Diabetes Self-Management Articles

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New Tools 2008

by Diane Fennell

The management of diabetes requires a certain amount of paraphernalia: A meter, lancing device, lancets, and test strips, for a start, and some people use many more devices and supplies than just these. Each year, product manufacturers work on developing both new technologies and devices for better diabetes control and refinements to existing technologies and devices. This year saw the arrival of a number of highly anticipated products, including an electronic lancing device and a new continuous glucose monitoring system, as well as the introduction of several tried-and-true tools newly equipped with innovative technology.

Lancing device

Product: Pelikan Sun electronic lancing device

Manufacturer: Pelikan Technologies, Inc.
(877) PELIKAN (735-4526)
www.pelikansun.com

What it does: The electronic Pelikan Sun lancing device incorporates a 50-lancet disk that automatically uses a new lancet for each blood glucose check; the user never has to see or handle a lancet. The device features 30 settings for depth, speed, and “dwell time” (the length of time the lancet spends in the finger), which can be customized for each finger. According to the manufacturer, the Pelikan Sun’s use of electronics, rather than a spring-loaded mechanism, to control the lancing process results in significantly less pain, smoother penetration and retraction of the lancet, spontaneous blood flow (meaning that the finger does not need to be “milked”), a quicker stoppage of bleeding, and quick healing of the lancing site. Additional benefits of the Pelikan Sun include the healing of bruised and calloused fingertips and improved sensation in the fingers.

Availability: The Pelikan Sun lancing device, a protective case for the device, lancet disks, and a carrying case for the extra lancet disks can all be purchased by creating a free account at www.pelikansun.com and clicking on “How to buy.”

Blood glucose meters

Product: Clever Chek Auto-Code Voice

Manufacturer: Simple Diagnostics
(877) DIABETK (342-2385)
www.simplediagnostics.com

What it does: A meter option for people who are blind or have limited vision, the Clever Chek Auto-Code Voice is a no-coding meter that has a large display and provides spoken instructions and blood glucose readings in either English or Spanish. A repeat function allows the user to view and hear up to 450 blood glucose results.

This meter requires a 0.7-microliter blood sample from the fingertips, palms, forearms, upper arms, thighs, or calves, and it returns results in 7 seconds. If the meter registers a blood glucose result above 240 mg/dl, it warns the user to check for ketones. Up to 450 readings can be held in the memory, and the meter can calculate blood glucose averages for 7-, 14-, 21-, 28-, 60-, and 90-day periods. Additionally, data can be uploaded and analyzed on a computer using free software available on the company Web site and a standard USB computer cable, available in most computer supply stores.

Availability: The Clever Chek Auto-Code Voice is available from retailers nationwide.


Companion talking meter

Product: Companion

Manufacturer: Omnis Health, LLC
www.omnishealth.com

What it does: Another option in the expanding realm of talking blood glucose meters, the Companion features a large display screen and an optional setting that provides audible instructions and blood glucose readings in English or Spanish. The meter, which is coded using a code chip, requires a 1.1-microliter blood sample from the fingertip, palm, or forearm, and returns results in 6 seconds. Up to 300 results can be stored in the memory and averaging is available for 7-, 14-, and 30-day periods. The Companion is covered by a lifetime warranty.

Availability: The Companion is available from various suppliers of durable medical equipment, including American Diabetic Supplies and Diabetes Care Club.


 Element meter

Product: Element

Manufacturer: Infopia USA
(877) 936-2363
www.infopiausa.com

What it does: The newest offering from Infopia USA, the Element is a no-coding meter that features a test strip ejector (meaning that used strips do not need to be handled after a blood glucose check) and that allows the user to mark blood glucose results that were taken after eating or physical activity. (This can be useful when assessing the effects of food choices and exercise on blood glucose levels.) The meter requires a 0.3-microliter drop of blood, takes 3 seconds to return results, and can be set with five optional reminder alarms. Up to 365 readings can be held in the Element’s memory, and the meter is set with a default for averaging 7-, 14-, and 21-day periods; the user can reset the meter to calculate averages for three customized time periods between 1 and 99 days.

The Element is compatible with the Eocone, Infopia’s data uploading and management system (a device that transmits information from the meter to a central online database that can be accessed by the user and health-care providers), using a cable available separately. Information from the meter can also be uploaded to a computer for analysis using a standard USB cable and software available for download from www.infopiausa.com.

