Month: December 2017

Type 1 Writes Diabetes Christmas Gift Guide III

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It’s hard to believe we are a mere two weeks out from Christmas! Where on Earth has this year gone? While I have absolutely no idea what I would like to request for Christmas in my typical indecisive fashion, here are a few of the things that have crossed my radar this year.

Think Like a Pancreas

Think Like a Pancreas is by far the best diabetes book that I’ve ever read. Written by Certified Diabetes Educator and longtime type 1 Gary Scheiner, the book is for anyone with diabetes who uses insulin. Starting with the very basics of what insulin does, the book goes on to provide the reader with a practical approach to getting the most out of insulin therapy. Great for both the person with diabetes and their loved one. Full review here!

Pump Peelz

It might sound shallow, but boredom of looking at the same device over and over each day is real. More so in the case of a device that’s attached to you 24/7. Pump Peelz are custom stickers designed to brighten your insulin pump, CGM receiver and selected blood glucose meters. I must admit to having never personally used these, but I sure do appreciate the value of a good sticker!

AccuChek Guide Blood Glucose Meter

The AccuChek Guide is hands down the best blood glucose meter I’ve ever used. It’s a bluetooth enabled meter, meaning that blood glucose readings are instantly transferred to the Connect app on your smartphone for instant review. Strips come in spill-proof containers, you have a backlight for testing in the dark, and there’s an eject button to send your used test strip in the direction of the bin. While the accompanying FastClix lancing device isn’t exactly ‘painless,’ it’s far superior to any others. Definitely worth asking your diabetes educator for one next time you’re in clinic. Blog to come in the New Year…

Rockadex Adhesive Patches

Looking for some sticky stuff to keep your diabetes devices stuck? I can’t speak highly enough of Rockadex adhesive patches, which are designed to keep Dexcom, Medtronic and FreeStyle Libre sensors stuck. Rockadex was started by the mother of a type 1 child here in Perth, with the primary goal of funding her daughter’s CGM costs. Today, her business has distributors all over the world!

Shop Casualty Girl Bags

Ever get sick of having to overfill your pockets and deliberate over what you need to bring with you every time you leave the house? Having a travel case handy with all of your essentials ready to go makes life so much easier each time I leave the house. These bags by Shop Casualty Girl are proving to be quite a hit among many of my diabetes friends.

Nike Air Max Shoes

Finally, my Nike Air Max Shoes are extremely comfy and look good with just about anything. Well worth the investment if you find yourself trekking around this Festive Season.

Merry Christmas, ya filthy animals. And a Happy New Year.

Vacation’s End.

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When my Lantus pen finally neared empty after my evening dose on Wednesday, I knew that I was just about ready to reconnect to my insulin pump.

Its been almost a month since I started this pump break, and it’s been just what I’ve needed to clear my head and feel a little more ‘free’ from my diabetes.

But I’m also beginning to feel a little over the effort required to physically inject my insulin, moreso at this time of the year.

When I was in the comfort of my own home with all the time in the world to spare, injecting wasn’t really a big deal. But when I was on the go and short of time, i was really starting to miss the convenience that wearing an insulin pump allowed me.

I really had to make a big point of injecting before I could go and have my morning tea or lunch. Which meant finding a place where I wouldn’t be disturbed, pulling out my iPhone, opening up the RapidCalc app, calculating my insulin dose and then concentrating on actually injecting it.

Concentrating?

Yep, concentrating.

If I didn’t put all of my focus towards the task of actual injecting, I ended up with those annoying little drops that manifested on the end of my insulin pen. I was left wondering how much insulin actually went in, shooting out half a unit to compare while deliberating over whether or not I should top up.

In case you’re wondering, there is a technique to avoid this. Gently lift the skin beneath your injection site (don’t pinch), inject your insulin, hold the pen in for 15 seconds after the injection, release the skin and then pull the needle out. I’m not sure I’ve quite mastered it yet, but I have successfully revealed a few clean needles by using this technique.

