Tag Archives: CGM

So, how’s that clinical trial going?

May 3, 2013 – 9:17 am

Funny you should ask.

First, let me bring you up to speed: I started participating in a clinical trial back in the middle of April. Participation means wearing a Dexcom™ G4 continuous glucose monitor (CGM), and giving daily updates (keeping a diary, if you will) about glucose readings, boluses, meals, how I’m feeling that day, and a host of other things. If you want to read about it, here’s a link:
http://clinicaltrials.gov/ct2/show/NCT01767831?term=iBOLUSED&rank=1

Okay, so how’s it going? Pretty well so far. I should tell you that we’re taking a break from the study for a short time so web developers can work out some details with the website we’re accessing. Our group in this study is the first to use this system, so it was inevitable that we’d run into a blip here or there.

But I am getting first-rate information on how my glucose is trending on a daily basis, and which foods really help or hurt my BG management. Hint: being away last weekend and eating out for every meal meant mostly high readings all day Saturday and Sunday. Being home this week and eating homemade meals has meant significantly lower readings and lower variability too. Too bad, ‘cause I like eating out. But I also like cooking for myself, so life’s a balance, I guess.

Also, I’m starting to think about my answers to all of the questions I’m asked when I log on daily and give my information. I’m thinking about meals and exercise, and stress and other things that I’m giving information on. I suppose that’s part of what they’re trying to find out in the study.

At any rate, I’m still happy to be participating, and I’m finding the CGM to be more of a help than a nuisance. As the study rolls on, I’ll give you what information I can without compromising the trial.
 
 
In the meantime… in case you’re interested in participating in a trial of your own (and not the legal kind), here are a couple of places to start:

From the USA’s National Institutes of Health:
http://clinicaltrials.gov/

Also, the Clinical Trials page on JDRF’s website lists a number of helpful links:
http://jdrf.org/research/clinical-trials/
 
 
Have a great weekend!
 
 
 

By StephenS | Posted in Diabetes | Also tagged , , | Comments (1)

Airport Security.

October 17, 2012 – 7:15 am

I was thinking yesterday about all of the travel stuff from last week. The good news is that I didn’t have a single issue going through airport security. I rarely do.

But my observations of the security process, for myself and others, revealed that there are some things that I think could be better through the entire process. So taking the “It Takes a Village” viewpoint, here are a few suggestions for everyone:

For TSA Screeners: Can we get a little consistency here? I always point out that I’m wearing an insulin pump as I start the process. Yet sometimes, I get walked through the metal detector and waved on, just like any other passenger. Other times, I get directed to the full body scanner (which I decline based on guidelines provided by my pump maker—more on that in a minute), then to the full pat-down. Then finally, always finally, they do the “touch your pump with both hands” routine where I touch the pump, and my pump and hands get swabbed with something that looks like it came from the inside of a diaper, and the diaper-like product gets run through the machine to check for explosive residue. But TSA: If I had explosive residue on either, wouldn’t you want to know that first? Oh well… it always goes okay, and I don’t have the kind of modesty that bothers me to go through that process. Or maybe I realize that for most screeners, it’s more uncomfortable for them to do the pat-down than it is for me to get it. Although it kind of bothers whoever I’m traveling with. They get through security in seconds; I get through security in minutes (sometimes, many minutes).

Let me say also that I realize I’m in the minority here, and I completely sympathize with anyone who has an issue with this process… there must be a better, smarter, higher-tech way to do this. Full body pat-downs of kids or anyone else just because they’re wearing a medical device is ridiculous. I won’t waste time today going into the myriad of reasons why.

For medical device makers: Why can’t your devices go through full body scanners? Is it because you’ve never tested them? Is it because you’re not sure, and you’re just hedging? Is it because you truly believe that the scanner could foul up the software?

Whatever the reason, my suggestion is this: Fix it. Make your device good enough to go through the scanner. Or if you think it might be good enough, run it through a scanner a few thousand times to test and make sure. If you’re unwilling to do either of those, please communicate with TSA personnel to let them know, so we won’t routinely get directed to the full body scanner just because we’re wearing your device. My guess is your device will handle the scanner just fine. But I won’t know until I know I can go through the scanner for myself, without fear of invalidating my warranty. Wouldn’t you like to be able to say to kids, “You can go through security just like anyone else”? Again, it takes a village, okay?

And that brings me to:

Travelers: Actually, I don’t have any advice for you. Except to 1) Do your homework; 2) Get there early; 3) Be calm; and 4) Be nice to TSA staff. People have bad days, or their bosses are giving them a hard time about being extra diligent with the screening that day, or something else. The more we can take a deep breath and go with the flow, the easier things will probably be.

