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/.
Thursday 27 September 2012
Test Drive - Tandem t: Slim
Wednesday 26 September 2012
Monday 24 September 2012
Diabetes Award Night
The Diabetes Awards Night
Diabetes Awards
surviving diabetesGot an idea for what the criteria should be?
Connecting pump - best decision ever
Thanks to Garden Variety Diabetic for this great poster!
http://gardenvarietydiabetic.blogspot.com.au/2012/04/keep-calm-and-carry-on.htmlIt has been six months since I began using my insulin pump 24/7. Under no circumstances would I voluntarily return to multiple daily injections.
It took about a year of gentle persuasion from my health care professionals for me to take the plunge. But once I decided to start using an insulin pump and made the connection I was instantly attracted. Much of my hesitation was around being continuously connected to a seemingly intrusive device that would be a constant and visible reminder of my diabetes.
Fortunately, those fears turned out to be without foundation. I have worn my pump happily with some snug dresses.
Before I made the pump connection I met two females who had their pump nestled in their bra. I find this is the best place for me to wear my pump, too.
The clinical pump representative and the diabetes nurse educator who trained me on using the pump were wonderful.
Like anything new, it takes time to become proficient. A reservoir and line change initially took me about 45 minutes, but I am now down to less than four minutes. It is important that I get this right because my life sort of depends on it.
It was also important that in setting my pump rates I did many blood tests. This allowed me to work with my health care professionals to find settings that were right for me. It was not uncommon for me to do 12 tests a day. It may seem a little excessive, but it helped me get set up and to ensure my pump was working well for the most important person in this instance: me!
So far I have been fortunate with only one tricky situation – around two or three months after I started using my pump it stopped delivering. Of course it would have to occur as I’m heading off to work. What is a girl to do? I reconnected the old reservoir which bought me enough time until recess (of course it had to happen on a day when I was teaching until recess). I was not yet at the speedy rate of four minutes per reservoir and line change, but I managed to get it done in much less than my initial 45 minutes.
As is the case for everyone with diabetes, not a day goes by that you don’t think about your condition. The rates that are set initially for your pump are not set in concrete, so as life events vary so do the needs of your pump.
As I spoke to a colleague about goals for the year I said I want to be pump master. Being a person interested in physical fitness, he thought I was referring to pumping iron or lifting weights and he started talking about his aim of increasing the weight he lifted. I just laughed and replied: “Yeah, but I pump 24/7. Can you match that?” When he realised we were talking about different pumping he smiled and ceased talking.
As far as I am concerned connecting to an insulin pump has been the best decision I have made for 2012.
I believe that you only get out what you put in and anything worth doing is worth doing properly. I am not saying it will all be smooth sailing and that you will magically get perfect BGLs by connecting to a pump.
I was experiencing hypos frequently and my multiple daily injections were like a broadband antibiotic, wiping out everything.
But with a pump I have greater control over the way and rate in which my insulin is delivered. It is not perfect, but then again nothing ever is. It is, however, a definite improvement.
Thinking of taking the pump plunge? We’ve got lots of information on our website.
Its hard to disagree!
Sunday 23 September 2012
Saturday 22 September 2012
Friday 21 September 2012
Thursday 20 September 2012
Monday 17 September 2012
Lauryn’s Poem About Type 1 Diabetes
Lauryn is a JDRF advocate who recently met with her local MP Tony Crook. After meeting with Lauryn, he wanted to help support her and all other Australians with type 1 diabetes, and encourage all other parliamentarians to do the same. This morning, he read her poem out in Parliament.
To be like Lauryn and help encourage other MPs to support type 1 diabetes, sign up to become a JDRF advocate and participate in Promise to Remember Me 2012.
Its lovely
Sunday 16 September 2012
Saturday 15 September 2012
Friday 14 September 2012
Wednesday 12 September 2012
Diabetes and Feelings
Its so much more than just blood sugars and insulin.. How about how you feel emotionally?
Tuesday 11 September 2012
Monday 10 September 2012
Saturday 8 September 2012
Reading Nutrition Labels - Diabetes Daily Voices
It never occurred to me that I needed to be cognizant of nutrition labels, and the accompanying ingredients list, until I began to make nutrition a bigger priority in my life with type 2 diabetes. I am here to tell you that paying attention to nutrition labels and ingredient lists is crucial with this disease. It’s just as important as testing your blood sugar and taking your medications on time.
