5 ms·

I've had Diabetes since I was eleven years old. For the last seventeen years. To be in good health, every day I have to: * Measure my blood sugar at least six

by pimeys 14y ago

I've had Diabetes since I was eleven years old. For the last seventeen years. To be in good health, every day I have to: * Measure my blood sugar at least six times a day * Take at least six shots of insulin * Always think what I eat. How many grams of carbohydrates is in the stuff I put into my mouth. * I have to be very careful with alcohol. I've once woken up by an emergency crew while having a hangover. Never again. (Weed is much better though.) * I have lots of small annoyances which require medical care every now and then. * Influenza is a catastrophe - it will take ages and my blood glucose is not going normal easily. Try to forget any of these, and bam your general health is at risk. It's not so easy all the time to be fully with your body and take care of yourself. What I would love is a bloodless way of measuring my glucose, a way to get the results to my iPhone and a way to calculate the amount of carbohydrates I have in front of me. No, a database of different foods is not enough. I have to do it 4-5 times a day, remember. When you have to do something many times a day for the rest of your life, it should be as easy as possible.

shanselman 14y ago
Have you thought about a pump (no shots, more accuracy) and a DexCom CGM (only finger stick a few times a day, pretty accurate). I complain in the post but I will say this, of you're serious about staying alive, you MUST get an Insulin Pump.
- phren0logy 14y ago
  MD here: (disclaimer - I'm A doctor, but not YOUR doctor, so ask YOUR doctor). Seriously consider a pump. Seriously.
- pimeys 14y ago
  I've always thought the pump is not for me. It seems to be pretty big and you always have to carry around it with you. My life is still pretty fast paced and sometimes that kind of machinery is just an annoyance to get along with. The shots are not the problem, the everyday need of full control of your life is.
  - shanselman 14y ago
    It's smaller than the phone you already carry around. It's mathmatically and demonstrably superior to shots. They have integrated CGMs now. Ask around, the folks with the fastest paced lives (diabetic Olympians, marathoners, world travelers, etc) ALL have pumps. Unless you have a 6% HA1C on shots, get a pump and live decades longer.
    - pimeys 14y ago
      Thanks everybody, I'll talk with my doctor tomorrow when I have an appointment.
    - kamens 14y ago
      Will back up Scott here -- while not an olympian, I rowed for 4 years on the pump and have biked x-country w/ it. I seriously doubt if I would've been up to doing either while managing injections instead of button presses.
    - LocalPCGuy 14y ago
      My wife is Type 1, and was on the pump but went off of it after about a year. Says she feels in more control without it, and that it gave her a false sense of "security." And she has had better results since, and more stable sugars. I don't know, obviously, not being diabetic myself, but I will say she went on the pump really soon after being diagnosed and didn't really have a chance to establish a routine first, and that probably played a large part in her doing better on shots right now. I've been encouraging her to start thinking about using the pump again, as I do feel that, used correctly, as I believe it is a better method, but she has to do what she feels works best for her. Being a developer myself, the idea that she has to use a custom cable and custom software to manage the data she has in her meter drives me a bit nuts. But the meter industry is, IMO, full of companies that don't really want to help users, they just want to get rich off of diabetics. I know thats a bit cynical, and I'm sure there are companies that sincerely care as well, but it's how I often feel about the meter industry.
  - crisnoble 14y ago
    I used to think the exact same thing, somehow I think I was really just afraid that someone would see thing thing embedded in me if I ever had my shirt off. When I finally got a pump I realized that it simultaneously keeps itself out of the way while allowing me quick access to my (approximate) levels. I can give my self insulin mid sentence in a board room meeting. I can see my levels dipping and get a lifesaver before it sets in. The worst that ever happens is that someone asks what the hell I am doing with a pager. In short, the pump CGM combo it is the best thing I have ever done.
- gte910h 14y ago
  You DO have to constantly calibrate the pump though. It's not a perfect solution. I am astounded there is not a close loop system yet.
  - femto 14y ago