Then there was the effort required to swap out blunt needles. Because they sure did hurt when I forgot to change them.

Injecting is a lot of effort to put in during my break when I really want to be savouring my coffee and Walkers Shortbread. Or when I’m in the car, trying to give a quick correction inbetween traffic light changes. Also in the middle of the night, when I actually have to switch on my lamp and physically get up out of bed to make sure I properly administer my correction dose.

I fully get that these are all first world problems, and I’m super grateful that I have the luxury and choice to choose the style of management that suits my needs.

On Wednesday evening before bed, I inserted a fresh pump site on my left side and loaded a fresh insulin cartridge. When I woke up on Thursday morning, I skipped my morning dose of Lantus and clipped my pump line into the clean infusion site on my hip. I rode out the day as the rest of my Lantus tapered off. By 3.30pm I thought I could safely switch my basal rate back on, and I was pumping insulin once again.

Why We Need to Stop Asking People If Their Diabetes Is Controlled

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In my latest column for Diabetes Daily, I’m talking about why I think this question is setting people with diabetes up for failure.

“I absolutely hate being asked how controlled my diabetes is. How on earth can such a complex condition be explained in a yes or no question? If a healthcare professional expects me to evaluate my diabetes management with a one-word answer, then they are setting me up for failure. It’s like asking me if I completed the marathon last week, without showing any interest in the journey or preparation that I undertook to get myself past the finish line.

When I think about control in the context of managing diabetes, I interpret it as keeping my blood sugar levels between 4 and 8 mmol/L all of the time. That’s simply far too rigid of a goal for me.”

You can check out the full column at Diabetes Daily here.

Farewell, #OzDOC.

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When I first dipped my toes into Twitter three years ago, the Oz Diabetes Online Community was one of the first places where I found peer support online.

I very much looked forward to Tuesday night Twitter chats, where participants would come together and answer structured questions about diabetes in a very supportive and engaging environment.

Inbetween chats, it was not uncommon to put a random diabetes question out there with the hashtag OzDOC and have it answered. OzDOC gave me the opportunity to network with other people with diabetes here in Australia, something I did not have in my own life at the time.

Over the past five and a half years, OzDOC has been largely led by co-founder and operator Kim. She has been the one responsible for making sure the moderator’s throne is occupied each week, and that there is a topic and questions ready to go.

Kim does a stellar job in welcoming participants to the chat, steering the conversation, and most importantly supporting and encouraging participants as they share candid insights about living with diabetes. To this day, chats just don’t feel the same when she is not in the moderator’s seat!

More recently, I stepped up and formed part of a moderator’s group of seven. Together we brainstormed topic ideas and took turns in moderating weekly chats. We’ve also seen healthcare professionals engage in our weekly chats, valuing the insights that I can only imagine would be difficult to gain in a clinic setting.

Another highlight from OzDOC would surely be having the opportunity to meet some of these amazing individuals at Abbott’s Diabetes Exchange in Sydney last year.

When Kim recently announced to the group her intention to step away from OzDOC co-ordination duties, it was a decision I totally understood. Running a support group like OzDOC in one’s own time is a big commitment each week. Even with a team of moderators, Kim still shoulders a great deal of responsibility in making sure chat slots are covered, questions are suitable, social media reminder posts are scheduled, and all of the other behind the scenes administration.

Members of the moderators group were offered the opportunity to take over Kim’s co-ordination duties, however nobody felt they were in a position or capacity to lead. I felt that realistically, this was not a commitment that I would be able to make next year and that the time was right for me to move on.

The final OzDOC chat will take place Tonight at 8.30pm AEDT. Be sure to also check out the Oz Diabetes Online Community Facebook page, where Kim has been sharing a bit of a retrospective over the past couple of days.

After tonight’s final chat, the @OzDiabetesOC Twitter account will cease. Does this mark the end for OzDOC? Who knows. If members of the community would really like for it to continue, then I’m sure that they’ll find a way.

