How to Handle Halloween for Children with Diabetes

It’s that time of year again: the leaves are falling, the temperatures are dropping, and all things scary and spooky are on store shelves. While pumpkin picking and catching a hay ride are (for all intents and purposes) “low carbohydrate” activities, trick-or-treating can be anything but. So, how do you handle Halloween with a young child with diabetes? Do you allow them to “be a kid” for an evening, and go all out on the chocolate and sugar spike? Or do you limit them to a few, portion-controlled treats, with a food scale nearby? While there’s no one right answer to this question, here are some helpful tips to make your Halloween a little less spooky this year.

Take the Focus Away from Food

This is helpful for all children, for all holidays. No holiday needs to be 100% about the food, especially for a child with diabetes. For Halloween specifically, focus on carving pumpkins, watching scary movies, dressing up in really elaborate Halloween costumes, and yes, if you and your child wish, some candy, too.

Noelle from California says, “Our kiddo is three so our main focus is on creating traditions that will be helpful for her later on with type 1. For parties, I create treats that aren’t food-related.”

Lila from New York City says, “We completely avoid the candy thing. Trick or treating isn’t a huge deal in our neighborhood, so this hasn’t been an issue yet.”

Kate, from Pennsylvania, says, “We go out a little, but limit the number of stops. After we get home, we go through our candy, keeping only what we really, really like. The rest, we give to the Switch Witch, and she brings the girls a little present in the morning as an exchange for giving her their candy.” There’s even a book you can buy that helps explain the magic of the Switch Witch.

Create Unique Traditions

Perhaps you have a spooky, scary dance party or movie night on Halloween, or the whole family dresses up in matching costumes to go walking around the neighborhood. Maybe you bob for apples or roast pumpkin seeds after carving, or let your child have a few friends sleepover. Creating unique family traditions that are inclusive will be beneficial not only for your child now, but will be helpful as they grow up with type 1 diabetes.

Be Wary About Restrictions

Be cognizant about putting too many restrictions on candy for your child. Children with diabetes are much more likely to develop an unhealthy relationship with food. If your child really wants to indulge, just make sure they’re carbohydrate counting appropriately, and let them enjoy themselves (within moderation, of course). Most of the time children intuitively eat anyway, and don’t actually end up eating that much candy.

Melissa, from Iowa, says, “We bring any candy home and carb count it ahead of time, and then put a post-it note on each piece, so our daughter can dose appropriately whenever she’s hungry or wants a treat.”

Plan Ahead

Like all things diabetes-related, it helps to plan ahead. Make sure your child eats dinner with some protein and fat before going trick-or-treating, so they’re not just eating sugar on an empty stomach, which can cause the roller coaster effect. Make sure you know where and how far they’ll be walking, or better yet, walk along with them. Have your child carry low snacks (they shouldn’t solely rely on candy that won’t have any nutrition facts or carbohydrate information on it), and make sure they’re drinking plenty of water. It’s helpful if your child also has fresh continuous glucose monitor (CGM) and insulin pump sites on, but not absolutely necessary.

Hannah says, “Planning ahead a learning to navigate holidays with type 1 diabetes is critical and so empowering once you find what works for you and your family.”

Don’t Stress the Small Stuff!

It’s important to remember that Halloween is only one night, and you shouldn’t stress the small stuff. Some parents of children with diabetes shy away from candy, while others let them indulge, and there is no one right answer. Do what works for you and your family, but don’t let the stress of one holiday ruin the evening for you and your child. Relax and let them have fun! They’ll be doing so much running around anyway that you’ll be glad they had the extra “low snacks” on them anyway.

Lija, from Minnesota, says, “We don’t do anything different for my type 1 and non-type 1, and it works out fine. We find that she tends to go low while out trick or treating, so she just eats and boluses a little while out; it isn’t actually a difficult holiday for us!”

The key is finding what works for you. There are no right or wrong answers. Here’s to a happy, spooky Halloween! Hopefully the candy (and subsequent blood sugars) are the least scary part.

How do you and your family handle Halloween in a household affected by diabetes? What tactics and strategies have helped you manage appropriately? Share your experience in the comment section below; we love hearing from our readers!

Source: diabetesdaily.com

Zoning in on Sick Day Management: Practical Tips, Strategies, and Advice

By Dr. Francine Kaufman

Pediatric endocrinologist Dr. Fran Kaufman shares tips for managing illness and diabetes: make a sick day plan, have supplies on hand, log your data, modify your insulin doses, and call your healthcare team. 

Everyone with diabetes who takes insulin needs to have a sick day plan. This is something you develop with your healthcare professional to help you manage the high and low sugar levels that can be associated with an illness. The following advice applies to people with type 1 diabetes and people with type 2 diabetes who take insulin – the advice may be different if you have type 2 diabetes and do not take insulin.

Click to jump down to a section:

When you get sick, you are at risk of becoming dehydrated from poor intake or from excessive loss of fluids due to nausea, vomiting, diarrhea, and fever (your body may lose more water when you have a high temperature). In addition, dehydration is common in diabetes because high glucose levels (above 180-200 mg/dL) cause sugar to enter your urine, dragging an excess amount of fluid with it. Illness also puts you at risk of developing ketones, which when coupled with high glucose levels can lead to diabetic ketoacidosis (DKA), a very serious condition. How do you know if you have ketones? Good question, click here!

The purpose of your sick day plan is to try to keep your glucose levels in a safe range – to avoid dehydration and to prevent ketones from rising to a dangerous level. When you get sick, you should contact your healthcare team to describe your symptoms, determine if they want to evaluate you or send you to a lab (for testing), and most important, to share the numbers that you will collect as you fill in your sick day log (more on this below). It is possible that no matter what you do, you might need to go to an emergency department or be hospitalized – but acting quickly, obtaining the right data, and doing your best to manage your glucose and hydration will minimize risks.

So what illnesses are we talking about? It turns out just about any common bacterial or viral infection – such as the flu (influenza), a cold (upper respiratory virus), tonsillitis, strep throat, an ear infection, stomach flu (gastroenteritis), a bladder infection, and even a skin infection, such as an abscess – can interfere with your diabetes management. However, right now, the greatest concern is COVID-19. An infection with COVID-19 can lead to very high glucose and ketone levels, putting someone at risk for DKA. Acting quickly to start your sick day plan, even if you end up needing to be hospitalized, is important.

When you get sick, your body needs energy to fight the infection and repair damaged tissue. The infections listed above, particularly those that lead to vomiting, diarrhea, fever, and dehydration, cause your body to release certain hormones (called stress or counterregulatory hormones) that tell your liver to release stored glucose and tell your fat cells to release free fatty acids that form ketones. In someone without diabetes, the body releases more insulin to control the rise in glucose and ketones; because you have diabetes, you have to take additional insulin to manage the high glucose and ketone levels. You want to get your sugar levels between 100-180 mg/dL. Blood sugars below 180 mg/dL will prevent excess urination that can dehydrate your body. Staying above 100 mg/dL helps keep you from dipping too low and risking severe hypoglycemia.

