FreeStyle Libre 3 Cleared in Europe – Smaller, Thinner, and No More Scanning!

This content originally appeared on diaTribe. Republished with permission.

By Matthew Garza and Katie Mahoney

The FreeStyle Libre 3 has been cleared in Europe for anyone ages four and older. The new continuous glucose monitor is as small as two stacked US pennies, provides real-time readings directly to the mobile app via Bluetooth, and has the same low list price

Abbott announced that the new FreeStyle Libre 3 has been cleared in Europe – see 40-second video here. This third-generation continuous glucose monitor (CGM) has many of the same features that make the FreeStyle Libre 2 so popular, including optional alarms, 14-day wear, and high accuracy. The FreeStyle Libre 3 also adds several new features:

  • Real-time, minute-by-minute readings are sent directly to the FreeStyle Libre 3 app via Bluetooth – moving this CGM from “on-demand” to “always-on,” so there is no need to scan the sensor every eight hours.
  • It is 70% smaller than previous models, making it the “smallest and thinnest” CGM sensor yet – it’s said to be about the size of two stacked pennies. Importantly, this new model will reduce the amount of plastic and carbon paper used, improving the production of the device significantly from an environmental perspective.
  • It is cleared for people with diabetes as young as four years old.
  • It is cleared for use in gestational diabetes and pregnant women with type 1 diabetes. We suggest that everyone who is pregnant and has type 1 diabetes try to get CGM, and that everyone else who is pregnant be tested for gestational diabetes as early on as possible.
  • It is cleared as an iCGM, meaning it can be used for automated insulin delivery (AID) development in Europe.
  • The new FreeStyle Libre 3 app, available for both iOS and Android devices, will contain many of the same features as the FreeStyle Libre 2 app (Libre View) including the all-important time in range graphs and ambulatory glucose profile (AGP). You can learn all about the AGP here.

Currently the FreeStyle Libre 3 is cleared for upper-arm wear, though we imagine people may try to use it “off-label” on their abdomen or other spots. There is no separate reader for collecting and monitoring sensor data, so people will use smartphones with the FreeStyle Libre 3 app in order to connect to the sensor.

The FreeStyle Libre 3 will be available at the same price as previous versions of the CGM ($109 for a one-month’s supply, without insurance); Abbott will continue to offer the FreeStyle Libre 2 at the same price for people who prefer the to scan their CGM. The FreeStyle Libre 3 is expected to launch in the coming months in Europe, and though we don’t yet know where it will first launch, we expect it may be Germany, like Abbott’s other CGM launches. In the US, Abbott has not announced any potential timeline for FDA submission or clearance. With the recent Libre Sense clearance in Europe, there is lots happening with this brand – stay tuned for more. Readers in European countries, we’d love to hear your early thoughts once you try the FreeStyle Libre 3!

Source: diabetesdaily.com

REVIEW: Companion Medical’s InPen, A Smart Delivery System

Companion Medical’s smart insulin delivery, the InPen, is a reusable injector pen plus user-friendly mobile device which allows individuals to improve their diabetes management. I choose multiple daily injections (MDI) over a pump for various reasons, but I cannot deny that a pump allows for more precise calculations. With InPen, people on multiple daily injections can achieve the same accuracy plus so much more!

What Is It?

The InPen is a reusable injector pen that not only helps you calculate your doses but also keeps a log of insulin data for up to a year. The InPen connects, via Bluetooth, to the smartphone app, and keeps track of all your insulin deliveries.

InPen is now approved for all ages (7 and over, or under the supervision of an adult), who are insulin-dependent. The pen can deliver between .5 units to 30 units of insulin, dialed in half-unit increments. The pen is compatible with the Lily Humalog, Novo Nordisk Novolog and Fiasp U-100 3.0 ml insulin cartridges.

InPen is compatible with all Apple iOS devices that support iOS 10 or greater. It is also compatible with Android (more info about compatibility here).

