5
Jun

News from Medtronic: the Minimed Connect

I saw something cool on my Facebook feed tonight: Minimed Connect will be available in the US sometime in the Fall of 2015.

 

What is Minimed Connect? It's an uploader that sends pump and sensor info to a smartphone, which then reads it via the smartphone app and lets you view your pump info via phone. It doesn't allow you to control  your pump, but it does let you set a "text message threshold" which will send out a text to friends/family/loved ones if your sensor glucose levels are too high or too low.

The uploader also sends your sensor data to your Carelink Personal account every 24 hours, so those reports will always be up-to-date in case you or your doctor want to log in and check out that info.

I feel like this will help out with the "pump alarms aren't loud enough" problem. It will definitely also be nice to have Carelink data updated automatically, rather than the current system that requires that the user manually upload their data (in my case, frantically the night before every endo appointment :P).

 

The article (and the ensuing comments) mention that the release is in the US only, and will cost around $200. They do not expect the device to be covered by any insurance carriers.

 

The comments also mention that they have no info about a Canadian release for now. I hope they provide an update about the Canadian release sometime soon!

7
Apr

Ketones and thoughts about lows

About two weeks ago I had an interesting experience with DKA.

 

I went to bed as usual, but woke up around 1:30 to go to the bathroom. I noticed my mough felt fuzzy, dry, and cracked, and (sorry: TMI moment coming up) peeing... hurt. This raised some alarm bells for me, since normally it isn't uncomfortable to pee.  I briefly panicked and wondered if this was the first symptom of a UTI. I've read several articles that discuss how UTIs are more likely to occur in people, specifically women, with diabetes, so given my symptoms, that was one of the first things I suspected.

 

I checked my bg and found that I was suuuuper high. The bathroom discomfort prompted me to check for ketones which, I discovered, were present in my  body in HUGE quantities.

 

I quietly wondered: Is it supposed to hurt to pee out ketones? <<file away under the "Google this later" category>>

 

 

I feel very lucky to have access to the healthcare team that I've got. When I realized I had ketones, I gave a correction bolus for how high I was and called my hospital. They directed me to the endocrinologist on call (since it was the middle of the friggin night), who called me a few minutes later to discuss what was going on. I explained the situation, and described how I don't usually have ketones, so I wasn't really sure what to do. Should I give extra insulin for the ketones? What if that extra insulin made me go low? Could I still go to bed with extra ketone-fighting insulin on board?

 

My worry was that if I gave the extra insulin that's normally required to treat high ketones, it would actually be too much, and in the morning I simply wouldn't wake up. I explained this to the doctor.

 

 

I don't think that anyone with diabetes has it easy, but I am pretty fortunate in that I am able to, with the usual loss of sleep and consultation with a medical team, tighten up my overnight insulin (basal rates) so that my blood sugars stay pretty stable overnight. This tends to change a few times a year, or when I experience extra stress, but for the most part I only tend to do a HUGE basal-rate-overhaul maybe 3 or 4 times per year. I only mention this to explain that when I go to bed, with basal rates that usually work for me and with the added benefit of my cgm, I don't always worry about whether I'll wake up in the morning. This night, I worried.

 

 

This story doesn't have a very interesting ending. I corresponded hourly with the on-call doctor, who gave me instructions for insulin and water consumption, and had me report on blood sugars and ketone levels until everything was back in range. I admit I did still wake up low, but it was a "mild" low ("mild" as opposed to "my glucose-starved brain is pretty sure I'm going to die, BUT maybe I can stave off death if I eat everything in the fridge"). I think I woke up at around 3.8, which for me is still a BG from which I can wake up. Low 3s or below means I won't wake up.

 

Looking back, it feels almost strange to think that at 3.8 I can accept that I woke up low but it was ok, whereas a 3.2 would probably have had me unconscious and missing my alarms, laying in bed until Boyfriend (or BFF) noticed something was wrong and gently nudged me, repeatedly, all the while shoving a ready-to-drink juicebox in my face and hoping I wouldn't throw it at him(/her) or drip the whole thing over a pillowcase (I've never done that while low... I swear.).

 

0.6 mmol/l (or around 10 mg/dl) can make the difference between waking up and not. I'm really not trying to be over-dramatic...just stating a fact.

 

It's weird to think of your own mortality. Some nights (some mornings...some days) I think I get closer to death than most. I guess one of the sad things is that you sort of get used to it over time.

 

 

10
Mar

Arm-sensor placement

Hello, ladies and gentlemen!  I would like to present to you... (drum roll please):

The WORST placement I've been able to find for an arm-sensor (...so far).

image

Forearm Sensor

The forearm is a terrible place for a sensor!

- It hurts
- It is sitting in muscle
- Have I mentioned that it hurts?
- It gets in the way when driving, working, or pretty much any time you might wish to use an arm rest
- EVERYONE CAN SEE IT, so on a day when you'll be frustrated enough by the bloody thing, you will also be pestered by every well-meaning coworker who has never seen your sensor before and wants to know what it is

On the plus side, that accuracy here isn't terrible?

image

Argh.

My BG levels are, though (...terrible, I mean). I blame the not-bolusing-for-coffee this morning... Whoops!

21
Feb

Overnight lows

I've been having some issues with overnight lows lately.

 

I've been setting a 70% basal overnight for the last few weeks. Most of me knows that a 70% basal will make me wake up ok; fortunately for me I have a pretty solid network of friends who help me to fee not-so-terrible when I've had some delicious delicious wine.

