes | KQED","description":"The new system joins a continuous glucose monitor with an insulin pump, which work together to keep blood sugar from going too high or too low. That will make it safer to sleep through the night.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"First Automated Insulin System Approved For Type 1 Diabetes","datePublished":"2016-09-30T17:23:53.000Z","dateModified":"2016-10-04T15:37:26.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"254629 http://ww2.kqed.org/futureofyou/?p=254629","disqusUrl":"https://ww2.kqed.org/futureofyou/2016/09/30/first-automated-insulin-system-approved-for-type-1-diabetes/","disqusTitle":"First Automated Insulin System Approved For Type 1 Diabetes","nprByline":"Miriam E. Tucker\u003cbr />NPR Shots","nprImageAgency":"Medtronic","nprStoryId":"495914413","nprApiLink":"http://api.npr.org/query?id=495914413&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2016/09/30/495914413/fda-approves-the-first-automated-insulin-system-for-type-1-diabetes?ft=nprml&f=495914413","nprRetrievedStory":"1","nprPubDate":"Fri, 30 Sep 2016 09:21:00 -0400","nprStoryDate":"Fri, 30 Sep 2016 05:00:00 -0400","nprLastModifiedDate":"Fri, 30 Sep 2016 09:21:23 -0400","path":"/futureofyou/254629/first-automated-insulin-system-approved-for-type-1-diabetes","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Food and Drug Administration's approval of a new insulin delivery system for people with Type 1 diabetes is a big deal.\u003c/p>\n\u003cp>With Type 1 diabetes, the pancreas makes little or no insulin so people have to replace it with either multiple daily injections or a pump. In either case, that process involves constant error-prone adjustments, particularly around food and exercise. Over the long term, high blood sugar levels can lead to organ damage, but over-correcting by giving more insulin can cause dangerous low blood sugars that can lead to unconsciousness.\u003c/p>\n\u003cp>The device, Medtronic's MiniMed 670G hybrid closed loop system, is made up of an insulin pump and continuous glucose monitor (CGM), both of which are already on the market separately. The new part involves the communication between the two devices.\u003c/p>\n\u003cp>Medtronic's \u003ca href=\"http://www.npr.org/sections/health-shots/2015/01/30/382172052/diabetes-technology-inches-closer-to-an-artificial-pancreas\">previous system \u003c/a>already had a feature that would shut down the insulin pump if the wearer's blood sugar dropped too low. But the 670G predicts when a person's blood sugar is dropping and prevents the low in the first place, and also corrects high blood sugars.\u003c/p>\n\u003cp>This is the first such machine in the world with that level of automation, and thus it is informally being called the first \"artificial pancreas\" system.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>However, it's called a hybrid rather than a fully closed-loop system because users will still need to signal that they're about to eat and estimate the carbohydrate count of the food so the device can calculate the additional amount of insulin needed. That means there's still the possibility of mistakes. But now if that count is off, the 670G will correct the error automatically.\u003c/p>\n\u003cp>For people with Type 1 diabetes, the new capabilities mean they can both sleep through the night without worrying about their blood sugars dropping too low and can go through their day without having to think about their diabetes all the time, according to Aaron Kowalski, chief mission officer for the JDRF, the organization that funds much of the \"artificial pancreas\" research.\u003c/p>\n\u003cp>\"You get almost normalized overnight blood glucose. For people with Type 1 diabetes, that's massively important,\" he said, adding that the overall 24/7 burden reduction means better quality of life. \"The diabetes isn't gone, but [wearers] can think about it less ...This is a historic milestone.\"\u003c/p>\n\u003cp>And more systems like this are coming.\u003c/p>\n\u003cp>Medtronic, via the Minimed division that it acquired in 2001, was the first to market because it's still the only company that manufactures both the insulin pump and CGM technology. But at least five other partnerships between other manufacturers are now developing closed-loop systems, some using already-available pumps and CGMs, others creating new devices. The systems will likely differ from one another in form, user interface, and in the algorithmic approaches embedded in the communication software, \"so people with diabetes will have more choices,\" Kowalski says, noting that JDRF is \"celebrating Medtronic because it's the first commercial system, but we're supporting the entire field.\"\u003c/p>\n\u003cp>Of course, the field still faces challenges. One of the major technological problems is that insulin deposited just under the skin takes too long to begin working; that's why people still need to signal ahead that they're about to eat. The JDRF is currently funding several initiatives working on making faster-acting insulins.\u003c/p>\n\u003cp>\"The faster the insulin works, the more closed the loop will be,\" Kowalski notes. \"It's not easy, but there's a lot of work going on.\"\u003c/p>\n\u003cp>Wearability is another issue. Some people simply don't want to be strapped to devices, even if it means better diabetes control. So, the JDRF has recently announced new funding for miniaturization of the devices.\u003c/p>\n\u003cp>And of course, there's the problem of access. While insurance coverage for insulin pumps is widely established, this is not the case for the CGM component. Medicare doesn't cover CGM technology, meaning that people now must give up those devices or pay out of pocket when they reach age 65. The JDRF is one of several organizations lobbying to change that, as well as to make sure that all payers recognize both the health and economic advantages of new diabetes technologies.\u003c/p>\n\u003cp>\"This is a priority for us,\" Kowalski says. \"We need to make sure people have access. Not just rich people, but anybody who will benefit.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For now, the 670G, which the FDA gave the nod on Wednesday, is only \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/UCM522974.htm\">approved\u003c/a> for people aged 14 years and older. But Medtronic is studying it in children ages 7-13 with the aim of making it available for them, too.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=FDA+Approves+The+First+Automated+Insulin+System+For+Type+1+Diabetes&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/254629/first-automated-insulin-system-approved-for-type-1-diabetes","authors":["byline_futureofyou_254629"],"categories":["futureofyou_452","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_309","futureofyou_1071","futureofyou_80"],"featImg":"futureofyou_254630","label":"futureofyou"},"futureofyou_234745":{"type":"posts","id":"futureofyou_234745","meta":{"index":"posts_1591205157","site":"futureofyou","id":"234745","score":null,"sort":[1472662317000]},"guestAuthors":[],"slug":"self-management-programs-for-disease-gain-favor","title":"Self-Management Programs for Disease Gain Favor","publishDate":1472662317,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>It’s clear that what patients with chronic illnesses do outside the doctor’s office — how much they exercise, what they eat and whether they take their medication — can affect their health conditions.\u003c/p>\n\u003caside class=\"pullquote alignright\">Managing one's own disease has been considered primarily an extra, but now its being recognized more and more as critical.\u003c/aside>\n\u003cp>But managing one’s own disease has been considered primarily a “nice extra,” said Kate Lorig, director of the Stanford Patient Education Research Center. Now, Lorig said, health systems, employers and insurers are starting to recognize that it is critical to good health care. And they are starting to invest in self-management programs.\u003c/p>\n\u003cp>“People with long-term chronic conditions spend 99 percent of their time outside of the health care system,” said Lorig, a professor at the Stanford University School of Medicine. “What they do with that time determines their quality of life, their health and also their utilization of the health care system.”