Featuring yours truly......!

About a year ago I was bimbling around on the Internet and happened to type into Google, something along the lines of 'Diabetes charities Hampshire', because I really had no idea what there was in my area other than JDRF South. I wasn't expecting to find much, but found myself typing it in anyway.

There had to be more than one diabetes charity, surely?

To my delight I stumbled across a charity based only 15 minutes down the road from me. Small world, ay! They are called the Diabetes Research and Wellness Foundation and despite being a small outfit, they have a big message; Staying well, until a cure is found.

Over the last year I have taken part in their Bootcamp event, have been brought to tears by their message of hope, have done a sponsored walk in their favour and have popped in for several cups of tea with their team. They make a really good cup of tea, FYI.

To my delight, they asked yours truly if I would like to write their tale end news piece for their February newsletter.

Um, would I ever!?!

I chose to write my piece about exercise because that is one of the true keys to success when 'staying well' with the 'betes, so seemed to fit quite nicely with their aims.

Unfortunately they don't have an online version, so I have copied it all down for you below. But check out their website on this link for more info on what they do and if you can, pop in for a cuppa sometime. I'm sure they won't mind......

My name is Anna and I am many things. A daughter, a sister, a wife and a friend. I love to surf and snowboard but can do neither whilst standing up. I love Autumn, Cornwall, black and white photography and animals. I am also a type 1 diabetic, juvenile onset, insulin dependent - the beast has many names. Diagnosed at the age of four, I must have been through every stage of acceptance in the book; I was the child who couldn't understand it, the teenager who fought against it, the young adult who reluctantly accepted it into her life and am now fully fledged (but still very young at heart!) adult who manages to negotiate each day with reasonable success.

For many years I struggled to achieve anything which looked like even basic control. In fact for me, 'stable' was a place you kept a horse, not something you could expect from diabetes. So after fighting against it for far longer than I care to remember, I finally took up the suggestion my team at Queen Alexandra Hospital in Portsmouth made, of trying an insulin pump. Even though the pump is still something which is only available on the NHS for type 1s who meet certain criteria, going onto a pump came with a wealth of information about carbohydrate counting, exercise and cutting yourself some slack when things go a bit 'wonky'. All of which can make a difference without ever having a pump.

Perhaps the biggest realisation for me was about the benefits of exercise. Having avoided it for many years and using excuses like 'my control just isn't reliable enough', starting exercising on a regular basis was one of the turning points in my diabetic control. I started going for walks in the country or strolling to and from work every day, all the while noticing my insulin requirements dropping almost by the day. I found that whilst cycling and for several hours afterwards, I needed only 10 per cent of the insulin I normally need in order to keep my sugars in range. I found that yoga brought my sugars down nicely every time and even my 10-minute cycle to and from work has my sugars in check by breakfast.

Earlier this year a friend even convinced me to try 'Body Combat'. Whatever you are thinking about how intense it sounds trust me, it's tougher! Imagine being with 50 other people while high octane music blares out and an instructor who apparently has limitless energy shouts through a microphone,while you attempt to mimic them (and fail drastically), all the while using moves from martial arts and - if you do it like me - 90s rave. Now also imagine that this exercise propels your fitness, energy levels, self confidence and general well-being faster forward than anything else you've tried.

So what is the key to exercising? As I found out, it is to treat it like an experiment. When trying a new exercise try to eat similar foods before and after and do it at the same time of day. Take a little carbohydrate (like a banana) before exercise to give your body a little boost, even if you need to inject for it. Be confident and don't write it off after the first attempt. It took me weeks of body combat to discover exactly the right formula and now I am at the front panting away, enjoying every minute and reaping the blood glucose benefits.

The message I want to get across is that it doesn't matter what form of exercise you do whether it is team games, high intensity cardio, a gentle stroll or even stretching; moving your body in any way allows your body to use the insulin you either put in or still produce yourself much more effectively.

And frankly, it makes you feel top notch!

