On Wednesday, the Juvenile Diabetes Research Foundation officially announced that it is teaming up with Animas Corporation to develop the very first Artificial Pancreas. This has been in the works for a very long time! They’ve been doing proof-of-concept studies for years including one here at the University of Virginia.
The device is going to be developed over the next few months and “should” be starting clinical trials by the end of the year. Depending on the difficulty it could be on the market in 4 years!
The term “artificial pancreas” is a little misleading I think. The first version of this system will not be fully automatic like the name suggests. It will have some sort of predictive algorithm to help prevent high and low blood sugars. But if it still requires any kid of human input can it really be called an artificial pancreas?
I also think that the term is a bit misleading to people who don’t understand how it works. I’ve already read several posts on message boards and Facebook groups proclaiming that the cure is here. I cannot reiterate enough that this IS NOT a cure! A cure to me means that I am no longer diabetic. I no longer need to have insulin injected into my skin. Therefore, in any form, this artificial pancreas should not be considered a cure.
In fact, calling it a cure could prevent an actual cure. If the world believes there is a cure, then they will stop pushing for the real cure. For example, when insulin discovered it was announced as being the cure for diabetes. I suppose at the time it was the cure because it kept people from dying. However, we now know that it is definitely not the cure. Yet, according to the ADA 1 in 10 people think that diabetes is cured and 19% aren’t even sure if it is!
I know that there also a lot of people who are upset that JDRF is giving money to this project instead of an actual cure. In response to these concerns I would like to point out that one of JDRF’s missions has always been to improve treatment until there is a cure. For example, it was JDRF who funded more CGM studies to ensure that insurance companies would cover it more widely.
I would not call the artificial pancreas the cure. I sincerely and truly and wholeheartedly believe that it is a huge step forward in more effective treatments that will keep all of us alive and healthy until there is a cure.
Today was my last endocrinologist appointment with my current doctor. It was definitely a bittersweet event.
My A1C wasn’t *quite* what I was hoping for but it certainly wasn’t bad! It was 6.7. We also discussed my weird after lunch/before dinner lows. We decided to change my lunch carb ratio from 1:10 to 1:12. This is literally the FIRST time my carb ratio has ever been changed since I started the pump 10 years ago. He also gave me two Bayer Contour meters to try out and to decide if I want to switch to Bayer and use the USB meter. Which I think I probably will regardless.
We also decided on who my new endo will be. So I have to call there tomorrow and set up an appointment. Yaaaaay (please note the enormous amount of sarcasm in this statement).
My favorite part of the appointment, as always, was discussing new trends in research. I love it! He told me about his reservations in the Artificial Pancreas Project and also how he loves Dr. Faustman’s BCG study as well as another study of an oral medication that could be used and without any possible side effects that the BCG may or may not cause due to it restraining the immune system.
Speaking of new research, tomorrow I definitely want to blog about the JDRF announcement today. I would write about it now, but Modern Family is coming on.
Well, my first few days using CGM have been interesting to say the least. The first 3 days were a bit stressful. My numbers didn’t really seem to be anywhere near close. I kept going low. And the pump never showed it. It would trend down but only drop to the 80s when I was really almost 40. It did this for two days! I was a bit stressed but just kept going. I set my low alarm to go off at 90 instead of 80 which helped a lot. It actually woke me up to check in the middle of the night when I was low.
This weekend my parents came to visit us for my birthday! It was a lot of fun. But while we were out doing wine tastings I had to restart my sensor. I knew this ahead of time and was ready for it when it timed out. But for some reason it kept doing weird things when I tried to restart it. It kept asking me to enter BGs when I shouldn’t have had to. After several hours of it doing this I just decided to turn it off to keep it from totally ruining the day. When I got home I decided to just take out the sensor and start a new one to see how it goes. Once I did that it went back to working. In fact, it has been far more accurate now!
Tonight is another sensor restart night so I’m anxious to make sure it goes well. I think I’m making progress and slowly learning how to read it and how the numbers on the pump relate to the numbers on my meter.
