Month: May 2018

DX2Sydney 2018

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I’m at home today, nursing a sore throat and a cold which was most likely picked up at the end of Abbott’s third annual DX blogger event in Sydney earlier this week.

DX – which stands for Diabetes Exchange – is now into its third year Down Under. Abbott was the first company in the Australian diabetes space, that I’m aware of, who began talking to consumers when the FreeStyle Libre was launched in May 2016. From there we have seen other companies follow suit, providing more platforms for the lived experience to be heard (no doubt with a little push from some of my fellow diabetes advocates).

It was nice to be reminded of my first encounter with this special group of advocates back in May 2016, and how much my voice has grown and evolved since then. This group of oversharers have become somewhat of a close knit family over a short space of time, with a few new faces entering the fold every year.

While we were primarily convened ahead of the launch of the LibreLink app in Australia on June 5, we also had the opportunity to present some feedback to Abbott on the FreeStyle Libre.

My question to both Diabetes Australia CEO Greg Johnson and the Abbott team was around whether partial subsidies for Flash Glucose Monitoring in the form of co payments would be an option, as seen with our test strips and pump consumables. 

I have only ever seen full reimbursement noted by Abbott in official communications, and wondered whether more of a focus on partial reimbursement would help get the FreeStyle Libre subsidised sooner. Bionic Wookiee David also rightly corrected Abbott’s term of ‘reimbursement’ with ‘subsidy,’ given that consumers won’t be reimbursed for anything should the product receive federal government funding.

Professor Johnson told us that co payments were certainly an option as we often see through Medicare, and that Diabetes Australia were surprised by the Federal Government’s last election promise of fully subsidised CGMs for people under the age of 21.

Abbott’s Regional Director Peter Chalikias told us that reimbursement decisions rested with the Federal Government and the Department of Health, with the company’s priority to get the FreeStyle Libre into the hands of as many people as possible.

Jessica Shi, Abbott’s QA & RA Manager, must have been reading my mind when she addressed the need for call centre staff to better gauge the level of expertise from the person with diabetes reporting an issue over the phone. Nothing is more frustrating than receiving a basic lecture on what interstitial fluid is!

Once again, I cannot express how important it is to get in contact with the call centre should you have any issues with the product. Some of Abbott’s current priorities based on user feedback are cost, adhesion and accuracy. Cost reductions that Abbott are able to make in the manufacture of the FreeStyle Libre get put back into research and development that will potentially help to address these user issues. 

Does that mean we’re likely to see the product shift towards something that more closely resembles a Continuous Glucose Monitor? Would Abbott not prefer customers to be using a more trusted, in house data sharing solution, rather than third party products such as the BluCon Nightrider?

At this stage, it’s understandably not a priority. I personally wouldn’t want to see the FreeStyle Libre change. Providing consumers with choice is important, and the product in its current iteration means that more people will be able to access Continuous Glucose Data.

“Do you feel that you have had any input into the FreeStyle Libre by attending these events?”

My answer to this question I was posed last week was simple. None. 

I don’t have a technical mind. I don’t know anything about all of the research, development and regulatory compliance that goes into making a medical device as such. 

Abbott also know that they don’t need me, or any of the other bloggers in the room to sell their hugely successful product. Yet their continued respect and commitment to hearing what’s important to (highly privileged) people with diabetes through these DX events, is where I hope I am making a very small difference.

Any company operating in the diabetes space that chooses to engage with people with diabetes is a good thing.

It’s been a pleasure to be part of the DX Family.

Disclosures: Abbott covered my travel and accommodation costs to attend the DX event in Sydney. I was also fed and watered through the duration of the event, and received a goodie bag which contained a FreeStyle Libre sensor. There was no expectation that I would blog about anything covered at DX2 Sydney. My opinions and my time, including the annual leave I took from work to be here, are as always my own.

Pump Complacency.

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What I have neglected to mention here is that, until arriving in Sydney, I had been disconnected from my insulin pump for almost four weeks.

You know what? It had been working pretty damn well. To the point where I was really starting to re-evaluate things. I was actually packing for Multiple Daily Injections, and had no intention of bringing any pump supplies along for my week in Sydney.

On the day prior to my departure, I began to think about how I may regret not having the convenience of a pump while trekking around Sydney. So, in my usual last minute indecisive fashion, I attached a new infusion site to my stomach prior to my birthday dinner on Tuesday night. I shoved a few spare infusion sites and insulin cartridges into my carry bag. I returned all of my pump junk back into my travel case.

