From 1983 to 1993, the Diabetes Control and Complications Trial (DCCT) randomized 1,441 patients with type 1 diabetes to either conventional or intensive glycemic control. Conventional control meant taking one or two daily insulin injections, while intensive meant taking at least three daily injections of insulin and at least four blood glucose monitoring tests. The Epidemiology of Diabetes Interventions and Complications study (EDIC) was conducted as a follow-up to the DCCT and took place starting when DCCT ended; it is ongoing today.
A report published in the Archives of Internal Medicine on July 27, written by the DCCT Study Group and led by David M. Nathan, MD and collaborators analyzed data from the DCCT and EDIC trials (thus the name DCCT/EDIC) and showed dramatic improvements in outcomes for patients involved in the study compared with those who had been diagnosed just 10-20 years before. The outcomes from patients that have had diabetes for thirty (30!) years were presented and showed that patients in the intensive group had significantly fewer serious complications, namely proliferative retinopathy, nephropathy, and cardiovascular disease (CVD) compared to patients in the conventional group (when you see the word “significant” in scientific literature, you know it’s a big deal). "Now in the modern era, knowing how to use insulin more physiologically has led to really dramatically different outcomes,” said Dr. David Nathan of Mass General, a highly regarded endocrinologist and researcher and one of the study chairs for DCCT/EDIC.
This is hugely encouraging news and strong scientific evidence that the strides we’ve made in treating diabetes has made a huge difference. The data presented should also encourage patients with type 1 diabetes to strive for tight glycemic control – and today, we know it’s easier to do this with insulin pumps and CGM and therapies like rapid acting analogs and Symlin. While we know it can be hard in this economy to afford the latest and greatest therapies and technologies, this data may well be the evidence we need to get insurers to pay for more in the US. Although there are no conclusions yet for patients with type 2 diabetes, we will watch to see if the same conclusions can be made. A great day for people with diabetes – proving that our hard work in trying to stay in tight control does pay off!
On July 29th, the JDRF formally launched a very exciting on-line Clinical Trials Connection service. The service was launched to help patients with type 1 diabetes and their families better understand the clinical trials landscape and inform them so that they can play an active role in the search for better technologies, therapies, and ultimately, a cure. This very cool (and free!) service provides descriptions of and access to both JDRF-funded and other clinical trials. After filling out a profile on the site, the service will match you to trials that you might be interested in.
The very cool part is that it's customized. So, Clinical Trials Connection allows you to search by trial location, compare trials side by side, and create custom reports of trials to save and share with your family and doctor and educator. This is a win-win-win in our view—it should help patients by ending endless searching on clinicaltrials.gov, it helps companies by finding people that are right for the trials faster, helps doctors advise patients on trials that are right for them, and facilitates the process so that the regulatory process can be faster overall. Ultimately, we believe the impact could be getting drugs and devices out to market quicker. We have just started testing this out ourselves and urge all patients with type 1 to enroll and try it out. The next step - let's convince another amazing advocacy organization to recreate this tool for those with type 2 diabetes and with prediabetes!
One of the team members was in New York City recently, and was startled to look up in a mainstream restaurant (she only went into McDonald's for a diet soda!) to see the calorie count listed on the menu. Like we've discussed before, we're huge supporters of having correct nutritional information out for consumers to see.
However, menu labeling has previously only been mandated by law to large chains, such as those with 20 or more units. One restaurant group claims that this eliminates 75% of the industry, thus harming consumers.
Wait...fast food restaurants on our side?! Maybe – we agree all restaurants should have nutrition labels posted (carbs in addition to calorie counts, of course!). However, it's a smooth move by this restaurant group who is petitioning Congress to expand the potential legislation to require more restaurants to post nutritional information. Like many big industry efforts, their intentions may not really be for the good of the consumer's health, but we're thrilled to see the discussion turn back to the merits of nutrition labels & the importance of this practice spreading nationwide!
