Hear ye! Hear ye! I have an announcement to make. About 3 months ago, a committee formed to explore the possibility of creating a new conference series for adults with type 1 diabetes. Most conferences are currently geared towards all types of diabetes, but a group of us felt there should be more for the unique challenges that are posed to adults living with type 1.

With that in mind, we are conducting an interest study for the conference. Who would you like to see at the conference? Tell us what is missing from Type 1 diabetes (besides the obvious **cure**). This will help us with programming, as well as securing sponsorships for the event. Besides giving you all you want from the latest and greatest in type 1 diabetes - you have a chance to leave your mark on this revolutionary event. At the end of the survey, there is a question about creating a name for the conference. The committee will choose the winning name. The winner will receive an autographed copy of Know Your Numbers, by Amy Tenderich and Dr. Richard Jackson. The second and third places prizes are a Six Until Me mug and a Diabetes Mine mug, donated by Kerri Morrone and Amy Tenderich.

The survey closes on Friday, September 7, 2007 so don't miss your opportunity to voice your opinion. Take the survey today!!

A little over 2 weeks ago I posted something about diabulemia on site where diabetics exchange their feelings, frustrations, and experiences with the disease. Two Type 1 diabetic women took the time to write me a very thoughtful hate mail. Hate is a strong word but these are some strong accusations. For starters, they said, "There ain't no such word as diabulemia. It's called diabetic stupidity." That is cut directly from the email, and as you can see - it was written with an arrogant disregard for the 450,000 people suffering from this serious condition.

I understand strong words come from passion. An email with the subject title "There's type 1, and then there are fools with type 1" could only have been composed with hateful passion. Within the passionate lines of this email were statements like "Insulin shock therapy was used in mental institutions (where you belong)." Not exactly nice words to come from a teacher - but again, the words were incensed with passion. Good, bad or ugly - feedback is terribly important to me because it conveys what matters to you. Knowing is half the battle.

By logging my experiences with diabetes on the web, these hate mailers refer to me as "You fool" for exercising my Freedom of Speech (First Amendment). To this I add -- thank goodness for the Freedom of Information Act. If I'm a Fool for sharing my experience with overcoming diabulemia and trying to lend consoling advice to others struggling with it - I'm a damn proud Fool! Hate on, haters!

As Bev just pointed out, diabulimia is a serious condition when a type 1 diabetic is not taking their insulin in order to lose weight. Diabulimia is a term that has only cropped up in recent years. Most people who experience diabulemia are stuck between two fears: taking increasing doses of insulin, which leads to weight gain, and the damage the destructive behavior is causing their body in the long-term.

One expert who has studied the phenomenon estimates that 450,000 type 1 diabetic women in the United States - one-third of the total - have skipped or shortchanged their insulin to lose weight and are risking a coma and an early death. Ann Goebel-Fabbri, a clinical psychologist at the Joslin Diabetes Center in Boston says, "People who do this behavior wind up with severe diabetic complications much earlier". Is that supposed to be a warning or a promise? It sounds like she's saying complications are inevitable - but if you're contented with the weight gain - you'll deter the early arrival of complications. Poor advice, doc.

The caution of do as you're told and complications will arrive later is not a very promising guarantee. The behaviors of tight diabetes control are almost tantamount to cultivating eating disorders. Studies show that women with type 1 diabetes are twice as likely to develop an eating disorder. After all -- good diabetes management requires a preoccupation with food, counting carbohydrates and following a diet. Sounds like the ingredients for an eating disorder - throw in a hormonal imbalance (genetically modified insulin that arrives late to the brain, unlike natural vertebrate pork and cow insulin) and you've got yourself diabulemia. Thanks again, Big Pharma!! Where is the prize in good diabetes management if you are punished with weight gain?

Once again Diabetes Health gets to the bottom of a breaking point question: why does insulin cost more than ever?

