Monthly Archives: October 2013

Recipe! Roasted Turkey Thighs.

This is not my own recipe… But it’s now mine in the respect that I’ll be going back to this one for some time.

Truth be told, there are two recipes not mine that are now mine in this post. Each with my own spin, based on what I had available at the time of preparation.

First, let’s talk about the salad. I saw Nigella Lawson do something like this on TV, then I added my own twist to it:

Begin with a couple of leaves of red leaf lettuce, then use fresh parsley for the rest of your greens. To that, I added little half-moon slices of red oinion, green olives, and thinly sliced peaches. On top I added some feta cheese. I served it with a peppery lemon vinaigrette (it sounds a lot fancier than it is), and it was delicious.

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Now, let’s talk turkey.

There was a sale on turkey thighs at the grocery store. I am not a turkey person, never have been. But The Great Spousal Unit is most definitely a turkey person, and I wanted to do something nice. Since I had never cooked turkey before (true), I went searching on the internet for an easy, but good looking recipe. I found it here. I only deviated slightly in the ingredients. The link has the recipe and some great in-progress photos, but if you don’t want to click over there, here’s the recipe, with the finished product below.

Herb Roasted Turkey Thighs Recipe

2 turkey thighs
A handful of garlic (I used 3 cloves), peeled
A handful of pearl onions, peeled (I didn’t have pearl onions, so I went with about half a red onion)
4 small potatoes, cut into chunks (I used two small-to-medium potatoes)
2 cups unsalted chicken broth
2 sprigs of sage
2 sprigs of rosemary
2 sprigs of parsley
2 bay leaves
a sprinkle of olive oil
salt & pepper, to taste

Preheat oven to 400°F. Let turkey thighs sit at room temperature for about 30 minutes before cooking.
Gather a few leaves from each herb sprig and finely chop to make about 2 teaspoons each. Rub chopped herbs onto each side of the turkey thighs along with a sprinkle of salt and pepper. Place thighs skin side down in a deep roasting pan. Bake for about 30 minutes.

Turn thighs over, then add potatoes, pearl onions, garlic, bay leaves and herb sprigs. Pour in broth and sprinkle all with a little more salt & pepper, then drizzle some olive oil on top. Roast for another 30-40 minutes, until thighs are done and potatoes are tender. Stir the potatoes once during roasting. Remove pan from oven, let thighs and potatoes sit covered with foil for about 20 minutes before serving. Place turkey and vegetables on a serving platter.

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Estimated carb count: 30 grams (though you might want to account for a little fat, since turkey thighs have a little more than say, breast meat)

Believe me, this tasted as good as it looks. If you luck into a sale like I did, this is a super autumn meal, even if you ditch the potatoes and just go for the salad and turkey.

 
 
 

October DSMA Blog Carnival. What would you say?

One of the hot issues in the DOC these days is test strip accuracy. It’s exciting to see outside agencies beginning to take note. With that in mind, let’s revisit our September 4th chat “Test Strip Accuracy” and talk about . . .

What would your comment be on meter accuracy at the Diabetes Technology Society meeting?

Well, I could say a lot of things. But I’d really want to say the perfect thing, of course. To do that, I think I’d have to point out that while we have lots of technology at our disposal, not all of it is the best technology available.

Just like many things in life, Diabetes often comes in degrees and layers of differences. We all know this, and we reflect that in our choices of tools to help us manage our glucose. Sometimes, rules in other countries make something available or not available to us, and we’re stuck with what we have. Here in the USA, we sometimes encounter the same thing thanks to insurance guidelines and medicare.

What that means is we’re all using different meters with different strips, many of which aren’t nearly as accurate as they should be. As accurate as they need to be. So we need the Diabetes Technology Society to understand these simple things:

– Lives depend on the accuracy of our devices.  Let me repeat:  Lives depend on the accuracy of our devices

– Continued accuracy, or lack of it at current levels could cost lives

– The proliferation of diabetes technology does not automatically equate to improved quality of the devices we use

– Quality and accuracy of our diabetes devices always needs to improve.  Ninety-nine percent accuracy still won’t be good enough when our lives are at stake, and right now we’re a long, long way from ninety-nine percent

– Ongoing, continuous post-market inspection of meters and strips, and holding manufacturers responsible for shortcomings will be a huge leap forward in improving and saving the lives of People With Diabetes

That’s what I would tell them.

If you’re living with diabetes, or caring for someone with diabetes, you know the importance, the hard work, of maintaining glucose numbers within a range that helps us to continue leading meaningful lives. Shouldn’t we expect at least as much from the Diabetes Technology Society, the FDA, and the manufacturers of our devices?

