Close Concerns Weblog

Color coded insulin packaging? Outstanding idea!

Simple ideas usually work the best.

 

Lilly recently announced the launch of their color differentiation system for their U-100 insulin products in the United States (think Humalog® and Humalin®). Our thought? EXCELLENT idea! We're glad to see it and not a moment too soon. We know there are plenty of people with diabetes who have accidentally used the wrong type of insulin. Some have put long-acting insulin in pumps; others have given 15 units of Humalog instead of Lantus without realizing; etc. But beyond the normal mistakes people can make (young and older alike), remember that there are many people in the United States that have problems understanding the doctor's instructions. Health literacy can be as much of an obstacle to diabetes management as access to insulin in the United States. It's definitely a problem we should be working on equally while researching for a cure as part of the care to keep everyone healthy while we wait!

We give a thumbs up to these improved safety measures that will help patients use insulin correctly. Remember, it's important to always look at the label and read it correctly, follow your doctor's orders, etc. and we are glad for the extra recognition factor to assist in correctly identifying insulin. Lilly plans to introduce the color differentiation system in all insulin products, from vials to pens to individual packaging. This follows Lilly's 2004 introduction of bar coding of packaging and insulin vials. The color system will be introduced throughout 2008 with colors indicating both insulin 'family' and insulin 'type' (burgundy for Humalog; blue for Humalin; yellow for Regular; insulin mixes will have two colors).

What do you think are other ways to address the health literacy obstacle to diabetes management?

Mediterranean Diet Slips Away as Pounds Pack on Population

Think of Greece: a beautiful country with sparkling waters, breathtaking villages among the cliffs, and a health and happy population.

Think of Greece today: with the help of an article in the New York Times, we now can visualize the same problems plaguing the younger populations that have been well-publicized in the United States for years. In fact, one father discussing his daughter’s weight problem scoffed about it: “We’re trying to keep her off sugar now. If we continue like this, we’re going to become like Americans, and no one wants that.” You better believe it!

The fact of the matter is that, although Americans have become the poster child for obesity (literally), obesity has become an international phenomenon. The World Health Organization performed a number of studies showing the rise in overweight and obese children in Scandinavian countries recently. Although the adult population’s weight has also risen, their taste buds still prefer the traditional Mediterranean diet over the lifestyle of convenient food that kids prefer, which may be their saving grace.

The Mediterranean diet, first seriously studied in the 1990s, had scientists amazed because of the lengthy lifespan and low rates of serious disease (despite increases in unhealthy habits of smoking and drinking).

What is the magical diet that is so special and is dying off in cultures both in Greece and worldwide? It consisted of a diet low in saturated fats and high in nutrients such as flavonoids; it was based on daily consumption of vegetables, fruits, unrefined grains, and olive oil for cooking and for flavoring. Compare this to your daily diet – you may notice a few things missing! Fish, nuts, poultry, eggs, cheese and sweets were a weekly rather than daily supplement. Additionally, red meat, refined sugar or flour, butters, and other oils and fats were only consumed rarely.

Many of us with diabetes create our own diets, a combination of the necessities of our lifestyle and somewhat of a semblance of compliance with doctor (and CDE and nutritionist)’s order. But here’s something to chew on – would incorporating the Mediterranean diet be such a hardship? It’s a return to more natural and less processed food, but it could be the key to more easily managing daily blood sugars and in the long term, as proven by the Greeks of the past, lessen the risk for serious complications and other conditions. Food for thought…

Welcome mental illness measures approved in Congress for people with diabetes

Diabetes and depression – easily known as twin diseases, as they often times go hand in hand.

Also hand in hand goes the frustration with insurance companies in trying to get coverage for visits with mental health specialist. We all know that our health care system needs some kind of overhaul, and it’s basically a relief to know that Congress is doing what it can in the meantime to crack down on insurance companies exploiting a loophole and preventing insurers from charging higher co-payments and setting stricter limits for mental health services. Insurers have been dancing around the 1996 law that forbids health plans to set annual or lifetime dollar limits on mental health care lower than limits for other services.

Sen. Amy Klobuchar (D-Minn) said it well: “We are eliminating the stigma and affirming the dignity” of people with mental illness with the passing of this bill and similar measures. THANK YOU! Other supporters include Sen. Ted Kennedy (D-Mass) and Sen. Pete Domenici (R-NM). The bill prohibits higher co-payments, deductibles, and out-of-pocket expenses for mental health services than those for treatment of physical illnesses. Okay, good, although co-pays are already pretty high for physical illneses – better yet would be to work on lowering deductibles overall!

Still, one thing at a time - we do see a sigh of relief coming from the diabetes community. Unfortunately, depression is often a complication of diabetes, regardless of the duration with diabetes, and many people have previously been unable to afford to see a mental health professional on top of the rising costs and other burdens of diabetes care. We hope this law is adequate enough to prevent insurers from discovering yet another loophole and instead step up and begin helping people with mental health concerns get appropriate care.