Availability: The Element is currently available from various mail-order and durable medical equipment suppliers.


Embrace talking meter

Product: Embrace

Manufacturer: Omnis Health, LLC
www.omnishealth.com

What it does: Featuring a slimmer, more discreet case than the Companion, its sister meter, the Embrace is a talking meter that can provide audible instructions and blood glucose results in English or Spanish. The meter, which requires a 1.1-microliter blood drop from the fingertip, palm, or forearm, is coded via a code chip and returns results in 6 seconds. The Embrace can hold 300 results in its memory and can calculate averages for 7-, 14-, and 30-day periods. The meter is covered by a lifetime warranty.

Availability: The Embrace is available from various independent pharmacies.


 Evolution meter

Product: Evolution

Manufacturer: Infopia USA
(877) 936-2363
www.infopiausa.com

What it does: The Evolution is an automatic-coding blood glucose meter that allows users to tag blood glucose readings with meal and activity markers, making it easier to determine how food choices and exercise affect blood glucose levels.

Evolution, which is compatible with Infopia USA’s Eocene data uploading system by means of a separately available cable, requires a 0.3-microliter blood drop and returns results in 3 seconds. The meter features automatic ejection of test strips so that used strips need not be touched. Evolution has five optional alarms and can store 365 blood glucose readings in its memory. Averaging is available for 7-, 14-, and 21-day periods; the meter can also calculate averages for three time periods chosen by the user.

Data from the Evolution can be uploaded to a computer and analyzed using a standard USB cable and software available at www.infopiausa.com.

Availability: The Evolution is currently available from mail-order and durable medical equipment suppliers.


FreeStyle Freedom Lite meter

Product: FreeStyle Freedom Lite Blood Glucose Monitoring System

Manufacturer: Abbott Laboratories
(888) 522-5226
www.abbottdiabetescare.com

What it does: Building on the platform of the FreeStyle Lite Blood Glucose Monitoring System, the FreeStyle Freedom Lite system is a small, no-coding blood glucose meter that features an easy-to-read display and large buttons incorporated into an easy-to-hold design. The meter has a highly visible yellow test strip port to make strip insertion easier and is compatible with FreeStyle Lite test strips, which require a 0.3-microliter drop of blood. The blood sample can be obtained from the fingertips, hands, upper arms, forearms, thighs, or calves, and results are returned in roughly 5 seconds. Averaging is available for 7-, 14-, and 30-day periods, and up to 400 results can be stored in the meter’s memory. Either the PC Link 2.6 data management software or the Co-Pilot Health Management System Version 3.1, both available separately, can be used to upload and analyze monitoring results on a computer.

Availability: The FreeStyle Freedom Lite is available at pharmacies nationwide.


Glucocard X-Meter

Product: Glucocard X-Meter

Manufacturer: Arkray
(800) 818-8877
www.glucocardusa.com

What it does: The Glucocard X-Meter, an affordably priced, no-code meter, requires a 0.3-microliter blood drop, which can be drawn from the fingertip, forearm, upper arm, or palm. The meter is designed to allow “double-dosing,” meaning that blood can be applied to the test strip a second time if the first blood sample is not large enough. Readings are returned in 5 seconds, and the meter can hold up to 360 results. The meter can average blood glucose readings over 14- and 30-day periods.

Availability: The Glucocard X-Meter is available from many online retail stores.


Maxima meter

Product: Maxima Blood Glucose Monitoring System

Manufacturer: US Diagnostics
(866) 216-5308
www.usdiagnostics.net

What it does: The Maxima’s 0.5-microliter blood sample, which can be drawn from the fingertips, forearms, calves, thighs, or palms, is the smallest blood sample required by any meter in the US Diagnostics line. This meter can provide averages for periods from 14 to 90 days, and the memory has a capacity of 250 readings. Results can be transferred to a computer with a cable, sold separately, and analyzed with the US Diagnostics software program, scheduled to be available by the end of 2008.

The Maxima Blood Glucose Monitoring System is backed up by a lifetime warranty.

Availability: The Maxima Blood Glucose Monitoring System was released in October 2007 and is available from select pharmacies, online retailers, and mail-order distributors.