This post is my October entry in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information at http://diabetescaf.org/2013/09/october-dsma-blog-carnival-3/
 
 
 

My big news isn’t so big after all.

I’ve been teasing for a couple of weeks regarding big news on the horizon. In short, I was hoping to be a part of Artificial Pancreas testing later this month. Sadly, that is not going to happen.

It’s not all bad news. The study requires participants to have a hemoglobin A1c between 6.0 and 9.5. Mine came in at 5.9. So I’m out because I’ve been working out too much, aggressively attacking abnormally high BGs, and losing a little weight (3 pounds in the last month).

I had blood drawn last week and the result came in under the 6.0 mark. They tested again yesterday to see if there was any difference, and that’s when I got the 5.9.

It’s strange– while I was waiting for the result yesterday, and after I got the result, I felt very much like I used to feel when my A1c would be up in the 8’s. Like I screwed up somehow. Like I’ve failed and I’m entirely to blame.

But how can I be pissed about a 5.9? After having a night (and a few Pabst Blue Ribbons) to think about it, I think the thing I’m really bummed about is the fact that it may be too late to get someone else into this study. I hope not. I don’t want the AP team, I don’t want someone who’s been waiting for a chance to participate, to miss out on what this would mean just because I wound up on the wrong side of the fence.

In the end, I just have to process my disappointment and remember that it is not about me. It’s about you, or your kid with T1D, or your spouse with T1D. The important thing is for development and testing to be successful. It’s not important that I am personally a part of it.

So it turns out my big news is actually nothing. I am talking with the team about another study which, honestly, seems kinda cool. If that comes to pass, I’ll let you know.

In the meantime, let me take this opportunity to remind you that clinical trials are important, and your participation could be a crucial piece of the puzzle toward making life better for People With Diabetes.

To find out about clinical trials taking place around the country, go to clinicaltrials.gov and put “diabetes” in the search box. A recent search found over 10,000 clinical trials. The site remains open during the USA’s government shutdown.

A great resource for finding out about clinical trials and participating in research is Type 1 Diabetes TrialNet. Funded by a number of organizations including JDRF and ADA, TrialNet is set up to explore ways to prevent, delay, and reverse the progression of Type 1 Diabetes.

Today I’m disappointed for me. However, I’ll be thrilled beyond measure if your participation results in something truly great for all of us. Make a commitment today to be a part of something that changes our lives forever.
 
 
 

Happy Friday – Thanks for the donations.

It’s Friday! Yaaaaaay! Better yet, it’s the eve of a week’s vacation. Because of work, I tend to go without during the summer months, so that means a bunch of days off in the fall. Maureen is on vacation too, and she’ll be heading to Florida to be with family. I’ll be staying home. But before vacation begins, I thought I would pass these tidbits along from my local JDRF chapter. Wherever we are, together or apart, we’ll be able to support the great diabetes efforts of JDRF by participating in the following:
 
 
Get your flu shot! Now! From September 1st through October 31st, Walgreens will donate $1 to JDRF per flu shot given when a customer presents the JDRF barcode/voucher or identifies themself as a JDRF supporter at any Walgreens (or Duane Reade location in the NYC area). – Find out more and get the barcode/voucher, go to:
http://jdrf.org/wp-content/uploads/2013/08/JDRF_Flu_Flyer_Walgreens.pdf

– Now through October 5th (that’s Saturday), Advance Auto Parts is doing the make a donation/hang a paper sneaker on the wall thing in their stores. Make a $1, $5, $25, or $50 donation and they’ll dedicate a paper sneaker in your name. More importantly, your donation will help to fund research toward advanced drugs, therapies, and a cure.

– Also through Saturday, Marshalls is doing the same thing. Go buy a new outfit and make a donation. Or just make a donation. That would be okay with me.

– Finally, if you’re a Wawa shopper (convenience stores on the USA’s east coast—really good coffee), you have until October 20th to donate to JDRF by adding $1, $3, or $5 to your purchase at the checkout, or by adding your loose change to coin canisters at the store.
 
 
If you can, please donate to one or more of these fundraisers. And tell everyone you know about them! Who says diabetes people always have to be the ones donating money for JDRF? Have a super weekend, watch out for the weather, and keep showing that diabetes who’s boss.
 
 
 

Minimed® 530G with Enlite®. Five questions.

So the Medtronic 530G and Enlite sensor are here, featuring a new pump and a new CGM (continuous glucose monitor) that talk to each other, with a never-before-available-to-the-public Low Glucose Suspend (LGS) feature. Essentially, when your CGM hits a pre-determined threshold, the new Med-T pump will suspend itself for two hours (or less, if you’ve recovered from a hypo event before the two hours are up).

This is a super development. It’s great that advances in glucose monitoring and insulin delivery and interaction between the two are making their way to the market.

