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SunFest with the Insulin Pump

2014 May 8
Sunfest with Diabetes

This past week was SunFest down here in south Florida.  It is a 4-5 day event with a lot of music from artists of all genre.  There is also a pretty large art festival too.  I believe that it started off as a large art festival and then music was added at a later time.  Anyway, I had never been to SunFest before because I am not a fan of music festivals. I love country music concerts, but don’t like festivals.  This is the first year that SunFest had a country music lineup, so of course I wasn’t going to miss that….plus I had a Groupon.

SunFest in south Florida just sounds hot and sweaty and muggy.  In the past, when I was using an insulin pump, my infusion sets usually fall off because of how much I sweat in these situations, so I was a little worried about the infusion set falling off and having to insert a new one in that crowded place.  Fortunately, it was overcast and raining off and on (which was ironic because David Nail was there and one of his hit songs as ‘Let It Rain’).

The infusion set stayed in the whole time and the CGM was working great, so I had a good feeling about the day.

The day consisted of only a few beers, some french fries, a cheesesteak, some rice and pineapple chicken, and a few other snacks along the way.  It’s SunFest, you have to have some unhealthy food!

I was a lot happier being on the pump than I would have been on MDI. It was a lot easier to take my insulin exactly when I needed, I had the CGM telling me when I was going low or high, and it was the perfect combination.  It made me remember why I used to say that I would never go back to MDI when I was on the pump.

It’s coming up on summer concert season, so there will be more of these stories to come.


24 – MiniMed 530G Edition

2014 May 5

After I left training for my new pump, I was back on my own and back to the pumping life.  As soon as I got in the car it felt so different again having that pump in my pocket and having to buckle my seatbelt without pinching the tubing while doing so.  I haven’t had to do this in almost a year.

Once I drove home, it was approaching dinner time and I knew that I was going to be cooking chicken breasts with steamed green beans.  As I set the steamer, which takes about 25-30 minutes, the alerts started.  One set of vibrates, then another set of vibrates, and then again and again.  There were several “Low Predicted” alerts that started going off.  I loved the fact that this alert was going off because when I am cooking, I am usually sweating and concentrating on cooking the food and not paying so much attention to the quickly dropping blood sugar.  I took some time to test after a few of the alerts and the meter test confirmed that I was not just going low, but was in that low state.  Little cup of juice while I waited for dinner to finish was all I needed.


Later that night was #DSMA and I finally had some free time to participate for the first time in a really long time and I loved the topic of getting to know you. I always want to know more about people other than just the fact that they have diabetes, it’s not the only thing about you, so it would be nice to know more.

Several times during DSMA, I did receive a No Delivery when trying to deliver a few correction boluses.  I was in the middle of things, so I just re-tried the bolus thinking maybe it was just a hiccup.  Received the message again, so then I did a rewind and tube priming, still received the No Delivery.  Since that didn’t work, I figured that maybe it was the tubing, so I grabbed another tubing and primed that one as well, same result, No Delivery.  I kind of figured that it was a bad site, but before I just change out the site, I try to troubleshoot it with other options other than losing an infusion set.

Unfortunately, it was a bad site and when I pulled it out, there was blood.  There wasn’t a lot because I was prepared for blood to come out and put pressure on right away.  After that, it was delivering perfectly fine and my blood sugar began to come back down to normal.

In fact, it started to come down too much come morning time.  I woke up around 6 a.m. and I saw that the CGM was reading 72, and I had the threshold suspend set at 70.  That meant, that it was going to go off soon and I hadn’t really explained the really loud noise of the Threshold suspend to Amanda yet, so she was going to get freaked out.  In order to avoid this, I changed the settings to 60 instead of 70.  I then tested with a meter and the CGM read 72, and the meter was 105.  I was not very happy with that large difference in reading.  I know they will never be the same, and we are to look at the trends of the CGM and not the number, but my BG was actually rising at the time, not falling.

