http://www.iflscience.com/health-and-medicine/4-year-old-australian-boy-receives-world-s-first-artificial-pancreas

Yeah I saw this on my facebook feed on the T1D foundation. The argument about whether it is a true artificial pancreas is kind of academic. It is actually the liver that releases glucagon while the pancreas stops secreting insulin when you are getting hypoglycemic so this is sort of a computer pancreas. The hope and research on the "full" artificial pancreas is a device than give insulin when you are high and glucagon when you are low but that is at least 5 years behind this device.

My son is almost 16 and going to college in a few short years so I would love to be able to give him (and myself) this kind of security blanket before he leaves the home.

Anyone have a good endochronologist in Dallas? The office of my current doc, who I've only seen once, it completely inept and hot garbage.

Sasan Mirfakhraee, M.D. at UTSW is ours. Outstanding.

I actually like the doctor, so I will give her another chance, but her office staff was terrible and the wait time was awful. If that happens again, then I will look to switch - thanks for the suggestion, culdeus.

Bump for the new discussion thread.

Any thoughts on the FDA approval of an artificial pancreas?

http://health.usnews.com/health-care/articles/2016-09-28/fda-approves-1st-artificial-pancreas-for-type-1-diabetes

Hopefully (surely?) the sensor is much more accurate than the one I had an experience with from Medtronic about two years ago.

I'm looking to do a refresh/upgrade of my current products and wanted to see what everyone else is using currently.

I'm still on a OneTouch Ultra 2 and a Medtronic MiniMed (that just went out of warranty but still works fine). I have a OneTouch Verio that my endo gave me, but I haven't started using it yet. Looks like the Contour from Bayer gets good reviews. For pumps, are Omnipod and the two new Medtronic pumps the main ones everyone is using? I honestly not that interested in CGM bc I sit at a desk all day and don't have issues with nighttime lows, though I know CGM is pretty mainstream at this point.

Also, I currently only use Humalog, which might mean I'm in the stone age? Are most people using a combo of long lasting and rapid insulin?

Quinn,

I finally broke down and moved over to the DexCom G5. I've been on it now for about six months. Honestly, I really felt like I had no other choice. I had two severe hypo episodes in a period of three weeks that landed me in the hospital. 50 plus stiches and a broken face later, I knew that my wife was on the cusp of a nervous breakdown so I relented and got on it.

I find, as I thought was mentioned earlier in the thread, the accuracy suffers in the first day or so, but afterwards, I find it to be very accurate. I'm glad I'm on it. I'm thinking of upgrading to the G6 which I think comes out in June.

As far as medication, I'm still on Levemire, Humalog, and Humulin R. I also still use my trusty One Touch Ultra Smart. I find the sensors offset the testing strips almost evenly. They're both expensive as all get out, but I am using a lot less strips now than I was.

Last A1C came in at 4.8. I haven't had any hypo episodes since I've been on the DexCom.

If you feel outdated using Humalog, imagine how I feel using Humulin R. Use what works best for you!

Thanks, RWC. I guess it's not necessarily that I feel outdated, and more so that I don't really know my options. I've tried to do a little bit of research on my own, but haven't found any great resources. My doctor isn't much help, either, so I'm looking for a new one for later this year. Being that it's time to replace my pump and my glucometer is fairly old, it seemed like a good time to upgrade everything.

I wish my 19 year old would use a CGM still. We bought them for him he just refuses to use them based on bad experience with the early models 10 years ago.

Frustrating parenting a young adult T1DM let me tell ya.

You don't use a pumo with the Dexcom, correct?

I started on the Medtronic 670 4 months ago. I have found it to be frustrating to use compared to my old 722 (it was 8 years old and the case was coming apart which forced me to upgrade). My A1c's are about the same as when I was on the 722, but it has cut the lows considerably.

The 670 does struggle with my diet. I love carbs. I LOVE carbs. I LOVE CARBS!!! I have had to adjust how I bolus with the 670 compared to the 722. The 670 (auto mode) has reduced my basal 50% compared to what I had it set for on the 722.

Is there a Type 2 diabetes thread?

I need diet suggestions (substitutes, simple recipes etc). I'm ok exercising but my menu choices are getting old. Thanks

ItsA&InotA&M said:

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Is there a Type 2 diabetes thread?

I need diet suggestions (substitutes, simple recipes etc). I'm ok exercising but my menu choices are getting old. Thanks

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I don't think there is, but you can definitely start one.

Quinn, does the fact that I have no idea what a pumo is answer your question? Assuming you meant pump?? If so, no, I've never been on a pump in the 35 years I've had diabetes.

ha, yes, meant pump. I was curious if those that use multiple types of insulin use a pump for the fast acting and take shots for the long lasting.

