‘I Suppose You Don’t Eat Chocolate’

‘There’ll be some really good bargains tomorrow,’ my boss said to me, referring to our Easter sale. (Also, one of the best things to come out of Coronavirus.) ‘Oh, I suppose you don’t eat chocolate,’ he replied.

‘I love chocolate,’ I said, desperately trying to pretend I didn’t know exactly where this was going.

‘Really.’ He seemed surprised. ‘I didn’t think you could eat chocolate, being a diabetic,’ he replied, in an inquisitive sort of a fashion.

Then, without even having to rack my brain for a witty/educational/de-stigmatising comeback, an utterly brilliant response just came out of my mouth.

‘I eat chocolate. I’m not too sure what other people with diabetes out there choose to eat, but I choose to eat chocolate.’

I have had this conversation hundreds of times. I’m sure I’ve written this blog post more times than I can count on my fingers. I am absolutely tired of writing it, just as I’m sure you are tired of reading it. But I’ll keep documenting the stigma, until the world finally gets it.

I want chocolate for Easter. Small eggs, hunting eggs, Dream bunnies, Lindt bunnies, Old Gold and Malteaster bunnies.

What I do or don’t choose to put into my mouth is nobody else’s business but my own. Contrary to what you might think, you are not being helpful by commenting on the food choices of any human being.

I live with diabetes 24 hours a day, 7 days a week, 365 days of the year (366 days in a leap year). Believe it or not, Easter really is no different. I really don’t need you to show even the slightest bit of concern about how I will manage my diabetes around it. I’ll be just fine.

The biggest problem that this diabetic faces this Easter is that he can’t seem to find any Cherry Ripe or speckled eggs on store shelves this year. They’re a favourite in our house, so if you do know of any tips, please be sure to send them my way.

Have a happy, safe and self isolated Easter.

Insignificance

Hi. How are you?

I’m still here. In the midst of everything going on at the moment, blogging and popping my head into the DOC now and then hasn’t exactly been at the forefront of my mind.

My need for news has definitely increased in recent weeks. Most of my phone activity of late has shifted toward the ABC’s excellent coverage, especially their live blog covering all of the key developments of the day in one place as they happen. Diabetes Australia’s updates also continue to do a fantastic job at keeping me both informed and reassured, even though social media has been on the back burner.

My need for connection and peer support has never been more important. My family helps me to make sense of this through many conversations over coffees and mealtimes. I’m checking in with friends, particularly thinking about some of my older ones whom I no longer work with. Going into work and being able to talk with my team mates and laugh over customer antics of the day is also extremely helpful in this department.

Most importantly, I need to keep myself aware of the current and ever changing health guidelines in order to keep myself safe during this time of crisis, just like any other person.

Diabetes has felt pretty insignificant in the context of what’s unfolding in the world right now. Quite honestly, I don’t feel any more concerned than I would if I didn’t have diabetes.

However, I am finding it difficult when people are asking me if I am worried, or if I am being ‘careful.’ I work really hard to take good care of myself each day, and now is no different. Even though I don’t need to prove this to anyone other than myself, it’s kind of disheartening that this is so unbelievable to the outside world.

I am also finding it difficult seeing so much content trying to editorialise diabetes and the coronavirus. I’m not even remotely interested in reading, hearing or giving into speculation of what a combination of diabetes and coronavirus might look like. All I will be paying attention to is the general health advice that everyone should be following right now.

I’m also finding it difficult hearing everyone making such a fuss about their safety away from home, when I don’t have much of a choice but to go to work each day to a job I’m extremely lucky to have. So, a massive shout out to all of the front line workers right now who are out there working under extremely difficult conditions, and rarely complain about doing so. Thank you.

I’m also busy chipping away at uni. It’s been a year since I embarked on this journey, and I’m grateful at how ‘settled’ I am with this routine compared to a year ago.

I’m getting outside as much as I can, and am very much looking forward to some cooler weather.

I’m also looking forward to a much needed Easter long weekend, and some much needed chocolate.

I’ll try to check in a bit more often, as time allows.

Stay safe, stay healthy and keep talking to each other.

Practicing Vigilance.

It’s hard not to feel anxious at the situation that’s unfolding here in Australia in the wake of Coronavirus, and the rest of the world. I don’t think I need to recap that for you here…

I am pleased to see the social distancing measures that have been put in place, particularly because at least the rest of Australia will see that this is something that we all have a responsibility to take seriously. I’m hardly capable of leading the country, so I’ll just trust that the measures we have in place are enough – and will evolve as needed. And that the Australian public will take this issue seriously to prevent transmission.

