What's in a Name? Type 1 v. T2. My Thoughts on a Petition to ResolveConfusion

I have to say that I was hesitant to post this, but then I thought I would like to see where this goes. Two moms started a petition to get the names clarified or changed for Type 1 and 2. The petition says very specifically why this is important and frankly, I agree. 

Revise Names of Type 1 & 2 Diabetes to Reflect the Nature of Each Disease

I've been annoyed for years. Whenever I'm in public and pull out my pump or CGM, I get, "what's that?" I explain and then, just yesterday and almost every single time, I get, "Oh! So it runs in your family?" Or, " My sister got it from eating too much candy." Or, "So you have to watch your sugar, don't cha?"

I have had diabetes, T1, for 29 years and it is only in the last five or so that this has become a really issue. Some confusion, but mostly, folks didn't know much at all, so the questions were limited. Now that Type 2 is increasing in children and more and more media and wellness programs are focused on it, folks don't really even realize there are two types. One autoimmune and one metabolic. Damn. They are not the same disease at all.

Today at work, standing by the elevator, there as a poster for a new Diabetes Management Program where they are going to help us control our diabetes and possibly stave it off. No reference to Type 1 or 2, let alone gestational or The other forms being discovered. Normally, irksome and I grumble under my breath and blow it off, but something's have changed and the name has a whole lot to do with it.

You've seen my posts about my tween. In 7th grade and she does everything possible to avoid letting anyone see her manage her diabetes. Few know and she wants to keep it that way for now. The main reason, other students only know about type 2. It's what grandma has or Uncle Joe. He's real overweight and had his big toe cut off. "It's real gross."

That is what my daughter wants to avoid. What do you say to that? Communicate with fellow 12 and 13 year olds? "Oh! You have this all wrong. I don't have what your grandma has, I have something that is completely out of my control. It's an autoimmune disorder..." Glare. "Whatever." On goes life. Misconceptions remain.

This poses a safety hazard, too. If friends don't know, what if there is an emergency. Wi makes the call for help? Maybes teacher who thinks the same thing?

So, I supported the petition because I'd like to see how it is responded to by the National Institute of Health and the others in the list. I'm not dying on the hill over this, but I am willing to talk about it on a forum at reaches a lot of people. The signatures were at right about 2,219 when I post this. Why not get a mass of signatures and see what happens. Type 2's don't care about this (according to my type 2 husband). They can have the "diabetes" brand. We can come up something more fitting of the disease we have to deal with daily forever. The disease that is not "cured by modifying our eating plan." Not angry, just irritated.

Let's make these numbers soar and see what kind of response is received. Click below to review:

Revise Names of Type 1 & 2 Diabetes to Reflect the Nature of Each Disease

Artificial Pancreas Bluetooth Based at JDRF T1 Now Conference

Here it is!! This is a shot (I only got one chance, so excuse the glare) of a smartphone that has an artificial pancreas program installed. It uses Bluetooth to take data from your CGM and your pump (Bluetooth enabled...hello Medtronic?) and combines the data into a program that can determine whether you need more insulin or less.

It watches your blood glucose and that gives micro blouses if you are trending high, or micro-suspends the pump to stop delivery of insulin in you are trending low. I wish I had the chance to get shots of all the screens, but one screen shows the CGM data in a graph and also how the pump is told to react, so you see the micro-blouses like a bar chart by hour/minute and also how the pump will suspend for short periods with the bar graph that goes below the line. So you see everything.

On this screen you can see it is connected to the CGM and the pump. You can see the "Closed Loop" is active. You have screens for adding food, medications, or exercise. He explained that much like autopilot on a plane, as captain, you want to take off and land the plane yourself, so you are active in the process of blousing for meals. But, if you are like my tween and forget, the AP will watch you trending high and bonus to keep you in target range. This is harder for your body than just planning and blousing, but let's say that pizza was really 45 carbs and not 60? The AP will watch you dropping and suspend insulin delivery to stabilize you. I bet that may not be enough in some cases, but what a help.

Tom Brobson, National Director for JDRF, who showed me this device, told a story about how when he got this thing, he went straight to a burger joint and ordered a huge burger and a huge order of fries. He said he took about 2 units of insulin for that huge meal and watched what would happen. You know what? He never got above 150 or so. The AP worked great at trending and anticipating his bodies needs.

The unit he was showing us was in a simulation mode now. But THIS is exciting. When he used the functioning device, he used it with his Omni Pod and his Dexcom G4 Platinum, both Bluetooth enabled.

While I had Mr. Brobson's attention, I proceeded to have a little rant about the FDA and Medtronic Minimed. More about the results of that conversation in my next post, but I feel better.

JDRF T1 Now Conference: I learned a lot!

Wow! I learned an awful lot at this conference. I totally enjoyed hearing Tom Brobson, JDRF National Director, talk about the artificial pancreas he got to wear. I'll talk about technology in my next post with a photo of his cell.

But really the biggest boost I got was from Dr. Stephen Ponder, who talked about how to get the most out of your CGM and how to time you meals with that constant flow of CGM information.

 OK, long timers, who thought that when "faster" acting insulin was invented in the 90s (Novolog, etc.) that that meant we could take insulin as we sit down to dinner?

I grew up the "Regular" insulin, which meant I had to take my insulin 30 minutes before I ate. I was under the assumption, probably falsley planted by my doctor or diabetes educators of long ago, that the new insulin would work in about 10 minutes. So, I thought, "Ahh! Time to eat my pasta dinner, better take insulin for the 45g of carbs." Well, 15 years later, I find out I was kinda wrong and CGMs help us see why.

Dr. Ponder explained that if you take insulin 20 minutes before a meal, you can see on your CGM that a slight bend downward in your blood sugars happens at 20 minutes post insulin and THAT is when you should start eating.

So, yesterday was my husband's birthday and I did a little experiment with this new process. I took insulin 20 minutes, maybe 25, before we sat down to eat surprise donuts! Yep. Donuts. My blood sugar never went above 165. How cool is that!

I also learned that when you correct a high, you shouldn't see much in terms of results for at least two hours. It seems awful silly that I didn't know that. I mean I did know it, but no one ever said to me, "You won't see results for two hours." I just experienced it. There is something so valuable about hearing a doctor or professional give you concrete information about something you have experienced intrinsically for more than two decades. Is that weird? To be so thrilled with info I generally knew, but now have specifics on and can apply to my management?

More on the horizon of diabetes care in my next post. Lot's of info that I'm trying not to get my hopes up about, cause it would be too awesome!

Attending the JDRF T1Now conference in Austin

JDRF Director, Tom Brobson speaking now. Will post thoughts later.

Wow! Exercise make your blood sugar go low

Ok, I'm not dumb about this fact, but I just started a couch to 5k app this morning. My sister and I are going to try to do it together, even though she is 200 miles away. We figure accountability is the key, at least for me. When I walk with friends or go to the gym and meet them, I go. I hate mustering the energy to exercise alone.

Anyway, my sister couldn't believe that I started this morning. Really, she probably thought I was the last person to step up before her. She is three years younger and in much better physical shape than me. But the spirit moved me, I bought new, expensive shoes and I'm off. I also thought I might as well track what I'm eating in another app. Baby, baby steps as I make my health more of a priority.

So, on my walk-to-jog day one, I figured it would kick my butt, so I reduced my basal rate to 75 percent. After 12 minutes I had to suspend my pump and when I hit the cool down I has double arrow dropping from 80. I had to stop, missing the five minute cool down. I also skipped a couple of the jog portions when I was walking up a hill or I was just wiped out. As my fanny hit the couch I was 55. I slurped a juice and ate some fruit and cheese.

I ate breakfast and took my normal insulin before I left. I'm thinking that i might need to do a 50 percent basal reduction next time, or maybe even suspend just before I go. Any advice here?  Can't wait to use my CGM to figure out this puzzle.

If I ever led you to believe T1 diabetes was easy...

...I'm sorry. Because it isn't easy. In fact, I have learned to cope so well that I'm surprised when I stop and look at all I have to deal with every single day. Stunned. Stunned by how much my daughter has to deal with every day.

Last night I was just too tired to get up and help my girl with a low, but o was awake and worried. My husband got up and took great care of her, even feeding her a completely unnecessary bowl of cereal and fruit with real whipped cream. She was starving at 3:30 a.m.

