Dexcom G4 Platinum

After writing about my experience with Tough Mudder, I knew it was time to start wearing my CGMS again, so I made a call to my trusty medical supply place and found out that the Dexcom Seven+ had been discontinued and that a new system was coming out: the Dexcom G4 Platinum.  Of course, this means all the sensors I currently have are useless as soon as the new equipment arrives (in late October or early November I’m told) so I’m hoping the batteries haven’t worn out on the Seven+ and I can use it for at least a few weeks.

OmniPod Errors

There are days when I get really annoyed at the OmniPod.  Today was one of those days.  I don’t so much mind when it has errors and you can recover easily from them and not lose the functionality of the device (e.g. I can still give myself boluses for meals, etc); however, I absolutely hate it when I lose functionality and have to replace parts of it.

As you can guess, I had to replace the Pod itself after the PDM (the little device that manages the insulin pump) decided to throw up all over itself with an error.  This error caused me to have to reset the device and lose the connection to the pod.  Now, that isn’t too bad until you realize, it can’t reestablish a connection to the pod, so you lose the insulin in the pod and the pod itself.  Insulet (the makers of the OmniPod) replaced the pod for me, so I’ll be receiving one in the mail soon, however, they don’t replace the insulin that I lost in the process of their device having issues.  I’ve tried to pull the insulin out of the pods before when they’ve messed up and I’ve been highly unsuccessful in these attempts.

I find it annoying that they haven’t come up with a better way to handle these issues where the PDM has a problem and not the pod.  The though of tossing a perfectly good pod (with insulin in it) and attached to my body because the device controlling it had an error that it couldn’t recover from seems a little stupid.  You’d think there would be a way to reestablish the connection and let the pod finish out its time delivering basal and bolus insulin to me.  All I can hope is that Insulet keeps working on the OmniPod and makes it more reliable and able to recover from errors like this without having to lose the pod to fix the problem.

Having said all this, there is still nothing better when it comes to insulin pumps on the market.  Seems like a sad state of affairs to me.

Another round of random musings about Type I Diabetes

I really have no clear thought as to what I’m going to talk about, just random things with Type I Diabetes.

Alcohol.  They say if you’re a type 1 you shouldn’t drink it at all.  However, if you receive ‘Diabetes Forecast’ (the ADA magazine for diabetics) you’ll see in the latest issue there is a large article on drinking wine and the benefits of drinking a glass of wine a day.  So, what are you supposed to do?  Follow your doctor’s orders and not drink it at all or drink a glass of wine a day?  Well, the truth of the matter is, you can drink it.  You just have to be more careful since alcohol affects your blood sugar.  You’ve got to learn how it affects its and what you can do to counteract any of the issues you may see.  The best book I’ve seen on how to handle alcohol as a T1D is ‘How to Think Like a Pancreas.’  Sure the title sounds stupid, but it is one of the best books you can buy on how to live a normal life with T1D.

The OmniPod insulin pump.  I’ve got one of these and there are days I think it is the most wonderful device ever made and there are days I curse Insulet Corporation and all their engineers.  Recently (end of last month), I had 3 out of my 10 last pods die and it left me without any pods for a few days.  Luckily I still had a Lantus pen sitting in the fridge from when I was not using the OmniPod.

Calling up Insulet to report all the pods dying just gets annoying and on certain days I just get so pissed off I just chunk the pod into the garbage and don’t call Insulet cause I couldn’t stand talking to people with how angry it makes me the pods die.  I understand it’s a relatively new technology, but looking back over the time that I’ve used the OmniPod the amount of pods I’ve had to toss has been a lot higher than I would have liked.  A single pod every few months wouldn’t be that bad, but I’m seeing myself have around one pod a month fail during priming.  Which really sucks because at that point you really can’t pull out all of the insulin you put into the pod.  So you’re out a pod and some insulin at the same time.  Which, the insulin brings me into my next issue…

Insurance companies.  I think they’re made to kill Type I Diabetics either through bleeding us dry or not giving us the support we pay for.  It’s the whole reason I think insurance companies should never be a for-profit venture — they aren’t out to help people, they’re out to make money.  We’re just a number and a revenue stream to them.  God forbid you have an actual issue, they fight tooth and nail to prevent you from having it.  Maybe one day I’ll have to enumerate my dislike of my current insurance company; today just isn’t that day.

