A window of opportunity is closing.

I really didn’t expect to write about this again, but… This still needs to be talked about. And for various reasons, this may be my last chance to write about it before our window of opportunity closes.

The U.S. Food and Drug Administration is in the process of drafting guidance for manufacturers of blood glucose meters. The guidance will be for future production of both over-the-counter meters (the ones we, as individuals, use), and the ones used in a clinical, point-of-care (i.e., hospital) setting.

As of right now, the FDA has opened up these draft guidance documents for public comment.

In other words, they want our input, and they’re even welcoming it.

But they will only accept our input until April 7. So please… Right now… Do something for me:

Go now to this one page, follow the instructions, take two or three minutes, and add your voice to something that will be extremely meaningful to me for years to come.
 
 
As I publish this post, only 167 comments have been posted on the OTC guidance.

As I publish this post, only 101 comments have been posted on the point-of-care guidance.

Every man, woman, and child in America with an internet connection should be commenting on this guidance.
 
 
Are you living with diabetes? Is someone you care about living with diabetes? Do you work with someone living with diabetes? Do you drive on a roadway with someone living with diabetes? Do you interact ever with someone living with diabetes? Are you starting to understand why this is important and critical and time-sensitive?

Maybe you don’t care about making meters more accurate. Or maybe you do.

If you’re living with diabetes, improving meter accuracy is important to you, and you know it, and you can do something about it.

If someone you care about is living with diabetes (and someone you care about is), improving meter accuracy is important to you, and you know it, and you can do something about it.

If you aren’t affected by diabetes at all, improving meter accuracy is important to you, and you know it, and you can do something about it.

Do something about it.

Go now to this one page, follow the instructions, take two or three minutes, and add your voice to something that will be extremely meaningful to everyone for years to come.

Future lives hang in the balance of blood glucose meter accuracy, and you can help win the day.

Thanks again to Christel Marchand Aprigliano and Bennet Dunlap for opening my eyes on this issue and leading the charge up the Hill of Guidance.
 
 
I now return you to your regularly scheduled day.
 
 
 

Champion Athlete With Diabetes: Couch to 5K, 10K, Tri, and beyond.

Can you believe we’ve handed out nine medals to Champion Athletes With Diabetes?

Inspirational stories have come from everywhere. By telling them, I hope I’m letting you know that you are capable of achieving more than you ever imagined too. Today’s story is exactly that.

KelleyKentMedal

Kelley Kent lives in the Richmond area with her husband Chris. On her blog, Below-Seven, she describes herself as an accountant by day, blogger by night, an MBA soon to be CPA, and a Type 1 diabetic. For the record, she’s one heck of an athlete. I’ll let Kelley tell the story from here:
 
 
I got married in May 2011. By November 2012, I realized that I had gained thirty pounds and was my heaviest ever. It was a combo of enjoying the first year of marriage and also transitioning from an office job to a job where I work from home-the kitchen became way too close to where I was working! I decided that something needed to change and my sister, who is really into fitness (she’s done half marathons, Olympic triathlons, ragnar races, etc.), suggested I try a Couch to 5k program.

In November of 2012, I started the Couch to 5k program. I’ve always been pretty athletic (playing basketball, softball, flag football, etc. growing up) but I’ve never been in very great shape. The first day of the C25K was rough. I couldn’t even run for one minute! But that’s why the program works so well; it starts off slowly and you build up quickly but not too quickly. I remember texting my sister when I first started that I couldn’t imagine week five where I had to run for five full minutes!

By January (2013), I was running close to a 5k (30 minutes!) and feeling great about my progress. My sister was signing up for the Monument 10k, a race in Richmond in April, and suggested I sign up as well since I had been doing well with the C25k. My husband, who was also doing the C25k with me, and I decided to sign up for the 10k training group and registered for the race. I was scared at first because 6 miles seemed impossible! But April 13th rolled around and I did it! I ran the entire race.

I’m a person very motivated by goals. After the 10k, I didn’t have any races that I was signed up for so my running slacked a little. I was so happy with my new hobby that I didn’t want laziness to take over. So I decided to sign up for an 8k in June, then a 5k in July and then a triathlon in August. The triathlon came about randomly. My sister was competing in an Olympic triathlon in June and I went to cheer her on. I didn’t know much about triathlons at the time but it ended up being a lot of fun to watch. While I was spectating, I thought to myself, I can swim, I can bike, and I have just gotten the running under my belt, I bet I could do a triathlon too! After watching my sister’s race, I decided to sign up for a sprint triathlon. A triathlon is a completely different beast than just running a race. For a triathlon, you have to figure out what to do with your pump during the swim portion; you have to deal with three different activities that all affect your blood sugar different; you have to test your blood sugar during the transitions, causing your transition time to be higher than non-diabetics. I was able to figure out and overcome those obstacles and I had a lot of fun while doing it! I’m debating doing another one this year (maybe even an Olympic).

