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Posts from the ‘Guest Diabetes Blogger’ Category

Think Like a Pancreas: The Blog.

I’ve known Gary for several years, and most of my interactions with him have been silly (confessing that my daughter busts out dance moves to the Philadelphia 76er’s theme song), so I leaned on his website to pull a formal bio description.  “An award-winning Certified Diabetes Educator, Masters-level Exercise Physiologist and person with type-1 diabetes since 1985, Gary Scheiner has dedicated his professional life to improving the lives of people with insulin-dependent diabetes. He was recently named 2014 Diabetes Educator of the year by the American Association of Diabetes Educators.”

Pretty awesome.  And now Gary is bringing his personal experience as a PWD and professional expertise as a CDE into the blogging space, with the Think Like a Pancreas blog.  I wanted to catch up with him about the how, and the why, of making the decision to join the online conversation:

Kerri:  For the few who don’t know your story, what’s your connection to diabetes?

Gary:  I was diagnosed with type-1 diabetes back in the summer of 1985 in a town just outside of Houston, Texas named “Sugarland”.  A coincidence?  I don’t think so.

Kerri:  Makes for a good story, though.  When did you start becoming aware of/involved in the DOC?  What sites were you frequenting back in the day?

Gary:  I was first “introduced” to the DOC by Allison Nimlos (nee Blass) (love that word, nee.  reminds me of the Knights of the Black Forest in Monty Python and the Holy Grail).  I’ve also been friends with Scott Johnson for many years, and anyone who knows Scott has to become connected with diabetes social media.  The first sites I can recall visiting were David Mendosa’s Living With Diabetes, Kelly Close’s diaTribe, Amy Tenderich’s Diabetes Mine, and the Children With Diabetes site (since I’m on their faculty).

Kerri:  So what made you decide to take the leap into social media?  

Gary:  Our national/international clientele are increasingly active on the web.  It seems like the best way to communicate.  Our practice has been publishing a newsletter for nearly 20 years.  It started out as a printed publication called “Control Solutions” which then morphed into an e-publication called “Diabetes Bites”.  However, putting them together was quite labor intensive.  Blogging allows me and all of our Integrated Diabetes Services clinicians to get the word out in a timely and simple manner (better known as “fast” and “cheap”).

Kerri:  What’s weirder:  Blogging or Twitter?

Gary:  It’s hard to get really weird in less than 140 characters.  But both have their place:  Twitter is great for sharing minor snippets of news and experiences.  Like today, I couldn’t believe that TSA at Seattle’s airport was merging people in the pre-check line with people who had no background checks whatsoever, and sending them all through the same minimal security process.  Talk about a major flight risk!  It also makes the pre-screen process a complete waste of time.  Anyway, I was able to share that on twitter – gave me a chance to vent and perhaps raise the ire of people who can do something about it.

Blogging allows us to delve more deeply into items of interest to the diabetes community.  We can offer up a mix of key facts, experiences and personal opinions in a concise and lighthearted way.  My “Sensor vs. Sensor” blog comparing the various CGM systems, for example, has become been a topic of online and live conversation worldwide since it came out last month.

Kerri:  In your blog announcement, you said you wanted to “keep it fresh, informative and unbiased, yet opinionated and entertaining.”  In a pleasantly-saturated market, how do you plan to do that with your site?    

Gary:  You have to remember, our blog team is very unique.  The information is coming from recognized experts – nurses, dietitians, exercise physiologists and mental health professionals who are certified diabetes educators.  There aren’t many bloggers with those kinds of credentials.  All of our clinicians have type 1 diabetes themselves and extensive personal and professional experience with virtually every diabetes medication, product, and form of technology on the market.  And we are not formally affiliated with any pharma company or device manufacturer.  That allows us to KEEP IT REAL and remain UNBIASED and CREDIBLE.  You won’t find that in too many places.

Kerri:  So what are your social media goals?  Looking to change the web? The WORLD?

Gary:  Just want to entertain and inform our little corner of the diabetes world.  Our focus is truly on the type 1 diabetes community, as well as type 2s on intensive insulin therapy who take their diabetes every bit as seriously as those with type 1.  I’ll be very happy if each post can make one person smile, learn something they can apply, or just nod and say “Hey! Now I get it!”