But I still wasn’t sure.

I stuck with Lantus for the first day of my trip, and decided that I’d just use the pump for boluses. That was, until the moment I heard that I would be given my own loaner Ypsopump to take home and roadtest on Wednesday night. I have not given another shot of Lantus since.

I’ve drafted a few versions of this post, plagued with thoughts of sounding too wishy washy or having said it all before. I’ve had a few interesting reactions around why I would do such a thing as take off my insulin pump.

I felt as though I had been consistently correcting high blood sugars with little effect throughout much of April. Rapid acting basal insulin was beginning to feel very inconsistent, and mealtime insulin wasn’t doing its job properly as a result.

In hindsight, I do feel that my pump was also making me complacent. I tend to take it for granted after a while, not doing the things that I should be. Like pre bolussing for meals, waiting for my blood sugar levels to fall back into range prior to eating and avoiding insulin stacking.

What I do know is that my blood sugars were amazing throughout much of that four week vacation. Insulin was working far better with Lantus as my basal, rather than rapid acting. Of course, it’s worth noting that insulin sensitivity is far better when I spend more of my day in range.

I’ve expressed time and time again just how monotonous it is to do the same thing day in, and day out when managing my diabetes. That’s why new accessories, tools, devices and even a shake up to insulin therapy helps to keep me feeling fresh and energised in the daily grind of diabetes management.

I don’t believe that one is better than the other when it comes to pens versus pumps. Nor do I believe that one form of insulin therapy will necessarily be the right thing for me, forever. Each has their positives and negatives, and the ‘right’ insulin therapy is the one whose flaws bother me the least.

This week, I have been ‘non compliant.’ My levels have looked pretty much like the typical holiday blood sugars you’d expect from eating more carbs than normal and being out of routine.

I am roadtesting the Ypsopump as we speak, but I’m not ruling out other options once I’m settled back into my usual routine.

 

FreeStyle LibreLink App Launches in Australia!

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I’m in Sydney over the next two days attending Abbott’s third annual DX event, which brings together a group of Aussie diabetes bloggers.

Abbott are launching the FreeStyle LibreLink app in Australia on June 5, and this can either complement or replace the fundamental role of a FreeStyle Libre reader. Abbott are letting me road test the LibreLink app for 24 hours, so hit the play button below to see how it all works.

I’ll be sharing further insights on LibreLink and the Ypsopump on Instagram, so send me a follow request if you’re not following me already!

Disclosure: Abbott have covered my travel and accommodation costs to be here. There was no expectation that I would try or blog about the LibreLink. As always, my time (including the annual leave I had to take to be here) and my opinions are my own.

YpsoPump Lanches In Australia!

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Did you just say that we’re getting a pump?

Yes.

To keep?

Yes. If you’re going to write about it, you need to know all of the facts.

All of the other bloggers were convinced that I must have misunderstood Ypsomed Australia’s General Manager, James Mayjor. I was convinced that perhaps he was just leading me on.

I walked away with the brand new YpsoPump, that officially launched in Australia today. Consumables are listed on the NDSS, meaning that Ypsopumpers will be able to access subsidised supplies just like any other pump.

I believe that a large group of Diabetes Educators will also be coming to Sydney for pump training over the next two days, so if you are thinking of starting on the Ypsopump there’s a good chance you’ll be able to find a trained CDE near you.

So, disclosures. My Life Diabetes Care covered my travel expenses and accommodation in Sydney to attend the launch of the Ypsopump. The team from My Life Diabetes Care kindly gave us a platform for the consumer voice to be heard, as well as hearing all sorts of crazy dinner conversations last night! If that wasn’t generous enough already, I was also given a Ypsopump, some infusion sets, reservoirs, pump cases and an inserter to trial.

So before you read any further, there is a pretty big bias in place. However My Life Diabetes Care have not paid for my time or my words which are, as always, my own.

First up, hooray for new pump choices in Australia!

Secondly, I honestly cannot believe just how sleek and lightweight the Ypsopump is compared to my chunky Animas Vibe that’s looking increasingly like something from the last decade. The My Life Diabetes Care team did highlight that the Ypsopump had been designed to fill the gap in a market filled with complex, medical looking devices.

I was also most impressed to hear about the My Life Diabetes Care portfolio of products, which included things like needles, pen injectors and blood glucose monitoring for people on Multiple Daily Injections and Structured Blood Glucose Monitoring. The tech is not for everyone, and offering choice to consumers is extremely important.

