Diabetic Live

Cellnovo, a company working towards the development of new insulin delivery technologies, recently received CE Mark approval for its mobile diabetes management system, the first of its kind that the world has seen. The approval is an important milestone for Cellnovo in offering new, flexible technologies that aid diabetics in managing their disease.

“This is Cellnovo’s first step in a journey to bring this mobile diabetes management system to the world,” said William McKeon, Chief Executive Officer at Cellnovo.

The management system, also called Cellnovo, utilized mobile, wireless technology to aid diabetics in the management of their disease. The system is composed of an insulin patch pump, a touch-screen handset equipped with a blood glucose monitor, and an extendable applications set.

“Cellnovo has created the first insulin pump that brings innovation and combines form with function, essential qualities in a device that patients have to interact with 24/7,” said Dr. Pratik Choudhary, a Clinical Lecturer in Diabetes at King’s College London.

The patch pump developed by Cellnovo is the smallest and most precise one yet. The touch screen interface that the system uses will also be familiar and easy to navigate for anyone who has used a handheld mobile device such as an iPhone.

“Cellnovo has combined advanced mobile and medical technology which may create a paradigm shift in diabetes care,” according to Irl B. Hirsch, Professor of Medicine at the University of Washington in Seattle. “For the multitude of patients who could benefit from pump therapy, Cellnovo could be a game-changer.”

Perhaps the most innovative feature of Cellnovo’s diabetes management system is its ability to receive and transmit data wirelessly and in real-time to a portal that both patients and physicians have access to. The automated transmission of blood glucose data simplifies the process of keeping track of such information for patients, removing the need for diabetics to keep track of every measurement. It also ensures that the data is collected quickly, accurately, and consistently, allowing constant and efficient monitoring of the disease by health care professionals. This new capability could redefine the models that physicians use to treat diabetics, according to Dr. Mark Evans, a lecturer and Honorary Consultant with the Institute of Metabolic Science at the University of Cambridge.

“The ability to see real-time data of patients who may be hundreds of miles away provides the opportunity to redefine our care model,” said Dr. Evans.

Dr. David Kerr, a Consultant Physician and Diabetologist at Bournemouth Diabetes and Endocrine Centre, was also optimistic about the role that Cellnovo could play in revolutionizing diabetes care. “Cellnovo has the potential to break new ground in bringing the first mobile diabetes management system to market. It is clear that new technologies for diabetes care, such as Cellnovo’s mobile health solution, are going to forever change the way we practice medicine and more effectively manage diabetes long into the future.”

Cellnovo previously announced that it would be partnering with LifeScan, a Johnson & Johnson company based in California, to utilize LifeScan’s blood glucose monitoring technology with the Cellnovo mobile management system.

“We wanted superb blood glucose monitoring technology inside our mobile handset and LifeScan is a market leader,” said William McKeon, Chief Executive Officer of Cellnovo. “Through our partnership with LifeScan, our combined technologies will advance care through connectivity.”

Cellnovo is a mobile health technology company based in the U.K. Cellnovo’s goal is to utilize mobile technology to allow diabetics greater freedom and simplifying the process of insulin administration and glucose monitoring.

A recent study of 3,400 Chinese adults, age 40 and over, has found that exposure to bisphenol A is not associated with an increased risk of developing diabetes. Bisphenol A is a chemical used in plastics that has been surrounded by controversy since some claimed it was responsible for health problems. The findings were published in the journal “Annals of Internal Medicine.”

The results of the study found that there was no correlation between levels of bisphenol A (better known as BPA) in the urine of study participants and their chances of having diabetes.

The 25% of the study participants with the highest urinary levels of BPA were found to have a higher risk of diabetes than those with a lower concentration of the chemical. However, the researchers did not find a “dose-response” relationship between BPA and diabetes — meaning that they did not discover any evidence that risk of developing diabetes increased as urinary BPA levels increased. The researchers said that, ultimately, they are unable to conclude whether there was a connection between BPA and diabetes.

Despite the research team’s findings, many are not convinced that they have put the issue to rest. Researchers outside the team have questioned the conclusions that they reached.

BPA is an endocrine disruptor: a chemical that can have a negative impact on normal hormonal activity in the human body. It’s also hard to get away from — it has been used for decades in the manufacture of hard plastics and linings for metal food and drink containers. Previous research has suggested that the large majority of Americans — about 95 percent — have some level of BPA in their blood.