Once again, little OJ and we were good to go.

It was now my first day working again wearing the pump and CGM full time, so I was obsessively checking my BG (I tend to do that the day of and after an endo appt!)

There were not many alerts throughout the day.  A few highs, a few low predicted, and one that made me happy because the meter check re-assured me that the CGM was doing it’s job.

For dinner, I was really going to put the pump and infusion set site to the test with a meal at Pei Wei, which is about 200g carb in just one plate.  This was going to be close to about 2 max boluses.  I took a max bolus and then 10 minutes later did a max square bolus with 65% now and 35% 30 minutes later.  It worked….a little.  There was a high blood sugar later, but nothing the pump could have done any better.

All in all, the first day with the 530G was not bad.  It will take a while for me to work out my basal rates again, but I will get there.  Wednesday night will be a full week with the system, so I’ll be doing a weekly CareLink report as well.

Medtronic MiniMed 530G with Enlite Training Recap

2014 May 2

As you may have read recently, I am starting a 90 day trial of the Medtronic 530G.  If you didn’t read it here, and you follow me on Twitter, I’m sure you have seen a large amount of tweets.  Tweeting is somewhat of a note taking service for me.  If I tweet it, then I can look back and remember a question I had or something that I wanted to write about.  This post is about the training session that I had with the local pump trainer for Medtronic.

MiniMed 530G Pump Training

Leading up to this trial, I had used a Medtronic pump for about 8-9 years of my 10 years with diabetes. I have been on MDI (other than a 4-6 week trial of SNAP pump) since June of 2013.  Since I have been on the pump for so long, I am very comfortable with using a pump and troubleshooting the pump.  Inserting infusion sets, filling reservoirs, changing out a battery, etc.  I can do these things in my sleep, no literally, I’ve done all of these while half asleep at 4 a.m., stopped at a red light, at sports arenas, and more.

With all of that real life experience, I tend to think, seriously, do I really need a training session?

The answer, yes.

Too many times, with anything in life, we get into the habit of doing things and they may not be the right way of doing it.  There’s the “by the label” way and then the “real life” way of doing things, and getting a refresher course on the “by the label” way is always great.  Not too mention when you have one of the most knowledgeable and passionate pump trainers around.

And I have both of those characteristics in mine.

Before showing up to the training, I read through the materials that were sent to me along with the pump and CGM.  These training materials brought back my memories from 9 years ago when I was scared to go on the pump and the talk of basal and bolus confused me. Now, it seems like second nature.  Also, the box the pump came in was awesome. It was white like a brand new Apple product, and if you know me, that’s a huge plus in my book.

The reading materials and workbooks are great.  They basically provide a bit of reading and then a few questions right after that and then on to the next lesson.

I did read the CGM training materials a bit more than the pump because I wanted to have as much knowledge as possible before entering the training, so that I could prepare for questions.  I recommend that before going to any training, or meeting or anything, do a review first and create a list of questions.  These questions may be answered naturally during the training, but some may not be.

Setting Up the Pump

Before we set the pump up there was an introduction time period where the trainer wanted to learn more about me, my diabetes and how I typically manage specific situations.  This means a lot to me because as we know, Your Diabetes May Vary, so getting to know me and my unique situation and training based on that is important.

I had already set the basal rates, patterns, bolus wizard information and set up all the alerts that I needed before I came to the training so these settings were just checked by the trainer.

After discussing the different basal patterns that can be set up (which I have a standard and Pattern A set up) it was time to get into the CGM training part.

