Medtronic holiday pump loan: Old dog, new tricks

Thankfully Medtronic, my favourite (and only) insulin pump company, have chosen to replace yet another pump belt clip after mine went camping with us in the New Forest and never made it home.  I'm losing count of how many times this has happened now but luckily for me, Medtronic don't seem to mind.

So there I was, ecstatic that the new clip had arrived in time to come away on holiday with us when something in their letter (normally binned without a second though) caught my eye:

Perhaps it was just the word 'holiday' that stood out because in just two short days Jamie and I jet off for our first anniversary two week Scottish Highland adventure, but out jumped a little sentence that may be of interest to anyone who's been on holiday and packed as though Armageddon is coming, just in case their pump dies in on them mid Pina Colada (or Hagis, whatevs).

According to the letter Medtronic, who customer service I have raved about before, now offer a 'Holiday Loan Pump' service.  It seems if you are heading off on your holidays and normally sport your own insulin pump, all you need do is drop them a line 4 weeks before you go and they will help you out with a loan pump as peace of mind, in case yours packs up for any reason.

All you need do is contact the Product Support Helpline on 01923 205 167 and there you have it, simple as can be.

Medtronic, you never fail to impress me!

And thanks for the clip, I'll be in touch again shortly, no doubt.

The Dexcom G4 - hubba hubba

So after having a chance to have a snapshot view of the sexy new Dexcom G4 (continuous glucose monitor) from, arguably, the market leader and gawking at its gorgeousness (yes, to a diabetic this ingenious piece of plastic and metal really is, gorgeous) I received the press release below from the lovely folk at Dexcom.  I thought you may like to have a read of it and check out the video of 6-time marathon runner and Olympic torch bearer Colin Rowland, giving his story of competing at sport with a Dexcom.  To be fair, you don't have to run a marathon to benefit from it, eating a bowl of fruit is a heck of a job easier too!

Are you a Dexcom user and have you had a chance to see/try this yet? Thoughts on a postcard (or comment) below!

My Glucose Sensor UK - Continuous Glucose Monitoring 

Press Release

With the Olympics hitting London health and fitness has been at the forefront of our community. Diabetes affects nearly 350 million people worldwide and nearly 1 million in the UK alone. On the back of the success of their life changing Continuous Glucose Monitoring device (Dexcom-Seven plus) Advanced Therapeutics are set to launch The Dexcom G4 ™ into the UK market place.

This latest product from Dexcom is an easy-to-use wireless device that is designed to simplify glucose management. The revolutionary technology brings enormous benefits to those within the diabetes community and is the very latest in sensor technology. Helping to take the guesswork out of diabetes management, the Dexcom G4 delivers exceptional accuracy with the user being in optimal control of their Blood Glucose Levels any time day or night.

Olympic torchbearer Colin Rowland is a pioneer of the new unit.

“I was diagnosed with Type 1 diabetes when I was very young. For a type one diabetic to even attempt to run a marathon is quite a feat. When I started using Continuous Glucose Monitoring it brought home to me how difficult It was to run the marathon without it. One of the biggest advantages for me is when I leave the house my wife will know that the G4 will assist me in just simply coming back home. The G4 is like my training partner, it made it so much easier. It allowed me to live my life, run a marathon, and run it well.

The beauty of Continuous Glucose Monitoring is all I have to do is glance at my wrist and I can tell what my glucose level is. It is picked up every five minutes automatically and it tells you whether it’s rising, falling, or steady. The system will inform me when it’s getting to high or low levels.”

Watch a video of how the unit has impacted Colin’s training here:

The system is made up of four components: the sensor, transmitter, Dexcom Studio software, and receiver. It can show you a new glucose reading every 5 minutes for up to 7 days of uninterrupted wear-time.

The Sensor is a flexible, round, fine probe that goes just under your skin to read glucose levels It is part of the sensor pod which is attached to the skin by an adhesive patch.

The transmitter wirelessly sends glucose information continuously to the Receiver which displays a reading every 5 minutes. The transmitter snaps into the sensor body to form a small, lightweight and discreet. The adhesive patch holds the Pod to your skin.