Studies conducted recently on animals have suggested that BPA could contribute to certain types of cancer and heart disease and that it could affect neural development in children. Since the controversy around the chemical arose, the major manufacturers of bottles and cups for infants have stopped using it in the manufacture of those products.

Still, the effect of BPA on humans is unknown and remains controversial. In two large studies, elevated levels of BPA were found to be linked to increased risk of heart disease, while a study conducted in 2008 showed that individuals with higher BPA concentrations were at a higher risk of developing diabetes. Despite the associations, however, a causal relationship between the chemical and those conditions has not been proven — only a correlation.

The study analyzed data from 3,423 men and women; 32% of the participants had Type 2 diabetes. The participants were divided into four groups according to the levels of BPA in their urine. The group with the highest percentage of BPA was 37% more likely to have diabetes than the group with the lowest levels of BPA. However, the group with the second-highest concentrations of BPA showed no increased risk of diabetes while the next lowest group did show an increased risk.

Dr. Guang Ning with Shangai Jiao-Tong University School of Medicine, head of the study, stated that there was no “clear, monotonic relationship” between the presence of BPA and an increased risk of diabetes. “The evidence was not sufficient enough to declare an association,” said Ning.

However, an editorial published along with the study stated that the approach the researchers took was “idiosyncratic” because it all but dismissed the group with the highest levels of BPA and the highest risk of diabetes.

“It would be great to see the data released to the wider scientific community,” said Tamara Galloway, professor at the University of Exeter in the United Kingdom and an editorial writer for the study.

A study conducted on elderly (over 65) patients who had been diagnosed with Type 2 diabetes found that they were not as aware of their own hypoglycemic conditions as were middle-aged (age 39-64) patients.

The objective of the study was to determine the subjective responses of elderly patients to hypoglycemic episodes. Such patients are at a higher risk for severe episodes, but their subjective evaluations of their own blood glucose levels had not been previously evaluated. According to the researchers, hypoglycemia is the limiting factor in the management of diabetes, and there is increasing evidence that hypgoglycemic episodes are an important factor in the management of Type 2 diabetes.

The study examined 13 older (over age 65) patients and 13 middle-aged (age 39-64) patients who had been previously diagnosed with Type 2 diabetes. None of the patients demonstrated any symptoms of neuropathy, heart disease, a history of stroke, or overt nephropathy, and none of the patients had experienced a serious hypoglycemic episode that required the help of another person within the last year before the study took place.

Patients were administered insulin and dextrose intravenously, with the controls for the administration located outside the room so the patients would be not be able to tell that they were receiving the substances. The patients were required to fill out a semi-quantitative symptom questionnaire, rating the severity of eleven symptoms of hypoglycemia including dizziness, tingling, blurred vision, difficulty to concentrate, faintness, anxiety, palpitation, hunger, sweating, irritability, and tremor. Once they were finished answering the questionnaire, the patients were asked to estimate their current blood sugar levels.

Researchers had also measured the patients’ reaction times using a standard vigilance task, requiring them to identify changes in frequency of a sound by pressing a button as quickly as possible.

Upon analyzing the results of the study, researchers found that baseline blood glucose levels did not differ between the older and middle-aged group reached a hypoglycemic plateau faster than the older group did. Baseline concentrations of insulin were also similar between the two groups. The results did show that the older patients failed to perceive neuroglycopenic and autonomic hypoglycemic symptoms that the younger patients identified. The researchers stated that the differences in subjective evaluations of hypoglycemic symptoms were not caused by alterations in neuroendocrine counterregulation since the hormonal responses were similar across both age groups.

The authors believed that more studies would be necessary to identify the reason behind the differences, stating that “The mechanisms underlying the severe impairment of hypoglycemia awareness in our older patients cannot be derived from our data.” However, they speculated that the brains of older patients showed a diminished capacity for perceiving its own cognitive and physiological alterations due to hypoglycemia. They suggested that the results had important implications for Type 2 diabetics and that elderly diabetics may be more at risk for severe hypoglycemic episodes since they are less aware of their own hypoglycemic states.

