July DSMA Blog Carnival


Blood glucose.  It’s front and center when it comes to diabetes.  It is how we get diagnosed and it is what we are trying to manage.  An important tool we use to manage our blood glucose is our meter and its strips.  But what happens if our meters aren’t giving reliable information?  Let’s explore that this month as we discuss a topic from the June 26th chat Fill in the Blank.  Weigh in on the following statement:

Test strip accuracy is important to me because______.

…because if they are not accurate then we are screwed!

Testing my blood sugars gives me a window into my health. It gives me an empirical/numerical value in which I can judge, and over time the blood sugar values can ultimately tell me how healthy I have been. Now certainly a high blood sugar every once in a while is nothing to stress about but it is still something I take note of and try to figure out what I did to make it high so I can log it into my mental diabetes database. I essentially like to keep track of a rough A1C day to day (CGM is wonderful for this). So of course having accurate testing devices is super important for me to have an accurate picture of my health.

One of the main things that frightens me is the knowledge that at some point in my life I could go blind or lose some fingers/toes or, hell, even lose a limb all because of diabetes. This really scares me. And because of this fear I try to always have complete control of my blood sugars. Its actually weird that high blood sugars upset me more then low blood sugars which are immediately dangerous. So having accurate test strips and glucose meters are crucial for me to know that I won’t have serious health complications due to diabetes or can at least prolong the diabetic health complications until I am way old and have health problems any way.

Since my diagnosis I have been using diabetes as a tool to live a more healthy life. Its my way of “looking on the bright side” of having diabetes. Pre-diagmonsis: I was very unhealthy. Never working out, eating too much crap, smoking cigarettes, and drinking too much too often; pretty much just being a stereotypical college guy. Post-diagnosis: I work out every other day, I heavily limit my sugar/carb intake, I don’t smoke, I rarely drink (and even more rarely over indulge); basically a complete 360 from where I was. And because I believe that my blood sugar testing equipment is accurate (or as accurate as possible) I know that the effort into being more healthy and controlling my blood sugars is not in vain.

So a simple answer to the original question: Test strip accuracy is important to me because I want to stay healthy.

“This post is my July entry in the DSMA Blog Carnival.  If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2013/july-dsma-blog-carnival-3/

Tandem T:Slim Review


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Recently I have acquired an insulin pump (Tandem T:slim) and it has made managing my diabetes so much easier. I essentially have insulin-on-demand now and no longer have to carry so many “diabetic supplies” such as my insulin pens (Humalog and Lantus) and extra pen needles. You no longer need to have two different types of insulin with a pump (fast acting and long acting) because you use fast acting insulin to compensate for the long acting insulin. It really has given me more control over my diabetes, therefore giving me more control over my life. I highly recommend any one who does not use an insulin pump to seriously consider getting one. Granted, they are not for every one but all I ask is you do not automatically rule it out.

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About a week ago my new t:slim pump arrived and I am absolutely loving it. Like I said it has really changed how I manage my diabetes. The t:slim has so many great features that really make it stand out and truly makes it a great pump.

Micro-Delivery System

First off Tandem has truly revolutionized the actual pumping technology of the insulin pump. They have developed a micro-delivery system to disperse the insulin in bursts rather than in one steady stream. Other pumps use a system that is essentially an electronic syringe whereas the t:slim uses an electronic syringe system with an addition of a device that separates the insulin into smaller doses. It was developed as a safety feature so you cannot not receive one big dose of insulin but rather several small ones. As an example say you need a bolus of 8 units, instead of getting all 8 at once the t:slim would give you 2u-2u-2u-2u over the course of a second. This video will display the micro-delivery system technology better:

Color Touch Screen

Another great feature of the t:slim is the color touch screen. The color screen makes the pump much more pleasant to look at while the touch screen makes it very user friendly. “But what if you accidentally hit the screen and administer a bolus to kill all other boluses?” Good question! The pump has a lock screen which you have to tap buttons in a sequential order to unlock, so it is nearly impossible that you will pocket bolus. On the screen itself, it displays graphics in the corners to let you know exactly how much battery life you have and how much insulin is left in the reservoir. Along the bottom of the screen, the pump shows you the Insulin on Board (IOB: the insulin still in your system) and well as the time remaining until the insulin is no longer in your system. This really gives you a good idea how much insulin to take and keeps you from “stacking” your insulin which can often lead to a low blood sugar disaster.