Tomorrow is also my endo appointment. My last one with my doctor who is leaving. Should be interesting. I honestly don’t know how my A1C is going to be compared to my last one (which was 6.5). My meter reading my 7 day average as 133 (!) and my 30 average as 153. I’m hoping my A1C turns out more in the 133 range because that would put the A1C at about 6.2 which would tie for the lowest it has ever been!! Keep your fingers crossed for me!
Today is finally the day! After years of anticipation and hope, I am FINALLY connected to a Continuous Glucose Monitoring System!!!
Waking up today was like Christmas morning. I could hardly contain my excitement! We had to take Jovi to the vet this morning which is probably good because it kept me from bouncing around the house all day. Turns out she has worms in her tummy. Poor little baby. I guess it’s not that unusual for a shelter cat to get worms. We just had to give her one dose of dewormer today and she’ll get another one tomorrow. Hopefully this will help her feel better so she can start becoming more comfortable in our house!
So once we got back I started frantically straightening up the house and trying to be busy to pass the time more quickly. Luckily my trainer, Michelle, called way earlier than I expected her to. She was only two minutes from our house! I did a little happy dance and gathered everything up on our kitchen table.
She started by having me turn off my the connection between my One Touch UltraLink Meter and my pump. Which I still don’t understand why they have it programmed the way it is. It forces you to manually enter all your blood sugars which is fairly irritating seeing as the pump doesn’t have number buttons. Buuuuut whatever. We got all the alarms set up. It was really helpful to have her input because I had completely different ideas of what numbers to set my alarms at than what they actually SHOULD be set at.
While we were doing this Michelle kept telling me how amazed she was that I already knew how to do everything. Apparently a lot of people don’t even look at the instructions before they meet with the trainer? And she was even worried that I might not have tried to charge the transmitter. I informed her that she definitely did not have to worry about any of that with me because I’ve been so anxious to get a CGM on that I kind of know everything there is to know about it without actually wearing one.
So, then we get to the only part I was a little nervous about. Insertion! I’ve always described the Sen-Serter insertion device as being just like the Sil-Serter device for the silhouette infusion set. This, in my head, made it seem like no big deal. But then I started thinking about how much I have bled in the past when I insert a silhouette. Needless to say I was a bit concerned. But again, it was great to have Michelle there to literally show me how to do it properly. She used the inserter on my skin to show me the best possible angles and the best possible sites. And eventually I pushed the button! I didn’t feel a thing! I do have a little bit of blood, but apparently that’s not a big deal.
Once you start a new sensor you have to wait 2 hours to actually get the thing working and to start getting numbers. So I said goodbye to Michelle and began another wait! I swear it was the longest 2 hours of my life! But eventually I checked with a fingerstick. 130. Awesome. So now I was officially getting continuous numbers!
Not long after that I started feeling weird. Like low weird. The pump said I was 84. I checked… 60. I thought “Hmm little off but not too bad” and treated the low and went about my business. About two hours later I felt low AGAIN but my pump said 82. I did a fingerstick… 46!!! Aaahh! The sensor screen didn’t even have arrows on it to tell me my BG was dropping or anything. So I got a little upset and was almost in tears thinking that my CGM wasn’t going to accurately tell me when I’m low. I was all sorts of depressed.
Luckily, thanks to my years of diabetes camp I have the advantage of having instant contact with other diabetics. So I sent a text message to Sara (She’s my best friend from camp. No really. We’ve been friends since we were like 11 and even lived together in college). She’s been on the CGM for awhile now and she told me not to worry that the first day is usually not as accurate! So I calmed down. A lot. Michelle also called to check on me and I explained the problem and she explained that the sensor can kind of get a rush of “other stuff” at the site of insertion because your body is trying to heal the little wound you just made. So after a little while it’ll be a little more accurate. So far since the low it has been pretty spot on within 10-20 mg/dl. Hurray!