Kerri:  And how can people connect with you? 

Gary:  First off, I have to make a living.  That comes from helping clients meet their diabetes management goals.  Our practice offers individual consulting services all over the world via phone and the internet.  Details are at our website, or people can call our office for more info:  toll-free in North America. 877-735-3648.  Outside North America +1 (610) 642-6055.

We also offer webinars on advanced topics in diabetes self-management at Type 1 University.

Our blog is called “Thinking Like A Pancreas, “named after my favorite diabetes book  – guy who wrote that must be some kind of genius) [Editor's note:  Clever, Gary.  Clever.]  , and it is located right on our website.

Our twitter handle is @Integ_Diabetes

Our facebook page is simply Integrated Diabetes Services

Kerri:  Anything else you’d like to add?

Gary:  When I’m in need of a good laugh, if The Simpsons aren’t on, I can always turn to the Kelly & Kerri shows (@diabetesalish and @sixuntilme).

Kerri:  Thanks, Gary!  Welcome to the blogosphere, and I’m looking forward to seeing how many Simpsons references you can cram into one post.  And if you have trouble adding links to your blog posts, don’t blame me:  I voted for Kodos.

Guest Post: A Do-It-Yourself Pancreas System.

Necessity is the mother of invention, and in some cases, that necessity comes with a side of love. My dear friend Dana Lewis (who threatens to wash my mouth out with soap every time I curse) and her amazing boyfriend, Scott Leibrand, have created a “Do It Yourself Pancreas System” that is revolutionizing not only Dana’s diabetes confidence, but potentially changing the landscape of diabetes management for us all.  Does that seem like too-big of a statement?  Read for yourself and see what patient-led innovation can really accomplish.

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I took a deep breath, intentionally pulled out my pump, and bolused. He asked if it was a pager and we continued our conversation.

That was our first date, and his first introduction to my diabetes. It wasn’t the big deal that I thought it would be.

On our second date, I hated to drink the toddler sized juicy juice from my coat pocket when walking on the beach before dinner, but that wasn’t a big deal, either. He only asked if it was for low blood sugar.

On our fourth date, when he opened his trunk to grab roller blades, I noticed a Costco-sized box of juice boxes. “I thought they might be good to keep in the car in case you run out of them in your purse,” he said.

The next few months were filled with other surprising moments as Scott started learning about diabetes, not only from me, but also from the DOC. I loved when he started following some of my d-friends on Twitter and saw other perspectives on life with diabetes.

I wasn’t sure what to think about all of this, though – especially because I was falling in love with someone for the first time, and it was with someone who was not only interested in understanding diabetes, but also in helping me find ways to make it easier. 

I joke about using Twitter partially so my family knows I’m alive, but it’s actually pretty true. I had shared with Scott what it was like living by myself and dealing with diabetes at night. I will sleep through any type of CGM alarm, even if I place it in a glass to amplify the audio of the alerts. I talked about wanting someone to be able to look remotely and see if I was alive based on CGM numbers. Scott and I started talking about other things we’d like to do, if only we could get the data off of my CGM in real time.

Then late last year, I stumbled across John Costik on Twitter. He was talking about viewing his son’s CGM data remotely. I emailed Scott saying we should talk to John and build upon what he was doing … and Scott tweeted John before he even responded to my email!

Thanks to John, we were able to upload my CGM data in real time. We created a system that would trigger custom CGM alerts to send to both me and Scott. If I wasn’t responding to CGM alarms and “snoozing” them in the system, Scott could see what my BG was and decide if he needed to call and check on me. If I was responding to alarms, he didn’t need to do anything except send e-hugs for lows.

We added a feature to the system to plug in how much insulin was in my body and how many carbs I had eaten. This enables me to track my BGs after a meal more accurately, and project if I am likely to go high or low. When my BGs come in higher or lower than estimated (for any reason), it shows me how far out of range I am projected to go and what I need to do to fix it (with an additional bolus for a projected high or using temp basals or carbs for an impending low). It also tell me how long I have before I drop below 80, to figure out if I have time to do a temp basal or if carbs are the best option to prevent a low.