 OneTouch UltraLink meter

Product: OneTouch UltraLink

Manufacturer: LifeScan, Inc.
(800) 227-8862
www.lifescan.com

What it does: The newest addition to the OneTouch line of blood glucose meters, the OneTouch UltraLink can wirelessly communicate monitoring results to either Medtonic’s MiniMed Paradigm REAL-Time System or its Guardian REAL-Time System (both of them continuous glucose monitoring systems). The meter requires a blood sample size of 1 microliter, can use blood samples from the fingertips, palms, or forearms, and returns results in 5 seconds. Readings can be flagged as before- or after-meal, and averages for these categories can be calculated, which may be helpful for determining how food choices affect blood glucose levels. The meter can store up to 500 results in its memory, and averages for 7-, 14-, and 30-day periods are available. Information can be uploaded to a computer and analyzed using either Medtronic’s CareLink Personal Software or LifeScan’s OneTouch Diabetes Management Software.

Availability: The OneTouch UltraLink is currently available to Medtronic Diabetes customers.


 Prodigy Voice meter

Product: Prodigy Voice

Manufacturer: Diagnostic Devices, Inc.
(800) 366-5901
www.prodigymeter.com

What it does: The recipient of the National Federation of the Blind’s Access Plus Award, the Prodigy Voice has a number of features designed specially for people who are blind or have limited sight, including audible instructions, readings, memory records, and averages; a repeat button that allows the user to replay a message or blood glucose result; and buttons that can be identified by touch. The no-code meter, which is equipped with an earphone jack that can be used for listening to messages privately, automatically turns on when a test strip is inserted and has an eject button for expelling used test strips. The Prodigy Voice requires a 0.6-microliter blood drop from the fingertip, palm, forearm, upper arm, thigh, or calf, and it returns results in 6 seconds. Up to 450 results can be stored in the memory, and averaging for 7-, 14-, 21-, 28-, 60-, and 90-day periods is available.

Availability: Prodigy Voice is available from select durable equipment suppliers and pharmacies.


 TRUEresult meter

Product: TRUEresult

Manufacturer: Home Diagnostics, Inc.
(800) 803-6049
www.homediagnostics.com

What it does: The TRUEresult is an affordable, no-coding meter that boasts a high degree of accuracy thanks to specialized technology in the test strips. The meter, which has an automatic test strip ejection button, requires a 0.5-microliter blood sample from the fingertip or forearm and returns results in as little as 4 seconds. When the TRUEresult registers a result over 240 mg/dl, it sounds an alarm alerting the user to check for ketones. Four optional alarms can be set to remind the user to monitor, and 500 results can be held in the memory. The meter can average blood glucose readings over 7-, 14-, and 30-day periods. The TRUEresult comes with a lifetime warranty.

Availability: TRUEresult has received FDA clearance and is expected to be available in pharmacies nationwide by the end of 2008.


 TRUE2go meter

Product: TRUE2go

Manufacturer: Home Diagnostics, Inc.
(800) 803-6049
www.homediagnostics.com

What it does: TRUE2go is the world’s smallest no-coding blood glucose meter. It is designed to be attached to the top of a bottle of test strips. (When that bottle is empty, the meter can be removed and attached to a new bottle of strips.) It was created as an on-the-go counterpart to the TRUEresult, which uses the same type of strips. The TRUE2go requires a 0.5-microliter drop of blood from the fingertip or forearm, takes roughly 4 seconds to return results, and can hold up to 99 readings in its memory. This meter also features a strip release button, doing away with the need to handle used test strips. The TRUE2go comes with a lifetime warranty.

Availability: TRUE2go is scheduled to be available in various pharmacies by the end of 2008.


WaveSense Jazz meter

Product: WaveSense Jazz

Manufacturer: AgaMatrix, Inc.
(866) 906-4197
www.wavesense.info

What it does: The WaveSense Jazz is a no-code meter from the makers of the WaveSense KeyNote and WaveSense Presto, with which it shares several features, including a large, backlit display and accuracy-enhancing technology that corrects for factors such as temperature, altitude, inconsistencies between test strips, and user error. Like its predecessors, the WaveSense Jazz requires a 0.5-microliter blood sample (obtainable from the fingertips, palms, or forearms), but unlike its forerunners, this meter uses a test strip that instantly fills from the end. Results are returned in roughly 4 seconds, and up to 1,865 readings can be held in the meter’s memory. Averaging and graphing is available for 3-day, 2-week, and 1-month periods, and a daily digest can be accessed to view information such as the number of blood glucose readings taken per day, the standard deviation of the readings (how tightly the values cluster around the average blood glucose reading), and the average blood glucose results over a 2-week period. Additionally, blood glucose readings can be tagged with a comment indicating whether they were taken before or after a meal, and averages for these categories can be calculated, as well. The meter also includes seven optional alarms that can be set to remind the user to check his blood glucose.

