TCOYD Fall 2012 Volume 41

NEWSLETTER

MY

Fall 2012 Volume 41

The Many Faces of Diabetes: It’s Not Just Type 1 or Type 2!

Dr. Edelman’s Corner

INSIDE Patient Power Page 3

Don’t Freak Out Page 4

Question of the Month Page 5

Belviq vs. Qsymia Page 6

A VOW to TCOYD Page 8

Know Your Numbers Page 9

6 Steps to Diabetes Success Page 10

Product Theater Page 11

MedSimple Page 12

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s it happens, there are many different types of diabetes including type 1, type 2, type 3, LADA (latent autoimmune diabetes in adults), MODY (mature-onset diabetes in adults) and gestational diabetes (usually occurs in women...haha). It is very important for you and your caregiver to know what type of diabetes you have, as there are important genetic and therapeutic implications. It is also not that rare for a person to have two types of diabetes at the same time, commonly known as hybrid or double diabetes. If that isn’t bad luck, I don’t know what is!

The most common type of diabetes is type 2, formerly called adult-onset or NIDDM (non-insulin-dependent diabetes mellitus), which accounts for 85 to 90 percent of cases worldwide. We now know that type 2 diabetes may require insulin in addition to oral medications. We also know that type 2 can show up in kids,

especially those whose parents have type 2 diabetes and who are members of an ethnic group where diabetes is more prevalent (African Americans, Native American Indians, Asian Indians, Latinos and Pacific Islanders). Type 2 runs very strongly from generation to generation and the main issues are insulin resistance (the tissues Many Faces (continued on page 2)

Special Acknowledgements Medical Advisory Board Chair: Ingrid Kruse, DPM Veterans Affairs Medical Center Alain Baron, MD CEO, Elcelyx Therapeutics John Buse, MD, PhD University of North Carolina Jaime Davidson, MD Dallas, TX Mayer Davidson, MD Drew University Daniel Einhorn, MD Diabetes & Endocrine Associates Robert Henry, MD Veterans Affairs Medical Center Irl Hirsch, MD University of Washington

Board of Directors Steven V. Edelman, MD Founder and Director, TCOYD Sandra Bourdette Co-Founder and Executive Director, TCOYD S. Wayne Kay President and CEO, CardioNexus Corporation Margery Perry Terrance H. Gregg CEO, DexCom, Inc. Daniel Spinazzola President, DRS International Contributing Authors Jennifer Braidwood Mackenzie Bear, PharmD, Candidate 2013 David Edelman Steven Edelman, MD Susan Guzman, PhD Candis Morello, PharmD, CDE William Polonsky, PhD, CDE Robyn Sembera

TCOYD Team Steven V. Edelman, MD Founder and Director Sandra Bourdette Co-Founder and Executive Director Jill Yapo Director of Operations Michelle Day Director, Meeting Services Michelle K. Feinstein Director of Finance and Administration Antonio Huerta Director, Latino Programs Roz Hodgins Director, External Affairs Jennifer Braidwood Manager, Outreach and Continuing Medical Education Jimm Greer Manager, Social Media David Snyder Manager, Exhibit Services  

MyTCOYD Newsletter Editor: Jennifer Braidwood Assistant Editor: Robyn Sembera Design: Hamilton Blake Associates, Inc. MyTCOYD Newsletter is offered as a paid subscription of Taking Control Of Your Diabetes. All material is reviewed by a medical advisory board. The information offered is not intended to constitute medical advice or function as a substitute for the services of a personal physician. On the contrary, in all matters involving your health, TCOYD urges you to consult your caregiver. Š2012 All rights reserved.

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Many Faces (continued from page 1)

of the body are resistant to the glucose lowering affects of insulin) and inappropriate glucose production by the liver.

Type 1 diabetes, formerly called juvenile-onset, accounts for 5 to 10 percent of diabetes cases worldwide.

Type 1 is an autoimmune condition where, for unknown reasons, the body attacks its own insulin producing cells of the pancreas. Every person with type 1 diabetes needs to take insulin in order to live. The pills we use to treat folks with type 2 diabetes are just plain ineffective for treating type 1.