If your glucose level is above 180 mg/dL, you need to consider increasing basal insulin doses, using an increase in basal insulin with the temp basal feature on your insulin pump, or giving repeated corrections of bolus insulin with a syringe, pen or pump. Usually, correction doses should not be given more often than every two to three hours to avoid “stacking” insulin, which could lead to low blood sugars. By having a plan for illnesses that starts your modified care early and by keeping in touch with your healthcare team, you are more likely to keep your glucose values in the 100-180 mg/dL range.

But you also have to be concerned about hypoglycemia. Low sugar occurs, particularly in children and the elderly, if the illness affects calorie and carbohydrate intake by decreasing appetite or by causing vomiting or diarrhea. Although low glucose is usually considered to be less than 70 mg/dL, during illness there is concern if glucose levels are below 100 mg/dL. If your infection or illness leads to low glucose levels, reducing basal insulin and not taking bolus insulin doses should be considered. If suspension of insulin is required, you should not suspend or delay taking the next dose of basal insulin for more than 60 minutes, because this increases your risk of developing ketones. Start sipping a sugar-containing drink, one tablespoon at a time. If hypoglycemia continues and you cannot make it better by ingesting sugar, consider the administration of low-dose glucagon. Low-dose glucagon can increase glucose level by 50-200 mg/dL in 30 minutes. To learn about whether low-dose glucagon is right for you, and at what dose, talk with your healthcare team.

To follow what is happening in your body, it helps to start a log of your glucose levels, ketones, fluid intake, and insulin doses. This sick log can be shared with your health care team. It should show improvement from one time period to the next (see below). Note: the biggest concern is vomiting; if you vomit more than twice in a time period or across two time periods, call your healthcare team.

The log shows only two days, because you should be better after 24 hours and completely on the mend after 48 hours. If you are not getting better, call your healthcare team.

Table

Image source: diaTribe

Here’s how to keep track (and why to keep track!) of these important numbers:

1. Glucose Levels: Check glucose levels every 1-2 hours. You may have to change this and check your glucose every 30 minutes if your levels are changing quickly. CGM trend data should be looked at every 10-15 minutes. Watch for rapid changes by looking at numbers and arrows. The goal is to keep your glucose between 100-180 mg/dL and without wide swings in values.

2. Ketone Levels: Urine ketones are often detected using a urine ketone strip. A small patch on the strip changes color depending on your level of ketones, representing negative, small, moderate, large and very large levels of ketones. Moderate, large, and very large levels are of concern. Ketones can also be measured with a fingerstick and a special ketone meter. The readings for blood ketones are more accurate and range from 0.0 to 3.0 mmol/L or greater. Blood ketone levels below 0.6 mmol/L are considered normal. Between 0.6 and 1.5 mmol/L ketones are high and show that your fat has broken down to form excess ketones. This puts you at risk of DKA if glucose levels are also elevated. Ketone levels above 1.5 mmol/L are serious, and you should contact your healthcare professional. Signs of elevated ketones:

  • Nausea and vomiting (which may also be present because of the infection)
  • Shortness of breath and labored breathing (your body is trying to eliminate the ketones through your breath so you can also smell them, they make your breath smell fruity)
  • Weakness
  • Altered level of consciousness and trouble staying awake (this is most concerning; call your healthcare professional immediately if this is happening)

Ketones should be tested at the onset of an illness and then every four hours.  If ketone and glucose levels are both elevated, your healthcare team might advise you to increase correction insulin doses further, by an additional 10-15%. If ketone levels are high and glucose levels are not high (less than 150 mg/dL), oral glucose and some insulin – reduced by about 50% – will help clear your ketones. Drinking water will also help reduce ketones as they are removed in the urine. To learn more about ketones, including what they are and how to measure them, click here.

3. Temperature: High fever can help show the severity of your illness, particularly if it is persistent.  We have learned that COVID-19 is associated with persistent high fever. Use the log sheet to document any medications you take to lower fever so that you can report this to your healthcare team.

4. Fluid Intake, with and without Sugar: Consuming liquids is critical if there is risk of dehydration. Fluids with sugar should be taken if glucose levels are between 100-150 mg/dL, and fluids without sugar should be taken if glucose levels are between 150-180 mg/dL. If you have vomited, wait 30-60 minutes before trying to drink, and then start with teaspoons of water or ice chips, progressing to tablespoons and ounces. The goal is to retain 4-6 ounces of fluids (or 2-4 ounces for young children) every 30-60 minutes until you can drink without risk of vomiting and as your thirst dictates. Food is much less important after vomiting; don’t try to eat food until you are on the mend.

5. Urination: Noting frequency and amount (small, medium, or large) is important to understand the ongoing risk of dehydration. As glucose levels reach the target of 100-180 mg/dL, you should see a decrease in both frequency and amount of urination, as well as less dehydration.

6. Vomiting, Diarrhea and Dehydration:  Vomiting and diarrhea can lead to dehydration. The signs of dehydration include dry mouth, sunken eyes, weakness, loose skin, rapid heart rate, and low blood pressure. Vomiting is also of great concern because it occurs not only from the illness, but as a result of DKA. That’s why vomiting that occurs throughout one time period or spans two time periods in your log means it is time to call your healthcare professional.  However, if you feel weak after vomiting only once or twice, it is always better to call earlier than later.

7.  Insulin, Amount and Time: One of the most important things to remember is that during an illness, you still need to take insulin. Even if you are not eating or drinking at the beginning, you need to have insulin in your body. Insulin allows sugar to enter your body’s cells to be used for energy, and you need more energy to fight off an illness. Insulin also reduces ketone formation and stops excess urination by lowering glucose levels. If you have high glucose, you might need 25-50% more insulin than you usually take, due to insulin resistance created by the extra stress or counterregulatory hormones in your body. If you have low glucose, you might need to take 25-50% less insulin than you usually take, but you still need some basal or background insulin on board.

8. Medications: At the beginning of an illness, you should consider calling your healthcare team to determine if you should avoid taking any of your routine medications while sick. This includes glucose-lowering pills or injections, such as SGLT-2 and GLP-1 drugs, or medications for blood pressure and cholesterol. In addition, it is important to write down any medications you take (name, dosage, time) to treat fever, vomiting, diarrhea, or other symptoms of your illness. Anti-vomiting medications may be helpful but should only be taken after discussing with your healthcare professional.

Key Messages:  

  • Know your sick day plan before you become sick.
  • Have supplies on hand. These include supplies to measure glucose, a way to measure ketones, a thermometer, sugar-containing fluids, glucagon, extra-rapid (or short) acting insulin, and medication to treat fever. Discuss with your healthcare team whether you should have medication for diarrhea and vomiting on hand.
  • Have all the contact information for your healthcare team available, and call them sooner rather than later.
  • Before you call your healthcare team, have the data listed on your log sheet written down, plus your symptoms.
  • Take insulin at modified doses to address both high and low glucose levels. You still need to have some insulin in your body, even if you are not eating.
  • Let someone help you while you are ill. It is too big a job to be done alone.

About Fran

Dr. Fran Kaufman is the Chief Medical Officer of Senseonics, Inc. She is a Distinguished Professor Emerita of Pediatrics and Communications at the Keck School of Medicine and the Annenberg School of Communications at the University of Southern California.

