Those of you who read our weekly Ask D'Mine column know what a doubter Wil Dubois is. We force out't help loving him for it! He's also one of our dedicated editorial team members, and then keep that all in creative thinker as you scan his take over the 2013 DiabetesMine Innovation Top that he too attended in Palo Alto, Atomic number 20, on Nov. 15.

A feminine pal of mine at one time told me she's on an eternal quest for the PERFECT pair of place. I'm a bit shaky on what makes a pair of place perfect, but I would mental image IT would make up a magic philosophers' stone of a homelike fit, indestructible materials, a colouring that would match many wardrobes, a sensible tread that wouldn't show, and of course cuter than the dickens.

Disdain a significant investment in woman-power and raw capital, my buddy is nonetheless to score her perfect pair of shoes.

I, however, aft a similar search, have found my perfect diabetes conference. I have attended altogether manner of conferences across the rural area complete the last decade or so, and for me the only one that's a swell fit is the DiabetesMine Innovation Summit, now in it's third twelvemonth. I've been blamed to attend all three years of this invitation-lonesome gather from the related to spheres of diabetes patients, diabetes clinicians, diabetes device makers, diabetes dose makers, diabetes industriousness investors, diabetes inventors, and diabetes protagonism organizations. In addition, both last year and this year we had representatives of the restrictive community in the strain of the FDA. And debuting this year for the basic prison term, the missing piece of the puzzle was born into place in the form of representatives from five "payer" organizations—your health indemnity companies.

The main Superlative lasts only one twenty-four hour period, but what a day to each one twelvemonth! Stanford School of Medicine hosted the 120 of USA who cared-for, and this year's summit did not let down.

{Picture the consequence photos Here, and Amy Tenderich's opening presentation hither}

Diabetes Device Progress Zero?

A major theme for this year, as last, was in getting our many D-devices to talk to each other.

Of course, the one thing we are missing in the individual propriety silos of D-tech is a common standard. We motive a diabetes JPEG, USB, or DVD. All the competing industry players distinguish the value of this, but it seems no single wish step up to the plate to make it materialize. To the saving comes a non-benefit Silicone Valley outfit (even they realize this is a cultural oxymoron) called Tidepool who briefed us on their ongoing development of a free out-of-doors-source D-data platform. One of last year's patient winners, Jana Beck, has just joined their team up, while another of last year's winners, Sara Krugman, is working on their user interface via her original healthcare design studio called Line. I think history wish judge their work A the NASA moonshot of diabetes. It's a wide effort that might change our humankind.

That aforesaid, early in the 24-hour interval, Anna McCollister-Slipp made a follow-up presentation from her last year's call to action and summed up that the progress on this front from last year was, well, non-real. She pessimistically pyramidical extinct that despite all the talk of better integration and various parties working jointly for common good, information technology just personal't happenin'. McCollister-Slipp is a ego-described policy nerd who closely follows goings on both in Washington Direct current and in manufacture. Her conclusion was that as no realistic action has been taken by diligence since the last Meridian, the only solution is armed rebellion. OK, I believably same that a little more strongly than she did, but she called on PWDs to organize and turn upward the heat on industry and government.

Uncomplaining Power Works

Speaking of political science, the FDA was represented this year by Courtney Lias, who runs the part of the FDA that approves meters and test strips, pumps, and CGMs. If you believe that the FDA is our opposition, intend again. This undermanned, understaffed, underfunded organization—which has a nearly impossible mandate—actually has a desire almost as large as our own desire to actuate D-tech forward.

Her bottom-descent message to industry: Talk to us early. The Food and Drug Administration is now uncoerced to be part of the design cognitive operation from the very beginning. In that way, device companies can know what is needed and expected as development goes forward, and avoid unexpected slowdowns and requests for more information down the moving.

Her bottom-line message to empowered patients: Hey, talk to us. Historical period. She says the lone way FDA knows what we need is if we tell them. She encourages more communication and more long-suffering involvement on advisory panels.

She also gave a nod to king rabble-waker Bennett Dunlap's well-crafted Strip Safely initiative. By the bye, White avens told Pine Tree State the campaign was fit to dump 2,440 tweets into the FDA inbox on a Thursday morning. The tweet footprint globally was nearly quintuplet-and-a-half million impressions, wildly exceptional his expectations and vividly demonstrating that atomic number 2 dispatch the nail on the head when information technology came to how important the emergence of strip accuracy is to all of us.

More significantly, Strip Safely worked. Information technology's a triumph for incorporated technological grassroots uncomplaining advocacy. Sort of our personal little Arab Spring. The FDA sat up and took poster. The wheels of modification are slowly opening to move, and I doubt that the never-say-die Mr. Dunlap will be content to sit on his laurels for long. (Thank Supreme Being for that.)

I'm a Doctor, Not a Villain…

New to the party this yr, and hopefully not for the last time, were the Payers. Conferred inalterable year's unexpectedly candid talk from the FDA, Summit organizers sagely regular a key chunk of time to learn the Payers' perspectives and to have a lengthy motion-and-answer geological period.

The main points the payers collectively wanted to tell us, it seemed, is that in the main, we patients are non their "customers." Our employers re, and the Payers seemed to view their role as one of saving their customers money. One even said they are "always looking for bran-new technology non to pay for." Hold your horses. It gets worsened. They also wanted everyone to do it that they survive in a heavily thermostated industry that is extremely competitive and exists connected razor-thin margins. They have to plan rate raises far ahead, while guessing what the FDA might approve. They discussed with cold honesty how they turn about deciding what to cover and not using a population-based calculus. IT was, candidly, some depressing and chilling. Until the fireworks started when our own Persevering Voices succeeder Corinna Cornejo used her affected role vocalize to give the panel an earful, and information technology went delightfully downhill (Beaver State uphill depending along your perspective) from there.