But at dinner she was 436. This after a long, long conversation on Sunday with her about being accountable for the food she eats and taking her blood sugar at school AND insulin. She is really struggling to keep her diabetes under wraps in middle school. Which means she is really struggling to keep it in control, too. I completely understand, but we challenged her to find a way to do it. She is smart, creative and capable of taking care of herself. So, she proudly told me as she got off the late bus that she checked her BG and got her insulin before lunch. Small victories. Then, she checks at home and she is 436. She burst into tears because she did everything right. Her infusion set was clogged. That doesn't make either of us feel better.

So emotionally, last night was rough. We had middle school drama to attend to and a diabetes triumph with the crashing realization that maybe no one is in control of this freakin' disease.

She was 115 when I went to bed at 11:00 pm, so I thought we were good until she stumbles in low. So this morning, I'm staring at her tired face sleeping and I know she isn't going to get up. She has standardized testing today and has to be there, but she just can't wake up.

I have crashed this morning. How can everything swing so wide in 12 hours? How is a growing girl supposed to manage this physically and emotionally? How can I have so little control over all of this? How can she be SO amazing and balanced and strong with so many obstacles that other kids her age don't face. I am so incredibly fortunate to have such an amazing kid.

I know I'm am a good mom, but really, I wonder everyday how I could do more to help her. I wonder if giving her so much responsibility is hurting her or helping her. She is 12. I wish I could send her to the school nurse so she could help take care of her, but that isn't my kid. She wants to do it herself. I wish I could have teachers gently remind her to check her BG before a test, but that isn't her or her school either. I wish she didn't have amazing field trips 9 hours from home with no cell coverage, so I wouldn't have to tag along.

And I also wish I didn't have diabetes, too. I almost can't write about it in the same post, because it is that big. My diabetes and her diabetes live in two separate worlds, because I struggle to do both successfully at the same time. I'm not "worried" about me. But it is totally there. I use a CGM to keep me from diving off the deep end. That's the best I've got.

I really wanted to post on Facebook this morning (or scream out to the world), "To anyone that I led to believe that managing T1 diabetes was easy, you were wrong." But I can't say stuff like that on Facebook. I don't want pity. But my friends have no idea what I deal with as a woman with T1 and a mom of a child with T1. I make it look easy. No one would ever understand. It is impossible to explain how much energy and spirit is required. None of my friends were up all night, worried all night, for their child's well being. It's just a tuck of the covers, a sweet kiss with a whispered, "Good night, sweetie! Sleep tight!"

New Years Resolution Update: I Quit the Gym. Boy, I Feel Better.

Yeah, I went to the gym, inspired by my walk challenge, which has been, well, challenging. I actually hadn't been in awhile. They supposedly renovated the place and when I walked in I saw new paint and stuff moved around and a lot (whole lot) of people working out like drones in front of the TVs. I wanted to swim. My body was achy and I heard the pool area was new, but it didn't look new, save for paint.

Anyway, I loaded up my gear and went to the desk and told them I quit. Whew! I feel better. No more feeling bad for not going. Paying and not going. Spending 20 minutes to get ready to go. No 20 minutes to unpack and get dressed after going. No more feeling like crap when I look around at all the college students who look just like I did at 23, but I didn't have to work for it then.

So, I came home and pulled out my Mari Winsor Pilates DVDs from like 1995. The 20 minutes workout was scratched (my copout go to) and won't play, so I did the hour. I did it Sunday too and when a friend asked if I wanted to take a walk that day, I said, "sure!"

Yesterday, I did my video again and am already stronger. Interestingly, even after my first workout, I had to adjust my car rearview mirror because my back was straighter. That was actually at the top of my list of priorities, work on my posture. Pilates does that and I love that I workout laying down almost the whole time (or rolling like a ball).

The steps challenge to do 5,000 every day, well, that is hard. In fact, I am super impressed my doctor does 10,000 every day. On an average day of just taking care of the kid, working, coming home I average about 1,200 steps with no extra effort. Sunday, when I went for a long walk, I only managed to hit 4,750. That is my peak since my last post. The days I'm doing Pilates, I'm generally not walking. I take me stairs...going down, and am trying to get more steps in, but other than going on long walks (time), I don't know how you hit 5,000.

So, I'm adjusting my goals a bit. If I do Pilates, walking be damned. If I don't, I need to take the dog on a long stroll.

That's my plan. I just need to move and the Pilates is stretching me like I need, lengthening my muscles and not killing me yet. I do need to accept a couple of the more challenging moves in the video that I have skipped. I did two new ones yesterday and was surprised I could get my legs over my head so easily. Anyway, stay tuned.

When's it Going to be All About Me?

I don't really want it to be all about me, but I need it to be at least front and center in my life. I am the caregiver of a tween with T1 diabetes. I am a mom with T1 diabetes. It's hard enough to be a mom and pay any attention to self care, but I think that I have slipped comfortably into the role of martyr. On any given day I wouldn't say that, but if you look at my health vs. my kiddo's, I have consciously or unconsciously put her right in front of me, which provides me a battery of excuses for letting my self go.

So the New Year is upon us and I see carts in the grocery stores stuffed with veggies. My gym, the one I pay for each month and haven't seen in awhile, keeps sending me personal trainer promotions, and I need a new pair of jeans. Ones that fit me both vertically, as I am really tall, and in circumference, which has become more challenging that it should be.

I'm not yet at my mid-40s and I have absolutely noticed the five pounds a year they say women stack on just through the aging process, but my own diabetes care makes it so much harder. Insulin, technically, makes you hold on to calories and store it away, that way you aren't letting it run rampant through your body and out with your urine.

Well, viscous cycle, here we come. As I gain more weight, I need more insulin. As I take more insulin, I gain more weight. Screwed, if I leave things alone, which is what I want to do. I want to focus my energy on my kid and family and community and everything else, because focusing on me is exhausting mentally. The games we play in our heads are so disruptive and completely unnecessary.

So, I downloaded a pedometer app and am trying to hit 5,000 steps per day. This is a bit of a challenge when I sit at my desk for my day. Yesterday I hit 3,755 because I took the dog for a walk, but that kinda makes things interesting. How can I add more steps to my day? I am mildly challenged by this, which is saying a lot, because exercise is on my list of to-dos just below emptying the dishwasher, which has become a 20-year battle between my husband and me. I fill, but I don't empty.

Anyway, I am not promising any miracles, nor am I trying to meet some ideal body weight. I would like to fit into easier-to-find-jeans and I need to make an effort at putting my health on the list higher. You know the oxygen mask airplane spiel, right?

I am going to visit my dietician and have her tell me what to do. I haven't seen her in 10 years, so I probably have some stuff to learn. I am also dumping all the clamor and dialog swimming in my brain around what I "should" be doing. Or how I should look or what my outcomes should be.

I know many moms read my blog who have kiddos with T1. I know self-care is hard for you, too. If your willing to share, I wonder how you set aside your responsibilities for them, in order to take care of yourself? Let me know.

Wow! Highest A1c Ever for My Tween

We visited my daughter's endo after wearing the Dexcom G4 Platinum Continuous Glucose Monitor for about two weeks. They actually had some numbers to work with when they looked at changes to be made.

I really hate visiting this practice. In fact I hate it so much we hardly ever go. Every appointment is two hours minimum and they want us back every three months? Crap, who has that kind of time with a middle grader in magnet school? I was dreading this appointment because we switched doctors so we could get in at the time I wanted. She is new and I was anxious.

Turns out I love her. She is young and related to my daughter really well. But she delivered some harrowing news. News I shouldn't have been surprised by, but it was a shocker. 8.8 Hemoglobin A1c. Dude. 8.8.

I remember being 15 and hearing the numbers 11. Yeah, really. I would sit in the endo office waiting room filling in weeks of my log book with 151, 127, 210, 101, 98, 164, 175, 97, 120. I remember the him looking at the numbers when he asked to see my hands. He looked at my finger tips and them showed me. Busted. No evidence of taking my blood sugar and back then the lancets were fat and damaging.

All throughout the holiday my kid has been drifting in and out of the 200s. Only when I give her a 125 percent basal increase does she stay closer to normal. Her sensor died a week ago and begged to have a break from it, so I'll put it on her today, but this is freakin' hard. Hormones are a real bitch!

By the way, she wore the first sensor nine or 10 days and the last one more than two weeks. It started irritating her where the corners of the rectangle poked into her skin, so I think we'll stick with one restart.

