Wednesday 19 December 2012
Wednesday 5 December 2012
Mamamia - This life long chronic disease doesnt have a cure. Lets help find one
Check out this website I found at mamamia.com.au
A view of a Mum & her newly diagnose T1D child
Thanks to The Age's Tony Wright - When life is lived one needle at a time
ONE hundred kids sat down to a lunch in Parliament's Great Hall on Thursday, only the menu on every table offering a hint there might be a distinction between these and any other children. Each plate of chicken breast with kipfler potato, zucchini and sauteed spinach, the menu informed, equated to 24 grams of carbohydrate. A slice of watermelon was 1.3 grams, ruby grapes were 0.75 grams apiece.
Most of us wouldn't have a clue why such esoteric detail would be of interest, but virtually every kid in the House and all their parents studied the numbers with intent. Carbohydrate, essentially, is sugar, and if you happen to suffer diabetes type 1, you must know precisely how much sugar is in your food, and therefore headed to your bloodstream.
The irony for those with type 1 diabetes is that sugar is both your friend and your enemy: you need a certain amount in your blood to keep your body operating and your brain sparking, but too much will cripple you.
You must discover, before you start, your body's existing sugar content, which requires you to prick your finger, draw blood and test it with a little electronic device. Then you must calculate how much insulin has to be injected into your body to deal with the sugar in your food, which is why a menu with detail about grams of carbohydrates is handy.
AdvertisementIf you do not inject enough insulin, your blood sugar content will soar and you will become very ill indeed. If you inject too much, your blood sugar will plummet and you will lose grasp on reality and head towards unconsciousness.
Either way, if you do not receive help, you will eventually die. It's a delicate computation, performed several times a day. It's not hard for it to go wrong.
And there, in bite-size detail, is daily reality for the 122,300 people in Australia diagnosed with diabetes type 1, also known as juvenile diabetes. Another six, most of them children, are diagnosed every day. Type 1 really ought to have another name, for it is a more terrifying beast than the much more common diabetes type 2, which is often considered a lifestyle disease and can be controlled by medication, diet and exercise.
Type 1 arrives without warning and has nothing to do with obesity or lack of exercise. Your immune system goes haywire, attacks your pancreas and suddenly, irrevocably, denies your body the ability to produce insulin.
From that moment, you must learn about carbohydrates and blood sugar, and accept that hypodermic needles or an insulin pump will remain your constant companions. For as long as you live.
Virtually all these people will come to conceal a secret: they fear going to sleep, afraid that they might not wake up. Sometimes, they do not. There is no cure.
A 15-year-old girl from Adelaide, Shanna McGrath, was MC at Thursday's Kids in the House luncheon. The event is organised annually by the Juvenile Diabetes Research Foundation to confront politicians with the truth about type 1 in the hope that decision-makers might find and grant the money necessary to support research towards development of an artificial pancreas - tantalisingly close - or the great hope, a cure.
Shanna told all those in attendance that since she was diagnosed with type 1 at the age of six, she has pricked her fingers 25,000 times. She loved life, but was never OK with the stress and anxiety that accompanied the knowledge of her disease, she said, nor all those times she has felt sick and exhausted.
She introduced Oscar, 8, who declared type 1 was ''annoying and I hate it - it makes me tired and the needles hurt''.
Many in the audience, including this reporter, wept as Justin and Lyndall Haydon, a policeman and a teacher from Sydney, told their story, their three-year-old daughter Mikayla scampering around the stage. Most of us knew precisely what the Haydons were talking about.
Mikayla was diagnosed with type 1 at 11 months. She almost died. Since then the disease has ruled the family's life, and the three-year-old has had her fingers pricked 7000 times.
All the trips to hospital, the exhausting business of checking Mikayla's blood sugar all day and at midnight and 3am, the need to force-feed her sugar or to resort to a glucose injection when she lapses into a sudden low - known as a hypoglycaemic episode - and to seek medical attention when her sugars rage high …
Her parents have used all their leave, have drained their savings to the point they can't hope to buy a house, and rely on extended family to help raise their spirits, or to cry with them.
''We nearly didn't make it here today,'' Lyndall said. On Tuesday Mikayla was raced by ambulance to hospital, and the family was still dealing with her unusually high blood sugar readings.
''Mikayla will have type 1 diabetes every day for as long as she lives unless a cure is found,'' Justin said.
A cure, or anything approaching it, will take money. The Juvenile Diabetes Research Foundation has raised $1.6 billion worldwide and more than $100 million in Australia, nearly all of it through the efforts of type 1-afflicted families.
Now researchers have established a clinical research network to throw all their efforts into developing better insulin pumps, an artificial pancreas, trials to transplant insulin-producing islets into the pancreas and other efforts to ease the agony of those who fear their next sleep may be the last. The network needs $35 million over four years: $7 million a year. In federal budgetary terms, it is a paltry amount. The National Disability Insurance Scheme got $1 billion this year simply to begin establishing itself.
Opposition Leader Tony Abbott on Thursday promised the Kids in the House that a Coalition government would provide the $35 million.
The Gillard government's Health Minister, Tanya Plibersek, came to the lunch and as she ascended the stage, the children and their parents held a collective breath. But when the minister had finished her address, there had been no mention of money.
''Promise to remember us,'' said Shanna McGrath as the politicians left to do battle over a 20-year-old slush fund.
Tony Wright's daughter, Fairfax journalist Jessica Wright, was diagnosed with diabetes type 1 nine years ago.
via theage.com.au
The type of Type 1 Diabetes article that helps to raise awareness
Monday 19 November 2012
Monday 12 November 2012
Thanks to JDRP - A leap forward in the quest to develop an artificial pancreas
JDRF-funded Australian research is breaking new ground with the Artificial Pancreas Project at Sydney’s Garvan Institute of Medical Research.
Associate Professor Jenny Gunton from the Garvan Institute and Dr Nigel Greenwood, an Honorary Senior Fellow at the University of Queensland, received an Innovation Grant from JDRF a year ago to carry out initial tests on prototype artificial pancreas software.
The JDRF-funded project used two virtual patients, generated by a simulator created by Dr Greenwood, an Artificial Intelligence expert. These virtual patients’ meal data and insulin data were obtained from actual patients with diabetes. After data analysis, the software calculated suggested insulin dosages, which were given to the simulated patients. Blood glucose readings were analysed after insulin delivery, over 55 simulated days.
The results of the testing period showed that the patients achieved blood glucose levels within the target range of 4.4.-7.8 mmol/L over 90% of the time. The average person with diabetes would be outside that range over 60% of the time. This is a remarkable result, and one that demonstrates the promise of an Artificial Pancreas.
“The ultimate aim for a ‘mechanical cure’ for type 1 diabetes would be to have a closed loop system – where you have an insulin pump which knows how much insulin to give at the right time,” said Associate Professor Gunton.
