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Posts from the ‘Robot Life’ Category

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.


Livongo Health: First Impressions of Their Meter.

Disclosure:  Manny Hernandez, SVP of Member Experience at Livongo Health, reached out to me a few weeks ago about test driving the Livongo meter.  Manny is my good friend, and diabetes is not my friend, so anything that helps a friend and also helps me take a bite out of diabetes is a welcomed opportunity.  For the purposes of this post, please know that the Livongo meter starter kit was sent to me at not cost, as were the test strips.  I offered to write about my experiences.  I’m not being paid for any of this.  All perspectives are mine.

For the last few weeks, I’ve been trying out the Livongo Health glucose meter.  These are my first impressions.  For another take, check out this post from the College Diabetes Network.  Time to purge thoughts:

The glucose meter is solid, and familiar enough to not be confusing.  The meter itself is big, but nice.  It’s much bigger than the Verio Sync that I’ve been using for the last two years, and I have a fear of dropping it on the floor and having it smash into a thousand pieces (as is my life trend).  The meter also did not fit into the bag I have been using for my One Touch meter, so I had to find a bigger bag.  The test strips are also much bigger (almost comically so).  But size, for me, doesn’t matter too much since my meter exists on my kitchen counter or in my purse, never in my pocket.  The color screen is very cool.  The touch screen is even cooler, and was appropriately responsive to commands from my digits.  Nicely done.

On the whole, checking my glucose was easy, especially since I’ve used lots of different meters in my years with diabetes.  The meter lets you know when the strip is ready for blood, and while you’re waiting for the countdown to the result, the meter gives you a little health fact.  “Did you know that laughing is a great way to reduce stress (make you feel better)?”  I would have loved to have been a fly on the wall for the meetings where they came up with dozens of these gems.  I enjoyed every, single one of them, even the repeats.  They gave a dose of personality and humanity to a task that is oftentimes less-than-enjoyable.

Syncing my results to the cloud wasn’t always seamless.  More often than not, my meter would claim that the connection to cellular signal {EDIT – I originally thought this was a wifi signal, but Manny let me know it’s a cellular connection.}  was too weak, and promised to send the result after my next check.  This didn’t bother me too much, but I with there was a manual way to send my results, instead of having to wait until the next check.  Hopefully that comes with the next iteration.

On the meter, the Snapshot Summary is very useful for me.  That’s why I like the Verio so much, because it uploads to my phone, giving me at-a-glance access to what my numbers have been like for the last two weeks.  The Livongo meter hits that same sweet spot.  The Logbook screen is basic and if this was my primary meter, it would be a good screen to track.  Same for the Patterns & Stats screen.  This screen was particularly helpful because it tracked my averages for specific times of day, and then gave me a percentage in-goal range on the same screen, for 14 days, 30 days, and 90 days worth of data.  Again, it’s hard to get a full feel for how functional these screens would be in my life because I’ve only been using the meter for about two weeks.  But a meter that logbooks automatically (automagically?) is an asset for someone like me who loathes to logbook.

The Activity option on the meter confused me, to be honest.  I wear a FitBit and I enjoy those competitions, but it’s easy to wear the FitBit on my wrist while I’m moving around.  Trotting around with my glucose meter on my hip is not going to happen.  Ever.  If this setting expanded to include activity trackers outside of the Livongo brand, that would be awesome.  Otherwise, this setting becomes akin to the one on the Apple watch (for me, anyway):  I already have a fitness tracker.  I don’t want to use four of them.  Communicate with the one I already use, or maybe allow for manual input?

The online portal is comprehensive.  I like logging into the online portal and seeing the weather for my location.  It was a touch creepy at first (I am predictably creeped out by how much the Internet knows about my location), but then it became a nice thing.  Like, “Hey.  Good morning, Kerri.  It’s 54 degrees out in your sunny corner of Rhode Island.  Put on a coat before walking to the bus stop, kitten.”  Only it didn’t call me kitten.  Though I’m sure that can be programmed in.

