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It’s official: Alto Pharmacy is a great place to work! We’re honored to join the community ofGreat Place to Work-Certified™ companies based on team member feedback and a rigorous assessment of our company’s culture and benefits.

Join us in delivering our industry-leading pharmacy care to millions of people across the country. As a member of the team, you’ll play an integral role in improving our customers’ quality of life and redefining what’s possible in pharmacy.

Be Part of a Great Place to Work — Join Our Team

Hear first-hand from members of the Alto technology teams.

Read the latest Alto blog posts covering healthcare, family health, managing diseases, and other Alto highlights.

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Evidence suggests that gut health may also belong on the list of heart disease risk factors. Here’s what to know about the link between heart health and gut health, including steps you can take to maintain a balanced gut microbiome.

What to Know About the Heart and Gut Health Connection

Different factors can increase your chance of developing heart disease, like age, family history, high cholesterol, and high blood pressure, among others. And now, evidence suggests that gut health may also belong on the list of heart disease risk factors.

There are trillions of bacteria, fungi, and other small, microscopic organisms called microbes housed in your digestive system. They are collectively referred to as the gut microbiome. In recent years, researchers have found that the gut microbiome affects more than your digestive health alone. Heart disease is one of several health conditions that may be at least partially fueled by an unhealthy balance of gut bacteria.

The good news? This is a heart disease risk factor you definitely have control over. Here’s what to know about the link between heart health and gut health, including steps you can take to maintain a balanced gut microbiome.

Metabolites and your cardiovascular system

During the digestive process, microbes produce substances called metabolites. One of these substances in particular, trimethylamine (TMA), is linked to your risk for cardiovascular disease and other chronic health conditions like diabetes.

TMA forms when the bacteria and other organisms within the gut microbiome consume choline, a nutrient contained in red meat, fish, poultry, and eggs. The liver then converts TMA into a substance called trimethylamine N-oxide (TMAO). 

The medical community has identified a connection between high levels of TMAO in your blood and deposits of cholesterol, blood-clotting material, and other substances in your arteries. These substances are collectively referred to as plaque, and its accumulation in your arteries is referred to as atherosclerosis, a leading cause of cardiovascular disease, heart attacks, and strokes.

A 2017 analysis of several studies on the connection between TMAO blood levels and cardiovascular health found a correlation between elevated TMAO levels and serious cardiovascular issues. In the studies, researchers looked at people from different categories of health conditions in multiple countries, like individuals with and without diabetes, and individuals with and without chronic heart failure. 

Each group included individuals with various TMAO levels. The results showed that people with the highest levels of TMAO were 62% more likely to experience serious cardiovascular issues like heart attacks and strokes. The link appeared to be independent of other key risk factors for heart disease like diabetes and obesity.

In addition to the findings about TMAO, researchers have also identified a link between gut health and inflammation (redness, warmth, and swelling around tissues and joints). Inflammation is part of the body’s natural response to an injury, but when it persists after the healing process and becomes chronic inflammation, it can lead to an ongoing high white blood cell count.  

Over time, this elevated level of white blood cells can affect other organs including your heart, lungs, and kidneys, which may influence your risk for heart disease and other chronic conditions like diabetes.

The majority of the body’s inflammatory cells are stored in tissues in your gut, and researchers have found that an inflamed gut can trigger inflammation elsewhere in your body. Certain gut bacteria produce substances that enter your bloodstream and create inflammation in every part of the body that they travel through. This inflammation in the walls of your blood vessels can eventually lead to atherosclerosis.

Researchers are still learning about the gut microbiome’s influence on your risk for various health conditions. One thing they do know for sure is that a healthy gut microbiome is an important component of your overall health, and there are simple steps you can take to maintain a balanced digestive system.

A balanced diet is a great starting point for better gut health. Start by limiting foods that are processed or high in sugar or fat — particularly cookies, sugary drinks, salty snacks, and frozen foods — as these can lead to increased inflammation. Opt for fiber-rich foods like beans, peas, bananas, and asparagus; fermented foods like kimchi, yogurt, miso, and kefir; and collagen-rich or collagen-boosting foods like salmon, mushrooms, and egg whites.

Staying physically active and avoiding unhealthy habits like smoking and heavy alcohol consumption can also improve your gut health. Looking for a fitness routine that fits your schedule and health needs? Aim for about 150 minutes a week or 30 minutes per day. Explore different activities until you find the one that’s right for you — whether virtually or in person.

Over the long term, stress can lead to many physical and mental health problems, including digestive issues. Staying physically active reduces stress, so you’re already tackling this risk factor simply by working out regularly.

Beyond exercise, check out Insight Timer, an app that offers free guided meditations or Moodfit, a free mood-tracking app. And since there’s an established link between stress and high blood pressure, heart disease, and stroke, these small actions can benefit several aspects of your health at once!

At Alto, we’re committed to making it as simple as possible to protect your heart health and stay on top of cholesterol-lowering or blood pressure management medications.  We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly

Reach out any time via text or phone at 1-800-874-5881 or in-app messaging.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

Proactively managing COPD with medication and lifestyle changes can help prevent periods of intensified symptoms, referred to as exacerbations or flare-ups. Here’s more on how to recognize, treat, and prevent COPD flare-ups.

