The other day somebody innocently tweeted that diabetes management was a team effort.That got me thinking and although it’s dangerous to push metaphors too far I don’t believe thinking of diabetes management in terms of a team is appropriate or helpful.
The team analogy implies that everyone has a role to play at all times and most importantly that everyone shares the joys of victory or the bitterness of defeat. This is simply not true. It is me and me alone who feels the hypos, the highs, the fear and reality of complications. Every finger prick, every needle, every blood test, dilated pupil exam or pump site change is felt by me alone. It is me who savours the ‘victory’ of a straight line on the Libre after eating pasta or the relief of a ‘clear’ complication screening. The closest I come to sharing this is the empathy in the diabetes community when rejoicing or commiserating with those of us who know exactly what it’s like. Continue reading →
A new pump is available in Australia, right now. The Ypsomed (pronounced ipsomed) has been TGA approved and will be reimbursed by your health fund and the consumables are on the NDSS. I was invited to attend a soft launch of the product and provided with a loan pump to ‘test-drive’. Ypsomed covered my travel and accommodation expenses to attend this event and lent me a pump to test drive. I have not been paid or expected to write about or comment on this or any other product.
The first thing I noticed about the Ypsomed is its size. It’s small and lightweight. I REALLY like that it is much smaller and much less bulky than my current pump (which is only a few months old and yet is the biggest pump I have ever owned).
It has a large, touch screen. Despite being small, almost the entire front of the pump is the screen, so it’s easy to read and use.
The pump is made in Switzerland (which has a reputation for quality in manufacturing) but 24/7 support is local rather than using an international call centre.
I was surprised to learn that Ypsomed has a long history of involvement in diabetes devices. They were, in fact, behind the Disetronic pumps available in the 80s through to the early 2000s. The current pump has been available in Europe since 2016.
The pump has a glass cartridge, which appeals to me as I feel the insulin may be less likely to degrade in glass and hope that at least there will be a tiny bit less plastic diabetes waste around as a result. Here’s hoping that Novo start bringing the pre-filled cartridges into Australia (they are currently available in Europe).
It is water proof (although I haven’t tested this…yet) and takes a AAA alkaline battery (the pump won’t accept lithium batteries).
A downside at the moment is that the pump doesn’t ‘talk’ to any of the CGMs, so blood sugar readings would need to be entered into the MYLife app manually in order to calculate correction doses. Ypsomed staff assured us that they are in talks with most of the CGM and Flash manufacturers
I understand that the Ypsomed blood glucose meter talks directly to the app for bolus calcs etc.
I haven’t actually attached the Ypsomed pump yet-I plan to in the next day or two (no sense wasting the full insulin reservoir in my current pump. I shall update this review about usability and button pushes and also the use of the app once I’ve worn it for a while.
I am excited about a pump that is smaller AND the fact that more players are entering the insulin pump market. I was worried with the withdrawal of J&J that we might end up with only one pump in Australia. I’m sure that every pump has its own pros and cons but if you are looking for a pump or an upgrade make sure you check out all available options. Some educators or endos tend to push the pump that they’re most familiar with, I’m all for choice-so make sure you see a sample of ALL the pumps in the Aussie market before you commit.
So the diet wars are hotting up again, I have a sense of deja vu… again.
I have had diabetes all my life and soon I will notch up 50 years. I’ve seen the advice chop and change over that time. Firstly it was eat loads of carbs at breakfast, morning tea, lunch, afternoon tea, dinner and supper. The distinction was made between starch and sugar. So it was thought that a piece of fruit would ‘burn up’ in your system more quickly than, say a slice of white bread. Then there was eat a balanced diet, then there was the Glycemic Index diet, then there was the carb counting and insulin dose ratio approach. Now we are learning that protein impacts upon blood sugar, as does eating fats but only if consumed with carbohydrate-so those after tight control are counting and blousing for protein and fats as well as carbs. Lately very low carbohydrate diets have been gaining attention and some very zealous followers.Continue reading →
UK endocrinologist and all round good guy, Partha Kar has been musing about patient involvement in funding allocations on his blog. I can’t help but respond, as Partha notes in his blog, he is thinking aloud and so am I, also playing devil’s advocate.