To Kim and to everyone else involved in the OzDOC community in some way or another, I just wanted to say a massive thank you. You have all made my world just that little bit smaller.

Pump Break: The Good, The Bad and The Ugly

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As I enter the fourth week of my pump break, I’m slowly beginning to remember some of the reasons why I abandoned Multiple Daily Injections in the first place. But if there’s one thing that’s keeping me from reconnecting right now, it’s the thought of attachment and doing those daily maintenance tasks once again.

This pump break has definitely made me more disciplined with my insulin dosing. Having to physically inject forces me to be more meticulous with my insulin decisions, rather than just lazily dosing another unit to counteract a rising BG. I am using less insulin on Multiple Daily Injections today compared with recent pump history and my initial six year tenure on Multiple Daily Injections.

RapidCalc, the app I am using as my bolus calculator, is telling me that my average bolus insulin is sitting at 19 units per day. I feel that those 19 units reflect most of my days, rather than being an average of variable numbers. Scrolling through my more recent pump history, boluses have become very variable, with most days ranging between 20 and 30 units.

Thinking back to those first six years on Multiple Daily Injections, I also remember lots of wild guesstimates, corrections and big mealtime insulin doses of 5-10 units at a time. Nothing seemed to be able to get the job done. With a much smoother Lantus regimen and a newfound dedication to carb counting today, I can give those small insulin doses of 1-3 units and actually get the job done.

Then there was Lantus. My number one reason for ditching the shots was Lantus. I could never seem to get the dose right at night, while during the day blood sugars felt unmanageable.

Today, my 66/33% split seems to be giving me the best coverage I could ask for from a basal insulin. Six units keeps me fairly steady overnight, with no significant effects of dawn phenomenon while I sleep. A further three units in the morning helps to combat morning insulin resistance, and makes the remainder of my day much more manageable as my nighttime insulin tapers off.

It’s not perfect. Just this weekend I’ve re-learned that skipping a meal will send me low. I also went low one night last week, after skipping my afternoon coffee and then eating a fairly low carb dinner. So yes, Lantus does like it’s routine. But what I am achieving today is more than I ever expected I could get from Lantus, so I’ll take it as a win.

Some aspects of my diabetes management are exactly the same as when I was pumping. Like the delayed bedtime spikes from afternoon snacking that need a correction at midnight. And the weekend blood sugars that tend to cruise a little higher than their weekday counterparts. As much as I’d like to blame my pen or my pump here, I only have myself to blame!

I really miss having my pump on me to conveniently bolus or correct a high blood sugar when I’m out and about. Just last week, I was interrupted mid-injection at work. Which is frustrating, because I really need to focus while I’m injecting to make sure that it all goes in. Which brings me to my next point.

The drops. Those bloody drops of insulin that manifest on the end of my pen needle when I pull out too quickly after an injection. I’m left wondering whether all of the insulin went in, or whether I need to give another shot. There is a technique, by the way. Gently lift the skin beneath your injection site (don’t pinch), inject your insulin, hold the pen in for 15 seconds post injection, release the skin and then pull the needle out.

I’m also finding it harder to rotate injection sites, as they are less visible than pump sites and I do several of them each day. I find myself continually going back to the usual suspect areas, which i know I shouldn’t be doing.

The most enjoyable thing about my pump break is being able to go for a walk in the afternoons and not worry about rapid acting insulin sending me low. Getting changed without having to accommodate a pump in the process. Laying in bed and not having to feel that chunk in my pocket. In fact, I think that this is the least I’ve thought about diabetes in several weeks.

I still remember some wise words from fellow d-blogger Ginger Viera. She says that both methods of insulin delivery have flaws, and that it’s up to us to choose the flaws that bother us the least.

With the Festive Season well and truly upon us and my first Lantus pen nearing empty, I’m wondering just how much longer this pump break will last me. I guess time will tell…