Bouncing back to things not insurance related and back to the whole blood-sugar management bit.  If you don’t already know, as a T1D you have two choices (well, three if you count doing nothing) to manage your blood sugar: multiple insulin types or the insulin pump.  The  multiple insulin types is what I was doing for a while.  It consisted of two insulins and using one to control my basal (or baseline insulin) and bolus (or mealtime insulin).  Normally it is done using Lantus (for basal) and Humalog (for bolus), these can be different, but these are what I used.  I didn’t mind using them, just carrying around insulin pens and the testing kit got to be a drag.  This led to my wanting to be on the insulin pump (and the fact I had a reaction to Lantus) I chose the OmniPod after examining all the other pumps since there was no tube and I only had to carry a testing kit.  Now, to the point I was getting to.

Whether you use the pump or pens, you have to constantly adjust your rates when you notice things are not the same.  It is even suggested you recalculate all your rates every six months regardless.  However, recently I’ve been noticing that my pre-meal, after-meal, and pre-bedtime blood sugar values are a lot higher than I would like.  So I’ve been making changes to my basal rates on my insulin pump hoping that these slight changes will fix it for me.  However, it isn’t looking like that is the case, so I need to run through the full testing (which is not fun since it requires skipping meals).

Finally, exercise.  This is the most important thing any diabetic can do to help themselves.  And sadly, I’ve been falling down on the job lately.  Work and school seem to take priority and I just haven’t carved out the time to work out like I should.  I don’t think this is a cause for my needing more insulin (I think it is related to the fact I’ve really come off the honeymoon phase for real and I’m now a brittle diabetic); but at the same time, working out does much more help than harm in the long run so I should be exercising.  I’m hoping that this week I’ll finally get back onto my workout routine and start making up for the few months that I’ve fallen down on the job because riding my bike 30 minutes or so a day isn’t going to cut it.

Types of Fats and Their Effect on Blood Lipids

I know I had posted this before I managed to destroy my website doing an upgrade (a long time ago, like before dirt in Internet time), but I know this is something that is worth knowing.

  • Cholesterol
    • Raises total blood cholesterol
  • Saturated Fats
    • Raises total cholesterol
    • Raises LDL cholesterol
    • Raises Triglycerides
  • Trans Fats
    • Raises total cholesterol
    • Raises LDL cholesterol
    • Raises Triglycerides
    • Raises HDL cholesterol
  • Polyunsaturated Fats
    • Reduces total cholesterol
    • Reduces LDL cholesterol
    • Reduces HDL cholesterol
  • Monounsaturated Fats
    • Reduces total cholesterol
    • Reduces LDL cholesterol
    • Reduces triglycerides when used in place of saturated fasts or carbohydrates
    • No lowering effect on HDL cholesterol
  • Omega-3 Fatty Acids
    • Reduces total cholesterol
    • Reduces LDL cholesterol
    • Reduces triglycerides
    • Decreases clot formation
    • May protect against cardiac arrhythmias

Diabetic Book Reviews

After leaving work at little early on Friday after not feeling the greatest and suffering some of the effects of high-blood sugar associated with Type 1 Diabetes, I decided it’d be very beneficial to me to read some book out there on the subject and see what I could learn.  I read Diabetic Athlete’s Handbook, Dr. Bernstein’s Diabetes Solution, Pumping Insulin: 4th Edition, and Think Like a Pancreas from Friday afternoon to Sunday morning.  Yes, this was a heck of a lot of reading, but when things concern your well-being, you tend to be able to maintain more focus than what you think you can.  All the books offer some great advice, some good advice, and some advice you’re just not going to take.

Diabetic Athlete’s Handbook is a great book discussing what changes a diabetic would need to make in order to perform at their peak during a given athletic activity.  The first seven chapters describe the basics of exercise, fitness, insulin, blood sugar control and other related subjects.  I’ll admit I found them very interesting since they describe in layman’s terms what is going on in the body when you exercise and how to best control your blood sugars.  The second section of the book is really what you want the book for.  This section provides guidelines on preventing low blood sugars while partaking in your particular athletic endeavor.  The book covers everything from gardening to football (both American and the rest-of-the-world) to motorcycle and off-road racing.  I found it worthwhile since I enjoy working out, mountain biking, and doing day hikes and nature trails.  This book has exactly what I need to do in order to remain safe without me having to go out there and find out for myself how to best handle it.

