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.

FreeStyle Navigator FINALLY Approved

Well, the time has finally come! The Abbott Diabetes Care FreeStyle Navigator Continuous Glucose Monitoring System is finally approved by the FDA and available!

I started this blog when I was admitted to a three month study of the Navigator and I wrote extensively about my experiences over the trail. It begins with my first day and continues through some trials and tribulations over the following three months.

I included lots of pictures of the unit, of the insertion process and it seems that it is virtually the same unit I used in trail, but they updated a few irritating things, like there was no way to escape out of the reports window without waiting for it to time out.

During the trail my blood sugars were more manageable, but it was only in my final week of the trial that I truly realized how profoundly this technology could improve my control. My doctor could see things that would never be seen with 8 tests per day. I had a drop in my A1C of 10 percent during the trail and that prompted me to buy the Minimed CGM when it came out with the Minilink.

I think there are comparable in technology, BUT the Navigator would give me alarms 30 minutes before I was low and that saved me more than once. Also, you have readings every minute, which can be very helpful as you are dropping.

The insertion of the sensor is MUCH better with the Navigator and you don't see this HUGE needle plunging into your belly like you do with the Minimed.

The Co-pilot software was awesome; way better than the Minimed version. I loved the visuals along with the numbers.

I could not find the pricing information on the web, so I called the hot line and held for 5 minutes. They took my personal information first, then told me the pricing would be as follows:

The receiver and transmitter kit, which also includes one box of Freestyle strips, batteries and lancets will range in price from $960 -$1040. The Sensor kit includes six sensors for approximately $360-390. That is $60 a piece folks. Not sure how much I appreciate that without insurance coverage.

If anything, I think this will give Minimed and Dexcom a run for their money, which I hope in turn, brings about sexier and more sophisticated devices from which to choose. I like my Minimed because it is contained all in one unit, but if I were to buy today, I would absolutely consider the Navigator.

Reminder: Freestyle Navigator Info in Archives

I was at Camp Bluebonnet today with my daughter and a bunch of great parents and their kids with diabetes and I was reminded of how grateful I am to not only have a CGM, but to have had the experience with the Navigator CGM that is still not released yet. For those of you just tuning in to my blog, and are interested in learning more about the Freestyle Navigator Continuous Glucose Monitor to be released by Abbott Diabetes Care later this year (crossed fingers), I have chronicled three months of trials in the first part of my blog archive.

Keep in mind, that my comments and photos were of a version that isn't necessarily going to be released, and the things that will most likely change are size and calibration times. I love my Minimed Real-Time, but the Navigator was awesome when the CGM projected lows or highs -- really quite accurately. I look forward to the day I can upgrade to the latest technology, but I count my blessings every day I have the sophisticated technology I do have.

There will always be a tomorrow, as with computer technology, but to utilize the best the market currently offers is an awesome experience and My A1C is the better for it. Next steps are to get this and all CGMS covered by insurance, but for now I count my lucky stars...Oh! my blood sugar right now is 138 post dinner.

Minimed REAL-Time CGM Curses and Gratitudes--Part II

Having the Minimed Real-time CGM is a blessing, but it can be really annoying, too. I need to be frank and this may horrify some people, but I prefer NOT to deal with my diabetes. I am not motivated to take my blood sugars and I have a pretty good sense of my blood sugars without checking 4-10 times per day. I got the CGM because I thought it would lessen my resistance to diabetes self-care, but at times the thing just annoys me. I don’t WANT to look at my pump or hear that damned alarm. The alarms rarely warn me of problems, this is specifically BECAUSE I have the CGM and am in good control with its assistance, but the darned thing is always asking for something.

Yesterday, I left my blood sugar kit at home and missed a calibration for 5 hours. This means the alarm goes off what feels like every 10 minutes, but it may be 30, and I want to toss the thing out the window. Common sense says, “Just check your BS first thing in the morning and last thing at night, but I forget, so no logical solutions are necessary.

Then the sensor ends, which means stopping, starting the thing again and then calibrating again, then calibrating again in six hours and again before bed. Meanwhile, I get a low reservoir alarm and my battery is getting low and I just want the thing to quit beeping at me. Oh! I put my pump on the left and not the right side, so I also wrestle with “weak signal” alarms.