Double diabetes is when someone has both type 1 and type 2 diabetes.

Unfortunately, they are not mutually exclusive. One is an autoimmune disease (type 1) and the other is a very common and hereditary metabolic condition (type 2). A typical scenario is an individual who gets type 1 as a kid but, since one or both parents has type 2 diabetes, as he/she gets older, he/she develops obesity, hypertension, abnormal cholesterol levels and high insulin requirements. This type of patient may be on an insulin pump, continuous glucose monitor and oral medications used for type 2 diabetes.

An important subcategory of type 1 diabetes is LADA. THIS IS THE MOST COMMONLY MISSED DIAGNOSIS IN DIABETES! LADA is, basically, when someone is diagnosed with type 1, or autoimmune diabetes, later in life as an older adult. The destruction of the insulin-producing cells of the pancreas (beta cells) happens slowly in LADA patients. The symptoms of LADA are not as severe as they would be in a newly diagnosed type 1 teenager who has

extreme thirst, urination, and weight loss. Elevated blood glucose levels in an adult who has not-so-severe symptoms is common with LADA and can fool the caregiver into thinking the patient has type 2 diabetes.

Gestational diabetes is another common type of diabetes. It refers to the development of diabetes while a woman is pregnant. The cause of gestational diabetes is somewhat related to type 2 diabetes because insulin resistance is present along with the added influence of female hormones that fluctuate during pregnancy. Most women revert to normal glucose levels after delivery.

However, women with a history of gestational diabetes are at high risk for developing type 2 diabetes during subsequent pregnancies and later in life.

MODY refers to any of the several hereditary forms of diabetes caused by genetic mutations passed along from family members such as the parents.

There are several types of MODY with a wide variety of symptoms ranging from almost none to the need for insulin.

There are genetic tests now that can help to make a diagnosis of MODY, which should not be confused with LADA, as they are very different.

Knowing the correct diagnosis is so important as it will guide the way to the best therapy, screening in family members and genetic counseling.

Lastly, we must always remember type 3 diabetes, which refers to the family members and loved ones who live with or care for someone with diabetes.

Steven Edelman, MD Founder and Director Taking Control Of Your Diabetes

Taking Control

“The meter took power from the doctor and gave it to the patient.”

- Ellen Kirk-Macri, RN, CDE

relatively normal throughout the day.

However, Bernstein was not a doctor and he had difficulty gaining the necessary attention from the world of medicine to change the standard of treatment for individuals with diabetes.

Bernstein pushed forward and wrote a paper describing his technique but without medical clout no major medical

By David Edelman and Jennifer Braidwood journal would publish it. In 1977, at 43 years old, Bernstein quit his job and started his journey to become a physirior to the 1970s, individuals The instrument weighed in at three cian—“I couldn’t beat ‘em, so I had to with diabetes checked their pounds, cost $650, and was only join ‘em.” Bernstein is believed to be sugars by simply urinating on strips. available to certified physicians the first individual to self-monitor his Unfortunately, this method of check- and hospitals. blood sugar and was an early advocate ing one’s blood sugar levels indicated for allowing every individual with how high blood sugars were four hours The very first blood glucose diabetes to have that very same BEFORE they were tested. When it device was developed in 1969. came to treating diabetes, testing one’s Emergency staff at hospitals used power in their own hands.