530G CGM Enlite Sensor Training

This to me was going to be the most important part of the training.  I previously used the Medtronic Sof-Sensor about 5 years ago and I absolutely hated it.  I didn’t like anything from the pain of insertion to the inaccuracy of the sensor.  I knew of new technology used and that the insertion method was supposed to be a lot better than the older version.  Before we inserted anything, we went through the CGM workbook and went through some math examples.  Instead of just always relying on the pump to do calculations, we need to know how to do these calculations of what it means when there is one arrow pointing down, or two arrows pointing down and know what these trends mean.

medtronic-530g-enliteWe then discussed the Low / High Prediction alerts that will alert you when the sensor is predicting a low within a certain time period that you set up.  I have mine set up for 20 minutes. So this means that if the sensor trends feel that your BG will reach your selected low point within 20 minutes, it will alert you before it’s too late.  I really like this feature because I sometimes don’t react to seeing double down arrows, so the predictive alert at least gives me a heads up to test and see if I need to correct.

The next discussion was then based on the Threshold Suspend feature that may automatically shutdown your basal rates once you hit a specified low point (60 for me).  This is great for those lows in the middle of the night, because from when I heard the alert, there’s no way that I can miss it.  I will go into more details on the threshold suspend in a later post.

Next, it was time to insert infusion set and sensor.

Inserting the Enlite Sensor

I filled my reservoir and inserted the infusion set first, not much to discuss here, I’ve done this thousands of times in the past.  I will say though that “my way” of inserting the infusion set is a lot easier and comfortable for me to do then the “by the label” way, but there’s not much of a difference, it gets inserted either way.

The Enlite sensor insertion device is great.  It is not intimidating like the old Medtronic Machete on the Sof-Sensor.  There is a “double-press” rule that is used for the insertion.  Basically, once the sensor is loaded, you “punch” the button to insert the device and hold down for about 5 seconds to make sure it sticks and that you applied enough pressure.  Then you press the button again and hold it in while you pull the insertion device away and bam, it’s inserted.  Pulling out the tiny needle is easier than pulling out the Dex needle in my opinion.



The tricky part is the tape that is required to be put over the sensor before the transmitter is attached.  The training book provides great  visual aids on how the tape is supposed to look and how it’s not supposed to look so this was very helpful.  The trainer told me about an area that I’ve personally never used before that she had great feedback on.  It is at the top part of my abdomen under my chest.  She also said that her feedback has told here that the transmitter being up and down as opposed to side to side was a lot better.  I figured I would give this new spot and side to side a chance.

That was it, I was now all connected to devices and just need to hit the start sensor button on the pump. Inserting was a breeze.  Applying the tape was a little difficult the first time because of the location and staring down at it, my depth perception was a bit off.  She only had to make a slight adjustment on the tape placement.  Connecting the transmitter than was pretty easy.

After I was connected, we just went through a few troubleshooting scenarios and practical situation examples and what would I do if “this” occurred.

It was then time to leave the office and head home and get started on my first day with the 530G.

I will be writing, in detail, about the first day.  After that, I will be writing about random thoughts about the pump, how I feel about certain features (alerts, accuracy, comfort, ease of use, etc.)

Please read my disclosure.

DRI Presentation – Reaching the Biological Cure: Resolving the Remaining Challenges

2014 May 1

A few weeks ago I received an email from the DRI about a presentation that they would be doing in south Florida that was practically walking distance from where I live (well, if I was exercising the way that I should, it would be walking distance!).  I knew that I would definitely have to RSVP and attend the event so that I could get some more information about the BioHub and hopefully share some information from those that are not keeping up to date with the DRI.

I know that a lot of you are still upset and have a bad taste in your mouth whenever the word BioHub or Biological Cure is used.  I also think that we all had a reason to be upset, but I’m not a big believer in just complaining about the past, I’m more worried about creating the future.

With that being said, I wanted to see where the DRI was with the BioHub project, so here is a cleaned up version of the notes that I took during the presentation.

When I first got to the event location and signed in, the first person I saw was Antonello Pileggi. I  spoke to him briefly (he was the presenter) and he talked about there being updates and they wanted to hold presentation to provide updates. He mentioned that they wish they could move faster because, but there are parts that are time consuming.

