This post is my June 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/june-dsma-blog-carnival-3/. I participated in the May blog carnival so this will be my second attempt/second go at a DSMA Blog Carnival and hopefully you will enjoy this one as much as you liked my last one.
The prompt for June is:
Regardless of which type of diabetes you have – T1 T2 or T3 – you probably use one or more diabetes devices on a daily basis. For this post, when we refer to devices we mean blood glucose meters, insulin pens or pumps, and all other diabetes medications. This month we’re going to revisit the May 15th chat on Diabetes Devices and really think about what we use. We’d like to know:
How do you select the diabetes devices you use? To others looking into new or replacement devices, what would be your best advice to someone shopping around?
I use the OneTouch Ultra 2 blood glucose meter and a OneTouch lancing device. They were the devices my doctor prescribed to me when I was first diagnosed, so I have not/did not shop around for any other glucose meters. I am unaware if there are other “better” ones out there, or if the one I have is top of the line, or if there is even a big difference between glucose meters. That being said, I have zero complaints with the meter. It is very accurate (from what I can tell) and you do not need much blood for the test strips which is definitely a plus.The supplies might be a little pricey but I figure most all diabetes supplies are expensive.
Two other essential devices are my insulin pens. I have a pen of Humalog and a pen of Lantus and obviously as a type 1 diabetic, my insulin “devices” are very important to me. For those who don’t know, the Humalog is the insulin I use before meals to counteract the food I eat, and the Lantus I take once every day and it is my long acting (basal) insulin that keeps my blood sugar in check for 24 hour periods. Although within the next couple of days/weeks I will be getting the t:slim insulin pump so I will no longer be needing my pens except for emergencies if the pump breaks down or something. Now, I did shop around for other pumps (looked at brochures and watched videos) but the t:slim really stood out as the pump for me. The sales lady made it a point to address how the t:slim was designed by diabetics where as other pumps were designed by engineers with diabetics in mind. I think using a product that is for diabetics by diabetics speaks volumes about that product and how people with diabetes can benefit from it. I look forward to beginning my life as a pump user.
Another device that I use and think very highly of is my Dexcom G4 CGM. For anyone who does not know, CGM stand for Continuous Glucose Monitoring. I wear a sensor in my abdomen which transmits my blood sugar levels every 5 min to the device shown above which plots it on a graph. It also tells me if my blood sugar is rising or falling too rapidly so I can react to it faster. I find this device almost invaluable and urge every person with diabetes to look into getting a CGM. The CGM has made me very much aware of my blood sugar trend and just how much food/insulin affects my blood sugar. And more importantly it made me aware that I was dipping low during the night and have since adjusted my basal insulin dose accordingly. I did a little research on other CGM’s but I felt Dexcom has the best system out and will have the best system in the years to come. Some of the brands of CGM take blood sugar readings every 20 minutes and have a start up time of 10 hours, while the g4 checks every 5 minutes and has a start up period of 2 hours. Those were big selling points for me. Although a potential negative I have found with wearing a CGM is that I feel naked and vulnerable if I have to go a long period of time with out it (which is not very often thank god).
As you know from a previous post of mine, I have been shopping around for an insulin pump to purchase. Everyone’s comments on said post were very helpful and I thank you all very much for your advice. A lot of your comments had to do with insurance coverage and until recently I had no idea what kind, if any, coverage my insurance provides for insulin pumps. I did some research and contacted my health insurance provider to discuss potential pump possibilities (see what I did there? 🙂 ). And to my pleasant surprise, they cover 80% of the cost of any insulin pump! Sure there is better coverage available but my insurance is not very good (cheap) so 80% is good enough in my opinion. In fact, I still have to call them twice a week to make sure they are working on getting the Dexcom system covered, which they barely are. They are so slow!
So all that being said, I have made the decision to get the Tandem t:slim pump. Tandem was accommodating enough to send a sales representative to my house to allow me to play around with the pump and ultimately hook myself up to it with a saline cartridge. And I must say I thoroughly enjoyed all aspects of the pump: the features, the size, the weight, the look; just about everything. The sale rep unfortunately was not able to give me a loaner pump to wear for a couple days, but I was able to wear the infusion set for a few days just make sure it was comfortable. And it is quite comfortable… or not uncomfortable, rather.
