Dexcom’s Chief Technology Officer Reveals Updates on the G7

We are almost through to the end of this year and we are all looking forward to new diabetes technologies coming out in 2021! Continuous glucose monitoring (CGM) technology is an incredibly useful tool that can improve diabetes management, and the release of Dexcom’s new CGM, the G7 is certainly one to look out for. For me, the sheer difference in size alone (the G7 will be about the size of a quarter, certainly an improvement over the G6!) is something to get excited about. Moreover, the company has completely redesigned the product, which will now be completely disposable, as opposed to previous iterations that included a reusable transmitter.

I recently talked to Dexcom’s Chief Technology Officer, Jake Leach to get the most recent scoop on what’s to come with the release of the highly anticipated new product.

When Will the G7 be Released?

Due to the COVID-19 pandemic, the start of clinical trials was delayed. Leach explained that the company used that time to integrate in even more technology with the G7. Clinical studies needed to get FDA approval for the G7 are currently in the process of getting started. Although they could not disclose specific details on timing, Dexcom confirmed that will see the product come to market in 2021. A broader launch is expected to come in 2022.

What About the Accuracy?

Dexcom has taken a lot of technologies of the G6 and made improvements on them. It will need to meet stringent accuracy requirements to be approved by the FDA. It is expected that the product will perform well and offer improvements over existing technologies.

What About the Wear Time?

Currently, the Dexcom G6 is approved for 10-day wear. However, many users try to circumnavigate this. Dexcom’s CTO had this to say about advancements for the G7:

“The platform is designed to extend the wear beyond 10 days, so the electronics, etc. are compatible with that. We are striving for a very high level of reliability for both the sensor and the adhesive patch. [So far, early studies have shown that] the right time frame for our customers is 10 days with this product, but we do intend to continue working to expand both the sensor and adhesive performance to go beyond 10 days. We feel that our customers deserve a sensor that is highly reliable for the full wear duration, and so 10 days is where we’re at with G7.

What About the Cost?

“We know that for CGM to be accessed by many many people, we need to continue to remove cost from the general system. So, G7 is designed to be highly manufacturable in very large volumes. We have our first G7 line up and running. We are using a fully automated assembly line. The product is not only highly reliable but also lower cost to manufacture. Providing users with the product that is disposable, there were hurdles that we had to overcome in engineering, to be able to provide a product where you are throwing away more components, but we are able to do that at a cost-point equal to or lower than G6.”

What About the Sensor Insertion?

The sensor insertion will be fully automated. Dexcom stated that the product will be even easier to apply than the G6, and that the applicator will be much smaller than the G6, reducing the environmental footprint.

“We specifically designed it to be as small as possible [but still large enough to ensure a comfortable insertion process]. Definitely smaller than G6…”

What About the Adhesive?

In the diabetes online community, I have recently been hearing more reports of adhesive-related allergic skin reactions, and speculations that perhaps there was a change in the adhesive formula being used. Here is what Dexcom had to say about that:

“Some very small number of users do have issues with irritation, and there is a number of different ways that can be addressed. It’s a balance between the adhesive properties of making the sensor stay on for the full duration and there are so trade-offs with irritation. We are very focused on minimizing irritation. We have made improvements to the patch where many users are seeing their sensors last longer, but we have seen a small number of irritation complaints and we are focused on [for both the G6 and the G7] always making improvements. We are focused on investigating what possibly could be causing these irritant properties. The G7 does have a different adhesive than G6 and we are looking to ensure that [causes] very little, if any, irritation.

What About New Integration with Other Systems?

“The way that we’ve designed our system is so that it can integrate with many different types of systems.”

In addition to integration with the Tandem’s Control IQ and Insulet’s OmniPod system, integration has also been developed for Companion Medical’s InPen as well as over 25 commercially-available apps. Leach also highlighted that as of now, the Dexcom CGM is the only product that has been approved for use with hybrid closed-loop insulin delivery systems.

What About New Predictive Modeling Algorithms?

Recently, Dexcom has partnered with the University of Virginia to conduct research on a variety of automated insulin delivery models and algorithms. Dexcom has also partnered with the European company Ypsomed to further develop CGM integration for automated insulin delivery systems. In addition, Dexcom is working to investigate the use of CGM data, in general, to provide users with key insights on blood glucose trends and potential therapy optimizations.

“Our general approach is to provide many options to our users. We know diabetes is a personal disease and everyone has different opportunities to connect with different devices, and what they feel fits into their lifestyle. We try to support as many options as possible so we do that through the pump integration, as well as the digital ecosystem of the app partners.”

What About the Data Display and Device Compatibility?

