Continuous Glucose Monitors

Why I Am Waiting.

3 Comments

Unless you’ve been living under a rock, you’ve likely heard of the whole We Are Not Waiting movement. You know, a bunch of people who are hacking their diabetes devices in order to enhance their functionality. Such as transmitting blood glucose data to other devices, turning a FreeStyle Libre into a CGM with alarms and even closing the loop between an insulin pump and a CGM.

You need look no further than the name of this movement to find the reason for it. People with diabetes really are at the mercy of device companies, regulatory bodies or, in the case of the snippet I read in yesterday’s paper, researchers who are currently attempting to regenerate organs in sheep!

I don’t see a cure on the horizon in the next ten, twenty or even thirty years. The business of business is business. Advancements no longer feel like a solution, but rather a pathway to the next enhancement or product. Both consumers and device companies seem too focused on feeding this diabetes technology frenzy.

The most realistic advancement that I do see on the horizon is a commercial closed loop system. That is, an insulin pump that communicates with a Continuous Glucose Monitor to automatically regulate blood glucose levels. There are a few systems currently in development in the US. Yet I don’t realistically see any of these getting into my hands here in Australia in the next five, dare I say ten, years.

I need look no further than the current insulin pump situation here in Australia. If online communities are anything to go by, Aussies are crying out for a new insulin pump option to hit the market here. There are insulin pumps listed on the TGA website that can be legally sold here in Australia, and yet we are left waiting at the mercy of distributors, device companies, marketers, financial strategists, and all of the other powers that be.

Better yet, it’s 2018 and people are still forced to do all sorts of questionable things in the name of INSULIN, the drug with a price tag that is skyrocketing by the day.

I have been reading up on the likes of hacking a FreeStyle Libre system and closing the loop over the past couple of months. There is a growing community of people here in Australia who are buidling and running homemade closed loop systems, and you can lurk or join them here.

I, however, have made the regrettable decision that I will have to wait.

For starters, I would have to commit to full time Continuous Glucose Monitoring. This is not currently subsidised for adults like me here in Australia. Nor is this, as well as the other hardware required, in my current budget while I am working toward other financial and career goals. Secondly, I don’t own a pump that is loop-able, and I don’t like my chances of being able to get my hands on one.

Finally, I’m not sure that I would be able to give any ‘we are not waiting’ efforts the due focus that they would inevitably require at the moment, with a lot of other priorities on my mind for the year ahead. As one Facebook group admin puts it, don’t bother asking for the idiots guide as these solutions aren’t for the faint headed!

I am frustrated. Not because I’m envious of others who do have the means to do so. Not because I can’t manage. Not because I don’t have good health, excellent access, good people around me or a good quality of life.

I am frustrated, because people with diabetes deserve so much better than what they’re currently getting.

Getting the Most Out of a Flash Monitor

2 Comments

I’ve recently started freelancing for Diabetes Daily, which means that from time to time I’ll be linking to some of my columns over there.

The topic I am most frequently asked about is the FreeStyle Libre. While my experience with the device has been an extremely positive one, I definitely didn’t hit my strides after my first sensor. Any shake up to your diabetes management is going to be an adjustment. In my first column, I wanted to share some of my tips and tricks for a smoother transition from finger sticks to flash monitoring.


Like the fact that getting out of the shower, or going from a dark room to a bright one, can cause momentary changes in the readings. 

Or that higher blood sugars can cause greater variances with a traditional blood glucose meter. 

And that I shouldn’t obsess over the small variances, because two blood glucose meters won’t ever produce an identical reading!

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

(That being said, Your Diabetes May Vary!)

 

Mixing Up Finger Sticks and Flash Monitoring

2 Comments

I don’t cope well with the continuous nature of glucose data. After prolonged periods of using my FreeStyle Libre, I tend to get a little fatigued and overwhelmed. I know that I’m not getting the most out of my flash monitor, which I pay a pretty penny for. Perhaps I might feel differently if I were not an insulin pumper as well, and the Libre was the only technical device I had to deal with.

Over the last couple of months, I’ve settled into a routine of wearing a FreeStyle Libre sensor for the first two weeks of the month, and then imposing a break which sees me going back to fingersticks.

Mixing up flash monitoring with fingersticks helps to keep things fresh and exciting for me. These little breaks help me to clear my head from the constant flow of data that’s just a scan away. It helps me to re-evaluate my glucose monitoring habits, and whether I am checking my blood sugar out of necessity or simply for the sake of it. It also keeps me from becoming too reliant on the Libre, considering it is costly and not currently subsidised here in Australia.

