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Prior to joining KQED, Amel worked at Al Jazeera America, Al Jazeera English, Democracy Now! and Punched Productions. She also helped produce \u003cem>Changing Face of Harlem\u003c/em>, a documentary that tracked gentrification in Harlem over a period of ten years. She is a 2013 graduate of Brooklyn Law School and is currently researching war on terror prosecutions for an upcoming book.","avatar":"https://secure.gravatar.com/avatar/c8b48ebc98e770640f3013c470d23f3e?s=600&d=blank&r=g","twitter":"amelscript","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"futureofyou","roles":[]},{"site":"science","roles":[]}],"headData":{"title":"Amel Ahmed | KQED","description":"KQED Contributor","ogImgSrc":"https://secure.gravatar.com/avatar/c8b48ebc98e770640f3013c470d23f3e?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/c8b48ebc98e770640f3013c470d23f3e?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/aahmed"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"futureofyou_444760":{"type":"posts","id":"futureofyou_444760","meta":{"index":"posts_1716263798","site":"futureofyou","id":"444760","score":null,"sort":[1538609096000]},"parent":0,"labelTerm":{},"blocks":[],"publishDate":1538609096,"format":"standard","disqusTitle":"Artificial Sweeteners Could be Sabotaging Your Microbiome, Says Study","title":"Artificial Sweeteners Could be Sabotaging Your Microbiome, Says Study","headTitle":"Diabetes Management | KQED Future of You | KQED Science","content":"\u003cp>Artificial sweeteners, widely regarded as a healthy alternative to sugar, may be sabotaging your gut biome.[contextly_sidebar id=\"yjhBwHasobhXnJ18NYXbIYtjXOq70PwF\"]\u003c/p>\n\u003cp>A new study published \u003ca href=\"https://www.mdpi.com/1420-3049/23/10/2454\" target=\"_blank\" rel=\"noopener\">in the journal\u003c/a> \u003cem>Molecule\u003c/em> found that \u003cem>E. coli\u003c/em> bacteria in the intestinal tract became damaged when exposed to several different kinds of artificial sweeteners.\u003c/p>\n\u003cp>The study zeroed in on six artificial sweeteners to determine their toxicity to the healthy bacteria present: aspartame, sucralose, saccharine, neotame, advantame, and acesulfame potassium-k.\u003c/p>\n\u003cp>The researchers used as markers special light-producing bacteria known as bioluminescent \u003cem>E. coli\u003c/em> that light up when toxicity is detected, according to the collaborative study by researchers at Israel’s Ben-Gurion University of the Negev and Singapore’s Nanyang Technological University.\u003c/p>\n\u003cp>Sucralose displayed the most significant effects, with as little as 1 milligram affecting a strain of the \u003cem>E. coli.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"This is further evidence that consumption of artificial sweeteners adversely affects gut \u003ca href=\"https://www.sciencedaily.com/releases/2018/10/181001101932.htm\" target=\"_blank\" rel=\"noopener\">microbial activity\u003c/a> which can cause a wide range of health issues,\" co-author Ariel Kushmaro, a professor of biotechnology engineering at Ben-Gurion, said in a statement.[contextly_sidebar id=\"zlhu2orfRNf238Xnhya1R1LkDBb9jMGv\"]\u003c/p>\n\u003cp>Disturbances in the gut ecosystem can seriously harm human health with previous studies showing that pathogenic\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425030/\"> bacteria\u003c/a> can cause many chronic diseases, including inflammatory bowel disease, obesity, diabetes, and cancer.\u003c/p>\n\u003cp>The presence of these chemicals is not always obvious, with many popular foods, such as microwave popcorn and fruit juice, labeling the ingredient as a \"natural sweetener.\" That's because the Food and Drug Administration has \u003ca href=\"https://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm456090.htm\" target=\"_blank\" rel=\"noopener\">yet to define\u003c/a> the term “natural” for use in food labeling.\u003c/p>\n\u003cp>Along with possible adverse health effects, the study warns that artificial sweeteners have become so ubiquitous that they're increasingly turning up in drinking water and groundwater basins.\u003c/p>\n\u003cp>\"They are resistant to wastewater treatment processes, therefore they are continuously introduced into the water environments,\" write the authors. \"Such concentrations [of artificial sweeteners] are among the highest known for anthropogenic trace pollutants.\"\u003c/p>\n\u003cp>\u003ca href=\"https://caloriecontrol.org/\" target=\"_blank\" rel=\"noopener\">Calorie Control Council\u003c/a>, the trade group for the artificial sweetener industry, criticized the study for relying solely on \u003cem>E. coli \u003c/em>bacterium, which they argue is not directly comparable to the human microbiome.\u003c/p>\n\u003cp style=\"font-weight: 400\">\"More specifically, it is unknown whether the changes to the bacterium noted in the study, or any changes in microbiome bacteria, are indicative of negative health outcomes in humans,\" the \u003ca href=\"https://caloriecontrol.org/\" target=\"_blank\" rel=\"noopener\">group \u003c/a>said in a statement emailed to KQED.\u003c/p>\n\u003cp style=\"font-weight: 400\">Moreover, the group says that all the sweeteners included in the study have been approved for use by several scientific and regulatory authorities, including the FDA.\u003c/p>\n\u003cp>To determine toxicity, researchers modified different types of \u003ci>E.coli \u003c/i>bacteria to emit light when experiencing distress. Researchers then could see what type of damage occurred, depending on which type of modified \u003cem>E. coli\u003c/em> glowed. Researchers found that each sweetener produced a specific fingerprint using three stripes of bacteria, with each stripe representing a different type of damage. From \u003ca href=\"https://www.livescience.com/63743-artificial-sweeteners-gut-health.html\" target=\"_blank\" rel=\"noopener\">Live Science\u003c/a>, quoting senior author Evgeni Eltzov:\u003c/p>\n\u003cblockquote>\n\u003cp class=\"p1\">The pattern of colors was unique for each sweetener; one might've caused more DNA damage than protein damage, for example. However, all sweeteners damaged the bacteria in some way, Eltzov said. But Eltzov noted that these findings don't mean the chemicals are \"toxic\" to humans. More research is needed to make that determination.\u003c/p>\n\u003c/blockquote>\n\u003cp class=\"p1\">One cited shortcoming of the study is that the concentrations of artificial sweetener used were higher than what's typically consumed in a can of diet soda. The \u003ca href=\"https://www.livescience.com/63743-artificial-sweeteners-gut-health.html\" target=\"_blank\" rel=\"noopener\">findings do\u003c/a> not\u003cspan class=\"Apple-converted-space\"> \u003c/span>\"tell us what happens in real life. It tells us what happens in a test tube,\" Dr. Kristina Rother, a senior research physician at the National Institutes of Health, told Live Science.\u003c/p>\n\u003cp class=\"p1\">\"Real life is just more complicated,\" Rother, who was not involved in the study, told Live Science.\u003c/p>\n\u003cp class=\"p1\">Still, she recommends avoiding artificial sweeteners.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp class=\"p1\">\"I haven't seen a study that says any of these six FDA-approved sweeteners make the gut microbiome better,” she says. \"So, my recommendation is very simple and very difficult to achieve: Live a healthy life, eat little processed food.”\u003c/p>\n\n","disqusIdentifier":"444760 https://ww2.kqed.org/futureofyou/?p=444760","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/03/artificial-sweeteners-could-be-sabotaging-your-microbiome-says-study/","stats":{"hasVideo":false,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":683,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":14},"modified":1538609096,"excerpt":"A new study that looked at several popular sweeteners indicates as little as 1 milligram is enough to turn gut bacteria toxic.","headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"A new study that looked at several popular sweeteners indicates as little as 1 milligram is enough to turn gut bacteria toxic.","title":"Artificial Sweeteners Could be Sabotaging Your Microbiome, Says Study | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Artificial Sweeteners Could be Sabotaging Your Microbiome, Says Study","datePublished":"2018-10-03T16:24:56-07:00","dateModified":"2018-10-03T16:24:56-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"artificial-sweeteners-could-be-sabotaging-your-microbiome-says-study","status":"publish","source":"Health","path":"/futureofyou/444760/artificial-sweeteners-could-be-sabotaging-your-microbiome-says-study","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Artificial sweeteners, widely regarded as a healthy alternative to sugar, may be sabotaging your gut biome.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>A new study published \u003ca href=\"https://www.mdpi.com/1420-3049/23/10/2454\" target=\"_blank\" rel=\"noopener\">in the journal\u003c/a> \u003cem>Molecule\u003c/em> found that \u003cem>E. coli\u003c/em> bacteria in the intestinal tract became damaged when exposed to several different kinds of artificial sweeteners.\u003c/p>\n\u003cp>The study zeroed in on six artificial sweeteners to determine their toxicity to the healthy bacteria present: aspartame, sucralose, saccharine, neotame, advantame, and acesulfame potassium-k.\u003c/p>\n\u003cp>The researchers used as markers special light-producing bacteria known as bioluminescent \u003cem>E. coli\u003c/em> that light up when toxicity is detected, according to the collaborative study by researchers at Israel’s Ben-Gurion University of the Negev and Singapore’s Nanyang Technological University.\u003c/p>\n\u003cp>Sucralose displayed the most significant effects, with as little as 1 milligram affecting a strain of the \u003cem>E. coli.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"This is further evidence that consumption of artificial sweeteners adversely affects gut \u003ca href=\"https://www.sciencedaily.com/releases/2018/10/181001101932.htm\" target=\"_blank\" rel=\"noopener\">microbial activity\u003c/a> which can cause a wide range of health issues,\" co-author Ariel Kushmaro, a professor of biotechnology engineering at Ben-Gurion, said in a statement.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Disturbances in the gut ecosystem can seriously harm human health with previous studies showing that pathogenic\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425030/\"> bacteria\u003c/a> can cause many chronic diseases, including inflammatory bowel disease, obesity, diabetes, and cancer.