Timesulin launches Indiegogo campaign today


Today Timesulin, the little company that makes this great insulin timer cap, goes live with a crowd funding campaign on Indiegogo

If you want to send a message to the FDA that we in the States should have great, useful, life-saving products as quickly as anyone around the world, sign up at the link above. 

With a small contribution, you can get one of the first caps when released in the States – and like me, find you don’t wonder whether or not you took your shot. You can also get a copy of my latest book, “Diabetes Do’s & How-To’s.”

I’ve been using this cap for more than two years, since the day I met John at the IDF World Congress in Dubai. I can’t tell you how many mornings I sit down at this computer, start working and wonder whether or not I took my long-acting insulin shot. Timesulin always lets me know. The reason I love this cap.

Share the news – yes we can get products over here that we want and need faster by pulling together. 

Would it surprise you to know, Timesulin is already in 40 countries around the world? Be part of the solution and you and millions will benefit.

What you need to know about checking your blood sugar


I haven’t posted anything in a while because I’ve been away on vacation, but I did write two articles just before I left that are well worth a look if you haven’t seen them. 

Both articles are about our blood glucose meters, why they give us the numbers they do, and why that’s critical to managing your blood sugar. What you should notice in the picture above is almost all the meters show different numbers on them ranging from 99 mg/dl to 118 mg/dl. I took my blood sugar on all of them at the same time and with the same drop of blood.

You’ll find the post about what other things are just as important as our glucose numbers in managing our blood sugar in the article, “Meter Accuracy Counts More — and Less — Than You Think” on the Huffington Post and information about how meters really work in, “Why Meters Can’t Tell Us Our Blood Sugar Levels” on DiabetesMine.com. Be prepared to be surprised. 

On the vacation note, sad to say, I returned on crutches. While taking a lovely walk through the charming town of Leiden in the Netherlands, I tripped over a cobblestone curb and ended up with a sprained ankle. 

More on that in the next few days.

T:slim pump has go-ahead and Apple-like features and screen

Screen Shot 2015-02-07 at 3.30.41 PM

Slimmer, color touch screen

Well it appears someone is listening to diabetes patients’ cry for devices that work-cool and look-cool. 

Today Tandem Diabetes Care announces it has approval from the FDA to market t:slim™, the smallest insulin pump with a color touch screen that works and looks more like your iphone.

Kim Blickenstaff, President and CEO of Tandem said, “In creating t:slim we spoke with more than 4,000 healthcare professionals and people with diabetes, and the clear message we heard was, “make it cool and make it uncomplicated to use.” 

While a traditional tubed pump, the t:slim is slimmer and has a rechargeable battery and USB connectivity to management software. 

t:slim launches the first half of 2012. The company is now putting customer support, sales and clinical and business operations in place in preparation.

For more product description, Amy Tenderich over at DiabetesMine breaks it all down – beautifully ;-).

New, less painful lancing device by One Touch


Delica Lancing Device – less pain, more labor 


Pelikan Sun – pain free but gone. Too costly for insurers 


Accucheck Multi-clix – a longtime favorite


I’ve been trying out a new lancing device sent to me by the public relations firm for One Touch. It’s called the OneTouch® Delica™ Lancing System and it’s available now at some retailers and will be available across the country mid-July.  

A few days after using it I emailed this report:


1. Thin needle and non-vibrating action makes lancing less painful than other similar devices (except for thePelikan Sun. However, I am sad to say it’s no longer being made.) 


1. Device is so lightweight that it’s sometimes hard to hold steady against my finger when lancing

2. Replacing one lancet at a time is time consuming and laborious

3. Thin needle is easy to bend, has happened already

I thought that would be that, and I’d return to my tried and true Accucheck Multi-clix. This is my favorite among typical lancing devices because it’s less painful and 6 lancets come in an easy-to-load drum.

But, I surprised myself. Every other time I lanced my finger I would reach for the Delica™, sturdiness be damned. 

I did actually find it less painful than the Multi-clix. And now I use it more often than my Multi-clix. Of course, I don’t change the lancets each time, probably after 6-10 finger pricks, and I’ll soon run out because my sample only came with 10 lancets. 

So I leave you to decide for yourself. 

The press copy says: 

The OneTouch Delica System features a new, proprietary 33 gauge lancet that is 40% thinner than current industry standard 28 gauge lancets.

