Diabetes Can Be Controlled But It Is a Constant Struggle!

Philipp was diagnosed with type 2 diabetes right after knee surgery in 2005 and his diagnosis was like a little odyssey. Before jumping into the interview with Philipp, here is what he shared about his diagnosis journey.

mySugr loves to show the many different faces and stories of people with diabetes in the real world. They do their own photoshoots and feature real people living with diabetes instead of using stock photos.

“I was diagnosed with diabetes in 2005, during the evaluation and testing to discover anything that would delay the total left knee replacement surgery.

Nobody mentioned anything about diabetes when I had blood work done the week before surgery.

But upon being admitted hours before my 8am surgery, I was told I was a borderline diabetic. I anxiously asked what does that mean? The technicians at the attending nurse stated that I had a predisposition to having diabetes.

As far as I was concerned, I either had diabetes or I didn’t. I couldn’t grasp the concept of borderline.

After surgery, and in the recovery room when I woke up, I didn’t think anymore about it.

However, once I was delivered to the ward and further tested that evening, I was told that I was now a full-blown person with diabetes. That was a shock, and I began gathering information from the staff. How could I go from borderline diabetes to having diabetes overnight? I wasn’t told what kind of diabetes I had until hours into the second day of my hospital stay. That is when I was diagnosed as type 2.

Upon my third day prior to my release, I was told that I was being prescribed oral diabetes meds and not insulin.

Several weeks later, I was dehydrated and became extremely thirsty and began drinking 32 oz. “slushy” drinks from the 7-11. One every hour.

It became so intense the next day. While my wife was at work, I became so concerned that I drove myself to the VA emergency room. After waiting more than 1 hour I was seen in the ER and after testing my blood sugar level, it was well over 300.

I was blessed for driving to the ER because my vision was super blurry and traffic was almost non-existent. What guided me mostly were the lane dividers that I could hear to guide me, muscle memory for guiding the vehicle and knowing how far away the VA was from our home.

The experiences that are key here are extreme thirst, extreme body temp rise, the extreme need to urinate multiple times in an hour, visual impairment, and potential for bad decision making that can wind up in a very serious situation.

 

1. What was your biggest fears/concerns when you were diagnosed with diabetes?

That it was a mistake. I wasn’t overweight, I exercised regularly and watched what I was eating.

2. What’s the hardest part/biggest struggle for you in living with diabetes day-to-day?

First was the prescription for diabetes medication that the result was not managing my sugar level. Second, not believing this disease couldn’t be eliminated. Third, monitoring my sugar regularly and the levels did not fall below 200.

3. What piece of advice would you give to a person who is newly diagnosed with diabetes?

My advice would be to research as much as possible to get accurate and reliable information regarding diabetes. Do not believe that diabetes can be eliminated. Diabetes can be controlled but it is a constant struggle.

4. Is there a phrase/statement about diabetes that drives you crazy?

Yes! The statement that diabetes can be eliminated by a regulated diet of certain meds drives me crazy.

5. When you think of the word “freedom” in terms of diabetes, what does that mean to you? What would make you feel more free?

Freedom for me would mean that diabetes can be cured in a certain amount of time.

Source: diabetesdaily.com

Review: Wellue 02Ring-Ring Oxygen Meter

It’s the year 2020 and unfortunately, due to the COVID-19 pandemic, many people are rethinking how to monitor and manage both their family’s and their own health. With so many doctors moving to telehealth, many are purchasing important health products so they can better assess and monitor their health conditions from their own homes.

The COVID-19 virus is leaving many patients with dangerously low levels of oxygen even when they are feeling well. An oximeter was one of the most coveted devices that people were searching for when COVID-19 began per many healthcare workers’ suggestion.  The Wellue O2Ring is a ring oxygen meter that tracks you and your loved one’s oxygen levels so that you can pick up this warning sign and get medical attention before the patient’s condition worsens.

Who Are They?

Wellue is a brand belonging to Viatom Technology that creates medical and wellness products that are consumer-friendly and help people to better detect and manage their health conditions. Wellue has many other medical devices available with medical-grade accuracy.

What Is It?

