Clinical Director

Written and clinically reviewed by Marissa Town, RN, BSN, CDCES One of the barriers to achieving “optimal glycemic control” is having insulin that works fast enough to match the absorption of foods. The rapid acting insulins that we currently have available take 20-30 minutes to be absorbed into the blood stream. In order to try and match the absorption of the food eaten, people with diabetes are encouraged to take their insulin ahead of time, know exactly what and how much they are going to eat, and hope that the timing and calculations work out. This is commonly referred to as […]

Written and clinically reviewed by Marissa Town, RN, BSN, CDCES Diabetes technology has completely transformed in the last ten years. Continuous Glucose Monitors (CGMs), Flash Glucose Monitors (FGMs), Hybrid Closed Loop Systems (HCLs), all help people with diabetes manage blood sugars more easily. But when is the “right” time for someone to start a new diabetes technology? The answer, as with most things related to diabetes, depends on the person. This answer also hinges largely upon access to a provider who will prescribe the technology and coverage of the device by insurance. For a while in the United States, there was […]

Written and clinically reviewed by Marissa Town, RN, BSN, CDCES When you live with diabetes, which is something that doesn’t ever go away, requires constant monitoring and decision-making, and it doesn’t always play by the rules … having friends who really “get it” can truly be life changing. It helps to have someone you can text or call when your blood sugars are out of whack no matter what you do. It is nice to have someone with whom you can share hilarious low BG stories with, like when you cried over literal spilled milk (true story). I can personally say […]

Advances in technology have helped ease some of the burden in diabetes self-management, and continuous glucose monitoring (CGM) has been one of the biggest game-changers. Having access to data in real-time, with directional arrows that help identify trends, allows people to make more informed decisions. Getting alerts that are customizable to help catch lows and highs earlier allows for tighter control. Since 1980, the gold standard for determining whether people were “in control,” and therefore less at risk for complications from diabetes, has been the Hemoglobin A1C .1 But the A1C is only an average, and therefore does not show […]

Diabetes is a disease that affects people of all types, and while there are many factors that affect how well diabetes is managed, some of them are not modifiable, such as race. Although the pandemic has brought the racial health disparities in the United States to the headlines, there is still so much work to be done. The data Back in 2004, the CDC reported data that was collected from 1979-2004 on people ages 1-19 years with diabetes. The data showed that the death rates were significantly higher for Black youth than white youth, and when the death rate declined […]

Keeping blood sugars within a tight target range is not exactly easy for people with diabetes. Fears about different diabetes-related complications, like kidney damage, heart disease, and retinopathy, are frequent among PWD and their loves ones, and these complications are often discussed by medical teams. But what about how diabetes affects the brain? A few studies from the 2004-2006 showed reduction in grey and white brain matter and that higher lifetime A1C, length of diabetes and severe hypoglycemia affect the reduction.1 (For info on grey and white matter, see here.) The brain continues developing and maturing until the average age […]

You may have never heard of it, but c-peptide is a measure of how the beta cells in the pancreas are making insulin.1 It is a hormone produced by the pancreas, released at the same time as insulin. It has no effect on blood sugar but is a useful marker of insulin production, since the pancreas usually releases c-peptide and insulin in equal amounts. You may have had it measured at diagnosis or in preparation for getting an insulin pump because your insurance required it. Odds are if you have had type 1 for a while your levels will be […]

One of the silver linings of the pandemic is that many health care providers, and organizations of all types for that matter, have been thrust into the world of all-things virtual. This has been really helpful for many people who have to drive hours to see their health care team, and helps people keep their social distancing practices until COVID is in the rearview mirror. In Diabetes Therapy, in an article titled, “Application of Telemedicine in Diabetes Care: The Time is Now,” Austrian endocrinologists argue that using telemedicine can help improve access to care and minimize the possible exposures to […]

Non-Alcoholic Fatty Liver Disease (NAFLD) is a condition where you have too much fat built up in your liver, and it can cause damage. It is estimated that 10-20% of the United States population has this condition and it can be hard to identify because many of the symptoms are silent.1 One of the major risks and concerns with this condition is developing scar tissue on the liver which causes permanent damage to the organ. The liver and the pancreas have a harmonious relationship for keeping blood glucose levels in range for healthy people, and in diabetes the communication is […]