\u003c/p>\n\u003cp>The presence of these chemicals is not always obvious, with many popular foods, such as microwave popcorn and fruit juice, labeling the ingredient as a \"natural sweetener.\" That's because the Food and Drug Administration has \u003ca href=\"https://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm456090.htm\" target=\"_blank\" rel=\"noopener\">yet to define\u003c/a> the term “natural” for use in food labeling.\u003c/p>\n\u003cp>Along with possible adverse health effects, the study warns that artificial sweeteners have become so ubiquitous that they're increasingly turning up in drinking water and groundwater basins.\u003c/p>\n\u003cp>\"They are resistant to wastewater treatment processes, therefore they are continuously introduced into the water environments,\" write the authors. \"Such concentrations [of artificial sweeteners] are among the highest known for anthropogenic trace pollutants.\"\u003c/p>\n\u003cp>\u003ca href=\"https://caloriecontrol.org/\" target=\"_blank\" rel=\"noopener\">Calorie Control Council\u003c/a>, the trade group for the artificial sweetener industry, criticized the study for relying solely on \u003cem>E. coli \u003c/em>bacterium, which they argue is not directly comparable to the human microbiome.\u003c/p>\n\u003cp style=\"font-weight: 400\">\"More specifically, it is unknown whether the changes to the bacterium noted in the study, or any changes in microbiome bacteria, are indicative of negative health outcomes in humans,\" the \u003ca href=\"https://caloriecontrol.org/\" target=\"_blank\" rel=\"noopener\">group \u003c/a>said in a statement emailed to KQED.\u003c/p>\n\u003cp style=\"font-weight: 400\">Moreover, the group says that all the sweeteners included in the study have been approved for use by several scientific and regulatory authorities, including the FDA.\u003c/p>\n\u003cp>To determine toxicity, researchers modified different types of \u003ci>E.coli \u003c/i>bacteria to emit light when experiencing distress. Researchers then could see what type of damage occurred, depending on which type of modified \u003cem>E. coli\u003c/em> glowed. Researchers found that each sweetener produced a specific fingerprint using three stripes of bacteria, with each stripe representing a different type of damage. From \u003ca href=\"https://www.livescience.com/63743-artificial-sweeteners-gut-health.html\" target=\"_blank\" rel=\"noopener\">Live Science\u003c/a>, quoting senior author Evgeni Eltzov:\u003c/p>\n\u003cblockquote>\n\u003cp class=\"p1\">The pattern of colors was unique for each sweetener; one might've caused more DNA damage than protein damage, for example. However, all sweeteners damaged the bacteria in some way, Eltzov said. But Eltzov noted that these findings don't mean the chemicals are \"toxic\" to humans. More research is needed to make that determination.\u003c/p>\n\u003c/blockquote>\n\u003cp class=\"p1\">One cited shortcoming of the study is that the concentrations of artificial sweetener used were higher than what's typically consumed in a can of diet soda. The \u003ca href=\"https://www.livescience.com/63743-artificial-sweeteners-gut-health.html\" target=\"_blank\" rel=\"noopener\">findings do\u003c/a> not\u003cspan class=\"Apple-converted-space\"> \u003c/span>\"tell us what happens in real life. It tells us what happens in a test tube,\" Dr. Kristina Rother, a senior research physician at the National Institutes of Health, told Live Science.\u003c/p>\n\u003cp class=\"p1\">\"Real life is just more complicated,\" Rother, who was not involved in the study, told Live Science.\u003c/p>\n\u003cp class=\"p1\">Still, she recommends avoiding artificial sweeteners.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp class=\"p1\">\"I haven't seen a study that says any of these six FDA-approved sweeteners make the gut microbiome better,” she says. \"So, my recommendation is very simple and very difficult to achieve: Live a healthy life, eat little processed food.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444760/artificial-sweeteners-could-be-sabotaging-your-microbiome-says-study","authors":["11428"],"series":["futureofyou_308"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_1617","futureofyou_1231","futureofyou_689","futureofyou_61","futureofyou_1618","futureofyou_1619"],"collections":["futureofyou_1093","futureofyou_1097"],"featImg":"futureofyou_444759","label":"source_futureofyou_444760"},"futureofyou_74790":{"type":"posts","id":"futureofyou_74790","meta":{"index":"posts_1716263798","site":"futureofyou","id":"74790","score":null,"sort":[1450713602000]},"parent":0,"labelTerm":{},"blocks":[],"publishDate":1450713602,"format":"standard","disqusTitle":"What if You Could Talk to Your Doctor About Cooking?","title":"What if You Could Talk to Your Doctor About Cooking?","headTitle":"Diabetes Management | KQED Future of You | KQED Science","content":"\u003cp>Is your doctor your go-to for nutrition advice? Neither is mine. And why would I expect that?\u003c/p>\n\u003cp>\u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2014/06/23/your-doctor-says-he-doesnt-know-enough-about-nutrition-or-exercise/\">According to recent polls\u003c/a>, fewer than a quarter of doctors say they've had sufficient training to provide nutritional advice to their patients. We all know about the Hippocratic Oath, but how about that other thing Hippocrates said: \"Let Food Be Thy Medicine.\"\u003c/p>\n\u003cp>For the American medical profession to live up to that, there'd have to be more than \u003ca href=\"http://www.drweil.com/\" target=\"_blank\">one doctor\u003c/a> in the country \u003ca href=\"http://www.drweil.com/drw/u/RCP00235/broccoli-pancakes.html#_ga=1.123472264.20458383.1450482611\" target=\"_blank\">widely known for prescribing broccoli\u003c/a>. Most medical schools aren't particularly dedicated to teaching their students about food.\u003c/p>\n\u003cp>That's \u003ca href=\"http://qz.com/545110/the-future-of-medicine-is-food/\" target=\"_blank\">beginning to change\u003c/a>, though, as schools like \u003ca href=\"http://tulane.edu/som/\" target=\"_blank\">Tulane University School of Medicine \u003c/a>in New Orleans, Louisiana, start thinking differently.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/12/FOY-cooking.gif\" rel=\"attachment wp-att-86425\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/12/FOY-cooking.gif\" alt=\"gif docs cooking\" width=\"480\" height=\"270\" class=\"alignright size-full wp-image-86425\">\u003c/a>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Would-be doctors at Tulane aren't just learning about nutrition. They're learning how to cook.\u003c/p>\n\u003cp>Dr. Timothy Harlan, known in the food media world as \u003ca href=\"http://www.drgourmet.com/pr/index.shtml#.VnSmYvkrJpg\" target=\"_blank\">Dr. Gourmet\u003c/a>, is also executive director at \u003ca href=\"http://tmedweb.tulane.edu/mu/teachingkitchen/\" target=\"_blank\">The Goldring Center for Culinary Medicine\u003c/a> at Tulane. Harlan says the program isn't just about helping students understand nutrition. The focus is on practical talk about food. Harlan wants Tulane-educated doctors to be able to teach their patients everyday skills in how to cook, what to cook and why.\u003c/p>\n\u003cp>\"Physicians talk about nutrition and diet all the time, but they don't talk about it in a way that communicates change to their patients,\" Harlan says, \u003ca href=\"https://www.youtube.com/watch?v=L0vWLn0lU5k&feature=youtu.be\" target=\"_blank\">in a video \u003c/a>produced by the school.\u003c/p>\n\u003cp>The students learn to make the most of low-cost ingredients, so they can cater to low-income communities. And Harlan says the school also provides cooking classes to practicing doctors and the public.\u003c/p>\n\u003cp>[youtube https://www.youtube.com/watch?v=L0vWLn0lU5k]\u003c/p>\n\u003cp>These skills are sorely needed in New Orleans. In 2010, 64 percent of adults \u003ca href=\"https://www.nola.gov/nola/media/Health-Department/Publications/Healthy-Lifestyles-in-New-Orleans-Community-Health-Data-Profile-final.pdf\" target=\"_blank\">were classified as obese or overweight\u003c/a>. That results in higher rates of diabetes, heart disease and high blood pressure.\u003c/p>\n\u003cp>\"We know from the literature that when people go home and start cooking from real ingredients for themselves that their health improves,\" Harlan says. \"We also know that they don't really know how to do that.\"\u003c/p>\n\u003cp>Cheryl Spann took part in the community cooking class, and says she's learned what good carbs are and how to cut back on sugar.\u003c/p>\n\u003cfigure id=\"attachment_74791\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-74791\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/11/Screen-Shot-2015-11-29-at-4.45.36-PM-800x445.png\" alt=\"The writing on the wall at Tulane's center for Culinary Medicine. \" width=\"800\" height=\"445\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/11/Screen-Shot-2015-11-29-at-4.45.36-PM-800x445.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/Screen-Shot-2015-11-29-at-4.45.36-PM-400x222.png 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/Screen-Shot-2015-11-29-at-4.45.36-PM.png 833w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The writing on the wall at Tulane's center for Culinary Medicine. \u003ccite>(Tulane University)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"My health is getting so much better now,\" Spann says in the school's video. \"And I do believe that when I see my primary care physician in the next month, I will no longer be taking hypertensive medicine and I will no longer be taking diabetes medicine.\"\u003c/p>\n\u003cp>Tulane's medical school was among the first to take on a licensed chef as an instructor. Its curriculum, \u003ca href=\"http://qz.com/545110/the-future-of-medicine-is-food/\" target=\"_blank\">developed in partnership\u003c/a> with the College of Culinary Arts at \u003ca href=\"https://experience.jwu.edu/\" target=\"_blank\">Johnson & Wales University\u003c/a>, has been sold to sixteen other medical schools.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If you're thinking this is the wrong time of year to talk about healthy food, Dr. Gourmet has \u003ca href=\"http://tulane.edu/news/newwave/121715_christmas-recipe_shitaki-cranberry-pork-loin.cfm\" target=\"_blank\">a luscious menu\u003c/a> for you. And you can tell your guests, when they're licking their fingers, that your holiday meal was recommended by a doctor. When's the last time you got to say that in a sentence?