Online Health – welcome attitude from Dr. Kalnicki

Knowledge is power, and now most people (including doctors!) are acknowledging the profound power of the Internet  and how it can help enable patients to take on more responsibility on the healthcare front.   A recent article in the New York Times focused on the trend for patients to go online to seek for information – and doctors contributing to the report encouraged them. Because doctors acknowledged the limited time they have to spend with patients, they asked their patients to bring information and their knowledge into the meeting, so that they have a foot up on what’s going on. Some of these doctors also do their best to educate patients about the right kind of websites. Dr. Shalom Kalnicki, chairman of Radiation Oncology at the Montefiore-Einstein Cancer Center, is one such doctor who tries to guide patients in finding more information. In the article, he noted the importance of doctors acknowledging that patients are surfing for information and expressed welcome enthusiasm about the new world of knowledge online: “It’s important that instead of fighting against it, that we join them and become their coaches in the process.”

Wow! A doctor who recognizes what real patients are doing and is trying to help us further! We wish more doctors – especially endocrinologists – would take this view. With diabetes, we know that as patients a 15 minute appointment every three months is not typically enough to help us manage diabetes 24/7/365. We thank the doctors and educators that have recognized terrific websites …

A second article in the New York Times recently described logging on for “a second (or third) opinion”. This one covered the different kinds of sites patients check out, such as general information, medical research, patients’ personal sites, disease-specific, and web-tool based sites. Why is it a novelty? We think doctors and the general public are beginning to catch on to something that we, the diabetes community, have been heavily involved in for a long time. We’re hoping that endocrinologists follow suit with other doctors and help people with diabetes understand the differences between a patient blog, based on personal experience; a scientifically-based organization site (such as the American Diabetes Association); and other sites that may pop up on a Google search for “cure diabetes” (ever checked out http://www.diabetes1and2.com/ ?).

We’re also thrilled that some organizations have taken to the Web for contests and have included health as a major entry category – like the Google 10^100 project that took in entries for ideas to help people all over the world. We’re pretty sure there are some great suggestions on how to help people with diabetes worldwide in there, and we hope you join us in January to check out and vote on the entries!

Why do you head to the Internet? Do you seek information and knowledge and/or a community? Let us know!

TODAY takes on diabetes

Dr. Anne Peters, endocrinologist extraordinaire and Director of USC Clinical Diabetes Programs among other things, will be front and center at TODAY’s segment on diabetes this Friday, October 10, in New York City. Dr. Peters will be featured in an upcoming diaTribe interview, which you can preview.

 

 

Maria Menunous is leading the TODAY segment to educate and raise awareness about diabetes, which is especially important to her since her father was diagnosed with type 1 several years ago. The TODAY show is having an open air plaza “fair” (open to the public!) with nutritionists, educators, and trainers to ask questions and share tips. The plaza fair will be outside NBC’s Studio 1A on 50^th street between 5^th and 6^th, from 6:30am and 10:00 am.  It’s a family event focused on answering diabetes questions and teaching you and your loved ones about diabetes.  ADA and JDRF are teaming up with TODAY on content for the segment – here’s three cheers from us for their collaboration!

 

We hope TODAY will take advantage of the crowds at the fair and get them moving that morning! Using the trainers to get people’s hearts pumping in addition to pulling on heart strings with touching stories of families impacted by the disease would be the best way to get our nation’s population moving in the right direction towards healthy lifestyles. We also hope that their “Diabetes 101” takes care of distinguishing the differences between Type 1 and Type 2 and acknowledging the unique difficulties of each! 

Taking Control Of Your Diabetes – see Dr. Steve Edelman before the year is out!

Taking Control of Your Diabetes in Santa Rosa, California on Saturday, October 11. TCOYD will feature a number of terrific sessions such as Dr. Bill Polonsky, diaTribe advisory board member and the speaker of our favorite quote on diabetes ever which is "Well controlled diabetes is the leading cause of nothing!”. Bill will speak on “The Personal Side of Diabetes: Overcoming Obstacles to Effective Self-Management” in the morning and an interactive afternoon session exploring ways to meet needs of both people with diabetes and their caregivers. Also up will be Dr. David Price, endocrinologist extraordinaire, now doing research at LifeScan, talking on the ABCs of diabetes and more specifically oral medication and non-insulin injectables to help treat type 2. UCSF’s famous Dr. Umesh Masharani is also in the lineup to lead a workshop, “Getting to Insulin Sooner: The Truths and the Myths About Insulin Use and Type 2 Diabetes”

In between sessions, make sure you stop by and visit us! diaTribe will be at the health fair.

The Bay Area’s own Amy Tendrich (http://www.diabetesmine.com/2007/08/tcoyd.html ) will be leading a hands-on session about online resources for people with diabetes. She is a web 2.0 (and health 2.0!) expert and as thousands in the diabetes community know, has one of the most valuable  blogs in healthcare on the web today.

Future TCOYD conferences will be in Des Moines on October 25 and include the 100^th TCOYD meeting in San Diego on Saturday, November 22! We know anyone who has gone to one of the TCOYD’s teams’ meetings knows that this is an amazing resource for people with diabetes – don’t forget Dr. Edelman has diabetes himself and really understands us. Hope you can make it …