How to Manage and Prevent a COPD Flare-Up

Proactively managing chronic obstructive pulmonary disease (COPD) with medication and lifestyle changes can help slow the progression of the chronic lung disease and prevent periods of intensified COPD symptoms, commonly referred to as exacerbations or flare-ups. 

However, these flare-ups may occur even when closely following your doctor’s individualized treatment plan, especially during the more advanced stages of COPD, so it’s important to have a plan in place to quickly address symptoms. Here’s more on how to recognize, treat, and prevent COPD flare-ups.

Recognizing the symptoms of a COPD flare-up

During a COPD flare-up, symptoms like shortness of breath and wheezing quickly intensify and lung function significantly changes. (Lung function refers to how well your lungs work, specifically how much air they can hold and how easy it is for them to empty air.)

Individual experiences of a COPD flare-up may vary, but many people often notice greater amounts of mucus clogging the bronchial tubes in their lungs and sudden tightening of muscles around their airways. Here are key signs and symptoms to be aware of.

More frequent or more intense coughing, wheezing, or shortness of breath

Changes in the color, thickness, or amount of mucus

Using more oxygen than usual, if your treatment plan includes supplemental oxygen

If you experience any of the symptoms above, the best step is to call your doctor right away. Each COPD flare-up can affect your long-term lung function, so it’s important to address symptoms as quickly as possible.

To effectively manage a COPD flare-up, you’ll want to create a COPD action plan with your doctor. Then, if you experience the signs of a flare-up, you’ll have a specific outline of the actions and medications that can help restore your breathing. Here are some of the medications your doctor may include in your individualized COPD treatment plan.

Short-acting medications like bronchodilators relax your airway muscles and open your lungs to quickly reduce discomfort. Albuterol (branded options include ProAir® HFA, Proventil® HFA, Ventolin® HFA) is commonly used to treat COPD exacerbations. This medication is typically taken through an inhaler, but can also be taken as a liquid solution for nebulizer use. (A nebulizer is a device that turns a liquid medication into a mist that you can inhale through a face mask. It allows the medication to travel quickly to your lungs.)

Although not common, potential side effects of bronchodilators include nervousness or shakiness, headache, throat or nasal irritation, and muscle aches. Your doctor can explain more about the risks and benefits of using a bronchodilator to treat COPD exacerbations when building your treatment plan.

Your doctor may also recommend oral corticosteroids, which are fast-acting medications that reduce swelling in your lungs and open your airways so that more air can move in and out of your lungs. They are primarily prescribed for short-term use, typically five to seven days.

Oral corticosteroids commonly used to treat COPD exacerbations include:

Prednisone (Prednisone Intensol®, Rayos®)

Some people experience mild side effects from short-term corticosteroid use, including swollen hands and feet, elevated blood pressure, increased appetite, and shifts in mood.

Many people with more advanced COPD use supplemental oxygen to increase their tolerance for physical activities, while others use it only to relieve shortness of breath during an exacerbation.

If your flare-up is more mild, you may take oxygen at home. When writing your prescription for oxygen therapy, your doctor will explain how and when to use the oxygen. It is important to follow all of your doctor’s instructions, including the flow rate setting (how much oxygen you’ll need per minute). The American Lung Association has resources for anyone starting oxygen therapy.

If your COPD has progressed to a later stage, some flare-ups may require treatment in a hospital setting. This allows healthcare professionals to more closely observe your symptoms and monitor vital signs like your pulse, temperature, and blood pressure. Consult with your doctor about specific symptoms to look out for that may indicate a need for more intensive treatment or monitoring.

How to lower your risk of COPD exacerbations

There are many steps you can take to lower your risk of a COPD exacerbation and reduce the frequency of COPD-related hospitalizations.

First, it’s important to closely follow your doctor’s recommendations, including taking any maintenance medications exactly as prescribed. (We designed our app to make it as simple as possible to do so, with medication management tools like reminders and auto refills that help you stay on track.)

In addition, try to limit your exposure to leading triggers of COPD exacerbations, including cigarette smoke (this includes secondhand smoke), indoor and outdoor air pollution, cold air, and household dust.

To keep the air inside your home as clean as possible, avoid perfumes and cleaning and hygiene products with strong odors. Use air purifiers and vacuum cleaners with a high-efficiency particulate air (HEPA) filter.

Lastly, the flu and pneumonia can worsen COPD symptoms and potentially lead to a flare-up, so it’s important to get your yearly flu shot and ask your doctor or pharmacist if you are eligible for the pneumonia vaccine.

We’re here to support your COPD treatment

COPD flare-ups can cause discomfort, but we’re here every step of the way to help you manage symptoms and get the medications you need, with free same-day delivery and easy-to-use medication management reminders in our app.

And our team of pharmacists are always here to answer your questions by phone, text, or chat. Reach out any time via text or phone at 1-800-874-5881, or in-app messaging.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

October is American Pharmacist Month, a time to celebrate the critical role that pharmacists and pharmacy technicians play within healthcare.

Celebrating American Pharmacist Month At Alto

October just might be our favorite month of the year, and for a good reason: it’s American Pharmacist Month, a time to celebrate the critical role that pharmacists and pharmacy technicians play within healthcare.