Source: diabetesdaily.com

Tackling Carbs with Tech

Many people who live with diabetes avidly avoid eating carbohydrates, as historically speaking, it has been notoriously difficult to cover carbohydrates appropriately with exogenous insulins. But with access to better, faster insulins and the uptick in the use of patient-friendly technology, things are changing, and people’s diets (and their feelings of freedom) have expanded more than ever. Here are the best tech-friendly hacks to tackle the carbohydrate conundrum.

MyNetDiary

This popular app has a searchable database with nearly a million food entries for people to access and look up carbohydrate counts on the go. The company also has a separate Diabetes app that allows users to track blood glucose levels, HbA1c results, and insulin doses, to track their progress over time. If you’re looking to lose weight, MyNetDiary can create a diet plan to meet your needs. You never have to feel restricted when eating meals with family or friends, having all your carbohydrate counting needs right at your fingertips.

Photo credit: GreaterGoods

GreaterGoods Nourish Digital Scale

This food scale is a game changer for those who cook with lots of fresh produce, where carbohydrate counts can vary quite a bit. This scale lets the user view nutrition facts for over 2,000 foods in the scale’s built-in database, and create up to 99 more custom entries. Measure individual ingredients, track full meals, and calculate daily carbohydrate intake much easier with this digital scale.

InPen

This revolutionary device is the only FDA-approved smart pen insulin system that helps prevent users from “stacking” their insulin doses and take the right amount of insulin at the right time. This device works in tandem with a phone app, where users can track insulin on board/active insulin, personalize your doses, sync with continuous glucose monitor (CGM) or glucometer data, and share reports with others. The pen itself is compatible with Humalog, Novolog, and Fiasp, and will even dose in half units. Eating carbohydrates has traditionally been much harder on multiple daily injections, but advancements such as the InPen are making strides to make life much easier for people with diabetes.

Use Alternative Pump Boluses

If you are an insulin pump user, dosing for a high carbohydrate meal can also be difficult, especially if the meal also has a moderate amount of protein and fat (which can delay the absorption of the glucose in the meal). To handle that, try opting for a combination bolus (a.k.a. Combo Bolus or Dual Wave Bolus,  for Animas or Medtronic users, respectively; Omnipod, Tandem t:slim users will use “Extended Bolus”). This is a hybrid delivery mode: a specified portion of the total insulin bolus is delivered upfront, as a normal bolus, while the rest is delivered over a specified period of time as an extended/square wave bolus.

For example, given a 12U dose delivered as a 60/40 combination/square wave bolus over 3 hours: 60% of the total dose (7.2U) will be delivered within seconds of pressing the “deliver” button; the remaining 40% (4.8U) will be delivered equally every few minutes over the next three hours. The result is an initial dose to cover faster-digesting foods, plus an extended amount of insulin action to deal with the slower-digesting foods (which tend to be fattier or have more protein), and to prevent postprandial spikes in blood glucose. Utilizing these settings can be extremely helpful when you’re eating foods like pizza, pasta, Chinese food, Mexican food, or ice cream. Always consult with your diabetes healthcare provider before making any changes to your dosing routine.

Dexcom CLARITY Diabetes Management Software

Photo credit: Dexcom

Dexcom Clarity App

This software can be helpful for patients already using the Dexcom continuous glucose monitoring system, but are wanting to track and change problematic patterns in their blood glucose. This app lets you set target goals for your blood sugars, will track time-in-range, detects patterns of highs and lows and will alert you to them, and will even give the user a predicted HbA1c result. You can also choose to share your data with your health clinic to make changes to your insulin routine or insulin to carbohydrate ratio in real time, and to really find what will work best for you for optimal management.

Living with diabetes is never easy, but thankfully technology has made counting carbohydrates and eating easier than ever before. What apps or tech has helped you to navigate food, eating, and counting carbohydrates? What’s worked best and what hasn’t? Share this post and comment below; we love hearing from our readers!

Source: diabetesdaily.com

Advocating for Better Care in the Hospital

Most everyone knows that landing yourself in the hospital with diabetes can mean trouble for your diabetes management. A recent study by the NHS showed that patients with type 1 diabetes are 3.5 times more likely to die from COVID-19, and people with type 2 diabetes are twice as likely to die from COVID-19 in the hospital as compared to people who don’t have diabetes.

Patients with diabetes have complained about the quality of care they receive in the hospital setting for a long time, and improvements are slow to reach the bedside. So, what gives? And how can you better advocate for yourself should you find yourself being admitted to the hospital any time soon?

Know Your Rights

Even though you’re in the hospital, you still have rights that doctors need to abide by. If you’re willing and able, some hospitals will let you sign a waiver allowing you to manage your insulin intake and test your own blood sugars while in-patient. If you’re on a continuous glucose monitor (CGM) and/or insulin pump, make sure you ask the nursing staff if you can stay on your technology for the duration of your stay.

Note: Staff will still come into your room and manually check your blood sugar with a hospital-grade meter every few hours, even if you have your CGM on. The more control you can have over your insulin intake and blood sugar management, the better.

John, who lives with type 1 and is from Iowa, says,

“About five years ago I had an overnight stay at the hospital for surgery, and the nurse told me that I had to remove my pump for the stay. I explained I would feel more comfortable with my own settings and control. She finally relented, but made me fill out a sheet every time I bolused or checked my blood sugar, and I was yelled at several times when I forgot to fill out the form… I was happy when her shift ended.”

Ginger, who lives with type 1 diabetes, recalls her experience in labor and delivery with her baby,

“They withheld insulin from me, and I had to take secret injections in the bathroom to keep my blood sugar at an even 90 mg/dL for the sake of my soon-to-be-born child.”

Managing in a New Setting

Managing diabetes in the hospital setting is extremely different from everyday life: your exercise and physical activity levels are way lower, you don’t have control over much of your diet, and things like infections and stress levels can leave your blood sugar sky-high. Keep in mind that you may need to increase basal rates or doses during this time, especially if you’re dealing with illness or infection on top of environmental change. Some ways to improve your management while in the hospital include:

  • If able, walk laps around the floor to get some steps in
  • Don’t request the “diabetic meal”- these meals are extremely high in carbohydrate, and are just fixed at a certain number of carbohydrates per meal. They are not low-carb. Instead, opt for ordering menu items “a la carte” where you can choose a few different protein options and low-starch vegetables as a side
  • Increase your basal rates or doses accordingly (do not just continually bolus, as this can cause your blood glucose levels to crash)
  • If you’re on an IV drip for hydration, make sure it is NOT a dextrose drip (this is the most common kind and will quickly send you into DKA)
  • Make sure the hospital staff allows you to dose for meals before you eat! (due to liability issues, many will try and force patients to dose after they’ve eaten).
  • Try mindful meditation or gentle chair yoga to calm the mind
  • Remind  yourself that your stay is only temporary

Amy, who lives with type 1, expresses her frustration over the meal options that hospitals often provide for their patients,

“Although the doctors were wonderful, I found that they, unfortunately, do not get involved with a type 1 diabetic’s diet. So my first night there (before surgery) I was given a very high-carb meal. Pasta, bread, fruit, and dessert. The nutritionist told me that this was the ‘recommended diet’ since it was pre-carb counted.”