By the way the Navigator had a HUGE range for transmission--10 feet at minimum. I rarely had a weak signal and in fact left the receiver upstairs in my bathroom all the time and still tracked readings. I put the Minimed pump under my back while I’m sleeping and I get a “weak signal” alarm; THAT is ridiculous.

A friend who started the CGM with me just left the thing off for a week and that sounds good to me because all the blessing I have received are slightly shadowed by frequent alarms of one kind or another.

I am really just not as deeply committed to my diabetes care as I thought I “should be.” I want to reiterate that this CGM is a GIFT and one of the best diabetes technological advancements since insulin. Sometimes I just don’t want to think about it AND I know that if I don't, I won’t do any permanent damage.

Day 2--Minimed Real-Time--I Like this!

I like this thing. I like having no additional baggage; I never really realized how stressful it was to carry around that extra unit with the Navigator. What if I lost it!

I wish I could look back at more information stored in the CGM. You can only scroll back for several hours to get readings. The bar graph is supposed to sub for that. I haven't downloaded the software yet (One of my least favorite activities is downloading software), so I'm sure that will be where I get my good data. I love having this number all the time. I finally figured out the calibrations. See comments from my last post from Noel about specifics related to calibrations.

Curious if any other Minimed wearers are interested in having this thing. My greatest challenge is NOT pushing my daughter to get one. We are ready to order at any second, but I want this to be her decision. Just imagine the joy of going to bed and knowing an alarm will sound if she drops or goes high. The joy of sending her off to school or one of the random day summer camps we send her to, knowing all she has to do is look at her pump to know where she stands.
This is a worry eliminator.

Really wish the CGM had the smarts of the Navigator in terms of alarms. They have the best thing since canned beer with an alarm that warned you 30 minutes before a low or high. THAT, my friends, is cool and it worked 97 percent of the time. Once, I got a warning of an impending hypo and my sugar was at 125. I thought, I'll take care of that after I drop off the kids. How fast could it be falling. Well within 30 minutes I was at 60, five minutes later I was in the 50s, five minutes later, and after a juice, I was in the 40s. IF I had headed the warning, I would have drank a juice, yes at 125, and watched as I dipped to the 80s and then slide back comfortably into the 100s. This happened many times. I loved that, so Minimed, this is the goal for the model next year.

Let me hear from you. I know money is the biggest obstacle to getting this thing, but would you want it? What do you think about the technology. Does the idea of this kind of technology, perhaps even having a closed loop system, make having diabetes more bearable? I am ashamed that the CGMs and pumps costs so much; that this technology is so inaccessible to so many people. I am very fortunate. Very fortunate indeed.

photo from www.freefoto.com by Ian Britton

Minimed Minilink and 722 Pump is Here!

Well, my Medtronic Minimed Pathway upgrade arrived today as well as the Minilink REAL-Time Transmitter. I am SO excited, except they said I really need to be trained before I hook this thing up. I am scheduled for training on April 23; that is a REALLY long time from now, so I called to see if I could move it up. No response back yet.

I read the directions last night and I am pretty sure I can figure this thing out fine. I do have one small issue before I move forward. I was using the clear version of the 712 and I said, "Hey, let's try something new!" So, I ordered the "smoke" colored pump and now that I’ve seen it, I really, really dislike it. It looks so medical and pager like. I called right away and they are going to overnight me a clear one on Monday. You know, if I am going to look at this thing 30,000 times for the next four years, I have to like it. So, it is worth the wait for me. Fashion first!

Some thing I’d like to note Comparing the Real-time and the Freestyle Navigator:

Alarms: Navigator gave warning alarms for impending lows or highs, the Real-time only warns WHEN you hit a self-prescribed low or high. So, I may set my warnings closer to normal, so I can use the trend arrows to determine if I am headed Far North or South.

Navigator was more complicated to snooze, and had no variation in times for snoozing. This was especially irritating with high blood sugars. The Real-time has a default one hour snooze on high blood sugars and a 20 minute snooze on lows, which can also be customized to meet your needs. I love that.

Arrows: Navigator had northeast and southeast arrows, Real-time has a single arrow north or single arrow south, which I guess says the same thing. We’ll see when I get it on.

