I was diagnosed with diabetes when I was fifteen years old. I lost twenty pounds and had the classic symptoms of excessive thirst and urination. I remember being yelled at by the other kids at the drinking fountain because I was taking so long and my teachers were reprimanding me for falling asleep during class.

I ended up in the ICU and I clearly remember all of the nurses telling me repeatedly, “You can live a normal life,

you can live a normal life.” I had no clue what they were talking about and, because of the way the nurses kept saying it, I had begun to get a little worried.

I also remember attending a diabetes class that first week while in the hospital. There I was, a young, naïve, and ignorant teenager with a new diagnosis of type 1 diabetes, sitting in a room with twenty-five older, mostly overweight type 2s. To be honest with you, the one thing that I

A Sweet Combination (continued on page 2)

Dr. Edelman’s Corner

A s a kid, I wanted to become a dentist because after my appointment was over, I would get to pick out a small toy from a big chest to take

home. I figured I would have all those toys to myself if I were the dentist! After aging a few years and developing type 1 diabetes, my career aspirations started to change.

Fall 2014 Volume 49

INSIDE

NEWSLETTERMY

A Sweet Combination Diabetes Professionals Living With DiabetesA Sweet Combination Diabetes Professionals Living With Diabetes

We Are OnePage 3

Inhale Your Way to Controlling Your Glucose Page 4

Giving Back... Fundraising Challenge Page 5

Paying Too Much for Diabetes Supplies? Page 6

Plan Ahead for Sick Days Page 7

The Positive Impact of Education and SupportPage 8

Question of the Month Page 9

TCOYD & Sanofi Form the First Patient Advisory Team Page 10

Know Your NumbersPage 11

remember from that diabetes education class back in 1970 was that ketchup has a lot of sugar in it. Even at that time, my instincts told me that this was not the best learning environment for someone like me and there had to be a better way. When I think back on those days, it reaffirms just how important it is for me and my team at TCOYD to continue educating and motivating the public about diabetes care and self-management.

Shortly after my diagnosis I knew I wanted to become an endocrinologist specializing in diabetes. In 1978, when I was studying physiology during my first year of medical school at the University of California, Davis, I remember quite vividly one of my professors citing the statistic from a textbook that 50% of people with diabetes die from diabetic kidney disease within twenty years after their initial diagnosis. During the lecture, my classmates were either trying to avoid eye contact with me or attempting to give me some type of visual sympathy from across the lecture hall. Both situations made me feel very uncomfortable. That afternoon we had a physiology laboratory and had to dissect the cadaver of a 25-year-old man who had died of diabetic kidney disease. At the

2 My TCOYD Newsletter, Vol. 49

Board of DirectorsSteven V. Edelman, MD Founder and Director, TCOYD

Sandra Bourdette Co-Founder and Executive Director, TCOYD

Edward BebermanChristine BeebeAudrey FinkelsteinS. Wayne KayMargery PerryDaniel Spinazzola

Contributing Authors Justine Abella, 4th Yr. Pharm Student Jennifer BraidwoodSteven V. Edelman, MDCandis Morello, PharmD, CDEJeremy Pettus, MD

TCOYD TeamSteven 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, CPA Director of Finance and Administration

Jennifer Braidwood Manager, Outreach and Continuing Medical Education

David Snyder Manager, Exhibit Services

Robyn SemberaAssociate Manager, CME and Outreach

MyTCOYD NewsletterEditor: Jennifer BraidwoodAssistant Editor: Robyn Sembera Design: Hamilton Blake Associates, Inc.

MyTCOYD Newsletter is offered as a paid subscription of Taking Control Of Your Dia-betes. 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.

©2014 All rights reserved.

A Sweet Combination (continued from page 1)

SpecialAcknowledgements

Steven Edelman, MDFounder and DirectorTaking Control Of Your Diabetes

time, I was 23 years old with eight years of diabetes behind me. My close friend, Ken Facter, always tried to comfort me by saying that at least I knew what I was going to die from! These early experiences motivated me to take better care of myself and devote my career to helping people with diabetes.

