Tuesday, 22 December 2020

2020 - More Light Than Darkness

 


It’s approaching the end of the year and thoughts turn towards what has happened in the past 12 months and whether it’s been ‘good’ or ‘bad’ and whether we come out the other side in a better place than we started it.

Over the last few days I’ve seen a few messages from public facing people in all walks of life signing off for the year with mainly negative phrases:


“What a terrible year that was!” 

“Glad to see the back of 2020!” 

“Good riddance to a bad year!” 

“Can we promise to wipe 2020 from history?”


First up the obvious bad. A lot of people will experiencing Christmas without a special someone for the very first time. This will be an even tougher time of year for them. The amount of people who have passed away earlier than expected cannot be ignored, or dismissed. Covid-19 is certainly a ruthless virus that has greatest effect on those with the smallest defence against whatever the body throws at them. And at times I’ve feared I, and members of my family, were in the often named group of 'vulnerable' people. 


Our family has been very fortunate in that none of us have been in a situation where we have felt the need to test or isolate. A few of our extended family have isolated as a precaution but nothing positive confirmed at any stage. 


For us without doubt the biggest hit has been the inability to see close family apart from very occasional garden visits. This break has been hard emotionally as there’s nothing like a hug from those you love when feeling a little wobbly. 


A late blow to the stomach has been the closure of international travel meaning a Christmas gift planned for delivery this week is stuck somewhere on the wrong side of the English Channel and it probably won’t arrive until the New Year. 


But let’s have a look at what has happened and how, even in what appears to be darkness, we have plenty of rays of light shining through.


Chez Sowerby 2020 has definitely had some highlights. Including:

  • More time spent with immediate family means more time to get done those things that always seemed to get delayed. The back garden had a bit of a makeover and we look forward to being able to have people round to enjoy it with us soon.
 


  • The one hour of exercise in the first lockdown definitely encouraged us to explore the local area and we had some great walks out, especially when the weather was wonderful. I know we are very fortunate to have these sights within 10 minutes walk and therefore have it much easier than others without the access we do.


  • I’ve worked at home at least 3 days a week for nearly 15 years now. With everyone else being forced to too it has strangely made me feel more connected to my colleagues than ever before with regular Pod meetings definitely helping. 
  • Connecting online with distant family is something we hardly ever did previously but the occasional quizzes of 2020 gave us chance to do that in a way we’d never have done before. We’re looking forward to doing one final 2020 one this week.

  • Haircuts were suddenly a thing to really appreciate!


  • We had an amazing holiday in the north of Scotland where we managed to escape the continuous news for a week to enjoy the scenery, wildlife and surprisingly great weather. It was a real tonic after 6 months of not going out, going out, not going to work, going to work, ……

  • We took the chance to splash around on the canal.

  • We even found some good football moments. There weren’t a lot of games played but memories were still created to be looked back on in years to come.

  • Our nephew got married to his wonderful bride in August. It was in doubt all through the year but they managed to organise a perfect celebration even with restrictions involved. Facebook Live streaming to us all stood outside followed by Prosecco and photos in the churchyard afterwards made it a very special. And with the most junior bridesmaid rocking a Dexcom with style we were very proud.

 

Which bring us on to diabetes. The end of 2019 was tough in the house with Martha’s diagnosis. But 2020 enabled her, and us, to learn how to get a handle on the condition and how to deal with wobbles. We’ll not eliminate them but we know how to cope and understand that there’s never blame attached to highs and lows; it’s just how it goes sometimes. And then half way through the year the extra cannonball of coeliac and going gluten-free arrived. That was, strangely, almost harder to handle. But she did, and she did it fantastically well. I must also say the support of the diabetes community has continued to be priceless for us and I thank you all.

Reduced activities provided an initial issue with numbers for both Martha and I, but as life became very repetitive and regular it also became easier to manage once the tweaks had been made.


Diabetes tech has still been advancing and people such as Tim at Diabettech, and Kamil at Nerdabetic have done a great job of keeping everyone up to date.  The future is so exciting and the great thing is that it’s for all treatment types. For so long everyone has been talking about pumps and CGMs only. Now more and more the next generation of insulin pens are also getting written and talked about. In the UK access to technology is slowly improving and future initiatives seem to be making this a more available reality rather than a dream.  


