Though Diabetes is nothing to celebrate, it is something to understand. Not only in the US, but in numerous places throughout the globe diabetes has now become an epidemic and the effects of the disease is one of the most critical drains on healthcare around the world.

Take some time to better understand diabetes. If you know someone with the disease, take the opportunity to ask them about it. To be honest, most with diabetes are willing to help clarify what the disease means for them.

Here are some resources for you to start your education:

The International Diabetes Foundation’s List of Diabetes Day Activities

The Juvenile Diabetes Research Foundation’s Research Page

The American Diabetes Association’s Diabetes Basics Page

As we all become better educated, it will be clear to everyone how important it is to find a cure. Help any way you can.

Though we are all hopeful for an eventual cure for Type 1 diabetes, the continued wins researchers are seeing in their quest to create an artificial pancreas is heartening.

Most of the focus in the news recently is on recent improvements in combining insulin pump technology with continuous blood glucose monitoring.  Intuitively it would seem simple.  Have a single device that measures blood glucose on a continuous basis and based on readings release insulin into the body.

Ah, but nothing is as easy as it seems.  Numerous challenges exist, but a key one is the lag between food consumption, what a glucose monitor measures, and the ability to get insulin into the system.  What needs to happen is to be able to predict glucose levels based on types of foods being eaten and immediately release the insulin to welcome the food. (Our body’s ability to do this is simply remarkable)

There are folks working on this problem luckily.  A recent article in US News and World Report describes the effort of a team of mathmaticians, let by Boris Kovatchev, that are developing algorithms based on specific individual’s insulin requirements.  So far they’ve had some luck.

Another group attempting to tackle this are out of the University of California Santa Barbara.  They recently released results of a study of a software program that they have developed to do just this kind of anticipation and ensure that not too much insulin is released.

Soon enough (in the next year or two? maybe?) all-in-one devices will be on the market to help manage this disease.

The California Nurses Organization obviously was quite pleased with the decision as it now appears that only licensed nurses will be allowed to administer insulin injections in California public schools (except in cases where either the individual self-administers or a parent administers).

What do you think about this?

Our own opinion is that this not only severely limits choices that a school and parent has for medical treatment, but it also binds schools to another layer of fiscal costs in a time when our schools (especially in California) are truly suffering.

In our own school, nurses are only on campus and available about 20 minutes each day during lunch. That’s all! Also, the actual nurse who arrives changes each day and we do not have a clear understanding of their schedule so we don’t know who to expect on any given day. Though some of the nurses have been fantastic – caring for our son and another child with diabetes and being proactive to ensure they eat everything in their lunch – others have been downright irresponsible. We have had a number of occasions where my wife (who has been showing up to train all these nurses) has had to hunt the nurse down or has had to keep them there in the office rather than running out “to a meeting”. It has been clear that if my wife was not there these individuals would have left campus without administering insulin.

The reason why there is such a turnover of nurses and limited coverage has not clearly been explained to us, but it is clearly a result of the difficult financial state of our district (the largest in the State) along with a rise in diabetes incidences.

Though we certainly appreciate a well-trained and caring nurse, it has become very evident that just because one holds a nursing license it does not explicitly equate to “well-trained” and “caring”. We would actually be much better off training a single, responsible, caring individual on how to calculate dosage and how to administer insulin rather than rely on the bevy of inconsistent nurses we have now.

Our own view is that this decision is simply a means of maintaining job security for the nurses rather than in any interest for the well-being of our children. Given that there is clearly a lack of adequate nurses in our country these days, this decision can only be seen as narrow and wrong.

I am sure that both the American Diabetes Association and the California Department of Education will be fighting this. We should lend our support.

Read more here: California School Nurses Org Applauds Court Ruling

It includes discussion of a new device to help diagnose diabetes by reading glucose levels through the skin, a new breath-based glucose monitoring device that would hopefully replace your normal glucose monitoring pricks, and a new injection ‘well’ that provides a painless way to take your daily insulin shots.

Reducing Insulin Punctures

For months, skeptical traders have expressed concern that the diabetes drug, if approved by the Food and Drug Administration, might end up with an FDA cancer advisory. Fears that the inhaler would never take off were still lurking Tuesday, even though MannKind said that trials of its Technosphere insulin delivery system showed no elevated cancer risk.

Analysts said those concerns helped push the company’s stock down 14% to $2.92 on Tuesday. MannKind shares have fallen 54% since April 1.

MannKind’s founder, Los Angeles billionaire Alfred Mann, remains optimistic. He says independent market surveys suggest that, even with an FDA warning, Technosphere will be a “blockbuster product.” It could pull in more than $1 billion in annual sales, he said in a phone interview.

And a warning label, which would probably blanket the entire class of insulin inhalers, is unlikely, he said. Technosphere should fly through the approval process and be relatively cheap to produce, he said.
“We fill a really poorly met need,” he said. “So we don’t understand the negativity.”

MannKind said Tuesday that results from a year of study suggested that Technosphere was as effective as traditional injection treatments, according to the company. Patients with Type 1 diabetes experienced stable or lower weight and better blood sugar levels between meals, MannKind said.

The company said the drug had no negative effect on lung function, a problem that had loomed over other inhalers.

The data came with news of a collaboration between MannKind and Pfizer Inc. and anticipation of MannKind’s Sept. 23 presentation at the UBS Global Life Sciences Conference.

“These observations confirm the results of earlier studies and build on the important differentiating features of this product, including its positive effects on fasting glucose levels,” Dr. Peter Richardson, the company’s chief scientific officer, said in a statement.

But for all its promises of producing a super drug, MannKind has been battered by bad buzz for much of the year.

Pfizer stopped selling MannKind’s Exubera powder in October after abysmal sales, sparking an exodus from inhaler development by pharmaceutical companies, including Novo Nordisk in January and Eli Lilly & Co. in March.

When Pfizer revealed in April that Exubera may have caused lung cancer in six patients, MannKind’s stock promptly plunged nearly 60%.

MannKind and Pfizer said Tuesday that they hoped to transition some Exubera patients — particularly those with severe fear of needles and negative reactions to insulin injections — to the Technosphere inhalant.

If approved by the FDA, Technosphere “will find itself in the unenviable position of having to entirely rebuild a decimated market in the wake of the notorious failure of Exubera,” Cory Kasimov, an analyst with JP Morgan, said Tuesday in a note to investors.

As reported in Los Angeles Times, September 17, 2008