Team Dario: Meet Professor Itamar Raz, M.D.

Editor’s note:  Members of the Dario team are committed to your success in helping you better manage your Diabetic condition.  Aside from the core team, we also have a group of advisors who are helping us stay at the forefront of what’s next.

Walking the hallways of Hadassah Medical Center in Jerusalem, you see a crossroads of humanity.
There, people from all walks of life, religions and cultures, can come to one of the leading hospitals and research centers in the world, where Professor Itamar Raz, M.D.- Head of the Center for the Prevention of Diabetes has his office.

In my recent visit to Israel, I had a chance to visit with Professor Raz, who serves as one of LabStyle’s Advisors and is a member of the Board of Directors.

London SocialTrials: Dario Listens:)

With Dario’s SocialTrials, we have our ear to ground.


We’re listening to you.

We’re engaging.

And we want to keep in touch with you once we are in your market.

We’re hoping you’ll join the Dario family and become part of our community.  Your feedback matters and we thank you taking part in our London session.

Curated Content: U.K. Christmas Diabetic Cooking Resources

We’re coming up on the Christmas holiday time which can often present challenges in enjoying the festive season, while minding our ways in what we eat.

Here’s some great tips from leading U.K. blogs and news sites to help you enjoy and be healthy during the upcoming holiday season.  If you are in the U.K. and have some helpful holiday cooking tips, share you recipes, and ideas here with our community.  Here’s a sampling…

“Diabetes and Christmas.” – via Diabetes.co.uk

“Top 10 Diabetic Recipes” – via Good Food Channel / UK

“Diabetic Christmas Pudding” – via Good Food Channel / UK

“Advice for Diabetics During Christmas” via The Telegraph

“Diabetic Fruit Cake” via BBC Good Food

Curated Content: New Zealand Diabetes Offers Vast Resources and Ideas for Christmas Cooking

Diabetes New ZealandOne of our favourite sites in New Zealand is none other than Diabetes New Zealand, who has some terrific and practical cooking tips for this coming Christmas season.   Here’s the best of the best for 2013.

Christmas Holiday Eating Tips

Christmas Holiday Planning

Christmas Cake Ideas

What you cooking, baking, serving for your Christmas dinner?   Leave a comment, share a recipe, and how maintain a healthy diet during the holiday season.

Dario’s Diabetes Platform Now Available on The Apple App Store in The UK, Australia and New Zealand

Diabetes management just got easier, social and much more enjoyable.

Today we’re announcing the world roll-out of the Dario™ diabetes management platform starting in the UK, Australia and New Zealand.

Screen Shot 2013-12-12 at 7.04.13 AM

Read All About It.   And Download the App.

Mashable just covered the story here.

If you are in one of these countries, you’re invited to download the complimentary app from the Apple App Store. The app works with all blood glucose monitoring devices. By simply manually inputting blood glucose information, you will be able to experience the novel functionality and benefits of Dario™’s iOS app.

To learn more about how Dario can work for you, please view our introductory video.

I’m love to hear from members of the community and get your take-away’s on the app once you have downloaded it. Leave a comment, or email me: alan at weinkrantz dot com.

Video: Meet Dario. Your Personal Diabetes Assistant.

As we get ready to launch in the UK, Australia and New Zealand, we’re hoping you can share this video with your friends and communities who might benefit from getting to know Dario.

Looking to Hear From Diabetic Voices

I am also looking to profile diabetic bloggers and those active on social networks who want to share their story, their content, and have a chance to evaluate the Dario app. Leave a comment or email me: alan at weinkrantz dot com and I will follow up with you.

Curated Content: Australia Diabetic Magazine on Facebook

Friends in Australia….we look all over the world, and in your own country to find and share the best content about your diabetes lifestyle.

Australia Diabetic Living - Facebook

The month of December can be really challenging with the Christmas holidays.    That’s why we not only like Australia Diabetic Magazine, but we also love their Facebook community.

Join in and learn from others.  And if you have some of your favorite recipes you can share with us, please leave a comment.

Happy holidays and healthy eating to you:)

Diabetic Voices: Mike Kendall’s Diabetes Blog Is A Family Affair

Mike Kendall’s approach to blogging at Every Day Ups and Downs is about diabetes is very much centered around his family.

