I was just reading up on Kerri’s recent blog entry and I’m afraid she isn’t that unusual when you look across the broad range of people with diabetes. She’s busy and diabetes tends to take a back seat until something serious comes around.

Here are a few suggestions for Kerri and the millions of people with diabetes like her:

Make sure you never go more than 3 months without getting your A1c.

With our HomeCheck kit you can get the highest quality A1c available in about 3 minutes from home. Just order online and mail it in. Voila - you now have a pretty good idea how things are going (vs last time) and can use that info to nudge yourself in the direction of your friendly neighborhood physician for your regular appointments as needed.

Bernard Farrell did a video review of our HomeCheck and posted it online at his blog here with the video shown below hosted on YouTube:

Find a way to easily track and identify blood sugar trends.

You can use a GlucoMON to automatically handle your logging and generate reports that allow for easy identification of blood glucose trends and to perform pattern analysis.  People who use the GlucoMON say that this only takes them about 1 minute a week with the GlucoMON when it used to take them 1 hour each month before.

And because it’s so easy they are actually managing this information on a weekly basis vs monthly.  Better information leads to better choices. You can read a GlucoMON product review by David Mendosa here and then subscribe or click on the link to his complete review at healthcentral.com

Leverage the power of the diabetes community as you seek reimbursement for new diabetes tools.

If you are going to pursue use of the new continuous glucose monitoring systems, you will most likely need to fight your insurance company to get reimbursed.  Fortunately there is an online resource sponsored by Diabetech called CGMSCENTRAL located at

http://cgmscentral.com  Everyone going after reimbursement one at a time is a very slow process. If there was a way to share information amongst the entire community the process of successfully securing reimbursement will go much faster. To be armed with knowledge is to be armed.

What else do you need to simplify diabetes?

If there are other areas of diabetes care that need simplification you should comment below.  After all, if you want things done you might as well tell someone (Diabetech) who has a track record of delivering a simplified version of diabetes care.

(psssst…. Kerri if you read this give me a call and I can set you up for a trial and see if we can make it easier for you to regain those good habits.)

Through my work with several diabetes centers, I know that the rates of new onset type 1 diabetes cases has skyrocketed lately. In fact at one center in Texas they have seen a consistent influx of new cases double the rate of normal starting about 9 months ago. Other centers are talking about this too although nobody seems to have a very good handle on this in the US. The new cases of diabetes aren’t normally reported (and not required by law) so there is only informal data and the centers are slow to check around and to let other centers know of their own experiences.

Now a couple of reports just came out at the ADA Scientific Sessions that nails down that there is in fact an increase on an order of magnitude. The reports come from Finland, the world’s highest rate of type 1 diabetes at 41 cases per 100,000. This is double the rate since 25 years ago.  They are projecting another doubling to a rate of 80 per 100,000 in the next two years.

The second report comes out of Canada and it backs up this notion of doubling that is slowly raising awareness:

A second report by researcher Jeffrey A. Johnson of the University of Alberta, Canada, echoed that. Dr. Johnson and colleagues found the prevalence of diabetes under age 20 increased by nearly 50% in the last decade, from about 19 per 10,000 in 1995 to 28 per 10,000 in 2006. The rise was most dramatic in younger children, leaping 93% in the 1-4 year-old age group; 51% for 5-9 years, 42% for 10-14 years and 30% for 15-19 years during that period.  The data do not differentiate between type 1 and type 2 diabetes, he said, but “the incidence is rapidly increasing and it is likely to be due to an increased incidence of type 1 diabetes.”

So what does this have to do with Arizona traffic… or any traffic scenario in any large city? You can only send so many cars across the given traffic grid in so much time… Unless you expand the grid or somehow make the grid smarter - more efficient. In Chandler, Arizona, a suburb of Phoenix, they experienced tremendous growth and still are. The city planners should be congratulated since they approved an extensive rework of their traffic management systems and installed a series of “smart cameras” at each intersection and implemented complex analytics in a centralized management system to automatically change the timing of lights at each intersection, automatically alert the traffic manager of accidents or malfunctions, etc… in order to maximize the throughput of traffic and improve safety for the city’s drivers and pedestrians.

Of course the other or more obvious thing to do is build more roads.  That’s what the construction lobby would propose. And of course they did build roads. Only problem is that new roads don’t remove the bottlenecks (intersections). You may have actually intensified the problem though since now more cars can arrive at the same intersection at the same time.

This is exactly what is happening to people with type 1 diabetes compounded by the simultaneous rise in type 2 diabetes in kids who are seen by these same physicians and diabetes educators.

There is a shortage of qualified physicians, especially those with pediatric credentials needed to deal with the vast majority of these new onset cases.  Some people say add more pediatric endos.  Suggest that solution to a pediatric endo and you’ll either get a laugh or a smack across the chops. Let’s just say that while we do need more it’s not something that will happen soon enough at a rate to keep pace with the onset of type 1.  In other words, just “building more roads” won’t solve the problem.

I guess we had better look at information technology akin to those smart cameras to increase the efficiency and reach of the qualified people we already have then.  That includes pediatric endocrinologists, pediatricians, diabetes educators, pharmacists, social workers, family psychologists and family members to name a few. Would it be possible to borrow from the concepts deployed in Chandler’s smart traffic system? Can we increase the effectiveness and efficiencies for the rare but skilled pediatric endocrinologists and their support staff? Can we increase the flow of knowledge to the newly diagnosed so that they can be better prepared to manage their own diabetes most of the time? Would it be possible to head off a dangerous episode of DKA before it forces the patient to visit the emergency room?

Yes we can and it’s called ADMS™ - Automated Diabetes Management System. Truth is that ADMS started its deployment even before the City of Chandler had completed their traffic system. I actually met with the man leading the project back in 2003 as part of our research behind development of ADMS. Our smart cameras include the GlucoMON®, HomeCheck™ and a few other devices. The intelligent analysis is taken care of inside of GlucoDYNAMIX™. And rather than send all of the exception reports to a traffic manager, we spent additional time figuring out how to get only the useful information, at the right time to the right person - automatically - ADMS is the traffic manager.

As for our smart cameras, we use those too inside of our Diabetes Housecall program. Imagine what it must be like to leave your car in the garage, no waiting room, no waiting. Just log on with your web cam and have a 30 minute one on one 3 times per year plus at least 1 visit per year face to face (vs the typical 5 minute drive by). Your diagnostics are already in front of your endo including your blood sugar profile, your A1c and any other data needed for the visit. This program is the first of its kind and growing rapidly in Texas and Iowa and soon in a few other states as well.

So much like the people of Chandler, Arizona, people with diabetes who want a safer and more efficient system now rely on Diabetech®’s ADMS technology and programs like Diabetes HouseCall™ that wouldn’t be possible without it.

So as I mentioned in the comments of my premature ‘missing the mark’ post, I am working on a post to illustrate Health2.0 in practice today. What seems like a quick post has turned into something much more substantial and important.

Therefore, I wanted to post today just to update my progress on what will be an interesting read as soon as it’s ready which will hopefully be sometime early next week.

There.  Now you can go about your day