The Advanced Technologies and Treatments for Diabetes conference 2012

The 7^th -10^th February 2012 saw the arrival of the international event known as the Advanced Technologies and Treatments for Diabetes (ATTD) conference, which I was lucky enough to be able to attend as a representative of INPUT and funding from Dexcom to assist INPUT in the work they do. The ATTD is a worldwide conference where research outcomes at the very forefront of technological advance are presented. Being only 5 years old it is still in its fledgling years, but growing noticeably each year. Although I was not at last year’s event, I am informed that there were around 1000 attendees. This year, there were 1600 and I’m sure there are many more who would have attended given half a chance. It is aimed at diabetic professionals (or professional diabetics, in my case) mainly being consultants, nurses and diabetes educators, although the odd advocacy service pop up here and there too!

Being an insulin pump user, a diabetes advocate and a bit of an inquisitive old lass, it is always of great interest to me to see where this diabetes technology beast is heading. We hear terms like ‘Artificial Pancreas’ and ‘non-invasive glucose monitoring’ thrown about on an almost daily basis now and yet many people in the diabetic community feel these are creatures of myth and seem to hold a ‘that’ll be the day’ attitude towards them. So to be involved in a conference where this research is being presented was an honour and frankly, somewhat of an eye-opening occasion for me. .

Clearly it would be impossible to go through each of the presentations, symposiums and workshops in detail. Not in the least because my less than scientific mind would never be able to recall all the details for you. But perhaps giving you an idea of the things that caught my eye would be of use.

One of the stands in the exhibition which I kept circling in a slightly cautious way, was that of C8 Medisensors. In case you haven't heard of them (I hadn't), they are bringing to market a non-invasive glucose monitor that uses Raman Spectroscopy technology which for those of you who don't speak 'medical journal', is effectively a light that shines through the skin and identifies how many glucose particles there are in the interstitial fluid. Phew, mouthful ay. Well, according to early tests they are showing promising results, although the last test only involved 6 people. I would need to see a significant higher amount before I would be convinced it would rival the likes of Dexcom 7+ and Medtronic Enlite. Now we all remember the success of previous non-invasive systems such as the Glucowatch, the remnants of which remains burned on the skin cells of countless diabetics who had the misfortune of using it. But this was impressive. In its current form it is a bit on the 'chunky' side, and is held around the midriff with a tight neoprene band. But for those parents out there who hate the feeling of piercing their children's skin with countless needles they have to face, I think this could be a contender. If, and only IF, they come good in clinical trials. Watch this space.

For quite some time I have been aware that in order to avoid post meal spikes I need to bolus 30 minutes before each meal, otherwise those spikes just creep in a couple of hours later. But we also know that each diabetic is different and we are told all the time to find our own way. So I was very interested in a lecture about bolus times in children using insulin pump therapy. In the results being demonstrated to the audience, the message was that 15 minutes was the optimum pre-meal bolus time to avoid those spikes. In addition to this the study, called “Fine Tuning of Insulin Pump Therapy in children with type 1 diabetes: The importance of bolus timing and type” demonstrated that making the most of dual wave boluses and separating correction boluses and meal boluses, would make all the difference. They found that with mediterranean food for example, boluses were split 70% straight away and 30% over 4 hours, while Pizza was 30% straight away and 70% over 6 hours. They also highlighted that the results of their study showed that when blousing for a meal, any correction bolus being included with the meal bolus, should be separated by 15 minutes, and that this would bring glucose down to normal via the fastest route. Fascinating stuff for me, someone who has always struggled to get my head about a dual waver

One of the key lectures for us to attend included INPUT’s very own Lesley Jordan taking to the stage. Lesley has been involved in a pioneering project to trial the Accu Chek Diaport, an intra-peritoneal (goes into the peritoneal cavity in the abdomen) infusion site which is permanently fixed (as long as the host wants it, that is). It is surgically implanted and regularly maintained and allows for insulin to be much faster acting (see number 3 on my list), removes the worry of hitting a bad site and means much better control. It may not be for everyone as it is surgically implanted but for those with site problems leading to frustration and poor control it provides a very useful tool in helping achieve control over their condition and maintain use of an insulin pump effectively. Lesley has been one of the Diaport 'guinea pigs' and thanks to feedback from her, the new and improved second generation is ready to launch.

