New Levemir Insulin Pen Delivery Device

September 11, 2014

Submitted by Kristen Rider, BSN, RN, CDE

NovoNordisk has launched the new insulin pen delivery device for Levemir insulin. Previously, Levemir was available in a vial or in a Flexpen. The new pen device is called the Levemir FlexTouch Pen. The new pen device now has no push-button extension. On the previous device, as the dose was dialed, the push button extended outward. The FlexTouch has a low-force touch button and a click after the dose is delivered. The new device can deliver up to 80 units in one dose (previously 60 with the Flexpen). Each pen device is prefilled with 300 units of insulin, as it was previously with the Flexpen. If you use a Levemir Flexpen, you will be seeing the new device in the near future, as the Flexpen will be discontinued. Levemir will continue to be available in a vial.

This information is not meant to replace your healthcare Provider’s advice. It is not an endorsement of this product or of the NovoNordisk company.

The Outpatient Diabetes and Nutrition Services Department at St. Anthony’s Medical Center can assist you with questions you may have regarding this change or other questions you have regarding your diabetes self-management. Call us at 314-525-4523 for more information.


Source: NovoNordisk, 2014

Beans the Magical Vegetable

August 29, 2014

by Alison Brinker, RD, LD

Beans are a wonderful source of low fat protein, carbohydrate and fiber.  The fiber in beans can actually help slow the absorption of carbohydrate into the blood stream causing a slower rise in your blood glucose.  A serving of beans each day can cut your “bad” LDL cholesterol by about 5% found a recent report in the Canadian Medical Association Journal.  Beans are also a good source of iron, folate and magnesium.  This recipe combines beans and red bell peppers.  Red bell peppers are a great source of vitamin C.  Consuming vitamin C along with high iron foods actually enhances your body’s absorption of  iron.  Another great example of this is chili.  Tomatoes are high in vitamin C so they will enhance the absorption of the iron from the beans and meat in the chili.  Enjoy!!


Bean-Pepper Slaw

In a large bowl, toss 2- 15 ounce cans pinto or pink beans, rinsed and drained, with 2 small red bell peppers, seeded and thinly sliced; 1 medium shallot, finely chopped; 3 Tablespoons, red wine vinegar; 1 Tablespoon extra virgin olive oil; and ¼ teaspoon each salt and black pepper.  Let stand 15 minutes.  Serving size: ½ cup=15 grams carbohydrate and 1 lean meat substitute or 1 carbohydrate serving and 1 oz meat substitute



Source:  Good Housekeeping, August 2014


Save Money by Controlling Your Diabetes

August 22, 2014

Not only is eating better and exercising healthy for people with diabetes, it can save them hundreds of health-care dollars a year, a new study finds.

The study, led by Mark Espeland, a professor of public health sciences at Wake Forest Baptist Medical Center in Winston-Salem, N.C., included more than 5,100 overweight and obese type 2 diabetes patients.

Participants ranged in age from 45 to 76, and were randomly assigned to either an intensive “lifestyle change program” focused on diet and exercise, or to a standard diabetes support and education program.

The patients in the lifestyle group had higher levels of physical activity and maintained a lower body weight, resulting in better diabetes control, blood pressure, sleep, physical function and fewer symptoms of depression, the team reported.

There were financial savings, too. Over 10 years of follow-up, the patients in the lifestyle intervention group had 11 percent fewer hospitalizations and 15 percent shorter hospital stays. They also used fewer prescription medications than those in the diabetes support and education programs.

Those benefits led to an average savings of $5,280 in health-care costs per person over 10 years, or about $528 a year, according to the study published online Aug. 21 in the journal Diabetes Care.

The cost savings for people in the lifestyle intervention group were similar regardless of age, initial weight, gender or race, Espeland said.

“Type 2 diabetes is a chronic disease that is affecting more and more adults, increasing their health-care needs and costs,” he added in a Wake Forest news release. “This study shows that by losing weight and being physically active, individuals can reduce these costs.”

Two experts weren’t surprised by the cost savings.

“It makes perfect sense that an intensive lifestyle intervention, focusing on weight loss and physical activity, would help control diabetes and reduce the cost of medications and complications related to type 2 diabetes,” said Nina Eng, chief clinical dietitian at Plainview Hospital in Plainview, NY.

Dr. Gerald Bernstein is director of the diabetes management program at Mount Sinai Beth Israel in New York City. He said that once diabetes develops, costs soar. Patients must obtain medications plus blood sugar testing equipment and strips, and they often have diabetes-linked complications that involve hospitalizations and/or surgery.

Therefore, “it is not surprising that reducing weight will lower the cost of medical care for an individual if they have diabetes,” Bernstein said.

St. Anthony’s Medical Center offers a variety of fitness classes.  Log on to to see a full description of the classes offered!





Gerald Bernstein, M.D, director, diabetes management program, Friedman Diabetes Institute, Mount Sinai Beth Israel, New York City; Nina Eng, R.D, chief clinical dietitian, Plainview Hospital, Plainview, N.Y.; Wake Forest Baptist Medical Center.

MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US);Health Day: Getting Healthier a Big Money-Saver for People With Diabetes (Robert Preidt August 21, 2014)   Available from:

This Information is not meant to replace your healthcare provider’s advice.  It is not an endorsement of any product.

St. Anthony’s Diabetes & Nutrition Education Office moves to new location

July 30, 2014

St. Anthony’s Diabetes Education & Nutrition Services Office has moved from the Medical Plaza building to a new location across Tesson Ferry; it is across the street from St. Anthony’s Medical Center, in the former Blockbuster building. The new address is: 9964-D Kennerly Road, St. Louis, MO, 63128; at the southern end of the Kennerly Center strip mall; 314-525-4508,option 2.

