Tandem’s Control-IQ Cleared for Ages 6-13: Automated Insulin Delivery for Children!

This content originally appeared on diaTribe. Republished with permission.

By Divya Gopisetty, Hanna Gutow, and Albert Cai

In exciting news, Tandem announced expanded clearance for the hybrid closed loop Control-IQ. The system is now available for children ages 6-13

The FDA cleared Tandem’s automated insulin delivery (AID) system, Control-IQ, for children ages 6-13, last week in the US. This system is designed to increase time in range for users and it does – see below for the data!

To date, the only other hybrid closed loop system available for children is Medtronic’s MiniMed 670G, which is approved for children seven years and older. Control-IQ is the first system with automatic correction boluses and no fingerstick calibration (thanks to the Dexcom G6 sensor that it uses).

Control-IQ launched in January of this year for people 14 years and older. Since then, more than 40,000 t:slim X2 pump users have upgraded their pump software to Control-IQ. We saw very positive real-world data presented at ADA this year – in the first 30 days using Control-IQ, users’ time in range increased by 2.4 hours per day, and individuals were in active closed loop 96% of the time.

At the ATTD conference in February, the trial for Control-IQ in children presented strong results. Results from that trial were used to get this week’s FDA clearance. In that trial, we learned that:

  • Children using Control-IQ spent 67% time in range, compared to 55% for children using a sensor-augmented pump. This is a massive difference that equals nearly three more hours in range each day.
  • Children using Control-IQ reached 80% time in range overnight, compared to 54% in the control group – similarly, this change is even bigger, at over six hours more daily time in range.

Control-IQ still should not be used in children under the age of six, in people who require less than ten units of insulin per day, and in children who weigh less than 55 pounds.

For more information on the system, check out Kerri Sparling’s Test Drive of Control-IQ where her time in range improvement was quite impressive! You can also Katie Bacon’s piece on one family’s takeaways (her own!) from the first month of their teenage daughter using Control-IQ.

Source: diabetesdaily.com

How Coming Out Helped Me Accept My Type 1 Diabetes Diagnosis

This content originally appeared on Beyond Type 1. Republished with permission.

By Peter Friedfeld

I’d like to tell you a bit about my journey. First, you have to understand something about me: as a lifelong hypochondriac, I always only ‘thought’ I got diseases. So imagine my surprise being diagnosed as a diabetic not once, but twice. The first time was in 2014, right after my 55th birthday when I was diagnosed as type 2. Then two years later in 2016 ­­I was re-diagnosed as a type 1.

I’ll never forget sitting in the office of my new Endocrinologist when he leaned over his desk and said thos­e words that I feared. “You are a type 1 diabetic.”

As he pulled out two boxes he said:

“You inject yourself with this every morning, and you inject yourself with this at every meal.”

I asked “For how long?”, thinking he’d say for a week, a month… And he looked at me straight and said …“for the rest your life!” That’s when the gravity of being type 1 began to sink in.

What I eventually came to understand is that taking my daily shots would be the easiest part of managing this disease.

My New Normal

I was scared to be alone in the early days, and not sure if I would wake up in the morning. After two years of finger pricks, I finally started to use technology (reluctantly) to help manage my Blood Glucose numbers. I remember my first night wearing my Dexcom sensor —which would wake me up if I went low overnight. I explained to my husband Patrick that we were in this together, and explained how when a sensor goes off I may need his help, especially if I’m experiencing a low, scared that I would sleep thru my alarm. Sure enough, that first night, my sensor went off and I hear Patrick wake up and say “ALEXA OFF!” and go back to sleep.

But in all seriousness, my husband has been incredible, and he is just one of the many people whose support has helped me successfully manage living with type 1 diabetes.

I struggled those first few weeks after diagnosis. I would go out with friends, unable to tell them the truth about my diagnosis, and hiding the fact that I was taking insulin. I felt isolated, alone, scared. I felt I had no future, no ‘normal’ life ahead of me. But these feelings were somewhat familiar, reminding me of a time, 35 years earlier, when I was struggling to come out as a gay kid.

This feeling of isolation —that once I ‘disclose’ who I am I will forever be ‘branded’ by others. I didn’t want to be thought of as type 1, just as I didn’t want to be thought of as Gay. But coming out back in the 80s taught me some powerful lessons that I would use on my diabetic journey.

Learning From the Past Life Challenges

I left the sheltered and at times suffocating world I grew up in on Long Island and moved to NYC in 1987, to what was then the heartbeat of gay NYC, at the intersection of Christopher and Bleecker Street. Coming out gay was a real struggle for me, much of which had to do with my own insecurities and hiding who I was for years. The secrecy had taken its toll. I knew I needed to reach out to find other people ‘just like me’. Finding my community created the instant connection that crossed all barriers, and a sense of belonging and acceptance was more than comforting, it was empowering. I had no idea at the time that this process of ‘finding community’ would provide the building blocks that would get me through a life altering diagnosis to come decades later.

