Accuracy. And Lots of Links.

Glucose meter accuracy is one thing that I feel very strongly about.  As everyone living with diabetes should.  I have been able to keep my A1c under 7% for the past 2+ years, something I have never done before in my 33 years with T1D.  But one of the things I need in order to be able to do that is an accurate glucose meter.

When using the OmniPod insulin pump, I mainly used the PDM as a glucose meter since it was built in – it uses Abbott Freestyle test strips.  I also have a One Touch Verio IQ meter which I posted about some time ago, really liking all of its features.  Even though it reads a bit higher compared to other meters for me, I’ve been using that as my main meter since shortly before I switched to the Tandem t:slim pump.

When Dexcom recently announced a software update to their G4 CGM product for more overall accurate results, of course I was thrilled.  I downloaded the update as soon as I could a few weeks ago.  Since the G4 was already very accurate for me (in terms of being in line with my fingersticks) even better accuracy sounded amazing!    Until it started reading off to my glucose meter and it’s been like that for the past few weeks, driving me crazy.  Has anyone else noticed this?

I received an email last week regarding the results of a J.D. Power customer satisfaction survey that noted Bayer ranks highest in overall satisfaction.  In the report, it also states “In addition to these results, Bayer recently presented data from two new analyses of previously published studies at the Diabetes Technology Society Annual Meeting 2014 that demonstrated the impressive accuracy of Bayer meters”.  This got me thinking to my own Bayer Contour Next Link USB meter that was tucked away.  I’ve tried it in the past and liked it and recall it being very close to my Dexcom readings.  So I decided to give it a try again.

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(In the above picture, the Dexcom had been calibrated with the Verio) I’ve done my share of meter comparisons and I don’t want to do that anymore.  Not only is each meter different, it stresses me out completely to do this.  So I’d rather not drive myself crazy if I can help it 🙂

Since Friday evening, there is definitely a notable difference of having readings much closer to my Dexcom than the Verio has had recently.  All I want is a meter and CGM I can trust for accuracy and consistency.  Since I already trust the Dexcom after 6 years of use, I need a glucose meter that will give me the same experience.  My diabetes management cannot be at its best without it.

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 (While I have mentioned specific glucose meter brands in my post, I am in no way bad mouthing any of them.  Everyone’s experiences vary and I am only writing about my own.) 

Let’s Change the World – Diabetes Blog Week 2014.

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So I’m playing catch up with Day 1 of Diabetes Blog Week.  And hoping I’ll stay caught up the rest of the week.  Stay tuned for that.

Day 1’s topic was “Let’s kick off Diabetes Blog Week by talking about the diabetes causes and issues that really get us fired up. Are you passionate about 504 plans and school safety? Do diabetes misconceptions irk you? Do you fight for CGM coverage for Medicare patients, SDP funding, or test strip accuracy? Do you work hard at creating diabetes connections and bringing support? Whether or not you “formally” advocate for any cause, share the issues that are important to you. (Thanks go out to Kim of Texting my Pancreas for inspiring this topic.)”

While every aspect of living with diabetes or caring for a loved one with diabetes means a lot to me; access to supplies, mental health, peer support, proper education, etc.  Nothing gets my blood boiling quite like test strip inaccuracy.  I’ve blogged about this a number of times and luckily we had the opportunity to raise our concerns to the FDA recently.  But the seriousness of this issue just boggles my mind in 2014.  When I was first diagnosed, like many other people with T1D, I didn’t even have a blood glucose meter.  And while I appreciate the ease in which I can have my pick of glucose meters today, none of that should matter if the results I get day in and day out are not completely accurate.  While I love a color screen or a nice back light or a quick five second reading or an app that automatically uploads readings, none of those things are as important to me as accuracy.  We dose ourselves with a medication that can be lethal if not administered correctly based on those results!

My ultimate goal living with diabetes is to do the best I can and stay as healthy as I can be.  And while access to supplies, my mental health from peer support and proper education will certainly help me do that, none of that will matter if my blood sugar readings aren’t accurate.