\u003c/p>\n\n","disqusIdentifier":"74790 http://ww2.kqed.org/futureofyou/?p=74790","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/12/21/will-your-doctor-one-day-prescribe-food-as-medicine/","stats":{"hasVideo":true,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":553,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":18},"modified":1477272904,"excerpt":"Tulane University isn't just teaching would-be doctors about nutrition. It is teaching them how to cook. ","headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"Tulane University isn't just teaching would-be doctors about nutrition. It is teaching them how to cook. ","title":"What if You Could Talk to Your Doctor About Cooking? | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"What if You Could Talk to Your Doctor About Cooking?","datePublished":"2015-12-21T08:00:02-08:00","dateModified":"2016-10-23T18:35:04-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"will-your-doctor-one-day-prescribe-food-as-medicine","status":"publish","source":"KQED Future of You","path":"/futureofyou/74790/will-your-doctor-one-day-prescribe-food-as-medicine","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Is your doctor your go-to for nutrition advice? Neither is mine. And why would I expect that?\u003c/p>\n\u003cp>\u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2014/06/23/your-doctor-says-he-doesnt-know-enough-about-nutrition-or-exercise/\">According to recent polls\u003c/a>, fewer than a quarter of doctors say they've had sufficient training to provide nutritional advice to their patients. We all know about the Hippocratic Oath, but how about that other thing Hippocrates said: \"Let Food Be Thy Medicine.\"\u003c/p>\n\u003cp>For the American medical profession to live up to that, there'd have to be more than \u003ca href=\"http://www.drweil.com/\" target=\"_blank\">one doctor\u003c/a> in the country \u003ca href=\"http://www.drweil.com/drw/u/RCP00235/broccoli-pancakes.html#_ga=1.123472264.20458383.1450482611\" target=\"_blank\">widely known for prescribing broccoli\u003c/a>. Most medical schools aren't particularly dedicated to teaching their students about food.\u003c/p>\n\u003cp>That's \u003ca href=\"http://qz.com/545110/the-future-of-medicine-is-food/\" target=\"_blank\">beginning to change\u003c/a>, though, as schools like \u003ca href=\"http://tulane.edu/som/\" target=\"_blank\">Tulane University School of Medicine \u003c/a>in New Orleans, Louisiana, start thinking differently.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/12/FOY-cooking.gif\" rel=\"attachment wp-att-86425\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/12/FOY-cooking.gif\" alt=\"gif docs cooking\" width=\"480\" height=\"270\" class=\"alignright size-full wp-image-86425\">\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Would-be doctors at Tulane aren't just learning about nutrition. They're learning how to cook.\u003c/p>\n\u003cp>Dr. Timothy Harlan, known in the food media world as \u003ca href=\"http://www.drgourmet.com/pr/index.shtml#.VnSmYvkrJpg\" target=\"_blank\">Dr. Gourmet\u003c/a>, is also executive director at \u003ca href=\"http://tmedweb.tulane.edu/mu/teachingkitchen/\" target=\"_blank\">The Goldring Center for Culinary Medicine\u003c/a> at Tulane. Harlan says the program isn't just about helping students understand nutrition. The focus is on practical talk about food. Harlan wants Tulane-educated doctors to be able to teach their patients everyday skills in how to cook, what to cook and why.\u003c/p>\n\u003cp>\"Physicians talk about nutrition and diet all the time, but they don't talk about it in a way that communicates change to their patients,\" Harlan says, \u003ca href=\"https://www.youtube.com/watch?v=L0vWLn0lU5k&feature=youtu.be\" target=\"_blank\">in a video \u003c/a>produced by the school.\u003c/p>\n\u003cp>The students learn to make the most of low-cost ingredients, so they can cater to low-income communities. And Harlan says the school also provides cooking classes to practicing doctors and the public.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/L0vWLn0lU5k'\n title='//www.youtube.com/embed/L0vWLn0lU5k'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\u003cp>These skills are sorely needed in New Orleans. In 2010, 64 percent of adults \u003ca href=\"https://www.nola.gov/nola/media/Health-Department/Publications/Healthy-Lifestyles-in-New-Orleans-Community-Health-Data-Profile-final.pdf\" target=\"_blank\">were classified as obese or overweight\u003c/a>. That results in higher rates of diabetes, heart disease and high blood pressure.\u003c/p>\n\u003cp>\"We know from the literature that when people go home and start cooking from real ingredients for themselves that their health improves,\" Harlan says. \"We also know that they don't really know how to do that.\"\u003c/p>\n\u003cp>Cheryl Spann took part in the community cooking class, and says she's learned what good carbs are and how to cut back on sugar.\u003c/p>\n\u003cfigure id=\"attachment_74791\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-74791\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/11/Screen-Shot-2015-11-29-at-4.45.36-PM-800x445.png\" alt=\"The writing on the wall at Tulane's center for Culinary Medicine. \" width=\"800\" height=\"445\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/11/Screen-Shot-2015-11-29-at-4.45.36-PM-800x445.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/Screen-Shot-2015-11-29-at-4.45.36-PM-400x222.png 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/Screen-Shot-2015-11-29-at-4.45.36-PM.png 833w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The writing on the wall at Tulane's center for Culinary Medicine. \u003ccite>(Tulane University)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"My health is getting so much better now,\" Spann says in the school's video. \"And I do believe that when I see my primary care physician in the next month, I will no longer be taking hypertensive medicine and I will no longer be taking diabetes medicine.\"\u003c/p>\n\u003cp>Tulane's medical school was among the first to take on a licensed chef as an instructor. Its curriculum, \u003ca href=\"http://qz.com/545110/the-future-of-medicine-is-food/\" target=\"_blank\">developed in partnership\u003c/a> with the College of Culinary Arts at \u003ca href=\"https://experience.jwu.edu/\" target=\"_blank\">Johnson & Wales University\u003c/a>, has been sold to sixteen other medical schools.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If you're thinking this is the wrong time of year to talk about healthy food, Dr. Gourmet has \u003ca href=\"http://tulane.edu/news/newwave/121715_christmas-recipe_shitaki-cranberry-pork-loin.cfm\" target=\"_blank\">a luscious menu\u003c/a> for you. And you can tell your guests, when they're licking their fingers, that your holiday meal was recommended by a doctor. When's the last time you got to say that in a sentence?\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/74790/will-your-doctor-one-day-prescribe-food-as-medicine","authors":["3252"],"series":["futureofyou_308"],"categories":["futureofyou_1060"],"tags":["futureofyou_426","futureofyou_80","futureofyou_595"],"featImg":"futureofyou_74811","label":"source_futureofyou_74790"},"futureofyou_28802":{"type":"posts","id":"futureofyou_28802","meta":{"index":"posts_1716263798","site":"futureofyou","id":"28802","score":null,"sort":[1440522002000]},"parent":0,"labelTerm":{"site":"futureofyou","term":308},"blocks":[],"publishDate":1440522002,"format":"standard","disqusTitle":"How One Doctor Used Mobile Tech to Aid Diabetes Patients","title":"How One Doctor Used Mobile Tech to Aid Diabetes Patients","headTitle":"Diabetes Management | KQED Future of You | KQED Science","content":"\u003cp>People whose diabetes requires insulin injections usually have to make a series of visits to the doctor’s office, to fine tune their daily dosage. But many low-income patients can’t afford to take those few hours off to see the doctor. As a result, they often live with chronically elevated blood sugars for weeks or months until they can find time to get to the clinic.\u003c/p>\n\u003cp>Now a new study from New York’s \u003ca href=\"http://www.nyc.gov/html/hhc/bellevue/html/home/home.shtml\">Bellevue Hospital\u003c/a> finds mobile technology can help low-income patients with the process of titrating their dosage, without them having to see a doctor.\u003c/p>\n\u003cp>For people with chronic conditions, \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/07/27/5-digital-health-trends-todays-tech-savvy-doctors-are-adopting/\">mobile technology\u003c/a> can provide crucial support and lower costs. Doctors have used mobile messaging to prompt hypertensive patients to measure their blood pressure, and to remind HIV-positive people to return for regular lab testing. For people tracking their overall health, Apple’s new HealthKit makes it easier for different health and fitness apps to exchange data.\u003c/p>\n\u003cp>So \u003ca href=\"http://www.med.nyu.edu/biosketch/levyn02\">Natalie Levy\u003c/a>, an assistant professor at the New York University School of Medicine and head of Bellevue Hospital’s Diabetes Program, decided to try mobile technology to help her low-income diabetes patients titrate their insulin remotely.\u003c/p>\n\u003cfigure id=\"attachment_30132\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/finger-prick.jpg\">\u003cimg class=\"size-medium wp-image-30132\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/finger-prick-800x600.jpg\" alt=\"When diabetics initially start taking insulin shots, they need to check their blood sugar at least once a day to make sure their medication dose is correct.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/finger-prick-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/finger-prick-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/finger-prick-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/finger-prick.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">When diabetics initially start taking insulin shots, they need to check their blood sugar at least once a day to make sure their dosage is correct. \u003ccite>(frankieleon/Flickr)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Bellevue, which has traditionally served New York’s poor, currently has about 5,000 diabetes patients a year. In a survey Levy conducted, one patient reported that it often took three to four months to return for each follow-up visit during the titration phase.