Diagnosis

Image source: Beyond Type 1

The 80s were a unique time in the struggle for LGBT rights (Q was not part of the acronym then). It was before the internet, before Instagram and Facebook, which meant finding others would be easier in the big city then it was back in the suburbs–all IRL-in real life. We found a collective strength in ‘community’ that we had to build from the ground up. It was a time when gay culture and awareness was just beginning to evolve in a more public way. I was also living in ground zero of the AIDS crisis in America—where our community literally had to fight for our lives. As our friends and loved ones died, we shifted our community from connection to action. And it was in those very dark days, I understood there was strength in numbers, that organizing began on the streets and there was power in the ballot box. We could change the world by being open with who we are, by educating our friends and family, to engage and not isolate. In the process, I learned how to be an Advocate – and that I could help raise awareness only by becoming visible first.

Ultimately, through my connection with others and in finding my own voice, I learned to be proud of myself and comfortable in my own skin. I learned as a gay young adult, the only limitation I had was myself. It took me a while, and so many were part of that journey.

25 years later, being faced with a new challenge of my type 1 diabetes (T1D) diagnosis—I drew on the strength of the lessons I learned, and eventually it became clear to me that I would need to come out once again. I knew I needed to find my T1D community, and embrace being a type 1 diabetic.

Finding myself again

Diabetes is often referred to as an invisible disease. I hear, “…but you don’t look sick”, just like I heard, “but you don’t look gay”.

I started searching online — I guess where everything starts today. I found an amazing resource in Beyond Type 1, an online community over a million strong. I read an article about Yoga and type 1, written by a type 1 health Coach Lauren Bongiorno. Lauren helped me understand that I can live a happy and healthy life, and helped me take control of managing my disease.

Lauren connected me to Erik Douds, a global adventurer who was biking and hiking around the world. I realized if Erik was able to bike 3000 miles across America, (with only two weeks of training I might add) – I should be able to manage to Bike around the Hamptons.

Both Erik and Lauren taught me how important it is to be able to take care of myself—and to have the confidence to be able to do that. And they both had my back. They opened my eyes to the power of this community. A community that has since connected me to so many — Susan, Rob, Jillian, Eoin, Austin, Jesee, Sarah, Qiana, Mia, Luke, Danielle, Matt, Bill, Alison, Thom, Dom, Peggy, Sara, Annalisa, Rachel, Raquel, Evan, Nate, David, Gerry, Arron and so many more. Proud T1Ds and allies.

Once again, it was thru this community that I learned as a type 1 diabetic, the only limitation I had… was myself.

When it comes to advocacy and education today, I lean on those early years coming out as a gay kid. Only by being visible can I affect the change I seek. I am passionate about talking to others about having type 1 diabetes, injecting in public, proudly wearing my Dexcom and identifying myself as a T1D (Yes I have the Rob Howe Diabetic Hoodie).  I love connecting, learning, and sharing—and being part of a community that is stronger than any individual voice.

Diagnosis

Image source: Beyond Type 1

I now recognize that we need allies in our fight as T1Ds, and that our numbers are too small to move the needle ourselves. We need our voices to be heard, and that requires our non-T1D friends, family and work associates to help amplify our voices as a community in need—of acceptance, of understanding, of healthcare for all, and for the cure we deserve.

My Story Is Only One Story

Today, 1.25 million people in America are living with type 1 diabetes, and every day an additional 100 people are diagnosed —at least 40,000 people per year —it’s a staggering number of lives that are changed forever. 

For so many, our lives are filled with frustration, burden and struggle. We need insulin every day just to stay alive. Insulin is a life-sustaining drug, but it is not a cure. We need a cure. And until that day comes, we need to help each other live the best life possible. It is our responsibility, to ourselves and to the community we created and are part of.

As for my husband Patrick—when we exchanged our vows, we said “for better or worse”. Well, my goal is to somehow make this experience part of the ‘better’. His support since day one has been unconditional. He lives each day as the life of a type 1 partner—watching over me, working with me, making sure I am safe and loved.

Finally, I recall asking my doctor a question that many of us asked when we’re faced with a chronic illness or life-changing disease “why me?” My doctor said, “Peter, it’s just your thing.”

At that moment, I thought I was alone and isolated in my battle with my new LADA diagnosis. But the reality was once I learned to open myself up to others and to embrace community— a lesson I learned so many years earlier, it was no longer ‘my thing’.  Today, 6 years into my new life, I  choose to make it a positive experience: to support those who struggle, to be supported, to learn, to help create and foster community, and to do all I can to help find a cure.

Source: diabetesdaily.com

Diabetes Deadliest Mistakes

Whether you are living with type 1 or type 2 diabetes, you likely take medication that helps keep you alive and functioning properly. We continually measure, count and remind ourselves to take our medication and/or insulin very meticulously to ensure we are taking the proper medication and correct doses.

But we are human, and mistakes do occur. Sometimes these mistakes can be deadly.

Recently, while mid-conversation, I managed to take 18 units of Fiasp instead of my long-lasting insulin, Tresiba. This has happened to me one time before when I was first diagnosed when I took 16 units of Humalog instead of Lantus. My endocrinologist sent me right to the hospital because at the time I was new, nervous and unable to handle it on my own. This time, the moment I released the needle from my skin my stomach dropped to my feet.

Fiasp is even faster-acting than Humalog and I knew I had minutes to ingest a whole lot of carbs to counteract the large amount of insulin I had just taken.