The Receiver is a wireless device that displays glucose trends so you can quickly and easily see where your glucose has been, where it is, and where it's heading and how fast it is changing. At about the size and weight of a small mobile phone, you can clip the receiver to your belt, put it in your pocket or handbag. Everything you want to see about your glucose at a glance.

Using the latest Dexcom Studio software you can download 30 days of information to your computer. You can see short- and long-term trends and patterns through customizable charts, so you can watch your improvements over time. In addition, view meal, insulin, health, and activity information entered into your receiver. This information can help you and your diabetes management team understand the impact that food, insulin, exercise, and medication have on your glucose levels.

Being at the very heart of the Diabetes Community ‘My Glucose Sensor UK’ is an online platform delivering the latest diabetes news and striking conversations with those whose lives it affects.

Join in the conversation here:

Facebook: http://www.facebook.com/MyGlucoseSensorUK

Twitter: https://twitter.com/GlucoseSensorUK

YouTube: http://www.youtube.com/user/MyGlucoseSensorUK?feature=mhee

The dulcet tones of the testing kit

With his First Class honors Degree at the University of Diabetes came many a lesson for my long-suffering but ever-supportive husband Jamie, or 'J-Dizzle' to those who know him well.  He had to hit the ground running when we first embarked on a relationship (that makes it sound very serious.  It wasn't.) and quickly learnt the difference between 'juice-guzzling Anna' and 'insulin-seeking-missile Anna', and what those states means to a diabetic.  He learnt that if I begin to wander around in the middle of the night convinced I have gone blind, it's best not to let me try and navigate the stairs on my own.  He learnt that blood test day in our house, is all but Armageddon.

He also learnt the harder lessons; the ones that don't bring quite so much entertainment.  He learnt that one day, if complications come a-knocking, we may need to make the decision together that children are just not for us.  He had to learn to squeeze my hand when finding out news from the Doctors which scares me, just a bit.  And he had to learn that living with a diabetic, isn't always easy.  In fact sometimes, it's damned hard.

But I sometimes forget, or maybe don't give him enough credit, for just how much of an impact my diabetes has on him.  Having sailed through the trials and tribulations above, taking every step in his ever-chilled out stride, I forget how much he has had to learn in the last 5 years.  He had to learn what I learnt over 25 years, in just a fifth of that time, and become an expert in his own right, if he too was to conquer my diabetes.  Along with all the 'usual' education of carb-counting, cannula-changing, prescription-hoarding and midnight fridge runs (and occasional sprints to the nearest 24 hour store selling pump-batteries, that's all we'll say about that!) he has picked up on so, so much more.  

Yesterday we spent the day with his family eating, drinking and being generally merry.  As well as checking I was OK after a platter of the finest home-made marzipan cakes, short breads and sausage rolls was presented (omnomnom) he also reminded me just how much diabetes has left its mark on him.  As we got in the car I decided it was time for a swift blood test.  Scrunched in the back of our tiny 2-person-masquerading-as-a-4-person car I pulled out my kit and unzipped the case.

"Do you want me to stop the car?" he asked from the driver seat.

Without even having looked away from the road the dulcet tones of the testing kit, now all too familiar after 5 years, told him diabetes was visiting us in that moment and demanded some action from him.

"No thanks, I'm good." I replied, smiling to myself that after this many years I could probably test upside down from a tree in the jungle (now there's a challenge).

Funny as it may seem, it is a bittersweet (diabetic pun, anyone?) reminder of how much our 'Type 3' diabetics go through.  I often see discussions about 'which is worse', to have it or to live with it.  I don't get involved with arguments like that because it's like arguing which is worse, day or night.  The two can't even compare!  But it was a big bump back down to ground remembering that everything I go through, he goes through.  He may not 'feel' the highs and lows, but he does live them.  He does feel them.

This is for you, Jamie. My favourite diabetes partner in crime.  I love you.

Who do you have around you? Or are you a type 3 yourself?