The one place I don’t particularly feel any heightened level of concern around is my diabetes. I don’t particularly feel the need to go shouting to the world that I am a high risk person, but I won’t judge you if that’s what makes you feel a little more at ease. At the dinner table last night, I was explaining to my family that my understanding is that the risks for PWD are not much different to anyone else. As with any other infection, diabetes may make dealing with an illness a little more difficult than not (See this piece from the International Diabetes Federation).

My diabetes back up plan is no different than normal. I filled my insulin prescription a month ago, and have more than enough there to see me through a good five or six months. I also have a backup script there in case of an emergency, which I know I won’t be needing anytime soon.

I keep three months worth of pump consumables in my wardrobe as per usual, and don’t intend on stockpiling any more. I place all of my orders directly through Diabetes WA’s online store, which saves me from being at the mercy of unreliable pharmacy wholesalers. (And yay for them finally stocking Choc-marshmallow glucose tabs!).

I also have some good friends in the Young Adult Diabetes Committee, and the broader diabetes community, who I know I can turn to for help in the unlikely event that I need it. Those diabetes people, as my Mum calls them, are some of the nicest people around. Use your community.

I don’t see the need to selfishly stockpile groceries. I must have at least a dozen supermarkets around me, something I frequently think is unnecessary, but is providing a lot of reassurance right now. I don’t anticipate any difficulty being able to access items, outside of people’s panic buying.

I guess I’m a little more anxious around going to work. I work in retail, but thankfully not a supermarket. But I do think supermarket workers are absolute heroes, and deserve your respect. So I guess I’m just being a little more vigilant than usual.

My hand hygiene is no different to what it usually is. I’ve been in a good routine of washing my hands for a long time, particularly before handling food and after activities involving contact with people and objects. I really credit that to not being sick all too often.

Yesterday, I trimmed my fingernails. I’m taking my water bottle home to wash every day, rather than once a week. From tomorrow, I’ve also decided that I won’t be using anything from the staff room kitchen.

Outside of that, I’ve been sticking to my New Year’s resolution of sleeping really well. More on that in another post. Keeping on top of my uni work. I’ve actually been reading. A lot (although I don’t see the hype in Mark Manson’s The Subtle Art of Not Giving a F***). I’m also super excited to FINALLY see people making moves on Survivor instead of following Dave like sheep.

The outdoors, as always, provides a great boost to my mindset. As does keeping peer support wrapped around me from friends with diabetes and the DOC. I’m also logging out of social media as and when I need to for my mental health during this time, too. And ignoring all sensationalist media, as always.

So, hi. How are you doing at the moment?

Talk to me, talk to your friends, talk to your fellow PWD. Take care of YOU.

I know that we’ll get through this. Stay safe.

Be Responsible.

I don’t ever like to think of my blog as giving advice. I share my own perspective on life with diabetes, you digest that however which way you wish. But today I’m going to break that rule and step on my soapbox for the next couple of minutes.

Earlier this evening, I came across a thread in a closed Facebook group. Not a diabetes one, for the record. The post in question was asking whether she was required to follow her employer’s request to self isolate at home for 14 days following upcoming overseas travel. For the record, her employer was rightly following direction from the Australian government.

What was worse was the commenters that followed. There were comments indicating no awareness of the requirement to self isolate, comments indicating no intention to self isolate following upcoming overseas travel, and comments suggesting that they were at equal risk in a retail workplace.

Not to mention that earlier this week, I learned that a friend had been in contact with someone who had not self isolated upon returning from overseas travel.

I just cannot believe that this is up for discussion.

This is not about what other people are or aren’t doing to precaution the spread of the Coronavirus.

This is not about how ‘fine’ you are feeling after overseas travel.

This is not about how ‘unlikely’ you are to observe symptoms.

This is not about how ‘low risk’ we currently are here in Australia.

This is not even about how disadvantaged you might be from not being able to go to work.

This is about protecting the people around you. The people you come into contact with every day and love and enjoy spending time with and hopefully don’t want to see harmed. It’s about minimising the spread of, from what I’m hearing is a highly contagious virus. It’s about minimising the burden on our health system here that will have to deal with this.

I count my lucky stars that I live in Australia every single day, and I really hope that the situation here remains the low risk that it currently is. I truly believe that responsibility rests on each and every one of us.

If you have returned from overseas travel, please think of the people around you and follow the government’s direction to self isolate at home for 14 days. If you are not feeling well, please think of the people around you and stay at home (or seek medical attention). Please wash your hands regularly. I’ve been doing this for years, and quite honestly it’s been my best defence against illness. Touch wood. And try not to touch your eyes, mouth or face.

A lot of this is simply common sense, regardless of what is currently happening.

