diabetes device

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

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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

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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

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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. 

What’s in the Exhibition Hall at the AADE conference

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Major buzzing in the hall

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EatSmart, this scale does it all

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Pelikan Sun lancing device, it’s gold

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A pocket glucose spray

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A dream pasta, Dreamfields

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Dr. Francine Kaufman closing the conference

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You can make a difference in a child’s life

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Now, to  conclude my last post, remarking on the annual American Association of Diabetes Educators Conference in Washington D.C. Let’s be honest, the most fun at one of these events is looking at all the stuff in the exhibition hall, and of course eating your way through it. I managed to do both: nibbling almost every few feet on low-fat blueberry yogurt, Activia, walnuts, cereal bars, Lean Cuisine, soft serve ice cream and lots of tidbits that resembled food but I’m not really sure they were. Gadget-wise, in truth I’ve been to a lot of exhibition halls and I didn’t find all that much new, but these things are worth mentioning:

  1. Eat smart. A small, great looking scale that measures everything and tells you how much it weighs, its calories, carb content and 7 or so vitamins and minerals. To be honest, my husband was immediately attracted to the gadgetry while I thought oh another thing to be bothered by. But, having it in our kitchen now and knowing that the plum in my fruit bowl I’m about to eat has 27.6 carbs is an incredibly useful addition to my management.
  2. Meters, meters, meters everywhere. Glucose meters have become a parody product, but I did see one that caught my eye by Intuity. You put your finger over a hole at the bottom, it pricks it and in seconds gives you your blood sugar reading. Notice, no test strip. Due out next January, now let‘s just hope they make it a little less masculine looking.
  3. On site A1c testing. I only learned recently many doctor’s offices offer A1c testing right in their office, while I’m always trekking off to the lab. Well, here at the show I could avail myself of five booths that would give me my A1c result within minutes, so of course I had to test this. I tried three different booths and came up with a 5.0, 5.4 and 5.5. Given that I’d just had my A1c done at the lab two weeks ago and it was 5.8, I’m inclined to say two of my three tests at the exhibition hall were in the ball park.Reli-On makes a kit where you smear some blood on a pad, mail it in and get your A1C results in a week.
  4. My lancing device ratings. Since we all know lancing devices cause more pain than injections I have a personal investment in keeping up with improvements in this area.
    1. First place winner– Pelikan Sun. It’s battery operated and has a feather touch. Downside: expensive, about $200 for the instrument and a little larger than a pack of cards. I’m told lancets should be covered by insurance Upside: you won’t mind testing 10x a day.
    2. Accucheck Multi-clix. The best, least painful cheap lancing device. It runs on a track so the lancet doesn’t shred your skin when piercing. My favorite run of the mill device.
    3. Renew from Can-Am Care. Operates on the same track technology as Multi-clix. Cool packaging and the only other stand-out in the pack. You can request a free trial sample online.
  5. Pumps are getting smaller and more are getting tubeless. Omnipod, the only tubeless pump right now promises a pump half the size within two to three years, I’m staying tuned, and Medtronics is working toward the same. I’ve always said when the pump is the size of a credit card, count me in.
  6. Omron, a company that makes blood pressure machines and pedometers is coming out with a new pedometer next year that’s slim, you can slip it in your pocket rather than clip it on your belt and it will work at any angle. I like the ease of putting it in a pocket. The husband loves the techie gadgetry.
  7. Glucose Rapid Spray. A tiny atomizer mist spray. 5 to 10 sprays onto your cheek will help bring your blood sugar up a bit when you’re going low. Handy to carry when away from home or exercising, but I’m told not a resue item. I’m waiting for my first potential low blood sugar to give it a try.
  8. Dreamfields. A dream of a pasta. I gave up pasta for a dozen years due to how high and how quickly it raised my blood sugar. Now Dreamfields has created a pasta that nets only 5 grams of carbs per serving and I know it works. They’ve reconfigured the pasta’s molecular structure and much of it is highly non-digestible when traveling through your stomach. It still tastes delicious but doesn’t break down into carb. I swear give it a shot. I find it at my local supermarket chain, Key Food, but they’re distributing many places.

Helping Third World Children with Diabetes

The conference was closed by Dr. Francine Kaufman, pediatric endocrinologist at the Center for Diabetes, Endocrinology and Metabolism at Childrens Hospital Los Angeles. Kaufman is a tireless advocate against childhood diabetes. She shared clips from a documentary she made for the Discovery Health channel, Diabetes: A Global Epidemic, where she traveled through Africa and India bringing medicine, training and treatment to poor children, families and caretakers. Countless children are dying of diabetes because there is no medicine, no meters, no test strips, no doctors. In places where insulin is obtained on an irregular basis children are given whatever is available. Can you imagine using only Humalog one month, then only Lantus another, then NPH yet another? How would you ever figure out your protocol? I get chills just thinking about it.