 

My overnight basal rates have been too high for a while, and the weird thing is that it seems to take having friends over for dinner and drinks to figure out that I need to do something more permanent than a 70% overnight basal.

Bah! I don't want to have to re-jig my overnight insulin rates! Sometimes changes, whether stress levels or natural life stuff, BLOW.

8
Nov

Pet Expo 2014

I took my pooch to the Pet Expo earlier today. Every year a convention centre in my city hosts a giant Pet Expo that showcases pet adoption agencies, pet food stores, etc. This is the second year I've brought my dog, and although he tends to find it pretty overwhelming, we still had good time!

 

Ben and I at the Pet Expo

Ben gives me face kisses while I try to get him to pose

We tried to get a picture on the Milk-Bone chair (they were giving away Milk-Bone tooth-cleaning bone and a printout of your chair picture) for a few minutes, but my Ben was having none of it.  Since he's such a small dog and kept very nearly getting kicked when he was on the floor, he actually spent most of the afternoon sitting in his pet carrier (pictured hanging off of my arm, above).

I started off wearing a sweater, but that place was SO crowded and I started to feel overheated pretty quickly. I stored my sweater in my bag and carried on with touring around the place. After attempting to get a good photo (and monopolizing the Milk-Bone chair) for a couple of minutes, we gave up and started getting ready to continue walking - BUT! There was a young woman hanging out outside the Milk-Bone area. I actually bumped into her on my way in to the chair, so I vaguely remembered her from when I apologized for bumping her.

As I was leaving she tapped me on the shoulder and gestured towards my cgm while she asked if I would mind if she asked what it was. I was a bit surprised (I kind of feel like most people just dismiss "medical stuff" in strangers and don't give it much thought), but I smiled and told her that of course I didn't mind. I explained in a few sentences how it was a continuous glucose monitor that helps me manage my diabetes, and she thanked me for explaining and we both went our separate ways.

 

I don't often see or talk to strangers who have questions about this stuff. People I know - yes, all the time. Friends, family, coworkers, alllll of these folks come up with questions and most of them don't feel shy about asking. It was nice to be able to educate someone today, and also pretty cool that someone felt curious enough to ask. & politely, too!

 

 

 

 

 

4
Nov

Enhanced Enlite: Day 10

It's still going! I was out late last night and forgot to calibrate before I went to bed, so I woke up to a blank cgm graph and a few hours of missing data. I gave it a new cal and so far it's been matching my bg levels pretty well.

I did have to tape it down again yesterday though. We'll see how much longer the new tape lasts -- arm sites tend to go through tape pretty quickly.

3
Nov

My first Enhanced Enlite sensor

I'm currently on day 8 of my first Enhanced Enlite sensor. I had to re-tape it on day 4, but other than that it's doing quite well. I restarted it as a new sensor as I approached the 6-day mark, and I've noticed that the sensr's accuracy is still just as good as it was in Round 1.I woke up to a meter BG of 6.4 this morning and a sensor BG of 7.0 -- a difference of only 0.6 mmol/l (around 11 mg/dl), which I consider to be pretty damn close.

Also: *happy dance* because I love waking up at 6.4 with a nice straight line graph on my cgm. What a lovely way to start a Monday!

3
Oct

New Enhanced Enlite

About a month ago Medtronic sent out a News Release about their "Enhanced Enlite" that would be available to consumers in Canada in October.

 

It sounds like it's got some pretty sweet improvements. The site talks about reduced sensor size (80% reduction in the size of what sits under the skin), new sensor design that will allow it to give better daily performance, new adhesive that's less likely to irritate skin, and changes to the connection between the sensor and transmitter.

I originally saw the news because I subscribe to Medtronic Canada on twitter. They tweeted about it, so I replied and asked whether customers on their Automatic Supply Agreement would be automatically switched to the new sensors in October.

Medtronic Canada's reply

Medtronic Canada's reply

They replied that no, users would have to call in and request the switch, since customers can decide whether they want to switch.

Very cool! I haven't called yet, but my next Automatic Supply order isn't due til the end of October, so I've got a bit of time to get it done :).

14
Sep

Sensor Bruise

I inserted a new sensor this afternoon. It bled a bit, but not much. I waited a few minutes, and after noticing no new blood, I attached the transmitter. I started a new transmitter on my pump then hopped in the car to do some shopping.

The sensor hurt. It was sore and hurt every time the fabric of my jeans stretched over it.  I started walking carefully to avoid jarring it, since it was aching more the more I moved.

I picked up groceries and noticed something odd as I got back in the car: a tiny red spot on my jeans. I checked it out when I got home, and not only had it kept bleeding badly enough to soak through my jeans, but it also left one huge mofo of a bruise on either side.

ow ow ow.

Sensor bruise in my leg

Ow ow ow.

Accuracy has thus far been crap, although the sensor has only been in for around 6 hours so I know I'll need to wait until tomorrow (and calibrate a few more times) before I can expect my sensor graph to be any good.

 

Still: Ow.

3
Sep

Alllllmost 6...

 

...Well, 5 days 23 hours isn't bad?

Such a good sensor, right up until around 5am...

Such a good sensor, right up until around 5am...

 

I suppose that's not completely accurate though. I probably only got around 5 days 19hrs of good use out of the sensor, but I left it in for a few extra hours before I pulled it because I thought it might come back from this. Nope!

 

Aw well; new sensor is in. I inserted this one at work! Other than not having a mirror so I could see better, and also the constant worry that someone would walk into my office and freak out (no one did), it went very smoothly!

 

 

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