Updates on my non-blogged about husband in the next post. Bad news. Type 2 is real diabetes.

Technology Only Gets You So Far: You Can Bring A Horse to Water...

So my daughter has been wearing the Dexcom Platinum G4 for about a month. It is SO nice to have her numbers, but it hasn't improved her memory. It is better, but she can't remember to take insulin before, or sometimes even after, she eats. Dude. What do I have to do? She has a thing buzzing at her to remind her! Ahh! 12.

Merry Christmas and Happy New Year to all!!

Amazing! Love Dexcom G4 Platinum

Anyone who has followed my blog for some time knows my daughter, 12, has T1 and refused to her core to wear a CGM. I forced the Minimed one on her in 5th grade for exactly one week and she promised me to never, ever wear it again. It took me an hour and a half to get the thing on her and the only thing that worked was a threat that she could not attend a birthday party until she had it on.

The threat worked, but I did damage. The whole, "this hurts me more than it hurts you," may not have been true. It broke my heart. Here I had in my hands THE thing that could make my life easier as a mom of a child with T1 and she didn't want it. She resented me forcing it on her. It also hurt.

Well, she is in 7th grade now and this morning her blood sugar was 135. In fact, in was in that range all night. I checked it by rolling over and looking at a hot pink Dexcom G4 Platinum Continuous Glucose Monitor!

My daughter and I were headed out of town Friday with her best friend. We planned to leave at 4:30 p.m. and she got off the bus at 4:00. She hopped in the car and I handed her the already charged receiver and she thought it was too cool!

I had everything ready to go to put on the sensor on and was all smiles when I said we needed to get it on before her friend arrived at 4:30. We danced in anticipitation for about six minutes, but I didn't lose my cool. I stayed smiling and encouraging and finally she said, "Just do it!"

I counted to three, pushed the plunger, pulled back the collar to remove the needle an carefully removed the inserter from the sensor base. Putting in the transmitter is awkward and was probably the worst part, because you have to push down hard to get it to click twice into the sensor base, but she was OK. We agreed, that was indeed the worst part.

She and I were both surprised that the transmitter is so much thicker than the Dex Seven Plus. Really, it is tall, but right now, in winter, it isn't an issue, but come summer, we are going to have some issues I suspect.

Anyway, we hit the road and she calibrated in the car two hours after starting the sensor and about an hour from our destination. Interestingly, her first BG check was 237, so she entered it as one of the first two calibrations. Her next BG was 135, so she entered that. The receiver asked for another check, thanks to the wide disparity, so she checked again and it was 132. The calibration took! I think the Minimed would have just said Cal Error and I would have had to wait and try again later.

Spending the night at my sister's house was to be the highlight of our trip. I was going to stay with my mom and my daughter and friend with Aunty, Uncle and baby. Her first night, my sister was up with the baby at 5:30 a.m. and she heard this crazy beeping. She text me to ask if she had an alarm set, but I was zonked out. She finally went in to investigate the sound and found her Dex buzzing and beeping. It said LOW in red letters, 55. My sister had trouble waking her up, but finally got a glass of juice in her. I am SO grateful! So, so grateful!!

It has been within 10 points accurate and is supposed to be stellar from day four to seven.

I asked my daughter last night what she thinks of it so far and she said she loves it!

More later about the pros and cons. I downloaded and used the software, have issues with the alarms and the transmitter size, but need a few more days to evaluate. For more info, read Kerri Sparling's blog Six Until Me for her first and second impressions of the Dexcom G4 Platinum.

Dexcom G4 Platinum On the Truck

Adolescent Needs: We're moving on Minimed to Dexcom G4 Platinum

I'm buying the new Dexcom G4 Platinum Continuous Glucose Monitor (CGM) this week. I've been waiting on the Minimed Enlite Sensors to get FDA approval, but my daughter (12) and I can't wait. I am floored by the changes her body is going through and how that impacts her blood sugars. One thing I know, she needs the latest technology available TODAY. I don't even want to wait for shipping.

I was up at 3:00 a.m. last night as her blood sugars have been near 300 for a few days. I keep bumping her basal to 120 percent, but last night, she was 275 after adjustments and I overrode the adjustment my a unit and set the temp basal at 130 percent. Then went back to bed and said a little prayer that it wasn't to much. She was 120 when she got up.

I've been sitting and waiting for the Medtronic CGM, but the FDA is too slow. I actually wrote a letter to President Obama with tears streaming down my face asking him if he could put a bug in the FDA's ear to hurry the hell up! It was more polite than that. I know it was going to fall on the desk of an intern, but as a mother, I have to do everything in my power to protect my child, so I'm buying the Dexcom G4 and she actually said YES to wearing it. YES!!! She called it "her CGM" the other day and you have no idea how big this is for us. She wants it!

I can keep this by my bed and if my daughter's blood sugar goes low or high in the night I'll hear the alarm! It was 20 foot range! I won't worry in my sleep anymore! I'm going to keep all alarms off and download nightly to see what she needs, but I don't want it interrupting her in school. I just hope she'll look at it once in awhile. I'll update when we have it, but I can tell you that I'm happy! The Dexcom Seven Plus works great. I just really dislike having an extra device to carry around.

Medtronic Survey of New Pump Style Options

So, I got an email from Medtronic Minimed yesterday to take a survey. It was supposed to take 25 minutes, so I as hesitant, but decided to go ahead and do it on my smart phone. I couldn't believe my eyes and I am SO mad I didn't take the survey on my desktop so I could capture some screen shots, a task I have yet to figure out or need on my phone. Anyway, the survey was comparing four different styles/functions of pump/Continuous Glucose Monitor (CGM).

There were technically two styles, but one offered artificial-like pancreas functions and one was just a pump with no CGM options, which just seemed weird. They both offered color screens on a remote control to manage pump/CGM functions. One was a rectangle about 1 1/2" x 2 1/2". It sat on a baseplate infusion set and had a "pump" with 200u of insulin inside. This affixed to your skin directly via the base plate infusion set. You had options to bolus from the pump directly, but there as no screen, so probably just an audible system. This would come in handy if you left the remote at home and were out.

The second style was a 2" round disc. It also had an infusion set that went with it and looked like the ones now, but the disc was a pump that held 300u of insulin. The pump could also be affixed directly to your skin or you could clip it to your belt, put it in your pocket and maybe your bra. It had no function for bolusing on the pump, but shared the remote shown with the other one.

The biggie deal here was when selecting which ones you liked best, it was clear they were trying to see if you were really interested in a CGM based artificial pancreas, because the questions said the pump would cease insulin delivery if blood sugar dropped below determined levels, or would correct for high blood sugars if it went above certain levels. The options given were one step beyond the Minimed 530G, the American version of the Veo.

So, while anxious to just get the 530G and the Enlite Sensors, this is exciting stuff. I was really confused why they would ask if I preferred a pump with a CGM that could shut off or auto bolus vs. a pump with nothing but a remote. Dude. That is so Omnipod!

One Last Idea on Manual Insertion of Medtronic Minimed Enlite

OK, I'm going to try one last time to get a sensor on manually and I think I might have an idea about how to fix this. I have been flattening my skin to make it more taught, like I do when I put on a Quickset infusion set. I think that could be my problem; creating too much resistance for the spring loaded needle.

I'm going to try to squeeze up a pooch of skin, so it is softer and squishier. Maybe that will allow the needle to slide in more effortlessly and not trigger the release of the needle. Wish me luck!

Oh! Someday these post may be relevant...when we can actually buy these in the U.S.

Just sayin'...

For What It is Worth, I Asked the President for Help

Tears streamed down my face this morning as I wrote a letter that will be read by an intern and probably never be seen by anyone who could offer help. I had to try though. Maybe if I write every single day, the White House can knock on the FDA's door and ask them what the hell is taking so long.

I simply can't understand. I won't understand how a product being successfully and readily used since 2009 in Europe, can take so long to approve here in the US. What is WRONG with this picture. And, when it is finally approved, American's will be falling over ourselves thankful to have four or five year old technology. I certainly don't blame the President for this, but I do think he could help. Just asking the question, "What is taking so long?" and "When is the Medtronic Minimed VEO and Enlite Sensor being approved and made available to Americans." It would be nice if there was a question about what the hell took so long, but I'm not picky. I just want this pump and CGM for myself and my child.

