NewNowNext November/December, 2008

A risk-free trial of basal insulin

This NewNowNext isn’t about a new product, but about a new trial program we recently heard about from Novo Nordisk, the makers of the long-acting insulin analog Levemir. If you’ve never used insulin before, and you and your doctor decide to start Levemir, Novo Nordisk will give you a money-back guarantee for your first three months of this once- or twice-daily insulin.

If you’re not satisfied after three months, you can send them your out-of-pocket expense receipts, and Novo Nordisk will refund your money. They’ll also give you a free pedometer—a great tool for lifestyle change—whether or not you like the insulin. We think that you and your healthcare team should always choose the treatment (and the insulin) that is best for you, but this program might help you get started. For more information, ask your physician about this offer or have them call Novo Nordisk at 1-800-727-6500. The offer is not valid for patients on Medicare or Medicaid and expires in May 2009.

Hypoglycemia rescue from Enject

Another ‘next’ that we’re watching is the GlucaPen from Enject. Everybody who takes insulin faces the risk of severe hypoglycemia (a medical emergency), and it’s vital to have glucagon readily available to boost your blood sugar in case of trouble. Because people often get disoriented during hypoglycemia, friends and loved ones should be trained in administering glucagon, and the GlucaPen is one tool that might help. Unlike the traditional glucagon kit, which requires that you manually mix glucagon powder with water before injection, the Gluca-Pen is a pen auto-injector (like an EpiPen) that automatically injects glucagon once the pen is pressed against the skin. No mixing needed—it’s easy and quick to use, and should be ideal for use in emergencies. GlucaPen has a needle already in place, and a needle shield that locks after use (eliminating the possibility of secondary needle sticks and allowing for safe disposal). This product is still in development, but Enject is doing its best to move the process along quickly—we think that it should be on the market in a few years.

Join the Tour de Cure 2009

Riding, racing, tandem biking, unicyling (not widely recommended), volunteering... there are multiple ways to participate in the American Diabetes Associations Tour de Cure 2009. Whether it is because you have diabetes, or you are an avid cyclist, or because you are looking for a fun filled family activity, the Tour de Cure is a great way to support work and research being done in diabetes prevention and treatment. This event will takes place in 40 states across the US. Last year, 32,000 cyclists were able to raise $13 million! It all starts with your $15 registration (it’s the early bird special and is only available till March 2009 after which it’s $25) and the $150 fund-raising minimum participation amount. The ADA provides a fantastic set of “Top 10 fund-raising tips” to get you started and it covers topics from online fundraising to matching gifts. What are you waiting for? Form a team, join a team, or be a team of one! Visit www.tour.diabetes.org/signup to register for Tour de Cure 2009 in your city! If you happen to live in Silicon Valley, look out for the diaTribe team on June 14th. We always love meeting diaTribe readers.

SmartInsulin—not your mother's insulin

SmartInsulin is being developed by SmartCells Inc. as what some have called a revolutionary new approach to insulin delivery. As many of you know, the fundamental problem with insulin is knowing exactly when to take it and how much to take – nobody wants to forget insulin during a high blood sugar episode, and it's obviously downright dangerous to take insulin when you're moving toward hypoglycemia. While there are "glycemic-dependent" drugs (Januvia and Byetta) that stop working when you reach normal blood glucose level, there is no such "smart" insulin. It's very easy to overdose insulin, particularly if you are trying to have very tight glucose control, and SmartInsulin might help to solve that problem.

SmartInsulin is essentially normal insulin combined with a special polymer (large molecule) that 'binds' the insulin so that it can't immediately be used by your body. However, when your glucose levels start to get high, the glucose molecules in your blood "unlock" the bound insulin allowing it to be used in your body. Since insulin is only released in response to glucose, this should ideally also prevent hypoglycemia from insulin overdosing. The goal is to develop the drug to be a once-daily injection that gives you insulin when you need it all day long – insulin for basal needs, for food, for stress etc. This project is still in early development, but it's receiving impressive grants from big agencies like the National Institutes of Health (NIH) and the Juvenile Diabetes Research Foundation (JDRF). Hopefully, the company will start human trials with the drug next year, but it will likely be many years before we might see SmartInsulin on the market. If you're interested, you can find more information about SmartInsulin at www.smartinsulin.com.