Monday, May 12, 2014

90 Day Memories

My 90-day BG Average
The OmniPod PDM maintains daily, 7 day, 14 day, 30 day, 60 day, and 90 day averages of your blood sugar (assuming you use the PDM as your meter or you manually input them into the device).  It also tells you what your lowest and highest number has been during that time frame.

When I look at this picture, I don't just see the numbers 35 and 402.  I see 35 and have an instant flashback to realizing my DexCom sensor had run its course.  It should have caught that 35 way back when I went below 70, but instead was still showing me in range.  I see 402 and remember my wonderful honeymoon in Mexico where I spent days on end eating, drinking, and dealing with spoiled insulin in the hot Mexican sun.  

I also see the true range of a Type 1 diabetic's blood sugars.  My A1cs over the last year have been the best I've had in my 18 years with diabetes, but that doesn't mean I don't still have extreme highs and lows.  
To most people, numbers are just numbers.  To a Type 1 diabetic, each number has a memory, a meaning, a feeling, a reaction.  Numbers aren't just numbers, they tell the story of our life.

Saturday, May 10, 2014

Basal Rate Testing

*Written shortly after I started on an insulin pump, but still good information...

About a month after being hooked up to the OmniPod I felt ready to tackle basal rate testing.  I am somewhat disappointed that my endo didn't care one way or another if I did this.  I think she has the mindset that we can just tweak things as we see them, but I'd rather do the test and get a true sense of what is happening when I am fasting.

My endo wasn't giving me much in the way of step-by-step directions on how to do a basal rate test so I turned to the DOC.  A simple Google search, "how to test basal rates" lead me to Karen's blog post: http://www.bittersweetdiabetes.com/2011/08/night-with-my-basal-rates.html.  In addition to Karen's helpful tips she had linked to an article written by Gary Scheiner that is a must read.  He explains in exact detail how to perform the test and, more importantly, how to change your basal rates based on your test results.  This article can be found here: http://diatribe.us/issues/13/learning-curve.  Gary also talks about basal rate testing here: http://diatribe.us/issues/26/thinking-like-a-pancreas.

Lastly, if you're interested in some worksheets that you can print out and write in your results as you go, click here: worksheets

I decided to test my basal rates in the following order: overnight, morning, afternoon, dinner.  The idea is once you get one segment of the day figured out you move to the next.  I also made adjustments after the first test and then used the very next day to test that same segment.  For example, the first night I did the overnight test I had to stop the test at 4 a.m. because I was low.  The next day I reduced my basal rates and then tested the overnight segment again.  This approach worked for me, but you can also do a few days of testing in a row and then make adjustments.  It's really a personal preference, if you ask me.  YDMV.  

Once I feel good about my basal rates it will make it easier to know if my I:C ratio and correction rates are accurate.  Here's to the never ending cycle of trying something and then trying it again and again and again.

Update...

After testing my basal rates and making adjustments, I obviously went back to eating and going about my normal day.  After a while I realized there was a part of the day that I was always staying too high.  To accommodate for this I ended up increasing my basal rates during that time and that did the trick.  In the end, if your body needs more insulin, it needs more insulin.  The body doesn't care if you're calling it "basal" or "bolus".  Don't get too hung up on having an insulin delivery pattern that matches some textbook or article.  Listen to your body.

Thursday, May 8, 2014

UPDATE: OmniPod & FreeStyle Test Strips

For the last 14 months I have used the blood glucose meter that is built into the OmniPod PDM, which uses FreeStyle test strips (not FreeStyle Lite, but the old school strips just called “FreeStlye”).  All FreeStyle test strip vials say to use code 16, however, there have been claims within the DOC that using code 16 actually results in getting a reading that is lower than you actually are.  Not dangerously low, but always about 15-25 points lower.  Back in August, I wrote this post outlining how I tested this theory and that I decided to use the FreeStyle strips, but would input code 18 into my OmniPod PDM.

Fast forward to February 2014, Abbott (manufacturer of FreeStyle strips) sent out a press release announcing the immediate recall of the FreeStyle test strips that are used with the OmniPod PDM.  The gist of the press release was that users were reporting that the old Freestyle strips were providing a much lower blood sugar reading than they actually were.  Sound familiar?  Coincidence?  Who knows? 

When I called Abbott to request my replacement strips (they sent everyone 400), I asked the agent just how much lower a blood sugar reading we were talking about?  For instance, if it says 65 am I really 200 or if it’s saying 65 am I’m really 80?  The agent couldn’t speak to any of my questions and was only equipped to input my address and ship out new test strips.  Sidebar: While advised not to by the press release and the agent, I did continue to use the remainder of my old test strips because my A1c results had been matching up nicely with my meter averages for many months and there was no way I was throwing away hundreds of expensive test strips.

A week or so later, the new test strips arrived at my door and that’s when it hit me: Will code 16 now work properly with the “new” test strips or do I still need to use code 18 to get them to report a more accurate reading?

I decided to experiment for a few days.  Each time I tested, I lined up an old strip and then three new strips.  First I would test with the old strip using code 18, then with the same drop of blood, I would insert a new strip, change the code to 16, test…insert a new strip, change the code to 17, test…insert a new strip, change the code to 18, test.  This resulted in 4 different glucose checks. 

After comparing the 4 numbers I quickly saw that using code 16 with the new strips still resulted in a number lower than my control number.  After a few tests I stopped checking code 16 on the new strips and continued to test code 17 and 18.  After 3 days of this and around 30 checks I came to the conclusion that imputing code 17 into the OmniPod PDM most closely matched the readings I was getting by using code 18 with the old strips. 

Coincidentally, I had my A1c drawn just one day before switching over to the new test strips, so in 3 months I will be interested to see how closely my meter averages match my A1c.  It will be another way to validate if code 17 is providing results that match the blood work. 

Abbott sent out another letter this week informing customers that all retail and mail order pharmacies should now have enough stock of the “new” test strips.  You will know you are receiving the “new” strips if the expiration date is August 2015 or later.  I received a 90 day supply from my mail order pharmacy the week of April 28 and all boxes were dated 2015/08, so I’m good to go. 

I’ll close by saying this has been my personal experience with FreeStyle test strips and the OmniPod PDM blood glucose meter.  You may be using these products with code 16 and have never noticed a significant difference between your meter averages and your lab work.  If that’s the case I wouldn’t change a thing.  However, if you are using these products and your meter averages are always significantly lower than your A1c, you may want to try a similar experiment to see what code works best for you.

Tuesday, April 1, 2014

OmniPod: Pod Change LIVE!

First ever attempt at posting a video to the blog!  All done in one take; no editing.

Staring: Me
Pump played by: OmniPod
Walk-on role: DexCom


Things I Learned After Filming:
1. Make your bed if it's in the shot
2. Easier solution, close your bedroom door
3. Hold the iPhone horizontally, not vertically
4. Meant to say at the end that with the OmniPod you perform this task every 3 days

*Best Vlog ~ Best of the 'Betes Blogs, April 2014

Sunday, March 30, 2014

Cupcakes

Every minute is a choice when living with diabetes. Today I made the choice to sit this close to cupcakes and not eat one. They smelled so good and a part of me, make that a large part of me, really wanted one, but more than that, I wanted my BG to stay in range and level like it had been all day.


Nice try, cupcakes, but you ain't got nothing on me.