There were also stands demonstrating the Omnipod, the Accu-Chek Combo, the Medtronic Veo and my particular favourite of the moment, the Cell-Novo. I had the chance to catch up with some old friends from Medtronic, meet new ones at Roche and Cell-Novo and had a chance to thank Dexcom for supporting INPUT and in a round about way, helped me attend such an inspiring event.

Friday the 13th

I am not a superstitious person. I own two black cats, have walked under countless ladders, I don't wink/wave or clap at magpies and seeing only one doesn't move me in the slightest. I often walk under scaffolding and I never throw salt over my shoulder, that is just plain messy. Dates in the calendar - particularly superstitious ones - mean nothing to me

But on Friday 13th January, I had an extremely unlucky day. After attending the funeral of my grandmother (you could argue that was worse for her than me but nevertheless, it was tough) I found myself having driven for 5 hours and in need of some quick fix food in the evening.

I tested my BGs en route to the shops to buy myself a Pizza and was a comfortable 8.8 mmol (that's pretty good - 4-10mmol is acceptable). I picked out my pizza and knowing how much pizza normally makes my stroppy little condition fly off the handle, injected what I would need for the Pizza nice and early, to give the insulin a chance to work before I bombarded my system with garlic bread and pizza dough.

This was all a good plan and in normal circumstances would probably have been the right way to go. However, after bolusing (delivering insulin through the pump) the amount I needed, I started to complain of how very tired I was from all the driving and asked Jamie, my husband, to take over for me.

It wasn't long before I was sat tucking into my pizza but also being very aware that the overwhelming feelings of tiredness I had been experiencing were actually a nasty hypo which had snuck up behind me without much warning. There was no shaking, nervousness, sweating, nothing. Not until this point, anyway. As my cognitive function began to slow down, leaving me with the last image I had looked at, no matter where I looked, the feelings of panic began to set in. But this wasn't like my usual panic. I usually just worry about where my glucose treatment is, but know that I can cope with it. I downed a huge glass OJ and hoped I would recover quickly.

But this time was different.

I began to convulse (something which I thought was impossible while still awake) and within moments was screaming because my mind could no longer understand what was happening around me. Jamie at this point had managed to lead me to the kitchen to wash my hands for a blood test, but that was the last time I would make any sense. Hearing the TV in the background, my mind had begun to convince me that people were in the flat. I knew for sure they were behind Jamie but he wouldn't turn around. WHY DIDN'T HE TURN AROUND?? I was screaming at him and panicking so much that he stood no hope of getting the Glucagon into me. I could barely see for shaky vision at this point, and the next thing I knew, Jamie was stood above me with the ambulance people on the phone, them asking if I was being violent (what with all the shouting and screaming).

The last thing I remembered was being collapsed on the kitchen floor, screaming and crying because there were people touching me and I couldn't see them (these were the convulsions, only my brain didn't have enough glucose in it to understand that).

As quickly as I slipped into that hypo, I was out again. Two ambulance men arrived within minutes - 3 to be exact, according to Jamie. At this point I was able to talk again, had stopped screaming and the large glass of OJ was taking full effect. As quick as that it was over. It took a while for my glucose levels to return to normal, but even after 2 glasses of orange juice I was still only 2.7mmol (anything below 3 is a serious hypo).

I can only imagine that the 8.8 I had seen only an hour before was on the way down at a drastic rate and that by the time I had taken my insulin for the Pizza I was fueling an already nasty hypo.

I have always been lucky in that hypos come and go for me with never a great deal of excitement. I haven't needed assistance for the last 10 years and expect it will be another 10 before it happens again. But it goes to show that even those diabetics who walk a reasonably stable glucose path can be struck by the odd stealthy hypo.

It also goes to show why even people with 'good' control would benefit from CGM. At the rate that one hit me, I would never have seen it coming even if I hadn't been tired, even if I hadn't eaten the Pizza.