All in all it’s been an exciting day, and I’m *SO* excited to see some results from this thing!!!!
Soooo I took a little bit of a blogging hiatus over the holidays. The past month and half has been a bit hectic. We’ve been back and forth between Virginia and Pennsylvania. We got a new kitty! Her name is Jovi (after the girl in Elf *NOT* after Bon Jovi). She’s been a bit nervous so we’ve been kind of stressed trying to acclimate her to us and the house and to Willow. I also have a job prospect that I should finally find out about definitively this week. More to come on that if I actually get it. The most important thing however…………
***I’M GOING ON CGMS!!!!!!**** FINALLY!
My insurance easily approved me and Minimed has finally worked with me and I am currently am in possession of a Minimed Continuous Glucose Monitor starter kit and 3 months of sesnsors! I’m so excited! It’s also killing me that I have to wait to put it on. My training meeting is on Wednesday (after Jovi’s first vet appointment).
Another exciting thing is I’ve actually started exercising for a change. My parents got us Wii Fit for Christmas and it has done WONDERS for my blood sugars! I’ve been going low a lot but once I’ve been checking frequently and haven’t been over 180 in days. Love it! Hopefully with the CGM I will be able to work out the basals for days I exercise to prevent the lows without spiking too high.
So that’s pretty much it for us. It’s been busy with family and holidays and what not. Hopefully now that things of calmed down, I will be able to blog a little more!
PS. One of our doctors just blogged about why they are leaving the state. And since my post on the subject was pretty popular I thought you all might be interested in it.
There hasn’t been much diabetes excitement for me today. My BG was a little high this morning but a correction bolus fixed that up for the rest of the day. In other news, Jeff had a fever yesterday. We were supposed to drive home today but the doc gave him antibiotics for a sinus infection. Therefore, we are leaving tomorrow instead. I’m anxious to go home and see my family.
So… I thought I’d share some awesome diabetes related videos with you today! What can I say? I love YouTube!
This first story is simply amazing. I can’t even begin to think about what this lady went through! She is unbelievably amazing! This video is from dLife. If any diabetic reading this doesn’t know what dLife is please check it out! It’s very cool!
The next one is a two-parter. I just thought it was so cool to hear Dr. Best talk about diabetes. I’ve always read about him and Dr. Banting but I didn’t even know video footage existed! I do think, however, that he’s stretching the truth a few things in there. At least that’s what I think from reading Michael Bliss’s The Discovery of Insulin. The patient in the interview is really cool though. It’s interesting to hear where they thought diabetes treatment was heading.
I posted this one on Facebook the other day, but I just want to make sure everyone I know watches it because it’s just too freaking adorable.
Let me start by giving you a little history of my experience with doctors and diabetes. From diagnosis (at age 3) until last year (with only a brief hiatus when I was young) I had been going to the same doctor. He technically was not an endocrinologist, but was a pediatrician who specialized in children with diabetes. He was my lifesaver. He was also the doctor at the camp I’ve gone to since I was 7. In fact, he’s pretty much the reason why I started going to camp in the first place. He got me on the pump. He was amazing. I’m pretty sure I ended up being his oldest patient ever. I was 22 when I had my last appointment with him. And the reason I stopped going to him was because he was retiring and downsizing his patient load. We ended every appointment with a hug. He came to my wedding. We danced at my wedding. He was/is very important to me! I trusted him with my diabetes for nearly 20 years.
The timing kind of ended up working out perfectly. Jeff and I were engaged so I knew I was going to be moving to Virginia.
I, however, was very worried about trying to find an endocrinologist to treat my diabetes. I had actually seen endos in the past but only for my thyroid because I was diagnosed with Grave’s disease a few years ago which is a form of hyperthyroidism. None of my experiences with these doctors were very pleasant. The first doc I saw was ok even though she had a very thick accent and was hard to understand at times. Everything she said did make sense according to all of the research I had done right after my Grave’s diagnosis. I lost that doctor because something happened with her visa and she was no longer able to practice. The last thing I want is to have my doctor constantly changing. It’s much better to have a doc who knows your patterns and your history.