My frustration is palpable. My desire to take care of my child and myself with the most comprehensive technology available is beyond words. My anger that I can't have what has sat on market shelves for more than three years in Europe literally brings me to tears. Problems this illogical really get to me.

So, I better get to work and hope that someone is doing something out there for the millions of people living with this disease. Something beside making another stupid glucose meter in a new shape or color.

Manual Insertion of Enlite Sensor...Fail.

I have only found this video online and not one single set of instructions for manual insertion of the Medtronic Minimed Enlite Sensor. The video is helpful, but I have found that on my adult skin, her technique was just not that simple. Repeatedly the needle would spring back into its holder as I plunged it into my skin. She does not show the insertion, but does a good job of explaining her process, however, since I have only had success with one sensor manually, I'm pretty frustrated.

Does anyone in Europe have the instruction manual and does it offer a manual insertion technique? What if you were traveling and left the Serter at home? There must be a way to do this without launching the needle back into its casing. I'm not leather, but I do think that a two year old might have the softest skin on earth. So, if any of my European friends who have the Enlite can share their experience, please comment.

My daughter is 12 now and I am watching her blood sugar spike for reasons that can only be hormonal. It is hard to manage. I can't be with her or monitor her anymore. Some days she has band sectionals at 7:00 a.m. and doesn't come home until after a volleyball game at 7:00 p.m. I sure would be nice to have this CGM. Seriously, what is the deal?

Really, an expert advice from lucky folks in Europe, would be appreciated!

Bayer's Contour Next LINK Meter Now Medtronic Standard

Looks like Medtronic is moving from the One Touch Ultralink to the Bayer Contour Next LINK I used in the trial! According to medGadget, it will now be the Medtronic standard, even shipping all of us the new meter. I want to thank Gene Ostrovsky for linking to my blog post on my meter use during the trial!

As I mentioned in my post, I liked the meter. It was a nice change from the boring, no-frills Ultralink, but I have about a million One Touch strips to use up. I'm trying to be patient, but it isn't the meter I want, its the Enlite Sensors. Happy for the new meter, but let's hope it is the next step before releasing the Enlite!

medGadget posts meter benefits as:

• Enables fast and easy bolus dosing and continuous glucose monitoring calibration
• Pass-through feature allows for easy downloading to Medtronic’s convenient online CareLINK software, replacing the CareLINK USB device
• Bayer’s No Coding™ technology makes testing easy by automatically setting the correct code each time a test strip is inserted
• Easy-to-read display with large, clear numbers (my favorite feature and the only thing "new" enough to matter)
  
• Fast 5-second countdown and small 0.6 μL blood sample
• Optional pre- and post-meal markers with audible reminders

This isn't a revolutionary product, but it is much more pretty and readable!

Here is the news release from Medtronic, posted on Tu Diabetes by Emily Coles.

Playing With Leftover Medtronic Enlite Sensors

So, I found another Medtronic Enlite sensor from the trial I packed up for a trip I took this summer and I have been playing with it a bit.

First, I had to insert it manually and this is much more difficult than it looked without proper instructions. But I got it and have worn it for nine days. Shhhh! Don't tell anyone. I'm actually going to restart it again this morning and see if I can sneak another three days with accuracy.

I am of course, using my old Medtronic Minimed Revel 723 pump, so it thinks the sensors end after three days, so I have to restart each time. At the end of the sixth day, I disconnected the transmitter and charged it, then reconnected it and started it like a new sensor. I got three more days, so now I'm going to try another restart and see what happens.

I'm so desperate to keep these sensors, I want to stretch them as LONG as possible. Over the trial I wore a sensor every single day and got mighty used to always knowing my blood glucose. I have grown reliant to the alarms to tell me when things are awry, so not wearing it creates a problem. I stubbornly refuse to use the harpoon sensors, but may be forced to if the FDA doesn't get its a** in gear and get this approved.

I'll let you know how it goes, but I want to be clear, I am stepping outside recommended protocols for using this sensor. I don't recommend doing this. I simply have nothing to loose as the end of my sensor life is very near and I want to see how long I can stretch it with accuracy!

Medtronic Enlite Trial: Over and All I Got Was Deep Longing!

The Medtronic Minimed Enlite Sensor Trial was great, but I am truly missing the whole set up. I did have a few sensors I found tucked in a suit case after my trip and have tried to insert them manually, but it is HARD to do it well. So I lost one, feeling like an idiot, and am wearing one now. I've had it on for 9 days. Shhh! Don't tell anyone.

I am wearing them with my old transmitter and when I say old, I mean old. Like 2009, old. But it works well, I just have to restart the thing after three days (I'm back on my pump that doesn't know they new sensors work for six days without restart). At the end of day six, I unplugged the transmitter and charged it, then plugged it back in a started over. Seems to be working very well.

To wrap up my thoughts about the Enlite Sensor:

1. It is simple and painless to insert with the serter. Harder, but not impossible manually.

2. Six days works great and I am certain you could try for more, but that would be a personal choice because this would only be approved for six day use.

3. The accuracy is spot on. Seriously. The variance I see with my harpoon sensors can swing, not wildly, but with more frequency. This Enlite is accurate with very minimal issues. I did have some, but they were temporary and fixed with calibration. One time I had to End the Sensor and restart, but I think that was somewhat a user error issue.

4. I want it for me. I want it for my 12 year old daughter. I want the MySentry for both of us. I want it now.

I can't understand what takes so long. This product has been available for three, going on four years, in Europe. New pumps are being released by small companies with better looks and cooler UI, but I want this. It isn't fancy looking, but it works. We can blame the FDA, but I blame Medtronic for not starting all this sooner. They move much too slow and the FDA brings progress to a trickle.

I am optimistic. The time is passing the same as ever, but I have worn this CGM since April with few breaks and I now rely on it to keep me safe. I can be a mom, focus on my child's care and not worry about myself. If there is a problem, it will be and I love the beeps are minimal.

Medtronic Trial: Enlite Sensor Questions

Still a little bummed I didn't get the Minimed Veo, but I've been thinking more and more about the Enlite Continuous Glucose Monitor Sensor and what it's introduction might mean.

Well, it would mean freedom from harpoons, but really, technologically, it would mean a pump upgrade. Rumor has it they would use the Revel in the US, not the official Veo from Europe, but that wouldn't mean we get to keep our current Revel model.

The current Revel's are programed for the Minilink CGM with a sensor life of three days. The Enlite is six days.

Also, I wonder if they will upgrade the transmitter technology. I'm not thinking so, because I still have issues with weak signals on my trial version. I really need a new transmitter for my personal system, but I don't think I want to upgrade until all of this stuff comes out.

While I totally appreciate the trail on the Veo, and I want it bad, I more than anything want the Enlite sensors for me and my 11 year old. However, I just bet the next major upgrade offered is a combo of a new "Revel" (with Low Glucose Suspend) and the Enlite together. I guess I initially had this thought that I could just order new sensors when they came out, and maybe a new transmitter for extra juice, but that is pretty wishful thinking.

I have amazing insurance (my husband works part-time for UPS and coverage is KILLER), so I'm actually not worried about cost, but this might mean we have to wait for both to be FDA approved, which scares me. I'm eternally sick of waiting on the FDA for new technology. Oh! So weary!

Will you upgrade if a new pump and new sensor system comes out as a packaged deal?

Medtronic Trial: No Veo

Coincidentally, my headline, "No Veo," or "I don't see," in Spanish, is true. My number wasn't drawn in the randomized trial for the Minimed Veo Low Glucose Suspend Insulin Pump. So, no new pump today. Apparently, very few people in Austin got their number drawn in this national study. Boo hoo!

However, I will continue with the Enlite Continuous Glucose Monitor (CGM) sensors and the Bayer Next Link  for another 13 weeks! YAY! I really love the Enlite.

I really would love your questions. I take a lot for granted and may not be telling you everything you want to know. I have a really busy week coming up, so if you post some questions you might have, I'll get answers to you before my next full post. Thanks for all your support!

Medtronic Trial: Headed to Appointment...

..to see if I get the Veo. Stay tuned this afternoon and cross your fingers!

Medtronic Trial: Upload Complete! Now the Wait. Veo or No Veo?

Today I uploaded my pump for the trial folks to analyze and see whether I am able to continue and be put in the random selection for the Veo Pump with Low Glucose Suspend. If my Carelink log meets some mysterious criteria, my number goes in a hat. If I am picked, I go Monday, May 7 to get trained on the Veo.

