Discover and read the best of Twitter Threads about #insulin

Most recents (24)

1a) Welcome to a 🆕#accredited #tweetorial on the importance of time in range #TIR in #diabetes . . . with additional emphases on #primarycare and on practice in 🇨🇦.
#FOAMed #endotwitter #MedEd @MedTweetorials #nephtwitter #cardiotwitter
1b) Hence we welcome2⃣ expert faculty from Canada: Ilana Halperin @ilanajhalperin, academic endocrinologist at @Sunnybrook and @uoftmedicine, and Noah Ivers @NoahIvers, #familydoc & researcher at Women's College Hospital @UofT ImageImage
2) Earn 0.75hr 🆓CE/#CME by following this🧵! This program is supported by an unrestricted educational grant from Sanofi Canada and is intended for #HCPs. Statement of accreditation & faculty disclosures at cardiometabolic-ce.com/disclosures/.
And so we begin . . .
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Sehr geehrter Herr @Karl_Lauterbach,
wie kann es sein, dass #Insulin schon wieder nicht lieferbar ist? Das Problem besteht nun schon seit dem letzten Jahr. Ich erinnere mich, dass ich damals schon bei Glatteis durch ganz Hamburg gefahren bin, um die Apotheken abzuklappern.
1/7
Wie kann es sein, dass (über-)lebenswichtige Medikamente nicht vorhanden sind? Neulich war es Amoxi, ein (zugegeben nicht ganz so überlebenswichtiges) Allergiemedikament, und das überaus wichtige Insulin.
Warum gibt es keine zentrale Datenbank? Wieso kann man nicht zentral
2/7
abfragen, wer wo welche Medikamente vorhanden hat? Wieso ist mein Rezept nur 4 Wochen gültig? Wieso muss ich jetzt erneut zum Arzt um ein anderes Rezept für eine andere Darreichungsform desselben Medikaments bekommen? Wieso muss ich überhaupt alle naselang zum Arzt um eine
3/7
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#Apologies can be steps towards assisting in #healing #medical #trauma. When my daughter was in @SanfordHealth for 2 months, virtually #secluded bc of accusations by #hospital administration that she causes her diabetic crisis a #hospitalist & #diabetic counselor accused 1
her of ‘stashing’ #Insulin in room. All visitors searched. No items in room unless searched - camera in room 24/7 YET she is accused of injecting #Insulin. My daughter again attempted to educate on post #TPAIT. After additional days, the #Diabetic #Counselor came back & 2
#apologized acknowledging how hard it was to control her #diabetes. It’s hard control when she is at #Baseline but if she is sick nightmare. That #apology meant the world 🌎 to my daughter. She continued to work w this #counselor throughout stay & after. YET #PatientRelations 3 Image
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a 🧵 In prep 4 today's 1pm @SenateHELP hearing on making #insulin affordable.
On graph: list price is roughly = net price (what pharma collects) + "rebates"/fees collected by Pharmacy Benefit Managers (#PBM) .

