Diabetic Live - Diabetes News, Information & Resources

Living Healthy With My Diabetes™

The SUPERVALU family of grocery stores (including Acme®, Albertsons®, Cub Foods®, Farm Fresh®, Jewel-Osco®, Shaw’s/Star Market™, Shop ‘n Save®, and Shoppers Food & Pharmacy®) has just launched “living healthy with my diabetes™,” a program that will feature a variety of year-round resources, as well as special limited-time services starting Nov. 7 through Nov. 20 during American Diabetes Month.

Following are some of the services available between Nov. 7 and Nov. 20:

Free blood glucose test screenings in selected locations (Saturday, Nov. 13, from 10 a.m. to 2 p.m.)
Health screenings for A1C, cholesterol and liver function for just $19.99
And in some stores, savings booklets for discounts on diabetes-related products, while supplies last.

Program elements that are available year-round include:

“Eating Healthy with Diabetes” store tours guided by specially-trained pharmacists and registered dietitians
Online diabetes-friendly menu ideas and recipes
In-store pharmacy services including education, self-management services, blood glucose screenings, blood pressure monitoring and face-to-face medication reviews
Diabetes products such as equaline® test strips, glucose tablets, blood pressure monitors, lancets, and latex and vinyl gloves

Better Choices, Better Health Pilot Program

Better Choices, Better Health, the new online version of Stanford University’s Chronic Disease Self Management Program (CDSMP). This new program is free for people in seven pilot states, thanks to a grant from The Atlantic Philanthropies.

Better Choices, Better Health is a six-week, interactive workshop designed for people with a range of chronic health conditions, including diabetes. Participants learn new ways to manage their symptoms, reduce anxiety, and find community resources.

A little more info about Better Choices, Better Health:

Workshops can be accessed from any computer with an internet connection—including dial-up—making them accessible for those without access to transportation or broadband.

Led by trained facilitators, many of whom live with chronic conditions themselves, participants discuss:

Dealing with anxiety and stress
Managing pain and other symptoms
Planning for the future
Locating and using community resources
Building communication skills
Asking for help

The seven pilot states are: California, Hawaii, Iowa, Maine, Massachusetts, New Jersey, and Oregon. We hope to expand this list soon.

The National Council on Aging has licensed the program from Stanford University, but workshops are open to individuals of all ages.

Even more info: http://www.ncoa.org/improving-health/chronic-disease/better-choices-better-health.html

Ben Vereen Takes Diabetes Personal

He sings, he dances and he can act. His name is Ben Vereen and he’s a diabetic. This star of stage and screen has taken his story to the people, and the people are listening.

Vereen struggled in his own past. He found out he was adopted in 1960 when applying for a passport to travel. His daughter died. He struggled with alcoholism. A car struck him. Had to learn to speak again after the accident, and more recently was diagnosed with Type 2 diabetes.

Today Vereen is in his 60’s, has a couple of movies and television movies that will debut soon and his one man show featuring music of Sammy Davis Jr. is a success. But according to DallasNews.com Vereen has a new message when it comes to diabetes, “Turn it around.”

Vereen also had a tough message for those who chose to consider themselves a victim of diabetes, “We need to stop seeing diabetes as a challenge or something that we suffer from, but rather it’s an opportunity to live a better life by taking better care of ourselves.”

To demonstrate his level of commitment to fighting diabetes Vereen has partnered with Sanofi-aventis to create an organization S.T.A.N.D. for Diabetes (Start Taking Action Now for Diabetes). The movement is self-described this way, “Whether you are an influencer in the world of entertainment, medicine, public health, or marketing, or someone living with or affected by diabetes in some way, we want you to look for opportunities in your daily activities to spread the message and become part of this movement. We challenge you to think differently about diabetes and imagine new ways to raise awareness about the disease and the importance of better blood sugar control NOW.”

Vereen is clear that it is his influence he plans on using to spread the news about diabetes, its causes, its struggles and ways to fight back. This is the call he makes to all of us – use whatever influence we have to reverse the trend of diabetes in our world.

According to a S.T.A.N.D. press release Vereen said, “When I was first diagnosed I did the things my doctor recommended — watching my diet, exercising more and taking my diabetes medication — but I wasn’t comfortable checking my blood sugar in public, but I’ve overcome my discomfort with the help of friends and family because I’ve learned that it’s so essential to control my blood sugar. Now checking my blood sugar is as comfortable as using my cell phone and my blood sugar is under control!”

