The Watering Hole

[beergeek]

Although can giver herself shots still, its more difficult with some of the problems that come with being diabetic for 30 years (loss of sensation in the extremities, retina degeneration which made her partially blind, etc.)

I hope she's not still using a vial and syringe.

http://www.opticlik.com/home.do

http://www.insulindevice.com/innolet/features.asp

[GRDadof3]

I hope she's not still using a vial and syringe.

http://www.opticlik.com/home.do

http://www.insulindevice.com/innolet/features.asp

We actually used the NovoPen Junior until we switched our daughter to a pump:

http://www.insulindevice.com/novopen_jr/demo.asp

It's nice, you just dial up the dosage, stick it, push.

[MAU]

Not all diabetics are candidates for the pump still. Lots of changes have been made, and lots are coming, but it still doesn't work for all.

[snoogit]

I hope she's not still using a vial and syringe.

http://www.opticlik.com/home.do

http://www.insulindevice.com/innolet/features.asp

She'd go to the click pen, if her insurance would get off their a**es and approve it already. We've had to fight tooth and nail just to get any support out of them I guess one of the big concerns is they don't make cartridges for Humalog, which is what she uses now (along with Lantus) Its finally to the point we can get something out of them, and move her to a better delivery system. But my mother definitely doesn't want a pump, she is adamant about that.

Edited February 2, 2007 by snoogit

[GRDadof3]

She'd go to the click pen, if her insurance would get off their a**es and approve it already. We've had to fight tooth and nail just to get any support out of them I guess one of the big concerns is they don't make cartridges for Humalog, which is what she uses now (along with Lantus) Its finally to the point we can get something out of them, and move her to a better delivery system. But my mother definitely doesn't want a pump, she is adamant about that.

We got a click pen free from our Doctor. Then they would write scrips for the Novolog cartridges, and our co-pay was just like other prescriptions. We still gave Lantus via syringe and vial once a day.

That's something that I hear a lot of adults say, and it puzzles me. I guess people are just adverse to change, but our daughter's A1C's have gone from averaging about 10 - 11, down to 7.5 - 8.2. It's just amazing. The next technology we are looking at is the CGM System (Continuous Glucose Monitoring System). It's unbelievable. We went to a seminar sponsored by Medtronic about it and it gives you Real Time blood glucose readings every 5 minutes (or 288 readings a day). The beautiful thing about it is that you know not only where you are, but where you are going. It gives you indicator arrows with alerts if your blood glucose has three or more readings in a particular direction, so that you can act on it. And if you have the Medtronic pump, the two devices will communicate with each other. We found out that even if you check blood sugars 6 - 7 times a day with finger pokes, the average diabetic is only within acceptable target range about 30 - 40% of the time. That greatly affects A1C's. Just waiting for it to get FDA approval for kids.

MAU, I was curious what diabetics are not candidates for the pump (if you don't mind me asking)?

Sorry for the rambling post.

[MAU]

MAU, I was curious what diabetics are not candidates for the pump (if you don't mind me asking)?

Ones like my brother who, while he's taken amazing care of himself over the past 20 years since being diagnosed, still has serious problems with their diabetes. Now that he's gotten older and so many improvements have been made in insulin he doesn't have problems like he used to, he still has drastic ups and downs. His body is already deteriorating. It's not fair that he takes such good care of himself (compared to a lot of diabetics out there who eat like crap or drink or smoke) but his body still fails him.

Anyway, i'm not in on all of the specifics, but his specialist (at UofM) has been recommending him to hold off on the pump till some more advances are made. Not exactly sure why.

[GRDadof3]

Ones like my brother who, while he's taken amazing care of himself over the past 20 years since being diagnosed, still has serious problems with their diabetes. Now that he's gotten older and so many improvements have been made in insulin he doesn't have problems like he used to, he still has drastic ups and downs. His body is already deteriorating. It's not fair that he takes such good care of himself (compared to a lot of diabetics out there who eat like crap or drink or smoke) but his body still fails him.

