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As we predicted last December, 2015 saw the release of the Dexcom G4 Platinum with Share receiver, the Tandem t:slim G4 insulin pump, the Dexcom G5 Continuous Glucose Monitoring System, the Medtronic 640G with SmartGuard in Europe, and two novel new insulins (both from Sanofi) – Afrezza inhalable short-acting and Toujeo basal insulin. Looking ahead to 2016, we’re optimistic about these seven diabetes products potentially hitting the market in the next 12 months. At the ADA Scientific Sessions in Boston this June, Insulet teased the crowd with a first look at the next generation controller for their popular patch insulin pump, the Phoenix PDM (Personal Diabetes Manager). The Freestyle Libre (consumer version) and Libre Pro (professional HCP-use version) might flash their way stateside in 2016.
Libre’s appearance in the Freestyle pipeline follows Abbott’s long commitment toward out-of-the-box calibration and this author believes it serves as an important proof of concept toward their next generation continuous glucose sensors. While Abbott has been tight-lipped about progress to bring Libre to the United States, we do know that the Libre Pro has been submitted to the FDA for potential launch in 2016. The Minimed 640G insulin pump may come to the States by end-of-year 2016, as Medtronic says they plan to submit to FDA early in the new year. The pivotal trial in the States was completed with Medtronic’s fourth generation sensor (the third in the Enlite series) and they submitted specs to the FCC in February for a transmitter designed specifically for the 600 series pumps (of which 670G will be the next in their pipeline), so we expect to see Medtronic skip the Enlite 2 here in the U.S. It wouldn’t be the end of a fiscal year without some speculation on what Dexcom has up its sleeves. Still, we know that Dexcom surprises even themselves with how quickly they can get product approved and rolled out to customers, with the original G4 Platinum approved within 90 days of submission to FDA. Novo Nordisk has another game-changer up its sleeve, as well, having announced just last week that an NDA has been filed for a newer, speedier version of Novolog (insulin aspart) for treatment of type 1 and type 2 diabetes. Another insulin coming to us in 2016 is Lilly’s new basal insulin, Basaglar – a form of insulin glargine (which you may recognize if you’re familiar with Lantus).
In October, we were thrilled to learn that Eli Lilly & Company acquired the rights to Montreal-based Locemia’s novel nasal glucagon. So other than the omnipod is there any other tubeless insulin pump on the market right now? The Diabetes Media Foundation is a 501(c)(3) tax-exempt nonprofit media organization devoted to informing, educating, and generating community around living a healthy life with diabetes.
The fine flour ground from dried coconut flesh is high in fiber and protein, low in carbohydrates, and gluten free.  According to writer, popular blogger, and personal chef Erica Kerwien, the flour can be used in a variety of foods and has many health benefits.
As a person with Type 1 diabetes and celiac disease, Kerwien’s cookbook appealed to me for health reasons. Kerwien started experimenting with alternative carbohydrates in the early 2000s, when her young son became ill and before he was diagnosed with Crohn’s disease in 2005. Like her SCD cookbook, Kerwien’s Healthy Coconut Flour Cookbook offers a variety of recipes that cover meals, snacks, and sweets. As I put the cake pan in the oven and watched the baking through the window, I was a little worried.
Other recipes I am eager to try are Scallion Pancakes with Soy Ginger Sauce, Cake Brownies, Garlic-Cauliflower Breadsticks, and Matzo Ball Soup.
There are several recipes here in the “Breads” category: flatbread, cornbread, tortillas, and biscuits.
Kerwien has tested “tricky or more complicated recipes with readers to make sure a recipe is reliable.” Even though ingredients and techniques may be new – a dairy-free Vanilla Creme frosting is made from soaked cashews and Medjool dates – readers are in Kerwien’s good hands. The book is thoughtfully written and designed, the recipes are tested and doable, and the food is good for your health and your palate.
An international consortium of university researchers has produced the most comprehensive virtual reconstruction of human metabolism to date. Scientists could use the model, known as Recon 2, to identify causes of and new treatments for diseases like cancer, diabetes and even psychiatric and neurodegenerative disorders. Doctors have long recognized the importance of metabolic imbalances as an underlying cause of disease, but scientists have been ramping up their research on the connection as a result of compelling evidence enabled by the Human Genome Project and advances in systems biology, which leverages the power of high-powered computing to build vast interactive databases of biological information. He likened Recon 2 to Google mapping for its ability to merge complex details into a single, interactive map.