Wellue O2Ring is a patented smart device that allows the patient to monitor their oxygen levels and heart rate for long periods of time and is designed to be comfortably worn overnight. The many features allow the patient to be notified of low oxygen and heart rate levels, collect data and send reports to their healthcare team. It also comes with a companion app that shows both data analysis and trends allowing the patient to feel empowered with information about their health.

Photo credit: Wellue

Some of the key features of the O2Ring are:

  • Overnight tracking: The device continuously tracks your oxygen level and heart rate.
  • Adjustable vibration and intensity alarm alerting you of low oxygen or abnormal heart rate.
  • Free PC software and Mac app which allows you to print and share all data with your healthcare provider.
  • The O2Ring is rechargeable and lasts 12-16 hours with stand-alone memory, meaning a smartphone is not even needed.

Where Can I Purchase and How Much Does It Cost?

Wellue sells its products on its website and it is also available at Walmart and Amazon. I found the lowest price to be on their website which was $170. Wellue is currently offering Diabetes Daily readers a 10% discount. You can purchase on their site using this discount code: BLDIABETES10.

Photo credit: Wellue

My Review

At a time where many are neglecting routine visits, settling for virtual care, and wondering what the future of healthcare looks like, this is the perfect time to invest in your health. Having medical products at home can help you stay ahead of your health conditions. Wellue also makes many other medical devices such as pediatric oxygen masks, blood pressure monitors with oximeters, forehead and ear infrared thermometers, and Babytone Fetal Heart Monitors, to name a few. All these products can help give you peace of mind about you and your family’s health.

Whether you struggle with chronic obstructed pulmonary disease (COPD), sleep apnea, asthma, pneumonia, or any other health conditions affecting your oxygen levels and heart rate, I highly recommend the O2Ring oxygen meter. It is comfortable to wear and it alerts the patient without disrupting their partner’s sleep, lessening the burden on our loved ones, which many of us stress over.

Being proactive with my health makes me feel empowered to manage my type 1 diabetes and my overall wellbeing to the best of my ability. Having technology like this at your fingertips (in this case, literally) can make taking care of your health a lot easier and add years on to your life. Wellue uses the same type of technology that hospitals do, which makes me feel extra confident that their products are of the utmost quality and accuracy. In summary, I highly recommend their products.

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

Making the Most of CGM: Uncover the Magic of Your Ambulatory Glucose Profile

This content originally appeared on diaTribe. Republished with permission.

By Cindy Takigawa and Frida Velcani

What’s an AGP report, and what does it show? Why does my AGP matter? How can I use an AGP report to improve my blood glucose levels and time in range?

Having diabetes is a full-time job: you have to simultaneously monitor your diet, activity, stress, and even sleep. On top of that, you need to calculate and manage the number of carbs you consume in each meal, and keep careful tabs on your blood sugar levels. The Ambulatory Glucose Profile (AGP) report, developed by the International Diabetes Center, is a tool that provides a simplified way to look at data on your blood glucose patterns and trends. It has been recognized as a standard of care for reporting continuous glucose monitor (CGM) data by the American Diabetes Association. In this article, we explain what an AGP report is and how you can use the information to help you navigate your diabetes management.

CGM App

Image source: diaTribe

What is an ambulatory glucose profile report?

An AGP report is a standardized, single-page report that includes glucose statistics like time in range, a summary glucose profile, and daily glucose graphs. It converts blood glucose readings from a CGM device into a detailed picture, allowing you to quickly visualize the time you spend above and below your target range. The report is based on at least seven days of CGM data, with 14 days of data (or more) considered ideal. Currently, many CGMs include a version of the AGP report in their devices and reporting software.

An AGP report that summarizes data provided by self-monitoring of blood glucose (SMBG) is currently being developed. This article focuses on CGM AGP reports.

Why does my ambulatory glucose profile matter?

The AGP report is the same no matter what device you use – it allows your healthcare team to assess blood glucose levels and trends in a standard way for everyone they see. Below you’ll find sample AGP reports from Abbott, Dexcom, and Senseonics.