If you would like to donate unused, unexpired medical supplies they are taking them atwww.Lifeforachild.org. You can also contribute $1/day and a child will receive medicine and testing supplies.

Having this podium I leave you with my own closing remark which is an observation: I found it profound that here in America we are literally dying of abundance: too much food and too many luxuries that make us lazy, while around the planet people are dying of scarcity: too little food, too little medicine and too few health care professionals.

It’s something to ponder, I think.

Where would you be without your meter? Speak out, change lives.

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Cast your vote to reimburse technology & its education

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Me? I’d be back like Journeyman to the world I lived in 25 years ago, never knowing what my blood sugar was, hopelessly trying to eat the same stuff every day and blithely thinking 200+ blood sugars was “doing well.” Pffff! How times have changed.

Now let’s change them again — for all diabetics! As we count down to Diabetes Day, tomorrow, I’ve been asked among the diabetes blogging community, to have your voice heard to get more health insurance coverage for the very things that keep us going with diabetes: Diabetes Technology — meters, pumps and continuous glucose monitors — as well as the education how to use these.

Here’s your chance to add your voice to the rising chorus of “yea-sayers.” Just fill out this survey and you’ll be helping to turn the tide, http://www.surveymonkey.com/s.aspx?sm=CeG1e2pg7dS0ajPv26na9g_3d_3d. You’ll be changing a life.

For more information, see Amy Tenderich’s article on her blog DiabetesMine: http://www.diabetesmine.com/2007/11/stand-up-for–1.html.

It takes only 5 minutes to change the world

Meter inconsistencies

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Screen Shot 2015-02-08 at 4.32.17 PM

I’m still hot on the Pelikan Sun (mentioned below) lancing device, and how lucky right now to have a lancing device that’s less painful. For after a truckload of new supplies hit my house yesterday: syringes, lancets, test strips and a new-for-me Freestyle Flash, last night and this morning I conducted a meter comparison test. And that meant a lot of finger-sticks.

I lined these 5 meters up to see if/how the results would vary. Pictured are the One Touch Ultra 2, Freestyle Flash, Freestyle Lite, One Touch UltraMini, and One Touch Ultra. One Touches seems to bond together like a family within a small variation. Last night, the One Touch Ultra 2 gave me a 90, Ultra Mini, 96, and One Touch Ultra, 91. The Freestyle Flash came in at 100, and Freestyle Lite, 105.  A 15-point outside spread, not terrible. Yet what was somewhat disconcerting was when I got the Freestyle Lite (newest model, no coding) at the Children with Diabetes conference last month, I ran this comparison test there several times. Each time the Freestyle Lite came in 30 points higher than the One Touches. What was it doing now at only 15 points higher?

This morning before breakfast I tested again in the same order, the One Touches gave me: 98, 96 and 85 (I have to say here, though, I believe the 85 was caused by the One Touch Ultra being the last to feed off one poor, squeezed drop of blood, where some intestinal fluid likely got mixed in.) Meanwhile, the Freestyle Flash reported, 105, and the Freestyle Lite, 113. Eliminating the 85 test result, the outside spread was 17 points. Pretty consistent with last night.

I did a second test round only minutes later this morning. I was just going to re-test the One Touch Ultra, since it had given me that 85, but I couldn’t help myself, and retested all the meters. This time I did the One Touch Ultra first — beside wanting to see if that 85 was an aberration, I didn’t want it to feel left out. Boo hoo. It came back with 100. The One Touch Ultra 2, a 105 and the UltraMini, a 101. The Freestyle Flash was 109. I had no more strips left, unfortunately, for the Freestyle Lite so it was left out of the line-up. Again, pretty consistent with my two other findings, yet now I was newly amazed that only four minutes later my blood sugar was already on the rise.

So what have I learned? For me, the three different meters from One Touch all gave different numbers yet not far apart. The two meters from Freestyle similarly gave different numbers, but not far apart from each other. Yet, they were 10-15 points higher than One Touch. And in Florida the Freestyle Lite was consistently 30 points higher than the One Touch family. I could say that the 30 point high was the meter itself experiencing the stress of being in Orlando in July! However, I think that’s probably not the answer.  Unfortunately, I have no answers, just lots of questions.

If this meter comparison interests you, and you have a bunch of meters at home, see for yourself. However, you will likely be only more confused and frustrated when you finish, since the question then will be, “Which one do I trust and follow?” As a type 1 diabetic, I will take an injection of insulin to correct down if let’s say mid-afternoon I’m over 140, and eat fast-acting carb to correct up if I’m under 50. Yet, if my blood sugar’s really 110 and not 140, I wouldn’t do anything, but smile. If it’s really 80 instead of 50, my smile would be all the wider.

I spent some time this morning searching other blogs for meter comparisons and found a great batch of comments that made me feel many have experienced my angst: http://sixuntilme.com/blog1/2007/05/meter_meter_averageeater.html

This is from a great site I just found, SixUntil Me.

