And Then You're At Jax » Blog Archives

Tag Archives: insulin pump

Type 1 Diabetes

Hundreds of endo appointments

Published by:

I’ve had Type 1 Diabetes for 28 years. I see my endocrinologist about every 3 months, so I’ve had over a hundred appointments so far. And to be honest, today’s appointment was the first one I prepared for.

I know the drill- it used to be to bring in my logbook (which as a teen could have been completely made up at times) and get labs drawn, only to find out what my a1c was, a week later. Now it’s a finger stick in the office for an a1c result within minutes and surrendering my pump to a nurse so she can download pages and pages of data. It’s roughly the same thing, every time.

Today was different. Today I had a short list of items to discuss. When I pulled out my planner, my endocrinologist seemed excited to have a new challenge.

Item 1: A new pump and CGM

In a week, the warranty for my current pump and continuous glucose monitor expires. I’m currently on the MiniMed 530G. I was on a MiniMed pump for the first 8 years of my pumping career. I switched to an Omnipod and dexcom for a few years and then when back to MM when the 530G was released. Although the pod works great for a lot of people, for me, the tube pump provides more consistent insulin delivery. As much as I enjoyed the freedom of the pod, ultimately a tube pump is just better for me.

If you asked me a few months ago which pump I would switch to, I would have immediately said the MiniMed 670. The closed loop is exciting. When I took the time to think of what was important to me, I found that:

  • I want fresh, new technology that also looks current.
  • I want and need flexibility in my CGM site location. I have to use my MM CGM off label- I cannot get reliable results on my abdomen.
  • I want the option to view my CGM data where it’s convenient for me- my phone, a watch, on my pump.
  • I want my pump to be as discreet as possible. Not bulky.

For me this means exploring the T Slim from Tandem with Dexcom. This combo meets my needs better. The device is colorful and simple to update the software for. Dexcom sensors require much less taping than my current sensors, which means that when my Rheumatoid Arthritis is making it difficult for me to reach my back or behind my arm, I can more easily insert a sensor. Dexcom data can be viewed on the pump, on my phone, on a smart watch, and even sent to my husband.

Of course now I wait to see if my insurance is as excited to pay as I am to get started…

Item #2: Weight Loss

I go to the gym as often as my RA allows (usually at least 3 times a week). Like a lot of people with diabetes, I have fallen into the trap of eating roughly the same things as I know the carbs and how much insulin to take. But, unlike a lot of people with diabetes, I also have Rheumatoid Arthritis which can make diabetes Management a pain, literally.

Everything affects my blood sugar- pain, inflammation, lack of activity due to stiffness, nausea, etc. I’ve found that my insulin use has gone up as I often have pesky highs when I’m feeling awful and they aren’t easy to bring down. And with all of the extra insulin, my weight isn’t easy to bring down either.

I asked my endo about meds that would reduce my daily insulin intake which would in turn, help with weight loss.

First med we discussed was Afrezza. I have seen so many fellow diabetics using it with great results. But I quickly learned that those great results weren’t worth the risks for me. Since Afrezza is inhaled insulin, there’s concern for how this affects your lungs. Because Rheumatoid Arthritis caused me to develop asthma and with the risk of RA and lung damage, my endo and I quickly decided that this wasn’t worth the risk at all.

Next up was Invokanna. This drug causes you to basically urinate sugar instead of allowing your kidneys to reabsorb it (this article is a great resource for explaining these meds in better detail). This comes with a higher risk for infection, especially a UTI. Since I’m extremely infection prone (thanks again RA), I quickly eliminated this one as well.

Lastly, my endocrinologist mentioned Victoza. In short, Victoza is a daily injection that helps slow glucagon production, slow ingestion, and decrease appetite. Side effects? Nausea for the first few weeks. I can deal with doubling up my Zofran if I have to- much less scary than an added infection risk or potential lung problem.

So yay! we found a medication to try. But now, I get to wait again to see if my insurance will cover this off label use.

While I wait for my heath insurance to determine my fate, I’d really like to hear from you. What pump are you on and why do you love it? Have you tried adding any medication to your insulin only regimen. What happened if you did?

Share
Favorite Things Hope Type 1 Diabetes

Only Human and Type 1 Diabetes

Published by:

human

I am a regular podcast listener. In fact, I love my podcasts and one of my favorites is Only Human. Today’s episode, The Robot Vacuum Ate My Pancreas, is worth every second of 33 minutes. Today’s topic is Type 1 Diabetes and features Dana Lewis (you can visit her on twitter here) and her artificial pancreas system.

There were two specific moments during this podcast that I felt the need to share this podcast with everyone I know. Hearing other Type 1 Diabetics, especially children and their parents, talk about how much their life has changed by using an artificial pancreas, brought me to tears. I cannot fathom being a parent of a child with Type 1 Diabetes- managing my own disease is difficult enough. Hearing a child’s little voice and then the voice of their parent, I could almost feel their relief coming through my car speakers.

My absolute favorite part of this show was when Kenny Malone compared keeping a car at exactly 70mph while driving, to keeping your blood sugar at the perfect number, was amazing. I have struggled for years with getting others to truly grasp the time and attention this disease demands from me. I think this explanation is going to help me tremendously in getting my disease a bit more understood.

Please take a listen (or read the transcript) and let me know your thoughts!

 

Share
Rheumatoid Arthritis Type 1 Diabetes

Tidepool Love

Published by:

Last Saturday I had the privilege of going to my local JDRF TypeOneNation Research Summit. I learned valuable information and got some reminders I really needed (like bolus 15 minutes before eating, duh). Aside from wanting to share everything I had learned and ask everyone I knew to donate to JDRF, I walked away with an important action item for myself. Get set up with Tidepool. And that I did.