Being a diabetes professional and living with this condition truly allows me to understand the struggles my patients are experiencing and to be an empathetic partner in their care. Yes, there is no denying that knowing the cold, hard facts about diabetes complications, hearing presentation

after presentation at diabetes meetings about eye, kidney, nerve, and heart disease, can wear on my mind; however, for me, the positives of working in the diabetes arena far outweigh the negative aspects. All diabetes professionals who are

living with diabetes and have decided to work in the field, from doctors to nurses, nurse practitioners and physician assistants, folks who work in the pharmaceutical and device industries, or are part of social media, all of us offer a very special insight that can make

the world a better place for all people with diabetes.

Being a diabetes professional and living with this

condition truly allows me to understand the struggles my patients

are experiencing…

Taking Control Of Your Diabetes 3

TCOYD in Motion

I was diagnosed with type 1 diabetes when I was 15 years old. Like so

many others diagnosed with the disease, diabetes has shaped my life in many different ways. Early on, I felt mostly self-pity and only could see the negatives to my new diagnosis. However, over the years, I have come to realize that the disease has perhaps given me more than it has taken away. Most notably, the disease has given me a purpose. It inspired me to go into medicine and ultimately to become an endocrinologist to treat others just like me.

I’ve come to realize that my experiences are not unique. Many patients diagnosed with type 1 diabetes seem to gravitate toward healthcare, and diabetes care in particular, as their career path. I can’t tell you how many other physicians, nurses, pharmacists, pharmaceutical reps, bloggers, etc, I’ve met in the diabetes world who also have type 1. A while back, Dr. Edelman and I started talking and found we both felt that it was important to get these like-minded

type 1’s together. Thus, We Are One was born.

We Are One, in its simplest definition, is an online collaboration of people living with type 1 diabetes who are, in one way or another, also professionally involved with diabetes. We Are One brings together doctors, educators, dietitians, personal trainers,

bloggers, pharmaceutical/medical device industry professionals, and anyone else who has type 1 and a diabetes centered profession. If you fulfill these criteria We Are One is for you and you can create a free profile sharing as much or

as little information as you would like. Members can search for other members by their type of practice, their location, their name, and a few other search criteria on the site. Emails can be sent to other members via the site.

I would like to think that We Are One is similar in some ways to Facebook or Linkedin, but with the idea of connecting a very specific group of people. Our feeling is that this is a unique group of dedicated professionals with personal insight into the disease, and it is important that these professionals find a way to connect. Members will likely use the site for their own personal needs, but I can imagine that I might send a message to a nutritionist with type 1 to get an opinion on a specific dietary question I had. Or maybe TCOYD will be traveling to a new city and I want to find some endocrinologists in the area with type 1 to come and speak. Also, with time, we plan to add a discussion board for members to post topics, share ideas, discuss patient care, and so on.

We are One brings together doctors, educators,

dietitians, personal trainers, bloggers, pharmaceutical/medical device industry

professionals, and anyone else who has type 1

and a diabetes centered profession.

By Jeremy Pettus, MD, Assistant Professor, UCSD; Type 1 Track Co-Director, TCOYD

A Place Where Diabetes Professionals with Type 1 Can Connectwww.weareonediabetes.org

We Are One (continued on page 11)

4 My TCOYD Newsletter, Vol.334 My TCOYD Newsletter, Vol. 49

Although there have been major improvements to injectable

insulins over the years, insulin users continue to deal with the challenge of injecting themselves several times a day. People who have these concerns now have a needle-free option to help manage their diabetes. On June 27, 2014, the U.S. Food and Drug Administration (FDA) approved Afrezza, a promising inhaled form of insulin to replace mealtime or “bolus” injectable insulin.

What is Afrezza?Afrezza is an insulin powder that is breathed-in (inhaled) through the mouth and is used to manage spikes in blood glucose in adults with type 1 or type 2 diabetes. Made as a small inhaler, Afrezza has been designed to be patient friendly and easy to use. The insulin powder is stored in blister card single-use cartridges and is available in two strengths. Similar to injectable insulin that is measured in units, Afrezza cartridges are also measured in 4 units and 8 units to allow for easy dosing conversions. If the prescribed Afrezza dose is higher than 8 units, more than one cartridge will need to be used, which also means more than one inhalation. Afrezza is only meant to

replace mealtime (regular or rapid-acting) insulin doses and does not replace long-acting or “basal” insulin requirements. Therefore, injections may still be necessary for people who need long-acting basal insulin such as glargine, detemir, or intermediate-acting NPH.