I don’t believe that we need to panic, but we do need to be responsible.

I’ll leave a link to the Department of Health website here.

I’ll also leave a link to this post from Diabetes Daily around Coronavirus and diabetes.

I’m also finding the Twitter ‘Moments’ that pop up on my search page extremely useful for news updates on Coronavirus.

I’ll step down from my soapbox now.

Thanks for coming to my Ted Talk.

Diabetes Tech Updates: March 2020

A flurry of diabetes tech announcements of late, so in no particular order here’s what I have been hearing.

Dexcom G6 CGM Receives TGA Approval for Use in Australia.

The Dexcom G6 CGM system finally received approval in Australia last week from the Therapeutic Goods Administration (TGA). This new iteration of the system has been much anticipated for it’s slimmer profile, 10 day sensor wear and zero calibrations.

Presumably Aussie distributor AMSL Diabetes will now be figuring out their launch plans. I imagine this might include obtaining supply of the product into Australia, training customer service teams and healthcare professionals, marketing and pricing the product, transitioning customers over from G5 to G6 as well as getting it listed on the NDSS. Mid-year seems to be a conservative estimate at the moment.

For those of us using rebatteried transmitters, I think it’s worth noting that the G6 is unlikely to be as affordable as the G5. My understanding is that the transmitter’s internal clock cannot be reset, meaning that the transmitter will automatically shut down after 110 days. Have a read of Katie’s post here. Given how popular rebatteried transmitters are here in Australia, I’ve no doubt that AMSL and Dexcom will be looking to phase out the G5 eventually.

Tandem’s Basal IQ Update to the t:slim Insulin Pump

The other piece of the puzzle is Tandem’s Basal IQ update. This is a low glucose suspend software update to the t:slim pump, used in conjunction with the Dexcom G6. The TGA has approved the pump (t:slim), the CGM (G6), and will now have to approve the system (Basal IQ).

We have no indication that Basal IQ has been approved in Australia as of yet. My understanding is that local distributors receive no insight into clinical trials or other considerations that get a system like Basal IQ approved by the TGA. Approval of the G6 would be a positive indicator that it’s not too much further away. I’m confident that it may be ready for a ‘surprise’ launch at the Australasian Diabetes Congress in August.

FreeStyle Libre on the NDSS

FreeStyle Libre is finally available through the NDSS for Aussies who meet the eligibility criteria for the CGM subsidy scheme. The hold up was due to Abbott and the Department of Health being unable to agree on a price for the product for almost a year.

As NDSS Access Points, pharmacies are now able to supply the Libre. This also gives consumers who don’t meet the eligibility criteria the option of purchasing the product through their local pharmacy. Many people have reported on social media that the pharmacy price of Libre is around $130 – which is around $37.50 more than ordering direct from Abbott. It would seem that Abbott obtained the price that they were seeking from the Department of Health over the past year.

That puts Abbott’s 14 day sensor roughly on par with the reimbursement that Dexcom receive for their 7 day sensor. I find it interesting that Abbott’s reimbursement is on par with CGM, given they have traditionally held the stance that their product is not a CGM and have lobbied for funding considerations separately to other systems. A lower reimbursement price may have enabled the subsidy to reach a wider group of people.

Mylife Diabetescare/Ypsomed YpsoPump

I caught up with my local rep from Mylife Diabetescare at the Young Adult Diabetes Committee’s event over the weekend. The company is considering (but not yet confirmed) moving away from the Mylife Diabetescare brand and using the more well known ‘Ypsomed’ brand. Ypsomed is the manufacturer of the YpsoPump and consumables, Mylife Diabetescare is the branding applied to the products. I think…

A CGM partner is expected to be announced this year. My understanding is that this will allow the user to integrate CGM data into the Ypsomed app, rather than an update to the handset. Ypsomed’s cloud based data management software also now has the ability to connect to Diasend, which was something I specifically remember trying to do when I trialled the pump in 2018.

Finally, I’m still waiting on greater choice of infusion sets, which is what would get me back onto the YpsoPump. I’m told that they’re on the way. I would also love to see an update to the app so that syncing pump data isn’t as slow!

AccuChek meters in Woolworths supermarkets

Last week, Roche sent through a media release indicating that select blood glucose monitoring products will be available in Woolworths supermarkets from March. The products include AccuChek 5 Instant Blood Glucose Meters, Instant Test Strips and Softclix lancets.

The product range focusses on glucose monitoring products that are not currently subsidised through the NDSS. My understanding is that the target market may be people who cannot access these products as easily – such as people with type 2 diabetes, pre-diabetes or people who may be at risk of diabetes.

Kudos to having more choices and greater access!