It also goes to show that not everyone gets hypo symptoms all the time. Mine normally hit me like a freight train. This one didn't. This one went all ninja on me!

An islet of Langerhans named Jeff

Explaining diabetes is never straightforward. Most people are lucky enough not to have to know what insulin, adrenaline, islets of langerhans or beta cells are, or what they all have to do with one another. But despite not needing to know, most people do show a general interest and I love to be the one to tell them. Any opportunity to put the record straight is a bonus, as far as I am concerned.

So when I was recently out having some coffee at a Krispy Kreme with my brother and neice, the arrival of the food at the table led to the inevitable retrieval of the pump from my pocket and my brother Ben, always keen to show her knew things, pointed out my insulin pump. Intrigued as most children are about new things she piped up, "What's that?".

Now normally anyone who looks that interested in my insulin pump is fair game as far as I am concerned. The problem is, I have never explained diabetes to a 4 and a half year old and explaining an insulin pump often baffles even those who understand diabetes and know the basics of the condition. So how do you manage it with someone who doesn't yet understand what insulin is, let alone the role it plays in the body.

As I thought about what to say and started stumbling over my words and starting over again and again, it dawned on me that perhaps she thought I didn't actually know what diabetes is! Clearly going down the route of "Once upon a time there was an islet of Langerhans named Jeff" wasn't going to go in the right direction and neither would in depth discussions about the pathophysiology of diabetes and lack of ability of the pancreas to produce and secrete insulin into the bloodstream, allowing for the transportation of glucose to the muscles for energy, was also going to confuse the hell out of her.

I looked at my brother in desperation. "How do I explain this?"

"With the truth" he encouraged me.

As I journeyed with her through some of the very basics about how 'when I eat food I can become ill unless I take a medicine called insulin', and explaining that 'my robot' (as Ben described it) helps me to stay well and have energy because it gives me my medicine, it was clear that I was losing her the further into the conversation we got, even if she tried her best to look as though it made sense.

But at least at the age of 4, she has heard the words diabetes for the first time. Hopefully in ten years time, she will be correcting her school friends when they spout 'facts' they have picked up in our media. Hopefully she will be the first generation of diabetic-free people who know what the hell it is all about.

So what is the message of this story and how do you tell a 4 year old about diabetes?

I still have no idea; I just love the idea that we did it in a Krispy Kreme.

Don't admit defeat, just change your attack

I've never been one for bottles of pills and potions to overcome illness. I don't believe in cough medicine. If I have a headache I drink a glass of water first and reach for the paracetamol later. When I do buy medicines, they often expire before I got a chance to develop that illness for a second time. I believe as much as I can in natural remedies. That being said, I don't reject drugs all together. That probably seems pretty obvious seeing as to survive I rely entirely on a synthetic vesion of the hormone insulin, which I pump into my own body through necessity more than choice, 24/7. I know that without it, I would only have a couple of days to live. But where ever possible, I like to avoid being on any drugs or medications and try to do what I can myself.

So when I was told at the beginning of this year that my cholesterol was just a touch higher than the doctors would like it and recognising that as someone who has put on a few pounds in the years since University, I decided to try and get that level down myself. I fully recognise that I do not have a genetic predisposition to have high cholesterol. I never had it before and in 25 years of diabetes, I was never at risk of it until I got a little *cough* 'cuddlier'. So when being threatened with taking a pill daily for the rest of my life, my first line of attack had to be my diet and exercise. You see I'd love to say I put on weight because I do loads of exercise and am in fact the size of a small rugby player because of my sheer muscle, but the truth is that while I try to embrace the natural natural, I also love Subway. And MacDonald's breakfast. And chocolate, the processed kind. And Subway. And cheese. And did I mention Subway?

So over the last 10 months I lost about 20 lbs, started doing body combat 1-2 times a week, cycling to work and doing cardio DVDs at home. I have tried to change my diet and generally follow a lower carb way of life (although I disagree very vehemently with ultra low carb). I do still have brown rice, potatoes now and then and the occasional slice of chilli bread (omnomnom). Low and behold as my weight and diet improved, so did my cholesterol. Markedly in fact. And I figured I was finally in the clear from the threat of high cholesterol.

