Wednesday, April 9, 2014

NYT Diabetes Article

The NYT ran an article about the expense of diabetes. You can read it Here.

As I was reading along, I came across this: "That captive audience of Type 1 diabetics has spawned lines of high-priced gadgets and disposable accouterments, borrowing business models from technology companies like Apple: Each pump and monitor requires the separate purchase of an array of items that are often brand and model specific.

A steady stream of new models and updates often offer dubious improvement: colored pumps; talking, bilingual meters; sensors reporting minute-by-minute sugar readouts."


Wait! Did the author use the word gadget to describe insulin pumps and continuous glucose monitors?

My iPhone is a gadget. My iPad is a gadget. I love them dearly. When my iPad was stolen two years ago I was inconsolable. Yet, I know that these little devices absolutely qualify as gadgets.

A gadget is nice to have, but not necessary. My insulin pump is necessary. I need it for several reasons.

1. My basal insulin needs change significantly throughout the day. My insulin needs in the afternoon are far less than morning and evening. If I took enough Lantus to keep my blood sugar steady in the morning, I was low in the afternoon. 

2. Levemir and Lantus made me feel unwell. Perhaps I have a sensitivity to the drugs. When I used them I felt a low level of sick all day. I didn't realize it was the basal insulin making me feel bad until I switched to pumping.  With Novolog only, I don't feel ill all day. When my pump broke and I used Levemir for 24 hours, that same sick feeling came back.

3. Timing insulin makes a difference in how high my blood glucose spikes after meals. Half of insulin up front, the other half over the next three hours. A quarter of insulin up front, and the rest over the next four hours... My ability to give myself the precise amount of insulin at the right times makes a difference.

4. I can control how much basal insulin I receive. I can turn it up, or down, as needed.


My pump changed my life for the better. Yes, my pump is pink. Yes, my pump has a name. XPU Mark II. (eXternal Pancreatic Unit) But, my insulin pump is not a gadget. Having my pump compared to a gadget like an iPhone was upsetting, but what got me angry was what came next in the article.

"A steady stream of new models and updates often offer dubious improvement: colored pumps; talking, bilingual meters; sensors reporting minute-by-minute sugar readouts."

I can agree pumps don't "need" colors, but the rest of that sentence is a facepalm moment.

Talking meters are necessary for people who are visually impaired.

A bilingual meter would be useful if a patient spoke one language and their doctor spoke another.

Dubious improvements and Continuous Glucose Monitors definitely do not belong in the same sentence. The use of CGM technology changed my life even more than my pump.

At 2:56 in the morning, my CGM alarmed because my blood sugar was spiking. The alarm woke me up before a disaster happened.




Sometimes it's not just the alarms that help. Sometimes the graph over a period of time tells a story. That day I put in a new pump site just before lunch. Everything went wrong after that. However, if I tested my blood sugar at 6 pm and 12 AM, I wouldn't have realized that my set wasn't working properly. A minute to minute readout showed me what time everything went crazy, allowing me to connect the dots.

If my CGM only alerted me to high blood sugar, or high patterns, it would be worth it. But, for me, what makes me so grateful is when my blood sugar goes low.



Any time my blood sugar drops low, my CGM alerts me. The lowest blood sugar I have ever recorded was >20. A blood sugar of >20 was terrifying. I never want to see that again. My CGM warns me long before I reach 20.

My CGM is powered by batteries. So is a smoke detector. No one calls a smoke detector dubious. Please don't call CGM's dubious technology. It has saved my life too many times.




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I am not a doctor. I do not have a medical degree. Nothing on this site qualifies as medical advice. These are lessons I'm learning at the University of Catastrophe. What I find to be correct answers in my classes may not be the right answers for you.

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