How a Low-Carb Diet Might Aid People With Type 1 Diabetes

Quote:

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Most diabetes experts do not recommend low-carb diets for people with Type 1 diabetes, especially children. Some worry that restricting carbs can lead to dangerously low blood sugar levels, a condition known as hypoglycemia, and potentially stunt a child's growth. But a new study published in the journal Pediatrics on Monday suggests otherwise.

It found that children and adults with Type 1 diabetes who followed a very low-carb, high-protein diet for an average of just over two years combined with the diabetes drug insulin at smaller doses than typically required on a normal diet had "exceptional" blood sugar control. They had low rates of major complications, and children who followed it for years did not show any signs of impaired growth.
The study found that the participants' average hemoglobin A1C a long-term barometer of blood sugar levels, fell to just 5.67 percent. An A1C under 5.7 is considered normal, and it is well below the threshold for diabetes, which is 6.5 percent.


"Their blood sugar control seemed almost too good to be true," said Belinda Lennerz, the lead author of the study and an instructor in the division of pediatric endocrinology at Boston Children's Hospital and Harvard Medical School. "It's nothing we typically see in the clinic for Type 1 diabetes."

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Link to the study:
Low-carbohydrate diets for type 1 diabetes mellitus: A systematic review

Quinn said:

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ha, yes, meant pump. I was curious if those that use multiple types of insulin use a pump for the fast acting and take shots for the long lasting.

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No, the pump delivers a bolus of fast acting insulin for food, then it also delivers a small amount of fast acting insulin almost continuously to replace the long lasting. You do not want to use the pump and then try to supplement with a long acting insulin by injection.

Ya I use a pump for Humalog now and have for many years, just didn't know if it could still be used if I set the basal rates to zero or extremely low and used it primarily for meal and recovery boluses, while using an insulin pin for long acting

I was diagnosed with diabetes in February of this year - a1c of about 7.5 as I recall. I'm 38 years old / 5'10" 160 so I was referred to an endo who determined I didn't have type 2, but they also did several tests for type 1 antibodies but didn't find any. However my brother was diagnosed with type 1 when he was little. So I'm being treated as type 1. My a1c a couple of days ago was down to 5.4 - I have been following the Bernstein book as well.

Also back in February, I had hip surgery due to a MTB injury. So I haven't been very active due to restrictions from ortho. But next week is my last follow up with him and I expect to be cleared to resume normal activities. So I'm looking for advice from type 1's who work out a lot.

I'm really uncertain how my sugars will respond to workouts. A year ago before the hip pain got really bad I was hitting the gym 3 or so days a week and doing 1-2 hour MTB rides once or sometimes twice a week. Do most folks eat some carbs before a workout to avoid going low? Being on a ride in the middle of the woods with nobody around and going low makes me really nervous.

I've been type 1 for almost 20 years and playing sports and working out the entire time. You'll have to experiment a little bit to see what works and doesn't work for you. Certain things will lower your bs more than others, and it might not be what you expect. For whatever reason, golf lowers my bs way more than lifting weights.

Things you can try:

- reduce insulin/basal rate before and/or during workouts
- eat a bar or drink Gatorade beforehand
- always have some type of carbs on hand with you
- not a bad idea to carry your glucagon with you
- if you work out with other people, give them a heads up so that they can help you if you need it.

AggieEE2002,

I find it strange how paranoid people are about low blood sugar. Low blood sugar for me is just a fact of life. I experience low blood sugar at least 3x per day, and when I do, I'll drink a small bit of Gatorade or I'll eat a Sour Patch kid (guilty pleasure). That fixes me right up and I go on about my business.

As far as working out, my sugar will typically rise when I lift, but that may be a function of when I lift. I normally lift around 6:00 PM, but on off days, I may lift at 11:00 in the morning and will experience more hypoglycemia than anything else. When I lift at night, I normally take with me a shot of 2 Humalog in the event I need it. I suspect my sugar rises as my basal insulin shot from the early morning is running out as is my lunch time insulin as well. If my sugar drops while working out, I'll eat a few chips, a few M&Ms, drink juice/Gatorade. It's not really a big deal. Just have some quick acting sugar with you and you will be fine. Remember, if you're trying to keep your A1Cs in range, watch how much sugar you eat when you're correcting low blood sugar. It doesn't take a lot of juice/Gatorade to correct. I've seen some people drink a whole can. That's way too much.

Last A1C was 4.8.

I'm not generally paranoid of going hypo - but do have some concern riding solo on a trail where it might be an hour or more before anyone would find me if something did happen. I'll probably stay away from solo rides for a while until I have had a chance to figure out how glucose level responds to mountain biking.