I managed to inhale over 200 g of carbs in 20 minutes in the midst of a mild panic attack. I was nauseous, jittery and scared for what lay ahead. The day wound up being a series of lows but I was lucky I came out of it unscathed. Had I not realized I took the wrong insulin I could have easily passed out, had a seizure or died. My original plan for the day was to kick it off with a walk to a nearby shopping center so had I not realized, my blood sugars could have plummeted and I could have been left for dead on the side of the road.

I got lucky. We all have gotten lucky. Some have not. Many of us, unfortunately, know people who have lost their lives due to a diabetes mistake; and yes, sometimes their own.

I asked our friends in the diabetes online community what their biggest and deadliest diabetes mistakes were and this is what they had to say.

“I forgot a snack after breastfeeding and had my first hypoglycemic seizure. The first reading they could get was 27.”

“I am a type 2 diabetic and sometimes get shaky and I know I need a snack. I grabbed a brownie as I left my house but I wasn’t feeling any better. I realized that I grabbed a low-carb brownie so it wasn’t going to help raise my blood sugar! I wound up having to stop for a soda.”

“I’ve mixed up my insulin before. 27 units of Humalog is much different than 27 units of Levemir!”

“In my last year before I quit drinking, there were 2 distinct times I can remember where I was so low and so drunk I couldn’t figure out how to get food to save my life. One time I had my friend help me. The other time I went back to sleep and miraculously woke up the next morning.”

“I took some expired test strips from someone in the diabetes online community. For days I kept reading really high and couldn’t understand why. Finally, I rage bolused and took a hefty correction dose. I started seeing spots and beads of sweat formulated all over my entire body. My reading was 28. Turns out those test strips were bad and I could have killed myself trying to save a couple of bucks.”

“I forgot to check my blood before I had breakfast and had a banana and shot up to 500!”

“I recently bolused for a snack twice. I was low in the middle of the night but the snack was larger than needed to fix so I did took a partial bolus and went back to sleep. I woke up and didn’t remember taking any insulin so I did it again. Rollecoasting ensued. I’ll mess up worse, I’ve only been at this for 2.5 years.”

“Bolused for 80 carbs instead of 8 before a workout without realizing it. Dexcom alerted and I quickly realized how much IOB I had. Apple juice and gels to the rescue.”

“I’m on Zyloprim for my gout and I fill my pill case once a week. I accidentally put Zolpidem in and was wondering why I kept waking up so damn tired!”

It is safe to say that managing our condition can be risky at times. We are administering medication and insulin, which can be extremely dangerous if the wrong dose is given. We must remain diligent at all times to avoid errors, all the while realizing that we are human and we do make mistakes. Have grace with yourself.

Have you ever made a dangerous mistake? Comment and share below, hopefully, we can help each other to avoid similar occurrences.

Source: diabetesdaily.com

Review: “Not Just a Patch” for Your CGM Sensors

What do you want to get out of a protective patch for your continuous glucose monitor (CGM) sensor?

For me, it’s all about extending the life of the sensor for as long as possible by keeping the adhesive in place and offering extra protection from moisture. I’ve tried many different patches for various versions of my Dexcom CGM (most recently, the G6) throughout the years. One big issue I’ve always had was not being able to change the patch effectively, without having the Dexcom adhesive peel off. I felt, once that patch is on, I’m more than likely stuck with it, until I actually change my sensor.

Enter, Not Just a Patch, a product that allows one to easily change the patch without disrupting the original sensor and its adhesive.

I received samples to try out from the company at no cost. I did not receive any additional compensation for this review and all opinions are my own.

Who They Are

Not Just a Patch was founded by Pete Loman, who lives an active lifestyle with type 1 diabetes. After being disappointed with the patches he’s tried, Pete began experimenting with creating his own. Eventually, he developed a unique product that offers complete coverage of the sensor, with the option of a non-stick area in the center of the patch for easy patch changes without disturbing the sensor adhesive. Altogether, the new product affords additional protection from moisture and also minimizes the possibility of the sensor becoming knocked off. Furthermore, the sensor not actually sticking to the patch (but rather around it) helps minimize the sensor and its adhesive coming loose when changing the patch, allowing for potentially longer sensor sessions.

Pete explains on his website,

“One key design improvement is the “non-stick” section of the patch. Namely, the middle piece of the patch doesn’t stick to the actual sensor, thereby allowing you to change the patch as often as you like, to suit your activity or your fashion choices. Furthermore, this feature allows complete coverage of the device, meaning that your CGM sensor is always protected and, you can have more confidence while wearing it.”

The Products

Currently, the company offers several types of patches that are compatible with the Dexcom G4, G5, and G6, as well as for the Freestyle Libre, Medtronic Guardian, and the MiaoMiao 1 and 2.

The patches are available for purchase in a variety of bright colors, ranging from neutral/nude to bright green, yellow, orange, blue, pink, etc.

For all available patches, the user has the discretion of removing the central portion of the adhesive backing, which would prevent the sensor from sticking to the patch (see image below).

Photo credit: Not Just a Patch

The patches can be purchased on the company website in packs of twenty and come in at just under $1 per patch in price.

My Review

Like many people with type 1 diabetes who use a CGM, I have tried various patches before. The distinguishing feature of this one was the patch not being stuck to my sensor. That feature definitely worked well, and I was able to seamlessly change the patch without affecting my Dexcom G6 or its adhesive whatsoever. Being able to have the entire device covered, as well as changing the patch easily and as frequently as I wish, also gave additional protection against moisture. Overall, it improved the life of the sensor adhesive and sensor performance.

