A lot of zeros.

Stephen draws attention to an important issue for the #DOC, the cost of insulin.

Diabetes Blog -

Like many, I’ve seen and heard the recent NPR story:
Why is insulin so expensive in the U.S.?

The story is based on research from Dr. Jeremy Greene from The Johns Hopkins University in Baltimore (still trying to get an interview), where he is a professor of medicine and history of medicine. He did some research on the history and cost of insulin, and published his findings in The New England Journal of Medicine.

The truth is, we all know insulin is very expensive here. And we all have our own opinions on why we think insulin is expensive here (where are the generics?). After reading a few of these stories this week (because diabetes stories with an impact aren’t reported for months, then the same story is reported by everyone in a few days), and then reading comments below each piece, I started to become overwhelmed.

Partly, it…

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Moving sale!

Man running along road, with mountain to left and sun setting
New roads ahead

Diabetes Free Press has a new site,

A few weeks ago, I decided to move the site to a self-hosted site, and I’ve spent the time since then trying to get some of the kinks out. Some kinks remain, but some I have a few interesting posts. So if you’ve liked what I’ve done here, you should like the new site.

Here are a few headlines to encourage you to click on over:

Please visit the new site and let me know what you think. Leave a comment or write me at

This site will be around for a while, if only to give me a playground to test out new themes. Eventually, it’ll have a redirect to the self-hosted site.

Photo credit: Joshua Sortino


I now pronounce you man and disease
New York man marries his diabetes

“Making my vows again to my diabetes I had a real and deep sense of commitment and renewal. Saying them out loud in front of a group of people, some of whom are my oldest friends, made me feel tremendously supported.”



Rx for kids: More recess

We know some schools are cutting back on recess. We know that childhood body-mass index can predict Type 2 diabetes later in life. And we know that over a lifetime, the cost of Type 2 diabetes is, on average, is $238,000 in the United States.

So I wonder what would happen if a pediatrician looked at an overweight child with a family history of diabetes, and prescribed 30 minutes of physical activity every day.

U.S. public schools must follow the Individuals with Disabilities Education Act, which special services for children who fall into one or more of 13 categories of disabilities: autism, deaf-blindness, deafness, emotional disturbance, hearing impairment, intellectual disability,  multiple disabilities, orthopedic impairment, other health impairment, specific learning disability, speech or language impairment, traumatic brain injury or visual impairment (including blindness).

Because it sounds vague, my attention turned to “other health impairment.” Here’s what the law says specifically:

(9) Other health impairment means having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that–

(i) Is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and

(ii) Adversely affects a child’s educational performance.

There’s “diabetes.” And interestingly, the law reads “such as,” not “limited to.” Quick show of hands, who has known a child who was far more “alert with respect to the educational environment” after he or she spent 30 minutes burning off some excess energy? All the hands are up. I thought so.

So getting back to the prescription for recess, I can imagine a principal begging off. That 30 minutes could take place any time before or after school, outside the important lessons that take place inside the schoolhouse. Teachers need what little time they have with students to make sure they’ve mastered math and writing.

I get that. We ask a lot of our schools, and sometimes we parents and taxpayers make unreasonable demands. But I also get that a teacher’s job would be much easier if schools didn’t treat recess or phys ed as an afterthought.

And now, that there’s plenty of research that connects a lack of activity to an expensive life of a Type 2 diabetic, I don’t think schools can take kickball or tag or tossing a football as something less than mastering a times table or subject-verb agreement.

I know that lots of parents face greater difficulties in dealing with school systems than my family ever did. I’d love to know if you’ve tried to advocate for more recess time. I’d love to hear your efforts — positive and negative — at negotiating the 504 process.

And how much recess does your child get? It seems like few schools offer any significant amount of recess, but is that wrong? Let me know. 

Leave a comment, or write me at 



Two Minute Diabetes  Advocacy: CGM Medicare is Back and FDA Goodness

          This is an important issue that all D’s, Type 1 or Type 2, should support.


708615_95129272It takes two minutes to make a difference for people with diabetes. Here’s the latest on how you can help.

CGM Medicare Bill: It’s Back!

Want the back story? It’s here.

Right now, Medicare does not cover CGM devices, leaving seniors with diabetes without access to this technology. Among the most important goals of our advocacy and education efforts is to ensure that those entering the Medicare program at age 65 do not experience disruption in their diabetes management. (None of us with diabetes is getting younger. If you are, please let me know your secret!) I don’t want a single person to be denied coverage of this device simply because of their age (or any other reason for that matter, but first things first, right?) and we have an opportunity to make a difference for our entire community.