When you say "low" 3x a day, what number do you consider low? Since being diagnosed I only had two episodes where I could "feel" the low (shaky, etc.) and both times it was in the 38-40 range.

I hear you on the full can - I've given up trying to use juice/soda/gatorade to correct lows and now just use glucose tablets. My corrections have been a lot more precise. "Just a couple of sips" of a DrP turns into "damn the can is empty" real quick for me (even though I stopped drinking soda years ago). Maybe I'm still breaking the addiction to carbs.

AggieEE2002 said:

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When you say "low" 3x a day, what number do you consider low? Since being diagnosed I only had two episodes where I could "feel" the low (shaky, etc.) and both times it was in the 38-40 range.

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Low for me is anywhere between 35 and 60. I probably hit 40 at least once or twice a day. That is why I'm on the CGM now. My body is highly functional at blood sugars that would have most diabetics sweating/shaking/etc. It got to the point where I was having a hard time detecting low blood sugar. The CGM help significantly in this regard.

Anytime I'm out and away from home, I always have a sugar source with me. If I was trying something new like mountain biking, etc., and my body was not used to low blood sugars, I'd probably not go with the glucose tablets as you have to eat many of them for a significant low and they'll not elevate sugar as fast as liquid; however, that's just me.

Getting the Dexcom G6 CGM this week. How has the CGM worked for you, RWC? Looking forward to putting it to use. I could use the help as my last few A1Cs weren't great as I started getting a little bit lazy after 20 years of this. I'm planning to get the tslim X:2 as well, as my medtronic pump is out of warranty.

Sunday was my 34th anniversary of being diagnosed with type 1. I have outlived my sister by 10 years now. (We were diagnosed at the same age, but she was 9 years older).

I did try the Medtronic CGM with the 670 pump. The Medtronic CGM sucks. The rep emailed me a couple of weeks ago and said that they have everything corrected, but I am not willing to fight with that again at this time.

The CGM did help me really tighten my basal rates. This did wonders in preventing lows. It will still happen on occasion, but it is not frequent like it used to be.

Congrats on 34 years - that's quite an accomplishment! I hit 20 years back in August.

I used the first gen Medtronic CGM in 2014 and it was pretty worthless. By all accounts, Dexcom is pretty solid and my insurance coverage for it is great so it's not an expensive thing to try out.

Congrats, guys. I hit 35 years a few weeks ago. I was 11 when diagnosed. I am on the Dexcom G5. I like it, but I do not like being tied to my cell phone all the time. You either have to carry the cell phone or the transmitter - I chose the cell phone.

It has protected me from dangerous lows by letting me know early on that my sugar is low. In this regard it has been invaluable. It has allowed my wife to regain her sanity as well. She was an absolute mess on those two occasions she came home and found blood all over the kitchen. It was then I decided that even if I did not want to be tied to a device, I owed it to her to do it. Now that I've been on it for a few years, I wonder how I ever survived without it.

I looked at the G6, but I don't like how the sensors need to be replaced every 10 days. I can get almost two full weeks out of my sensors with acceptable accuracy with the G5. I have gotten on a few occasions more. At any rate, the sensors and transmitters are very expensive. If I can get a few more days from each sensor, to me it is worth it.

In short, I highly recommend the Dexcom unit.

There are several hacks to restart a G6. YouTube has your back.

So this happened last night

https://imgur.com/AdhYDeA

Had what seems like a pod fail and an hourish later occlusion alarm and G6 squawked at the exact same time. Not like a minute apart, like both alarms sounded within seconds.

G6 is still the absolute bomb.

First A1C with the tslim x2 and the Dexcom G6 was 5.8, which was a great improvement over my last few A1Cs. I know that A1C isn't everything, but it was nice to see a reflection of what I've been observing on a day to day basis. Wish I had gotten a Dexcom CGM sooner! Definitely would recommend it to any t1d.

I ordered my rileyhub and will begin the process of converting g6/Omni to closed loop.

Still waiting on my insurance to approve the G6, but I suspect that will happen any day now. Are any of you checking periodically just to ensure the G6 is accurate? Not having to calibrate periodically could be a nice little perk, but I'm wondering how the G6 is as far as accuracy if you don't have to calibrate?

RightWingConspirator said:

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Still waiting on my insurance to approve the G6, but I suspect that will happen any day now. Are any of you checking periodically just to ensure the G6 is accurate? Not having to calibrate periodically could be a nice little perk, but I'm wondering how the G6 is as far as accuracy if you don't have to calibrate?

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I still ***** my finger and test a couple times a day. Majority of the time its within 10 points of the CGM. There is some lag when my blood sugar is rising or falling, but it gets the general details right.