Currently, I am well into my second 10-day run with my sensor, after using the most recent sensor restart hack, and I am happy to say that not only is the sensor performing well, but I noticed while changing the patch that the original sensor adhesive looked almost brand new, despite an already long wear time.

Overall, I would say that while the product initially appears similar to what’s already available, and is comparable to others on the market as far as material, shape, color, and overall design goes, it definitely offer its unique advantages.

Summary

I liked this product. It performed well to protect my sensor from moisture and I really enjoyed being able to easily change the patch without dealing with it sticking to and peeling off the Dexcom adhesive. If you’re someone who has an active lifestyle and is hoping to get more life out of their sensors, I’d definitely recommend giving this product a try!

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Have you tried this product? What are your thoughts? Please comment below; we love hearing from our readers.

Source: diabetesdaily.com

6 Ways to Extend the Life of a Glucose Sensor

If you are living with type one or type two diabetes, you know that wearing a continuous glucose monitor makes managing your diabetes a whole lot easier. It also keeps you safe and gives you peace of mind. Unfortunately, it is a tremendous expense. Transmitters can cost around $300 dollars and they might expire every few months. A three-pack of sensors might cost around $400 but you will need them more often as they only last for so many days per FDA regulations. Keep in mind the price varies depending on the specific CGM, and insurance, copays, and deductibles.

The longer we can preserve a sensor, the less money we will have to spend. This is sometimes challenging, especially if a young child is wearing the sensor. But there are measures we can take to get more life out of our sensors. Please keep in mind that this is not recommended by the CGM companies, so extend the sensor at your own risk.

Here are six ways to get more life out of your CGM sensor:

1. Extend the Sensor Life

Clever technologists have discovered how to restart a Dexcom sensor to extend its life beyond ten days. The process works by exploiting a bug in the sensor pairing process. We recently updated our article, How to Extend the Dexcom G6 Sensor Beyond the Ten Day Hard Stop, and will continue to do so as any changes arise. And if you are using the Dexcom G5 sensor, here are instructions on how to extend that one.

2. Keep It Dry

While this isn’t necessarily realistic, the less moisture that touches and goes under the Dexcom sensor, the better. If you can dry your Dexcom thoroughly after showering or swimming, it is more likely to continue to stay intact and last longer. Some people even go as far as blow-drying it before putting on their clothes. Has anyone else noticed a Dexcom wet spot on their jeans after putting them on soon after showering?

3. Location Is Everything

Just like diabetes is different for everyone, so is the most optimal placement of their Dexcom. I personally love wearing mine on my thigh, I find it doesn’t get in the way during CrossFit and I no longer have compression lows. Once I got used to being conscious of it while dressing, this has been the best location for me.

Many parents of small children living with diabetes prefer to put it on their abdomen but others have better luck placing it on the child’s upper buttocks. This is an area that usually has the most fat and when it is out of sight, it is out of mind. This is helpful with young kids who might constantly touch or play with it.

For some people who wear pumps and Dexcom, finding a location for all their sites, while also being sure to rotate sites, can be very challenging. Many of my diabadass friends prefer their arms and find they get their longest life there!

4. Create a Barrier

By using a product like Skin Tac, you can create a barrier between the tape and skin. This will make for less irritation leading to longer life. It is also non-latex and hypo-allergenic but people with sensitive skin should always test the product first. It also removes easily with alcohol, making it an easier process for children.

There are also many products on the market that are overlay adhesives that are guaranteed to get you more life out of your sensor. One of my favorites is Pump Peelz as pictured below.

where to put dexcom

5. Keep It Clean

Avoid applying lotion to the adhesive, it will only saturate and soften up the material causing it to start to peel. Also, this time of year be conscious of where you apply your suntan lotion, this will also lessen the life of your sensor and additional adhesive if you have one on.

6. Be Cautious

No matter where you decide to place your sensor, there will be nuances that come with it. For me, being aware of its placement on my thigh has become second nature and I rarely have issues with ripping it off. The more aware you are, the better.

Getting the most life of your sensor means fewer insertions and more cost savings. Taking a few simple measures can make a huge difference for your sensor life!

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Have you found any other creative ways or have any tips to share on how to extend the life of your sensor? Please comment and share below!

Source: diabetesdaily.com

What’s Coming and What’s Delayed in Continuous Glucose Monitoring?

This content originally appeared on diaTribe. Republished with permission.

By Albert Cai

Updates and delays from Abbott, Dexcom, Medtronic, and Senseonics

With several clinical trials on hold due to the COVID-19 pandemic, we’re bringing you a roundup of the latest updates on future continuous glucose monitors (CGM). Understandably, the FDA also announced a few months ago that it would focus its efforts on devices related to COVID-19. With the disclaimer that it’s impossible to know exactly when the pandemic will subside, when trials might resume, and how FDA reviews might be affected, here is the latest news we’ve heard from companies.

Click to jump to a product, which are organized alphabetically.