We started calling it the “do it yourself pancreas system”, or #DIYPS.

Before #DIYPS, it took more guessing to try to prevent or fix a low without causing a rebound. #DIYPS’s calculations help me reduce the extra carbs I use for lows by allowing me to more precisely use temp basals. It’s also brought my average blood sugar down and reduced total time spent high or low. You can see the difference from before I started using the system, and after, by looking at my 30-day trailing estimated average glucose (eAG).

#DIYPS is especially helpful during those “oh no” (or something that involves soaping your mouth afterward) moments – like when you put in a new pump site and two hours later you get a “no delivery” alarm. I had this happen last week; my BGs were rising suddenly, I supposedly had insulin on board, but in reality my pump hadn’t been able to deliver my basal insulin for the last two hours, and the corrections hadn’t really gone into my body either. I didn’t know if any of the insulin had gone in or how high I was going to rise.

Previously, I would have guessed and hoped for the best. With #DIYPS, I was able to use the system’s constant re-calculation of my data to safely give a big correction bolus to replace the un-delivered basals & boluses from the past two hours, and use it to come down to a safe level. In this case, I managed to level off flat in the mid-90s for the next few hours. Of course, this all had happened after midnight – so the other great benefit of #DIYPS in this situation was feeling like I could go to sleep safely. Even with a lot of insulin on board to correct this who-knows-how-high BG, I could trust #DIYPS to alarm and wake me up if I was projected to go out of range.

You can read more about how #DIYPS works here (and why it’s not an artificial pancreas), and Scott’s perspective on it here. We’re not done, and we’re hoping to partner with folks who are interested in helping us build on the system. But we are not waiting until an artificial pancreas is out on the market to make the quality of life with diabetes better. Right now, the #DIYPS user interface is pretty simple. But, my biased opinion is that it’s incredible – how can it not be when it gives me the peace of mind of being able to sleep safely at night?

#DIYPS – and Scott – have also taught me that just because I can do something myself, doesn’t mean I have to. Yes, I can do all the calculations #DIYPS does, but I don’t have to spend as much time thinking about it now over the course of the day (although I do validate any action I take with my own assessment of my CGM data or BG reading). Reducing the cognitive load of diabetes means I have more time and energy to spend living my life. That’s something else to fall in love with.

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Following Dana and Scott’s journey on Twitter via the #DIYPS hashtag, or through Scott’s blog.  (Because Dana does not blog.  She changes the world via Twitter. Although she can be gently asked to guest post, which is why I’m so happy she bit the blogging bullet and shared her story here today.  Thanks, Dana!!  And look – I didn’t curse at ALL through this whole write-up!)

Guest Post: Timesulin, Innovation, and the Sniff Test.

People with diabetes know what people with diabetes want, and John Sjölund is no exception to this rule.  Diagnosed with type 1 diabetes just before he turned four, he has created a simple, streamlined solution to make multiple daily injections easier to manage:  Timesulin. I’ve used his product, and thought of it as “informed MDI’ing.”  Recently, he kicked off an Indiegogo campaign to raise funds to help bring Timesulin to the US market, and today, he’s sharing the how and why of that effort.

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If we haven’t yet had the opportunity to meet, you won’t know that diabetes doesn’t define me. Diabetes has, however, given me a platform to speak to amazing people, to ensure I live healthier than most of my non-D friends and it’s put me on a path to try to make life for all of us around the world with diabetes a little easier. In fact, I have made this my mission!

I have lived with type 1 for 28 years, first diagnosed a couple of days before my fourth birthday. I really have never known a different life to one that consists of 6-10 finger pricks a day, 4-6 insulin injections and constantly checking in with my body to check whether my blood glucose levels are high…or that dreaded low. That said, diabetes has never held me back from leading a life that is full, high-paced and filled with excitement! Kickboxing, triathlons, sky diving or traveling off the beaten path (horseback riding in Lesotho??) …I decide what I want to do and then make adjustments to allow me to do whatever I set my mind to, despite my faulty pancreas.

