Tuesday’s Daily Piece: Gout Reduction Benefit with SGLT-2 Inhibitors

In a recent study published in Annals of Internal Medicine, sodium glucose cotransporter-2 (SGLT2) inhibitors were found to have a reduced risk for gout as compared to glucagon like peptide 1 (GLP-1) agonist. In this study patient taking SGLT2 inhibitor had 36% reduced risk of developing gout. The study design, population-based cohort study, is not the most robust study design as well as gout risk factors were not accessed in the study. While this is promising, more studies are needed.

https://annals.org/aim/article-abstract/2758844/assessing-risk-gout-sodium-glucose-cotransporter-2-inhibitors-patients-type

Image result for gout
This image has an empty alt attribute; its file name is image-6.jpeg

Please share your thoughts and subscribe to receive my blogs.

#gout #reduction #SGLT-2 inhibitors

Follow me on Twitter and Facebook @ReecesPiecesDi and Instagram.

Saturday’s Daily Piece: Ozempic and Cardiovascular Benefit

The benefits or harms of diabetes medications on cardiovascular health matters in a major way. In recent years, medications particularly select GLP-1 agonists and SGLT-2 inhibitors have shown major cardiovascular benefits. Ozempic, a GLP-1 agonist, now has a FDA indication for reduction of major adverse cardiovascular events (i.e. heart attack, stroke) in adults with type 2 diabetes and known (diagnosed) heart disease. Please click more for details.

https://www.prnewswire.com/news-releases/fda-approves-ozempic-for-cardiovascular-risk-reduction-in-adults-with-type-2-diabetes-and-known-heart-disease-updates-rybelsus-label-300988672.html

Image result for ozempic heart indication
This image has an empty alt attribute; its file name is image-6.jpeg

Please share your thoughts and subscribe to receive my blogs.

#heart #reduction #Ozempic #indication

Follow me on Twitter and Facebook @ReecesPiecesDi and Instagram.

Tuesday’s Daily Piece: New Lower-Priced Insulin

We all know that cost of insulin is HIGH!!! Several of the insulin manufacturers are implementing various cost lowering and/or savings programs that aim to address the pricing concerns. Eli Lilly in 2019 created lower-priced version of meal time insulin, Humalog. Now in 2020, they will now be introducing two additional lower-priced versions of their insulins, Humalog Junior KwikPen and Humalog Mix 75/25. The list price will be $265.20 for a pack of five KwikPens. While this is certainly a move in the right direction, I am still deeply concerned about the cost of insulin.

https://www.reuters.com/article/us-lilly-insulin/eli-lilly-to-launch-half-priced-versions-of-two-more-insulin-products-idUSKBN1ZD1JN

Image result for eli lilly half price insulin
This image has an empty alt attribute; its file name is image-6.jpeg

Please share your thoughts and subscribe to receive my blogs.

#lower #priced #insulin #diabetes

Follow me on Twitter and Facebook @ReecesPiecesDi and Instagram.

Saturday’s Daily Piece: Not All Clicks Are Equal

Recently, a person with type 2 diabetes shared with her health care provider that she counted the number of clicks to deliver her Victoza dose in a similar fashion as her Lantus dose. For insulin pens, each click of the pen indicates increase of 1 – 2 units of insulin. She understood each click after the first click of Victoza pen to increase her dose by 0.6 mg. However, this is not the case. Education in how to properly use each pen device is key as they are not equal in number of clicks to deliver correct dose.

Image result for victoza pen
This image has an empty alt attribute; its file name is image-6.jpeg

Please share your thoughts and subscribe to receive my blogs.

#counting #clicks #pen #device #diabetes

Follow me on Twitter and Facebook @ReecesPiecesDi and Instagram.

Tuesday’s Daily Piece: Additional Rapid Acting Insulin Option for Children with Diabetes

Insulin aspart with niacinamide (Fiasp) is now approved for use in pediatric (children) with diabetes. Niacinamide allows for faster absorption of insulin aspart. Fiasp was approved in 2017, and expanded to use in insulin pumps in 2019. Excited to have another rapid acting insulin analog options for children. To learn more, please click below.

https://www.medscape.com/viewarticle/923435

Image result for fiasp
This image has an empty alt attribute; its file name is image-6.jpeg

Please share your thoughts and subscribe to receive my blogs.

