Addressing Sanofi’s global device developers

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Yesterday I had the pleasure of speaking to 80 people involved in, and committed to, the development of medical devices. I was addressing Sanofi’s global device developers offering the “Patient Perspective.” How I interact with devices – how they help me manage my diabetes, and my life, where they let me down and what else I’d like to see.

For me, it’s always a joy to share what living with diabetes is really like, and help others understand the good, the bad and the ugly. I calculated that living with type 1 diabetes 41 years, I have taken 76,115 shots and 60,972 finger pricks. I have spent over a billion seconds of my life calculating how many carbs are in what I eat, when I will take my walk, whether I need to refill my scripts, see my doctor, take a correction shot and on and on.

The heads nodding in the audience told me they either “got it” or their eyes were being opened. I also shared my views about what devices I use – glucose meter, Solostar insulin pen, Timesulin insulin pen cap, ACCU-CHEK Multiclix lancing device, Dexcom G4 CGM and a low-tech little key chain that carries 4 glucose tablets.

The t:slim insulin pump was on my “cool” list, looking as it does like an iPhone. And the Lantus Solostar and Apidra insulin pens on my “oops” list. So similar in design and color, I know too many patients who have confused them and landed in the hospital.

In the end, my advice for Sanofi’s team to better know how to design products we want to use is to “Be a patient.” La vida loca, “live the (crazy) life” of someone with diabetes. Check your own blood sugar 8-10 times a day, log your blood sugars and count carbs in your meals.

And spend time talking to people with diabetes. How else would you know why I love my CGM (affectionately known as “Pinkie”) yet don’t use an insulin pump?

My parting image was this little girl up there – me at three. She had no idea diabetes was coming down the pike in 15 years; that that diagnosis would change her life forever.

Yet, she and I are hopeful for the devices that will still come. And the one I’m truly waiting for is the one that lets the one I use most often, my brain, retire.

It will be the device that when I’m walking, eating, watching a movie, standing on line at airport security or making love doesn’t have me wondering, “What’s my blood sugar now and what do I have to do about it?” Because it has already taken care of it for me.

American Diabetes Association conference highlights


I want to tip my hat tonight to my colleague Amy Tenderich over at for her reporting on the American Diabetes Association’s (ADA) annual conference that just ended today. 

Once a year the best and the brightest get together to report out new scientific research discoveries, this year as you might imagine there was a lot of discussion about the artificial pancreas closed loop system. It’s also the best place to roam through the exhibition hall and see what new devices are coming to market, and I hear there are also now presentations on the behavioral aspect of managing diabetes.

Amy wrote two posts on what she found there which I encourage you to take a look at. It’s an easy way to get yourself up to date pretty quickly on what’s going on in diabetes research and products and catch some of the highlights of the conference:

What’s Hot from ADA 2012

ADA 2012: Diabetes Company Updates from the Expo Floor

The 1st annual “Food for your Whole Life Symposium” shows we know a lot, but aren’t making good use of it


For the public and health professionals, NYC


David L. Katz, M.D., M.P.H., F.A.C.P.M., F.A.C.P.


Michael Roizen, M.D. and conceptualizer ofRealAge


Eat your nuts and berries!



The first of hopefully an annual event was held this past June 6 & 7– the“Food for your Whole Life Health Symposium” – spearheaded by Dr. Oz. It was a two-day free event held at the Grand Hyatt Hotel in New York City to explore how food and lifestyle choices affect overall health. And, to better arm dietitians to help patients make better food choices.

I happened to miss the first day that was open to the general public and drew 1,000 people, but attended the second day exclusively for health professionals, largely dietitians and some diabetes educators, and media. 

I find it interesting with all the constant information coming at us these days on health and healthy eating that people just aren’t indulging in it. So I asked the same questions of everyone I met while meandering between lectures and standing on the long line into the ladies room: “Why, with all the information out there on healthy eating, are people fatter than ever?” “Why are half the people with type 2 diabetes not managing their diabetes very well?” “What has to change so that people change their behavior?”

I heard the same reply from everyone—there is too much information out there and it has become too confusing. Some of it is contradictory, and none of it is laid out for people to act on easily.

In a private interview I conducted (yes, I’m still getting used to this Huffington Post blogger status) with a key speaker at the symposium, Dr. David Katz – a Yale University researcher and authority on nutrition, weight management, and the prevention of chronic disease and a leader in integrative medicine and patient-centered care – he confirmed these observations. He also pointed to the media’s collusion. With an endless need for “new” news and a ravenous appetite to titillate us, the media barrages us with an endless supply of findings that has left the general public reeling with confusion. The result:  heightened stress and not knowing what to do. The other result: people do nothing. 

Katz has been working along with several others on a nutritional ranking system called “NuVal™” that’s being piloted by Kroger, a chain grocery. Kroger is piloting it in 23 stores in Lexington, KY. It’s anticipated they will roll NuVal out to their additional 2500 stores in 31 states.

NuVal ranks foods from 1 to 100 as a guiding system on nutrition to help consumers make healthier choices among a category of food. For instance, you’ll know the healthiest crackers among all the available crackers in the supermarket.

Right now NuVal is in 600 stores with another 400 stores rolling it out later this year.  Katz believes if people begin to choose the most nutritious foods in most categories, these small shifts can make a significant health difference. Katz also shared with me that his wife, a PhD, returned to their house one day with five loaves of supermarket bread and said basically – You pick the healthiest one!  