Transmitter: Real-time Minilink ~ Rockin’ Roll small! Rechargeable battery that lasts 14 days or more! It feels nice; like a smooth river rock or shell. Interesting how shape and feel can influence your feeling about something. It doesn’t feel medical; it almost feels like an accessory. Someone in marketing was thinking on this one and I, as a marketing guru, appreciate this. Navigator was large in comparison and very device-like. I am certain they will make this smaller and hopefully sexier.

Sensor: Can say too much because I am only looking at it, but the Navigator had disposable inserters and you didn’t see what was being plunged into you. The end result was a tiny; an itty bitty (VERY itty bitty) tube attached to a micro-chip going 5 mm under the skin. The Minimed Real-time is pretty cool looking with clear plastic and it is small on the surface, but the needle looks really long and think. The tube looks really long, but is inserted at a 45 degree angle. I like the reusable inserter, isn’t particularly loud, but we’ll see more when in use. I definitely like less waste associate with this system.

Reporting: Navigator had a wide variety of on-board reporting; 2, 4, 12 and 24 (I think this combo) hour line graphs and statistics (which I found useless). It appears, although I haven’t delved further, that you have instant access to a 3 hour and a 24 hour line graph on the pump for the Real-time. I thought a lot about this and it makes sense to me. This allows you to see immediate trends post meal, post high or low, etc. I was hoping to see a 12 hour, but really, I think the 24 hour will be fine, again, for spotting trends over the course of days.

Software: It appears there is a web-based program when you can upload your real-time info. I haven’t explored this further, but I have to say that I really liked the Navigator Co-pilot software’s visual and data based reporting systems. It also appears that the Real-time has similar data and charts available, but there were some nuances in the Co-Pilot that I really liked, so I am anxious to compare.

Look, if you are wearing a pump already I think this thing is amazing. Not having to carry two units around is a blessing for me fashion wise and also the pump is attached to me, which means I won’t loose it. If you are on MDI, the Navigator will rock your world when it comes out. Although I know Minimed has a separate CGM as well, I can’t say anything about it because I have never looked at it.

It is 40 degrees and raining in Austin this morning and this is coming off of multiple days hitting almost 90 degrees. Hope the Easter bunny can hide his eggs in the backyard tomorrow! Oh! I asked my husband for help with Easter bunny items this year and he bought lots of empty eggs and got a roll Sacagawea dollars and half-dollar coins instead of so much candy for our little T1 girl. He also hit the dollar store for silly little things, but we are mixing this with chocolate eggs and gum (couldn’t find sugar free gum eggs, too bad—8 carbs each). We quit buying sugar free chocolates etc, because they give you a stomach ache and are only a few carbs less than real chocolate. Any other creative ideas around this holiday are appreciated.

Have a lovely holiday weekend!

Photo by Ian Britton--(c) www.freefoto.com

A1C Results Are In--10 Percent Decrease!!

Howdy Folks!

I just got my A1C results and I saw a nearly 10 percent decrease in my A1C since the beginning of the Freestyle Navigator Continuous Glucose Monitor Trial. When I started I was at a shocking 8.3 and my results were 7.5 after three months. As I have mentioned, it took me a good while to get the swing of how tightly I could control my diabetes with the flood of continuous readings. I also discovered how drastically my hormones affected my blood sugars at minimum of seven days PMS. I ran around 200 for well over a week each month of the trial only to get my alternate basal pattern adjusted to hopefully a good range for next month. So I can only imagine how nicely it would have come down if I had the CGM for another few months.

I've been talking with my Minimed Rep and I really want the Minilink. It appears you can wear the sensor for as long as 15 days (although 7 is recommended), but that changes the affordability factor considerably. Initial investment will be $399 to upgrade my 712 to the 722 pump, then $1,000 for the transmitter, which includes 10 sensors. I am going to work to get insurance to cover this thing and use my own statistics to show its benefit. I am sure they have lots of stats from their own study to show impact on blood sugars and A1C results too.

