I have almost two FULL boxes of the 300 unit cartridges for the Deltec Cozmo. If you are in the NYC area and could use them — please let me know.
Jul 12
I might have to go down to Coney Island to check these guys out before the baseball season comes to an end. Two type-1 diabetics playing for the Brooklyn Cyclones (minor league). One player uses a pump, the other does not. I really think that is great — they both are using what works well for them.
http://cityroom.blogs.nytimes.com/2010/07/10/sweat-bats-right-slides-left/
Jul 11
Heat safety is something I am acutely aware of on a personal level. As a diabetic athlete, it is of even greater necessity because I can use my senses to identify low and high BGs. However, when high heat temps, and high humidity hit my BG sensitivity is thrown out the window. This is because I am constantly thirsty, always a little tired and may or may not have a heat headache.
I found this guide made by Gatorade for the NFL (and football players in general):
It’s a pretty good guide and very informative using football references to make their points on heat safety. The points are quite clear — prevent, prepare, hydrate, and plan. I have to admit, my plan for heat stroke would obviously not to hit that point, and to be aware enough before that point to seek professional help, since I usually train alone. But for preventing, knowing the symptoms are key. One thing I did not realize is that it can take 10-14 days to acclimate to warmer conditions. However, the biggest point is to hydrate regularly and properly. Replacing electrolytes and sodium (and sometimes carbs too) seem like a no-brainer these days, but it was not too long ago when that was not as common knowledge.
Personal Story
As a kid, I once had the unfortunate experience of an ambulance ride and ER visit. During the summer months of June, July and August from a young age, we learned how to race sailboats. All day, every day; with a break at noon on land for lunch. One day I passed out during lunch. An ambulance was called, and the people around me knowing I was a Type 1 Diabetic, the EMTs instantly administered Glucose via gel under my tongue. However, by this point I was already coming to (since I was being fed Coke from the fountain). Upon being admitted to the ER, I learned that I was both dehydrated AND had low sodium. A disastrous combination – with a slightly low, and at that point in the ER I was trying to lower my BG after way too much soda and Glucose gel while they got fluids into me by IV.
Learning Experience
Stay hydrated, watch the color of your urine. And make sure you urinate regularly. And test frequently (like I really needed to say that).
Jul 11
- Put the OmniPod on my arm for the first time….totally sold. Now let's get back to complaining how big the PDM is… #
Jul 04
- @DMomBlog that's pretty quick for a pod change! in reply to DMomBlog #
Jun 29
http://blogs.fasterskier.com/krisfreeman/2009/12/02/nerves-of-sugar/
As a diabetic I have to balance the “fight or flight response” on my own. I get nervous before a race and release sugar just like everyone else. Unfortunately my regulatory system is broken and I have to give myself the appropriate amount of insulin. This is where things get tricky. How nervous I am affects how much sugar I release into my body: more Nerves equals more glucose . The difficult part is there is no real way to monitor how nervous I am.
-Kris Freeman, 12/2/2009
This post by Olympian Kris Freeman really gets me thinking. How to monitor your nerves to find out how much the natural release of sugar into your body? It’s not just elite athletes like Kris that have this happening, this happens to me all the time on the bike, on boats, or even heading into a big meeting. Your body has a physical response to a mental stimulus.
I personally have found some correlation in the length of time I spend “nervous” – basically preparing and how long/how high the BG can go. In sailing, there is a half hour-to-fifteen minute period to the start where I will spike. When cycling or running, it really depends how long I am waiting around to start. The more time spent standing around, the higher I will go (the more time I have spent thinking rather than doing).
It would be interesting to see if any breathing or relaxation exercises have any effect.
Jun 28
The future is patch pumps (and I don’t think this is a new revelation). They are simpler, contain fewer parts for the end user, and have fewer parts to fail. If failure occurs, you simply throw away the patch and grab a new one. Looking at the future of infusion sets and canulas is pretty exciting (BD working on smaller Pen needles can eventually transfer to infusion sets).
I am an outsider to the Insulin Pump industry, and a relatively new user at that. I know some who have been on them since the ’70s. I started using a tubed pump in 2004 (Deltec Cozmo). However, the writing is on the wall so to speak as to the next natural transition for these devices – patch pumps (pods): tubeless, auto-insertion, cartridge built in, smaller.
The OmniPod has been out for a couple of years, and since then many of the kinks that I have read about seem to have been worked out (it’s still not great from a usability standpoint). The Jewel pump that is slated for release next year may have the ability to communicate with an Andriod mobile phone. The Solo and the Jewel are patch pumps that are semi-removable. OmniPod will eventually release a “pod” that is significantly smaller than the current model. MiniMed is working on one — however, from their IR presentations it seems that it took a bit of a back burner and was bumped farther down their pipeline.