I was by far the youngest person at the presentation, except for one kid probably under the age of 13.  The primaril age was over 50-55 years old (I probably shouldn’t be guessing people’s ages). I could over hear a lot of conversations being had about grandchildren having type one and that they didn’t have diabetes but were there to learn more for their grandchildren.

The presentation opening up with President, CEO Joshua Rednik introducing himself. He does not have diabetes anywhere in his life, but did a great job explaining his journey of becoming the President of DRI.  I personally do not mind that he is not affected by diabetes in his personal life because sometimes decisions are better made from a business frame of mind than they are emotionally.

Next up was Antonello Pileggi.

He is a scientist, so scientists usually talk fast and most of the time, I do not understand what they are are talking about, so I will be asking for clarification, and hopefully a guest post from Antonello himself about the presentation.

When it comes to diabetes research and the scientific and biological stuff, I need things simplified, so one great image that was presented was that Insulin and glucagon are the ying and yang of diabetes control.

There were a lot of slides about the need for control and there was a graph of a J that reflected that tight control led to less retinopathy and other “pathy”‘s, but then there was a shift where too tight of control can lead to seizures, death, etc.  This is something that I was previously familiar with, but as I mentioned above, I’m not 100% sure what the knowledge of the attendees were, I’m assuming pretty darn high based off the questions asked.

One very cool slide that was shown to use was a bunch of images of different islets (pig, monkey, human, rodent) and how they have similarities and differences and why these differences are why rodents have been cured, but not humans.  One neato piece of information given was that there have been no known occurrences of type 1 diabetes in monkeys.  If they have T1D in the wild, they don’t survive and none have been reported within zoos.

There was some data, that was passed over too quickly before I could type it all up about the numbers on the amount of orgons that are donated.  Basically, the pancreas is pretty much the lowest donated organ.  This led to a brief discussion about the JDRF nPOD relationship.  I was not familiar with this and do not know much about it, so if you do, please leave a comment below.

Remember when I said there is a lot of biological / scientific stuff that I don’t quite understand?  Well, here is one of them.  I do plan on doing a bit of reading on this topic, but just wanted to share at least some of it so maybe you can do the same.

There was a discussion that  IL-2 at low doses may promote regulation of the immune system and control autoimmunity in type 1 diabetes.

What is IL-2?

It stimulates immune cells and their functions……sorry but that’s about as far as I got on that. (Please remember, I am looking to get further details regarding these topics).

A little more about the BioHub was discussed.

The omentum is the area they want to transplant islets. Using Thrombin which creates plasma gel. Then fold omentum over and basically create a sandwich. (Like how technical I’m making this?)

There was a brief Q&A at the end of the presentation and I did not want to post any of these answers until I did get some clarification from the DRI.

If any of what I just wrote above is totally wrong, then please let me know.  Like I said, I am writing this from my perspective and my level of knowledge.  I will not pretend to be a scientific writer and to completely understand the biological side of this disease.

Check back for some follow ups on some of the items mentioned above.

Medtronic 530G Trial Beginning – Disclosure

2014 April 28

Tomorrow is my training in order to start using the Medtronic 530G.  I have been reading through the training documents and it has been bringing me back almost 9 years ago when I first started on the Medtronic pump.  At that time I was very nervous and didn’t understand how an insulin pump really worked and was scared for my training.  Preparing for this training is a lot different.  I have a lot of confidence in my knowledge of the pump and feel that I could do a good job training and helping others use their pumps.

However, I want to treat this as if I’ve never used a pump before and try and learn things that maybe I’ve never utilized before.

With that being said, I must fully disclose my relationship with Medtronic.  Back in January I was invited to the Medtronic Diabetes Advocate Forum. Medtronic paid for my airfare, hotel, meals and any additional expenses during the trip. Shortly after the trip, I was given the opportunity to wear the 530G for a 90 day trial. During this time, Medtronic will provide the necessary supplies (pump, CGM, infusion sets, reservoirs, strips, sensors, etc.). In return, I will provide Medtronic with my honest opinion of the 530G system, as well as the training materials and the StartRight program. There is no monetary compensation for the trial or my review of the product.  All opinions expressed will be mine and mine only.