The pump is touch screen, although not a full colour pump. The biggest difference to my late Vibe is that the bolus calculator is not contained in the pump itself, but rather done in the My Life Diabetes app. So, I would calculate my bolus in the app, and then administer the recommended dose using the pump. The pump then connects all of my insulin dosing data to the app via a Bluetooth connection.

Infusion sets come in either steel or teflon, are available in a variety of lengths, and also have the option of manual insertion. Another noticeable difference for me compared to the Animas was the lack of a 45 degree angled cannula.

If you hadn’t noticed my enthusiasm already, I obviously hooked up straight away. It’s still very early to draw any more conclusions, but I will have more to share in the coming weeks. For the time being, I’m more than happy to stow my late Animas Vibe away in my pencil case.

P.S. A photo where I’m actually smiling!

P.P.S. Could we have thought of a better product placement? From left to right: Ashley (@hangrypancreas), Melinda (@melindaseedt1d), Renza (@RenzaS), Rachel (@yoga4diabetes), Me (@FrankSita) and CDE Blogger Extraordinaire Jayne (@JayneEdHealth).

Review: AccuChek Guide Blood Glucose Meter

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The AccuChek Guide has by far become my new favourite blood glucose meter in recent months.

I first received this meter from my friend Tammy of Diabetes: Forever and Always, before also picking up another one from the trade hall at the ADS-ADEA conference last year. There was, of course, no expectation that I would write or even use the meter itself.

The Guide has been around for a fair while, with it’s first claim to fame being the “spill proof” capped test strip vials.

Strips can also be easily accessed by simply sliding them out of their place, without having to stick your fingers in there and fumble around for one.

While this meter does use a slightly larger blood sample (0.6uL) compared to my FreeStyle Insulinx (0.3uL) and OneTouch Verio IQ (0.4uL), the accuracy more than makes up for it. Past meters have shown big variances from two consecutive readings, aren’t consistent with other meters, or the readings simply don’t match up with my feelings,. Even on grubby working hands, I have found the Guide’s accuracy to be the most consistent and superior.

I also like that I can see the blood go onto the strip, compared to my previous FreeStyle Lite strips which had me guessing whether it was blood or sweat had gone onto the strips.

My biggest gripe, as with other meters, is the strip fill errors. If I don’t get enough blood on the test strip on the first go, which often happens when I’m quickly trying to check during a red light on my way home, I have no choice but to start over with a fresh strip. Alternatively, both my Optium Xceed (does that meter still exist?) and the FreeStyle Insulinx gave me an additional 60 seconds to apply more blood.

One thing that disappoints me most is that every meter in the AccuChek family uses a different line of test strips. In comparison, the FreeStyle family only has two kinds of strips (to my knowledge). This definitely limits my enthusiasm to trial other meters, and does prove inconvenient when trying to stockpile test strips for spare or travel meters.

The guide comes with AccuChek’s FastClix lancing device, which is pretty damn amazing. Each cartridge change contains six lancets, meaning that I can change my lancet six times by simply sliding the little white knob. Unfortunately, this still does not motivate me to change my lancet any more often! There are also 11 depth settings, making the finger pricking experience pretty comfortable.

By far, my favourite feature of this meter is its Bluetooth connectivity to the AccuChek Connect smartphone app. Every time I check my blood sugar, the reading is wirelessly transferred to the app on my smartphone. The app makes it so convenient for me to review my blood glucose data, without the hassle of having to force myself to sit and upload each meter to my computer with its corresponding USB cable.

When you test your blood sugar as often as I do, you’ll get a nice graph of patterns and time in range, which has been really helpful to me while I’ve been adjusting to my pump break.

The app also has a built in bolus calculator that can be accessed with a single use code from a healthcare professional, however this feature has been recalled in Australia for some time. I’m currently using RapidCalc for bolus calculations on my iPhone while I’m on my pump break, but I would love to integrate my insulin dosing into the Connect app as well.

The biggest tradeoff to the additional features is a faster drain on the meter’s standard coin cell battery. I might get 2 months of battery life from checking my blood sugar 10 times per day on my main meter, alternating between a spare and a FreeStyle Libre as well.

The AccuChek Guide is an amazing, amazing meter that has all the bells and whistles for 21st century diabetes management. It definitely helps keep me feeling excited and motivated in managing my diabetes.

Bells and whistles aside, however, the biggest sell for me is that it’s a meter that I can trust.

It’s definitely worth asking your diabetes educator for one on your next visit.