Based in Bristol, England, Mike was diagnosed with type 1 diabetes in 1991 while studying for the final year of my Graphic Design course. He and his wife,  Jane have two wonderful daughters.   In 2010, they decided as a family to start contributing their which would allow each of them to write about their own experience of living with the condition.

Team Dario: Israel Lax, Director of Global Sales and Marketing

Israel Lax brings fifteen years of experience to the medical device space.

When Israel joined LabStyle, he began to cultivate relationships with distributors in the UK, Australia and New Zealand where the company is now launching its App.

Going forward, you will see Israel at major trade shows we have coming up such as Medica and the Diabetes World Congress.

Israel lives on a moshav – a  cooperative agricultural community with his family, about eighty miles north of our global headquarters in Tel Aviv.

“Balance is very much part of my being,” Lax shared with me.  “And staying in balance is very much a part of our platform approach to better and more data-driven Diabetes management.”

Book Review: “What On Earth Can I Eat?” Australia’s Alan Shanley Helps Diabetics

Alan Shanley was diagnosed with type 2 diabetes in 2002. He is a retired engineer who lives in a beautiful seaside village in Australia but wanders the world whenever he can.  He’s also written “What on Earth Can I Eat,” which you may order on Amazon in your respective country.

Mind you that Shaley is neither a doctor nor a dietician.  He’s s diabetic who, after being diagnosed in 2002, spent a year on journey of discovery to  simply try to find the answer for his own way of eating and later passing that knowledge on to others on diabetes web forums around the world.

BookCoverCroppedHe spends his mornings reading and writing about diabetes and travel and has been active on a number of diabetes forums for several years, including the ADA forum and the dLife forum.

He also writes on his blog Type 2 Diabetes – A Personal Journey and his travel blog Born Under a Wandering Star.

Diabetic Voices: How “Rich the Diabetic” Inspires A Lifestyle Approach to Better Managing Diabetes

Editor’s Note:  I’m looking to connect and meet with diabetics on the social web who’d like to share their knowledge about they manage their condition.  

Meet Rich Nagle, who blogs at Rich The Diabetic.  A diabetic most of his life, Rich has a compelling story worth listening to.   Based on the tenants of nutrition, support and fitness, Rich has an extensive body of work and a wonderful story about his coming back to life.  Literally.  Listen and learn from Rich the Blogger.

Dario Listens: User Feedback Will Help Us Help You Make the Most of the App

Our recent announcement of our App launch, had some terrific coverage which you can read about here in TechCrunch and The Next Web.

While we’re proud of this milestone, we never rest on our laurels.

Just recently, a team from our company went to the UK, before the announcement and had a chance to demo the App and get feedback on the Dario platform.

As you can see from sample feedback above, we’re listening to users and will continue to engage with people from all walks of life who want to better manage their condition, gain greater insights into their diabetic condition.

It’s from you we’ll learn and continue show you how to discover and make the most of our platform approach  to the App.   And remember, the more you use the App, the better the job the App will do for you.

The “Second Wrist” May Not Always Be On Your Wrist… At Least for Now.

I’m a huge fan of Robert Scoble.  As Rackspace’s Startup Liaison Officer, he’s always on the forefront of what’s next and has been an early advocate of Google Glass.  In the interview here with Julien Blin, they discuss the vision of what they call the “second wrist.”

While I see vision, I wonder if the “second wrist,” at least for the next few years, will remain on your smart phone / mobile device   In our case, and in our approach to software and platform technologies, the smart phone / mobile device will remain centric to capturing the complete diabetic experience,  from monitoring to therapy.

Hello. I’m Alan and Here To Listen and Connect With You.

DSC03793My name is Alan Weinkrantz, and I am coming on board as Story Teller in Chief for LabStyle Innovations’ first brand, Dario.

As we prepare going to market in 2014, my first goal is to listen and engage with you.

If you are a Geek or Diabetes journalist or blogger, I’d love to connect and hear from you and in time, share our story, get you product samples, and share what we believe is a compelling approach to Diabetes management.