According 2 a 2021 @SenFinance "rebates" alone accounted for… twitter.com/i/web/status/1… Image
@SenateHELP @SenFinance @BernieSanders @SenBillCassidy @BoesingLoretta @NSmithholt12 @Free2CareHC @MsPattiPatti @nickjonas @tomhanks @VWOfficial @alldiabetesnews 2. With #PBM making most of the $ In the Insulin market (and for other meds) it's wild that there is little #transparency for PBM.
All of the red ovals show places where we cant see the $
Pic from our @Free2CareHC report: free2care.org/files/report.p… Image
3. If @SenateDems and @SenateGOP and @USCongress and @POTUS want to remedy the cost of Insulin and other drugs, hopefully they won't make the same mistake they did with the Inflation reduction act, "USA will NEVER solve the drug pricing problem without PBM reform – and instead… twitter.com/i/web/status/1…
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Warning ⚠️ ⛔️ : Uncomfortable Thread 🪡
My tweets lately have focused on my daughter’s #healthcare at @SanfordHealth & our struggle to access appropriate & compassion care where her agency is not taken away. I know the threads my be uncomfortable for some particularly if you 1
are a #medical professional. I am aware that many are thinking 💭‘what’s the back story’, ‘something they did caused this no #medical facility or #medical #professional would partake in this’. I get that. There IS a back story. A child at 2 wks having her 1st #hereditary 2
#pancreatitis flare. In 1st grade undergoing her 1st #transplant. In 6th grade undergoing 2nd #transplant. Complications, no real follow up. Complications being ignored. Physicians both on #transplant team as well as others questioning her symptoms, her #pain. Dismissing & 3
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So @SanfordHealth has continually accused my daughter of injecting herself w #insulin to create crises. Well she has security guard monitoring 24/7, all bags searched. Her #bloodsugars have dropped & skyrocketed with no rhyme or reason. We have told them this happens. There is 1
a note 📝 in chart from specialists that outlines (ignored) only thing looked at behavioral plan that highlights her insulin injecting 😡. #DiabetesEducator comes in & asks if she has #insulin on her as her #BloodSugar ‘doesn’t make sense’ 🤦🏻‍♀️. This is abusive. I have been told 2
they have the knowledge to care for her. She has been abused by security yelling at her calling her druggie (their words) & saying she injects herself with #insulin. Doesn’t matter if proof is right in front of face that what they are blaming her for is not accurate. They are 3
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Migraine, a common neurological disorder, may be a metabolic as much as a neurological disease, with the migraine attack serving as a warning signal to increased oxidative stress and/or hypometabolism. (1/21) #neurotwitter #hypometabolism
Despite being primarily studied in terms of neuro-vasculature and neurotransmission, recent research suggests that migraine's pathogenic mechanisms may be linked to metabolism and mitochondrial dysfunction. (2/21) #mitochondria
Magnetic resonance spectroscopy studies have consistently shown decreased ATP levels and abnormal mitochondrial function in migraineurs, suggesting a metabolic component to the disorder. (3/21)
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Insulin receptors and IGF-1 receptors, along with their signaling partners, are found throughout the brain. I think this needs a thread. 🧵(1/13)
IGF-1 receptors are involved in important #brain processes, including neuronal growth and survival, regulation of synaptic plasticity, and modulation of #neurotransmitter release. They are implicated in neuroprotection and #cognitive function. (2/13) #science #neuroscience
Many of you are familiar with insulin, but maybe you don't know well enough what its important roles are in the brain. Insulin affects neurotransmitter channel activity, brain cholesterol synthesis, and mitochondrial function. (3/13) #mitochondria
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Uncontrolled #epileptic fits stopped by #insulin

1. A man aged 75 had for five days experienced tonic-clonic #seizures involving the right side of the face and right upper and lower limbs at a frequency of 20-30 per day. He had mild weakness of right arm and leg.
#MedTwitter
2. Patient was admitted in ICU under Medicine Unit. MRI brain and lumbar puncture were normal. New onset diabetes was detected for which he was treated with subcutaenous insulin.
Fits persisted despite treatment with midazolam and phenytoin. He was referred for neurology opinion
3. Patient was conscious but appeared exhausted. Review of blood tests showed high glucose of 350 mg/dL and mildly low sodium levels.
The diagnosis was obvious by now.
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I usually tweet about #obesity but since I recently had a pt with type 2 #diabetes go from 100 units/d insulin to 0 with tirzepatide, this is a good time to review #insulin management when you start a GLP1 / GIP

#endocrine #endocrinology #research #clinicians
1/
SURPASS-5: tirzepatide + basal insulin vs. placebo

Method: If baseline A1c<8, ⬇️long acting insulin dose by 20% at start of study

Result: At end of study, insulin was ⬇️11% for 15-mg tirzepatide group vs. ⬆️75% for placebo

jamanetwork.com/journals/jama/…

2/ Image
SUSTAIN-5: semaglutide 1.0 + basal insulin vs. placebo

Method: If baseline A1c<8, ⬇️long acting insulin dose by 20% at start of study

Result: At end of study, insulin ⬇️15% for 1-mg semaglutide group vs. ⬇️4% for placebo

academic.oup.com/jcem/article/1…

3/ Image
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#Moderna is quadrupling the cost of #covid #vaccines, from $26/dose to $110-130. CEO Stephane Bancel calls the price hike "consistent with the value" of the #MRNA vaccines. Moderna's costs are $2.85/dose, for a 4,460% markup on every dose:

arstechnica.com/science/2023/0… 1/ Moderna headquarters in Cambridge, Mass. On the left side of
If you'd like an essay-formatted version of this thread to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

pluralistic.net/2023/01/24/nat… 2/
Now, obviously the manufacturing costs are only part of the cost of making a vaccine: there's also all the high-risk capital that goes into doing the basic research. 3/
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The less we eat, the longer we live

