Shoot Up or Put Up

The Freestyle Lite - with a really rubbish reading

While this tragic world of ours is filled every day with calamity, conflict and catastrophe there are perhaps a few rays of sunshine that poke through the heavy gloom, which give us something to live for and stop us from bashing our owns heads in with a handy paperweight.

My personal happiness list includes waking up next to my wife (ahhh!); roast chicken and the guitar solo from Iron Maiden’s Hallowed by thy Name. With these three things in place I’m sorted and life is good.

But now, having used Abbott’s Freestyle Lite blood glucose meter for the best part of a week, there is now another bright ray of sunlight in the gloomy slough of despond that is diabetes – as it is, in fact, a bloody good meter.

First impressions of the Freestyle are great – it’s absolutely tiny, sleek and looks pretty cool. If only it’d had been in black rather than utilitarian blue it would have scored full marks on the sexiness scale, but we can live with it.

The sample size is a tiny 0.3μL but this is slightly let down by the longish testing time of five seconds – if it had been 3 seconds I would have been ecstatic (well, perhaps not ecstatic exactly – it is only a meter after all and everything’s relative).

Speaking of the test strips, they’re a bit odd. Rather than sucking up your bloody gore through the bottom of the strip as with pretty much every other meter out there, you aim your finger at the side of the strip instead. Once you’ve worked this out (of course, I never read the manual and so it took me a while) the strips are just as good as any other with pretty good “slurpiness”. [Update June 2010 - this, and some other Abbott meters, now come with Abbott's new strips which include their "ZipWik" technology which claims to suck up your blood even better than the old strips. This is a resonable claim because they do - they're now probably the best and most slurpy strips on the market at the minute].

The only slight downside with the Freestyle’s strips are that you don’t actually get to see your blood being sucked in – it’s all hidden away under a black section of strip. I find seeing your life-blood being drawn in is useful feedback to ensure you’re actually doing things correctly.

However the strips do have a great, great feature which more than compensates for this minor gripe. As you know, with most strips and meters, if you don’t put enough blood on the strip the meter will churn away as usual and then display an error message asking you to repeat the test. Nothing is more infuriating – after you’ve struggled to get a tiny drop of blood out of stone-cold fingers – than the meter moodily rejecting your sacrificial blood offering. But with the Freestyle Lite, if the meter detects you haven’t put enough blood on it lets you know and gives you another 60 seconds to squeeze another drop out. This is intensely good – it saves a tonne of frustration and stops you wasting test strips, which I guess is a boon if you actually have to pay for them (God bless the NHS!)

The Freestyle Lite has all the usual meter accoutrements – averages over 7, 14 and 30 days; it can be plugged into a PC to produce fancy graphs and the irritating beep can thankfully be turned off.

But I’ve left the best for last – this is the first meter I’ve tested that actually passes the 4am hypo test because – wait for it – it has an internal LED that lights up the test strip! Halle-bloody-luiah! This simple addition allows you actually see where your blood is on your finger, instead of having to randomly stab the test strip around in the pitch dark. Once you’ve successfully sucked up enough blood the meter automatically turns off the strip light and turns on the meter backlight. Bloomin’ marvellous! Why this isn’t a feature on lots of other meters I don’t know, it’s just so handy.

So all in all Abbott’s Freestyle Lite is a very good, sexy, well thought out meter – so much so that once I’ve got my prescription sorted out it’s becoming my regular every-day meter; so this particular ray of sunshine is sticking around!

Sample size - 5/5
0.3μL

Test time – 3/5
5 seconds

Test strip calibration – 5/5
No coding required.

Test strip slurpiness – 5/5
[Update June 2010] Excellent, especially with Abbott’s new strips. But not seeing blood being sucked in is a little disconcerting

Memory - 3/5
400 results – enough to be going on with

Sexiness – 4/5
Petite and cool looking – though if it was black it would be cooler!

Beeping 5/5
Beeping can be turned off

4am test – 5/5
With a lit up strip and automatic backlight it’s the acme of meters when faced with a 4am hypo.

Grand total: 35/40

Read about our reviews, or check out the manufacturer’s web site.

I think a unit of insulin is a huge amount. One too many is the difference between me waking up and going to work, or waking up drenched in sweat jibbering complete rubbish and scaring the husband.

Equally, a unit less than I needed for dinner is the difference between a very pleasant evening with friends and an evening spent with my tongue stuck to the roof of my mouth and a fuzzy headache while I battle to get my blood sugar down from the ceiling.

In my world a unit of insulin is a big thing, it’s massive. A unit of insulin to me looks like a biscuit, half an apple, a small yoghurt or 5 fruit pastilles.