This is similar to how you can get a street view of a single house or zoom out to see how the house fits into the whole neighborhood, city, state, country and globe. As a multi-scale representation of the human metabolic network, Recon 2 provides essential context for data being reviewed by researchers. One of the most promising applications for the network reconstruction is the ability to identify specific gene expressions and their metabolic pathways for targeted drug delivery. Recon 2 allows researchers to use this existing gene expression data and knowledge of the entire metabolic network to figure how certain drugs would affect specific metabolic pathways found to create the conditions for cancerous cell growth, for example. Recon 2 is already proving its utility, according to Ines Thiele, a professor at the University of Iceland and UC San Diego alumna, who led the Recon 2 effort.
Thiele said Recon 2 accounts for almost 1,800 genes of an estimated 20,000 protein-coding genes in the human genome. Before we monetize virtually every dashed and solid line on there, legalize the healing plantz first?
March 6, 2013 by de Broglie It is interesting because you can identify something wrong and then study the chart to look at the different ways that something in wrong. March 6, 2013 by trakk Innovation that leads to more innovations.
March 6, 2013 by melajara This is the kind of semi structured data to feed Watson with. Humans will be at a loss drowning in this ocean of data but Watson could pinpoint regularities and make human understandable summaries of metabolic profiles to be linked with the prevalence of some pathologies. Besides, for Watson, it would be a step in the right direction for a deeper understanding of biology.
March 6, 2013 by humanitarian This is by far a fantastic opportunity to detect disease at its infancy, and provide treatment early so that vast expenses and suffering can be mitigated. The Kurzweil Accelerating Intelligence newsletter concisely covers relevant major science and technology breakthroughs (daily or weekly) via e-mail. Daily use of deep penetrating exfoliating skincare, containing alpha hydroxyl or beta hydroxyl acids (i.e. Skin Peels draw impurities out of the skin, resulting in possible breakouts, but this is a good sign of the skin clearing itself out. The milia can be lanced with either an electrolysis needle or a micro lance needle, which will pierce an opening. Those with oily skin can sometimes use some very harsh drying products, to help dry up excess oil, resulting in dehydrated areas of skin. A welcoming atmosphere from the moment you walk in.Every staff member i encountered was both friendly and accommodating. My therapis was excellent very friendly and professional im delighted with my manicure and pedicure and would definitely book her again.
Treatment was calming and conforting, gave me the feeling that for the duration of the treatment I was the only person in her world. A new survey reveals that many Hispanics are aware that diabetes is dangerous, but compared to non-Hispanics, they are poorly informed about how to best treat the disease. Additionally, the survey showed that compared to non-Hispanic blacks and whites with diabetes, Hispanics with diabetes are more likely to be worried that, besides themselves, someone in their family would develop diabetes.
The findings of the survey are crucial because Hispanics are more than twice as likely as non-Hispanics to develop diabetes, Delgado says.
The survey was conducted by the National Alliance for Hispanic Health, a science-based nonprofit organization that since 1973 has focused on improving the health and well being of Hispanic Americans.


Delgado says the survey raises awareness that there is an information gap when it comes to effectively informing Hispanics about how to properly and effectively treat and manage diabetes.
For instance, Drago points out that Hispanics are generally more concerned that family members might have diabetes rather than whether they have diabetes because family tends to be culturally more important to Hispanics than non-Hispanics. There are other cultural reasons why Hispanics with diabetes generally lack the proper tools to take better care of themselves, according to Delgado. Further complicating the issue of how to effectively communicate the need for better care is that not all Hispanics are from a single culture.
Salmun says while the survey will assist in helping to better understand Hispanics and their relationship to diabetes so better communications can be crafted, it’s only a step—and a rare step at that. Delgado agrees, and points out that it was only in 1989 that the national model for a death certificate initiated a designation for Hispanics under race. The previously approved G4 Platinum System is for insertion of the sensor in the abdomen only.
