tcoyd vol 34
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Dr. Edelmans Corner
For those of us with type 1 diabetes, we have fast and long acting insulin analogs, insulin pumps and pens, home glucose monitors and continuous glucose monitors (CGM). I feel that the avail-ability of CGM devices is the single
greatest advance for people with type 1 diabetes since the discovery of insulin 90 years ago. One of my resolutions is to educate healthcare providers about this powerful technology, alert and educate the people most affected by this condi-
F or all of us living with diabetes, there has never been a better time to make some New Years resolutions about taking and keeping control of our diabetes with confidence. In years past, it has been extremely dif-ficult to achieve our individual goals due to the lack of safe and effective medications and devices. 2011 truly marks a new era for people with any type of diabetes in terms of living a long and healthy life. The moving target and biggest challenge, which will require education, motivation and self advocacy from all of us, will be getting access to these advances.
Winter 2011 Volume 34
Resolutions (continued on page 2)
A Startling Wake Up Call What You May Not Know About Sleep Apnea Page 3
New Additions for Your Diabetes Toolbox Page 4
Winter Skiing TipsPage 6
Up Close & Personal with XDM ParticipantsPage 8
New Cities Added for 2011 ConferencesPage 12
Sweeten Your New Years ResolutionsSweeten Your New Years Resolutions
On the cover: (from bottom left) Alice Howe, Julia Baron, Dr. Steve Edelman, Sandy Bourdette, Michelle Day, (from top left) Roz Hodgins, Antonio Huerta, Jennifer Braid-wood, Jill Yapo, Jimm Greer and Michelle Feinstein. Not pictured: David Snyder.Staff New Years Resolutions, page 11.
Dr. Edelmans Corner
tion that CGM can help them live a much more normal life and fight each and every road block that the insur-ance industry puts in front of me in order to get access for my patients. It is a rare person with type 1 dia-betes who would not benefit from a CGM device, which will help them predict the unpredictable and reduce the frustrating ups and downs of this condition. At this time next year, I hope to share more informa-tion about the Artificial Pan-creas Project, ultra rapid acting insulin and more advances in the prevention and reversal of type 1 diabetes.
For all of you out there with type 2 diabetes, we have several new oral medications as well as a new obesity drug just approved by the FDA. One of the biggest advances is the development and availability of the relatively new class of agents called GLP-1 agents or Incretins (Byetta and Victoza). These medications not only lower glucose levels safely without causing hypoglycemia, but they also help with weight loss. Several medica-tions we use now to treat type 2 diabetes cause weight gain and hypoglyce-mia, which is frustrating for PWD and healthcare providers. It now comes down to educating the medical community (only
a fraction of the people in the country with type 2 diabetes have been pre-scribed Byetta or Victoza) and once again, to fight like hell to get it for them. On the horizon are newer medications that are effective and safe as well as patch pumps and even more weight loss agents.
Your New Years resolution needs to be focused on getting smart and getting access. You cannot rely on
your healthcare provider to research every potential new option to help get or keep your diabetes under control. You
need to know your individual goals for glucose (A1c), cholesterol levels and blood pressure. Help your caregiver take better care of you by being an active partner in your diabetes man-agement. Keep up-to-date with the opportunities provided by the new healthcare reform act and do not back down from your insurance company if you are being denied a drug or device that you and your doctor have deter-mined to be beneficial for you. It is a sweet time for obtainable New Years resolutions that will help us live life
first and be diabetic second. I wish you all a happy and healthy New Year.
2 My TCOYD Newsletter, Vol. 34
Medical Advisory BoardChair: 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 DirectorsSteven V. Edelman, MD Founder and Director, TCOYD
Sandra Bourdette Co-Founder and Executive Director, TCOYD
S. Wayne Kay CEO, Response Biomedical Corp.
Terrance H. Gregg President & CEO, DexCom, Inc.
