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Posts from the ‘Diabetes Tech’ Category

The NEW Jerry the Bear.

Since they’re local to me here in Rhode Island, I drove up to the Jerry the Bear office to meet with my friends Aaron Horowitz and Hannah Chung, creators of Jerry the Bear.

“It’s awesome to see you guys! Where have you been the last few years?”

After hugs and hellos, I realized my question was unfair. Because they haven’t been hiding but instead, the team behind Jerry the Bear has been working tirelessly to change their business in efforts to meet their mission of getting Jerry into the hands of every child diagnosed with type 1 diabetes globally.

That’s quite a mission. But if anyone can accomplish this goal, the driven, passionate, creative, and all-heart team behind Jerry can.

Just your friendly neighborhood Jerry the Bear!

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“As a business, we know that Jerry the Bear works, but in order to succeed and survive, we need to make the business work. We’ve been working to move our company from a direct to consumer model to a business-to-business model. This means we’re not selling our bears directly to people but instead have partnered with two different distributors in order to get Jerry into kids’ hands,” said Jerry the Bear co-founder and CEO, Aaron Horowitz.

Namely, they’ve partnered with Beyond Type 1 to handle domestic and international orders (except Canada) and Diabetes Express for our neighbors to the north.

“We want to improve life with diabetes for kids by giving them something positive to associate with diabetes,” said Hannah Chung, co-founder and CCO.

The Sproutel team did a lot of research in developing new Jerry. In addition to marathon sessions with post it notes, building paper prototypes, and “body storming,” the team went into the field to access kids in their natural play habitats. Hannah told me that she went to playgrounds during the development phase in order to work with kids and see if they could hold a bear and a phone at the same time, testing out how the app might be physically managed by their target age range of 4 – 9 years old.

“I’d go into the playground with a bear peeking out of the back of my backpack and a handful of permission slips, talking with kids and their parents. We play games like Simon Says in order to see if kids could find the bear’s belly button or elbow, and whether or not they preferred phones or tablets.”

The mental image of Hannah traipsing through Rhode Island playgrounds with a mission to improve the diabetes experience and a stuffed animal keeping watch over her shoulder sums up the Jerry philosophy for me. This team – Hannah, Aaron, Joel Schwartz, and Brian Oley – are changing the way newly diagnosed kids with diabetes are introduced to diabetes.

I think about my own diagnosis back in 1986 – what a difference it would have made to be handed a friendly bear instead of an orange to practice injections on.

In meeting the new Jerry the Bear, the first thing I noticed was that the touch screen tummy of his predecessor was gone. Coming in at a price point of $55 versus the $299 cost of Original Jerry, New Jerry (henceforth known simply as Jerry) is a soft, plush animal without any plastic or metal hardware attached to him. He’s snuggle-ready. Looking similar to my daughter’s army of Build A Bear stuffed animals and sporting giant, Beanie Boo-esque eyes, Jerry looks like huggable buddy, the perfect comfort companion for kids with diabetes.

What’s replaced the touch screen belly, however, is an amazing upgrade. Jerry now comes with a digital world that lives on an iOS or Android device, and the app is completely free. And on Jerry’s plush body are scannable patches that serve as unique QR codes, giving rise to augmented reality play.

“We were excited to see Pokemon Go! come out and see such success,” said Aaron. “Jerry has that same kind of virtual world superimposed onto the real world. Now it is easier for Jerry’s actions to be procedurally detailed.”

Checking Jerry's BG.

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This means that you’re not just squeezing the pad of Jerry’s finger, but instead you’re walking through all the details of checking blood sugar, from putting the test strip into the meter, pricking his finger, squeezing out a drop of blood, and applying the blood to the strip. The tasks feel real, and they feel thorough.

DO feed the bear!

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The app doesn’t require an actual Jerry the Bear stuffed animal to engage in Jerry’s world, though, and that’s one of my favorite upgrades to this experience. While Jerry himself requires a purchase, the app is free for download. And with that download comes a full world of diabetes experiential learning through the Jerry lens.

“My favorite things about [new] Jerry are that you can explore Jerry’s world in full just on the app, and also that scanning his sites gives you detailed steps around how to use Jerry’s diabetes kit,” shared Hannah. Aaron agreed, adding, “Also that you can experience Jerry instantly through the app. And that the action of scanning changes the world around you, through augmented reality play.”

“What’s the weirdest thing you saw during the test group sessions?” I asked.