“It will be compatible with both Android and iOS. One thing we are doing with the G7 app is we are integrating more insights into the app. So, G6 does a great job of showing glucose information, trends, as well as the ‘urgent low soon’ alert. G7 is taking that even farther and starting to integrate in a lot more of the some of the functionality from Clarity, some of those insights you get will be built into the G7.”

Dexcom is also working to enhance some features of their apps for data sharing with support people and clinicians. In addition, a receiver will still be a part of the new system, for those users who want an alternative to using their smartphone for data display.

Staying Ahead of the Competition

The CGM market is growing rapidly, with more and more companies coming out with competitive products. We asked Dexcom where they view themselves and what their advantages are over other systems.

“We feel that G7 is going to be a whole new level of comfort and convenience in the CGM ecosystem and the integration that we can build on with both insulin pump partners and the digital ecosystem of  apps… is a significant differentiator between [us] and some of the other competitors. We’ve been providing real-time CGM data since day 1, and we want to continue to expand and improve and provide users with new tools that enable them to take control of diabetes.

Moreover, the use of CGM technology is also expanding in the clinical setting, and Dexcom is a big player there.

“With COVID, we got approval for emergency authorization use for Dexcom CGM in the hospital. During the pandemic, since the beginning, hospitals have been acquiring the G6 from us and using the device in the hospital setting. It has performed very well. It also limited the need for interaction between healthcare providers and the patients [with COVID].”

We thank Jake Leach for taking the time to provide us with the most updated information. Sounds pretty great to us, and we look forward to learning even more and updating our readers as more details come to light!

Do you use a Dexcom CGM? What are your thoughts on the advances in CGM tech? Please share your thoughts in the comments.

Source: diabetesdaily.com

Keto Gravy Recipe for Roasted Meats

This content originally appeared on Low Carb Yum. Republished with permission.

Regular gravy is usually thickened with wheat flour or cornstarch. We all know wheat flour isn’t low in carbs.

But, is cornstarch keto?

At about 7 grams of carbs per tablespoon, cornstarch can be a low carb option if a small amount is used. However, most people on a keto diet avoid grains and excess carbs. So you’re better off not using it.

In the past, I’ve made xanthan gum gravy. And sometimes, I’d blend xanthan gum with guar gum but, I’m not a fan of using either of those “gum” thickeners these days.

Instead, I prefer using glucomannan!

However, all of these low carb thickeners can make your sauce turn into a thick pudding. So you need to add just the right amount to prevent the liquid from thickening too much, especially as it cools.

That’s why I decided to create an easy keto gravy that’s thickened with egg yolks, some puréed onions, and a little butter or coconut oil. Plus, the onion and butter not only thicken but adds flavor.

low carb gravy

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Keto Gravy Recipe for Roasted Meats

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Although using coconut flour and almond flour may work for a keto gravy recipe, there are much better choices for a flourless gravy.
Course Condiment
Cuisine American
Keyword gravy
Prep Time 5 minutes
Cook Time 15 minutes
Total Time 20 minutes
Servings 8 people
Calories 79kcal

Ingredients

  • 2 cups pan drippings and water or meat stock
  • 1/2 cup onion
  • 2 large egg yolks in small bowl
  • 1/4 cup butter flavored coconut oil or butter
  • salt and pepper to taste

Instructions

  • Strain pan drippings and add enough water or stock to make 2 cups. Place in a pot and reduce the liquid to thicken a bit by boiling down for about ten minutes.
  • Add onion to liquid and finely puree with a stick blender or high speed blender. Cook the onion for a few minutes to further reduce the liquid.
  • (To prevent cooking the egg, the hot liquid needs to be incorporated into the egg yolk very slowly) Remove from heat and slowly pour about 1/4 cup of the hot liquid into the egg yolks while whisking to temper them. Gently pour the egg yolk mixture into the hot liquid in the pot while whisking.
  • Continue to whisk and simmer the gravy liquid. Whisk in the coconut oil or butter and stir until smooth. You can continue to simmer. Butter tends to thicken the gravy better than coconut oil, but the gravy will thicken more as it cools with the coconut oil.

Notes

If the gravy is not as thick as you’d like, you can add in a little glucomannan, gelatin, coconut flour, or xanthan gum to get the right consistency.

For a lower-carb gravy, the onion can be left out, but another thickener like gelatin will likely need to be used or the liquid may be too thin.

Nutrition

Serving: 2tbsp. | Calories: 79kcal | Carbohydrates: 1g | Fat: 7g | Saturated Fat: 6g | Cholesterol: 46mg | Sodium: 237mg | Potassium: 19mg | Vitamin A: 185IU | Vitamin C: 0.7mg | Calcium: 8mg | Iron: 0.1mg


Please note that the nutritional information may vary depending
on the specific brands of products used. We encourage everyone to check specific
product labels in calculating the exact nutritional information.