The information revolution on blood sugar in this fashion was similar the device to tell the difference diabetes management didn’t end with to operating a vehicle with a speedbetween people with diabetes the advocacy of Bernstein and the ometer showing the speed the car and unconscious drunks. availability of the meter. It continued to was going 10 miles back. grow as individuals with diabetes truly So how did people effectively Richard Bernstein, a type 1 began to understand what made their manage their diabetes? They basically diabetic, and not a physician at the followed their doctor’s instructions time, was determined to take control diabetes tick. Patients began sharing results with their doctors, others wrote and hoped for the best: avoid sugar, of his diabetes. Bernstein asked his measure out meals, and take the same wife, a doctor, to order the instrument books, some started organizations and once the 21st century hit, a slew of amount of insulin at the same time for him. Once Bernstein had access websites began to appear. every day. Perhaps that approach to one of the very first blood glucose In 2005, David Edelman (no relation worked sometimes or perhaps it didn’t. meters he began testing his blood to Steven Edelman) founded Diabetes Either way, the patient never really sugars 5 times a day. He quickly Daily (www.diabetesdaily.com) with knew. discovered that successful diabetes Elizabeth Edelman shortly after she Then things changed. The management was a very intricate very first blood glucose device was process and that his blood sugar levels was diagnosed with type 1 diabetes. developed in 1969. Emergency staff fluctuated wildly throughout the day. Originally shocked by the diagnosis, Elizabeth found comfort and support at hospitals used the device to tell Within a year Bernstein had refined from women just like her that she met the difference between people with his diet and insulin regimen to the diabetes and unconscious drunks. point that his blood sugars remained Patient Power (continued on page 11)

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Taking Control Of Your Diabetes

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Living Well

10 Things to Know When Diagnosed with Type 2 Diabetes

By William Polonsky, PhD, CDE and Susan Guzman, PhD

No, it probably isn’t a mistake

When first diagnosed, many people find it difficult to believe. They think it must be a terrible mistake, believing that perhaps another test is needed or thinking maybe it will just go away. This is a very natural response to the shock of receiving the diagnosis. Unfortunately, it is very likely that your diagnosis is real and diabetes is here to stay. You’re now part of the very large and growing club of people with diabetes: a club, we understand, that you would prefer not to join!

Ignoring diabetes after

being diagnosed is a very bad idea

You can’t feel when your diabetes is out of control, so you may think you don’t need to worry about it. But diabetes ignored and left unmanaged can cause damage to your body. Yes, odds are good that you can live a long, healthy life with diabetes, but only if you are working to control it now, not sometime later. So see your doctor regularly, take all your medications, stay active, and learn more about the foods you eat. For your health, get involved in your own diabetes care.

This isn’t your grandmother’s diabetes

With 21st century technology and care, we now know you can live a long, healthy life with diabetes. The diagnosis of diabetes is NOT a death sentence. Terrible outcomes, like blindness, amputations and kidney problems, are largely preventable. Thanks to modern medicine, people developing diabetes today have an excellent chance of living long, healthy lives, free from serious complications. With good care and attention, you can be one of those people.

Diabetes is not your fault Don’t blame yourself for developing type 2 diabetes, and don’t let anyone else blame you either. It is not caused by laziness or a lack of willpower. Eating sweets didn’t do it. Type 2 diabetes is a genetic disease. And when you have these genes, certain factors—like being overweight—can trigger it. More and more people are becoming heavier and developing type 2 diabetes because most jobs now require little physical activity, life is more stressful, and too many foods tempt us that are high in calories, large in size and much too convenient. Your genes and the environment are the major culprits, but that doesn’t mean you are now helpless to protect your health.

So read on!

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Knowing your numbers should be your first step To manage diabetes, there are so many things you will be advised to do and change. No wonder it can feel so overwhelming. You can’t do everything at once, so where should you start? Begin by making sure the critical diabetes tests are being done and that you, not just your doctor, know the results. After all, you can’t know what to do differently if you don’t first know how you’re doing. At the least, find out about your blood pressure, cholesterol and A1C numbers. You need to know what your numbers mean and what you and your doctor can do to get, or keep, those numbers in a safe range.

You won’t be limited to eating nuts, twigs, and birdseed You can still eat your favorite foods, just not all at once. Boring diets are no longer necessary and there is no need to deprive yourself.

However, attention to the size of your meals is critical. You will also need to learn more about the contents of the food you typically eat (carbohydrates, fat and calories), which foods you should eat more or less of, and how those foods affect your blood glucose and overall health.

Question of the Month

Not taking your pre-

s cribed medications is a dangerous thing to do

From the first day of diagnosis, most people require medications to keep diabetes in check and maintain good health. Many people worry that taking medications might be bad for their health, as well as too costly.

