... test, don't guess!

Okay, technically, the folks over at dLife say that, but it has been known to come out of my mouth a time or two, also.

Since blood glucose testing is so important for people with diabetes, I love it when I hear about new forms of testing technology. For years, us parents of kids with type 1 have been wanting a cell phone that also acts as a glucose monitor. This would cut down on the amount of "stuff" our kids have to tote around and would give us the comfort of knowing that our kids were testing when away from home. Well, that wish is now a reality. Enter the GlucoPhone!

I ordered a new GlucoPhone (GP as I will refer to it henceforth) last week for my daughter. By Friday it had arrived and was waiting for me on the kitchen counter when I got home from work!

Currently Verizon is the only carrier to work with the GP. Hopefully this will change soon, so that it is more accessible to others who use different carriers. In the box we received a brand spanking new Verizon VX5200 cell phone. This phone is far superior to my daughter's current, pay-as-you-go Virgin Mobile phone. We also received a second box that contained the "GlucoPack," the part of the device that attaches to the VX5200 and incorporates the blood glucose testing aspect. We also received a lancing device and 25 free test strips (I ordered an additional 50 strips as well). After taking the phone to a Verizon Wireless store to be activated, I spent all of 5 minutes setting up our online account at GP's website. Then I started playing!!! So here is how it works.


First, you must initialize the GP program on your phone and select "Check Blood Glucose". The screen then prompts you to insert a strip and apply blood to the strip. The prompt is displayed but can also be heard over the speakerphone, which is wonderful for smaller kids who maybe can't read well just yet. (Note: the sound can be turned off, for those requiring a more discrete testing environment.) The test strips look similar to most and require a 3 μl blood sample size, which is rather large compared to her Freestyle Flash meter (.3 μl ). But it gets the job done, right!?!?! Yes, yes it does. I poked myself while I was playing around, since my daughter was out and about. My first reading came out at 110 (the test using our Precision Xtra meter said 105 from the same drop of blood -- so overall it was pretty accurate).

When setting up your account online you can specify a cell number to use to send each test result as a text message. So once you receive the test result, you press the soft key for "send" and you get a message saying "sending the result". Once the result is sent you see a confirmation screen that actually thanks you for testing (which I absolutely love!) and says, "Your result has been sent successfully. Check your records at www.glucophone.net".

Within a second of seeing this confirmation screen on the GP, I received the text message on my cell phone that said, "Samantha's Blood Glucose is at 110 mg/dl."




WOW!!! It was virtually instantaneous! I am quite pleased with the GlucoPhone so far and hopefully it will continue to live up to these standards.

... knowledge is power

NOTE: This post was moved from my old Vox blog and was originally posted on April 9th, 2007.

I guess I should mention what the insulin pump actually does for a person with diabetes for those not in the know. My pal, Jen, asked me about it on the phone tonight and I realized that in all of my postings I never mentioned what pumping is all about.

What is insulin anyway?
In order to accurately describe pumping, it is necessary to understand the basics of how insulin works in the body of a person without type 1 diabetes. For all of us without diabetes, our pancreas regulates our blood sugars by releasing two different hormones, glucagon and insulin. When going about your daily tasks, the pancreas lets out small doses of insulin constantly. It keeps the blood sugar range from going too high by increasing the insulin to turn food into energy. It keeps the blood sugar from dropping too much by releasing glucagon (this stimulates the release of glycogen from the liver), ultimately raising the blood sugar. The pancreas is a well oiled machine that keeps our blood sugar in really tight control. It is thought that even before we take a bite of food at a meal, our pancreas has already started delivering higher levels of insulin to balance with the food we consume.

Insulin is necessary to take every bit of food we consume and turn it into energy. But people who have type 1 diabetes no longer make enough insulin to turn food into energy. Without insulin the blood sugar rises to high levels and the body compensates by making you drink lots of water to dilute the level of sugar. When this happens no sugar enters the cells of the body and therefore it cannot be used as fuel. In response the body thinks it is starving because it has no sugar available for use in the cells. So it starts burning fat stores for fuel. The body literally starts eating itself. All of this makes a person with developing diabetes very sick. Without treatment this person would die in a very short amount of time (weeks, not months).