Two notes:  In updating my personal health profile on the Livongo portal, I entered my diagnosis date (9/11/1986) and realized that the year option only went back to 1979.  Is that because it was taking my birthday into account?  If so, clever.  Less-than-clever is the field about my last A1C.  I was able to note when my last A1C was taken, and also what the value was.  But I did not have the option NOT to enter a value.  I didn’t like this.  When it comes to health information stored on an external website, I prefer the option to share or not share.  Forcing the A1C value felt … forced.

The online portal allows me to add folks to access my data, in as much real-time as possible.  I can add people (Chris, my mom, my best friend) to be alerted to my blood sugars when they are out of range.  If I had a child with diabetes, this would be a terrific option because it would help me stay on track with what’s going on when my kid is out of my arm’s reach.  But as an adult with diabetes, I don’t need to alert my family and friends if I check and am low or high.  I realize this flies in the face of my decision to share CGM data, but there’s a difference for me:  my CGM data will stream to the cloud and alert my family in the moments when I might not be awake or aware enough to check my blood sugar.  A low in the middle of the night is not always confirmed with a glucose check.  Most of the time, I wake up knowing I’m in trouble, and I treat without checking first.  The important thing is bringing up the low; I don’t need to know the exact number.

The portal also allows a health team to be created (or at least documented), letting me add my doctor to receive updates from my meter in a comprehensive way.  Again, this isn’t something I have any plans to take advantage of, but for people who need and/or want to be in more constant contact with their medical team, this is a terrific option.  (I don’t think my doctor wants to hear from me all the time, but when I was pregnant, I know she would have loved receiving my logs every two weeks, instead of me faxing them to her office.)  Through the portal, you can also access a Livongo health coach (from their team of CDEs) who will walk you through different issues at a pace set by you.  I haven’t tried this feature out yet, but if you have and can offer some feedback, I’d love to hear it.

The meter results are what matter most to me, though.  Size, color, bells, whistles, etc don’t matter when it comes to accuracy.  I have an inherent mistrust of all data (I think it stems from the lack of trust I have for my stupid pancreas), so I check and double check new devices until I feel comfortable with them.  To that end, I’ve used my Verio meter every time I’ve used my Livongo meter, and have checked both of those results against my CGM data.  (Excessive?  Yep.  But the meter came as part of a trial experience, so it wasn’t an out of pocket cost.)  Overall, the Livongo meter ran lower than the Verio meter.  Not enough to cause an uproar, but enough that I noticed every time.  My Verio meter was closer to my Dexcom on the whole, but I also use the Verio to calibrate my Dexcom, so there’s a data bias in play.  But everything was in line, well enough, to make me feel comfortable making insulin decisions off the Livongo results.

Did I trust the results?  Yes.  Well enough, at least, to be honest.  It’s hard for me not to defer to the tech that shows me as higher because when shown lower results, my brain immediately thinks, “Yes, but what if I’m actually the higher number?  That should be corrected.  I don’t want to be lulled into a false sense of security.”  I plan to use the Livongo meter to calibrate my next Dexcom sensor, to see if that shows a noticeable trend difference.  I’ve talked about new tech here on SUM often, and the running theme seems to be that I balk at change.  “New” and “different” are always initially met with a “get off my lawn” response, because I don’t like adjusting to anything new.  (Case-in-point:  The clip on the Animas pump made me crazy at first, because the top of it was just ever-so-slightly different from the Minimed one.  It took me at least two weeks to adjust to how that felt.  But then I got used to it.  Same with the new G5 transmitter, which is slightly thicker than the G4 transmitter, and it currently feeling like a doorknob attached to my thigh.  I’m sure I’ll adjust to that newness, too, but it takes me some time.  Also, you’re welcome to stay on my lawn.  I don’t mind.  It will just take a few days for me to get used to you being there.)

Looking at the cost.  There is an early access program being offered by the Livongo team right now (but rapidly drawing to a close, so if you want to sign up, I’d recommend doing that today.  Manny advised that the offer is “winding down as we speak.”).  For more details, you can click on this link or on the image below.  I’m not sure about insurance coverage for this meter and it’s associated services, but I do know that the early access program offers a deal with subscription.  From the website:  “The In Touch blood glucose monitoring system and all supplies, including unlimited strips and lancets — even shipping costs — are covered as part of your subscription.  Your participation as an early access member costs only $25 per month (guaranteed for 2 years).”  It’s the “unlimited” promise, as it pertains to the test strips, that peaks my interest for sure.  Strips are the priciest part of testing my blood sugar, so “unlimited” is a nice and welcomed bonus.