With this life, however, few things are as routine as taking my four daily insulin shots – one before each meal and a slow-acting injection at bedtime. And maybe it’s because I usually have a thousand things on the go, but over the years I have often caught myself feeling unsure of whether or not I had taken my shot. Do you know that feeling? I would step out of the shower, ready to get to bed and then have that sinking feeling, ‘Ugh…Did I take it, or not?’ or sit down for dinner and then have that niggling worry hit me.

Not having a way of knowing for sure was driving me nuts! The best method I had was to ask my then-girlfriend, Susan (now my wife and pregnant with our twin boys, due any day now!) if she had seen me take my insulin. Too often, we had to resort to the Sniff Test.

The ‘Sniff Test?’ Indeed.

Susan has a keen sense of smell and would sniff my belly, legs or arms to see if the smell of insulin was present around the injection site, which was the sign that I had already taken it. After a shower, however, the method was less reliable as the smell of body wash would mask the pungent smell of insulin. The sniff test just wasn’t a fail safe method to see if I had taken my insulin or not, something that 77% of physicians estimate happens as many as six times a month for those of us with diabetes, according to a study done by Novo Nordisk. Also, I tend to take my long-acting insulin in the backside … and Susan often exerted her right to not have to sniff that region in the name of healthy living!

Frustrated with the existing solutions that were available to me from large pharmaceutical brands, I gathered a team, which included my brother Andreas, one of the creators of Skype, to create Timesulin – a smart replacement cap for your existing insulin pen to simply show how much time had passed since the last shot. By having this basic information you can make decisions that will help you avoid an accidental missed or double dose of insulin – which can have very serious effects. Very importantly, we didn’t want Timesulin to incorporate wi-fi, bluetooth or USB plugs or any other mumbo-jumbo that I felt complicated life with diabetes (it’s worth noting that I am a tech junky, know html and CSS, can program, but when it comes to diabetes I believe in the idea of ‘Keeping it simple’). I’m proud to say that we created a product that encompassed all of this – and is today being sold in forty countries around the globe – two years after launching to consumers in February 2012!

As proud as I am on a personal level that our simple solution has helped so many people, I am super frustrated that we haven’t been successful in getting our product to the United States. Why you may ask?

  • Requirements for U.S. regulatory registration (which function well, we are supporters of keeping people safe) on medical devices are lengthy and more expensive than in Europe. It is a big undertaking for my team both in cost, time and resources to get it done, with no 100% guarantee that it will be worthwhile
  • The sheer size of the U.S., which makes distribution and logistics a challenge.
  • The costs of marketing a new brand in a market cluttered with medical advertising from big pharmaceutical brands with enormous budgets.

Most importantly, I realized that patients in the United States are not given the same choices about which devices will help them live their best possible life with diabetes. I want to change this.

We just launched a crowdfunding campaign on Indiegogo to help us raise the funds necessary to file for approval from the FDA and help us get Timesulin approved for distribution in the U.S. I am particularly excited about this as it truly lets those of us living with diabetes the ability to vote and decide for ourselves what tools we need. Is Timesulin going to solve everybody’s challenges with diabetes? Of course not, but it can play one small yet important part in allowing people to not be afraid of taking a double dose. Since I couldn’t find a solution that worked for me, I decided to start Timesulin. I have been super frustrated at not being able to empower other people to make that same decision for themselves, and I think that crowdfunding may just have the potential to help us.

This is just the start, we have lots of other ideas that we want to launch, which may not be blockbusters that cure diabetes, but can go a long way, until a cure is reached, in making life with diabetes a little simpler, less complicated and perhaps less scary.

We need your help to get there, and without the support of other people with diabetes, it will be impossible for us to keep innovating.

I know it has made things much easier for myself – and for Susan! – and importantly, we no longer have any of those awkward restaurant moments when it’s a toss up between pulling my shirt up to have her ‘Sniff Test’ my belly and taking the risk of an accidental double dose when I simply feel unsure of whether or not I had already administered my insulin dose. These days I just glance at Timesulin and know.

