Saturday’s Daily Piece: Financial Savings: Unlimited Test Strips and Insulin Savings from Novo Nordisk

Affordability of healthcare continues to be change particularly for persons living with chronic health conditions. Discounts and savings programs are ALWAYS welcomed. DiaTribe recently published an article providing details for unlimited glucose test strips at a fixed monthly rate through mySugr, One Drop, DarioHealth and Livongo. Please click below to get the details (and subscribe to DiaTribe as they publish amazing articles).

https://diatribe.org/how-get-unlimited-test-strips-and-personal-diabetes-coaching?utm_source=diaTribe&utm_campaign=9e060716e4-EMAIL_CAMPAIGN_2019_08_26_11_15&utm_medium=email&utm_term=0_22467a8528-9e060716e4-152660205

NovoNordisk has announced new cash discount program for its insulin products (NovoLog, Tresiba, Levemir) – $99 for a months’ supply (available in January 2020). Additionally, they are releasing new NovoLog and NovoLog mix follow on brands (authorized generic) at price of $279.41 for 5 pens – half cost of branded product.

https://www.novonordisk-us.com/media/news-releases.html?122971&utm_source=Closer+Look+Subscribers+2018&utm_campaign=37cd46968c-2019-09-06_NN_affordability_programs09_06_2019&utm_medium=email&utm_term=0_c55d924bf1-37cd46968c-412262441

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#unlimited #test strips #insulin #savings

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Wednesday’s Daily Piece: Updated European Guidelines for Diabetes, Prediabetes and Cardiovascular Disease

Diabetes does not occur in a silo rather with other chronic diseases particularly cardiovascular. Therefore, it makes since guidelines should ideally should address both cardiovascular and diabetes. European Society of Cardiology collaborated with European Association for the Study of Diabetes in the development of principles to guide treatment of these chronic conditions. Europe is ahead of the game. To learn more details of these guidelines, please click below.

https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehz486/5556890

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#EASD #ESC #cardiovascular #diabetes #prediabetes #guidelines

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Daily Piece: Hypoglycemia Risk Associated with Tramadol

Tramadol, a pain medicine with low abuse potential, is commonly prescribed in the U.S. A retrospective analysis recently found an association of hypoglycemia with tramadol use as compared to other pain medications . To learn more about this analysis, please click below.

https://www.nature.com/articles/s41598-019-48955-y

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#hypoglycemia #tramadol #association

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Daily Piece: Dapagloflozin Benefit in Heart Failure

In persons with diabetes, we are concerned about cardiovascular (heart) disease and seek to prevent it. GLP-1 receptor agonists and SGLT-2 inhibitors are two drug classes that have proven their benefit in persons with type 2 diabetes with or without heart disease. It is worth noting that some drugs within each of these classes work better than others when it comes to preventing primary and secondary heart related events. Within the SGLT-2 inhibitor drug class, canagliflozin and empagliflozin have proven their heart related benefits. Well now, dapagliflozin is proving its benefit for persons with type 2 diabetes with cardiovascular (heart) disease. Just this week, results from phrase III trial (DAPA-HF) revealed dapagliflozin decreased risk of cardiovascular (heart related) death and decreased worsening of heart failure in persons with heart failure with reduced ejection faction with or without diabetes. If you want more details on this trial, please click below.

https://www.astrazeneca.com/media-centre/press-releases/2019/farxiga-met-primary-endpoint-in-landmark-phase-iii-dapa-hf-trial-for-the-treatment-of-patients-with-heart-failure-20082019.html

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#heart #failure #cardiovascular #death #reduction #dapagliflozin

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Daily Piece: Gestational Diabetes Blog

I recently had the opportunity to write a blog on gestational diabetes for Diabetes Sisters (a great peer support organization for women living with prediabetes and diabetes). In this blog, I tell the story of a gestational diabetes clinic that I had the opportunity to serve for 10 years.

https://diabetessisters.org/article/gestational-diabetes

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#gestational #diabetes #blog

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Changing the Name of Diabetes Education Specialty

It has been almost two weeks since I last posted a daily piece. I took a few days of vacation followed by attending the American Association of Diabetes Educators Annual Meeting. It is always such a fun event full of networking and learning (and meeting new friends!). I have some news to share…diabetes educators are now DIABETES CARE AND EDUCATION SPECIALISTS. Now, I am excited because this title for the specialty best captures the variety of services and support that these specialists can provide for persons living or at risk for diabetes. Wow!

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#diabetes #care #education #specialists #AADE

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Daily Piece: July 31st Updates to ADA Living Standards

Three important updates to the ADA “Living” Standard to know about are the incorporation of:

  1. International consensus report on continuous glucose monitoring and time in range (which tells a much more thorough story than A1c) (Standards 6 and 7)
  2. Results of Researching Cardiovascular Events with a Weekly Incretin in Diabetes (REWIND) trial which reveals reduction in cardiovascular events with dulaglutide in adults with type 2 diabetes with or without existing cardiovascular disease (now that is exciting!!!) (Standards 9 and 10)
  3. FDA’a approval of liraglutide in pediatric patients with type 2 diabetes, and publication detailing drug’s effects in this population (a game changer as we now have more metformin as non-insulin options in pediatrics) (Standards 9 and 13)

Boy, such exciting updates! To review the updated standards for more details, please click below.

https://care.diabetesjournals.org/content/42/Supplement_1?utm_source=living-standards-update-073119&utm_medium=email&utm_content=diabetes-care-website-2&utm_campaign=PRO&s_src=email&s_subsrc=649516