Pharmacists are one of the most accessible healthcare professionals, seeing people 5 to 8 times more frequently per year than primary care providers. And as such, they are integral to your overall health and well-being. 

You may not realize all the responsibilities that a pharmacist’s role encompasses. In addition to filling your prescriptions, they also educate on medication usage, advocate for changes that improve care, and problem solve clinical, ethical, managerial, economic, and legal compliance issues, becoming a trusted resource to the individuals they care for. Extensive training and education are required to enter the profession: a pharmacist must earn a doctorate in Pharmacy and complete state-specific licensing requirements before becoming licensed to practice pharmacy.

At many traditional retail pharmacies, each pharmacist is expected to tackle a broad assortment of tasks that often leave them feeling overwhelmed and stressed, like managing transactions for customers, answering questions about where non-pharmacy items are stocked, and contacting insurance companies on top of ensuring prescriptions are dispensed properly and safely. At Alto, however, pharmacists align with one of several practice areas — fulfillment, customer care, and onboarding — so that they are able to focus on specific aspects of pharmacist practice and deliver exceptional care to Alto’s customers.

Fulfillment pharmacists are responsible for inventory management, medication preparation, physical quality checks, and dispensing, all to make sure the right medication arrives at your door, on schedule. Our customer care pharmacists review prescriptions for accuracy and for potential complications with other medications on file; provide individualized consultations on dosing, side effects and other concerns; and partner with healthcare providers on clinical recommendations. And our onboarding pharmacists — a relatively new role at Alto — are a bridge to an individual's broader team, supporting healthcare providers and ensuring continuity of care between prescriber and pharmacy.

“At Alto, we are proud of our customer-focused services and forward-thinking means of providing those services,” shares Ashley Lee, Onboarding Pharmacist. “Being a pharmacist at Alto gives me the unique opportunity to not only practice patient care, but also to design it to be meaningful to as many individuals in need as possible. The innovation never stops here at Alto.”

How Alto pharmacists serve our communities

There’s no shortage of opportunities for a pharmacist to support an individual with their medication needs or to be a partner in their health journey alongside their doctor’s office, family and other support networks. Here are just a few of the many roles that Alto pharmacists fulfill.

Literally. Our pharmacists are educators who mentor other pharmacists-in-training. Sandra Aziz, Pharmacy Compliance Program and Training Manager, is responsible for training new Pharmacy Managers and Supervisors at our dispensing sites, ensuring they have the resources needed to be effective managers and to oversee their pharmacy location’s compliance program and daily operations.

Sandra also manages our internship programs for pharmacy students. Alto offers an immersive 10-week Pharmacy Operations Management summer internship program for eligible students at Howard University’s School of Pharmacy (HUCOP). The program provides an opportunity to gain a breadth of experience across clinical pharmacy care, operations, and business development. Students also have the opportunity to actively influence Alto’s software development and implement ideas that further preventative healthcare and pharmacist involvement in community health.

Sandra also launched our Introductory Pharmacy Practice Experiences (IPPE) and Advanced Pharmacy Practice Experiences (APPE) programs, which allow students from pharmacy schools across the country to select Alto as a practice site. While at Alto, they are exposed to highly skilled and entrepreneurial pharmacists, engineers, and operations experts with whom they can partner to challenge, reinvent, and improve pharmacy. 

“It’s been really rewarding to see more pharmacy students expressing interest in our programs,” Sandra said. “We have a rare opportunity to give students an experiential learning experience that you won’t find at any other pharmacy. At Alto, our pharmacists work cross-functionally across operations, engineering, and design to build a better, more intuitive community pharmacy from the ground up. We focus on challenges faced by patients, providers, and payers, and find solutions that optimize experience, transparency, and health outcomes.”

Read our previous post, 'From Pharmacist to Professor: Sandra Aziz Spotlight'.

They’re also here to teach you! Our pharmacists are happy to chat on the phone for however long you need to offer individualized support. Many customers use these one-on-one consultations to learn how to give themselves injections as part of fertility treatment or diabetes management or to confirm special storage or dosing instructions, but our pharmacists are happy to share their expertise on any question related to your prescriptions or health needs.

For example, did you know that our pharmacists are experts on managing side effects? As a bridge between you and your doctor, our pharmacists review all of your current medications to identify any potential symptoms or medication interactions, and they’re available to talk through any questions or concerns.

Lawmakers in several states have recognized the accessibility of pharmacists and their potential to play an even larger role in healthcare, specifically in the HIV prevention space. California became the first state to allow pharmacists to prescribe HIV prevention medication like pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) in 2019, and Colorado became the second in November 2020. Pharmacists at Alto’s California locations are able to prescribe PrEP and PEP, and we’re currently working to bring the service to our Colorado location.

“As healthcare providers in the community, there is a big opportunity for us as pharmacists to play a critical role in HIV prevention and help increase accessibility to medications like PrEP and PEP,” explains Susan Sun, Specialty Pharmacist. “It’s been wonderful to see growing recognition of a pharmacist’s impact even outside of the healthcare community, and the recent legislation that allows pharmacists to prescribe in some states is just a start. It’s a privilege for pharmacists to be a part of these exciting changes and make HIV prevention easier for others.”