1. This seems to be true.
A recent extensive review of studies done in geographies with maximum 100+ aged people showed that most of them practiced some form of calories restriction (CR) right from childhood.
#fasting #Longevity #MedTwitter
2. Calorie restriction (CR) is defined as consuming fewer (10-30% lower) calories as compared to usual.
This can be achieved by either intermittent fasting, or time-restricted feeding or substantially reducing carbohydrate intake.
#nutrition #HealthyEating
3. In ageing, #Insulin increases and insulin sensitivity decreases, which increase the risk of #diabetes, #obesity and #cardiovascular diseases. CR reverses these- reduces insulin levels and increases insulin sensitivity. #Glucose levels also reduce with CR.
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The myopic focus of companies on profits has been criticized in recent years. Mads Øvlisen, the former CEO of @NovoNordisk, explains how the pursuit of a corporate purpose beyond short-term profits, can actually lead to higher long-term profits @TimaBansal
forbes.com/sites/timabans…
Corporate purpose isn’t just about vision and values, it’s about keeping an eye on the long term. Upholding #corporate purpose requires leaders to resist the short-term demands of shareholders & investors in order to build good & successful companies #CSR
forbes.com/sites/timabans…
In 1971 for the first time in Novo Nordisk’s history, #Øvlisen’s father-in-law had to make the decision to lay off employees. Faced with a similar challenge, Øvlisen worked hard to relocate them elsewhere in the organization, even if the fit wasn’t perfect
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Last week, Julia Belluz (@juliaoftoronto) published an article not on what #obesity is, but what it isn't: a personal failing. In it, she argues that obesity is not one thing, it's many. That's right. It's not OBESITY. It's OBESITIES.

nytimes.com/2022/11/21/opi…
This week, my colleague Ilene Fennoy and I published a paper delineating the history of all of these obesities. Nonetheless, people still argue whether obesity is a problem of energy storage (#insulin) or a problem of energy balance (#calories).

karger.com/Article/FullTe…
Because both are true. One set of causes (insulin, cortisol, genetics, obesogens) are a problem of energy storage. Another set of causes (nutrition, sedentariness, addiction, epigenetics, microbiome) are a problem of energy balance.
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HELL YES—Eli Lilly CEO now admit the #insulin tweet flap “probably” signals they need to bring down cost. Twitter trolling is working. As I reported—@LillyPad execs went into full raging panic when the “free insulin” fake tweet went out. Keep pressure on!
arstechnica.com/science/2022/1…
If only to keep pushing for lower insulin prices… it’s worth staying on Twitter. Cuz we need to hit @LillyPad at every turn, as well as pressure @sanofi @Diabetes_Sanofi and @novonordisk to stop price gouging insulin.
You know what’s 100x worse than price of gas? Price gouging on insulin that gets people killed.
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1/ November 14th is #WorldDiabetesDay

Let’s look back at one of the most influential #RCTs for

how we given insulin in #T2DM?

the #RABBIT2 trial🐰🧵

#Insulin #MedTwitter
2/ The #RABBIT2 study looked at the (1) efficacy and (2) safety of basal-bolus vs. sliding-scale #insulin in non-critical inpatients🏥.

Basal-bolus regimens consisted of a combo of #Glargine (basal) and #Glulisine (mealtime).

The primary outcome was average glucose🍬.
3/ See below for a graphical depiction of how the study was performed👇:
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💊💊TWEETORIAL ALERT!! 💊💊
Because last week was a busy week for #insulin tweets, @KhrystaBaig and I have saved this Tweetorial for our new @JAMA_current paper for a...um...less busy time. AHEM, remember? 👇 Follow along, will you? 1/10 Image
A little background before we dive into GIFs. While #insulin isn't free, it is only $35 on some plans in #PartD as part of the @CMSinnovates #SeniorSavings Model. But who saves money under this model? 2/10
jamanetwork.com/journals/jama/…
The #SeniorSavings Model allows plans to cover insulin at $35 copays with every fill. But in 2021 and 2022 you had to enroll into a plan to get $35 insulin. If you didn't pick a Model participating plan, you could have paid too much! 3/10
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Let me start with #insulin. In the 1970s, insulin was extracted from the pancreas of animals. In the 1980s, @Genentech, working with Eli Lilly (@LillyPad), developed insulin using a new technology that I call #PrecisionFermentation. It wasn’t animal insulin. It was human insulin.
The mainstream would say: “health care is slow, it can’t be disrupted.”