The device system components (sensor and transmitter) are unmodified from the previous system. Before the approval, the FDA reviewed data from a pivotal clinical study of in-clinic and home-use patients to assess the accuracy and precision of the system. The pivotal clinical study demonstrated that the G4 Platinum (Pediatric) System performance in pediatric subjects was not as accurate as the performance of the same device in adults. In a pediatric clinical study, larger differences were observed between this CGM device and actual blood glucose values compared to those differences observed in the adult clinical study. In a pediatric clinical study, a significant number of low glucose events were not detected by CGM. Research on CGMs is underway as part of a developmental artificial pancreas device system (APDS) for people with type 1 diabetes, a device that includes a CGM and an insulin pump. Also launched in 2015 were Eli Lilly’s Trulicity GLP-1 agonist and Novo Nordisk’s Tresiba basal insulin. The chunky plastic PDM controllers we saw in the UST200 and UST400 models will give way to a sleek, sexy color touchscreen interface.
The first of its kind, the Libre is a factory-calibrated flash system, which means that, rather than continuous display of interstitial glucose readings, the user wears a small sensor in the skin beneath a flat, round, white, disc-shaped transmitter and carries (in the consumer version) a small device that the person can use to scan the sensor and display a reading at any time.
The Pro version is meant to be used by health care providers to collect glucose data – which is blinded to the patient – for analysis and treatment changes and would have an easier pathway for reimbursement than the consumer version.
This is the most revolutionary change in design we’ve seen from Medtronic, with a whole new colored user interface, new buttons, and a portrait orientation – shifting the long-standing insulin pump paradigm from pager to smartphone. If 2015 was the year of the Dex – with two integrated pump partners (Tandem and Animas) and two new products (G4 Platinum with Share and G5), then 2016 is going to be about their building capacity for what’s to come. In the meantime, we expect to see a new insertion device for their sensors and hope to learn more about the G5 strengths and opportunities as the long line of customers waiting for Santa Claus to bring them their G5 systems unwrap those tech goodies. Sanofi filed for New Drug Appliaction (NDA) with FDA for its GLP-1 agonist Lyxumia (lixisenatide) in September 2015.
Novo Nordisk’s Xultophy, a combination of their commercially successful GLP-1 agonist Victoza and their brand new basal insulin Tresiba, also had its NDA put in front of FDA in September and will likely beat Lixilan to market. According to their press release, the “faster-acting insulin aspart contains a short-acting insulin and two well-known excipients, a vitamin and an amino acid, to increase the initial absorption rate and an earlier blood sugar lowering effect.” What does this mean for people with diabetes? Easy to carry, easy to dose, easy to implement, nasal glucagon will do for people with diabetes what the Auvi-Q has done for people with allergies – make a life-saving, every-second-counts emergency treatment fairly fool-proof to administer. I love my G5 and need to replace my old Minimed with something that has G5 integration as soon as a pump comes on the market that allows that.
It’s better for blood sugar and weight maintenance because of high fiber content, and it’s suitable for grain- and gluten-free diets.  In Kerwien’s new cookbook, The Healthy Coconut Flour Cookbook (Fair Winds Press, 2014), coconut flour is featured in recipes for cakes, cookies, and brownies, for sure, and also crepes, flatbread pizza, shepherd’s pie, and Mexican lasagna.
I want to eat well and diversely while counting my carbohydrates and avoiding grains with gluten. In an e-mail interview, she reported that, before her son’s illness, she had “always loved to bake and cook, but didn’t spend much time doing so… beyond salads, pasta, and brownies.” Changing her and her son’s diet to the Specific Carbohydrate Diet (SCD) was “a huge paradigm shift” for her. The presence of local strawberries in the market prompted a craving for a shortcake-type dessert. It seemed wetter than regular batter, and, indeed, the measure of coconut flour (just ? cup), as compared to the measure of other ingredients, was small. Kerwien’s aim in developing recipes for baked goods, she told me, is to “make it have great taste and texture in its own right, possibly even better.” One of my family members, who enjoyed the cake, called it “tasty and different” and “not sugary in a cake kind of way,” although I found it sweet enough. Both coconut and almond flour are used to coat the chicken before sauteing in oil and butter. The pictures and Kerwien’s commentary entice.  For these and all the recipes, she suggests additions (frosting for the brownies!), side dishes, and substitutions. What’s missing is a sandwich bread or roll, and Kerwien admitted in the interview that “good bread is hard to replicate, and even harder is a good bagel.” People who love sandwiches may want, therefore, to bake her tortillas or flatbreads. The Healthy Coconut Flour Cookbook has an internal coherence to it, and a staple recipe may be tweaked for variety or even used in a more complex recipe as a base. Each person’s metabolism, which represents the conversion of food sources into energy and the assembly of molecules, is determined by genetics, environment and nutrition. This is essential to understanding where and how specific metabolic pathways go off track to create disease,” said Bernhard Palsson, Galletti Professor of Bioengineering at UC San Diego Jacobs School of Engineering.