Quick background- I have a Minimed 530G with Enlite system. I also have the Minimed Connect which you can learn about here. I upload to Carelink via the Connect and I pretty much just glance at my screen, look over the past few hours, and try to make decisions on my diabetes. Sounds like a great plan, right? Uh, no.

Everything affects Type 1 Diabetes- food, stress, sleep, activity, hormones, etc. I’m fortunate enough to have Rheumatoid Arthritis to complicate things even further. My pain increases my blood sugar so much that I have a higher basal rate in the evening, for when my pain is at its highest.

Wouldn’t it be great to view my Continuous Glucose Monitor data and make little virtual notes on it, throughout the day to reference my pain, what I ate, when I exercised, when I felt stressed, etc.? Maybe it would look like this?

Screenshot (4)

So cool, right? It’s Tidepool’s software (with the best name ever) Blip and it’s corresponding app, Blip Notes. Setting up Tidepool is a breeze- they are one of those wonderful sites where your username and password work for everything- no need to create 5 different combos for one site. You download the uploader (haha) and off you go! Don’t worry if you don’t have Minimed products like me, it works for most of those other companies too.

Even without the Blip notes, the data is impressive and informative. It shows things like how many fingersticks you’ve done (I need to work on that too…), boluses entered, basal tweaking you’ve done, etc.

Screenshot (1)

 

Screenshot (2)

 

For me, Blip notes is the icing on the cake. Free and easy to use. You create a new note, select one of your frequently used hashtags (at the top) or create a new one, add your note and done! Super easy, very quick..time and date are automatically added (you can change if needed).
image                             image

I’d love to hear your thoughts on Tidepool- have you tried it? If so, what’s your favorite thing about it?

Share
Type 1 Diabetes

Disservice 

Published by:

Today I realized that I am often doing a disservice to the Type One Diabetes community. How? By publicly acting like everything is ok, all the time. 

I went out to dinner with my husband Saturday night. I faced a common problem, where to put my pump when I’m wearing a dress, without a belt. I decided to clip it to my bra, towards my back, under my arm. I had a cardigan on, so I could easily access it but wouldn’t have such a noticeable lump. 

As most Type One diabetics know, going out to eat can sometimes present a problem. Dining out for me means unpredictable eating times, foods that raise my blood sugar unexpectedly, etc. Because of this, I was checking what my blood sugar was, on my CGM, often. Each time I had to pull my bra strap a little to get the pump’s display into view. If I needed to use the buttons, I had to pull it completely out of my dress. Putting it back was another story..basically had to reach down by dress (via the armhole) to clip it back into place. Add on that my Rheumatoid Arthritis had me so stuff it was difficult to turn my neck. I was so self conscious. God forbid anyone saw me using an insulin pump! 

At the table next to me, a few feet away, was a young man in a wheelchair. I couldn’t stop noticing him. Why? Because he was so relaxed, having a great time, while I was going to ridiculous lengths to hide my disease. 

Type One Diabetes isn’t something to be ashamed of. I didn’t cause it, I definitely don’t want it, but it’s part of who I am. It’s been part of my life for over 26 years. I shared what else I hide in my post for Diabetes Blog Week. I have to make a conscious effort to stop hiding. I love seeing someone with an insulin pump on and now they’ll be able to spot me too. 

Share
Daily Prompts Type 1 Diabetes

Helpless

Published by:

I’m playing catch up! The Daily Prompt for January 7: Helpless

Helplessness: that dull, sick feeling of not being the one at the reins. When did you last feel like that- and what did you do about it?

I feel this way every day..I just wouldn’t call it helpless. As anyone who has had Type 1 Diabetes for quite some time (25 years for me) knows, you can do the exact same things 2 days in a row and have completely different blood sugars each day. Sometimes your blood sugar is low, no matter how many glucose tabs you eat, and how little insulin you take. I’m sure there’s an explanation- hormones, weather, who knows..but it happens. Every day, my little mechanical pancreas helps me hold the reins for the hopefully-not-so-bumpy day that lies ahead.

Share
Type 1 Diabetes

Stop, Calibrate, and Listen.

Published by:

Up and running on the Minimed 530G. Up until about an hour ago, my numbers correlated with how I felt and my Dexcom G4. Naturally, I removed my Dexcom, feeling pretty confident in my Minimed system. So wrong.

20131102-221928.jpg

Update: 11/04/2013

Must have been a fluke with the new system..maybe it just needed time to warm up but all day yesterday and today, things have been great! My Enlite CGM number is within points of my fingersticks and I’m quite pleased with having everything on one device. Check out a post later this week when I’ll compare the Omnipod, Dexcom G4, and Minimed 530G with Enlite.

Share
Type 1 Diabetes

Insulin Pump Woes

Published by:

At the end of September, I realized I was over Omnipod. Walking around with a beeping golf ball stuck to my abdomen for the past 5 years was finally getting old. As much as I really didn’t want to have a tube constantly linking me to my insulin pump, I decided that I’m old enough (33, yikes!) to not care about hiding a pump or answering the inevitable questions that come with it. 
 
MiniMed quickly got approval from my insurance (100%, boom!) and I received the MiniMed Paradigm Revel a week later. 
 
It only took me a few minutes to get started, as the pump settings & insertion were virtually the same as they were 13 years ago when I started on a MiniMed pump. 
 
Within a few days, MiniMed called to say the 530G system was *finally* FDA approved and would be on its way. 
 

This arrived last Thursday: 

 
Sweet, right?! Except for one thing- they made me promise, basically in blood, that I wouldn’t start the system without reading the textbook that came with it and attending an in-person training. I am so anxious to ditch my Dexcom G4 CGM and have everything on one handy device that, shhhh, if they don’t schedule my training in the next few days, I’m putting myself on the 530G system this Saturday. 
Share