 

Diabetes Art Day 2014.

Happy Diabetes Art Day!  If I’ve learned anything from Diabetes Art Day over the past few years, it’s that I’m really not too creative.  And I’m okay with that!  Most of the time anyway 😉  Thank you so much to Lee Ann for creating this event – I really do love all the passion you put into it and seeing what everyone else creates.  I’d have to say my favorite form or art is photography.  Especially since I used this last year too!  Without further ado, here is my piece for 2014:

A world with diabetes is a world with numbers.

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We Can Do This.

Happy Friday everyone!  And a happy Labor Day to my US friends too!  I’m not sure how it got to be the end of summer already but here we are … September is approaching and pumpkin is everywhere 🙂

I am taking Kerri’s lead today and posting about a very important issue.  The Strip Safely campaign is well under way.  But there is something else that is needed from us to ensure that the tools we use to manage our diabetes is taken very seriously by the FDA.  They are planning future patient meetings on various diseases and conditions to better understand them.  Don’t you think they need to get a better view of the challenges of living with diabetes and how the tools available play a huge role in that?  Don’t you think since the number of people being diagnosed with diabetes keeps growing and growing, a solid understanding of this disease from the people who have it would help?  I do.  And I’m sure many of you would agree.  So let’s get together and make our voices heard.  Take a few minutes to sign this petition, please.  And pass it along.  We need 5,000 signatures so get to it!

Please sign here.

Strip Safely.

Two posts in one day.  Another first for me 😉

Strip Safely.  This is a fairly new collaboration within the diabetes online community to spread knowledge about the fact that the glucose test strips we use today, yes in 2013, are not completely accurate.  I have known this and it is an issue that bothers me greatly.  I think about all the people with diabetes who are not aware of an issue like this.  Those that are outside of the diabetes community.  Those that take their BG readings for granted.  And it can set someone up for major tragedy.  Since I know my BG meter is not 100% accurate, I always double and triple check if I get a questionable reading.  Too high or too low or totally off from my Dexcom, continuous glucose monitor.  Someone who is naive to meter accuracy, would go ahead and dose insulin based on a questionable reading.  That could lead to an immediate danger of an insulin overdose or not administering enough insulin which could lead to high blood sugar and the subsequent complications.

I don’t want to go back to the days of urine testing where you knew in what “range” your sugar was.  When I was diagnosed in 1981 that was the method used to test glucose levels.  You peed on a strip (similar to ketone test strips) and your urine turned it a certain color depending on how much glucose was in your urine.  Probably from hours ago.  That color represented a range of readings.  When I bolus from my insulin pump today, it doesn’t ask me what range my blood glucose is.  It asks for a specific reading that is used to calculate a precise amount of insulin needed to either correct a high or cover carbohydrates.  Carb counting and insulin dosing can be difficult enough at times without factoring in an inaccurate blood glucose reading.

Every single thing about diabetes management lies in the blood sugar.  How can one possibly manage blood sugar if they do not know with certainty what it is?  The answer?  One cannot.  And when people’s lives are at stake I can’t think of any better reason to campaign for better test strip accuracy and oversight over that market.

Take the time to write a letter to your elected officials. Urge them to attend the Diabetes Technology Society meeting taking place on September 9th.   Tonight on Twitter, there is a special time designated between 8 and 9pm, EST, to tweet about this issue to your elected officials.  They need to be aware of this important issue.  We need support to get this resolved.  Don’t forget to use the hashtag #stripsafely 

Diabetes Grab Bag. Copied.

I am all about accessories.  Handbags, wristlets, phone or tablet cases, meter cases.  I’ve got quite the collection of these things.  And lucky for me, diabetes gives me more devices that I can accessorize!  After reading Kerri’s post today on her Diabetes Grab Bag, I decided to post my own to answer her question, what’s in your diabetes grab bag?

