Diabetes and Travel

Holi-daze

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I’m back home this week after some much needed time out in Melbourne, and unfortunately back to the grind tomorrow. I didn’t really believe that Melbourne was capable of producing so many nice days (sans an icky 44 degrees at the Australian Open on Thursday), but it was nice to spend so much time outdoors. 

As I was on the plane home over the weekend, I came to this realisation that I hadn’t once given a thought to work throughout the week. Nor e-mails. Nor meals. Nor agendas or general life admin. 

It was a stark contrast to the (very limited) time that I had off over Christmas. I spent my time clearing out my filing cabinet. Catching up on the magazines and newsletters that I hadn’t gotten around to over the year. Clearing some virtual space on my Macbook. Vacuuming the dust from the floor and wiping away the coffee and bloodstains from my desk. 

I was still thinking about the daily grind. The time was over before I knew it.

Going away is truly amazing in its ability to pull me away from my environment and take my mind away from the grind. No morning alarms. No work. Nothing to think about except for what I wanted to do today. By the time it was over, I felt as though I had been gone for ages. 

The only thing that I did have to bring with me, unfortunately, was diabetes.  

Holidays are always a bit of a fine balance. There are lots of extra carbs (read: plenty of coffees and trips to Brunetti). But there’s also a lot of extra walking, which has the potential to send me low. 

Overall, I was pretty happy with my BGs while I was away. I was more generous than usual with my insulin guesstimates, thinking about the greater likelihood of going high after the carbs rather than low. There were a couple of lows, but all of the walking around mostly helped to keep things level. There were a few stubborn blips, particularly in the evenings, but overall I didn’t spend my nights battling sustained highs. 

Now, reality has sunk back in. But I feel somewhat refreshed. And ready to tackle what this year has in store for me. 

Road Trip.

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When I go travelling (and that’s a very loose term, given I have never ventured beyond Australia), I spend a lot of time thinking about whether I have packed enough supplies to last me the distance. I give a lot of thought to how I will manage if I get stranded, lost, delayed or even robbed. I pack for the trip through airport security and the plane, in an attempt to make my load as light and convenient as possible.

What I don’t really give a lot of thought to, however, is how I will manage my diabetes on the trip. Travel tends to be a break from the daily grind, and diabetes management unintentionally tends to go onto the backburner. It’s also full of spontaneity which, for me, includes a lot of unplanned carbs (read: Cannoli) and physical activity.

This weekend, my travel plans were a little different to what I was used to. I wouldn’t be travelling by air, with the luxury of being able to sleep, write or watch Netflix from the comfort of my seat. I wouldn’t be sightseeing or walking a lot, either. I would be seated behind the wheel of my car, making a road trip three hours south of Perth to spend some time with family.

This time around, I was increasingly conscious of looking after my blood sugars while I was making my way through country roads at 110 kilometres per hour. I didn’t particularly want to be sharing screen time with my insulin pump, pricking my fingers or thinking all that much about blood sugars.

Even though I would inevitably be eating out, I was increasingly conscious of ordering something that would be simple to carb count. I chose bacon and eggs at a local Dome along the way, with an iced latte. I gave a small bolus for the coffee and half slice of toast that I ate, and ran an extended bolus to cover the protein over two and a half hours.

I might have pulled my Libre reader out three or four times during the drive home, which came back with a number that remained fairly steady the entire time. The most eventful moment was me needing to pull over to take off my jacket as the overcast south western skies transitioned into warm Perth sunshine.

I didn’t spend too much time thinking about my diabetes during the road trip, and the spectacular drive was a surprisingly nice mental break.

During a conversation over the weekend, one of my family members suggested that I must know my body really well, and how it reacts to all of the variables that affect blood sugars. It couldn’t be more spot on.

I have so much accumulated knowledge when it comes to managing my diabetes, and I definitely need to channel some of that into a better game plan next time I hit the road (which is more likely to be a plane).

#HealtheVoicesAU 2018

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Last weekend, I was lucky enough to get to Sydney to attend HealtheVoices (which I learned is actually spoken more like ‘healthy voices’ rather than ‘health-e-voices’).

After seeing the wild popularity of this conference among folks in the diabetes community who had attended US editions in recent years, I was curious to see what it was all about. This was the second edition that had been held in Australia, and my first time attending. Even if I didn’t get anything out of it, I figured it would still be worth attending just to catch up with some of the diabetes gang that would be there.

