AADE 2013

I just got home from the American Association of Diabetes Educators’ 2013 conference (AADE 2013) in my current hometown of Philly, and I am exhausted. But fatigue shall not stand in the way of a report! Here, in no particular order, is a list of goings-on and newsworthy events from the exhibit hall: 

1. Medtronic, maker of the Minimed insulin pump, has just launched a pretty amazing-sounding educational program geared toward guiding new pump and CGM (continuous glucose monitor) users through their first six months on insulin pump/CGM therapy. Called Start Right, the goal is to help new pumpers transition from multiple daily injections to pump therapy as smoothly as possible (or to help people get started on CGM) — and to get basic questions out of the way so that doctors’ appointments can be more effective. (Instead of spending your appointment talking about the technicalities of an insertion device, for example, you could focus instead on tweaking your basal rates — or address any other sort of question that only a doctor is qualified to address.) 

I think it’s a great idea, and a huge improvement over the current system, in which follow-up support depends a great deal on what your doctor’s office decides to provide. When I got my first Medtronic pump 12 years ago, for example, I remember a session in which I learned how to put an insertion site into a piece rubbery, flabby fake skin, but I don’t recall any follow-up to find out if I had technical questions. I also remember holding my insulin pump for the first time and feeling like I was going to cry — something about the pump really solidified the idea to me that I had a serious disease. (I had only been diagnosed a year ago at that point; I now think of my pump as something that gives me freedom, but at that particular moment it represented something scary that was wrong with me.) That’s another nice aspect of the Start Right program — you’re paired with one particular support person who guides you through your entire six months. Not only can that person help you with the technical details of getting started, but they can provide emotional support as well, something that’s so often missing from today’s health care environment. I think that it’s a great addition to Medtronic’s already (in my view) stellar customer service, and I commend them for it. Spread the word!

2. I bought a Vitamix. I don’t know how this happened. 

3.WTF IS GOING ON WITH MEDICARE TEST STRIP REIMBURSEMENT!?

I am hoping to write a longer piece about this, but here is something all patients should be aware of — and should be up in arms about: in July, the Medicare National Mail Order Program For Diabetes Testing Supplies went into effect for diabetes test strips. To make a very complicated issue simple(r), what this meant is that Medicare is drastically reducing the reimbursement amount for diabetes test strips that Medicare recipients receive by mail. So drastically, in fact, that the four main test strips manufacturers in the US market — Roche, Bayer, Abbott and J&J — were excluded from the supplier list (the reimbursement rate went from $77.90 for 100 mail-ordered strips to $22.47, a 71 percent decrease). This means that if you are on Medicare and use any of their meters, you’re going to have to switch. 

If glucose test strips were truly a commodity — that is, with equal quality and accuracy — competitive bidding might make sense. Lord knows that Medicare costs are spiraling out of control. But problem is, they’re not. Some brands (like the four mentioned above) are far better than others. For example, the FDA just did a voluntary recall of 21 lots — that’s as many as 61 million strips — from a company called Nova Diabetes Care. According to the FDA, “The test strips under recall may report a false, abnormally high blood glucose result.” 

Considering that I use the numbers on my blood glucose meter to calculate my insulin dose and — oh, right — if I give myself too much insulin I could KILL MYSELF, I don’t quite get the logic here. If one person overdoses on insulin and gets sent to the emergency room, the resulting cost would be thousands of dollars — that’s a hell of a lot of test strips. (Not to mention pretty unpleasant for the person in the emergency room.) Even scarier, Medicare tends to influence the private insurance market, so this may well trickle down into the non-Medicare world as well. (And wait, there’s more: competitive bidding is set to begin for insulin pumps in January!)

Stay tuned for a more in-depth look at this — but in the meantime I highly recommend checking out StripSafely.com , a website put together by advocates from the online diabetes community, and writing a note/sending a tweet/using Twitter Vine to make a short video and sending it to your congresspeople. Medicare costs need to be cut, but not if it puts accuracy at risk. I mean, by this logic, why should we even cover test strips? I hear urine tests are much cheaper.

4. AADE offered yoga classes throughout the conference. I don’t know how many people actually took them up on it — I find that my conference outfits do not lend themselves well to downward facing dog — but I think it’s such a great idea. As mentioned above (and in everything else I write), I feel that emotional management is one of the most difficult parts of life with diabetes, and I’ve found yoga and mindfulness training to be enormously helpful. If you weren’t at AADE or if your skirt prevented you from participating, I highly recommend checking out a class when you’re home, or even just googling mindfulness and trying to incorporate a couple techniques into your life. It’s useful whether or not you have diabetes.

5. Most diabetes educators are women. Like, I’d say about 99.9 percent of them. (At least those who attended the conference.) What’s up with that? Where are the dudes? Also, if you’re a single guy looking to match up with a sensitive and empathetic woman, you may want to crash next year’s conference. 

6. I will attend any conference that offers me a free hbA1c test. Thank you, Novo Nordisk. (They also donated $10 to a diabetes non-profit for every test they performed.) Pleased with my result, I then got double servings at the Daisy cottage cheese booth, which was offering sample cups with a delightful assortment of fresh berries. My world has expanded beyond Breakstone’s. This is embarrassingly exciting for me. 

7. I then stopped by the GlucoRein booth, a medical food company (meaning that it actually has to be approved by the FDA) that claims to lower post-meal spikes, especially among Type 2s. I am skeptical, but intrigued. Its active ingredients are supposedly chlorogenic Acid and L-Cysteine, neither of which I know anything about. Anyone have experiences with this product? Most mentions I find online are about PCOS, not diabetes. 

8. I continue to be intrigued by the Tandem t:slim insulin pump. It’s as close to an iPhone as you’re going to get with an insulin pump. And in addition to being very intuitive and user-friendly, it allows much more customization than my beloved Paradigm.

9. Anyone else think it’s odd for the Sugar Association (tagline: “sweet by nature”) to have a booth at a diabetes conference?

10. The Calorie King is Australian. I would not have guessed this. 

Catherine Price

Catherine Price (www.catherine-price.com) was diagnosed with Type 1 diabetes when she was 22 years old. She has written for publications including The Best American Science Catherine Price is a professional journalist who was diagnosed with Type 1 diabetes when she was 22 years old. Her work has been featured in publications including The Best American Science Writing, The New York Times, Popular Science, The Los Angeles Times, The San Francisco Chronicle, The Washington Post Magazine, Salon, Slate, Men’s Journal, Health Magazine, The Oprah Magazine, and Outside, among others. A graduate of Yale and UC Berkeley’s Graduate School of Journalism

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Catherine Price

Catherine Price was diagnosed with Type 1 diabetes when she was 22 years old. She has written for publications including The Best American Science Catherine Price is a professional journalist who was diagnosed with Type 1 diabetes when she was 22 years old. Her work has been featured in publications including The Best American Science Writing, The New York Times, Popular Science, The Los Angeles Times, The San Francisco Chronicle, The Washington Post Magazine, Salon, Slate, Men’s Journal, Health Magazine, The Oprah Magazine, and Outside, among others. A graduate of Yale and UC Berkeley’s Graduate School of Journalism