Pointing to his optimistic nature Vereen refers to his condition as “lifeabetes.”

One of the key ways S.T.A.N.D. encourages others to influence is through social media like MySpace, Facebook and Twitter. These mediums are a preferred way for many to communicate making them an incredibly potent tool in spreading the news both personally and in wall posts or tweets.

The key reason this is suggested is because it’s easy for everyone to do. There is no need to speak publicly (unless you’re gifted to do so and want to). There is no need to lobby congress (unless you are determined to do so). This is effectively a 21st century attempt at a grassroots movement that spreads the news and invites people to action. People like Ben Vereen – people like you.

Recall of the Medtronic Pumps

In August of 2007, the Medtronic Neuromedulation Company sent a letter to each of its customers. The top of the letter displayed this phrase: “Urgent Medical Device Correction, August 2007.” The letter disclosed some unsettling information about the SynchroMed EL infusion pumps.

The letter sent a clear warning to all those who had purchased a SynchroMed EL infusion pump prior to September of 1999. Mounting evidence had produced proof that pumps made before that date could stall at an unexpectedly high rate. The wear and tear on pumps made before September of 1999 could result in a sudden stoppage of delivery. Stalled pumps ceased delivery of insulin.

The letter emphasized the importance of its message. It indicated that the recall of the SynchroMed EL pump was a Class 1 recall. Any recall constitutes an action taken to address a problem with a product. The FDA can call for the recall of a medical device. A Class I recall underlines the harm that could result from continued and widespread use of a medical device with a particular problem.

The actual recall process had been initiated by the Medtronic Neuromedulation Company. As indicated, the Company had sent letters to each of the customers who had purchased a SynchroMed EL infusion pump. The Company had also completed another important step in the recall process.

When a company recalls a medical device, it needs to do more than just contact those who have previously purchased that device. It also needs to forewarn any customers who might now be thinking about buying that device. When a Company initiates the recall of a medical device, it must also put out a press release. In that release it must make clear what the name of the device that has been shown to be a potential threat to users of that device.

The Medtronic Neuromedulation Company had released such a statement to the press. It had also distributed information that could help customers to better identify the problem pump. Finally, the Company had acted to make the necessary changes in the pumps, changes that would eliminate any potential harm to a diabetes patient who was using that same pump.

The FDA led oversight of the actions taken by the Medtronic Neuromedulation Company. The FDA worked with Company officials to get out clear and complete information on the product that was being recalled. In addition, the FDA had asked the Company to issue a public statement, a statement outlining its recall strategy.

Once the Company had initiated its proposed recall strategy, then the FDA had conducted an audit of the Company. The FDA used that audit as a way to judge the effectiveness of the ongoing recall. The FDA also took steps to monitor the efforts being made to correct the device deficiencies, the deficiencies that had led to the recall.

Although the FDA has designed the recall process to limit the number of consumer concerns, the Agency realizes that some customers might still have questions. For that reason, it has announced several channels by which concerned customers, possibly diabetes patients, can direct their questions to those most apt to have the correct answer.

Diabetes patients who use or have used the SynchroMed EL infusion pump can obtain more information by calling 1-800-707-0923. They can also go online to this website: www.fda.gov/MedWatch/report.html. A diabetes patient who can not make a phone call or does not have access to a computer has yet another option. He or she can send a Fax to 1-800-FDA-0178.

Should a diabetes patient care to mail a letter to the executives at the company conducting the recall, then that patient should address that letter to:

Medtronic Neuromedulation Company
800 53rd Ave. N.E.
P.O. Box 1250
Minneapolis, Minnesota 55440-1250

Diabetes and Medicare Supplies – Part 2

If information is power than knowing as much as you can about the Medicare benefits you’re entitled to can be very helpful in your care. The Center for Medicare and Medicaid Services provides more details.

Before a beneficiary gets a supply, it is important for them to ask the supplier or pharmacy the following questions:

Are you enrolled in Medicare?
Do you accept assignment?

If the answer to either of these two (2) questions is “no,” they should call another supplier or pharmacy in their area who answers “yes” to be sure their purchase is covered by Medicare, and to save them money.

