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Ever since the article on Glucoboy surfaced on our website, we have been receiving several e-mails on how to purchase the Glucoboy. Questions from healthcare professionals and patients from all over the world: United States, Dubai, Israel etc.

Information on purchasing GlucoBoy can be found here.

Thank you for the 200+ inquiries on the purchase procedures for Glucoboy but because of time restraints, we feel that this is the best way to notify everyone.

Just a note: we are not affiliated with Nintendo nor endorse any products

americandiabeesassociation.gifAmerican Diabetes Association (ADA)
This is as “must” source for newly diagnosed diabetics or those wishing to learn more about their condition. The site has sections for those who were recently diagnosed, those with Type 1, or Type 2 Diabetes along with an “Ask the Pharmacist” area. The ADA also supplies a newsletter that diabetics may subscribe to in order to receive news and events occurring in the world of diabetes.

For a much more interactive presentation on Diabetes provided by the ADA, users may watch Link for Life. Also available is a Diabetes Risk Test.

Not all glucometers work the same way and the importance of measuring ones blood glucose cannot be stressed enough. For those who need more help in learning to use your meter, please check this link. According to the FDA, it lists the Diabetes Education programs recognized by the American Diabetes Association. These Recognized programs meet the National Standards for excellence in diabetes education.

researchandwellness.gifDiabetes Research and Wellness
This is a non-profit organization that offers free diabetic resources including free a pocket diary, diabetes identification card and diabetes necklace. The necklace will alert healthcare providers about your condition before they treat you.

diabetesnecklace.jpg

Drug Companies Diabetes Resource Sites
Drug companies offer online diabetic tools for diabetics and especially for those patients who are using their meters.

Novo-Nordisk: Diabetic management features such as a diabetes care plan, menu planning tools, and stories written by patients on ways to live with diabetes

BD Diabetes: Provides flash-based patient education animations on how to draw, mix, and inject insulin. It even has a section for diabetes and pets.

Health 2.0 Sites
MySugarLevel
Tracking sugar site that charges users for access. Allows users to track and monitor sugar levels.

SugarStats
Site that allows you to monitor your suguar levels along with your foods. It provides users with graphs and trends.

TuDiabetes
Community for those affected by Diabetes. The site contains social networking features such as blogging, adding friends, and groups.

dLife
Diabetes resource that contains Q&A with experts, recipes, the “Wall”, and blood sugar management, among others.

Other related:
Johnson and Johnson’s Tour de Cure

This is from the pile of cool products you may not know existed. The GlucoWatch is made by Cygnus, Inc of Redwood City, CA and was approved by the FDA on March 22, 2001. In March of this year, Animas Corp of West Chester, PA bought out Cygnus for $10 million. As of July 31, 2007, Animas will no longer be marketing the GlucoWatch.

What is it?
The GlucoWatch Biographer is a glucose monitoring device that a patient wears like a wrist watch. Glucose measurements are taken non-invasively through the skin every 20 minutes for up to 12 hours at a time. The GlucoWatch measurements are not intended to replace finger-stick glucose measurements, but instead should be used to detect trends and patterns in glucose levels. It is only approved for use in adults age 18 and over.

How does it work?
After a 3-hour warm-up period, the patient calibrates (sets) the GlucoWatch Biographer using a finger-stick measurement. After calibration, the Biographer will begin monitoring glucose values. A low level electric current pulls fluid through the skin into gel discs in the Biographer. Electrodes in the Biographer measure glucose in the collected fluid for up to 12 hours at a time. The GlucoWatch Biographer also contains a built-in alarm that can be programmed to alert the user when results fall below pre-set low levels and above pre-set high levels.

Why is it used?
The GlucoWatch Biographer is not intended to replace fingerstick measurements but used to see the rise and falls of glucose throughout the day that intermittent fingerstick measurements cannot tell. This additional glucose information may help people with diabetes and their healthcare practitioners better manage their disease by providing more information on glucose trends.

So why was this product so successful?