The study was authored by Jan P. Breber, M.D., with the Department of Internal Medicine I at the University of Luebeck in Germany; Kamila Jauch-Chara, M.D., with the Department of Psychiatry and Psychotherapy at the University of Luebeck; Manfred Hallschmid, Ph.D., with the Department of Neuroendocrinology at the University of Luebeck. Corresponding author was Bernd Schultes, M.D., with the Interdisciplinary Obesity Center at Kantonsspital St. Gallen in Switzerland.

Mutinational pharmaceutical company Novartis recently announced at the 47th annual Meeting of the European Association for the Study of Diabetes that results from a recent study demonstrated that Galvus® (vidagliptin) is similar in safety profile to placebo when it is used in conjunction with other anti-diabetic therapies in patients who have Type 2 diabetes and moderate to several renal impairment. The study, sponsored by Novartis, also showed that vidagliptin significantly improved glycemic control when it was added to current therapies.

Vidagliptin, a dipeptidyl peptidase-4 (DDP-4) inhibitor, is the largest of its type. It is used to treat patients with Type 2 diabetes with moderate to severe renal impairment, a condition known to be difficult to treat.

The study was randomized, double-blind, parallel-group, and placebo-controlled. It was conducted across multiple facilities and lasted 24 weeks. The study tested vidagliptin 50mg qd for safety and tolerability among 294 patients who had moderate renal impairment and 221 who had severe renal impairment. The groups were randomized, receiving either vidagliptin or placebo.

Researchers used glomerular filtration rate (GFR) to measure the renal function of the patients. Moderate renal impairment was defined as < 30 mL/min/1.73m while severe impairment was defined as 30 to < 50.

The data produced by the study showed that safety and tolerability of vidagliptin 50mg in patients with both moderate and severe renal impairment was typically similar to placebo.

Adverse events in patients with moderate renal impairment were similar in those receiving placebo and vidagliptin (68% and 73%, respectively), while serious adverse events registered at 9% in both groups. Only 3% of the patients on vidagliptin developed adverse effects leading to discontinuation of the medication compared to 5% on placebo; 1% of both groups died during the course of the study.

Adverse effects in patients with severe renal impairment were similar to moderate renal impairment patients at 73% on vidagliptin and 74% on placebo. 19% of the serious renal impairment patients taking vidagliptin experienced serious adverse effects compared to 21% on placebo; 2% of the vidagliptin patients died compared with 4% of the placebo patients.

Patients in the moderate renal impairment group who were treated with vidagliptin showed slightly higher rates of hypoglycemia, comparable to those in the severe renal impairment and placebo groups; this confirms a previous report that vidagliptin is associated with a low risk of hypoglycemia.

“Safety is the primary concern in the treatment of patients with renal impairment and this study demonstrated strong safety results with vidagliptin, without compromising on efficacy,” said Ameet Nathwani, M.D., Global Head of Cardiovascular and Metabolism Development Franchise with Novartis Pharmaceuticals. “Renally-impaired patients are a particularly vulnerable and high-risk T2DM population3 with limited therapeutic options.”

Patients with severe renal impairment who took vidagliptin displayed a higher rate of infections and infestations than patients taking placebo. Most of the adverse effects reported in the study were mild or moderate.

Patients showed a statistically significant decrease in blood glucose levels when vidagliptin was added to other anti-diabetic therapies — 0.7% from baseline in patients with moderate renal impairment and 0.9% in patients with severe renal impairment. The once-daily 50mg dose of vidagliptin was most effective in patients with average renal impairment; patients with normal renal function saw maximum efficacy from taking two daily doses of vidagliptin 50mg.

Vidagliptin is a DPP-4 inhibitor that prevents the breakdown of incretin hormones, which are responsible for stimulating insulin production in the pancreas. It targets the dysfunction in islet alpha and beta cells in the pancreas that causes increased blood sugar levels for those with Type 2 diabetes.

A Phase III investigation of linagliptin (trade name Trajenta® in Europe) that lasted 102 weeks has shown significantly lowered blood glucose levels in adults who have been diagnosed with Type 2 diabetes. The results of the study were presented at the 47th yearly meeting of the European Association for the Study of Diabetes (EASD) by Boehringer Ingelheim and Eli Lilly and Company. The findings demonstrated that linagliptin, a DPP-4 inhibitor, showed a positive safety profile in addition to reducing HbA1c levels by 0.8% over a long term period in patients who were treated with the medication for the entire duration of the study.

