Accu-chek serious market comeback

July 27, 2009

avivacombo_spirit_mFor at least a number of years, Roche Diagnostics, through their Accu-Chek brand has been providing people with Diabetes with products on the Insulin Pump and Glucose Monitor markets. While this products have been heavily marketed, many people think they were not exactly leaders in the field.

Here in Australia, Medtronic and Animas are the two most prescribed brands of pumps, and many health processionals recommend people don’t choose the Spirit, which is the current generation of Acchu-Chek insulin pumps.

Now everything may be about to change, with the release of the Accu-Chek Combo System. Initially available in the UK, this combo of pump and glucose meter has the potential of making Roche a serious player in the market of Insulin Pumps.

The Pump has a number of characteristics often found only in pumps made by the bigger pump players. This first notable feature is the connectivity between the meter and the pump. By using Bluetooth technology, the meter has the capability of acting as a remote control for the insulin pump. More importantly, the communication is interactive and two-way, which means that “information flows between blood glucose meter and insulin pump automatically or on command, as appropriate”.

avivacombo_face_mmol_mThe other feature that was visibly missing on the previous Accu-Chek pumps was a bolus wizard. This new system, however, comes with a new feature called bolus adviser. While I have not yet seen how it actually works It sounds very positive. The pump also saves all the data about blood glucose, food, boluses, etc, serving as an electronic diary to keep all the information in one device.

Now, of course, the big question is whether the pump is as look as it goods, or even whether its going to be enough to bring Accu-Chek pumps back from the dead. Personally, I will have to hold my judgement until I get to see one in the flesh, which is likely to take a while considering this pump is still only available in Europe.

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Medtronic involved in research fraud scandal

July 22, 2009

moneyforeheadLast week the Wall Street Journal published an article on the doctor who is currently being investigated for falsifying data on a study for one of Medtronic’s products. While the issue is not related to their Diabetes division, one could not avoid to think the implications this may have on the biggest manufacturer of insulin pumps.

The issue is related to a former Army surgeon, Dr. Timothy R. Kuklo, who alledgedly reported that a bone-growth product sold by Medtronic had much higher success than other doctors had experienced. According to reports, there are also documents that show that Medtronic may have financially supported Kuklo’s research.

According to reports published on Fierce Health, Medtronic has also made payments of almost $6 million in consulting fees, with some surgeons being paid in the high six figures in a single year. Medtronic, for its part, isn’t denying that it’s made consulting payments, but says that the payments weren’t kickbacks. Instead, it says, it paid doctors a legitimate fee to assist the company in determining how its devices could be best designed and used.

This event raises a broader issue that it’s not nearly as discussed as it should be, and is thequestion of whether companies get into the Diabetes market to do good, to get rich or just for glory. Diabetes is a growing illness, and inevitably attracts a lot of investment as there is a lot of money to be made. Whether the motivation is to finally find a cure or just to keep us alive and paying is the big questions.

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Is the artificial pancreas really on its way?

July 16, 2009

For a while now people with diabetes have been hearing that a cure may be just 5 years away. After almost 90 years of having injected insulin as the only way of staying healthy with D there may finally be light at the end of the tunnel.

There is a number of interesting paths being pursued by researchers. One that seems to be taking a lot of traction is the artificial pancreas. While a lot of improvement has been done in insulin pump therapy in the last few years, the pump manufacturers seems to be still far from an automated closed look system.

Researchers at the University of Virginia Health System tested a computerized system that controlled overnight glucose levels and reduced hypoglycemia levels five-fold. The new system has been tested on 20 people with Type 1 diabetes, also known as juvenile or insulin-dependent diabetes. Each patient was admitted to the hospital twice for 24 hours each time. All patients had identical eating, sleeping, and exercising activity during the admissions.

Here is an video from JDRF about the Artificial Pancreas project:

“This artificial pancreas could one day greatly improve the current methods of self-treatment for Type 1 diabetes.” said lead investigator Boris Kovatchev, associate professor of psychiatry and neurobehavioral sciences in the university School of Medicine. “Instead of a patient having to measure his or her blood sugar with a glucose meter several times a day and self-administer insulin injections, this system would continuously regulate the patient’s blood glucose, much like the way a non-diabetic’s pancreas functions.”

Is the artificial pancreas really on it’s way? Well, maybe we need to wait another 5 years….

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Type 1 Diabetes in the Developing World

July 9, 2009

diabetes-environmental-factors-insulinMany of you already know I’m not a native Australian. I was born in a little corner of South America in front of the Caribean. A beutiful country unfortunately plagged with many of the problems of the developing world.

