Not Just a Patch

Admittedly, I don’t particularly like having to wear any adhesive over my CGM sensor. I’ll usually hold off on applying an external adhesive for as long as I can, although I have been caught out once or twice in recent weeks. I only just managed to rescue last week’s sensor by the skin of its teeth (it was dangerously dislodged from my arm).

However, adhesives have become a necessity in order to get my sensors to the 14 day mark. Occasionally I’m able to get my sensors to 21 days, but I don’t find the readings too consistent or reliable.

I’ve been trying out the ‘Not Just a Patch’ adhesives in-between sensors over the past few months, which were gifted to me by the Not Just a Patch team.

Back in January, I had a brief Zoom chat with founder Pete, a fellow type 1 from Sydney. Pete went to uni in Perth and could instantly recognise the Fremantle Doctor blowing away as I sat on the steps outside the loading dock during my lunch break.

I guess what makes Not Just a Patch a little bit different from its competitors is that the patch covers the entire sensor. Pete explained that the biggest point of difference with these patches, unknown to me at the time, is that they are designed to be easily removed and replaced. Check out how easily they pull off in my video below!

Pete did warn me that G5 was a little more challenging compared to slimmer sensors such as FreeStyle Libre or Dexcom G6, and I did find these a little bulky to wear. On the plus side, they were much easier to apply and I liked not having to stress about getting the perfect application around the edges of my sensor.

You can find Not Just a Patch here. Pete’s also got a podcast called ‘The Dialogues’ featuring some familiar diabetes advocates, which you can also find in your podcast app.

Go With The Flow

It’s definitely been Easter week in my corner of the world. Hot cross buns and Easter eggs have been getting me through work and uni this week, counting down the days to a much needed four day long weekend. My personal picks are the yellow bags of Cadbury mini eggs and hollow hunting eggs. Bonus points if you picked them up on sale at Woolies last week.

This past week has been disgustingly humid. It’s the second spell we’ve had here in Perth this month that doesn’t seem to want to go away. You know, the kind of weather that sucks the life out of you, amplifies the irritating chirps of the crickets at night and also throws you some unexpected and nasty lows.

Like this morning, while I was in the midst of resetting my transmitter clock and replacing my sensor. I didn’t have access to reliable readings. I’d switched off my phone’s Bluetooth connection and Dexcom notifications earlier after persistent alerts to unreliable patches of readings that came and went. I’ve already been running reduced basal rates of around 10% for much of this month.

All of a sudden, I found myself struggling to go through the motions of my task at hand. My hands were clammy. I was sweating, but perhaps it had simply been mistaken for the weather. I reached for my meter, whose reading gave me a reaction of ‘yikes.’

I reached for a jukebox from the drawer, and guzzled it down. I had to sit down. I slowly began to feel warmth return to my body, but I was still craving something comforting and more pleasant than juice. I nibbled on a jellybean from the drawer, and eventually followed up with a cup of tea and biscuit.

If there’s one skill I’ve learned about living with diabetes, it would have to be learning to adapt to my surroundings and just going with the flow.

It’s Easter this weekend. There will be chocolate, there will be food, there will be drinks and there will be good company. I could choose to impart rules and strategies for how I will navigate Sunday lunch and the Easter egg hunt.

But quite honestly, just like every other day of living with diabetes, I think I’ll just go with the flow.

The Vaccine Edit

I was really surprised (and still am) to learn that we have our first Coronavirus vaccines that will be rolling out in Australia today and over the coming weeks. Admittedly, I knew very little about vaccines before Christmas.

I’ve been checking into the excellent Coronacast podcast throughout 2020, and it’s become a daily listen on my way to work or on my walks. Hosts Norman Swan and Tegan Taylor have such excellent views on epidemiology that I’d be more than happy for them to be making our decisions around outbreaks. Did I mention that they are only around a 10 minute listen?

In recent weeks, Coronacast has provided some considerable insight into vaccines. To mark today’s commencement of the vaccine rollout in Australia, I thought I’d paraphrase some of what I’ve learned here (to the best of my ability).

I’ve learned that the vaccines have been proven to protect against COVID-19 disease if infected. It would likely mean that fewer people would become severely unwell or end up in hospitals.

What we don’t yet know is whether vaccines can prevent transmission of COVID-19. Could a person that’s been vaccinated still spread the disease to another person? Time will tell. If the latter were the case, then we would need 100% of the population to be vaccinated (which is unlikely) for our vaccine strategy to be successful.

Australia has two vaccine frontrunners, Pfizer and AstraZeneca. A small supply of imported Pfizer vaccines are being rolled out this week to front line workers such as those working at our quarantine hotels, borders and healthcare professionals in those kinds of settings. Also in ages care settings. 3.8 million imported doses of the AstraZeneca vaccine were also approved by the TGA last week, with locally manufactured doses of this vaccine pending approval. This is the vaccine that most Aussies will be receiving, should they choose to be inoculated.