How Does the Afrezza Inhaler Work? Once the insulin is inhaled, the onset of action is fast (within minutes). Because the medication works very quickly, Afrezza should be used at the beginning or within 20 minutes of the meal. A key difference with Afrezza is its shorter duration of action (1 hour) compared to injectable mealtime insulins (2-3 hours). Since Afrezza actions are short lived, a second inhalation of Afrezza may be necessary if blood glucose remains elevated one hour after the meal.

What Can You Expect from Taking Afrezza?Clinical studies show that Afrezza reduces hemoglobin A1c (HbA1c) equally versus mealtime insulin injections over a six-month period. Hypoglycemia (low blood glucose)

is the most common adverse effect associated with all insulins, including Afrezza. However, Afrezza is different from injectable mealtime insulins because its fast onset and shorter duration of action more closely mimics how our body normally regulates insulin. Scientific trials in over 3,000 people show that Afrezza’s fast-on and fast-off characteristics reduce the risk of hypoglycemia compared to injectable mealtime insulins. Also, studies suggest a consistent weight advantage in individuals with type 1 or type 2 diabetes using Afrezza. Individuals with type 1 diabetes noticed a modest weight loss with Afrezza in contrast to weight gain with injectable mealtime insulins. In insulin-using individuals with type 2 diabetes, Afrezza was associated with less weight gain over a one year period. Afrezza may also cause temporary respiratory effects such as cough,

By Candis M. Morello, Pharm D, CDE & Justine Abella, Fourth Year Student Pharmacist at UCSD

Afrezza®: Inhale Your Way to Controlling Your Glucose

Ask Your Pharmacist

Afrezza (continued on page 12)

Taking Control Of Your Diabetes 5

TCOYD is a grassroots organization that speaks from its heart. They

don’t talk down to their audiences or make them ashamed of their condition; they engage their audiences, they fill their souls, and that’s important because living with diabetes is about so much more than blood sugar numbers,” said Audrey Finkelstein, Executive Vice President of Marketing, Sales, and Clinical Affairs at Aspire Bariatric. Audrey is one of the many gracious individuals who has helped TCOYD inch closer and closer to our goal of raising $75,000 in new donations this year.

Earlier this year, The Leona M. and Harry B. Helmsley Charitable Trust challenged TCOYD to raise $75,000 in new donations by May 14, 2015 and, if that challenge is met, they will match the $75,000. “It’s an exciting endeavor that is really pushing us to reach out into the diabetes community and beyond in order to help people become engaged and activated when it comes to their own philanthropy and diabetes education,” said Sandra Bourdette, Executive Director for TCOYD.

The challenge requires the gifts be $2,000 or more and from a person, foundation, or corporation who has never given that amount previously. Donations raised will go toward the development and expansion of a variety of TCOYD programs and initiatives, including the type 1 and type 2 conference tracks; whereas, the $75,000 match will be entirely focused on supporting type 1 specific initiatives.

“I really believe that Dr. Edelman offers a service to people with diabetes and their loved ones that isn’t available anywhere else. There is nothing else like it. He really makes a difference,” said Audrey.

If you are interested in making a gift to help TCOYD meet our

By Jennifer Braidwood

challenge, please contact Dr. Edelman or Sandy Bourdette directly via email (steve@tcoyd.org and sandy@

tcoyd.org). “TCOYD is a very worthwhile

organization. If you are going to give, it’s the perfect time because there is the dollar-for-dollar match and that makes your gift amount doubled. If you are a person living with diabetes, or if you love a person living with diabetes, this is the organization that can help him or her take better care of themselves, live longer, and be healthier.”

TCOYD sends Audrey Finkelstein a very special thank you for her generous gift and bringing us that much closer to meeting our match challenge.