The next doc I saw was really freaking scary. He was very old. He told me he doesn’t “do” insulin pumps. He also almost poked my eyes out when measuring my eyes (enlarged eyes is a symptom of Grave’s). No really, he almost poked out my eyes. He made the measuring thing so small that instead of touching the very outside corner of my eyes, it was going to go directly into my pupils. The look on my mom’s face was classic. And I’m pretty sure I backed away pretty dramatically. He also only took this measurement once so I’m really not sure how he would be able to tell if my eyes were changing in size.
So, the point is, I was really not so excited about having to find a full time endocrinologist to take care of my diabetes.
However, I pretty much I hit jackpot (again). I did some research online and ended up finding an incredible doctor! He has a private practice here in Charlottesville which is co-owned by an internal medicine doctor. It is a small practice. There’s no revolving door of doctors. I was even more excited when I found out that this endo is actually diabetic himself! At my first appointment we discussed different types of pumps and meters and CGMS. He told me about all kinds of research that’s going on. I was in diabetic heaven! He also hooked me up with every lab test necessary. I had never been tested for a Vitamin D deficiency before and it turns out I am actually deficient in Vitamin D. My new doc explained to me that there are studies going on linking D deficiencies to autoimmune disorders including diabetes and Grave’s disease. I felt like so much of my life had been explained. I looked at the timing of my diagnoses and the depression I tend to go into in the winter time. It just felt really good that it could be the answer to my life long unanswered question of “Why me?”
Jeff and I have also been going to the other doc in the office as our primary care physician. He is simply… amazing! He has helped us so much. Jeff hurt his back about a month after the wedding and has been on medical leave. And our doc has done literally everything possible to make Jeff feel better and make him as healthy as possible.
Jeff had an appointment with our PCP today and I tagged along (like I usually do because it’s like visiting family). In the middle of the appointment our doc says, “Ooooooh I have some bad news for you guys… We’re moving.” I felt my heart hit the floor! It turns out because of some changes to the Virginia State Constitution in recent years which are incredibly discriminatory, our doctors have to move because their lawyer doesn’t think their business and finances are safe. Virginia apparently is very harshly and extremely against gay marriages, civil unions, or any kind of domestic partnerships to the point where they are driving all of the gay couples out of Virginia. Lovely.
So, my doctors are leaving me for a state that will welcome them with open arms. And I don’t blame them. But now I am stuck going through the process all over again. I’ve been pretty depressed all day. I’m really hoping I can get lucky for a third time but I know the chances of that are slim. I am constantly hearing stories from other diabetics about how they hate their endos. Not to mention I will likely have a PCP who is clueless about diabetes. Ugh.
I really wish the Virginia House of Delegates and most of the Commonwealth’s voters weren’t bigoted jerks. I really wish they would realize how their stupid and discriminatory amendment was hurting more people than they realize! Charlottesville is losing two of its best doctors and it’s solely the fault of the awful amendment.
Last night was awesome! When I went to bed my BG was 130. My first thought was “UGH! Not again!” But Jeff and I discussed it (we do this often, it helps me to bounce ideas off of him) and I decided to try a temp basal but not cut it back as much as I did the other night. I set it for 80%. Jeff checked me around 7am (because he’s just that amazing) and I was 132. Hurray! I got up a few hours later and was 131! Success!! I don’t know why this miraculously worked or if it will work again, but I’m certainly going to try!
I think one of the best advantages of using a pump over a long acting insulin like Lantus or Levemir is the ability to set a temp basal! I LOVE how I can just set my basal back to a certain percentage if I need to. It keeps me from having to eat at bedtimes sometimes and also prevents me from having to eat before exercising. I just love having the CHOICE of eating or not! It’s something I think a lot of “nons” don’t understand. Sometimes when I’m really sleepy and curled up in bed, I really don’t want to have to go scrounge up a pack of crackers to eat because then I’m not going to be able to sleep as well. I always hate eating before exercising a whole lot too. It makes me feel all icky.