#children #diabetes #insulin #Fiasp

Follow me on Twitter and Facebook @ReecesPiecesDi and Instagram.

New Year’s Blog: Preparing for Cost of Diabetes Medications in the New Year

2019 year-end expenses hit CGee hard.  Between the car insurance, property taxes and household maintenance issues hitting all at once, all money in the budget has been spoken for with only a few dollars left in the checking account. CGee wonders now how he will afford the copay for his once daily basal insulin.  CGee decides to ration what insulin he has left and actually feels he has a plan.

Image result for cost of medications

The ushering in of 2020 may create dreadful challenges in affording diabetes medications depending on your prescription drug coverage.  A few questions to consider prior to the start of the new year.

  • Is your drug formulary (list of medications covered by your insurance usually put into tiers) changing?
  • Are your medication copays changing?
  • Is the deductible for medications changing?   If uncertain, for employer-based health plans, contact your employee benefits department or human resource department for answers to these questions.  If you are participating in a government sponsored health plan, contact the phone number provided most likely on the back of your prescription drug card.  

For those who have an employer-based health plan, inquire if any employee wellness program or disease state-based program pairs you with a nurse or health coach for additional support in managing your diabetes.  The perk of these programs is often reduced or $0 medication copays.

Bottom line – Be proactive regarding drug formulary changes by doing your homework before going to the pharmacy to pick up your refill this month.  

Additionally, regarding generic medications, always ask whether the cash price is less than copay through insurance coverage.  A really helpful tool for generic medications is to find the lowest cash price using GoodRx.

Image result for goodrx

Additional helpful resources throughout the year:

  • If enrolled in commercial insurance plan (i.e. employer based), many pharmaceutical companies offer savings programs through co-pay cards. 
Image result for needymeds
  • Insulin specific savings programs for cash paying patients: may be less than insurance copay
    • Sanofi Insulins Valyou Savings Program (Lantus, Toujeo, Admelog, Apidra) – $99 monthly prescription program
      • May receive up to 10 vials or 10 boxes of pens (or any combination of the two). Fixed
    • Novo Nordisk Cash Card Program
      • $99 per month for 3 vials or 2 packs of FlexPen/FlexTouch pens with any combination of NovoNordisk analog insulin (Novolog, Tresiba, Fiasp)
  • New update from Novo Nordisk
    • Free, one-time supply of insulin to people in immediate need and at risk of rationing medication

The costs of all medications continue to be a challenge no matter your walk of life.  Rather than simply not taking medication or not filling a prescription, let your pharmacist, physician, nurse practitioner or physician assistant know that you cannot afford your medication and work with them collaboratively to find affordable medication options.  Your medical team is here to help, and they will be glad that you explained your personal situation to allow them to assist you with other available options. 

Back to CGee, he debates internally whether to cancel his appointment with his medical team.  CGee feels embarrassed there is no money to afford the medication and does not read the “non-adherent to your medications” label attached to the medication again.  The last time he did this it was painful enough.  CGee decides to bite the bullet and keep the medical appointment.  During the visit, CGee shares with his medical team that medication cost is a real challenge for him.  To his delight, they empathize with CGee and identify ways to help him afford the cost of medications.

Remember, your medical team wants to help you and not judge you. The medical team can’t help if you don’t share your challenges with cost of medications. Trust me, you will not be the only one asking!

This image has an empty alt attribute; its file name is image-6.jpeg

Please share your thoughts and subscribe to receive my blogs.

#medication #cost #savings #diabetes

Follow me on Twitter and Facebook @ReecesPiecesDi and Instagram.

Wednesday’s Daily Piece: Happy New Year 2020!

Well, time for the fresh beginnings of a new year and decade. The last decade was exciting times for diabetes medication and technology advancements, and peer support for those living with diabetes. I can not begin to wrap my mind around the advancements in diabetes that we will see in this new decade. My wish for each of you is to break free from the stigma and guilt of diabetes, and to live rich full lives achieving your greatest dreams. One practical tip in closing is to join a peer support community in 2020. Since my prediabetes recently came back, I will be joining Diabetes Sisters – yes, it is for women with prediabetes, Type 1 and Type 2 diabetes. The struggle is real, and don’t do it alone.

