A few days ago an Accu-Chek Aviva blood glucose meter arrived in my mail. The meter itself was nothing new. Three years ago when Roche Diabetes Care introduced the Aviva I wrote a glowing review of it, appropriately titled “Viva Aviva!“

What is new is the smallest item in all those papers that accompany a new meter nowadays. It’s a wallet-sized card that Roche calls the Accu-Chek Connect.

This is one powerful little card! For some people it means that we don’t have to pay more than $15 for each prescription we get for Accu-Chek Aviva test strips.

The Front of the Discount Card

The Back of that Card

[Read more →]

Today people who have diabetes can be thankful that the United States doesn’t have a single-payer health care system. Based on two Canadian studies released today, most of us could face the prospect that our health insurance would soon cease to cover the cost of testing with blood glucose strips.

The studies both proposed that Canada could save money by cutting benefits to people with type 2 diabetes who are using drugs other than insulin. Last year 63 percent of people with diabetes in the province of Ontario who weren’t using insulin used on average 1.29 test strips per day. Although many of us would say that’s too little, one of the studies concluded that it’s too much.

The Canadian Medical Association Journal CMAJ on December 21 released these studies subject to revision. You can read the full-text of one study at “Blood glucose test strips: options to reduce usage.” The full-text of the other new study is at “Cost-effectiveness of self-monitoring of blood glucose in patients with type 2 diabetes mellitus managed without insulin.”

Each article recognizes that those of us who inject insulin have to test regularly to avoid hypos, if for no other reason. All type 1s and about one-fourth of type 2s inject insulin. [Read more →]

If we can easily test our blood glucose and cholesterol levels, why can’t we test the level of omega 3 fatty acids in our blood? Nothing — not cholesterol or even C-reactive protein levels — is better at predicting sudden cardiac death, which still causes about 60 percent of cardiac disease death in the United States, according to an analysis by Centers for Disease Control researchers.

For years this lack of an omega 3 blood test puzzled me. No more. It has finally arrived.

The HS-Omega-3 Index uses a standardized methodology to measure the percentage of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) in red blood cells. It also measures the ratio of omega 3 to omega 6.

Some cold water fish like salmon, mackerel, herring, albacore tuna, and sardines have a lot of this healthy omega 3 fat. I follow the standard recommendation to eat one of these fish at least twice a week. I supplement my fish with krill oil capsules for even more omega 3. [Read more →]

We now have a test that can determine hidden risks of heart attack and stroke. It’s called the PLAC Test and is the only blood test that the U.S. Food and Drug Administration has approved.

The PLAC test helps us identify hidden risks for heart attack and stroke by measuring for Lp-PLA2. This is the cardiovascular-specific inflammatory enzyme implicated in the formation of vulnerable, rupture-prone plaque.

The conditions that this test helps to identify are two of the country’s three most serious health problems. The American Heart Association estimates that at least 65 percent of people with diabetes will die from a cardiovascular event, such as a heart attack or stroke.

Fortunately, we have a simple blood test that goes beyond traditional risk factors to help identify those of us at increased risk of heart disease and stroke. ThePLAC Test, developed by diaDexus Inc. in South San Francisco, can help us assess our risk for both conditions.

Lp-PLA2 is an enzyme in the blood primarily associated with low-density lipoprotein (LDL, the “bad” cholesterol). LDL carries Lp-PLA2 to the walls of coronary arteries. There the enzyme can activate an inflammatory response, making plaque more prone to rupture. [Read more →]

One of the biggest complaints about the American health care system is tests that are both expensive and needless. This is a report from the front lines of one expensive test that saved me from lots of grief.

I’m almost 500 miles from my home in Boulder, Colorado, passing through the little Southwestern Colorado town of Durango. Fewer than 20,000 people live here, and I didn’t know any of them.

But I had a stomach ache that started at dinner Wednesday. By midnight I was feeling bad enough that I looked in the Yellow Pages for a 24-hour pharmacy where I could buy an antacid. I struck out.