The results showed not only the effectiveness of linagliptin, but its usefulness in the long term. “These results show that the efficacy achieved by linagliptin is reliable and meaningful in a clinical setting, but also that it is durable over the long term,” said Professor David Owens, Clinical Professor with the Department of Medicine at the Cardiff University School of Medicine in Wales, U.K. “This is especially important in chronic conditions such as type 2 diabetes.”

The data provided by the study demonstrates the effectiveness of linagliptin as well as the patients’ ability to tolerate it as a medication for Type 2 diabetes over a period of 102 weeks. Linagliptin was tested as a treatment by itself, as a dual treatment with metformin or pioglitazone, or as part of a multiple medication treatment along with metformin and sulphonylurea. After 24 weeks of blinded treatment, patients showed a reduction in HbA1c level of 0.8%; those results were durable, lasting throughout the remaining 78 weeks of the investigation. On average, the participants experienced a low incidence of hypoglycemic events while their body weight stayed about the same.

A separate investigation lasting 12 weeks demonstrated linagliptin’s effectiveness and durability when used as a dual medication in combination with metformin. The test used a group of patients who had been diagnosed with Type 2 diabetes and were taking uncontrolled metformin twice daily, a dose of 1500mg per day. The group was further split into two separate groups; one group took linagliptin 2.5mg twice daily — to simplify dosing, as the patients were already taking metformin twice daily — while the other group received linagliptin 5mg approved doses once daily. After adjusting for placebo, the results indicated that the two groups showed a comparable reduction in HbA1c, at 0.74% for the group taking linagliptin twice daily and 0.8% for the group taking the medication once daily.

“Linagliptin is a new treatment that is primarily excreted unmetabolised via the bile and gut, and so delivers reliable HbA1c reductions at one dosage strength for all patients, even for those with declining hepatic or renal function,” said Professor Anthony Barnett, a consultant physician with the Heart of England NHS Foundation Trust as well as Emeritus Professor of Medicine at the University of Birmingham in the U.K. “One dosage strength for all patients will help make the process of prescribing easier and more straightforward for physicians.”

The findings of the investigation demonstrate meaningful effectiveness of linagliptin, with good safety and tolerability markers, across patients with all types of Type 2 diabetes — from those who have been newly diagnosed with the disease to those with significant renal impairment.

Linagliptin was developed by Boehringer Ingelheim and is being marketed by Eli Lilly. Linagliptin inhibits DPP-4, an enzyme that degrades glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP).

The U.S. Department of Agriculture has long held the food pyramid in high esteem as a recommendation for the types of foods we should be eating and their ratios to other foods. Within recent months, however, the USDA has redesigned its nutritional recommendations in the form of a plate, with portions of vegetables, grains, protein, fruit, and dairy represented as “slices of the pie.” The new dietary recommendations, detailed by the USDA at www.myplate.gov, was praised by some and criticized by others.

The Harvard School of Public Health and Harvard Health Publications are two of the groups that have leveled criticism against the new “plate” initiative. In response, they have created the “Healthy Eating Plate,” their own version of the USDA’s food plate.

According to Walter Willett, professor of epidemiology and nutrition as well as chair of Harvard School of Public Health’s department of nutrition, the USDA’s “My Plate” initiative is “simple,” but it might be “too simple.”

“It doesn’t have the details necessary to make healthy food choices,” said Willett. The lack of detail in the types of foods that we should aim for mean that you could follow the advice from My Plate and still eat a “horrible diet,” according to Willett. “It’s pretty useless.” In response to the perceived lack of detail in the USDA’s My Plate, Harvard’s Healthy Eating Plate is more specific about the types of food that are being recommended.

As with the USDA’s plate, half of Harvard’s plate is made up of fruits and vegetables, with slightly more vegetables than fruit. However, the Harvard plate specifically notes that potatoes don’t count as vegetables in this situation — Harvard researchers recently conducted a study that associated potato consumption with increased weight gain over a long period of time.