I have to say, it has been really hard to get motivated to take my blood sugars regularly. My motivation over last weekend was largely fueled by my enthusiasm at the end of the study, but before this study I was not looking after myself like I should(duh, 8.3 my highest A1C reading in 10 years or more). It is so easy for me to turn my attention to my child's diabetes and I almost feel justified in neglecting my own health. It isn't a sadistic thing, I am a mom and we tend to look after everyone before ourselves anyway; with a child with type one it is especially strong draw to forget about yourself.

Anyway, my blood sugars have been really tight when I check, but I trend toward low and don't have a lot of awareness. So, I'll keep drawing blood until I can afford to jump into the CGM with Minimed.

Minimed Minilink Available Monday, March 12, 2007

New Minimed Minilink will be available Monday, March 12, 2007





I am so excited about this. I am only 24 hours sans the Freestyle Navigator CGM and desperate to *know* what my blood sugar is. For the first time in history, I am checking my sugars religiously and logging it into the CoPilot program I still have downloaded on my computer. I had to return the CDs and the bluetooth device, but I can manually input my food, insulin, exercise and blood sugar readings and still benefit from the excellent visuals this program gives me.

Photos from Drea: http://drea-girlonthego.blogspot.com/2007/03/minimeds-new-minilink-transmitter.html

Adios Freestyle Navigator--May be Avail. Dec. 2007!

I went to return MY Navigator today. I shed a single tear as I ripped the adhesive from my arm, pulling off my last sensor. They downloaded my info and I filled out a very long survey similar to the last one with questions about the trade-off of having a smaller sensor (See my post on January 14, 2007). There wasn’t a comment page, so I said if you want to know what I really think from the perspective of my daily use go the www.diabetesselfcare.blogspot.com. I did manage to squeeze in some notes into an area of the survey that had room for comments about things that had nothing to do with my actual thoughts.

My Endo came in to look over my readings and was shocked at my last week. I was in the green—that’s normal-- almost all the time. He noticed my sharp drops to almost-low post meal and we changed my bolus ratio slightly, but overall I am kicking booty.

I spent a lot of time with the woman who works for Abbott Diabetes and who is responsible for this trial. I sat down and told her what I thought. First, I told her how impressed I am with the Navigator; that this is the best invention since insulin. I described how it saved me from countless lows and in the very last week of the trial I fully realized the power of constant readings—we made such minute adjustments to my bolus wizard and basal rates that I am in really good shape for a while. BUT without checking in with my CDE or Endo on a regular basis, I could not have realized what this information means for my control. I also told her about the issues that I felt needed addressing (also see Jan 11 post).

So what else can I tell you? OH! I think the Navigator may be out before Christmas! She wasn’t specific, other than to say it is probably coming out this year.

I went to the doctor and the doctor said...

...I have a bunch of changes to make. This is my last week with the Navigator and I am beginning to get pretty bummed about that. Yesterday I met with my diabetes educator, who hung the moon, and we looked at my blood sugars from the CGM on the CoPilot software. She'd look at day after day of readings and say, "See here, you are dipping a little at 5:00 a.m. and you seem to be rising after lunch each day."

There is NO WAY she could have ever seen those changes without the CGM. We made a new pattern for my week (or two) of hormonal changes after I ovulate (TMI for you guys, but I bet you have hormone fluctuations, too) and we made many adjustments to my basal rates and also to my sensitivity.

I also learned that my older version of the Minimed pump (712) does not have a way to change the duration of the insulin board based upon what kind of insulin you use. It is automatically set to assume that it is hanging in there for eight hours after a bolus, whihc really messes with correwctions post meal. I have seen with the CGM that two hours post meal (where I had a correction with my meal) it says 216. I try to do a correction, but it says 0.0, assuming I have insulin on board that will cover the high. I check again at four hours, still high and says no correction, BUT, the insulin is long gone. SO, now if I see highs four hours after a meal or correction and my sugar hasn't gone down, I will ignore the 0.0 and do the correction.

I would have ever seen the subtly and nuance of my blood sugars and reaction to food without this thing.

Can you hear the woe in my voice? I talk about this CGM like it is a friend who has walked away from me to hang out with the cool kids. Of course, I can just go buy the Minimed version, but I want the smaller sensor; I want second generation technology, not the huge two piece unit. I want one with the kinks worked out. So, I wait and I guess I'm going to have to check my blood sugars more than a couple times a day.

