One in ten Americans has diabetes. It’s a public health emergency that has only grown more urgent during the pandemic as the medical community works to understand the link between COVID-19 and new diabetes cases. While game-changing technology is being deployed against the disease, many Americans lack access to these innovations or even more basic treatment options.

Medical experts joined The Post to explore the state of diabetes care in America, the little-understood link between the COVID-19 virus and diabetes, the high cost of insulin, and the most promising solutions for getting diabetes treatment to all those who need it. Join Aaron Neinstein, MD, associate professor of medicine and director of the Center for Digital Health Innovation at UCSF, Rita Rastogi Kalyani, MD, MHS, editor in chief of the Johns Hopkins Diabetes Guide, and Jennifer Raymond, MD, MCR, division chief for the Center for Endocrinology, Diabetes, and Metabolism at Children’s Hospital Los Angeles.

Highlights

Rita Rastogi Kalyani, MD, MHS said covid-19 could spur new onset diabetes in patients with risk factors for the disease. “In one meta-analysis… that was done last year, it was reported that up to 14-percent of hospitalized patients with covid-19 had new onset diabetes. And so we know that when people undergo a stress response or a tremendous inflammatory response as occurs with covid-19, this can put the body under stress and in those who may already have risk factors for diabetes, push them over the edge, to rising blood glucose, particularly in the setting of steroid use, which is often used pretty early on with covid-19, severe covid-19 infection, and to the development of diabetes as well.” (Washington Post Live)
Rita Rastogi Kalyani, MD, MHS said insulin prices have risen as much as 300-percent over the last decade, and the pandemic’s economic hardships have made it difficult for low-income people to afford their medication. “Over the past decade, we’ve seen tremendous rise in the cost of insulin that far outpaces inflation. Almost 300-percent for some of the synthetic analog insulins, if you look at their current list price compared to where they were ten years ago. And especially during the pandemic, these increasing costs burdened with the economic hardships that many people in the United States are facing makes it increasingly difficult to afford insulin and use insulin as described[…] I definitely have had patients in my clinic come and say at times that they’ve had to delay the refill of their insulin because they’re waiting for their next paycheck.” (Washington Post Live)
Aaron Neinstein, MD added that insurance companies can add barriers to people receiving CGM devices. “Half of people with type 1 diabetes do not have continuous glucose monitors and that is a really unfortunate shame because it is considered standard of care today… and everyone with type 1 diabetes should at least be offered a continuous glucose monitor... There are still some issues at times with insurance coverage. And one of the things that’s a common misunderstanding is that while many insurance plans cover continuous glucose monitors, they do put a lot of barriers in front of us… So there are a lot of systemic issues that are standing between people getting the CGM devices that they need today.” (Washington Post Live)

Guests

Aaron Neinstein, MD

Provided by UCSF.

Dr. Aaron Neinstein, Associate Professor of Medicine at UCSF, leads the Digital Patient Experience team at the UCSF Center for Digital Health Innovation. His digital health resume spans leading UCSF’s ambulatory Epic EHR implementation, development and deployment of numerous digital health solutions transforming digital patient experience and virtual care delivery across UCSF, research and advocacy advancing US federal health policy in interoperability and patient data access, and co-founding of Tidepool, a non-profit creating open-source software to empower people with diabetes. Dr. Neinstein was an inaugural inductee as a Fellow of the American Medical Informatics Association (FAMIA). Board-certified in Endocrinology, Clinical Informatics, and Internal Medicine, he maintains an active clinical practice focused on the care of people with diabetes, and was named by Marin Magazine to the 2020 Bay Area [415] Top Doctors List. Dr. Neinstein is a renowned expert in diabetes technology as a nationally-invited speaker, peer-reviewed author, invited writer to outlets like CNBC and Medscape, and advisor to numerous companies.

Rita Rastogi Kalyani, MD, MHS

Provided by Johns Hopkins Medicine.

Rita Rastogi Kalyani, MD, MHS, FACP, is an Associate Professor of Medicine at the Johns Hopkins University School of Medicine in the Division of Endocrinology, Diabetes, and Metabolism and a nationally-recognized thought leader, researcher, and clinician in diabetes who is dedicated to improving the health of diverse populations. She is actively involved in diabetes education and public awareness initiatives.

Dr. Kalyani graduated with an undergraduate degree from Harvard College and completed all of her medical training at Johns Hopkins. Dr. Kalyani's clinical practice is based in the Johns Hopkins Diabetes Center. She is the Editor-in-Chief of the Johns Hopkins Patient Guide to Diabetes website. An author of more than 125 peer-reviewed research publications, Dr. Kalyani’s research has been funded by the National Institutes of Health and focuses on diabetes and aging.

Dr. Kalyani previously chaired the American Diabetes Association’s clinical guidelines committee, responsible for the organization’s annual position statement titled the “ADA Standards of Medical Care in Diabetes,” and has been appointed to national committees for the Endocrine Society and American College of Physicians. She serves as President of the ADA’s Maryland Community Leadership Board of Directors and is passionate about heightening awareness of diabetes and its complications in the community. Dr. Kalyani is a consultant to the Maryland Department of Health on the statewide diabetes action plan and co-leads the Maryland Diabetes Quality Task Force. She is a member of the U.S. Food and Drug Administration’s Endocrinologic and Metabolic Drugs Advisory Committee. Dr. Kalyani has developed international programs for diabetes care in the Caribbean, Middle East, and Asia.