HealtheVoices is run by a company called Janssen (pronounced yaan-sen), which I believe is the pharmaceutical division of Johnson and Johnson. Their mission is to create a world without disease, and hence this program which is designed to support online health communities and advocates.

I guess this was a uniquely unique conference experience for me, because it put diabetes into a broader perspective of other health conditions. Just like diabetes, many of the other conditions represented there appeared largely invisible. I’d be lying if I said I didn’t find myself wondering where diabetes ‘sits’ in relation to all of the other conditions there.

Some of the other health conditions represented there included crohn’s, colitis, arthritis, various cancers and cystic fibrosis related diabetes. There were people living with the conditions, representatives from health organisations and carers. I was once again on the receiving end of stunned looks upon telling people I had travelled all the way from Perth.

SANE Australia, who appeared to be a major partner of the conference, supplied at least 20 or 30 mental health peer ambassadors, which speaks volumes about the prevalence and need to address mental health.

Throughout the weekend, I found myself explaining to others how the diabetes community operates, and how the diabetes ‘gang’ has become somewhat of a close knit group through social media, industry sponsored events, advocacy work and similar interests.

As I was listening to keynote speeches and personal experiences being shared on stage, I was left wondering what ‘community’ looked like for people living with health conditions other than diabetes.

Just last week, I wrote about how I have so many different ‘tribes’ that make up my diabetes support system. It couldn’t be more true. Because no matter where I am or who I am with, being part of the diabetes community always makes me feel that I am part of something bigger. I always, always, always feel like I am part of a community that has my back.

I really wondered about the dynamics of other health communities, what sort of a role consumers have in those communities, and whether they were as ‘closely knit’ as mine.

Something tells me that the diabetes community really is leading the way.

Disclosure: Janssen ANZ covered my flights, accommodation and shuttle to Sydney airport to attend HealtheVoices. Dad gave me a lift to and from Perth airport, and I happily paid for my train fare into Sydney CBD as I wished to arrive earlier in the day. I was fed and watered across the duration of the event, and also received a tote bag with some HealtheVoices stationery. 

The only condition of my attendance is that I would disclose the above if I chose to share my experience online. These thoughts are entirely my own. I happily gave up a day of annual leave from work to attend, as well as my Saturday.

Cellnovo on Show at the Diabetes Congress

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I had the pleasure of reconnecting with the Cellnovo team at the Australasian Diabetes Congress last month.

The Cellnovo insulin pump launched 12 months ago, with the availability of consumables on the NDSS eventually delayed by a month. The system consists of a small rechargeable pump that sticks to a velcro patch on the body, a very short line and an infusion set that sits within close proximity to the pump. The system is controlled wirelessly via a mobile handset. You can read more of my observations from last year’s launch here.

There were rumours circulating earlier this year around the system being unable to withstand the heat of the Australian summer. I was told that this issue was nothing more than a temperature sensor in the pump that alerted users when insulin was at risk of spoiling, such as during hot days at the beach (Tandem’s t:slim pump also contains an insulin thermometer). I believe that the system may have since been upgraded to address the uber-sensitivity of the alarms.

Last year Aaron Crook was the sole sales rep, travelling all over Australia where the demand took him. There are now several new additions to the team. I was pleased to meet a dedicated sales rep for Western Australia, who reminded me that we had met previously when she had worked for Roche (and shown me how to use the eject button on the AccuCheck Guide!)

Cellnovo will soon be rolling out a new handset to all of their customers. The upgrade features a larger screen than its predecessor, and is also much slimmer and sleeker to hold in my hands. I am told the primary reason for this upgrade is enhanced performance. The team are also in disagreement on its new colour scheme, which gets a thumbs up from me.

The upgrade has come at the expense of the test strip port that was built into the handset. For the Cellnovo customer who may not be too keen on attachment, the prospect of now having to carry a blood glucose meter may be a big deal.

For the time being, users will need to manually enter their blood glucose readings into the handset to use the bolus calculator. However I was told that the handset will soon be compatible with a variety of wireless blood glucose meters, meaning that readings will wirelessly transmit to the handset via Bluetooth.

I really like the idea of having a separate handset to control the pump. With the emerging integration of diabetes management into smartphone apps, phone performance and battery drain has definitely been very noticeable for me in recent months. It’s also good to know that I could leave my phone on my desk if I wish to.

Cellnovo may not sit in the ranks of Medtronic or Tandem, but they are clearly focussed on filling a gap in the insulin pumping market. There are many people who don’t wish to take up insulin pump therapy for the sake of attachment and pump lines and weight and complexity.