Keto Gravy Recipe for Roasted Meats Recipe

Source: diabetesdaily.com

Support Small Diabetes Businesses This Giving Tuesday

Giving Tuesday, “A Global Generosity Movement,” will take place on December 1st this year.  Founded in 2012, this initiative strives to promote giving in all of its forms.

“It’s a simple idea: whether it’s making someone smile, helping a neighbor or stranger out, showing up for an issue or people we care about, or giving some of what we have to those who need our help, every act of generosity counts and everyone has something to give.”

It is perhaps the understatement of the year that 2020 has brought considerable challenges upon all of us. Particularly hard-hit are many small businesses, with so many logistical challenges imposed by lockdowns, new regulations, and overall lack of revenue due to the COVID-19 pandemic.

We hope to bring more awareness to Giving Tuesday, and this year, we are featuring some of our favorite diabetes-related small businesses. Here is a roundup of some of our favorites. We hope we can all give a little to help small companies get back on track and thrive as much as we can during these difficult times.

Check these out and please tell us about your favorites in the comments!

Myabetic

Myabetic is a small business that offers a variety of diabetes-specific cases, pouches, purses, backpacks etc. for sale. They have a large inventory of high-quality products and there really is something for everyone, whether you are a teenager, preschooler, businessperson, or stay-at-home parent. Check out our review of several products and browse for your favorites. One of these could certainly make an excellent gift for a loved one with diabetes this holiday season!

Pump Peelz

We are always on the lookout for great products to use with your pump or continuous glucose monitor (CGM). Pump Peelz offers a fantastic and large collection of high-quality, functional, and unique-looking tapes for a variety of medical devices, including CGMs, pumps, blood glucose meters, and more. Not only that, but this company went above and beyond to do their part during the pandemic this year by building intubation boxes! Check out our review of their products and browse for the latest designs to suit your specific needs.

Sugar Medical

Another company that boasts a wide repertoire of diabetes accessories is Sugar Medical. The company was started in 2009 by a woman with type 1 diabetes who is on a mission to “bring style and quality into the lives of people living with diabetes.” From backpacks to purses to insulated pouches for your insulin, there are a variety of options in their collection to suit your unique requirements.

Genteel

Living with diabetes, for most of us, means poking your finger to check your blood glucose levels, usually every day. Genteel has developed lancing devices that are virtually pain-free. These products are admired by many and are an especially great tool for younger children who may be particularly fearful of checking their blood sugar. Check out our review of these devices and learn more about how they work and how to purchase.

Frio

Maintaining insulin integrity is at the heart of optimal diabetes management. However, because it’s not temperature stable, insulin can quickly lose its efficacy, especially in hot temperatures. Frio pouches are easy-to-use, as they are activated by water, long-lasting, will withstand high heat (over 100 degrees F!), and are an incredibly useful product for anyone who uses insulin. Check out their full inventory and see for yourself – these are definitely worth-while!

Will you be participating in Giving Tuesday? How will you give back during this particularly challenging year? Please share your thoughts in the comments below!

Source: diabetesdaily.com

My Review: Sun Basket Meal Kit Delivery

Here at Diabetes Daily, we recently tried out several different meal kit delivery services and we learned that while pricey, they did save us a lot of time and mental efforts when it came to preparing meals for our family. One of the caveats for our family’s meals is that we often eat a lower-carb diet to help optimally manage our type 1 diabetes, while other family members may eat a little bit higher carbohydrate than we do, not entirely avoiding items like pasta and potatoes.

One of the reasons we chose to try out the Sun Basket meal kit delivery service was because they seemed to offer a lot of different options we thought would be able to meet our very low-carb requirements while also offering additional options that would please other family members. We received several meal kits and snacks at no charge and all opinions are my own.

Sunbasket box

Photo credit: Sun Basket

Sun Basket

Sun Basket offers a variety of meal kit delivery plans and strives to provide numerous options, including, among others:

  • Gluten-Free
  • Mediterranean
  • Pescatarian
  • Vegan
  • Carb-conscious

The company aims to source their food responsibly and be environmentally-friendly by working with local farmers and ensuring that their packaging is recyclable whenever possible. Also, over 99% of the food shipped by Sun Basket is organic.

Excitingly, the company offers a variety of meal types, including breakfasts, lunches, dinners, and snack items as well.

You can view the specific meal kit plans here and also check out the pricing breakdown here. The average price per serving comes in at about $11-12 USD.

Our Review

We sampled the following items from Sun Basket:

Overall, we were very happy with the product packaging (complete in a brown paper bag), protein and produce quality, as well as with the ease of following each recipe.

