Comments on: Diabetes, cycling and technology https://justanothercyclist.com/2010/08/30/diabetes-cycling-and-technology/ Sun, 15 May 2011 08:22:29 +0000 hourly 1 http://wordpress.org/?v=3.1.2 By: Fromkin https://justanothercyclist.com/2010/08/30/diabetes-cycling-and-technology/comment-page-1/#comment-749 Fromkin Wed, 02 Mar 2011 00:53:00 +0000 https://justanothercyclist.com/?p=1013#comment-749 Well, it's official, our 14 year-old part-Siamese cat, Blue, is diabetic. I know it's not a contagious condition, but what the hell? Now, I've been diabetic since the end of July, when my surgeon removed my bleeding, tumorous pancreas. Yesterday, we took Blue to the vet for some tests. He's been lethargic, drinking a lot of water and urinating frequently. Kerry thought it might be the result of Mirolax, which the vet suggested to help with his constipation. After looking up Blue's symptoms on the Internet (a great electronic encyclopedia of everything), Kerry concluded he was diabetic, and asked me to take his blood sugar. I used my old meter and test strips (I'm on a pump now), and sure enough, it was nearly 400 MG/dl at one point. So, we hustled him into the vet yesterday, and the results came back today. Not only is he diabetic, but also he has a basal cell carcinoma on a back toe (we'll have that removed when the diabetes is under control. So, he's on Hill's M/D wet food ($31 for a case of 24 cans), and tonight I start giving him Lantus, 2 units twice a day. By coincidence, I went to see my endocrinologist today, and after explaining about Blue, he gave me a sample bottle of Lantus; I already have a boxful of syringes I don't need since going on the pump. So, we'll try this for a month. Our vet thinks it's possible that he'll be OK by then and not need continuing insulin. We'll see. Poor Kerry, having to take care of two diabetics in the family. Anyway, I'm doing fine. My A1C is down to 6.8, my blood pressure is down to 117 over 79, and I'm feeling great. Once the snow and rain stop, I'll be back out cutting wood. And once he's feeling better, Blue will be back taking walks with us. Well, it’s official, our 14 year-old part-Siamese cat, Blue, is diabetic. I know it’s not a contagious condition, but what the hell? Now, I’ve been diabetic since the end of July, when my surgeon removed my bleeding, tumorous pancreas. Yesterday, we took Blue to the vet for some tests. He’s been lethargic, drinking a lot of water and urinating frequently. Kerry thought it might be the result of Mirolax, which the vet suggested to help with his constipation. After looking up Blue’s symptoms on the Internet (a great electronic encyclopedia of everything), Kerry concluded he was diabetic, and asked me to take his blood sugar. I used my old meter and test strips (I’m on a pump now), and sure enough, it was nearly 400 MG/dl at one point.

So, we hustled him into the vet yesterday, and the results came back today. Not only is he diabetic, but also he has a basal cell carcinoma on a back toe (we’ll have that removed when the diabetes is under control. So, he’s on Hill’s M/D wet food ($31 for a case of 24 cans), and tonight I start giving him Lantus, 2 units twice a day.

By coincidence, I went to see my endocrinologist today, and after explaining about Blue, he gave me a sample bottle of Lantus; I already have a boxful of syringes I don’t need since going on the pump. So, we’ll try this for a month. Our vet thinks it’s possible that he’ll be OK by then and not need continuing insulin. We’ll see. Poor Kerry, having to take care of two diabetics in the family.

Anyway, I’m doing fine. My A1C is down to 6.8, my blood pressure is down to 117 over 79, and I’m feeling great. Once the snow and rain stop, I’ll be back out cutting wood. And once he’s feeling better, Blue will be back taking walks with us.