At the start of the year when the virus was first emerging I was very lucky to be able to get to ATTD in Madrid. However since then all those types of events have flipped online. I’ve also been fortunate to contribute to some of them through either presenting or taking part in discussions with other people with diabetes. Even when speaking I always learn something from them and the value of the question and answer segments should never been downplayed. Also having them forced to be moved online has made access much easier for those of us not located in a big city.  I hope this can continue in some way even when movement is free once again.


While in Lockdown #1 the wonderful Jen asked me to be part of her Type 1 on 1 Podcast series. It was a great therapy session and I really enjoyed looking back at my life with diabetes and also how it affected us all when Martha was diagnosed.


New diabetes technology is being launched all the time and I look forward to being able to, hopefully, try some of it out very soon. When I do I’ll share here whether it works for me or not.


2020 has definitely been a year for the family and I feel very lucky to have my most wonderful wife and children to share it with.


If you’re reading this, and have got this far (well done!), the challenges of 2020 will have affected you in your own personal way. We've each had fences to overcome and for some those fences are still being climbed over. I really do hope though that you can also see your own moments of light in what is commonly viewed as being a completely dark year.


And yes, it’s slightly disappointing not to have that last gift wrapped and ready for Christmas Day but it will be something to look forward to in what can be a wonderful 2021.


Merry Christmas and Happy New Year!



Going Live With The 670G

******** Hmm. So I found this in my drafts when it should have got published in 2019. Oops. Here it is anyway, I hope it's still helpful.😀********

Hey! I'm glad you've arrived here. Whether it was on purpose or an accidental click you are welcomed with open arms and payment with a bag of Haribo.*




In my last article I talked through the decision making process for my pump refresh. For those that haven't read it I'll cut to the chase, it's the Medtronic 670G. If you want to know my full reasoning have a look To Loop or Not to Loop.

So what's happened since? Well at the start of July I was booked in for training and the handover of the shiny new pump. Unfortunately due to illness this had to be cancelled and postponed to early August. I wasn't too chuffed about this and asked very politely, yes I was polite, if I could get my hands on it so that I could get used to the buttons and menus before receiving the full AutoMode training in August. After an awkwardly long pause my diabetes team said “Yes!” I may have let out a little yelp and done a little jump of excitement at that point.

So I went along and picked it up.

You can see how that went and how I got set up by having a look at the three videos I did:
here - Getting to know the Medtronic 670G System - Chapter 1
here - Getting to know the Medtronic 670G System - Chapter 2
and here - Getting to know the Medtronic 670G System - Chapter 3


*Haribo bags subject to availability and numbers of hypos between now and the claim being submitted.

******** Hmm. So I found this in my drafts when it should have got published in 2019. Oops. Here it is anyway, I hope it's still helpful.😀********

Tuesday, 2 June 2020

Podiabetes



Welcome readers! For those of you visiting for the first time I say a hearty "Hello!" and I hope you like what you see. Feel free to have a meander back through the archive. As we'll come to shortly, I've been having a reminisce about all of my diabetes and certainly a lot of my blog-life. There's some decent stuff in there I think and I hope you like it too.

So before I wrote my first blog here, I'd spent a little time in the world of Twitter and other lesser known forums. I started to meet some fantastic people with Type 1 Diabetes. And one of those people was the most wonderful Jen. Otherwise known as Miss Jen Grieves. Over the years we've stayed in touch and it's been great to see her turn her blog into a multi-media encompassing library with something for everyone.

Last year she delved into the world of Podcasting with her Type 1 on 1 series. It was great to see her speaking to some fantastic people who all tackle this little monster called Type 1 Diabetes in their own special way. It came as surprise recently when she dropped me a line asking if I'd be part of her Season 2. Nervously I said yes and we arranged to have a chat over my experience of diabetes through the years.

It was great to speak to her and I hope you find it interesting to listen to my verbal ramblings, and pseudo counselling session, under the expert guidance of Jen.

Before you click away and listen to what we talked about, thank you, as always, for taking the time to visit my page. If you've got any questions or comments please leave them below, find me on the socials or drop me a line to the email address at the top of the page.

Transistor 
Google Podcasts
Apple Podcasts

Stay safe and enjoy!