Be sure to “like” us on Facebook. By joining our

online community you will be closely connected to TCOYD, others who have diabetes, and get the latest and greatest updates on

diabetes care and management. Find us on Facebook today and say hello! We would love to hear from you.

Stay In Touch with TCOYD

“

Giving Back

Generous Donor Helps TCOYD Move Closer to Meeting Fundraising Challenge

6 My TCOYD Newsletter, Vol. 49

Product Theater

If you have diabetes you know that the cost of care and daily diabetes

management can be expensive. Medications, devices, even test strips, all add to the overall expense of managing your diabetes day-in and day-out.

Paying Too Much for Your Diabetes Testing Supplies? Take the Co-Pay Challenge Today and Find Out.

Did you know that not all test strips are created equal, especially when it comes to how much they cost? One way to lower the cost of your monthly supply of test strips is to look for brands that are preferred or covered by your insurance plan.

OneTouch® has the lowest co-pay on the most health plans*.You may want to check with your insurance company to see if OneTouch® is a preferred product on your health plan. If it is, you will pay the lowest co-pay available from your health plan for OneTouch® Test Strips and diabetes testing supplies. Also, OneTouch® Testing Supplies are always covered by Medicare Part B and have a $0 out-of-pocket expense for those with supplemental Medicare insurance†.

Take some time today and see if you can cut the costs of your diabetes testing supplies. Bring the attached coupon to your phamacy to see if you qualify for a OneTouch Verio®IQ Meter at no charge.

*Some health plans may have more than one test strip covered at the lowest co-pay. Not a guarantee of coverage and payment. †Coverage and payment may be subject to co-insurance, deductible, and patient eligibility requirements.

Taking Control Of Your Diabetes 7

Blood Glucose Can Become More Difficult to Manage When You’re Sick. Knowing What to do in Advance May

Help You Recover Faster.

Keeping your blood glucose under control means having

routines and sticking to them. You know what to eat and when to eat. You know how often to check your blood sugar and what to do if it’s too high or too low. But when you get sick, everything changes.

Routine illnesses such as flu, sore throats, and stomach viruses can be especially challenging for people with diabetes. Even though you might not want to get out of bed to brush your teeth, you must stay on top of your blood glucose. “Any illness creates stress in the body as it tries to get rid of infection,” says Fernando Ovalle, M.D., an Endocrinologist at the University of Alabama at Birmingham School of Medicine. “This can increase levels of certain hormones, which can in turn cause an increase in glucose levels, even if you aren’t eating very much,” he says.

On top of that, when you are ill—especially if you have a fever—judging your blood glucose levels based on how you feel can be difficult. Angela Gaskins-Younger of Branford, Connecticut, who has

type 2 diabetes, learned this the scary way. Angela, 50, knew she was coming down with something; she had a fever and wasn’t feeling good. She checked her blood glucose and it was high, so she took some rapid-acting insulin. But she took too much. Soon she began to feel shaky and sweaty, which are symptoms of low blood glucose. “I wasn’t sure if the shakiness and the sweating were due to the fever or my blood sugar being too low,” Angela says. “I just couldn’t think clearly.” Fortunately, she soon managed to get her glucose under control without a 911 call.

Joyce Lekarcyk, RN, CDE, clinical education program manager at the Joslin Diabetes Center in Boston, advises keeping one word in mind when you are sick: more. More blood glucose checks, more fluids, and sometimes more medication. “Even if you take one or more pills, you may have to take on insulin temporarily,” she says. Don’t wait until you are sick to prepare for those sick days. Talk with your health care provider and make a game plan today. With a little planning and extra care, routine illnesses will stay just that—routine.

Sick-Day Basics What to Eat

If possible, eat the amount of carbohydrate you usually need. If you have no appetite, substitute drinks that have the same carb values as foods you typically eat.

If you can’t keep food down, drink plenty of caffeine-free, sugar-free fluids to help you stay hydrated. Aim for about 1 cup of liquid every hour. If you can’t keep down fluids, try ice pops or ice chips.

What to Take Check your glucose at least four

times a day during mild illnesses, and every three to four hours during more serious illnesses.