I’ll check back in a few weeks with second impressions of the Livongo meter.  If there’s anything specific you’d like to know more about, please ask!  Thanks to Manny, and the team at Livongo, for letting me give this meter a go.



As a Kite.

Woke up to this little gremlin number on my meter:

Gross, gross start to the day. #DOCtober #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

I pulled my site and immediately blood streamed out, leaving a trail down the side of my hip and actually running onto the bathroom floor (which is DISGUSTING and makes me feel like queen of the macabre).  The site was sore and tender and 12 hours past the “three day” mark, which may explain why it went gross on me.

Regardless of the “why,” the day started with an insistent need to pee and then drink a ton of water from the faucet.  And then change my pump out.  And then rage bolus.  And then start the day determined to have this be the One Thing that Sucks today instead of letting it set the stage for a crappy Tuesday.

Lower Arm Real Estate.

“Rotating sites?  Hell yeah, I rotate.”

… sort of.

I’m good about rotating my pump and CGM (continuous glucose monitor) sites, but I’m decent, at best, about exploring new real estate.  Most of the time, I use my outer thigh or lower back/hips for my CGM, going back and forth between those four areas.  This sounds like proper rotating, in theory, but in practice, I am re-using and abusing the same patches of skin.

Because my skin has a persistent and scaly reaction to the sensor adhesives, it takes several weeks for parts of me to heal after they do their seven days of data due diligence.  Which means that I need to stay the eff away from my last two most recent sensor sites, or else a skin reaction blooms in a matter of hours, regardless of preventative measures.

tl;dr – My skin hates everything and I need new real estate for my diabetes devices.

I’ve seen a few of my PWD friends sporting their sensors on their arms, but until recently, I’ve never been able to keep an arm sensor stuck.  On me, the tape always comes loose and even extra adhesive goes rogue on me.  Arm sensors, up where I used to pinch up and do injections on the back of my arm, are a disaster for me.

But a few days ago, I took a crack at a lower arm sensor, placing it six inches or so above my elbow.  It’s more on the front of my arm (giving my bicep a strangely LEGO’ish look), but so far, so good.  The adhesive is staying put, the Toughpad seems fine, and no skin irritation here on day three.

Above the elbow Dexcom sensor. #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

Placement of sensor on arm. My arm. (Why does this caption sound so formal?! Over and out.) #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

I’ve been having trouble keeping sensors comfortably stuck in the last few weeks, so I’m hoping a true and proper site rotation helps heal what ails me.  Otherwise, I may scratch my skin into oblivion and will be forced to slather it with Brad Pitt lotion.

[Dexcom disclosures. And all my other disclosures, if you'd like some light reading.]

ALL NEW Jerry the Bear Revealed.

My daughter loves Jerry the Bear.  And not because he’s this fancy teddy bear aimed at teaching children about type 1 diabetes.  She doesn’t care a whole lot about that.  She likes that Jerry is soft and cuddly and has a friendly face, and that he also needs her to give him food and check his blood sugar.

Birdy getting to know Jerry the Bear. #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

“Like you do, Mom,” she says while she counts the carbs in the snack Jerry is about to have.  She’ll bolus him, feed him, and then drag him outside to her playset, where she and Jerry play in the clubhouse.

It’s not about diabetes, it’s about life.  But as she’s playing with this toy, she’s learning about diabetes in a way that speaks directly to her five year old sensibilities.  Jerry is a powerful teaching tool.

Today, there’s a new Jerry the Bear in town, the brainchild of Hannah Chung and Aaron Horowitz (two Rhode Island locals, making them even more awesome in my Rhody Pride mind).  Hannah and Aaron were kind enough to answer a few questions about Jerry and what’s coming next for the Sproutel team.

Kerri:  How long have you been working on the new Jerry, and what is new about this iteration of the amazing bear?

