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Showing posts from November, 2015

American Diabetes Month 2015: Day 24 - Travel == Bad

Day 24 and a trip to see family has begun.  I woke up at 3 AM in order to pack and get ready for my 5:55 AM flight.  I posted last week about how travelling with any medical equipment is bad, but I've come to really hate flying with diabetes and an insulin pump.

As I got to the security check-in as if on queue when I asked to opt-out of the milimeter wave detection device (standing x-ray scanner) the TSA agent told me that, "You will be fine in there."  I waited some time to get my personal pat down (which I still believe does nothing to actually help our national security) whic takes time and is a burden.  It really is as if the people who are defending our front line are completely ignorant to anyone having an opinion.  i only hope my return voyage has only metal detectors so I don't have to deal with the opt-out lecture I generally receive from the TSA agents who decide that taking liability for my medical equipment is in their best interest

American Diabetes Month 2015: Day 23 - Closed Loop systems

Day 23, I wanted to continue the discussion on the closed loop systems.
What is a closed loop system? A closed loop system is a complete system that takes feedback from a sensor of sorts and automatically respond to that feedback.  Some examples of closed loop systems include: self-driving cars, airplane autopilot, cruise control, vacation e-mail message auto-reply, etc.  While for each of these some of the sensors are pre-programmed things (autopilot, cruise control, email auto-reply) the ones that are not pre-programmed plans are still very much in development.
Why don't you want a closed loop system? Of the above examples of closed loop systems, the only one that really comes close to what MIGHT be necessary to convince me is self-driving cars.  Look at all of the money that has been invested in that by the big-name companies like Google, Ford, Tesla, etc.  I look at the amount of money that's been spent on that and figure it'll take as much, if not more to get the se…

American Diabetes Month 2015: Day 22 - Hard to write

It's day 22 and I've had a hard time trying to figure out what to write.  It's not that I don't have loads of content to write about (I totally don't btw) but I feel like I don't want to re-hash things that I've said before.  There is an absolutely astronomical amount of information on diabetes.  I probably get messaged once a week with questions about how I feel about a "cure" to diabetes or how there's a new device that closes the loop between my CGM and my Insulin Pump.  In the long run, how should I feel about this?  How do I respond to ever question that I'm asked along these lines?

My 'theory' on any of the magical cures is that until I see strong research about the cure being used on people with type 1 diabetes, I'm hesitant to be positive about it, not because I'm a pessimist, but because I'm a realist.  I spent far too long doing research in college to realize that in general, it takes decades to go from animal…

American Diabetes Month 2015: Day 21 - Pizza

Day 21, and there's of course more fun to talk about today.  Last night I had pizza, why did I have pizza, because I was too lazy too cook myself a real meal.  What exactly is the problem with eating pizza? It causes blood sugars to go a bit wonky.

When I say wonky, I really mean that it caused some issues overnight.  Pizza is a strange mix of bread, sugar, cheese, meat and veggies.  While pizza is delicious, I always know it will require constant attention after consuming.  The mix of the fat, carbohydrates, and proteins is on that many insulin pumps have a specific bolus for dealing with it.  On my Medtronic insulin pump it was called a "dual wave" bolus, on my current Animas Vibe it is called a "Combo Bolus."  In the end, the bolus has two patterns to it it has a normal bolus (to deal with normal food things) and then a "square" bolus or extended bolus that essentially increases the basal rate for a given amount of time.  While this extended bolus…

American Diabetes Month 2015: Day 20 - Hypoglycemia

It's Day 20, I'm starting to feel when I start the blog post like this that I'm back in Elementary school counting the days of the school year.

It's continually harder to find more topics to talk about on my blog, mostly because I feel like I've hashed out all of the previous things at some point.  After having days with good blood sugars recently, I've decided to look back as last year's posts and came across the second day that I posted.  I talked about low blood sugars.  The scariest part of having a low blood sugar is the sensation that comes from it.  There is a lot of light-headedness that comes from it, and sometimes balance is difficult to keep up.  Another thing that's hard to do is...test your blood sugar, which is definitely something that should be done.  On top of low blood sugars, high blood sugars can be bad as well, just harder to determine without testing.  Many of the times, I'll keep my sugars just above normal range when I am dr…

American Diabetes Month 2015: Day 19 - Why is education important?