In a clinical study of nearly 200 people with diabetes, 4 out of 5 reported the OneTouch Delica Lancing System was virtually painless/pain free and the most comfortable Lancing Device they have ever used.

And yes, I can attest to its non vibrating motion and 7 adjustable depth settings. 
The estimated retail price is $19.99 and includes 10 lancets. 100-count OneTouch Delica Lancets have an estimated retail price of $15.99. Both the device and lancets are covered by Medicare Part B and most private insurance plans.
Turns out quite by accident, Amy Tenderich over at DiabetesMine is also reviewing pain-free lancing devices today, so you can catch additional info. 
As for me, I still like that my Accucheck Multi-clix is sturdy, easy to hold and load so it doesn’t require fussing or touching the needle. 
Guess, I’ll have to make the big decision when my Delica™ lancets run out.

Diagnosing diabetes with the A1C may mean you’re cured!

A fellow type 1 friend of mine was trying to get a CGM to better control her blood sugar. 

She’s had diabetes for more than two decades. Her blood sugar bounces from high to low often enough that her doctor felt a CGM would be extremely helpful, even though her A1C is just below the American Diabetes Association recommended 7%. 

Of course the A1C is an average of your last two to three month’s worth of blood sugars. That means you can have lots of blood sugars around 250 mg/dl and lots around 50 mg/dl, and average out at 150 mg/dl – just below an A1C of 7%. 

While this averaging game is nothing new to me, what was new to me is that her insurance company would not cover a CGM because the liaison between the insurance company and the CGM company said my friend’s diabetes was cured. Why? Her A1C is under 7%. 

My friend’s doctor told her he’s seen this coming ever since companies decided to diagnose type 2 diabetes with the A1C test. The American Diabetes Association has recently recommended this along with an international committee from several other diabetes organizations including the International Diabetes Federation and the European Association for the Study of Diabetes.

One main advantage they cite for using the A1C test to diagnose diabetes is that it can be taken any time of day, and without fasting. 

Yet, at what cost does this come? If an A1C of 7% or above will mean you have diabetes then will insurance companies say a well-controlled diabetic, who has an A1C under 7%, does not have diabetes? If that’s the case then I’ve been cured for years and didn’t know it. Funny, though I still experience hypos and highs no non-diabetic gets.

Will patients lose having tools that could help them better manage their diabetes with this diagnosing criteria? I know one who already has. 

My CGM sensor report


The CGM iPro sensor I wore for five days (see post below) came off Monday morning in a hurricane. Not exactly what you think, but I like the drama. My walk from the subway station to the hospital to see my CDE was in a rainstorm at high gale winds we rarely see here in New York – umbrellas discarded on the streets, puddles knee-high. Were it not for the fact that my iPro site was itching like mad for two nights from the sticky tape over it I’m not sure I would have braved the storm at all.

By the time I arrived at the hospital the entire front of my jeans was soaked so that I was wringing water out of the cuffs. I was eternally grateful that not only did I brave the storm, but that my CDE did as well. Moments later the CGM came off, a lot more easily than it went in thank goodness, and we downloaded the results. Luckily the battery lasted for as long as I wore it, just over five days. That’s not always the case, but it was here. Hallelujah!

Then we stared at pages of graphs, charts and numbers of my blood sugar numbers as picked up by the sensor every five minutes and I got to see my patterns throughout the day, and night. 

Since I was doing finger sticks at least four times a day along with wearing the sensor, my daytime numbers were not surprising, and, my daytime numbers are typically understandable to me. When I’m a little high it’s usually because I didn’t calculate the carbs in a meal or snack correctly. When I’m a little low it’s usually for the same reason, or my powerwalk lowered me slightly more than I expected. Being insulin-sensitive, as many type 1s are, a half unit of my rapid-acting insulin has an impact. 

During this five day period I also went high after a birthday lunch for my mom who turned 80 – a poor calculation on the calamari and spring rolls! But mom, you’re worth it. And I discovered just as routine is my savior, so is my experience. Since I was logging my numbers, I used the carb counts on packages more than usual and that led me more astray than the educated guesses I typically make based on years of testing. Perhaps it’s because food manufacturers are allowed a 20% margin on the carb counts listed on their packages, so beware.

But what I really wanted to know from this experiment is what my numbers do overnight, and that was the reveal. Around midnight they start sliding downward hour after hour. Around 5 AM they are at their lowest, in the high 50’s/low 60’s, and then they begin to gradually come up between 5:30 and 6:30 AM and then rise more swiftly. If I wake up and test my blood sugar around 6:30 AM the number’s usually around 75 or 80, a half hour later they’re 90 or 100. A half hour after that they’re climbing over 100. This is without doing anything or eating anything.

