Diabetes Pharmacist : Diabetes Pharmacist Blog : Focus Express Mail Pharmacy : Insulin Pumps, Diabetes Supplies and Information

New drug Juvisync combines Merck's diabetes pill Januvia with the popular cholesterol drug Zocor. Patients with both diabetes and high cholesterol are at increased risk for heart disease, stroke, kidney disease and other chronic conditions

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I just read that "cabin pressure changes during air flights may affect insulin pumps causing patients to receive too much or too little medication." Does anyone have any experience with this?

The article  continues :"Researchers at John Hunter Children’s Hospital in Newcastle, Australia investigated insulin pumps used by patients with type 1 diabetes to deliver insulin. The study, published in the journal Diabetes Care, found that when ten insulin pumps were flown on a commercial flight, they were affected by air pressure changes. Air pressure decreases during takeoff caused the pumps to deliver extra insulin, and air pressure increases during descent caused some insulin to be sucked back into the pumps, resulting in an insufficient amount of insulin being dispensed. The air pressure causes bubbles to form and expands existing bubbles, affecting the amount of insulin being given. Researchers advise diabetics to be aware of the effects of pressure changes, and possibly disconnect the pump before takeoff and landing."

I would think and hope that the pump manufacturers have taken flying into account. But, maybe I'm wrong. Can someone who wears an insulin pump and travels by jet frequently give us some insight?  Thanks!

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October is American Pharmacist Month and in honor of that, I'd like to remind everyone how important your pharmacist can be; both in the prevention of Diabetes as well as in helping people manage their Diabetes. Pharmacist Services can include:

• Nutrition and Diet Counseling
• Exercise Instruction
• Blood Glucose Monitoring Advice
• Medication Therapy Management
• Healthy Behavior Management
• Guidance in skin care, foot care, dental care, eye care, proper injection technique, etc.

Studies have shown that when a pharmacist is involved in the management and self-care of patients with Diabetes,  both test results and patient outcomes improved. 

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Being a  pharmacist for many years means that I've been "trained" to eat quickly,  before a patient walked into the store. Furthermore, a long time pharmacy "myth" is "if you want people to walk into the store, order a hot meal."  Other than causing a little indigestion, eating fast hasn't bothered me. But now, a new study suggests that fast eaters have a higher risk of developing Type 2 Diabetes.

According to the Japanese study, people who eat food quickly  are twice as likely to develop impaired glucose tolerance, known as pre-diabetes. In impaired glucose tolerance (IGT), blood glucose levels are higher than usual,  but not high enough to cause diabetes. However, without proper treatment, 40 to 50 per cent of people with IGT will develop Type 2 Diabetes within ten years. One theory is that eating quickly increases postprandial blood glucose, the amount of sugar in the blood soon after eating.

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A recent study of more than 1,000 men and women over age 60  found that people with diabetes were twice as likely as the other study participants to develop Alzheimer's disease within 15 years. They were also 1.75 times more likely to develop dementia of any kind.

"It's really important for the [public's] health to understand that diabetes is a significant risk factor for all of these types of dementia," says Rachel Whitmer, Ph.D., an epidemiologist in the research division of Kaiser Permanente Northern California, a nonprofit health-care organization based in Oakland, California

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A new study suggests that getting a good night’s sleep may stave off the development of type 2 diabetes in obese adolescents.

“We already know that three out of four high school students report getting insufficient sleep,” said study investigator Dorit Koren, M.D., a pediatric endocrinologist at The Children’s Hospital of Philadelphia. “Our study found to keep glucose levels stable, the optimal amount of sleep for teenagers is 7.5 to 8.5 hours per night.” She added that this is consistent with research in adults showing an association between sleep deprivation and increased risk of type 2 diabetes.

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The staff at Focus Pharmacy speak to people with Diabetes all day. Lately, I hear, they've been getting a lot of "Where have you been all my life?" and "THANK YOU for being there for us"  from new customers. And some "We couldn't afford our medications and supplies if it wasn't for you, thanks!" from long time customers.  Just wanted to let those who don't know about Focus Pharmacy that:

• They stock all brands of insulin pump supplies including Medtronic,Omnipod, & Accu-Check
• They accept the insurance payment as payment in full (where allowed)
     so you have NO COPAYS To Pay
• Insurance claims and billings are handled by them - no paperwork for you.
• FREE overnight shipping of all your medications (they are a full service pharmacy too) and supplies.
• A live person will always answer your phone calls M-F, 9-5 ET 
• You can order your refills on-line anytime
• A pharmacist is available for emergencies 24 hours a day, 7 days a week
• They guarantee 100% satisfaction.
•  No Membership or Hidden Fees Ever
• If your insurance, qualifies, you get a $50 gift card with your first order!