Through the balance of the year, you are going to meet and hear from some of the core members of our team who are bringing Dario’s vision to the marketplace.   Many come from the traditional medical device world.   Others come from other tech industries and academia.

Our CEO, Erez Raphael, has a personal story to share that illustrates that we’re more than a company.  We’re a family of doctors, industry experts, and people who left other career paths in the medical device space to join the team, because we are incredibly passionate about our mission.

We just received our CE mark, green-lighting us for our initial launch in the U.K., followed by other European markets as well as Australia and New Zealand.

There’s more ahead in the months to come.  I’d love to hear from you in the comments section.   I’m hear to listen.

Questions, Questions, Questions

There are people who don’t understand type one diabetes.  Children and adults will ask you questions.  What do you do if you get questions like:

Did you get diabetes because you ate too much?

Are you on drugs?  Why do you use needles?

Can you keep up with the rest of the kids if you’ve got diabetes?

Strategies to deal with questions about type one diabetes

There are two strategies to take.  One is to ignore the questions and the people asking the questions and the other option is to educate.   Letting the questions and the people asking them get to you and make you feel badly is NOT one of the options.

So if your feelings are hurt or you feel in anyway “put down” when you hear these questions, educating and advocating is the best strategy to take.

Example answers to questions about juvenile diabetes

Having answers to these kind of comments already prepared in your mind can help you deal more effectively with them.

Here are some ways to respond:

Did you get diabetes because you ate too much?

“Type one diabetes is not caused by eating too much, or by being fat or by eating sugar.  I didn’t do anything to get type one diabetes.”

Are you on drugs?  Why do you use needles?

“I need insulin for my type one diabetes.   I need to inject it through the needle.”

Does it hurt?

“Of course it hurts to inject myself or prick my finger for testing.  I’m human.”

Can you keep up with the rest of the kids if you’ve got diabetes?

“Yes, I can do everything you can do.  There are many athletes with type one diabetes.  Gary Hall Jr. is a 5 time Olympic gold medalist with Type 1 diabetes.”

Can you eat sugar?

“Yes, I can eat sugar and I can eat anything you can eat.”

Educating as advocacy

One reason you might answer the questions is to help other people with juvenile diabetes.  Remember, if you have educated just one of these people, you’ve saved some other person with type 1 diabetes from having to answer that person’s questions.  And that person may actually share the facts about type 1 diabetes with others.  So you are saving many more people from this experience.

However, there will be times when all these questions are overwhelming.  Sometimes you may not want to answer them.  That’s fine.  Be yourself.

Doing the work of an organ as important as the pancreas can be hard.  Know that you are doing the best you can.

[there are videos that might be appropriate for this on youtube.  Here is an example:  http://youtu.be/Y2tzeWp_rvk ]

What’s a Diabetes Kit? Why Do I Need One?

 A diabetes kit is a packet of tools especially created to deal with the extreme highs and lows that can happen with type one diabetes.  Having a diabetes kit doesn’t mean you are not working hard to control your diabetes, it is just added insurance in case something happens.

For teenagers as well as children, growing and changing can increase the likelihood of extreme highs and lows.  Its just part of the body’s physical changes.

Your diabetes kit

The diabetes kit is an insulated bag or backpack.  It should contain

1)   a blood glucose meter with glucose test strips

2)   a lancet (with your Dario glucose monitoring device you have both #1 and #2 on this list covered)

3)   alcohol wipes to clean your testing site

4)   fast acting insulin in case your blood glucose is too high

5)   a syringe (even if you have an insulin pump, always carry a syringe with you)

6)   glucose tablets, fruit drink, candy or any other fast acting simple carbohydrate for low blood sugar

7)   a notebook to record what happened (again with your Dario glucose monitoring system, you have this covered)

8)   a pen

9)   emergency contact information

10)         diabetes card

11)         glucagon kit for severe hypoglycemia

12)         directions on using the glucagon kit

13)         ketone urine test strips

What is glucagon?  Why include it with my diabetes kit?