“This is perfectly normal,” said my CDE and nothing to worry about. In the morning your liver is pumping out glucose-raising hormones to get you ready for the day (dawn phenomenon). Even if you’re a little over 100 before you take your injection, it’s fine.” O.K., I’m relieved about that since my boundaries are admittedly narrow. 

“Can I prevent the overnight slide or morning rise?,” I asked. “Not really, this is your body and you’re doing fine. The only thing that might reduce the overnight low is cutting back on your Lantus one unit, but I don’t think you need to do that. You don’t go that low at 5 AM and then you come back up. “Would a pump level this out?,” I asked. “Yes, and that’s when most of my patients change to a pump, when multiple injections just can’t do more for them.”

So what I know is I’m working the MDI (multiple daily injections) system as best I can. I keep my blood sugar between 120 and 140 before I go to sleep, on the higher end of that range if I’ve had wine with dinner since that creates a slightly greater drop overnight. Then I blunt the morning rise with one unit of my rapid-acting insulin as soon as I wake up and take the rest of my breakfast dose just before or during my morning meal.

My concern that I drop so low overnight, like to 30 or 40 mg/dl, that my liver shoots out glucagon to save me from dying turned out to be false. That is a relief. Also, while I don’t log my numbers ordinarily, I’m already obsessive enough, if you log your numbers – and for most people this is an invaluable exercise – make sure you also note what you eat and any exercise. Most log books don’t give you space for this. So log your numbers on a simple sheet of paper. A bunch of numbers without these references is an incomplete picture.

I highly recommend if you have access to wearing a trial CGM for a few days to see your pattern that you do so. This kind of information can lead to an important change or modification in your treatment plan. I know I’ll be sleeping better from now on.

Note: Our bodies are different. Don’t base any of your own treatment decisions on my results. Check with your health care provider to be safe.

Just a little bionic

UnknowniPro sensor – 5-day CGM

Noticing I was becoming a sugar-testing junkie recently, I opted to get hooked up to a CGM for a 5 day trial period, save some finger skin and see if I could learn something. 

My recent addiction to knowing where my numbers are, beside a proclivity to perfection, is largely because my blood sugars rise sooo rapidly in the morning. Can I shut the barn door more quickly so I don’t have to do two boluses before breakfast? The first to merely blunt the rise. 

My new CDE put this on me in her office and what should have been a rather simple affair turned out to be quite a painful one. I wasn’t prepared for the tugging, gripping and sensation of tearing skin when this thing went in. In fact you’ll see quite a bit of redness around it which is my blood. My CDE told me it is not uncommon to bleed and not a problem. OK, but it didn’t exactly lift my spirits and it did make me utter, “Diabetes is not exactly a pain-free disease!”

When I left my CDE’s office, newly bionic, I walked about 20 blocks to meet a friend for lunch. Each footfall, I was overly aware of this gizmo dug into my side and the very fact that my walking was impacting my blood sugar. A weird thing for your brain to be so focused on an automatic body function. When I sat down to lunch I copped the banquette seat feeling vulnerable and exposed to any passer by who might ram into my poor abdomen. Well, it’s not really on my abdomen, but I don’t know what you’d call this side area.

Leaving the restaurant I began to experience my plastic gizmo differently. I felt somehow as though it was now my helpmate. As though I was not in this all alone anymore. I found this quite comforting and recognized it as a wholly new feeling.

Now, two days in, I’m used to my CGM, it doesn’t hurt but the five inches of sticky tape that’s holding it in place grips and pulls as I twist and turn. And while my plastic companion is (hopefully) tracking my numbers, so am I four times a day in a log book, along with carb counts and activities, just in case anything goes awry. 

I will keep you posted next week when gizmo comes off. It would be dandy to have learned something more than which pants slide easily over gizmo and which ones don’t.  

Someday my pump will come – maybe it’s almost today

Solo in action

Today I’m truly excited. Today Medingo’s new Solo MicroPump the tiniest, thinnest, lightest, tubeless pump is almost here. Yes, apparently almost. If you sign up here they will let you know when it will be available in your area.

