This year has marked my 10-year anniversary of having Type 1 diabetes (I celebrated with pizza and a McFluffy by the way!) The milestone has me thinking about how medical technologies have improved my life and some of highs and lows (literally) of living with insulin-dependent diabetes.
When I was diagnosed (age 17), like for many others, it was said that a ‘cure’ is ten years away (I think it’s a rolling ten years!). While we don’t have a ‘cure’ yet, research funded by the Juvenile Diabetes Research Foundation (JDRF) and bio-tech companies such as Medtronic has come a very long way! I’ve been watching intensely the past 10 years. Research has been geared towards both biological and technological solutions to insulin production and delivery. In this blog I will share with you how technology has improved my prospect of living with Type 1 diabetes.
2003-2006 (age 18-21) my diabetes management looked at bit like this: 4 injections a day; needing to eat every 3hrs to prevent hypos; finger-prick tests 4-6 days per day; hand-recording blood sugar levels, grams of carbohydrates eaten & insulin dose in a diabetes management booklet. This recording was critical for on-going monitoring of trends in blood sugars and therefore insulin dose requirements. I had to get myself a ‘handbag’ for the first time to carry all this stuff around with me every where, including a ‘mini snack-bar’ for when I hypoed. (This bag was affectionately named “The Bag of Evil”). I was the ‘perfect’ diabetic during this time, with my HbA1c (average blood glucose level) being in optimum range (<7). This level of intensity caused me to suffer from ‘diabetes burnout’ AKA depression (which isn’t an uncommon side-effect of Type 1 diabetes). I was fearful of long-term complications. Diabetes was controlling my life.
In 2006 I was set up with my first insulin pump. This insulin pump changed the way I was to live with diabetes forever. I had some freedom from diabetes. I had freedom with food – I was able to choose when I wanted to eat (as the pump provides base-line insulin instead of injection peaks and troughs) and I could choose how much carbohydrate I had at each meal/snack (as the pump allows insulin to be more accurately dosed based on carbs eaten). The pump also stored data so I could relax a bit with recording every time I ate and took bolus insulin. I became a bionic woman! (well that’s what my friends call me). In the beginning of using the insulin pump it was very intense with all the training and getting my insulin settings right. After “Pumpie” and I got to know each other I started to relax with it and took on the attitude that I’m going to do what I like in life and diabetes will just have to tag along.
Studies, travel, work, sheep farming (yes I’m a country girl) became my focus and I became a bit too relaxed with my diabetes. My diabetes management became very reactive eg. If my blood sugar is high (hyper) I take a correction bolus (insulin), if I’m low (hypo) I eat. Intense monitoring became more sporadic (so once every 3-6 months (sometimes 12-18 months) I would record all my diabetes management data for a couple of weeks into an electronic spread-sheet and send this to my Diabetes Educator and/or Endocrinologist for review. I can’t say that this later attitude led to optimum HbA1c results (sitting around 8-9% which is a little high and could be improved) but I no longer suffer from diabetes burnout and I’m happy. I’m thinking I’m finding the balance (much easier said than achieved!) I’m grateful to my diabetes team over the years for knowing when to give me space and when to push.
This year (2013) I have become very excited about the recent advancements in diabetes management technology. I’ve been watching this space for a couple of years and I knew that I wanted to be part of it. It’s even on my life vision board. Diabetes management for me is about to take on a new level, which will again make life a bit easier. Let me introduce you to Real Time Continuous Blood Glucose Monitoring. Yes that’s right “real time” – Gen Ys love real-time! Here’s how it works:
The sensor (left side in photo) reads the current glucose level in the tissue/fluid just below the skin. The attached transmitter wirelessly sends the reading taken every 5 minutes to the pump, where it can be seen on the pump screen. (Insulin pump and insulin delivery site on the right).
By being able to see my trending glucose levels through-out the day allows me to understand patterns and respond to trending glucose levels quicker, compared to only a few finger prick tests through-out the day. How sexy is that!!
Now here is where the scientist in me is really doing cart-wheels! At the end of six day life of the sensor, the week’s worth of data can be downloaded and a comprehensive report (15 pages) is produced, detailing daily trends and glucose level response to meals, insulin, exercise etc. The best part is that I don’t have to manually collect and analysis this information – it does it all itself. Score!
I couldn’t believe the difference exercise made to my glucose levels actually – with similar insulin and carb intake, my glucose levels are much better on physical days in the paddock compared to office bound days. So yeah I need to exercise during the week to reduce the need for more insulin (doh). Seeing the stark difference between paddock and office days on these graphs was a light bulb moment that I didn’t fully appreciated before.
· The accuracy of sensor could be improved, removing the need to calibrate the sensor with fingertip glucose testing four times a day.
· Having the sensor listed on the NDSS to reduce cost and increase up-take. Currently it costs $75 for 6 days. (I wear it once every 4-6weeks at the moment).
· Carelink software needs to become compatible with newer OS (Windows and Mac)
· Setting up my new Contour Link blood glucose monitor that also wirelessly talks to the insulin pump.
· Artificial pancreas – bring on the day when this technology takes on its own brain and delivers insulin & glycogen without me asking it to.
I sincerely thank:
· My Diabetes Educators Anne Marks and Kristine Wright
· The Juvenile Diabetes Research Foundation, Medtronic-diabetes and Reality Check
· The “Type 3” diabetics in my life – family and friends who don’t have diabetes themselves but live the life of one through me.
Wow! Real time glucose monitoring – the retired nurse in me says who would ever have thought! Diabetic diets is something I could never get a handle on. Last year I realised that I am getting more like my Mum evey day, including my weight :-(. Given my age, diabetes type 2 is a real possibility which Mum had. I got off my expanding bum and became more physical in retirement (easily done on our property) in addition to closer attention to what went into my mouth. Now that I am 18kg lighter, I have concluded that spinning wool burns calories! ;-p
Wow 18kg that is amazing Karen. Good on you! Sounds like I need to take up spinning!!