Allie from Brooklyn agreed that getting adequate care in the hospital setting was almost impossible,

“a hospital I was in once denied me insulin for a full 24 hours because they couldn’t get an endocrinologist on call to come consult…”

Advocate for Yourself

When all else fails, you must advocate for yourself. Being in a hospital can be lonely and scary, but if you’re well enough to advocate for better care, you must. Many hospitals and providers are not up to date on the latest diabetes technology and care, so arm yourself appropriately. Some helpful information to have on hand:

  • Contact information for your endocrinologist and primary care physician
  • A printed out diabetes medical management plan detailing how you manage your diabetes to provide to the hospital staff
  • A printed list of all your prescriptions
  • Contact information for your pharmacy and pharmacist
  • An emergency contact’s information

Judy, a type 1 from Georgia, laments,

“…after the hospital began hydrating me (with a dextrose drip), I continued to get worse. They ended up not even putting me on an insulin drip, and removed by insulin pump so during that time I had no insulin on board whatsoever. Eventually, I was transferred to the ICU until an endocrinologist finally realized what was going on…”

Advocating and standing up for yourself can sometimes be the best guarantee that you will receive the treatment you need and deserve when in the hospital setting.

Diabetes is a multifaceted condition affecting major organs and entire body systems. It requires close, quality care and fine attention to detail. As diabetes can affect everyone differently, one must work with their healthcare team to create and follow a care plan based on one’s individual needs. Making sure that patients get this quality care in the hospital setting is crucially important, both for acute and long-term health outcomes.

Source: diabetesdaily.com

Can You Manage Diabetes Well Without Lots of Money?

If you live in a country like the United States, where the majority of health insurance is privatized and there is no strong social safety net, it can feel as though managing a chronic disease like diabetes requires nothing but lots of money. And it does. As of 2017, diabetes cost the United States a staggering $327 billion dollars per year on direct health care costs, and people with diabetes average 2.3x higher health care costs per year than people living without the disease.

Diabetes is also devastatingly expensive personally: the cost of insulin has risen over 1200% in the past few decades, with no change to the chemical formula. In 1996, when Eli Lilly’s Humalog was first released, the price for a vial of insulin was $21. In 2019, that same vial costs around $275. Studies show that 1 in 4 people ration insulin simply due to cost. Diabetes Daily recently conducted a survey study, with almost 2,000 participants, of which an overwhelming 44% reported  struggling to afford their insulin.

So where does this leave patients who don’t have tons of money to spend on insulin and supplies, or who don’t have adequate health insurance coverage for the technology to help prevent complications? Can you manage diabetes well without lots of money? The short answer is yes. The long answer is a bit more complicated.

Best Practices for Managing with Less

If you have insurance coverage, but are unable to afford a continuous glucose monitor (CGM) or insulin pump, it’s advisable to follow best practices for optimal diabetes management. According to the Mayo Clinic, one should test their blood sugar:

  • Upon waking
  • Before meals and snacks
  • Before and after exercise
  • Before bed
  • More often during illness
  • More often when traveling or changing a daily routine
  • More often if on a new medication

One study has even shown that following a lower carbohydrate diet can improve health outcomes, reduce complications, and cut down on medication costs for people living with diabetes.

The study goes on to say that, “…insulin dependent diabetics can expect to half or third their insulin requirements. Less insulin injected results in more predictable blood sugars and less hypoglycemia.” However, no patient should ever feel pressured to follow a low carbohydrate diet solely to control the cost of their medications. There can be more effective ways to manage the cost of medications and supplies.

Photo credit: Adobe Stock

No Matter What You Think, Get Coverage

People with diabetes need health insurance coverage. In the short term, this makes sense, as insulin and things like insulin pumps, continuous glucose monitors, syringes, and test strips are expensive. But it also makes sense long term as well. People with diabetes can face serious complications as they age: diabetes is the leading cause of adult blindness and amputations, and is a leading cause of stroke, kidney failure, heart disease and premature death in its sufferers. Having health insurance helps pay for things like surgery, preventive screenings, doctors’ appointments and follow-up care, and any additional medicine and needs that’s needed.

It may seem cheaper to forego coverage, but don’t. Check to see if you’re eligible for Medicaid in your state. If you are, this comprehensive coverage will help you access affordable medication, doctors’ visits, emergency and preventive care. If Medicaid is not an option, see if you qualify for a tax subsidy on the federal or your state’s health exchange. There, you can find a range of affordable options that will cover your diabetes care and (especially) insulin prescriptions.

Get Help Paying for Insulin

Even if you have health insurance coverage, the cost of your insulin may be prohibitively high. According to the CDC, between 2007 and 2017, the percentage of adults aged 18-64 enrolled in a high deductible health plan rose from 10.6% to 24.5%. These plans have a high dollar amount that consumers must meet before their plan kicks in to help pay for things like prescriptions or hospital stays. Some high deductible health plans have deductibles as high as $10,000. This means that someone with diabetes could potentially pay the full $275 a vial for their insulin, every time they fill their prescription, until they reach their $10,000 deductible. These types of plans are cheaper monthly (have lower premiums), but don’t offer great coverage.

If you need help paying for your insulin, you can get low cost insulin through these assistance programs:

  • Eli Lilly’s $35 Co-Pay Program: Launched in early April in response to the COVID-19 crisis, Eli Lilly is introducing their Lilly Insulin Value Program, which allows anyone with commercial insurance and anyone without insurance to fill their monthly prescriptions of insulin for $35.
  • Novo Nordisk: Novo Nordisk has recently launched a $99 program, where people needing insulin assistance can purchase up to three vials or two packs of FlexPen®/FlexTouch®/Penfill® pens or any combination of insulins from Novo Nordisk Inc. for $99.
  • Sanofi: Launched in 2019, Sanofi’s program allows people living with diabetes in the United States to pay $99 for their Sanofi insulins (with a valid prescription), for up to 10 boxes of pens and/or 10 mL vials per month.
  • Medicare: Medicare recently unveiled a pilot program that would cap the cost of insulin. The Medicare Part D Senior Savings Model would cap insulin co-payments to $35 per month, starting in January 2021. Seniors must sign up for a plan that will qualify under the pilot during the open enrollment period, which is October 15 through December 7.
  • Buy a State-Regulated Health Plan: If you live in Colorado ($100 per prescription per month), Illinois ($100 per 30 day supply), Delaware ($100 per 30 day supply), New York ($100 per 30 day supply), Utah ($30 per 30 day supply), West Virginia ($100 per 30 day supply), Maine ($35 per 30 day supply), New Mexico ($25 per 30 day supply), Virginia ($50 per 30 day supply), Washington ($100 per 30 day supply), or New Hampshire ($30 per 30 day supply) and you buy a state-regulated health plan, you are eligible for a copayment cap on insulin (implementation dates pending, but Colorado was the first bill to be implemented and it went into effect January 1st, 2020).

