Sunday 19 October 2014

CGM: A happy distance

Since the first time I inserted a Dexcom sensor and saw my 5-minutes-apart glucose readings flash up on the screen in front of me in real time, I have never looked back. It was a commitment, deciding to self-fund the arguably expensive tool to manage my blood sugars, but a sacrifice it was not.  My choice to use CGM wasn't about the SafetyNet it provides, although that is a selling point in itself. Instead, it filled in the frustrating gaps I experienced when trying to gain better control.  

Going all non-integrated, again.
But last night, as I pulled myself firmly into the back of my peaceful sleeping husband, matching my shape with his, and trying to improve the already bad night's sleep I was having, my Animas Vibe, now having my CGM readings integrated into it on an almost permanent basis thanks to the convenience that brings, started to violently vibrate in the small of his back.  He awoke with a fright, and patient soul as he is simply asked, "Are you OK?"   It was the third hypo of the night, and it was the third night like this in a row. As tired as I was of treating hypos, I'm sure his tiredness was greater still.  He didn't even need to be awake.  A safety-net it is, but a sleepless night and being awoken by the endless buzzing beeping and frightful noises of the Vibe were enough for me.  I treated my hypo - a slight dip below 4.4 mmol - and turned my CGM function off, leaving the redundant but brand-new sensor in my arm. 

This morning I decided to switch back to my handheld receiver.  The downside being that I have to carry yet another device with me.  But the benefit being I don't have to keep it attached to myself, or my long-suffering husband, for a little while.  I quite often don't hear the initial beep or vibrate of a first hypo warning.  And quite often, my blood sugars are simply nudging above and below the alarm line.  That way, a slight drop in blood sugars which was always going to correct itself doesn't need to be the frustrating interruption it sometimes needs to be.  And my husband can sleep easy.

And sometimes, we just need a break from it all.

Friday 10 October 2014

The cure? Could it be?

Diabetes 'cure' stories are ten-a-penny these days; as a routine today as collecting your prescription or brushing your teeth. Some hinge on theories or ideas still decades off materialising into anything tangible. Others - okra-cocktails and vegan-raw-superfood diets - are simply hokum. I barely register them anymore, because the psychological bashing that allowing yourself to believe that the rigmarole and emotionally-draining long-term management of a chronic condition could be over, is a bashing I am happy to forego. 

But this morning, as I stood over respectable broadsheet 'The Times' laying on the pile of newspapers at the corner shop, reading and re-reading the title, my heart started to thump a little faster, and I was oblivious to the world around me. 

"Diabetes: a cure at last" it read.

I'd seen a photo of the headline in my Facebook timeline and for the first time ever, had made the effort to pick up a copy and take a closer look at the research. In the past efforts to cure diabetes have been dogged by issues. Islet transplants overshadowed by the need for anti-rejection drugs and limited lifespan of the cells once transplanted, not to mention the 3-4 donors (passed-away people) need per diabetes patient. Stem cell researchers needing to did a way to tailor cells to each individual patient, a task so major that those diagnoses would outweigh cured patients at a rate of knots. And then there was the 'bio-hub' fiasco. A great idea, but little more than an idea, pulling at the heart strings of parents and adults desperate to see an end to diabetes. If was no more than a funding drive, aimed at bringing in the dollars before it could get underway. 

The story in today's paper, was different. It wasn't an idea. It wasn't a piece of research now setting our to address the many anomalies they identified. It wasn't a funding drive. It is a piece abut the success scientists working at Harvard - already 23 years in the making - have seen in identifying a strain of genetically modified stem cells which can be transplanted into ANY person with type 1 diabetes, and 10% of people with type 2, in large enough quantities to eliminate the need for insulin. The cells, protected within a proud capsule (think bio-hub, only already in existence) allowing them not only to be protected from immune attack, but also removed quickly if they were to stop working. The study did say that it would be a number of years before we would be using this routinely in patients, but that it is already in final non-human primate trials, before human trials begin.

Could it be? 

What's more, the article tells of how one of the lead scientists, Professor Doug Melton, chose this field of research when his son was diagnosed with type 1 at six months old. Later, his daughter would receive the same diagnosis. I liked this guy already, now, I really understand his passion. 

As I sit here in my car having thumbed through the pages of the article, my CGM alarming to tell me that my glucose levels have gone over the range I need them to be in today already, the idea that there may be an end to this one day is a dream. It seems possible, but in the murky, strange way a dream does: moments of vivid clarity followed by moments of 'naaaah, it can't be'. 

I will let the human trials commence before I let my mind set on the idea of one day not having to worry and fret my way through each day, living a life dictated by numbers, portion sizes and thinking about the future in all the wrong ways. What's more, the idea that my children, who one day may face the same diagnosis, may avoid the decades of injections, food measuring and finderpricks I have, somehow gives me peace. 

I hold on to hope. 

Friday 3 October 2014

The rough(ish) with the smooth

I'd known when my consultant handed me my blood test forms, with a few more boxes ticked than I care to think about, that my latest set of results were not going to fare all that well.  My recent wrist operation, teamed with a trip abroad and countless (wonderful) hours at the computer arranging the Adventure D launch weekend, mean I have been wildly inactive in recent weeks and have been relying on fast food. And I know what that means for my HbA1c.  

As I approach my mid (arrrrghhhh!) 30s (wait, WHAT!) I consider more and more how I might approach a pregnancy one day, and know that in order to vastly reduce any risk of the endless list of complications thrown as us PWDs with an achey baby-maker, I know that ideally I need to get my HbA1c down towards the 6mmol or below mark.  You would think that with CGM, a pump and my knowledge of which foods do, and don't, work as well for me, I would be able to nail this. Not so.  My approach to managing the busy events of my life of late has been to use my CGM as a safetynet, my pump as a justkeepmealivegoddamnit tool and my diet has been, well, let's not even go there.

My penultimate A1c result was an attractive 6.4%.  My latest was a somewhat less-so 7.6%.  

Normally 7.6% wouldn't concern me greatly, but it highlights for me the battle that wannabe mothers have on their hands, and that no amount of 'getting by' will suffice when considering motherhood with type 1.

And it's back to the drawing board for this little goof-off.