The “grain” section is more clearly defined to mean “whole grains” such as brown rice, whole wheat bread and whole grain pasta instead of refined and processed grains such as white rice and bread. The “protein” area of the plate is also more specifically defined as “healthy proteins,” including poultry, beans, fish, and nuts, which limits consumption of red meat and recommends cutting out processed meats, bacon, and cold cuts entirely.

A glass of milk has long been held as a healthy drink, but the Harvard Healthy Eating Plate eliminates the serving of dairy that the USDA’s plate recommends, instead encouraging people to drink a glass of water, tea, or lightly-sugared coffee. According to Willett, the Healthy Eating Plate only has room for one or two servings of dairy per day.

The Harvard diet includes a bottle of oil to the side of the plate to represent the healthy unsaturated fats found in foods like olive oil. According to the Harvard plate, we should limit butter while trans fats should be eliminated completely. According to Willett, the USDA plate does not provide enough detail about “the type of fat that should be used when we put something on our bread, on our vegetables [or] when we bake or cook,” says Willett.

The Myplate.gov initiative seeks to simply the sometimes complicated process of choosing a healthy diet. Among the no-nonsense recommendations are eating less and avoiding oversized portions, eating at least half of your grains as whole grains, and drinking water instead of sugary drinks.

A registry analysis reports that patients who had been diagnosed with Type 2 diabetes and used insulin therapy to manage the disease were 19% more likely to die after a percutaneous coronary intervention than were diabetics who managed the disease through oral antiglycemic medication or with diet.

Even after researchers adjusted the results to account for the severity of the diabetes, the results remained the same. The findings were reported by Dr. Anna Norhammar with the Karolinska Institute of Sweden at the yearly meeting of the European Association for the Study of Diabetes.

“Patients with type 2 diabetes who are taking insulin are at a very high risk after cardiac angiography, especially if they have a history of previous myocardial infarction or renal complications,” said Dr. Norhammar. “We need to give these patients special attention and intensive handling.”

Dr. Norhammar’s research team used data on patients from two Swedish registries: the Swedish Coronary Angiography and Angioplasty Register (SCARR), which indexes all patients who have undergone those procedures, and the National Diabetes Registry, which holds data on about 70% of the Swedes diagnosed with diabetes. The research team identified 14,079 patients who had been indexed in both registries from 2001 through 2009; these patients were used to find the results of the study.
Patients were separated into four groups according to the type of treatment they received: those treated with diet alone, those treated with oral medications alone, those treated with insulin and oral medications, and those treated only with insulin.

The mean age of the patients was 69 years. The patients taking insulin only had the disease for an average of 15 years, while the patients who were being treated with therapies other than insulin had the disease for an average of 6 years.

Mean hemoglobin A1c in the patients rose along with the intensity of the treatment, from 6.5% in the group treated with diet to 7% in the group treated with oral medication to 7.8% in the groups treated with only insulin or with oral medication and insulin. The diet-only group had a 13% chance of developing retinopathy, compared to a 54% chance in the insulin-only group.
The insulin-only group also saw increased rates of heart failure (24%) compared to the other groups; the diet-only group was at 14% while the oral medication-only group was at 12% and the combination therapy group was at 17%. A significant number of the insulin-only group (39% of the patients) had suffered heart attacks while 29% of the diet-only group had such heart failure.

About 70% of the patients had been diagnosed with hypertension. The group treated with only insulin had a greater chance of developing renal insufficiency and peripheral artery disease, but the numbers were not statistically significant.

The patients’ angiographic results also varied according to the type of treatment they received. Of the patients treated with diet only, 22% had normal angiographic results; 17% of the insulin-only group had normal results. The insulin-only group had a higher rate of three-vessel disease, with 30% of the group developing the disease while only 23% of the diet-only group did the same.

After six months of treatment, the mortality rate was higher for the insulin-only group at 9%. Less intensive therapies indicated lower mortality rates, with the diet-only and oral medication group experiencing a 5% mortality rate and 7% for the combination therapy group.

By the four year mark, mortality in the insulin-only group was at 22% while the diet only group was at 15%; at the eight year mark, the insulin-only group’s mortality rate was over 50% while only 38% of the diet-only group had died.

Dr. Norhammar says it is unclear whether insulin-only treatment is directly responsible for the greater risks of disease and mortality or if it is simply a sign that the patient has a more advanced disease, which is likely to cause more complications and mortality.

