Diabetes and Travel

Red Light.

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I glance at the watch on my wrist. I know that it will only take me a minute, but it’s 4 o’clock and I really want to get out of here already.

I make the trek outside, where my car is conveniently parked in its usual spot at the end closest to the centre door. It’s a longer walk in the morning, when I have to come in through the back entrance, but completely worth it at the end of the day.

I hop inside my car, and place my belongings on the vacant seat beside me. I know that it will only take me a minute, but I really just want to start making my way home where afternoon coffee is calling my name.

I place my keys in the ignition, lock my doors and wind down my windows. I reverse out of my spot and make my way out of the carpark, cutting through some of the quieter residential areas in order to avoid the pile up of traffic on my way out of the centre. I make one final right, which takes me back out onto the main road and in a far better position traffic wise.

Finally, I have what I’ve been waiting for as I begin to apply my brakes, slide my gears back into neutral and cars begin to bank up in front of me. A red light.

I only have a minute, but I know I can do it.

I dive into my bag, pull out my travel case and grab my meter, strips and lancing device. I quickly pop open the cap on my test strip vial and slide out a fresh strip, sticking it into my blood glucose meter. I prick my finger with the lancing device, and squeeze my fingertip. A little drop of blood appears on my fingertip, but I know its not enough. I squeeze again, harder, like I’m holding on tightly for dear life.

Part of me knows I don’t have enough blood, but the other hasty part of my brain watching the traffic light tells me I can do this. I bring the meter closer to my fingertip, and let the blood slide onto the end of the test strip.

A shrill BEEEEEEP! Sounds from my meter as a strip fill error appears on the screen. My absolute pet hate when it comes to living with diabetes.

I furiously rip out the useless test strip, pop open the cap on my vial of strips and slide out a new one. I stick it onto the end of my meter, shove my lancing device right up against the tip of my finger and prick again. This time, blood flows more freely. Satisfied, the test strip laps it up and decides to give me a blood glucose reading.

I quickly wipe the excess blood on my fingertip against the side of the test strip as the light changes to green and traffic begins to move. I fling everything on the passenger seat beside me, which I’ll clean up during the next red light.

The YpsoPump Launch Event

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My first week with the YpsoPump saw me in holiday eat-and-bolus-without-really-thinking-too-much-about-diabetes mode. Not to mention that it was my return to insulin pumping following a month long break. Week two saw me back at home with one of the worst Winter colds I’ve had in years and some of the craziest insulin resistance I’ve seen. It’s now week three and I’m just beginning to return to some sense of normality with the ‘betes.

Safe to say, I feel as though I’ve already been through a lot with this pump in the short time we’ve known each other. I really am enjoying the YpsoPump for its sleekness and light weight nature, and you can also check out my Instagram stories for more insight here. I’ll have some more to share here soon, I just don’t think I can fairly review a pump without using it for a good few weeks.

I had never even heard of the YpsoPump prior to searching the TGA website earlier this year in desperation for any signs of new insulin pump choices following the demise of Animas. I then noticed fellow blogger Ashley of Bittersweet Diagnosis had been trialling the YpsoPump, indicating that an Australian launch was on the horizon. A bit later on, I was fortunate enough to receive my own invitation to a launch event held in Sydney three weeks ago.

We were introduced to a Swiss company called Ypsomed (pronounced “Ipsomed”). As a manufacturer of tailor made insulin injection pens and autoinjectors, the company vision is to make self care simpler and easier. We were told that the company had a long, successful history of insulin pumps in the world, dating back to 1985. The YpsoPump had been designed to fill the gap in a market filled with complex, medical looking devices.

Ypsomed’s portfolio of diabetes products fall under the company’s Mylife Diabetescare brand. Encouragingly, their portfolio extended to people on Multiple Daily Injections and structured blood glucose monitoring. Products included clickfine needles, lancets, injection pens and a new Unio Neva blood glucose monitor using a custom brand of test strips. Not to mention that YpsoPump’s companion ‘Mylife’ smartphone app would also be useful to people not on a pump (it’s a free download from your App or Google Play store).

We were shown a roadmap of future upgrades to the YpsoPump system. This included the addition of the Unio Neva blood glucose meter that would send blood glucose readings to the Mylife smartphone app via Bluetooth. Ypsomed are also in discussions with manufacturers to add CGM integration into the pump. The YpsoPump will eventually be able to be controlled remotely via the smartphone app, but this looks to be at least 12-18 months away.

Ypsomed is also manufacturer of the wildly popular Omnipod tubeless insulin pump, which received TGA approval some time ago but has not yet managed to surface. The NDSS funds insulin pump consumables here in Australia, while private health insurers fund the actual device. Ypsomed have not been able to find a way to fit the funding model here in Australia due to the disposable nature of the Omnipod.