As a side note I have interacted with Dr Kar on twitter and he is genuinely interested in patient thoughts and is an advocate for patient involvement and the patient voice, so I trust he’ll take this as another step in the “debate”.
“Policy role can be much fun…it can also be very troubling…making judgement calls which may affect many is never easy- and it does always make me wonder- how much benefit would direct patient involvement help? I mean- lets get this right- absolutely a must, we all should do it…but how much would that help if- say- there came the question of allocating money to services?”
He goes on to suggest that patients will think in silos just like everyone else
“could patients help or even directly advise where to allocate that money?
Or would they be dictated by their own niche? …The argument that those who live with it- know more what to do with the money also falls a bit flat- when say a Type 1 diabetes person has to make a call over wider budget of diabetes- lest[sic] face it- their knowledge of living with Type 2 diabetes is the same as mine- nearly non-existent. Tricksy, isn’t it?”
Have you ever wondered how your diabetes would react if you were able to test it under “laboratory conditions”. Well I came pretty close last week-damn close to being the perfect diabetic-for 5 and a half hours anyway. Continue reading →
There’s been WAY more good in my life, both diabetes and otherwise than bad or ugly this year. A fact for which I’m grateful but as the year lurches towards its conclusion I’ll add to the nostalgia doing the rounds with some reflections of the good, the bad and the ugly as I see it in the world of diabetes in 2017.
If low carb works for you, that’s great and if you want to share your success on social media, great, go for it. What is not cool is lecturing/haranguing and shaming people who don’t treat their diabetes in the same way you do. Everyone’s metabolism is surprisingly different so lay off the judgement and assumption that because it works for you, it must work for everyone.
It’s 2017, the internet has been a thing for over 20 years. Why are health professionals in Australia still relying on faxes to do referrals etc? This is ugly or maybe bad or perhaps both.
Insulin has been available to sustain life in people with diabetes for 97 years. Why are people with type 1 in one of the world’s richest nations having to ration insulin because they can’t afford it? The answer is that companies are doing what they are obliged to do,maximise profits. Society is failing in its duty to limit that profiteering. Democratic governments should act in the best interests of their people, it is a disgrace that the US government has failed for decades to do this. #insulin4all and @T1international are great but they shouldn’t be necessary.
Whilst I am enormously grateful for the level of taxpayer subsidy we receive in Australia, it is disappointing that we’re still waiting for the “imminent” announcement regarding subsidisation of the Freestyle Libre and that CGM has been subsidised based on age rather than clinical need. (Notwithstanding that the subsidisation is wonderful and due in no small part to tenacious advocacy work by those in the type 1 community).
I also take this opportunity to remind everyone that the price paid for NDSS products has risen with the CPI for people with diabetes BUT the government has not paid anymore for the products and is in fact, looking for a reduction in price from the producers. Let’s not be complacent about the cost of living with diabetes.
It was fabulous that Diabetes Australia recruited social media junkies 🙂 with diabetes to report on the ADS-ADEA Annual Scientific Meeting. This conference was great in that not only were a small group of us enabled to attend to share the proceedings with others, but there were many voices of people with diabetes throughout the conference.
The social media world made my life so much easier when my out of warranty pump failed. A million thanks to the person who sent me their “spare” pump to save me from injecting Protaphane and also to the endo who communicated with me so quickly and facilitated my new pump. The system worked for me despite me not being as ontop of things as I should have been (shouldn’t really have let my pump get so far out of warranty.)
Diabetes actually gave me more than it took this year-opportunities to travel, shared experiences and friendship. I don’t know whether the “gift” that keeps on giving will strike back in 2018 or beyond (and some years it’s definitely taken a lot) but to all my friends with type 1 D thanks for your support and comraderie here’s to kicking diabetes’ arse for another few decades. Cheers!
Imagine being gathered around the Christmas tree and and unwrapping a startling visual reminder of diabetes complications. Well this is what some British diabetes organisation is suggesting people with diabetes might like to find in their Christmas stocking.