Computer software for uploading and analyzing blood glucose results is available separately.

Another version of this meter currently awaiting FDA approval, the Jazz Wireless, will be equipped with Bluetooth technology to enable it to wirelessly transfer information to a computer.

Availability: The WaveSense Jazz is scheduled for release in 2009.


WaveSense KeyNote meter

Product: WaveSense KeyNote

Manufacturer: AgaMatrix, Inc.
(866) 906-4197
www.wavesense.info

What it does: The debut meter from AgaMatrix, the WaveSense KeyNote features rubber grips, a large, backlit display, and patented technology that improves the accuracy of blood glucose readings.

The pocket-size WaveSense KeyNote requires a 0.5-microliter blood sample, which can be obtained from the fingertips, palms, or forearms, and takes roughly 4 seconds to return results. Up to 300 results can be held in the meter’s memory, and averaging and graphing is available for 14-, 30-, and 90-day periods. An alarm sounds and the display screen flashes when a blood glucose reading is above or below a level set by the user, and six optional alarms can be set to remind the user to check his blood glucose.

Computer software for uploading and analyzing blood glucose results can be purchased separately.

Availability: The WaveSense KeyNote is available on the Web sites and shelves of various retailers, as well as from many direct delivery suppliers.


WaveSense Presto meter

Product: WaveSense Presto

Manufacturer: AgaMatrix, Inc.
(866) 906-4197
www.wavesense.info

What it does: The WaveSense Presto, the first no-code meter developed by AgaMatrix, features rubber grips, and a large, backlit display. Its blood glucose measuring technology can correct for factors such as temperature, altitude, inconsistencies between test strips, and user error.

The WaveSense Presto requires a 0.5-microliter blood sample, which can be obtained from the fingertips, palms, or forearms, and it takes approximately 4 seconds to return results. Up to 300 results can be held in the meter’s memory, and averaging and graphing is available for 14-, 30-, and 90-day periods. An alarm sounds and the display screen flashes when a blood glucose reading is above or below a level set by the user, and six optional alarms can be set to remind the user to take a blood glucose reading.

Computer software for uploading and analyzing blood glucose results can be purchased separately.

Availability: The WaveSense Presto is currently available. For more information, visit www.wavesense.info/where-to-buy.

Home HbA1c test

Appraise Home A1c Kit

Product: Appraise Home A1c Kit

Manufacturer: Heritage Labs International LLC
(888) 764-2384
www.appraisetests.com

What it does: The Appraise Home A1c Kit allows users to check their HbA1c level from home, without a prescription. Your HbA1c level is an indicator of blood glucose control over the previous 2–3 months. The kit includes an alcohol pad, a gauze pad, a bandage, a return envelope, and a lancet to be used to collect a small blood sample from a fingertip. The sample is collected onto a piece of filter paper that absorbs the blood; the paper is then enclosed in the postage-paid mailer and sent to the Heritage Labs International laboratory in the Kansas City, Missouri, area for evaluation. Results are available in as little as three days and can be retrieved online at www.appraisetests.com or received by regular mail.

Availability: The Appraise Home A1c Kit is available online as well as at various retail locations nationwide, including Rite Aid. It is also available at Wal-Mart, where it is sold as the ReliOn A1c Test.

Continuous glucose monitors

 FreeStyle Navigator CGMS transmitter

 FreeStyle Navigator CGMS

Product: FreeStyle Navigator Continuous Glucose Monitoring System

Manufacturer: Abbott Laboratories
(888) 522-5226
www.FreeStyleNavigator.com

What it does: The most recent addition to the universe of continuous glucose monitors, the FreeStyle Navigator is designed to provide real-time glucose levels from the interstitial fluid (fluid between the cells) just under the skin every minute for up to five days at a time.

The system is comprised of a sensor, a transmitter, and a receiver, the last of which comes equipped with a built-in FreeStyle blood glucose meter. The sensor is inserted into the skin of the abdomen or the back of the upper arm with an introducer needle and is then attached to the transmitter, which adheres to the skin. To ensure accurate results, the system must be calibrated with a blood glucose reading from the meter once after a 10-hour start-up period and again at least three more times over the five-day period.