The AGP report shows patterns in a user-friendly way so that people with diabetes can easily identify the times of day when glucose levels are consistently low, high, or fluctuating. The general goal for people with diabetes is to have their glucose levels stay within the target range of 70 to 180 mg/dL for at least 70% of the day, spending less than 4% of their time in hypoglycemia (under 70 mg/dL). The information from an AGP report can help you have a discussion with your healthcare team about goals for your diabetes management and ways you can achieve them. The data offered by this report can help make your care far more precise and effective.

What exactly does your AGP show?

The standard AGP (designed by the International Diabetes Center and shown above) will show your data like this:

  • Glucose Statistics and Targets: This section displays metrics including average glucose, glucose variability, and Glucose Management Indicator (GMI), which can be thought of as your predicted A1C. It also includes the dates and number of days in the report, as well as the percent of time that the CGM was used to collect data. While time in range goals can be individualized, the expert-defined goals for various groups of people with diabetes can be found in this section. You can read more about time in range targets here.
  • Time in Ranges: This color-coded bar chart helps you visualize the percentage of time spent above and below your target range.
  • Ambulatory Glucose Profile: This graph combines all of your glucose readings over time to display your trends across a 24-hour period. At the end of this article you can find examples of what this will look like for your specific CGM.
    • Black line: the median of all the readings. Half of your glucose values are above the middle black line and half are below.
    • Green lines: this is your target glucose range.
    • Dark blue area: 50% of glucose values lie in this area.
    • Light blue area: 90% of glucose values lie in this area. This percentage may differ between AGP reports. The International Diabetes Center report includes 90% of glucose values, while the Eversense report shows 80% of glucose values.
    • Dotted blue lines: 5% of the highest and lowest glucose values are above and below this line, respectively.
  • Daily Glucose Profiles: Each box shows your glucose pattern from a single day.
    • Yellow area: instances of high glucose (hyperglycemia).
    • Red area: instances of low glucose (hypoglycemia).

How can I interpret an ambulatory glucose profile report?

An AGP report combines several days of blood glucose readings into one snapshot. Once you have identified daily patterns, you can work with your healthcare team to adjust your medications and insulin dosing to spend more time in range. You may also discuss timing of food or physical activity, what you are eating, or ways to reduce stress. Here are some steps you can take to understand your data:

1.     Look at your time in range. The goal is to shift the numbers into the 70 – 180 mg/dl target range while having fewer lows and extreme highs. Each AGP report includes a bar chart of your time in range; one way to see this goal in action is to aim for more “green” and less “red” on the bar chart.

2.    Keep track of the usual times you wake up, go to sleep, eat meals and snacks, and are physically active. Food, activity, medication doses, and dozens of other factors can affect your blood glucose levels. Recording these activities and their timing will help you understand your AGP report and the patterns you see.

3.    Identify times when your glucose levels are lowest and highest, and look for times of more variability. Speak with your healthcare professional about what factors may be causing highs, lows, and variability in your AGP and how you can reduce them. The wider the shaded blue areas on your report, the more variability there is in your glucose levels.

4.    If you can, compare your current and past AGP reports, and create an action plan with your healthcare team. What strategies did you use previously to make changes? Identify a few steps to improve your glucose patterns moving forward.

To learn more about how people with diabetes and healthcare professionals can use AGP, click here. For more resources on time in range, check out diaTribe’s comprehensive library here.

Abbott AGP

CGM App

Image source: diaTribe

Dexcom AGP

Dexcom

Image source: diaTribe

Eversense AGP

AGP

Image source: diaTribe

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

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

Teenage Boy Receives Novel Stem Cell Therapy

Editor’s note: This article was updated on 7/31/2020 for accuracy regarding the specific stem cell treatment used. 

A lot of research is ongoing to develop novel therapies for type 1 diabetes. Many investigators are now focusing on the potential of various stem cells therapies. One approach involves using mesenchymal stromal cells (MSCs) (which can be obtained from the umbilical cord) and directly injecting them into the pancreas in an effort to induce insulin production. These kinds of treatments are still in the early experimental stages, with some clinical trials ongoing.

Seeking an Experimental Treatment Abroad

Just last week, Vera and her son Aaron set out to have the procedure done at Cryovida in Mexico. After having a difficult time managing his diabetes, Vera vowed to do whatever it took to lessen the burden for both her son and herself. Since Vera first posted about their upcoming journey, the diabetes online community became intrigued. Vera even started a Facebook page where people could learn and ask their questions. I thought it would be good to hear from Vera about the whole experience and how Aaron is doing now.