Yes, there are diabetes medications that have negative side effects, but these are typically outweighed by the positive benefits to your long-term health. To stay healthy, your goal shouldn’t be to take fewer medications, but to make sure your numbers (A1C, blood pressure, and cholesterol) are in a safe range. Talk about the pro’s and con’s of medications with your doctor, and ask about other options, especially if they are too bothersome or expensive. Then you can make an informed decision.

By Steven Edelman, MD

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hould a person with diabetes be on a high protein diet with very low to no carbohydrates? How safe is this type of diet in the long run? Is it true that eating a high protein diet can cause damage to your kidneys over time?

A special thanks to all of our Facebook fans who sent in questions for Dr. Edelman!

Answer: As a person with diabetes, it is hard to balance the types of foods we are supposed to eat. Protein is great in many ways. It doesn’t raise blood sugar levels as quickly as carbohydrates and, if you are eating the right types of protein, lean protein with little fat, such as chicken, it can be super healthy. A high protein diet can also help reduce your appetite. Some nutritional studies done on animals have shown that a diet super high in protein can cause a decline in kidney function, but these studies have not been conducted in humans. What it always boils down to is moderation.

Moderation is key! A good rule of thumb to follow is this: Consume about 0.6 gram of protein per kilogram of body weight. A kilogram equals 2.2 pounds so, as an example, for a 70kg (154 pound) man it would be 42 grams of protein per day.

Don’t do diabetes alone

Protecting your heart should be your first concern

Heart disease is the major health concern for people with type 2 diabetes. Attention to lowering the risk for heart problems is the main reason why people with diabetes are living longer than ever. According to scientific studies, the most important areas to address, in order of importance, are: smoking, blood pressure, cholesterol, A1C, and fitness. Talk to your doctor about your risk and what you can do.

Focus on developing a healthier lifestyle, not weight loss

Increasing your fitness regimen and choosing healthier foods (for example, more fruits and vegetables, smaller portions, and less saturated fats) will have a bigger impact on your diabetes and heart health than losing weight. This is good news, since weight loss can be frustrating and difficult. Of course, exercising more and making smarter food choices may lead to a lower weight over time. But keep the focus on improving your health, not just improving your weight.

Good diabetes care takes attention and effort, and you may at times feel overwhelmed, discouraged, isolated or even burned out. Your motivation can be sapped by the stresses of daily life or even problems with depression, which are common in people with diabetes. To protect yourself, make sure you identify at least one person in your life who will support you and your efforts to manage diabetes. It could be anyone: a family member, good friend, trusted health care professional, or a support group. Also, find a doctor you really trust, can be honest with, and feel is on your side. Living well with diabetes is always easier when someone you like and respect is cheering for you.

William Polonsky is the Founder and Chief Executive Officer of the Behavioral Diabetes Institute and an Associate Clincical Professor at the University of California, San Diego Susan Guzman, PhD, is a clinical psychologist and is the Co-Founder and Director of Clinical Services of the Behavioral Diabetes Institute (BDI), a non-profit organization devoted to the emotional side of diabetes.

Taking Control Of Your Diabetes

5

Ask Your Pharmacist

What is Belviq?

patients using Belviq, along with diet and exercise, lost at least 5% of their In June of this year, the FDA starting weight (about 12 pounds) over approved the first new weightloss medication since 1999. the first year, compared to only 23% using diet and exercise alone.

Belviq (lorcaserin is the With the history of safety problems drug name), a tablet associated with weight-loss medithat is taken twice cations, the FDA was cautious in daily along with a approving Belviq. Fenfluramine, half healthy diet and exercise routine, of the infamous weight-loss medication Fen-Phen, acted at a different serotonin promotes chronic weight receptor and caused heart valve damage, forcing the its removal from loss in obese the market in 1997. This danger is not adults. It is particularly useful for something that the FDA wanted to repeat with Belviq. In 2010, the FDA those with weight rejected the first request for approval of related conditions such as high blood pressure, high Belviq and demanded more studies on its safety, especially in the heart. Heart cholesterol and type 2 diabetes. function was monitored in nearly 8,000 patients during Belviq’s approval and How Does Belviq Work?