Dave

PS. I mentioned Diabetes UK (as they are now) camps from my youth. Here is a trophy I won at Springhill Camp in the late 1980's for tidiest tent. As I said in the Pod' sport wasn't my strength back then! 



Tuesday, 14 January 2020

One Hat Is No Longer Enough


Since starting to put down my thoughts in word on this page I've also read with interest the views of parents of children with diabetes. Reading their stories I’d often sit a little bit too comfortable and be grateful that I was only looking after myself. Well you can guess what happened next.

In summary my daughter Martha gained the unhelpful antibodies and was diagnosed with Type 1 just over a month ago. The diagnosis bit is covered expertly by her here - My diagnosis

Looking back there was a viral infection about a month before. For the week prior to diagnosis all 4 Ts existed in some way. But a bunch of assumptions on what the cause might have been for these independent factors meant we didn't join up the dots immediately. And you'd think we'd know what to look for!

To say it hit us hard is putting it mildly. And that's coming from a family already managing my diabetes 24/7. It might be wrong to feel lucky in a situation like this but, if it was going to arrive anyway, I'm glad the whole family's experience of me helped us to hit the ground running. Being able to do a quick doom-laden finger prick on the morning of diagnosis gave us the key fact. From there we followed the process through. Knowing that it would be tough but not impossible enabled us to see the light. I can only imagine the horror and uncertainty that will come if a newly diagnosed child is in your family and all this information that you need on day one is suddenly dumped from a great height.

I'll take a pause here and thank the fantastic team that dealt with us on the day and have done ever since. It was flawless. A call by Laura to the GP surgery at 8am, appointment with GP within 3 hours, referral straight to paediatric ward at Royal Lancaster Infirmary, diagnosis confirmed by a range of nurses, doctors, and blood-suckers, meetings with consultant, dietician and DSN and release home (at our request) all before 7pm. We will forever be grateful for your speed and human touch on a day that wasn't easy emotionally for any of us. 

Talking with my parents later it brought back memories of me as a 3 year-old being made to run up and down the hospital corridor so that they could see what would happen with my co-ordination when my blood sugars dropped and I had a hypo. Thankfully none of that here!


All credit to Martha, she was the one pushing the 'no-limits' boundaries from day one. Within an hour of the formal diagnosis a professional asked her about the sport she plays. Her response was that two days later she would be playing for her school in a football cup final at Morecambe FC. There wasn't even a thought in her mind that diabetes could stop this. And it didn't.

Very quickly it became apparent that all the decisions I make silently in relation to handling my diabetes we would need to teach Martha. And that's been hard. Anyone with Type 1 will probably agree that not all choices made are logical or fully proven. There's an awful lot of "well, let's try this and see if it works". A definite difference though if the experiment is on someone else's body. It's well shared that at least 42 factors influence blood glucose. (Because 42 is the answer to life, the universe and everything.) Now I need to pass on those factors.

I'm experienced at managing an adult's Type 1 using a variety of of technology. Now it's a clean start with injections, finger-stick blood tests and a quickly added Libre. We've played it safe all the way. Despite the urge to get straight into carb counting, dose adjustment and Libre we hung back and waited for the green light from Martha's team. Any changes to insulin dosage, exercise strategy or carb-ratio is discussed with them first as they have much more experience with 12 years old and type 1 than I do; a few decades have passed since then for me. There's also now Youtube which is always a great source on helping see things in action. As an example look at my little helper when I did one for inserting a Libre. That person also appeared in quite a lot of my other diabetes video blogs which is a sadly ironic now.

The impact on the non-D members of our immediate family can't be understated. Diagnosis in a family with no-one with diabetes leads to a very steep learning curve for all but it's a shared learning experience. I know Laura found it hard as the mum will naturally have a big part of the early diabetes decision making. Because I'm, sort of, experienced Martha naturally asked me a lot of questions early on and for Laura this must have been hard to see. We both had stages of grief at what was lost but I was able to slip into organisational automode and just work through it. Thanks to this blog and other social media I also have quite a large network of people I could call upon for support.* Laura didn't have this although the contact from other mums since has helped a lot. For Martha's brother he has been fantastic in wanting to help her and make sure she is OK. Proud of you Joe. I don't want to speak for him but I know it's been hard to see this happen to his sister.