There were many reason why the GlucoWatch didn’t succeed, but in my personal opinion as a healthcare practitioner, the primary reason is because it wasn’t accurate. The reason that the GlucoWatch wasn’t accurate is because the glucose that they measure was plasma glucose that had traveled through all the tissue of the skin, whereas fingerstick measurements take the glucose out of whole blood (a droplet of blood). A practioneer and a patient needs to count on the accuracy of any test measurements, the GlucoWatch just did not provide that stability. It’s a great idea, and one that is critically needed, but the execution needed some work.

A phenomenon that most diabetics often encounter is hypoglycemia or an abnormally low level of blood sugar. Because the brain runs primarily on glucose, hypoglycemia may severely harm the patient, putting them into a coma or worst. The most common causes of hypoglycemia are certain classes of anti-diabetic medications or insulinomas. Whatever the cause, it is recommended that diabetics carry glucose tablets in case of a hypoglycemic event.

Novo-Nordisk has just released a kit called the GlucaGen HypoKit (see picture below) that allows a patient to inject glucagon directly into their system.

Taking a look at this needle and syringe system, it looks intimidating to use. The directions released from Novo Nordisk are as follows:

Just in Case – Simple Steps for Use

  1. Insert the needle through the stopper and inject all the liquid into the vial
    Insert the needle through the rubber stopper on the glucagon vial. Inject all the liquid in the syringe into the vial. The rubber stopper can be stiff, but the needle is strong enough to puncture it.
    Step 1
  2. Gently shake the vial
    Leave the syringe in place and gently shake the vial until the powder is completely dissolved.
    Step 2
  3. Withdraw all of the liquid into the syringe
    While the needle is still inside the vial, turn the vial upside down and while keeping the needle in the liquid, slowly withdraw all the liquid into the syringe.
    Step 3
  4. Inject the solution into loose tissue
    Insert the needle into loose tissue under the injection site and inject the glucagon solution.
    Step 4
  5. After GlucaGen HypoKit Treatment, Give Extra Carbohydrates
    As soon as the person awakens and is able to swallow, he or she should be given extra carbohydrates. This is especially important in children and adolescents. These carbohydrates can include a fast-acting source of sugar — such as a regular soda pop or fruit juice — and a long-acting sugar — such as crackers and cheese or a meat sandwich.* It is recommended that the person with severe hypoglycemia be examined by a doctor.

My question is, why didn’t Novo Nordisk make it easy to use like the Epi-Pen?

The directions for the EpiPen is as follows: 1) pop the safety cap 2) jab the pen into your thigh 3) call 911.

In an emergency situation, an individual does not have time to fidget with a needle and syringe (the effects of hypoglycemia is light-headedness, shakiness, confusion).

Novo Nordisk, turn the GlucaGen into the GlucaPen, and then perhaps you’ll save some lives.

glucoboylogo.pngglucoboylogo.pngGlucoBoy, a game compatible with the Game Boy Advance or DS Lite, was launched in Australia a couple of weeks ago on World Diabetes Day. The Glucoboy makes monitoring and achieving blood sugar goals fun. Whenever a user performs a glucose test, points are awarded which allows the user to unlock games. More points are awarded if the user’s blood sugar falls within the specified goals. The points may be spent in the game or the GRIP online community. Users post their scores to the GRIP community to see who has the best scores in a town, country, and world.

glucoboyheros.jpgThere are 2-full length games along with a mini-arcade (3 additional games). Games are played by inserting the Glucoboy cartridge into the Nintendo Gameboy.

The idea was created by Paul Wessel who noticed that his 9-year-old son would constantly lose his glucose monitor but not his gameboy. Mr. Wessel states “That moment something came to me – if I could combine blood glucose testing and video gaming technologies, perhaps Luke would be more motivated to test.”

It took Mr. Wessel 3 years to obtain Nintendo’s approval to make this device. The development is well worth the wait. The Glucoboy will prove to play a critical role in providing the incentive for kids to be compliant with their blood sugar monitoring.

glucoboyhowto.png

To purchase Glucoboy: Link

November 14, 2007, the FDA announces that GlaxoSmithKline‘s (GSK) Avandia (rosiglitazone) is to bear a second blockbuster killer – a black box warning label. Like all black box warnings, it states that doctors should be careful about prescribing the drug and to especially weigh out the pros and cons. Specifically in Avandia’s case, the drug exacerbate conditions of heart failure patients (which was the first one that it received in August of this year) and then now a second label is to be added indicating that the drug could cause heart attacks heart related risks (this correction was also made by the FDA). This drug has been known for since its introduction to worsen heart failure and presumably prescribers were not writing it for their patients who had heart failure, but the news for heart related risks and ambiguously, for heart attacks, is new.