Feeling pretty confident after completing the triathlon, I decided to get a little crazier and I signed up for a half marathon in November. Then I went one step further and signed up for another half marathon in January. I started running in November 2012 and one year later, I completed a half marathon. It’s pretty remarkable what the human body and mind can accomplish. I NEVER thought I would run a half marathon in my life! Somehow I have transformed into thinking a 5k is a short run! I started running because I wanted to shed a few pounds and I lost about 25 pounds (close to my 30 pound gain!) In addition to the weight loss, running included an even better benefit, getting my A1C below seven, a goal I have been working towards for years! Running is now a part of my life and something I hope to do for the rest of my life.
 
 
I think the interesting thing about Kelley’s story is that here she was, living her life, diabetes in hand, and she just woke up one day and said “I want to do this”. And she made it happen.

Maybe you’re feeling like you’ll never be the kind of athlete that Kelley is. So what? I won’t either. What’s important is to get moving, and to persevere through whatever might try to stop you. Despite all the things that could have gone wrong, Kelley handled it all in a way that was surprising even to her. You know what? Even if surprising to you is walking around the block every day for a week, I’m know you’re capable of the same kind of determination.

That’s what makes these stories so inspirational, and so worthy of recognition by all of us. Not the actual accomplishments. It’s the strength that comes from knowing we turned fear and loathing into courage and fortitude. That’s where champions are made.

Are you achieving athletic goals while living with Type 1, Type 2, or another flavor of diabetes? Send me your story, and I’ll send you a medal just like Kelley’s. Click here to find out how to get yours.
 
 
 

Looks can be deceiving.

I had a wierd high and a strange low in the past four days. Neither fit the stereotypical low or high.
 
 
Thursday night at about 3:00 a.m., I found myself with a very dry throat and an overwhelming urge to use the bathroom. When I came back, I did a quick BG test to find a 53 mg/dL staring me in the face. Not a common occurrence.
 
 
Sunday, the tables were turned. I had completed a hard hour-plus workout at the gym. I spent extra time to recover and drink lots of water to rehydrate my muscles. Apparently, it wasn’t enough, because when I got back into my truck, a quick test revealed 260 mg/dL as the result. Probably too low of a temp basal during the workout, and I was still dehydrated.
 
 
Moral of the story: Things are not always what they may seem. And test, test, test.
 
 
 

Like these Friday Links.

Happy Friday everyone… Hope your weekend is shaping up to be a good one, even if the weather still doesn’t look much like mid-March. Let’s hope that changes soon. I’ve got a bike ride to train for!

Today’s samples from the Diabetes Online Community are on a number of topics. If you haven’t seen them already, I hope you’ll take a look. You might learn something new, or come away with a different perspective.

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First, some recaps of diabetes events:

From Christopher Snider at A Consequence of Hypoglycemia, a recap of the TCOYD conference in Sacramento last weekend:
http://tobesugarfree.com/2014/03/10/a-few-thoughts-about-tcoyd/
 
 
From Jen at See Jen Dance, a recap of the same:
http://seejendance.com/2014/03/09/how-much-is-too-much-data/

Both are great perspectives.

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From Karen Graffeo at Bitter-Sweet, a recap of JDRF Government Day in Washington, and a heartfelt plea for more D-Advocates. We can never have enough.
http://www.bittersweetdiabetes.com/2014/03/jdrfgovday-highs-and-lows.html

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After reading this, you’ll never look at flying with an insulin pump the same way again. Seriously. Here’s a great post from Melissa Lee at A Sweet Life that describes why sometimes we may have high BGs on airline flights, and why we may also experience “baggage claim lows” once we’ve touched down:
http://asweetlife.org/feature/what-you-should-know-about-flying-with-an-insulin-pump/

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Bea at Cranky Pancreas is a fantastic Type 2 advocate who I really enjoy reading. She recently talked about her start of the Type 2 medication Victoza, side effects, and what it’s doing for her BGs:
http://crankypancreas.com/?p=5244

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When you meet someone new with diabetes, the conversation doesn’t happen the same way every time. Check out these interesting encounters:

From Alecia at SurfaceFine

From Sara at Moments of Wonderful

From Scott at Rolling in the D

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Finally, ‘cause it’s Friday, you need to read this post (if you haven’t already) from Kelly K. at Diabetesaliciousness, who goes all third person when she describes reconnecting with her first diabetes friend 30-some years after diagnosis. This will give you that warm, mushy feeling you may be seeking on a gray day:
http://diabetesaliciousness.blogspot.com/2014/03/joe-my-very-first-friend-with-diabetes.html

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Okay… work needs me. And I need to work. Hope today is the start of a fabulous weekend. Enjoy!
 