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#ADA #updates #CGM #dulaglutide #pediatrics #liraglutide

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Daily Piece: Now Available – Latest Blog, Preparing for In Person Meeting, in the Advocacy Summer Series

Advocacy Summer Series

Part II: Preparing for In Person Meeting

Hi, it’s Mandy from Gainesville again to share my stories and tips preparing for the in-person meeting with a legislator.  Like most things in life, advocacy requires PATIENCE and most of all – PRACTICE.  You may not get a reply on your first request for an in person meeting with a legislator. I learned this lesson in late 2018 when I contacted a local office of a U.S. Senator to only receive no reply to numerous emails.  You bet I was frustrated, and I had to remind myself this is an exception to the rule to not receive any reply after several attempts. 

It is also worth mentioning; you do not have to travel to Washington, D.C. to meet with federal legislators or even travel to your state capital to meet with your state legislators.  Rather, you can meet with them locally – yes, locally in their districts where it is so much more convenient and they are more accessible. 

Do not be disappointed if you meet with staff member rather than the legislator.  Over time, I have developed a working relationship with Joel, deputy chief of staff, for my Congressman.  I always walk away from the meetings feeling like he listened and he will share the materials and my message with the legislator.  I have yet to be disappointed.  Do keep in mind that staff members do change and the next time you call don’t be surprised if you are reintroducing yourself and your purpose.

Back in May, I participated in the American Association of Diabetes Educators (AADE) Public Policy Forum during which my fellow Georgia diabetes educators and I met with Charlotte, staff member with one of our U.S. Senator’s.  Charlotte listened, took notes, asked clarifying questions and provided the information shared (verbally and materials left) with the Senator during a briefing.  Yet, again I walked away confident that my advocacy goals had been accomplished. 

Always come prepared for the meeting. Yes, have your key points about the proposed legislation and any available statistics – these are called your “Talking Points”. Also, have a story to share of how a constituent will be impacted positively by the legislation.  Stories are powerful as they connect the legislation  to their constituents – suddenly, it becomes more personal to the legislator. Even better is if the legislation directly impacts the legislator, a staff member’s family or even their close friends.  Stories are the bridge that transforms proposed legislation from an abstract to worthy of consideration.  An additional advocacy, Congressional Budget Office (CBO) number for proposed federal legislation is important to legislators and their staff, so do your best to provide the number during your visit. I would be remiss if I did not remind you to dress professionally – no, this does not mean a suit but business attire is appropriate.

How many times have you walked away from a meeting not really remembering the details?  Okay, you are normal.  Legislator’s and staff members are no different than rest of us.  While they most likely will take notes during the meeting, it is vital to provide written materials that summarize your request backed with statistics and evidence.   Additionally, ask if you can provide the more detailed information after the meeting which brings up the all-important follow up email and hand written thank you note (yes, a hand written note). 

Bottom line, you are selling your passion.  Whether you meet with a legislator or their staff member, the passion you exhibit will be seen over your lobbying – passion sticks.  Federal legislators have access to a wealth of research, while state legislators typically have limited access to research. You become part of their research team by providing them with balanced and accurate data – they will appreciate the data and YOU!  Lastly, legislators whether state or federal see a much bigger picture – they must look beyond what is directly in front of them.  Please do not be discouraged, but rather remember to sell your passion, and be patient and persistence as it may take several meetings and potentially a few years for your advocacy efforts to pay big dividends. 

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#advocacy #legislative #preparation #meeting

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Daily Piece: FDA Approval of Nasal Glucagon is Game Changer

FDA’s approval this week of Lilly’s nasal glucagon (Baqsimi) is a true game changer. No more reconstitution!! It comes in portable, compact package containing fixed 3 mg dose. The list price is $280.80 for one pack and $561.60 for two pack. It is approved for treatment of severe hypoglycemia in persons four years of age and older. Baqsimi should be available within pharmacies within a month.

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https://investor.lilly.com/news-releases/news-release-details/baqsimitm-glucagon-nasal-powder-3-mg-first-and-only-nasally?utm_source=Closer+Look+Subscribers+2018&utm_campaign=3fc7210552-2019-07-24_Lilly_Nasal_Glucagon07_24_2019&utm_medium=email&utm_term=0_c55d924bf1-3fc7210552-412262441

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#nasal #glucagon #severe #hypoglycemia #Lilly

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Daily Piece: SGLT-2 Inhibitors and Fracture Risk

SGLT-2 inhibitor drug class has been a game changer in the treatment in of type 2 in its novel approach and more recently in terms of cardiovascular and renal benefits. At the same time, warnings such as fracture risk (specific to canagliflozin) have arisen previously in an overall safe drug class (when prescribed appropriately). While data from Canagliflozin Cardiovascular Assessment Study (CANVAS) showed a small but significant fracture risk increase with canagliflozin, a recent large population based database (aka real world data) did NOT find an associated increased fracture risk with SGLT-2 inhibitors. It is important to note that person with Paget’s disease, osteomalacia or hyperparathyroidism (risk factors for fractures) were excluded from this database review. The controversy over fracture risk will continue although using common sense in prescribing can go a long way in lowering fracture risk with this drug class. Please click below if you are interested in more details regarding this real world data.

https://care.diabetesjournals.org/content/early/2019/07/10/dc19-0849

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#SGLT-2 #inhibitors #fracture #risk #real world #data

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