JDRF’s Head of Research Development Dr Dorota Pawlak says: “Combining diabetes expertise with mathematical innovation, this project draws on resources more commonly found in the military or robotics industries, and applies them to the next big diabetes breakthrough, an artificial pancreas. This approach to modelling possible human outcomes could expedite some of the lengthy and expensive steps of research that would usually be required.”
The next step for this project is human clinical trials.
For more information, please see the press release on the Garvan Institute website.
via jdrf.org.au
Its news like this about a diabetes cure that keeps a smile on your face
Friday 9 November 2012
My favourite re-blog - An open letter to the Media re: Diabetes
It’s November 9th, and that means it’s D-Blog day. Today, the entire Diabetes Online Community is encouraged to write a post of similar topic on their personal blogs. And today, we’re encouraged to share them with media outlets far and wide. Want to include yours? Write your post and link it here: http://diabetestalkfest.com/blog/?p=507
Our topic today:
Choose a form of Media Outlet to write an open letter to, such as NY Times, CNN, Local/National Newspapers, TV and why it is so important for them to let the world know that diabetes is more than just being overweight and having too much sugar. It is about reporting stories about Type 1 and Type 2 diabetes. Let them know what kind of things you would like them to write about. If there are specific articles or reports they got wrong, let them know about it! Let’s get it right!
My letter is going to all of the local TV stations here in my city, and it goes like this:
Dear News Director,
We’re in the middle of a very important month for me, and others like me. November is Diabetes Awareness Month. Next Wednesday, November 14 is World Diabetes Day.
I’ve been living with Type 1 diabetes for nearly 22 years, from the time I was 28 years old. I’d like to take the opportunity during this important month to talk about how your organization covers diabetes over the course of the entire year. Over the years, I’ve seen stories about diabetes reported many times, and some of those times, I’ve become concerned about how diabetes is covered, or how issues related to diabetes are covered. I’m very concerned about how this affects the way people with and without diabetes view each other. So if I may, let me dispel a few diabetes myths.
Diabetes is all the same. Actually, there are many types of diabetes. The most common are Type 2, where the body has trouble using the insulin it produces. About 90% of new diagnoses are Type 2. There’s Type 1, which is an autoimmune disease characterized by the destruction of insulin-producing cells in the pancreas. But there’s also Type 1.5, or Latent Autoimmune Diabetes in Adults (or LADA), which researchers are still discovering more about, and Gestational Diabetes, where women have high blood glucose levels only during their pregnancy. It’s discovered in about 4 percent of all pregnant women.
It’s important to note the differences in diabetes, because while we all have the same serious, chronic condition, the way we approach and treat the different forms of diabetes can vary widely.
Diabetes is preventable. Let me say it clearly: People don’t get diabetes from too much sugar, or by being overweight. I developed Type 1 diabetes because my body’s immune system attacked my pancreas and killed the insulin-producing cells there. I was in great shape, at an optimal weight, active all the time, and otherwise, very healthy. In addition, many Type 2s are diagnosed without being overweight and while maintaining healthy diets.
Diabetes can be cured. Actually, it can’t. We can help mitigate the effects of diabetes through diet, exercise, and overall blood glucose management, but we can’t cure diabetes through or drugs, or meditation, or blueberry yogurt, or anything. Anyone who says different is woefully under-informed.
People with diabetes cannot eat sugar. In fact, we
via happy-medium.net
Thanks to Happy-Medium.net, what a great article and I completely agree
Thursday 8 November 2012
Sunday 4 November 2012
“If each person helps another person, the world will change”
Dear TuDiabetes Friends
I come to you for help! I believe, it is crucial that our community comes together and take ownership of the wonderful opportunity of doing something really BIG: As you might know, We have less than 14 days to reach our 20000 Big Blue Test entries in order to raise $100,000 for people with diabetes in need. BECAUSE OF THE NOV. 14th DEADLINE, we need to act fast!
I also want to present to you the video we did for the Big Blue Test grantee in Haiti. Please take few minutes to watch the work we could help make possible if we reach our goal.
2012 BiG Blue Test diabetes grantee: FHADIMAC, Haiti
I am so proud of this video. I wish you could been in Haiti with us to realize first hand how important it is that we are able to raise the funds to help nonprofits like FHADIMAC. The video the best next thing I can give you as a good reason to step up! It shows among other things, the power of coming together in helping ourselves and helping others: the element behind our program, and how we can help people empower themselves and others... I believe it is a strong statement to why it is important we do whatever its in our power to reach our goal so we can raise the $100000 Roche has committed for these charities.
I come to you to ask YOU to PLEASE STAND UP and DO THE BIG BLUE TEST! In fact, IF HALF THE COMMUNITY COMES TOGETHER ON THIS, WE RUN NO RISK OF MISSING OUR GOAL!
What to Do?1. DO THE BIG BLUE TEST: Do it once or take the chanllenge and do it everyday. It will make a difference. Each test equals a live saving donation of $5 to these charities: http://www.bigbluetest.org/faq/.
2. SPREAD THE WORD | Enlist your Friends/Family/Community: Write a blog-article, contact your local newspaper, send an email to all your contacts, use Intagram. Twitter, facebook to engage other people. (#bigbluetest). Take a Big Blue Test challenge and exercise for 14 days in a row with your family or by yourself and record it using the app or the #bigbluetest
3. ORGANIZE A LOCAL BIG BLUE TEST EVENT: Read this short post with easy instructions, no headaches entering data, I promise… “The idea of you sitting at the computer and logging 100 Big Blue Tests on the Big Blue Test website, however, is less than wonderful (even with the ease of the new Big Blue Test iPhone app now available in the iTunes app store). There are a couple different ways for you to get us batches of results. Pick which way works best for you” READ MORE:Please DO take ownership, if we come together on this, we WILL do something big! Help yourself and help others, we are not alone in this, I know we can count on our community to make the donation to these year Big Blue Test grantees possible, while we help ourselves learning the benefit of geting active
Thank you, we are counting on YOU,
Andreina D.
via tudiabetes.org
What a beautiful message... The Big Blue Test is a great Diabetes related initiative and TuDiabetes is a great site to promote it!
Saturday 3 November 2012
2012 Review: Blood Glucose Meters
As according to the Consumer Reports, ranking of the top 21 glucose meters available in the United States in their November issue. Do you agree?
Friday 2 November 2012
Thursday 1 November 2012
Blue Cupcake, the Diabetes Answer to Hallmark Cards
via diabetesmine.com
When i saw it was called Blue Cupcake my mind when somewhere else but great idea for Hallmark cards
Sunday 28 October 2012
What if you could help stop Type 1 Diabetes before it even started?