And now, so can you! Please help us succeed with this campaign and help everyone who’s ever needed a “Sniffer.”

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You can follow the Timesulin efforts through their Twitter account, learn more about the product on their website, and you can help support the campaign by visiting their Indiegogo page.  And if your significant other has ever sniffed your skin for insulin, show them this post; they are not alone.

Guest Post: Crusading for CGM Coverage.

I’ve used a Dexcom continuous glucose monitor (from the 3-day STS system to the G4 Platinum) since 2006, and the positive influence it has had on my diabetes management and overall quality of life is undeniable.  But as it stands now, when I reach the Medicare age, my coverage for CGM use will be denied.  Susan Berger, an advocate and caregiver for her husband (who has diabetes), is working to change that fact.  Today, Susan is guest posting about why CGM coverage is important, and how we, as a community, can help ensure that coverage.

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Marc and I were high school sweethearts.  He was a year ahead of me.  When he graduated, he did a four year stint in the Air Force, 18 months of which were spent overseas in Okinawa.  Two months after he was discharged, we were married.  We lived in California for five years and this is where our daughter was born.   We returned back home to the east coast – Philly to be exact, where we lived for one year before moving to Harrisburg, PA and opening up a Hobby and Craft Shop.  We operated that business for 19 years, working side-by-side daily.  We also had a son during this period.  In 1996 we decided to go in a new direction and opened an Italian Ice and Ice Cream Shop, once again working side-by-side.  It was just a few months after we opened this business that Marc was diagnosed with type 1 diabetes.  What an irony to be in a business where you’re surrounded every single day with sweet ices, creamy ice cream and all types of toppings needed to make sundaes, shakes, etc., and being a diabetic.

His diabetes has impacted us in so many ways, probably too numerous to mention in one blog post.  Before he was fortunate enough to have a continuous glucose monitor (CGM), there were many times when his sugar would plunge downward so rapidly that I would either have to rush to get some juice into him if he was still conscious, or if I couldn’t catch it in time, use the glucagon to revive him.  Once he got a CGM (paid for by private insurance) I would describe our life as becoming pretty normal, practically back to prediabetes.  Much of the worry dissipated because we knew that the warning would go off he his blood sugar dipped too low.  When the CGM stopped working, and Medicare disallowed payment for a new one, life became extremely difficult once again.  We were back to all the fear and worry.

Marc has had some pretty close calls and it’s only either by luck …  or God watching over him that he hasn’t caused harm to either himself or anyone else.  There have been two incidences where he became completely disoriented while driving.  Both times he had been stopped by the police and fortunately for Marc, who makes his living by doing quite a bit of driving, his license wasn’t taken away.  When they realized he was diabetic, EMS was called to revive him and once he became cognizant, he was sent on his way.  Then there have been those times when I’ve had to revive him in the middle of the night.  I have used the glucagon many times over the past 15 years but my hands still shake when I have to give Marc a shot.


Our children live in Atlanta and I used to be able to visit them on a fairly regular basis, but now, I never leave Marc alone at night.  If he can’t go, then I can’t go.  I missed a wedding in Los Angeles because he couldn’t take the time off.  And I can’t have weekend get-a-ways with the girls because of the fear of leaving him alone at night.

Medicare guidelines do not provide for coverage of Continuous Glucose Monitors. I am an advocate for my husband who desperately needs a new CGM and previously received CGM coverage under private insurance before reaching age 65. I am a crusader for the entire diabetes community, whether you are on Medicare, will soon be on Medicare, have a Continuous Glucose Monitor presently, or might need one in the future. In December 2013 Representative Carol Shea-Porter [D-NH1] introduced a bill into Congress, H.R. 3710: Medicare CGM Coverage Act, which provides for coverage of Continuous Glucose Monitoring Systems by Medicare if recommended by a doctor. My recent post Baby Steps talked about the bill and many members of the Diabetes Online Community (DOC) asked how they could become involved in this crusade. I have just received an email from Congresswoman Shea-Porter’s Legislative Assistant, Marjorie Connolly, and she suggested the following:

  • The most effective step you can take is to ask your own Representative to cosponsor the bill.
  • Call your Congressperson’s DC office and ask for the email address of your Congressperson’s Legislative Assistant for health issues.
  • Email the Legislative Assistant the text of Shea-Porter’s Dear Colleague letter (link) along with a personal note. That way they will understand why the issue is important to you, the constituent, and they will also have the Dear Colleague to show their boss so that he/she will know how to sign on. The roster of the House of Representatives along with phone numbers is available here.