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Many [diabetic patients] have jobs that don’t provide sick leave or they have young children or grandchildren in their care,” she says.\u003c/p>\n\u003cp>Wearables like FitBit or Jawbone cost far too much for most of Levy’s patients, and less than half of this population owns a smartphone. Nearly all of Bellevue’s diabetics, though, have mobile phones with a text messaging feature.\u003c/p>\n\u003cp>Levy’s team designed a pilot study—called the Mobile Insulin Titration Intervention, or MITI (pronounced “mighty”) Study—where a small subset of Bellevue’s insulin-dependent diabetics, 33 patients, got a daily reminder to take a morning blood sugar reading and text that value back. Nurses reviewed the information daily on the web, to check for values that were too high or too low, indicating the insulin dose needed to be adjusted.\u003c/p>\n\u003cp>Once a week, the patients spoke by phone to the diabetes nurse to adjust dosage as needed. This routine lasted 12 weeks. A control group of 27 patients got the usual kind of care and titrated their insulin with in-person office visits.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It got my head in the game.\"\u003ccite>Diabetes Patient,\u003cbr>\nBellevue Study Participant\u003c/cite>\u003c/aside>\n\u003cp>The results of the study were \u003ca href=\"http://www.jmir.org/2015/7/e180/\">published\u003c/a> in the \u003ca href=\"http://jmirpublications.com/\">Journal of Medical Internet Research\u003c/a> in July and the differences between the two groups were stark. Of the group that got daily text messages and weekly phone calls, 88 percent were able to get their blood sugars within an acceptable range. Only 37 percent of the comparison group managed to control their blood sugars.\u003c/p>\n\u003cp>Levy and her team also estimated that the remote titration group saved about two hours of time, plus the $15 co-pays that many other participants paid for office visits. The intervention appears feasible, too, since patients sent blood glucose values back more than 80 percent of the time, indicating that the daily task wasn’t too arduous.\u003c/p>\n\u003cp>Moreover, Levy says the mobile titration patients reported feeling more in control of their illness and more accountable for complying with medical advice.\u003c/p>\n\u003cp>“I was actually checking my finger sticks every day,” one participant noted in a post-study survey. Said another, “It got my head in the game.”\u003c/p>\n\u003cfigure id=\"attachment_30154\" class=\"wp-caption alignright\" style=\"max-width: 399px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch.jpg\">\u003cimg class=\" wp-image-30154\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch-494x600.jpg\" alt=\"Bellevue is the oldest public hospital in the United States. The majority of its patients come from underserved communities in New York.\" width=\"399\" height=\"485\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch-494x600.jpg 494w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch-400x486.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch.jpg 512w\" sizes=\"(max-width: 399px) 100vw, 399px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Bellevue is the oldest public hospital in the United States. The majority of its patients come from underserved communities in New York. \u003ccite>(Beyond My Ken/Wikimedia Commons)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Levy says mobile tech offers a new avenue for helping patients manage their chronic diseases.\u003c/p>\n\u003cp>“It’s so important for diabetic patients to see the things that they eat,” she says, “their level of activity, their med compliance—all those variables—and their fasting blood sugars the next day.”\u003c/p>\n\u003cp>Dominick Frosch, a patient-care researcher at the \u003ca href=\"https://www.moore.org/\">Gordon and Betty Moore Foundation\u003c/a> in Palo Alto, echoes Levy’s sentiments. He advocates for making patients with chronic diseases the primary managers of their illness. The clinician, he says, is a “consultant” for developing a day-to-day management plan.\u003c/p>\n\u003cp>If doctors don’t take stock of what patients are realistically capable of, Frosch says, “they end up prescribing treatments patients can’t fit into their lives.”\u003c/p>\n\u003cp>Often, minor modifications can make a huge impact. And the more flexible doctors can be at using various media, Frosch says, like phone, email and patient portals, the better they can be at getting patients to manage their own illnesses.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>MITI may soon become a hospital-wide program at Bellevue. The Health and Hospitals Corporation that runs Bellevue and other public hospitals in New York City is now looking into improving the security for sending and receive secure private health information over text messages. Levy is looking forward to when that hurdle is crossed and the MITI protocol can be provided on an ongoing basis to a much larger pool of diabetic patients.\u003c/p>\n\n","disqusIdentifier":"28802 http://ww2.kqed.org/futureofyou/?p=28802","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/08/25/how-one-doctor-used-mobile-tech-to-aid-diabetes-patients/","stats":{"hasVideo":false,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":937,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":21},"modified":1477279537,"excerpt":"Many low-income patients can't see a doctor regularly when they start insulin shots, but one study found mobile tech can keep them on track.","headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"Many low-income patients can't see a doctor regularly when they start insulin shots, but one study found mobile tech can keep them on track.","title":"How One Doctor Used Mobile Tech to Aid Diabetes Patients | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"How One Doctor Used Mobile Tech to Aid Diabetes Patients","datePublished":"2015-08-25T10:00:02-07:00","dateModified":"2016-10-23T20:25:37-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"how-one-doctor-used-mobile-tech-to-aid-diabetes-patients","status":"publish","nprByline":"Rina Shaikh-Lesko","path":"/futureofyou/28802/how-one-doctor-used-mobile-tech-to-aid-diabetes-patients","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>People whose diabetes requires insulin injections usually have to make a series of visits to the doctor’s office, to fine tune their daily dosage. But many low-income patients can’t afford to take those few hours off to see the doctor. As a result, they often live with chronically elevated blood sugars for weeks or months until they can find time to get to the clinic.\u003c/p>\n\u003cp>Now a new study from New York’s \u003ca href=\"http://www.nyc.gov/html/hhc/bellevue/html/home/home.shtml\">Bellevue Hospital\u003c/a> finds mobile technology can help low-income patients with the process of titrating their dosage, without them having to see a doctor.\u003c/p>\n\u003cp>For people with chronic conditions, \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/07/27/5-digital-health-trends-todays-tech-savvy-doctors-are-adopting/\">mobile technology\u003c/a> can provide crucial support and lower costs. Doctors have used mobile messaging to prompt hypertensive patients to measure their blood pressure, and to remind HIV-positive people to return for regular lab testing. For people tracking their overall health, Apple’s new HealthKit makes it easier for different health and fitness apps to exchange data.\u003c/p>\n\u003cp>So \u003ca href=\"http://www.med.nyu.edu/biosketch/levyn02\">Natalie Levy\u003c/a>, an assistant professor at the New York University School of Medicine and head of Bellevue Hospital’s Diabetes Program, decided to try mobile technology to help her low-income diabetes patients titrate their insulin remotely.\u003c/p>\n\u003cfigure id=\"attachment_30132\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/finger-prick.jpg\">\u003cimg class=\"size-medium wp-image-30132\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/finger-prick-800x600.jpg\" alt=\"When diabetics initially start taking insulin shots, they need to check their blood sugar at least once a day to make sure their medication dose is correct.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/finger-prick-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/finger-prick-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/finger-prick-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/finger-prick.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">When diabetics initially start taking insulin shots, they need to check their blood sugar at least once a day to make sure their dosage is correct. \u003ccite>(frankieleon/Flickr)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Bellevue, which has traditionally served New York’s poor, currently has about 5,000 diabetes patients a year. In a survey Levy conducted, one patient reported that it often took three to four months to return for each follow-up visit during the titration phase.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Many [diabetic patients] have jobs that don’t provide sick leave or they have young children or grandchildren in their care,” she says.\u003c/p>\n\u003cp>Wearables like FitBit or Jawbone cost far too much for most of Levy’s patients, and less than half of this population owns a smartphone. Nearly all of Bellevue’s diabetics, though, have mobile phones with a text messaging feature.\u003c/p>\n\u003cp>Levy’s team designed a pilot study—called the Mobile Insulin Titration Intervention, or MITI (pronounced “mighty”) Study—where a small subset of Bellevue’s insulin-dependent diabetics, 33 patients, got a daily reminder to take a morning blood sugar reading and text that value back. Nurses reviewed the information daily on the web, to check for values that were too high or too low, indicating the insulin dose needed to be adjusted.\u003c/p>\n\u003cp>Once a week, the patients spoke by phone to the diabetes nurse to adjust dosage as needed. This routine lasted 12 weeks. A control group of 27 patients got the usual kind of care and titrated their insulin with in-person office visits.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It got my head in the game.