Check the fine print of any health insurance plans on the federal or your state’s exchange to see if they are eligible for the copayment cap. More states are introducing legislation in 2021, so keep an eye out for a bill proposing some similar changes in your state!

Get Help Paying for Supplies

Several companies have launched affordability programs in response to the COVID-19 pandemic. A few new programs are:

  • Dexcom: Is offering up to two shipments of 90-days of Dexcom G6 Continuous Glucose Monitoring System supplies, with each shipment consisting of one transmitter and three boxes of three sensors for $45 per 90-day supply shipment. For existing customers only, if you qualify.
  • Omnipod: Is offering a six-month supply of products (60 pods) free of charge. The program is focused on current US customers who have lost jobs and health insurance as a result of the pandemic.
  • One Drop: This online subscription package charges the consumer a monthly fee, and you get access to cheaper test strips, online personal health coaching, and a mobile app to track your progress. If your health insurance doesn’t adequately cover test strips, this can be an affordable and effective way to go.
diabetes advocacy

Photo credit: T1International Instagram

Advocate for Change

If you see or are experiencing injustice, you should always try and advocate for change. This means writing letters to your elected officials, calling your members of Congress, petitioning your health insurer, testifying for bills that support better health care coverage, and raising your voice to improve policies that will benefit all people living with diabetes. Get involved in the diabetes online community on Facebook or Twitter. Sign up to become an advocate with T1International. Donate to your favorite diabetes charity who’s working to make things better.

Show up at your state capitol and talk to people about what it’s like to live with diabetes, how expensive it is, and how crucial good coverage and affordable medications really are. You can live a great life with diabetes, but coverage, laws, regulations, and policies can always be better. And things won’t improve until we have everyone at the table, advocating for change.

How are you able to manage well with less to spend? What policies or changes would you like to see in the US healthcare system that would make management easier for you? Share this post and your story, below!

Source: diabetesdaily.com

New App Uses Artificial Intelligence to Predict Blood Glucose Levels Without a CGM

It’s hard to deny that technology advances are improving the lives of people with diabetes worldwide. From smart insulin pumps that integrate with continuous glucose monitors (CGMs) to various applications with predictive features and alarms, the diabetes tech world continues to evolve rapidly.

One company, January.ai, has recently announced its new artificial intelligence (AI) platform can accurately predict blood glucose responses to various meals. The company was founded in 2017 by Silicon Valley veteran and CEO Noosheen Hashemi and  Mike Snyder, the Director of Genomics and Personalized Medicine at Stanford, with the vision of improving lives by providing comprehensive health data. The concept was recently validated, and the company has developed a user-friendly app to help people with diabetes learn more about what affects their blood glucose levels and improve outcomes.

How It Works

The new algorithm relies on machine learning approaches to predict individual blood glucose responses to different meals and activities. To achieve this, the algorithm considers the users’ heart rate, and logs of their food and medication data, developing a personalized model for each patient to predict glycemic outcomes. The initial “training” period takes four days, and does incorporate data from a CGM; however, no CGM data is needed to make the predictions past the initial training period.

As per the recent press release,

“The company developed a series of underlying technologies including derived nutritional values, glycemic index and glycemic load, which estimates how a person’s blood sugar will rise based on the food they eat, for 16 million foods. January.ai built its own mobile application to capture and unify various data points into one AI platform, collecting nearly 25 million data points for the study.”

At the American Diabetes Association (ADA) 80th Scientific Sessions, the research team presented the outcomes of this algorithm in predicting the glycemic responses of over 1,000 participants. Some were diagnosed with pre-diabetes or type 2 diabetes, while others represented healthy participants.

Participants wore a CGM as well as a heart rate monitor for ten days. They also tracked their activity levels, specific food and water intake, as well as their medication doses. Following the four-day learning period., the algorithm developed an “individualized model” for each participant. Next, the system’s ability to accurately predict blood sugar responses without using any CGM data was put to the test. Excitingly, the predictive values were in close accord with the actual CGM readings, which were used to validate the accuracy of the predictions.

Rahili S. et al. 2020 (Presented at the ADA 80th Scientific Sessions) The above slide shows the model’s glucose prediction for a 33-hour period based on a participant’s heart rate, food, and medication data, compared to their actual glucose levels.

The App

The team has applied their state-of-the-art algorithm to develop an app that enables users to track their heart rate and blood sugar levels, as well as get a comprehensive picture of how factors like specific foods and exercise patterns affect them, personally. Moreover, due to the machine learning features, patients can also be alerted to potential pitfalls before they even consume a particular meal. The app also features various data displays, related explanations, suggestions, and offers rewards for making improvements.

Image source: January.ai

Summary

The ability to accurately predict changes in blood sugar levels using just heart rate data, and food and medication logs, can offer a more affordable and non-invasive way for those with diabetes to learn about how different foods affect their blood sugar levels.

Noosheen Hashemi, Founder and CEO of January.ai had this to say about what their product could do for those living with diabetes:

“Despite extensive efforts, the healthcare community has not been able to slow the rapid rise of diabetes, nor develop effective treatments. We believe that by applying AI to a mix of biological and behavioral data, we can empower people with the personalized insights and specific recommendations they need to enjoy better health.”

What are your thoughts on this technology? Please comment below, we love hearing from our readers!

Source: diabetesdaily.com

One Year into DIY Looping

One year ago, I built a DIY hybrid-looping insulin pump, using my Dexcom G6 and Omnipod. For those who aren’t in the know, DIY “looping” is basically “hacking” your insulin pump with a single-board computer, such a Raspberry Pi or Riley Link, to make it communicate with an existing continuous glucose monitor (CGM) to make basal adjustments accordingly.

It’s important to note that this is NOT FDA approved, but the #WeAreNotWaiting community has been sharing information on how to build your own DIY looping insulin pump for years now, and I took the plunge in 2019.

In July I celebrated one full year on my looping system, and wanted to share my thoughts on 365 days of looping.

I Still Have Diabetes

I remember when I first set up my Riley Link and switched on “auto-mode.” I had this magical vision of never counting carbohydrates again, limitless runs without lows, and forgetting what the thirst of a high blood sugar felt like. Then I realized, just as quickly, that I still have diabetes.

Even though my Dexcom continuous glucose monitor (CGM) readings now communicate with my insulin pump and make basal adjustments accordingly, the “hybrid” part means that it doesn’t anticipate, nor account for, any carbohydrates eaten. I also need to tell my pump when I’m about to exercise, and for how long. Since the insulin pump does not operate on artificial intelligence (AI), it cannot anticipate what I’ll do next.

So yes, I still have lows on runs and I still have highs when I eat something that isn’t appropriately accounted for. I still have to count carbohydrates and no, I haven’t forgotten what the Death Valley-like thirst of a 350 mg/dL feels like, although it happens less frequently.

My HbA1c Isn’t That Much Lower

I have always been maniacal about tight diabetes control. My A1cs have hovered in the low 6s for the last 10 or so years. With Loop, I immediately thought that my control would be *perfect* and I would ride out the 4s and 5s into an eternal sunset. NOPE. My latest A1c was 5.9%, which I am rightly ecstatic about, but it’s less than 1% point lower than I was on MDI and a CGM.