Team Sproutel:  We’ve been cooking up “new Jerry” in our labs for the past 9 months or so. This new version of Jerry is built from a curriculum centered on general health and wellness education for all kids. We now have expansion packs to customize Jerry’s eduction for kids with type 1 diabetes and food allergies.

Through our work with kiddos with type 1 diabetes and our research into other childhood conditions we began to realize that there are certain pillars of health education that apply to all children. We see this new bear as a platform to deliver high quality health education to all kids.

Kerri:  Why move from an embedded device to Jerry’s new “portal?”  And what are some of the different features of the portal?

Team Sproutel:  Jerry’s new portal is a window into Jerry’s world. As you wave the portal over Jerry’s body it show’s an x-ray view of what’s happening inside. Besides being cool, the new portal enables some neat features. First of all, it means that Jerry is now washable! This is something that parents really wanted because it wasn’t so easy to keep little Jerry clean with all of the playtime he was getting. It also enables us to grow Jerry’s world with new characters. Next year we plan on releasing additional plush characters from Jerry’s world, like his little sister Isabella, who will be brought to life with the same portal.

Kerri:  I see you’ve moved from diabetes into food allergies.  How are you able to have one bear to unite them all?

Team Sproutel:  With this new bear we’ve created a core set of play patterns that are fun for all kids. In order to keep Jerry happy, you have to feed him healthy foods, exercise with him, and keep him nice and clean with a good tooth brushing. This enables us to layer disease specific education on top of Jerry’s core functionality with expansion packs. For each condition we have an accessory (like an insulin pen or epi-pen), condition specific storybooks that teach hard skills, and new behaviors (like a blood glucose level!).

Kerri:  What’s next for our friend Jerry?

Team Sproutel:  Our aim is to continue adding more conditions onto the Jerry platform! We have a long list we’re currently thinking of for our next expansion pack and welcome any suggestions.

Kerri:  How can the diabetes community help move the mission of Jerry the Bear along?

Team Sproutel:  We have so much love for the diabetes community. For the past 3 years it’s felt like we’ve had a new family, one that has supported our growth and loved us unconditionally. We couldn’t be more grateful! It would be incredibly to have the support of the diabetes community to spread the word of what Jerry has done for kiddos with T1D and the hope for what he can do for all children.

Kerri:  And lastly, how can families order their own Jerry the Bear?

Team Sproutel:  We’re currently taking pre-orders on our website for the new Jerry the Bear at a special 30% off discount.

The press release from Sproutel this morning has some great information about Jerry, including Sproutel’s mission to continue to give back to the community.  From the release:  “Best suited for children ages 4 to 9, Jerry the Bear will be available to preorder at $99. Sproutel has pledged 1% of sales to help fight obesity and hunger through the Food Research and Action Center (FRAC). Expansion packs will support finding a cure for type 1 diabetes through the Juvenile Diabetes Research Foundation (JDRF), and food allergies through Food Allergy Research and Education (FARE).”

You can find out more about Jerry the Bear, and his team, through their website.  Or by following @JerryTheBearCo on Twitter.  Or by watching this video about the new and improved Jerry.  Huge thanks to Hannah and Aaron for continuing to remain true to the cause and the community, and for creating a profoundly effective teaching tool that you can hug.


In almost ten years of using a CGM, I’ve never, ever had this happen.

This morning, when I went to insert a new Dexcom sensor, I followed all the usual protocol:  Put a Toughpad down against clean skin, place the sensor adhesive against the Toughpad, and then insert the sensor right through into my skin, allowing the giant needle to pull back into the applicator, leaving the sensor wire embedded in my skin.

Right?  So imagine my surprise when I pulled back the applicator and instead of seeing a sensor housing ready for the transmitter, I instead saw the stupid needle sticking out of my leg.


It hurt, so instead of documenting the needle in my skin (as a good diabetes blogger should – ? – in efforts to get the best grost), I pulled it the hell out and inspected it to make sure there wasn’t anything wrong with it.

The needle in my Dexcom sensor application tool. Filed under "oh hell no." #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

And you know what’s wrong with it? IT’S HUGE.


The sensor was damaged when the needle gave up on me, leaving the sensor wire poking out from the underside of the transmitter. Pointless prick. :)


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