The JDRF-funded Type 1 Diabetes Prevention Trial, also known as the Intranasal Insulin Trial (INIT II), has created a great video to help spread awareness of type 1 diabetes.
Click through to see the video on their Youtube channel.
If you and your family would like to participate, please visit www.stopdiabetes.com.au for more information and to register for the trial!
via jdrf.org.au
Its a nice thought
Friday 26 October 2012
Thursday 25 October 2012
Wednesday 24 October 2012
Monday 22 October 2012
What it really feels like to be high!
Its funny that we sometimes say it but never think about what others would think if they overheard
Saturday 20 October 2012
3 Things Health Professionals can learn with Diabetes
Jane K. Dickinson has lived with type 1 diabetes for 37 years. Today, she is a registered nurse and CDE, located in Steamboat Springs, CO. When it comes to her own diabetes management, she uses syringes with Novolog and Lantus insulin. On top of meeting with patients, Jane is the coordinator for the master’s program in “diabetes education and management” at Teachers College Columbia University. She strives to help her students connect with their patients on a new level, to become a source of motivation for progress and change. You can check out her own diabetes blog where she writes about everyday things and how they relate to diabetes.
Here, Jane shares 3 things she’s learned from her patients with diabetes:
- Every person with diabetes is unique. Unfortunately, due to time constraints, budgets, and the need to be as efficient as possible, health care has become very standardized, which can lessen the ability to offer more individualized care.”In my diabetes education practice, I’m very fortunate to have 60 minutes to meet with each patient — which is a lot compared to what some health care providers have. The remaining challenge, though, is how many times I get to meet with that patient and follow-up, either because they’re too busy or their insurance won’t pay for more than one visit in a certain amount of time.”
- There are common threads for everyone with diabetes. People clearly benefit from being part of a community. There is a fine line, she says, between keeping within the structure of the standardized system and making sure the patients gets specifically what they need and want in their appointment.”Gradually, I see my patients getting more active online. Locally, I don’t see people getting involved in diabetes-related groups, but I am noticing patients finding support and encouragement from other people with diabetes in online communities. Having a connection makes a tremendous difference. I have noticed there seems to be more online interactions with type 1 patients than those with type 2, but that is gradually changing, and I am referring more and more of my patients to online communities.”
- It’s not about me! Jane’s strongest focus when communicating with her patients is to inform, motivate and support them, rather than lecture or tell them what to do.”I’ve heard health care professionals say, ‘I got my patient to do this,’ and ‘I got my patient to do that.’ It’s not about me or your physician, and what I ‘convinced’ you to do as my patient. It’s about what they do in their life. I’m here to facilitate my patients’ progress, and educate them. I am not trying to convince or force or sway someone to do something.”
Stay tuned for more articles and interviews with Jane over the next few months! Do you have questions or articles from the perspective of a CDE living with diabetes that you’d like to read? Post your comments and suggestions here and we’ll be sure to consider them!
Related:
-->
Friday 19 October 2012
Path to a Diabetes Cure - Australian research breakthrough for autoimmune diseases
Australian JDRF-funded researchers have discovered two particular proteins are essential in the development of autoimmune diseases including type 1 diabetes.
The study found that the absence of these two proteins, called Bim and Puma, led to an accumulation of ‘self-reactive’ immune cells that attacked different organs of the body. In healthy individuals, the body protects itself from autoimmune disease by forcing these self-reactive immune cells to die or become inactive.
This study, published by Professor Andreas Strasser and his colleagues at the Walter and Eliza Hall Institute of Medical Research, showed that the death of self-reactive immune cells was an important component of protecting the body against autoimmune disease.
The results of this study could impact not only the direction of type 1 diabetes prevention research, but also research into other autoimmune diseases. Future research can target these proteins to investigate the potential for preventing the onset of type 1 diabetes. This research will also pave the way to further understand the root causes of autoimmune diseases.
To support similar research studies into type 1 diabetes, please donate at www.jdrf.org.au/giving.
via jdrf.org.au
Its great that research like this is making small steps
Wednesday 17 October 2012
Smartphone-Based Glucose Monitors and Applications in the Management of Diabetes
Smartphone-Based Glucose Monitors and Applications in the Management of Diabetes: An Overview of 10 Salient “Apps” and a Novel Smartphone-Connected Blood Glucose Monitor
- Joseph Tran, BS,
- Rosanna Tran, BS and
- John R. White Jr., PA, PharmD
According to the American Diabetes Association, the direct and indirect costs of diabetes in the United States have exceeded $174 billion, and there are 25.8 million U.S. children and adults with diabetes.1 Numerous resources are available to help patients increase their role in the management of diabetes while simultaneously improving their metabolic parameters. Although the Internet is a burgeoning source of information and resources, the average patient often lacks the skills for finding and using the most optimal health care information.2
It is important for health care providers (HCPs) to educate patients about the available pragmatic technological resources for the management of their diabetes. Specifically, smartphones have become an integral component of daily life for many people in the United States. In 2011, > 85% of Americans owned and used a mobile phone, and half of those users also had Internet access with their mobile devices.3 The implementation of smartphone applications and tools for the management of diabetes may be an effective option in reducing the progression of diabetes and improving quality of life.
Consistent self-monitoring blood glucose (SMBG) has been shown to be a useful tool in improving glycemic control in type 2 diabetes.4 The use of smartphone applications (“apps”) has already been shown to be a useful method for accurately logging and managing SMBG results. SMBG data that are logged on a smartphone app can be easily reviewed with HCPs to make recommendations about exercise, diet, or medications. A meta-analysis revealed that using SMBG data stored in and/or shared through a PDA (personal data assistant), logbook, the Internet, fax machines, and other innovative technologies, along with consistent feedback from an HCP, enhanced glycemic improvements and reduced hospitalizations.5
The goal of using smartphone apps is to effectively manage diabetes by improving glycemic control and, ultimately, preventing or delaying further complications of diabetes.6 Smartphones or devices such as the iPod Touch and the iPad (sometimes referred to as “iOS devices” for their operating system) offer a variety of diabetes apps that also may be helpful in the management of other aspects of diabetes care such as exercise, carbohydrate counting, and medication adherence.
This article provides a cursory review of 10 salient, easy-to-use smartphone apps that may be useful to patients with diabetes. These applications were chosen by the authors based on their utility and ease of use. It should be noted, however, that there are many more potentially useful available apps not included in this review. We also review a new SMBG technology integrated directly into a smartphone (iBGstar, Sanofi Diabetes, Bridgewater, NJ).
