Favorite Diabetes Things

A few of my favorite (diabetes) things:
There are many products on the market targeted specifically for people with diabetes.
Below are some of my favorite items I've come across over the years and use on a regular basis.  

AccuCheck FastClixNever in a million years would I have expected myself to list a lancing device as one of my favorite diabetes related things, but I do love it!  The FastClix features a drum containing 6 pre-loaded lancets, making it easy and hassle free to change lancet after each use.  Sharp lancet = less pain, less callouses. 

Gold Bond Ultimate Diabetics Dry Skin Relief

"Diabetics are prone to dry skin"  I'm not sure if that's medically accurate but I tried this product a few weeks ago and love it.  It absorbs quickly, isn't greasy and lasts for a few hours.  All things I want in hand lotion!

SpiBelt

I use my Diabetic SpiBlet for all of my workouts at the gym. Zumba, weight training, and everything in between.  With my insulin pump in the SpiBelt I don't worry about it falling and getting damaged.  It's also easy to move the belt around during my workout if I need to move it based on what I'm doing.  

PumpPeelz

PumpPeelz are decorations for your insulin pump, CGM and blood glucose meter, or as they say "Decorating Diabetes."  I have them on my meter, and my insulin pump.  Pictured here are my Medtronic Diabetes 630G insulin pump and Counter 2.4 meter, both wearing Pump Peelz. 

GlucoLift 

Glucose tables are another one of those things I never thought I'd add to a list of favorite things, but these are better than any others I've tired. - and I've tried a lot including those orange white tabs from BD back in the 90s.These are all natural, and not as chalky as others on the market, and when you open the bottle there's no puff of powder!  

My favorite are the wild berry.  

*I purchased all of these items on my own, there is no sponsorship involved with this post.  

I Wasn't Low Last Night - it was the cat

I love my tabby cat, Shelby. But she thinks night time is play time.

Shelby jumps on and off me all night.  She knocks things off the night table, and she also rubs the corner of the night table.  All.  Night.  But I wouldn't have it any other way even though I'm tired most days.

My husband is on juice box duty over night.  Not that I can't get them myself, but I feel better nudging him and asking for one, so he has an awareness that I'm low.

Last night Shelby was extra active in her pursuit of knocking everything over.  At one point I said, a bit too loudly, "Shelby, stop!!"  and within seconds my husband gave me a juice box.  Or rather, placed it on my back.  At some point I realized it was there and put it aside.

This morning he asked if I was ok, after the overnight low (sometimes my blood sugar is higher in the morning after an overnight low), and I said I wasn't low.
C: "Didn't  I give you a juice box?"
Me: "Yes, but I wasn't low. I was yelling at Shelby."
C: "Oh, that is why you didn't immediately take it."
C:  "Maybe "Shelby stop" sounds a lot like "I need a juice box?"

  Did I mentioned this was a WhatsApp chat, which made it even funnier, at least to us.

Is Diabetes a Scapegoat?

Some days I want to scream "not everything I'm feeling is related to diabetes!!!" 

 and before you ask, no, my blood sugar isn't low 

Does diabetes impact how I feel? 

Often.

Does diabetes impact my moods?

Often. 

Does every headache have to mean low or high blood sugar?
No.

Does being very thirsty mean I have high blood sugar?

Sometimes.

This is along the sames lines as doctors saying "diabetics are prone to..."  when they have no explanation for why you are sick.  

Are we giving diabetes too much credit?

There are a lot of twists and turns and variables and can impact just about everything.  
But please, do not assume  if I'm hungry, grumpy, tired, agitated that "its the diabetes."  Sometimes it is, and sometimes it isn't.  I do check my blood sugar, and wear a CGM and 99% of the time in tune with what's going on. 

Goodbye MTM

I cried when I learned that Mary Tyler Moore passed away today.  

I'm not normally the type to cry with the news of someone famous passing, but this time I did, and I've had a heavy heart all day.  

When you meet, or read about another person with type 1 diabetes you feel an instant kinship.  You know at some point you've dealt with the same low blood sugar, high blood sugar, silly thing people say, issues with health care professionals, and so on, and I felt that connection with Mary Tyler Moore despite having never met her.  I watched her on tv, heard her speak, and read her book  Growing Up Again.

I cried for the battle she fought.

I cried for the others with T1D who lost their fight.

I cried for the loss of life.

And then I pulled myself together and looked into how else I can get involved with the diabetes community and make a difference today, tomorrow, and for the future.

Goodnight MTM.

More than my A1C

I know I am more than my A1C.  

I know that my total health is important, and that trying to keep highs and lows at a minimum is important.  

But today's A1C result was 5.9 and I have to say I am damn  proud of that number. 

5.9 is my lowest A1C in my 40 something year career with type 1 diabetes.
My endocrinologist  commented that my diabetes is in "tight control" which is also something I haven't heard before.

My goal was not to get my A1C below 6.  My goal was and remains  to keep it between 6-6.5 where it's been for a number of years, thanks to my continuous glucose monitor.

For the most part I have always done a pre-bolus.  I've figured out how to use different bolus options for pizza and Chinese, which I wrote about a few weeks ago:   You Can't Eat That, or Can You?  The only thing I changed in the last few months has been when my CGM alerts on high.  I set that to 180 so if I do need to take a correction bolus, it can get going before my blood sugar gets too high for my liking.  
So, while I know I am more than my A1C, I still celebrate this small victory! #itsthelittlethings

Clinical Trials

Yesterday was a tough and long day.

Despite the fact that I thoroughly read the 22 pages of paperwork, and  asked a ton of questions at the consent visit, I knew what to expect for this clinical trial. Yes, I knew it would be 11 or 12 hours of mostly sitting, but I wasn't counting on it being physically tough.  And I didn't realize just how tough it truly was until I fell asleep the second I got on the commuter train to go home.