Anyway, i'm not in on all of the specifics, but his specialist (at UofM) has been recommending him to hold off on the pump till some more advances are made. Not exactly sure why.

I'm sorry to hear that. My cousin's husband is a "brittle diabetic". He's probably about 35 or 40 yrs old now. He used to have severe highs and lows every week, and went to the emergency room often (probably once a month). He went on a pump about 4 years ago, and his situation has totally changed for the better. He now goes months without having any severe highs and lows, and I don't think he has had to go the emergency room since. It might be worth it to get a second opinion on that.

I know your brother is older, but we've heard from several people around the state that a lot of endocrinologists are hesitant to recommend the pump, especially in the Lansing area. Who knows why. Here at Devos Children's, they are much more into the technology, and have thousands of kids in their practice on pumps. They are also putting a group of children on a trial run of the CGM system this year. They are considered one of the foremost practices in the midwest for Type 1 Diabetes. I don't know if they treat adults though, but it might be worth checking in to. Dr. Wood is the head of the practice.

[MAU]

I'll suggest it to my brother - thanks!

[GRDadof3]

I'll suggest it to my brother - thanks!

Let me know if I can help (via PM). I can even find out who my cousin's husband went to.

[Veloise]

It's not fair to turn a presidential funeral into a rally cry -- thats what it felt like.

Amen, bro.

"We are the deciders." --Molly Ivins, in her final essay

[beergeek]

MAU, I was curious what diabetics are not candidates for the pump (if you don't mind me asking)?

Here's a very brief synopsis: http://www.mayoclinic.org/endocrinology-rst/qanda.html

First, pumps are pretty tech-heavy. To make broad generalizations, the elderly or those who are not tech-friendly do poorly. Many people think a pump means less frequent fingersticks but it's actually the opposite - plan on 6+ checks a day for someone on a pump. The person has to be motivated as a pump is labor-intensive, it's certainly easier to do 2 shots of 70/30 a day and call it good. Pump users also have to be able to count carbs, which is difficult for many. But the long-term benefits of glucose control are worth the effort for some. At work, I tend to see the worst cases (average about 3 amputations/week here for uncontrolled diabetics), and God-knows-how-many diabetic neuropathy patients I have per week. Preventative care goes a long ways.....

Edited February 3, 2007 by beergeek

[GRDadof3]

Here's a very brief synopsis: http://www.mayoclinic.org/endocrinology-rst/qanda.html

First, pumps are pretty tech-heavy. To make broad generalizations, the elderly or those who are not tech-friendly do poorly. Many people think a pump means less frequent fingersticks but it's actually the opposite - plan on 6+ checks a day for someone on a pump. The person has to be motivated as a pump is labor-intensive, it's certainly easier to do 2 shots of 70/30 a day and call it good. Pump users also have to be able to count carbs, which is difficult for many. But the long-term benefits of glucose control are worth the effort for some. At work, I tend to see the worst cases (average about 3 amputations/week here for uncontrolled diabetics), and God-knows-how-many diabetic neuropathy patients I have per week. Preventative care goes a long ways.....

I'd have to disagree with the first part. We went from 4 - 5 shots per day to 0, which was a much bigger benefit than trying to reduce finger-sticks. We do 5 finger-sticks a day and a site change every 3 - 4 days. A pump is much less labor intensive than all the rigamarole required for calculating your carbs, calculating your coverage, drawing the correct dosage of insulin into the syringe , tapping out the bubbles, prepping the site, finding a site that hasn't been overused, making sure you hit fat tissue, making sure you deliver the whole dosage, disposing of the sharpy; and its as easy to operate as a cell phone. Like all technology, once it's programmed (with your doctor), then all your insulin/carb ratios for different meals are already calculated, so it's as easy as "punch in the mealtime, punch in the carbs, deliver". If you decide you're still hungry at the end of your meal, you can give yourself another bolus in two seconds. Plus, you can set it for different basal rates for different times of the day, something that is impossible to do with long-acting Lantus. It's definitely not for people who have poor control now, but for those with good control to make it better. And you can review your blood sugar levels with your doctor every 6 months or so, and reprogram your ratios if need be.