The infusion set I have been wearing is the Cleo 90 and it seems like a good set. I am not too sure of the differences in the infusion sets other then ones a steel needle opposed to a plastic/rubbery insertion. And one is at a 45 degree angle opposed to the 90 degree insertion that the Cleo is.
I have been in close contact with Tandem recently and so far they have superb customer service. They have a very nice and knowledge staff that is eager to help make people with diabetes lives easier/better.In fact a good few of the employees I have spoken to are diabetics or spouses of diabetics, so they know quite a bit about the D-lifestyle.
So, a few days ago I faxed them the required paper work and contacted my insurance provider to get the ball rolling so I can hopefully acquire the pump soon-ish.
Today I went to see the endocrinologist that my family doctor recommended to me, and unfortunately I did not get very much out of the experience. Knowledgeable, nice, personable guy and had very nice and well mannered nurses, but unfortunately he did not tell me anything I did not know already.
For whatever reason I had high hopes for this visit and went there thinking that some mind opening, game changing information would be given to me. But that was not the case. I should not have been thinking that way to being with. In fact, I had been thinking several days ago that maybe I should have just canceled my appointment because it was already a month after my diagnosis and I was getting in a pretty good routine as it is (CGM, blood testing, insulin dosing, counting carbs etc.). So as it were, I will be more then likely going back to the family doctor for A1c tests and checkups. Which is perfectly fine by me. The doctor and I have a good relationship and he is very knowledgeable on Diabetes (as well as other doctoral subjects).
On the bright side, the endocrinologist did give me a bunch of literature for insulin pumps, which I have been thinking about investing in soon. I do not have a clue which one I would want and still need to do plenty of research on the subject. But the literature he provided was a step in the right direction for that.
I ordered some highly recommended adhesive from amazon a couple days ago and it finally arrived. The OpSite Flexifit is the best option if one wants to wear their Dexcom sensor for more then the recommended 7 day time period or if your sensor adhesive is not sticking well to your skin. I bought the 2 in wide, 11 yard long roll, so hopefully that will last me for a long time. This adhesive is widely used by hospitals and other medical personnel for procedures because it is transparent and sticks to skin (which can get oily/sweaty) very well. When I was in the hospital for my DKA, they used some of this adhesive to secure the IV leads onto my arm.
Yesterday night I hit a new all time low. My other post mentioned how my lowest blood sugar level to date was a 91, now my all time low (that I know of) is a 54. Luckily I had my dexcom system alert me to the decreasing blood sugar levels.
The weird thing is that I didn’t do anything out of the ordinary. So this leads me to believe that I have been dipping low in the middle of the night all along ( yikes!). Another weird thing (I have not decided if this is a good thing or bad thing yet) the only symptom I displayed was shakiness. So this brings three things to mind:
1. I was not low enough to have other symptoms
2. I have a tolerance to low blood sugars
3. I have hypoglycemia unawareness
It is finally here! My brand new Dexcom G4 Continuous Glucose Monitoring (CGM) system. I am pretty pumped about this piece of technology. The main reason I got this system is to see how my blood sugar levels are during the night while I sleep; going too low while sleeping is a fear of mine. For those of you who do not know what this is, it checks my blood sugar levels every five minutes and plots it on a graph. The picture above is the Receiver. It is a portable handheld device with a screen that shows my current blood sugar level and graph that shows the trend (going higher or lower). One of the best features of this device are the alarms that sound when ever your blood sugar levels go outside of the high and low parameters you set to help you avoid hyper/hypoglycemia.
The picture above is the transmitter. It is hooked into a sensor that is in your body to monitor the sugar levels. This transmits to the receiver every five minutes to give you a play-by-play as to what your blood sugar is doing.
Pictured above is the senor applicator. It is a plunger-like device that uses a small needle to insert a sensor probe that is attached to an adhesive pad that the transmitter locks into.
Here is the transmitter/sensor combo on my skin (apologies for the body hair). This first insertion felt a little uncomfortable and so did wearing the patch, but now that I have been wearing it for several hours I don’t even notice it.