blog

17.11.24

diabetes tech corner

Woah hey! Recently I’ve had an opportunity to come across some new diabetes tech - now I’ve had a while with each I wanted to use it as an opportunity to yap! The technology I use for diabetes management is something I interface with every day, and slight changes bring some significant impacts on my daily routine. This may be a little too expository, but I think it’s real interesting!
(I'm going to be including a good amount of background information and a bit of explanation of existing tech for context, apologies!).

At my recent endo appointment I had two things come up - the simpler of the diabetes related concerns was getting approved for subsidy for a dedicated reader that interacts with my Continuous Glucose Monitor*. The other I’ll get to in a second!

*a device that, as you probably guessed, continually monitors glucose. It graphs this information across the day with many more data points than a finger prick at a few points would, without the hassle of drawing blood. It only needs to be replaced every few weeks, too. While with its quirks (a small margin of error in accuracy, not working for 10 minutes at a time for whatever reason), it is really nice having that information available in a way that’s much easier to visualise than single, fairly isolated data points and placing yourself in time. Very useful things

CGM

The company that makes my glucose monitor I’m with at the moment (Abbott, FreeStyle Libre 2) is fairly reliant on its mobile app, utilising NFC scanning available in most new phones. Having an app is a pretty good deal in some ways – most folks have their phone on them always. It’s an existing piece of tech that cuts out the barrier of having to add to the list of phone-wallet-keys-insulin-needles-lollies when leaving the house. Any easing of small inconvenience when it comes to chronic disease management is definitely felt.
It does come with downsides though, which funnily enough comes from the same place as the upsides. Sticking on the functionality of an important medical device to your phone, as I’ve found, is more of a liability than I’m comfortable. Firstly the battery, of course, which is divided unevenly amongst the many daily functions of a smartphone. Additionally, staying in contact with family + friends, while an important part of my life, is not something I want/need every second of every day. I’ve had this app-reliant CGM for maybe 2.5 years now, and it’s become pretty tiring not having the choice to not keep my phone with me at all times. The liability is one of time, too: opening my phone opens up the possibility to spend much more time than I initially intended. ADHD, Silicon Valley psychologists, poorly trained discipline etc etc etc etc

two more baby complaints

Ok so! All of this to say: I got a subsidy for a dedicated sensor that I can carry around instead of my phone. Wowza! Now I can exist safely without having a phone on me always. The last time I looked into this there was this dumb form that I had to give to my endo and GP and ask for a reason I couldn’t just use the app (much cheaper for them to develop for, I guess), but this time I couldn’t find it. I don’t know if the system’s changes or I was just looking in the wrong places but we got here! I was worried about forking out $100 but ended up being totally free through the NDSS (yayyyy we love public health schemes).

It is a pretty groovy device. Has some alarms when it can detect blood sugar is out of target range, same as the phone can, but it has the option to vibrate or make a small/big noise rather than the single option of the phone alarm. Which loud as fuck and Not The Best if you’re sharing a bed with someone/in a public space ever.

I think my only complaint is that it’s really lightweight. I have flung it a few times on bad days with tremors. But idk maybe I’ll just tape a rock to it or something. It’d be cute if it had a little loop that I could tie some thread to (like those flip-phone charm chains) so I could carabiner it to pants instead of having it in one of many pockets or bag compartments. Might DIY this, glue an eye bolt to it or something. But that is all.

NovoPen 6

The other thing I brought up to my endo was not something I was expecting would provide an opportunity to explore new tech! But here we are. Basically, my metabolism is a bit silly in the mornings and it’s hard for my insulin injections to keep up. Injecting 20 minutes before eating is recommended for bolus injections, but I rarely have the foresight or time to plan as such. A few other factors impact my blood sugar at that time, and they get pretty high after breakfast irregardless of what I eat.

Compensating with more insulin results in very quick crashes mid-morning which is not great for many reasons including brain damage (uh oh!), and mostly just feeling physically like shit the rest of the day. Sometimes, though, the sugar just won’t come down and it’s impossible to tell which it is until hours afterward, even with routine. Obviously also not very good. So! My endo told me about another insulin available with faster actuation – something that’d curve the grey area of the sharp raises in BGL in the morning. Good news: it exists, it’s on the NDSS, it’s a similar solution to an insulin I’ve been on for many years now. Less good news: options for how it’s sold is limited, and it has been only distributed in vials the past few years. My understanding is that standalone vials are often only used with proper big syringes, and that would be a really annoying process to encounter multiple times, daily. Compared to the flexpens, I'm used to, at least. (For context, a disposable pen with a vial preinstalled, and an easy-to-use ticker to measure dose) Better News: these vials have a reusable pen specifically made for them, that work exactly the same as the flexpens. Woohoo!!

NovoPen 6 babeyyyyyy

This isn’t actually super high tech, all things considered – at least compared to the flexpens. It's kinda the same thing. It is nice though, replacing the vials themselves instead of the whole pen. I’ve always felt a little wasteful throwing out all of the usable material that comes with each of the flexpens. It’s also kinda heavy? It reminds me of a really fancy mechanical pen. A good hunk of metal. The niftiest of all, though, is the memory it has for previous doses. Whenever you inject, it remembers the dosage, and starts recording the time since then. I cannot count how many days have been thrown out by muscle-memorying the wrong dosage or just straight up forgetting if I’ve injected yet. Even though this doesn’t happen super often, it’s great having the peace of mind to be able to look at what my last injection was.
Great news: it can share this memory with a CGM reader to automatically add data points of when insulin was injected, and how much, to the blood sugar graph. Really wonderful for reviewing patterns and adjusting dosage/eating/whatever.
Less great news: it only works with the app. Oops! Too late.

The insulin itself is working well so far, though! Initial dizziness and some other physical symptoms (maybe just the heat) have subsided. Definitely helping a little with the morning BGL spikes, but still trying not to give myself too many hypos. It's an adjustment period so far!

All good things considered, I have do have one gripe with the build of this pen. I mentioned before that it's a bit heavy, and it kinda bugs me. Sometimes I adjust my dosages while the needle is already in me (lazy, maybe, but injecting multiple times a day has exhausted any motivation to think things through 100% before it's in my body) and this pen makes it feel real clunky. It's a two handed affair instead of one handed. The plunging of the injection itself is a really smooth mechanism, but makes it hard to stop a unit or two short if needed. Can't really decide if I like that or not! These are the smallest of small problems but these things are a little uncomfortable (compared to what I'm used to) and it's uncomfortable often.

Anyway! Thanks for reading. These things are most likely going to be in my life for years to come, and I'm glad I've got the space to meditate on them a little. Appreciate you reading, hope life is good!
x Lucah