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Posts from the ‘Insulin’ Category

Prebolusing the Sh*t Out of Things.

Now, at the halfway mark of my pregnancy, insulin resistance is becoming a bit of a thing, and is going to progress into an Actual Thing as the weeks go on, which happened last time and I’m prepared for but it still a bit whoa and this sentence is a run-on.

Which means that basal rates are creeping up ever-so-slightly (my pre-pregnancy basal total was around 13u and I’m now up to 16.2u) and my insulin:carb ratios starting to dance (pre-pregnacy was 1:10, am now 1:9 … except lunch is 1:12 because why would things be consistent?).  When I first found out I was pregnant, my endocrinologist told me that post-prandials contribute most to macrosomia, so keeping my post-meal blood sugars as in-range as possible would help mitigate that risk.  (But let’s take a look at the risk list … pre-existing diabetes?  Check.  Over 35?  Check.  Previous pregnancies?  Check.  Having a boy?  Check.  Cool.)

The plan?  Actively and aggressively pre-bolusing the shit out of my meals.

This sounds like an excellent plan, in a perfect world.  Pre-bolusing works well for me when the bolus is delivered at least 20 minutes before eating, the meal is properly carb-counted, and nothing delays the process of eating.  But one monkey wrench in that process can muck the whole mess up.

Pre-bolusing can feel spooky, like I’m tempting fate and inviting a low.  Not doing it is like opening the door for a high.  The middle ground could use some xanax.

Over the last few weeks, my pre-boluses have been executed with precision.  A few fistfuls of jellybeans have worked their way into rotation when I’ve bolused too early, but that’s to be expected.  The temp basal option on the t:slim is stupidly easy to employ, so sometimes I use a temp basal to help back me out of a mild low, but overall, I’ve seen my post-prandials come down nicely and hopefully my ultrasounds continue to show a very boring, predictable pregnancy progression.

Makes meals interesting, though.  They’ve become a game of roulette.

“Do you think we’ll get seated right away?”  Or, “I forgot to pre-heat the oven and now dinner is going to be 15 minutes later than I thought.”  Or, “Fuck.  I forgot to eat!”

I’m pre-bolusing all over the place.  Usually it works fine.  Sometimes I end up wicked low.  But every time, it’s in effort to keep my post-prandials from causing chaos in my kid.

Spare a Rose 2016: Final Totals.

In 2016 the diabetes community, both online and off, made a huge difference for children with type 1 diabetes in developing countries.  This year’s Spare a Rose campaign raised $25,331 from 537 donations, saving 422 children.

Read that again, please?

Four hundred and twenty-two children.

Through the endless generosity of people in this community, donating their time to share the message, their ability to rally support, and their willingness to give both emotionally and financially, we helped save the lives of 422 children.

Since the beginning of the Spare a Rose campaign back in 2013, we’ve directly influenced the lives of 1,422 children in 36 countries.  This is a big deal.  Each number in that 1,422 represents a single kid, no longer struggling for access.  Imagine if that were your kid.  Imagine if that were you.

Thank you to the companies who participated and matched donations, who shared it with their employees, and who threw their social media muscle behind the effort.  Thank you to the individual members of the DOC who, far and wide, shared the donation link and their reasons for believing.  Thank you to Life for a Child for providing a way for small change to make a big difference.

And thank YOU.  This campaign is effective because everyone owns it, and everyone benefits from it.  The lives of these children are improved because of you.  You shared the donation link.  You told your coworkers.  You reached into your own pocket and spared five dollars.  Every voice matters.

The difference we made as a community, for our community, is because of you.

#Insulin4All: A Chat with Elizabeth Rowley.

Last week at the International Diabetes Federation’s World Congress in Vancouver, I had a chance to briefly reconnect with Elizabeth Rowley from T1D International.  We talked about the #Insulin4All campaign and the work she and her team are doing to help provide access to people with diabetes around the globe, and how our online community can work together to improve lives across the globe.  Today, she’s sharing some of her thoughts on how we can change the world for PWD.

Thanks for taking the time to talk today, Elizabeth!  I see that the #Insulin4All was popular on World Diabetes Day again this year.  Can you tell me more about that campaign? 

The #insulin4all campaign was started last year by a network of organisations called the Access Alliance that are passionate about access to insulin, diabetes supplies, care, and education for all people with type 1 diabetes.

World Diabetes Day (WDD) started in 1991 in order to “draw attention to issues of paramount importance to the diabetes world” and has since become a huge day in the diabetes community for raising awareness about diabetes. The Access Alliance felt that while WDD is a wonderful thing, the true spirit of the day had been somewhat lost because people around the entire globe with diabetes were often forgotten. We wanted to do something more. So many people living with type 1 diabetes struggle to survive because they cannot afford or access their life-saving insulin, blood glucose strips, or basic healthcare. Others are caught in conflict where there is little humanitarian assistance for people with diabetes.