That does not mean that we should take any crap from TSA staff. When people are wrong about proper procedures, you are absolutely right to set them straight. When people are rude or unprofessional, you are absolutely right to point it out. TSA has a job to do at airport security. That job does not involve making us feel like we’re criminals if we didn’t get everything perfect before we hit their checkpoint today.

Okay, enough ranting. My point is, we all have a part to play. If we do our best, or at least try to do our best, we’ve done our part. Now let’s see if we can get the other players in this game to do theirs.

By the way, here’s the Transportation Security Administration (TSA) website’s latest update, and a few links to pages that have travel information for various manufacturers:

TSA

Medtronic

Animas

OmniPod
 
 
 

By StephenS | Posted in Travel | Also tagged , , , | Comments (0)

Me and my pump.

April 23, 2012 – 11:26 am

The pump has been with me for a little over 2 years now. Officially, it’s a Medtonic Minimed Paradigm® Revel 723 pump. Unofficially, I have a love-hate relationship with it. Actually, you can make that a like-hate relationship. But that’s not as bad as it sounds.

When you add up the score, it’s not all that bad:

Pros
First and foremost is the convenience factor. I can go just about anywhere (not the water) with it and get insulin when I need it. A good example for me is my too infrequent day trips to New York. Instead of injecting a great deal of Lantus and hoping that my BG stays in range all day, or taking along a flexpen with something fast-acting and then looking for a quiet place alone from time to time (try finding that in Manhattan), I have what I need resting on my belt. Love that convenience.

It does help me keep my numbers in line a little better, but my numbers were pretty good for about a year before going on the pump. What the pump does is make it easier to manage my numbers. When I was first diagnosed with type 1, I was put on a twice per day Humulin 70/30 product. Same dosage every day, no matter what. That lasted for about 14-15 years. Then after having a difficult time handling lows, I was introduced to Lantus. It changed my life. For about two years. After that, I started to have additional issues with lows in the morning and highs late in the day. So the answer to that was to cut down on the Lantus and use a fast-acting insulin (Apidra) for boluses prior to eating.

By the way, this was the first time I’d heard about the word “bolus”, or even the idea of adjusting insulin dosage based on my BG and my carb intake. About 18 years into my diabetes. Until then, it was the same dosage, same time, every day, no matter what.

The next part is my fault. I found the bolus idea to be too much of a nuisance during the day (crazy, I know). Particularly because I work in a conservative environment where appearing to be out of the norm has, in the past, sometimes been seen as weakness. So I only bolused with the fast-acting insulin at night, at home, where only my family would see it. At work I still check my BG before lunch in a separate room with no windows. People at work know about my diabetes. Some of them have freaked out about it at times. Or maybe I’m still a little unsure about giving them a reminder about it every workday.

I eventually started looking into insulin pumps about 3 years ago. I decided I wanted to check it out. I loved the idea of having continuous delivery, and the fact that I could program everything in, even variances to my routine (I’m talking temp basal adjustments). I finally got hooked up with the Minimed after I started with my super Endocrinologist, who has been great.

Cons
The hardest part about wearing a pump is that you are wearing a pump. It is attached to you, 24/7/365. You can’t understate that. But let me be clear in saying that you can get used to it. And if you’re not fond of giving yourself multiple injections per day (never a problem for me), I guess one stick every few days is not so bad.

I am not a CGM (continuous glucose monitor) wearer. I tried it for a while after going on the pump, but there were two big reasons why I gave it up. First was the annoyance of having another thing attached to me all the time. The other was that I’m very concerned about real estate (??). I’m starting to read about some of my fellow pump-wearing PWDs who are finding that some sites have scar tissue after being injected many times. I’m interested in preserving potential sites as long as I can, so while a CGM might help me get real-time BG info, it’s not yet worth me destroying extra real estate. Maybe later, but not now.

In the final analysis, I am happy to have the pump. I am very happy that I have an employer that cares enough (I’m being honest here) to cover my pump, and pump supplies, and strips, and lancets, etc. It makes me sick to see people lose their benefits and think, “what if they or their family has to deal with this disease on their own?”. And I’m looking forward to the improvements that technological advances will bring to the market. Maybe the real estate issue won’t be such a big deal in the future.

And one final thought: This is just my blog… it’s very much a personal journal of my life with diabetes. Every pump and CGM decision is a personal one. You must decide for yourself. If you’re thinking about whether to take the plunge, get advice, not opinion. Get the facts, not a viewpoint. I wish you the best of luck, and the most of happiness.

By StephenS | Posted in Pumps | Also tagged , , | Comments (0)