Insulin shot

Injections ... for now
My daughter has been on insulin injections since she was diagnosed at the age of four. She doesn't just have one or two shots per day, she has more like four, and when she's sick you can easily double that number. I don't say this to complain or to make you feel sad, I tell you this so you'll understand what we currently are doing to keep her blood sugar in good control. For type 1 you cannot take a pill to treat diabetes. You can't just watch your diet and eveything will be oaky. You must take insulin or you will die ... soon.

Pumps

Pumping!!!
The pump makes things so much easier. First of all, instead of getting poked with a needle four times per day, you only get a needle poke every other day. The insulin is delivered through tubing that connects to the body, called an infusion set. The other end of the infusion set connects to the pump, which is a small electronic device (the size of a pager or cell phone) that contains a reservoir with insulin. The computer inside the pump helps deliver small little bits of insulin throughout the day, very similarly to the way the pancreas does. So with the new pump, my daughter will get a super small dose (we are talking tenths of units here, folks) every three minutes. This function aims at keeping her blood sugars steady throughout the day. Because this is a machine and not an actual human organ, it doesn't work anywhere near as well as the pancreas, but it is much better than shots. In addition to the little bits of insulin delivered during the day (called basal dose), the pump also delivers a bolus dose.

Infusion set

A bolus dose is a dose of insulin that is delivered when the blood sugar is too high or at a meal (or snack) time based upon the amount of carbohydrates eaten. So right now if Samantha wants a couple of pieces of candy for a snack, she either has to take a pass and miss out on the Easter candy (because the insulin needed to cover that amount of food would be too small to administer via syringe) or she would have to eat a little more than a couple of pieces so that she could receive a bolus dose by shot. But once she starts on the pump she can have those two pieces of candy, enter them in the pump and the pump will deliver the right amount of insulin to cover those consumed carbs. When dinner time comes around we count up every gram of carbohydrate eaten and we input it into the pump. Based upon a bunch of calculations and definitions (I won't bore you with them) previously set up in the pump's computer, the pump recommends a meal bolus dose. We can accept the recommended dose or we can modify it. Similarly, when the blood sugar rises out of target range the pump recommends a correction bolus dose to bring it back into the preset range. Once the dose is accepted it is "pumped" out of the reservoir through the tubing and into the body.

The benefits of pumping over injections are many. First of all, there is a reduced risk of low blood sugars (which happen regularly with injections). Second, it keeps the blood sugars from fluctuating so much and if everything is set up correctly, it can lead to much better blood sugar control. Good blood sugar control reduces the risk for complications (blindness, heart disease, amputation, kidney failure, etc.). Anything that does that and allows my daughter more freedom with food and fewer needles, makes me a very happy mom!

... thank god for technology!

NOTE: This post was moved from my old Vox blog and was originally posted on April 26th, 2007.

Yay! We are live with insulin! Everything went really well at pump start today! Samantha has a kidney infection, so that complicates matters a bit as infection makes her more insulin resistant. But, we are doing good! Here are some pics.

This is Samantha's infusion set. She has 10 viable sites on each side of her tummy and 6 viable sites on each side of her upper tush. Having so many site options to rotate will greatly reduce scar tissue build up and site problems! The infusion set in this picture is a different type of set she will normally use. This one is called the Comfort Short and requires a manual insertion (using an introducer needle -- no cool little insertion device with this guy). We decided to give it a try so that we would know how to insert a different set if she does not do well on her prescribed sets. This set goes in at an angle and works great for kids without many fatty areas. You need fat for sub q insulin delivery! Luckily my kid has some padding so chances are the other sets will do just fine.

Skb infusion

This second photo is the pump itself. We all started calling it Greenie before it ever showed up and the name just stuck. Although Samantha did inform us in the car on the way home that Greenie is in fact a girl pump. This home screen shows the name and current basal rate. Basal rate is the rate at which the small little doses of insulin are delivered over the period of one hour. This screen shows that she gets .7 units of insulin per hour this time of night. Since that .7 unit is split up into tiny doses delivered every 3 minutes, the actual doses delivered are insanely small.

Greenie

Picture number three and four are her supply box and the typical supplies needed for one set change. The box is kept on the kitchen counter for quick access for treatment of lows and set changes. We decorated it together.

Well I guess that's it for now. I am sure I will have plenty of updates in the coming days. Wish us luck on a smooth start!