Re-printed

Diabetes is often referred to as a 'hidden' disease.  When Elliott on the TV show Scrubs once told Type 2 diabetic character  Turk, "If you want sympathy get a disease people can see', I couldn't help but laugh.  In many ways, the fact our condition is mostly hidden, is a benefit.  I don't have to worry that an interviewer's prejudices mean the wheels on my chair make them put that 'cross' next to my name.  I am never teased or bullied (other than my family, which I am kinda fond of).  I don't stand out. I am judged on my abilities, not my 'disabilities'.

But the down side of that is that people with diabetes can feel very alone.  I read an article while at University once talking about how people with hidden conditions find it hard to identify an in-group the same way a wheelchair user might. During times when diabetics find managing their condition hard, it is that in-group that helps you through.  It's your fellow diabetics, your friends, your family.  Even the nurses at my GP surgery, who I laugh and joke with, are part of my diabetes in-group.

Diabetic burn-out, a well-recognised time of 'I need a rest' that diabetics can go through, usually polarised by  people not having an in-group for support, hit me around a year ago.  The posts on the blog began to become more sparse (a sure-fire sign that my thoughts are elsewhere) and blood testing and carb-counting had dwindled to embarassing levels.  When my DSN (Diabetes Specialist Nurse) asked me why I had gone three days without testing, I lied and told her I had lost my machine and was using a spare.  I hate liars. 

During that time, I stumbled upon the photo above,which was being used in an artistic education programme by artist Dana Heffern, whose aim is to educate non-diabetics.  This photo had a profound effect on me. At the time I was in the depths of burn out, struggling with what diabetes was doing to me both every day and over my life.  I was tired of the constant effort and dedication demanded of me, which only resulted in average health. I was angry.

When I saw this photo I couldn't take my eyes off of it.  I could think of only one singular word to describe it;  Mutilated.  Seeing the holes in the fingerprint, which when magnified felt like bomb craters, fuelled my very anger.  Your finger print is part of your identity, so much so that even identical twins do not have the same prints.  It is part of who you are.  It is yours.  This striking image was showing me what diabetes does to people; it mutilates them. 

That image haunted me for several months and even now calls out to me when I see the pock-marks in my own fingerprint.  But with the ending of the burn-out phase came a new lease of life for diabetes.  I threw myself back into volunteering for events, attending groups and bloggers forums and picking myself up off the floor with a new determination to wipe that very floor with my condition.

Now, when I look at that image I know that diabetes has changed me.  Beyond recognition, probably.  But not for the worse in fact I feel it has done quite the opposite.  Those marks on my fingers are a sign of the in-group I belong to, one which happens to be about 3 million strong in this country alone.  They plot my journey one crater at a time, and are my proof that diabetes hasn't taken me prisoner just yet.  They are my evidence that I will live a long, healthy, happy life because I am trying to.  They are evidence of my care for myself.  They are also unlike any other person in the world. That makes them as much part of my fingerprint as the very print itself.

I may have a 'hidden' condition but I have chosen to wear my condition for all to see.  I have chosen to find my in-group by wearing an insulin pump and shouting about it.

You, are my in-group, and my fingerprint is both damaged, and as perfect, as this one.

Non-invasive CGMs - The one to watch

Last week I had the pleasure of meeting up with some fellow bloggers and a team from C8 Medisensors, the company bringing to the market the much-anticipated non-invasive continuous glucose monitor somewhat catchily named, 'the HG1-c'.  I mentioned them briefly after happening upon their stand at the ATTD earlier this year and last week provided an opportunity to get some waffley blogger-types together in a room to discuss the Hg1-c, the company, the history and the future. It's all bright, by the way.

In a nutshell this investigational device (not yet CE approved) consists of a small box, around the size of today's smart phones or an insulin pump, which is held in place around the midriff by a neoprene belt.  Here it measures the amount of glucose in the fluid beneath the skin using Raman Spectroscopy technology. For those of you who - like myself - don't speak 'medical journal', Raman Spectroscopy is effectively shining a light through the skin.  This light reacts only with glucose molecules and can therefore identify how much glucose is present.  It then feeds this back to an app on a smart phone (Apple version in the pipleine) for you to keep a near real-time eye on your glucose.  Ingenious, I think you'll agree.