That was until my most recent eye exam.

As I sat with the eye doctor I gave her a little run down of my last results as usual; HbA1c of 7%, BP is 90/120, cholesterol is a little high but I am addressing this etc etc.

As she navigated her way around my retina with her painfully bright light which we are supposed to look at, sitting at a distance which in any other situation would be totally inappropriate and bordering on lapdancing, I couldn't help asking her how things were going.

She commented that there was a lot more going on in my right eye than my left, which I was fully expecting. I have had background retinopathy for some time, which is the weakening and dying of veins and capillaries at the back of the eye caused by high blood sugars, which leads to tiny breaks and bleeds (haemorraghes) on the retina. When new veins attempt to grow in order to counteract this, they too will break and bleed. They can eventually lead to blindess but before it does there is huge amounts you can do to stop or at the very least, seriosuly delay it. With the pump and some major work I had managed to get this to a plateau. Things were getting all that much better, but they also weren't getting worse. So imagine my surprise when I asked if there was anything I should be aware of or concerned about:

"Nope. There is evidence of high cholesterol but I would expect that from what you have said."

Ermmm, what? Cholesterol damage in my eyes?? When was that part of the deal?

Call me ignorant, but little did I know that cholesterol has a significant impact on the eyes. I thought the high blood sugars and dying vessels was it. But if that wasn't enough, it turns out that cholesterol plays an enormous role here too. Perhaps this should be obvious seeing as cholesterol causes the blockages to veins and arteries and predominantly sight problems experienced by diabetics are related to vein/capillary deterioration/blockage in the eyes. But I had never actually been faced with this explanantion. It turns out that various veins in my eyes are begining to show 'cotton wool' like evidence that the areas where the veins and capillaries join, are starting to struggle. A good article about it is here, so read if you want to know more about it.

As I do with all things, I go into a state of panic for the first minute. I usually stare blankly at the person delivering the news to me and then start to try and piece together how to tackle it. I couldn't walk away without getting the doctor's thoughts on the Simvastatin, which has been available to me but always refused, for years. I told her all about what I was doing to lower my cholesterol, but asked her for a frank opinion about the pills.

I'm better when things are in plain English.

"Well, a two-pronged approach will always be the best option. Continue with the diet and exercise but in the meantime, why not take the Simvastatin as well? The evidence of high cholesterol in your eyes isn't permanent and can still heal. If you attack this from both angles you will by far have the best chance of stopping this."

"So could I come off them if I manage to get the cholesterol down to a very low level?"

"Absolutely."


That was the decider. As much as I would love to address the cholesterol issue from every angle other than pills, I am not taking chances with my sight for the sake of pride or wanting to do things 'the natural way'. 'Natural' is not walking with a stick or needing the assistance of a dog. My sight is just too precious to me.

So I decided that rather than view this as a sign of my failure, it is a sign of my determination. After 25 years I have managed to keep all complications at bay. Even the background retinopathy is at a 'young' stage and can still be stopped.

Any war is won by the clever deployment of troops. So I'm sending in some from the North and some from the South. One day I hope to come off the Simvastatin and allow my cholesterol to return to its natural tree hugging status but until then, exercise and diet are my sword and Simvastatin is my shield.

Three weeks in and finally at peace with it.

How quickly we adapt

Have you seen that John Lewis Christmas advert on TV at the moment, where the doe-eyed little boy is counting the minutes to Christmas, apparently desperate to open his presents, only for us to discover that truly he just wants to give his own lovingly wrapped, crinkled and adorably wonky present to his parents?

Well, in a weird, completely different and only very tenuously related way, it reminds of when I first went on a pump. More specifically, when I first had to change a cannula. Why? Because when I first attached for the first time in January 2010, I was acutely aware of everything about the pump. The pump itself, heavy feeling and enormous. The tubing, which I tucked away as neatly as possible and found myself being somehow telepathically aware of its positioning at all times and most of all, I was aware of the cannula.