Photo credit: Allison Caggia

We thoroughly enjoyed all of their meals and found them to be easy on our blood sugars. One stand-out was the steak with roasted sweet potatoes. I had never tried chimichurri before and was pleasantly surprised by the flavor. Also, I am a sucker for sweet potato fries and the little cubes only took a few minutes in my air fryer. I plan on preparing them this way moving forward. I also enjoyed the other meals and found the instructions very easy to follow and perfect for the cook-challenged.

Conclusions

Overall, here at Diabetes Daily, we were very happy with the meal kit and snack options offered by this company. We like the idea of having the a-la-carte options when it comes to the snacks, in addition to the variety of meals that are offered each week. We appreciated the organic protein and produce and was very pleased to see that everything was very fresh. The available options made it easy for us to stick to lower-carb eating while allowing our families the option of having more carbohydrates on the side. If you’re considering investing in a meal kit delivery service, Sun Basket should definitely be on your radar, especially if you need a variety of options to please your family!

Source: diabetesdaily.com

Rowdy Bar: The First Prebiotic Energy Bar

Rowdy Bars are a deliciously healthy option for ultrarunners, kid athletes, busy moms, and everything in between. This tasty energy bar promotes good gut health while providing your body with essential protein and prebiotic fibers.

I received samples from Rowdy Bar at no charge. I was not additionally compensated for this review and all opinions are my own.

What Are Rowdy Bars?

Rowdy Bars were created to help promote a healthy gut and a positive outlook on life. The bars are loaded with fiber, protein, and healthy fats and will not spike blood sugar. The secret ingredient is yacon root, which is a root vegetable, that is made of mostly insoluble fibers. These are sugars that the body does not digest, which gives this vegetable its health benefits. Yacon has anti-hyperglycemic effects which means that the body will not absorb it, therefore not spoking our blood glucose levels, which is very helpful for those of us living with diabetes. It also helps prevent the build-up of bad cholesterol, lowers blood pressure, and boosts liver health, along with other health benefits.

All of the bars are non-GMO and gluten-free. They are also dairy-free and soy-free. Each bar is under 200 calories, and range in carbs from 15-23 grams, but you must take into account the fiber, which will make the net carbs much less. There is minimal fat and each one packs 8-14 grams of protein, depending on the flavor bar you choose.

Who Are They?

Kellie, as an ultrarunner and outdoor enthusiast, was always mindful of what she ate. In 2013 she started a clean eating journey, but at the same time started experiencing bad stomach pain, which led to gallstones. After getting her gallbladder removed and being diagnosed with hypothyroidism, she believes the root of these issues began with her digestive health. She continued on her clean eating journey, educated herself further and Rowdy Bar came to life.

How Do They Taste?

I was pleasantly surprised by the taste of all of the Rowdy Bars I received. This bar is more of a chewy consistency but also packs in some crunch. My favorite was the Chocolaty Cookie Dough. It had chunks of rich chocolate in each bite. It did not taste like a low-sugar substitute, it tasted rich and delicious. I also loved the Peanutty Dark Chocolate where the peanut butter tasted like the real thing. The Blueberry Almond Tart is a delicious choice in the morning to pair with a cup of coffee on the go. The Sunflower Butter and Berries is another one I love to start my day with, this flavor is a great combination! While I am not a fan of coconut, the Chocolate Coconut Cashew was well-liked by a friend at the gym and gave her the energy she needed to push through our workout.

Where Can I Purchase Rowdy Bars and What Do They Cost?

You can buy Rowdy Bars directly from their website or you can use their store locator to find a retail store by you. Prices start at $23.99 for a box of 12 and if you subscribe you can benefit from discounted prices. Also, be sure to check their social media as they do offer sales and promotions.

Conclusion

Rowdy Prebiotic Bars are a great choice if you are mindful of a healthy gut and a healthy lifestyle. These bars are loaded with fiber, protein and healthy fats and are low on the glycemic index thanks to their special ingredient, yacon root, so these bars will not spike your blood sugar. You can enjoy a healthy snack without the worry, I highly recommend it!

Source: diabetesdaily.com

Caramel Apple Cider Mimosa

This content originally appeared on TCOYD: Taking Control of Your Diabetes. Republished with permission.

By Sarah Severance

This is a fun twist on a traditional mimosa, but keep in mind it does have about 22 grams of carb and 10 grams of sugar per serving. To keep the carbs and sugar lower, you can make sugar free spiced apple cider and chill it before adding it to the champagne.

* Always drink responsibly.