Bolus and Basal Insulin

The pump also has some unique features when it comes managing and using your insulin. You can set your basal rate down to the third decimal place. Mine right now (I am still fiddling with the numbers a little bit) is .487, which means that every hour I receive .487 units for a total of 11.7 units over 24 hours. The three decimal places really gives you a lot of control over your basal rates and provides greater accuracy when setting your rates. You can also setup temporary basal rates for times when you are sick/stressed, have low/high blood sugars, disconnecting for a couple hours, or anything that requires an altered basal rate.

In the course of making a profile (which stores all your info) you will input values for your insulin to carb ratio, a correction factor, and your ideal blood sugar level. The insulin to carb ratio means 1 unit of insulin counteracts X grams of carbs. The correction factor is a ratio that represents 1 unit of insulin lowers your blood sugar X mg/dL. When administering a bolus, the pump takes into account your current blood sugar level, the amount of carbs you are about to eat, the IOB, the correction factor, and the carb ratio to give you a projection/recommendation for a bolus amount to keep you at your target blood sugar level. Of course you can manually change the recommendation if you feel it is too much/not enough insulin. The pump also has a quick bolus feature which allows you set a desired insulin amount and can administer it with the touch of a button. You can also extend a bolus meaning you can administer X% of a bolus now and X% at a later time which is good for long periods of snacking or maybe even pizza.

Other Nice Features

  1. Water tight up to 3 ft for 30 minutes
  2. 300 unit insulin reservoir
  3. USB conectivity
  4. T:connect application to keep track of insulin usage and other diabetes data
  5. Alerts and reminders (re-test blood sugar after low/high, low insulin the reservoir, low battery, bolus not delivered, etc.)

This is just a brief overview of the Tandem t:slim’s more unique features. If you want to find out more about this pump you can check YouTube for more videos and you can also check out there website here. As I mentioned before the pump has been life changing and seriously recommend people to check out the t:slim and insulin pumps in general.

Pump Love


As you may or may not know, I bought an insulin pump and have been using it for less than a week now but I can already say that I love it. It has made my life so much easier. I no longer have to carry a separate case for my insulin pens and needles. The less I have to carry around the better. In fact, the only part of pumping that really worried me was being able to sleep with the pump clipped onto the waistband of my boxers and the hose getting tangled or pinned underneath me. But I have been sleeping fine with it and the hose/pump has not been bothersome at all. Which is good because lord knows I value my sleep.

The Tandem representative that came to my house was very helpful but ended up not wanting me to get hooked up to the pump. She requested some orders from my doctor for my basal rates, carb ratios and correction factors but the doc has yet to come through. So she did not want me to do anything with out the doctors consent. But me being an eager beaver decided to just hook myself up any way and use the numbers which I know to be accurate from my experiences. So I made the decision to bypass the doctor for now until I hear word and can cross reference our numbers.

But all that said, let me reiterate how much I am enjoying the pump and I definitely recommend the t:slim to people new to pumping or people who just want a new pump. Keep and eye out for a full review of the features of the T:slim in the coming days.

Finally!


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After a few months of waiting it is finally here, my new Tandem t:slim insulin pump! I am pumped (nice pun eh?). Unfortunately it took several months for me to actually get the pump but the wait is finally over. Last week I received confirmation that my health insurance provider deemed the pump to be “medically necessary” and have decided to cover some of the expenses. So here I am a week later with my brand new insulin pump and just in time for my birthday too!

The only down side is I have to wait until Friday before I can hook my self up. Well I guess I don’t have to wait but it is advised that I do. On Friday, the Tandem rep in my area is coming over to my house again to help me get setup with my basal rates and to train me on the pump. Talk about good customer service, eh? It’s not every day a company sends some one to your house to help you out. She has been nice enough to contact my doctor and endo to get my basal rate information so she can fully help get me started pumping.

I am really looking forward to start pumping as well as beginning my life as a complete diabetic cyborg! I have a feeling this pump will be a game changer!