\"\u003ccite>Diabetes Patient,\u003cbr>\nBellevue Study Participant\u003c/cite>\u003c/aside>\n\u003cp>The results of the study were \u003ca href=\"http://www.jmir.org/2015/7/e180/\">published\u003c/a> in the \u003ca href=\"http://jmirpublications.com/\">Journal of Medical Internet Research\u003c/a> in July and the differences between the two groups were stark. Of the group that got daily text messages and weekly phone calls, 88 percent were able to get their blood sugars within an acceptable range. Only 37 percent of the comparison group managed to control their blood sugars.\u003c/p>\n\u003cp>Levy and her team also estimated that the remote titration group saved about two hours of time, plus the $15 co-pays that many other participants paid for office visits. The intervention appears feasible, too, since patients sent blood glucose values back more than 80 percent of the time, indicating that the daily task wasn’t too arduous.\u003c/p>\n\u003cp>Moreover, Levy says the mobile titration patients reported feeling more in control of their illness and more accountable for complying with medical advice.\u003c/p>\n\u003cp>“I was actually checking my finger sticks every day,” one participant noted in a post-study survey. Said another, “It got my head in the game.”\u003c/p>\n\u003cfigure id=\"attachment_30154\" class=\"wp-caption alignright\" style=\"max-width: 399px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch.jpg\">\u003cimg class=\" wp-image-30154\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch-494x600.jpg\" alt=\"Bellevue is the oldest public hospital in the United States. The majority of its patients come from underserved communities in New York.\" width=\"399\" height=\"485\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch-494x600.jpg 494w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch-400x486.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Bellevue_Hospital_entrance_arch.jpg 512w\" sizes=\"(max-width: 399px) 100vw, 399px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Bellevue is the oldest public hospital in the United States. The majority of its patients come from underserved communities in New York. \u003ccite>(Beyond My Ken/Wikimedia Commons)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Levy says mobile tech offers a new avenue for helping patients manage their chronic diseases.\u003c/p>\n\u003cp>“It’s so important for diabetic patients to see the things that they eat,” she says, “their level of activity, their med compliance—all those variables—and their fasting blood sugars the next day.”\u003c/p>\n\u003cp>Dominick Frosch, a patient-care researcher at the \u003ca href=\"https://www.moore.org/\">Gordon and Betty Moore Foundation\u003c/a> in Palo Alto, echoes Levy’s sentiments. He advocates for making patients with chronic diseases the primary managers of their illness. The clinician, he says, is a “consultant” for developing a day-to-day management plan.\u003c/p>\n\u003cp>If doctors don’t take stock of what patients are realistically capable of, Frosch says, “they end up prescribing treatments patients can’t fit into their lives.”\u003c/p>\n\u003cp>Often, minor modifications can make a huge impact. And the more flexible doctors can be at using various media, Frosch says, like phone, email and patient portals, the better they can be at getting patients to manage their own illnesses.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>MITI may soon become a hospital-wide program at Bellevue. The Health and Hospitals Corporation that runs Bellevue and other public hospitals in New York City is now looking into improving the security for sending and receive secure private health information over text messages. Levy is looking forward to when that hurdle is crossed and the MITI protocol can be provided on an ongoing basis to a much larger pool of diabetic patients.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/28802/how-one-doctor-used-mobile-tech-to-aid-diabetes-patients","authors":["byline_futureofyou_28802"],"series":["futureofyou_308"],"categories":["futureofyou_1060"],"tags":["futureofyou_571","futureofyou_309","futureofyou_469","futureofyou_572","futureofyou_80","futureofyou_547"],"featImg":"futureofyou_30504","label":"futureofyou_308"},"futureofyou_27622":{"type":"posts","id":"futureofyou_27622","meta":{"index":"posts_1716263798","site":"futureofyou","id":"27622","score":null,"sort":[1440091922000]},"parent":0,"labelTerm":{"site":"futureofyou","term":308},"blocks":[],"publishDate":1440091922,"format":"standard","disqusTitle":"This Robo Eye Doctor May Help Patients With Diabetes Keep Sight","title":"This Robo Eye Doctor May Help Patients With Diabetes Keep Sight","headTitle":"Diabetes Management | KQED Future of You | KQED Science","content":"\u003cp>Would you trust an algorithm to make a medical diagnosis?\u003c/p>\n\u003cp>In the past six months, hundreds of the most talented data scientists from all over the world\u003ca href=\"https://www.kaggle.com/c/diabetic-retinopathy-detection\"> \u003c/a>\u003ca href=\"https://www.kaggle.com/c/diabetic-retinopathy-detection\">entered a competition\u003c/a>, sponsored by the \u003ca href=\"http://www.chcf.org/\">California Healthcare Foundation\u003c/a>, to build just such an algorithm. The winner, Benjamin Graham, a professor of statistics from the University of Warwick, developed a computer program that rivaled human experts in identifying signs of diabetic retinopathy from an eye scan.\u003c/p>\n\u003cp>Health experts say this could have major implications for the 347 million people who have diabetes worldwide. Diabetic retinopathy affects 40 to 45 percent of people with diabetes. Without treatment, it often leads to severe vision loss. Early detection can make a huge difference, and an algorithm could step in where resources are scarce.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"At some point in the near future we’ll be limited less by what technology can do and more by people’s willingness to trust it.”\u003ccite>Anthony Goldbloom,\u003cbr>\nCEO, Kaggle\u003c/cite>\u003c/aside>\n\u003cp>\"There has been this dream in our community to develop an algorithm that can read images of the retina,\" said Jorge Cuadros. He's a clinical professor in the department of optometry at the University of California, Berkeley, and the CEO of \u003ca href=\"https://www.eyepacs.org/home\">Eyepacs\u003c/a>, a clinical application for exchanging eye-related information. Cuadros has been exploring algorithms and their utility for diabetic retinopathy for more than a decade.\u003c/p>\n\u003cp>According to Cuadros, connecting patients with diabetes to the right treatment has proven to be an ongoing public health challenge, particularly in rural and low-income communities. Among other things, he added, a computer algorithm could do the vital work of \"triaging\" by prioritizing the patients most at risk of the disease, when there's a giant pile of eye scans.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The algorithm could also help human specialists avoid making mistakes. Graham's winning algorithm had an \"agreement rate\" that was roughly 10 percent higher than a human-only approach. What this means is that the algorithm and a human expert were more likely to agree on a diagnosis than two human experts.\u003c/p>\n\u003cp>\"At some point in the near future we'll be limited less by what technology can do and more by people's willingness to trust it,\" said Anthony Goldbloom, cofounder and CEO of \u003ca href=\"https://www.kaggle.com\">Kaggle\u003c/a>, a San Francisco-based web startup that hosted the competition.\u003c/p>\n\u003cp>\u003cstrong style=\"line-height: 1.5\">Smarter than Humans \u003c/strong>\u003c/p>\n\u003cp>Cuadros had his doubts when he initially learned about the competition, which kicked off in February of this year.\u003c/p>\n\u003cfigure id=\"attachment_28014\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/goldbloom.jpg\">\u003cimg class=\"size-medium wp-image-28014\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/goldbloom-800x600.jpg\" alt=\"Anthony Goldbloom is cofounder and CEO of Kaggle.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/goldbloom-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/goldbloom-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/goldbloom-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/goldbloom-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/goldbloom-960x720.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Anthony Goldbloom is cofounder and CEO of Kaggle. \u003ccite>(Christina Farr/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"I wondered whether an algorithm could be as good as a human,\" he said.\u003c/p>\n\u003cp>But a new wave of tools had emerged in recent years that use sophisticated machine-learning technology for medical diagnosis. In recent years, startups like \u003ca href=\"http://www.enlitic.com/\">Entilic\u003c/a> and \u003ca href=\"https://www.cellscope.com/\">Cellscope\u003c/a> have developed sophisticated technology to find signs of diseases like cancer from patients' medical images.\u003c/p>\n\u003cp>So Cuadros, through his work at Eyepacs, agreed to provide thousands of anonymous eye scans to the data scientists. These images had already been graded by one or more human experts as sight-threatening or not.\u003c/p>\n\u003cp>Graham differentiated between the scans by leveraging neural networks, a branch of machine-learning that teaches a computer to map the function of the brain. \"The winner applied this technique to develop the algorithm in ways that would not have been possible five years ago,\" said Goldbloom.\u003c/p>\n\u003cp>According to Cuadros, human specialists get it right about 90 percent of the time. The error rate is in often due to tiredness or problems with the quality of the image.\u003c/p>\n\u003cp>\"What was so amazing is that there was a very high correlation between the algorithm and the human experts,\" Cuadros said. \"But when there was a disagreement, sometimes the algorithm got it right and the humans were wrong.\"\u003c/p>\n\u003cp>\u003cstrong>What's Next for the Algorithm?\u003c/strong>\u003c/p>\n\u003cp>New programs have \u003ca href=\"http://www.chcf.org/projects/2009/diabetic-retinopathy-screening\">p\u003c/a>\u003ca href=\"http://www.chcf.org/projects/2009/diabetic-retinopathy-screening\">opped up\u003c/a> in rural parts of California in recent years to incorporate screening into primary care visits, with results interpreted remotely by ophthalmologists via an eye scan. One immediate use for the algorithm is to notify photographers in real-time whether they need to retake the image.