The next book, Dr. Bernstein’s Diabetes Solution is billed as ‘The Complete Guide to Achieving Normal Blood Sugars.”  I won’t disagree with the title, the book is very thorough on what exactly Dr. Bernstein does with all of his patients from how to draw insulin correctly to what diet you should eat.  Although he never comes out and says anything he doesn’t seem to be a fan of Insulin pumps which I think are wonderful things (thanks to my severe hypoglycemic reactions to the long lasting insulins like Lantus); however, the advice can still be followed by pump users even if you have to modify some of his advice.  Personally, I’m not a fan of his diet routine described in the book, but, I see where he is coming from and do intend to integrate some of his ideas into my diet.  I am also very big on his idea of getting all diabetics down to normal blood sugar levels seen by non-diabetic people, even if it will take them a little bit of time to drop their blood sugars and feel comfortable in doing it.  The section devoted to supplies that all diabetics should have is complete and matches almost exactly what I was told when I first visited my endocrinologist.  In fact, many of his ideas were used by my endocrinologist and diabetes educator so it was almost like redoing the first few visits at the doctor’s office.

Pumping Insulin: 4th Edition is nothing like Pumping Iron with Arnold Schwarzenegger unless pushing a button on a pump is like doing bench presses :).  Pumping Insulin is probably the best book for general information I read this weekend.  It goes into detail on everything needed to adjust and determine initial bolus and basal doses as well as carb to insulin ratios and correction factors when using a pump.  If you’re on an insulin pump or thinking of going onto one, this book is worth getting.

Think Like a Pancreas sounds like a children’s book, but it is most definitely not.  I was amazed that this book covered situations that occur in the real world and doesn’t tell you to just “don’t do it.”  For instance, drinking alcohol; most diabetic books will say never drink it, this one says, you can drink it, and here is how to make sure you don’t suffer from the low blood sugars afterward.  Of course, one still needs to exercise some form of discretion because getting hammered isn’t going to help you adjust your pump and there aren’t many people I’d trust to adjust settings on my pump.  This book in content is much like Pumping Insulin and covers most of what Pumping Insulin covers, just sometimes not as in as much detail.

If you’re looking for a good general reference book I think Dr. Bernstein’ book is the best bet.  If you’re looking for information on helping you adjust to a pump and are an adult Think Like a Pancreas is better than Pumping Insulin, but if you’re prone to forgetting things, Pumping Insulin is better.  Finally, if you’re an athlete or like to think of yourself as one; Diabetic Athlete’s Handbook is worth the purchase.

And now… the Diabetic Internet Meme (because every disease needs at least one)

After seeing this, I decided I’ll follow the crowd and join in on the diabetes meme.

What type of diabetes do you have: Type 1

When were you diagnosed: When I was 27 (I was fashionably late to the Type 1 Diabetes party).

What’s your current blood sugar: 100 mg/dL before breakfast

What kind of meter do you use: The Lifestyle one built into my OmniPod and the Dexcom Seven+ when I’m not completely ticked off at it.

How many times a day do you test your blood sugar: At least 7 times (pre- and post-meals, and bedtime) and sometimes up to 11 times a day depending on how I’m feeling.

What’s a “high” number for you: For resting anything over 110 mg/dL, for post meal, anything over 160mg/dL

What do you consider “low”: Anything below 75 mg/dL, I feel it

What’s your favorite low blood sugar reaction treater: Some sort of candy like Skittles or M&Ms

Describe your dream endocrinologist: Not having one :), but since that isn’t the case right now, I really like the one I have.  They allow me to have a lot of say in what I am prescribed and explain everything to me.

What’s your biggest diabetic achievement: Not getting completely down about having it, especially after knowing what it’s like to not have it.

What’s your biggest diabetes-related fear: Amputation of a body part and/or failure of a vital organ (other than the pancreas).

Who’s on your support team: Parents, family, close friends, and my dog.

Do you think there will be a cure in your lifetime: Honestly, no, there needs to be a shift in the way diabetes is viewed.  We’re controlling the symptoms and not the cause.  I know some people are working on the cause, but I believe there are going to be many reasons why the auto-immune system decides we don’t really need beta cells.

What is a “cure” to you: Having my body go back to how it was before I was diabetic.  Otherwise, I’d like to see the loop close between the CGMS and Insulin Pumps.

The most annoying thing people say to you about your diabetes is: Did you eat a lot of sugar as a kid?  (What person DIDN’T inhale massive amounts of sugar as a kid?)

What is the most common misconception about diabetes: That type 1 can be controlled through diet and exercise like type 2.  This is just a problem of both types being called “diabetes” and then when newscasters and articles talk about “diabetes” they really mean “type 2 diabetes.”

If you could say one thing to your pancreas what would it be: It’s not your fault my auto-immune system hates you.  Then I’d need to have a sit down talk with my auto-immune system and figure out what it doesn’t like about my pancreas.