So far the benefits of the system include being vastly cheaper than the current traditional CGMs available such as the Navigator, the Enlite and everyone's favourite, Dexcom.  The price of the unit is approximately £2500 which although still a very large outlay, is a drop in the ocean in comparison with the traditional CGMs.  In fact over the anticipated 4 year lifespan of the device, that is a saving of approximately £10,000.  Imagine how much diabetic chocolate you could buy with that!

Other benefits include being non-invasive and therefore painless, having no expensive parts to replace, it is relatively discreet (although perhaps not underneath any negligee when preparing to seduce the husband/wife!) and the accuracy is comparable with the current systems.  CGM accuracy rates currently range anywhere from 75-89% and the information we were presented with clearly showed that for trend information allowing you to make better self-care choices, this system performs as well as any of those above.  

There are a few drawbacks to mention.  For all those parents out there thinking how fantastic this will be for your little ones, we were categorically told that this device will only receive CE marking for adults.  So alas if you are interested in this, using it on children would be considered 'off-label'.  

It is also - in my opinion - rather on the 'chunky' side at this point thanks to being worn on a girdle style belt and the need for a battery pack alongside the monitor. But for me, this is a trade up I would make for the sake of more affordable, reliable and non-invasive CGM.  I have tiny marks all over my abdomen from the many cannulas I have worn over the years, so the idea of a monitoring device that doesn't even pierce the skin, is wonderful. 

It also isn't waterproof so no skinny dipping while wearing your C8 girdle, because you can't return it if you wreck it, OK? And due to the need for no movement between the skin and the laser for it to work without interruption, it isn't recommended during exercise at the moment.  

That said, if you are looking for a more affordable, reliable CGM system that is up and running in 15 minutes, is close to the 'gold standard' of glucose monitoring and is run through your phone meaning no extra devices to carry around, then I strongly suggest you make your own enquiries about this system.

The plan at the moment is to roll out in the EU imminently, followed by Switzerland, Norway and eventually, Iceland.  So to the Norway readers I discovered a while back - you know who you are - keep your eyes peeled.

The message really is keep your eyes on this company.  If they can get CE approval then they may well have version one of a contender for the likes of the market leaders who have become such a household name in the diabetes community.  We are bombarded with information about how beneficial CGM can be.  Well, maybe C8 are about to bring us the first step closer to CGM being a routine part of our care in the UK.

Watch this space.

I've attached some photos of some very engrossed-looking bloggers for your entertainment...

I hate to say it but...

For the last few days my blood sugars have resembled that of someone harbouring some kind of sugar addiction. My BGs, have been nuts!
Today, for example, I woke up this morning to a very unwelcome 15.5mmol which after a great whack of a correction dose, grudgingly shifted down to 8mmol. Of course, having eaten a 'sinful' bowl of berries and yoghurt, they are now back up rocking a 15mmol. Having switched cannulas and ultimately sticking on a 150% temporary basal rate, I continue to battle against my diabetes today, determined to keep the high teens at bay. I can feel my limbs screaming.

I would be annoyed about it, seeing as I find unexplained high blood sugars infuriating, but I know exactly where I went wrong. The 'right on the money' approach I had adopted which only a week ago had me rocking 6s and 7s all day, was the old exercise and diet system. It isn't rocket science. It never fails. Only a week ago I was low-carbing, gorging on vegetables like they were going out of fashion and exercising every day, without fail. Whether it was a walk with a dog from the local pound, a hardcore body combat class or a yoga session (deceivingly sweat-inducing), I was doing something - anything - every day.