At what age was Aaron diagnosed with type 1 diabetes?

He [had] just turned 15.

How have Aaron and your family been managing with his diabetes leading up to this life-changing procedure?

Probably the hardest time in our lives. In the honeymoon stage, my son’s attitude was almost impossible to deal with. As he got used to monitoring and stabilizing, he improved. My son is on the spectrum, so he was always difficult. He would forget to take his long-lasting insulin, not cover for the junk he would eat, and his sugars were almost always over 500. It was living in hell. Six months ago, my son came to live with me in Mexico (he was living with my mom in NJ, because he wanted to finish school, and we moved to Mazatlan, Mexico 3 years ago). When he came his blood work was so bad that the doctor didn’t know how he was walking. His A1C was over 20, his triglycerides were over 700! The doctor immediately changed his insulin. He said they had him on such a low dose, no wonder we could never control it, and put him on cholesterol meds, which my son never took. Just two months later my son’s triglycerides went down to normal (and he never took a single med for it; It is just the fresh food here), and his A1C was down to 18. By the time we went for the procedure, his A1C was down to 15.9. My son still doesn’t listen, and eats tons of junk, does not cover for it. I have to be on top of him 24/7 to check his blood and take his insulin. So, if this works I may retire from my position of a drill sergeant.

What prompted you to start looking for possible cures or treatments? How did you hear about Stem Cell Educator Therapy?

My son [was] almost dying, and his dream to go into the military was taken away from him. My husband is a retired Vet, his father is a retired Vet, my grandfather was a retired Vet. We are a military family. This may give him the opportunity to serve, which is all he wants. I heard about it from research. I started googling diabetes cures and ran across different articles for stem cells. I always read everything, I rarely follow what is being pushed by news or politicians. I sit and read.

What are the benefits of this procedure for a patient living with type 1 diabetes? And what are the risks involved?

Well, ultimately a full cure, but for those that do not get cured, it lowers their need for insulin substantially. Risks… honestly not much [from] the procedure itself, but the normal risk, possible bleeding, pain in the area. Long term, diabetes can come back. Scientists still have not figured out how to protect the new beta cells from being attacked again by your immune system. For me, that is a risk I can live with. Even if he gets a year diabetes-free, I would pay and do the procedure again. The longest known case has been diabetes-free for 3 years now.  I am hoping [the]  next huge development will be scientists figuring out how to protect the new beta cells.

How did Aaron feel about it? Was he nervous? Excited? Or a little bit of both?

OMG, he was a mess. At first, he was stoked about it. He couldn’t wait. Then came time for the procedure, and he was like, “nope”. He was sitting in the huge cat scan room where they were doing the procedure saying “no, I don’t want it”. I had to tell the anesthesiologist to get him sedated ASAP, or my son was about to run out of the hospital in the gown down the street!

How was it dealing with Renu and Cryovida? How were the doctors? Were they able to speak English so they could communicate with Aaron?

First, I am lucky enough to live in Mexico, but I speak horribly. We were able to set up the full thing in one week. The reps did everything. They spoke perfect English. Once at the hospital, the doctors spoke English, Went through every piece of paper I signed, explained everything to me and my son. Let my husband and I be in the room until the procedure started (even though the hospital had a rule; one person per family due to COVID). After the procedure, all the doctors came in, explained everything. Gave me all the paperwork. The reps from Renu came with us from Mazatlan to Guadalajara, a six-hour drive, and stayed the whole full three days with us to make sure everything was okay. It was an overall great experience.

Image credit: Vera Mazatlan

How long did the procedure take and generally speaking, how is it done?

They were done in an hour, but most of the time was prep. The actual procedure takes 10 minutes. They make a hole in the femoral artery and lead a scope into the pancreas, where they then inject the cells.

How does Aaron feel now after the procedure? Did he have a lot of pain right after?

He feels amazing. The first thing he noticed is that his eyesight was no longer blurry. He was only in pain on the first day. Now he is back to his crazy self. He also has tons of energy. He was so sluggish before. That is the biggest change.