If a beneficiary cannot find a supplier or pharmacy in their area that is enrolled in Medicare and accepts assignment, they may want to order their supplies through the mail, which may also save them money.

Therapeutic Shoes and Inserts
If a beneficiary has Medicare Part B, has diabetes, and meets certain conditions (see below), Medicare will cover therapeutic shoes if they need them. The types of shoes that are covered each year include one of the following:

One pair of depth-inlay shoes and three pairs of inserts; or
One pair of custom-molded shoes (including inserts) if the beneficiary cannot wear depth-inlay shoes because of a foot deformity and two additional pairs of inserts.

Note: In certain cases, Medicare may also cover shoe modifications instead of inserts.
In order for Medicare to pay for the beneficiary’s therapeutic shoes, the doctor treating their diabetes must certify that they meet all of the following three conditions:

They have diabetes;
They have at least 1 of the following conditions in one or both feet:
Partial or complete foot amputation;
Past foot ulcers;
Calluses that could lead to foot ulcers;
Nerve damage because of diabetes with signs of problems with calluses;
Poor circulation; or
Deformed foot;
They are being treated under a comprehensive diabetes care plan and need therapeutic shoes and/or inserts because of diabetes.

Medicare also requires the following:

A podiatrist or other qualified doctor must prescribe the shoes, and
A doctor or other qualified individual like a pedorthist, orthotist, or prosthetist must fit and provide the shoes to the beneficiary.

Medicare helps pay for one pair of therapeutic shoes and inserts per calendar year, and the fitting of the shoes or inserts is covered in the Medicare payment for the shoes.

Insulin Pumps and the Insulin Used in the Pumps
Insulin pumps worn outside the body (external), including the insulin used with the pump, may be covered for some people with Medicare Part B who have diabetes and who meet certain conditions. If a beneficiary needs to use an insulin pump, their doctor will need to prescribe it. In the Original Medicare Plan, the beneficiary pays 20% of the Medicare-approved amount after the yearly Part B deductible. Medicare will pay 80% of the cost of the insulin pump. Medicare will also pay for the insulin that is used with the insulin pump.

Medicare Part B covers the cost of insulin pumps and the insulin used in the pumps. However, if the beneficiary injects their insulin with a needle (syringe), Medicare Part B does not cover the cost of the insulin, but the Medicare prescription drug benefit (Part D) covers the insulin and the supplies necessary to inject it. This includes syringes, needles, alcohol swabs and gauze. The Medicare Part D plan will cover the insulin and any other medications to treat diabetes at home as long as the beneficiary is on the Medicare Part D plan’s formulary. (Source: cms.gov)

Diabetes Connection to the Bone Cells

It’s not often that you hear of medical science discussing diabetes and bones in the same sentence. Usually the heart and kidneys are the discussed in connection with diabetes, but new research suggests that the human bones may have a bearing on how the human body manages insulin.

MedPageToday indicates, “In the July 23 issue of Cell, [and] from two separate research teams [there is an indication] that insulin receptors in osteoblasts mediate release of the hormone osteocalcin, which speeds up glucose metabolism elsewhere in the body.”

MedicineNet.com defines osteoblasts as, “A cell that makes bone.” Meanwhile, “The hormone osteocalcin is secreted solely by osteoblasts (bone making cells) and thought to play a role in the body’s metabolic regulation and is pro-osteoblastic, or bone-building,” according to Wikipedia.

According to Gerard Karsenty, MD, PhD, of Columbia University in New York City, “The two studies suggest that drugs working through the osteocalcin pathway, if not the hormone itself, could be effective treatments for type 2 diabetes.

“Insulin signaling in osteoblasts [is] a critical link between bone remodeling and energy metabolism,” cited MedPageToday.com

The exciting part of this research is the fact that this provides a new link of potential in how the body works to correct health issues. As mentioned in the opening paragraph it is not often that anyone has spoken about diabetes and bone health in the same sentence.

The end result could be that individuals with diabetes may want to gain as much information about how the human bones can actually help regular blood sugar (glucose) as possible.

MedPageToday indicated these, “experiments also revealed what they called a “previously unappreciated” function of insulin in bone — that it boosts activity of an osteoblast regulatory molecule called Runx2, the end effect being that insulin helps promote osteoblast differentiation.”