The key difference is that my time in range has increased from around 30% to 75%, and the number of lows that I experience has gone down from around 3 per day to 3 per week. It’s easy to have a low HbA1c when you have highs and lots of lows to average it out- it’s much harder (and healthier!) to have a lower HbA1c with few lows. And plus, I just feel healthier. And that has made all the difference.

Dexcom graph by Christine Fallabel

It’s a Mental Vacation

Being a human pancreas 24/7/365 is not easy (why didn’t anyone tell us this at diagnosis?!). In addition to running a household and having a full-time job (and texting everyone back, and maintaining some semblance of a fitness routine, and trying to eat something green at every meal), being an organ all of the time is hard work.

More than anything, a year into looping has given me the mental break I didn’t know I needed. Sure, I still have to count carbohydrates, adjust for exercise, and dose for meals, but hours can go by where I don’t think about diabetes at all, and that never used to happen. My mental distress has gone way down, and I don’t experience diabetes burnout at nearly the frequency I used to. This also helps maintain my motivation to continue to take care of myself and my diabetes.

Dosing Is More Discreet

As I make my way through my 30s, this is less of an issue (if you have a problem with me dosing in public, the problem is you, not my diabetes), but looping has definitely made checking my blood sugar (read: checking my phone) and dosing (also read: checking my phone) way more discreet in public than manually testing my blood sugar and dosing used to be. It’s also more hygienic (I change my insulin pump with plenty of alcohol swabs every 3 days from the comfort of my home), and more convenient. This is perfect when I’m out at a crowded concert, or squeezed into a small table at a restaurant.

It can also cause issues. For instance, if I’m in a public place where cell phones aren’t allowed, sometimes it’s difficult to explain that my iPhone is actually durable medical equipment (DME) that I need to survive. Let’s just say there have been some teachable moments.

Loop app screenshot by Christine Fallabel

I Am Happier

When I was diagnosed with type 1 diabetes in June of 2000, my doctor told me that the cure was just 5 years away. I thought the cure was just around the corner, we all did. And learning that the “cure” is still out of sight, 15 years hence, has been a hard pill to swallow.

I’ve dealt with anxiety and the impending depression of only someone who has a chronic disease with no cause and no cure can experience, but having something like Loop feels like someone is finally on my side, looking out for me, and making things just a little bit easier when the load becomes too heavy of a burden to carry. I can go to sleep and know that my basal will immediately shut off if I start to go low overnight. I can relax if I’m digging into dinner at a friend’s house and I don’t know the exact carb count for a meal, knowing my basal will tick up to cover the difference.

Having a Loop feels a little bit like you have a certified diabetes educator (CDE) and best friend just sitting on your shoulder, making constant adjustments, never judging, and ensuring that you have a better go of it, a little bit of help when you need it. And that help has been life-changing. The cure may never have been 5 years out, but with Loop, I finally feel okay waiting just a little bit longer.

Do you DIY Loop? How has your experience been? Share this post and comment below; we would love to hear from you. Follow the #WeAreNotWaiting hashtag on Twitter to learn more about the DIY movement.

Source: diabetesdaily.com

Watch Type 1 Diabetes on Netflix

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

By Alexi Melvin

If you’ve browsed Netflix in the last couple of weeks – as I’m sure the majority of us have throughout shelter in place – you may have stumbled on a few representations of type 1 diabetes in major Netflix shows.

The double-whammy of type 1 diabetes (T1D) related content is thanks to Netflix having released both “The Baby-Sitters Club” and “Say I Do” only two days apart from each other.

Usually, when we know diabetes has been represented in a show or movie, the collective “oh no, what did they say about it this time?” sinks in. However, these shows did a pretty decent job. In “Say I Do,” a wedding reality show, the groom with T1D was able to tell his own diabetes story in a way we’ve not often seen done. It was refreshing. In “The Baby-Sitters Club,” the beloved character with diabetes from the book series has an entire episode dedicated to her experience. It’s not a perfect representation, but it is more screen-time for diabetes than we normally see.

The Baby-Sitters Club

This Netflix reboot – released on July 3rd – of the beloved book series, turned TV series, turned 1995 film of the same name is a more modern take, but for the most part stays true to the original characters. One of these familiar characters is Stacey, a new member of the BSC and New York City transplant.

In episode 3 of the season, “The Truth About Stacey,” Stacey’s “secret” is finally revealed. She has type 1 diabetes.

Not to go too deep into spoilers, but let’s just say that Stacey (and her mother, in part) has felt a lot of shame in the past about her T1D and is hesitant to reveal it to her new group of friends. Her competency and safety as a babysitter is questioned as a result of the revelation, but luckily it’s not a spoiler to say this matter is resolved, since The Baby-Sitters Club wouldn’t be what it is without Stacey.

The show gets a few things wrong but don’t worry – it all wraps up with a bedazzled insulin pump in full view.

Say I Do

Released on July 1st, “Say I Do” has already made a name for itself as a super sweet guilty pleasure for reality show enthusiasts. Episode 1 introduces us to Marcus LaCour and his wife, Tiffany, whose first wedding years prior was an epic disaster. Now, they’re given a chance at doing it over again, having the real wedding they always hoped for.

Marcus is immediately transparent with the show’s three hosts that he has type 1 diabetes, having been diagnosed at age 15. During a conversation about food for the wedding’s reception, Marcus goes into detail about his diagnosis and T1D management today. He shares details like temporarily losing his sight on the way to the hospital, how losing his health insurance at one point led to tough decisions for the family, and that he maintains lower-carbohydrate eating habits that help him manage his blood sugar levels.

What Was Done Well

The overarching theme within Stacey’s T1D struggles in The Baby-Sitters Club is that she has found a new support system that accepts her for everything that she is – so, why shouldn’t she accept herself too? To see a young girl dealing with a new diagnosis have such a strong team of friends that truly have her back is refreshing, and something that every person impacted by diabetes deserves.

Growing up in the 90s, the 1995 The Baby-Sitters Club film was a favorite of mine. After I was diagnosed with T1D at age 14, one of the very first things that flashed through my head was this movie’s scene when Stacey fell down in the middle of a hike because she was low. It was the only portrayal of someone having type 1 diabetes that I was even remotely familiar with.

The ’95 film version of BSC left us with way more questions than answers when it comes to what type 1 diabetes is. We knew that Stacey had something called “diabetes.” We know that her mother was very insistent that she “eat something” before her hike. And we knew that she fell down because she didn’t eat. But any further detail about insulin injections, blood sugar management, differentiation between the types of diabetes and what causes type 1 diabetes was entirely lacking.

In the Netflix reboot of BSC, we get a clearer picture of what T1D looks like. The story has been modernized, so we get an updated look at how T1D is managed with the insulin pump hooked to the front of Stacey’s waistband. We also see Stacey dive much deeper into the inner turmoil that goes along with a T1D diagnosis. Type 1 diabetes is much more visible here than we’ve seen it before in past film and TV attempts.