Proven Utility of Apps
Several studies have evaluated the use of smartphones in the management of diabetes. One study6 analyzed the evolution of data management tools for managing SMBG using iPhone apps. Apps were reviewed based on a series of criteria, including glucose, carbohydrate, and insulin data, as well as hypoglycemia and hyperglycemia events. Analyzed apps included Diabetes Logbook, Blood Sugar Diabetes Control, and WaveSense Diabetes Manager. Selected participants were observed and given a written questionnaire to complete for each of the apps. The results showed that WaveSense Diabetes Manager enabled participants to input preselected SMBG values and perform tasks faster than the other apps. The study concluded that the ability to record, analyze, and concurrently share and obtain feedback on SMBG data using an iPad or iPod Touch may potentially benefit patients.
Another review of the use of apps7 was based on a meta-analysis of studies that analyzed the use of mobile phones for diabetes self-management and its impact on A1C. The authors searched electronic databases including Pubmed, EMBASE, and the Cochrane Library and identified and evaluated 22 articles with regard to the effects of smartphones on A1C. Although the methods of smartphone intervention were diverse in their approach to reinforcing lifestyle change, healthy diets, and exercise, the pooled difference in A1C was a 0.5% reduction compared to control groups in both type 1 or type 2 diabetic patients. In subgroup analysis, patients with type 2 diabetes reported a greater A1C reduction (0.8%, P = 0.02) than patients with type 1 diabetes (0.3%, P = 0.02). These results suggest that the use of mobile phones leads to improved A1C and self-management in diabetes care.
Review of Apps
This section offers brief reviews of 10 diabetes-related smartphone apps. Information about these apps is summarized in Table 1.
Diabetes Buddy
With its sleek, modern layout and strong contrasting colors, Diabetes Buddy8 (Krodzone Technologies) is tastefully designed and allows users to log diabetes-related data values in only a few keystrokes (Figure 1). The app's overview section shows a monthly calendar on which daily logs are displayed. Users can record glucose values, physical activity time, carbohydrate intake, and water consumption.
Diabetes Buddy and TRACK3, another app discussed below, have a similar food database. However, Diabetes Buddy has an additional function that allows users to add personalized recipes. The carbohydrate content for the entire recipe is then broken down per ingredient. The carbohydrate log section displays the total daily grams of carbohydrate consumed and remaining grams of carbohydrate available based on logged food items. In the same section, the app also displays other daily nutritional data, including the total amounts of calories, fiber, sugar, and protein consumed.
Figure 1.Diabetes Buddy app.
Overall, Diabetes Buddy excels in its logging capacity but could be enhanced with an alarm reminder for blood glucose readings and medication intake. Recorded data can be sent through e-mail, but an external spreadsheet software is required for the receiver to open and evaluate it. Diabetes Buddy could benefit from an organized table that automatically displays all of the logs directly in the e-mail. Still, it is a reasonably useful app.
Diabetes Log
The developers of Diabetes Log9 (Distal Thoughts) sought to create an app that is succinct without the extra features that may confuse users who are new to electronic data tracking. This app provides a logical and easy-to-use approach to logging data. It features three options: glucose, food, and medicine.
Given its goal of simplicity of use, Diabetes Log would be improved by offering automatic synchronization of patients' data values to HCPs' offices for continual monitoring recommendations. Nonetheless, this app may be valuable to patients who are new to smartphone technology.
Diabetes Pilot
Diabetes Pilot10 (Digital Altitudes) contains the essential logging features in addition to a comprehensive database that includes nutritional information on thousands of food items. It also contains information about carbohydrate, fat, protein, fiber, sodium, cholesterol, and other nutrients. There is a useful logbook to record and monitor medication intake, food, weight, and blood glucose averages for 7, 30, 60, and 90 days. This app also offers an insulin calculator that takes into account the fiber, protein, and carbohydrate content of foods entered for a meal and calculates the number of insulin units required to reach a targeted blood glucose value.
Two drawbacks of this app are that there are additional costs to purchase the software needed to synchronize recorded data and food information to a computer, and the insulin calculator does not consider additional factors such as exercise, previous dose, or other causes that could affect the amount of insulin needed. Thus, this function of the app should be used with caution and with this limitation in mind.
Diamedic
Diamedic11 (Nicholas Martin) is especially useful for patients with type 1 diabetes because of its capacity to track basal program settings for insulin pumps and ability to calculate corrective and mealtime insulin doses. It offers an assortment of graphs and charts such as histograms, scatter plots, and pie charts to view weekly blood glucose readings. There are also scatter-plot graphs to view weekly trends in A1C, insulin units, carbohydrate intake, weight, and pulse changes.
View this table:Table 1.Summary of Features on 10 Smartphone Apps for Diabetes Self-Management
Unfortunately, the medication logbook contains a set list of diabetes and cholesterol-lowering medications, and adding other medications is not feasible.
Glucose Buddy
This app12 (SkyHealth) can guide any patient through the activities of recording and monitoring glucose, medications, carbohydrate intake, and A1C and enables data to be easily synchronized online to the Glucose Buddy's Web site. One distinct feature is its ability to give reminders, which can be tailored to user preferences. For example, it can remind users to check their blood glucose and take their medication at specific time intervals.
Glucose Buddy also incorporates social media such as Facebook and Twitter to communicate to users about updates and changes to the app. There is also an online forum enabling users to share their experiences and have questions answered from others regarding topics such as insulin pumps or gestational diabetes.
Limitations of this app include a $3.99 fee to enable blood pressure and weight logging. For the effective management of daily carbohydrate intake, a separate app called CalorieTrack is required in addition to Glucose Buddy. This app is convenient to use, but it is still in the early stages of development, and some operating issues remain to be resolved.
iDiabetes
iDiabetes13 (iHealthVentures) is a simple app that is solely used to record blood glucose values. One convenient aspect of it is its ability to e-mail HCPs with the logged blood glucose data.
However, the app's format is limited when logging blood glucose values because of it lacks a specific section in which to record each diabetes-related medication. The medication list provided includes only injectable medications and does not include oral diabetes agents, although there is an option to manually log medications that are not listed. Additionally, there are no instructions about how to use the app; the only available customer assistance is through e-mail.
LogFrog DB
LogFrog14 (Amphistyle) is one of the most versatile diabetes apps available and can be easily used by both young children and adults (Figure 2).
Of the apps reviewed here, it is one of the easiest to navigate. The instructions to review the app are concise and simply accessed by tapping the frog animation on the main screen. There is also an interactive pinwheel containing multiple categories, and specific data are stored by spinning the pinwheel. The categories on the pinwheel are depicted through icons instead of words. For example, there are 24 exercise routines demonstrated by stick figures performing each activity. In addition, recorded data can be exported to e-mail or Google documents in a colorful, organized table.
Unique features of this app include specific sections for logging comprehensive medical examinations, including eye, foot, and dental exam results, laboratory values, and even electrocardiogram and X-ray findings. Average blood glucose can be viewed for 7, 30, or 90 days.
One limitation is that there is no integrated food database, which would be helpful in obtaining information about the nutrition and carbohydrate content of various foods. Also, the icons on the pinwheel are small and may be difficult for some viewers to read.