Take your usual blood glucose-lowering medications unless instructed otherwise.

If you take metformin and are vomiting, wait to take your metformin until you can keep down food and liquids.

If you take insulin, you probably will need the full daily dose.

If you have any doubts about what to do, or questions on dosages, call your health care provider.

Call Your Doctor If . . . Your blood glucose is higher

than 250 mg/dl for more than two readings.

You have persistent nausea, vomiting, and/or diarrhea.

Your glucose readings are consistently low.

You are at all unsure of what to do.

Living Well

Article Provided By: Diabetic Living magazine

more confident about controlling their diabetes, and 72% of individuals reported feeling less distressed about living with diabetes. 93% of individuals were more motivated to keep up with their diabetes self-management. These statistics show how powerful just one day of diabetes education can be.

Opportunities for EducationDiabetes self-management

education (DSME) is an important tool to meet the challenges of living a healthy and productive life. However, it’s important to note that although many DSME programs exist, many people report not having access to education. The DAWN2 study also identified a need for not only greater access to education and support but also increased awareness and utilization of the resources that are available. Improved access to education, specifically for people who are less likely to participate in diabetes education, is needed. These may include older adults, people with type 2 diabetes, males, and people living in large cities.

Despite people reporting not having access to education, there are actually American Diabetes Association® (ADA)– approved DSME programs and certified diabetes educators in every state and most major cities throughout the country. To find a diabetes educator near you, visit diabeteseducator.org. Click on the, “About Diabetes Education’’ tab and then click, ‘‘Have Diabetes? Learn More.’’ The ADA and the

8 My TCOYD Newsletter, Vol. 49

Taking Control

The Impact of Diabetes

It’s no surprise that diabetes can impact not only your physical

health but also your emotional health. A recent study titled Diabetes Attitudes, Wishes and Needs 2 (DAWN2™) looked at the experiences and unmet needs of people with diabetes, their family members, and healthcare providers, and found that nearly half of all people who live with diabetes have high emotional distress related to their condition.

To improve quality of life, people with diabetes need to find ways to reduce the impact that living with the condition has on their overall well-being. The DAWN2 study found that diabetes education plays an essential role in doing just that, helping people with diabetes elevate their day-to-day lifestyle. This can be done in various ways but, first and foremost, individuals need to be engaged in their healthcare and play a pivotal role in the successful management of their condition.

The Role of EducationBy participating in diabetes

education, people:•Feltbetterequippedtomanage

their diabetes •Weremoreactivelyinvolvedin

their diabetes care •Receivedmoresupport•Reportedbetterwell-being

compared with people who had not participated in diabetes education

Over the years, Taking Control Of Your Diabetes (TCOYD) has been guided by the belief that every person with diabetes has the right to live a healthy, happy, and productive life. TCOYD’s day-long educational conferences inform and motivate people to take a more active role in their condition. Post-conference survey results show that 93% of individuals who attend TCOYD’s all-day educational conferences and health fairs reported feeling

Talk to your healthcare team about programs and resources available in your area. Also, visit the TCOYD resource page for a comprehensive list of credible companies, organizations, and communities that provide valuable education and support. https://tcoyd.org/resources/links.html

Living with Diabetes: The Positive Impact of Education and Support in the Face of Distress

JDRF have local branches in almost every city and provide individuals with access to in-person support groups, educational materials, and a wide variety of other services and tools (accessible at www.diabetes.org and www.jdrf.org respectively). Be sure to connect with your local branch today. There are also a number of not-for-profit and government organizations, diabetes drug, and device companies, as well as online blogs and communities available to individuals with diabetes all over the country. Are you looking for a good online diabetes community? Check out dLife.com, DiabetesDaily.com, and diabeteshandsfoundation.org. These sites offer online forums, discussion boards, recipes, and advice on diet and nutrition, as well as fun and informative videos and articles about the latest diabetes management strategies. TCOYD also has a YouTube channel, TCOYDtv, where Dr. Edelman himself gives online viewers bi-weekly advice and tips.