If you’ve forgotten, glucagon is a hormone produced by alpha cells of the pancreas.  This hormone tells the liver to release stored glucose (which is called glycogen).  The kit contains a syringe pre-filled with diluting solution and a vial of glucagon.  The glucagon kit is used for severe hypoglycemia.  It is used when:

·      you are not able to eat or drink a fast acting simple carb

·      even after repeatedly eating a fast acting simple carb your blood sugar stays low

·      you are unconscious

·      you are having seizures

What about ketones?  Why keep urine strips in my diabetes kit?

Ketones are a product of the body burning fat for energy.  When there is too little insulin in the blood, the glucose in the blood will not be transferred to the cells.   Testing for ketones should be done if your blood sugar level is above 240 mg/dL.

Juvenile diabetes is part of your life but it doesn’t have to keep you from living.  Being a pancreas is not easy.  Carrying a diabetes kit is just another piece of insurance to be sure that “Nothing Holds You Back.”

What’s for dinner? Or lunch? Or breakfast? Oh my…

 

Planning meals can be the bane of a mother’s or father’s existence and if your child has juvenile diabetes it can seem more daunting. You are probably asking yourself: does my child’s diet need to change?

Type 1 Diabetes and Food

As long as your child’s blood sugar readings are kept in normal range, meaning they get the insulin they needs to process the carbohydrates they takes in, they can eat anything.

Blood sugar tests and Food

However, you might need to determine how your child reacts to different foods.  We’re all different and we react in different ways to foods and food ingredients.

You might want to substitute foods that cause blood glucose instability with others that have less impact on insulin needs.   An example is substituting milk or water for juice or sugary sodas. Other drinks that contain sucralose or agave nectar are also good substitutes.

Snacks like cheese and/or peanut butter and celery are great because they also don’t require as much insulin to cover them.

You may be giving insulin that matches the carb level and your child’s blood sugar spikes anyway.  This is because we all metabolize foods at different rates.   Using blood sugar test strips to figure out what foods spike or even cause lows is the only way.   Recording your child’s blood sugar test strip results in a food chart is a great strategy.  Sometimes you need only substitute based on the amount of sweeteners in the brands you usually buy:  look for sugar, honey, high fructose and corn syrup in the ingredients list.

However, your child may be able to eat foods with these ingredients in them…it depends on what the other ingredients are in the product and how your child metabolizes them.  Similarly certain preservatives, starches and fillers can impact your child blood sugar level.  It’s all trial and error.

Don’t eliminate all sugar

But don’t try to eliminate all sugar from your child’s diet.  This isn’t a good idea because it is impossible to keep tabs on all your child’s food intake.   It’s not emotionally healthy for a child to have mom and dad hovering over every bite.  In fact, banishing sugar can backfire.  The child hides treats from parents and parents try to second-guess their child.  Uncontrolled blood sugar levels result.

Giving your child sugars can actually help to train your child in appropriate sugar consumption.  For example, you can teach your child to pair something sugary with protein, like nuts, cheese or meats.  Additionally teach your child that treats are for after meals.  And be sure that your child with type one diabetes isn’t singled out in the family.  Keep your whole family on the same sugar consumption rules.  Look for foods made with xylitol, agave nectar, coconut crystals and stevia leaf are all natural sweeteners that are less likely to increase blood sugar levels.

So life goes on…with a few adjustments.  So what’s for dinner?

“We’re losing our connection…you’re breaking up” :Type 1 diabetes and Insulin resistance

When you are on a cell phone call you want to stay connected but sometimes you lose your connection.  In a way, the cell phone is like something that can happen in the body between your cells and insulin.  Making a connection and keeping a connection between your cells and insulin is essential to the process of glucose absorption.  A break in that connection is called insulin resistance or impaired insulin sensitivity.

What is insulin resistance?

When your body’s cells don’t respond to insulin, the condition is called insulin resistance.  To understand insulin resistance you have to look at a person whose pancreas and other body cells are connected or functioning properly.   As that person eats, their blood glucose rises and causes their pancreas to produce insulin.  Insulin passes through the bloodstream persuading fat and muscle cells to take up blood glucose.  It also tells the liver to hold onto its glucose stores.

The fat and muscle cells in a person with insulin resistance don’t respond to the presence of insulin and this lack of response leaves glucose in the blood stream.

Human growth hormone, blood sugar readings and insulin resistance

Going back to the cell phone analogy, imagine you lose the connection, you keep driving, you get back into range and get reconnected.  That’s what happens when your child has a growth spurt.