That energy drink or the next can of soda you drink may not seem like it’s doing that much harm, but people are getting an enormous amount of calories from drinks today. While mankind lived for thousands of years on water alone, we now have a huge array of tasty (and sometimes seemingly healthy) beverages available every day, from fruit juices to soda to cappuccinos, and they all have the potential to flood our bodies with an enormous number of excess calories.

“It’s a huge problem,” says Katie Warwick, dietitian with the Toronto Western Hospital who works with patients who have received a recommendation for bariatric surgery. “A lot of our patients aren’t aware of how many calories they’re actually drinking. There’s the misperception that if it’s healthy, such as milk or juice, the calories don’t cause weight gain.” In other words, fruit juice may provide vitamin C and other important nutrients, but it also provides lots of energy in the form of calories, just as any other food does. And that extra energy can induce a caloric excess that causes your body to store fat.
Canadian beverage companies are beginning a two-year initiative that will emphasize the amount of calories contained in a drink right on the packaging. Similar companies in the U.S. have started a similar campaign.

Not only are we consuming more sugary and high-calorie drinks, but we’re consuming more of them in a single sitting. “For years the beverage industry considered 591-mL a multi-serve portion,” says Justin Sherwood, the president of the Canadian Beverage Association. “But our research shows that many consumers are now drinking it in one sitting.”

Data from Statistics Canada shows that middle-aged Canadian men in their 30s and 40s receive 16% of their daily caloric intake from liquids, while women receive 14.3% of their intake in liquids. In younger generations, it’s even higher: men in their 20s receive 20.4% of their calories from beverages and women 17.9%.

Those numbers are far out of line with what is considered healthy. According to Barry Popkin, a professor of nutrition at the University of North Carolina at Chapel Hill and leading obesity researcher, people should gain more like “between five and ten percent” of their daily calories from beverages.

It’s so easy to consume an excessive number of calories from beverages because they don’t activate the satiety mechanisms in our bodies the way solid foods do. The hormonal process from the gut signaling that we’re full is not fully realized when we consume calories in liquid form. Since we don’t feel full, we can consume hundreds of calories from a liquid and still feel like we need to eat some solid food.

According to Barry Popkin, “Our thirst mechanism developed separately from hunger so we could constantly drink water but eat only when food was available.” For thousands of years, mankind relied only on water; this evolutionary advantage has turned into a disadvantage as we have been exposed to tasty beverages that flood our bodies with extra calories.

Most of the offending beverages consist of simple sugars. These sugars move quickly through the gastrointestinal tract; they do not promote satiety or provide the fiber and fats that slow down digestion the way solid food does.

A recent study published in the New England Journal of Medicine found that the foods most responsible for contributing to the obesity problem include potatoes, potato chips, and high-sugar sweetened beverages.

The Juvenile Diabetes Research Foundation (JDRF) recently announced on September 14 that it is sponsoring a $100,000 Challenge, calling for the development of new methods for discovering and creating a glucose-responsive insulin medication for treating insulin-dependent diabetes. The JDRF is a global leader in promoting research and development in prevention and medication for Type 1 diabetes. The challenge is open to the public; it can be found at InnoCentive.com, a website that allows the global community to work together in solving problems across a wide variety of fields.

The JDRF is utilizing InnoCentive’s base of “problem solvers” to encourage the development of a transformative and sophisticated insulin medication for diabetics. The JDRF hopes that the drug will improve glucose control, reduce or eliminate the need for frequent blood sugar testing, and decrease the chances of long-term complications arising from diabetes.

The ultimate goal of the challenge is the development of a glucose-responsive insulin medication; such as a medication would only activate when the body requires it, releasing the proper amount of insulin into the bloodstream upon the detection of high blood glucose levels. It will also regulate blood glucose levels in diabetics while requiring only a single dose each day, or even less if possible.

According to Aaron Kowalski, Ph.D., assistant Vice President of Treatment Therapies at the JDRF, modern insulin treatments and blood sugar monitoring technologies place an unnecessary burden on diabetics. “Today, insulin treatment requires diligent monitoring and burdensome administration, often several times a day, every day,” says Dr. Kowalski. This remains the only way to regulate blood sugar levels for the millions of individuals with insulin-dependent diabetes worldwide. Although research has propelled the development of better and faster-acting insulins, the disease is still hard to control because of the way insulin is administered to patients.