\u003c/p>\n\u003cfigure id=\"attachment_28015\" class=\"wp-caption alignright\" style=\"max-width: 398px\">\u003cimg class=\" wp-image-28015\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Blausen_0312_DiabeticRetinopathy-800x600.png\" alt=\"An illustration depicting diabetic retinopathy\" width=\"398\" height=\"299\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/Blausen_0312_DiabeticRetinopathy-800x600.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Blausen_0312_DiabeticRetinopathy-400x300.png 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Blausen_0312_DiabeticRetinopathy-960x720.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Blausen_0312_DiabeticRetinopathy.png 1024w\" sizes=\"(max-width: 398px) 100vw, 398px\">\u003cfigcaption class=\"wp-caption-text\">An illustration depicting diabetic retinopathy ne immediate use for the algorithm is to notify photographers or clinicians when they should retake the eye-scan in real-time. \u003ccite>( Blausen.com staff / Wikiversity Journal of Medicine )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But it remains to be seen whether the algorithm will make its way into clinical practice as a diagnostic tool that will replace or support human specialists. The next step is a more formal clinical trial to convince other decision-makers in the medical community. The trial will include 1,000 patients and will kick off later in the year.\u003c/p>\n\u003cp>Cuadros hopes the algorithm may ultimately prove useful in places where \"virtually zero percent of patients with diabetes get retinal exams.\" In North Africa, for instance, nonprofit groups are leveraging telemedicine services so providers anywhere in the world can look at people's eye scans. But the limiting factor is that a high-quality Internet connection is required. \"In future, these clinics would only need the algorithm and an inexpensive retinal camera,\" he said.\u003c/p>\n\u003cp>Globally, the algorithm could potentially alert a human specialist to look more closely at one scan over another. It may also be useful in nudging primary care providers when a patient needs to see a retinal specialist immediately, rather than a regular eye doctor.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The regulatory climate is far more tricky in the U.S., Cuadros said, as there are barriers to computers performing eye exams without a human specialist present. \"Unless this policy changes,\" he said, \"there will be fewer incentives for clinics to rely on the algorithm.\"\u003c/p>\n\n","disqusIdentifier":"27622 http://ww2.kqed.org/futureofyou/?p=27622","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/08/20/this-robo-eye-doctor-may-help-patients-with-diabetes-keep-sight/","stats":{"hasVideo":false,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":1006,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":23},"modified":1477279838,"excerpt":"Some of the world's most talented data scientists participated in a competition to develop a computer program that could identify signs of diabetic retinopathy from an eye scan.","headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"Some of the world's most talented data scientists participated in a competition to develop a computer program that could identify signs of diabetic retinopathy from an eye scan.","title":"This Robo Eye Doctor May Help Patients With Diabetes Keep Sight | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"This Robo Eye Doctor May Help Patients With Diabetes Keep Sight","datePublished":"2015-08-20T10:32:02-07:00","dateModified":"2016-10-23T20:30:38-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"this-robo-eye-doctor-may-help-patients-with-diabetes-keep-sight","status":"publish","path":"/futureofyou/27622/this-robo-eye-doctor-may-help-patients-with-diabetes-keep-sight","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Would you trust an algorithm to make a medical diagnosis?\u003c/p>\n\u003cp>In the past six months, hundreds of the most talented data scientists from all over the world\u003ca href=\"https://www.kaggle.com/c/diabetic-retinopathy-detection\"> \u003c/a>\u003ca href=\"https://www.kaggle.com/c/diabetic-retinopathy-detection\">entered a competition\u003c/a>, sponsored by the \u003ca href=\"http://www.chcf.org/\">California Healthcare Foundation\u003c/a>, to build just such an algorithm. The winner, Benjamin Graham, a professor of statistics from the University of Warwick, developed a computer program that rivaled human experts in identifying signs of diabetic retinopathy from an eye scan.\u003c/p>\n\u003cp>Health experts say this could have major implications for the 347 million people who have diabetes worldwide. Diabetic retinopathy affects 40 to 45 percent of people with diabetes. Without treatment, it often leads to severe vision loss. Early detection can make a huge difference, and an algorithm could step in where resources are scarce.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"At some point in the near future we’ll be limited less by what technology can do and more by people’s willingness to trust it.”\u003ccite>Anthony Goldbloom,\u003cbr>\nCEO, Kaggle\u003c/cite>\u003c/aside>\n\u003cp>\"There has been this dream in our community to develop an algorithm that can read images of the retina,\" said Jorge Cuadros. He's a clinical professor in the department of optometry at the University of California, Berkeley, and the CEO of \u003ca href=\"https://www.eyepacs.org/home\">Eyepacs\u003c/a>, a clinical application for exchanging eye-related information. Cuadros has been exploring algorithms and their utility for diabetic retinopathy for more than a decade.\u003c/p>\n\u003cp>According to Cuadros, connecting patients with diabetes to the right treatment has proven to be an ongoing public health challenge, particularly in rural and low-income communities. Among other things, he added, a computer algorithm could do the vital work of \"triaging\" by prioritizing the patients most at risk of the disease, when there's a giant pile of eye scans.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The algorithm could also help human specialists avoid making mistakes. Graham's winning algorithm had an \"agreement rate\" that was roughly 10 percent higher than a human-only approach. What this means is that the algorithm and a human expert were more likely to agree on a diagnosis than two human experts.\u003c/p>\n\u003cp>\"At some point in the near future we'll be limited less by what technology can do and more by people's willingness to trust it,\" said Anthony Goldbloom, cofounder and CEO of \u003ca href=\"https://www.kaggle.com\">Kaggle\u003c/a>, a San Francisco-based web startup that hosted the competition.\u003c/p>\n\u003cp>\u003cstrong style=\"line-height: 1.5\">Smarter than Humans \u003c/strong>\u003c/p>\n\u003cp>Cuadros had his doubts when he initially learned about the competition, which kicked off in February of this year.\u003c/p>\n\u003cfigure id=\"attachment_28014\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/goldbloom.jpg\">\u003cimg class=\"size-medium wp-image-28014\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/goldbloom-800x600.jpg\" alt=\"Anthony Goldbloom is cofounder and CEO of Kaggle.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/goldbloom-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/goldbloom-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/goldbloom-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/goldbloom-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/goldbloom-960x720.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Anthony Goldbloom is cofounder and CEO of Kaggle. \u003ccite>(Christina Farr/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"I wondered whether an algorithm could be as good as a human,\" he said.\u003c/p>\n\u003cp>But a new wave of tools had emerged in recent years that use sophisticated machine-learning technology for medical diagnosis. In recent years, startups like \u003ca href=\"http://www.enlitic.com/\">Entilic\u003c/a> and \u003ca href=\"https://www.cellscope.com/\">Cellscope\u003c/a> have developed sophisticated technology to find signs of diseases like cancer from patients' medical images.\u003c/p>\n\u003cp>So Cuadros, through his work at Eyepacs, agreed to provide thousands of anonymous eye scans to the data scientists. These images had already been graded by one or more human experts as sight-threatening or not.\u003c/p>\n\u003cp>Graham differentiated between the scans by leveraging neural networks, a branch of machine-learning that teaches a computer to map the function of the brain. \"The winner applied this technique to develop the algorithm in ways that would not have been possible five years ago,\" said Goldbloom.\u003c/p>\n\u003cp>According to Cuadros, human specialists get it right about 90 percent of the time. The error rate is in often due to tiredness or problems with the quality of the image.\u003c/p>\n\u003cp>\"What was so amazing is that there was a very high correlation between the algorithm and the human experts,\" Cuadros said. \"But when there was a disagreement, sometimes the algorithm got it right and the humans were wrong.\"\u003c/p>\n\u003cp>\u003cstrong>What's Next for the Algorithm?\u003c/strong>\u003c/p>\n\u003cp>New programs have \u003ca href=\"http://www.chcf.org/projects/2009/diabetic-retinopathy-screening\">p\u003c/a>\u003ca href=\"http://www.chcf.org/projects/2009/diabetic-retinopathy-screening\">opped up\u003c/a> in rural parts of California in recent years to incorporate screening into primary care visits, with results interpreted remotely by ophthalmologists via an eye scan. One immediate use for the algorithm is to notify photographers in real-time whether they need to retake the image.\u003c/p>\n\u003cfigure id=\"attachment_28015\" class=\"wp-caption alignright\" style=\"max-width: 398px\">\u003cimg class=\" wp-image-28015\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/Blausen_0312_DiabeticRetinopathy-800x600.png\" alt=\"An illustration depicting diabetic retinopathy\" width=\"398\" height=\"299\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/Blausen_0312_DiabeticRetinopathy-800x600.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Blausen_0312_DiabeticRetinopathy-400x300.png 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Blausen_0312_DiabeticRetinopathy-960x720.