    Are the papers here [1] relevant? I sat in on this conference session as a student, and don't have access to the full papers to check my recollection. As I recall, most of the papers revolved about the theme of closed loop control of blood sugar. At the time this was presented, the results were billed as the biggest advance in Intensive Care in recent history. The authors claimed to have hard numbers, showing that closed loop control of blood sugar for ICU patients was delivering (something like 40% if memory serves me???) fewer deaths for ICU patients. I'm not in the ICU area, so I don't know if the techniques outlined in the paper made it into clinical practice or real products. If so, you'd think it would trickle down into diabetes management. As a non-diabetic, am I completely misunderstanding the problem? The International Federation of Automatic Control (IFAC) is the peak body for control research, so there's a good chance you will read about any new closed loop system there. [1] http://www.sysid2006.org/Wednesday.html#web4 http://www.sysid2006.org/Wednesday.html#web4 --- Edit: A couple more links from my poking around. Might provide some reading if closed loop control of diabetes is of interest. http://www.medschl.cam.ac.uk/paediatrics/pages/wilinska.html http://www.medschl.cam.ac.uk/paediatrics/pages/wilinska.html Closed Loop Insulin Infusion for Critically Ill Patients (with pictures of an actual device): http://www.clinicip.org/ http://www.clinicip.org/ --- Edit: Found the actual numbers here: http://cordis.europa.eu/search/index.cfm?fuseaction=proj.document&PJ_RCN=6536578 http://cordis.europa.eu/search/index.cfm?fuseaction=proj.doc... 42% reduction in mortality, compared to the old insulin control method, which I presume is open-loop?
  - shanselman 14y ago
    You mean calibrate the CGM? There's no pump calibration needed.
    - gte910h 14y ago
      My relative is definitely calibrating some instrument related to the pump multiple times per day.
- Shivetya 14y ago
  A pump does not remove the need for shots and as for the accuracy, well that is up for debate. You still have to learn the bias of the readings it generates versus the manual test. It is a lifestyle change from shots, you will be moving the point of insertion quite a bit and some sports may be better served with a shot regimen. There is one nice feature of having a pump, with an always attached device you can get warnings when your asleep which can save your life. Many of these devices will either beep or vibrate or both when you enter a danger range. Even if it does not alert you it could alert whomever your sleeping with; even pets will take notice and possibly wake ya. Last note, most insurance plans expect the pump to be replaced after a couple of years so find out up front how many years before you should expect to replace it.
SkyMarshal 14y ago
You, and everyone with diabetes, should seriously read the first chapter of this book [1]. The author discovered he could treat his wife and son's diabetes with a major diet change, by eliminating all foods that cause a blood sugar (and resulting insulin) spike - sugar, HFCS, grains, most processed food, etc. His assertion is that he current method of treating diabetes is based on classical mechanics, 1-in-1-out, etc., where you measure your blood sugar and try to manually maintain it at a certain level with sugar and insulin. But ... 1) the human body is a complex, non-linear, dynamic system. It is based on and responds to signalling, genetic triggers, etc., and ... 2) you don't need to micromanage your body, it will take care of itself as long as you don't essentially poison it. 3) the old method presumes there is something wrong with your body, when in actuality, the problem is with the way your body reacts to 'modern' (post-agricultural) foods. Diabetes is a symptom of that, so cut those foods out, and diabetes goes away. It may not apply to all types of diabetes, IANAE, but seriously, stop by a bookstore and spend 20m reading just the first chapter (maybe 2, can't recall exactly), and figure out if it's something worth looking into further. 1. http://www.amazon.com/The-New-Evolution-Diet-Paleolithic/dp/1605291838 http://www.amazon.com/The-New-Evolution-Diet-Paleolithic/dp/...
- Daniel_Newby 14y ago
  > ... the old method presumes there is something wrong with your body ... The comment you replied to is presumably about type 1 diabetes, an inflammatory disease that destroys the body's ability to produce insulin. You are referring to type 2 diabetes.
- joeconway 14y ago
  I realise your intentions are good, but most diabetics get the paleo advice every other day.
  - shralpmeister 14y ago
    ...and they should take it to heart. I went from >12% to <6% A1C by cutting out carbs, taking a low dose of metformin (750mg slow release per day) and throwing in a bit more light to moderate exercise. Credit to Dr. Bernstein (http://www.diabetes-book.com/ http://www.diabetes-book.com/) who is a type I diabetic himself, but really we're now hearing the same things from Taubes, Lustig, the Paleo folks and many others. Obviously low carb diets alone aren't the whole solution. Berstein's book contains a wealth of information on living with diabetes well into old age. It's a great read for diabetics or for anyone caring for a diabetic.
sergeo 14y ago
Please don't consider this as a plug, just trying to help. Our company, MyNetDiary, provides an awesome food diary app (the only 5-star paid diet app on the iPhone). It's highly polished and uses some very advanced tech under the hood. The most frequent word in user review is "easy". For almost a year, we are working on a special diabetes tracking app built on top of it. It does not integrate with BG hardware (would need FDA Class 1 approval), but we are exploring options. The app will help you keep track of foods, exercise, and - with manual entry - your BG readings and insulin. We've been doing this for 5 years and know what we are talking about - this is the best app for tracking diabetes. It's a couple of weeks from release, we are testing release candidate. If you are interested in trying it sooner, we can provide an Ad-Hoc build for iPhone. More info: http://www.mynetdiary.com/diabetes-tracker-for-iPhone.html http://www.mynetdiary.com/diabetes-tracker-for-iPhone.html My contact info is in profile.