The receiver’s monitor incorporates TRU Directional Arrow indicators, or arrow graphics, that show the direction and rate at which the interstitial fluid glucose level is changing. If glucose levels are changing too quickly to achieve an accurate reading, the FreeStyle Navigator will prevent the user from calibrating the system with a blood glucose reading. In addition, customizable alarms can be set to alert the user when glucose levels are approaching a too-high or too-low level.

The transmitter should be kept within 10 feet of the receiver as much of the time as possible to ensure that information is received. The transmitter is water resistant when submerged in up to 1 meter of water for 30 minutes. (The receiver should not be submerged in water.) The system is approved for use in people age 18 and older.

Availability: The FreeStyle Navigator is currently available by prescription. For more information on how to obtain a system, visit www.FreeStyleNavigator.com and click on “Purchase.”


Product: Open Choice

Manufacturer: DexCom, Inc.
(877) DEXCOM4 (339-2664)
www.dexcom.com

What it does: The Open Choice is a continuous glucose monitoring system with three separate elements that work together to provide real-time glucose measurements every five minutes for up to seven days. The key difference between this DexCom system and its predecessor, the Seven System, is that the Open Choice can be calibrated using any blood glucose meter, rather than just the OneTouch Ultra.

The Open Choice uses a sensor inserted under the skin of the abdomen to monitor the glucose level in the interstitial fluid, the fluid between the body’s cells. A transmitter that snaps into a Sensor Pod at the sensor insertion site wirelessly sends information from the sensor to the receiver, which can show the current glucose level as well as glucose trends for 1-hour, 3-hour, and 9-hour periods. An alarm sounds if the user’s glucose level falls below 55 mg/dl; optional alarms can also be set to warn the user when his glucose level has fallen or risen outside a customized range.

The Open Choice is not intended to replace traditional blood glucose monitoring and must be calibrated with two readings from a standard blood glucose meter two hours after a new sensor is inserted and with an additional reading at least every 12 hours thereafter.

Availability: The Open Choice is available as a software upgrade to current users of the Seven System and by prescription only to new users. For more information, call DexCom at (877) DEXCOM4 (339-2664).

Insulin pens

Humalog KwikPen insulin pen

Product: Humalog KwikPen, Humalog Mix75/25 KwikPen, and Humalog Mix50/50 KwikPen

Manufacturer: Eli Lilly and Company
(800) LillyRx (545-5979)
www.humalog.com/patient/humalog_kwikpen.jsp

What it does: Each disposable pen in the KwikPen line comes prefilled with 300 units of either insulin lispro (brand name Humalog), insulin lispro mix75/25 (Humalog Mix75/25; a mixture of 75% intermediate-acting and 25% rapid-acting insulin), or insulin lispro mix50/50 (Humalog Mix 50/50; a mixture of 50% intermediate-acting and 50% rapid-acting insulin). The pens can be dialed in one-unit increments up to a maximum dose of 60 units. If too many units are dialed accidentally, the dose can be corrected by turning the knob in the reverse direction. Pens should be stored in the refrigerator before the first use and kept at room temperature once opened.

Availability: The Humalog KwikPen, Humalog Mix75/25 KwikPen, and Humalog Mix50/50 KwikPen are available by prescription in retail pharmacies nationwide.

Needles

NovoFine Autocover needle

Product: NovoFine Autocover 30G

Manufacturer: Novo Nordisk Inc.
(800) 727-6500
www.novonordiskcare.com/insulin-pen-needles

What it does: The NovoFine Autocover 30G is a disposable 30-gauge, 8-millimeter insulin pen needle. The needle is encased in a protective shield both before and after an injection, a feature that may be helpful for people who are concerned about accidental needle sticks or who prefer not to see any needles during the injection process. The NovoFine Autocover 30G is designed for one injection only, and has a safety lock to indicate when a needle has already been used. It is made for use with Levemir, NovoLog Mix 70/30, and NovoLog FlexPens.

Availability: The NovoFine Autocover 30G can be obtained at select pharmacies. The needles may require a prescription in some states.

Syringes

PIC Insumed Syringes

Product: PIC Insumed Syringes

Manufacturer: Medical Plastic Devices Inc.
(866) MEDPLAS (633-7527)
www.medplas.com

What it does: Packaged with a clip-on magnifying glass, PIC Insumed Syringes make seeing, and therefore drawing up, insulin doses easier. The syringes are available in a 30-gauge version as well as a 31-gauge version, the thinnest available in the United States. Both the 30-gauge and 31-gauge needles come in an 8-millimeter length, and the 30-gauge needle is also available in a 12.7-millimeter length. The 30-gauge syringe holds 100 units, while the 31-gauge syringes come in 50-unit and 33-unit sizes.