Figure 2.LogFrog DB app.
TRACK3
TRACK315 (Coheso) is available in both the iTunes Store and Android Market. This app is intended for users who are more concerned about managing meals and exercise activity. It offers a food database that includes an extensive list of restaurant menus and brands of packaged foods, along with their nutritional contents. Specific nutritional content can easily be saved into a favorites section, making it more convenient for users to log the foods they regularly eat.
The app also allows users to create a food journal and to share it with their HCPs. It also offers a comprehensive list of exercise activities that can be logged, ranging from ballroom dancing to different degrees of aerobic exercises.
TRACK3 includes an insulin calculator that determines the amount of insulin doses, taking into consideration users' correction factors and insulin-to-carbohydrate ratios. It also provides a designated section where users can directly e-mail questions to their product support team.
WaveSense Diabetes Manager
In a 2010 review of diabetes data management tools available at that time, Ciemins et al.16 rated WaveSense Diabetes Manager17 (AgaMatrix) (Figure 3) as the easiest, fastest, and most trustworthy app, with the fewest requests for help. In the realm of free apps, WaveSense continues to rank high in usability, convenience of data charts, and overall design.
WaveSense has a personalization feature that allows users to select from different wallpapers, enhancing its usability and visual appeal. A partnership with dLife, an online diabetes resource, provides educational videos about living with diabetes covering topics such as athletes with diabetes, recipes, and health.
Overall, WaveSense delivers an effective package for data monitoring and provides useful charts and comprehensive health information. However, although very easy to use, this app lacks the capability for logging nondiabetes medications, blood pressure, or weight and does not include an alarm function as a medication or SMBG reminder.
Your Diabetes Diary
People with diabetes can use Your Diabetes Diary18 (Leichhardt) in conjunction with their HCP. It has an HCP version, as well as a separate guardian version (allows a parent or guardian to monitor). This feature enables HCPs and guardians to have access to all entries made by the patients who use it. A variety of specific parameters such as cholesterol, BMI, creatinine, and results of dental and foot exams can be logged and monitored through graphs.
Figure 3.WaveSense Diabetes Manager app.
One drawback is that the extensive user guide can be time-consuming when users are learning how to navigate the app. Still, this product may be effective in cases where bidirectional access is a consideration.
New and Emerging Technologies
iBGStar
As the market for diabetes apps grows, novel technologies continue to emerge. The U.S. Food and Drug Administration recently approved an innovative blood glucose monitoring device called the iBGStar (Figure 4). This monitor connects directly to any Apple iOS device such as an iPhone, iPod Touch, or iPad. Results of blood glucose readings are immediate and displayed using an iBGStar diabetes manager app. Also, the iBGStar device can be used independently of the iOS device, and glucose values can be synchronized to any iOS device at a later time.19
Figure 4.iBGStar blood glucose monitoring device.
To ensure accurate glucose readings, iBGStar uses dynamic electrochemistry. This technology is created by a complex mathematical method that automatically adjusts for factors that can lead to inaccuracies in blood glucose readings such as temperature, humidity, and hematocrit levels.19 Studies have shown the device to be 99.5% accurate and to meet the International Organization for Standardization's standards for glucose monitors (ISO 15197).20
The IBGStar app was created from the WaveSense Diabetes app described in the section above. The features of the WaveSense Diabetes app are nearly identical to the iBGStar app. Subtle differences in the iBGstar app include improved interface resolution, which is crisp, clear, and visually appealing, and the omission of the video feature of the WaveSense Diabetes Manager app, which contains information on various topics related to living with diabetes.
Traditional SMBG using lancets can be painful and time-consuming; however, promising new technology may one day provide a solution to this problem. High-tech devices such as EyeSense (Grobostheim), which is now in development, may offer alternative procedures for patients to measure their glucose levels without using a lancet. This external meter will be able to determine a blood glucose reading via a small photometer implanted in the interstitial fluid below the conjunctiva of the eye. In studies, this method has been shown to perform as well as conventional blood glucose meters. It is anticipated to become available in 2013.21
Summary and Conclusions
With the advancement of technology, methods for monitoring glucose and other metabolic parameters have become more simple and convenient. As advanced technology continues to become more ingrained into everyday life, it is important for HCPs to have a firm understanding of these new tools.
The apps reviewed in this article demonstrate tremendous versatility, usability, and functionality at nominal or no cost. Some less expensive apps may not meet the needs of all users; however, some patients may find the extra features of more expensive apps to be overwhelming. Apps such as Diabetes Log, which is free in the Apple iTunes store, provide the main essentials for diabetes monitoring, whereas Diabetes Buddy, which costs $6.99, is a more comprehensive app that offers additional features for more detail-oriented users. Selecting the most appropriate app for a given patient will require consideration of the need for lifestyle modifications such as diet and exercise as well as the user's knowledge of and experience in using smartphones.
These apps also provide alternative avenues in chronic management of multiple disease states in addition to diabetes. Features that store blood pressure and cholesterol data and weight management tools are included in some apps.
As new apps continue to emerge and become more refined, smartphone users will have more options to conveniently track their glycemic control and overall health, which can ultimately improve their ability to effectively manage their diabetes.
In addition, new and emerging devices such as iBGStar and Eyesense may offer still more convenience for users to track their glucose levels while on the move, making the process of SMBG simpler than ever before.
Footnotes
Joseph Tran, BS (PharmD student), and Rosanna Tran, BS (PharmD student), are doctorate in pharmacy candidates, and John R. White, Jr., PA, PharmD, is a professor and interim chair of the Department of Pharmacotherapy at Washington State University College of Pharmacy in Spokane. Dr. White is also a deputy editor of Clinical Diabetes.