Well, here’s the S-curve of #PrecisionFermentation human insulin. Human insulin disrupted animal insulin in about 13 years.
#PrecisionFermentation is a concept that I coined in my @rethink_x report ‘Rethinking Food and Agriculture’ with @CatherineTubb in September 2019.
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Regarding @LillyPad and the false announcement that insulin would be free. From a girl living in a country (NZ) where insulin costs me, through our big pharma subsidisation program $5 per insulin type per quarter, and OTC around $40-60 a vial. A Thread. /1
@LillyPad First of all, I'm tagging you in every tweet of this thread. Hopefully all your rich disgusting shareholders will read this and realize the true cost of the money you feed them. After hearing what I went through, I hope your black hearts give out. SHAME ON YOU ALL! /2
@LillyPad I am a 38 year old, who was diagnosed in '85 at 3 yrs old with this nightmarish, unforgiving, difficult to control, and stressful disease, Type 1 Diabetes (T1D). As with most diabetics I was put on a regime of 2 insulins per day, a long acting twice a day, which /3
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STATEMENT from #WhiteHouse PLEASE read!>>Congressional Republicans have laid out their mega MAGA trickle-down economic plan clearly. Their economic plan will raise costs and make inflation worse. Their five part plan includes:
1/24 #BlueIn22 #RepublicansAreHarmfulToAmericans Image
$3 trillion in tax cuts skewed to the wealthy – which would add to the deficit and make inflation worse  2/24 #RepublicansAreHarmfulToAmericans #VoteBlueIn2022 Image
“GOP wants to push to extend Trump tax cuts… Republican lawmakers gear up to push 2017 tax law after midterm elections, despite potential impact on inflation.” Washington Post 10/17/22 #RepublicansAreTheProblem #VoteBlueIn2022 Image
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lowcarblifestylehub.com
The first ever event of its kind, the Men’s Health Matters Series is brought to you by The Low Carb Lifestyle Hub.
3 day virtual series capturing knowledge, wisdom, inspo from incredible men in the health space, sharing why men’s health matters.
1/
Each presenter answers a series of questions designed to show you how you can also make health matter.
Qu asked: why does health matter; what where the lightbulb moments to rethink how to optimise their health; what tips can you share to help others optimise their health.
2/
Many also covered in depth about their particular area of interest, and other important factors to be considered when it comes to achieving health in this modern world. These men have shared from their heart and minds, how to make it easier to optimise your own health.
3/
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#PfizerGate Hey guys! Look at a "DETAILED" (hahahah) list of what #Biden is doing with his #IRA ... lol...

whitehouse.gov/briefing-room/…
"locks in on average $800 per year lower health care premiums for 13 million Americans (fyi there's 350 million americans), lowers seniors’ prescription drug prices, and caps their out of pocket expenses for prescription drugs at $2,000 per year...and $35/mo insulin"....
Know that Trump already capped insulin at $1100/YEAR ($90/mo) so while $55/mo difference is a lot for some people, it hardly helps inflation for the rest of the country! Further, $2,000/year? That's something to shout about? Further yet, lowering premium costs for 3.7% of the...
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The tragedy of non-diagnosis of #T1D, results from the #T1Dindex -G. Ogle:

Missed T1D diagnoses are legion 💔

1⃣9⃣8⃣7⃣ Sydney: a 15yo boy passed away because of misdiagnosis as he'd just had chicken pox

#ISPAD #ISPAD2022 #dedoc°voices @lifeforachild @ispad_org 1/n Image
The tragedy of non-diagnosis of #T1D, results from the #T1Dindex -G. Ogle:

1⃣9⃣9⃣6⃣ Phnom Penh: no child alive with T1D in Cambodia then.
A boy had a late diagnosis, had had a dose on #insulin, but no fluid yet. He passed away 💔

#BG: 105mmol/1890mg

#ISPAD2022 #dedoc° 2/n Image
The tragedy of non-diagnosis of #T1D, results from the #T1Dindex -G. Ogle:

2⃣0⃣1⃣5⃣ Ghana: an 18yo girl was misdiagnosed with ectopic pregnancy because of acute abdomen, died during theatre where T1D diagnosis was made 💔

#ISPAD2022 #dedoc°voices @lifeforachild @ispad_org 3/n Image
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🧵Managing preschool behaviours to optimize diabetes:

Preschool challenges w/T1D - impredictability:
▶️ food intake
▶️ sleeping
▶️ activity
▶️ higher variabiilty in #insulin requirements
-Susana Patton

#ISPAD #ISPAD2022 #dedoc°voices #patientvoice @dedocORG @ispad_org 1/n
Managing preschool behaviours to optimize diabetes:

Tips to take back:
▶️ safe space to talk about meal or changing sites that can bring distress and higher #BG
▶️ recognise what's going well
-Susana Patton

#ISPAD #ISPAD2022 #dedoc°voices #payitforward @dedocORG @ispad_org
Managing preschool behaviours to optimize #diabetes:

We promote physical activity because we found out that preschoolers w/T1D have less than other preschoolers.
-Susana Patton

#ISPAD #ISPAD2022 #dedoc°voices
#diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org
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