\u003c/p>\n\u003cp>A new \u003ca href=\"http://www.jmir.org/2016/6/e164/\" target=\"_blank\">study\u003c/a> found that diabetic patients who participated in a largely online self-management program designed at Stanford had lower blood sugar levels and took their medication more regularly. The study, authored by Lorig and others and published in the Journal of Medical Internet Research, also showed that many participants exercised more and had fewer symptoms of depression.\u003c/p>\n\u003cp>Self-management programs have been around for a long time, and Stanford is considered a leader in developing them. Researchers are now experimenting with online and telehealth versions. In-person workshops have been proven effective in numerous studies, but the virtual programs have been less amply studied.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In the new, peer-reviewed study, 1,010 patients nationwide completed the six-week disease management workshop online and another 232 attended workshops in Georgia, Indiana and Missouri. The results were measured over a six-month period, though nearly 30 percent did not complete the questionnaire.\u003c/p>\n\u003cp>Nationwide, about half of adults have at least one chronic condition, and 1 in 4 has multiple illnesses, according to the Centers for Disease Control & Prevention. In California, roughly 14 million Californians are living with chronic disease and more than half have multiple diseases, according to a 2014 report by the California Department of Public Health.\u003c/p>\n\u003cp>Diabetes is one of the most common chronic diseases. About 2.5 million Californians have been diagnosed with it, and another 13 million are believed to have prediabetes or undiagnosed diabetes, UCLA researchers \u003ca href=\"http://healthpolicy.ucla.edu/publications/search/pages/detail.aspx?PubID=1472\" target=\"_blank\">reported\u003c/a> last year. Nationwide, about 22 million people have been diagnosed with diabetes.\u003c/p>\n\u003cp>Many chronic diseases could be prevented — up to 80 percent of strokes and cases of heart disease and type 2 diabetes, for example — by eating better, getting more exercise and reducing stress, according to the California Department of Public Health. And that, in turn, could reduce health care expenditures, research shows. In California alone, 42 percent of annual health care expenditures are for treating arthritis, asthma, cancer, cardiovascular disease, diabetes and depression, a 2015 \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25414965\" target=\"_blank\">study\u003c/a> found.\u003c/p>\n\u003cp>The patients in the Stanford study were recruited through Anthem Blue Cross. Throughout the course of the program, called Better Choices, Better Health, patients discussed several topics, including how to take medicine correctly, deal with fatigue and pain, and communicate with family and friends.\u003c/p>\n\u003cp>Dr. Laura Clapper, medical director of Anthem Blue Cross, said self-management for any chronic disease — and diabetes in particular — is crucial for members. “It strengthens the patient as a health care consumer,” she said. “They are empowered to ask good questions.”\u003c/p>\n\u003cp>And that, she said, makes for cost-effective care. Clapper said members who are better informed are “better users of health care dollars.”\u003c/p>\n\u003cp>The self-management program, licensed by Los Angeles-based Canary Health, isn’t designed only to give patients information. Rather, it allows them to discuss what matters to them and to draw up individual plans to improve their health, said Canary Health’s CEO, Adam Kaufman.\u003c/p>\n\u003cp>“The consumer should be an equal if not a greater partner in their health journey,” Kaufman said. “We have under-invested in this primary question in the health care system: What matters to you?”\u003c/p>\n\u003cp>Canary Health also offers Stanford’s online self-management programs for other diseases, including arthritis, heart disease and depression. Previous studies have shown that patients who participated in self-management programs had fewer emergency room visits and hospitalizations.\u003c/p>\n\u003cp>Lorig said one of the keys to the success of the workshops is getting patients to believe they can make changes. “The secret sauce seems to be giving people the confidence they can do things,” she said.\u003c/p>\n\u003cp>Ruby Mims, 71, who has had high blood pressure for the past decade, participated in one of the online self-management workshops this summer. The retired IRS agent from Raleigh, N.C., learned about it through her insurer, the Government Employees Health Association.\u003c/p>\n\u003cp>Mims said her older sister died of a stroke last year and she is doing everything she can to stay healthy, including walking and cutting back on soda and sweets. She said talking to others with hypertension gave her new ideas for managing her illness and made her feel less alone.\u003c/p>\n\u003cp>“Being able to help each other…was very uplifting,” Mims said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Health systems, employers and insurers are starting to invest in self-management programs.","status":"publish","parent":0,"modified":1475112349,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":911},"headData":{"title":"Self-Management Programs for Disease Gain Favor | KQED","description":"Health systems, employers and insurers are starting to invest in self-management programs.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Self-Management Programs for Disease Gain Favor","datePublished":"2016-08-31T16:51:57.000Z","dateModified":"2016-09-29T01:25:49.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"234745 http://ww2.kqed.org/futureofyou/?p=234745","disqusUrl":"https://ww2.kqed.org/futureofyou/2016/08/31/self-management-programs-for-disease-gain-favor/","disqusTitle":"Self-Management Programs for Disease Gain Favor","nprByline":"Anna Gorman\u003cbr />California Healthline","path":"/futureofyou/234745/self-management-programs-for-disease-gain-favor","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>It’s clear that what patients with chronic illnesses do outside the doctor’s office — how much they exercise, what they eat and whether they take their medication — can affect their health conditions.\u003c/p>\n\u003caside class=\"pullquote alignright\">Managing one's own disease has been considered primarily an extra, but now its being recognized more and more as critical.\u003c/aside>\n\u003cp>But managing one’s own disease has been considered primarily a “nice extra,” said Kate Lorig, director of the Stanford Patient Education Research Center. Now, Lorig said, health systems, employers and insurers are starting to recognize that it is critical to good health care. And they are starting to invest in self-management programs.\u003c/p>\n\u003cp>“People with long-term chronic conditions spend 99 percent of their time outside of the health care system,” said Lorig, a professor at the Stanford University School of Medicine. “What they do with that time determines their quality of life, their health and also their utilization of the health care system.”\u003c/p>\n\u003cp>A new \u003ca href=\"http://www.jmir.org/2016/6/e164/\" target=\"_blank\">study\u003c/a> found that diabetic patients who participated in a largely online self-management program designed at Stanford had lower blood sugar levels and took their medication more regularly. The study, authored by Lorig and others and published in the Journal of Medical Internet Research, also showed that many participants exercised more and had fewer symptoms of depression.\u003c/p>\n\u003cp>Self-management programs have been around for a long time, and Stanford is considered a leader in developing them. Researchers are now experimenting with online and telehealth versions. In-person workshops have been proven effective in numerous studies, but the virtual programs have been less amply studied.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In the new, peer-reviewed study, 1,010 patients nationwide completed the six-week disease management workshop online and another 232 attended workshops in Georgia, Indiana and Missouri. The results were measured over a six-month period, though nearly 30 percent did not complete the questionnaire.\u003c/p>\n\u003cp>Nationwide, about half of adults have at least one chronic condition, and 1 in 4 has multiple illnesses, according to the Centers for Disease Control & Prevention. In California, roughly 14 million Californians are living with chronic disease and more than half have multiple diseases, according to a 2014 report by the California Department of Public Health.