There are many diabetics such as my husband who never realized that when they went on Medicare, their CGM would no longer be covered. When the denial for coverage comes, and it inevitably will because Medicare considers the CGM a precautionary device, the arduous journey through the Appeals system is daunting, exhausting and psychologically taxing. The wait for a decision is beyond description and we have waited for 8 months. The entire process will only get harder as baby boomers become Medicare-age in greater numbers. We need to do something about this sooner rather than later. The only way to fight Medicare’s denial of the CGM is to get the guideline changed.

The best thing that we can do now is to let our voices be heard and join with Congresswoman Shea-Porter and her new cosponsor, Congressman Matthew Cartwright [D-PA17] in asking Congress to pass H.R. 3710, the Medicare CGM Coverage Act of 2014. Here is the Sample Letter and a copy of Shea-Porter’s Dear Colleague email blast. Don’t delay because the sponsors of this bill have begun their full-on push for support and every voice is important. If you are a fellow advocate and want to know how to help, click to download this document.

Please leave a comment on this post or email me [email in the advocate letter] if I can assist you in any way. You don’t have to be a person with diabetes to write the letter. You can be the son, daughter, mother, father, friend or as myself, the spouse of a diabetic. Please do this for all of those who so desperately need a CGM and can’t afford to pay for it out of pocket.

I love my husband and want him to be around for along time.  This is the reason why I became an advocate.  But just as important, in the time that I have been blogging, I have met many men and women who like Marc need a CGM and can’t afford to pay for the device and the sensors out of pocket.  And I have also been contacted by many who are worried that when their time comes to go into the Medicare system, they will experience what we are experiencing now.  I know that together we can make sure that Congress hears our voices and supports H.R. 3710.

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Thank you, Sue, for speaking up on behalf of PWD.  (And for more on this issue, check out Kim’s post at Texting My Pancreas, and look through these discussions on TuDiabetes about CGM and Medicare coverage and on the ADA website.)

Guest Post: How the MiniMed 530G Changed My Diabetes Management (Without Ever Even Seeing it in Person)

SUM is being borrowed today by Christopher Angell, fellow PWD and creator of GlucoLift, so that he can share his thoughts on the Minimed 530G … without having ever seen or used the system.  What is he on about?  Find out …

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Leading up to the launch of the Medtronic 530G (and what a long lead-up it was) I kept asking myself “What’s the big deal?” It seemed like, apart from a new sensor (which some data had already shown to be a minimal improvement over their previous sensor, and a far cry from the already-extant Dexcom G4 Platinum) the only real innovation was the introduction of the low glucose suspend (LGS) feature, which shuts off insulin delivery after a series of alarms alerting the user about low blood sugar are ignored. “How useful could that possibly be?” I wondered.

We’re constantly told that, because of the action curve of our rapid acting insulins, changes in pump basal delivery should be calculated for events 30-60 minutes in the future. So how does shutting off my basal drip help me if I’m crashing NOW?

Still, my curiosity got the better of me.

Now, I don’t use a Medtronic pump (Tandem t:slim), or a Medtronic CGM (Dexcom G4), and I don’t even get all of my basal insulin from my pump (my current split is about 57% from my pump and 43% from a single bedtime Lantus injection). So my experience is probably in no way directly comparable to what someone using the Medtronic system would experience. Nonetheless, I started experimenting with what I’ll call MLGS (manual low glucose suspend). I didn’t use it for all of my lows, but there are a couple situations where I’ve found it to be rather useful.

The first is where my bolus and my food may be correctly matched, but are out of step. For example, say I bolused for a meal that’s mostly protein, fat, and some slower carbs, like a steak with sides of spinach and broccoli. Then after the meal, I notice a slow dip on my Dexcom, but I KNOW that once the meal starts digesting, there will be plenty of food to give the insulin I have on board something to do.