What we need is sophisticated insulin that will take the guesswork out of managing diabetes by developing a novel insulin that works in the same way insulin works in people without diabetes. By fostering novel approaches from diverse problem Solvers within and outside the diabetes field, we hope this Challenge with InnoCentive will help speed progress toward the development of glucose-responsive insulin- progress urgently needed by people with diabetes.”

Dwayne Spradlin, CEO and president of InnoCentive, commented on the new project.

“JDRF is an organization that recognizes the importance of innovation in the healthcare industry,” said Spradlin. “This approach of looking beyond traditional researchers to gain new insights, ideas, and solutions illustrates their commitment to finding a better way to treat diabetes. We are excited to be partnering with JDRF finding new ways to enhance the quality of life for patients while helping patients better manage their disease.”

InnoCentive.com is a platform for connecting businesses or organizations looking for solutions (“seekers”) with interdisciplinary scientists and research groups who have the resources and capabilities to offer solutions (“problem solvers”). The platform is an “open source” model that encourages scientists from all over the world to offer their own solutions to the problems. Cash rewards are offered for the best solutions, typically in the $10,000 to $100,000 range. Solutions have come from countries all over the world, including the United States, Europe, Russia, India, China, and Argentina.

InnoCentive is based in Waltham, Massachusetts. The idea for the company came to its founders in 1998 and it officially launched in 2001.

Josefina Hernandez didn’t think that eating a bag of chips to prevent her blood sugar from dropping would be cause for getting fired. But Hernandez, who worked at a Walgreens in San Francisco, found her employment terminated when she did just that.

Hernandez, who has worked at Walgreens for 18 years as a cashier, was fired for eating a bag of chips so that her blood sugar wouldn’t drop too low. According to her attorney, Cindy O’Hara, Hernandez is a diabetic. “She reached for a piece of candy in her pocket. She didn’t have one so she grabbed a $1.39 bag of chips and ate some to raise her blood sugar to avoid an emergency,” said O’Hara.

According to O’Hara, the assistant manager of the Walgreens store noticed Hernandez grabbing the bag of chips. Hernandez was suspended for three days following the incident, then went on vacation.

But after returning from vacation, Hernandez said she was pulled aside, brought into the office, and terminated as an employee. She said that the management fired her because she ate the chips before she paid for them. However, she says she did pay the $1.39 that before the end of her shift.

O’Hara is an attorney with the U.S. Equal Employment Opportunity Commission. The Commission filed the lawsuit because it believes that incident is a clear case of discrimination against someone with a disability — in this case, diabetes.

“An employer has a duty to accommodate people who have disabilities and take that into account and in this case it was clear that the action that Ms. Hernandez took was because of a disability,” says O’Hara. Thus far, Walgreens has not offered any comment on the lawsuit.

According to the Americans with Disabilities Act, or ADA, employers are prohibited from discriminating against individuals with disabilities. The ADA recognizes diabetes as a disability, citing figures that nearly 17 million Americans over the age of 20 have been diagnosed with diabetes while over one million new cases of the disease are diagnosed each year. Individuals with diabetes can perform a variety of job functions, but according to the ADA, diabetics still receive discrimination from employers due to myths and stereotypes — such as the beliefs that diabetics are unable to drive, will require substantial sick leave, or will require frequent breaks. However, many diabetics work without restrictions or changes to normal schedules so employers typically aren’t even aware that employees have diabetes. Any accommodations that a diabetic may request, such as meal breaks, regular work schedules, and rest areas typically do not add any extra cost for the employer.

The Americans with Disabilities Act considers diabetes to be a “disability” when it “substantially limits one or more of a person’s major life activities” — activities that an average person can carry out with little or no difficulty, such as eating. Further, the ADA considers diabetes a disability when it causes adverse side effects that significantly limit a major life activity of the diabetic, even if the disease is currently being treated through diet, exercise, and insulin treatment and is no longer a limiting factor on those activities. Lastly, the ADA considers diabetes a disability if it does not affect the major life activities of an individual, but the individual’s employer treats him or her as if it does.

The ADA determines whether an individual’s diabetes is classified as a disability on a case-by-case basis.