What Does It Do?

I made sure to use this pen for about a month before writing my review. I am in awe of how easy this pen makes my management. Up to now, to be quite frank, I am guilty of a lot of “WAGS” (wild a** guesses) and then winding up too high or too low. I also really never kept tabs on when my last insulin dose was, so would find myself stacking quite often. Thanks to InPen, a lot of this carelessness has been eliminated. Here are all the amazing things it can do:

1. Insulin delivery information

The InPen connects to the app via Bluetooth which allows the app to store your insulin delivery information and shows you how much insulin you have taken and how much you have on board. There have been so many times when I would correct a high, not realizing I still had insulin on board, which led to episodes of hypoglycemia. As you can see here, your information appears in real time from your lock screen.

InPen Screenshot 1

Screenshot from Companion Medical

2. Built-in calculator

The InPen has a built-in calculator to help you get the most accurate dose possible. Your physician enters your settings, and it will give a recommendation on how much to dose. It takes into account your previous insulin delivery, your current blood sugar and the number of carbs you are eating. Since I have been using this feature, my blood sugars have improved greatly.

InPen Screenshot 2

Screenshot from Companion Medical

3. Reminders

It also has a reminder to take your long-lasting insulin. There have been so many times when I can’t remember if I took my Tresiba. I know this is a common problem for people on daily injections. This takes the burden off of the individual and has proven to be one of my favorite features.

InPen Screenshot 3

Photo credit: Companion Medical

4. Reports

The InPen generates reports that you can share with your healthcare team. These comprehensive reports will allow for easier decisions regarding changes to your diabetes management.

Screenshot from Companion Medical

5. Temperature alerts

The InPen comes complete with temperature alerts! It will notify you anytime your pen is in temperatures too hot or too cold which could make your insulin ineffective. This will come in handy during my next vacation or even if I leave my bag in the car for too long.

6. Syncing to Dexcom

InPen can sync up to the Dexcom continuous glucose monitor, via the Health app. This allows you to see your continuous glucose monitor graph on your logbook and reporting feature of the app.

Screenshot from Companion Medical

How Can I Get the InPen?

Many commercial insurance companies cover InPen, you can fill out this form and a representative will contact you about your copay. They also have a copay assistance program.  Commercially insured InPen customers will not have to pay more than $35 dollars a year which is a small price for better control.

Conclusion

I think InPen is a game-changer for anyone on multiple daily injections. With all of the capabilities the InPen offers, I can achieve better blood sugar numbers. I feel more in control of my diabetes because now I am confident that I am administering the right doses. I am also avoiding stacking insulin, which means fewer blood sugar roller coasters, and now I also have reminders to take my long-lasting insulin.

InPen can also help empower children to make better choices and manage their own diabetes. You can even sync two different pens if a child wanted to leave one pen at school and one at home.

Using InPen has helped me take back some control of my diabetes. It allows me to feel more in control and allows me to spend less time thinking about my condition. I can’t imagine going back to MDI without InPen in my toolbox and highly recommend this to anyone else who prefers injections over the pump.

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

COVID-19: Apps to Stay Active at Home

Within just a few days, the world as we know it has changed. We are all now understanding the reality of this disease, COVID-19,  and are being forced to social distance and stay home whenever possible. Some of us have taken work to our living rooms, homeschooling our children, making 3 meals a day for an entire family, all while trying not to panic that either you or your loved one falls under the high-risk category.

We mustn’t forget about self-care. It is important for us to be in a good place mentally, emotionally and physically for ourselves and anyone else who may need us. It is also proven that staying active boosts our immune system, which we all need more than ever.

With so many workouts available online, there is no shortage of things to do from your own home or yard. Depending on what you like, here is a variety of ways to stay active while being stuck at home.