You may have noticed that there are times when your child has a series of high blood sugar readings.  Then later they return to normal.  As your child goes through growth spurts, larger amounts of human growth hormone are present in the body.  Human growth hormone causes insulin resistance in your child.  When the period of intense growth slows, the connection returns and the child’s insulin resistance disappears.  This type of insulin resistance is normal in growing children.

When insulin resistance is a problem with juvenile diabetes

For someone with type 1 diabetes, long term extremes in glucose highs and lows can increase the likelihood of developing insulin resistance.  Years of poor control and imbalance in food intake, insulin intake and exercise greatly increase the risk of insulin resistance.

Balance is the Key with Type 1 diabetes

Your job is to teach your child balance.  Encourage your child to exercise 30 minutes –moderate exercise like walking or biking:  three or four times a week will suffice, although more is OK.  Teaching proper eating habits like balancing carbs with protein intake to reduce glucose highs and lows is the other part of the key to balancing glucose levels.  Reviewing blood glucose readings and insulin doses to determine patterns is also part of what you should do and what you should train your child to do as they mature.

Finally, you have heard this before, but it bears repeating.  Cut yourself some slack!  It’s not easy being a surrogate pancreas.

Tight control? Say what?

Commercials for pantyhose or perhaps the turning radius of that fancy car you always dreamed of owning?

No, tight control, in this case, means keeping your blood glucose levels within a limited range.   Specifically it means maintaining period A1c readings at around 7% for an extended period.

What is an A1c test and what does it tell me about my child’s type one Diabetes?

An A1c test or HbA1c test is a blood test that measures the amount of glycohemoglobin in the blood.  Glycohemoglobin is the protein that forms when hemoglobin (the blood protein that carries oxygen) binds with glucose.  In a person who doesn’t have diabetes, glycohemoglobin levels are around 5 to 6% of the total hemoglobin in the blood.  The more glucose there is in the blood, the higher the level of glycohemoglobin in the blood.  Someone with juvenile diabetes who has higher than normal levels of glucose in the blood will have more glycohemoglobin in their blood.

The hemoglobin in your blood remains in circulation for 60 to 90 days.  The amount of glycohemoglobin in your blood represents the average amount glucose in the blood over the last 2 to 3 months.   The A1c test gives your medical team a pretty good measure of where you child’s blood sugars have been over the last 2 or 3 months.

If a person’s A1c test is 7%, that means that their average blood glucose levels have been at 150 mg/dL.    It the reading is 8% that means that their blood glucose levels have averaged to around 180 mg/dL.  Anything higher than this and the team will probably review their treatment regimen.

A high reading on this test doesn’t mean that parents aren’t keeping a close eye on their child’s diabetes.  Generally it means that there needs to be a change in insulin, probably because your child has grown.

Should you try to keep “tight control” of juvenile diabetes?

Keeping tight control with children is difficult because there are many variables that are affecting their blood sugar levels, like the fact that they are growing.  However, the goal of tight control can help you to instill some good habits that will help your child in the future.

Regular mealtimes and blood glucose tests

Making sure your child eats three meals with a balance of proteins, carbohydrates and fats is key to good regulation.  If it is possible, keep grazing to a minimum but instead provide timely snacks, keeping 3 hours between eating.  To stave off over night low, have your child eat protein, like peanut butter crackers and milk before bed.

Review blood sugar and insulin doses to see patterns.

Keep a log of activities, carb intake and insulin dosages.  If you miss, don’t fret because blood glucose meters and insulin pumps have memory functions.  Review you log and try to figure out your child’s patterns.

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Look at the ratio of basal insulin to bolus insulin

Basal insulin should be at least 40% of the insulin your child receives in a day.  Generally it should not be more that 50%.  If it is less than 40% or more than 50% your child’s blood sugar readings are not stable.

You can’t imitate a healthy pancreas perfectly

So don’t go crazy over this.  Part of your job as a parent of a child with type one diabetes is loving your child.  Moderation is key.  Overdoing and obsessing over blood sugar readings and carbs counts to the exclusion of fun and love does nothing but alienate your child.