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[IP] Re: insulin-pumpers-digest V9 #941



-------Original Message-------

From: insulin-pumpers-digest
Date: 07/18/06 06:30:55
To: email @ redacted
Subject: insulin-pumpers-digest V9 #941


insulin-pumpers-digest     Tuesday, July 18 2006     Volume 09 : Number 941



PLEASE edit the subject line of your reply messages.
####################################################
This issue of the digest contains:
Profile of Dean Shoup <email @ redacted>
Profile of Belinda <email @ redacted>
Profile of Sally Conner <email @ redacted>
Profile of Elizabeth <email @ redacted>
RE: [IP] MiniMed Reservoir
Re: [IP] Re: your mail
[IP] Dealing with insurance companies
[IP] Re: Profile of Sally Conner <email @ redacted>
[IP] Re: implant
[IP] Re: Flying with a pump
Re: [IP] 508 MELTDOWN
[IP] CGMS and reasonable post prandials
Re: [IP] 508 meltdown aka your mail
Re: [IP] I agree wholeheartedly with Linda and Dax
[IP] Dumpster Diving
Re: [IP] CGMS and reasonable post prandials
[IP] re:  I agree wholeheartedly with Linda and Dax
RE: [IP] CGMS and reasonable post prandials
Re: [IP] 508 meltdown aka your mail
RE: [IP] Re: MM questions
[IP] Monday Night Chat
Re: [IP] dexcom VS minimed
Re: [IP] Minimed CGMS Realtime or DexCom
Re: [IP] dexcom VS minimed [Link for Minimed 522/722 CGM manual]
[IP] Minimed gets FDA approval for CGMS separate from pump
Re: [IP] Minimed gets FDA approval for CGMS separate from pump
[IP] My appointment with the CDE today
Re: [IP] Minimed gets FDA approval for CGMS separate from pump
Re: [IP] My appointment with the CDE today
RE: [IP] CGMS and reasonable post prandials
[IP] Brad and CGM
[IP] Re: flying with the pump
RE: [IP] Re: Is anyone using inhaled insulin?  Opinions?
>


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Date: Mon, 17 Jul 2006 23:23:23 -0400
From: Eric Jensen <email @ redacted>
Subject: Re: [IP] Minimed CGMS Realtime or DexCom

Rick Stockton <email @ redacted> wrote:

> Are you using my site recommendation, exactly along your
> side, or are you sticking them in somewhere else?

My first three were on my abdomen, toward the middle, and the current
one is on my upper buttock (which has cut down on my habit of showing it
to people!).  Anywhere else (including along my sides) I hardly have any
subcutaneous fat at all - don't know how it would go to try to put a
sensor in there, but seems like I'd hit muscle.  I'm 6'3", 175 lbs -
don't have much body fat.  Generally I'm fine with that, but lately I've
been wishing for a bit more to "soften the blow" (literally). ;-)

Have any other lean people tried alternate sites for Dexcom or Minimed
CGMS sensors?

Thanks,

Eric
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Date: Mon, 17 Jul 2006 23:27:59 -0400
From: Eric Jensen <email @ redacted>
Subject: Re: [IP] dexcom VS minimed [Link for Minimed 522/722 CGM manual]

Nikos Filippou <email @ redacted> wrote:

> Your question is right and I really want to hear an answer from
> someone who knows. But I have a point. When you enter results to Bolus
> Wizard it's always appear an extra screen where 722 asks if you want
> to pass the result to the sensor for calibration and you van answer
> Yes or No. I believe that BD-link works the same way asking if you
> want to use the result for calibration or not.

Ah, that sounds good.  I had exactly the same thought as Linda -
sometimes you *don't* want to calibrate the sensor with a given
fingerstick...
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Date: Mon, 17 Jul 2006 23:34:12 -0400
From: Eric Jensen <email @ redacted>
Subject: [IP] Minimed gets FDA approval for CGMS separate from pump

Looks like Minimed just got approval for a standalone version of their
continuous glucose monitoring sensor and receiver in a unit that is
*not* part of a pump:


http://wwwp.medtronic.com/Newsroom/NewsReleaseDetails
do?itemId=1152884580852&lang=en_US

>From the picture, it appears to be the same sensor and transmitter they
are using with the 522/722 pumps, but this unit will position them to
compete directly with Dexcom in the CGMS market for those users not
using pumps at all, or using pumps other than the 522/722.

No pricing info yet that I can see on the website.