Please check out the disclosure page for full disclosure of the site.

Usher Please Take it Nice & Slow

2014 April 23

I never thought I would work a 1997 My Way song title into the title of a post, but thanks to Usher, I have been able to.

I’ve seen a lot of people commenting and talking about the announcement by Usher that his child has type 1 diabetes.  And for the most part, I disagree with a lot of what I’ve been seeing.

There’s been a lot of, “I hope he uses his celebrity status to advocate for diabetes” or “hopefully he will donate money to help find a cure”.  I’ve also seen the, “what a sad story, hope him and his family are doing fine with the diagnosis”

The latter is what I think is the best thing that should be said at this time.

Christel wrote a great post yesterday and I recommend that you read it.

She basically wrote everything that I was thinking before I could type it myself.  Focus on your child and the diagnosis and learning as much about the disease as you possibly can.  I’ve just hit my 10 years living with the disease and I’m learning things almost every single day.

Let’s be clear about one thing though, just because you are a celebrity and you have a large network and reach, does not mean you have to be an advocate of anything.  If you do not feel like being an advocate, don’t.  If you are not advocating for the right reasons, then don’t do it at all.  If your heart and passion is not in the advocacy world, then don’t do it!  I have more respect for a celebrity that turns down endorsements and advocating for something just because they are being paid to do it.

Advocacy is not just putting your name on an event or a fundraiser. I live in the south Florida area, so I see a lot of news about Ray Allen, who plays for the local Miami Heat, and what he does with the local community and JDRF and DRI.  His heart is in it.  If he didn’t do these things, I would not lose any respect for him.  Advocacy is not always easy, in fact, it hardly ever is.

This is not just about Usher and advice for just a celebrity with diabetes or a child with diabetes.  This is for anybody that goes through a diagnosis, either themselves or a child.  Focus on yourself and your family before you go out looking to help others.  It’s not stingy, it’s what’s needed.  Don’t feel obligated to do advocacy work. If you can do it, and your heart is in it, then absolutely do it.  But don’t do it because it’s forced and something that you feel like you should be doing.

Holding Myself Accountable

2014 April 16

When things go wrong, excuses usually begin to fly. This is not only true with diabetes, but also with anything in life.  So, this morning when it was time to review my latest blood work, I was going to hold myself accountable for whatever the numbers told us.  I was not going to blame it on the diabetes, but my choices.

I knew going into reviewing the labs that my A1C was going to be higher and that there may be some issues with the lipid panel because of the horrible diet and forgetting what the inside of my gym looks like.

A1C was a little higher than last time, but lower than what I thought.  I honestly felt that my A1C was going to be between 8.0 – 8.5 because I’ve seen the numbers on my meter and they have been bad, probably my worst 3 months in the past 5-6 years.  Which is also why I knew it was time to go back onto the pump and get off of MDI.  The A1C was 7.5.  Not good, but better than I expected.  It was 7.1 six months ago, so I obviously wanted to improve on that, but didn’t.

Everything else in the lab results was good, except for one big issue.  Triglycerides.

I’ve never had an issue with my triglycerides being high because I always had some form of exercise, not intense, but would get at least an average of 15 minutes per day.  My triglycerides were 455.  If you know about triglycerides, then you know that’s pretty damn high.  The doc was concerned about this number obviously, but as I’ve written before, we have a great relationship and she does not scold me, but provides me with the information I need to make better decisions and make improvements.

There was a side of her that wanted to put me on medication, but she knows that by giving me a warning and doing labs again in 90 days, that it will motivate me to improve that number that she feels I won’t need medication.

