Author: Frank

A Decade With Diabetes

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If I could best describe diabetes, I would say that it’s incredibly monotonous. How do I psych myself up to check my blood sugar, count the carbs in my food and deliver my insulin? How do I psych myself up to check my blood sugar again, count the carbs in my food again and deliver my insulin again?

One of the hardest things about diabetes is being able to muster enthusiasm to do this thing day in, day out. How do I keep my diabetes management feeling fresh and exciting? How do I keep myself feeling energised to put in the best effort I possibly can each day, without ever getting a break? How do I keep myself motivated when diabetes suddenly decides that what was working for me yesterday, is not going to work today?

Today marks a decade with diabetes. It doesn’t really feel like a decade. It feels like forever. I can also say that it doesn’t really feel like anything extra special when you have to do this all day, every day for the rest of your life.

Technology is one of those things that has firmly helped me to manage my diabetes in the best way that I possibly can. I acknowledge my privilege in being able to say that. The t:slim is a massive upgrade to the old Animas Vibe which constantly fatigued me. Being able to leave the house with nothing more than my phone and glucose tabs is the best feeling in the world. My rebatteried Dexcom has given me a greater level of convenience in my day to day with diabetes which I’ve never had before.

But it would undoubtedly be the power of peer support that helps to re-energise me in my diabetes efforts on a daily basis. From the #OzDOC chats of old, to being part of the Young Adult Diabetes Committee, right through to events like DX and the Diabetes Congress where I’ve met so many amazing people with and connected to diabetes. It fills my cup to the point where its overflowing, each and every time.

I’ve invested so much into myself over these past ten years, and I’m not sure that I ever would have found the motivation to do that if it weren’t for the community I have wrapped around me.

So, I guess today doesn’t feel like anything particularly special. It just feels like any other ordinary Saturday. Outside of Mother’s Day plans, I don’t really have anything special planned for today. I think I’m just grateful for that sense of normality. Well, as close to normality as possible when you have diabetes.

A decade with diabetes has beyond surpassed my expectations.

Thanks for being a part of it.

Invalidated

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One of the things that I feel most passionate about when it comes to diabetes is language. Perhaps second only to peer support. I quite often find myself thinking about the deeper impact of things that I see shared on social media, things said in presentations, things written in articles and how that might make other people feel.

Language Matters. Language has the power to influence the way we think, feel and behave. Language has the power to become reality. (So much so, that Diabetes Australia wrote a whole position statement on it…)

I have to admit that one of the things that doesn’t quite sit right with me lately is the suggestion that it is of the utmost importance that people with diabetes be controlling their blood sugar right now. Or something to that effect.

The way that reads to me, is that it’s only going to be the people with poorly controlled blood sugar who will be at greater risk of Coronavirus. In exactly the same vein as the suggestion from a few weeks ago that ‘only those with pre-existing conditions will be at risk.’ We don’t throw people under the bus in the diabetes community. If you ask me, that’s a really poor way to motivate someone to take care of themselves.

I can’t help but think about how some people in our community might be feeling about these messages. Let’s say, for example, someone who is newly diagnosed and is not seeing the 5.5 that’s on the box of their blood glucose meter very often. Or in the case of my life in the past week, the story of my extremely stubborn blood sugars that are resistant to the same amount of insulin that was sufficient last week. I must admit that even I’m feeling a bit invalidated by this messaging.

I have absolutely no problem with anyone who might feel inclined to use this time to provide additional focus towards their diabetes, if they see fit. (Although I would love to know where you are finding this spare time, because I certainly haven’t found any…) I have absolutely no problem with encouraging good hygiene, good health behaviours and preparedness. Go and have a look at Diabetes Australia’s socials.

But diabetes is a tough gig. When you live with diabetes, every day is diabetes day. Every week is diabetes week. Every month is diabetes month. I refuse to believe even for a second that people with diabetes aren’t trying. I can honestly say that I don’t know a single PWD who isn’t doing their best, under extremely trying circumstances.

I’m not going to suggest that it’s not important to manage blood glucose, but a number isn’t the only marker of people’s efforts in their diabetes management.

People with diabetes deserve a medal just for continuing to show up each and every day during an extremely challenging time.

Diabetes Tech Updates: May 2020

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Another month, and another smaller flurry of diabetes tech news.

Among the most exciting news, I recently had a chat with my local AMSL rep. The recently approved Dexcom G6 Continuous Glucose Monitor is expected to launch into the Australian market in June, once stock hits our shores. Training is well underway for company reps. It’s expected that the launch will initially cater to the private market, as it will likely be a little while longer before G6 is available through the NDSS for users who are accessing the government subsidy.

Basal IQ, the predictive low glucose suspend update to the t:slim, has also been approved (this is per my rep, I can’t find a source myself). AMSL are planning to launch this later in the year, in a staggered fashion once G6 is a little more settled into the market.

In other news, Ypsomed have finally announced the long promised CGM partner for their insulin pump. An update to Ypsomed’s mylife app will integrate CGM readings from the Dexcom G6 (and future Dexcom iterations). The mylife app currently receives data from the YpsoPump via a Bluetooth connection, and is where users perform their bolus calculations.