]]> By: Jay https://justanothercyclist.com/2010/08/30/diabetes-cycling-and-technology/comment-page-1/#comment-736 Jay Tue, 01 Feb 2011 16:37:00 +0000 https://justanothercyclist.com/?p=1013#comment-736 You bet. Went on the pump yesterday. Interesting experience. Hooked up easily at the diabetes center. But my educator suggested clipping the pump to the small fifth pocket on my jeans rather than my belt. While shopping, the pump fell out and dangled by the infusion set before I could pull it back up and clip it to my belt. Had a slice of pizza at COSTCO and gave myself a bolus with the remote. Everything seemed fine until I got home a couple of hours later and took my BG - 408! Gave myself 4 units of HumaLog and changed the infusion set and canula, which I assume pulled out of my body when the pump fell. BG started going back down through dinner to 124 before bed (my target is 120). Had a Glucerna mini-snack bar before bed, and woke with a BG level of 147. I suspect that we might have to jigger the basal rate during the next couple of weeks. Sleeping with a soft-belt pump pack went OK. Last thing I wanted was an occlusion or another pull-out. Looking forward to my next finger prick. You bet. Went on the pump yesterday. Interesting experience. Hooked up easily at the diabetes center. But my educator suggested clipping the pump to the small fifth pocket on my jeans rather than my belt. While shopping, the pump fell out and dangled by the infusion set before I could pull it back up and clip it to my belt. Had a slice of pizza at COSTCO and gave myself a bolus with the remote. Everything seemed fine until I got home a couple of hours later and took my BG – 408! Gave myself 4 units of HumaLog and changed the infusion set and canula, which I assume pulled out of my body when the pump fell. BG started going back down through dinner to 124 before bed (my target is 120). Had a Glucerna mini-snack bar before bed, and woke with a BG level of 147. I suspect that we might have to jigger the basal rate during the next couple of weeks. Sleeping with a soft-belt pump pack went OK. Last thing I wanted was an occlusion or another pull-out. Looking forward to my next finger prick.

]]> By: Jay https://justanothercyclist.com/2010/08/30/diabetes-cycling-and-technology/comment-page-1/#comment-735 Jay Tue, 01 Feb 2011 16:37:00 +0000 https://justanothercyclist.com/?p=1013#comment-735 You bet. Went on the pump yesterday. Interesting experience. Hooked up easily at the diabetes center. But my educator suggested clipping the pump to the small fifth pocket on my jeans rather than my belt. While shopping, the pump fell out and dangled by the infusion set before I could pull it back up and clip it to my belt. Had a slice of pizza at COSTCO and gave myself a bolus with the remote. Everything seemed fine until I got home a couple of hours later and took my BG - 408! Gave myself 4 units of HumaLog and changed the infusion set and canula, which I assume pulled out of my body when the pump fell. BG started going back down through dinner to 124 before bed (my target is 120). Had a Glucerna mini-snack bar before bed, and woke with a BG level of 147. I suspect that we might have to jigger the basal rate during the next couple of weeks. Sleeping with a soft-belt pump pack went OK. Last thing I wanted was an occlusion or another pull-out. Looking forward to my next finger prick. You bet. Went on the pump yesterday. Interesting experience. Hooked up easily at the diabetes center. But my educator suggested clipping the pump to the small fifth pocket on my jeans rather than my belt. While shopping, the pump fell out and dangled by the infusion set before I could pull it back up and clip it to my belt. Had a slice of pizza at COSTCO and gave myself a bolus with the remote. Everything seemed fine until I got home a couple of hours later and took my BG – 408! Gave myself 4 units of HumaLog and changed the infusion set and canula, which I assume pulled out of my body when the pump fell. BG started going back down through dinner to 124 before bed (my target is 120). Had a Glucerna mini-snack bar before bed, and woke with a BG level of 147. I suspect that we might have to jigger the basal rate during the next couple of weeks. Sleeping with a soft-belt pump pack went OK. Last thing I wanted was an occlusion or another pull-out. Looking forward to my next finger prick.