Remember, it is critical to look for education offered by credible organizations, institutions, and individuals that offer up-to-date information and support.

The bottom line is that diabetes education can help to reduce emotional distress. It can positively impact an individual’s involvement in self-managing his or her diabetes and helps those with diabetes to feel empowered to take control. Ultimately, this may lead to a better quality of life and overall well-being.

©2014 Novo Nordisk All rights reserved. 0714-00022251-1 October 2014

By Steven Edelman, MD

Taking Control Of Your Diabetes 9

I am a 47-year-old male and I was diagnosed with type 2 diabetes ten years ago. I am currently on 54 units of Lantus at night, as well

as two oral medications during the day (metformin and Trajenta). My morning glucose readings are pretty good, normally between 80 and 130mg/dl; however, my A1c is 7.6%. Why is my A1c so high? Can the new inhaled insulin Afrezza help?

Answer: As you know, Lantus is a basal insulin that is meant to keep your glucose levels under control overnight and in-between widely spaced meals. You are also on two very good oral medications that work well with insulin. The reason why your A1c is high is probably because you are bouncing up too high after meals (post-prandial hyperglycemia). This is a common scenario in folks like yourself who have had type 2 diabetes for a long time. It is also pretty common for all type 1 diabetics. Afrezza is the new rapid-on-rapid-off ultra fast-acting inhaled insulin designed to take with meals to prevent the glucose values from rising excessively high after eating. It may be of great benefit to you and, if my theory is correct, will lower your A1c to goal safely and effectively. Talk to your doctor about incorporating it into your diabetes care regimen.

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

Question of the Month

Taking Control Of Your Diabetes Is Generously Supported By:

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before enrolling in a clinical study. In the coming months, the research team will be holding teleconferences and face-to-face meetings with the TCOYD Diabetes Patient Advisors to help develop some of the data collection technology used in their studies.

Clinical trials require hundreds, and often thousands, of people to volunteer for research studies and this is where the Diabetes Patient Advisors will help make participation a little easier for individuals who would like to be part of the research process. The feedback received from our TCOYD Diabetes Patient Advisors will assist Sanofi US in simplifying study designs so that things like reducing the time required of the research volunteers and the tools used to collect the research data are more user-friendly.

To learn more about clinical research, you can visit the Center for Information and Study on Clinical Research Participation (CISCRP) at www.ciscrp.org, which is a non-profit organization supporting clinical trial public education. The FDA also has great reference materials at www.clinicaltrials.gov.

Over the last twenty years Taking Control Of Your Diabetes has

played a pivotal role in diabetes education and self-advocacy for individuals across the country. However, what may come as a surprise to some is TCOYD’s many contributions to the advancement of clinical research and development, which often times takes a backseat to our dynamic all-day educational and motivational conferences and health fairs. Some of you may have already heard about the new online TCOYD Research Registry, a place for individuals with diabetes to register themselves and later be notified about upcoming clinical trials and studies (visit www.tcoydresearchregistry.com for more information). This exciting initiative allows people with diabetes to get personally involved in the ever-evolving world of diabetes care and management. However, getting involved in a clinical trial or study can be a tricky space to understand if it’s your first time. More so, developing a clinical trial that is

relevant to the advancement of diabetes care and research, as well as the person living with diabetes, and is easily understood by potential study participants is an even more delicate and crucial space for researchers to navigate.

That is why members of the TCOYD diabetes community found it imperative to begin collaborating with a biopharmaceutical company to help design some of their research studies. Sanofi US recognized that clinical research was missing one key element – the perspectives of those living with type 1 or type 2 diabetes. As a result, Sanofi US and TCOYD have formed the first Diabetes Patient Advisory Team to work as an extension of Sanofi US’s diabetes research team. Currently, there are thirteen individuals, along with Dr. Edelman and Sandra Bourdette, collaborating with Sanofi US to review protocol designs and provide valuable insights into what it is like to live with diabetes. The goal of the feedback is to make it easier for people with diabetes to participate in clinical trials and also guide the research teams to create the type of information people want to know

10 My TCOYD Newsletter, Vol. 49

TCOYD and Sanofi US Form First Diabetes Patient Advisory Team

By Steven Edelman, MD

Taking Control Of Your Diabetes 11

The Dexom© G4 continuous glucose monitor measures a persons

glucose every five minutes, 24/7. The image below is the CGM

download from a 64-year-old male with type 2 diabetes. He was being

treated at the time of this download with Levemir at night in addition

to metformin.