Whatever the case maybe, Avandia now has a second black box warning. According to the TNS Healthcare’s Diabetes Dynamics USA™, for the time period from July through September 2007, 70% of all prescribing instances of Avandia was through discontinuation. Avandia and their drug groups (GSK has combination drugs which contain Avandia) is a $2.3 billion a year drug (according to GSK). What typically happens to drug which gets a black box warning is that their prescription rates drop down to 10% of what it was before (Pfizer‘s Celebrex did). For GSK, this means a loss of $2.1 billion in gross revenues. Prescribers shy away from writing black box labeled drugs because it increases their likelihood of being sued for malpractice as lawyers tend to pick at details that are out of normal practice. Avandia, now has two black box warnings.

Yet another damnation to Avandia emerged when the US Department of Veterans Affairs (VA) revealed last month that it is removing Avandia from its list of approved drugs, and will severely limit its use. The VA will recommend that patients currently taking Avandia may continue, but strongly urge doctors to discus the associated risk with their patients. VA sales of Avandia represent about 8 per cent of total US Avandia sales, which have fallen an estimated sixty per cent since May.

Avandia is an anti-diabetic drug which was approved by the FDA in May of 1999 for single therapy or in combination with other anti-diabetic medications such as metformin (Glucophage). Avandia belongs to a group of drugs called thiazolidinediones or “insulin sensitizers”, in the medical community, it is recognized that thiazolidinediones is not a very good group to be used as monotherapy for diabetes but is great in adjunct therapy to other medication as their results are synergistic. The only other drug in this group is Actos (pioglitazone) of Takeda Pharmaceuticals. Takeda is the largest pharmaceutical company in Japan.

Sources here . FDA . here .

I bring a challenge to glucometer makers, make a meter that is so simple to use that a patient does not need instructions prior to using it.  (Glucometer is a trademarked brand of the Bayer Company but is also used generically to refer to all types of blood glucose meters). 

The problem.
Your current meter comes in 4 parts.  The meters are designed to be smaller but after you add all four parts up and put it into the carrying case, it’s not so small after all.  The parts are:  The meter, the test strips, the lancet device and the needles (or lancet).  Why can’t you make all these things into one device?  Do you not realize how hard it is to explain to a 75 year old patient how to take his blood sugar?  He has to first clean his hands.   Load the needle into the lancet device.  Poke himself with the needle.  Put the test strip into the meter.  Align his fingers into the strip and draw up enough blood.

PEOPLE DON’T TEST REGULARLY BECAUSE IT’S TOO DIFFICULT TO!

I don’t understand the marketing reasoning behind such difficult testing techniques.  If you only design a simpler device, you’ll have people testing them three to six times daily and you’ll get more profit!

There have been some breakthroughs on the technology of blood glucose testing.  Some of which includes infra-red readings and plasma readings, and both of which are non-invasive.  The later refers to a device which the patient would wear like a watch.   The device draws out the plasma (the watery part of the blood) from the blood, through the skin and into the device.  A laser beam is then passed through the plasma to determine the glucose content.  Unfortunately, such technologies are not quite perfected yet.  Historically, testing techniques that do not use whole blood (including the red blood cells part) is not an accurate measure of one’s blood glucose measure.  In the plasma example, what is making the test less accurate is that as the plasma passes through your tissue and skin, it picks up more glucose/drops some off and the reading is not adequate.  

To reiterate my challenge.
Make a simple device that a patient can put to their finger, press a button, and the device does the rest of the work to get the reading.  This would include pricking the skin and retrieving the blood.  And please….do away with the calibration business.  Why does a patient need to punch in the numbers on the bottle when it could be printed on the test strip and read by the meter.

Thank for your dedication into making this device.  I promise to tell all my patients (my dad included) to use it and all my contacts to recommend it. [if it’s good that is]

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[Last modified: 12/08/07]