"Where is it?"

"Did I just knock it?"

"Has it come out?"

"Should it feel this, well, invisible?"

I knew the exact hour and minute when it needed changing; three days after first putting it on. Of course I couldn't last the full 72 hours,what with me having the patience of a chocoholic in a Lindor factory and vaguely recall removing it at about 2.5 days.

What a difference two years make. Nowadays I have the once clumsy and fiddly process down to about 10.5 seconds flat, need to give it no second thought and funnily enough, if I don't set my alarm on my phone to tell me when to change, can easily go a day or two longer before my immune system and blood glucose tells me it has outstayed its welcome.

I guess it shows how easily we adapt to new situations and also how we also get excited about the silly little things. I suppose it was also the first 'big' challenge I had as a pumper. Could I change the cannula? Would I do it right? Would it hurt? I still remember the questions. The biggest one at the time still being, will this work for me? After all, without successful cannula changes, the pump was a no-go track. Every time I see that advert I think of my own excitement, anticipation and wonky attempt at changing those first few cannulas.

Turns out it was one of the most simple aspects of being on a pump and I had nothing to worry about.

Fifth Annual Insulin Pumps Association conference

Last week (apologies for the delay) I was invited by INPUT to attend the Fifth Annual Insulin Pumps Association conference in Manchester. Never one to miss the opportunity to jump face-first into events like this, I gladly accepted and before I knew it was boarding a train to Manchester and syncronising hypos with Lesley of INPUT fame.

On arrival and another spookily timed skyrocket out of (ahem) 'optimal range' on both our parts, Lesley and I were having dinner with some of the many other attendees at the conference including several bods from Roche and some healthcare professionals from a number of different hospitals around the country. It wasn't long before one of the sales managers from Roche had spotted that I was on a Medtronic pump and had begun their sales pitch at light speed. Frankly the Combo pump and blood glucose meter did impress, seeing as I was rifling through my bra for most of the duration of the meal to adjust insulin doses as each delicious (and very non-low carb) course came out, while all those with the combo remote controls were testing and bolusing (taking a shot of insulin for their meal) with ease. Truthfully I think the next pump for me will be a tubing free one seeing as the tubing is, for me, the biggest drawback of pumps in general. But it did show me that while my beloved Paradigm VEO was top of the market (again, just in my opinion) when I got it two years ago (is it really two years already??), it has been somewhat overshadowed by the newer sexier pumps on the market in recent years. Funny how quickly things move nowadays isn't it? Our diabetic predecessors must have been using metal and glass syringes for the 50 year mark before hypodermics came in, and now within 2 years the sexy new pump you once sported is the equivalent of the cassette tape to the ipod or what the horse and cart is to the Porsche.

It was with an eager attitude that I met Lesley for a suprisingly low carb but tasty full English breakfast the next morning and with that the conference was under way.

The exhibitions room was as always packed with impressive stands. But this being the first pump specific conference I had attended I was keen to get stuck in, knowing full well that the newer model Omnipod would be on show and I was hoping, the Cellnovo as well. I'd heard rumours about the Animas display which can be seen at these events and true to form, the most eye-catching stand had to be theirs, with a fish tank fully equipment with water, lights, real fish, plants and yes that's right, their insulin pump (!) suspended mid-tank. Although most pumps posit the same level of waterproofness (fairly confident that isn't in the dictionary) Animas are one of the only (if not the only) pump provider who are happy to guarantee their pump when submerged in shallow water. Great waterproofity? Waterprooficiousness? What IS theword!

There were also displays from Medtronic, Adanced Therapeutics (the company who bring the Dana pump and Dexcom CGM to the shores of the UK), Omnipod and my personal holy grail, Cellnovo.