The research on this finding was “funded by the Fond de la Recherche en Sante du Quebec, the National Institutes of Health, and the Juvenile Diabetes Research Foundation.”

The long and short of the research suggests that it is possible the bone making cells interact in a more significant way with diabetes by infusing the hormone osteocalcin into the body. This hormone is helpful in regulating diabetes. The hormone appears to act in concert with the bone-making cells to create an atmosphere that is equipped to help with the in-body care needed to thrive with diabetes.

According to MedPageToday both research groups suggested, “In total, the findings demonstrate the delicate and interactive nature of the processes underlying bone formation and resorption.”

The research may further indicate what possible ways this knowledge can be used to accelerate the body’s ability to accept a more efficient flow of information and successful implementation and absorption of insulin within the body, and used by bone making cells.

The body is a very complex organism that is often discovered to be more complex than we ever realized. DNA is an example of the complexity, but even within that undeniably unique set of body blue prints we continue to learn more and more about not only the various parts of our internal structure, but also how those parts interact in ways we never imagined.

These latest studies remain a prime example of how that plays out in scientific data and potential medical fixes for those occasions when two parts of the body that normally work well together are in the midst of a struggle.

Diabetes and the Potential Impact of AMPK

If you’ve ever watched a survival type show on television then you know there are extremes in food availability that people endure and they seem to come out of these issues safely. There is a chromosome protein that acts as a rescue device and the discovery of how it functions may have a huge impact on how diabetes is treated.

According to Medical News Today, “Researchers at McGill University and University of Pennsylvania have uncovered new insights into how a protein known as the AMP-activated protein kinase, or AMPK, a master regulator of metabolism, controls how our cells generate energy.”

Imagine if you will, a drill sergeant in the Army. He commissions soldiers to go from one place to the next to fulfill the needs of the overall operation. He’s in charge of many soldiers and each is told what to do and when to do it. This is a picture of what AMPK is like in the human body.

If the AMPK determines the body’s resources are not required for energy then it will not willingly allocated energy resources without just cause.

McGill Professor Russell Jones is quoted in Medical News Today as saying, “”The discovery that AMPK goes directly to the DNA to affect gene transcription is a breakthrough in our understanding how signals from outside the cell are transmitted to change gene expression. It is like an electrical circuit. We have figured out how AMPK mediates the connection.”

If you’re wondering why this is big news the answer lies in what medical science can potentially do with this information. They may be able to effectively send new orders to the AMPK allowing the use of energy cells to be used in metabolism – even during times when the AMPK would not normally do so.

As a society we’ve encountered an alteration in our overall lifestyle. Where once we were more active in physical labor today we are much more sedentary so our bodies are not used to the idea of needing to burn added fat or energy cells.

Medical News Today helps explain the process. “AMPK’s main role is to sense cell stress. In this study, cells were stressed with ultraviolet radiation and low levels of glucose, a common source of cell energy. In the sequence of events after stress, AMPK picks up the cell-stress signal and travels to the nucleus to bind to the tumor suppressor gene p53. This in turn, causes a phosphate to be added to a histone near the p21 gene, which activates transcription. The function of the p21 protein is to stop or slow down the cell cycle.”

If medical science can simulate cell stress then it may be possible to induce a more effective use of glucose and a fat burning metabolism as it works to encourage AMPK to regulate a change that gains benefit from an effective use of blood glucose.

Medical News Today reports, “The work conducted by the researchers holds promise for new therapies for a number of diseases including diabetes and cancer. For example, AMPK is a target of metformin, the most commonly prescribed drug for the treatment of Type II diabetes. By understanding how AMPK can directly change gene expression, this may lead to the identification of new disease-associated targets and potential therapies.”

In the end this is one more potential therapy that may result in improved care for those who live with diabetes.

Diabetes and Medicare Supplies – Part 1

It can sometimes be confusing to know what exactly is covered under the U.S. Government’s Medicare program when it comes to diabetes. The Center for Medicare and Medicaid Services provides some details.