Remember that this bill will also help when artificial pancreas technology…

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The ResearchKit link to Henrietta Lacks

Here’s a great point of view on ResearchKit. Should individuals profit from the data they provide to these massive studies? Lisa Suennen, writing for MedCityNews, compares the ResearchKit studies to the story of Henrietta Lacks, whose cancer produced cell lines that are still used today.

At what point will those who contributed their data for free wake up and say, “hey wait a minute, that new drug that made a gazillion dollars this year, they did that with my data; how do I get a piece of that action?”

It’s one thing to agree to contribute to research, it’s another to contribute to some big drug company’s corporate jet.   It would be awfully nice if Apple had figured out a way for those who contribute data to this incredible research effort also have a way of receiving royalties, or at least free iPhone minutes or iTunes downloads or 1 hour on the Merck corporate jet.

It’s a fair question. If your data contributes to a corporation’s profits, can you make a claim to some of those profits? When signed up for GlucoSuccess, I didn’t bother to read the lengthy forms the software displayed. I’ll bet I clicked a button that signed away any rights. But the larger question remains, should I be able to make a claim?

What do you think?



The lifetime cost of Type 2 diabetes in the United States is $283,000, making the U.S. the most expensive nation to live with the disease, according to research conducted by the University of East Anglia.

The research, led by Till Seuring, found that in high-income countries, like the U.S., the cost burden mainly falls on government or health insurance budgets.

But in low- and middle-income countries, a large part of the burden falls on the person with diabetes and their family due to very limited health insurance coverage, Seuring said. And two-thirds of new Type 2 diabetes cases are being reported in middle-income countries — such as Mexico, India, China and Egypt.

The UEA research was published in PharmacoEconomics, drawing on 109 studies assessing the economic effects of Type 2 diabetes around the world. Medical News Today reported on the study.

Said Seuring:

Our findings underline the fact that diabetes not only has strong adverse effects on people’s health but also presents a large – and at least partly avoidable – economic burden.

For both rich and poor countries, the results mean that better prevention and management of diabetes has the potential to not only bring good health but also economic gains.



Thoughts on the JDRF TypeOneNation Summit

Some random thoughts on the JDRF TypeOneNation Summit which was held in Maryland recently:

— An impressive number of people took part.

Something like 900 people were in attendance. It made me think that these kinds of conferences need to happen more often in smaller communities. Lots of good information was shared that needs to reach more people. It’s easy to imagine that the breakout session on Type 1 students deserves to be in every school district.

And the burden doesn’t have to fall on JDRF’s shoulders. We have enough advocates, vendors and health care providers who can take up the challenge to create a first-class effort in more communities.

— No media attended.

A few months ago, I would have been the editor who would have told the JDRF organizers that I didn’t have a spare reporter to send to a Saturday event. An alternative might have been to put more responsibility on bloggers and others who can put the word out on social media. The organizers encouraged tweeting, but there could have been more. Talking points, press releases, background material, photos … all the things that a member of the working press might expect. Bloggers can pick up the slack.

— Many of the salespeople were diabetics themselves.

At least four people from four different companies described how they used the products they were hawking, whether it was a CGM, insulin pump or insulin itself. (BTW, Novo Nordisk EchoPen looks awesome. It’s an insulin pen that remembers your last dose. I can’t tell you the number of times I’ve had to struggle to remember whether I remembered my Levemir.)

— Carb counts at lunch

The event was at the Montgomery County Convention Center, which is run by Marriott. The hotel thoughtfully supplied the carb counts for what they served. My only quibble was that the carb counts should have been at the front of the line, not the end.


Ban the cupcakes!

Boston pediatrician Claire McCarthy used to think that schools that banned cupcakes went too far. Nothing wrong with occasional sweets, she believed, so long as the rest of your diet was healthy. She’s come around

Now, I get that banning sweets from school parties or fundraisers or whatever isn’t going to make all parents feed their children healthy foods and thereby end childhood obesity. But it does force families to think together about alternatives — and gives kids a chance to eat healthy foods with their friends, which sometimes is exactly what’s needed to break through the resistance. And when kids bring in non-food treats like those tattoos, it reinforces the idea that celebrations don’t always have to include food (so un-American, but true).

My children are grown; it’s not my problem. But I think kids get enough junk food. Giving them one less opportunity — or several considering every student has a birthday — won’t deprive them.

From the blog, a great resource to learn about what doctors are thinking.