\u003c/p>\n\u003cp>Diabetes is one of the most common chronic diseases. About 2.5 million Californians have been diagnosed with it, and another 13 million are believed to have prediabetes or undiagnosed diabetes, UCLA researchers \u003ca href=\"http://healthpolicy.ucla.edu/publications/search/pages/detail.aspx?PubID=1472\" target=\"_blank\">reported\u003c/a> last year. Nationwide, about 22 million people have been diagnosed with diabetes.\u003c/p>\n\u003cp>Many chronic diseases could be prevented — up to 80 percent of strokes and cases of heart disease and type 2 diabetes, for example — by eating better, getting more exercise and reducing stress, according to the California Department of Public Health. And that, in turn, could reduce health care expenditures, research shows. In California alone, 42 percent of annual health care expenditures are for treating arthritis, asthma, cancer, cardiovascular disease, diabetes and depression, a 2015 \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25414965\" target=\"_blank\">study\u003c/a> found.\u003c/p>\n\u003cp>The patients in the Stanford study were recruited through Anthem Blue Cross. Throughout the course of the program, called Better Choices, Better Health, patients discussed several topics, including how to take medicine correctly, deal with fatigue and pain, and communicate with family and friends.\u003c/p>\n\u003cp>Dr. Laura Clapper, medical director of Anthem Blue Cross, said self-management for any chronic disease — and diabetes in particular — is crucial for members. “It strengthens the patient as a health care consumer,” she said. “They are empowered to ask good questions.”\u003c/p>\n\u003cp>And that, she said, makes for cost-effective care. Clapper said members who are better informed are “better users of health care dollars.”\u003c/p>\n\u003cp>The self-management program, licensed by Los Angeles-based Canary Health, isn’t designed only to give patients information. Rather, it allows them to discuss what matters to them and to draw up individual plans to improve their health, said Canary Health’s CEO, Adam Kaufman.\u003c/p>\n\u003cp>“The consumer should be an equal if not a greater partner in their health journey,” Kaufman said. “We have under-invested in this primary question in the health care system: What matters to you?”\u003c/p>\n\u003cp>Canary Health also offers Stanford’s online self-management programs for other diseases, including arthritis, heart disease and depression. Previous studies have shown that patients who participated in self-management programs had fewer emergency room visits and hospitalizations.\u003c/p>\n\u003cp>Lorig said one of the keys to the success of the workshops is getting patients to believe they can make changes. “The secret sauce seems to be giving people the confidence they can do things,” she said.\u003c/p>\n\u003cp>Ruby Mims, 71, who has had high blood pressure for the past decade, participated in one of the online self-management workshops this summer. The retired IRS agent from Raleigh, N.C., learned about it through her insurer, the Government Employees Health Association.\u003c/p>\n\u003cp>Mims said her older sister died of a stroke last year and she is doing everything she can to stay healthy, including walking and cutting back on soda and sweets. She said talking to others with hypertension gave her new ideas for managing her illness and made her feel less alone.\u003c/p>\n\u003cp>“Being able to help each other…was very uplifting,” Mims said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/234745/self-management-programs-for-disease-gain-favor","authors":["byline_futureofyou_234745"],"categories":["futureofyou_1060"],"tags":["futureofyou_309"],"featImg":"futureofyou_30153","label":"futureofyou"},"futureofyou_212953":{"type":"posts","id":"futureofyou_212953","meta":{"index":"posts_1591205157","site":"futureofyou","id":"212953","score":null,"sort":[1470067229000]},"guestAuthors":[],"slug":"devices-beat-dogs-in-detecting-low-blood-sugar-but-dog-owners-satisfied","title":"Devices Beat Dogs in Detecting Low Blood Sugar -- But Dog Owners Satisfied","publishDate":1470067229,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>For people with diabetes who take insulin, the risk of losing consciousness from low blood sugar is a constant fear. Devices called continuous glucose monitors (CGMs) can alert wearers to dropping levels, but not everyone has access to them. And even among those who do, some prefer a furrier and friendlier alert option: a service dog with special training to alert owners when their blood sugar reaches dangerously low levels.\u003c/p>\n\u003caside class=\"pullquote alignright\">Despite many false alerts from their canines, surveyed dog users were very satisfied and fairly confident in their ability to detect hypoglycemia.\u003c/aside>\n\u003cp>These dogs are trained in a variety of ways, and although they receive certification, there is no universally accepted test to ensure their competence. Fully trained dogs can cost in the $20,000 range and typically aren't covered by insurance, although some nonprofit organizations can help offset the cost.\u003c/p>\n\u003cp>But as the popularity of diabetes alert dogs to detect hypoglycemia has increased dramatically, their effectiveness is largely unknown, according to Evan Los, a pediatric endocrinologist at Oregon Health & Science University who has studied their use. \"Though dog trainers and dog users are generally enthusiastic,\" he notes.\u003c/p>\n\u003cp>Moreover, it's not clear exactly what the dogs may be detecting. Are they actually \"smelling\" low blood sugar, or are they reacting to typical hypoglycemia symptoms in their owner, such as sweating or shaking?\u003c/p>\n\u003cp>Two new studies add scent to the trail. One, published in the journal \u003cem>Diabetes Care\u003c/em>, suggests that the dogs may be smelling a particular substance in the person's breath that rises as blood sugar falls.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But a second study, presented by Los at the recent meeting of the American Diabetes Association in New Orleans, found that although the dogs do appear to detect low blood sugar, they also often alerted owners when they didn't have low blood sugar, and were usually slower than a CGM to alert to actual low blood sugar.\u003c/p>\n\u003cp>\u003cstrong>Sniff test?\u003c/strong>\u003c/p>\n\u003cp>In the \u003cem>Diabetes Care\u003c/em> \u003ca href=\"http://care.diabetesjournals.org/content/39/7/e97.long\">study\u003c/a>, Sankalpa Neupane and colleagues at the University of Cambridge measured the amounts of volatile organic compounds in exhaled breath in eight adult women with Type 1 diabetes. When the patients were given insulin infusions to induce hypoglycemia, levels of one of the most common VOCs in human breath, called isoprene, rose \"strikingly,\" the researchers said.\u003c/p>\n\u003cp>No relationship was seen between hypoglycemia and any other VOC, including acetone, ethanol or propane.\u003c/p>\n\u003cp>It's not clear exactly why this happens, but one theory is that isoprene may be a byproduct of cholesterol production, which may be influenced by blood sugar levels. Or the fast heart rate and blood flow that accompany hypoglycemia may simply result in the delivery of more isoprene to the lungs.\u003c/p>\n\u003cp>While diabetes alert dogs were the impetus for this study, the researchers didn't test dogs to see if they react to the chemical. It's certainly possible that isoprene isn't the whole story, says Dr. Mark Evans, the study's lead investigator and a University of Cambridge lecturer. \"All we have done is find one signal,\" he told NPR. \"I suspect that dogs respond to a combination of cues including [VOCs], but also subtle behavioral cues.\"\u003c/p>\n\u003cp>Asked to comment, Los said, \"Their study didn't test whether dogs have any ability to detect or alert to different concentrations of isoprene, so ... whether this is a compound used by the dogs is unknown.\"\u003c/p>\n\u003cp>\u003cstrong>Doggie over-do?\u003c/strong>\u003c/p>\n\u003cp>Los became interested in diabetes alert dogs when some of his patients asked his advice about getting them. \"I didn't know anything about them. It turns out almost no one did, but patients were using them anyway.\"\u003c/p>\n\u003cp>He and his colleagues studied eight patients with Type 1 diabetes, ages four to 48, along with their own trained dogs for one week each, comparing the dogs' accuracy with those of both fingerstick and CGM blood sugar monitoring.