For example, researchers looking at how metabolism sets the stage for cancerous tumor growth could zoom in on the “map” for finely detailed images of individual metabolic reactions or zoom out to look at patterns and relationships among pathways or different sectors of metabolism. Palsson and other scientists in the field have already successfully demonstrated the utility of such models in simple organisms such as yeast and E.coli.
Large gene expression databases are available for human cells that have been treated with molecules extracted from existing drugs as well as drugs that are in development. They could then conduct virtual experiments to see whether the drug can fix the metabolic imbalance causing the disease. Thiele said Recon 2 has successfully predicted alterations in metabolism that are currently used to diagnose certain inherited metabolic diseases. Instead they accumulate on the top of the skin as well as deep within the pores, trapping the natural oil secretions of the skin (sebum), causing a blocked pore. I had the Island journey package which was superb, my skin feels rehyrdrated and smooth and the back massage was exceptional. The survey may reveal ways to enact more effective communication tools to better inform Hispanics about improving their diabetes care. She was surprised to discover that many of the messages about diabetes prevention that stress the dangers of suffering from diabetic complications, such as kidney failure and glaucoma, more often repelled Hispanics than motivated them to take better care of themselves if they already had diabetes. Fifty percent of Hispanics in the United States are from Mexico, Drago says, while forty percent are from other countries. FDA has approved the expanded use of the Dexcom G4 Platinum Continuous Glucose Monitoring System for patients with diabetes ages 2 to 17 years. The new Dexcom G4 Platinum (Pediatric) System includes the upper buttock in addition to the abdomen as sensor insertion sites. One hundred and seventy-six patients ages 2 to 17 wore the G4 Platinum (Pediatric) sensor for seven days (168 hours).
In addition, the performance of the hypoglycemic detection alert in the pediatric study was poor relative to that seen in the adult study, particularly at blood glucose concentrations below 70 milligrams per deciliter of blood. An artificial pancreas system would monitor glucose levels and automatically pump the appropriate amount of insulin as determined by a computer algorithm. As for Libre for home use, we’re still betting here on 2017, though the pivotal study of Libre in the United States was completed in March 2015.


Xultophy is already approved in Europe, but was held up here until its Tresiba component could be approved.
As stated in the FDA press release, “Basaglar is the first insulin product approved through an abbreviated approval pathway” because it is “sufficiently similar to Lantus to justify reliance.” Lantus’s patent expired in 2015 and it will be interesting to watch glargine’s progress under a competing label. Locemia had said they planned to submit to FDA in late 2015, early 2016, so it’s our best guess that Lilly might follow a similar timeline. Her cookbook’s attractive design and photography promised more — delightful, tasty, and even beautiful food.
For a recent occasion, I made the Yellow Cake recipe and served it with whipped cream and berries as recommended.
When I made the Yellow Cake, I followed her advice for reducing carbohydrates even more by replacing maple syrup with Stevia as sweetener. As a result, they have been able to engineer these organisms in the lab to improve the efficiency of ethanol production and predict drug resistance in bacteria. It is made up of dead skin cells from the lining of the pore that is mixed with sebum produced by the oil gland. They can be caused by products that are too rich for the skin, oily make up and lack of exfoliation.
Avoid cleansers & moisturisers containing mineral oil (parafinum liquidum) and lanolin. It is very important for those with naturally oily skin not to use products for dry skin when some dry flaky patches appear; this is a common mistake that is made. With 6 month old twins I needed a quick boost and chance to unwind and that’s exactly what I got.
And Dexcom G4 PLATINUM (Pediatric) is the first CGM device approved for persons with diabetes in the 2-6 age-range and the only CGM device that offers an alternate sensor wear site on the upper buttocks for added flexibility. This may affect any part of the body but usually affects the peripheral extremities like feet, toes, fingers, hands, penis etc. Though the Phoenix will be Bluetooth-enabled, this PDM will not yet be integrated with the Dexcom G5, though we should see that product quickly on its coattails given that value-added capability.