Caramel Apple Cider Mimosa

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Caramel Apple Cider Mimosa

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A fun variation on the classic mimosa, this crisp and refreshing brunch companion may be your new favorite. Pop some bubbly and find something to celebrate!
Servings 2 servings
Calories 127kcal

Ingredients

  • 2 tbsp. sugar or sugar substitute
  • 2 tbsp. cinnamon
  • 2 tsp. caramel sauce
  • 1 bottle champagne
  • 4 oz. spiced cider (half a cup)

Instructions

  • Mix sugar and cinnamon together.
  • Rim each champagne flute in caramel sauce and then dip in the sugar/cinnamon mixture.
  • Fill each glass with desired amount of champagne (we did 1/2 flute).
  • Add a splash of spiced cider (we did 2 oz) per glass.

Notes

Always drink responsibly. 

Nutrition

Calories: 127kcal | Carbohydrates: 21.5g | Fat: 5g | Fiber: 4g | Sugar: 10g


Please note that the nutritional information may vary depending
on the specific brands of products used. We encourage everyone to check specific
product labels in calculating the exact nutritional information.

Caramel Apple Cider Mimosa Recipe

Source: diabetesdaily.com

Four Steps to Managing Your Fear When Raising a Child with Type 1 Diabetes

By Bonnie O’Neil

The fall chill in the air deepens as the leaves begin their inevitable eruption into glorious color. Children squeal with delight at the prospect of being frightened by houses decked out with ghosts, witches on broomsticks, and ghoulish creatures. This is October, the month when a little Halloween fear can actually be fun.

But, for most of us, fear is not a matter of child’s play. We can’t easily tuck away our fears like so many Halloween decorations, simply exchanging them for thoughts of thanksgiving because the calendar says we should.

When my son was diagnosed with type 1 diabetes at age five, I thought my greatest fear in managing his type 1 diabetes (T1D) would be injecting him with insulin. I would soon discover there were far greater fears awaiting me as his caregiver.

“What if his blood sugar drops precipitously low while I’m sleeping?”

“What if I can’t control his ketones and blood sugars when he has a stomach virus?”

“What if I don’t manage his blood sugars tightly enough when he’s young? What does that mean for his long-term health?”

These are the fears shared by every T1D parent within our collective community when the world is moving in its proper orbit. But these are not normal days and the world seems to be spinning in ways that leave us feeling particularly out of control. Living with the restrictions of the pandemic for eight long months now, our fears have taken on an additional dimension.

“How can I keep my child safe from getting COVID?”

“What if my child gets COVID? What will that mean for him?”

“When will it be safe for my child to resume her normal activities like school, work, and play?”

I know fear all too well. Despising the consequences of yielding to fear, I nevertheless fall prey to its temptations and cling to it as I would a best friend. I carry fear with me as a fire between my temples, a tornado deep in my gut. Awash with fear, it’s easy to descend from the present into an imagined world of what-ifs.

Fear is a cloaked villain, lurking in the shadowlands of our minds. Catching us by surprise, fear for our child’s safety can overwhelm our thoughts, locking us in repeating mental loops. Once that unseen villain kidnaps our thoughts, how do we escape his suffocating stranglehold? Next time the fear villain shows up unbidden, try these steps to send him packing.

1. Acknowledge Your Fear in Managing Your Child’s T1D

So often we feel the emotion without taking the time to name it. We hope by ignoring it, it will go away, when actually, the opposite is true. The more we ignore fear, the greater influence it has over us. Instead of ignoring fear, face it. Sit with it. Name its source by identifying the roots of your fear. You may be surprised to discover you’ve carried this same type of fear for a long time, even before your child’s diagnosis. Talk about your fears with a trusted friend, a therapist, or a counselor.

2. Lean on Meditation or Prayer When Fear Rises up and Feels Beyond Your Control

When we’re deeply afraid, we naturally experience an accelerated heart rate because our body’s sympathetic nervous system activates its natural defensive mechanisms. Once put into motion, we experience increased pulse and breathing rates, elevated blood pressure, and tensed muscles. Intentionally breathing slowly and deeply activates the parasympathetic nervous system, calming the body by decreasing blood pressure, heart and breathing rates, and relaxing tense muscles. Deep breathing exercises associated with meditation and the slow breath prayers practiced in many faith traditions help calm our body when fear surges.

3. Stay Present

We fear what we suspect might happen in the future. When we stay grounded in the present, it’s harder for our thoughts to slip away into uncharted territory. Practicing centering prayer or mindfulness helps us grow in our ability to stay present and teaches us how to reel our thoughts back in if they begin to stray too far into what-if scenarios. When fear overwhelms you, take some time to focus on the present by repeating the word or phrase you use in mindfulness or centering prayer. Repeated slowly, in the rhythm of a deep in-breath followed by a deep out-breath, our heart rates slow, our minds settle, and we stay grounded in the present.