Abbott FreeStyle Libre 2

CGM

Image source: Abbott FreeStyle

What’s new? FreeStyle Libre 2 keeps the same “scanning” feature as the original FreeStyle Libre, but adds Bluetooth connectivity. This is important because it enables optional high and low glucose alerts. Users who enable these alerts will be able to get a notification on their reader or phone whenever their glucose reading goes above or below their specified ranges. Looking ahead, the Bluetooth feature will also allow FreeStyle Libre 2 to be part of automated insulin delivery systems (AID), like Insulet’s Omnipod Horizon.

Like the original FreeStyle Libre, FreeStyle Libre 2 has 14-day wear, is factory-calibrated (no fingerstick calibrations required), and can be scanned with either a phone or a reader device (the reader for FreeStyle Libre 2 is blue, instead of black). Importantly, FreeStyle Libre 2 will be offered at the same price as the original FreeStyle Libre.

When’s it coming? The FreeStyle Libre 2 has already launched in a few European countries (we know of Germany and Norway) and will launch in others soon. In the US, FreeStyle Libre 2 has been under FDA review for over a year. In March, Abbott said that it was working through “some finishing items” and was “very confident” the device would be cleared soon.

Dexcom G7

Dexcom

Image source: Dexcom

What’s new? Dexcom’s G7 will be fully disposable (the transmitter and sensor are combined and thrown away together) and have longer wear (we believe somewhere around 14-16 days). Remember that the Dexcom G6 sensor lasts for 10 days but has a transmitter that is re-used for 90 days. The G7 will be considerably slimmer than G6 and will have a lower cost of manufacturing in bulk, though consumer pricing is not yet determined – we imagine it will be similar. The G7 will keep the same accuracy, no fingerstick calibrations, and Bluetooth connectivity as the G6.

Dexcom has been developing G7 in partnership with Verily, the division of Alphabet formerly known as Google Life Sciences. There has been mention from Verily that an accelerometer may also be built-in to the G7 device, but we aren’t sure if that feature made it into the final version of G7. Having a built-in accelerometer could allow the G7 to also track physical activity, like a Fitbit or other fitness tracker.

When’s it coming? Dexcom planned on launching G7 in “early 2021,” but with most clinics placing new trials on hold, Dexcom is expecting a “minimum delay of approximately six months.” It’s difficult to know when clinics will be able to conduct trials (and when people will feel comfortable enrolling in trials), but assuming a six-month delay, G7 could be on the US market sometime in the second half of 2021.

Medtronic “Project Zeus” CGM

Abbott FreeStyle

Image source: Medtronic

What’s new? Medtronic’s next CGM, referred to as “Project Zeus,” will reduce the number of required fingerstick calibrations and have improved accuracy (compared to its current offering, Guardian Sensor 3). The new CGM will require day-one calibration (unclear on the number of fingersticks that will be required on day one), compared to Guardian Sensor 3, which requires at least two fingerstick calibrations every day. Medtronic expects Project Zeus to launch with a “non-adjunctive” indication, meaning users will be able to bolus insulin based on CGM reading alone, and not have to perform a confirmatory fingerstick. the new CGM will keep the same seven-day wear, size and shape, and reusable transmitter component as the Guardian Sensor 3 (pictured above).

When’s it coming? The trial for Project Zeus began in June 2019 and is expected to wrap up within the next month. Medtronic expects to submit the CGM to the FDA by the “end of the summer.”

Senseonics Eversense XL (180-day)

Eversense XL

Image source: Eversense XL

What’s new? The “XL” extended life-version of Senseonics’ Eversense in the U.S. will have the same size and features as the original Eversense, but the Eversense XL is implanted for 180 days, rather than the 90-day Eversense. As a reminder, the Eversense sensor is implanted in the users’ upper arm in a clinic and remains there for the sensor duration; a silver-dollar sized on-body transmitter is worn on the outside of the arm to deliver readings to a smartphone. Senseonics is targeting reducing calibrations from 2 per day to 1 per day with same non-adjunctive indication.

When’s it coming? Eversense XL is already available in Senseonics’ European markets. The trial for Eversense XL in the US wrapped up in late March, and Senseonics has previously aimed for FDA clearance in “late” 2020. We aren’t sure whether that timeline has been pushed back due to COVID-19, but the fact that the trial has already completed is encouraging.

Source: diabetesdaily.com

A D-Mom’s Changed Perspective Using Basal IQ

Technology continues to make managing our diabetes easier. Continuous glucose monitors, apps for carb counting and insulin pumps have all alleviated some of the stress of managing our condition. Tandem Diabetes created Basal IQ technology, which allows us to spend less time worrying about going low and let our devices do the work. For a person living with diabetes, this means less stress and more sleep.

Basal IQ technology helps reduce the frequency and duration of lows by predicting glucose levels and suspending insulin if the blood sugar level is thought to go below 80 mg/dL or the Dexcom reading goes below 70 mg/dL. Insulin delivery will start automatically once the blood glucose starts to rise again.

Basal IQ is different than the newly released Control IQ, in that Control IQ can adjust insulin delivery, including the delivery of automatic correction boluses as needed, therefore helping patients avoid episodes of hyperglycemia. Using either one of these systems also means fewer fingerpricks, as you will no longer have to get manually take your blood glucose reading.