In honor of American Pharmacist Month, we’d like to say a big and heartfelt thank you to our incredible team of 175+ pharmacists. Each of you plays a critical role in the wellbeing of our customers, the strength of our provider relationships and the quality of our service — we’re grateful for your hard work all year long. 

Here are just a few of the faces responsible for providing exceptional pharmacist care at Alto!

There are 1.6 million Americans living with type 1 diabetes, including about 200,000 young people under 20 and 1.4 million adults aged 20 years old and older. Here is a high-level guide to living with type 1 diabetes at any age.

How to Live with Type 1 Diabetes at Any Age

There are 1.6 million Americans living with type 1 diabetes, including about 200,000 young people under 20 and 1.4 million adults aged 20 years old and older. While type 1 diabetes is typically diagnosed during childhood or adolescence (it was once referred to as juvenile diabetes), a diagnosis can come at any age 

Living with type 1 diabetes is a lifelong journey, and insulin therapy and blood glucose monitoring will remain constant. Some aspects of diabetes management, though, apply only to certain age groups, like coordinating with school staff about a child’s type 1 diabetes care plan or prioritizing heart disease prevention as you get older (more about that later).

Below, we’ve highlighted  things to be mindful of with type 1 diabetes treatment for various age groups. This is intended to be a high-level guide to living with type 1 diabetes at any age, and your diabetes care team (or your child’s) will help you develop an individualized treatment plan with recommendations for insulin dosage, blood sugar targets, and blood sugar monitoring frequency.

Type 1 diabetes and children: blood sugar monitoring at school

Individuals with type 1 diabetes are unable to produce any insulin, a hormone produced in the pancreas which helps convert sugar, or glucose, into energy. Getting started with insulin therapy is one of the first steps after a type 1 diagnosis, and is an important part of living with type 1 diabetes at any age. Daily insulin therapy, along with blood sugar monitoring and meal planning, allows people with type 1 diabetes to maintain healthy and consistent blood sugar levels.

While the goal of insulin therapy is to keep your blood sugar levels as steady as possible throughout the day, fluctuations are natural. Checking blood sugar levels several times each day allows you to stay within a healthy range. Younger children with type 1 diabetes will need help with both insulin administration and blood sugar monitoring, and during the school day you may need teachers and other school staff to provide support. It’s also important that someone at the school understands how to administer glucagon if your child’s blood sugar falls too low (known as hypoglycemia).

Here are some steps you can take to simplify your child’s treatment needs and make sure you’re prepared for an emergency.

Communicate with your child’s teacher and/or other school staff before classes begin to make sure they’re aware of your child’s type 1 diabetes diagnosis. 

Discuss daily treatment needs like blood sugar monitoring and insulin therapy as well as potential complications that may arise, like low blood sugar, and how to spot the signs and symptoms.

You may also want to consider an insulin pump. They have become increasingly common in diabetes treatment, especially with children, due to their convenience, ease of use, and automated timing of insulin injections 

The American Diabetes Association has resources that you can share with school staff to help them understand how to support your child’s diabetes care plan. And the JDRF has a back to school checklist, which includes all the information your child’s teachers should know.

Read our previous blog to learn more about managing your child’s type 1 diabetes.

Teens and young adults: managing diabetes away from home

Learning how to navigate life with greater independence and less structure as you enter your late teens and twenties often takes on additional importance if you have type 1 diabetes. You may now be responsible for aspects of your own diabetes treatment that parents or other adults previously helped with.

For many young adults living with type 1 diabetes, this transitional period requires learning about the logistical aspects of diabetes care, like filling prescriptions, ordering supplies, and scheduling appointments. And whether you’re living far from home or nearby, it may be time to find a new doctor, as many young adults switch from seeing a pediatrician to an adult healthcare provider around the ages of 18 - 21.

To avoid any gaps in your diabetes treatment, plan ahead and work with your pediatrician and your support system, including your parents or other relatives, to create a plan for finding an adult healthcare provider. Make sure that you also have the information you need to stay on track with your diabetes management, like how to navigate health insurance, or how to use diabetes supplies like a continuous glucose monitoring device (CGM)  or insulin pump. 

It’s understandable if other challenges related to your diabetes care needs arise for the first time during this stage of life. For many young adults, there’s a learning curve with handling other illnesses when you’re away from home. For example, the flu can become more complicated if you have diabetes, since it may affect your calorie intake, which in turn may affect your blood sugar levels. Once you’ve found a primary care provider, ask them about additional steps to take when you’re sick, like checking your blood sugar levels more frequently or consuming carbohydrate-rich soft food and liquids .

It’s also important to understand how alcohol use can interact with insulin therapy and affect your blood sugar levels. Ask your doctor for recommendations about drinking safely when living with type 1 diabetes, and be honest with them about your alcohol consumption so that they can best address your individual health needs.

You may also benefit from working with a certified diabetes educator during the transition from your teens to adulthood. A diabetes educator is a healthcare professional with extensive knowledge of diabetes who has been certified to coach individuals living with the condition. They can make sure you have all the necessary information to successfully manage your diabetes.

Maintaining a balanced life with type 1 diabetes

It may feel like life has only gotten faster during your late twenties and into your thirties and forties. However, staying on track with your diabetes management is as important as ever — and for some individuals, you may be first learning of your type 1 diabetes diagnosis during this busy time.