Day 19, and Thanksgiving is only a week away folks!  I've been recently watching a lot of House M. D. and Scrubs when I am doing work at home as I find both of them funny and interesting.  I guess since I've been in the hospital a fair amount of time, I find it interesting to see Hospital settings portrayed.  The episode that came across last night was Episode 6 of Season 4 of Scrubs.  This is the episode where Turk is diagnosed with diabetes.

It's striking to me how well that the show portrays the fact that even doctors don't necessarily understand the disease as much as the Endocrinologists or nurses who interact/deal with it on a daily basis.  In the grand scheme of things, the people who REALLY have the best information are those who are continually researching and dealing with it.  It came up last year when I told a bit of the story of how I was diagnosed.  When I was diagnosed, my dad (who is a Doctor) didn't know very much about the treatment of diabetes oth…

American Diabetes Month 2015: Day 18 - Quick push, busy day

Day 18.  Wednesdays are by far my busiest day of the week, with playing trivia and such, so I'll make this short and sweet.  I love being able to help other people figure out what diabetes is and how it can affect them.  I've written loads about this in the past, and suggest that if you haven't already taken a look at them, that you go back and read through them.

Some background on diabetes and how it affects type 1 vs. type 2 diabetics http://blog.daviddellsperger.com/2015/04/the-ups-and-downs-of-living-with.html

Metrics for tracking how well a diabetic is doing with their diabetes http://blog.daviddellsperger.com/2015/05/114-101-83-84-7171-what.html

History of my diagnosis and first few days in the hospital/education http://blog.daviddellsperger.com/2015/07/9-years-ago.html

Regular Diabetes maintenance information and some of the very important things I work on, on a continual basis http://blog.daviddellsperger.com/2015/07/diabetes-maintenance.html

American Diabetes Month 2015: Day 17 - Daily Supplies

Day 17 and I kind of wanted to continue from yesterday's post.  I talked about the type of gear that I travel with on a regular basis, and the amount of things that I keep in places, but when I'm going for a normal day, I still have to be prepared for anything that may come my way.

As I said yesterday, my normal usage of supplies (and pills, etc) is as follows:

4-6 Test Strips1-2 Lancets (I'm a bad diabetic from what I've been told since I only change the lancet twice a day at most)230-300 Units of Insulin0 or 1 infusion set and reservoir On top of what I use to maintain, I also have a set of emergency supplies that I have in various locations, mostly my desk at work, backpack, car, and home which includes: Glucose Tablets (to increase blood sugars if it becomes too low)1-2 Extra Infusion Sets (because you never know when you might need them)Extra Insulin (have a bottle at work and home, not in car or backpack because of temperature)Extra vials of Test Strips (work and h…

American Diabetes Month 2015: Day 16 - Traveling

Day 16, and we're closing in on American Thanksgiving (look, I'm excited, okay?)

Today, because of the upcoming trip that I will be embarking on, I wanted to discuss air travel with diabetes and the supplies.  Traveling by air with diabetes is not a fun venture.  Diabetics have a lot of sharp, pointy objects that they travel with, additionally they have a lot of liquids that they travel with. On a short trip, I travel with a minimum of 1 infusion set per day (you never know what could happen) and 1 bottle of insulin for every 3 days of trip.  I use about 250-300 units of insulin per day.  For a 6-day trip, I'm bringing quite a bit of supplies in order to keep myself safe in the face of any issue that might come up.  On top of the insulin pump supplies, I carry a canister of 50 test strips per week gone (and usually that's just the extra set as I have a canister in my case with the "active" bottle of insulin that I currently have.  In my glucose meter pouch, I…

American Diabetes Month 2015: Day 15 - Are you okay?

Day 15 of 30 this month.  50% of the way through the month where my star is Diabetes.

