Holiday greetings to you, your family and friends,


I hope 2019 was a good year.

Thanks to your support, we have been able to continue our work in underserved communities in Los Angeles—doing research, providing programs and education, and trying to reduce existing healthcare disparities for people with diabetes.

We have also been able to raise the bar for people on the Westside of Los Angeles, with new treatments and technologies that further enhance our ability to treat diabetes. I have never felt so confident in my ability to forestall and prevent the complication of diabetes, at least in patients who have access to high-quality healthcare. However, due to the ever-growing lack of healthcare professionals who are going into the field of diabetes, I feel increasingly compelled to educate primary care providers and to mentor young people in the field. I also believe in expanding the role for diabetes educators, like our own Mary Rose, who are capable of providing innovative care and support to people with diabetes.

I'm so proud of our teams in both the East and the Westside of the city. Please consider adding your support to our centers in your end-of-year charitable donations.

I am once again on the ADA Professional Practice Committee where we write the national guidelines for diabetes care. This time, I am the lead on the Technology Standards. It is one of the most intense, time-consuming volunteer jobs one can do, but it is also one of the most gratifying. It forces me to review everything in the field of diabetes and then work with the other committee members to interpret it and create a useful guide for other providers.

In other news, you may soon be seeing ads for Rybelus, a once-daily pill form of Ozempic (a once-weekly injection). This drug class is for people with type 2 diabetes and it is incredibly effective at controlling glucose levels while offering the added benefits of weight loss and protections against heart disease. Rybelus is a bit complicated to use—it needs to be taken daily on an empty stomach with no more than 4 oz of water and you have to wait 30 minutes before eating or taking another pill. I think some people will continue to take their once-weekly injection of Ozempic while others will prefer the new pill. I'm also hopeful that this oral medication will be something more readily used in primary care than the injectable form.

The second FDA-approved hybrid closed-loop insulin pump will be available in January. This is the Control-IQ version of the Tandem X-2 pump that works with a Dexcom G6 CGM to automatically prevent low glucose event and it will be updated with software to help with highs as well. We have many patients who have been waiting for the update while others are joining the #We’reNotWaiting movement, building their own iPhone Loop controllers to deliver insulin with hacked OmniPod devices. The web version of our summer newsletter article provides links to instructions on how to build the open-source version of Loop and will be updated with information on the new Tandem system.

As more patients are taking advantage of telemedicine visits, I am finding that I love this form of communication. I enjoy seeing people in their home settings and there are no complaints about how long the drive was into the clinic. I do not think it completely replaces an in-office visit, where I can often do more tasks, but I think it is terrific if interspersed with in-person trips to the clinic. And it is definitely useful for patients who live far away or have busy jobs or family responsibilities. Here is how you can connect.

The recent fires in California are a reminder that people with diabetes have an additional reason to be ready for fires, earthquakes and other emergencies and getting through the holidays with diabetes creates additional challenges in terms of managing weight and glucose control. Mary Rose has some great advice on how to manage the season.

As always, we appreciate any support you can offer for our clinical and research programs. Happy 2020!





Message from the Director