A common challenge of living with type 1 diabetes in adulthood is fitting daily treatment needs into a busy schedule. If you work long days in a physical setting, it may feel inconvenient to take insulin and check your blood sugar while on the job. You may find that an insulin pump is a good option for you since you won’t have to worry about remembering the timing of your injections.

Ultimately, deciding how much of your health situation to share with an employer is a personal choice, but at least one person should be prepared to offer support in the event of an emergency if you work on site. Make sure they know the signs of low blood sugar, how to administer emergency glucagon, and where you keep your supplies.

If you are a woman living with type 1 diabetes and considering starting a family, sharing your family planning goals with your primary care physician can help you have a healthy pregnancy. Your A1C levels — your average blood sugar levels over a period of two to three months, which your doctor will check periodically during your regular visits — are even more important in the months before pregnancy. This is because your blood sugar levels can impact the development of your baby’s organs during the first 8 to 12 weeks of your pregnancy.

Ask your doctor to clarify your A1C goals and how long to maintain them before pregnancy. And once you find out you are pregnant, contact your healthcare provider as soon as possible to find out if you need to make any changes to your treatment.

Your risk for many conditions like heart disease, high blood pressure, high cholesterol, and dementia all increase as you age. When living with type 1 diabetes, preventative care and healthy lifestyle choices are even more important, as many aging-related health risks intersect with potential diabetes-related complications.

Men and women living with type 1 diabetes have a higher risk of developing heart disease than those without the condition. High blood pressure is common in older adults with diabetes, which can lead to a greater risk for strokes and heart attacks and may also affect your vision and kidney function.

It’s important to keep track of your blood pressure and cholesterol levels and follow your doctor’s recommendations for treatment, which may include lifestyle changes and medications. And depending on your overall health, you may need a loved one’s support with managing certain aspects of your diabetes care, like administering insulin and recording blood sugar readings.

Living with diabetes at any age is easier with a reliable pharmacy partner. At Alto, we’re committed to making it as simple as possible to manage your diabetes, with free same-day delivery and medication management tools like reminders and auto refills in our app. And our dedicated diabetes support team is here to ensure that you have all the information you need to follow through on your individualized treatment plan.

Reach out any time via text or phone at 1-800-874-5881, or in-app messaging.

We’re excited to welcome Christopher Tidball to the Alto team as Director of Product Management, Supply Chain & Fulfillment. Learn more about his passions both in and outside of work and what drew him to Alto.

Introducing Christopher Tidball, Director of Product Management - Supply Chain & Fulfillment

We’re excited to welcome Christopher Tidball to the Alto team as Director of Product Management, Supply Chain & Fulfillment. Most recently, Christopher led a large team of product managers, engineers and program managers at Amazon to power the company’s most complex fulfillment operations. 

As Alto continues to expand our geographic footprint and customer base, Christopher’s nearly 20 years of industry experience will support us in scaling our systems, so that we can continue to deliver the same high standards of care and service to even more communities.

We recently sat down with Christopher to learn more about his passions both in and outside of work, what drew him to Alto, and the operational opportunities he’s most excited about. 

Welcome to Alto! What inspired you to join the team?

Before a recruiter ever reached out to me about a role at Alto, my wife and I were very satisfied customers. We had been on a long journey of trying to start a family, and that ultimately led us to a fertility clinic that recommended Alto. We had a great experience from day one: the app was easy to use, the same-day deliveries from couriers were always on time, and Alto’s pharmacists walked us through the various medications in our delivery and answered all of our questions. 

Alto’s focus on the customer experience was immediately clear, and I made a mental note that this was the type of company I’d like to work for. Fast forward a few months later, a recruiter reached out and introduced me to the leadership team whose passion and experience sold me on leaving Amazon to come here.

As the Director of Product Management - Supply Chain and Fulfillment, I'll focus on the technology investments that can help us continue to grow and offer exceptional service to our customers. “Supply chain” covers a lot of ground: procurement, inventory, pharmacy operations, delivery, and more. There are tons of opportunities to automate processes to make it easier for Altoids to run the business, especially as we grow and expand. 

What areas of the business are you most excited about?

The operations side has always been exciting to me—it's where the magic happens. At the end of the day, if we don't have sustainable, efficient ways to fulfill the promises we make to our customers, we won't survive. 

Alto has a great business model, and many happy customers to show for it, but there’s always room to continue to innovate and improve the delivery experience. It's one of the few in-person interactions we have with the customer and we want to make it exceptional.

Tell us about life outside of Alto. Are you doing anything interesting at the moment?

I'm a pilot in training — I'm about 75% of the way to getting my single-engine license. I live in Seattle so the aerial views of the city, Puget Sound, and the Cascade Mountains are absolutely breathtaking. Flying gives you a sense of freedom that reminds me of when I first got my driver's license.

You can find more information about Christopher or connect with him directly on LinkedIn. If you have any questions about Alto, or are interested in joining our team, please visit alto.com/careers.