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/Blausen_0312_DiabeticRetinopathy.png 1024w\" sizes=\"(max-width: 398px) 100vw, 398px\">\u003cfigcaption class=\"wp-caption-text\">An illustration depicting diabetic retinopathy ne immediate use for the algorithm is to notify photographers or clinicians when they should retake the eye-scan in real-time. \u003ccite>( Blausen.com staff / Wikiversity Journal of Medicine )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But it remains to be seen whether the algorithm will make its way into clinical practice as a diagnostic tool that will replace or support human specialists. The next step is a more formal clinical trial to convince other decision-makers in the medical community. The trial will include 1,000 patients and will kick off later in the year.\u003c/p>\n\u003cp>Cuadros hopes the algorithm may ultimately prove useful in places where \"virtually zero percent of patients with diabetes get retinal exams.\" In North Africa, for instance, nonprofit groups are leveraging telemedicine services so providers anywhere in the world can look at people's eye scans. But the limiting factor is that a high-quality Internet connection is required. \"In future, these clinics would only need the algorithm and an inexpensive retinal camera,\" he said.\u003c/p>\n\u003cp>Globally, the algorithm could potentially alert a human specialist to look more closely at one scan over another. It may also be useful in nudging primary care providers when a patient needs to see a retinal specialist immediately, rather than a regular eye doctor.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The regulatory climate is far more tricky in the U.S., Cuadros said, as there are barriers to computers performing eye exams without a human specialist present. \"Unless this policy changes,\" he said, \"there will be fewer incentives for clinics to rely on the algorithm.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/27622/this-robo-eye-doctor-may-help-patients-with-diabetes-keep-sight","authors":["3252"],"series":["futureofyou_308"],"categories":["futureofyou_1062"],"tags":["futureofyou_309","futureofyou_566","futureofyou_80","futureofyou_567","futureofyou_565"],"featImg":"futureofyou_28013","label":"futureofyou_308"},"futureofyou_2832":{"type":"posts","id":"futureofyou_2832","meta":{"index":"posts_1716263798","site":"futureofyou","id":"2832","score":null,"sort":[1431455329000]},"parent":0,"labelTerm":{"site":"futureofyou","term":308},"blocks":[],"publishDate":1431455329,"format":"standard","disqusTitle":"Everyone Should Track Their Blood Sugar -- Not Just People With Diabetes Like Me","title":"Everyone Should Track Their Blood Sugar -- Not Just People With Diabetes Like Me","headTitle":"Diabetes Management | KQED Future of You | KQED Science","content":"\u003cp>\u003cem>This is a perspective from Cyrus Khambatta, a person with Type 1 Diabetes and the founder of \u003ca href=\"http://www.mangomannutrition.com/\">Mangoman Nutrition and Fitness\u003c/a>\u003cbr>\n\u003c/em>\u003c/p>\n\u003cp>Continuous glucose monitoring, which uses tiny sensors under the skin to check blood sugar levels, is going to be a very big deal -- and not just for people with diabetes.\u003c/p>\n\u003cp>I have personal experience with monitoring my glucose levels, having been living with diabetes now for 12 years. The insights that I have gained from understanding my blood glucose patterns 24/7 have been transformative.\u003c/p>\n\u003cp>I've learned how my body responds to various types of food, exercise, stress, viruses, altitude, dehydration and extreme temperatures. And with years of historic data, I can now predict how my blood glucose readings will be in the current moment.\u003c/p>\n\u003cp>Here are the population groups that I believe can benefit most from continuous glucose monitoring, otherwise known as CGM.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>People With Diabetes and Prediabetes\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Continuous glucose monitoring was originally developed specifically for people with type 1 diabetes, in order to monitor their glucose levels at all times -- not just periodically with a prick of a fingertip.\u003c/p>\n\u003cp>This population is obviously the most in need, given that inadequate production of insulin results in highly variable blood sugar values. Continuous glucose monitors have proven to be extremely useful for this patient population. The technology has given both people with diabetes and their doctors an ability to fine-tune an insulin-dosing strategy to minimize blood sugar fluctuations.\u003c/p>\n\u003cp>Some individuals with type 2 diabetes are given CGMs as well. On occasion, they are used only temporarily in order to gain some immediate insight into daily blood sugar fluctuations. Others use such continuous monitors in the long-term to support a blood glucose management program.\u003c/p>\n\u003cp>But people with diabetes may have some challenges with today's continuous blood sugar monitors.\u003c/p>\n\u003cp>One of the main problems with the current technology is that it is often difficult to obtain, even with comprehensive health insurance. I've heard from people with type 1 diabetes, who have a difficult time getting their hands on a continuous monitor. And many doctors are overburdened with excessive paperwork to request that a patients' insurer cover the cost of a CGM and/or insulin pump.\u003c/p>\n\u003cp>Existing CGMs have come a long way, and now provide wireless blood glucose sensing that can be interpreted on a handheld mobile device.\u003c/p>\n\u003cp>Despite this, many users have told me that the devices feel pseudo-bionic. On one side of their abdomen sits a sensor that reads glucose on five-minute intervals and then transmits that data to a handheld wireless receiver; on the other side sits an insulin pump insertion site that is physically connected to the insulin pump via clear tubing. Many people with Type 1 Diabetes become frustrated with these devices and insertion sites, which adds to the overall strain of living with diabetes.\u003c/p>\n\u003cp>The cost of the device can also be prohibitive for many people with diabetes. Assuming that insurance covers the handheld receiver, each sensor can cost between $10 and $15 after insurance coverage, and last between three and five days. Over the course of a month, this can easily add up to over 100 dollars.\u003c/p>\n\u003cp>Fortunately, companies like \u003ca href=\"Sano.co\">Sano\u003c/a> are paving the way for a more advanced, less invasive technology. All the user has to do is wear a clear adhesive strip (similar to a clear band-aid) and microneedles gain access to interstitial fluid. The strip measures concentrations of various metabolites including glucose, then wirelessly transmits this information to a users' smartphone or smartwatch.\u003c/p>\n\u003cp>In my opinion, this new type of CGM may push existing technology out of the market, because it breaks down many barriers to entry including cost, insurance coverage and the need for an external peripheral device.\u003cbr>\n\u003cstrong> \u003c/strong>\u003cbr>\n\u003cstrong>Recreational and Professional Athletes\u003c/strong>\u003c/p>\n\u003cp>The second population of individuals that I believe will strongly benefit from CGM technology are recreational and professional athletes. Endurance athletes in particular (runners, swimmers, cyclists and triathletes) will benefit most, as the technology provides them with insight into blood glucose patterns they can then use to develop an optimal fueling strategy for long events.\u003c/p>\n\u003cp>One of the main difficulties facing endurance athletics is understanding exactly how much food to eat and at what times to eat. Many athletes spend a significant amount of mental energy optimizing their food intake strategy in order to avoid \"\u003ca href=\"http://www.runnersworld.com/nutrition-runners/science-behind-bonking?page=single\">bonking\"\u003c/a> during a race.\u003c/p>\n\u003cp>Unlike people with diabetes who experience large fluctuations in blood glucose throughout the day, non-diabetic individuals experience small fluctuations. A perfectly functioning pancreas can control blood glucose throughout the day. But for an athlete, understanding how these small changes in blood glucose affect athletic performance is invaluable.\u003c/p>\n\u003cp>Understanding one's current blood glucose value as well as the magnitude and direction of change can make the difference between a good performance and a great performance. Athletes that are privy to this information in real-time can make decisions that can drastically affect their immediate performance and their recovery as well.\u003c/p>\n\u003cp>\u003cstrong>Medical Professionals and Coaches\u003c/strong>\u003c/p>\n\u003cp>The third group of individuals who can leverage continuous blood sugar devices include medical professionals, such as doctors, nurses, hospice care providers, as well as nutritionists, fitness coaches and professional sports coaches.\u003c/p>\n\u003cp>There are many companies currently working on wireless systems to provide doctors with real-time or pseudo-real-time information about the daily glucose patterns of their patients. When given access to this information, a doctor can modify an individual's insulin dosing strategy, exercise regimen or medication strategy more frequently than if they waited for the patient to return for a follow-up visit. In this way, doctors and medical professionals can make faster decisions to benefit their patients rather than having to wait an average of three months between in-person appointments.\u003c/p>\n\u003cp>One of the main complaints that I hear from other people with diabetes is that they don't trust their doctors anymore. The reason for this is simple: In a 15 minute-long appointment, a doctor is generally incapable of analyzing large quantities of blood sugar data in order to make an intelligent and progressive set of decisions to benefit the patient.\u003c/p>\n\u003cp>As a result, many patients with diabetes feel alone and helpless, having to wait multiple months for another anti-climactic appointment. Those that are ambitious will make modifications themselves, or seek advice from other people with diabetes, support groups or nutritionists like myself.\u003c/p>\n\u003cp>In the same way that an athlete can monitor their glucose levels and make adjustments, coaches who understand how to interpret blood glucose patterns can use this information to provide guidance for their athletes.\u003c/p>\n\u003cp>There is no doubt in my mind that the advancement of cost-effective and accurate wearable technology that provides insight into blood sugar levels will pave the way for an entire industry of glucose-related products and services for non-diabetic individuals.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>When this technology is placed in the hands of millions of people across the planet, we will begin to see how valuable this information can be in making real-time decisions about stress, nutrition, sleep, immunity, and athletics.