HOWEVER, I have today, Thursday and the morning on Friday to use this tool and work out the kinks of the changes we made. Pretty drastic changes and I am excited to see if they fix my low-highs (low 200s).

Headed to a press conference at 11:00 a.m. at the Texas State Capitol where a very positive stem ell research bill that supports research for degenerative diseases and conditions (that means diabetes) will be announced.

I have to give it back...

I got a call from my Endo's office today to remind me of my final appointment related to the CGM study. It is on Friday, March 9 and no, Abbott did not choose to extend the study. Sad, sigh...

I have been running high all week...made adjustments to my basal rate with little effect. It is PMS; hormones make diabetes so difficult! Even with the CGM it is hard to"watch" and evaluate yourself all the time. Definitely more to share on that subject later.

Adding Insulin and Food Data into Navigator

I just had a great question from Val about how the insulin and food information is input into the

Navigator, so I thought I'd post some more photos to show you how.

Next, you have to go back to the main screen as pictured in the second image and select "Meals," then:

Freestyle Navigator Software--CoPilot

Thought it was about time I posted some screen shots of the Navigators software--CoPilot, so you can see how this works. I have to admit, I haven't downloaded my stuff very often, but obviously the potential for achieving very tight control is astounding. I thought these screen shots could be enlarged, but they look very lo res (aren't). Don't know how to fix that.

This is a shot of the Daily Combination screen. The line graph is obviously my blood sugars over a day, the circles as sized in relation to how many carbs I ate and the bar graph (largely irrelevant visual) shows how much insulin. The nice thing is that you can see patterns how highs in relation to boluses or food. The screen on the program is not sizable, so here is the bottom half of the screen shot:

Shows actual carbs and insulin numbers. Could eliminate the bar graph for insulin and just show on one screen under food, but I really like the circles. I am very visual, so I see patterns easier than just looking at numbers.

This is the Diary List. Pretty impressive amount of data. I like the apple, indicating a meal. Neat-o!

Glucose Modal Day shows multiple days of readings together. I am showing three days, but you can look at as many as your eyes can handle. Great for showing serious dips or highs at specific times each day. The triangles indicate a finger stick test at calibrations.

Straight ahead Histogram Report. Pretty green , eh?


Gotta love the Pie Chart. There are a million more charts below the first row, but you get the idea. My favorite is the absence of yellow!

Stats, stats and more stats. Plenty of data and oh, by the way, if your Endo is hooked up, you can link to his/her computer and upload your info when you need assistance or adjustments to your insulin levels. Haven't used that function, but it is cool!

Good stuff. Lot's that can be improved upon, but overall, the most helpful program I have ever downloaded related to my diabetes equipment. Again, the Daily Combo is my favorite, but the software doesn't have a feature to click through days; you have to enter in the date from the calendar and wait for it to find it. Major silly.

Sickness

So, last week my six year-old daughter woke up with an excruciating earache. She screamed for hours and the following day she ran a little high, but presented ketones. I got them down with an increased basal rate, but in the meantime, I was awake with her several hours at night helping her manage the pain in her ear (nothing was working) until the doctor finally prescribed oral antibiotics. I slept about five hours a night for five nights.

Saturday, as the medicine began working for my daughter, I started to feel sick. My blood sugars were OK, but I had the most awful feeling in my head (between nose and throat). I took herbs, zinc, vitamin c and thought I would surely kick this sickness, after all I just don't get sick often. Sunday I was stuffy with a sore throat, still believing that I was about to ward the thing off, but then came Monday.

Oh! I felt like total crap. Mild fever at 5:00 a.m., blood sugars beginning to soar, ketones with a blood sugar of 230. Sickness was here. I spent Monday morning ignoring that it was bad; I kept thinking it would be gone in a few hours and around 2:00 p.m. my CGM went dead.

I had a warning that my battery life had one week on it, but that warning was wrong and it died in three days. At this point, I ripped the thing off, because you can't just replace the battery, you have to change out the sensor too. I fell asleep for four hours and woke up feverish and miserable. My ketones were now high and I had to go back to finger sticks.

Somehow I mustered the energy to change my infusion set (which I thought might be occluded), give myself a shot to counter my 300 blood sugar; I replaced the sensor and batteries in the receiver and went back to sleep. That was exhausting!