The Next Evolution of Our Company Values

A lot has changed at Alto since Matt and I first set out to transform the pharmacy experience back in 2015. (For one thing, we no longer work out of a storage closet.) In the past two years alone, we’ve quadrupled our team to more than 1,000 Altoids and opened new locations in Denver, Las Vegas, Seattle, New York City, Houston, Dallas, San Jose and San Diego.

Our mission — improving the quality of life for everyone who needs medicine — will never change, but a team of 1,000 needs a different recipe for success than one of 100. And as our team continues to grow, along with our geographic footprint, we’ve revisited our core values so that we can move forward with intention and clarity during this next phase of Alto’s journey.

Here are the values that guide our work today.

This was at the top of our founding values, and it’s still here. In fact, our resolve to put patients first has only gotten stronger — not because it’s what is best for the business, but because it is our only reason for being in business. Each member of our team strives to build a world where healthcare companies truly prioritize the needs of their patients, and we’ll do everything in our power to make that a reality.

My personal favorite of all our new values, dancing in the storm is about embracing the bumps in the road — and there are many when you’re taking on challenges within healthcare — and recognizing that you can always choose joy. We strive to help our teammates do the same by infusing a little bit of levity and laughter into the workday. It only takes one person to start a dance party!

Humility is not thinking less of yourself, but thinking of yourself less. Nor is it the absence of strong opinions, but the willingness to learn and change our minds. Sometimes our ego takes over — that’s only human. But we try to be mindful of it, and willing to let go of our ego and instead put our mission, customers, and teammates ahead of ourselves.

We view ourselves as creators of our circumstances, responsible for our actions and our own well-being. When we don’t like an outcome, we don’t project blame onto others or ourselves, but rather take radical responsibility for how we created the situation. More than any other value, this is an opportunity for deep internal reflection, and by practicing it consistently, we can maximize our own individual growth.

We say what is true for us in the moment, even when it is uncomfortable. We support our teammates to do the same by recognizing the validity of their experience and not taking it personally. Leading with candor isn’t always easy, but it feels much better to live authentically and honestly and to work with others who do as well. Candor doesn't have to be angry or hurtful - it can be kind and binding, compassionate and respectful.

It’s easy to become paralyzed by fear, overwhelmed by all of the possibilities in a complex situation. So unless a decision involves customer or employee safety, we don’t wait for perfect information. We trust our intuition and common sense and simply forge ahead, knowing that mistakes are in fact one of the best ways to learn.

There are no shortcuts or silver bullets in an industry as complex as healthcare. The way to achieve transformational change is through continuous improvement over a long period of time. When we’re overwhelmed by the magnitude of what we’re trying to accomplish, we remember that what each of us does adds up — one step at a time, one customer at a time — and that with small but steady progress we can accomplish great feats.

As a company grows, issues no longer affect a few customers, but a few thousand. It’s tempting to only look at trends and aggregates, but we know this is a trap. Greater distance from individual examples creates more opportunity for misunderstanding, bias, and incorrect assumptions. So we look beyond surface-level data and dive deep into the details. Only then can we fully understand an issue to its core.

Values themselves are just words, and the words themselves are not that important. What’s important is how we live them day in and day out, and the culture they support. In the months ahead, we’ll continue to integrate these values into the fabric of our company processes, our products, our customers’ experiences, and our work lives. And this work is not something just a few leaders or HR team members do - every Altoid has a hand in bringing these values to life and co-creating our culture.

Build Tomorrow’s Pharmacy with Us — Join Our Team

If you are passionate about creating a great company culture, join us in delivering our industry-leading pharmacy care to millions of people across the country. As a member of the team, you’ll play an integral role in improving our customers’ quality of life and redefining what’s possible in pharmacy.

View open roles in design, engineering, IT, sales, patient care, and more.

Diabetes educators are healthcare professionals with extensive knowledge of diabetes who have been certified to coach individuals living with the condition. Read on to learn more about how they can help with your diabetes treament.

What Does a Diabetes Educator Do and How Can They Help You?

Diabetes management involves a lot of information — about diet, exercise, medications, blood sugar monitoring, and other components of treatment. Some of this information may be new, and it’s understandable to feel overwhelmed if you or your child has been diagnosed with type 1 or type 2 diabetes. That’s why there are diabetes educators — specialized healthcare professionals — who are here to offer support at every step of the way.

Diabetes educators are healthcare professionals with extensive knowledge of diabetes who have been certified to coach individuals living with the condition. Their credentials — which are awarded by a national certification organization called the Certification Board for Diabetes Care and Education — must be renewed every five years. This ensures that they are familiar with the latest breakthroughs in treatment, including any updates in insulin therapy or supplies and medications.

They’re here to help you learn how to administer insulin and use diabetes supplies like glucose meters and continuous glucose monitoring devices to monitor your blood sugar. They can also help with insurance navigation, support programs, and connecting you with others living with diabetes. Additionally, diabetes educators can address lifestyle questions about the daily challenges of living with diabetes, such as “how can I design a meal plan that’s right for me?” and “should I take any precautions when exercising?” to help you feel informed about your diagnosis. 

In addition to helping make day-to-day life with diabetes more manageable, research has found that a diabetes education program can lower your risk for diabetes-related health complications like kidney damage. 

Beyond providing relevant information about your diabetes diagnosis, a diabetes educator can help you make lifestyle changes to strengthen your health. They meet each of their clients where they are to develop an individualized diabetes management plan.