The aim of the campaign is to unite as a diabetes and global community to show governments, companies, and individuals that we recognize the problems mentioned above. It’s important that we stand together to work towards tangible solutions. The campaign gets bigger each year around World Diabetes Day, but we want everyone to support #insulin4all every day of the year.

How can people participate?

The easiest way to support the campaign is by using the hashtag on social media and spreading the world about the issues. There is a lot of content on the Tumblr page and on the T1International website that you can share to promote and push for #insulin4all. You can also still submit an #insulin4all image on the Tumblr page. All you need to do is take a picture of yourself holding up a piece of paper with #insulin4all written on it, submit it to the campaign page, and share it widely.

How does this campaign bring the mission of insulin for all to a higher level and what is your goal?

The diabetes community is a hugely powerful force and we have seen it unite to push for change from topics such as general diabetes awareness to access to CGMs. Many people with diabetes don’t realise that millions are dying premature death because they can’t access the basics that everyone living with the condition needs to survive. We want people to know that this is happening and we want to unite to change the situation. As with any change, the first step is to understand the problems to find the best solutions. The next step is building a force of advocates to ensure that change happens. That is what this campaign has already begun doing and will continue to do until everyone can live a full life with diabetes.

What makes this campaign different from other insulin access efforts, like the 100 Campaign?

The #insulin4all campaign is somewhat unique in that last year, for example, it had participation from people in over 40 countries around the world. It is very important to share the voices of others, especially those who are facing lack of access to insulin and supplies, and we are so glad to be able to do that through this campaign.

We support the 100 Campaign and love its clear and powerful idea of 100% access to insulin by 2022. Despite the hashtag, #insulin4all’s focus is not only on insulin, but on all of the ‘pieces of the diabetes puzzle’. Even if you have insulin, for example, if you don’t have a syringe to inject it with, or a means to know your blood sugar levels, you’re still in grave danger. We feel strongly that all of these things need to be taken into account when building solutions.

Finally, while we know the #insulin4all campaign is a powerful awareness and advocacy tool, we also know that it alone will not create sustainable change. The annual campaign is part of a wider organisation and movement that is working towards that change. T1International and the other Access Alliance members are taking on a truly collective and collaborative approach because we recognize that we are stronger when we work together. The members of the alliance all work with and are part of diabetes communities around the globe which helps us ensure that we fully understand the many complex issues faced by people with diabetes. *If you want to join the Access Alliance, get in touch with elizabeth@t1international.com*

Do you think the diabetes online community has global reach and can make a truly global difference?

Part of the issue we are bringing to light is that the diabetes online community is probably not global enough. This was certainly one of the motivations we had in setting up the campaign and the Access Alliance in the first place. We have been heartened to find that, as people learn about these issues, many are shocked and stunned – and they want to do something about it. We are confident that #insulin4all will grow the number of people that know about the issues and will therefore grow our power in numbers to speak out against the injustices.

Yes, change is possible, but there are no easy answers or quick fixes when it comes to ensuring everyone around the world can obtain insulin, syringes, test trips, glucometers, and the diabetes education needed to keep them alive. That makes it even more important that we determinedly search for those answers and find appropriate solutions. It’s an ongoing process but it’s a vital one if we are to see the kind of change that is needed for our brothers and sisters with diabetes around the globe.

Is there anything else you’d like to add?

“Life with diabetes is complicated. Access to vital insulin, diabetes supplies and medical care should not be.” If you agree, support #insulin4all today or get in touch with elizabeth@t1international.com if you want to get further involved.

Spare a Minute for Spare a Rose?

The Spare a Rose campaign is on tap again for February 2016, and time is marching on at a very quick clip.

Now is the perfect time to start thinking about your involvement in the 2016 campaign, and how your workplace can get involved.  Have you seen the Spare a Rose In My Office site?  You’ll find some tips on making Spare a Rose a company-wide effort.  (Hey Diabetes Companies … I’m looking at you.)

Media campaigns are already thinking about their February outreach efforts, so now is also a great time to connect with your local diabetes organization or media outlet, asking them to support people with diabetes in developing countries.

We’re in this together.  And we can use Diabetes Month as our catalyst for coming together to support our own.

To reiterate, from last year’s campaign,

“From February 1 – 14, the diabetes online community is hosting our annual Spare A Rose campaign.  You remember that one, right?  The one where you send eleven roses instead of twelve on Valentine’s Day, taking the value of that saved rose (averaged out to $5) and donating that to the International Diabetes Federation’s Life for a Child program, which provides life-saving insulin and resources for children with diabetes in developing countries.

We need you.

Yes, you.