Then there’s the issue around the efficacy rates among these vaccines. Efficacy is the percentage reduction in disease among the group of trial participants who received a vaccine compared to those who did not. I believe the Pfizer vaccine had an efficacy rate north of 90%, while AstraZeneca’s was only around 62%.

Per Coronacast, Astra’s trial was a little messy – with some participants receiving an unplanned half dose and then a full dose of the vaccine – leading to a higher efficacy rate among a sub group of around 2,000 trial participants. The TGA has recommended two full doses of the Astra vaccine 12 weeks apart and, per Coronacast, this should see an efficacy rate nearly as good as Pfizer.

We’re also being told to expect that these vaccines may become seasonal in the same nature as the flu shot. It might be that we need a booster shot, the vaccine needs adapting as the virus mutates, or a combination of both.

Assuming that diabetes meets the criteria of a ‘medical condition,’ Aussies with diabetes are likely to be offered a vaccine in Group 2, with approximately 5 million people ahead of me in the queue – as per this handy tool from the ABC. But again, I’m not particularly interested in drawing lines between diabetes and COVID19. I’ll be happy to wait my turn, because there are definitely people who need it more than I do.

The prospect of a vaccine still gives me a little anxiety. I don’t think it’s going to be a replacement for good hygiene or physical distancing for quite some time. I do worry that the complacency that’s clearly set in will only be accelerated. While the virus continues to ravage on overseas, we cannot afford to get complacent. Nor is this a reason to open our international borders anytime soon.

Despite our privilege here in Australia, I think it’s fair to say that 2021 hasn’t been much different to where we ended 2020. Just like diabetes, the nature of this pandemic has changed thanks to more transmissible variants – just when we thought we had it under control. We’ve had some scary escapes from our strict hotel quarantine measures in Adelaide, Sydney, Brisbane, Perth and most recently Melbourne – all of which resulted in various forms of short localised lockdowns and restrictions.

So, I’m definitely feeling hopeful that these vaccines might give us a little more stability here in Australia has we continue our unique way of life inside this amazing bubble.

Highly recommend listening to Coronacast – they’re very easy 10 minute daily episodes – check it out here.

Start with this episode on what/what not to expect from a vaccine. Everything in the last month or so has been highly relevant to vaccines.

30 Grams

I haven’t been able to stop thinking about a really enlightening article I read at Diatribe in recent weeks. Cherise talked about a glass ceiling that she had for the number of carbs she entered into her pump, and explored why she was hesitant to declare the actual number of carbs that she was eating.

I’ve lost count of the times where I’ve subconsciously entered 30 grams of carbs into my pump, even when I know I’ll probably be eating more.

30 grams is the number I’ve been conditioned into thinking is the ‘right’ amount of carbs for a meal. Many corners of the diabetes community send out messages that less insulin is better, and even worse, demonise food choices.

Today, my mentality has evolved to eat as much as I need to meet my own needs and not some unrealistic ideals of what is right. However, I can’t think of too many times where I will enter more than 30 grams into the bolus calculator of my insulin pump. It’s more of a wait-until-my-blood-sugar-starts-going-up until I’ll top up with more insulin.

30 grams also feels like a safe number. Even moreso after weeks of nasty hypoglycaemic episodes caused by a combination of hot weather and correcting extremely stubborn blood sugars until I’ve over-done it. You know, the ones where I have to stop what I’m doing completely because I can’t concentrate and I feel yucky.

My time in range has been suffering, for a while now. It was definitely a contributing factor to the fatigue that led me to take a pump break over Christmas. But even now that I’m comfortably settled back into pump life, that problem is still glaringly obvious.

50, or 60% at best, does not reflect my best effort. I know that I’m not supposed to judge myself on my numbers, but I feel guilty at seeing so much yellow and red on my Dexcom Clarity reports. Not to mention that my diabetes just feels so much harder to manage.

One of the hardest things about managing diabetes is that the dynamics are always changing. There are times where I need less insulin because it’s hot and I’ve been more active than normal. Then there are times where I need more because I’ve been ‘slacker’ than usual. You always have to stop and think about what’s going on, and what to do to fix the problem.

The lockdown that much of Western Australia was plunged into earlier this month, quite honesty, came at just the right time. It was just the perfect chance to take away some of those distractions – that background noise that comes from the daily grind – and just give my diabetes a little bit more love and attention that I can’t always seem to muster.

I think Cherise’s post couldn’t be more accurate, especially in the context of my own hesitation to go beyond 30 grams – and it will definitely be a focus for me going forward.