A diabetes education program is most effective when it addresses specific goals. The Association of Diabetes Care & Education Specialists (ADCES) has identified several key areas of diabetes care that a diabetes educator’s work can focus on, including the following:

Healthy, balanced eating is a big component of managing your diabetes, as carbohydrate intake is one of several factors that affect your blood sugar levels, along with physical activity and insulin. However, having diabetes doesn’t mean that you have to give up your favorite meals altogether. A diabetes educator can help you understand which foods to limit and guide you in meal planning to spread your carb intake throughout the day.

In addition to the overall health benefits of exercise, like strengthening heart function and lowering stress, physical activity helps individuals with type 1 or type 2 diabetes maintain a healthy weight and manage blood sugar levels.

It’s much easier to achieve your fitness goals when they are clearly defined, and your diabetes educator is here to help bring specificity to your exercise plan. Since the key to sticking with a fitness routine is choosing activities you actually enjoy, your diabetes educator will help you find a moderate-intensity workout that you can see yourself doing three or four days a week (swimming, jogging, brisk walking, and dancing are a few options.) Remember that it’s okay to take it slow when starting out and build your way up to more intensity.

Keeping track of your blood sugar levels is a critical part of your diabetes management plan, as the goal of insulin therapy is to keep your blood glucose levels in a healthy range. By regularly monitoring your blood sugar, you will be able to understand the effectiveness of your medications and determine if you need to make any changes. This can also offer insight into how diet and physical activity affect your blood sugar levels throughout the day.

In addition to helping you get comfortable with your blood sugar monitoring devices, a diabetes educator will help you find your preferred system for logging blood sugar levels, whether it’s an app like mySugr, Health2Sync, or Diabetes Connect, or a physical notebook. They can also work with you on understanding how additional factors like food intake, physical activity, and stress levels impact blood sugar.

There are a variety of available diabetes medications, and each person’s needs are different. Individuals with type 1 diabetes take insulin every day to maintain healthy blood sugar levels. Some individuals with type 2 diabetes take insulin as well, while others take oral or injectable medication to help their bodies use insulin more effectively. 

In addition, some people with diabetes also take blood pressure or cholesterol-lowering medications to lower their risk of diabetes-related complications. A diabetes educator can help you understand the purpose of these medications, walk you through insulin injections, and help you manage side effects.

It’s important to speak with your doctor before making any changes to your medication timing or dosages. Your diabetes educator can be a great resource in helping you determine if you need to discuss any potential medication adjustments with your doctor.

Diabetes affects you both physically and emotionally, and it’s important to take care of your mental health in addition to staying on track with medications and blood sugar monitoring. In fact, feeling emotionally balanced while living with diabetes will strengthen your physical well-being too, as too much stress may increase your blood glucose levels.

To help you find your preferred coping strategies, a diabetes educator will generally steer you away from unhealthy habits — drinking, smoking, and withdrawing from social connections — and guide you toward healthier ones like meditating, journaling, and building a support network. It also helps to go easy on yourself as you work towards fitness goals and celebrate small wins.

Insurance coverage for diabetes education programs

Diabetes education programs are covered by Medicare and most private health insurers. However, a formal referral from your doctor is often required to get coverage. In addition, your diabetes education program must meet certain standards set by the U.S. Department of Health.

The ADCES has a map to help you search for an accredited diabetes education program near you.

We’re here to support your diabetes care plan

Just like your diabetes educator and other members of your support team, Alto will be here to help you manage your diabetes diagnosis. In fact, many diabetes educators, who understand how important it is to have a reliable diabetes pharmacy partner, refer their patients to us.

"When I refer patients to Alto, it's one thing they don't have to worry about."

We make it simple to follow your diabetes treatment plan, with proper packaging of temperature-controlled medications and free same-day delivery right to your doorstep. We’ll also tackle any insurance-related legwork too to ensure that you get the medication and supplies you need at the best possible price.

Insulin pumps have become increasingly widespread in diabetes treatment in recent years due to their convenience and ease of use. Read on for more information about these devices.

The Role of Insulin Pumps in Diabetes Treatment

Both type 1 and type 2 diabetes involve complications with the body’s production of insulin, a hormone produced in the pancreas that converts sugar into energy. People living with type 1 diabetes do not produce any insulin at all, so they have to take insulin every day to keep their blood sugar levels in a healthy range.

Insulin therapy may also play a role in managing type 2 diabetes, since individuals with the condition do not produce a sufficient amount of insulin to regulate blood sugar levels. However, some individuals with early-stage type 2 diabetes are able to manage their blood sugar with other medications and healthy lifestyle habits — make sure to consult with your doctor on the best course of treatment given your needs.

There are several methods available for delivering insulin into the body, including syringes,  insulin pumps, and pens. Insulin pumps have become increasingly widespread in diabetes treatment in recent years due to their convenience and ease of use.

There are a variety of insulin pump options to choose from. Read on for more information about these devices.

What is an insulin pump and how does it work?

An insulin pump is a small electronic device that delivers doses of insulin at specific times. It mimics the activities of a normally functioning pancreas by delivering small, continuous doses of insulin throughout the day and surges of insulin while you eat. You set the schedule, and it is easy to make adjustments if your dosage changes or if you eat or exercise more than usual on any given day.