Back to the Basics

Calisthenics is probably the most underrated form of exercise. And it is great to do at home since no equipment is required. Also, anything cardio-related will strengthen your heart and your immune system! Try to do a routine of a certain amount of rounds and repetitions of moves like burpees, sit-ups, push-ups, lunges, squats. One of my favorite free apps for calisthenics is Madbarz. This will be sure to get your heart pumping and leave you feeling energized!

Take It Online

It is really wonderful how people are coming together during this time. Many gyms, fitness companies, and coaches are providing their clients and the public with free workouts. Here are a few to check out and this is a great time to try something new!

  • BeachBody – They are offering a two-week trial to new members.
  • Nike Training Club – This app is offering free workouts designed by trainers. It is available on both iOS and Android.
  • Tone It Up – This fitness program for women is offering a free month for new users.
  • Skyting – This yoga television is allowing new members one week free. Perfect time to try a different form of exercise, yes I’m talking to you powerlifters!
  • Barre3 – This full-body workout will help you work on your cardio, build strength and leave you feeling refreshed and empowered. They are offering two weeks free.
  • Comptrain – If you love CrossFit like me, this website is for you! They offer free workouts daily that are challenging and sure to humble us all!

Get Moving

Oftentimes, people think exercise has to be at a gym or running in a park but that is not the case! Doing a good thorough cleaning of your house (which we could all use right now), doing loads of laundry or cleaning out your closet is sure to burn some calories! Track your steps and calories burned on a device like Fitbit.

Dance Party

If you have children who enjoy Tik Tok, Just Dance, and other interactive dance games and apps, this is the time to get onboard! You can bond with your children while getting in a sweat.

No matter what you do to stay active, it is vital for both our bodies and minds. Getting fresh air, vitamin D and keeping our bodies moving is key not only for our physical but our mental health as well. The fact that it boosts our immune systems, too, is a great perk!

What will you do to stay active during these uncertain times? Share and comment below,  let’s all help each other!

Source: diabetesdaily.com

Shadow’s Edge: Video Game Designed to Help Kids Cope With Chronic Disease

Being a kid is hard enough as it is. Add in having a chronic disease and it can make those very special years potentially very isolating ones. Shadow’s Edge is a virtual reality game that allows children to process and express their feelings about their disease — or whatever else they may be going through. This mobile game can help change the experience of a serious diagnosis, or challenging times, by combining art therapy and cognitive behavior therapy and giving children a safe place to not feel so alone.

Action video games can help reduce depression in teens and Shadow’s Edge hopes to help bring positivity and community to those who need it most. Founder and philanthropist, Sherri Sabrato Brisson, is a brain cancer survivor who initially co-wrote a book, “Digging Deep: A Journal for Young People Facing Health Challenges ” with Rose Ofner, to help kids process their chronic disease or serious illness and it had great success. She then met Rosemary Lokhorst, who is now the game producer because of how much she loved the concept and that is how Shadow’s Edge was born.

Shadow’s Edge is a free and completely donation funded, virtual city that has just been overtaken by a storm, much like our lives after being hit with a diagnosis of some kind. The storm removes all the color from the city, much like our disease has the potential to take away some of our happiness…if we let it. The object of the game is to bring back the color to the city through writing and art, which helps empower the player to take on whatever it is they are going through.

Shadow's Edge

Photo credit: Shadow’s Edge

So far, Shadow’s Edge has worked with many organizations and university clinics in the US, Brazil and in Europe, focusing on kids and teens with cancer, and has received very good feedback, especially from doctors. Currently, they are running a complex research study nearby the Lurie Children’s Hospital in Chicago, with more than 100 kids testing Shadow’s Edge. So far, the results have been fantastic, and the game is helping these children build up the resilience to tackle the challenges they are facing.

I was able to chat with Sherri to find out more about Shadow’s Edge and their plans for the future.

Sheri, the journey you went through with brain cancer must have been so traumatic. Did writing your first book, Digging Deep: A Journal for Young People Facing Health Challenges, prove to be therapeutic? What about creating this game?