Previously, I would have eaten one or two proactive glucose tablets to keep the insulin busy while the steak and veggies get over their stage fright. Now, I’ll just unhook my pump, or set a temp rate of 0 units for 15-30 minutes. And as long as I didn’t way over-bolus, that dip tends to reverse on its own, and I’ve managed to avoid unwanted, unnecessary carbs (delicious though they may be). This is especially useful if I’ve eaten a late dinner, and don’t notice the dip until after I’ve brushed my teeth. I can still get into bed, unhook, and read until I see the CGM line flatten out, then hook back up, without re-fouling my pristine pearly whites.

The other situation where I find myself implementing MLGS is with my serious, all-hands-on-deck lows. You know, the ones where every second spared from their depths means less of a hangover, and more of my day returned to my control. There are two caveats to using MLGS with this type of low. The first is that, since I’m not at my most functional when these lows hit, I’m more likely to use the “unhook the pump” method than the “very responsibly set a temp rate” method. This means that it’s very important to remember to re-attach my pump after I turn the corner on the low. The second is that since disconnecting, even for a little while, leaves me more vulnerable to a rebound high, I always treat these lows with glucose tablets, as opposed to my fridge-clearing binges of yore. I know when I’ve eaten enough glucose to right the ship, but I have to be disciplined enough to trust it and not pile another 50g of future disaster carbs on top.

When I do those two things successfully, my bad lows feel less bad, and I seem to recover from them faster. Can I measure/prove this? No. Do I care? Not really. If it feels to me like it’s working, and I believe it’s an improvement, then it kind of is, even without hard data to verify or explain it.

So even though I’ve never used the new Medtronic MiniMed 530G, or even seen one in person (as far as I know), it has nonetheless made a positive contribution to my diabetes management toolkit, which, when you think about it, is pretty impressive.

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Christopher Angell is the founder of GlucoLift glucose tabs (I have a stash of them in my cabinet, and they are so much better than your average glucose tab) and a good friend, diagnosed with type 1 diabetes at the age of 30.  He’s contributed here before, exploring the t:slim insulin pump and both travel and dental woes.  For more from Chris, you can check out the GlucoLift company blog.  To taste test GlucoLift glucose tabs for yourself, you can purchase them from their online store, or write to caring@glucolift.com for samples.  Tell ‘em Loopy sent you.

Guest Post: T1International – Making an Impact Through Art.

With Diabetes Art Day just behind us and now in the middle of the Spare a Rose, Save a Child campaign, the concept of art and awareness for the greater diabetes good is on the forefront.  Which is why I’m excited to host a guest post from Elizabeth Rowley, founder of T1International, who is aiming to raise funds for the AYUDA organization through artwork.  Take it away, Elizabeth!

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I’m Elizabeth Rowley and I am the founder of T1International. I have lived with type 1 diabetes for almost 22 years and my passion is diabetes around the world, particularly access to insulin and diabetes education. It is hard for me to accept the fact that people are still dying due to lack of insulin, despite it being made available for use by people with diabetes almost 100 years ago. My background in international development and hunger to learn more about these problems and their potential solutions let me to create a web site about global diabetes organizations and topics.

Through T1Internatioanl, I discovered the organization AYUDA (American Youth Understanding Diabetes Abroad) and I knew that it was something I wanted to be a part of. Having recently completed the IDF Young Leaders in Diabetes training in Melbourne, where I connected with young people living with diabetes from all corners of the globe, I was inspired to do more to create the change I want to see in the diabetes community.

I am fundraising to volunteer and to make AYUDA programs possible. In June, I will go to the Dominican Republic to plan and put on a summer camp for kids with diabetes (and their families). Diabetes camp meant the world to me when I was growing up, so this is the perfect opportunity for me to give something back and ensure that kids who are lacking in supplies and education get the knowledge to help them survive and thrive with diabetes. For many, it will be their first chance to interact with others living with diabetes. You can read more about my motivation for the program, and the program itself, at my fundraising page here or at www.t1international.com/ayuda.