Aaron laughed. “You wouldn’t believe how often kids feed Jerry’s butt.”

So there’s that.

While Jerry is aimed at helping kids in the  4 – 9 year old range who are newly diagnosed with diabetes, his potential reaches FAR past that specific demographic.  Jerry, in our home, has been used to help my daughter understand her mother’s diabetes.  He’s been a teaching tool to show kids in her class and our neighborhood what diabetes is all about.  Imagine Jerry as part of a diabetes camp experience, where teenagers can lean on levity and being silly with a stuffed animal to work through some of their frustrations.  Or helping open up discussions for all age ranges about diabetes distress or burnout.  Jerry could be a powerful conduit for conversation for all people touched by diabetes.

This little bear has potential, and plenty of it.

One more thing:  I’d love to share Jerry with two Six Until Me readers, and all you need to do is leave a comment.  Through a random number generator, I’ll select two commenters to ship a snuggly Jerry to.  This giveaway will be open until Sunday night at midnight eastern time, and winners will be notified by email.

Want to enter?  Leave a comment, and be sure to include your email!

You can check out Jerry the Bear’s new app by downloading it from iTunes or Google Play. You can also follow Jerry on Twitter, Facebook, or Instagram. To order your own Jerry, visit Beyond Type 1 (or Diabetes Express, if you’re in Canada). Thanks to the Sproutel team for letting me come over and play!

Dexcom Rash: Updated.

Frigging rash.  The issue first presented itself back in August 2012, leaving me scratching my head and itching my sensor sites for the next four years.

At first, I tackled the problem by trying a pile of different barrier tapes, but the only one that brought about any semblance of relief was the Toughpad.  For about a year, I used a Flovent inhaler (sprayed on my skin before applying the CGM sensor), but I was cautioned against it by my first dermatologist, who cited that the skin would become thinner and compromised after prolonged use.  For the last few years, I’ve used the Toughpad exclusively, and it’s held the rash at bay.

Sort of.

It’s never ever perfect.  I’m still itchy as eff sometimes when I’m in the midst of using a sensor (like right now, with my sensor on my right thigh and the skin around the Toughpad is bright red and I want to scratch it off until my nails break but the low alarm that went off two nights ago saved my ass entirely so I’m leaving the sensor on as long as I can stand it).  The rash doesn’t seem to be concentrated underneath the Toughpad as much as before, but now I appear to be allergic to the Opsite Flexifix tape.  Add that to the fact that I get skin irritation even if I put the new sensor next to any place where a sensor has even BEEN for the last month.

A week or two ago, I went to the dermatologist to further investigate my Dexcom rash and to hopefully find different ways to scratch that itch, so to speak.

The new dermatologist circled me like a shark, only maybe a shark in search of medical journal material.  “You’re having an allergic response to the medical device adhesive?”

“Yes.  Since 2012.”

He paused.  “So just don’t use that medical device?”

“Not an option.”  (Totally not an option, especially these days, when I can’t feel my low blood sugar symptoms and I don’t take action on my high blood sugar symptoms unless the CGM is alarming.  This is why I wear a CGM.  And while I’m taking care of two little kids, this is why I will continue to wear my CGM.)

“Okay …” said the dermatologist, looking at my arm and thighs again, assessing the skin damage.  “A Flovent inhaler, too?  You mentioned using that in the past?”

“Yes, but after being warned it would thin out my skin, I stopped.”

“Good call.  Listen, I think we can try two things:  a topical steroid cream, or a non-steroid topical cream.  I would like try the non-steroid one first, because the same skin-thinning issue would happen otherwise.”  He handed me a prescription.

We scheduled a follow up appointment and I was sent on my scratchy way.  The cream, it turns out, comes with a dozen different creepy warnings that have made me very reluctant to try it while breastfeeding my son, but I did put a little bit on my rash and, within the hour, my rash was on fire and the urge to itch was all consuming.  I’m not touching this stuff again until after I’m done breastfeeding, and even then I’ll be very conservative, in case I’m allergic to this shit, too.

I’m not sure what people are doing these days to manage their adhesive irritations, but I’m reaching the end of my available skin real estate.  Any advice out there? It’s been a very long few years of wearing the CGM 24/7 and I’ve just about run out of sites that aren’t already scaly and raw.  I hear rumors about a “sensitive” adhesive being released by the Dexcom team, and about certain elements being removed from the current adhesive makeup, but until those products are shipped to my house and not sending my skin into circus mode, I’m at an itchy loss.

Review: Verio Flex Meter.