]]> By: JustAnotherCyclist https://justanothercyclist.com/2010/08/30/diabetes-cycling-and-technology/comment-page-1/#comment-716 JustAnotherCyclist Sun, 23 Jan 2011 20:21:00 +0000 https://justanothercyclist.com/?p=1013#comment-716 If you'd be interested in writing a guest post about your experiences with the new equipment, I'd love to post it here. If you’d be interested in writing a guest post about your experiences with the new equipment, I’d love to post it here.

]]> By: Jay https://justanothercyclist.com/2010/08/30/diabetes-cycling-and-technology/comment-page-1/#comment-715 Jay Sat, 22 Jan 2011 01:31:00 +0000 https://justanothercyclist.com/?p=1013#comment-715 UPS brought my pump and supplies today; going for education on it Tuesday. UPS brought my pump and supplies today; going for education on it Tuesday.

]]> By: JustAnotherCyclist https://justanothercyclist.com/2010/08/30/diabetes-cycling-and-technology/comment-page-1/#comment-701 JustAnotherCyclist Sun, 09 Jan 2011 22:05:00 +0000 https://justanothercyclist.com/?p=1013#comment-701 It is working. I don't think I can honestly give it an unbiased assessment at this point since I was kinda forced to it. I still like the OmniPod better - but do keep my previous sentence in mind before you give too much weight to my apparent anti-Ping sentiment. I'm very glad to hear that your insurance is covering what you want though. That's great news! It is working. I don’t think I can honestly give it an unbiased assessment at this point since I was kinda forced to it. I still like the OmniPod better – but do keep my previous sentence in mind before you give too much weight to my apparent anti-Ping sentiment.

I’m very glad to hear that your insurance is covering what you want though. That’s great news!

]]> By: Fromkin https://justanothercyclist.com/2010/08/30/diabetes-cycling-and-technology/comment-page-1/#comment-700 Fromkin Sun, 09 Jan 2011 03:43:00 +0000 https://justanothercyclist.com/?p=1013#comment-700 Just got my insurance determination yesterday that they've approved me for the insulin pump. Hoping to go on soon. How's the Ping working out for you? Just got my insurance determination yesterday that they’ve approved me for the insulin pump. Hoping to go on soon. How’s the Ping working out for you?

]]> By: JustAnotherCyclist https://justanothercyclist.com/2010/08/30/diabetes-cycling-and-technology/comment-page-1/#comment-670 JustAnotherCyclist Sat, 18 Dec 2010 22:40:00 +0000 https://justanothercyclist.com/?p=1013#comment-670 That makes two of us. After the insurance fiasco, I'm now sportin' the Animas OneTouch Ping on my belt now too. That makes two of us. After the insurance fiasco, I’m now sportin’ the Animas OneTouch Ping on my belt now too.

]]> By: Jay https://justanothercyclist.com/2010/08/30/diabetes-cycling-and-technology/comment-page-1/#comment-669 Jay Fri, 17 Dec 2010 22:34:00 +0000 https://justanothercyclist.com/?p=1013#comment-669 Just made the decision to go with the Animas One-Touch Ping. Not an easy decision, but my week with the Medtronic CGM left me cold. According to the Animas rep, when FDA approves the Animas/Dexcom joint device, I'll be able to upgrade to that new unit - with the Dexcom transmitter - for $299. Maybe less, since my insurance company will pay for CGM. I'll let you know how it all works out. Just made the decision to go with the Animas One-Touch Ping. Not an easy decision, but my week with the Medtronic CGM left me cold. According to the Animas rep, when FDA approves the Animas/Dexcom joint device, I’ll be able to upgrade to that new unit – with the Dexcom transmitter – for $299. Maybe less, since my insurance company will pay for CGM.

I’ll let you know how it all works out.

]]> By: Jay https://justanothercyclist.com/2010/08/30/diabetes-cycling-and-technology/comment-page-1/#comment-662 Jay Wed, 15 Dec 2010 03:31:00 +0000 https://justanothercyclist.com/?p=1013#comment-662 Thanks. That's what I've been thinking as well. Thanks. That’s what I’ve been thinking as well.