Basal IQ technology has given many people living with diabetes, and those who love them, a little more rest and some peace of mind. A pivotal study showed the use of Basal-IQ Technology on the t:slim X2 Insulin Pump demonstrated a 31% relative reduction in time spent below 70 mg/dL when compared with a CGM-enabled pump without Basal-IQ Technology. Important to note, the less amount of time spent at lower glucose levels did not mean more time spent at higher glucose levels. Maintaining your target range has become a lot easier thanks to Basal IQ technology.

Photo credit: Allison Hoffman

One woman, Allison Hoffman, who helps manage her 10-year-old daughter, Becca’s diabetes, raved about the changes to her overall well-being since switching over to Basal IQ technology after relying on Omnipod for the past few years.

Here is her story:

For 7 years my mornings were absolute hell. While I would see others sleeping in, meditating, going to the gym, etc, I was a slave to Becca’s whackadoodle blood sugar swings, which would often start around 5:00 AM. My body learned to wake up at this time, and that I doubt I’ll ever be able to change.

My mornings would include me running up and down the stairs entering the bedroom, praying I wouldn’t wake her and deny her the right to sleep in, suspending insulin (audible beep I couldn’t silence), sticking glucose tabs in her mouth, often with the pay-off of a horrible blood sugar spike. I would start 95% of my days this way.

And the frustration! No adjustments to her settings were right. If I reduced her insulin she’d go high; .35 too low, .4 too high. I would wake up at 3:00 am to set a temp basal to get the amount she needed that Omnipod didn’t have as a preset-still wouldn’t work. Nothing I did was right.

Since starting on t:slim pump with basal IQ, I finally have my mornings back. It allows more fine-tuned insulin delivery and suspends when it predicts her to go low. As long as her sensor is good, and her insulin settings aren’t way off (I will always need to determine her insulin needs, it isn’t automatic), I can have a pretty peaceful morning now.

I can watch the news, or another show, or read, and my coffee doesn’t go cold. I can sit with my dog on my lap and not have to jump up every ten minutes to go deal with diabetes. I can breathe. And Becca can sleep peacefully.

I’ve made four seesaw activities for my students this morning and she’s still sleeping.

7 years of hell. I finally have my mornings back.

If you are living with type 1 diabetes and are considering a pump, you may want to look into t:slim X2 pump along with the Dexcom G6 so you can make use of the new Basal IQ or Control IQ technology. Their slogan is “live more and worry less” and I am so glad this seems to be the case for so many.

Have you tried out this technology? How has your experience been?

Source: diabetesdaily.com

How to Extend the Dexcom G6 Sensor Beyond the Ten Day Hard Stop

Some clever technologists have discovered how to restart a Dexcom sensor to extend its life beyond ten days. The process works by exploiting a bug in the sensor pairing process.

Katie DiSimone walked us through the process. Katie is involved in the community of people who are building homemade automated insulin delivery systems using current insulin pumps and continuous glucose meters. Since the original article was written, Katie has joined the Tidepool organization which is dedicated to making diabetes data more accessible, actionable, and meaningful for people with diabetes, their caretakers and for researchers as well.

Since our last update, new transmitters have been released. These newer models are more stubborn and are more challenging to “hack”. The specific transmitter ID  will dictate which restart sensor method you should use.

Please see Katie’s instructions to determine which is the preferred method for your transmitter ID.

The method that seems to be working amongst the diabetes online community (and myself; I currently have the transmitter starting with “8G”) is the “pop-out method.” This means you need to physically pop out the transmitter, which can be a little tricky but doable. Here is a video on how to do it, I have had luck with an old credit card.

For this method you will need to:

  • Stop session (it does not matter if the sensor expires on its own first or not)
  • Pop out the transmitter (Some people cover the site during the 30 min period or even insert an old transmitter to prevent stuff from getting in there/ also the wire moving, as the transmitter holds it in place)
  • Set a timer for 30 minutes (I’ve heard that 15-20 minutes works, but have not tried this)
  • Pop the transmitter back in
  • Restart the sensor (make sure to save the previously used code; I snap a picture of it so this way you will not have to calibrate)

There are instructions on how to restart the sensor using the receiver so that you continue to receive current glucose values throughout the 2-hour wait. Here are the instructions on how to do so.

Caveats

The Dexcom G6 has not been tested or approved by the FDA for restarting sensors. There is no guarantee of sensor accuracy. Extend the sensor life only at your own risk.

A previous version of this post has been updated.

Source: diabetesdaily.com

COVID-19: Jessica’s Senior Year Comes to a Halt

The COVID-19 pandemic is affecting everyone, and high school seniors, in particular. Allison talked to one student about her perspectives.

Hi Jessica, thank you so much for taking the time to talk to me. The COVID-19 pandemic has left us all in fear, especially for those who are elderly or have pre-existing conditions. Knowing that we fit this demographic adds an extra layer to this difficult time.  

I know you are a senior in high school and the class of 2020 really has an interesting story. You were born into the world during the time our country was attacked on 9/11, and you’ve experienced life in a “comeback mode” (financially, mentally and emotionally) which likely made you all stronger and more resilient watching the world rebuild.

I’d imagine you’ve worked your whole life to get to this point and you were looking forward to this special year. Thank you for taking the time to talk to us about your feelings as many are trying to digest their emotions and figure out how to articulate, process and express them. 

How long have you been living with type 1 diabetes?

I have been living with type 1 diabetes for 10 1/2 years.