I generally use between 50 and 60 units a day (although I get really stroppy when ignorant travel insurance companies ask me how many units I use a day as if the answer will give them any meaningful information, but I digress).  Do you know what 50 units of insulin looks like? Its nothing. Tiny, miniscule, I take at least twice as much medicine to sooth an irritating cough several times a day.

My daily elixir of life boils down to this – less than a teaspoon full!

Learning to drive at 88mph

This is a public service announcement. Very soon there will be a new hazard on the roads in and about Edinburgh. This hazard is particularly lethal and all drivers in the area should use extreme caution when venturing onto the public highways.

Yes, you’ve guessed, I’m learning to drive!

“But Tim”, I hear you cry, “you’re ancient, surely you’ve passed your driving test?” Well, the sad fact is that I’ve got to the ripe old age of 32 without ever having had a single driving lesson (except for an hour on a disused airfield near Bath with my mate Dave ten years ago – but I don’t suppose that really counts).

Up until fairly recently I’ve always been a city slicker, happy to dwell in the pollution, noise and misery of city centres. This may have had it disadvantages (for example, I used to live on the top floor of an utterly tiny tenement flat in the centre of Edinburgh; it was 160 years old and had subsided like mad about a century ago – therefore there wasn’t a single level surface in the whole damned place). However, it did mean I was within easy walking distance of work and the pub. So why bother spending the cash on driving lessons?

But now I’ve moved out to the suburbs and while we live on a fantastic bus route (thanks Lothian Buses!) I’ve run out of excuses and it’s time to book some lessons.

Now, as most drivers will know us pancreatically-challenged pariahs can’t get a full UK driving licence. No, we’re only allowed a limited licence and so we have to re-apply to the DVLA (Driver and Vehicle Licensing Agency) every three years who then make sure we haven’t been mowing down innocent pedestrians while in hypoglycaemic comas at the wheel.

I suppose that’s fair enough really; I wouldn’t want to be in charge of a tonne of quickly moving metal while my BG hovered around 2.0 – that’s just insanity. But what gets my goat (and Alison’s – I know as we were chatting about it via email recently) is that similar rules are not applied to other drivers.

If you pass your test at seventeen a driver with a working pancreas gets a full licence that doesn’t expire until their 70th birthday. That’s just over half a century between passing a simple test and being reassessed – now surely that’s insanity.

Aside from the whole not-producing-insulin thing, diabetics are usually quite healthy – the same cannot be said for the populace at large. Just think of the myriad drivers out there who never have their eyes tested, who might be effected by Type Two and not know or suffer from the zillions of other things that might effect their ability to control a vehicle.

So while I might be a hazard on the roads from now the terrifying thought is that there are already a load of hazzardous drivers out there already.

As a dedicated, old-school web geek (I hand coded my first web site in 1995!) the term “Web 2.0″ is slightly annoying. But we have to embrace technology and all that jazz, so your soaraway Shoot Up now has a page on trendy social networking phenomena(TM) Facebook, which you can find here.

If you’re already a Facebook member, join up and we’ll all have a whale of a time. If not, we’ll delete the page and forget it ever happened.

Yawn!

Boredom comes in many flavours. Waiting for trains that have been delayed yet again by damp leaves or suicidal cows on the line are boring. Watching the end of documentary on geese farming in Essex while you wait for that new comedy to come on the TV is boring. Impatiently waiting your turn in a dank, dripping, seedy Bangkok bordello is boring.

But with the new Bayer Contour blood glucose meter I’ve found a brand new flavour of boring.

Up front the Contour is a perfectly fine meter – it tests your blood and spits out a result, which is I guess what we’re all after in a meter; but the Contour seems to do it without the slightest interesting feature to raise it up above the morass of other meters currently available on the market that fight for the attention of the pancreatically-challenged populace.

Looks-wise Contour is okay, it’s certainly not as sexy as the funky Nano, but it’ll do. I guess. It’s similar in a way to those Toyota Corollas which come in that hideous watery light-blue that seem to be driven exclusively by old age pensioners. It’s not entirely offensive to the eye but it hardly sets the world on fire with an eruption of thrilling colour and design.

In terms of features, the Contour has everything you would expect from a modern meter. On the plus side, it has a reasonable memory for your results and it doesn’t need to be calibrated with each new set of strips which is always a welcome addition.

On the minus side at 0.6μL the Contour needs quite a large sample size which is a bad thing as I prefer to keep my blood in me rather than smeared all over multitudinous test strips. The test time of five seconds is also relatively sluggish but just about acceptable.

Perhaps a redeeming feature is that the Contour can be used in two modes – what I like to call “Idiot Mode” and “Clever Mode”. Idiot Mode does nothing but take your blood and spew out a reading which I suppose is handy if you can’t be bothered faffing about with extra features and functions. However, the “Clever Mode” where you can turn on pre and post meal markers and note unusual readings isn’t really all that clever in that these are functions common to pretty much every meter out there; but at least you have the option to turn them off. Clever Mode also includes an alarm which can remind you to do a test after a meal – again mildly handy for the negligent diabetic.