*A quick word of thanks to the all people who have either reached out to me or responded to my requests for help. The cushion of support felt is priceless. You know who you are. Thank you x

Now that it's post Christmas and we're more than a month in, normality is starting to arrive. The usual sport driven activities are being worked into her treatment and she was fantastic in managing everything. Last Sunday with two intensive football games lasting over an hour that were only 75 minutes apart. She bossed it.

For my diabetes, this has gone into autopilot. And for this I am eternally grateful for my 670G. It's allowed me to drop the ball a couple of times and fixed things through the night when I've not bolussed correctly or just eaten badly. I absolutely love this piece of kit. Considering 1979 or now I know Martha is 'lucky' to be in a place where the 670G, other homemade artificial pancreases and devices like the Libre exist. Some of it might not be right for her now or in the future but the fact they exist at all is just mind-blowing.

Since New Year Martha has had a lot of lows that we needed to record so that we could find a pattern to share with her team. And thanks to the food diary and Diasend this has been used to make a couple of adjustments. It's highlighted to me that there's no substitute for detail when trying to identify a pattern. And so my note taking has kicked to try and improve my numbers too.

So my Diabetes Hat wearing now comes in two forms. One for me and one that I share with Laura and Joe for Martha. Martha has her own hat. It has definitely allowed me a better perspective on what being a parent of a child with diabetes is like and I do hope and believe that my time stabbing and dosing myself will help a little. Time will tell.

Thanks for reading and once again I'll point you to the real leader and expert in Martha's diabetes - https://martha1diabetes0.blogspot.com/


Monday, 7 October 2019

Aye, Aye Captain


“You’ve done really well to have type 1 diabetes for over 40 years and not have anything like this happen to your eyes before.”  A sentence that was meant to be kind and reassuring but one that hit me like a knife. 

Complications have always hung over me like a blade but this was the first time I’ve truly felt they are an inevitability for me rather than just a possibility. 

On the day before I’d been driving my daughter to, another, football game and suddenly my vision changed. It wasn’t blurred and I could drive safely but it was like I had dirty glasses on and the floaters were very noticeable. 

After I got home my wife persuaded me, strongly, to visit our local optician. I was of the mindset of burying head in sand but she rightly refused to let me do that. Thank you as always L. 

Sadly the optician had left for the day but the kind assistant willingly phoned around all opticians within 15 miles to try and get me seen as quickly as possible. The only one who could help within 24 hours was Boots who slotted me in the next day. I was fine with this as it reduced the sense of urgency and stopped me feeling like I was making too much fuss. 

By the end of the day all objects had disappeared and I was convinced I was over reacting. However after waking, the effects slowly reappeared though at a lower level. 

At the appointment I had usual measures taken and eyes dilated before she had a good look into the back of my eyes. The diagnosis was posterior vitreous detachment. Or in other words a change that’s not reversible but normally appears a couple of decades later than where I am now. 

Thanks to the advances in technology I now have some of the leading, available, diabetes kit attached to my body 24/7. But this doesn’t mean I can avoid everything. 

I also know that life throws awkward arrows at lots of people and a slightly affected vision is pretty low scale in the world of permanent body changes. I continue to thank my lucky stars that I’ve got this far with, still, nothing major hitting me and I’m going to keep remembering that as much as I can. 

That doesn’t mean I can’t be a little scared now and again. I wouldn’t be human if I wasn’t. When it happened I was a lot scared and today I’m still a little bit worried. Thankfully I’ve got a wonderful wife and family around me who always support and I’m very lucky to have them with me when I wobble. Though my daughter was a touch disappointed when i pointed out I don’t need a guide dog. Yet. 

But I’m not moping and not looking for sympathy. It is what it is and thanks to sharing here I can keep perspective on where I am and how fortunate I am. 

Thanks for reading and good luck to you all. 

PS. Yes I know I’m a little behind on my 670G blogs. A short summary is that’s not perfect but it’s bloody amazing and I love it. Longer review to follow next time.

Wednesday, 3 July 2019

To Loop or Not to Loop (Part 1 of x parts)



Pleased to meet you, I’m Dave and I’m a lapsed blogger.