I’m extremely lucky for a number of reasons. In the diabetes side of things, I was diagnosed as an adult, which means that I didn;t have to deal with the extra burden or growing up with D. More importantly, I was diagnosed here in Australia, were we have an advanced health system.

Not everyone is as lucky as I am.  There are 84 million people with Diabetes in the developing world, and this number is expected to increase to 228 million by 2030. Unfortunately, these people are the ones that have less resources available to manage the condition. The health system in most developing countries is also in much poorer shape.

ecuadorsmThere is a number of organisations trying to improve the lifes of people with Type 1 diabetes in  developing countries. my favourite is Insulin for Life a not-for-profit organisation that collects and distributes insulin and other diabetes supplies that would otherwise be wasted. This supplies are then distributed to places like Bolivia, Ecuador, Kosovo, Zimbawe and 65 other countries.

There is no easy solution to this problem. For many of us, it’s a matter of keeping our diabetes under control while we have a cure. In the developing world, however, many people die because they don’t have access to the basic tools to manage the condition. If a cure is important for everyone with D, it is even more needed for people in vulnerable situations.

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Drinking with D: Diabetes and Alcohol

July 6, 2009

alcoholThis weekend I was at a friends birthday, and as I poured my 3rd Vodka I rememembered (rather vaguely) something I read somewhere… Diabetics should not drink more than two standard drinks a day. We’ll, as some of you may have guessed by now, I didn’t put my glass down, and kept drinking a few more. Don’t get me wrong, I’m all for responsible drinking, and firmly believe that everyone should stay in control. On the other hand, I’m also human, and I know that some people occasionally go over the line a bit.

As I recovered from the effects of a big night out, and kept a close eye on what my blood sugar was doing, I decided to look again for what the advise on alcohol and diabetes was. To my surprise and disapointment while information on the subject is widely available, it also seem to be mostly impractical, specially once you have decided to breach the “only two drink” rule.

alcohol-422270While doing my research, I finally found hope… in the page of the New South Wales division of Diabetes Australia. They say “Research indicates that in general, the level of alcohol consumption associated with the least risk for people with diabetes is the same as that for the general population”. In English, this basically means that the two drink rule also applies to non diabetics. From my point of view this gives me comfort in the fact that if a lot of people without diabetes drinks beyond the official recommendation, then it should be possible for people with D to drink a bit more than just a couple of beers if they choose to do so.

The best resource I’ve found so far, is the Drinking and Going Out factsheet created by Reality Check, a network of young adults with Type 1 diabetes. The guidance in this document is very pragmatic and much more actionable than most of the other resources I’ve found on the net. It starts with the basic implications of alcohol and diabetes:

  • Alcohol impairs the liver’s ability to produce glucose in the event of a severe hypo
  • Early signs of hypos can look the same as drunkenness (for you and people around you).

It subsequently goes into some recommendations to handle alcohol, which I’ve found very useful. Personally, I’ve found that the main thing for me is to keep the balance of alcohol and carbs right. Of course this is not as easy as it sounds, and I’ve found that frequent monitoring is a must in this cases.

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Review: Medtronic Minimed Quickset infusion set

July 2, 2009

quickserterA few weeks ago I conducted an evaluation of various infusion sites sets for my Minimed Paradigm. After writing about the Thinset reservoirs, the Inset II and the Cleo 90, I thought it would only be fair to write a formal review of the Minimed Quicksets. These are one of the standard  sets made for the Paradigm, but is also available with a luer lock connection for other pumps.

Advantages

The Quickset is a high quality set, well built, and very reliable. The adhesive is the best of all the sets I’ve tried, and in my case has resisted water, sweat and serious abuse for well over 3 days.

The other good thing is the inserter. It uses a high precision spring loaded mechanism. It goes in quickly and without any pain. Having a reusable inserter also means less waste, and less impact to the environment.

Disadvantages

The downside of having a reusable inserter is that you need one wherever you are changing your set. This can be challenging for emergency kits and backup supplies. Inserters are not cheap, and at $60 each, I won’t be buying one for each of my backup kits  anytime soon.

The other slight disadvantage is size. The Quickset adhesive is slightly bigger than the other sets, and is white, so it’s bit more visible.

Verdict

Overall, this is probably the best set I’ve used so far, so I will probably keep using it on my pump. I will, however, keep a couple of the other sets in my backup kits, one in the car and one in the office.

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