Belviq works by activating showed no significant difference in the development of valve abnormalities as important nerve endings in seen with Fen-Phen. Still, the FDA is the brain called serotonin requiring six post-marketing studies to 2C receptors. Serotonin is a evaluate the long-term effect of Belviq brain chemical (neurotranson the risk for major adverse cardiac mitter) that carries messages events such as heart attack and stroke. from one side of the brain to another. Generally, serotonin delivers The most common side effects for people with diabetes include hypoglymessages about mood, emotions, cemia (low blood glucose), headache, sleep, and, most importantly in this back pain, cough and fatigue. case, appetite. Although the exact mechanism of Belviq is not known, What is Qsymia? activation of the serotonin 2C The FDA approval for Qsymia receptor is thought to trick your brain shortly followed Belviq in July of this by delivering a message telling your year. Unlike Belviq, Qsymia is a combrain that you are not hungry. This bination product of two previously leads to a decreased appetite and a approved medications, phentermine feeling of fullness, even after eating and an extended release topiramate. only a small meal.

Phentermine is considered the “safe” half of the combination medication What Can You Expect formally known as Fen-Phen. It from Belviq? has been used as a single agent for During a clinical trial studying short-term weight loss and appetite people with type 2 diabetes, 47% of

Belviq vs. Qsymia: New Weapons in the Battle Against the Bulge

By Candis M. Morello, Pharm D & Mackenzie Bear, Pharm D Candidate 2013

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ccomplishing a healthy weight requires a delicate balance of eating right, physical activity, hard work and dedication. However, for some, healthy eating and exercise just aren’t enough.

This year the US Food and Drug Administration (FDA) has approved not just one, but two new weightloss medications, Belviq and Qsymia to help people combat weight concerns.

6 My TCOYD Newsletter, Vol. 41

control since Fen-Phen was taken off the market. Topiramate has been approved since 1996 for the treatment of seizure disorders and, later, for prevention of migraines. Since its approval, topiramate has shown to have significant weight loss as a “side effect”. This is good news for people who need to lose weight! Together as Qsymia, these two medications are approved for chronic weight management in adults, particularly those with weight related conditions such as type 2 diabetes.

How Does Qsymia Work?

The two medications in Qsymia have two different proposed mechanisms responsible for weight loss. Phentermine is thought to increase the release of two catecholamines, norepinephrine and dopamine.

Catecholamines are hormones in the body released during times of physical or emotional stress. They contribute to responses such as your heart racing, heavy breathing, and tunnel vision during a “fight or flight” response.

Increasing the release of these catacholemines is also associated with weight loss through appetite suppression.

Norepinephrine and dopamine directly act on the center of your brain responsible for feeling satisfied after a meal.

This makes sense because you are rarely hungry during moments of panic or stress. Topiramate’s mechanism of weight loss is a bit more of a mystery.

Although it has been shown to reduce appetite and increase satiety, how it works is under investigation. The current thought is topiramate increases fullness after eating and makes foods taste less appealing.

What Can You Expect from Qsymia?

During a clinical trial, 62% of patients on the recommended dose of Qsymia lost 5% of their total weight over the course of a year when combined with diet and exercise, compared to only 20% of those using diet and exercise alone. Unfortunately,

the success of this combination product may be limited by its side effects, which are a combination of the two medications it contains. Common adverse effects of phentermine include what you would expect from a “fight or flight” response, including an increase in heart rate, dry mouth, insomnia and constipation. Side effects of topiramate include taste changes, dizziness, and mood changes.

Just like Belviq, Qsymia was first denied approval by the FDA in 2010 because of safety concerns. Qsymia’s clinical trials did not establish the risk of the medication causing major cardiac events. Therefore, the manufacturer is now required by the FDA

to conduct a 10 year post marketing study to evaluate the long-term effect of Qsymia on the risk for major adverse cardiac events such as heart attack and stroke. This means that the study will be conducted after the medication is released to the public and during its initial ten years.