Availability: PIC Insumed Syringes are available in boxes of 100 in retail pharmacies throughout the United States.

Sharps disposal container

On the Go sharps disposal container

Product: “On the Go” Sharps Transport and Disposal container

Manufacturer: MEDport LLC
(800) 299-5704
www.medportllc.com

What it does: The “On the Go” Sharps Transport and Disposal container is designed to provide a means of safely transporting and discarding used syringes. Each small case, approved to hold one syringe apiece, is leak- and impact-resistant and features a temporary closure mechanism for transportation and a permanent closure mechanism to be used when disposing of the syringe.

Availability: “On the Go” Sharps Transport and Disposal containers are available in boxes of 6 and 12 online at www.medportllc.com, from Wal-Mart stores throughout the United States, and at CVS pharmacies under the CVS brand label.

Insulin vial protector

 Securitee Blanket vial protector

Product: Securitee Blanket

Manufacturer: Regato Enterprises, Ltd.
www.securiteeblanket.com

What it does: The Securitee Blanket is a small, neoprene sleeve designed to protect an insulin vial from breaking while also providing a more secure grip and making the vial more visible. The sleeves come in two sizes and in a variety of bright colors.

Availability: The Securitee Blanket is available from a number of online retailers. Visit www.securiteeblanket.com for more information.

Insulin pump

Amigo insulin pump

Product: Amigo Insulin Pump

Manufacturer: Nipro Diabetes Systems
(888) 651-PUMP (7867)
www.niprodiabetes.com

What it does: The Amigo Insulin Pump made its official debut in May 2008. This pump, which holds up to 300 units of insulin, can be programmed with four basal profiles as well as a temporary profile. It also features three bolus dose delivery options in addition to a bolus calculator that helps determine appropriate mealtime or “correction” doses. The Amigo is compatible with any standard infusion set and is water resistant at 1 meter for 35 minutes.

Availability: The Amigo Insulin Pump is available by prescription. To start the process, call (888) 651-PUMP (7867).

Combination blood glucose meter and insulin pump

OneTouch Ping device

Product: OneTouch Ping

Manufacturer: Animas Corporation
(877) YES-PUMP (937-7867)
www.onetouchping.com

What it does: The OneTouch Ping is a blood glucose management system composed of an insulin pump and a meter-remote that communicate with one another wirelessly. The meter-remote can be used to measure blood glucose, calculate a bolus dose, and remotely control pump functions such as delivering bolus doses. The two components of the system must remain within approximately 10 feet of each other to ensure that information is transferred.

The meter-remote requires a 1-microliter blood sample, which can be drawn from the fingertip, forearm, or palm, and returns results in 5 seconds. Readings may be tagged with comments indicating whether the results were influenced by a meal, exercise, or particular state of health (such as stress or menstruation). This device can hold at least 20,000 results in its memory; averaging is available for 7-, 14-, 30-, 60-, and 90-day periods. As an additional feature, the OneTouch Ping can store information for up to 500 foods from the CalorieKing.com database and can also be programmed with customized food information (for homemade items, for example). Information from this food database can be used in conjunction with the bolus calculator to help determine bolus doses for meals and snacks.

The insulin pump can deliver bolus doses in increments as small as 0.05 units and has a basal rate increment of 0.025 units per hour. It has a self-illuminating, flat-panel screen, can hold up to 200 units of insulin in its reservoir, and is waterproof at up to 12 feet for as long as 24 hours. (The meter-remote cannot get wet.)

Availability: The OneTouch Ping is available by prescription. For more information or to obtain the forms needed to order one, visit www.animascorp.com/get-insulin-pump-ping.aspx or call (877) YES-PUMP (937-7867).

Drugs

Product: Colesevelam (Welchol)

Manufacturer: Daiichi Sankyo Inc.
(877) 4DSPROD (437-7763)
www.welchol.com

What it does: Welchol is a member of a class of drugs known as bile acid sequestrants, which help lower blood cholesterol. This type of medicine works by binding to bile acids in the intestine and preventing them from being reabsorbed. Because bile acids are synthesized from cholesterol, and because the body needs bile to help with digestion, the liver works to produce more of it, using up cholesterol in the process.