\u003c/p>\n\u003cp>The dogs did alert the owners over three times more often during low blood-sugar episodes than when blood sugar was normal. But just 12 percent of the 16 to 20 average weekly alerts occurred when the patient actually had hypoglycemia.\u003c/p>\n\u003cp>And when both the dog and the CGM alerted, the CGM alerted first in 73 percent of low blood sugar events, an average of 22 minutes sooner than did the dog.\u003c/p>\n\u003cp>Los speculates that the dogs might also be reacting to high blood sugars or rapid changes in blood sugar, situations that CGMs also detect and provide feedback for. \"Given that a CGM differentiates its alerts clearly, the dog is operating at a disadvantage.\"\u003c/p>\n\u003cp>\u003cstrong>A dog's world\u003c/strong>\u003c/p>\n\u003cp>Despite the many false alerts, surveyed dog users were very satisfied (8.9 on a 10-point scale) and fairly confident (7.9/10) in their dog's ability to detect hypoglycemia.\u003c/p>\n\u003cp>Evans told NPR those results don't surprise him. \"I suspect that dog owners are more tolerant of false negatives [from their dog] than a device falsely alarming, which really irritates.\"\u003c/p>\n\u003cp>For patients without CGMs who have a trained dog and find it helpful, Los says that \"I would never tell them to get rid of it, because it's alerting them to more hypoglycemia symptoms than they would otherwise know about.\"\u003c/p>\n\u003cp>More research is needed, he said, to determine whether particular training approaches, breeds or other factors might make dogs better hypoglycemia-detecting best friends.\u003c/p>\n\u003cp>\"Although it appears CGM outperformed trained dogs in this study, it is intriguing that dogs were able to detect some hypoglycemia,\" Los said. \"Perhaps understanding what factors impact dog reliability could help optimize dog performance.\"\u003c/p>\n\u003cp>Then there's the warm fuzzy effect. Other possible benefits not measured in the study could include having a positive partner in the daily management of a chronic disease, Los added, especially one \"in which the daily tasks are not very rewarding.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of the bonus material for NPR's podcast and show Invisibilia, which this week tells the tale of a woman who uses a blood-glucose monitoring app to track the health of her twin sister from afar. \u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Can+Diabetes+Alert+Dogs+Help+Sniff+Out+Low+Blood+Sugar%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Trained dogs are increasingly being used to help people with diabetes detect hypoglycemia. One study finds the dogs can indeed do that, but aren't as reliable as a continuous glucose monitor.","status":"publish","parent":0,"modified":1475119242,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":28,"wordCount":1021},"headData":{"title":"Devices Beat Dogs in Detecting Low Blood Sugar -- But Dog Owners Satisfied | KQED","description":"Trained dogs are increasingly being used to help people with diabetes detect hypoglycemia. One study finds the dogs can indeed do that, but aren't as reliable as a continuous glucose monitor.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Devices Beat Dogs in Detecting Low Blood Sugar -- But Dog Owners Satisfied","datePublished":"2016-08-01T16:00:29.000Z","dateModified":"2016-09-29T03:20:42.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"212953 http://ww2.kqed.org/futureofyou/?p=212953","disqusUrl":"https://ww2.kqed.org/futureofyou/2016/08/01/devices-beat-dogs-in-detecting-low-blood-sugar-but-dog-owners-satisfied/","disqusTitle":"Devices Beat Dogs in Detecting Low Blood Sugar -- But Dog Owners Satisfied","nprByline":"Miriam E. Tucker\u003cbr />NPR Shots","nprStoryId":"487772706","nprApiLink":"http://api.npr.org/query?id=487772706&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2016/07/29/487772706/can-dogs-help-sniff-out-low-blood-sugar-in-diabetes?ft=nprml&f=487772706","nprRetrievedStory":"1","nprPubDate":"Fri, 29 Jul 2016 12:53:00 -0400","nprStoryDate":"Fri, 29 Jul 2016 05:00:00 -0400","nprLastModifiedDate":"Fri, 29 Jul 2016 12:53:18 -0400","path":"/futureofyou/212953/devices-beat-dogs-in-detecting-low-blood-sugar-but-dog-owners-satisfied","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>For people with diabetes who take insulin, the risk of losing consciousness from low blood sugar is a constant fear. Devices called continuous glucose monitors (CGMs) can alert wearers to dropping levels, but not everyone has access to them. And even among those who do, some prefer a furrier and friendlier alert option: a service dog with special training to alert owners when their blood sugar reaches dangerously low levels.\u003c/p>\n\u003caside class=\"pullquote alignright\">Despite many false alerts from their canines, surveyed dog users were very satisfied and fairly confident in their ability to detect hypoglycemia.\u003c/aside>\n\u003cp>These dogs are trained in a variety of ways, and although they receive certification, there is no universally accepted test to ensure their competence. Fully trained dogs can cost in the $20,000 range and typically aren't covered by insurance, although some nonprofit organizations can help offset the cost.\u003c/p>\n\u003cp>But as the popularity of diabetes alert dogs to detect hypoglycemia has increased dramatically, their effectiveness is largely unknown, according to Evan Los, a pediatric endocrinologist at Oregon Health & Science University who has studied their use. \"Though dog trainers and dog users are generally enthusiastic,\" he notes.\u003c/p>\n\u003cp>Moreover, it's not clear exactly what the dogs may be detecting. Are they actually \"smelling\" low blood sugar, or are they reacting to typical hypoglycemia symptoms in their owner, such as sweating or shaking?\u003c/p>\n\u003cp>Two new studies add scent to the trail. One, published in the journal \u003cem>Diabetes Care\u003c/em>, suggests that the dogs may be smelling a particular substance in the person's breath that rises as blood sugar falls.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But a second study, presented by Los at the recent meeting of the American Diabetes Association in New Orleans, found that although the dogs do appear to detect low blood sugar, they also often alerted owners when they didn't have low blood sugar, and were usually slower than a CGM to alert to actual low blood sugar.\u003c/p>\n\u003cp>\u003cstrong>Sniff test?\u003c/strong>\u003c/p>\n\u003cp>In the \u003cem>Diabetes Care\u003c/em> \u003ca href=\"http://care.diabetesjournals.org/content/39/7/e97.long\">study\u003c/a>, Sankalpa Neupane and colleagues at the University of Cambridge measured the amounts of volatile organic compounds in exhaled breath in eight adult women with Type 1 diabetes. When the patients were given insulin infusions to induce hypoglycemia, levels of one of the most common VOCs in human breath, called isoprene, rose \"strikingly,\" the researchers said.\u003c/p>\n\u003cp>No relationship was seen between hypoglycemia and any other VOC, including acetone, ethanol or propane.\u003c/p>\n\u003cp>It's not clear exactly why this happens, but one theory is that isoprene may be a byproduct of cholesterol production, which may be influenced by blood sugar levels. Or the fast heart rate and blood flow that accompany hypoglycemia may simply result in the delivery of more isoprene to the lungs.\u003c/p>\n\u003cp>While diabetes alert dogs were the impetus for this study, the researchers didn't test dogs to see if they react to the chemical. It's certainly possible that isoprene isn't the whole story, says Dr. Mark Evans, the study's lead investigator and a University of Cambridge lecturer. \"All we have done is find one signal,\" he told NPR. \"I suspect that dogs respond to a combination of cues including [VOCs], but also subtle behavioral cues.\"\u003c/p>\n\u003cp>Asked to comment, Los said, \"Their study didn't test whether dogs have any ability to detect or alert to different concentrations of isoprene, so ... whether this is a compound used by the dogs is unknown.\"\u003c/p>\n\u003cp>\u003cstrong>Doggie over-do?\u003c/strong>\u003c/p>\n\u003cp>Los became interested in diabetes alert dogs when some of his patients asked his advice about getting them. \"I didn't know anything about them. It turns out almost no one did, but patients were using them anyway.\"\u003c/p>\n\u003cp>He and his colleagues studied eight patients with Type 1 diabetes, ages four to 48, along with their own trained dogs for one week each, comparing the dogs' accuracy with those of both fingerstick and CGM blood sugar monitoring.