(*There’s a rather complicated disclaimer for this series of posts. In summary I’m getting paid nowt and haven’t got anything because all choices and decisions have been driven by me. It might spoil the end if you read it now but if you want to it’s down at the bottom. Thanks)

It’s been a while since my keyboard and video device were fired up for the purpose of this blog and, as always, I apologise for my tardiness. Like everyone with Type 1 diabetes, at times I often struggle to fit managing my condition into a busy life and in this instance the blogging has dropped off a little. Oh well, time to pick it up again with a new series. The thinking here is that if I say that I will write the next one I probably will. Anyway, you’re rambling again Dave; crack on.

Almost exactly 8 years ago I decided it was time to sort out my condition and grab hold. At the time I was injecting and testing at less than optimal frequency. Once I became engaged with my diabetes I quickly arrived at a point of deciding whether to stay with multiple daily injections or shift to an insulin pump regime. If you’d like to revisit my headspace at that time please have a read of my ‘To Pump or not to Pump’ blog from back then. Also at that time I was very fortunate to have started to get to know the wonderful Every Day Ups and Downs Mike who was going through the same decision making process.  (BTW If you click on the link above and never come back I’d understand, his articles are always 5 star.)

After saying yes to the pump I got to choose, from a choice of one, the Medtronic Veo. A few weeks later I ended up with Fred.





Over the years in-warranty replacements, and the very kind lending of pumps from elsewhere – you know who you are - have kept me with the same pump model. I now have Pink and we’re comfortable with each other.



Me and Adam (or Red or Pink) were, mostly, very happy together. We did however, have a break in 2015 when I had a brief, #gifted, fling with a 640G for 64 days. 



Thankfully Adam wasn’t bitter and took me back as long as I promised not to be unfaithful again. And this is how it has been since 2011.

Those of you who have an insulin pump may be scratching your head and wondering how and why I haven’t been forced to update my out of warranty pump before now. To be fair, I’m not entirely sure. I think the 640G thing confused hospital systems about how old my pump was. I also smiled nicely quite a bit and said it was working fine and I’d sort it once it broke. “Surely it’s better I’m saving the upfront costs that a new pump would bring?”

A key reason for me not switching was that I didn’t want to get locked in to another 4 years when technology was advancing so quickly. I genuinely loved the SmartGuard function of the 640G that helped to reduce my hypos but I also knew that something that would also deal with the highs shouldn’t be too far away. And if Medtronic were working on that I hoped the competitors would be too.

Over this time what began as a small revolution started to take hold. #WeAreNotWaiting and other groups of wonderful engineers were using existing technology to build their own ‘artificial pancreata (AP)’*. This has also become known as Looping. The origin of this is the idea of closing the loop between blood glucose measuring and insulin delivery so that it is done with very little input from the person with diabetes. 

*No, I didn’t know what the plural of pancreas was either. Every day is a school day.

If looping and #wearenotwaiting are new terms for you I’d recommend some background reading as others with much more experience describe it much better than me. This excellent article by Tim is a great place to start.

#edit Tim has also pointed me towards this excellent book Automated Insulin Delivery by a leader on the subject Dana Lewis avaiable in print or as a free download. "Dana is a creator of the “Do-It-Yourself Pancreas System” (#DIYPS), founder of the open source artificial pancreas system movement (#OpenAPS), and a passionate advocate of patient-centered, -driven, and -designed research." In summary; an expert in this field. Follow her.

One piece of the jigsaw used in a lot of the homemade systems was a Medtronic pump that looked exactly like mine. And if the original Adam had survived until today he would have been one of that kind.

Unfortunately for me, over time Medtronic locked down the pumps after the media went a little hysterical about pumps being able to be controlled remotely to give lethal doses. It was all about the version number of the pump software. My current one is version 2.8B. To be able to loop I needed version 2.6A or younger. At one stage, with permission, I went hunting through a box of old pumps at my diabetes clinic and came away with a few possibles. Unfortunately as soon as I put the battery in, the version number was always too new. And this week they have issued a soft recall to remove all the hackable pumps from use; for safety reasons obviously.

All the reading about looping online was drawing me in and over the last couple of years the idea of a more automated system has appealed more and more. Tied with this I have been wearing, and paying for, an Abbott Freestyle Libre almost full-time for nearly 4 years so the idea of not using continuous monitoring in a more productive way seems negligent. Slightly deteriorating hypo awareness has also made me realise that from a safety point of view adding a few automated airbags into my diabetes care would be a very good idea.