Abbott has not historically had the kind of smooth, fast-track relationship with FDA that companies like Dexcom have mastered. We expect to see all three of these GLP-1 drugs available in pharmacies by next year’s end. Another note of interest is that Basaglar is not approved as a biosimilar product, as the manufacturer must actually apply for biosimilarity through a specific application process. The recipe was simple to follow, with only eight ingredients and all of them common ones but for the coconut flour. My family found it delicious and far more delicate than the breaded chicken piccata often served in restaurants or prepared at home with chicken breasts dredged in egg and flour.
As Merck and other companies prepare for a rollout of their own forms of insulin glargine in the coming years, we hope that choice in basal insulin therapy will increase for patients and that prices…perhaps…decrease. I just wish tandem would get the dual chamber pump out so people can have better control of there sugars. In her “Baking Tips” section, Kerwien explains that coconut flour is a hydrocolloid, “absorbing moisture and binding ingredients together.” This may explain what I noticed as a wet look, and other bakers should anticipate that the experience of using coconut flour in recipes would be different from using wheat and other grain flours. Extra hydration can be added without adding oil by using the ingredient hyaluronic acid in a serum. According to estimates from Diabetes UK, those with diabetes are fifteen times more likely to require a major amputation of a limb commonly due to gangrene compared to the general population. In the UK around 5,000 people with diabetes have an amputation as a result of gangrene annually. The area first becomes red and then gets discoloured to brown and may finally become black. This will be sent to a laboratory for testing to find out whether your ear infection is caused by a bacterial or fungal infection.
These are usually prescribed as ear drops but your GP may prescribe tablets if you have widespread infection or you’re at risk of having a severe infection. This is called internal gangrene and may affect the gall bladder or the intestines trapped within a hernia. You may need to have your ear cleaned and any discharge or wax removed by your doctor or nurse before using ear drops to treat an infection.
You may be asked to lie down or tilt you head to the side with your affected ear facing upwards when you use ear drops. Sometimes, it’s advised to keep still for ten minutes after using ear drops or a spray.
These may usually be administered as injections for more rapid action and may be followed up with oral antibiotic pills once the gangrene shows signs of healing. A healthy diet, regular exercise and stoppage of smoking may go a long way in prevention of gangrene.
In both types of diabetes long term high blood sugar damages the small arteries and blood vessels that supply the end parts of the body like fingers and toes. In the peripheries like toes and fingers this leads to decrease in the blood vessel diameters by narrowing of the lumen. There is excessive swelling of the affected part due to release of the toxins from the invading bacteria. This may be of three further types: traumatic gas gangrene occurring after injury non-traumatic gas gangrene recurrent gas gangrene caused by C. This bacteria attacks the soft tissue and the fascia, which is a sheath of tissue covering the muscle. NF can occur in an extremity following a minor trauma, or after some other type of opportunity for the bacteria to enter the body such as surgery. Trying to remove ear wax yourself can also cause an ear infection, as you may damage the skin of your ear canal.
Because of potential complications, it is important to diagnose the disease process as early as possible Although antibiotics and aggressive debridement have been broadly accepted as the standard treatment, the death rate remains high.(5) Meleney's synergistic gangrene This is a rare type seen in patients after surgery. One of the identifying symptoms is the presence of extremely painful lesions, which usually form in the second week after surgery or minor trauma. Ear syringing itself carries a risk of ear infection and isn’t recommended as a treatment if your ear canal has been previously inflamed or damaged.
Blood also carries nutrients, such as glucose, amino acids, and fatty acids essential for the normal functioning of the tissues. This makes them less sensitive to small injuries that may leave open sores prone to infections. These people include: those with HIV AIDS those with cancer and on chemotherapy and radiotherapy smokers long term alcoholics long term drug abusers diabetics those with severe malnutrition or deficient diets elderly obese the overweight those with long term end stage kidney disease Causes of gas gangrene Gas gangrene was a common occurrence until the middle of the 20th century when war injuries were exposed to spores containing the causative bacteria present in soil. During the Civil War in the USA nearly half of the soldiers receiving gunshot wounds developed infection with many progressing to gas gangrene. Gas gangrene has become uncommon in modern warfare due to better surgical management and treatment. This is seen in those who have sustained an injury with a blunt instrument, after child birth, long term intravenous drug abuse or penetrating injury such as caused by a laceration or a surgical procedure.




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Comments

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