And finally, for children, it's much easier for the school secretary to give a meal bolus on a pump than give shots.

The major downside is the cost if not covered fully by insurance.

*I'm not affiliated with any pump manufacturers, and I'm not a doctor.

[twoshort]

Got my issue of GR Mag today, someone amongst us (and urbanplanet as a whole) got some serious press time

Edited February 3, 2007 by twoshort

[beergeek]

I'd have to disagree with the first part.... A pump is much less labor intensive than all the rigamarole required for calculating your carbs, calculating your coverage

You missed my point. You're describing intensive insulin therapy (basal-bolus). The VAST majority of diabetics won't do more than 2 doses of 70/30 a day, or one dose of Lantus a day. They don't count carbs, they check blood glucose once a day if that (and it's random whether it's pre- or post-prandial, so trying to evaluate control with the readings is useless). Those that are dedicated enough to do basal bolus are the easiest to transition to pumps...

And I am a doctor (although I'm not a physician...fo' real).

[Veloise]

Got my issue of GR Mag today, someone amongst us (and urbanplanet as a whole) got some serious press time

Is there a piece on the Georgetown Grange and its square dances? GRMag came out and took photos, probably catching me in some.

[GRDadof3]

You missed my point. You're describing intensive insulin therapy (basal-bolus). The VAST majority of diabetics won't do more than 2 doses of 70/30 a day, or one dose of Lantus a day. They don't count carbs, they check blood glucose once a day if that (and it's random whether it's pre- or post-prandial, so trying to evaluate control with the readings is useless). Those that are dedicated enough to do basal bolus are the easiest to transition to pumps...

And I am a doctor (although I'm not a physician...fo' real).

I'm only familiar with Type 1 diabetics and intensive insulin therapy (basal/bolus) 24 hours a day. I honestly have no idea what Type 2 diabetics go through, or even whether a pump is worthwhile. To me they're two completely different diseases.

[dtown]

Got my issue of GR Mag today, someone amongst us (and urbanplanet as a whole) got some serious press time

Who was that?

[Rizzo]

^I read an article about the The Grand Valley A.I.A. Chapter and how it started a project on the architecture of the Grand Valley Region. The two individuals interviewed for the article, A.I.A. members Mr. Lott and Mr. Gillette are UPrs. I believe there are others.

I'm not sure if that is what twoshort was referring too...

Edited February 4, 2007 by Rizzo

[twoshort]

^I read an article about the The Grand Valley A.I.A. Chapter and how it started a project on the architecture of the Grand Valley Region. The two individuals interviewed for the article, A.I.A. members Mr. Lott and Mr. Gillette are UPrs. I believe there are others.

I'm not sure if that is what twoshort was referring too...

I was referring to the interview w/ our fearless moderator....

[Nitro]

......Mr. Gillette are UPrs. I believe there are others.

Holy crap, I didn't know my dad was on this board.............

He's the only Mr. Gillette I know!!!

Edited February 4, 2007 by Nitro

[GRDadof3]

I was referring to the interview w/ our fearless moderator....

I actually did that interview with Curt way back in November.

[egrguy]

Fifth Third secretive about changing its colors

I wonder if this signals a sale of the bank in the future? Interesting... I love to speculate!

Edited February 6, 2007 by jdkacz

[twoshort]

I wonder if this signals a sale of the bank in the future? Interesting... I love to speculate!

Why would they spend all that money on new signage if they're just going to sell?

[egrguy]

Why would they spend all that money on new signage if they're just going to sell?

You dress up for the interview...

I was just following Chris's examples that were given, but I don't think its out of the realm of possibility, especially as 5/3 is a regional banker.

[GRDadof3]

The NY Times article about Grand Rapids and walkability has now hit the China Daily.

I think GR has gotten more publicity in the last month than ever in its history.