I had a great chance to have a talk with Gary from Omnipod, who went some way to reassuring me that the teething problems I had experienced when I first made enquiries about their system had now been ironed out, thanks to a multiplying workforce and a chance to get their feet under the British market table. The new pod is certainly smaller than the old one and a contender against the much smaller and sleeker Solo (don't get too excited, its not avaialble here yet) and Cellnovo (watch this space, VERY soon). In truth I still have my doubts about Omnipod but only based on the fact that Medtronic's customer service still is - as far as I am concerned - second to none. That being said, the mention of Medtronic brings me on nicely to the holy grail of the day, the Cellnovo.

For anyone concerned about customer service, one of the head honchos at Cellnovo used to be on the Medtronic team and not just any team at that. She started the whole blogger forum craze and was, from what I hear, absolutely a key player in getting Medtronic's customer service at the very high level it is, which has been continued and pushed forward by their Justin Gray. So for a 'new' company who are just about to release their pump in the imminent future, I have a lot of faith they will do well. This, brings me to their pump.

I have looked at the website god knows how many times, but had until this point never had an opportunity to see it. 'Miniscule' is probably the most fitting term, considering inside it there are hundreds of parts, computers, insulin resevoirs and so on and so forth, that allow it to do it's job. It is technically a patch pump as the pump itself sticks to the skin using a velcro attachemnt, but the tubing between the pump and cannula can be varied allowing you to continue to put it in a pocket if you wish. That may sound like it defeats the point, but I have come across suprisingly large amounts of people who say they would like the option of hiding the pump if they were wearing a slinky dress or tight fitting shirt. I don't share these needs, but completely understand the concern. With the Cellnovo, that is possible. It is also equipped with a smart-phone like handset which allows real time measuring of impact of activity on BGs, acts as the remote control for the pump and frankly for the growing numbers of young people on pumps, will be a fantastic selling point. Considering for the most part young people are already well familiar with touch screen phones and wireless handsets.

It was great to see the Cellnovo and their team in action and provided there are no horror stories about the pump failing or customer service nightmares, I imagine this will be the kind of pump I aim for next, albeit in two years time!

But the reason above all else that I was there,was to attend the conference and hear the speakers. The name of this year's conference was 'From Cradle to Grave' and the overall message of the conference was that insulin pumps can be used in ANY portion of society and at ANY stage of life. We were given case studies of people at end-stage renal failure who were on pumps, babies as young as days old who we were shown photos of (which to be honest I found a bit shocking due to the very tiny body connected to the pump, although the shock was more a feeling of sadness that someone so 'new' had to already live that life). We talked about the benefits for pregnant women, children and pretty much every group you could imagine.

I see a specialist team at Portsmouth who are without a doubt a proactive and insulin pump friendly team without whom I would not have been on the incredible journey I have travelled in the last two years, but without a doubt they had nothing on the speakers at these conferences. In Cambridge they purport to have 50% of all their Type 1 child patients on pumps, which without a doubt blows the NICE benchmark out of the water and deeply puts to shame all those PCTs who are yet to welcome and encourage pumps for their most at risk patients. The word 'proactive' doesn't even begin to cover how forward thinking many of these professionals were. When I arrived at Cellnovo, the chair of the conference was even stood next to me (although I didn't know who he was yet) asking questions about what the benefit to the patient, this pump would have. The benefit to the patient; have you ever heard such madness! In some areas they seem to disregard even the benefit to the PCT, let alone the humble patient!

We had a fantastic talk from Candice Ward from Cambridge University Hospital about where the artificial pancreas project was going and how CGM and pump technology could well be the key components which will significantly impact the lives of diabetics. Although it was clear she felt this was not quite an imminent success, she did intimate that it was on the horizon and creeping closer to us day-by-day. My brain has a little party whenever someone says that.

All in all it was a fantastic day and the messages I took away were:

• Don't buy it if you are told your clinic doesn't do pumps, talk to INPUT.



• No matter your age, demographic or favourite day of the week, ASK THE QUESTION OF YOUR SPECIALIST



• No-one is too young, too old, or 'too far gone' (whatever that means) not to benefit from a pump



• Cellnovo are the ones to watch



• There ARE some highly proactive hospitals in the country, so ask about changing if your clinic fob you off.

All in all a brilliant day.