]]> By: JustAnotherCyclist https://justanothercyclist.com/2010/08/30/diabetes-cycling-and-technology/comment-page-1/#comment-661 JustAnotherCyclist Wed, 15 Dec 2010 00:55:00 +0000 https://justanothercyclist.com/?p=1013#comment-661 Yea - there is variation - especially after first changing the sensor. It takes a few hours of calibration (2-3 finger pricks) before I trust it to be "in the ball park" The other thing is I see a 10-15 minute lag between blood sugar levels and CGM readings. This is normal - as the GCM measures blood sugar indirectly via interstitial fluid. More than the specific numbers, for me the GCM is valuable for trends. I check my GCM while riding and it shows me falling - and I haven't eaten anything since it started falling - I know I need to take on some carbs or I'll be hypo shortly. Yea – there is variation – especially after first changing the sensor. It takes a few hours of calibration (2-3 finger pricks) before I trust it to be “in the ball park”

The other thing is I see a 10-15 minute lag between blood sugar levels and CGM readings. This is normal – as the GCM measures blood sugar indirectly via interstitial fluid.

More than the specific numbers, for me the GCM is valuable for trends. I check my GCM while riding and it shows me falling – and I haven’t eaten anything since it started falling – I know I need to take on some carbs or I’ll be hypo shortly.

]]> By: Jay https://justanothercyclist.com/2010/08/30/diabetes-cycling-and-technology/comment-page-1/#comment-655 Jay Sun, 12 Dec 2010 21:01:00 +0000 https://justanothercyclist.com/?p=1013#comment-655 I'm curious about your experience with Dex Com CGM. This Medtronic GCM I've been trying out has been all over the place. After finally getting it up and running, the CGM readings sometimes have been the same as or within 3-4 points of my finger sticks, but sometimes from 20-50 points different! For instance, at 2 a.m. I got an alert that there was a weak signal. After getting the signal back, I found that my glucose reading had dipped on a diagonal graph from from 238 (finger-stick read 286) at bedtime (big meal, lots of carbs, but 6 units of humalog beforehand) to 110 at 1:30 a.m. Concerned, I did a finger-stick and got a reading of 86. Ate a glucerna snack bar to make sure I didn't go hypo. Are you having that kind of variation between your CGM meter and finger-sticks? Jay I’m curious about your experience with Dex Com CGM. This Medtronic GCM I’ve been trying out has been all over the place. After finally getting it up and running, the CGM readings sometimes have been the same as or within 3-4 points of my finger sticks, but sometimes from 20-50 points different! For instance, at 2 a.m. I got an alert that there was a weak signal. After getting the signal back, I found that my glucose reading had dipped on a diagonal graph from from 238 (finger-stick read 286) at bedtime (big meal, lots of carbs, but 6 units of humalog beforehand) to 110 at 1:30 a.m. Concerned, I did a finger-stick and got a reading of 86. Ate a glucerna snack bar to make sure I didn’t go hypo.

Are you having that kind of variation between your CGM meter and finger-sticks?

Jay

]]> By: Jay https://justanothercyclist.com/2010/08/30/diabetes-cycling-and-technology/comment-page-1/#comment-652 Jay Sat, 11 Dec 2010 01:08:00 +0000 https://justanothercyclist.com/?p=1013#comment-652 Thanks. I'm trying out the Minimed continuous glucose monitor during this weekend, just to see if the CGM is worth it for me. If not, it makes the decision between Animas and Minimed a more even choice. I'd appreciate your updates. Thanks. I’m trying out the Minimed continuous glucose monitor during this weekend, just to see if the CGM is worth it for me. If not, it makes the decision between Animas and Minimed a more even choice. I’d appreciate your updates.