Are Either Weight Loss Medications Right for You? Two new weight-loss medications have been approved, but the real question is, which one, if any, is right for you? Both Belviq and Qsymia are marketed for chronic weight management for obese adults with a body mass index greater (BMI) than 30 or for adults with a BMI greater than 27 and who have at least one weightrelated condition such as high blood pressure, type 2 diabetes, or high cholesterol. A BMI is a measurement of fat based on height and weight and is a necessary qualification in order to use Battle Against the Bulge (continued on page 10)

Taking Control Of Your Diabetes

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Giving Back

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to TCOYD

By Jennifer Braidwood and Robyn Sembera

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f you’ve attended one of our conferences and health fairs, chances are you have probably crossed paths with Lynn Senecal.

Soon after her type 1 diagnosis at the age of 16, Lynn attended a diabetes camp and it was there that she found her life passion.

“I eventually became a Registered Dietitian and a Certified Diabetes Educator because of my experience with diabetes first-hand,” Lynn said.

Soon after, she started attending TCOYD Conferences and Health Fairs.

“As a diabetes educator I was impressed with the empowerment that attendees walked away with.

I saw that feeling of empowerment shining in people’s eyes at my very first TCOYD conference and I’ve seen it ever since.”

TCOYD is doing the best thing that can be done until there is a cure: educating and empowering anyone directly or indirectly affected by the disease.

“TCOYD does for patients what we educators throughout the world attempt to do, but can’t, because of the lack of time and money. I donate all I can to TCOYD because I have seen first hand the impact that their conferences have on all

of their attendees. People walk out of a TCOYD conference with a newly found pep in their step, with a new sense of empowerment, of knowing that they can help themselves.”

On July 21, 2012 Lynn was married to Kenneth Barker and aside from making the day solely about themselves, TCOYD was graciously there in spirit. In lieu of a fine china dining set, a fancy juicer or latest kitchen gadget for wedding gifts, the bride and groom requested that guests make a difference by donating to TCOYD. YOU too can help TCOYD continue our mission of educating and empowering people with diabetes, and help inspire others, so that one day, we all can see a life free of diabetes.

Please make your gift today!

Visit tcoyd.org and click on the “Giving” tab!

Innovation...Saying that we’re dedicated to defeating diabetes is one thing. Actually doing it is quite another.

Financial investment and the most advanced research are part of the equation, but not nearly enough to reach our goal. To confront this epidemic, it will also take something that drives Novo Nordisk: passion.

We pursue our goal with a passion that can only come from a company with an 85-year history of innovation in diabetes care. We dedicate significant resources to diabetes research and will continue to do so until a cure is found. We endow advanced research facilities, and are at the forefront of stem-cell research in diabetes. The results? The broadest diabetes product portfolio available for patients. Programs that make a real difference in patients’ lives. And a vision for Changing Diabetes and defeating it in our lifetime.

ChangingDiabetes-US.com 1-800-260-3730 Changing Diabetes

My TCOYD TCOYD Newsletter, Newsletter, Vol. Vol. 41 40 8 My

Know Your Numbers

By Steven Edelman, MD

T Taking Control of Your Diabetes 4th Edition

D

r. Edelman has spent the last couple of months putting the finishing touches on the 4th Edition of his book Taking Control of Your Diabetes. The book will be available for purchase in mid November and will encompass the most relevant cutting-edge information on medications, treatments, technologies and care for individuals with diabetes. In addition to the most up to date information on diabetes management Dr. Edelman’s book will also have a few new and exciting chapters.

Taking Control of Your Diabetes 4th Edition will be available for purchase though our website by visiting the homepage at tcoyd.org and clicking “Store” on the top right hand side of the page. You can also join our Sweet Membership program and receive the book as part of your membership.

his logbook is from a 42 year old woman who is overweight. She was diagnosed with type 2 diabetes about two years ago. Oral medications did not work and she was started on insulin one year ago. She was put on one of the newer medications for type 2 diabetes called Byetta and lost 70 lbs! Eventually, she was tapered off of her insulin to avoid low blood glucose values, which is expected when extreme weight loss occurs. Despite this weight loss, her blood sugar values and her A1c did not change dramatically.