Reluctantly, I realized that the only place I could buy something that would counteract stomach acidity was the local urgent care facility or hospital emergency room. So back to the Yellow Pages I went. Since the local urgent care closed at 7 p.m. my only choice seemed to be going to a hospital. [Read more →]

When Roche Diabetes Care invited 29 of us who write about diabetes to “Social Media Summit” last week, some of us had the opportunity to visit their factory in Indianapolis that produces Aviva test strips. I toured the factory with Bryan Langford, the director of the product supply team for Roche Diagnostics Operations.

The Accu-Chek Aviva is the only meter and strip combination manufactured in America. Roche makes the Aviva meter in Huntsville, Alabama. Roche built the Indianapolis plant a couple of years before the company launched the Aviva in July 2005.

The other meter that Roche currently markets here is the Accu-Chek Compact Plus. Roche manufactures the test strips for that meter in Germany and manufactures the Accu-Chek Compact Plus meters in Ireland. [Read more →]

Roche Diabetes Care this week took a bold and potentially dangerous step into the unknown. This leading manufacturer of blood glucose meters invited 29 of us who write about diabetes to what they called the “Social Media Summit.” During the past 14 years that I have specialized in writing about diabetes no other diabetes company had ever reached out to us.

When my invitation first arrived, I didn’t recognize the term “social media.” I now understand it to mean bloggers and other patient advocates, like me, who write about diabetes.

On Wednesday and Thursday we met with top company executives at Roche’s North American headquarters in Indianapolis, Indiana. Luc Vierstrate, Roche’s Senior Vice President and General Manager of Roche Diabetes Care North America, kicked off the event over dinner Wednesday. Roche executives turned out in force, probably outnumbering those of us who write about diabetes. At dinner I sat between the medical director and the vice president of sales, each of whom have type 1 diabetes. [Read more →]

The U.S. Food and Drug Administration is finally planning to require that our blood glucose meters will meet high standards of accuracy and precision.

Dr. Margaret Hamburg, the new head of the FDA, recently wrote the American Association of Clinical Endocrinologists, or AACE, that the agency is pressing the International Organization for Standardization, or ISO, to set higher standards of accuracy and precision. “If the ISO standard for accuracy is not revised, the agency…may instead recognize other (higher) performance standards for SMBG [self monitoring blood glucose] devices for management of diabetes,” according to a letter and attachment that she sent to AACE President Dr. Jeffrey Garber, and past presidents Drs. Daniel Duick and Richard Hellman. Dr. Hamburg’s letter was a positive response to a formal request that the AACE made to the FDA in May.

Anyone who has ever tested his or her blood glucose for more than a month or so must be appalled at how inaccurate our blood glucose meters are. In the past ten years or so I must have written a dozen articles pointing out how bad they are.

The FDA didn’t tip its hand yet by putting in writing to the AACE just what new standards it plans to require. But the agency did drop a hint.

About half of the last 31 blood glucose meters that the FDA approved for sale in the U.S. would meet performance standards within 10 mg/dl, when reading should be less than 75 mg/dl, and withing 15 mg/dl, when the reading should be above 75 mg/dl, according to the attachment Dr. Hamburg sent Dr.Garber. The FDA recognizes that when our blood glucose levels are below 75 mg/dl, accuracy becomes even more important.

This morning’s New York Times reported this big news for all of us with diabetes. Even though I subscribe to the print edition, I was out hiking in the Rockies today and haven’t read the paper yet. Thanks to two of my favorite diabetes professionals, Certified Diabetes Educator Karen LaVine and Dr. Richard K. Bernstein, for emailing me the link to that article. This is such good news that I needed to write about it today.

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

Dental disease is a wake-up call that your diet is harming your body, concludes Dr. Philippe P. Hujoel. He reviewed the two hypotheses about whether or not dental disease is a warning that we are headed toward chronic system illness. After examining all the evidence, he concludes that it is.

“The five-alarm fire bell of a tooth ache is difficult to ignore,” Dr. Hujoel told me. He is professor of dental public health sciences at the University of Washington School of Dentistry in Seattle.

But we do tend to ignore it.

He lays the blame squarely at the feet of Ancel Keys and his believers. Dr. Keys promulgated the lipid hypothesis and focused on excess fat intake as the primary cause of systemic chronic non-communicable diseases — like diabetes. For Dr. Keys a healthy diet consisted of increasing our intake of “fermentable carbohydrates.” [Read more →]