In response, we were told that a smaller ‘YpsoPod’ is currently in development with an expected 2021/22 completion. One half is disposable while one half is durable, meaning that this pump would fit the funding model in Australia.

Everything sounded really encouraging, with Ypsomed assuring us that they are here to stay and committed to the Australian market. This includes a dedicated Australian based customer service team. I’m also looking forward to catching up with a member of the Ypsomed team visiting Perth this week.

At the end of the day, more choice for people with diabetes is always a good thing. A massive thank you to Ypsomed Australia for having people with diabetes there.

Disclosures: Ypsomed Australia covered my travel and accommodation expenses to attend the launch event in Sydney. I was fed and watered across the duration of the event. I also received a YpsoPump and consumables to take home and trial. There was no expectation that I would blog about Ypsomed or the YpsoPump. My opinions and my time, including the annual leave I took from work to attend, are my own.

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.

Taking a Plunge

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The shimmering blue water slowly began to emerge as I made my way up the highway, perfectly contrasted and coordinated at the same time with the bright blue sky above.

I manoeuvred into the right turn lane and made my way into the carpark, which was almost deserted on a Thursday afternoon. I grabbed my blue and white AMSL drawstring bag containing a towel, bottle of sunscreen, a dry shirt and glucose tabs.

My insulin pump was clipped to the inside of the pocket in my swim shorts, still running as per normal. My blood sugar was 9.3 before I left home. With 2 units of insulin left to act from lunch and some protein in play, I felt fairly confident to let it ride.

My comfy brown thongs with blue and red striped cotton straps came off as I buried my feet in the soft, white sand. I made my way closer to the shore line and perched my bag in the sand, setting up ship.

I disconnected my pump from the infusion site on my stomach and wrapped it up in the beach towel in my bag, not overly worried about insulin spoiling on that breezy thirty degree day. I slapped a load of sunscreen over my pale skin, recalling sore throbbing red marks of sunburn that were a painful reminder of previous non-compliant days in the sun.

The gentle wind whipped through my hair and burst onto my face. I could feel the refreshingly cold water hit my toes as I began to wade my way into the water. The salty sea spray hit my face as the waves crashed over the water and the bottom half of my body became submerged underneath it.

With the top half of my body feeling the cold of the sea spray, I took a plunge beneath the water.

As the waves pushed their way over me, crashed and then receded, with the sun shining brightly over the clear blue sky, I wasn’t thinking about diabetes. I wasn’t thinking about work. I wasn’t thinking about life.

I was drifting there, savouring the moment.

It felt good.

Review: Myabetic ‘Banting’ Diabetes Wallet

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I’m feeling a bit unsure about the new Myabetic bag that I received for Christmas.

After years of having to decide what to bring with me every time I left the house and walking around with bulky pockets and slipping pants, travelling with a pencil case to house my diabetes gear was a huge relief.

Everything fits in there quite nicely. Meter, test strips, lancing device, spare lancets, spare batteries, insulin, spare needles, an infusion site, spare insulin cartridge, spare pump cap, spare battery cap and my Animas coin to open up my pump. Plus, it looks nice and roomy in there if I need to reach in and grab something.

I carried my pencil case with me everywhere. My only desire was to find something a bit more compact and impact resistant. Which brought me to Myabetic.

When I first opened the parcel containing my new ‘Banting’ Diabetes Wallet, named after the creator of insulin himself, my initial impression was that it looked a lot bigger in real life than it did on the website.

As I began trying to squeeze all of the gear from my pencil case into the little zips, pockets and compartments of the Myabetic, I immediately felt very restricted with what I could carry.

The large velcro envelope housed my meter and test strips. The loop adjacent to the meter pouch was intended for test strip tubes, however the wider oval shape of my Accu Chek guide test strips rendered it unusable. I did manage to squeeze my glucose tabs there, but not without a great deal of effort.

There were two loops equipped to carry insulin pens, and I opted to use the spare loop to carry my lancing device.

There was a removable waste pouch which cleverly housed used test strips and needles. I opted to use it to house my spare (unpackaged) pump site and infusion set. The final mesh pouch was just enough to fit spare needles, lancets and batteries.

I genuinely did like that compared to my pencil case, the Myabetic was a lot more compact and easier to carry around. Not to mention impact resistant. But unfortunately, it was also just a bit too flashy for my liking, even when I carried it with me to a wedding earlier this month. Perhaps in this regard it would be more suited to the girls.

Having to open all of the little zippers and compartments to get to my stuff also felt like a lot of effort when I already have a needy chronic condition to manage. I’m also carrying pump gear on me, so perhaps things would be simpler if I were just on Multiple Daily Injections.

I’ve no doubt that the Myabetic is a clever creation and has won itself legions of fans all over the world. For the time being, though, I think I’ll just keep mine in the spare drawer until a special occasion calls.

The Myabetic collection of diabetes bags can be found here. For those of you in Australia, they are also distributed through Rockadex and One and 2.