However, I have also found fingersticks challenging after using the Libre. Over the past year or so, I’ve been learning a lot about my blood sugars and applying some of these observations towards my diabetes decision making. I usually apply a new sensor with the intent of, for example, analysing my overnight line or basal testing my work day mornings. But with diabetes being diabetes, two weeks is simply not enough to complete all of those little tasks I’ve set out to achieve.

Coming off the Libre has felt a bit like driving somewhere south of the river without directions. I’ve often found myself feeling lost in those little problem spots, anxiously trying to keep my head above water with finger sticks. By the time my self imposed break is up, I’m ready for a new sensor.

However at the moment, I find myself in somewhat unchartered territory.

I’m currently in my longest stretch on fingersticks since I first began using the FreeStyle Libre last year. There are two unopened boxes of Libre sensors on my shelf, and I haven’t felt any desire to put them to use in some time.

I don’t feel like I am struggling without it. I’ve applied what I’ve learned and observed. The problem spots are slowly but surely smoothing out, and starting to feel less problematic. I feel…comfortable.

I guess I have always perceived the Libre as a tool to evaluate elements of my diabetes management, rather than a tool to directly make my decisions from every day.

At the moment, I feel like I am where I have wanted to be for a long time.

Mystery of the Varying Overnight Basals

1 Comment

Last week was an exhausting week for many reasons that had absolutely nothing to do with diabetes.

Yet surprisingly, my blood sugars have been cruising along at the best they’ve been in weeks.

I’ve been struggling with my overnight basal rates in recent weeks. There have been some uncomfortable overnight lows, and then there have been other mornings where I’ve woken up frustratingly high. Alarms have been going off 2 or 3 times each night, instead of the usual one.

Things have felt rather inconsistent of late, so I decided to slap on a new FreeStyle Libre sensor last week to try and nut things out. I think I have finally cracked the mystery of the varying overnight basal needs.

If I go to bed sitting in the 7s or 8s, my overnights look something like this.


Looking at the gradual rise from around 4am, I’d be ready to make a basal change.

But when I go to bed sitting in the 5s or 6s on the same basal rate, my nights end up looking like this.

So it seems that my insulin sensitivity is far better when I go to bed in the 5s and 6s. I cruise along much more smoothly during the night, and my blood sugars get off to a much better start when my day begins in range.

So I’m now trying to be a little more bolder with my corrections at bedtime, in the hopes that I can replicate these levels and a decent night’s sleep more often.

Diabetes has so many little intricacies. It always keeps me on my toes, and I’m still learning new things about it after seven years.

Libre-less

1 Comment

It’s no secret that I have continued to use the FreeStyle Libre with much enthusiasm in recent months, albeit intermittently. I frequently talk about it on Twitter, I often refer to trend arrows in my blog posts and it’s a popular subject of messages that arrive in my e-mail inbox. Not to mention how instagrammable that graph is, especially when the line is flat.


Yeah, paying $95 to monitor my blood glucose like this every two weeks absolutely sucks. But overall, it has improved the quality of my life, and I am starting to come around to justifying those costs.

For my needs, it is perfect. I check my blood sugar frequently through the day, so this fits the bill nicely in adding some convenience to that. I like that the hardware is minimal, and that it doesn’t use a lot of real estate on my body. The only upkeep is the round sensor every two weeks, which makes it a cheaper alternative to Continuous Glucose Monitoring.

I guess where I have struggled the most is setting boundaries around the data. I find it easy to become obsessed with the numbers after wearing it for too long.

My behaviour hasn’t been too healthy during the life of my last sensor. I’ve been compulsively checking my levels before I’ve even finished my dinner, and again on the couch in the evenings while I’m watching television. The trend arrows have been really frustrating to see at times, and I find it hard to remind myself that they are only temporary. Against better judgement, I do tend to micro manage data, which sends me low far more often than I should be.

So why haven’t I taken a break from it sooner? Firstly, I wanted to give myself every advantage in getting the best hba1c that I could. Turns out that I was being much too hard on myself, because it exceeded my expectations by a country mile. Then earlier this month, I hit a speedbump where I was literally spiking after everything that I ate. I was too scared to be without it until I had figured the problem out. But I am slowly moving past that issue (more on that, soon).

I’ve been Libre-less for almost a week now, and all that anxiety is gone. I stop to check my blood sugar prior to meals, and one and two hours after meals. I’m forced to think about whether I actually need to check my blood sugar, or whether I’m simply doing it because I can. My head isn’t consumed by numbers so much, and my mood isn’t dependent on trend arrows. In fact, the numbers have been better than they were during the life of my last sensor, and I’m not hypoing so often from micro managing.

The morale of this story is that time away from the tech is equally as valuable as the tech itself. It gives me a chance to actually appreciate the tools I am using, and what I’ve been able to achieve with them.

My life is more than just numbers, and time away from the tech is definitely helping me to realise this once again.