]]> By: JustAnotherCyclist https://justanothercyclist.com/2010/08/30/diabetes-cycling-and-technology/comment-page-1/#comment-651 JustAnotherCyclist Fri, 10 Dec 2010 22:17:00 +0000 https://justanothercyclist.com/?p=1013#comment-651 Personally, given the option I feel that OmniPod is the absolute best choice for cyclists - and probably for any athletes. I currently use one, and have for the last 6 months or so. I wear my pods on the back of my arms. I actually go into some detail about those in my post <a href="https://justanothercyclist.com/2010/09/13/an-open-letter-to-diabetic-cyclists/" rel="nofollow">An open letter to diabetic cyclists</a> That being said - I'm going off of the OmniPod. I changed insurance, and my new carrier (Kaiser) won't pay for the OmniPod. I hate hate HATE the fact that my insurance is deciding the best course of treatment for me - but such is our crappy system. I've opted to go with the <a href="http://www.animas.com/animas-insulin-pumps/onetouch-ping" rel="nofollow">Animas OnTouch Ping</a> myself. The biggest reason is that I believe the workability of a wireless (and tubeless) device that I can hold in my hand <i>while riding</i> and give myself insulin is absolutely critical. I haven't gotten my hands on one of these yet, but from what I can tell I can't adjust the basal rate from the remote unit. That really sucks if true. With the minimed, all control is in the device that connects to the infusion set, and thus you've got to negotiate all of that stuff out from under your jersey while you are riding. I'm really disappointed that I have to make this change - the OmniPod worked out beautifully for me. We'll see how the OneTouch ping works out going forward. Now the fact that my insurance is giving me a hard time and making me jump through a bunch of hoops to even see if I can get my Dexcom Continuous Glucose Monitor supported - well, that just flat pisses me off. I'm still right in the middle of all of that non-sense, so I'll let you know how it goes. I'm actually preparing a letter that I'm going to submit to them to contest their red tape, and I'll probably post it her verbatim. Personally, given the option I feel that OmniPod is the absolute best choice for cyclists – and probably for any athletes. I currently use one, and have for the last 6 months or so. I wear my pods on the back of my arms. I actually go into some detail about those in my post An open letter to diabetic cyclists

That being said – I’m going off of the OmniPod. I changed insurance, and my new carrier (Kaiser) won’t pay for the OmniPod. I hate hate HATE the fact that my insurance is deciding the best course of treatment for me – but such is our crappy system.

I’ve opted to go with the Animas OnTouch Ping myself. The biggest reason is that I believe the workability of a wireless (and tubeless) device that I can hold in my hand while riding and give myself insulin is absolutely critical. I haven’t gotten my hands on one of these yet, but from what I can tell I can’t adjust the basal rate from the remote unit. That really sucks if true. With the minimed, all control is in the device that connects to the infusion set, and thus you’ve got to negotiate all of that stuff out from under your jersey while you are riding.

I’m really disappointed that I have to make this change – the OmniPod worked out beautifully for me. We’ll see how the OneTouch ping works out going forward.

Now the fact that my insurance is giving me a hard time and making me jump through a bunch of hoops to even see if I can get my Dexcom Continuous Glucose Monitor supported – well, that just flat pisses me off. I’m still right in the middle of all of that non-sense, so I’ll let you know how it goes. I’m actually preparing a letter that I’m going to submit to them to contest their red tape, and I’ll probably post it her verbatim.

]]> By: Jay https://justanothercyclist.com/2010/08/30/diabetes-cycling-and-technology/comment-page-1/#comment-649 Jay Fri, 10 Dec 2010 03:08:00 +0000 https://justanothercyclist.com/?p=1013#comment-649 Became a Type 1 diabetic after having my bleeding pancreas removed in late July. After recovering from surgery (and using Lantus and Humalog) I cycled until the snow came. Going with an insulin pump soon. Practical choices are Animal OneTouch Ping and Medtronic Paradigm Real-time Minimed. Any thoughts by diabetic cyclists out there. Became a Type 1 diabetic after having my bleeding pancreas removed in late July. After recovering from surgery (and using Lantus and Humalog) I cycled until the snow came. Going with an insulin pump soon. Practical choices are Animal OneTouch Ping and Medtronic Paradigm Real-time Minimed. Any thoughts by diabetic cyclists out there.

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