Either way, I will continue with the trial, but I may only be testing the Enlite CGM with a Revel pump and not the Veo. I hope to make the trial, mostly so I can tell you all about it! Cross your fingers for me!

Medtronic Trial: Bayer Contour Next LINK Investigational Meter

I promised details on the investigational Bayer Contour Next LINK Meter provided with my pump for the trial, so here you have it. A picture says a thousand words, so I'm going to take advantage of that. Forgive me, however, for the not-so-great picture quality. I had to use my phone camera today, as the other camera's batteries were dead. FYI - If you click on an image, you can see it in a larger format. You also have the option of clicking through all the image up close.

Bayer Contour Meter has a USB connection for charging and downloading readings,

Results are displayed across the screen first in a big bold font, then it shoots to a smaller font as seen as it sends the results to the pump. Tough shot: Green bar says, "Results Sent."

There is a useful "Notes" screen that includes this and the following image.

Notes also includes "Activity," which isn't pictured

The meter also includes a reminder to recheck your blood sugar. I haven't used this yet, but this is a new feature, so I'm trying it out.

This is the Menu screen.

This is what you see when you select "Trends."

The is an image of the Logbook. The text under this reading has a scrolling, "Sent, High Blood Sugar."

Same scrolling text and amber color for a low. Font is white if reading is normal.

Easy on/off button, which seems like a silly thing to show you, but if you have the One Touch UltraLink, you understand. Just try turning the sucker off without throwing it out the window. Such an incredibly simple thing to make so hard.

Pretty cool! I didn't give it enough credit in my first post, but I also hadn't played with it much at that point. I don't upload the meter into Carelink, all results are sent to the pump, so they are uploaded with the pump info. However, if you needed to upload the meter only, you could. Whatcha think?

Who Knew Hormones Could Do That to My Blood Sugars?

I can't believe the last several days.

Here is a snap shot of my blood sugars in mg/dl:
Tuesday: 468 - 55
Wednesday:  478 - 45, 15% of my readings below 70
Thursday: 218 - 40, with 13 % of my readings below 70

The highs were easy; occluded infusion sets. The lows, well, I spent three nights with blood sugars I could not bring up over 80. I drank a total of 15-18 juice boxes, ate cereal, whole grain bread with Nutella and I even did a temporary basal rate last night of 45% so I could sleep. This drastic measure kept me normal and I never climbed above 150 mg/dl until morning. I was SO low and it was exhausting!

The alarms on the CGM; thank God for them, but they drove me bananas. I woke up to a screaming alarm that had been pressed underneath me and my covers with a 45 mg/dl BG, I drank two juice boxes and hoped that would be the end the alarms for the night. After all, I'm tired people!  I crashed back to a 45 mg/dl induced sleep, and BAM! Twenty minutes later, screaming alarm wakes me and I'm 55. Drink another juice and the cycle continues for three nights.

Boy Alert: I am going to discuss hormones, as they relate to blood sugars and, yes, my period!

Finally, I decided to call my doctor and he adjusted my basal rates, but could all this be because of dropping estrogen and progesterone levels? I got my period today and I'm wondering if I would have the same problem tonight. I'm not going to risk it, I changed the basal rate, but this is kinda concerning. I really, really had trouble handling this.

I have a history of BG's being high the week before my period. I also know of one other time I had this exact trouble with lows happening overnight that weren't fixed with a juice box or two, and it was the day before I got my period. But this time, we are talking three consecutive days of overnight lows before my period! Yikes.

I have always wanted a better understanding of how female hormone cycles impact blood sugar levels. I track my cycles and I track my blood sugars with the CGM, I need software to marry to two sets of data and show me some correlation. I want to know how to cope with this before it is a problem. I used to have a couple different basal patterns for the week before, but I switched pumps and never reprogrammed the rates.

I'm just going to call this a freak accident and hope I don't get disqualified from the trial because of this wacky stuff. It was weird and I hope its over!

Ladies, what are your experiences with blood sugar fluctuations throughout your cycle? Ever had anything like this happen?

Medtronic Trial: Minimed Enlite Sensor ROCKS! So Tiny and Comfortable!

How do I love thee, Minimed Enlite Trail Sensor? Let me count the ways...

Seriously folks, I love this sensor. I've had it on since Monday and I have had some hard diabetes days. I'll get to that in another post, but so far, I can't feel a thing and it works like a charm.

I'm not going to go into how to put it on, because all of that is in a video on the Medtronic website.

Some things I love about the sensor:

• 69% reduction in size compared to previous sensor. We are talking a HUGE difference in size, which meant a HUGE difference in needle required to plunge the thing in your body.
• Adhesive tab that holds the Minilink Transmitter in place.
• Specially designed adhesive that slips over the sensor head before you put on the Minilink. Although, it is super soft and easily gets stuck together, so you have to be quick and hold it on all sides.
• Can't feel a thing. Going in, or wearing it. Nothing. Completely comfortable.
• Six days of wear.

Some things I love about the Serter (although I think that is a silly name):

• Hidden needle.
• Easy enough to load, but requires thought.
• Needle retracts after insertion and you don't have enormous needles to dispose.
• I like that you press the button to unlock the sensor, then let go of the button to release the needle and sensor. Don't know why this matters, but it feels less scary that pressing the button and waiting for the scary click. I only have done this once in the trial office, so I'll fill you in on my next experience.

Other than those things above, it works just like the previous sensor on the pump. Same requirements for calibration, but they are recommending we calibrate multiple (as many as four) times per day, but only two are required for wear. Another thing, I think I can get this on my daughter! Really, this is huge.

Do you wear the Medtronic CGM now? What do you love most and what are your biggest beefs?

Medtronic Trial: End of Second Week

So, I am ending the second week of the pretrial where I am just wearing the Medtronic Minimed Revel with no sensor and no Veo trial pump. I just have to be sure to check my blood sugar four times a day with the Bayer meter mentioned in my previous post, my ketones each day and log everything into a trial version of Carelink each Friday.

Monday I get the Enlite Sensor. I'll try to take some photos to share. Really thrilled about this and the easier to insert sensors.

FYI - Diabetes Daily has asked me to guest blog about the trial, so I will post a link to that next week.

Curious if any of you have tried or even seen the MySentry yet? I would really like to know how this works, especially for parents with T1 kids. Do you want one as much as I do?

Medtronic Minimed Trial Part two: Got Some Stuff

I had my second visit for the Medtronic Minimed Veo and Enlite Sensor trial on Monday. I was given a new Revel pump and a new meter from Bayer that links to the pump. It has a color screen. It is under investigation as well. I was also given a binder full of papers and log sheets, a blood ketone meter, ketone strips (I have to check every morning. Ugh.).

I will have to upload my readings to CareLink under a trial username each Friday and log my ketones and notes, like the fact that I have a cold right now. Also need to record exercise, lows, etc.

In two weeks I go back and get the Medtronic Minimed Enlite Sensor and can't wait to tell you about it. If you've read my blog long you know how much I hate the harpoon of a sensor they offer now. I like the results, but the UI is sucky.

One bit of info that isn't confirmed, but intriguing is that Minimed intends to continue to use the Revel model, not the Veo, but upgrade the technology in the Revel. Not sure why, but I guess the study is for the technology, not the device itself.

I just want all of this to come to market. I want the Medtronic Sentry for my kid and I want the hippest thing out there to help us manage this pain in the ass disease.

FYI - I am wearing the Dexcom 7 Plus CGM until I get the Enlite. Wearing it makes me remember why I really like the Minimed; it is all in one. I am constantly losing my Dexcom receiver in my bathrobe pocket, in my car, in my jeans that almost made it to the wash. Sigh. Hurry Minimed!

First Visit: Minimed Veo and Enlite Sensor Study

Well, I passed all my screening questions for the Medtronic Minimed VEO and Enlite Sensor study. They asked me 4,000 questions that all ended with the answer, "No." They drew three tubes of blood and then gave me 47g worth of carbohydrates in the form of one and a smidgen of a bottle of chocolate Boost. Then I had to wait two hours.

I thought I was free to read or something, but then came out a stack of paper, seriously 2 1/2 inches thick, with a bunch of yellow sticky notes. It was my entire medical history! She went through every single sticky noted page asking if I was on this medication anymore or that, when my knee surgery happened, etc. Lordy, I'm glad I'm not sickly, because this took almost an hour!