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According to a recent study of people with Type 2 Diabetes, among high insulin users (using more than 150 units daily) insulin pump delivery  saved more than $12,000 over 4 years vs.Multiple Daily Injections (MDI) because basal rates dropped dramatically owing to better insulin absorption said certified diabetes educatorPhyllis Wolff-McDonagh, DNP, at the annual meeting of the American Association of Diabetes Educators.

 MDI were significantly more expensive than pump therapy for the high insulin user  patients: $41,100 vs. $28,826. With the potential cost savings from improved glycemic control factored in, insulin pumps could also prove cost savings even for the moderate-use group, Dr. Wolff-McDonagh pointed out. Cost calculations included both supplies (syringes or pen needles, pump plus pump supplies) and the insulin.

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 Researchers associated with the National Cancer Institute (NCI) and the National Institutes of Health (NIH) have found that the presence of diabetes increased the 10-year risk of thyroid cancer by 25% among adults 50 to 71 years old. Women were at a particularly high risk.

No one is quite sure why there is a connection although both diseases are endocrine disorders and are linked to autoimmune problems.

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Well, It seems that all of us here in the  Philly area are in the crosshairs of Hurricane Irene as it slowly moves up the east coast of the U.S. . Since this type of thing rarely happens to us here in the NorthEast, I thought it may be a good idea to mention some items on the FDA Hurricane Preparedness Checklist  that would be important to people with Diabetes. It is of utmost importance to read the entire list as well!

1. Drugs Exposed to Water

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Roche Insulin Delivery Systems has announced today that it has discontinued the ACCU-CHEK FlexLink Plus infusion sets as well as the ACCU-CHEK LinkAssist Plus insertion device. An alternative replacement is the ACCU-CHEK UltraFlex infusion sets and the ACCU-CHEK LinkAssist insertion device.

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 The American Journal of Clinical Nutrition recently published a study suggesting that eating as little as one serving a day of red meat increases your risk of type 2 diabetes. Taken from dietary surveys of more than 200,000 participants in the Harvard Nurses’ Health and the Health Professionals Follow-up studies,Dr. Frank Hu, a professor of nutrition and epidemiology at the Harvard School of Public Health, said  "we found that one serving per day of processed meat like a hot dog or sausage was associated with a 50 percent increased risk of diabetes compared with people who ate processed meat less than once a month." (Unprocessed meats in the diet led to a 20 percent increased risk)

Dr. Hu suggested the following:

• The high iron content of red meat can increase inflammatory chemicals, which can destroy insulin-producing beta cells.
• The nitrates in processed meats may also be toxic to beta cells, which could explain why processed meats contributed even more to risk
• Last, those who ate the most red meat also tended to eat fewer fruits and vegetables and were more likely to smoke and be obese.

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As seen in the latest issue of UPDATE from Independence Blue Cross, here are 7 changes that you can make in your life  that may help prevent diabetes:

1. Understand your risk factors. These include obesity, family history of diabetes, hypertension, a low HDL cholesterol level, being over the age of 45, etc
2. Take a diagnosis of pre-diabetes seriously .
3. Get at least 7 hours of sleep .
4. Lose weight. This is THE most important lifestyle change to reduce your risk.
5. Eat Right.
6. Stay Active.
7. Stop Smoking.

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I try to learn something new everyday. I knew that the sweetener Fructose was not good for most people and especially people with Diabetes. I just didn't know how bad it was. Here are some facts from Dietician Joan Endyke and others who ask if YOU knew the following regarding Fructose:

• As opposed to other sugars, fructose is metabolized in the liver, converted to triglycerides (fat) and sent to the bloodstream, causing triglyceride levels to rise and  increasing the risk of diabetes and heart disease.
• Fructose  diminishes the effects of leptin, a hormone that regulates appetite,  leading to overeating, weight gain and belly fat.
• Excessive fructose can lead to gout. 
• Sucrose, better known as table sugar, contains 50% fructose
• Commonly used sweetners like molasses, honey, apple & grape juice concentrates all contain at least 50% fructose.
• Pepsi, Coke, and Sprite contain "Really High Fructose Corn Syrup" (RHFCS) with 65% fructose. These results were  recently published in the journal Obesity and easily explains why consuming large amounts of soft drinks can also  lead to diabetes and heart disease.
• There is growing evidence that excess fructose consumption may lead to insulin resistance and eventually Type 2 Diabetes.

To everyone, eat healthy, excercise daily , and read the labels on your food. Avoid foods containing high amounts of fructose.

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