\u003c/p>\n\u003cp>The dogs did alert the owners over three times more often during low blood-sugar episodes than when blood sugar was normal. But just 12 percent of the 16 to 20 average weekly alerts occurred when the patient actually had hypoglycemia.\u003c/p>\n\u003cp>And when both the dog and the CGM alerted, the CGM alerted first in 73 percent of low blood sugar events, an average of 22 minutes sooner than did the dog.\u003c/p>\n\u003cp>Los speculates that the dogs might also be reacting to high blood sugars or rapid changes in blood sugar, situations that CGMs also detect and provide feedback for. \"Given that a CGM differentiates its alerts clearly, the dog is operating at a disadvantage.\"\u003c/p>\n\u003cp>\u003cstrong>A dog's world\u003c/strong>\u003c/p>\n\u003cp>Despite the many false alerts, surveyed dog users were very satisfied (8.9 on a 10-point scale) and fairly confident (7.9/10) in their dog's ability to detect hypoglycemia.\u003c/p>\n\u003cp>Evans told NPR those results don't surprise him. \"I suspect that dog owners are more tolerant of false negatives [from their dog] than a device falsely alarming, which really irritates.\"\u003c/p>\n\u003cp>For patients without CGMs who have a trained dog and find it helpful, Los says that \"I would never tell them to get rid of it, because it's alerting them to more hypoglycemia symptoms than they would otherwise know about.\"\u003c/p>\n\u003cp>More research is needed, he said, to determine whether particular training approaches, breeds or other factors might make dogs better hypoglycemia-detecting best friends.\u003c/p>\n\u003cp>\"Although it appears CGM outperformed trained dogs in this study, it is intriguing that dogs were able to detect some hypoglycemia,\" Los said. \"Perhaps understanding what factors impact dog reliability could help optimize dog performance.\"\u003c/p>\n\u003cp>Then there's the warm fuzzy effect. Other possible benefits not measured in the study could include having a positive partner in the daily management of a chronic disease, Los added, especially one \"in which the daily tasks are not very rewarding.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of the bonus material for NPR's podcast and show Invisibilia, which this week tells the tale of a woman who uses a blood-glucose monitoring app to track the health of her twin sister from afar. \u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Can+Diabetes+Alert+Dogs+Help+Sniff+Out+Low+Blood+Sugar%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/212953/devices-beat-dogs-in-detecting-low-blood-sugar-but-dog-owners-satisfied","authors":["byline_futureofyou_212953"],"categories":["futureofyou_1060"],"tags":["futureofyou_310","futureofyou_309","futureofyou_1002"],"featImg":"futureofyou_212957","label":"futureofyou"},"futureofyou_43784":{"type":"posts","id":"futureofyou_43784","meta":{"index":"posts_1591205157","site":"futureofyou","id":"43784","score":null,"sort":[1443388802000]},"guestAuthors":[],"slug":"mindful-bear-aims-to-teach-kids-about-healthy-eating","title":"‘Mindful’ Bear Aims to Teach Kids About Healthy Eating","publishDate":1443388802,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>For Caylin Proffitt, who was diagnosed with Type 1 diabetes at the age of five, healthy food choices aren't really -- well -- a matter of choice. But it's not just children with diabetes who should avoid too many sugary treats.\u003c/p>\n\u003cp>Several years ago, Caylin's mother Kristina learned about an interactive \u003ca href=\"http://www.jerrythebear.com/\">toy bear called \"Jerry.\"\u003c/a> Children can keep Jerry in \"optimal health\" by tracking his pretend blood sugar levels and feeding him healthy food cards, which can be swiped across the bear's mouth.\u003c/p>\n\u003cfigure id=\"attachment_43810\" class=\"wp-caption alignright\" style=\"max-width: 329px\">\u003cimg class=\"wp-image-43810\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/09/caylin-376x600.jpg\" alt=\"Caylin Proffitt with Jerry, her 'smart' bear and dietary consultant.\" width=\"329\" height=\"525\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/09/caylin-376x600.jpg 376w, https://ww2.kqed.org/app/uploads/sites/13/2015/09/caylin-400x639.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/09/caylin.jpg 593w\" sizes=\"(max-width: 329px) 100vw, 329px\">\u003cfigcaption class=\"wp-caption-text\">Caylin Proffitt with Jerry, her 'smart' bear and dietary consultant. \u003ccite>(Kristina Proffitt )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>This week, Sproutel, the company behind Jerry the Bear, released a version of the toy targeted to all children ages five to nine. While the original bear aimed to help kids with diabetes, the new bear is focused on general wellness, nutrition and \"mindful\" eating. It's also more mindful of family budgets, priced at $99, down from the original $300.\u003c/p>\n\u003cp>Parents of children with diabetes or food allergies can buy a special version for for $149, and access additional props, like an insulin pen or epinephrine pen. The new bear comes with \u003ca href=\"https://sproutel.wistia.com/medias/sl1d6sw0qr\">animated story books\u003c/a>, which provide further education to kids about nutrition and general health.\u003c/p>\n\u003cp>\"Carb counting and being mindful about their eating is difficult for kids,\" said Kristina Proffitt, who lives near Nashville, Tenn. \"But I remember my daughter giving Jerry a healthy lunch, and then deciding she would have something similar.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It remains to be seen whether the bear will appeal to children who have not been diagnosed with diabetes. Sproutel's founder and CEO Aaron Horowitz says the company uses research from the fields of gaming and behavioral science to change children's behavior in a fun and engaging way.\u003c/p>\n\u003cp>Moreover, studies have shown that teddy bears can relieve anxiety for children, \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/18847160\">particularly those who are chronically sick and hospitalized\u003c/a>. Sproutel's team plans to build on this research with a \u003ca href=\"http://pbn.com/Sproutel-to-receive-150K-in-federal-SBIR-funding,106341?utm_source=PBN+Master+List+-+All+Subscribers&utm_campaign=75512105cd-2015_0605_daily6_5_2015&utm_medium=email&utm_term=0_0e86591c9b-75512105cd-29912049\">$150,000 grant \u003c/a>from the National Institutes of Health. The team will use the money to conduct a small pilot study to determine whether\u003cspan class=\"s1\"> Jerry the Bear can reduce stress in the home.\u003c/span>\u003c/p>\n\u003cp>\"We've seen all kinds of studies where kids with diabetes can better manage their own disease by taking care of pets or toys,\" said Michael Chae, executive director of the Bay Area branch of the \u003ca href=\"http://www.diabetes.org/\">American Diabetes Association\u003c/a>. \"Really, we see benefits in any new, digital methods that can make it less onerous for children.\"\u003c/p>\n\u003cp>So far Jerry has found a home with about 500 families. That's about four percent of children who were diagnosed with diabetes last year. Horowitz says early data shows that kids are using Jerry the Bear for an average of one hour per week, which he takes as an indication that they are engaging with the toy.\u003c/p>\n\u003cfigure id=\"attachment_43806\" class=\"wp-caption alignleft\" style=\"max-width: 480px\">\u003cimg class=\"size-full wp-image-43806\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/09/jerry-the-bear-team-1.jpg\" alt=\"The Providence, RI-based team behind Jerry the Bear. \" width=\"480\" height=\"320\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/09/jerry-the-bear-team-1.jpg 480w, https://ww2.kqed.org/app/uploads/sites/13/2015/09/jerry-the-bear-team-1-400x267.jpg 400w\" sizes=\"(max-width: 480px) 100vw, 480px\">\u003cfigcaption class=\"wp-caption-text\">The Providence, RI-based team behind Jerry the Bear. \u003ccite>(Sproutel )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Horowitz came up with the idea for Jerry the Bear with his friend and co-founder, Hannah Chung, when he was an undergraduate at Northwestern University.