Discussion: A 70 pound weight loss will have a profound affect on any type 2’s blood pressure, cholesterol and especially blood glucose levels. It did not happen with this woman, who was my patient, so I thought something was really strange. I ordered a GAD Antibodies test which is used to diagnose LADA or Latent Autoimmune Diabetes in Adults (See Dr. Edelman’s Corner). The GAD test was positive. This person had both type 1 and type 2 diabetes and because I stopped her insulin (all type 1 diabetics need insulin), she did not improve as expected. Now she is on both an insulin regimen and oral medications that work well with insulin.

Taking Control of Your Diabetes is Generously Supported By: Platinum Corporate Sponsors

Gold Corporate Sponsors

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Taking Control Of Your Diabetes

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By Jennifer Braidwood

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ecently Dr. Edelman participated in a very special online interactive video project called 6 Steps to Diabetes Success, developed by one of TCOYD’s sponsors, Liberty Medical. The program consists of six interactive videos and quizzes that teach users the fundamentals of how to manage their diabetes. A leading provider of diabetes supplies for over 20 years, Liberty, has prepared this program to provide a broadbased online disease management overview. The course is very user friendly—like a high quality educational TV show that incorporates the perspectives and personalities of the

Battle Against the Bulge (continued from page 7)

either of these medications.

While neither medication should be taken while pregnant, the topiramate in Qsymia is associated with birth defects and women of child-bearing age should not take this medication without an effective form of birth control. Qsymia should also be avoided in those with glaucoma, overactive thyroid, or those on an MAO-I antidepressant for risk of serious side effects. Belviq should be used with caution in those currently

10 My TCOYD Newsletter, Vol. 41

six hosts—Dr. Edelman being one of them. It takes about one hour to complete, and you can do it on your own time from your computer, iPad, or smartphone. Best of all, it’s free.

Just go to DiabetesEducation.com and start watching the videos. The topics range from nutrition, exercise and medications, to complications, and coping. Clinically reviewed by Dr. Edelman and other diabetes

experts, the program is an important step toward making disease selfmanagement education more widely available and addressing the urgent need to teach 26 million people with diabetes how to take proper care of themselves. Be sure to watch 6 Steps to Diabetes Success and share the link www.DiabetesEducation.com with your friends and family.

on antidepressant therapy and those with a history of migraines, anxiety or psychotic disorders.

these medications have demonstrated successful weight loss and benefit in dieters throughout their clinical trials. Along with a healthy lifestyle, reduced calorie diet and exercise, either Belviq or Qsymia may be an additional step forward in the battle against the bulge.

The Bottom Line With the release of two new weight-loss medications, the FDA is providing medicinal options to fight the significant battle of obesity in the United States. This is a step towards recognizing obesity as a disease in itself that contributes to many other serious medical risks including heart disease, depression and type 2 diabetes. Although the long-term side effects are yet to be shown, both of

Submitted by: Candis M. Morello, Pharm D, CDE, FCSHP, Associate Professor of Clinical Pharmacy at UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences, Clinical Pharmacist at VASDHS. Mackenzie Bear, PharmD Candidate 2013 at UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences.

Product Theater

Medtronics MiniMed 530G Seeks Market Approval

By Robyn Sembera

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edtronic, Inc., a global leader in medical technology, has recently designed a first of its kind product that can actually control insulin delivery… automatically.

Although not FDA approved just yet, the MiniMed® 530G is in it’s final module of the pre-market approval process as of June; not to mention a similar product has been a hit in 50 other countries. Combined with an insulin pump integrated

with continuous glucose monitoring, this technologic system works off of Threshold Suspend Automation, which means automatically stopping insulin delivery temporarily if the sensor glucose level is equal to or below the low threshold value. Until Threshold Suspend Automation, there has never been an approved therapy in the United States to automatically intervene when sensor glucose becomes severely low. Medtronic’s

The best part is, there are dozens of other sites just like Diabetes Daily. online. The Edelman’s decided to People with diabetes still need to build a place where everyone could strictly monitor their blood sugars connect, share stories, and seek a every day but now they can also better life. The approach resonated draw on the experiences of hundreds and soon they had thousands of thousands of their peers. The visiting every day. amount of knowledge and its easy Since then, over ten million accessibility is rapidly raising our people have visited the site and posted diabetes management IQs. It’s also over half a million messages about allowing individuals with diabetes to living with and managing diabetes. obtain information at a high-speed Tens of thousands of people sharing rate that simply didn’t exist a decade the knowledge that they’ve learned ago. This transformation is as big as through countless little experiments home blood glucose testing itself. and experiences is extremely powerful.