If you’ve read the closing paragraph in my “50 Diabetes Myths” book (Myth #50, If I wear an insulin pump, my diabetes is really “bad”) you know I wrote, 

When I give a diabetes presentation, people always ask me whether I wear an insulin pump, and the answer is “no.” Primarily it’s because I’m used to injections and don’t mind them, I’m able to keep my A1C in the nondiabetic range through careful attention to my eating, exercise, and general health, and I don’t want to have a piece of equipment attached to me. However, as I have told everyone, and will go on record as saying, when the insulin pump is closer to the size of a credit card, I will be the first one in line to get mine.

In full disclosure, I haven’t seen or tried the pump but I am, for sure, looking at a new generation of insulin pumps that Omnipod began. Two years ago I participated in the focus group for Solo MicroPump and the prototype for it has been sitting here beside my computer since. It has been a symbol of hope for me that the product would actually come to fruition one day.

Like Omnipod, which I wore for a few hours to experience the feel of it but didn’t use because it was too big and clunky for me, the MicroPump is tubeless and is operated by a remote control. The MicroPump consists of two parts, an insulin reservoir and pump base. The reservoir holds 200 units of insulin and the video text says is replaced “when empty.” However the video voiceover says, “according to your insulin manufacturer’s recomendation.” So, I’m not sure what that means. The pump base is replaced every three months. There is automatic cannula insertion like other pumps. But unlike the Omnipod, you can disconnect this pump for short periods of time, you don’t discard it but refill it, saving you space and storage, and even if your remote is not with you, (I just know this will happen to me!) you can bolus by pressing buttons on the side of the pump.   

As for insurance coverage, Medingo says on its Solo MicroPump web site that they are “currently working with insurance companies to gain reimbursement…insurance companies have been very receptive to the product and our Pay-as-You-Pump model.”

So now all that remains in my mind is do I want to try the first generation or wait six or 12 months for the second? If you’re at the AADE conference this week, the Solo MicroPump is being introduced in the exhibition hall.

Blood sugar meters may improve

May 6 5 16 PMMy home test: different meters, different results

Would it surprise you to know that the meter you use to test your blood sugar may be wrong by 20%? And that a 20% margin of error for many patients results in seizures, unconsciousness and coma? 

This past June the international group that sets the standards for meters was pressed to tighten them, and we can only hope it’s happening according to the recent article in the New York Times, “Standards Might Rise on Monitors for Diabetics.” Officials said they would keep pushing until monitor accuracy improves.

But it makes you wonder how those who oversee meter accuracy could be so casual and negligent in the first place. Insulin is a dangerous drug, take too much you could die, take too little and high blood sugars will lead to complications; we’re all depending upon our blood sugar readings to keep us from harm. If my meter shows 100 mg/dl my blood sugar could be 80 or it could be 120. 80 means I’m close to caving and may need to take some extra sugar, however if I’m really 120 extra sugar will push me into high blood sugar. 

Something as simple as Tylenol or Vitamin C may also give false readings. In a world where we can land on the moon and talk into a wireless phone and get your email on a two inch screen, can we not create meters that give accurate blood sugar results? A government study revealed among five popular meters, results varied up to 32%! Two meters, both made by Bayer, differed by 62 points!

Really I find it shocking that with diabetes on the rise and health care costs skyrocketing, we still don’t have meters we can assuredly rely on. 

The Apidra pen arrives this year

UnknownApidra SoloStar® Pen

Unknown-1Lantus SoloStar® Pen

Just a bit of news: Apidra, a rapid-acting insulin used before meals like Humalog and Novolog has just won FDA approval to be packaged in a prefilled disposable pen, to be called ” SoloSTAR®.” They’ll be available in pharmacies sometime this year.

Apidra and Lantus are both Sanofi-Aventis products. If you use the Lantus pen SoloSTAR®, (Lantus being long-acting insulin most patients use once or twice a day to cover the fasting state), the two pens will come in different colors to help tell them apart. And trust me, there are endless accounts of patients mixing up their rapid and long-acting insulins because the pens or vials look so much the same. However, I’ll have to reserve judgment as what I saw didn’t look that far afield from the Lantus pen: a grey blue vs. a blue grey? What’s so hard about making it in green or orange? 


I’m an Apidra user after years of using Humalog. For me, Apidra works faster than Humalog which means I need to use less and its quicker action gives you the advantage of injecting during and sometimes after a meal depending on what you’re eating. This takes a lot of the guesswork out making my doses a wee bit more accurate.