In “Say I Do,” Marcus takes enormous care to share his story, and the producers took equal care in spending time on his story. From Marcus, we learn what a type 1 diagnosis can mean for a family, and what it means to him personally.

Is There Still Room for Improvement?

Absolutely. There needs to be even more transparency and accuracy within our portrayals of diabetes in pop culture. There are unclear moments in episode 3 of The Baby-Sitters Club, such as Stacey’s “episode,” which appeared to be a seizure from a severe hypoglycemic event. However, it was also presented as possibly coinciding with her diabetes diagnosis, which would have meant high blood sugar and possibly diabetic ketoacidosis (DKA), as opposed to a low.

The lens with which we are meant to view a type 1 diabetes diagnosis could also have been a little less dark. I question whether Stacey’s T1D storyline perpetuates the idea that having type 1 is means for bullying or shame. Nevertheless, it ultimately morphs into a more optimistic tone.

When it comes to reality television like “Say I Do,” we need more Marcus LaCours! And we need more show showrunners and producers who take care with telling these stories well. When we think about documentary style TV, not a lot of examples come to mind of people we’ve seen that live with T1D. If they do, not a lot of time is spent on clarity around what diabetes is and means for the person living with it.

The more we all choose to use our platforms to educate others about type 1 diabetes, like Marcus did in “Say I Do”, the more stories will emerge, and the more our experience of diabetes will be normalized, better understood, and seen as just one part of a complex person or character, not just a plot device or the butt of a joke.

Source: diabetesdaily.com

Would You Restrict Carbs to Ease Diabetes Management? (ADA 2020)

Children and adolescents with type 1 diabetes are currently living at a time of a big diabetes technology boom. Continuous glucose monitors (CGMs) and insulin pumps are becoming more popular and offer the promise of better glycemic management and more freedom and peace of mind. As research and clinical trials on automated insulin delivery systems are in full-swing, clinicians from The Joslin Diabetes Center, Yale University, and Harvard University were interested in understanding various patient preferences. In one study, they posed the following question:

Would young people with type 1 diabetes be willing to limit their carbohydrate intake to a maximum of 50 g per meal if this meant they wouldn’t have to administer a manual bolus using an artificial pancreas (AP) system? 

The outcomes of this research were recently presented at the American Diabetes Association (ADA) 80th Scientific Sessions.

To help understand patient perspectives and preferences on this subject,  39 participants (average age 17 +/- 4.7 years) were recruited at two study centers. These patients had an average diabetes duration of 9.4 +/- 4.9 years and an average HbA1c of 8.4 +/- 1.1 %. Interviews were conducted with each participant and parents to gauge their views on the willingness to “limit carb intake to 50 g per meal/snack if this would eliminate the need to manually bolus for food when using the AP system.”

Based on their analysis, the study authors derived the following major insights:

  1. The majority of participants (and their parents) would prefer to have the option of eating more than 50 g per meal/snack and were willing to manually bolus for the excess carbs.
  2. Most believed that 50 g per meal or snack was too restrictive.
  3. Young people generally agreed that automation would “reduce self-care burden.”

The researchers concluded,

“An aversion to food restrictions overpowers the desire for an AP system that can independently manage glucose levels though limited carbohydrate intake. Carbohydrate limitations appear to increase self-care burden more than the time and effort expended on carb counting and bolusing. Future AP systems should consider options that enable users to choose to bolus manually for large meals and to forego bolusing for smaller ones.”

Here are a few notable quotes from the participants, which were highlighted in the poster presentation:

“I think that, if I had to choose between bolusing or limiting my carb intake, I think I would rather bolus, just because nobody really wants to be told what to do.” (25-year-old female)

“Every once in a while she wants to have an ice cream. You know, I think she should be allowed to have these things sometimes when she wants them. I don’t want her to be too restricted.” (Mother of a 16-year-old.)

Sadly, despite continuing advances in technology, the glycemic management for youth with type 1 diabetes has been stagnant or worsening, depending on the age group, for decades. As per the most recent available data, the average HbA1c for young people with type 1 is about 8.7%, similar to what was observed in this cohort. Automated insulin delivery could offer an important solution to so many young people who do not meet the ADA-set glycemic targets (currently, the organization recommends individualizing the A1c goals, from as low as <6.5% all the way up to <8% for some patients).

This study provides an interesting snapshot into what many young people with type 1 diabetes appear to consider very important — the freedom to eat whatever they want and bolus for it. 

There has been a long-standing debate, often in the diabetes online community, and sometimes among healthcare providers, about a low-carbohydrate approach for young people. Many have highlighted the benefits, and exceptional success stories. They are not just anecdotes, either. At least one study has demonstrated exceptional outcomes of carbohydrate lowering for youth with type 1 diabetes, with excellent adherence and reported quality of life, a normal average A1c of ~5.7%, and a very low rate of adverse events.

Nevertheless, some question difficulty of maintaining a lower-carbohydrate diet, and concerns have been cited over the potential for the development of eating disorders as a result of “restricted eating”.

When it comes to developing AP systems, this study suggests that many young patients would prefer more flexibility in the upper threshold of their carbohydrate intake and are willing to put in the work to manually bolus for and accept the outcomes, whatever they may be, of higher carbohydrate eating patterns, in lieu of sticking to a recommended carb limit and not having to manually deliver their insulin dose. Of  course, this is just a small study, and the results may be skewed towards this perspective due to the predominance of teenagers in this cohort. Also, it may be interesting to evaluate a shift in this perspective, if any, following a formal diabetes education program to explain to patients and parents, in detail, the benefits of lowering carbohydrate intake for diabetes management in general, and in the context of AP technology.

What are your thoughts on the subject? We love hearing from our readers.

Source: diabetesdaily.com

Insulin Pump Therapy for Those Living with Type 2 Diabetes: Doris’s Story



LEARN MORE ABOUT THE MINIMED™ 630G SYSTEM

My name is Doris, and I am a wife, small business owner, volunteer and an Assistant Director at a non-profit agency. I’m always busy, which is why some are surprised that I also live with type 2 diabetes. Managing my diabetes hasn’t always been easy. In reading my story, I hope you can take away some of the lessons that it took me years to learn.

20 years ago, I noticed that I was feeling sick each morning and it was a struggle to get myself together. One morning, I arrived at work and was extremely tired and nauseous. A co-worker took me to the emergency room where I was diagnosed with type 2 diabetes. I was in my thirties then. At the time, I was dealing with other health challenges as well. Adding this serious disease to an already full plate was overwhelming to say the least. I knew very little about type 2 diabetes. I thought that diabetes was common and I could handle it, so I wasn’t really too worried. In my naivety, I thought if I just took the medication prescribed for me and avoided sugar, I would be just fine. Boy was I wrong! I learned very quickly that I needed to educate myself about the disease, causes, symptoms, treatments, and find a specialist.

I have been living with type 2 diabetes for over twenty years now. I have had so many changes in my drug therapy regimen, I can’t count. No matter what combination of medications and insulin I took, or changes I made to my diet or exercise, my A1C levels would not stay consistently at or below 7. I have been hospitalized twice due to elevated blood sugar levels. I even sought help from diabetes specialists, but I still wasn’t able to get control of my blood sugar the way I wanted. Throughout the years, I really struggled with always being tired and listless. Some days I couldn’t even make it out of bed. It was a struggle being able to do activities. My family and friends thought I was being lazy or anti-social because I would pass on so many events. They did not understand how I was being affected.