For years, my love for the One Touch Verio Sync meter knew no limits.  Despite a slightly MS-DOS interface that only showed me one result at a time and didn’t let me scroll back to other results unless I loaded them to the Reveal application, I loved this meter.  It was small, it was accurate (as compared to my Dexcom CGM, which I feel is my personal gold standard), and it was covered my by insurance.

I really liked how it worked with the Reveal app the most, though.  I have always struggled with maintaining a blood sugar logbook, and being able to bluetooth my results to my phone and have them collect in an at-a-glance and also an in-depth data map took the heat off my data angst.

But not everyone loved the Sync.  And recently, it was scrapped and replaced by the Verio Flex meter.

I resisted the Flex mostly because I hate change (<– curmudgeon font), but a few weeks ago, I finally switched over (after putting my two Verio Syncs into a cryptex).  Here are my initial thoughts:

PROS:

The Verio Flex turns off immediately after you take the test strip out of it.  This is a nice change from the Sync, where it would either have to time out or be pushed off using the button after each blood sugar check.  The auto-off helps conserve battery (more on why that matters in the CONS section).

There’s a small color chart on the bottom of meter screen (on the actual housing of the meter – see picture) where an arrow shows up underneath each BG result to indicate low, high, or in range.  While this isn’t as useful for me because I’m familiar with the ranges recommended for me, this could be a really useful feature for folks newly diagnosed or who aren’t as familiar with in-range and out-of-range.

It comes with a Delica lancing device, which is my favorite, if you can say such a thing about a device meant to pierce skin.

It’s durable and decently priced.  I paid $19.99 for mine at CVS and when it dropped onto the hard kitchen tile that same night, it did not smash to bits.

CONS:

The battery life doesn’t appear to be awesome.  My glucose meters in the past have taken over a year to burn through a battery, but I’ve already replaced the Flex battery after about a month.  I’m sure the bluetooth transmission cycles the battery quickly, but it was irritating to have to switch out the battery so soon.  I like my t:slim pump because it can be plugged in and charged versus needing to keep a stash of AA batteries, and I liked the Sync for the same reason.

No light!  On the Sync, there was a light at the top of the meter that was bright enough to test in the middle of the night without turning on the lamp.  This was an awesome feature, and I have no idea why it was removed from the Flex, but it’s SORELY MISSED.  Never underestimate the value of a little light that keeps you from putting blood on the strip in a mangled way, wasting the strip.

And the syncing feature takes a while.  I feel like the Sync synced faster while the Flex takes more time to flex its bluetooth muscle.  The way the data maps on the app is identical, so that’s fine, but getting that data there is something I have to remember to do, so every second matters.

Overall, the Flex is similar enough to the Sync that I won’t bust the cryptex back open yet, but hopefully the next iteration will be better on battery, upload automagically to my pump, and the light will return!

Gift Ideas for People with Diabetes.

What do you get for the person who has everything … except a working pancreas?  Here are six (until me) of my favorite d-related things:

  1. Medical alert jewelry.  Looking for medical alert jewelry that isn’t clunky or ugly? I’ve always loved this simple, classic bracelet from StickyJ Jewelry and have been wearing it daily for the last few years.  It’s comfortable and chic!
  2. Diabetes books.  This one is entirely self-serving, but if you’re looking for some diabetes reading, you can pick up a copy of my book, Balancing Diabetes, or check out any of these other titles that are diabetes-centric.  Nothing like curling up with a good, islet-inspired book.
  3. Jerry the Bear.  How about some diabetes that you can cuddle?  Check out Jerry the Bear, a stuffed animal designed to teach kids about diabetes through play.  (Read more about how my daughter bonding with Jerry here.)
  4. Donate.  You can make a difference for PWD by donating to your favorite diabetes organization or charity.  Help support Children with Diabetes and keep this amazing conference going, or give thanks through the Diabetes Hands Foundation thank you cards, or consider sparing a rose to help provide life for a child.
  5. Diabetes accessories.  Bring some festive flair to your diabetes devices with accessories from Tallygear or Myabetic.  These two shops blow the basic black meter case out of the water.
  6. Diabetes decals.  Dress up your meter, or pump, or Dexcom with some designs from PumpPeelz.  You can even design your own decal right on their website!

Happy shopping, and if you have a favorite diabetes product, service, or accessory you’d like to share, please feel free to do that in the comments section.

t:slim with a Twist.