Putting the CGM and Canula for insulin into the same auto-inserting patch? Sounds very feasible to me. You start to combine these different advances and you can see a product in the next 5-10 years that is very exciting. Yes, I am hinting at the first (more likely second) phase of an artificial pancreas that removes the complexity of the insertion devices, and combines the “stuff” into the fewest number of packages possible. Put on a single, tiny patch, get a canula each for insulin, glucagon, and CGM. At the other end would be a receiver. Most likely the receiver should be a mobile phone with some software to control the patch pump/cgm and has the artificial pancreas software installed. The software on the phone would automatically sync with a website and backup all my setting and records.
I admit there are a large number of baby steps involved before the device I imagine exists. However, the OmniPod is the device we should have had in the early 2000′s. Ideally, the development from small firms will push the large firms to develop the devices that will be the future of this industry.
Solo (recently acquired by Roche)
http://www.solo4you.com/
Jewel
http://www.jewelpump.com/
OmniPod (Insulet)
http://www.myomnipod.com/
Jun 25
I preface this with that I really have not met many (if any) serious sailors as type 1 diabetics.
Sailing comes in many opposing variations — sometimes we go for a short cruise, or a long cruise. Sometimes we race around the buoys for a few hours. More often than not I am finding myself on the water all day racing with a couple of 20-30 minute breaks between races. And every now and then I am involved in much longer distance races (50, 90, 185 mile) that can take a day or two to complete. Although I have yet to be talked into it — this years’ Bermuda race (635 miles from Newport, RI to Bermuda) took a solid 5 days of sailing — one of the slower years for the race.
While racing sail boats, your movements are mostly confined to specific, pre-defined areas. Therefore, the most important part of the whole day is going from land onto the water. You need to be stable – limited Carbs on Board and limited Insulin on Board with a normal BG since there is limited access to gear. Although I normally run somewhat high BGs before boarding — mostly due to adrenaline of getting out to the race course. That normally settles itself without any correction since there is plenty of work to do to get the boat race ready.
Longer races of 1-2 days are a little more interesting and require backups - I have never needed to do a site/Pod change at sea. However, I always bring backups, as well as Lantus and Novolog pens so that I could switch should I have a failure of some sort.
To temp basal or not?
For me, I do not temp down. Typically, the work on a sailboat are quick bursts of energy and undetermined times. However, I also eat rather irregularly onboard a boat (mostly with small snacks). Rarely do I bolus for these snacks unless it is something like a sandwich. A cookie or chips will simply raise my BG as I am hopefully feeding the basal.
I raced most of my life on MDI, and find it much more comfortable for sailing. However, trying to give yourself an injection in heavy seas trying not to get knocked around too badly is a bit of a fight. As in life, there are positives and negatives to everything.
Jun 18
Low carb? Not me. I’m a high carb intake type 1 diabetic. Breakfast is usually a bowl of cereal and milk (not a small bowl, but a bowl that is about 1.5-2 serving sizes). I eat lots of pizza. Cheese and crackers are a fantastic snack (and easy to bolus if you are counting the crackers in advance). Some days I may eat 500 grams of carbs, other days I may eat 100 grams. It all depends upon the needs of my body that day and how hard I am working.
As long as I am not constantly consuming carbs to keep BGs within range (a BG control issue) – I am happy to consume carbs to keep my body energized.
Reading another athlete with T1:
Carbs are not my problem. I take Novolog insulin analog to replace the insulin my body isn’t producing. And as a type 1 diabetic friend once said, “I’m not on an insulin budget.”
If you are working hard and burning energy, you need carbs (sometimes a disgusting amount). End of story.
Jun 16
In my opinion, the biggest annoyance with insulin pumps is the sites and changing sites. It is substantially better with the OmniPod for insertion. However, the biggest problem has to do with pooling of insulin at the site. Basically, eat a big meal, and take a large bolus. The insulin has a tendancy to pool at the site. And if I decide to change my infusion set/pod a short time after taking this insulin — well, most of it is going to fall out.
Even though I give myself the correct dosing, if I decide to change my site after eating, I will go high unless I administer a guesstimate of how much insulin I have lost. A big part of the calculation has to do with how long after eating/how long after giving myself the bolus. Almost impossible to get right.
Moral of the story: never give yourself a bolus right before you change your set. It never works.
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