Doubly upset with insulin manufacturers for look-alike insulin pens

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On the top Tresiba long-acting basal insulin. On the bottom FIASP ultra-rapid insulin

Please Novo Nordisk, what are you thinking? Both your Tresiba and FIASP insulin pens are nearly identical. I know already I will at least once, if not more, grab the wrong pen and take seven times my mealtime dose accidentally.

For the first time ever, after 46 years with type 1 diabetes, I’m using Novo Nordisk’s insulins for both my basal and bolus: Tresiba and FIASP.

This is the picture I took this morning of my pens just after looking down at the Tresiba pen in my thigh as I had my finger on the plunger having just pressed it, thinking, “Oh, my god, is that my Tresiba in my leg or the FIASP? SH*T!!!” All I saw was a navy blue pen.

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The caps look different because the Tresiba pen (on the bottom) has a Timesulin cap on it.

I switched to Tresiba and I’m experimenting with FIASP after being a long time user of Sanofi’s Lantus and Lilly’s Humalog. I’m very happy with both insulins. Tresiba covers me a full 24 hours plus, while Lantus only stretched to about 19 hours. And FIASP, which I’ve just started to see if it actually is faster than Humalog, appears to be. No complaints about the insulins. In fact, I’d recommend them easily.

But how could those at pharma companies, whose hands these pens flow through upon creation and sale – device designers, engineers, research and development, business development, marketing and strategy professionals – not consider the risk to patients of confusing these two pens? Untold numbers of people with diabetes will use both these products – just as the company would like them to.

How could one not notice that the identical color of the pens, design and shape will cause many customers to mix them up and result in potentially life-threatening consequences?

I’ve already done it, mixed up my short acting and long acting pens once with two pens from two different companies that were not identical.

Novo Nordisk is not alone, although I find the choice of navy blue for both pens egregious. Here are Sanofi’s Lantus (basal insulin) and Apidra (bolus insulin) pens. Also, far too similar. In “real life” the color difference is not as pronounced; they both share a blue/grey hue.

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Luckily, this morning the correct pen was in my leg. But trust me, in the middle of making breakfast and picking up a pen to take one of my six or so shots a day, the day will come when I take seven units of FIASP (my Tresiba dose) when I meant to take one. Am I to blame? Sure. But make it easier for us to avoid potentially life-threatening mistakes. Make insulin pens mistake-proof.

Why can we not have pens that are dramatically different colors, especially from the same company, different shapes, different texture or make a sound when you take off the cap. Users of insulin pens already take it upon themselves to distinguish their pens by putting duct tape or rubber bands around one pen, or keeping their pens in different rooms. It should not be so hard.

I’d like to see the company that embraces the hippocratic oath, “first do not harm” and reflects it in the pens they put in our hands.

You can do more, you can do better to help people with diabetes have one less thing to worry about – taking an insulin overdose – when they take their medication multiple times a day.

 

Grace for the new year

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Reflecting on this past year I realize how truly rich I am. How many experiences and adventures have colored my days. How many friends and colleagues have enriched my journey. And how grateful I am for family who always give me, and the husband, a safe space to land.

I hope 2019, amid the noisy, chaotic world, is a year we all find our inner stillness; that quiet, vast and unflappable place within us. And that you be touched by the grace of those who come along your path just as you have graced other’s paths.

Wishing you peace, happiness and health in the new year.

The language of diabetes and diabetes-speak

Of all that’s happened in diabetes this year, it was also the year of bringing people’s attention to the judgmental language embedded in our diabetes culture. I offer congratulations to the American Diabetes Association and the American Association of Diabetes Educators who jointly created a white paper on the topic. Among the paper’s recommendations is replacing “diabetic” with “people with diabetes.” Replacing  “test” blood sugar with “check” blood sugar. To never, ever label people with diabetes as “non-adherent” or “non-compliant” and, in general, to use language that is factually correct and judgment free.

That said, there is another language in diabetes. It’s the talk that goes on between those of us who tread water every day with this condition.