One of the biggest discussions I have with many people who see me using needles to fill up my insulin pump reservoirs and testing my blood sugars tends to deal with asking if I am okay.  In the end, it's a lengthy discussion about how much of my life is a continual assessment of how I'm actually doing.  Taking out my insulin pump helps me to fix issues that I'm either feeling, or preparing for (i.e. eating food) and taking out my glucose meter is the way to assess my current situation.

I think of all of the tools in my arsenal of trying to live.  Being a diabetic is a continual assessment of the current situation, you are replacing your body's normal biological functions with a bunch of technology.  It's hard to think of it that way, but from a purely system/state-machine look, it's exactly what is going on.  I look at the input data which includes the CGM sensor and Glucose …

American Diabetes Month 2015: Day 14 - World Diabetes Day

Day 14.  Today is World Diabetes Day.  I had a plan to make a really elaborate and well thought-out post for today, but I feel like there are better ways for you all (and me) to spend my day.  Hopefully this post works today, if not, it'll probably post at like 5 pm tonight.

Enjoy the day, get informed, and don't judge us diabetics for poking ourselves with sharp objects, bleeding on things, and then licking the blood off of our fingers!

http://www.idf.org/wdd-index/

American Diabetes Month 2015: Day 13 - Rambling about things and stuff

Day 13 (almost didn't post because, you know Lucky 13 and such).  It's been a rough month, rough week.  Things always have a way of causing some major breaking lines within any given time period.  Yesterday really brought me down.

As I said in the past, ordering pump supplies (or really any medical supplies not through a pharmacy) is a pretty terrible experience.  As I stated previously, ordering supplies is a process that should be very easy, there is a history of orders, there's all sorts of credit cards and insurance on file.  Especially with re-orders or orders in the same year for Insurance, and the same conditions (reaching deductible, reaching out of pocket maximum, etc.) it's important for these situations to go without any problems.  I continue to encounter problems with ordering these supplies online from some companies, but have not has the same issues when ordering from other companies.

Additionally, yesterday, I got a crazy error on my CGM sensor that led …

American Diabetes Month 2015: Day 12 - Medical Technology Part 4

Day 12, continuing on the medical technology trend, feel free to read part 1part 2, and part 3 first as part 4 will build off of all of these.  
Part 3 talked about some of the software that's embedded in the medical devices.  Today, I would like to talk about the software that's either installed to interact with those devices.  Getting data off of a device is one of the most important things for me to do.  It's important, because I change my pump settings or dietary choices rather often based on the data that I can get.  In the end, the data that's available simply through my pump or CGM is limited to at most 1 day, and doesn't give much granularity or ability to average data in a consistent way.  The issue with this comes with the fact that as I mentioned on Monday (part 3) these devices usually don't have a standard port for data transfer, like a MicroUSB, MiniUSB, or even something like bluetooth to transfer data.  
My insulin pump uses IR (Infrared) tran…

American Diabetes Month 2015: Day 11 - Partnerships

Day 11, and I have some awesome things to talk about.  For the last 2 days (Monday and Tuesday) I've been attending an amazing developers conference in Kansas City called Midwest IO (http://www.midwest.io) where a bunch of amazingly brilliant software engineers, software developers, software architects, etc. (read: nerds) talk about the things we love to do.

The keynote of the conference was about partnerships.  It was an amazing talk and I suggest you watch it because it was amazing to be at and see in person.  But the biggest piece about the talks is that without partnerships, there are issues moving forward and progressing.  Dr. Jeff Norris has 3 examples of partnership opportunities and the outcome of those partnership opportunities.

Similar to some of the examples, many diabetics have a very STRONG partnership with someone who helps them out.  Much of the time, this partnership ends up being with their endocrinologist or one of the staff who works with their endocrinologist…

American Diabetes Month 2015: Day 10 - Ordering Supplies

Day 10.  33.33333333333333333333333333333333% of the way through this month, and I feel like I could probably post more every day than I come up with on a single day, but then I'd have to have more time in the days.  Today, I want to talk about supplies.  This includes supplies for my insulin pump, glucose meter, prescriptions, all of it.