Daniel Spinazzola President, DRS International
Contributing AuthorsSteven V. Edelman, MD Chris Sadler MA, PA-C, CDEJulia BaronRoz HodginsUrban Miyares
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
Antonio Huerta Director, Latino Programs
Alice Howe Senior Manager, Web Development
Roz Hodgins Director of Development
Julia Baron Manager, Public Relations and Outreach
Jennifer Braidwood Continuing Medical Education Associate
Jimm Greer Administrative Assistant
David Snyder Exhibit Services Associate MyTCOYD NewsletterEditor: Julia Baron Design: Hamilton Blake Associates, Inc.
MyTCOYD Newsletter is offered as a paid sub-scription 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 physi-cian. On the contrary, in all matters involving your health, TCOYD urges you to consult your caregiver. 2010 All rights reserved.
Steven Edelman, MDFounder and DirectorTaking Control Of Your Diabetes
Resolutions (continued from page 1)
It is a rare person with type 1 diabetes who would not benefit
from a CGM device, which will help them predict the unpredictable
and reduce the frustrating ups and downs of this condition.
Taking Control Of Your Diabetes 3
A StArtling WAke Up CAllWhat You May Not Know About Sleep Apnea
My wife had complained about my loud snoring for years, but I never associated it with how fatigued and sleepy I felt, espe-cially in the afternoons. I would often struggle to keep my eyes open when charting on my patients at the end of the day or when reading medical journal articles. I just wrote it off as being tired due to working long hours and pushing myself too much. I had recently become more informed of sleep apnea and its telltale symptoms after we did a research study in our patients with type 2 diabetes. In this study con-ducted by Dr. Einhorn, 35 percent of our patients had sleep apnea (49 percent of men and 19 percent of women tested had the disorder). I had even diagnosed sleep apnea in
many of my patients, but didnt rec-ognize the same symptoms in myself.
After another day of falling asleep into a stack of charts on my desk, I finally asked my wife, Have you ever noticed if I stop breathing during the night for short periods? She initially said she wasnt aware of it, but within a few days she came back to me saying that indeed there were frequent pauses in my breath-ing during the night. Sure enough, a diagnostic sleep study followed and I joined the ranks of the millions of people who have been diagnosed with obstructive sleep apnea.
Sleep apnea is a common condi-tion that typically goes undiagnosed. Signs and symptoms include: Excessive daytime sleepiness Waking with an unrefreshed
feeling after sleep Having problems with memory and concentration Experiencing personality changes Headaches Heartburn or a sour taste
in the mouth at night Getting up during the night
to urinate (nocturia) Sweating and chest pain
Risk factors for obstructive sleep apnea include: Excess weight. Fat deposits
around your upper airway may obstruct your breathing. However, not everyone who has sleep apnea is overweight. Thin people develop the disorder, too.
Sleep Apnea (continued on page 5)
From the Desk of Chris Sadler, MA, PA-C, CDEChristopher E. Sadler, MA, PA-C, CDEChris is affiliated with Diabetes and Endocrine Associates in La Jolla, California. He specializes in inten-sive insulin therapy using MDI and insulin pumps, management of type 2 diabetes and other endocrine disorders. He is the current president-elect of the American Society of Endocrine Physician Assistants.
Author or coauthor of several jour-nal articles and abstracts on continuous glucose monitoring and other diabetes related subjects. Mr. Sadler has presented at local and national conferences on dia-betes related topics. He also has extensive experience in clinical research. Mr. Sadler is past president of the San Diego Association of Diabetes Educators and currently the vice president of the American Society of Endocrine Physician Assistants.
Symptoms of sleep apnea that are often unnoticed by those who are affected: Episodes of not breathing (apnea) during sleep Loud snoring. Almost all people who have
sleep apnea snore, but not all people who snore have sleep apnea
Restless tossing and turning during sleep Nighttime choking or gasping spells
4 My TCOYD Newsletter, Vol.33
Here is where Onglyza comes in:
Onglyza works by inhibiting the enzyme (DPP-4) that breaks down the incretin