Interestingly, the majority of our conversation was around why I don't take my cholesterol medicine. The answer, "I forget" over about six years was not amusing to her. She said, "Part of eligibility of this study is compliance with its protocol." I replied, "It's the pill popping I have trouble with. I can check my blood sugar regularly."

Anyway, I will go into more detail about the requirements of the study, but oh! Joy! No confidentiality agreement, other than their obligation to protect mine. So I will write with Revel (get it?).

My next visit will start with the results of my blood work, which are measuring kidney function. If I am okey dokey, I will be trained and outfitted with a Revel pump, which I already wear. I kinda begged not to have to sit through two hours of training on a pump I own. She said she would see what she can do.

Then I have to comply with study protocol, which includes four BG checks per day and probably downloading into a guest Carelink account and uploading my pump info. If I comply, they will give me the Minimed Enlite Sensor and watch me for a couple weeks. I think I then get my name thrown in a hat and I will be randomly selected for either the VEO with the Enlite or the Revel with the Enlite Sensor. In my mind, I win either way, but I hope I get the VEO pump.

Have you ever participated in a trial? Let me know what you tried and if you blogged about it.

Type 1 Diabetes, Motherhood and Control Don't Mix

Yesterday morning at 6 a.m., some rumbling thunder woke my daughter before I could come get her out of bed. I was in the office downstairs and sighed deeply, gratefully, because waking an 11 year old takes about half a century every morning. I usually roll her around, push on her, tickle her and check her blood sugar until finally, after threats of missing the bus, she pulls herself up.

It isn't over at that point, because she has to be physically out of the bed before I can walk away. Her snuggley green blanket and pillow are just too tempting.

But this morning, I heard her sleepy feet hit the floor and she called down good mornings. I replied cheerfully with a reminder to check her blood sugar. A few minutes later, as I take the couscous off the stove for her lunch, I hear her call down.

"Mom. I'm 439." I head for the stairs and She is standing there and I can see she is already thinking of how she can avoid an infusion set change. Such a pain in the neck, and it was only two days ago we changed it.

I give her a shot of insulin for half the correction and change her infusion set, giving her the other half of the corection. She sits down, looking pale and tired and says she feels nauseous. We check her ketones, and of course, they are high. I get her some water, and even a bottled green tea, and tell her its the best medicine we have next to insulin. That if she can just sit tight and sip the water every few minutes, it will help her feel better.

She has about 10 minutes before the bus comes and she says, "I'm okay. I'll take a bottle of water and get to feeling better on the bus." She struggles to put her things in her 60 pound, 6th grade backpack. She looks at the clock, sighs, and continues to stuff. I take her hand, gently pull her up to a standing hug, which she doesn't resist and I say, "Go watch TV, drink water and we'll get you to school late." She relents.

She is in a middle school magnet program for the Humanities and Law for International Studies and really likes school. Missing school for any reason is tough, as every minute in class is crammed with content, but she felt like crap. So, she trudged upstairs, kicked off her rain boots and curled up to watch TV. I implored her to drink. Again, nothing except water and insulin will help, but I know her and she won't.

So the struggle begins for me. Just last night she told me a story about her best friend in theater class the day before. Her friend attended one day of a diabetes summer camp with my daughter and got this awesome backpack, along with all the other families. Her friend's regular backpack broke last week (under the weight of eight classes of books) and she pulled out the camp freeebie to use. In theater that day, her friend had left the backpack open and some girls saw inside and started taunting her, "Ooooo! You got diabetes! Mmmm, girl, I can't believe you got diabetes!" The freebie backpack was labeled inside with "I Have Diabetes" and a list of doctors and phone numbers to call in an emergency.

Her friend quickly stammered, "No, no I don't have diabetes. It is just a free backpack I got." The mean girls kept it up and her friend was left to "defend" herself against the attack.

This story gave me pause. It shook me to realize how fragile middle schoolers are around fitting "in." It made me think, why the hell is this a big deal, but my daughter has told me often enough, that you have to lay low. Anything that sets you apart as different, can turn into a problem. You don't want problems in 6th grade. You have two more years with these growing kids and smooth is the best path.

It upset me that her friend had this reaction, but I know it couldn't be helped. She was being "accused" of having diabetes and the stupid freaking two different diseases have become one in most people's eyes. I get very defensive about the metabolic disorder, T2 and the immunosuppressive disorder, T1. Defensive is what I get. Pissed off really.

I remember being at a loss for words after this story. Delicate lines to dance around when dealing with self confidence and a chronic disease. I think I simply said, "Well, I guess she is lucky she doesn't actually have to deal with diabetes."

So, as time ticked by yesterday morning, which felt like forever to me, her blood sugar was dropping slowly, but she still felt nauseous. I implored her to drink, and she wouldn't, because of course, she felt like total crap. I got angry that she wouldn't even try and this is the circle of motherhood that I wish I could jump out of. I wish I could quit feeling so completely compelled to tell her what to do and expecting her to do it. She doesn't. Not because she is defiant. Not because she is contrary, but because she has her own mind and can think for herself. Her thoughts are often different from mine, which infuriates me (and overwhelms me with joy). Every time I open my mouth, I think that maybe she will really "hear" me this time. It is important. My words matter and can help her, if she would only listen. And it never works. I am a communicator, and my words don't matter.

However, over the long haul, I know my sage advice does make a difference. She makes great choices, does awesome in school, is loving, kind, compassionate and extraordinarily independent. But in the moment of this morning, with pale skin, nausea, all curled into the fetal position, I want her to drink water. I want her to try to help herself feel better. I know how to do it. JUST LISTEN!!

She takes a tiny sip from her bottle to get rid of me. To love me. To quell my need for control.

I relayed this story to a friend at dinner last night. It's been weeks and weeks since I spent time with my friend and she listened to me gap-mouthed. When I was through, she said, "Uhh! I had no idea. You never talk about diabetes. I thought she was doing really well." To which I replied, with realization that I don't talk about it, "This is part of what we do every single day." Many, many days are good, more than we would care for are not so good. It is a struggle that we handle very, very well, but the struggle, the care, the energy to maintain diabetes is constant.

It took my girl about three hours to feel well and see her blood sugars in normal range. She was starved, so I picked her up a fast food breakfast (parental guilt reward for enduring diabetic nightmare) and dropped her off at school. I beg her to take her blood sugar at lunch, and she does, like she does everyday, but really that only happens about 40 percent of the time.

I kiss her cheek and send her off.

Now, here I sit to unload all the layers of the last 24 hours, which mirror that last 27 years of my life and the last six years of hers. There is no sadness in this, I am not depressed or hopeless. I'm very proud of my daughter. Frankly, I am proud of myself. But this is real. The challenge to manage and control so many things that are completely outside of me. The challenge is containing all those layers of love, care, concern, compassion, and frustration; keeping them from containing me.

Minimed VEO and Enlite Study Start Date at End of March

Well, I am officially signed up to start the study at the end of March. There is an initial meeting, then a pump training. I think I get the new Enlite Sensor then and have to wear it for two weeks to see if I am a compliant study participant. I need to check my blood sugar four times a day and log "events" like low symptoms and exercise.

Check out this video on inserting the Minimed Enlite Sensor. Dreamy!!!

I don't log anything now, but I think I can handle it. If after two weeks I am a good girl I will be randomly picked to either wear the new pump or continue to wear the Revel and the Enlite Minimed Sensor.

Either way, I am stoked.

The other night, I went to bed with no CGM or BG reading (I was low apparently at bed). I bolted up at 1am and discovered I was 39. I drank two juice boxes and went back to sleep. At 4am I had exactly the same dreams that woke me the first time, and I check and was 50. If I had the new pump, it would have prevented those extreme lows. Dude. Better than my mother!

Anyway, I love a good study, but I really hope this is FAST! I want this technology for my girl. She is amazing and is doing really well managing her diabetes. 6th grade has been a challenge, but I am so incredibly happy with her self sufficiency, even if not perfect.

Lately I have been asking her to be the investigator. If she is high, I ask her to figure out why. She searches her pump history and has to relay what caused the high. No judgement. Just facts. Gentle, consistent investigation.

One recent change offered by our awesome CDE was the she automatically click through every blood sugar on her pump. What I mean is she checks her BG, it is 167, she continues to press activate until she gets an insulin delivery number or not. Not matter what, she just corrects every number. Sometimes it is no correction, but this is to establish the habit of at trying to bring BGs back to normal range.