Given that the Ypsomed app can also be used in MDI mode, I think CGM integration is a big win for those who aren’t using pumps, too. It’s also fantastic to see Dexcom forging partnerships with different players in the market to facilitate greater choice to people with diabetes. Because more choice for people with diabetes is always a good thing. This is expected to launch in Europe later this year/early 2021. No news as to when this will launch in Australia.

The press release goes on to suggest that Ypsomed are also working toward their roadmap which was outlined to us at YpsoPump launch event in May 2018. This involves eventually having the pump remotely controlled via the mylife smartphone app. Ypsomed also has the option of adding a hybrid closed loop feature, powered by the Dexcom TypeZero algorithm (I believe this is the same algorithm that is powering Tandem’s Basal IQ/Control IQ updates).

The official press release is here.

In some older news, there are temporary limits to the supply of insulin pump consumables via the NDSS for Aussies. In response to increased demand out of COVID-19, Diabetes Australia has advised limits of 2 boxes of insulin pump consumables and 2 boxes of cartridges per order. Test strips, needles and syringes are limited to 3 boxes per order. Please only order what you need.

In somewhat of a more unusual announcement, Roche Diabetes Care have added child resistant battery compartments to AccuChek Guide and Instant S blood glucose meters. I personally think the Guide is the best blood glucose meter I’ve ever used, and it’s great to see Roche’s commitment to standard blood glucose monitoring which is still important to so many people.

If you have any questions, feel free to pop them in the comments and I’ll do my best to answer.

Flu Shot

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This morning, I got my flu shot.

Flu shots haven’t traditionally been something that I’ve made the effort to get done. I don’t tend to catch colds all that often. I usually look after myself by regularly washing my hands, which is something I have been doing well before the government began telling us to. Did I mention that I’m slack when it comes to scheduling an appointment when I could be putting up my feet?

However this time last year, I’d only just started my degree. I knew that the last thing I wanted was to catch a cold or worse while I was anxiously studying for my first exams in several years. So, I figured I’d get it done.

Then of course, comes this year. If there ever was a year to get a flu shot, this would probably be it. No, there’s no vaccine against Coronavirus, but there is a vaccine that will help to make it less complicated. And it’s free to people with diabetes.

I asked my GP how he was going amongst all of this, and he equally seemed to be doing it tough right now. With patients reluctant to visit practices, he’s been inundated with phone calls requesting prescriptions and free advice over the phone. He’s also been offering free bulk billing to thank his patients for their support – even though I would have been happy to pay his very small out of pocket fee.

He also noticed the extremely shabby Dexcom on my arm, and couldn’t believe how big it was compared to FreeStyle Libre. He also couldn’t believe that pumps and CGMs don’t talk to each other yet. If only…

Anticipating some spectacular insulin resistance, I put a temp rate of 150% on as soon as I took a seat in the waiting room. Then, I drove down to the beach and walked it down along the coast in this spectacular weather we’ve been having this week. I added another 50% to my lunchtime insulin dose, and surprisingly my graph is looking as spectacular as the weather outside today.

Third Time Lucky?

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Yesterday was A DAY.

I had plenty of revision to do, but I couldn’t take my eyes away from my rising Dexcom graph. My blood was boiling. I felt anxious, and somewhat helpless. I couldn’t concentrate, despite my best intentions.

I’d only just replaced a cartridge of spoiled insulin the evening prior, after battling high blood sugars all weekend. Not to mention the insulin resistance that’s been brought on by the cooler weather. So I was still feeling more than a little paranoid, but also assumed that I was more than likely overreacting.

I gave a correction, but I still couldn’t take my eyes away from that graph. Do I set a temp basal rate? How long should I wait until correcting more? Has this insulin cartridge gone bad as well? Could that whole packet of insulin cartridges be bad? Maybe I should have waited until my insulin was at room temp before filling my cartridge last night?

Then, the rational side of my brain started waging an internal war against the irrational.

You’re being stupid. You woke up a bit higher than usual this morning, and that is what normally happens when that is the case. You’re seriously going to throw out a second cartridge of insulin!? That’s so wasteful.

Lunch panned out okay, but only thanks to the wave of active insulin and temp rates I’d used to bring down my breakfast. But after an up arrow following my afternoon coffee and cookie, I knew that my paranoia wasn’t for no good reason.

I opened a brand new box, and pulled out a fresh cartridge, hoping against all hope that this would be my third time lucky.

Things are playing out much nicer today. I’m still playing around with temp rates, but overall I feel that my body is responding properly to insulin again. I now have a box of insulin cartridges in my fridge, from which I’ve drawn two bad vials, that I’m feeling pretty dubious of. I probably won’t throw them out, but I don’t foresee that I’ll be game enough to use them again in the near future.

I hate days like these. Days that are unpredictable, days that take away my valuable time and days that have me doubting myself. I’m not used to having days like these. I like predictable. I like knowing what to expect when it comes to my diabetes.

I know that when I’m paranoid, there’s probably a damn good reason for it.