The problem is, as most people know all too well, taking even a few days off means your body becomes less sensitive to insulin, and you start to need more. Add to this two family BBQs which had me reaching for the hot sauce (sugary as hell once you get past the chilli 'bite) and tucking into a range of delicious breads. On day 1 I put the blood sugars down to the BBQ, day 2 I told myself that day 3 I would get back on it and day 3 even having got my diet back in check, the lack of exercise in my life is glaringly obvious.

I miss my 6s and 7s.

The hardest part about getting back on track, is actually getting back on track. The climb back onto the wagon is a hell of a trip up, when your legs feel like you've run a marathon before you even get out of bed. When you are rocking 15s it is so hard to even think about going back to the gym and even walk is the last thing you feel like doing.

But that is exactly what I will be doing tonight. Forcing myself to go for a walk, even for 20 minutes. And I'm back on the low-carb veggie wagon and tomorrow, I'm gonna give the gym studio a battering!

These moments

This weekend my brother invited me join him at a small meet-up called 'The Little Green Gathering', held at a local sustainability centre where he was giving a talk on the Zeitgest movement, something he is as passionate about as I am about diabetes advocacy.  I've been saying for some time that I'd come along to one of his talks, so this evening I decided to join him and come good on my promise.   But as so often happens when we aren't searching for it, it was an unexpected, wonderful moment that made the event.

Knowing that he was on for an hour and with a serious coffee addiction meaning I would be a fidgety twitcher if I didn't visit the little girls room, I nipped off to the ladies for a loo-stop.  As I waited for a cubicle to become free, two people filed in behind me: a mother and her daughter,  talking amongst themselves.  Normally their conversation would have passed over me barely registering, but all of a sudden a familiar phrase caught my attention.

"We should do your numbers in a minute." Mum said.

I've heard those words before.  I've heard them on more than just a few occasions.  As I eavesdropped them discussing numbers and times I wanted so badly to turn and let them know my little secret too, but the door of a cubicle opened and without meaning to I found myself locking the cubicle door behind me, saying goodbye to that moment.

It's a good job I pee fast.

As I emerged from the cubicle I made it just in time to see a crisp, clean looking testing kit sprawled in front of the young girl, cradled in the open hands of the mother.  Even that image speaks a thousand words, doesn't it?

I squeezed past and whispered to them, "me too," gesturing towards the open kit.

"Sorry", mum said, now making eye contact with me.

"Me too." I repeated.

"Really?" Her eyes now fixed on mine.

"Yup" I smiled.  

"Type 1 or 2?"

"Type 1" (weirdly proud).  

"When were you diagnosed?" She questioned.

"Oh god, 25 years now. So, 1986 I guess."

"Wow, she has had it a month." Glancing over to her child.

And there it was; the future of diabetes.  A bight young thing getting accustomed to a lifetime of hand-washing, loo-testing and number-crunching.  As mum and I exchanged stories the bubble around us grew as I was only distantly aware of people coming in and out of the cubicles behind us.  Like bathroom checkers, we were pushed from one spot to another as people negotiated the room we had commandeered to share this moment.

We talked pumps, diagnosis and injections, and as mum pulled out the needle from a correction dose of insulin, the future generation of diabetes and I high-fived and smiled.  Stupid, crappy injections.  We shared a knowing glance.

I couldn't leave without swapping details.  Having only been on board for a month but already speaking a language they should never have needed to learn, I wondered how many questions mum might have in her head.  Does it get easier? How long does it take to learn? Are you happy?  Will she be OK?

We swapped emails and addresses and promised to keep in touch  so we could ask all the questions we want, without the whirring of a hand-dryer somewhere in the background.  

As I went to leave the room I heard, "Are you a hugger?"

"Oh yeah, I'm a hugger." I replied.

Hug isn't the word. Embrace is closer to the mark.  An embrace that lingered a moment longer than it would have even between friends.  With that and a "Welcome to the club, kid.  We're all pretty awesome", we parted ways with a smile and a promise.

These are the moments I live for.  A moment which could so easily have been missed if any one of us had changed our path.  If we'd doubled back, done that test elsewhere, not mentioned anything about numbers.

I don't know how, but somehow, every time, diabetes finds a way to bring us together.