by pimeys 14y ago

shanselman 14y ago

Have you thought about a pump (no shots, more accuracy) and a DexCom CGM (only finger stick a few times a day, pretty accurate). I complain in the post but I will say this, of you're serious about staying alive, you MUST get an Insulin Pump.

phren0logy 14y ago
MD here: (disclaimer - I'm A doctor, but not YOUR doctor, so ask YOUR doctor). Seriously consider a pump. Seriously.
pimeys 14y ago
I've always thought the pump is not for me. It seems to be pretty big and you always have to carry around it with you. My life is still pretty fast paced and sometimes that kind of machinery is just an annoyance to get along with. The shots are not the problem, the everyday need of full control of your life is.
- shanselman 14y ago
  It's smaller than the phone you already carry around. It's mathmatically and demonstrably superior to shots. They have integrated CGMs now. Ask around, the folks with the fastest paced lives (diabetic Olympians, marathoners, world travelers, etc) ALL have pumps. Unless you have a 6% HA1C on shots, get a pump and live decades longer.
  - pimeys 14y ago
    Thanks everybody, I'll talk with my doctor tomorrow when I have an appointment.
  - kamens 14y ago
    Will back up Scott here -- while not an olympian, I rowed for 4 years on the pump and have biked x-country w/ it. I seriously doubt if I would've been up to doing either while managing injections instead of button presses.
  - LocalPCGuy 14y ago
    My wife is Type 1, and was on the pump but went off of it after about a year. Says she feels in more control without it, and that it gave her a false sense of "security." And she has had better results since, and more stable sugars. I don't know, obviously, not being diabetic myself, but I will say she went on the pump really soon after being diagnosed and didn't really have a chance to establish a routine first, and that probably played a large part in her doing better on shots right now. I've been encouraging her to start thinking about using the pump again, as I do feel that, used correctly, as I believe it is a better method, but she has to do what she feels works best for her. Being a developer myself, the idea that she has to use a custom cable and custom software to manage the data she has in her meter drives me a bit nuts. But the meter industry is, IMO, full of companies that don't really want to help users, they just want to get rich off of diabetics. I know thats a bit cynical, and I'm sure there are companies that sincerely care as well, but it's how I often feel about the meter industry.
- crisnoble 14y ago
  I used to think the exact same thing, somehow I think I was really just afraid that someone would see thing thing embedded in me if I ever had my shirt off. When I finally got a pump I realized that it simultaneously keeps itself out of the way while allowing me quick access to my (approximate) levels. I can give my self insulin mid sentence in a board room meeting. I can see my levels dipping and get a lifesaver before it sets in. The worst that ever happens is that someone asks what the hell I am doing with a pager. In short, the pump CGM combo it is the best thing I have ever done.
gte910h 14y ago
You DO have to constantly calibrate the pump though. It's not a perfect solution. I am astounded there is not a close loop system yet.
- femto 14y ago
  Are the papers here [1] relevant? I sat in on this conference session as a student, and don't have access to the full papers to check my recollection. As I recall, most of the papers revolved about the theme of closed loop control of blood sugar. At the time this was presented, the results were billed as the biggest advance in Intensive Care in recent history. The authors claimed to have hard numbers, showing that closed loop control of blood sugar for ICU patients was delivering (something like 40% if memory serves me???) fewer deaths for ICU patients. I'm not in the ICU area, so I don't know if the techniques outlined in the paper made it into clinical practice or real products. If so, you'd think it would trickle down into diabetes management. As a non-diabetic, am I completely misunderstanding the problem? The International Federation of Automatic Control (IFAC) is the peak body for control research, so there's a good chance you will read about any new closed loop system there. [1] http://www.sysid2006.org/Wednesday.html#web4 http://www.sysid2006.org/Wednesday.html#web4 --- Edit: A couple more links from my poking around. Might provide some reading if closed loop control of diabetes is of interest. http://www.medschl.cam.ac.uk/paediatrics/pages/wilinska.html http://www.medschl.cam.ac.uk/paediatrics/pages/wilinska.html Closed Loop Insulin Infusion for Critically Ill Patients (with pictures of an actual device): http://www.clinicip.org/ http://www.clinicip.org/ --- Edit: Found the actual numbers here: http://cordis.europa.eu/search/index.cfm?fuseaction=proj.document&PJ_RCN=6536578 http://cordis.europa.eu/search/index.cfm?fuseaction=proj.doc... 42% reduction in mortality, compared to the old insulin control method, which I presume is open-loop?
- shanselman 14y ago
  You mean calibrate the CGM? There's no pump calibration needed.
  - gte910h 14y ago
    My relative is definitely calibrating some instrument related to the pump multiple times per day.
Shivetya 14y ago
A pump does not remove the need for shots and as for the accuracy, well that is up for debate. You still have to learn the bias of the readings it generates versus the manual test. It is a lifestyle change from shots, you will be moving the point of insertion quite a bit and some sports may be better served with a shot regimen. There is one nice feature of having a pump, with an always attached device you can get warnings when your asleep which can save your life. Many of these devices will either beep or vibrate or both when you enter a danger range. Even if it does not alert you it could alert whomever your sleeping with; even pets will take notice and possibly wake ya. Last note, most insurance plans expect the pump to be replaced after a couple of years so find out up front how many years before you should expect to replace it.