I feel that Cellnovo is the option that may get many to reconsider their feelings toward insulin pump therapy.

Disclosures: Diabetes Australia covered my travel, accommodation and registration costs to attend the Australasian Diabetes Congress. These are my own views, and not those of Diabetes Australia. My time, including the annual leave I took from work to attend, was my own.

The Diabetes Social Media Summit

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On the Tuesday prior to the Australasian Diabetes Congress, I was lucky enough to be a part of the Oz Diabetes Social Media Summit. Brought together by a company called Ascensia Diabetes Care, the afternoon brought together a group of Aussie diabetes bloggers in Adelaide. You can also check out Renza’s recap of the Summit at Diabetogenic, and also search for #OzDSMS on Twitter to see what was Tweeted through the day.

Prior to being invited to this event, I honestly didn’t know a lot about Ascensia. I knew that these guys were connected to the Contour blood glucose meters many Medtronic insulin pumpers use. The ones that wirelessly Bluetooth blood glucose readings to the pump.

I’ve also seen Ascensia pop up on Twitter over the past couple of months, and much to their credit it is a handle that I would actually want to follow. Their feed is definitely one of those ones that genuinely wants to be a part of the diabetes community, rather than constantly spruiking company culture. I genuinely got the same feel from the team who were present with us in the room (and I’m not just saying that because they supplied a coffee machine!).

Ascensia were formed from the sale of the Bayer Diabetes Care business, and their point of difference is that they’re only focussed on diabetes. Part of the reason for our convention was the launch of their Contour Next One wireless blood glucose meter, which apparently boasts the greatest level of accuracy on the market. Bionic Wookiee David Burren has written more about the meter here.

In a room full of privilege, it was really good to hear standard blood glucose monitoring being given the emphasis it deserved. CDE Cheryl Steele from Victoria presented to us on the importance of having an accurate device to calibrate a CGM, and Bionic Wookiee David is living proof of a backup plan!

Grumpy Pumper hit the nail on the head in highlighting that the majority of people with diabetes actually manage with blood glucose monitors and insulin pens. I still manage on finger pricks for about 50% of the time, and I certainly welcome innovation in blood glucose monitoring as well.

I was happy to hear Ascensia’s vision for interconnected diabetes management, rather than pushing one line or avenue of products. We were told that their aim is to be a calibration partner of choice for insulin pump and CGM systems, as well as having formed partnerships with several data management platforms such as Diasend. All of this gives us more choice in the technologies that we may wish to use around our blood glucose meter. More choice for people with diabetes is always a good thing.

During the afternoon, we also heard from special guest Grumpy Pumper from the UK. Despite the persona he portrays online, Grumps is honestly a really genuine guy. Diagnosed in 1994 with no internet or social media, Grumps was doing the best he could with the limited information he had at the time. His sentiments definitely resonated with me and others in the room, which really says something about how many people with diabetes there are still being left in the dark today.

Grumps also shared with us his movement around encouraging other people with diabetes to talk about diabetes complications. It started with a foot infection and a simple Tweet expressing that he wasn’t ashamed of his diabetes complications, assuming that he wasn’t the only one who had them. He has inspired people to open up about their diabetes complications through a hugely popular series of guest posts on his blog.

To be honest, I was a little quieter than normal during this event. Usually, you can just tell that I want to say something by reading the look on my face. But these conversations were bigger than issues we’ve tackled at previous diabetes events. There were questions left unanswered that I honestly don’t know how to tackle.

I am a really, really privileged person. I don’t represent all people with diabetes. If I’m being honest, I’ve been struggling lately with the idea that perhaps I’m not as ‘identifiable’ as I once was because of the privilege I have.

How do we get the level of engagement that was in that room at OzDSMS, outside the room? How do we make sure that every person with diabetes knows about all of the options available to them in managing their diabetes? As Grumps put it, how many people will actually know that there’s a new blood glucose meter on the market today?

Disclosures: Ascensia Diabetes Care hosted me at the Adelaide Convention Centre, before migrating us to Adelaide Oval for dinner, on the Tuesday prior to the Australasian Diabetes Congress. I was already in Adelaide as a guest of Diabetes Australia.

I was fed and watered across the duration of the afternoon and evening. I also received a goodie bag containing a Contour Next One meter, test strips, information packets and lancets that will likely last me a lifetime.

There was no expectation that I would blog about the event. My opinions and my time, including the annual leave I took from work to attend, are my own.