\u003c/p>\n\u003cp>As a child, Horowitz suffered from a medical condition called Growth Hormone Deficiency, which required regular injections. He saw a need for \"smart\" toys that could help future generations of children manage chronic illnesses, including diabetes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We noticed in our early research with children with diabetes that they treated their teddy bears as if they had the disease,\" he said. \"They were role-playing everything they couldn't quite bear to do with their own bodies. That was what kicked us off.\"\u003c/p>\n\n","blocks":[],"excerpt":"Jerry the Bear, a 'smart' toy initially targeted to kids with diabetes, is looking to expand his territory. ","status":"publish","parent":0,"modified":1477274014,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":14,"wordCount":627},"headData":{"title":"‘Mindful’ Bear Aims to Teach Kids About Healthy Eating | KQED","description":"Jerry the Bear, a 'smart' toy initially targeted to kids with diabetes, is looking to expand his territory. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"‘Mindful’ Bear Aims to Teach Kids About Healthy Eating","datePublished":"2015-09-27T21:20:02.000Z","dateModified":"2016-10-24T01:53:34.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"43784 http://ww2.kqed.org/futureofyou/?p=43784","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/09/27/mindful-bear-aims-to-teach-kids-about-healthy-eating/","disqusTitle":"‘Mindful’ Bear Aims to Teach Kids About Healthy Eating","customPermalink":"2015/09/24/mindful-bear-aims-to-teach-kids-about-healthy-eating/","path":"/futureofyou/43784/mindful-bear-aims-to-teach-kids-about-healthy-eating","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>For Caylin Proffitt, who was diagnosed with Type 1 diabetes at the age of five, healthy food choices aren't really -- well -- a matter of choice. But it's not just children with diabetes who should avoid too many sugary treats.\u003c/p>\n\u003cp>Several years ago, Caylin's mother Kristina learned about an interactive \u003ca href=\"http://www.jerrythebear.com/\">toy bear called \"Jerry.\"\u003c/a> Children can keep Jerry in \"optimal health\" by tracking his pretend blood sugar levels and feeding him healthy food cards, which can be swiped across the bear's mouth.\u003c/p>\n\u003cfigure id=\"attachment_43810\" class=\"wp-caption alignright\" style=\"max-width: 329px\">\u003cimg class=\"wp-image-43810\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/09/caylin-376x600.jpg\" alt=\"Caylin Proffitt with Jerry, her 'smart' bear and dietary consultant.\" width=\"329\" height=\"525\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/09/caylin-376x600.jpg 376w, https://ww2.kqed.org/app/uploads/sites/13/2015/09/caylin-400x639.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/09/caylin.jpg 593w\" sizes=\"(max-width: 329px) 100vw, 329px\">\u003cfigcaption class=\"wp-caption-text\">Caylin Proffitt with Jerry, her 'smart' bear and dietary consultant. \u003ccite>(Kristina Proffitt )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>This week, Sproutel, the company behind Jerry the Bear, released a version of the toy targeted to all children ages five to nine. While the original bear aimed to help kids with diabetes, the new bear is focused on general wellness, nutrition and \"mindful\" eating. It's also more mindful of family budgets, priced at $99, down from the original $300.\u003c/p>\n\u003cp>Parents of children with diabetes or food allergies can buy a special version for for $149, and access additional props, like an insulin pen or epinephrine pen. The new bear comes with \u003ca href=\"https://sproutel.wistia.com/medias/sl1d6sw0qr\">animated story books\u003c/a>, which provide further education to kids about nutrition and general health.\u003c/p>\n\u003cp>\"Carb counting and being mindful about their eating is difficult for kids,\" said Kristina Proffitt, who lives near Nashville, Tenn. \"But I remember my daughter giving Jerry a healthy lunch, and then deciding she would have something similar.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It remains to be seen whether the bear will appeal to children who have not been diagnosed with diabetes. Sproutel's founder and CEO Aaron Horowitz says the company uses research from the fields of gaming and behavioral science to change children's behavior in a fun and engaging way.\u003c/p>\n\u003cp>Moreover, studies have shown that teddy bears can relieve anxiety for children, \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/18847160\">particularly those who are chronically sick and hospitalized\u003c/a>. Sproutel's team plans to build on this research with a \u003ca href=\"http://pbn.com/Sproutel-to-receive-150K-in-federal-SBIR-funding,106341?utm_source=PBN+Master+List+-+All+Subscribers&utm_campaign=75512105cd-2015_0605_daily6_5_2015&utm_medium=email&utm_term=0_0e86591c9b-75512105cd-29912049\">$150,000 grant \u003c/a>from the National Institutes of Health. The team will use the money to conduct a small pilot study to determine whether\u003cspan class=\"s1\"> Jerry the Bear can reduce stress in the home.\u003c/span>\u003c/p>\n\u003cp>\"We've seen all kinds of studies where kids with diabetes can better manage their own disease by taking care of pets or toys,\" said Michael Chae, executive director of the Bay Area branch of the \u003ca href=\"http://www.diabetes.org/\">American Diabetes Association\u003c/a>. \"Really, we see benefits in any new, digital methods that can make it less onerous for children.\"\u003c/p>\n\u003cp>So far Jerry has found a home with about 500 families. That's about four percent of children who were diagnosed with diabetes last year. Horowitz says early data shows that kids are using Jerry the Bear for an average of one hour per week, which he takes as an indication that they are engaging with the toy.\u003c/p>\n\u003cfigure id=\"attachment_43806\" class=\"wp-caption alignleft\" style=\"max-width: 480px\">\u003cimg class=\"size-full wp-image-43806\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/09/jerry-the-bear-team-1.jpg\" alt=\"The Providence, RI-based team behind Jerry the Bear. \" width=\"480\" height=\"320\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/09/jerry-the-bear-team-1.jpg 480w, https://ww2.kqed.org/app/uploads/sites/13/2015/09/jerry-the-bear-team-1-400x267.jpg 400w\" sizes=\"(max-width: 480px) 100vw, 480px\">\u003cfigcaption class=\"wp-caption-text\">The Providence, RI-based team behind Jerry the Bear. \u003ccite>(Sproutel )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Horowitz came up with the idea for Jerry the Bear with his friend and co-founder, Hannah Chung, when he was an undergraduate at Northwestern University.\u003c/p>\n\u003cp>As a child, Horowitz suffered from a medical condition called Growth Hormone Deficiency, which required regular injections. He saw a need for \"smart\" toys that could help future generations of children manage chronic illnesses, including diabetes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We noticed in our early research with children with diabetes that they treated their teddy bears as if they had the disease,\" he said. \"They were role-playing everything they couldn't quite bear to do with their own bodies. That was what kicked us off.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/43784/mindful-bear-aims-to-teach-kids-about-healthy-eating","authors":["3252"],"categories":["futureofyou_1060"],"tags":["futureofyou_309","futureofyou_597","futureofyou_61","futureofyou_80"],"featImg":"futureofyou_43809","label":"futureofyou"},"futureofyou_34158":{"type":"posts","id":"futureofyou_34158","meta":{"index":"posts_1591205157","site":"futureofyou","id":"34158","score":null,"sort":[1441383356000]},"guestAuthors":[],"slug":"why-google-is-going-all-in-on-diabetes","title":"Why Google is Going All in on Diabetes","publishDate":1441383356,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Millions of people with diabetes prick their finger more than five times a day to monitor their blood glucose levels. And that's a painful and expensive process.\u003c/p>\n\u003cp>But now, Google's Life Sciences division is putting its immense resources behind new initiatives aimed at helping them better live with the disease.\u003c/p>\n\u003cp>\"It's really hard for people to manage their blood sugar,\" said Jacquelyn Miller, a Google Life Sciences spokeswoman, in an interview with KQED. \"We're hoping to take some of the guesswork out of it.\"\u003c/p>\n\u003cp>Earlier this week the new Google Life Sciences unit announced that diabetes is the company's first major disease target. It may come as a surprise that Google, a company that helps people search online for flights and restaurants, and dabbles in other ventures like self-driving cars, is investing in new therapies to treat disease.