Did your diagnosis help shape you as a student? Did it make you more organized? Responsible?

As I was diagnosed at such a young age, 7 years old, I had to grow up faster than most kids. I learned how to be more responsible and independent at a young age which I believe has helped prepare me in unique ways for the future as I go off on my own. Living with and managing type one diabetes is a 24/7 job that constantly requires my attention and maintenance. Having to deal with all of this has greatly helped shape me as a student, as I have to be organized, responsible, and meticulous with my diabetes, just like with school work and deadlines. I’ve learned to take responsibility for my own actions and to stick up for myself.

When you heard the virus was picking up speed, what were your first thoughts? Fears? How did you prepare for staying at home? 

The first thoughts I had when I heard about the coronavirus were all about my diabetes and the higher risk I am at. I was constantly worried that I would be exposed at school or in other public outings. I feared how I could possibly manage the disease if I got it, and on top of that having to deal with my diabetes and the effect it would have on me. When the Stay at Home Order was passed, my family and I made sure we had all the necessary diabetes supplies, including insulin, blood glucose meters and strips, lancets, ketone meters, etc. We didn’t know how long we’d be stuck at home so we wanted to be prepared.

Many people have found their blood sugars all over the place amidst the crisis, what do you do to stay on top of your management during this challenging time? 

Not being able to go anywhere has really given me some extra time. With this time, I have now started to workout every day, which has greatly helped my blood sugar levels. Also, now that I have so much time, I can give more attention to my diabetes and be more consistent with looking at my Dexcom and correcting my highs, even the ones that are hardly above goal. I have found this to greatly help my A1c levels.

Photo credit: Jessica Oser

I know senior year comes with a lot of well-deserved celebrations. What are you most upset about? 

There are many things that I am upset about missing this year. For one, prom and graduation were both canceled. I did not get a junior prom, so this would have been the only prom I’d get to go to. Also, I was looking forward to graduation with my class and celebrating with friends and family after a lifetime’s worth of hard work. Also, I am upset that we had our last day of high school without knowing it. I didn’t get to say a proper goodbye to friends and teachers.

At this time of year, seniors are typically celebrating their college decisions and looking forward to a stress-free rest of the year. How did this impact that carefree feeling that you’ve probably looked forward to for so long?

The coronavirus has lasted longer than what some people have thought, so now my college orientation has been switched to online. I was looking forward to meeting people and potentially making some friends before the semester started. I was also looking forward to walking around campus more and getting acclimated to the campus and how things work. Also, now that the rest of the school year is online, things have been getting confusing for how they will transfer over to colleges, which just causes more stress for students.

There is no doubt that the Class of 2020 has experienced a lot in their short lifetime. You were born into the world the year of 9/11/2001 and now we are facing a global pandemic. This has to help define each of your characters. How do you feel it has impacted you as a person and your perspective on life?

I believe that having to go through so much and surviving it every time has made us stronger and more perseverant. We continue to get back up and live life to the fullest both during the hard times and once the hard times are over. I believe it’s taught us to have a more positive attitude and outlook in life.

Photo credit: Jessica Oser

Has COVID-19 impacted any of your plans academically and/or career-wise?

Some colleges are switching to online for the first semester. This has not happened for my college yet, but we are still waiting. If it does, we will be robbed of the excitement of the start of our first year at college.

If you had one silver lining to come out of COVID-19 what would that be?

While times right now can seem very dark, I believe that there are a few tiny silver linings that can be found. For one, while it was horrible not being able to have a proper goodbye to friends and teachers, I also view it as better, because we didn’t have to go through the emotional pain of seeing everybody for the last time, as we didn’t know it was the last time. Also, we now have extra time to focus on our personal well-being and spend time with family. I believe that this virus will bring our generation closer together.

How do you personally deal with stress and grieving all the things that COVID-19 has taken from you this year? How do you recommend people express their emotions?

As I mentioned previously, I have started to workout every day. This has always helped me deal with my mental health and now that everybody has the time, I strongly recommend that they do the same. Also, whenever I find myself going through a chain of thoughts that could lead to anxiety, I distract myself right away or I switch around my thinking and try to live day by day instead of viewing everything all at once. Thinking about things one step at a time majorly helps and keeps you from getting overwhelmed. Lastly, expressing emotions through journaling can really help too. You can get everything out and off your chest and view it as forgotten and trapped in your journal.

Photo credit: Jessica Oser

In what major way do you feel this pandemic will change the course of lives of your generation unequivocally and across the board?

I think that living through this pandemic will make our generation stronger and more wise. We’re going to live through it and see that everything will be ok, even if it doesn’t seem like it now. So, in the future, if something horrible happens again, we will have had the experience of making it through the hard times and coming out even stronger. We’ll know that everything will be ok, and that knowledge and experience can help us in the future when other hard times occur, as we know we’ll make it through those times too.

If you had one message to say to your fellow classmates of 2020, what would you say?

This too shall pass. We all have to stay strong and know that this won’t last forever. There are more fun times ahead that we’ll get to go through together and they’ll be even sweeter. This will all be nothing but a memory soon.

Thanks so much for taking the time to speak with me! I wish you and your family nothing but good health and happiness. And I know you will do great things with your future once this is behind us!