While an insulin pump’s consistent delivery of insulin is effective in keeping your blood sugar levels within a healthy range, it is still important to check your blood sugar throughout the day using either a blood glucose meter or a continuous glucose monitor (CGM). Some newer insulin pumps are connected to a CGM, which allows for both automated glucose monitoring and insulin delivery.

Many people who use insulin pumps find them to be more convenient than insulin injections, particularly while on the go. Insulin pumps offer the flexibility to work, socialize, or engage in just about any other activity without stepping aside to give yourself an insulin injection. And their automated, adjustable delivery makes it simple to maintain healthy blood sugar levels: not only do you not have to worry about missing a dose, but you can easily add, remove or modify a dose depending on your calorie intake and level of physical activity.

Most insulin pumps are designed to store dosing data, so you and your doctor’s office will have easy access to details about your insulin regimen should you need to make any adjustments to your treatment plan. 

Depending on the type of insulin pump you have, the device may be able to streamline other aspects of diabetes management. In addition to the automated blood sugar readings offered by CGM-connected pumps, some pumps have tools to help with carbohydrate counting. (Monitoring how many carbohydrates you consume is an important aspect of diabetes management as they increase your blood sugar, and your daily insulin dosage depends on your insulin-to-carb ratio.)

Insulin pumps deliver very precise doses of insulin, so there is a low risk of complications. However, it’s important to make sure you know how to properly set up your pump and to continually monitor your blood sugar levels. Your doctor or a diabetes educator can help you get started.

Choosing between an insulin pump and other delivery methods is ultimately a matter of personal preference, but they are often a good fit for children and anyone who has had difficulty remembering the timing of their insulin injections. You may also want to consider using an insulin pump if you absorb food slowly or if you often experience low blood sugar as a result of insulin use (also referred to as an insulin reaction or hypoglycemia). Consult with your doctor to choose the best insulin delivery method for your individual health needs.

Many women who are pregnant or trying to conceive also benefit from the consistent and precise delivery of an insulin pump, as blood sugar management is especially critical while your baby’s major organs develop. If you are pregnant or thinking of becoming pregnant, you may want to ask your doctor if an insulin pump is right for you.

There are two main types of insulin pumps: tubed insulin pumps (sometimes referred to as traditional insulin pumps) and insulin patch pumps. Tubed insulin pumps deliver insulin from a delivery chamber — in this case a container located within the pump — into a tube inserted beneath your skin, usually on the abdomen. (A healthcare professional like your doctor or a diabetes educator can show you how to insert the tubing.) Manufacturers of commonly used tubed insulin pumps include Medtronic and Tandem®.

Insulin patch pumps combine the delivery chamber and tube into a single “pod” placed on your skin with an adhesive patch. Insulin patch pumps do not have any external tubing and are controlled wirelessly. Commonly used patch pumps include Omnipod® and V-Go®.

You can put a tubed insulin pump in your pocket, on your belt, or attach it to a strap beneath your clothes. Insulin patch pumps are most commonly placed directly on your stomach or arm. Both types of insulin pumps require you to change the tubing or pods every one to three days. A diabetes educator or healthcare provider can answer any questions and help you become more comfortable using the device.

What to consider when deciding to use an insulin pump

When talking to your doctor, here are some considerations that may help you determine if an insulin pump is the most convenient way to manage your blood sugar, or your child’s.

An insulin pump may feel slightly more complex than injections, as it involves frequent interactions with technology. Your diabetes care team can help you become more comfortable with the device.

You will need to verify which type of pump(s) your insurance plan covers and decide if those options are the right fit for your needs and budget.

Whether you go with a tubed or patch pump, you’ll have an electronic device attached to your skin, which may take some getting used to. There are lots of ways to make them less visible, if that’s a concern.

If you’re still unsure, remember that you’re allowed to change your mind! While insulin pumps are most commonly used on a continuous basis, the device is not permanently attached to your body, and some people switch to injections for certain periods of time. 

For example, some children with diabetes may use an insulin pump during the school year but take insulin via injections during the summer. There is room for flexibility as long as you discuss your plan with a healthcare professional and follow their recommendations.

Most insurance plans have separate medical and pharmacy benefits. In most cases, professional services provided by your doctor will fall under medical benefits while prescription diabetes medications — including insulin — will fall under pharmacy benefits. 

Pumps, CGMs, and supplies like test strips will likely be covered under a third type of benefits: the Durable Medical equipment (DME) section of your policy. There may be restrictions on the brands or suppliers that are available, and it’s important to check with your specific policy to understand what will be covered and under which sections.

Tubeless patch pumps like Omnipod® and V-Go® are often covered with your pharmacy benefits. If that’s the case, Alto may be able to help you get started with your insulin pump. We will work with your insurance (if applicable) and any third party savings programs so that you can get your insulin pump at the lowest possible price.

A diabetes pharmacy partner you can rely on

At Alto, we believe a pharmacy should be a partner in your diabetes care. We have a dedicated diabetes support team to ensure that you have everything you need to follow through on your individualized treatment plan. Reach out any time via text or phone at 1-800-874-5881, or in-app messaging.

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