Nutrition labels can be sneaky, though. The FDA has guidelines for food manufacturers to follow (obviously, or I doubt they would go to the trouble), but there are ways for those manufacturers to fool you. Here are some tips that should help you to navigate those labels:
- Trans Fats: We all know that trans fatty acids are bad for us. Many food producers are doing a creditable job of removing the offending ingredient from our foods, but it’s still there. The FDA has specific guidelines for what goes on those labels. We can be fooled if we see that there are 0 grams of trans fats but you should know this: “If a serving contains less than 0.5 gram, the content, when declared, must be expressed as “0 grams.” Therefore, it may say zero but there could still be trans fats in the food. How can you know? Read the ingredient label. If you see partially hydrogenated oils, then there are trans fats in the food.
- Serving size: Every nutrition label must tell you the serving size they used to calculate the nutrition information. A problem arises when you assume that the nutrition is for the whole package when in reality it might be ½ the package or possibly less. Be sure to look at the top of the nutrition label for the serving size and number of servings in the package. Be aware of this when comparing different products as well. One jar of peanut butter might list nutrition information for 1 Tbsp. and another might be listing the nutrition for 2 Tbsp. Make sure that you’re comparing apples to apples.
- Carbs and fiber: Intake of carbohydrates is an important thing for people with diabetes to pay attention to, regardless of your food plan or medication regimen. Total carbs are listed with sub-categories for fiber, sugars and sugar alcohols etc. below. Foods that are higher in fiber are better for us than something with no fiber. Therefore, a food that has 15 grams of carbohydrates and 3 grams of fiber is much better for you than something with 15 grams of carbohydrates and zero grams of fiber. Look for more fiber-dense foods.
- Ingredients and health claims: Many food producers will put health claims on the front of their packages in order to lure you into thinking that the food is healthy. The FDA also has guidelines for this explained here. You may see a heart symbol on the package or claims that the food is whole grain. It’s still important for you to look at the list of ingredients to be sure you know what you’re eating. Ingredients are listed in order of content percentages, ie: highest amount first. I was fooled into thinking that the frozen waffles I was eating were healthy, but when I read the ingredients I realized I was basically eating frozen paste. Don’t trust the front of the package; look for yourself.
Shopping this way takes more time but you will be a better informed, healthier person if you just read. Eventually you will know which foods work well for you and fit into your food plan. A little time spent up front will pay off in huge dividends down the road.
Related:
-->
One of the biggest challenges -- trying to get labels and carbs correct
Friday 7 September 2012
Why Meters Can’t Tell Us Our Blood Sugar Levels : DiabetesMine: the all things diabetes blog
Its an increasingly hot topic as PWD discover the individual power they have to make decisions
Thursday 6 September 2012
Wednesday 5 September 2012
Tuesday 4 September 2012
Monday 3 September 2012
Skillet Chicken Parmesan - Diabetes Health
Note: Recipe courtesy of "Eat What You Love: More Than 300 Incredible Recipes Low in Sugar, Fat and Calories" (Running Press 2010)
Although my boys love to order Chicken Parmesan when we dine out, the health content is always a concern -especially since it usually arrives thickly breaded, deeply fried, smothered in cheese, and served on a mountain of spaghetti! Here's a terrific easy stove-top recipe that's filled with all of the same great flavors but none of the excess fat and carbs.Ingredients & Methods
Serves 41/3 cup breadcrumbs
1/3 cup grated Parmesan cheese
1/2 teaspoon dried oregano
1/4 teaspoon garlic salt
1 large egg
4 boneless, skinless chicken breasts (about 1 pound)
1 tablespoon olive oil
3/4 cup jarred marinara sauce
3/4 cup shredded part-skim mozzarella cheese (3 ounces)Nutrition at a Glance (per serving)
Calories
340
Protein
39 g
Sodium
840 mg
Carbohydrate
13 g (Sugars 1 g)
Fiber
0 g
Total fat
14 g (Sat fat 6 g)
Cholesterol
135 mg
Food Exchanges:
4 Lean Meat, 1 Medium Fat Meat, 2 Vegetable, 1 Fat, 1/2 Starch
Weight Watcher Point Comparison:
7
Method:
1. In a shallow bowl, mix together the breadcrumbs, Parmesan cheese, oregano, and garlic salt. In another shallow bowl, beat the egg until frothy.
2. Wrap the chicken breasts in plastic wrap and place on a cutting board. Gently pound each breast with a mallet to an even thickness (about 1/2-inch). Dip each chicken breast into the beaten egg to coat, and then roll in the breadcrumb mixture.
3. Heat the oil in a large nonstick skillet over medium-high heat. Add the chicken and cook for 4 to 5 minutes on each side, or until the chicken is well browned and just cooked through.
4. Spoon the marinara sauce evenly on top of the chicken, and sprinkle the mozzarella on top. Cover the pan, reduce heat to low and cook for 3 more minutes, or until the cheese melts.