4. Practice Letting Go of Perfection

No one gets everything “right.” Making any decision involves trade-offs. You have an awesome responsibility in caring for your child’s chronic illness, but you can’t determine and control all outcomes affecting her. Some of us naturally have a higher desire for control than others do. If that’s you, remind yourself frequently that you’re doing the best you can, but ultimately, you’re not in control of all things. Releasing control is not a weakness; it could become your greatest strength. Give yourself permission to release control and then visualize yourself letting go.

And when fear rises up in the middle of the night, take a few deep breaths and allow your centering word to carry you back to the present, away from the fear.

Source: diabetesdaily.com

How the Keto Diet Paved the Way for a “Normal” Life

By Matt Barrie

I have type 1 diabetes since age three, and am now 37 years old. Living a ‘normal life’ has always been my number 1 goal, but how this has manifested has been different through different stages of my life. As a teenager, I hung out with friends and wanted to do all the same things as them, eat the same things as them and just be a ‘normal’ kid. I made it through, although there were several seizures and hospital visits.

My twenties had their ups and downs both with health and life events. I had weight fluctuations from quite low to an extra unhealthy 20 lbs., and my HbA1cs were also all over the map. By 26, I made some big changes and adopted a healthy, standard carb-diet lifestyle and enjoyed that sense of ‘normalcy’ that we all crave. I played soccer, ran, skied, and lifted weights.

By my late twenties, I made some big life-changing decisions, like heading back to school to change direction with my career. Through studying and supporting myself at the same time, my health began to slip slowly and steadily. By the time my degree was finished, I had put on 50+ lbs., had developed very unhealthy eating habits, and could barely make it up a flight of stairs without being out of breath.

Doctors were giving me all the warnings, my HbA1c was up in the 8s and 9s and most significantly, the diabetic retinopathy that had begun to develop in my 20s worsened and progressed into macular retinal edema. So, monthly visits to the ophthalmologist (daily, when I developed an infection from the injections I was getting that almost took my eye!) became my new normal. With fear as a driving factor and determination as the driving force, I jumped into action, although not sure where to begin.

keto diet

Moussaka made with eggplant, zucchini, cashew-béchamel, ground beef sauce and cheese. Photo credit: Matt Barrie

I started experimenting with the ketogenic diet after reading that it had proved successful for many people with diabetes, both types 1 and 2. This was around 3.5 years ago. Most of the success I read about then was regarding type 2 diabetes and reversing it with the diet.

I was very curious though how I could make this work for myself so the experimenting began. I tried cyclical, where you rotate carbs in and out, but this didn’t work. I tried semi-strict, with the infamous ‘cheat days’ which I needed at the time to preserve those foods I ‘missed’, but ultimately this didn’t work either. I tried many different iterations of the diet and for two years saw small successes – up to 20 lbs. [weight loss] here and there. It was enough to keep me going but I never saw that breakthrough success that I was truly after.

After the summer of 2019, I had taken a ‘break’ with visiting relatives and had gained back all my losses and then some. It was very discouraging, but it was the motivation I needed to make a serious change. I hit a saturation point where I knew I couldn’t keep continuing on the way I had been. I weighed in over 210 lbs., which on my 5’8″ frame felt like [an extra] 100 lbs. I committed to myself that I would be absolutely strict keto, I signed up with a trainer twice a week to stay accountable, and committed to running twice a week. I also began practicing intermittent fasting with the 16 hour/8 hour split between my fasting and eating window.

Photo credit: Matt Barrie

Within the first month, I dropped 15 lbs. and the weight and body composition began to change week by week, month by month. By the time the pandemic hit, I was well on my way to my weight loss goal and was able to stay on track. I lost 50 lbs. by April of 2020 and have been working on building lean muscle mass ever since!

My insulin needs have dropped significantly – basal by about a quarter and fast-acting by over 3/4! My HbA1c is in the low 6s and most significantly, I have reversed my macular edema and the retinopathy seems to be going into remission as well. My ophthalmologist was blown away that there was no fluid in my retina.

Photo credit: Matt Barrie

It’s hard to put into words the effect these lifestyle changes have had in my life. My energy, ability to perform, clarity of mind, spirit, and purpose are all significantly improved. Thinking and being told by convention that carbs were essential led me to high levels of insulin resistance, fat storage, yo-yo blood sugars, and unnecessary highs and lows due to over-correction. I now enjoy steady blood glucose levels during exercise, during waking hours, and overnight. I’m also enjoying much lower insulin needs and feel confident that my risk of diabetic complications is significantly decreased.