\u003c/p>\n\u003cp>But according to Michael Chae, executive director of the Bay Area Chapter at the American Diabetes Association, Google's decision is a no brainer. It's a highly lucrative opportunity -- in 2012, the total cost of managing diabetes was $245 billion in the U.S. alone -- and the timing is just right for technology companies to enter the field.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"There's been an explosion of wearables, data and analytics,\" he said. \"People with diabetes are more comfortable living in a measured world.\"\u003c/p>\n\u003cp>Chae envisions a future where people with diabetes can measure their blood glucose levels on a continuous basis, using painless methods. One of Google's emerging products is a contact lens embedded with a glitter-sized sensor that can measure glucose levels in tears. \"There's a whole lot of innovation at once,\" he said.\u003c/p>\n\u003cp>\u003cstrong>'I Didn't Feel Like a Normal Human Being'\u003c/strong>\u003c/p>\n\u003cp>The methods that Cyrus Khambatta uses to manage his Type 1 diabetes haven't changed much in the past decade.\u003c/p>\n\u003cp>Khambatta, \u003ca href=\"http://www.mangomannutrition.com\">a nutritionist\u003c/a> based in San Francisco was diagnosed with the disease at the age of 22. Each day, he pricks his finger between six and 10 times. He uses a lancet to draw a little blood, which he adds to a test strip, and feeds the strip into a glucose meter to check his blood sugar levels.\u003c/p>\n\u003cp>Before meals and exercise, he injects himself with a syringe filled with insulin. He dials up the amount of insulin based on the data from the glucose meter. The insulin required at any given time is related to many factors, including stress, sleep, exercise and diet, Khambatta explained, and involves a high attention to detail combined with some degree of guesswork.\u003c/p>\n\u003cp>\"Unlike a migraine or acne, diabetes management is all about developing an understanding and manipulation of numbers over time,\" he said. \"Diabetes is very quantitative.\"\u003c/p>\n\u003cfigure id=\"attachment_34870\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-34870\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/09/unnamed-800x600.jpg\" alt=\"Khambatta regulates his insulin levels with a glucose meter, syringe and lancet. \" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/09/unnamed-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/09/unnamed-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/09/unnamed-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/09/unnamed.jpg 1046w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Khambatta regulates his insulin levels with a glucose meter, syringe and lancet. \u003ccite>(Cyrus Khambatta )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Khambatta describes his style for managing disease as \"old school\" compared to some of his peers. Many other diabetes sufferers use more modern alternatives for glucose monitoring, such as a patch with \u003ca href=\"http://www.dexcom.com/continuous-glucose-monitoring\">tiny needle-based sensors under the skin\u003c/a>, which connects to a transmitter and an insulin pump.\u003c/p>\n\u003cp>But for Khambatta, these options still require a good deal of effort, as the sensor needs to be changed every two to three days, and they serve as a constant visual reminder of his condition. When he tried them, he said: \"I didn't feel like a normal human being.\"\u003c/p>\n\u003cp>In the near future, he said he also hopes that companies will develop non-invasive, continuous glucose monitoring, which wouldn't draw blood or cause pain or trauma.\u003c/p>\n\u003cp>\"That's the holy grail,\" said Cameron Sepah, medical director from \u003ca href=\"https://omadahealth.com/\">Omada Health\u003c/a>, a San Francisco-based company that focuses on technology for diabetes prevention. Sepah said such a sophisticated blood sugar-tracking system could be paired with a device that delivers insulin, and thus act as an \"artificial pancreas.\"\u003c/p>\n\u003cp>\"Health companies have been working on this for years,\" he said. \"But Google has a history of taking on very ambitious projects.\"\u003c/p>\n\u003cp>\u003cstrong>Why Google? \u003c/strong>\u003c/p>\n\u003cp>Google made a name for itself with search technology, but it has dabbled in more ambitious \"moonshot\" projects from self-driving cars to stratospheric Internet balloons.\u003c/p>\n\u003cp>The life sciences' team, which initially worked with Google's secretive research arm Google X, spun out from the Google search engine business in August. Both entities will be held under an umbrella organization \u003ca href=\"http://www.theguardian.com/technology/2015/aug/10/google-alphabet-parent-company\">called Alphabet. \u003c/a>\u003c/p>\n\u003caside class=\"pullquote alignright\">'It's really hard for people to manage their blood sugar. We're hoping to take some of the guesswork out of it.'\u003cbr>\n\u003ccite>Jacquelyn Miller, spokesperson for Google Life Sciences\u003c/cite>\u003c/aside>\n\u003cp>The life sciences unit is led by molecular biologist Andy Conrad, who has helped the company secure partnerships with top drug makers and medical device companies. Conrad seems to be taking a different tack than the \u003ca href=\"http://www.informationweek.com/healthcare/electronic-health-records/5-reasons-why-google-health-failed/d/d-id/1098623?\">the ill-fated \"Google Health\u003c/a>\" team, which offered a personal health record product and closed in 2011 because of a lack of traction, by seeking the input and assistance of more established players in the medical sector.\u003c/p>\n\u003cp>Google Life Sciences earlier this week announced a partnership with \u003ca href=\"http://www.sanofi.us/l/us/en/index.jsp\">Sanofi\u003c/a>, maker of an insulin inhaler and a slew of other products for people with diabetes. It is also working with \u003ca href=\"http://www.jnj.com/\">Johnson & Johnson \u003c/a>on \u003ca href=\"http://ww2.kqed.org/futureofyou/robotics-surgeons-google-jandj\">surgical robots\u003c/a>; Novartis and Dexcom on \u003ca href=\"https://www.novartis.com/news/media-releases/novartis-license-google-smart-lens-technology\">diabetes-related projects\u003c/a>, and Biogen on\u003ca href=\"http://www.bloomberg.com/news/articles/2015-01-27/google-biogen-seek-reasons-for-advance-of-multiple-sclerosis\"> potential treatments for multiple sclerosis\u003c/a>.\u003c/p>\n\u003cp>But the diabetes opportunity appears to be the primary focus. Data and analytics is Google's area of expertise, and as Miller puts it, diabetes management is fundamentally an \"information problem.\"\u003c/p>\n\u003cp>Patients with diabetes lack clear information about how variables like nutrition and exercise affect their blood sugar levels, she said. And these kind of insights could help them adjust their insulin levels and avoid serious outcomes, like stroke, heart disease and hypoglycemia.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But don't expect any of the products from the Life Sciences team to hit the market next week. Given the technical challenges and the regulatory requirements, experts say, it could take years before any new device reaches patients.\u003c/p>\n\n","blocks":[],"excerpt":"\"It's really hard for people [with diabetes] to manage their blood sugar,\" Google told KQED. \"We're hoping to take some of the guesswork out of it.\"","status":"publish","parent":0,"modified":1477274349,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":1063},"headData":{"title":"Why Google is Going All in on Diabetes | KQED","description":""It's really hard for people to manage their blood sugar," Google told KQED. "We're hoping to take some of the guesswork out of it."","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Why Google is Going All in on Diabetes","datePublished":"2015-09-04T16:15:56.000Z","dateModified":"2016-10-24T01:59:09.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"34158 http://ww2.kqed.org/futureofyou/?p=34158","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/09/04/why-google-is-going-all-in-on-diabetes/","disqusTitle":"Why Google is Going All in on Diabetes","source":"Future of You","path":"/futureofyou/34158/why-google-is-going-all-in-on-diabetes","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Millions of people with diabetes prick their finger more than five times a day to monitor their blood glucose levels. And that's a painful and expensive process.