Since I have an abundance of accessories for my BG meter devices, I do like to switch it up.  I tend to get bored using the same thing day after day.  My favorites are from Myabetic or Sugar Medical Supply or Stick Me Designs.  (If you haven’t checked them out, they each have great stuff!)  But lately I have thrown in a regular cosmetic case for use to carry my meter and supplies, like Kerri, Kim, Rachel, Alanna,  to name a few.  I like it because it’s compact yet big enough to hold all the things I need to test.  Or treat a low.  And keeps my meter or PDM handy instead of securing it within the case.  I can even throw my Dexcom receiver in there when it’s not next to me.

I also carry with me a separate case that holds my emergency supplies.  Two extra pods, an unopened vial of insulin in my Securitee Blanket vial protector, syringes, batteries, alcohol swabs.  So yes, I too carry a ginormous tote bag full of stuff 😉

Diabetes History.

Unfortunately I’m not talking about some major breakthrough in the research for a cure or some mind blowing new product on the market.  I am referring to history that was made yesterday in my own diabetes world.  I had my quarterly appointment with the endocrinologist but it was also my annual physical with her, so a much more comprehensive exam.  As usual, I was nervous.  I hate that I get nervous every time I see her but I can’t seem to help it.  Thankfully yesterday was probably one of my best appointments.

I had printed out my BG readings for her, in all sorts of different report variations, from downloading my OmniPod PDM the night before.  In scanning over them, I wasn’t too pleased with what I saw.  In the past month, my BG was in the 80-180 mg/dL range only 61% of the time.  180-250 was 23%, over 250 was 5%, 60-80 was 9% and under 60 was 2%.  In other words, higher than I would have liked.  My last A1c test was done at the end of April so I was overdue for my normal 3 month routine.  That last result was over 7% and had crept up .2% since the time before that.
As I’m sure I’ve mentioned before, in the past 5-6 years, I have been much more diligent with my diabetes management.  Between going on the pump, testing more frequently, using the CGM uninterrupted for the past 3+ years, keeping up with my appointments with the CDE, trying to stick with a regular exercise routine.  Despite my efforts though, I have only had an A1c under 7% once.  Four years ago.  And to this day I still think it was a mistake!  However, yesterday it happened again.  Since I am not shy about sharing my A1c levels , it was 6.7%.  (although it seems much easier to share when it’s a good result!) I literally hesitated for a moment when Dr. K said it and I said to her “wait, what?”  It was a complete shock.  My overall BG readings have not been much better or worse than they usually are.  And especially after feeling that my readings have been higher than I’d like, having almost a 1% drop was not at all what I was expecting.

I was almost too happy to care at the moment about why.  But later I really started thinking about it.  And honestly the conclusion I came up with is that I wish I knew what I had done right the past 4 months so that I could keep doing it!  I’d say in the past 4 months I’ve been more consistent with exercise than before.  Yet I wouldn’t say I’ve been consistent ALL the time.  (the past 2 weeks for instance have lacked exercise big-time)  So the only thing I can think of that had such an impact is my choice of BG meters.   When I used older One Touch meters and when I first started using the PDM with the Freestyle strips earlier in the year, I always thought the readings ran low.  Since switching to the newer Verio IQ as my primary meter and more recently changing the calibration code on my PDM, my readings run higher.  Could this be the magic trick?  Is there a scientific reason this could be?  I’m not sure and I guess I shall see if this trend continues.  And I sure hope it does.

In other news, I have lost some feeling in my feet but this I knew.  At my physical exam last year, Dr. K saw this and sent me for an NCV test which came back normal.  Yesterday was the same – I stopped feeling the vibration on my feet from the tool thingy (tuning fork?) before it actually stopped vibrating.  I do get major pain in my legs when I walk so she had them do a Doppler test.  Which also came back normal.  So the feeling loss in my lower extremities does not appear to be from nerve damage or circulation issues.  While I’m glad it is not for those reasons, I’m stumped as to what it could be from.  Something else I will keep monitoring.

Good appointments like this leave me feeling happy, naturally.  And hopefully not so nervous for the next one.