 
 

Prescription burnout.

I’m fortunate. I have access to and participate in medical, dental, and vision insurance through my employer (The Great Spousal Unit is also covered under my plans). It’s not cheap to have this coverage but, for the most part, I’m able to manage the costs. Despite needing to schedule appointments and, you know, actually go to doctor appointments, I’m able to do what I have to do to navigate my way through the healthcare system here in America.

Except when it comes to prescriptions.

Dealing with prescriptions is hard. The reasons for that vary, but they’re mostly related to the number of items I have to keep track of, the fact that they all seem to need to be renewed at different times, and the stupid way my prescription provider operates.

For the record, I get insulin, plus backup insulin, glucagon, a few daily pills I need to take, and test strips through my prescription provider.

Almost all of these, except the glucagon kit and the backup insulin, which I don’t need to renew all the time, are on different rotating 90-day schedules. Meaning, I have to go to my provider’s website and renew my prescription, or my doctor can electronically submit prescriptions to the provider. Though that turned out to be a major hassle with the provider, which I’ll explain farther down the page.

I generally don’t suffer from diabetes burnout, but I do suffer occasionally from prescription burnout. It’s not that I have to renew my prescriptions every 90 days. It’s that I may need to renew one prescription this week, and another in three weeks, and another ten days after that, and another the following week. Keeping track of which script needs to be renewed when takes some doing.

I try to keep track of it on my Outlook calendar at work. That works okay, except when I’m not at work, and as long as the Exchange server doesn’t go down and wipe out everything I carefully scheduled (which happens occasionally).

Then there’s the cost. My provider introduced a huge change in their formulary list this year, which is costing me an additional 1200 dollars during 2014. I don’t even want to go into that.

So there’s the volume of everything that needs to be renewed, and the quirky scheduling of everything, and then there’s this:

When renewing my prescription online, the provider has my credit card information so they can process my order at the time it’s placed. So they have my credit card information on file.

The last time I visited my endocrinologist, she was kind enough to get me new prescriptions for things I had run out of refills for. The best part was (or so I thought), she was able to send the script directly to the provider so they could fill it. Great, right? Ummm, no.

A couple of weeks (or so) goes by, and no prescriptions. Part of the order included my insulin, so I’m starting to worry a bit. I give the provider a call. It turns out they haven’t filled my prescription because they “didn’t get payment yet”.

Me: You have my credit card information on file… what’s the problem?

Prescription provider phone rep: We can’t fill the order without your authorization of payment.

Me: You do it when I renew prescriptions all the time… how is this different?

Prescription provider phone rep: We can’t fill the order without your authorization of payment.

Me: This is a highly inefficient way of doing business. My doctor sends the prescription directly to you, then I have to wait to find out it’s not coming, then I have to call you, then you tell me I have to provide payment when you already have my credit card info on file.

Prescription provider phone rep: We can’t fill the order without your authorization of payment.

Okay, I realize there’s a difference between “providing payment” and “authorization of payment”, but still… why do I have to find this out on my own? Why was I led to believe my prescriptions would be shipped when they weren’t? Why was I not told that they were waiting for my okay before filling my order?

I don’t want to say the provider did this on purpose. I don’t think their purpose was to deny or delay my prescriptions. After all, if they don’t fill a prescription for me, they don’t make money. And that’s where the problem lies.

It’s just my opinion, but it seems to me that prescription providers, more than any other entities providing goods, services, or prescriptions through an insurance plan, are not about the patient at all. Not in any way, shape, or fashion. No… they are purely profit centers, and they operate as such. I don’t think my provider wanted to deny my coverage. I just think they skimped on customer service and expediting orders in an effort to make a few extra bucks. They hired someone to think this all out, but they didn’t pay top dollar, so what they got was a system that doesn’t really work at all.

And they don’t seem to care about it, because, let’s face it… once I’m on their plan, they have me for the entire year. At that point, they don’t have to be nice, or helpful. They just have to squeeze as much money from me as they can. If they have a stupid, inefficient way of doing that, who cares? They know I’ll be back when my next prescription needs to be filled.

I suppose it hasn’t occurred to providers yet that better customer service could help expedite orders, rather than having them sitting in a queue somewhere. More orders, more money, more profit. And I suppose it hasn’t occurred to them yet that a superior level of customer service could have a positive effect on patients, and the plans they’re covered under, which might make their plans more appealing to additional clients in the first place. More orders, more money, more profit. That requires too much forethought, I guess. I wonder if they even know what that word means.

Oh yeah, it’s prescription burnout I’m feeling. Or prescription provider anger. Either way, it’s not healthy. And my provider is perfectly okay with that. As long as I keep coming back for more.
 
 
 

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