I’ll pause here to say that the following is how my thinking has developed over time. Just because it is different to others' doesn’t make mine or their decision wrong. Your Diabetes May Vary has never applied more than it does at the moment with so many different treatment options possible.

So which way would I go?

For me it has come down to two key questions, which are linked very closely.

1: Which pump, or system, would I like to have the most?
2: Which are available to me?

In my inner psyche I do like rules and staying on the grid. Saying that I’m not averse to bending the rules a little. Until NHS funding was secured in April for my Freestyle Libre I was using a MiaoMiao device to enable me to get my glucose readings delivered to my watch. There was risk here as the readings didn’t have the official device’s adjustments for temperature etc but I accepted and accounted for those risks to give me convenience and alarms.

Over time I have discounted the idea of paying for an older Medtronic pump or buying a newer one from another country. As demand has grown both would have probably cost upwards of £500. And with that price comes no assurance on how long it would last before I'd need to purchase another.

So now it comes down to options for new pumps that are on the market that have automation built in or where it can be tagged on.

As it is the list I could see available is:

Home built systems: Dana RS plus Dexcom, Omnipod plus Dexcom plus Rileylink, Accu-chek Combo plus Dexcom plus Smartpix or Realtyme.

Manufacturer built systems: Medtronic 670G plus Guardian 3, Tandem t:slim X2 (with Basal IQ imminent, Control IQ forecast for 2020) plus Dexcom G6.

So how did I reduce the list down to a top three very quickly? Well, I’m afraid the first two to go are the Omnipod and Accu-chek combo. The Omnipod for no other reason than I like a tubed option. I know exactly where the bit that I need to give me insulin is. It’s attached to me somewhere. The Omnipod needs its handset and I would lose this. There’s no doubt here. My forgetfulness is legendary and the day would come when I’d walk out the door, get on the train and shout a few swear words because the vital bit was next to the kettle at home.
And the Combo? I'll be frank, it just doesn't excite me. I know I can automate my pancreas with it but I've got another 4 years to go with a new pump and it will be in my pocket for most of that time. I'd prefer a colour screen. And if no colour then it needs to be smaller; a la mylife YpsoPump. There you go, no logical reason to cross it off the list but it's a personal choice so I'm letting myself be irrational.

So three to go…

Dana RS – One of the smallest pumps in the world it also uses Bluetooth to communicate with a smartphone to allow management through an app. Also designed to be compatible with Android APS that will allow automated insulin delivery decisions to be made based on reading from a compatible CGM. At the moment the most popular CGM brand to use for this is Dexcom. The UK distributor for the pump is Advanced Therapeutics, sensors are direct from Dexcom.

Medtronic 670G System – An upgrade on the 640G, the 670G uses, Medtronic only CGM, to continually read the glucose level in the body and deliver basal insulin according to that. Once fully in automode it does not require patterns to be set as it is continually updating. The wearer still needs to enter carbohydrates for meals. A downside for many people is that the target BGs are much higher than people can set with homemade systems. Another downside for some is Medtronic’s Guardian 3 sensor. I have always found the earlier Enlite sensors to be good but others have not. This has has knocked some people’s confidence in the brand and has a knock-on effect to those who have never tried but hear the testimonies. My usual mantra applies here; unless you've tried you can't be sure how it would work with your body. On top of that in the UK are also issues currently with sensor and consumables supply. For me, I’ve not had an issue but the others have had problems and that could be a concern going forward. The 670G is supplied in the UK directly by Medtronic only through centres that have been approved for supply.

Tandem X2 – The Tandem is a fascinating option. A new entrant to the pump market it is manufactured more in the way of a mobile phone than an insulin pump. This means that as features are developed these can be refreshed through software updates rather than a whole new pump. This helps to reduce the fear of committing to something for 4 years when the next big change is "in the next 12 months".
New deployment in the UK has Basal IQ live and existing users will be updated soon. This works in a similar way to SmartGuard on the Medtronic 640G. Using the Dexcom G6 sensor it suspends insulin before the wearer hypos and resumes basal delivery once the numbers are safe again. The next upgrade is Control IQ. This will add in the ability to automatically deliver insulin when the wearer’s blood glucose is above a predefined number.
No confirmation either way on whether there will be a cost to upgrade the software in the UK. Dexcom sensors are available from Dexcom direct and the pump and consumables are supplied to hospitals by Advanced Therapeutics.