Keto Diet - Matt Barrie

Left: Sablefish (black cod) with puréed butternut squash, pan-fried Brussels and topped with red cabbage sauerkraut. Right: Grilled pork chop with seared zu Chinju, roasted carrots and cauliflower. Finished with mushroom cream sauce. Photo credit: Matt Barrie

I can’t shout from the roof loud enough that the ketogenic lifestyle can be such a powerful tool for diabetes management! I’m not saying it’s the only way, but it has certainly worked for me and changed my life. At first, you do miss the foods from a standard carbohydrate diet that we are all programmed to accept, but with time the cravings go away and the way you feel on the other side is totally worth it! It doesn’t even feel like a sacrifice anymore and being creative in the kitchen to make satisfying, delicious food is all part of the fun!

Left: Zucchini tuna melts with cheese and avocado mayo. Right: Cauliflower, bacon and asparagus soup with homemade almond flour cheese scone. Photo credit: Matt Barrie

If you’d like to follow my journey and pick up any tips and tricks I’ve discovered along the way, I’ve recently started a public Instagram account. You can follow along @type1ketoguy.

Source: diabetesdaily.com

The GMI Spells A New Way to Evaluate Your Glucose Numbers

This content originally appeared on diaTribe. Republished with permission.

By Dr. Laurel Messer

Though A1C has long been used as the primary metric for evaluating someone’s estimated average blood sugar, the glucose management indicator (GMI) is an alternative that can provide the same insights without the need for a blood draw. It can also provide this information for much shorter time periods to evaluate lifestyle changes, illnesses, and new medications

For the past four decades, A1C and fingerstick blood sugars have been used to assess diabetes management. A1C (or hemoglobin A1C) measures how much sugar is bound to proteins in red blood cells (called glycated hemoglobin) and provides an estimated measure of glucose levels over a long period of time – the two to three months that red blood cells survive in our bodies.

The A1C does have limitations but is a number that people with diabetes and healthcare professionals are comfortable with and understand how to interpret. The purpose of this article is to show that the Glucose Management Indicator (GMI) is another measure for glycemic management and can be interpreted in a similar way to A1C. GMI is one more tool for the diabetes toolbox – click to learn about another tool, Time in Range.

GMI used to be called the “estimated A1C” or the “eA1C,” because it is meant to approximate an A1C lab value. Instead of being determined by how much sugar is attached to hemoglobin molecules on red blood cells, GMI is calculated directly from the mean (or average) glucose value from a continuous glucose monitoring device (CGM). This means that GMI is a more direct and more accurate measure of glucose levels – it can be calculated for a shorter period of time (the ideal minimum is two weeks), without the need to wait two to three months and to have a laboratory blood draw. Any person wearing a CGM can calculate their GMI in a matter of seconds if they have enough glucose values, and many CGM devices automatically do the calculation using your mean glucose; the calculator can be found here.

To be clear: A GMI can only be calculated if you have a CGM, but if you do have that device, here are the advantages of using GMI.

In addition to providing an additional assessment of glucose values, GMI eliminates misinterpretation of the variance in A1C caused by a number of factors including kidney disease, iron deficiency, sickle cell disease, the use of certain medications, and differences between racial and ethnic groups. Two people could have identical glucose data but different A1C levels depending on their rates of red blood cell survival and glucose attachment to proteins (referred to as glycation), with much more variation within races than between races. However, these same two people would have the same calculated GMI, giving them a more accurate and consistent understanding of their diabetes management and their risk of health complications.

The best feature of GMI (compared to A1C) is that you can (and should!) choose different periods of time to calculate. For example, you can calculate a GMI for the past two weeks, which you cannot do with an A1C, since A1C correlates to glucose levels over the preceding two to three months. Have you ever had an A1C level affected by one week of illness with very high glucose levels? For many people who receive an A1C level at clinical visits two to four times a year, this can be frustrating, as it highlights a time of high glucose values rather than the overall glucose management for that period. Calculating a GMI can be helpful with illness: a clinician or person with diabetes can select a period of time (for example, two weeks) before or after the illness to get a better sense of overall glycemic management that includes or eliminates the period of illness. Time in Range is another helpful metric for understanding glucose levels during a distinct (and even shorter!) time period.

GMI can also be useful to assess the impact of a lifestyle change, like a new diet or exercise regimen, or a medication adjustment. For example, a person could calculate GMI for a two-week period, change diet to lower carbohydrates, and calculate another GMI for the two weeks after the change. This would give a more accurate and immediate indicator of the effect of the change, compared to an A1C measurement drawn at a clinic that cannot focus on the time in question. Another example would be starting a new medication that affects glucose levels. In addition to assessing daily trends in glucose levels, a GMI after one to two weeks on a new medication can provide valuable information on whether medication doses need to be changed.

Finally, in the time of COVID-19 and increased telehealth, GMI is the perfect substitute for a lab-drawn A1C. No blood draw and no in-person clinic visit is required. That said, remember that your GMI may run higher or lower than your lab-drawn A1C for many reasons discussed above – like red blood cell turnover, health conditions, medications, and more.