When Fred Banting and Charles Best first discovered insulin in 1921, they sold the patent for a dollar ($1) so that insulin could quickly become available for life-saving use. Within 2 years, Eli Lilly had sold over 60 million units of its purified extract of pig and cow pancreas. Over the next 60 years, purification and duration improvements were applied to insulin. However, each new version of insulin came with a new patent and a higher price tag. By the 80s, yeasts were being used as tiny insulin-making factories. Once the gene for human insulin was inserted into one yeast DNA, the yeast multiplied ad infinitum, and each new yeast came with a little copy of human insulin. This breakthrough, naturally, carried with it a big, profit-making patent.

In 1996, the FDA approved the first insulin analog. Newer insulins are called analogs because they're similar to human insulin-- but not quite exactly. Before being put into the yeast, the human genetic material is slightly changed, to produce slower or quicker acting insulin, for instance. Each one of these improvements comes, of course, with a patent. And all these patented insulins cost - big time. For the entire story, comments from influential diabetes advocates and the evolution of insulin price gouging - see the full article at Diabetes Health!

Slow and steady wins this race -- and that is why Flamel Technologies took the more natural approach with basal insulin in developing Basulin. The results in a comparison study with Lantus showed patients, while on Basulin, experienced 50% less hypoglycemic events.

Basulin is a controlled release of human insulin, not an insulin analogue like Lantus. The goal with Basulin is to deliver human insulin in order to reduce the risk of potential immune response which can be created by artificial insulins. Lantus has been the preeminent leader since its introduction in 2000. However, Lantus is an insulin analog, meaning that its molecular structure has been changed slightly, to sustain this long-lasting effect. The long-term effects and safety of insulin analogues have not been established.

In a human study, patients formerly treated with Lantus were then changed to Basulin. On the day prior to replacement of Lantus with Basulin, 11 hypoglycemic events were experienced in the 30 patients receiving Lantus. Once these patients were switched to Basulin for the 14 day trials, an average of only 5.1 hypoglycemic events per day occurred. This result is very encouraging, because hypoglycemia is a severe and commonly observed event in T1DM patients. Here is the billion dollar question (In 2006 over 60% of $8.9 billion was spent on long-acting insulin) -- is this more natural Basulin more fat-loving (like real human insulin) in comparison to the insulin analogue Lantus?

For more the more than 300,000 users that once relied on animal-derived insulin, the final chapter of animal insulin is finally ending for the US market. In December 2007, Novo Nordisk has officially decided to discontinue making animal-insulin. Their explanation doesn't go into great detail why they chose to discontinue it. But the supporting evidence they use to warrant the decision is a little weak.

Novo says, animal insulin is derived from the pancreas of slaughtered animals. This statement is as true as the statement "human insulin is derived from the pancreas of slaughtered humans". Novo continues, since that time there has been significant improvement of insulin quality and formulation. Absolutely true! In fact, a Novo pork product was shown to be greater than 99% pure, while an Eli Lilly human insulin only exceeded the 97 percentile. As a consequence, demand for these old animal insulins has declined by as much 20% in the last year to a point where approximately 2% of all insulin users are currently using these products. Largely due to the fact doctor's were advising their patients they must prepare to switch to GM insulin because animal-derived insulin would be nearly impossible to obtain. True. The research that introduced GM insulin (back in the 80s) was preemptive, at best. The claims supporting it was better than the existing insulin choices was clearly debatable .A telling similarity to the discovery about Avandia.

The long-term results of GM insulin and its analogs would prove to be a nightmare if the right questions were asked, and the data properly collected. Is it fair for any of the companies to ask us to change from an insulin product we have grown to love? No, but much like the off-Broadway play suggests: We love you (as a customer). Your diabetes is perfect (for our bottom line). Now change your insulin (we don't feel like making that kind anymore). Too bad type 1 diabetics forced to change to GM insulin didn't have the outspoken advocates like those taking Avandia.