SkyMarshal 14y ago

You, and everyone with diabetes, should seriously read the first chapter of this book [1]. The author discovered he could treat his wife and son's diabetes with a major diet change, by eliminating all foods that cause a blood sugar (and resulting insulin) spike - sugar, HFCS, grains, most processed food, etc. His assertion is that he current method of treating diabetes is based on classical mechanics, 1-in-1-out, etc., where you measure your blood sugar and try to manually maintain it at a certain level with sugar and insulin. But ... 1) the human body is a complex, non-linear, dynamic system. It is based on and responds to signalling, genetic triggers, etc., and ... 2) you don't need to micromanage your body, it will take care of itself as long as you don't essentially poison it. 3) the old method presumes there is something wrong with your body, when in actuality, the problem is with the way your body reacts to 'modern' (post-agricultural) foods. Diabetes is a symptom of that, so cut those foods out, and diabetes goes away. It may not apply to all types of diabetes, IANAE, but seriously, stop by a bookstore and spend 20m reading just the first chapter (maybe 2, can't recall exactly), and figure out if it's something worth looking into further. 1. http://www.amazon.com/The-New-Evolution-Diet-Paleolithic/dp/1605291838 http://www.amazon.com/The-New-Evolution-Diet-Paleolithic/dp/...

Daniel_Newby 14y ago
> ... the old method presumes there is something wrong with your body ... The comment you replied to is presumably about type 1 diabetes, an inflammatory disease that destroys the body's ability to produce insulin. You are referring to type 2 diabetes.
joeconway 14y ago
I realise your intentions are good, but most diabetics get the paleo advice every other day.
- shralpmeister 14y ago
  ...and they should take it to heart. I went from >12% to <6% A1C by cutting out carbs, taking a low dose of metformin (750mg slow release per day) and throwing in a bit more light to moderate exercise. Credit to Dr. Bernstein (http://www.diabetes-book.com/ http://www.diabetes-book.com/) who is a type I diabetic himself, but really we're now hearing the same things from Taubes, Lustig, the Paleo folks and many others. Obviously low carb diets alone aren't the whole solution. Berstein's book contains a wealth of information on living with diabetes well into old age. It's a great read for diabetics or for anyone caring for a diabetic.

sergeo 14y ago

Please don't consider this as a plug, just trying to help. Our company, MyNetDiary, provides an awesome food diary app (the only 5-star paid diet app on the iPhone). It's highly polished and uses some very advanced tech under the hood. The most frequent word in user review is "easy". For almost a year, we are working on a special diabetes tracking app built on top of it. It does not integrate with BG hardware (would need FDA Class 1 approval), but we are exploring options. The app will help you keep track of foods, exercise, and - with manual entry - your BG readings and insulin. We've been doing this for 5 years and know what we are talking about - this is the best app for tracking diabetes. It's a couple of weeks from release, we are testing release candidate. If you are interested in trying it sooner, we can provide an Ad-Hoc build for iPhone. More info: http://www.mynetdiary.com/diabetes-tracker-for-iPhone.html http://www.mynetdiary.com/diabetes-tracker-for-iPhone.html My contact info is in profile.