In addition to its cholesterol-lowering effects, Welchol has also been shown to improve blood glucose control in people with Type 2 diabetes. As such, this drug is the only medicine approved for both lowering LDL (“bad”) cholesterol and controlling blood glucose.

Welchol is available in 625-milligram tablets and is taken either in one 6-tablet dose or two 3-tablet doses daily with meals. It is approved for use alone or with statins (another class of cholesterol-reducing drugs) for managing cholesterol and for use in combination with the diabetes drugs metformin (Glucophage, Glucophage XR, Riomet, Glumetza), a sulfonylurea (DiaBeta, Glynase, Micronase, Glucotrol, Glucotrol XL, Amaryl), or insulin for blood glucose control in adults with Type 2 diabetes.

Welchol should not be taken by people with a bowel obstruction, a history of pancreatitis (inflammation of the pancreas) caused by high triglycerides (a type of blood fat), or a triglyceride level over 500 mg/dl, and caution should be used in people with triglyceride levels over 300 mg/dl. This medicine may interfere with the absorption of the vitamins A, D, E, and K, the sulfonylurea glyburide, the synthetic thyroid hormone levothyroxine (Synthroid and others), and birth-control pills containing ethinyl estradiol and norethindrone. It is therefore recommended that people who also take vitamin supplements or any of these drugs take them at least four hours before taking Welchol. The most common side effects of Welchol are constipation, indigestion, and nausea.

Availability: Welchol is available by prescription.


Product: Repaglinide and metformin (PrandiMet)

Manufacturer: Novo Nordisk Inc.
(800) 727-6500
www.prandimet.com

What it does: PrandiMet combines the diabetes drugs repaglinide and metformin into a single tablet to be used, in addition to a healthful diet and exercise, for blood glucose control in people with Type 2 diabetes. Repaglinide is sold under the brand name Prandin and works by stimulating the pancreas to release insulin in response to a meal. Metformin is sold as Glucophage, Glucophage XR, Riomet, and Glumetza, as well as in generic forms, and works by increasing insulin sensitivity in the body and decreasing the amount of glucose produced by the liver.

PrandiMet tablets are available in strengths of 1 milligram/500 milligrams and 2 milligrams/500 milligrams of Prandin and metformin, respectively. Tablets should be taken two to three times daily with meals, up to a maximum dose of 4 milligrams/1,000 milligrams per meal or 10 milligrams/2,500 milligrams per day.

Kidney function should be assessed before starting the medicine and at least annually thereafter. People with kidney impairment or metabolic acidosis (a condition in which the blood becomes excessively acidic), as well as those taking gemfibrozil (Lopid) and itraconazole (Sporanox), should not take PrandiMet. The most common side effects reported with use of this medicine are hypoglycemia (low blood glucose) and headache.

Availability: PrandiMet was approved by the U.S. Food and Drug Administration in June and is currently scheduled for release in the latter half of 2008.

New drug indications

Product: Insulin aspart (NovoLog)

Manufacturer: Novo Nordisk Inc.
(800) 727-6500
www.novolog.com

New indications: Rapid-acting NovoLog insulin mimics the body’s first-phase insulin secretion, the burst of insulin released from the pancreas after glucose from a meal or snack hits the bloodstream. NovoLog is delivered by pump or injection, typically before the start of a meal or snack. In March 2008, the FDA approved this insulin for use in insulin pumps by children ages 4–18.


Product: Tadalafil (Cialis)

Manufacturer: Eli Lilly and Company
(877) CIALIS-1 (242-5471)
www.cialis.com

New indications: Cialis, an oral drug used to treat erectile dysfunction, was originally approved in doses of 5 milligrams, 10 milligrams, or 20 milligrams, to be taken up to 36 hours before sexual activity. Cialis is now approved for once-daily use in doses of 2.5 milligrams or 5 milligrams. Men should discuss with their doctor which dosing regimen is more appropriate.

Discontinuations

Product: Insulin human (rDNA origin) inhalation powder (Exubera)

Manufacturer: Pfizer Inc.
(800) 438-1985
www.pfizer.com

Reason for discontinuation: Exubera, a rapid-acting, inhalable insulin, was designed to be administered via the handheld Exubera Inhaler. According to Pfizer Inc., because Exubera did not meet customers’ needs or the company’s financial expectations, sales of the product were discontinued in September 2008.

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