The Contour generally performs as well as any other meter when it comes to using it in the pitch dark – in other words not very well, meaning you have to turn on the bedside light and wake up your slumbering wife – though I did find the smooth buttons harder than some to use.

So all in all, the Contour is certainly not a bad meter – it does most things reasonably well – but with other meters out there that offer so much more this meter’s going to be confined to the boring bottom of my boring spares drawer.

Sample size - 2/5
0.6µL, hmm somewhat vampiric

Test time - 3/5
5 seconds – slightly sluggish, but acceptable

Test strip calibration - 5/5
No calibration needed. Yay!

Test strip slurpiness - 4/5
Yum, nice n’slurpy

Memory - 4/5
500 readings

Sexiness - 2/5
Dull as a train spotter at Reading station

Beeping - 5/5
Can thankfully be turned off

4am test - 2/5
Smooth buttons difficult to find in pitch darkness, backlight is fine but no light on the test strip

Grand total – 27/40

Read about our blood glucose meter reviews or check out the manufacturer’s web site.

As I mentioned in an earlier post I went along to the Scottish Diabetes Action Plan Consultation organised by Diabetes UK yesterday evening and it was all quite interesting. The meeting was intended to give the Scottish Government feedback on what us pancreatically-challenged ruffians want out of our health service and so, in my view (for what it’s worth) it’s quite important.

The first thing that struck me was the light buffet that was kindly laid on for us. Being a meeting exclusively made up of diabetics it, of course, consisted of ultra high-carb pasta and potato-salad. To rub in this paradoxical smorgasbord all the more, I noticed there were some Diabetes UK “Watch what you Eat” leaflets dotted about, advocating a low GI diet. My sides almost split with the irony of it all, but the soup was nice.

The second thing that struck me was that, not for the first time, I was the one token person-who-wasn’t-retired in attendance. Sorry to point it out – if any of the attendees are reading this – but I have to say I did bring the average age crashing down somewhat. But even saying that, at a positively ancient 32, I’m still not exactly representative of the “juvenile” diabetes community.

I’m pretty sure the east of Scotland has diabetics under the age of thirty and I’m also pretty sure that the lack of young people this is not wildly unusual at these things. So why is this?

To be honest I’ve no idea. Having a say is vitally important in any aspect of life – for example, I think that people who can’t be bothered to vote in elections are contemptible idiots who have no right to complain about any service they receive from government or indeed any action that government takes in their name. It’s the same with healthcare – you have no right to bitch about poor healthcare or lack of NHS funding for pumps or new technologies if you don’t take part in feeding into consultations like these.

After doing all this, you still might not get what you want but, by God, you then have every right to make a nuisance of yourself and bitch, bitch, bitch. And, tell you what, I love bitching!

…thankfully didn’t get a visit from me. A quick update following last Wednesday’s post. The brief version is that insulin pumps and CGMS are wonderful things and at this moment I won’t hear a word against them. Now for the slightly longer version.

On Wednesday evening I stopped taking the evil drugs that were making me need insulin by the bucket. Then I prepared my ropes for a challenging abseil down from the dizzy glucose heights I’ve been frequenting for the past week.

I’d feared a catastrophic plummet down into the Valley of the Hypos where zombies walk freely and glucogel slime oozes down the streets. Where you’re constantly in a cold sweat, your legs are made of blancmange and your body is no longer under your own control.

I secured my safety line by reducing my basal rates down to my pre-drugs level and stopped doubling all carb boluses. Next step was to stake out the low. On Thursday morning I sat quietly, armed with juice box mortars and fruit pastille grenades waiting for the anticipated hypo to sneak up at any time.

My CGMS was never far from my side, I felt like a fighter pilot constantly scanning the radar for incoming attack of the low blood sugar variety.

Then it came. At first a gentle decline, soon gathering pace. I checked my ammo:

• Basal rate reduced – check
• No insulin on board – check
• Verify CGMS reading with finger prick – check
• More sugar on stand-by than I could possibly need – check

The downward trend slowed but continued. I fired a warning shot across the bows and ate an apple. The trend slowed further. At 4.7 with no insulin on board I had my finger on the trigger of the juice box mortar but held my fire. I’ll give that incoming low 20 minutes to turn round and retreat, or else its both barrels with the juice box.

CGMS started to creep upwards giving me scores like a mediocre ice dancing competitor – 4.7, 4.7, 4.8, 5. Success! The Valley of the Hypos will not be receiving visitors today.