I did this from my bed with a 102 fever and I swear, it is never just one thing with diabetes. It is the infusion set, your are out of strips for your meter, you can't find a battery, the control solution has disappeared, you are out of juice AND milk; all your syringes are gone, the prescriptions aren't refilled, the insulin fell on the floor and broke open (and you don't have a refill at the pharmacy). I've just come to expect to sit down with every supply I own, because one issue leads to another and I really hate getting up to look for one more thing..

So, the smartest thing I did was get my hubby to call the doctor and get me medicine last night. If they worked for my daughter, they would work for me and here I sit, fever free (although rambling a bit).

My CGM wanted calibration at 3:00 a.m., and I was 60, the lowest I've been in sometime, as I get a warning at 65 and usually correct it immediately. So I had to check again in 20 minutes and again at 5:30 a.m., but I was so glad to know it was on and working.

Last night I slept 11 hours and today I did nothing. This blog is the most I did and it was nice to be quiet, even though I can't breathe through my nose. My dear sweet husband bought me tissue with lotion in it; I never really knew how valuable that gift could be.

Photo from www.parody.org/.../tissue_box_cosy/index.html, where you can learn to make your own fuzzy tissue cozy!

CGM Revelation

So I learned something today that has me pretty jazzed. I was volunteering at my daughter’s elementary school power washing portable buildings before a big painting overhaul. I had to run home for something and I glanced at the CGM because I felt a little like I was getting low. It read 167 with a south east arrow. I had an instinct grab a juice box for the road. Sure enough, thirty minutes later I got a projected low alarm.

The SE arrow was an indicator, but that doesn’t necessarily mean I will go below 60; I may head to 85 and stabilize. But I am beginning to recognize the “feelings” I have and draw a direct correlation with what happens to my blood sugars over the next hour. The CGM is validation of what my body is already telling me very subtly.

So, with information comes trust; trust in my intuition. If I wasn’t wearing the Navigator, I wouldn’t know exactly what was going on and these very slight changes would be easy to ignore. I would have never grabbed that juice and would have found myself surprised and low. The thing that is killing me is how carefully my body tells me what is going on, but when I didn’t have the constant flow information with the CGM, I couldn’t process the very slight changes I felt as a sign of things to come. I am accidentally training myself to recognize how my body reacts .

This is by far the coolest revelation I've had using this device and I will have a much better understanding of my body even when I have to give the Navigator back. I pray they extend the study another three months. I would really love to see how much my A1C changes now that I am learning so much. This stuff takes time. I wonder if this side benefit as been documented by other patients. I’ll ask at my next check in.

Photo by Leslie LeCornu © 2006

Slacker Heaven with the CGM and a Word About Diabetes/Life Balance

Have I mentioned lately that I really love this CGM? I just downloaded the software, which I was obviously very hesitant to do, because I didn’t want all that information. I get diabetes overload. I am approaching 25 years with the disease and I just get plain sick of thinking about it, which is the perfect time to have a CGM. You blow everything off, but an alarm sounds if you creep high, or you slide below 60. This is a freaking miracle! I can blow off diabetes and still know that I am doing well with an occasional glance at the receiver. A-O.K. This is huge for the mental health of the lot of us!

So, it is time to address one of the main reasons I started this blog; I have chosen a life at peace with diabetes, a life with balance. My philosophy on the subject is not particularly common; there is more than enough doom and gloom out there. I don't go there.

Since I was 14 I have had a good relationship with diabetes. I have my moments, but overall I have been very thankful that of all the illnesses out there, I was afflicted with one that forces me to eat healthy and do the things that EVEYONE should do to live long and healthy lives. As I have grown older, I became conscious of the importance diabetes played in my daily life, but it didn’t run my life. Well, actually diabetes had a lot more control of my life until I got an insulin pump (more on my very strong opinions about the pump later).

I rarely went to support groups, because the one or two I attended were filled with a lot of complaining, worry, suffering and misery. I didn’t need that. They were also filled with people who had been living with diabetes for 30 + years and they were experiencing complications I really didn’t want to hear about as a teenager.