Dare to Compare: A Chicken Parmesan dinner plate (or should I say platter), at a typical Italian restaurant can serve up over 2000 calories, 125 grams of fat, 100 grams of carbohydrate and 4000 mg of sodium. Serve this with a serving of whole grain blend pasta and a great green salad for a healthy dinner everyone can enjoy.
The truth about Diet Coke
It breaks my heart, too.
I’m referring to the study that highlighted the major risk that diet sodas may pose. According to the study, those who drank diet soda on a daily basis became 48% more likely to have a heart attack or stroke.
Diabetics are already at increased risk for these problems. We don’t need anything driving the risk upward.
Now the results of the study are preliminary and many in the medical field aren’t comfortable with telling people to quit drinking diet soda just yet. This study did have a small sample size and I could use that to tell myself it’s ok to drink diet soda. But I won’t. Small sample size or not, at the very least, this study, conducted through the good ol’e scientific method is cause for concern or attention. And they didn’t say 2%, they said 48%. That gets my attention.
So although it seems pushy and mean and I know I’ve already talked about diet soda on this site before, I’ll say it again, we all need to reconsider why we drink diet sodas (those of us that do).
Are they SO GOOD that we can’t stop drinking or cut back despite our desire to be healthy?
I love diet coke, too. I love it to the point of remembering stupid things about it, like: When I was 15 years old, I had gym class before history class, which was my last class of the day. There they were, my two favorite classes at school, side by side. Our history teacher was awesome. He let us talk about everything instead of just make us take notes. I had about six good friends in that class. We’d throw our trash from across the room to see who would make a “basket” and we would try to up one another’s answers to questions from the teacher just for some friendly competition. The teacher allowed us to make jokes and laugh. This was also the only teacher who let us have drinks in class. So after gym everyday, just that year, I’d go to the vending machine all sweaty and get me a diet coke (I so prefer it out of an aluminum can) and I’d enjoy the heck out of it in that laid back history class. Ahh the memories…
You see what I mean?
Anyway, I wouldn’t call it the devil. I’d just say that maybe it’s a good idea to drink less or think about doing so.
Related posts:
Misconceptions about Diabetes
Over the weekend, I was watching a movie in which one of the lead characters claimed to have diabetes. As soon as he threw his syringes on the table and said that after eating all those lollies and junk food and being obese as a child, this has led him to develop diabetes, I put my face in my hands and cringed… Throughout the movie, he mentions he can’t have any fatty foods but then proceeds to have a massive alcoholic binge later on – evidently without any diabetes-related consequences.
Things like these that pop up in the media are increasingly frustrating for me and, no doubt, my fellow diabetes buddies. After a huge whinge about it with a close friend and fellow d-buddy of mine, she suggested we write to the production company of the movie to properly educate them on diabetes. Firstly, my respect for her went up (not that it was low before) because even though we whinged about it, she was set to do something about it.
A lack of education about diabetes per se generates the discriminatory stigmatisation of diabetes that we see today. And this, in turn, is unfair to people like me who don’t fit the stereotypes and really all people living with diabetes. People need to understand that diabetes is associated to a variety of things and is not always due to modifiable lifestyle choices. Diabetes may be due to an autoimmune condition and genetic predispositions may play a major role in the development of diabetes. Yet when the word ‘diabetes’ surfaces in everyday conversation, it’s automatically linked to obesity and poor lifestyle choices. The stigma then rises because if it’s a preventable disease, it must be your fault that you have diabetes. And having been on the receiving end of that accusation, I can tell you it hurts!
When I was diagnosed and told my then-manager, he asked if it was the ‘good kind’ or the ‘bad kind’. I stared at him dumbfounded wondering which form diabetes could possibly be the ‘good kind’?! I’ve had people trying to comfort me by saying, ‘Well all you have to do is watch what you eat then it’ll be fine’, simply because they know someone who controls their diabetes through lifestyle changes. Although, I don’t know if I prefer that over ’Does that mean you can’t eat a lot of foods?’ Diabetes management can come in many forms ranging from making appropriate lifestyle changes, to oral medications to insulin administering or a combination of all of the above.
Diabetes is a huge area of focus at the moment due to the rising obesity rates worldwide. I think it is also important to educate the public a bit more on diabetes in general. Things such as the differences between type 1 and type 2 as well as the management strategies of diabetes and particularly the dietary component of diabetes are all important basic educational steps to reduce the stigmatisation associated with diabetes.