You’re part of this, you know.  If you’re reading these words, or any words written by a person touched by diabetes, you are touched by diabetes.  Maybe you’re the parent of a child with diabetes.  Maybe you’re an app developer looking to connect with the diabetes community.  Maybe you run a magazine that hosts health-related articles.  Maybe you’re a PR company that hopes to influence the diabetes community.  Maybe you’re a representative from a diabetes company, or a teacher who has a student with diabetes in their class, or a researcher who studies this disease.

We need you to help amplify the Spare a Rose message.  You can donate to the charity, share the Spare A Rose link with your friends and colleagues, and truly take this initiative, this passion – and our global community –  to a powerful new level.

If you’ve emailed a diabetes advocate, asking them to share your latest press release or to engage in your survey, please spare a rose.

If you work in the diabetes industry and you leave diabetes in your office when you go home at night, remember that people with diabetes don’t ever leave diabetes behind.  And that many people with diabetes struggle to gain access to the drug that keeps them alive.  Considering bringing this campaign to your office.  Please spare a rose.

If you are touched by diabetes in any way – the partner of, the friend of, the coworker of, the child of, the parent of, the neighbor of a person with diabetes – please spare a rose.

If you are part of the greater patient community, I’m asking you to walk with the diabetes community for two weeks and help us make a difference in the life of a child.  With your raised voices, we make a greater difference.  Please spare a rose.

This is where we shine, you guys; where we take care of our own.  Where we can take our collective power, not as people with picky pancreases but instead as people with full and grateful hearts.  Show your love for this community on Valentine’s Day by sending one less rose to a loved one and instead providing life for a child.

Flowers die.  Children shouldn’t.

Please spare a rose.

And please spread the word!”

Bionic Pancreas Update and Call to Action.

A few weeks ago, I met with Ed Damiano and we spent an afternoon talking about recent developments in the bionic pancreas program and what’s up next.

“Here’s our new device,” he said, placing the iLet on his desk, inadvertently putting it right next to his cell phone, which didn’t look much bigger/thicker by comparison.  (I asked for a quarter for comparison, because otherwise this thing could look as small as a whisper, or as big as a toaster, depending on how you feel about devices that day.)

“It’s pretty.  In that device sort of way.  So this is the single device, right?  No more two pumps, one CGM receiver, etc?”

“Yes.  We have two different cartridges in this single device – one for insulin, one for glucagon – that will absolutely not fit in the wrong way.  You can’t make a mistake; there’s no cross-channeling.  The cartridges are already filled, so they aren’t dealing with air bubbles.  There’s no LCD in this device, as that contributes to the bulk, and the e-ink screen [similar to that of an Amazon Kindle] has good contrast and good resolution.  It also has capacitive touch.”

I’ve seen the older device in action at Clara Barton Camp last summer.  It was amazing to hear what little kids thought about wearing three different devices.  But one device should be easier to tolerate, especially when your blood glucose is in range as a result.  So what’s the next step?  How does this thing go from on your desk to on my hip?”

“The iLet exists because of donations from people who believe in this project.  We want to build the consumable parts of this within the next nine months – that’s the infusion sets, tubing, and caps.  We’re on track to do that if we can get the money raised throughout the end of this year.  1.5 million is our 2015 goal.  The next big goal is to test in clinical trials by the last quarter 2016.”

“Tell me more about the clinical trials?”

“Trials will take place in four different sites, out-patient study that’s several weeks long.  It’s a bridging study that goes from the iPhone-based system to the iLet – helps pave the path final pivotal trial.  The pivotal trial takes us straight to FDA submission.  Each study substantiates and builds confidence between investigators and agencies.”

As a person with diabetes, it’s weird to be reminded of many hands are involved in allowing access to technology development and release into the wild.  And how much money is required.

“Can you show me how far we’ve come?  I saw the new iLet device at Friends for Life this summer, but some perspective would be awesome.  What did the first iteration look like?”

Ed’s team kindly dug back into the archives for this photo, which shows the old laptop-based system attached to a study participant.  (And for another old-school take, you can read Abby’s experience with the clinical trials here and here.)

From a team and a laptop and tubes and wires to a single device.  This is the kind of progress that excites me, because it’s happening NOW and the results have already changed lives.  After close to thirty years with diabetes, I’ve seen progress that has made insulin delivery easier and glucose monitoring easier, but the bionic pancreas is a whole new and astounding shift towards life with diabetes.

“And once it’s all said and done, there will be a device similar in look and feel to what I’m using now, only it will be a closed loop.  Which means the pump and the sensor talk to one another, and work with one another independent of my interaction.  Which means I don’t have to think about diabetes nearly as much.  Maybe not much at all,” I said to Chris, all in one breath, when I got home.  “I’m excited.  This is exciting.  I haven’t been this excited in a long, long time about diabetes.”

I believe that the bionic pancreas technology will make my diabetes less of an intrusion, ripping the dangling preposition “with diabetes” off of my life.

To learn more about the bionic pancreas program, please visit the website.  And if you believe in this mission, please consider making a donation to the project.

 

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