So, here is to holding myself accountable. No more bolusing 40-50 units for one meal. Yes, you read that right, 40-50 units for just one meal!  No more just sitting on the couch watching horrible reality tv shows (my wife loves that shit!) and more of getting back to the gym, walking around the neighborhood, ANYTHING.

Here’s to lowering triglycerides

YMCA Diabetes Prevention Program

2014 April 9

Last week I was contacted by someone at my local YMCA because they were given my information from my endo (she’s not an endo, I don’t know her exact title, but she’s who I see at the endo office). As I’ve written about before, my endo office is great with sharing information that I give them about diabetes inititiaves and outreach programs going on, which is why they put me in touch with the Y.

Last Friday I had the chance to meet with Robin from the Y to discuss the Diabetes Prevention Program. If you have not heard of this program, no worries, because I didn’t either until Friday when I stepped into the office. Basically, the program helps those that have a high risk of developing Type 2 diabetes and works with them to reduce their risk for developing T2D (or help slow it down) by making improvements to their overall health (eating, exercising, lifestyles, etc.) This program is based off of research done by the NIH that these changes in lifestyle can help reduce the numbers of Type 2 Diabetes diagnosis.

Before anybody tries to jump all over me, I know that diet and exercise is not going to stop everyone from getting Type 2 Diabetes, but we all do know that these changes help prevent those that are at risk. read more…

A Decade with Diabetes

2014 April 3

So today is my 10 year Diaversary. I’ve been living with diabetes for a decade now.  That feels very weird to say.  It almost doesn’t even seem real.

Growing up and not knowing anything about diabetes, there are a lot of things I always dreamed and thought that I would do when I got older and I had no idea that I would be doing those with diabetes.

Turning 21 and going out with all of my friends….with a BG meter and insulin pump.

Moving in with my now wife….and having a storage area in the closet for my diabetes supplies.

Getting married….at that time with a syringe and vial of insulin in my tux pocket.

Going on a honeymoon….. with a package of syringes and lots of insulin.

Having kids….and worrying about if my child will also have diabetes.

And many, many more life events that occurred during these past 10 years.

Every year around this time, I think back on the night that I went to the hospital and think about the couple of months leading to me being rushed to the ER and think about if I knew then what I knew now. This is the number one reason why I am so adamant about getting general diabetes information to the public, so they never get to an 858 blood sugar and almost go into a coma without even knowing what is going on.

I’ve told my diagnosis story plenty of times, but a brief version goes like this. For 2-3 months before being diagnosed, I had every single possible symptom of high blood sugars that existed.  I was drinking water like a boss and going to the bathroom every 5 minutes. I felt bad for my college roommate at the time because I was getting 20 times during the night to go to the bathroom.

On a Friday night at college, I was sick all day long and vomited at least 5-6 times. Finally around 9 p.m. while getting sick again in the community bathroom on the 7th floor of the dorms, a friend of mine from across the hall was in the bathroom at same time and said he was taking me to the hospital because I “looked like death” and that’s when the phone call to my parents happened and I was taken to the ER with an 858 blood sugar.

Two interactions from the ER that night replay in my head almost every single day.  First, when the triage nurse pricked my finger and said that I need to be rushed to a bed right away because the meter wouldn’t even give her a reading. At that time, I had no idea what that even meant.  The second interaction is when the ER doctor walked in and said, “Chris, you have type 1 diabetes”

And that’s when my new life began.

I have learned so much about this disease in these 10 years. It shocks me how many people living with type 1 diabetes barely even know enough about their diabetes to manage it.  I’ve met so many incredible people that have been such a positive influence on my life and motivate me to manage my diabetes better.  Hell, I would have never met my wife if it wasn’t for being diagnosed with diabetes.

One decade down, many more to go.



Blogging Over at dLife Today

2014 March 31

Check out my post over at dLife today on the release of Medtronic’s i-Port Advance.

I remember seeing this i-Port product about 5-6 years ago, but it was not owned by Medtronic, so it’s interesting to see it making a come back.