DIABETES EDUCATION SERVICES: the St. Anthony’s Diabetes Education Program provides Diabetes Self-Management Training (DSMT) for a variety of topics, including diabetes lifestyle changes, meal planning and weight loss strategies, monitoring blood glucose, medication management, and problem-solving skills. Individual and group class sessions are available. Instructors include Certified Diabetes Nurse Educators and Certified Diabetes Dietitian Educators (CDE’s). Many insurance companies will cover Diabetes Self-Management Training or Medical Nutrition Therapy with a physician’s referral. A Physician’s referral is required for an appointment. The education Staff also hosts a quarterly support Group meeting. For more information about our services, call 314-525-4508, option number 2. Also, visit for updates, diabetes news, and archived recipes.

NUTRITION COUNSELING: Appointments are available for Medical Nutrition Therapy (MNT). Registered, Licensed Dietitians provide: education, coaching, counseling, and intervention for nutrition-related medical diagnoses including: gastrointestinal conditions, renal disease, cardiovascular disease, diabetes, and cancer. Many insurance companies will cover Medical Nutrition Therapy with a Physician’s referral; a physician’s referral is required for an appointment. For more information about our services, call 314-525-4508, option number 2.



Afrezza inhaled insulin recently approved

July 14, 2014

Afrezza is an inhaled, ultra-rapid acting mealtime insulin therapy designed to improve glycemic control in adults with Type 1 and Type 2 diabetes. In patients with type 1 diabetes, it must be used with a long-acting insulin.  Afrezza is a drug-device combination product, consisting of an inhalation powder in a single dose cartridge & a small inhaler. Each cartridge can deliver a dose of 4 units or 8units; For doses exceeding 8 units, inhalations from multiple cartridges are necessary.  It is administered at the start of a meal with onset of action 12 to 15 minutes later. Peak action is usually seen about 90 minutes after dosing & the effects last about 160minutes. The insulin contained in Afrezza is regular human insulin.

Adverse affects seen in trials: Acute bronchospasm has been observed in patients with asthma and COPD. Lung Cancer: increased cases were seen in clinical trials; however, data was insufficient to determine whether Afrezza has an effect on lung or respiratory tract tumors. Others include: hypoglycemia, Diabetic Ketoacidosis, cough, throat pain or irritation, headache, fatigue, nausea urinary tract infection, weight gain. Before starting Afrezza, a medical history, physical exam and spirometry (FEV1) tests should be performed in all patients to identify potential lung disease. Long-term safety and efficacy of Afrezza in patients with chronic lung disease has not been established. Afrezza causes a decline in lung function over time as measured by FEV1. Pulmonary function should be assessed at baseline, after the first 6 months of therapy, and annually thereafter, even in the absence of pulmonary symptoms.

Additional info: insulin exposed to temperatures higher than 98.6°F (37°C) should be discarded. Store unopened product in refrigerator. If a foil packet is not refrigerated, the contents must be used within 10 days. Inhaler may be stored refrigerated, but should be at room temperature before using. Before use, cartridges should be at room temperature for 10 minutes.


New insulin pen delivery device

July 4, 2014

NovoNordisk has a new re-usable insulin pen injector device, NovoPen Echo, that was recently approved for use. It uses NovoNordisk Penfill insulin cartridges (prefilled, 3ml=300 units).  The Echo allows delivery of insulin doses in 1/2 unit increments, with a max dose of 30 units per use. It has a “dose memory” that displays the amount of insulin most recently injected and the time that has elapsed since that dose (in full hour increments). The pen device comes in red and blue, which could be helpful if using 2 types of insulin. It uses a non-replaceable battery that lasts about 4 to 5 years.

This information is not meant to replace your healthcare Provider’s advice. It is not an endorsement of this product or of the NovoNordisk company.

Diabetic Peripheral Neuropathy Awareness

June 11, 2014

TheMissouri General Assembly has designated the 3rd week in June as Diabetic Peripheral Neuropathy (DPN) Awareness Week.  This year it is June 16th through June 21st. The State resolution cited statistics that in 2009, 346 thousand Missourians were diagnosed with diabetes. DPN is a serious condition that can occur, as a result of damage to the lining of the nerves, from prolonged exposure to poorly controlled blood glucose. The areas of the body most affected by DPN are the legs and feet. Nerve damage to the feet can cause numbness, pain, tingling, a burning sensation, or loss of sensation. Loss of sensation can result in injury and/or an open wound. Due to diminished circulation, elevated blood glucose can interfere with healing and may cause infections or gangrene. As many as 40 to 60% of lower extremity amputations are due to severe forms of DPN. If you already have DPN, discuss treatment options with your Health Care Provider; there are several medications available to help with nerve pain. The goal is to prevent it from getting worse by improving blood glucose control. The Legislature is encouraging all Missouri residents to observe this week by raising public awareness regarding the symptoms and treatment of DPN.

St Anthony’s Diabetes Education Program provides diabetes self-management training (DSMT) for a variety of topics including diabetes life-style changes, meal planning & weight loss strategies, monitoring blood glucose, medication information, and problem-solving skills. Instructors include Certified Diabetes Nurse Educators and Certified Diabetes Dietitian Educators (CDE’s). Many insurance companies will cover DSMT or Medical Nutrition Therapy (MNT). For more information about our services, call 314-525-4508, option 2.


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