I've been rocking my new insulin pump for nearly three months now which means it's time to re-order supplies.  Previously, when I would get insulin pump supplies, I'd get a three-month supply plus an extra box, so that I can wait until the 3-month point for the supply reorder.  With my new pump, I did not get this extra box, so I have to open my order earlier.  The issue with ordering and getting insurance to cover the cost is that there is always a problem (at least for the first re-order after getting a new device).  While there have been a lot of improvements in this process, there have still been many systematic issues with the pr…

American Diabetes Month 2015 - Day 9: Medical Technology Part 3

Day 9.  It's been an interesting series of events since I started my blog posts, but that happens over a 10-day period all of the time.  Today's post is a continuation in the Medical Technology series, feel free to read parts 1 and 2 before, but it's not necessary.  One of the biggest holes in technology with respect to diabetes is the software.

Disclaimer: I am a software developer for a healthcare IT company.  The opinions in my blog are my own and may not necessarily be the opinion of my company.

There are many forms of software and almost all of the software needs a lot of help.  Software on the devices (CGM, Insulin Pump, Glucose Meter) is archaic and laggy.  Every piece of equipment has a similar issue.  Remember when I compared my insulin pump purchase research to researching for a new cell phone.  One of the very important factors is the quickness and efficiency of the software on these devices.  The major issues with integrating more items into a single low-power…

American Diabetes Month 2015 - Day 8: Daily Struggles

Day 8, and what a week it has been.  I started this excursion a week ago today and I feel like the impact is real and effective.  Today, I want to talk about things that don't go so well, and how I deal with them.  I'm pretty sure that I've discussed this before, but I think it's still important to talk about this.

As I have said in the past, diabetes is a life-long disease.  I will never not have diabetes, unless there is some miracle cure, and I'm not holding my breath at this point.  What this means is that no matter what happens on a single day, I still have to keep track of things.  Truthfully, I have some days where my blood sugars are bad, not deathly bad, but just bad.  What do I do in the situations where my sugars are bad, and it seems like there's nothing that I can do to improve it?  I let my body take some time to react.  There's a certain amount of relaxation that needs to take place in order to get prepared for the fact that there is a combi…

American Diabetes Month 2015 - Day 7: Medical Technology Part 2

Day 7.  As I said before, I'll be continuing the theme of explaining the technology that I use with my devices, then go on to explain some of the holes.  WARNING: There is some fun mathematical discussion in this post, if it scares you, feel free to skip today's lesson.

Where we last left off (on Day 5) I had talked about meters and my insulin pump as far as technology goes.  Today, I would like to touch on glucose sensors.  I first tried out glucose sensors back in 2009 when I was in Iowa City with my Medtronic Paradigm 712 insulin pump.  At the time, the sensors were very large, in both size of needle being inserted and in the transmitter that attached to the inserted needle, but they also have a very short lifespan for being inserted, mostly due to their size.  I ended up stopping with the use of my continuous glucose monitoring for two major reasons.  One of those reasons is still an issue with CGM sensors now, but the issue with CGM sensors is that the first day of data i…

American Diabetes Month 2015 - Day 6: Statistics

Day 6, 20% through the month and hopefully these posts have been helpful to you all.

Today, I want to talk about some of the statistics with Diabetes.

According to the American Diabetes Association, nearly 30 million children and adults in the United States have diabetes, 86 million Americans have pre-diabetes, and roughly 1.7 million Americans are diagnosed with diabetes every year.  This 1.7 million equates to one person every 19 seconds, or 4,660 diagnoses per day.  Diabetes costs the US a lot of money as well, 1 in 5 health care dollars are spent caring for people with diabetes and 1 in 10 health care dollars are spent treating diabetes and its complications.

Despite what many will tell you, diabetes is a real problem.  Diabetes affects 9.3% of the American population, but can impact the lives of so many people.  Around 11.1% of Americans are considered prediabetic, so in the long run diabetes may affect up to 20% of the American population which means that around 1 in 5 people…

American Diabetes Month 2015 - Day 5: Medical Technology

Day 5 starts...now.  Well, today I wanted to kind of continue the conversation about the technology that I use and about Medical Technology in general.