- American Diabetes Association(R) Inc., 2012
REFERENCES
- ↵
: Diabetes statistics [article online]. Available from http://www.diabetes.org/diabetes-basics/diabetes-statistics. Accessed 8 April 2012
- American Diabetes Association
- ↵
: Features of mobile diabetes applications: review of the literature and analysis of current applications compared against evidence-based guidelines. J Med Internet Res 22:1–16, 2011
- Taridzo C,
- Fernandez-Luque L,
- Arsand E,
- Hartvigsen G
- ↵
: The Wireless Association: Wireless quick facts, year-end figures [article online]. Available from http://www.ctia.org/media/industry_info/index.cfm/AID/10323. Accessed 10 April 2012
- CTIA
- ↵
- ↵
- ↵
: Evolution of data management tools for managing self-monitoring of blood glucose results: a survey of iPhone applications. J Diabetes Sci Technol 4:949–957, 2010
- Anoop R,
- Hou P,
- Golnik T,
- Flaherty J,
- Vu S
- ↵
: Effect of mobile phone intervention for diabetes on glycaemic control: a meta-analysis. Diabet Med 28:455–463, 2011
- Liang X,
- Wang Q,
- Yang X,
- Cao J,
- Chen J,
- Mo X,
- Huang J,
- Wang L,
- Gu D
- ↵
: Diabetes Buddy: Control your blood sugar. Available from http://itunes.apple.com/us/app/diabetes-buddy-control-your/id387128141?mt=8. Accessed 14 April 2012
- Apple iTunes
- ↵
: Diabetes log. Available from http://itunes.apple.com/us/app/diabetes-log/id288141660?mt=8. Accessed 12 April 2012
- Apple iTunes
- ↵
: Diabetes Pilot: Software for diabetes. Available from http://www.diabetespilot.com/iphone. Accessed 12 April 2012
- Diabetes Pilot
- ↵
: Diamedic. Available from http://itunes.apple.com/us/app/diamedic/id287188419?mt=8. Accessed 13 April 2012
- Apple iTunes
- ↵
. Available from http://www.glucosebuddy.com/glucose_buddy_app. Accessed 9 May 2012
- Skyhealth: Glucose Buddy
- ↵
: Blood glucose (sugar) tracker: iDiabetes. Available from http://itunes.apple.com/us/app/blood-glucose-sugar-tracker/id306085838?mt=8. Accessed 14 April 2012
- Apple iTunes
- ↵
- ↵
: Track3 - Diabetes planner and carb counter. Available from http://itunes.apple.com/us/app/track3-diabetes-planner-carb/id318622618?mt=8. Accessed 12 April 2012
- Apple iTunes
- ↵
: An analysis of data management tools for diabetes self-management: can smart phone technology keep up? J Diabetes Sci Technol 4:958–960, 2010
- Ciemins E,
- Coon P,
- Sorli C
- ↵
: WaveSense Diabetes Manager. Available from http://itunes.apple.com/us/app/wavesense-diabetes-manager/id325292586?mt=8. Accessed 14 April 2012
- Apple iTunes
- ↵
: Your Diabetes Diary for iPhone 3GS, iPhone 4, iPhone 4S, iPod Touch (3rd generation), iPod Touch (4th generation) and iPad on the iTunes App Store. Your Diabetes Diary. Available from http://itunes.apple.com/us/app/your-diabetes-diary/id514186309?mt=8. Accessed 13 April 2012
- Alle iTunes
- ↵
: iBGStar blood glucose monitoring system receives U.S. FDA 510 (k) clearance, Dec. 7, 2011 [article online]. Available from http://sanofi.mediaroom.com/index.php?s=64&item=57. Accessed 20 April 2012
- Sanofi Diabetes
- ↵
: Clinical accuracy of the patient self-testing blood glucose meters BGStar and iBGstar [article online]. Available from http://www.ikfe.de. Accessed 20 April 2012
- Mitri M,
- Sachsenheimer D,
- Borchert M,
- Yap A,
- Forst T
- ↵
: The great dream of diabetic patients [article online]. Available from http://eyesense.com/en/konzept.htm. Accessed 22 April 2012
- Eyesense
An overview of 10 different apps to help manage diabetes..
Im currently using the iBGStar and can highly recommend
Monday 15 October 2012
Friday 12 October 2012
Thursday 11 October 2012
Tuesday 9 October 2012
Monday 8 October 2012
Thanks to dLife.com - Where's Waldo Pump?
It's really amazing how our radar goes off when we see an insulin pump on someone's hip. I believe this remarkable ability is universal amongst our friends in the diabetes community.
In a crowded room, our eyes just lock onto it. If Where's Waldo wore a pump, we'd be all over it.
There it is! Ooh! And there's an air bubble!!! Ooh! And look over by the ancient mummy exhibit. I see four test strips on the ground!
The one I spotted the other night, however, was low-hanging fruit.
The supermarket cashier moved my items along the conveyor belt and placed them in plastic bags.
"These mini pretzels mixed in with the ice cream ... " she said. "Mmmmm. Awesome!"
"Oh yeah, "I said, in agreement.
And then I zeroed in on it. And spoke without thinking.
"My son has the same pump."
Immediately after it left my lips I was thinking maybe I shouldn't have.
"Oh," she said. She seemed surprised.
"I'm sorry," I said. "I hope you don't mind ..."
"No, no," she said. "I'm just not used to people knowing what it is. Most people think it's a beeper."
She was likely in her mid-40s and had a pleasant smile.
She asked about Charlie's age and how long he had been on the pump. She sighed and shook her head when I told her. She told me that she was 17 when diagnosed but just recently started with the pump. She asked about the CGM and I told her Charlie has it but it's a lot for a little kid to wear. She didn't seem to be in any rush to get one for herself.
"Oh!" she said, as if we were old friends, "I have to tell you something!"
She told me about first being outfitted with the pump. She recalled going home and showing her husband her "circuits" around her waist as if she was a robot. She laughed with that pleasant smile, demonstrating the tubes shooting out from every direction.
She seemed excited to be talking about diabetes. Maybe it wasn't too often that the topic came up in the supermarket.
And if not for the pancreatically flawless man behind me in line organizing his pile; blissfully ignorant of the number of carbs he and his family would be consuming in the coming week -
I could have talked to her for hours.
via dlife.com
The joy of finding like-minded pumpers
Want to see Scott's thoughts on Medtronic My Sentry product?
I used to be a Deltec Cozmo user but I went the other way and started happily loving Medtronic
Friday 5 October 2012
Get Involved - #DOC - The Diabetes Online Community
via nicediabetes.com
Sometimes it feels likes no one else understand the days when life is hard. However guess what there is a whole community out there trying to muddle their way through the same thing
Monday 1 October 2012
Thursday 27 September 2012
Test Drive - Tandem t: Slim
Touchscreen meets insulin pump in Tandem’s new t:slim
by Adam Brown
“Design is a funny word. Some people think design means how it looks. But of course, if you dig deeper, it's really how it works … To design something really well, you have to get it. You have to really grok what it’s all about. It takes a passionate commitment to really thoroughly understand something, chew it up, not just quickly swallow it. Most people don’t take the time to do that.”
Those were the words of the late Steve Jobs in an interview with Wired in February 1996. More than a decade later, Tandem Diabetes Care took this idea to heart with its new t:slim touchscreen insulin pump, which it designed after conducting a remarkable 4,000 in-depth interviews with patients, healthcare providers, and caregivers. Tandem really wanted to get inside the minds of people who take insulin – pumpers and non-pumpers alike. The new pump was approved by the FDA in November 2011 (see new now next in diaTribe #38) and launched just last month. I was able to get trained on the t:slim at Tandem’s San Diego headquarters soon after it launched, and what follows is my experience wearing the device over the past week. So far, three themes have emerged: some clear differences from other pumps, a focus on simplicity and convenience, and an attention to safety.