Getting insulin in her during/after/before meals is another story, but we make progress and she is doing just fine. She is an expert carb counter, but her memory is another story.

I recently learned that as soon as we *think about* or smell food, our blood sugar starts to rise; the digestive process begins. Really we should be shooting insulin 15 minutes before we eat. I remember as a kid I had to take it 30 minutes before eating.

Anyway, I'll update after my first office visit and hope they don't throw a confidentiality agreement my way. I love tracking my experiences in studies.

Participating in Medtronic Minimed VEO and Enlite CGM SensorTrial

Yippee! I am going to participate in a four to five month trial that may put me on the Medtronic Minimed VEO, which has been available in Europe. The thing that makes me most giddy is the opportunity to try the new Continuous Glucose Sensors, called Enlite. YAY!

The Enlite CGM Sensor can be worn for 6 days and has a much different profile in terms of the size of the insertion needle and the inserter. YAY!

The VEO offers a Low Glucose Suspend (LGS) feature to halt insulin delivery when the CGM senses you are low. Both devices are long overdue to the American Market, so if I can help speed this sucker to market, SIGN ME UP!

I want this technology for me, but mostly I want it for my daughter. She is 11 now and middle school is so trying for a T1 kid. I can't hold her hand anymore, so I'd love it if the technology would give her more support.

I'll post more after my first appointment. Of course, there are lots of hurdles to qualifying, so cross your fingers for me!

Medtronic Minimed MySentry $2,400!

I just got off the phone with Minimed and was pretty surprised to find the newly announced Minimed MySentry costs $2,400 and is not covered by insurance. It is cool, but I think I am more surprised by the lack of insurance coverage than the price. Hmm. Not surprised, but disappointed. Do you know what would have been smart, to annouce the upcoming release with the price, so we could get the sucker budgeted into our flexible spending accounts. The year just started and I've already ordered $500 in diabetes related supplies. There is no way I can forgo $2400 of my yearly allotment to buy this through flexible spending, but I might have budgeted for it in October. Shame!

I would love to have this thing, except I will never get the existing Minimed CGM on my daughter. I am so glad they are working on new products, but they REALLY need to fix the harpoon.

Really, what I need is an app that will read my daughters CGM or even her blood glucose meter and I will get alerts from it or be able to check on her when she is away.

Medtronic makes good products and really are industry leaders, but I am so incredibly sick of waiting for upgrades and better technology.

It is painful to wait for Medtronic Minimed to move and the MySentry product is a huge advancement (that I was promised five or six years ago), but they need to pick up the pace.

Oh! my goodness it is painful to wait. I swear the blood glucose monitors are exactly the same as I had in 1983, except 40 percent smaller and 40 seconds faster. Painful!

What are you waiting to see?

Another Dexcom Pro and Another Con

I forgot something in my last post about the Dexcom Seven Plus. PRO: I love that I can wear the sensor for two weeks. Shhh! It's kinda a secret, but some folks I know get three weeks out of it if the glue holds.

However, CON: the receiver needs to be charged, so if you can remember to plug it in at night next to your bed, you are safe. Forget and the battery can go caput and you are out of luck until you can charge it again. I was out of town this weekend and forget the power cord, so it ran out of juice into day two and I was left hanging.

Not a huge issue, but a different one from the Minimed which has you charge the transmitter.

FYI- My site is getting hammered with comment spam. Hundreds of posts a week, so forgive me if I can't get them all deleted in a timely fashion. Don't click on them, it only encourages them. Blogger/Google, get your S*** together and stop this crazy madness!

I like Dexcom better than Minimed! Yeah, I said it!

Jury is in! I have worn the Dexcom 7 Plus off and on for a few months and also switched out with the Minimed CGM. Frankly, the Dexcom is just more user friendly for several reasons. It has cons too, so let me lay them out Pro and Con style:

Pros

• Sensor is TINY and doesn't hurt (much) going in. Much like an infusion set.
• Lasts at least 7 days
• Very, very accurate. Only a couple times I've had it off the mark and it was after the seven days of wear. Often within one or two mg/dl.
• Alarms are quite and unassuming, but you know they are there. This is a big one for me. I hate the alarms on Minimed. They are obnoxious and difficult to program. Not impossible, but it requires a lot of effort to shut the thing up. I would need a whole other post to talk about the difference it makes to have the alarms more like Dexcom, so I'll leave it here.
• You still get readings after a calibration request. This is also huge. I press the button to check my numbers and a polite little message says "Check BG." I can't, so I don't, but the graph ticks along doing its best without my calibration. I get out of my meeting three hours later and it is still holding my numbers, but I know that I need to calibrate, so I check my blood sugar, see it is really close tot he Dexcom, but I forgot to enter it in the Dexcom before my next meeting. I check the unit half-way through my meeting and see my polite little reminder and think, Darn it! I forgot to plug in my reading. Oh! Well, I can do it when I'm through." AND get no annoying, blasting reminders every 30 minutes. Really, this is BIG for me.

Cons:

• Separate unit, which I have lost and then found. Bad for me!
  
• Doesn't talk to my pump.
• Can't merge the data

Running out of steam, but that is it in a nut shell. Minimed better get off ther asses. I have been waiting for a VERY long time and upgraded to get their technology coming out. But they have always failed on UI and don't seem to listen to their market.

I still love my pump, but I desperately wish Medtronic Minimed would step it up A LOT!

Better Success with Accuracy

Well, the Dexcom caught a low in the middle of the night and it was right about the low, but 30 mg/dl off. But juice was administered.

I have to say, my daughter is being a champ with middle school schedules. Rough second day, but overall its been great.

For the first time I can remember, she is feeling self conscious about pulling out her meter and pump. She's worried, because the rules are so strict and kids think she is using a cell phone, which means an automatic detention. So many new kids she doesn't know, so the looks and questions like, "What's that?" get annoying.

Glad its Friday! Saturday, my girl is doing a roller derby camp all day. Should be fun!

Not Accurate, So Far: Dexcom 7 Plus

Last night I was awakened by an alarm that said 47. Actual blood sugar was 90.

Today, alarm says 401, actual reading is 234. Calibrated and its back to 254, but still.

Like trending arrows: Dexcom 7 Plus

I like the constant trending arrows; pointing east for level sugars and northeast/southeast for going up or down steadily, but not fast and of course, north or south, which is pretty way to figure out.

I know folks have been blogging about this product for years, but I might as well document mine.

Also, to clarify, I have great insurance, so this experiment is largely affordable. I still like my minimed cgm, but my daughter tried it once and that was the end of that. Harpoons don't play well with kids, do we are giving this a try.

My girl had never really cared about taking her blood sugar in front of folks, but 6th grade its so different. Eyes are on every move she makes and we need diabetes to be as discreet and private as possible.

Can't hear alarms on Dexcom 7

Well, accurate  readings, but the alarms and not loud enough and the vibrating is absolutely not strong enough.

Also, the receiver is easy to put down and walk away from. Potential problem.

Trying out Dexcom 7

We are trying out the Dexcom 7.  My daughter won't wear the Minimed, so we are giving this a try. She just started middle school and I really want her to have this technology, and I am furious that the FDA has held up the approval of the new, rumored improved, Minimed sensor.

First report of the day; couldn't feel the vibrating alarm to calibrate and it was very close to the body. Not a great sign, if you need alarms privately.

More later.

Disorienting Low and a Car

I had a doozy of a low this week. It has been a LONG time since I got low and felt out of control. When I was younger I had some lows that had me begging for help or caused amnesia, but it really has been years. Now, I usually get low, feel it, drink a juice and move along or more often than not my CGM catches me as I fall.

This week I have been dropping a lot. Don't know why, hormones or absence of them, who knows, but Thursday my CGM was giving me alarms about predicted lows and I was in full work mode. Trying to solve a problem and I just wouldn't stop until I had it fixed. The CGM was reading 70 and I really should know better, that 70 probably means 50, but I didn't stop to take care of myself.

On a mission, I drove home from work to pick up my daughter from school, dropped her off at the house and headed to the computer store to buy a cable. I had a problem to solve and I needed that damn cable.

In the car, I felt so out of sorts. Despondent, anxious, weird, but not so obviously that I recognized what was happening. I had been having a hard week, really under pressure and I was thinking to myself that maybe this feeling I had was a new normal. That I'd feel this way forever. It was weird.