Temp basals are amazing! And I really hope it works again tonight. If it does, I may need to look into making some permanent basal adjustments.
As diabetics we often talk about how people “just don’t understand” and generally when we say this we are talking about negative things. Whether it’s our ability to consume sugar, our frustrations with numbers, or dealing with concealing a pump in a sundress, we always talk about how “nons” just don’t seem to understand what we all have to go through.
This week I’ve been thinking about something POSITIVE that non-diabetics don’t understand. The sheer joy of finding an awesome new infusion site! A few days ago when I changed my set, I noticed this nice little fleshy spot near my hip. Usually, I hate doing it near my hip because I have this weird fear of it hurting more because of the bone. However, I found this nice spot just far enough away that it felt ok to insert.
I also usually hate putting it near the waistline. There is nothing worse than accidentally pulling out your site when you’re getting dressed, going to the bathroom, buckling your seat belt, or any other various reasons to have things moving around in that area. It’s especially frustrating when you don’t know that the cannula has pulled out, until you are puking from extremely high blood sugar. This spot, as you can see the picture, sits nicely above the waistline of my jeans and therefore does not come with the risk of being pulled out.
One more thing that you have to consider in this area is whether it’s going to get bumped a lot. These situations can occur also when changing or going to the bathroom but can also happen when sitting in the chair or sleeping in different positions. Again, this site is perfectly in between my hip and my back area that it doesn’t get bumped at all. In fact, I keep forgetting that it’s even there!
I’m glad I could share a very happy post with you today! I found an awesome infusion site! And I’m excited to use it on the other side of my body when I change it tomorrow! Woohoo!
Lately (and by lately I mean for the past year and a half) my biggest problem with my blood sugars has been at bedtime. Last August I had a scary one. This was before Jeff and I were married and I was living at my parents house in PA. I apparently went incredibly low sometime in the early morning. I also apparently had conversations with my younger brother (who was unable to realize I was low at first) but I don’t remember anything until I came-to in the hallway outside my room with my dad standing over me pouring Coke in my mouth. It’s so incredibly scary when this happens! But it makes me glad that I’ve never had to live alone.
That morning my mom called me to ask me a question (I of course was still in bed). She thought I sounded funny and was worried (she’s my mom) that this was more than sleepiness so she called my brother. He came in and said something to me and I responded so he told her that I was fine. She still didn’t think I was fine so told him to go in again. He tossed me a little tube of glucose tabs which apparently made me angry. My brother apparently started to realize something was up. So my mom called my dad because he was able to get home quicker. When I was finally conscious I learned that he had put that gross gluco-gel stuff in my mouth which made me cry (which I found funny after the fact since we always joke at camp about how nasty it tastes). I also was apparently fighting him and he had to restrain me to treat me. Needless to say it was an incredibly bad low. I’ve only had a few like this before but this is probably the worst I’ve had since going on the pump 10 years ago.
So, that’s how I finally realized I was having lows in the middle of the night. Since then, I have NOT been able to get my overnights under control. I have gone to the doctor many times since then and even switched doctors. I’ve changed basal rates and they work for a couple weeks and then I just start dropping again. I don’t understand it all.
The reason for this post today is because for the past week and a half I’ve been using the basal pattern that I use for certain times of the month when my blood sugars tend to be lower even though it isn’t actually the time to use it. I keep dropping. I don’t feel comfortable going to bed unless my BG is in the 200s. Which really isn’t good in the long run, but I’m just so afraid of dropping in the middle of the night.
Last night I checked about an hour before bed and I was 130. I ate a pack of crackers. An hour later, I was still 130. Whaaaaat? So I set my basal rate back to 75%. And I woke up 250! UGH!!
In conclusion, I absolutely HATE bed time. It’s so stressful for me and makes it hard to sleep and hard to have decent blood sugars.
Posted by cgstrauch 