Part One: Differences from Other Pumps
Adam’s Favorites
- iPhone-like touchscreen
- Rechargeable battery
- Highly customizable “personal profiles” for insulin delivery
From the minute I opened the shipping box, it was clear that the t:slim pump was somewhat different from other pumps I’ve used – included with the pump were a USB charging cable and adapters for both the wall and car. Even the included user manual comes on a credit-card-like thumb drive. But the most obvious difference between the t:slim and other pumps is the touchscreen. I found this to be the most compelling feature of the pump and a major departure from the button-driven devices I’ve used since I began pumping in 2002.
The Touchscreen
Most important, the touchscreen is easy to use, intuitive to navigate through, and responsive. I appreciated the screen’s very bright, high contrast, full color design, which also incorporates highly readable bold font and large icons that make selection easy and mis-taps rare. Unlike some other medical device touchscreens, I also appreciated that the t:slim screen did not require a lot of finger pressure to use – it’s right on par with using an iPhone or Android smartphone. The one minor shortcoming of the t:slim touchscreen is it doesn’t have the smartphone swiping (i.e., to navigate up, down, left, and right) that I’m so used to. Instead, you must hit a down or up arrow key, though this was a fairly minor inconvenience because few of the menus take up more than one screen length.
The Battery
Another departure from other pumps is the t:slim’s rechargeable battery, which lasts seven days on a full charge. A dead battery would take about 90 minutes to completely charge, and on average it takes about a minute of charge time for every percentage point of battery life (i.e., if the pump is at 80% battery life, that’s about 20 minutes to fully charge it). Tandem recommends plugging in the t:slim for 10-15 minutes every day to “top it off” – I did this while I showered (see water resistant information below) or when sitting next to my computer, and the t:slim would always return to 100% battery life. The pump can be charged whether or not you are connected to it.
Although a rechargeable battery is new to insulin pumps, I found it refreshing and fairly easy to remember to plug it in – I’m used to doing it for my Dexcom Seven Plus CGM, my LifeScan OneTouch Verio IQ blood glucose meter, my cell phone, my laptop, my iPod, and pretty much everything else these days. The included charger cable is the very common micro-USB computer cable used for many consumer electronics, and I was happy to see Tandem include a wall adapter and car adapter. There are also a variety of battery packs, solar chargers, and the like for those who will not have access to electricity (Tandem is not currently selling these but they are easy to find online). I was glad to hear this is an option since I know many pumpers that are into outdoor camping and backpacking where charging would be a challenge.
Personal Profiles
The third biggest difference between the t:slim and other pumps is setting up the pump’s insulin profiles and bolus calculator settings. Traditionally, a pumper sets up basal rates by time of day in one menu, an insulin to carb ratio by time of day in another menu, a correction factor by time of day in a third menu, and a target blood glucose or range by time of day in a fourth menu. The separate menus do not interact, meaning that a change in one parameter (e.g., the time a basal rate changes) is not reflected in the other menus. On past pumps, at least for me, this process has sometimes resulted in a disjointed insulin profile, with parameters that do not match up. Tandem has improved and streamlined this process, which is good news in our view because we worry a lot about optimizing glycemic management. In a recent dQ&A survey, fewer than 60% of patients and 50% of educators thought that their insulin pumps were configured optimally – very disappointing from a patient perspective!
In the t:slim’s personal profile menu, all four parameters – basal rate, correction factor, insulin to carb ratio, and target glucose – are set for a particular time of day. These appear in a single menu and are saved together. The entire day’s worth of settings is then saved within a particular profile, which you give a custom name and can easily and quickly duplicate. I have one profile called “Home” that is based on my level of activity at home and my normal diet and wake up time. But I also have a “Travel” profile with different settings, as well as a “Sleeping in” profile for going to bed later and waking up later. It’s very easy to toggle between these profiles, and it’s all located in one centralized menu. You can have up to six different personal profiles and up to 16 time segments within each.
A New Delivery Mechanism
Instead of a conventional piston driven delivery, where a mechanical screw drives a syringe built into a reservoir (the way a Medtronic, Animas, Roche, or Insulet pump works), the t:slim uses a micro-delivery technology. This means that very small amounts of insulin are shuttled from the reservoir to the infusion set, and the full insulin supply is never directly exposed to the user’s body (as it is with other pumps). Notably, the pump can deliver in increments of as little as 0.001 units, compared to 0.025 for the Animas OneTouch Ping and Medtronic Paradigm and 0.05 units per hour for the Insulet OmniPod. While I cannot say that I noticed a difference from these novel accuracy and safety features in my blood glucose numbers over the last week, I can say it was comforting to know that the pump has these innovations. Perhaps Tandem will eventually conduct studies to examine whether these are indeed beneficial for glycemic control, fewer pump-related accidents, etc.
Changing an Infusion Set and Cartridge
The one area where the t:slim was different from other pumps – but in a way that created more hassle – was when it came time to change a reservoir and pump set (the t:slim works with any luer lock infusion set). The process took me an average of around nine minutes with the t:slim, more than double the average of four minutes it took me on the Medtronic Paradigm and Animas OneTouch Ping. The process is slow for a few reasons: 1) the pump takes a bit of time to automatically clear air out of the new cartridge (I appreciated this, since air bubbles can cause some unexplained and frustrating highs); 2) because of the micro-delivery technology, it takes the pump a couple minutes to prime and fill the tubing with insulin; and 3) you are guided via step-by-step on-screen pictures and prompts, which take extra time to clear relative to the Animas and Medtronic pumps. As we understand it, the cartridge change process is a leading cause of calls into manufacturers’ support lines and one of the reasons Tandem included this extra guidance. In the future, I think Tandem could improve the process by prefilling the cartridges with insulin (similar to the Asante Pearl) or perhaps speeding the priming process by allowing users to turn off the pictures once they have the process down. On the plus side, the cartridge does hold 300 units of insulin, a notable feat considering the t:slim is about 25% slimmer than the Animas OneTouch Ping and Medtronic Paradigm insulin pumps. As a reminder, only the Medtronic Paradigm 723 holds 300 units.
Part Two: Focus on Simplicity and Convenience
Adam’s Favorites
- Very simple menu layout, intuitive user interface, and fast navigation
- Bolus menu design
- Quick bolus feature
The marketing tagline for the t:slim is “touch simplicity,” which is most evident in the device’s user interface. The pump is very similar to the user interface concept and button design pioneered by the iPhone: 1) a touchscreen to use it; 2) a button on top that blacks out the screen and locks it; and 3) a button on the face of the device that immediately takes you back to the home screen at any time. Since the home screen is really the hub of the pump’s software and the starting point to perform any action on the device, I really liked having a single button take me there immediately. It was much faster than on other pumps I’ve used, where you keep hitting a back button to exit a menu.