His A1c was above 10% and, from his hourly trend information,

I saw several areas for improvement: 1. He was going to bed too high.

He bounced high after dinner and went to bed in the 200 mg/dl range.

2. He stayed high all night long. 3. His post-lunch glucose values were

through the roof.

One big area for improvement was to control his post-lunch and

post-dinner glucose values with either a fast-acting insulin analogue

(Apidra, Novolog or Humalog) or inhaled insulin (Afrezza). Once these

improvements were made, his overnight values got better since he went

to bed in the mid 100 mg/dl range.

Know Your Numbers

(continued from page 3)

The site will also be searchable by the general public and non-members. The exception will be that non-members will not be able to email members directly. However, let’s say a medical professional has a patient who is moving into a new area and the medical professional wants to suggest another provider with type 1. In that case, the medical professional could go on the site and quickly find different types of providers in the area with type 1.

After formulating the idea and working on the site for over two years, we are finally ready to launch it! We honestly don’t know where the site will guide us, but our feeling is that getting folks registered is just step one. The future is full of different possibilities for how We Are One will be best utilized. For now, if you yourself would like to create a member profile, or if you would just like to surf the site to see how many type 1s in the field are out there, please go to weareonediabetes.org and have a look. See you online!

NonprofitOrganizationU.S. Postage

PAIDSan Diego, CAPermit No 1

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

Stay connected to TCOYD visit www.tcoyd.org

Taking Control Of Your Diabetes1110 Camino Del Mar, Suite “B”Del Mar, CA 92014 | www.tcoyd.org

Tel: (800) 998-2693 (858) 755-5683 Fax: (858) 755-6854

TCOYD Conferences & Health Fairs 2015 Schedule

12 My TCOYD Newsletter, Vol. 49

February 7 Augusta, Georgia Augusta Convention Center March 7 Santa Clara, California Santa Clara Convention Center March 28 Austin, Texas Austin Convention Center April 25 Honolulu, Hawaii Honolulu Convention Center May 16 Kansas City, Kansas Overland Park Convention Center June Date TBA Native American, California Location TBA September 26 San Diego, California San Diego Convention Center October 17 Omaha, Nebraska CenturyLink Center November Phoenix, Arizona Date TBA Location TBA

throat pain or irritation. Clinical trials have also shown that a small number of Afrezza users experienced minor changes in lung function. Consequently, a pulmonary (lung) function test before the drug is started, after six months of use, and then annually is required when using Afrezza.

Is Afrezza Right for You? If you do not have lung problems, smoke, or recently quit smoking, and need mealtime insulin, Afrezza may be an option for you. People with chronic lung conditions such as asthma or chronic obstructive

Submitted by Candis M. Morello, Pharm D, CDE, Professor of Clinical Pharmacy at UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences, Clinical Pharmacist at VASDHS

Justine Abella, Fourth Year Student Pharmacist at UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences

pulmonary disease (COPD) should not use Afrezza because of the possible risk of experiencing shortness of breath or difficulty breathing. The use of Afrezza is not recommended in people who smoke or have recently quit smoking (within six months) since safety and efficacy has not been established in this population.

The Bottom LineAfrezza offers a needle-free option for mealtime insulin users to control their postprandial (after-meal) glucose concentrations. Studies have shown that Afrezza lessens the risk of hypoglycemia, and is more weight neutral versus subcutaneous insulin injections. Patients who used

Afrezza in studies reported having a more positive attitude toward insulin therapy and a higher treatment satisfaction. Afrezza’s inhalation delivery system eliminates the burden of multiple injections throughout the day and expands the treatment options available for people with diabetes. Keep an eye out for continued research on Afrezza and other needleless alternatives, such as patches or nasal sprays, in the near future.

Afrezza (continued from page 4)