We are at a unique place in the Not only does it create a forum for history of the world. Not only do you information exchange, but it also have access to all of the world’s inforcreates a sense of community, and an mation (if you can figure out what instantaneous feeling that you are not to type in the search box!) but you alone and you don’t have to be scared. also have the power to add your own (continued from page 3)

MiniMed® 530G helps aid the development of the artificial pancreas, a system that closely mimics the insulin delivery of a healthy pancreas using advanced technology that continuously monitors glucose levels and automatically adjusts insulin delivery with minimal or no patient interaction.

Keep your eyes peeled for the MiniMed® 530G!

experiences to the mix. Anyone with access to the Internet has the tools to easily participate in a global conversation.

And this conversation is truly global. Diabetes Daily has members who are logging on to their website via mobile phones in some of the poorest countries in Africa. Internet access is not yet universal, but with the global mobile phone revolution we are quickly approaching that point.

Seize this opportunity. You have access to more communal knowledge than any of the hundreds of millions who have gone before you. So join an online support network. Listen and learn. Add your voice to the conversation. Improve both your life and the lives of others.

You have the power.

David Edelman is the founder of Diabetes Daily www.diabetesdaily.com.

Taking Control Of Your Diabetes

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TCOYD Conferences & Health Fairs 2012 Schedule

Taking Control Of Your Diabetes 1110 Camino Del Mar, Suite “B” Del Mar, CA 92014 | www.tcoyd.org

Tel: (800) 998-2693

(858) 755-5683 Fax: (858) 755-6854 Nonprofit Organization U.S. Postage

February 11 Washington, D.C.

March 3 Sacramento, CA

April 14 Honolulu, HI

April 15 Maui, HI

May 19 Raleigh, NC

June 23 San Ysidro, CA - Latino September 8 Missoula, MT September 15 Sacramento, CA - Latino September 22 Des Moines, IA

October 27 San Diego, CA

November 3 Oceanside, CA - Latino

December 1 Austin, TX

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San Diego, CA Permit No 1

For schedules, bios, trailers and more, visit www.tcoyd.org

TCOYD is a not-for-profit 501(c)3 charitable educational organization.

It’s Easy…and Simple! It’s MedSimple

By Jennifer Braidwood

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ust when we feel we’ve struck the right balance between the foods we eat and the meds we take, the unpredictability of everyday life for a person with diabetes changes everything. I’m sure you would agree… it’s complicated.

Without that balance, that perfect mix of managed medications, healthy diet and lifestyle, we are at risk of physical decline. It is too easy to make mistakes like missing a dose or forgetting to call in a prescription to the pharmacy. As a matter of fact, roughly half of all persons with diabetes do not take their meds the way they should. The result is poor health and costly medical expenses.

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My TCOYD Newsletter, Vol. 34

It’s frustrating spending so much time and money just trying to live life.

Wouldn’t it be great if life with diabetes were simpler?

That’s exactly why Dr. Anuj Bhargava, Co-Director of the 2012 TCOYD Conference in Des Moines Iowa, created a free Smartphone app that helps you simplify this significant piece of keeping the balance.

It is called MedSimple™: Meds Made Simple.

One great feature of MedSimple is the cost-savings!

If there’s a coupon or patient assistance program out there, you can be sure

MedSimple has it listed. You can also set reminders so you never miss a dose and know when it’s time to call in a refill. What’s more, MedSimple can carry a complete list of your doctors, all the meds you have been prescribed, and your pharmacies, all on your Smartphone in your pocket or purse!

MedSimple is comprehensive and free! Download the app today in the Apple App Store or Google Play, or visit www.MyDiabetesHome.com to access the online version of the platform.

Life with diabetes is all about finding the balance, and that’s simpler than ever thanks to MedSimple.