Eric
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Date: Mon, 17 Jul 2006 23:37:58 -0400
From: "Phyllis Abram" <email @ redacted>
Subject: Re: [IP] Minimed gets FDA approval for CGMS separate from pump

It can be used with any pump so the user would not have to get a 522/722
until
they are ready to do so.
Phyllis
  ----- Original Message -----
  From: Eric Jensen
  To: email @ redacted
  Sent: Monday, July 17, 2006 11:34 PM
  Subject: [IP] Minimed gets FDA approval for CGMS separate from pump


  Looks like Minimed just got approval for a standalone version of their
  continuous glucose monitoring sensor and receiver in a unit that is
  *not* part of a pump:


  http://wwwp.medtronic.com/Newsroom/NewsReleaseDetails
do?itemId=11528845808
52&lang=en_US

  From the picture, it appears to be the same sensor and transmitter they
  are using with the 522/722 pumps, but this unit will position them to
  compete directly with Dexcom in the CGMS market for those users not
  using pumps at all, or using pumps other than the 522/722.
..
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Date: Mon, 17 Jul 2006 23:43:50 -0400
From: Elizabeth  Blake <email @ redacted>
Subject: [IP] My appointment with the CDE today

I saw the nurse practitioner/CDE today.  At my last appointment back
in April she told me to stop taking the Lipitor and fosinopril.  Back
in April my A1c was 4.9 and I had been having many bad lows, and she
chewed me out for that and for not calling her about it.I let her
make a bunch of changes to my pump settings at the time, raised my BG
targets etc.

So today the results of my lab tests were:
A1c: 6.3 - she was ecstatic while I was a little disappointed.  I've
been in the 5 range for so long and I know that I was in that range
due to many lows, but still...  I would have been happier if it was
6.0 and that would have satisfied her as well.
Blood Pressure: 110/60
Total Cholesterol: 166
LDL (bad cholesterol): 77
HDL (good cholesterol): 82
Triglycerides: 36

So all of my numbers are good even without the medication.  I have
really been trying to watch what I eat.  I've been easing up on the
salt shaker and have cut way back on my meat consumption.  I have
chicken or turkey once or twice a week now.  I drink skim milk and
use other fat free or very low fat dairy products.  Egg Beaters
instead of eggs most of the time, although I like a hard boiled egg
once a week or so.  I'm eating a lot more veggies and beans.  She
told me not to lose any more weight, which is always nice to hear!

Today she also changed my insulin:carb ratios for lunch and
dinner.  Lunch is now 1:25 and dinner is 1:28.  My basal rates from
8pm-9am were all lowered a bit.  Hopefully all of the changes will
work out.  I had been going low again after dinner and during the
night.  I had to eat a snack before bed or else I'd wake up low.

So this was probably the best visit I've had with her.  She only
yelled at me because I was disappointed in my A1c.

I also got new prescriptions for strips & HUmalog and mailed those
away to Caremark this afternoon.  Hopefully there won't be any
problems getting them filled.  I'm due for a strip refill at the end
of the week and if Caremark takes too long I might have to go back to
the evil pharmacy for a refill on my old script.


- --
Liz
Type 1 dx 4/1987
Minimed Paradigm 715 5/2005
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Date: Mon, 17 Jul 2006 22:13:00 -0700
From: Antonio <email @ redacted>
Subject: Re: [IP] Minimed gets FDA approval for CGMS separate from pump

It looks like the 522 without the reservoir and infusion set.  I'm
waiting for the next generation to get it, so I'll be glad when that
happens...

Antonio in LA,Age 40, Type 1 since 1993
MiniMed Paradigm 515, OneTouch Ultra, MiniMed Carelink and PAL software

Eric Jensen wrote:
> Looks like Minimed just got approval for a standalone version of their
> continuous glucose monitoring sensor and receiver in a unit that is
> *not* part of a pump:
>
  >
http://wwwp.medtronic.com/Newsroom/NewsReleaseDetails
do?itemId=1152884580852&lang=en_US
>
> >From the picture, it appears to be the same sensor and transmitter they
> are using with the 522/722 pumps, but this unit will position them to
> compete directly with Dexcom in the CGMS market for those users not
> using pumps at all, or using pumps other than the 522/722.
..
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Date: Mon, 17 Jul 2006 22:19:27 -0700
From: Antonio <email @ redacted>
Subject: Re: [IP] My appointment with the CDE today

Good job and congratulations on excellent numbers!