In college, I was fed up with having no one around me who understood my daily issues, so I started a support group for 18 – 35 year olds in Austin, Texas; the majority of us were in our twenties. We talked about how we handled going to parties, making sure our friends kept an eye on us. We also discussed dealing with low blood sugars when no one has your back; your room mate is a total slacker or never around and you are left stumbling to the fridge for OJ hoping you don’t pass out on the way.

As the mother of a child with diabetes, I have constantly had to adjust my expectations of our life and of myself. I have lived my life before baby with a “good is good enough” mentality around my own diabetes, but this is my child we're talking about. She is small, sweet and innocent; how can this be happening to us? But trial and error have helped me find that there is no one in the world who can care for my child better than me. No endocrinologist, no nurse--even her diabetes educator can’t be more in tuned with her than I am. I worked to understand what our challenges are and I can see that diabetes isn’t the end of her life; it is part of who she is and part of who we are as a family.

My daughter is six and a half. She wears a Medtronic Minimed Pump; she has since the first month of diagnosis and she knows how to use it. She loves to count her carbs and show off her math skills; she independently takes her insulin after she finishes a meal and has checked with me to confirm her math. She loves to “guess how many carbs” are in things and takes a good deal of pride in not needing help. This skill and comfort with her role in managing diabetes has made trips to day camp, play dates with friends and sleep overs much easier, but that challenge was never hers, it was mine.

In future posts I’ll write about how a life with diabetes can be a life of balance. I'll also fill you in on my new Navigator Co-Pilot software.

Photo by Leslie LeCornu © 2006

CGM Trial: Gratitude and Curses

Some notes about the things I am most grateful for and some things that have just been bothersome about the Navigator.

Grateful:

• Seeing B.S. 24 hours a day
• Using line graphs to determine trends and problems that I can fix
• Impressive CGM's receiver and transmitter distance range: I left my receiver in my bathrobe pocket after getting dressed and it was still tracking me downstairs for hours.
• Ability to shower with transmitter, but can't really imagine that other companies wouldn't create something with the same capabilities. For God's sake, we take showers once in awhile.
• Love the warnings for projected highs and lows, especially the lows. Avoided a few hair situations
• Transmitter is relatively small
• I just learned that when looking at a particular screen, you can hold the up or down button to keep the screen active and not time out. Wow. Good to know!

There maybe lots more I love, but I am anxious to skip to the curses and get them off my back!

Curses:

• Calibrations lately have been extremely inconvenient IF I don't put the sensor on at night. I changed it at 10:00 a.m. last time and the calibration bell rang at 8:00 p.m., while I was at an event. I waited until I could calibrate it around 10:00 p.m. and the calibration failed because my blood sugar was dropping too fast. This meant I had to wait 30 minutes, and again it failed. This went on until I finally got the calibration about 11:30 p.m., BUT I had to calibrate again in two hours--1:30 a.m. I was TOTALLY exhausted and was very frustrated by this. I will not put this on again in the day time. Same problem can happen with nighttime application if you are in meetings first thing in the morning. Overall, the calibrations have been frustrating when you are not perfectly free to take care of your diabetes FIRST. Sometimes that is not possible and at times this blessing can feel really inconvenient.
• The darned sensor and transmitter are vulnerable--really. I was out of the shower, putting on lotion, and I bumped the transmitter as I was doing my arm. At first I was concerned about the lotion messing up the adhesive (I had no overbandage; I thought I learned this lesson already), but I actually dislodged the transmitter from the senor base. It fell off inside my shirt sleeve about ten minutes after I was dressed. This prompted the above a.m. re-insertion.
• Screen is HARD to read.
• There are no "back" buttons on many screens you would really like to go "back" on, like the line graphs--you are looking at a two hour screen and you want to see the six hour; you have to wait like 30 seconds for it to time out, and then scroll through three screens to go back to the line graphs.
• The alarm sound is annoying; really grating on your nerves. Wish I had sound options (like a cell phone) since this is something I am living with daily and have to hear every day.
• The HIGH blood sugar alarm should have an option that if an "insulin" event is added, the alarm shuts down for 30 minutes. If you are over 300 and you give insulin, it takes awhile for you to come down, but the alarm keeps going off ever 5 or 10 minutes. Now, there is a "mute alarm for an hour" option, but I need to be warned if I haven't dropped in 30 minutes. Otherwise, I just go about my day and perhaps my infusion set is clogged, I won't know if I mute the alarm. Did I mention I don't like the alarm sound?
• Sometimes I can't find the receiver. I leave it upstairs, in my car, in my purse, on my desk, it falls out of my bag, is in my back pocket of my jeans, fell in the crack of the couch, but unlike my cell phone, I can't call it to track it down by sound. This is a real problem, but I can't think of an easy solution. The company that fixes this could rule the market!
  