About 4 years ago, I had to change my primary doctor because of insurance coverage. The process of having to find a new doctor was always exasperating to me because I wanted to find someone that was truly solutions-based and took time with their patients. I ended up finding a family practice doctor near my home. I liked the fact that she was always very candid with me about my out of control blood sugar levels, high A1C, and the other medical complications I was dealing with due to type 2 diabetes. She was increasingly concerned as the test results showed that I was heading toward serious complications with my kidneys. One day, I visited her office to review my test results, and we had a serious discussion on what my prognosis looked like. She felt it was important to discuss my options. I began crying because I felt so defeated and helpless. She spoke to me about insulin pump therapy. I knew very little about it. I thought it was only offered to patients that have type 1 diabetes. She gave me some literature and told me to think about it and let her know if I wanted to pursue it further. I went home and discussed it with my husband and other family members. I was depressed about the situation because the quality of my life looked bleak. I did some research on insulin pump therapy but couldn’t find much information about it or how it was used with type 2 diabetes patients.  I called my doctor and asked her to give me some more details of what the therapy consisted of. My level of apprehension was pretty high at this point, so she scheduled some time for me to meet with a nurse who specialized in insulin pump therapy.

I spoke to Shelly, a nurse from Medtronic, who was able to give me better insight into what the therapy would involve and how I could benefit from it. Her knowledge about the therapy, the disease, and her willingness to answer what felt like a million of my questions gave me some hope. After that conversation and further research, I knew that I had to try insulin pump therapy. I put my initial skepticism away and without further hesitation, I told my doctor to sign me up.

When my MiniMedTM 630G pump arrived, I met with Shelly for my product training. I initially thought it was complicated. There were too many parts and too many steps for me to get this right! I became nervous, but I knew how important it was for me. I took a deep breath, concentrated, and with Shelly’s guidance, was able to successfully start insulin pump therapy. I still had a lot of questions concerning the pump. Shelly’s number was on speed dial for a while. The more I used the pump, the more my confidence with handling the pump grew. I was so amazed at this technology and how the device could adapt to my changing needs.

After a month of using the pump, my blood tests results came back and I was ecstatic. My A1C level had dropped and I was seeing much better blood sugar levels. I do the happy dance every time I get a blood sugar level under 100.

I have been using the pump for over 3 years, and have had such a positive experience using the pump. I can’t believe the difference it has made in my live. Most notable to me is more energy— I don’t feel tired and sluggish anymore. I’m able to be more active and participate more in daily activities. When it comes to my blood sugar levels, they are more stable now and my A1C level is at 7.1! I could have never imagined that happening before.

I am no longer a home body either. I am always busy, on the go, and wanting to do more. I look at my life 3 years ago and I was facing a totally different scenario. Things that I had put on hold, I am now pursuing. Using the pump has changed my life drastically. I no longer see just dark days ahead of me— I see the chance to live my best life. I get so emotional when I speak about my experience with the pump. It’s motivated me to figure out what I could be doing to help others. I believe in the product so much that I signed up to be an Ambassador for Medtronic, so I can share my journey with others.

As I reflect on my experiences researching and ultimately using the pump, one of my major takeaways is that you must be committed and dedicated to the process. Although I have certainly grown accustomed to using the pump, it was a bit of a struggle for the first few months. Even now, I have to always remember small things like having additional batteries and pump supplies on hand. In addition, I plan my schedule to ensure that I can continuously use the therapy, even when I travel.

Another takeaway is that it’s important to talk with someone that’s living with type 2 diabetes and using insulin pump therapy. Although I received excellent information form the nurse, nothing beats speaking to someone who has firsthand knowledge.

Finally, be proactive and learn about the coverage that your medical insurance provides when it comes to the cost of the pump and the supplies.

Overall, my experience using insulin pump therapy as a diabetes management tool has definitely benefitted me and what I do in my life. Things don’t always happen the way you plan them, but when you have the right information and know where to go to find answers, your possibilities keep growing and for that I am thankful!

LEARN MORE ABOUT THE MINIMED™ 630G SYSTEM

The testimonial above relates an account of an individual’s experience with 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.

Important Safety Information: MiniMed 630G System with SmartGuard Technology

Indicated for the continuous delivery of insulin, at set and variable rates, for the management of diabetes mellitus. MiniMed™ 630G system is approved for ages 14 years or older with Guardian™ Sensor 3 and MiniMed™ 630G system is approved for ages 16 years or older with Enlite™ sensor. Both systems require a prescription. Insulin infusion pumps and associated components of insulin infusion systems are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks of insulin pump therapy. Pump therapy is not recommended for people who are unwilling or unable to perform a minimum of four blood glucose tests per day. Pump therapy is not recommended for people who are unwilling or unable to maintain contact with their healthcare professional. Pump therapy is not recommended for people whose vision or hearing does not allow recognition of pump signals and alarms. Insulin pumps use rapid-acting insulin. If your insulin delivery is interrupted for any reason, you must be prepared to replace the missed insulin immediately. Replace the infusion set every 48–72 hours, or more frequently per your healthcare professional’s instructions. Insertion of a glucose sensor may cause bleeding or irritation at the insertion site. Consult a physician immediately if you experience significant pain or if you suspect that the site is infected. The information provided by CGM systems is intended to supplement, not replace, blood glucose information obtained using a blood glucose meter. A confirmatory fingerstick using a CONTOUR®NEXT LINK 2.4 meter is required prior to making adjustments to diabetes therapy. Always check the pump display when using a CONTOUR®NEXT LINK 2.4 meter, to ensure the glucose result shown agrees with the glucose results shown on the meter. Do not calibrate your CGM device or calculate a bolus using a result taken from an Alternative Site (palm) or a result from a control solution test. If a control solution test is out of range, please note that the result may be transmitted to your pump when in the “Always” send mode. It is not recommended to calibrate your CGM device when sensor or blood glucose values are changing rapidly, e.g., following a meal or physical exercise. The MiniMed™ 630G system is not intended to be used directly for preventing or treating hypoglycemia but to suspend insulin delivery when the user is unable to respond to the Suspend on low alarm and take measures to prevent or treat hypoglycemia themselves. Therapy to prevent or treat hypoglycemia should be administered according to the recommendations of the user’s healthcare provider.

WARNING: The SmartGuard™ Suspend on low feature will cause the pump to temporarily suspend insulin delivery for two hours when the sensor glucose reaches a set threshold. Under some conditions of use the pump can suspend again, resulting in very limited insulin delivery. Prolonged suspension can increase the risk of serious hyperglycemia, ketosis, and ketoacidosis. Before using the SmartGuard™ feature, it is important to read the SmartGuard™ feature information in the User Guide and discuss proper use of the feature with your healthcare provider.

See www.medtronicdiabetes.com/importantsafetyinformation and the appropriate user guides for additional important details.

Source: diabetesdaily.com

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