Ashley Ng, of Caufield, is 22 years young and was diagnosed with type 2 diabetes (MODY) in 2009. She is currently halfway through her honours year at Deakin University looking at the effects of nutritional supplementation in the healing of diabetic foot ulcers. Ashley also works at the university as an academic support worker and student ambassador on the side. In her spare time (of which she has little) she enjoys driving out to national parks for walks and taking part in a variety of sports. She also plays clarinet in the Western Region Concert Band.
Oh, and did we mention her rocking blog?The thoughts and opinions expressed in this blog are Ashley’s own.
Sunday 2 September 2012
Diabetes and The Plate Method - Diabetes Article by Marianne Tetlow
Auremar/PhotoSpin
One of the treats of managing life with diabetes is the new methodology to controlling blood glucose levels (BG). Diabetics now have the ability to eat anything they choose, as long as they administer enough insulin or medication to take care of the carbohydrate count.
I have enjoyed this option, but find it doesn’t always benefit my health.
When I was initially diagnosed, I was told to eat in balance. I was ordered to eat a balanced amount of protein, carbohydrate, fat, milk and vegetables.
This has worked at times, but I have other eating strategies that have been more beneficial to both my BG control as well as my overall health.
Part of the trick in managing tight BG control is to keep it from fluctuating. The fewer fast-acting carbohydrates or simple carbohydrates I consume, the less my BG peaks.
Therefore, the less insulin I have to administer to correct it and the risk of over compensating and then dropping to a hypoglycemic level BG is less. I am not an advocate of not eating any carbohydrates.
I like use the “plate method”. I recommend dividing up your plate into fourths.
I recommend 2/4 of your plate be filled with non-starchy vegetables. These provide you with many of the vitamins, nutrients and fiber that your body needs.
These do not raise your BG level as fast and require less insulin. I also recommend making 1/4 of your plate a lean protein source. This also limits the impact on BG.
I recommend that the last 1/4 be made up of complex carbohydrates. These will raise BG levels, but provide some balance and usually some fiber.
As a Type One diabetic, I also usually consume milk and fruits, but in limited quantities. Eating with the “plate method” has lowered my overall BG and improved other areas of health such as weight, cholesterol and blood pressure.
However, as a T1, it is impossible to get my BG to a stable number and permanently keep it there.
I exercise and I occasionally get low BG or hypoglycemic. If I do inject more insulin than needed I might get low BG. I would then eat a piece of fruit or a yogurt.
I manage to incorporate these foods in on an “as needed” basis.
Saturday 1 September 2012
DSMA: Interview with a Pancreas
WANTED: Self-starting leader who isn’t afraid to call the shots, and can bring a creative style to a challenging body of work.
Do Your Parents Nag About Diabetes?
“What is your blood sugar? Are you sure that you don’t need me to talk to Jimmy’s parents about your diabetes? You might like summer camp. Are you sure you don’t want to go? Steve has a pump and really likes it, are you sure don’t want to give it a try?”
How many times has one of your parents asked you a question like these? Too many times to count? If my mother had a penny for each time I responded to one of her questions with, “Mom, stop worrying! I’m fine,” while I was growing up with diabetes, she would have…well, a lot more money in her pocket!
Looking in from the outside, parenting a child with diabetes looks incredibly stressful, and the most stressful moment might be simply going to sleep and hoping your child is going to be safe during the night.
The lack of control they have can be frustrating, simply because: this is your diabetes! You are the one who ultimately decides if you are going to embrace your diabetes by turning each negative into a positive. Or if you are going to deny your diabetes by pretending that it does not affect your life. The decision is yours.
Diabetes is not easy even if “You Make Diabetes Look Easy” as Ginger Vieira explains in her recent article. In my experience I have found the following to be helpful in managing my diabetes:
- Commitment to improve
- Positive attitude to help you cope with the rough days
- Loving support system to help you along the way
The first two, commitment and a positive attitude are intrinsic and can be turned on like a light switch. But having a loving support system is something that people who have diabetes search for every day. It may be what brings you to Diabetes Daily?
Your support system often starts with your parents and over time evolves to include friends and (hopefully) the diabetes community. Extending your support system to include friends and the diabetes community by sharing your diabetes with them, may be the most important thing that you ever do because it can increase your confidence in managing your diabetes. As you become more confident in managing your diabetes, your parents might have less anxiety about watching you assert your independence with diabetes. Easy.
So the next time one of your parents asks you, “Have you checked your blood sugar?” keep in mind that they are reminding you that they are still there for support. I will never say that diabetes is an easy thing to manage, but in comparison to how stressful life can be for parents who have a child with diabetes, actually living with it can be easier!
Instead, explain to your parents what support looks like to you. What can they do to support your diabetes management? Explain it to them clearly, and kindly.
Related:
-->
- Searching for related topics
