19th Annual Diabetes Product Reference Guide

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Diabetes patient advocate and expert, Nadia Al-Samarrie brings to you her “19th Annual Product Product Reference Guide” for people living with diabetes so they can make informed decisions to avoid the devastating effects of diabetes complications.

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Nineteen Annual Product Reference Guide and Going Strong!

When we started our Annual Product Reference Guide in 2003, in many instances, the diabetes products we featured were radically different from the ones we are featuring today in 2021-2022.

Type 2 diabetes patients diagnosed years ago have been witnesses to a steady increase in the reliability and the range of medications and devices designed to make managing type 2 more manageable and effective.

For type 1 patients, the main improvements have come in insulin delivery devices and insulin itself. Very long-acting basal insulins like Toujeo  and Tresiba  have relieved many type 1s of the burden of injecting themselves two or three times daily if they want their basal insulins to work reliably throughout the day. Here’s a preview of what you’ll see in this product guide:

Page 18 Continuous Glucose Monitoring:

CGM is one of the two main components of the “artificial pancreas” (the other is the insulin pump), a high-tech approach to helping users maintain steady and ongoing control over their blood sugars. The CGM measures current blood sugar levels and can even anticipate where users’ blood sugar levels are heading. This data is sent to the insulin pump, which responds by injecting the proper amount of insulin to deal with blood sugar fluctuations.

Page 10 Blood Glucose Meters:

A continually improving technology while still holding a steady or even declining price point. BGMs have gained new capabilities within the past decade, including tracking owners’ blood glucose trends, communicating with other devices, and downloading data to them.

Smartpens, such as the InPen from Medtronic and Bigfoot Unity from Bigfoot Biomedical, can also connect with BGMs, which allows the pens to calculate insulin doses.

The Medtronic and Bigfoot pens can also communicate with CGMs, which provide real-time blood sugar readings and trends the pens can act upon. Novo Nordisk’s NovoPen  6 and NovoPen  Echo Plus can connect with Dexcom’s G6 CGM.

Page 6 Fast-Acting Glucose:

Whether they are type 1 or type 2, most people with diabetes are very wary of hypoglycemia, where blood sugar levels can drop so low that they put a person with diabetes in danger of falling into a coma. That’s why fast-acting glucose should be in every type 1’s and type 2’s medicine chest, pocket, or purse. You can purchase them in a tablet or gel form in many flavors. How they work is simple. The tablets consist of 4g of glucose with sugar the body can metabolize the fastest.

If blood sugars drop dramatically, a much faster means of raising blood sugars is required. This is provided either by a nasal spray or injection of glucagon. The nasal spray from Eli Lilly works immediately because it is absorbed directly into the bloodstream via nasal tissues. Injectable glucagon is made by Lilly, Novo Nordisk, and Xeris Pharmaceuticals.

Page 14 Insulin Delivery Devices:

The advantage to these devices are twofold: 1.) they deliver exact doses of insulin, removing the threat of over-or underestimating needed amounts of insulin. 2.) The needles are hidden, removing one of the significant barriers to use by diabetes patients who don’t like to watch a needle penetrating their skin.

Page 16 Insulin Syringes:

One of the first things diabetes patients learn when injecting insulin is to track where they inject and vary injection sites. Users may start injections on the left side of their abdomens and then slowly move injection sites right to the other side of the abdomen. Diabetes experts caution against injecting insulin in the same place, time after time. Doing so leads to lipodystrophy, where fat under the skin can form lumps or indentations that obstruct insulin absorption.

Page 20 Insulin Pumps:

Over the years, these devices have become smaller and sturdier, to the point that athletes, dancers, yoga students, and other physically active users can wear them confidently without worrying that they may break, buckle, or disconnect from their infusion sets. These pumps are one of two components of the “artificial pancreas” (continuous glucose monitors are the other), a device that can function as a substitute for a healthy pancreas by constantly monitoring blood glucose levels via a CGM, which the insulin pump responds to by injecting—or delaying—an appropriate amount of insulin.

Page 22 Insulin:

In the United States, there are three insulin manufacturers: Eli Lilly, Novo Nordisk, and Sanofi. Each company has a solid footing in the marketplace and can rightfully expect its insulin sales to grow, thanks to the increasing number of people who are being diagnosed with diabetes steadily. For now, the price of various insulins has been pretty much set in stone. Older insulin types, such as basal insulin Humulin, are relatively inexpensive, especially when compared to newer basal insulins, such as Sanofi’s Toujeo  and Novo Nordisk’s Tresiba. Each of those two insulins is effective up to 24 hours, with Tresiba  maintaining its effects for up to 42 hours.

Page 26 Type 2 Medications:

This category has become a vast marketplace with decidedly different medications for type 2 diabetes. Reading this section offers a quick lesson in the many approaches to managing type 2 that have come up through the years. Type 2 medications have primarily focused on making the liver produce less glucose or stimulating patients’ pancreases to increase their insulin output. The latest development is medications that make the kidneys shunt some glucose they process into the urinary tract rather than send it back into the body.

Wishing You the Best in Health!

Nadia Al-Samarrie, Founder

Publisher, Editor-in-Chief

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