\u003c/p>\n\n","disqusIdentifier":"2832 http://ww2.kqed.org/futureofyou/?p=2832","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/05/12/everyone-should-track-their-blood-sugar-not-just-people-with-diabetes-like-me/","stats":{"hasVideo":false,"hasChartOrMap":false,"hasAudio":false,"hasPolis":false,"wordCount":1186,"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"iframeSrcs":[],"paragraphCount":30},"modified":1477282614,"excerpt":"As a person with diabetes, Cyrus Khambatta tracks his blood sugar levels in real-time. He believes that other groups can benefit from this technology, whether it's endurance athletes or doctors.","headData":{"twImgId":"","twTitle":"","ogTitle":"","ogImgId":"","twDescription":"","description":"As a person with diabetes, Cyrus Khambatta tracks his blood sugar levels in real-time. He believes that other groups can benefit from this technology, whether it's endurance athletes or doctors.","title":"Everyone Should Track Their Blood Sugar -- Not Just People With Diabetes Like Me | KQED","ogDescription":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Everyone Should Track Their Blood Sugar -- Not Just People With Diabetes Like Me","datePublished":"2015-05-12T11:28:49-07:00","dateModified":"2016-10-23T21:16:54-07:00","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"guestAuthors":[],"slug":"everyone-should-track-their-blood-sugar-not-just-people-with-diabetes-like-me","status":"publish","path":"/futureofyou/2832/everyone-should-track-their-blood-sugar-not-just-people-with-diabetes-like-me","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This is a perspective from Cyrus Khambatta, a person with Type 1 Diabetes and the founder of \u003ca href=\"http://www.mangomannutrition.com/\">Mangoman Nutrition and Fitness\u003c/a>\u003cbr>\n\u003c/em>\u003c/p>\n\u003cp>Continuous glucose monitoring, which uses tiny sensors under the skin to check blood sugar levels, is going to be a very big deal -- and not just for people with diabetes.\u003c/p>\n\u003cp>I have personal experience with monitoring my glucose levels, having been living with diabetes now for 12 years. The insights that I have gained from understanding my blood glucose patterns 24/7 have been transformative.\u003c/p>\n\u003cp>I've learned how my body responds to various types of food, exercise, stress, viruses, altitude, dehydration and extreme temperatures. And with years of historic data, I can now predict how my blood glucose readings will be in the current moment.\u003c/p>\n\u003cp>Here are the population groups that I believe can benefit most from continuous glucose monitoring, otherwise known as CGM.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>People With Diabetes and Prediabetes\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Continuous glucose monitoring was originally developed specifically for people with type 1 diabetes, in order to monitor their glucose levels at all times -- not just periodically with a prick of a fingertip.\u003c/p>\n\u003cp>This population is obviously the most in need, given that inadequate production of insulin results in highly variable blood sugar values. Continuous glucose monitors have proven to be extremely useful for this patient population. The technology has given both people with diabetes and their doctors an ability to fine-tune an insulin-dosing strategy to minimize blood sugar fluctuations.\u003c/p>\n\u003cp>Some individuals with type 2 diabetes are given CGMs as well. On occasion, they are used only temporarily in order to gain some immediate insight into daily blood sugar fluctuations. Others use such continuous monitors in the long-term to support a blood glucose management program.\u003c/p>\n\u003cp>But people with diabetes may have some challenges with today's continuous blood sugar monitors.\u003c/p>\n\u003cp>One of the main problems with the current technology is that it is often difficult to obtain, even with comprehensive health insurance. I've heard from people with type 1 diabetes, who have a difficult time getting their hands on a continuous monitor. And many doctors are overburdened with excessive paperwork to request that a patients' insurer cover the cost of a CGM and/or insulin pump.\u003c/p>\n\u003cp>Existing CGMs have come a long way, and now provide wireless blood glucose sensing that can be interpreted on a handheld mobile device.\u003c/p>\n\u003cp>Despite this, many users have told me that the devices feel pseudo-bionic. On one side of their abdomen sits a sensor that reads glucose on five-minute intervals and then transmits that data to a handheld wireless receiver; on the other side sits an insulin pump insertion site that is physically connected to the insulin pump via clear tubing. Many people with Type 1 Diabetes become frustrated with these devices and insertion sites, which adds to the overall strain of living with diabetes.\u003c/p>\n\u003cp>The cost of the device can also be prohibitive for many people with diabetes. Assuming that insurance covers the handheld receiver, each sensor can cost between $10 and $15 after insurance coverage, and last between three and five days. Over the course of a month, this can easily add up to over 100 dollars.\u003c/p>\n\u003cp>Fortunately, companies like \u003ca href=\"Sano.co\">Sano\u003c/a> are paving the way for a more advanced, less invasive technology. All the user has to do is wear a clear adhesive strip (similar to a clear band-aid) and microneedles gain access to interstitial fluid. The strip measures concentrations of various metabolites including glucose, then wirelessly transmits this information to a users' smartphone or smartwatch.\u003c/p>\n\u003cp>In my opinion, this new type of CGM may push existing technology out of the market, because it breaks down many barriers to entry including cost, insurance coverage and the need for an external peripheral device.\u003cbr>\n\u003cstrong> \u003c/strong>\u003cbr>\n\u003cstrong>Recreational and Professional Athletes\u003c/strong>\u003c/p>\n\u003cp>The second population of individuals that I believe will strongly benefit from CGM technology are recreational and professional athletes. Endurance athletes in particular (runners, swimmers, cyclists and triathletes) will benefit most, as the technology provides them with insight into blood glucose patterns they can then use to develop an optimal fueling strategy for long events.\u003c/p>\n\u003cp>One of the main difficulties facing endurance athletics is understanding exactly how much food to eat and at what times to eat. Many athletes spend a significant amount of mental energy optimizing their food intake strategy in order to avoid \"\u003ca href=\"http://www.runnersworld.com/nutrition-runners/science-behind-bonking?page=single\">bonking\"\u003c/a> during a race.\u003c/p>\n\u003cp>Unlike people with diabetes who experience large fluctuations in blood glucose throughout the day, non-diabetic individuals experience small fluctuations. A perfectly functioning pancreas can control blood glucose throughout the day. But for an athlete, understanding how these small changes in blood glucose affect athletic performance is invaluable.\u003c/p>\n\u003cp>Understanding one's current blood glucose value as well as the magnitude and direction of change can make the difference between a good performance and a great performance. Athletes that are privy to this information in real-time can make decisions that can drastically affect their immediate performance and their recovery as well.\u003c/p>\n\u003cp>\u003cstrong>Medical Professionals and Coaches\u003c/strong>\u003c/p>\n\u003cp>The third group of individuals who can leverage continuous blood sugar devices include medical professionals, such as doctors, nurses, hospice care providers, as well as nutritionists, fitness coaches and professional sports coaches.\u003c/p>\n\u003cp>There are many companies currently working on wireless systems to provide doctors with real-time or pseudo-real-time information about the daily glucose patterns of their patients. When given access to this information, a doctor can modify an individual's insulin dosing strategy, exercise regimen or medication strategy more frequently than if they waited for the patient to return for a follow-up visit. In this way, doctors and medical professionals can make faster decisions to benefit their patients rather than having to wait an average of three months between in-person appointments.\u003c/p>\n\u003cp>One of the main complaints that I hear from other people with diabetes is that they don't trust their doctors anymore. The reason for this is simple: In a 15 minute-long appointment, a doctor is generally incapable of analyzing large quantities of blood sugar data in order to make an intelligent and progressive set of decisions to benefit the patient.\u003c/p>\n\u003cp>As a result, many patients with diabetes feel alone and helpless, having to wait multiple months for another anti-climactic appointment. Those that are ambitious will make modifications themselves, or seek advice from other people with diabetes, support groups or nutritionists like myself.\u003c/p>\n\u003cp>In the same way that an athlete can monitor their glucose levels and make adjustments, coaches who understand how to interpret blood glucose patterns can use this information to provide guidance for their athletes.\u003c/p>\n\u003cp>There is no doubt in my mind that the advancement of cost-effective and accurate wearable technology that provides insight into blood sugar levels will pave the way for an entire industry of glucose-related products and services for non-diabetic individuals.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When this technology is placed in the hands of millions of people across the planet, we will begin to see how valuable this information can be in making real-time decisions about stress, nutrition, sleep, immunity, and athletics.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/2832/everyone-should-track-their-blood-sugar-not-just-people-with-diabetes-like-me","authors":["8610"],"series":["futureofyou_172","futureofyou_308"],"categories":["futureofyou_1060"],"tags":["futureofyou_312","futureofyou_310","futureofyou_311","futureofyou_315","futureofyou_309","futureofyou_314","futureofyou_270","futureofyou_80","futureofyou_313"],"featImg":"futureofyou_2968","label":"futureofyou_308"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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