MEDICARE – PART B

Medicare covers certain supplies if a beneficiary has Medicare Part B and has diabetes. These supplies include:

Blood glucose self-testing equipment and supplies;
Therapeutic shoes and inserts; and
Insulin pumps and the insulin used in the pumps

Blood Glucose Self-testing Equipment and Supplies

Blood glucose self-testing equipment and supplies are covered for all people with Medicare Part B who have diabetes. This includes those who use insulin and those who do not use insulin. These supplies include:

Blood glucose monitors;
Blood glucose test strips;
Lancet devices and lancets; and
Glucose control solutions for checking the accuracy of testing equipment and test strips.

Medicare Part B covers the same type of blood glucose testing supplies for people with diabetes whether or not they use insulin. However, the amount of supplies that are covered varies.

If the beneficiary

Uses insulin, they may be able to get up to 100 test strips and lancets every month, and 1 lancet device every 6 months.
Does not use insulin, they may be able to get 100 test strips and lancets every 3 months, and 1 lancet device every 6 months.

If a beneficiary’s doctor documents why it is medically necessary, Medicare will cover additional test strips and lancets for the beneficiary.

Medicare will only cover a beneficiary’s blood glucose self-testing equipment and supplies if they get a prescription from their doctor.

Their prescription should include the following information:

That they have diabetes;
What kind of blood glucose monitor they need and why they need it (i.e., if they need a special monitor because of vision problems, their doctor must explain that.);
Whether they use insulin; and
How often they should test their blood glucose.

A beneficiary needing blood glucose testing equipment and/or supplies:

Can order and pick up their supplies at their pharmacy;
Can order their supplies from a medical equipment supplier, but they will need a prescription from their doctor to place their order; and
Must ask for refills for their supplies.

Note: Medicare will not pay for any supplies not asked for, or for any supplies that were sent to a beneficiary automatically from suppliers. This includes blood glucose monitors, test strips, and lancets. Also, if a beneficiary goes to a pharmacy or supplier that is not enrolled in Medicare, Medicare will not pay. The beneficiary will have to pay the entire bill for any supplies from non-enrolled pharmacies or non-enrolled suppliers.

All Medicare-enrolled pharmacies and suppliers must submit claims for blood glucose monitor test strips. A beneficiary cannot submit a claim for blood glucose monitor test strips themselves. The beneficiary should make sure that the pharmacy or supplier accepts assignment for Medicare-covered supplies. If the pharmacy or supplier accepts assignment, Medicare will pay the pharmacy or supplier directly. Beneficiaries should only pay their coinsurance amount when they get their supply from their pharmacy or supplier for assigned claims. If a beneficiary’s pharmacy or supplier does not accept assignment, charges may be higher, and the beneficiary may pay more. They may also have to pay the entire charge at the time of service and wait for Medicare to send them its share of the cost. (Source: cms.gov)

Diabetes, Cashews & Dementia

What do cashews and dementia have in common? They are commonly linked with diabetes. The first as a preventative aid and the second a byproduct of uncontrolled diabetes.

According to TopNews, “A new study by the researchers from Universities of Montreal, Canada and de Yaounde Cameroun has indicated towards the effectiveness of the cashew seed extract against diabetes.”

Pierre Haddad is a professor of pharmacology in Montreal who indicated, “Cashew seeds extract have effectively stimulated the absorption of blood sugar by muscle cells, among all the extracts tested.”

The reason the research is significant is because the cashew is a natural and sustainable resource that can be used in cost effective treatment of diabetes. Obviously more research will be needed, but the use of cashews in the care of diabetes may be viewed as another positive in the ongoing quest to find treatments and an ultimate cure for diabetes.

Haddad is quoted by TopNews as saying, “Our study validates the traditional use of cashew tree products in diabetes and points to some of its natural components that can serve to create new oral therapies.”

Cashews come from a fruit known as cashew apples. The apple is small and typically rots within 24 hours of picking. The research extended to the apple, the leaf and the bark of the cashew apple trees. Cashews are said to be anti-inflammatory and can be used to control the blood sugar levels in those living with diabetes.

Meanwhile, TopNews also reported, “Mayo Clinic’s Florida campus and the University of California have conducted a research on whether dementia varies with people having diabetes or not. Blood samples of 211 people with dementia and 403 without dementia were collected to compare the ratio of two dissimilar types of amyloid beta proteins in blood.”