Here is the technology that I amusing on a daily basis:

Insulin Pump (Animas Vibe)Glucose Meter (One Touch VerioIQ)Glucose Sensors (DexCom G4 Sensors)
The decision on technology used in Medical fields tends to be way different than other technological choices.  The first factor is if the item is compatible with the rest of your care needs.  In the end, this is similar to if a mobile phone is compatible with your apps, and your work's e-mail and your phone carrier.  Anymore, this is not a difficult task for shopping for a mobile phone, but there are many, many users of mobile phones and only very few users of insulin pumps.  There's no talk about insulin pumps on websites like The Verge or Engadget, so you have to rely on the online-posted reviews by people like me, or just trust what the sales representatives say.  Additionally…

American Diabetes Month 2015 - Day 4: Questions

Day 4...chugging along.  I think there are a few things I'm going to do with today's post.  First off, It's the fourth day, but I'm writing this a bit in the past.  I'm trying to get my 30 posts for the month, and because of that I want to help myself prepare more content.  So, I'm wondering what kinds of questions I can answer.  I like to be completely transparent with things as there are always questions about what kinds of things that I have to do throughout the day to cope with the transitions.

One of the questions that I frequently get asked (mostly about my pump) is if it hurts.  And it's a complicated question for a few reasons, because in the end, pain is relative, right?

To answer the question, I will approach it two ways.  There are two factors that are things that are considered painful.  The first painful activity is testing my blood glucose.  While this activity is one that's very highly required, it CAN hurt, it CAN be painful.  The beau…

American Diabetes Month 2015 - Day 3: Progress

It's Day 3!  We've been to the base information of American Diabetes Month, and I gave you a bit of background on one of the issues that begins to cause issues in my day-to-day operation.  Today is a brand new day, though.  There are so many positives to the changes that I've made in my live over the last 18 months.

I've touched on this in the past, but the Hemoglobin A1c is the tool that is used to determine how close you have been paying attention to your blood glucose in the past (more emphasis on the recent past).  Prior to leaving college, I had taken VERY poor care of my blood sugars, sometimes going DAYS without testing.  This is a highly dangerous thing to do, and I don't suggest anyone follow what I did when I was in college as I'm sure it will have caused irreparable damage that I won't really find out about until much later in my life.  What changed is that I started getting the idea that my life was important, that my blood sugar being in the c…

American Diabetes Month 2015 - Day 2: Biomedical Clock

Day 2.  Alright, got through one day this month so far.  The craziness of Daylight Savings time doesn't just extend to the fact that I have electronics that do not automatically update the time, like my microwave, oven, insulin pump, and glucometer; but the fact that when you shift things by an hour for good, there are some biochemical changes that I have the pleasure of dealing with.

My insulin pump has settings of basal rates that change from hour-to-hour.  These settings may change on the half-hour (x:00 and x:30 where x is the hour).  This means that the change of 1 hour if not observed properly can cause some issues to the balance that my body normally gets.  Whenever I travel to a different time zone for a short period of time, I do not change my insulin pump clock, because even though it may be "incorrect" my body shouldn't get used to the change in time zone as I tend to keep about the same schedule.  Also, I have found out that with my insulin pump now also …

American Diabetes Month 2015 - Day 1: Intro

This month, November, is considered to be American Diabetes Month by the American Diabetes Association.  What this means is that throughout the entire month of November, my blog will be a bit re-branded in support of this movement.

I did this same call to action last year after doing a little bit of research and attempted to post on my facebook once a day about something that has affected me with respect to diabetes, or some information about diabetes that would potentially help others out.  Today will be much less of information and much more of informing you to look out this month for some more posts.  I can't promise a post a day because I get super busy on the drop of a dime, but I will try to do it daily as I can actually pre-post things to be released at a specific time on my blog.

So, what can you expect from this?  Hopefully some information to help you understand the daily struggles that I go through with diabetes.  How good successes feel, how bad failures feel, and how…