Have you noticed any changes to his blood sugars yet? Do you notice any fewer peaks and valleys? Has he tried experimenting with new foods or is this too soon?

When can he expect to see some results? I have noticed his blood sugar is lower, even after he eats junks. He is 17, controlling him to eat right is IMPOSSIBLE! They said I should start seeing a real difference in about 45 days to 6 months. Depends on each person.

Now that is it over and behind Aaron, how is his perspective looking forward to living with this disease? Is he glad he did it? I bet he can’t wait to see the results!

He is beyond grateful to possibly be given a chance to be diabetes-free. He still wants to go into the military. To him, this is a gift he would never get. I made him a promise [that]  if there was a way to cure him, I would pay any amount of money, and go anywhere to do it. I have fulfilled my promise.

What would you share with our community who has been so intrigued by your story, any advice you could share having gone through this with your own child?

Never give up hope, and never take no for an answer. If the doctor is not giving you the answer you want, get a second, third, fourth, doesn’t matter how many opinions. There is always hope and new science out there. Yes, it can be expensive, but ask yourself, what is your child’s health worth to you? Also, READ EVERYTHING. Science changes monthly. Keep reading, keep joining groups, keep reaching out. Forget what you hear on the news and from politicians, you are the advocate for your child. Go against the grain, and be a trendsetter. Those are the people that make a difference.

Vera, thank you so much for sharing both you and your son’s experience. We wish Aaron nothing but health and happiness and we will continue to follow his journey!

What are your thoughts on this kind of experimental treatment? Is this something you would consider? Share and comment below!

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

Are CGM Users Aware of Time in Range?

This content originally appeared on diaTribe. Republished with permission.

By Eliza Skoler and Rebecca Gowen

dQ&A surveyed 2,540 CGM users with type 1 or type 2 diabetes to find out how aware they are of their own time in range: 87% of respondents knew how much time they spend in range daily

Time in range is the percentage of time that a person spends in their target blood glucose range (70-180 mg/dl). This measurement of diabetes management along with time below range and time above range helps people assess patterns and trends throughout the day to inform daily treatment decisions in a way that A1C cannot. It is also becoming more well-known and accepted in the world of diabetes as a good indicator of diabetes management.

dQ&A, a market research company, wanted to measure people’s awareness of their own time in range. They surveyed 2,540 people with type 1 or type 2 diabetes who use continuous glucose monitors (CGM). The following question was posed to respondents: “Do you know roughly what percentage of your day (on average) you typically spend with your blood sugar between 70-180 mg/dl?” For those people who answered yes, dQ&A then asked them what percentage of time they typically spend in the target range (70-180 mg/dl) each day. It is important to note that the majority of people included in this survey were White, had type 1 diabetes, and were using an insulin pump.

Important survey results included:

  • 87% of all respondents knew roughly how much time they spent in range each day, while 13% did not. These results were generally consistent across several factors including people with type 1 and type 2 diabetes, adults and children, and people with type 2 diabetes who were or were not taking insulin.
  • 29% of respondents reported that they typically spend 71-80% of their day in range. 30% of the people surveyed reported a time in range above 80% while 41% of respondents reported a time in range lower than 71%.
  • People with type 2 diabetes who are not taking insulin are significantly more likely to report spending 91-100% of their day in range (36%), compared to adults with type 1 diabetes or people with type 2 diabetes on insulin (9% and 11%, respectively).
  • Time in range was higher in older age groups. The group with the lowest self-reported time in range was people under the age of 18: only 44% of people 18 years or younger spent more than 70% of the day in range, compared to 56% of people ages 18-44, 62% of people ages 45-65, and 68% of people over the age of 65.

Our takeaways from this data:

  • Among people who use CGM, the majority acknowledge time in range as a measurement of their glucose control. However, we believe more people can be educated on how to understand and act on their time in range data.
  • The majority of people with type 1 and type 2 diabetes report achieving the  time in range target of more than 70% and this was particularly true for those in older age groups.
  • An important focus should be placed on helping young people find strategies to improve their time in range and incorporate it into their self-management.

To learn more about time in range click here.

Source: diabetesdaily.com

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