We encourage you to discuss the use of GMI and CGM with your diabetes healthcare team. GMI can be interpreted the same way as an A1C, but for the reasons stated above, it can also be more accurate and can be used as a tool to determine the effect of illness, lifestyle changes, and medication adjustments. We also hope to help diabetes care professionals become more comfortable with GMI and other CGM-derived glucose metrics, which take in the whole picture of daily glucose control. Next step, Time in Range! (GMI can bridge A1C and Time in Range – but that is another story.)

About Dr. Messer

Dr. Laurel H. Messer, PhD, RN, CDCES, is a nurse scientist and certified diabetes educator at the Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO. She has spent the last 15 years studying how to best utilize new diabetes technologies, and remembers fondly teaching families to wrap up their corded CGM system in a plastic shower bag for bathing. Ok, not that fondly, but look how far we have come! Dr. Messer works with the Barbara Davis Center PANTHER team (Practical Advanced Therapies for diabetes), conducting clinical research trials on promising technologies to make life better for children, adolescents, and adults living with type 1 diabetes. Get in touch at Laurel.Messer@cuanschutz.edu.

Source: diabetesdaily.com

Injection Device Helping a Family Manage New Diabetes Diagnosis During COVID

Injection Port Device Help Family Whose Son Lives with Diabetes

Jennifer, like many others, has worried about her family’s health during the coronavirus pandemic.

In June, she was diagnosed with COVID-19. Shortly after, her 13-year old son Mason started feeling ill. Unsure if he too had contracted the virus, they visited their local emergency room. Soon after, the family was informed that Mason was living with type 1 diabetes. In this post, Jennifer discusses her family’s experience and the ways they are managing Mason’s diabetes during the global pandemic.

Mason came to me and said he didn’t feel right. Upset tummy, sinus issues, and a small headache. We took him to a local emergency room, and sure enough his rapid test was positive for COVID-19. The doctors also said that his sugar was pretty high. They asked if I could watch his levels at home over the next couple of days and if his sugars remained high, then I should call our family doctor. We left the ER on Tuesday evening. By Thursday, I called our doctor because his sugars never went below 200 mg/dL. We were put in touch with an endocrinologist, who advised us to take him to the hospital where he was diagnosed with diabetes. 

As a parent, all fears set in. I was worried that I didn’t know enough about diet and medication. I worried about if my son would ever feel normal again.

I was surprised that Mason was able to start giving his own insulin almost immediately, and he preferred it that way. In the three months since he was diagnosed, I have probably only given 10 shots! 

I was introduced to the i-Port Advance™ injection port through a Facebook page. I posted that we were having issues with him taking too much insulin before meals, and then he was too full to finish what he had dosed for. Several parents came back and suggested we try an injection port! I called my doctor’s office the next day and they were super excited to let him try it.

Almost immediately, Medtronic sent us a box of the i-Port Advance™ injection port to try at no-cost. I could not express my happiness! I was thankful the company was willing to let us try the port before we purchased. As a parent, this was such an amazing feeling and it was one of the first easy experiences we had since Mason was diagnosed! 

Mason fell in love with the injection port, and so did I! When he used the port, it was the first time since he was diagnosed that he didn’t feel like an outcast. Although he is incredibly diligent with what he eats and doesn’t take advantage of his insulin, he is a kid! He wants little treats, he wants to hang out with friends his age, and eat cupcake or have snow cones from time to time. All of which he had stopped because he hated sticking himself all the time and taking shots in front of people. Now, he can take a little extra insulin if he needs to. He can hang out with friends and not feel like an outsider because he can’t eat what they do! I’m also happy because he is building up less scar tissue with 1 stick every 3 days compared to 12-15 injections.

As a parent, I’ve been so happy to watch his outlook change. He knows that he can manage this disease and he isn’t constantly worried with taking another shot! 

Mason’s family enrolled in the 12-day evaluation program offered by Medtronic. To learn more, click below.

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The testimonial above relates an account of an individual’s experience using a Medtronic device. The account is genuine, typical and documented. However, this individual’s experience does not provide any indication, guide, warranty or guarantee as to the response or experience other people may have using the device. The experience other individuals have with the device could be different. Experiences can and do vary. Please talk to your doctor about your condition and the risks and benefits of Medtronic devices.

Safety Information: i-Port Advance injection port

i-Port Advance injection port is indicated for patients who administer or receive multiple daily subcutaneous injections of physician prescribed medications, including insulin. The device may remain in place for up to 72 hours to accommodate multiple injections without the discomfort of additional needle sticks. i-Port Advance injection port may be used on a wide range of patients, including adults and children. For more, please see http://www.medtronicdiabetes.com/important-safety-information.

Source: diabetesdaily.com

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