Jennifer Raymond, MD, MCR

Provided by Children’s Hospital Los Angeles.

Dr. Jennifer Raymond is the Division Chief for the Center for Endocrinology, Diabetes, and Metabolism and Chair of the Virtual Care Committee at Children’s Hospital Los Angeles (CHLA) and Associate Professor of Pediatrics at the Keck School of Medicine of USC.

Dr. Raymond’s main research and clinical interest is improving patient outcomes through novel clinical approaches and behavioral interventions, specifically in disadvantaged adolescents and young adults. She also has a particular interest and expertise in utilizing telehealth to increase the reach of clinical and behavioral interventions. Dr. Raymond is interested in sustainable and efficient clinical care models that can be replicated in multiple care settings, with racially, ethically, and socioeconomically diverse young people.

She received her medical degree and completed her residency in Pediatrics at the University of Kansas. She completed her fellowship in Pediatric Endocrinology and Master of Clinical Research at Oregon Health and Science University.

Content from Abbott

Medical experts joined The Post to explore the state of diabetes care in America, the little-understood link between the COVID-19 virus and diabetes, the high cost of insulin, and the most promising solutions for getting diabetes treatment to all those who need it. Join Aaron Neinstein, MD, associate professor of medicine and director of the Center for Digital Health Innovation at UCSF, Rita Rastogi Kalyani, MD, MHS, editor in chief of the Johns Hopkins Diabetes Guide, and Jennifer Raymond, MD, MCR, division chief for the Center for Endocrinology, Diabetes, and Metabolism at Children’s Hospital Los Angeles. (Washington Post Live)

This content was produced and paid for by a Washington Post Live event sponsor. The Washington Post newsroom was not involved in the production of this content.

Tracey D. Brown, Chief Executive Officer of the American Diabetes Association

Tracey D. Brown is Chief Executive Officer of the American Diabetes Association (ADA), the nation’s largest voluntary health organization and a global authority on diabetes.Tracey joined the ADA in June 2018 after her tenure as senior vice president of operations and chief experience officer at Sam's Club, a division of Walmart, Inc., where she was responsible for creating meaningful member experiences, directing member strategy, marketing and branding, go-to-market execution, data and analytics and membership operations.

Tracey brings more than 25 years of experience in driving global business growth, leveraging data to connect consumers with brands and creating omni-channel experiences to escalate customer loyalty. Prior to joining Sam’s Club, Tracey was chief executive officer and managing director of RAPP Dallas, a data-driven integrated marketing agency. Before RAPP, she served as chief operating officer for direct marketing agency Direct Impact, where she coordinated strategic, tactical and overall company operations.

Previously, Tracey was director of worldwide consumer marketing for Advanced Micro Devices, where she drove global marketing and demand generation activity around the world, including China, India, Russia, France, Spain, Italy and Japan. Early in her career, she served in leadership positions at American Express, Proctor & Gamble and Exxon Mobil.

Tracey earned a master of business administration degree from Columbia Business School in New York and a bachelor of chemical engineering degree from the University of Delaware.

Tracey, who lives with type 2 diabetes, recently served as a volunteer and fundraiser for the ADA in her local community. She joined the ADA’s National Board of Directors in January 2018, before transitioning to her new role as CEO. She and her family resides in the Washington, D.C. metropolitan area.

Jared Watkin, Senior Vice President, Diabetes Care at Abbott

Jared Watkin is Abbott’s Senior Vice President, Diabetes Care.

Prior to assuming this role in June 2015, he served as Divisional Vice President, Technical Operations.

Jared joined our company in 1996, when Abbott acquired Medisense, Inc. Since then, he’s held a number of key positions in Abbott Diabetes Care, including Senior R&D Director and Divisional Vice President, Research and Development.

In what he describes as his "proudest Abbott moment," Jared led the team that developed our innovative Freestyle Libre Flash Glucose Monitoring System; and as he looks to the future, he's committed to "keeping Abbott Diabetes Care at the forefront of innovation, allowing us to provide better health, and a fuller life, to people with diabetes."

Jared earned his Bachelor of Science degree in Biochemistry from the University College of Wales, Aberystwyth, United Kingdom.

Moderated by Jeanne Meserve, Journalist, CTV News

Jeanne Meserve is a homeland security expert and analyst, moderator, and award-winning journalist. She is currently a Security Expert for Canada’s CTV News and co-host of the SpyTalk podcast. While a correspondent and anchor at CNN and ABC Jeanne earned her profession’s highest honors, including two Emmys and an Edward R. Murrow Award. She also contributed to two CNN Peabody Awards.

Jeanne is a member of the Homeland Security Experts Group and the Transatlantic Commission on Election Integrity, and serves on the board of the non-profit Space Foundation.

She moderates discussions on topics ranging from technology and security, to medicine and the environment. Her clients include AtlanticLIVE, Washington Post Live, the Munich Security Conference, the Halifax International Security Forum, and the global conferences of the International Women’s Forum.

At CNN Meserve created the homeland security beat, covering intelligence, law enforcement, cyber, aviation, border and port security. She anchored worldwide coverage of the Yitzhak Rabin assassination and the death of Princess Diana, and was the first to report on the devastating flooding in New Orleans after Hurricane Katrina. She was a key member of the CNN political team during the 1996 and 2000 elections. While at ABC News she covered the State Department and reported from the Middle East, Asia and Europe.