I am not taking this fundraising lightly. My husband (who also has type 1 diabetes) and I recently opened an online marketplace through T1International, which has been something we have wanted to do for a long time to use our combined interest in art, and all things creative, to support international diabetes causes. The T1I Marketplace is an online shop where you can purchase artwork made by people with diabetes (and supporters of people with diabetes) in exchange for donations to the AYUDA program. Every item you ‘buy’ will support kids in the Dominican Republic to live happier, healthier lives – so it’s a win-win! In the future, we hope that the T1I Market can be used to fundraise for other causes as well, so we won’t stop after we reach the AYUDA target.

Be sure to have a look, and please note that we can customize almost anything to make sure your art is special to you. Here is a selection of some of the diabetes-related art up for grabs at the marketplace:

To see more art and donate/place your order, visit the marketplace, and you can visit the AYUDA website for more information about the registered charity.  Thank you!

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Thanks, Elizabeth, for making a difference in our global community!

Guest Post: Telltale Signs That I Have Low Blood Sugar.

My low blood sugar “tells” have changed over the last twenty-seven years, ranging from numb lips to crying jags to shaky hands.  The scariest symptom of all, though, has been the complete absence of symptoms, which is part of the reason why using a CGM has been such a big leap forward for me. 

Dan Fleshler has had type 1 diabetes since 1962. He blogs (more seriously) about the lessons and mysteries of diabetes at The Insulin Chronicles.  And today, Dan has offered a tongue-in-cheek guest post about his hypo signals (including one about lettuce that made me laugh out loud).

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“Hypoglycemic unawareness” plagues me and many other people with diabetes (PWDs). It occurs when the body’s warning signs of low blood sugar –sweat, fatigue, blurred vision, etc.– either don’t kick in or aren’t recognized. When that happens and we’re unaware that we need to eat glucose, our brains don’t get enough of it and the result can be irrational and even dangerous behavior.

I’m thinking about getting a continuous glucose monitor (CGM), which will beep when I have low blood sugar. But I’m worried that I won’t be able to get used to it and hear that sometimes CGMs don’t work. Fortunately, there is another solution offered by clinicians: every PWD should develop a set of telltale, distinctive, personal warning signs to help them recognize their lows.

In my case, I know my blood sugar is getting too low whenever:

  • I pick up two heads of lettuce from a supermarket bin, call them “Paul” and “Ringo,” and loudly berate them for the break-up of the Beatles. When that happens, I know it’s time to grab the glucose tablets!
  • I walk up to a policeman I have never seen, bare my teeth and accuse him of causing the pogroms against Jews in the Ukrainian town of Kishiniev, in 1904 (my grandmother used to tell me about them).   That’s a sure sign, a dead give-away!
  • I find myself repeatedly shouting “Meep meep,” like the Roadrunner cartoon character, when I am being chased by a policeman whom I’ve accused of causing the Kishiniev pogroms.
  • I find myself agreeing with Glenn Beck.  Danger! Danger! My brain is starving for glucose!
  • Just before a Yankees game, I stand with the scalpers outside of Yankee Stadium and shout, “Who doesn’t need tickets?! I’ve got no tickets!”  Another telltale signal: I ask people walking towards the Stadium, “Excuse me, have you seen the philosopher Ludvig Wittgenstein?”
  • I burst into tears and feel heartbroken because I can’t manage to kiss the small of my back.
  • Cradling my cat Sammy in my lap, I tell him, “You’re leaving for Swarthmore tomorrow and I know freshman year won’t always be easy. I want you to know you can call me any time. I’ll be there for you.”  You’ve probably read that some dogs can recognize when their owners have hypoglycemia.  Sammy has learned to leap out of my lap whenever I mention Swarthmore. Works every time!

Hypoglycemic unawareness can be a very serious problem.  If it haunts you, please consult your physician or certified diabetes educator and find ways to prevent it.  They should help you develop your own personal, internal barometers.  Of course, please feel free to use mine.

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Dan, thanks for posting today.  Lettuce know if you have any other strange symptoms that crop up!  ;)

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