I got to the store and I asked if this cable would fix my issues and they showed me the package and pointed to the info I needed, but I couldn't read it or focus and just asked them to be sure this is what I needed.

I got home (THANK GOD), sat down at the table with my hubby, pulled out my blood sugar kit and I was 37. I looked at the meter and said, "Wow...37." My man got me a juice box and I drank it, but as I sat there I felt strongly that I was supposed to be doing something. I asked him, "Am I supposed to be dong anything?" He said, no. Quiet. I asked if he was sure and he replied yes. Quiet. I said, "I am just supposed to sit here?" He said yes and so I sat there, waiting for the juice to hit.

This is the first time I can remember since I was in my 20s that I was actually "disoriented." I really didn't have a clue what was going on. My CGM was still saying 70, so it was just a little off (HA!), but I somehow instinctively got out my kit.

I am so grateful for adrenaline when I was on the road. Without that, I could have met a very sad and disoriented end.

My 10 Year Old is Now Hooked Up: CGM

Well, we pulled the trigger and got our daughter the upgrade for her Minimed insulin pump to a Revel with the Continuous Glucose Monitor. I warned her it was coming, but I was not prepared for the resistance to putting the sucker on her.

The pump is great, the CGM sensors, not so much. They are freakin' huge needles and it took me one hour to convince her to let me put it on her. We iced her bum, we talked, we cajoled, we pleaded, we reasoned, but the only reason she consented was because we had a birthday party to go to, the clock was ticking and I refused to back down.

We had to establish the rules of engagement. Three kisses, then I had to count to three, but I couldn't touch her with the inserter until three. Then I had to say "ok" before I pushed the button.

She did it and cried like a baby. Said it hurt like hell. It bled a little, but she said it hurt for a good 20 minutes, but she was fine by the time we reached the party.

We didn't start the sensor until after the party and the sensor had its wick wet, so calibration was immediate. She thought it was pretty cool when the blood sugar numbers finally popped up on the screen of her pump.

She watched it through the afternoon and into evening. We'd ask, "Have you taken your blood sugar lately?" with a smile and she would whip out her pump and tell us the number.

We calibrated at bedtime, but she lost the sensor around 11:00 pm. I positioned it closer to her Minilink Transmitter and she was fine, until 3:00 am. She came in and said she was high, so I wanted to check against her meter and it was off. CGM said 315, meter said 230. That was significant enough for me, because the calibration had about the same difference earlier in the evening. I sat in the dark and decided to turn off the CGM and restart the sensor.

By morning things seemed to match, but she was still running high. She took some Advair for breathing difficulties and I know that was shooting her blood sugars up. She called me from school and said the thing was beeping all morning. High blood sugars, missed bolus warnings, even though she bolused. I reminded her it is going to take time to balance her insulin levels to match what is happening in her body. When that happens, she hopefully won't hear any beeps at all .

More in my next post, but I'm not sure I will be able to convince her to put that sensor on again. We'll see. More later.

Ten is a Magic Number and When Girl's Brains Drain Like a Sieve

I've fallen off the blog for awhile, but I have a new mission and I welcome your help. My daughter just turned 10. She has been an amazingly compliant and helpful kids with diabetes. She knows more than most people about the disease and has always been very independent in her management.

On one of my previous posts, a reader told me to, "Let go. If you don't want Mutiny how about listening to your child instead of being a constant nag." Fair enough. My post was mostly sarcastic, but the fact is that every single day this week she forgot to take her insulin at one point each day, we ended up having lots of talks. I asked, "What would need to happen for your to remember to take your blood sugar and insulin?" She looked me in the eyes and said she honestly doesn't know.

I asked her what the benefits would be if she remembered and we talked about those. I also asked what the downside of not remembering is and we discussed all the ways that it sucks.

She is a SUPER kid. Bright, fun, loving, not rebelous at all, but she is just not remembering the task at hand. So I started asking friends about their girls, kids without diabetes, and it appears that 10 year old girls develop holes in their brains.

I did some more asking around, teachers of fith grade included, and they all agree that at this life stage, that self-centeredness abounds; that they really can't think the way they did even just a year ago, which explains a lot.

Another friend, who has a 10 year-old girl and a 12 year-old boy, told me he has been reading a book, Getting to Calm: Cool-headed Strategies for Parenting Tweens and Teens, which takes you into the emotional and mental world (brain) of our growing kids. I haven't read it yet and I tend not to enjoy books full of good advice (I read the first 30 pages of How to Tall, So Kids Will Listen. How to Listen, so Kids Will Talk about eight times). But here's what my friend, who has read a lot of it said.

He said that the girls at 10 are in a stage of "pruning and blooming." Their prefrontal cortext is said (simplified) to "orchestrate thought and action in accordance to internal goals." At this age, this is being "pruned," so to speak, meaning that developmentally, this part of the brain is somewhat out of order for a period of years often referred to by parents as teenage hell.

He said that beginning around age 10 for girls, they are very challenged at staying on track; starting one thing and moving to the next and then to the next. Diabetes is very much a series of steps that align with an internal goal of staying healthy and keeping mom out of her business.

So here is one scenario this week.

Snack time at school, 10:00 am
R: "Hi Mom, my blood sugar is 218.
Me: "OK, just please remember to put your blood sugar in your pump if it has gone off screen."
R: "Ok, Mom. I will. Love you. Gotta go!"

Lunch Time, 12:30 pm
R: Mom. Uh. Mmm. Uh, Mom? I don't know how this happened, but I'm 428.
Me: Ok. Did you take insulin for your snack?
R: Uh, I think so.
Me: Can you check your pump please?
R: Uh. Ok, hold on a sec. Mom? No.
Me: Ok. Didn't we talk at snack time? I believe you said you were 218. Don't you remember me telling you to be sure to put your BG in your pump?
R: Yes.

You know how the rest goes. Correction and everything is fine...until Wednesday. Same scenario, but she was at a friends house for dinner.

R: I'm 400.
Me: What did you eat?
R: Barely anything. A few crackers.
Me: Did you have milk?" She shakes her head, no. "Did you have any other carbs?
R: No...Oh! wait! I did have one of those, mmm, what do you call them? Mexican breads with the sugar on top?
Me: What kind of bread? Pan Dulce or the crispy ones rolled in sugar?
R: Uh. Those.
Me: Did you take Insulin?
R: I guess I forgot.

I am actually ok if she has a treat, but she knows full well, that that means she has to take care of that snack. She KNOWS this!

So, I need some strategies to help her remember, because it is obvious to me that everything has leaked out of her brain.

Today, I gave her a green rubber O-ring bracelet and told her that this is a physical reminder to take her blood sugar and take insulin. Her teacher is going to help remind her, but also give her something to tape to her desk which will remind her of these important tasks.

So, any advice you all have is welcome. I am totally willing to support her until her brain is whole again (18 or so they say), but finding ways that don't embarrass her, make her diabetes overt to anyone else and aren't hard for me to manage are the goal.

I'm hungry because I'm low, not because I'm hungry.

But here I sit eating a bowl of cereal. My blood sugar is 56. I feel low and I feel hungry. I drank a juice box, but no, I could not resist the call on Honey Bunches of Oats and milk. In fact, I think I'll have another bowl.

No, the juice hasn't quite hit yet...

Kids get easier...right?

Seriously, today has been a long day. We had citywide swim championships today and now my girl is over at a slumber party where cake will be served at midnight. She is nine, almost 10 and she is an amazing kid. She forgets stuff, like taking your blood sugar or bolusing, but she tries. I just hate leaving her in the hands of other families.

It isn't that I think anything will happen per se, but I worry that nothing will happen. They won't remind her to check her sugar before cake and won't remind her to check before sleep, but most important, she won't remember to call me and tell me how its all going...blood sugar wise. Uggh.

Three minutes before cake-o-clock. She was low all evening. She was 58 when I was at their house. She was 63 at 9:30 at the pool (they checked her when I asked!!!!). Wonder how she is doing now. Really, I wonder.

One more minute before cake-o-clock.

Wonder if she'll call me? I feel like a lovesick teenager waiting for a boy to call. "Does he like me?" "Is he thinking of me?" The answer to both ruminations here is, "No! She is at a birthday party! She isn't thinking about you, or your worry!" But I do bet she is taking just fine care of herself. Mommy has some letting-go work to do, but it can wait until she is 25. Goodnight!