So I have a theoretical shortlist of pumps I’d like to move on to next.

I like to share a lot on these pages about my health and don’t tend to keep any of my box closed. For the next paragraph though you’re going to have to just accept it without the reasoning and move on without too many questions. Sorry.

I now also have CGM funding possible through my team. This is not available for all and I understand how fortunate I am but as always there are criteria to meet and I meet them.

So which way do I want to move and which way can I move? I really can’t pick between the three although my inbuilt preferences are to lean towards the 670G and the T-Slim. I like the concept of full integration although the lack of talking to my phone and watch are frustrating.

Next up came a discussion with my, outstanding, consultant and we talked through the options. I enjoyed the conversation. Although the end result was almost pre-determined it was a real bouncing of ideas and reasoning. First off the list is sadly the Tandem. The clinic currently has no-one on this pump and not much resource in the short-term to learn how to support it. I certainly could push for it but this will inevitably take some time and a lot of work.

Next to go is the Dana RS. There are some in clinic on this but the team's experience is less and the need for an Android phone to loop is also a drawback for fruity Dave. It really is the small things that make a difference. An option could be to carry a dedicated AP phone that would do the brains part. But that's something else to carry on top of pump, normal phone, spares etc.

Which leaves the “world’s first artificial pancreas”. This phrase makes me smile as Medtronic were also using the term “artificial pancreas” in 2015 with the 640G. One of those parts where marketing inflates the reality slightly. My clinic has supplied Medtronic pumps for a long time and therefore have experience of the support and Carelink systems. For me, I’m also experienced in using the sets and Carelink which is the software that analyses the data after the event. This means this part of the change isn’t as big a step as it would be with the other pumps. I know it’s wrong to feel safe with a brand when there are ongoing supply issues. However, I’ve not experienced any problems where supplies were at zero so can only judge based on my own memories. I haven’t used the Guardian 3 CGM sensors but when I’ve used Enlites before they’ve always worked OK with me.

Making any decision involves a list of pros and cons. At the moment for me, the pros of the 670G vastly outweigh the cons and I’m excited about getting the chance to give it a go. 

Until then me and Pink will continue bolusing and getting along until mid-July.

I’m hoping to update my progress with the pump as I get to know it more and more. I'll delve more into the pluses and minuses of the system set-up next time. Among these are the forecast impact on my, always supportive, family when the alarms are going off through the night for calibrations etc. It will impact the whole house I am sure. I never underestimate how much my little Type 1 affects the lives of those closest to me and the worry it adds. I am hoping that the 670G can reduce the worry a little thanks to the airbags built in to keep me safe. Thank you as always and I love you lots.

I hope you’ll join me on this journey into a new approach to managing my diabetes. In other news I now have a new camera tripod so the return of the vlog is a possibility. Which will please and disappoint in equal measures I think.

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PS. I'll finish with a picture taken of me by Kirstina at the top of Scafell Pike. This was a walk I did with my son, sister and brother-in-law to raise money for the fantastic JDRF. We left at 01:15 so we could be at the top by sunrise. We managed this and we came back down safely before a lot of people had woken up. If you have a spare £1, $1 or €1 any donations towards finding a cure for Type 1 diabetes are gratefully received here.




Disclaimer time – It’s quite possible you know about my 640G blog posts and have assumed Medtronic have somehow pulled a few strings and promised me lavish weekend trips to the Geneva to ‘encourage’ me to have a 670G set-up. They haven’t. They did however pay for a train fare for me to go down to exotic Watford late last year to let them tell me all about the ‘system’. As always it’s interesting to hear what 'evil pharma’ are saying and as I know my integrity is solid I keep an open mind. It’s obviously up for you to judge my independence. My thought process is that if I have enough annual leave left, I’d always prefer to be in the room giving my thoughts, feeding back experience and challenging claims if given the opportunity. 
For full openness I’ve also previously signed an agreement with them to force me to write in an honest way and confirm I will not be paid for anything I say about Medtronic. However, I haven’t talked to them at all about the ‘choice’ I have made and it’s possible they are reading this as new news for the first time.
And for those who are still mumbling “well he’s been bribed with an apple Danish and fizzy water so he would say that wouldn’t he” thank you for reading this far, I wish you all the best and a fond farewell.