The Payers must not have been paying attention to the opening routine of this year's Summit: an emotion-aerated TV digest of the pleas of our patient winners for access to good tools that talk to apiece other and simplify the daily burden of diabetes control. There were any add up of non-quite an-dry eyes in the way by the end of the vid. Mine enclosed.

The reps of the Payers seemed to represent caught flat-footed away the flood of near-violent emotion that erupted. Several of them were doctors, who became highly antitank about their roles. One actually aforementioned He'd uttered in dozens of public forums and had never been uncovered to such anger. The clueless disconnect between the panel members and how their actions affect United States reminded me a bit of the AADE panel's actions at the Roche Friendly Media summit in 2010.

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Some of the attendees expressed sorrow to me later at the tone that this panel took on, and wondered what might have been cooked to sedate things falling.

Personally, I'm glad we didn't attempt to quash the discussion. Anger is a huge component part of having diabetes. Insurance companies do birth to make population-based decisions, but they too need to interpret in doing indeed, they are oft screwing with the lives of real people. We are so much more than numbers, and I think people World Health Organization pot entirely with numbers want a periodic refresher about the outcomes of their decisions on our lives. It was obvious that no of them had whatsoever clew about what information technology is like to live with diabetes — except for the woman from the Arkansas Health Commutation, who's living with type 2, and clearly "gets it." And, hey, it's not care we let the audience throw rotten vegetables at them. (AmyT wisely removed all the rotten vegetables from the room at the start of the academic session.  😉 )

Speaking of AmyT, I thought she brilliantly summed finished the session aside quoting an of age Spiritual leader proverb: "Entirely beginnings are fraught with difficulties" (which sounds better in Yiddish, she tells me).

But the Payers then went on to campaign a second wave of ire when the moderator asked how patients seat second-best pass on with insurance plans and basically gave the do: your doctor should be the one calling us — information technology's the doctor's job to advocate for you. This second wave of ira came not from patient voices this time, but from the clinicians present, who blew a collective gasket. Skillful doctors already spend countless hours on the phone advocating for their patients, without being compensated for this (unlike lawyers WHO tin can bill every moment worn out on a client's behalf, doctors don't begin stipendiary for phone calls, prior authorization paperwork, appeals, essential visits, or remote wake of information—and every last this can eat skyward a huge pct of a physician's prison term all month).

In fact, one endo told me later that the time effect of dealing with insurance companies has robbed her of such billable forbearing prison term that her practice has damned money every twelvemonth for the last triplet geezerhood. She stays in the plot for the love of her patients, but were it not for her husband's income, she would already be out of businesses. She worries that there won't embody a genesis of young docs to fill her place when she drops numb on the job (probably pursuit a heart attack generated by stressful to "mouth off" to an indemnity company on behalf of united of her patients).

Tidbits, Sour-tasting and Otherwise

* In other news of the mean solar day, the amazing results of our enduring survey that shows that pretty much no indefinite downloads their data because it is such a hassle to do so.

* Those damn Europeans (we love you) get all the goodies first because the European version of the FDA does not require additional condom data on precedent devices like pumps, meters, and CGMs. Rather, they only ensure that the devices meet manufacturing standards. This lets device companies trade their wares concluded in that respect, patc doing the medical institution trials required to sell their train finished Here in the The States. (It's important to billet that not all Europeans are happy or so this.)

* Speaking of beyond our borders, Canadian Patient Voices winner Amy Tekrony was absolutely appalled at her first close-up look at American healthcare, as was our winner from down under, type-1 and D-pappa discoverer Simon Carter.

* None mmol/L in Deutschland. Patient winner Julia Neese and I were comparing our Dex G4s (her BGLs were waaaaaaaaay better than mine) and I was surprised to learn that the Germans use mg/dL like we do. I had always thought they were mmol/L like the relaxation of Europe. While she's generally happy with her country's approach to health care, she told me that getting CGM covered is quite trick and she's been paying out of pocket for the technology that she says has completely revolutionized her spirit and health. Said technology, nevertheless, was busy one of its notorious ??? moments, but she had the satisfaction of putting the misbehaving unit right-hand under the nose of one of Dexcom's senior VPs. Sadly, I was pulled away and didn't hear how that conversation ended!

* Speaking of Dexcom, in the very near future day they might cost unlocking their system, making their data transparent. I was too technical school-stupid to understand the technical details and acronyms, but after hearing the pleas from my more technical school-savvy peers for better access to the data flowing from the G4, a senior Dex Executive sitting at my table picked up his smart phone and sent a request up the intellectual nourishment chain of mountains, locution, "I Don River't see any reason why we shouldn't do this." Retain your fingers interbred.

* Everyone in attendance got a skillful logotype-increased gymnasium bag containing (complements a of Target) a Misfit Shine — that cool new activity tracker appliance that retails for $120. Nice! I understand they gave them forth at the Stanford MedX conference, too, but since I missed that opp I was glad to get on the receiving last Here.

* And in my favorite WTF moment, OmniPod introduced a new pod that actually raises your blood sugar instead of lowering information technology. They donated both milk and dark self-coloured-chocolate fuel pod replicas. Yummy, only I didn't find the carb calculate on the inside of the (empty) box until the next day. It was 26 carbs per pod. I very wrongly guessed 18, thus I'm again calling for a carb-sniffing wand from my high-tech interior designer colleagues…