The Menu Design
I did not need to open the instruction manual to figure out the t:slim’s menu layout, and the overall design made navigating through the pump quite fast. Taking a combination meal and correction bolus for 30 grams of carbs and a blood glucose of 165 mg/dl took me an average of nine seconds on the t:slim, compared to double the time (18 seconds) with the Medtronic Paradigm and nearly triple the time (26 seconds) with the Animas OneTouch Ping. I know a matter of seconds may not sound like a lot, but when you’re bolusing multiple times a day (I take an average of six boluses per day), every day, that adds up.
The t:slim’s home screen displays the most critical pump information: two large buttons called “Bolus” and “Options,” a battery life indicator (in both percent and an icon), an insulin reservoir indicator (in both units and an icon), the time and the date, and insulin on board (IOB) in both units and time remaining. IOB is my favorite part of the home screen because I use it so religiously, and it’s such a meaningful improvement for me over other pumps that only display IOB in units remaining and hide this vital information in a status menu.
The Bolus Calculator
Since bolusing is the most common interaction a user has with a pump, I appreciated that this was front and center on the home screen. Clicking the “Bolus” button immediately takes you into the bolus menu, where you can enter carbs and/or a blood glucose level if the carb calculator is turned on, or just insulin units and a blood glucose if the carb calculator is turned off. You can quickly override the calculator’s dose by clicking a box at the top of the screen and inputting your own number of units. “Options” allows you to suspend insulin, set up profiles, load a new reservoir (what Tandem calls a “cartridge”), set a temp basal, and view history.
The bolus screen is a perfect example of how the t:slim’s user interface is simple and convenient. The side-by-side, large block design makes it very clear what can be entered, while a running tally at the top totals the insulin dose. A tab at the bottom allows you to click and view the full delivery calculation in a nice vertical arithmetic layout. Entering a blood glucose value or number of carbs pulls up a touchscreen numeric keypad (like dialing a phone number), and cleverly, Tandem has included an addition sign that will tally the carbs from multiple foods. This struck me as a great addition considering how tiring diabetes math can sometimes be.
Extending and Quick Bolusing
After entering the information for a bolus, the final screen before delivery gives you the option of extending the bolus – this was just a toggle switch and was available for every bolus, unlike on other pumps where you must preselect an extended bolus before entering anything into the bolus calculator. The t:slim also has a great quick bolus feature that uses only the screen lock button on top of the pump. Increments can be in units of insulin or carbs, making the t:slim the only pump that offers either option for a quick bolus. I used this feature to program and deliver a bolus without looking at the pump (!) and to very quickly take a bolus without unlocking the pump screen and using the carb calculator.
Part Three: Safety
Adam’s Favorites
- 10 seconds to cancel a bolus
- A plethora of confirmation screens, alerts, and warning messages
It’s great to make a cool looking, sleekly designed insulin pump, but it’s also a medical device infusing insulin. Consequently, I was glad to see a vast array of safety features built into the t:slim – confirmation screens galore, alerts when you have not completed an action for 90 seconds (e.g., you were in the middle of calculating a bolus and forgot to deliver it), red bold text to draw attention to important items, an automatic screen lock following a bolus or when the screen is tapped three times in quick succession (e.g., to prevent accidental touchscreen taps while in your pocket), and a user interface feature called “dynamic error handling” that prevents the user from selecting illogical items in real-time (e.g., you can enter 100 grams of carbs, but the pump prevents you from adding another zero for 1,000).
My favorite safety feature of the pump was the cancel/stop bolus button. After programming and confirming a bolus, the t:slim gives you approximately 10 seconds to cancel the bolus before it ever starts delivering it. On other pumps, programming and confirming a bolus initiates delivery immediately, so unless you have lightning fast fingers, cancelling the full amount of the bolus is very challenging. I found this feature of the t:slim valuable when I had second thoughts about the bolus I just gave. The cancel bolus button also appears right on the home screen as a red “X” during the 10-second grace period, so there is no need to dig into a menu and hunt around for this feature.
Part Four: The t:slim’s Durability and Cost
Durability
As an outdoorsy and active person, I was initially concerned about the t:slim’s durability. Tandem has told me that if a user accidentally cracks the screen, the pump will be replaced under warranty. While I can’t say I did my own extensive crash tests, I know that many young attendees at the recent Children with Diabetes Friends for Life conference had “contests” to try and break the trial t:slim pumps, and it was pretty challenging for them to do so – I think in the end it took one t:slim pump thrown at another one to crack it (and it was still fully functional)! The starter kit comes with a hard plastic case that wraps around the pump for additional protection, and the t:slim touchscreen also has a pre-applied protective film. I have not worn the pump long enough to have too many accidental drops, but the durability will be on the top of my mind as I get more experience with the device.
Water Resistance
Unlike the Animas pumps and Insulet’s OmniPod, the t:slim is not completely waterproof. According to the company, the t:slim has been tested in three feet of water for 30 minutes (what’s known as an IPX7 rating, similar to Medtronic pumps) – essentially, it’s “water resistant.” However, I must confess that I’ve broken multiple pumps due to water damage, so this is a concern for me. The pump worked fine after I submerged it in a cup of water for ten minutes, though I will need to wear it for a longer period to fully test its durability and water resilience.
Cost and Insurance
And of course, the very, very important question is cost. Insurance companies typically pay for a new insulin pump once every four years, though this can vary. Tandem has already signed contracts with some major insurers, and is currently working with customers on a case-by-case basis to obtain insurance coverage. We understand that the t:slim has a higher list price (about $6,995) than the Medtronic Paradigm Revel (about $6,500), Animas OneTouch Ping (about $6,300), and Insulet OmniPod (only around $600 for the starter kit, although “pods” are more expensive than sets on an ongoing basis), so that is an important consideration for those who must pay co-insurance. However, Tandem has a large staff dedicated to reimbursement, so if you are interested in getting the t:slim pump, the best way to figure out your situation is to contact Tandem directly.
Closing Thoughts
I was impressed and plan to keep the t:slim assuming my insurance will help cover some of the cost (fingers crossed!), though the devil will be in the details since I changed to my current pump fairly recently. That said, I’m definitely still interested in trying the upcoming Animas Vibe (integrated with the Dexcom Gen 4 CGM), Insulet’s smaller second-generation pod, and Medtronic’s MiniMed 530G with low glucose suspend – as a reminder, all these devices are currently under FDA review or will be submitted to the FDA soon. Indeed, this is a great time for patients with so many innovations coming, and I had a great week trying out something so new. For more information on Tandem’s t:slim, see new now next in diaTribe #38 and Tandem’s website at http://www.tandemdiabetes.com/products/t-slim/.
via diatribe.us
Subscribe to:
Posts (Atom)