Antonio in LA,Age 40, Type 1 since 1993
MiniMed Paradigm 515, OneTouch Ultra, MiniMed Carelink and PAL software

Elizabeth Blake wrote:
> So today the results of my lab tests were:
> A1c: 6.3 - she was ecstatic while I was a little disappointed.  I've
> been in the 5 range for so long and I know that I was in that range
> due to many lows, but still...  I would have been happier if it was
> 6.0 and that would have satisfied her as well.
> Blood Pressure: 110/60
> Total Cholesterol: 166
> LDL (bad cholesterol): 77
> HDL (good cholesterol): 82
> Triglycerides: 36
>
> So all of my numbers are good even without the medication.  I have
> really been trying to watch what I eat.  I've been easing up on the
> salt shaker and have cut way back on my meat consumption.  I have
> chicken or turkey once or twice a week now.  I drink skim milk and use
> other fat free or very low fat dairy products.  Egg Beaters instead of
> eggs most of the time, although I like a hard boiled egg once a week
> or so.  I'm eating a lot more veggies and beans.  She told me not to
> lose any more weight, which is always nice to hear!
>
> Liz
> Type 1 dx 4/1987
> Minimed Paradigm 715 5/2005
..
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Date: Tue, 18 Jul 2006 05:53:20 -0400
From: "John S Wilkinson" <email @ redacted>
Subject: RE: [IP] CGMS and reasonable post prandials

JAMA  Vol. 295 No. 14, April 12, 2006
Activation of Oxidative Stress by Acute Glucose Fluctuations Compared With
Sustained Chronic Hyperglycemia in Patients With Type 2 Diabetes

Conclusions:  Glucose fluctuations during postprandial periods and, more
generally, during glucose swings exhibited a more specific triggering effect
on oxidative stress than chronic sustained hyperglycemia. The present data
suggest that interventional trials in type 2 diabetes should target not only
hemoglobin A1c and mean glucose concentrations but also acute glucose
swings.

http://tinyurl.com/z9nko

John S Wilkinson,
Rome, New York




- -----Original Message-----
From: email @ redacted
[mailto:email @ redacted] On Behalf Of Bob Kerns
Sent: Monday, July 17, 2006 8:32 PM
To: email @ redacted
Subject: RE: [IP] CGMS and reasonable post prandials


  How high should our peaks be? As low as possible. Even if the peaks do no
more harm than their  impact on your A1c, reducing your variability will
allow a beter A1c without increasing your risk of hypoglycemia.

"Close to 400" is high.

  Anyway, the technique you describe -- using a lowered temp basal, and
taking that insulin as an immediate bolus -- has a name: Superbolus. It
really does help.

- -----Original Message-----
  From: email @ redacted
[mailto:email @ redacted] On Behalf Of
Susan Fisher
Sent: Monday, July 17, 2006 15:10

What are we to expect as our PEAK after eating?

The ADA guidelines are for 2 hrs after eating.

I want to know what you think is a reasonable number 30 m to 1 hr after
eating.

I fear that THIS is where my bad a1c's lie :(

My dexcom has proved my basals accurate to slightly overagressive
(downward trends) while fasting.   My overnights are rock stable.
Everything is stable.

But if I eat more than 30 g at a meal, I skyrocket to close to 400...
but am of course back in range by the 2 hr to 3 hr point.

I never imagined my peaks were that bad :(

I see symlin in my future :( bah!   For now, I am bolusing 30 m. prior
to eating.   Next step is to bolus extra and temp basal LOWER after
eating (attack the peak with a little extra, but don't crash 2 hrs
later)....
++++++++++++++++++++++++++++++++++++++++++snip+++++++++++++++++++==
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Date: Tue, 18 Jul 2006 03:43:25 -0700 (PDT)
From: Tanya Cook <email @ redacted>
Subject: [IP] Brad and CGM

  Thanks for the info. Brad. I have to see the CDE next month after vacation
 I
believe she wants to hook me up the the minimed Guardian for a few days and
see
what happens? My husband isn't too convinced that the CGM's are the best
resource right now because they are so new and not covered by insurance. But
I
am trying to convince him it is the best device available right now for the
situation I am in, hypo-unawareness.
Hope it continues to give you good results!

Tanya


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Date: Tue, 18 Jul 2006 03:48:46 -0700 (PDT)
From: Tanya Cook <email @ redacted>
Subject: [IP] Re: flying with the pump

  I haave never had a problem with flying with my pump. When walking through
the
screening area, they just ask my what is at my side, and I tell them insulin
pump, and I walk through. I have never set off any alarms.

Tanya

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Date: Tue, 18 Jul 2006 07:11:52 -0400
From: "Pollard, Marie" <email @ redacted>
Subject: RE: [IP] Re: Is anyone using inhaled insulin?  Opinions?

dLife did a story on inhaled insulin on Sunday past.  Since the inhaled
insulin goes to the lungs and all the research (long time use) has not
been done, they don't know how it effects the lungs when using it for
years.  The man using it still had to take a shot of long acting
insulin.

- -----Original Message-----
From: email @ redacted
[mailto:email @ redacted] On Behalf Of Denise Owens
Sent: Sunday, July 16, 2006 12:17 PM
To: email @ redacted
Subject: [IP] Re: Is anyone using inhaled insulin? Opinions?

We are wondering if anyone has experience with inhaled insulin?  If so,
what is your experience?

Denise[IMAGE]
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End of insulin-pumpers-digest V9 #941
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