Our Scottish diabetic cohorts might be interested to know that the Scottish Diabetes Group is reviewing the Diabetes Action Plan. To help with this, Diabetes UK is hosting a feedback session on the 22nd June at 6:30pm in the Lyceum room of the Novotel in Edinburgh, Lauriston Place.

Like everyone who keeps their finger on the diabetic pulse I’ll be there – so say “hello” if you’re also popping along. I’m the incredibly handsome chap who’ll be sitting at the back (where all the cool kids sit).

Programme – 7pm to 9pm

• Presentation: Better Diabetes Care Consultation
• Questions & Answers
• Completing the Survey

A needling problem

As we all know there are a few choices when it comes to managing Type One diabetes. We can rely on multiple daily injections (MDI), using a pump or other solutions – such as homoeopathy. The latter option usualy results in a slow, lingering death and other answers, such as inhaled insulin are just rubbish. So it’s basically down to MDI or pumps.

For the last wee while, pumps seem to be given as the must-have diabetic accessory. Without one you’re seen as a throwback to the early 20th century, having little progressed from the days of Banting and Best. Essentially you’re the diabetic equivalent of the caveman (or, of course, cavewoman) – a drooling, half-mad imbecile pitied by the pump-wearing community.

Well, the tide has turned my friends as I’m coming out in support of MDI!

“For God’s sake, why?” You may ask. Well, in my view MDI has a lot going for it. No, it really does.

The main benefit of MDI is its simplicity. There’s no complicated machinery for one thing. I haven’t been able to set the timer on any video player or DVD recorder I’ve owned for the last ten years. That I might be put in control of a complex device on which my life wholly depends is frankly terrifying. If I had a pump I would end up with the diabetic equivalent of my favourite program being recorded over by a repeat of Masterchef – as happens with monotonous regularity with my video (whatever the diabetic equivalent of that could possibly be…)

Second; MDI is extremely portable, robust and virtually indestructible. Should I choose to go out hoola-dancing in a grass skirt on a tropical island (now that’s going to be a hard image to shift…) then I can do that without the slightest difficulty. A quick squirt of humalog and I’m away. There are no problems wondering where I’m going hide my pump in my grassy skirts or whether the mile of tubing I have attached is going to pop out during the wild equatorial festivities.

It’s also worth remembering that contrary to popular belief you can actually maintain very good control with MDI. I don’t like to brag (well, actually I do) but my last five A1C’s have all been 6.5% or below – all achieved by just using simple old humalog and basic lantus. By carefully adjusting the long and short term injections you can get a really good balance that’s just right for you. If you can do this with basic equipment then why bother with the expense and complications of pumps?

So there we have it – MDI rules and pumps suck! Comments below please – bring it on!

Sir Steve, rowing yesterday

In an interview with the BBC, four time Olympic gold medallist Sir Steve Redgrave says “diabetes has to live with me, not me live with it”. Now there’s a man after my own heart. That could have been me speaking. I have the same expectations of my diabetes.

Then he talks about the careful balancing act of wanting people to see that diabetes doesn’t stop him, but equally not wanting to make it seem inconsequential and easy to live with. I’m now jumping up and down shouting “me too, me too!”. It seems we diabetics want it all ways. Don’t pity me, but have some respect for how hard this is at times.

By this point I’m thinking, I may not be very good at rowing (I can do once round the boating lake but then my arms start to ache and we start going in circles because my right arm gets tired quicker than my left) but when it comes to diabetes I’m Olympic standard.

I’m heartened to hear that Sir Steve’s latest sporting injury was acquired slipping down a hill whilst getting to his car – this sounds like exactly my kind of sporting injury, clumsy and unnecessary. As a child I broke my arm through the very dangerous activity of falling off the sofa.

As I read on I’m not in the least bit surprised when Sir Steve says “Every waking moment you’re aware that you’re diabetic, but you develop a new sense – what you’re going to eat, how much insulin you’ve got to take with that food that you’re taking, what sort of a stressful day you’re going to be living because that affects the blood sugar levels as well…so you’ve got to look at a lot of different things.”
redgrave.jpg

Yes, yes and triple yes, that’s exactly it, couldn’t have put it better myself. That’s the thing about diabetes, it’s always there, it never goes away.

Of course, as my diabetic twin, Sir Steve uses a pump like me. I knew this already because I got overexcited a couple of months ago when my eagle-eyed husband spotted his infusion set through his T-shirt on a TV show. I know this makes me sound like some kind of stalker-type freak but really I’m not, it’s just surprisingly exciting to see someone else with a pump out in the real world rather than at a diabetes event.

I therefore (modestly) conclude that even if my rowing is pretty poor, my attitude to diabetes is Olympic gold medal winning standard. And as I think diabetes is best played as a team sport, please join me on the podium to collect your medal.