OK, that is enough. I am obviously VERY grateful for the opportunity to be in this trail. I hope that some of the annoyances are resolved with use and the company listening to the users. This technology is AMAZING. I am awed at the potential, and even how far the technology is applicable to my life. I know the above curses are VERY easy to fix; they are just background noise to the benefits I have received.

CGM in NYC

Well I loaded up my CGM supplies (and a LOT of other stuff) and headed to New York City on Thursday for meetings. When I finally arrived after MANY delays due to weather at 1:30 a.m., I put on a new sensor and transmitter.

The following morning, I was unable to calibrate it--the sensor had failed. SO, I waited until 10:00 p.m. on Friday to try again, because it just doesn't make sense to do it any other time with the 10 hour and 12 hours calibrations (I had room mates and didn't want the thing beeping annoyingly at 1 a.m.).

Friday afternoon, after my calibration failed , I found that my BG kit with both my blood glucose meter AND my CGM receiver had fallen out of my bag at a previous appointment. I trucked back across town to get it, deciding that I MUST leave the Receiver/BG Kit in the hotel in case that happens again.

I put on a second sensor Friday night and it failed to calibrate the next morning. I was furious! Here I am eating NYC bagels (like 80 carbs), gnocchi and pizza and I don't have my beloved CGM. I NEVER thought to bring more than two sensors, because I should have only needed one for a four day trip, so I was out of luck. But I left the Receiver (my back up finger stick B.G. test) in the room safe and sound, then went shopping.

At FAO Schwartz, I started to feel low, so I pulled out my regular blood glucose kit to check my sugar and low and behold--ERROR. Oh! For Gods sake! I tried three more times, trying to warm the battery (which was almost new), tried a different bottle of strips; nothing worked. I ate three glucose tablets and begged my friend, still at the hotel to meet us for lunch and bring my CGM receiver.

Overall, the trip as fantastic, my blood sugars were good, but I expended an enormous amount of energy worrying about my equipment and my blood sugars, and trying to solve these problems. I was dreadfully paranoid the rest of the trip, constantly feeling my bag for the B.G. Kit, my cell phone, my camera (I felt like I was going to lose everything I owned; it all seemed so precious). This was hard on me emotionally and you know what? It is NOT easy to travel with diabetes.

I put a new sensor on last night when I got home and my first calibration failed this morning. I was about to throw the CGM out the window, but I tried again and found that my blood sugar was dropping too fast to calibrate. From 150 to 90 in about 10 minutes, then to 82 in about five minutes. I was up and running after a call to the friendly Navigator Support team. We suspect that my first insertion of the sensor in NY had too much blood (which it did--I was exhausted and didn't really clean it well) and that might have also gotten on the transmitter where it touches the sensor.

I am really glad to be home and glad to have this thing back on my arm and working.

I will be downloading the CGM software tomorrow. I finally upgraded my hard drive and am anxious to test out the Navigator Co-Pilot.

© 2007 Photo by Wendy L. Morgan

CGM: Back to Normal

My test results since last night have been right on target, back within 10 mgdl.

Also, found an article from the University of Clagary Titled, "Discovery opens door to new diabetes treatment: Discovery of a critical role for sensory nerves in diabetes opens door to new treatment strategies." Intersting and worth a look:

http://www.ucalgary.ca/news/december2006/diabetes-discovery/

CGM: Discrepancy

Well tonight is the first time I have seen a more than 10 mgdl discrepancy in my blood sugar readings on the CGM vs. a finger stick test.

I ate a snack and forgot to bolus right away and after while I was 277. I wanted to confirm it with a finger stick and it said 315.

Maybe when my blood sugar comes down a bit, it will be more stable. Interesting note.