Being the inquisitive sort, after I got excited about the news, I started asking myself questions. Five came to mind in about ten minutes. I don’t have answers to these questions. Maybe no one does. But since it’s my blog, I thought I would ask them here.

A couple of my questions came after reading a fine piece on the 530G at Diabetes Mine. They interviewed company officials and provided some information that I’ll be referencing here. If you’d like, feel free to read their story, then come back here.
http://www.diabetesmine.com/2013/09/new-medtronic-device-gets-fdas-nod-but-dont-call-it-the-veo.html
 
 
Now, the questions:

1. Who gets priority when the orders start coming in?
Will it be new Medtronic customers? Replacements? Upgrades? Influence-peddlers (bloggers, diabetes organization muckety-mucks, etc.)? In all honesty, this is kind of a non-starter for me, because a)There’s really no way for me to find out, and b)The supply will probably outstrip the demand for the product within the first year anyway. By then, we’ll forget how bad some folks wanted it right now back in October 2013.

2. In replacement/upgrade scenarios, what happens to used pumps?
I could (and should) have asked this long ago, but what happens to the old pumps? If the 530G is the greatest system out there, I certainly would like to upgrade. But if someone can’t do that, either because of cost or other factors, I would feel great knowing my Revel™ pump is still going strong, working its magic for another patient. Is that even possible? If not, will the pump’s material be recycled somehow? How does this work today?

3. New users of the 530G will work with a trainer, like they do when starting on other Minimed pumps. What kind of education will 530G users get?
I ask this question because while I was trained, I was not educated about insulin pumps and pump therapy in general before starting on my pump. I was good at getting my A1c down, but there was still a lot I didn’t know. Thanks to my fantastic endocrinologist, I was able to get up to speed pretty quickly. Still, I did not know what insulin on board meant until I read about it online. So theoretically, I could have had the 530G, stacked my boluses up to the ceiling one evening, had the threshold suspend feature kick in on my pump, and still had plenty more insulin acting in my system for a while. Without knowing what was happening to me or why.

I don’t want a new user of the 530G to find out about IOB the hard way like I did.

4. The Diabetes Mine piece mentions that the 530G will not communicate with Medtronic’s MySentry remote monitoring system because the FDA didn’t clear it to communicate wirelessly. Isn’t the CGM communicating wirelessly already? And why do they need FDA approval for something like that?
I remember being at the JDRF Research Summit in Bethesda, Maryland back in March. People working on artificial pancreas technology at the University of Virginia’s Center for Diabetes Technology presented, and among the things they revealed was a remote monitoring feature. Parents in attendance were super-interested in this, and they asked the presenters about whether something like that might be available soon. I remember the UVA presenters said that they didn’t anticipate rolling out the remote monitoring ahead of any device they might be working on. But they also said that they didn’t believe something like that needed FDA approval, because it wasn’t doing anything medical. It was just reflecting what was already going on with the AP system, and the remote monitoring itself wasn’t being used to make any medical decisions for patients.

And like I said above, the Enlite CGM will be communicating wirelessly with the pump already. Shouldn’t be too hard to get it to talk to the MySentry too.

5. Finally: What’s all this artificial pancreas posturing about?
You knew I would ask this, right? This is a little touchy for me. Rhonda at FifteenWaitFifteen wrote about being uncomfortable about this too. Medtronic, and by extension now, many in the media, are using the term “Artificial Pancreas” when referring to this system. The LGS feature in this system is very AP-like. But after seeing numerous talks about artificial pancreas technology, from more than one source in the past year and a half, I can tell you that the 530G is not an artificial pancreas device in the way I think of one.

Last time I checked, no one copyrighted the term “artificial pancreas”, so Med-T is within their rights to tout it as an AP device if they want to. But I worry about two things: First, will using the term with this device, which doesn’t have all of the features of artificial pancreas technology, cause non-D friends, family, and co-workers to think this is the holy grail, and now we shouldn’t have any trouble with our diabetes from here on out? Second, will using the term “artificial pancreas” like this eventually dilute the term for all of us, to the point where just a CGM that talks to a pump will be considered an AP device? We’re just now making big strides in technology that will benefit many with diabetes. When an outfit uses the term “artificial pancreas”, I don’t want it to be less than I’ve been led to believe it will be. Just my two cents. Feel free to disagree.

Full disclosure: Okay, half disclosure. I have a particular interest in this topic, especially right now, and I recognize that this may skew my viewpoint. More about that next week.
 
 
So those are my five (plus) questions on the Minimed 530G with Enlite. As with almost everything, time will probably provide the answers. Do you have any questions of your own? Have any answers for mine?
 
 
 

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