On July 28th, 2009, the Senate Judiciary Committee voted 13 to six, endorsing the Supreme Court nomination of Sonia Sotomayor, who has type 1 diabetes. All 12 Democrats on the committee voted for Judge Sotomayor, while only Senator Lindsey Graham of South Carolina voted in favor. This vote predicts a smooth path for her confirmation as the first Latina member of the Supreme Court, and the first Justice with type 1 diabetes. Read the NYT article here
In our latest issue of diaTribe, Jim Hirsch explains how he got involved in the White House's efforts to handle the fallout. Click here to continue
And don't forget to sign up for the diaTribe CGM Giveaway.
This month, we’re excited to be able to give away one $500 credit for DexCom merchandise! This contest is open to everyone, regardless of whether they’re diaTribe readers already, so help us spread the word about CGM by forwarding this post! Click here to enter the giveaway
Last night, President Obama discussed healthcare and healthcare reform at his fifth news conference. There’s a lot of discussion about politics and getting the reform bill through Congress, but aside from that, we’re so inspired to hear our president say this:
If we can get those people insured and instead of having a foot amputation, because of advanced diabetes, they're getting a nutritionist who's working with them, to make sure that they are keeping their diet where it needs to be, that's going to save us all money in the long-term."
--President Barack Obama, July 22, 2009.
You know what? He gets it! We have to invest now in diabetes education and tools to keep us healthy – and happy – as we wait on a cure. By this method, we’ll save money, but more importantly we’ll save lives.
Also, here’s what he said about reform:
This is not just about the 47 million Americans who don't have any health insurance at all. Reform is about every American who has ever feared that they may lose their coverage, if they become too sick or lose their job or change their job.
Fantastic. And, thank you. Just, thank you.
Today marks the final day of Sonia Sotomayor's confirmation hearing. The New York Times believes that the Senate will likely vote on Sotomayor by early August and the Wall Street Journal just recently reported that the GOP will not filibuster Sotomayor. It seems like smooth sailing from here on out for Sotomayor. If confirmed, Sotomayor will not only be the first Latino female on the Supreme Court, but also the first Justice with type 1 diabetes.
We are particularly excited about having a Supreme Court Justice with diabetes as it should inevitably help raise awareness of diabetes. In addition we expect it to be very important in waylaying many of the common misconceptions that the general public has about type 1 diabetes. Also, for the 15,000 children diagnosed with type 1 diabetes each year in the US alone (and their parents), it will be encouraging and inspiring to know that they can live a full life despite having type 1 diabetes
From our latest issue of diaTribe
Sonia Sotomayor is the first Supreme Court Justice nominee with type 1 diabetes. Jim Hirsch explains how he got involved in the White House's efforts to handle the fallout. Click here to continue. Click here to continue
In diaTribe #16 we wrote extensively on the huge presence of continuous glucose monitors (CGM) at ADA in our conference pearls. This month, we’re excited to be able to give away one $500 credit for DexCom merchandise! This contest is open to everyone, regardless of whether they’re diaTribe readers already, so help us spread the word about CGM by forwarding this email! Click here to enter the giveaway.
Check out Nick Jonas and fellow diaTribe advisory board member Howard Steinberg (founder of dLife) who will be on dLife together this Sunday. Nick's pretty elusive so we were excited to hear that we'd really get to hear him riff about diabetes. Among other things, Howard said he acknowledged that sometimes diabetes can rob some of the joy. Boy, can it ... though we try to be super glass-half-full, it still is hard every day just to get back to 100 where everyone else starts! Members of dLife can catch a sneak peak here. See the show Sunday night on CNBC 7PM ET, 6PM CT, 4PM PT
Forget a sit-in. We're joining the test-in to commemorate TuDiabetes and EsTuDiabetes reaching 14,000 members. Inspired by Kelly Rawlings (editor of Diabetic Living), the goal is to have 14,000 people test their blood glucose at the same time today - 4pm EST, July 14th.
Want to join in and help raise awareness of diabetes and the importance of testing blood glucose regularly? We certainly do!
Here's how to participate:
Update: Every available member of our team (even those of us without diabetes!) participated in the test-in. Our results are listed below. Kelly was a little low at the test time, but after a snack is now at 82 mg/dL!
Kelly 68 (70 with her continuous glucose monitor)
Be sure to check out our new issue of diaTribe here.