Several months ago, I switched insulin pumps.  (Here is the post about the switch, and please read this post about the disclaimer that initiated the switch.  My full disclosure page is here.)  My first impressions of the t:slim pump were drummed up over a year ago, after trialing one for a few weeks, but my real t:slim immersion came once I switched in full.

Funny thing is the timing of that switch.  When I packaged up my Animas pump in favor of a Tandem one, I had also just found out I was pregnant.  Which means that I was adjusting to life as a pregnant PWD and also to a new insulin pump.

tl;dr – There’s stuff about the t:slim pump I wouldn’t have appreciated so soon were it not for the baby-en-route.

Because dude, if I had switched a year ago, I would have been all, “Oh, it looks so cool and the touchscreen is badass, and the fact that it’s flat all the way across the front makes it easier to tuck into my clothes,” making the wearability the most important part of my switch.  Yeah, wearability matters, but not as much as ease of use and OUTCOMES does these days.

(None of the following is medical advice; remember, I’m not a doctor and currently can’t even see my feet in full these days.)

#tslim #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

Entering a bolus is stupid-easy.  And this matters, since every blood sugar counts double these days (for me and for my growing son).  It takes me a few seconds to unlock the pump and bang out a bolus, and only a few extra seconds to add crucial information like my current blood glucose and the carbs I’m consuming.  Part of my over-arching problem of diabetes management is keeping apathy from creeping in; the all day, every day tasks of type 1 diabetes wear on me in a way that prevents me from taking advantage of everything technology has to offer.  Oh, so an insulin pump can calculate my insulin on board (IOB) and the dose I need to bring down a blood sugar back into range, or what’s needed to cover X amount of carbs?  HANDY INFO!  The only thing I have to do is enter that information and it spits out a result?  ALSO HANDY.  But having to scroll forever to enter information is enough to keep me from entering that information.

It’s pathetic, how often I was taking 2u of insulin because it seemed “close enough” to cover what I needed, instead of spending the time calculating the proper dose.  Being able to input this necessary information in a matter of seconds makes me actually DO IT.  My endo is very pleased with this uptick in my management, and my A1C 100% reflects these efforts.

#tslim #diabetes

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Changing my basal rates is stupid-easy.  Being pregnant means that my insulin needs are changing rapidly.  First trimester brought about insanely sticky hypoglycemic events, which equaled out to dialing down my basal rates significantly and making frequent use of the temp basal option.  (Again, it’s about the button pushing – it takes me seconds to set a temporary basal rate.  Ease of freaking use FTW.)  Second trimester showed a steady climb in my weight and insulin resistance, with a marked rise in my basal rates and my insulin:carb ratios.  And now, at the beginning of the third trimester, shit is changing all over the place, with some basal rates going down a little bit and my insulin:carb ratio almost double what it was pre-pregnancy.  There’s a lot of math going on in my baby-building body, and being able to change my rates after reviewing my data on Diasend and t:connect makes for easier management.

Holding more insulin is stupid-easy.  The t:slim holds a ton of insulin (300u) and as my pregnancy progresses, I may need that cartridge to be filled in full, instead of the half-way filled I’ve been doing for the last six months.

#tslim #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

Seeing my status is stupid-easy.  One button push shows me how much insulin is on board, how long it will be active, shows how much insulin is left in the reservoir, the percentage of charge left in my battery, and the time.  Oh, and what day it is.  (This matters, as the day and time are bits of information that are being eaten regularly by intense pregnancy brain.)

Not everything is stupid-easy.  This isn’t a list of perfect moments with my insulin pump.  There are pros and cons, and the time it takes to change out the cartridge and infusion set is still cumbersome.  I also am not a fan of the luer-lock tubing bulge, as it takes on a “third nipple” appearance more often than I’d prefer.  And I’ve seen more occlusion alarms with the t:slim than I did in the past.  But I’ll these cons over the pros, especially when I review my lab work from Joslin and see how strong my numbers are.

Being more on-target through my pregnancy is not stupid-easy.  Let’s not make my successes as a pregnant PWD the product of an insulin pump, shall we?  I am working my ass off to make sure my body and my baby are healthy, with just over 11 weeks left to go before we release this particular Kraken.  But having a piece of technology that alleviates the bolus math angst, makes it impossible to forget whether or not I’ve taken my basal insulin, and being able to bang out a correction dose in a matter of moments helps take the pressure off, at least a little bit.

… even if the beeps and boops might startle my developing fetus.  (If that study has any truth to it, my poor kids are screwed.)

 

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