Katz also said regarding diabetes that many doctors tell their patients in very vague terms what to do, like “Lose some weight” and “Get some exercise.” These directives fall right off patients’ shoulders as soon as they walk out of their doctor’s door. He also said most doctors think diabetes patients are “non-compliant” because they have no willpower, but Katz made it abundantly clear that it is not a matter of willpower, but the enormous lack of translating all this information into easy-to-understand, actionable steps.

The day I attended the symposium, the speakers elucidated us on the upcoming changing dietary guidelines, likely out in November, and took us through a healthy eating map from childhood through old age. The message, throughout however seemed pretty consistent: eat mostly fruits and veggies, whole grains, lean protein and healthy fats.

Dr. Michael Roizen, Chief Wellness Officer at the Cleveland Clinic with numerous other impressive titles behind his name, and Oz’s writing partner, closed the event outlining Cleveland Clinics’ progressive “Lifestyle 180 Program” that they first test-piloted on employees of the Clinic with remarkable results and a cost-savings to the Clinic well worth the investment.

For patients, the program encompasses a six week immersion program that is geared to change the four factors 75% responsible for chronic illness: smoking, food choices and portion sizes, physical inactivity and stress.

Very briefly, the program includes overhauling one’s cultural climate, largely your kitchen ridding it of toxic foods, having participants experience “I can do it” aha moments, muscle memory of right eating and exercise and a buddy system. One of the bottom line messages was – while our genes are our inheritance, our lifestyle determines whether they get turned on or not.

For those with diabetes who have gone through the program, Roizen said 60% were able to discontinue one or more of their medications for blood sugar, cholesterol or hypertension (high blood pressure) within six months.

Most of the people I met at the event thought it was of value and, for me, it only points to the urgency with which we are all recognizing we must turn this ship around that is so badly headed in the wrong direction.   

The principal sponsor of the event was the California Walnut Commission. Affiliated sponsors numbered 7, including Healthcorps and the Wild Blueberry Association of North America.  

I did manage to sample the delicious wild blueberries which I was told are available in my favorite grocery, Trader Joe, as well as other chain groceries. I also got to grab a few packets of 1 oz servings of walnuts – that’s about 7 whole walnuts. Unfortunately, I also managed to forget the bag I stowed them in, leaving it under my conference table. 

Obviously, I need to eat more berries and walnuts to improve my aging memory!

All aboard: Amtracking through Pennsylvania with diabetes


These last two weeks I’ve been “Amtracking” up and down the East Coast: From New York to Cambridge, MA two weeks ago and  last week to Harrisburg, PA and then back from Philadelphia to speak to patients and nurses. This work I do has to my surprise led to seeing a lot of the country.

Not having ridden Amtrack for probably a decade it was a delightful surprise – almost stepping back into a more genteel era. The seats are wide, comfy and provide plenty of leg room, unlike those I’ve grown used to now in airplanes’ economy class. The conductors are pleasant, “Hello, how are you doing today?” While stepping aboard on one leg of my journey, the high steps made it difficult to lift my wheeling case. Not a problem, the conductor had it in tow before I even thought how was I going to manage it.

Amtrack also has a “Quiet Zone.” A car where no cell phone use or loud conversation is allowed. What a delight. Between the gentle rolling of the train and the silence I fell off to sleep for an hour. Moreover, two restrooms in every car, never a line! I am forever changed. Next time I go somewhere Amtrack goes and the trip is not more than a few hours I will opt for the age-old comfort and civility of train-ing over plane-ing. Moreover, it allows you to bypass going through airport security where a hand search reveals syringes and begs questions, an insulin pen raises a red flag and one is supposed to (I rarely do) extricate one’s self from seat, climb over two fellow passengers and scuttle off to the restroom to take a shot. 

I was train-ing to speak to two groups of patients and nurses amid the rolling hills of rural Pennsylvania. My train stop was Harrisburg, where I was picked up by Betsy Wargo, a dedicated diabetes educator who serves the nearby area through Wellspan, and had invited me to be the key speaker for their annual diabetes health fair. The fair was held at Gettysburg Hospital in historic Gettysburg, home of one of the major battles of the Civil War and Abraham Lincoln’s famous address. At the hospital I had the pleasure of addressing about 70 patients as an author and fellow patient. I shared my personal story of getting diabetes at 18 and what it’s been like to live with, dispelled many of the diabetes myths that confuse most people and explained the power of tapping into our positive emotions to better manage diabetes. These of course are the topics of my two books.

Focusing on what we want (happy, healthy life) rather than what we don’t want (complications) and putting more energy into our positive emotions, for instance appreciating what we have, forgiving ourselves when we muck up, patting ourselves on the back for all we do and taking pride in our efforts – helps us do better. Oprah often says, “When you know better, you do better.” What’s also true is, “When you feel better, you do better.” Afterward Betsy and I toasted the successful evening over a drink at the famed bar inside the hotel and talked passionately about how to help patients improve their self management.

The next day I was picked up and driven to Springfield, a town just outside of Philadelphia, where I presented my Taking Control program to another 70 patients. I followed an endocrinologist in the line-up and when I finished my talk numerous people told me how much they got out of what I said. It doesn’t hurt to have a powerful story to share or to follow a doctor who has just pummeled your audience with target numbers, facts and figures.

Then it was back on the train home to the Big Apple where I, for one, was riding on a high. As we approach Thanksgiving, more and more for me it is not an annual event. Throughout the year I give thanks for how fortunate I am to be doing this work and how grateful I am for all who make it possible.