As a survivor, I can tell you, I know how difficult it was for me to even know how I was feeling at the time, let alone be able to express these feelings.

On my 25th anniversary of survivorship from brain cancer, I envisioned a world where every young patient has real-time access to the tools he or she needs to build emotional resilience through their experience.

I started by co-authoring Digging Deep: A Journal for Young People Facing Health Challenges, with Rose Offner, MA. I donated 35,000 journals to hospitals across the country, but it still wasn’t enough. So, we decided to meet young people right where they are—on their phones, playing games.

Seeing the success of your book shows that there is a need for resources and tools for people who have serious illnesses or a chronic condition. How do you think Shadow’s Edge can help fill that gap for our children?

Just like the physical journal, Shadow’s Edge helps teens build their emotional endurance to tackle the challenges they face through the power of their personal narrative. There are very few resources directed at teens today. Our aim is to meet them where they are – on their phones, playing games. So this time, teens are engaged through their medium—their phones or tablets—to express themselves through writing and now, covering a city in graffiti! Through gameplay, teen players realize they needn’t stay in their confined world—they have the power to reshape their world into whatever they choose. Through their expression, they can create beauty where there was once dilapidation: There can be light; There can be color; There can be hope. And, there can be a community.

“When starting to play Shadow’s Edge, a teen may not even know how they feel or what is troubling them. As they continue through their journey, they often discover they are at a different place emotionally in the end—there may be a sense of resolution, a greater understanding, a place of peace”.

I know for me personally, when I was diagnosed with type one diabetes, finding community changed everything for me. I was so much better off mentally and emotionally and had a much better outlook on my future. How does playing this video game help children connect with others? 

Yes – connection is key to build resilience and to feel better! Teens asked us for a space that is theirs only, where they can express things for themselves, as they are not always clear or ready to connect. Interestingly, this working with oneself helps to reach out. Additionally, the game has an in-game sharing space (once you reach the new level, Disillusionment). There you receive a means to see other players’ art and provide messages of support and where you can publish your graffitis. The community aspect is one that we are focusing on to expand – it is the key ask of players to build on.

I could see how the concept can be applicable to many different obstacles a child could be facing, what other areas are you focusing on and what do you hope to accomplish?

We are expanding the content so that teens facing a variety of difficult situations can benefit from it – these can be changes in the family like a divorce or death of a family member, bullying, anxiety, stress, depression, identity questions.

Shadow’s Edge has the potential to help so many children going through hardships. Where do you see Shadow’s Edge going from here?

We are working on expanding the community aspect of the game. We want to create a community around self-expression where teens facing all kinds of challenging situations can share, collaborate to create art, find psychoeducational content and just connect with each other.

As a brain cancer survivor, what message would you like to share with people facing a health battle of some kind? 

Your challenge does not define who you are, you define this. When you are ready, take an active role in opening up–every time you tell your story you tell it a little differently, this make you integrate it and see new perspectives. Practicing this also supports you to understand you are stronger than you think, getting comfortable with your story and owning it as a part of you, but not all of you.

Shadow’s Edge is available on both IOS and Android, and available in 6 languages.

They also have a special website dedicated to helping parents and healthcare professionals who are helping a young person with illnesses, see more information at www.diggingdeep.org.

Source: diabetesdaily.com

A Ketogenic Diet with Intermittent Fasting

This content originally appeared on Diabetes Stories. Republished with permission.While I’m typing this my right foot is in a surgical shoe. New Year’s Day I broke a bone in my toe and badly bruised my foot. For those who want the gory details: the husband and I were sleeping at my mother’s house and I […]
Source: diabetesdaily.com

Waking up with My Sleep Cycle

This content originally appeared on Type 1 Writes. Republished with permission.The one problem that I have been trying to solve for the better part of last year is why I often find myself feeling so tired. Despite getting a solid 7-9 hours of sleep each night, I was waking up most mornings feeling like I had gotten […]
Source: diabetesdaily.com

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