Image result for happy new year 2020 images
This image has an empty alt attribute; its file name is image-6.jpeg

Please share your thoughts and subscribe to receive my blogs.

#Happy #New #Year #2020 #Peer #Support

Follow me on Twitter and Facebook @ReecesPiecesDi and Instagram.

Thursday’s Daily Piece: Icosapent ethyl (Vascepa): Unique Medication in Heart Health Toolkit

When it comes to a healthy heart, our cholesterol (lipid) numbers matter in a major way. FDA’s recent approval of icosapent ethyl as adjunctive therapy to lower risk for heart (cardiovascular events like heart attacks and strokes) in adults with elevated triglyceride levels (150 mg/dL or higher) and established heart (cardiovascular) disease or diabetes with 2 or more risk factors for heart disease (i.e. body mass index of 25% or greater, high blood pressure, physical inactivity, family history).

So why is this a big deal? This is the first FDA approved drug to reduce cardiovascular risk among adults with elevated triglyceride level as add on to maximally tolerated statin medication. Now we have another medication in our tool kit for reducing risk for cardiovascular event.

https://www.fda.gov/news-events/press-announcements/fda-approves-use-drug-reduce-risk-cardiovascular-events-certain-adult-patient-groups

Image result for icosapent
This image has an empty alt attribute; its file name is image-6.jpeg

Please share your thoughts and subscribe to receive my blogs.

#FDA #Vascepa #CV #Event #Risk #Reduction

Follow me on Twitter and Facebook @ReecesPiecesDi and Instagram.

Tuesday’s Daily Piece: Game Changer -Tandem’s Control-IQ Technology FDA Approval

FDA’s approval of Tandem’s Control-IQ, automated insulin delivery (AID) system, is game changer. Why? It is the first insulin dosing software to win fast approval by FDA “interoperability” approval pathway. The interoperable automated glycemic controller device automatically adjusts insulin delivery by connecting to an alternate controlled enabled pump (ACE pump) and integrated continuous glucose monitor (iCGM). Automated insulin dosing (AID) system typically consists of pump, CGM and software to control system of compatible devices. With regards to Tandem, Control-IQ combines Tandem’s t:slim X2 insulin pump, Dexcom G6 CGM and algorithm built into the pump to give automatic bolus doses and adjust basal insulin delivery.

New Tandem pumps with advanced hybrid closed loop algorithm Control-IQ will ship by end of January 2020.

https://www.tandemdiabetes.com/products/t-slim-x2-insulin-pump/control-iq

https://www.fda.gov/news-events/press-announcements/fda-authorizes-first-interoperable-automated-insulin-dosing-controller-designed-allow-more-choices

Image result for control iq tandem
This image has an empty alt attribute; its file name is image-6.jpeg

Please share your thoughts and subscribe to receive my blogs.

#FDA #Control-IQ #Interoperability #Tandem

Follow me on Twitter and Facebook @ReecesPiecesDi and Instagram.

Thursday’s Daily Piece: Medicare Eligible – Prescription Medication Coverage

The time arrives that you are eligible for Medicare. You have your Medicare Part A and B so you are good to go. Right? Not so fast. Medicare Part A covers hospitalization. Medication Part B your outpatient office visits, certain vaccines (i.e. flu and pneumococcal), durable medical supplies (i.e. blood glucose testing supplies, insulin pumps and supplies (must meet certain criteria to qualify), continuous glucose monitors (must meet certain criteria to qualify).

What about your prescription medications? Well, Medicare Part D covers prescription medications and certain vaccines (i.e. shingles). Another option for prescription drug coverage is a Medicare Advantage Plan (combines Medicare Part A, B and prescription drug coverage). Well if this is not confusing enough, there are specific annual enrollment periods for Medicare Part D and Medicare Advantage Plans. Below is a link that provides more details on the open enrollment period. Bottom line Medicare Part A and B will not cover your prescription medications.

https://www.medicareresources.org/faqs/when-is-the-next-medicare-open-enrollment-period/

Image result for medicare
This image has an empty alt attribute; its file name is image-6.jpeg

Please share your thoughts and subscribe to receive my blogs.

#Medicare #prescription #drug #coverage

Follow me on Twitter and Facebook @ReecesPiecesDi and Instagram.