In the end, I agree with what many commented. Use one meter that seems to correspond to your A1cs and symptoms, and expect no meter is entirely accurate.

Still, I am both horrified and saddened that since testing is the best weapon in our arsenal to keep blood sugars in target range and complications at bay, we cannot even rely on the accuracy of our meters. So I want to ask someone — why is there no universal standard, and where is the quality control in the meter industry?

The sun shines on my new lancing device

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Less Pain, More Convenient

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I remember someone once telling me, “I don’t participate in trials for new medicines because you never know….but devices, that’s another story!” So, here’s my story. I’m testing a new lancing device that’s already on the market in Australia and coming to market here in the fall.

The device is made by Pelikan Technologies. I saw it exhibited at the Children with Diabetes conference I recently attended. It’s a great lancing device for anyone, and especially for children because it truly is less painful. Here’s the deal: it has 30 different depth settings, holds a cartridge of 50 lancets so you always get a fresh one and never prick your finger accidentally, but the real deal-maker is — when you press the button to fire the lancet, you feel the lancet come out and just softly brush against your finger. A second later, it enters with the softest touch. It’s a little hard to explain, but amazing.

Now dialing a typical lancing device from ‘1’ to ‘2’ to ‘3’ seems so primitive. I’ve also learned using this device, that different fingers vary in skin textures, from rough to smooth, and benefit from a different depth setting. From my pinky to my thumb, I change the depth setting for each finger from 0.4, 0.6, 0.7, 0.8 to 0.9. 0.9 on my pinky would hurt like heck. 0.4 on my thumb wouldn’t penetrate the skin. So once you work out the right depth setting for each finger, you’re assured minimal pain and the amount of blood you need. 

While I ordinarily change my lancets with the coming of each new moon, having them change automatically in the machine both combats my laziness, and really does help minimize pain. And of course, the idea is less pain promotes more testing.

This first digital, battery-operated, lancing device also results in less skin damage, minimal bleeding and faster healing of bruises. All around, this device is heads above anything else I’ve ever seen or tried. Its cool gold color is nice too.

The company is at work building in a meter to make the Pelikan Sun a one stop-shop. I’m glad to hear that because the only disadvantage this lancing device offers me right now is it’s bigger than I really want to carry around. 

I’m sold on this company’s ethics too. As they say on their web site, “All profits from the sale of Diacare products, including the Pelikan Sun, go towards Diabetes Australia-NSW’s research, education, awareness and advocacy programs.” Personally, in today’s global world of diabetes research, I don’t particularly care who gets there first.

Check your equipment – sometimes it’s your head, sometimes it’s your meter

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Learn. It lightens the load

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My desire in doing this work is to help people live more successfully with diabetes. For me that means you know how to: 1) manage your blood sugars through food, fitness and medicine and 2) manage the emotions of living with a chronic illness. Given my nature, I’m more drawn to the psycho-social aspect.

In general, the attitude we bring to our diabetes and how we cope. I’m also drawn to how we create happiness and contentment in life and curious whether diabetes impacts our happiness quotient. I have heard now from most people that diabetes hasn’t really changed their level of happiness. Many, in fact, tell me that it has enriched their lives, impelling them to reach out to help others and appreciate their blessings. Nice huh? This morning, however, I was brought quickly out of the clouds as I took my first out-of-bed reading.

I extracted a test strip and put it in my One Touch Ultra meter, pricked my index finger and got a reading of 144. Well, 144 isn’t terrible, but it isn’t my usual 98 or 85 or 68. Surprised and perplexed I tested again. Second prick – 113. Now with two numbers so different, I did a third test – 112. OK, now I could pretty much trust the latter two tests. Before I go any further let me first address those of you saying, “What’s she complaining about, I’d be happy with 144!” Well I’m not complaining, but I want to share something worth remembering – sometimes diabetes involves managing your head, and sometimes, managing your equipment.

If your blood sugar reading seems out of line, it may not be correct. It’s worth doing a second test, or a third. When I saw 144 I first thought, hmmm, I did eat a little cheese and fruit before going to bed. Darn, I knew I should have gotten up and covered it with extra insulin but I just didn’t feel like it. Then again, would a slice of Manchego and a few strawberries really spike me 50 points? Seems unlikely. So I thought what else could have caused this? And then I realized that when the blood crept up the test strip on that first test it didn’t completely fill the strip. This is likely why I got a false read. 

Your blood sugars won’t always make sense. There are just too many variables going on in your body for diabetes to be a perfect science. However, the more you test the more you’ll get to know how food, exercise and medicine typically affect your blood sugars and that’s valuable information. Particularly when something doesn’t seem right. If your numbers in general don’t make sense, do what every other TV commercial today tells you to do, “Talk to your doctor.” If an occasional number doesn’t make sense, think what could be the cause. It may avert an action, like an extra dose of insulin, that will cause an even bigger problem. Believe me I’ve been there too.