It has been said that Alzheimer’s is a form of diabetes because insulin levels are extremely low in patients with Alzheimer’s. However, the report suggests that dementia in diabetes is different than Alzheimers, “The findings show that people who have diabetes are more likely to get affected by vascular disease, which affects blood flow in brain vessels causing dementia. People who suffer from dementia without diabetes are affected by brain plaque deposits, which are generally found in Alzheimer patients,” said TopNews.

The study was published in the Archives of Neurology. TopNews reports, “Those having dementia without diabetes can cure the same by taking high levels of vitamin E in their meals, as Vitamin E guards the brain against oxidative stress, which causes Alzheimer.”

To avoid dementia in adults the findings suggest that, “The intake of four antioxidants — vitamin E, vitamin C, beta carotene and flavanoids — can improve the function of the memory.”

In diabetes, dementia is often the result of vessel damage between the heart and brain. By understanding the cause medical practitioners may be able to better guard against the instance of dementia by assisting their diabetic patients with information and medication that may prove helpful.

These two stories continue to point to the wide variety of tools researchers are using in order to gain a better understanding of diabetes and how it affects patients. Similarly they are also working to use every available resource to better the lives of their patients.

The overall care of those with diabetes continues to improve with each passing year and research findings like these assist in advancing the cause of care.

Medicare and Diabetes Prevention

There is a greater cost involved in treating diabetes than preventing it. The U.S. Government realizes this so they have included prevention programs in their Medicare plan.

While this list isn’t complete it does take a look at prevention programs related very specifically to diabetes and related illnesses for those who participate in Medicare.

Cardiovascular Screenings
Helps detect conditions that may lead to a heart attack or stroke. This service is covered every 5 years to test your cholesterol, lipid, and triglyceride levels. No cost for the test, but you generally have to pay 20% of the Medicare-approved amount for the doctor’s visit.

Diabetes Screenings
Checks for diabetes. These screenings are covered if you have any of the following risk factors: high blood pressure (hypertension), history of abnormal cholesterol and triglyceride levels (dyslipidemia), obesity, or a history of high blood sugar (glucose). Tests are also covered if you answer yes to two or more of the following questions:

Are you age 65 or older?
Are you overweight?
Do you have a family history of diabetes (parents, siblings)?
Do you have a history of gestational diabetes (diabetes during pregnancy), or did you deliver a baby weighing more than 9 pounds?

Based on the results of these tests, you may be eligible for up to two diabetes screenings every year. No cost for the test, but you generally have to pay 20% of the Medicare-approved amount for the doctor’s visit.
Diabetes Self-Management Training

For people with diabetes. Your doctor or other health care provider must provide a written order. You pay 20% of the Medicare-approved amount, and the Part B deductible applies.

EKG Screening
Medicare covers a one-time screening EKG if you get a referral for it as a result of your one-time “Welcome to Medicare” physical exam. You pay 20% of the Medicare-approved amount, and the Part B deductible applies. An EKG is also covered as a diagnostic test.
Flu Shots

Helps prevent influenza or flu virus. Covered once a flu season in the fall or winter. You need a flu shot for the current virus each year. No cost to you for the flu shot if the doctor accepts assignment for giving the shot.

Glaucoma Tests
Helps find the eye disease glaucoma. Covered once every 12 months for people at high risk for glaucoma. You are considered high risk for glaucoma if you have diabetes, a family history of glaucoma, are African-American and age 50 or older, or are Hispanic and age 65 or older. An eye doctor who is legally authorized by the state must do the tests. You pay 20% of the Medicare-approved amount, and the Part B deductible applies.

Medical Nutrition Therapy Services
Medicare may cover medical nutrition therapy and certain related services if you have diabetes or kidney disease, or you have had a kidney transplant in the last 36 months, and your doctor refers you for the service. You pay 20% of the Medicare-approved amount, and the Part B deductible applies.

Welcome to Medicare Physical Exam (one-time physical exam)
A one-time review of your health, and education and counseling about preventive services, including certain screenings, shots, and referrals for other care if needed. Medicare will cover this exam if you get it within the first 12 months you have Part B. You pay 20% of the Medicare-approved amount. When you make your appointment, let your doctor’s office know that you would like to schedule your “Welcome to Medicare” physical exam.

More information about these and other services can be found at the Medicare website