Since the study was designed to test how well glucagon worked in a controlled setting, my blood sugar was purposefully kept low, with very careful and constant monitoring.

Despite the fact that my blood sugar stayed between 45-60 for close to 5 hours, I felt mostly ok.  I was able to talk, and form complete sentences which I typically can't do in this blood glucose range. In a normal day if my blood sugar drops from 120 to 50, I'm a puddle of mush.  I'm not sure if the reason was because my blood sugar stayed low for so long, or that there wasn't a sudden drop, or if there was something else going on, I'll let the investigators figure out that piece of the puzzle.

Hour 6 was the hardest, I felt ready to give up, I was whiny and didn't feel my best.  But, it passed relatively quickly and I was able to laugh at myself.

While it was a hard and long day, I didn't give up.  I kept thinking "without people like me, there can't be advancements in diabetes treatments."  And to me, that's everything.  Knowing I'm doing everything I can to potentially help other people with diabetes makes me happy.

It took me a long time to find my first clinical trial to participate in.  The government website clinicaltrials.gov  is hard to navigate and hard to determine if you might qualify.   There are apps and sites now that make finding a trial close to you, that you may qualify for a lot easier. I found the one I'm currently involved with through the JDRF Clinical Trials Connection site:
http://www.jdrf.org/research/clinical-trials/

If you do decide to participate in a clinical trial read you are provided with. Ask a lot of questions.  Then ask some more questions.  While I was surprised with how hard my day was yesterday, I look forward to the second appointment of the same nature in a few weeks.

Life Before Bolus Wizard

It's hard to imagine life before bolus wizard, isn't it?  Before bolus wizards, before insulin pumps, before Lanuts and Trujeo, and Apidra there was NPH, Regular, Ultra Lente.  Diabetes management consisted of an exchange diet and a sliding scale for insulin.  The exchange diet was basically an allotment from the food pyramid per meal:  for breakfast you might get 1 milk, 2 starch, 1 fat, and 1 fruit.  The sliding scale for insulin delivery consisted of something along the lines of: if your blood sugar was between 80-120 you'd take 4 units of short acting insulin and 10 units of long acting.  And that in a nutshell was diabetes management in the 1980s. (and way before that was urine testing and a shot of mixed beef/pork insulin).

Fast forward a bit to 2000 when I decided to pursue insulin pump therapy, for more flexibility with managing my disease.  In 2000 there were two companies in this space. Medtronic Diabetes, and Disetronic Medical Systems.   I chose Medtronic Diabetes because I was aware of the company, and their history, and felt it was the right option for me.  Before starting on the pump, as a patient at the Joslin Diabetes Center in Boston I had to meet with a social worker and diabetes educator to ensure I was going on a pump for the right reason.  To them "I want to go on a pump so I can eat donuts all day" wasn't a good reason, but wanting more flexibility in my life was.

Between 2000 and today I have used several  MiniMed pumps.  Each new pump included the addition of more innovate technology than the previous:

• 2000:  MiniMed 508 This pump came out in 1999 and I started on it in the spring of 2000.   It featured bolus and basal, and a temporary basal option, and came with a remote control to deliver a bolus! 
• This pump operated on 3 watch size batteries, which made me a frequent customer at Radio Shack.

• 2004: Paradigm 512:  This pump came to market in 2003, and  my best guess is I started on it sometime in 2004.  This pump introduced us to bolus wizard, and the blood glucose meter transmitting readings directly to the pump.  
• Bolus wizard calculates the amount of insulin a person should take based on input from the insulin pump user including active insulin, blood glucose level, and number of carbohydrates in a given meal.
• I use this feature daily - to determine if a correction is needed for high blood sugar, and to help figure out insulin dosing for food.  

• 2011: Revel: This pump came to market around 2010/2011, and I most likely started using it around that same time. The Revel introduced us to the continuous glucose monitor (CGM), and SofSensor. 
• I was an early adopter of this pump due to the continuous glucose monitor.  
• The SofSensor worked well for me, but I was a chicken when it came to the insertion process and insurance didn't cover CGM back then so I didn't use it frequently.

• 2014: 530G with Enlite  This system was approved by the FDA in 2013 and I started on it in 2014.  This system introduced the Enlite sensor and threshold suspend, and an easier  CGM sensor insertion process.

• Threshold suspend (also known as Smart Guard) was a turning point for me with my diabetes management.
• As a person with a history of overnight low blood sugar, the idea of the pump stopping delivering insulin once the cgm readings  reached a set low number (that I worked on with my doctor), was a game changer.
• The Enlite sensor/cgm system has worked great for me.  My cgm readings and blood glucose readings are often within a few points from each other. 

• 2016: 630G system with smart guard technology:  This pump came to market in August 2016 and I have been using it since October.  This system introduced us to a new platform, a vertical pump layout, waterproofing, and large color screen.

• I wasn't initially sure about this one.  On paper it seemed like a shinier version of my beloved 530G.  But, I'm glad I made the switch. 
• Some of my favorite features:
• The screen which shows everything I need to know about my diabetes management at a glance.  
• The Guardian transmitter: this transmitter has a stronger signal, and as such I haven't had any connection issues since starting the pump.  With the 530G I received weak signal errors on a weekly basis. 
• Alarms:  The alarm chimes have changed, and there are more volume options which have been great.

We've come a long way in 16 years.  From a basic insulin pump, to an insulin pump that can stop insulin delivery based on a low blood sugar reading from a continuous glucose monitor, and for that I am grateful.  And this is only the beginning.  I look forward to seeing and hopefully being able to use the hybrid closed loop system, which eventually become (I hope) a fully closed loop system where the pump does most of the work.  I look forward to one day having less decisions to make about my diabetes management.