\u003c/p>\n\u003cp>But now, Google's Life Sciences division is putting its immense resources behind new initiatives aimed at helping them better live with the disease.\u003c/p>\n\u003cp>\"It's really hard for people to manage their blood sugar,\" said Jacquelyn Miller, a Google Life Sciences spokeswoman, in an interview with KQED. \"We're hoping to take some of the guesswork out of it.\"\u003c/p>\n\u003cp>Earlier this week the new Google Life Sciences unit announced that diabetes is the company's first major disease target. It may come as a surprise that Google, a company that helps people search online for flights and restaurants, and dabbles in other ventures like self-driving cars, is investing in new therapies to treat disease.\u003c/p>\n\u003cp>But according to Michael Chae, executive director of the Bay Area Chapter at the American Diabetes Association, Google's decision is a no brainer. It's a highly lucrative opportunity -- in 2012, the total cost of managing diabetes was $245 billion in the U.S. alone -- and the timing is just right for technology companies to enter the field.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"There's been an explosion of wearables, data and analytics,\" he said. \"People with diabetes are more comfortable living in a measured world.\"\u003c/p>\n\u003cp>Chae envisions a future where people with diabetes can measure their blood glucose levels on a continuous basis, using painless methods. One of Google's emerging products is a contact lens embedded with a glitter-sized sensor that can measure glucose levels in tears. \"There's a whole lot of innovation at once,\" he said.\u003c/p>\n\u003cp>\u003cstrong>'I Didn't Feel Like a Normal Human Being'\u003c/strong>\u003c/p>\n\u003cp>The methods that Cyrus Khambatta uses to manage his Type 1 diabetes haven't changed much in the past decade.\u003c/p>\n\u003cp>Khambatta, \u003ca href=\"http://www.mangomannutrition.com\">a nutritionist\u003c/a> based in San Francisco was diagnosed with the disease at the age of 22. Each day, he pricks his finger between six and 10 times. He uses a lancet to draw a little blood, which he adds to a test strip, and feeds the strip into a glucose meter to check his blood sugar levels.\u003c/p>\n\u003cp>Before meals and exercise, he injects himself with a syringe filled with insulin. He dials up the amount of insulin based on the data from the glucose meter. The insulin required at any given time is related to many factors, including stress, sleep, exercise and diet, Khambatta explained, and involves a high attention to detail combined with some degree of guesswork.\u003c/p>\n\u003cp>\"Unlike a migraine or acne, diabetes management is all about developing an understanding and manipulation of numbers over time,\" he said. \"Diabetes is very quantitative.\"\u003c/p>\n\u003cfigure id=\"attachment_34870\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-34870\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/09/unnamed-800x600.jpg\" alt=\"Khambatta regulates his insulin levels with a glucose meter, syringe and lancet. \" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/09/unnamed-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/09/unnamed-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/09/unnamed-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/09/unnamed.jpg 1046w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Khambatta regulates his insulin levels with a glucose meter, syringe and lancet. \u003ccite>(Cyrus Khambatta )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Khambatta describes his style for managing disease as \"old school\" compared to some of his peers. Many other diabetes sufferers use more modern alternatives for glucose monitoring, such as a patch with \u003ca href=\"http://www.dexcom.com/continuous-glucose-monitoring\">tiny needle-based sensors under the skin\u003c/a>, which connects to a transmitter and an insulin pump.\u003c/p>\n\u003cp>But for Khambatta, these options still require a good deal of effort, as the sensor needs to be changed every two to three days, and they serve as a constant visual reminder of his condition. When he tried them, he said: \"I didn't feel like a normal human being.\"\u003c/p>\n\u003cp>In the near future, he said he also hopes that companies will develop non-invasive, continuous glucose monitoring, which wouldn't draw blood or cause pain or trauma.\u003c/p>\n\u003cp>\"That's the holy grail,\" said Cameron Sepah, medical director from \u003ca href=\"https://omadahealth.com/\">Omada Health\u003c/a>, a San Francisco-based company that focuses on technology for diabetes prevention. Sepah said such a sophisticated blood sugar-tracking system could be paired with a device that delivers insulin, and thus act as an \"artificial pancreas.\"\u003c/p>\n\u003cp>\"Health companies have been working on this for years,\" he said. \"But Google has a history of taking on very ambitious projects.\"\u003c/p>\n\u003cp>\u003cstrong>Why Google? \u003c/strong>\u003c/p>\n\u003cp>Google made a name for itself with search technology, but it has dabbled in more ambitious \"moonshot\" projects from self-driving cars to stratospheric Internet balloons.\u003c/p>\n\u003cp>The life sciences' team, which initially worked with Google's secretive research arm Google X, spun out from the Google search engine business in August. Both entities will be held under an umbrella organization \u003ca href=\"http://www.theguardian.com/technology/2015/aug/10/google-alphabet-parent-company\">called Alphabet. \u003c/a>\u003c/p>\n\u003caside class=\"pullquote alignright\">'It's really hard for people to manage their blood sugar. We're hoping to take some of the guesswork out of it.'\u003cbr>\n\u003ccite>Jacquelyn Miller, spokesperson for Google Life Sciences\u003c/cite>\u003c/aside>\n\u003cp>The life sciences unit is led by molecular biologist Andy Conrad, who has helped the company secure partnerships with top drug makers and medical device companies. Conrad seems to be taking a different tack than the \u003ca href=\"http://www.informationweek.com/healthcare/electronic-health-records/5-reasons-why-google-health-failed/d/d-id/1098623?\">the ill-fated \"Google Health\u003c/a>\" team, which offered a personal health record product and closed in 2011 because of a lack of traction, by seeking the input and assistance of more established players in the medical sector.\u003c/p>\n\u003cp>Google Life Sciences earlier this week announced a partnership with \u003ca href=\"http://www.sanofi.us/l/us/en/index.jsp\">Sanofi\u003c/a>, maker of an insulin inhaler and a slew of other products for people with diabetes. It is also working with \u003ca href=\"http://www.jnj.com/\">Johnson & Johnson \u003c/a>on \u003ca href=\"http://ww2.kqed.org/futureofyou/robotics-surgeons-google-jandj\">surgical robots\u003c/a>; Novartis and Dexcom on \u003ca href=\"https://www.novartis.com/news/media-releases/novartis-license-google-smart-lens-technology\">diabetes-related projects\u003c/a>, and Biogen on\u003ca href=\"http://www.bloomberg.com/news/articles/2015-01-27/google-biogen-seek-reasons-for-advance-of-multiple-sclerosis\"> potential treatments for multiple sclerosis\u003c/a>.\u003c/p>\n\u003cp>But the diabetes opportunity appears to be the primary focus. Data and analytics is Google's area of expertise, and as Miller puts it, diabetes management is fundamentally an \"information problem.\"\u003c/p>\n\u003cp>Patients with diabetes lack clear information about how variables like nutrition and exercise affect their blood sugar levels, she said. And these kind of insights could help them adjust their insulin levels and avoid serious outcomes, like stroke, heart disease and hypoglycemia.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But don't expect any of the products from the Life Sciences team to hit the market next week. Given the technical challenges and the regulatory requirements, experts say, it could take years before any new device reaches patients.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/34158/why-google-is-going-all-in-on-diabetes","authors":["3252"],"categories":["futureofyou_1060"],"tags":["futureofyou_309","futureofyou_131","futureofyou_80"],"featImg":"futureofyou_34595","label":"source_futureofyou_34158"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. 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But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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