My friend just emailed me with this photo of her pump. The photo came with this message, “Just when I’m feeling like I’ve eaten too much and not been exercising…my pump responds with this.”

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You’re wondering what this means. She and I have been talking about noticing the number “111” on her pump and my CGM over the past weeks. Why? Because 111 is called an angel number, a symbol of spiritual awakening, pointing you to your purpose in life. We think it kinda fits us and we think noticing how frequently it shows up is a hoot.

So I of course wrote her back in diabetes-speak —

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Shall we just say I had to laugh when this came up for me this morning —

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Salt, Sugar, Fat: the book about creating the irresistable trifecta

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My last post was about the non-nutritious food served on airlines. If you want to learn how, as a nation, we have ended up with an overabundant supply of not food, but food-like substances, as journalist Michael Pollan, calls them, you should read, Salt, Sugar, Fat: How the Food Giants Hooked Us, by New York Times journalist Michael Moss.

The book is an eye-opening account of the food industry from when it began to employ scientists and marketers, and collude with the government and certain health organizations, to create cheaper food with few real ingredients and many chemicals. How and why the government began paying farmers to overgrow corn, wheat and soy, and how they all promote these fake foods as healthy with false nutrition claims.

There are so many devious, just-this-side-of-lying, and outright lying strategies about the nutritional value of these concoctions of chemicals, you will find the book jaw-dropping; unfortunately, in the worst way.

For example, America’s beloved Velveeta cheese, is a processed cheese-like product invented in 1918. Today, as over the years, its formula has changed, it is labeled as a “pasteurized prepared cheese product,” no longer technically cheese. Certainly it bears no resemblance to cheeses either made by artisanal makers here or in Europe, where the process is slow and personal and the prime ingredient, milk, comes from grass-fed cows.

Oscar Mayer Lunchables, which became a runaway lunch best-seller amongst kids, had not a speck of nutrition in it. It was the company’s way to reel in more money. Tang, which captured America’s heart when astronauts took it into space, has more sugar in it than soda. Cheap hamburger meat, that goes through bleaching and worse, that got termed “pink slime” finally got pulled off supermarket shelves when enough people complained. Trust me, I was raised on Carnation Instant Breakfast Drink and Pop Tarts and daily tuna fish sandwiches on Wonder bread. And an all time favorite, Chef Boy Ar Dee canned ravioli!

The history of how quick, cheap, processed foods arose is fascinating and all here. It started with a Kellogg brother, John Harvey, a doctor, nutritionist and health activist who created a sanitarium for people to regain their health in Battle Creek, Michigan. One of this main staples on the menu was whole grain cereal, no added sugar. When his brother, Will Keith Kellogg, in John’s absence on a trip to Europe, added sugar to the cereal and saw how people loved it, he split away from his brother and created the first sugar-laden breakfast cereal – Kellogg’s Frosted Flakes. Frosted with what? Sugar. American breakfast was born.

Coca Cola is given a lot of attention as a genius company for strategizing and turning the entire world onto Coke. During WWII they got Coke out to soldiers on battlefields, adding a patriotic feel to the product, and into gas station vending machines across the country.  Sad to say today as Americans recently began to drink less Coke, understanding the health risks, Coca Cola began exporting Coke overseas to hook poor people in underdeveloped nations.

You cannot read this book and not understand why we’re facing our current healthcare crisis and epidemic of chronic illness. And why what you eat is at the root of health, and disease.

Best and worst airline food

Each time I’m on an airplane I marvel again at how unhealthy the food is. Yes, if I can, I bring my own food on board, but that’s not always possible. I don’t eat the white bread roll and chemical-heavy salad dressing. I don’t eat whatever processed snack item they may serve like fake pizza. If I actually get a meal, I usually eat the protein and veg of the entree, skip the dessert, and save the cheese for a few hours later.

How interesting that someone actually rated the best and worst foods among most airlines. Turns out Alaska Airlines came in first place. Darn, not much chance I’m going to Alaska anytime soon.

Still, it’s interesting to see how our major and smaller airlines stack up – A ‘diet detective’ rates the best and worst US airline foods or health.

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