The Corner Booth

We joined a gym in late July and my diabetes management habits have been noticeably different since then. Combined with lower-carb eating (roughly half the time), I have noticed a dramatic difference in my blood sugars and overall diabetes management and health. Sure, there are days when I feel so much more tired. Because workouts can be physically demanding and energy-draining. But most of the time, even after working out and when my muscles are whining, I feel invigorated and more on top of my game. My diabetes data (and habits) show it's working: Insulin Use:  During the height of my gym-workouts over the past several months, I noticed that I was using roughly a third less insulin than before -- both my Tresiba basal dose decreased every 24-36 hours, and my monthly box of Afrezza inhaled insulin is lasting noticeably longer and even impacting how often I need to refill my Rx for it. BG Range: Yes, my average glucose has dropped from the low 200s into the high-100s. It...

 You've seen them on TV and online. You couldn't help that they caught your eye or made your ears perk up, in spite of yourself. We’re talking about those ever-more-prevalent diabetes commercials, most brimming with smiling happy faces and energetic excitement about whatever the product aimed at PWDs (people with diabetes). Sometimes it's just hard to swallow. Yep, some even have catchy tunes, big-name actors or celebs, or creative spins to bump up interest in these disease-whacking offerings. Have you seen the latest TV spots for once-weekly Ozempic , for example? "OH... people with type 2 diabetes are so EXCITED...!" We clearly have a problem in the U.S. when it comes to being bombarded with marketing by Pharma and device companies, and that's come up in the recent conversation about healthcare cost and drug pricing regulation . Only the USA and New Zealand allow these televised ads to pop up like they do. But stepping aside from that big serio...

You can never fully appreciate the magic of a Friends For Life diabetes conference until you have the opportunity to attend one yourself. For me, that chance came most recently with a short journey to Niagara Falls, Ontario. Just picture a beautiful rainbow shining in the misty sunlight over the great natural wonder of the falls, and that's pretty much how I felt being surrounded by "my diabetes tribe" in Canada, those who "get it" when it comes to living with diabetes. I've been lucky enough to attend a few different FFL events over the years, from the big summer conference that brings thousands to Orlando, FL, each July to other smaller events sprinkled around the country. This #FFLCanada18 gathering in early November (just as Diabetes Awareness Month kicked off) was my first one outside the U.S. and certainly made an impact. Like all the wonderful FFL events, it featured a variety of talks on all manner of diabetes topics -- from managing exerci...

There's a lot of fuss and excitement about the newest diabetes device approved for people in the U.S.: Medtronic's long-awaited 530G system and Enlite sensor... But at the same time, there's a significant amount of frustration by PWDs (people with diabetes) and others in the know who feel they're being misled on a number of fronts about this new device. I'm one of them. Let me preface this by saying: Many are very excited about this being a huge step forward in eventually achieving the closed-loop dream, because the 530G's ability to automatically shut off insulin between 60 and 90 mg/dL is a key step forward. However, we (all) have to be honest about what this product actually is and is not -- and the vendor's enthusiasm cannot fuel too-pushy sales pitches and marketing efforts. First off, this device is NOT an artificial pancreas , but rather just one piece of the puzzle required to eventually create one. Unfortunately, Medtronic's been sitting back a...

I received a bill in the mail the other day, recapping the costs from the most recent visit with my endocrinologist here in Southeast Michigan. One particular fee caught my eye, and made do a double-take in terms of reviewing just exactly what I'm paying for when going to see my diabetes doctor. Instead of a tidy little co-pay, a larger dollar amount screamed from the statement, delivering what felt like a punch to the gut. On top of that, this additional charge caught me off-guard: This is the 8th endo I've seen in the three-and-a-half decades with type 1 diabetes, and while this is by no means the highest bill I've ever been sent for a single office visit, that particular fee ruffled my feathers more than others. Sure, I've noticed the fee schedule before: a $5 processing charge for calling in a prescription; $10 for obtaining blood sugar logs or lab documents; and $25 for a pre-authorization letter to insurance or a form letter for traveling. These "physician se...

Medtronic Diabetes is putting its money where its mouth is, telling insurers that its first-generation closed loop technology is so good that the company is willing to pay for any emergency room visits that occur while someone is using these newest devices. The pump-CGM company has captured headlines recently with this bold move that signals what we'll likely see more of as we head into the universe of "value-based" care and insurance -- where proven outcomes will dictate the coverage and reimbursement we see from payers and product manufacturers. The whole notion of VBID (value-based insurance design) is still in its infancy and we're all trying to pinpoint the Pros and Cons. At least one expert describes it as bridging the gap between "Star Wars Innovation" and "Flinstone's Delivery" in healthcare, by shifting the emphasis to how products and services actually impact real-world outcomes of patients. Simply put, if they aren'...

We all knew it was going to happen eventually. Now, the time has come. My third-party diabetes supply company has put a policy in place to limit the number of test strips I'm allowed each month, as a direct result of my being on a Dexcom G5 continuous glucose monitor. The reasoning for this policy stems directly from the FDA's decision  in late 2016 to allow CGM data to be used instead of fingerstick test results in making medication dosing and other treatment decisions. The supply company that I'm required by my insurer to use for all D-supplies has finally gotten wind of this "replace fingersticks" language, and as a result is trying to cap the number of glucose test strips that Dexcom CGM users can get each month. From their perspective, this might seem logical. But as someone who's struggled with type 1 diabetes since the age of 5, I know better. I'm not OK with this, and am fighting this flawed policy. As all of us T1Ds who use CG...

My third-party supplier has recently tried to limit test strips for those using a Dexcom CGM system. In fighting this policy, I penned this letter. While I've been able to get more strips as prescribed, my hope is also that this letter leads to deeper consideration at the policy level by this Michigan company. - - - - - - - - - - - - - - -  --> August 6, 2018 Michael W. Hoskins ---------- ---------- ---------- ---------------- J&B Medical Supply --------- Wixom, MI 48393 Dear ------- and J&B Medical Supply: I am writing this in response to recent letters received from J&B Medical starting on July 24, 2018, regarding the allowable amount of glucose test strips for those who also use the Dexcom G5 continuous glucose monitor (CGM) as part of their diabetes management. Per your letter, “ all regular diabetic testing supplies are included in the coverage of your Dexcom G5 sensor .” And further, due to the Dexcom G5 b...