Source: diabetesdaily.com

Pump Peelz Does Their Part and Creates Intubation Boxes

We spoke to the founders of Pump Peelz, about the COVID-19 pandemic and important work they’re doing to help.

Hi Scott, thank you so much for taking the time to talk to me. The COVID-19 pandemic has left us all in fear, especially for those who are elderly or have pre-existing conditions. Knowing that we, or someone we love, fits this demographic adds an extra layer to this difficult time.  It is more important than ever to come together and help each other through these uncertain times.

I know you and your wife Emily started Pump Peelz in 2011 with the goal of creating adhesives to help empower people living with diabetes to express themselves and to feel confident in their ability to manage their disease. I know the diabetes community thanks you, and I now wear my Dexcom loud and proud!

How long has your wife Emily been living with type 1 diabetes?

She just celebrated her 10th diaversary in January!

What prompted you to start on this venture of creating adhesives for our community?

Emily was diagnosed while we were both in college. We were taking a few graphic design courses and noticed that at that time there were no graphics, skins, or adhesives for insulin pumps or CGM’s. We took it on as a class project really… and slowly built the business at night for the first few years before taking on Peelz full time and purchasing our own equipment at a specialized facility.

When you heard the virus was picking up speed, what were your first thoughts? Fears? How did you prepare for staying at home?

Emily read to our son, Oliver’s, preschool class for their “Reading Month’ on March 12 and almost immediately after class, the virus started making headlines in our area. We actually had discussed possibly keeping him home for a little while and talking to the teachers to keep us healthy at home. But later that day, his school became canceled indefinitely anyway. I think we have the same fears and concerns as everyone… Our initial fear was for Emily being immunocompromised but we decided to self-quarantine for the past month to keep her and our family safe. We have groceries delivered, we have only one person at the office at a time, and are really keeping busy at home with our 3 year old.

Being that Emily falls under high risk, what extra precautions have you taken? 

She really hasn’t gone anywhere since March 12. We take drives and will go for walks in the park and our neighborhood. We mostly have groceries delivered or I will go by myself with my facemask and gloves… I also keep sanitizer in the car. Our office is stocked with Lysol and cleaning supplies to keep all surfaces clean.

Being that you are a small business, how has COVID-19 affected your business so far?

We’ve tried to find different uses for our machinery to try and help a local medical facility. It has given us an opportunity to be more creative and experiment for the better good. Our main business struggle at the moment is simply keeping up while maintaining social distancing and keep our priority on everyone staying healthy. We’re being open and upfront on our website to let people know that during this time, it’s taking us a little longer to produce products.

An intubation box allows doctors and nurses to safely intubate COVID-19 patients | Photo credit: Pump Peelz

How did your local hospital find you? Did they know that you would have the equipment necessary to create intubation boxes?

I knew right away that our facility has capabilities beyond what we normally manufacture. I started early on reaching out to our friends in the medical field to let them know that we have the capability of making masks, cutting materials for face shields, or anything else that might come up. It just so happened that our local hospital system heard this and asked us to make an intubation box for their ICU which they currently have in place.

I am sure you have been extremely stressed about the pandemic, what were your initial thoughts about taking on this task?

I try not to stress too much about things I can’t control. This was one thing that was asked of us that I knew we had the capability to produce and something that we could control to help.

It is so amazing that you quickly learned how to create such a necessary and urgently needed product. How exactly were you able to design and produce it?

We launched our Patch+ product late last year which was the most challenging product for us to produce. We had to purchase new equipment, have software designed, and create processes to rapidly prototype and get products out quickly and efficiently. Because we just made it through this project I felt that I understood our machinery enough to know that this task was possible. I quickly found a website called intubationbox.com that had the assembly instructions… I simply modified their steps so that our laser cutter could easily cut out the pieces like a puzzle. Once I figured it out, I saved those files because I thought someone else could also use them.

It looks like you have been sharing this information on social media and hoping that others follow suit and do their part. Where can people find information on how to create intubation boxes?

Go to intubationbox.com and there is a material list sheet of things you can pick up at Home Depot or Lowe’s. You can email me directly at scott@pumppeelz.com and I can send our vector files to anyone that wants them. They can also follow the instructions and use normal hand tools to produce these. I also recommend talking to your local print shop or sign show to see if they could use our files to cut the acrylic sheets.

Ear relief straps for healthcare workers. These go behind your head and hook onto the straps of a mask rather than the straps rubbing the back of your ears. | Photo credit: Pump Peelz

I must say seeing your post about how you are helping out during this time of need was such a ray of sunshine on what seems to be the longest gloomiest day in a long time. How does it feel knowing that you are helping save lives?

That was really nice of you to say that. We can all pitch in just a little to do something bigger than ourselves. That can be simply staying at home to ‘slow the spread’ or it can be offering your sewing services to make masks, offering a 3D printer at a school to make face shields, or building a box. We all have little talents or things that we can do to help each other… this just happened to be ours.

Going forward we are taking the remaining materials from our boxes to make Mask Relief Straps to take the pressure off of the ears of nurses and doctors who are wearing them all day long. You can look up photos on Google to see what I’m talking about!

Thank you so much for taking the time to talk to me. I know personally, I thank you guys every time I can get more life out of my Dexcom thanks to your adhesives, but now you are truly heroes!

Source: diabetesdaily.com

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