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by Faith

Review: Glooko logbook and meter sync cable

11 October, 2012 in General reviews, Kit & equipment

The year is 2012. This is the year that I use my iPhone to monitor my sleep, bike rides and even where the nearest earthquake is. Yet, I have never really got to grips with using it to monitor my diabetes. This is most likely due to the fact that seeing all my blood glucose results (highs, lows and all) on one neat little graph incites a deep seated terror in me! However, I shunned my fears and valiantly tested the kit…

How it works
The Glooko logbook allows you to download all your results from your blood glucose meter into a free app on your iPhone. This is done via a rather pricey cable (ÂŁ32.50) which connects the two devices. If you have an Accu-Chek meter, you are extra lucky as you have to pay out another ÂŁ12.25 for the infra-red adaptor. Then you just connect the two devices and sync.

Diabetic maths

Inside the app, you can view your results much like you would do in a paper chart but you can also record details such as the amount and type of insulin you administered, what you ate, exercise, feelings, favourite ABBA song etc. You can also directly email these to your doctor or yourself. In theory, it is simple enough for a diabetic chimp to do. However, I had to try quite a few times to get the devices to recognise one another.

I also made rather a fundamental error in assuming that all Accu-Chek Aviva testing kits are equal. Glooko would not recognise my Aviva combo, nor does it recognise certain meters that are not black in colour. Odd but true! So if you’re already sold by my review, please check carefully that your meter is compatible.

What it’s like to use
So, once I had dug out a black coloured Aviva Nano, I was in business! I uploaded my horrific results and examined them in the log book. If anything, chimps have been taken into account too much throughout the design process; I found the log-book overly simple and lacking functionality. You can look at your blood sugars, click on them to see what you ate/bloused at that time but that’s about it. It would be great to have a few simple graphs or colour code blood glucose results to aid in visualisations of patterns.

What blood sugars look like within the app. Astute readers will notice these blood sugars are really terrible by British standards!

The best feature…
The star feature of the app is the carb counting functionality. If you want to know the amount of carbs in your mid-morning scotch egg, just search their database and specify how much you ate. You can also search by restaurant although this has been developed for an American audience so common British restaurants e.g., Pizza Express, Wagamama etc. aren’t listed. Unfortunately for Glooko (but lucky for you!) this is free to use.

Room for improvement…
As a pump user, I am continually astounded that no one has developed an app that allows you to enter your basal insulin rate. It seems such a simple thing to add in but is still missing from this app!

I believe some of the oddities like not being able to graph your results or manually enter readings are related to some strict (and fairly mental) regulations by the American FDA who act on the basic assumption that diabetics are deviants who given the chance, will manipulate their blood glucose data to take over the world. The good thing is that the Glooko folks sound pretty passionate and dedicated to continually developing the app for the European market so in time things will probably improve.

My diagnosis…
Although I generally adhere to the principle of “Keep It Simple, Stupid!”, at present the app is actually basic rather than simple. As owner of an AccuChek Combo pump that allows me to record my carbs, download data to a pc and Bluetooth to my pump (yet ironically cannot Bluetooth to Glooko), there just aren’t enough benefits of using this app to motivate me to get my iPhone out every time I test to enter the insulin and carbs. I would gladly pay a few pounds for the app if I could directly Bluetooth my results to my phone. However, paying out £45 for what is essentially an electronic table (plus good carb counting app) seems a bit steep. However, Glooko will probably amend these issues way faster than every kit being equipped with Bluetooth.

If anyone else would like to road test the system, please send me a private message via ShootUp, or leave a comment below.

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by Alison

A cheaper, non invasive, continuous glucose monitor could be around the corner

3 September, 2012 in Kit & equipment

Continuous glucose monitors have been around for a while now, indeed I’ve been using one to improve my control for the last 5 years. The market has been dominated by three main players, all with very similar devices, at very similar – and for many out of reach – prices. That could be about to change.

I spent a few hours with California based C8 MediSensors last week looking at their new take on CGM, which just like the blood glucose meter, was invented by the father of a diabetic child looking at current treatment and thinking, we can do better than this. Rather than measure glucose levels from the inside, using a sensor beneath the skin, their device fires a beam of light through the skin to measure the level of glucose in the interstitial fluid. That’s right, no needles and no blood. They’re in the process of gaining CE Mark approval which will allow them to sell their optical CGM device in Europe, hopefully this year.

You wear the device, which is slightly bigger than an insulin pump, and its smaller battery pack next to your skin, attached via a material belt that goes around your waist. You view your BG measurements via an app on your smartphone.

Looking at this from the view of someone who already uses CGM, I’m excited. I know the benefits (and frustrations) CGM can bring, but I also know that that funding can be very hard to get and the ongoing cost of consumables make it too expensive for many people to consider. The C8 has the potential to change this. Let’s take a closer look…

The facts about C8 MediSensors Optical Glucose Monitor System:

  • Accuracy: company data shows it to be in the same accuracy range as standard invasive CGM – like any CGM, this is about giving you a better view and context to your glucose levels, not an accurate number at a particular moment you can use to bolus from – you still need blood tests for that.
  • Techy stuff: the C8 uses Raman Spectography to fire light through your skin and vibrate your molecules. As each molecule has a unique signature, the device can identify the glucose molecules and count them (in all honesty, it’s a bit more complicated than that, but you get the idea, there’s a full explanation here).
  • Cost: this is a major winner. The C8 will retail at US$4,000 (around ÂŁ2,500 at today’s exchange rate). That’s about the same cost as one year’s supply of CGM sensors based on using one a week. The C8 will be guaranteed for around 2 years (varies according to country) and is expected to last at least 4, with running costs minimal in the tens rather than hundreds or thousands of pounds. That makes CGM, while still not cheap, significantly more affordable. Plus it comes with a 30 day money back guarantee – so you have time to play around with it and if you decide it’s not for you, send it back.
  • Availability: hold your horses, this is an investigational device not yet on sale anywhere. CE Mark approval is on the cards for later this year, after which it will launch in Europe. I have no timescales on a US release.

Using non invasive CGM:

  • No pain: as it’s non-invasive there are no needles or insertion devices. Skin irritation is always a concern when you have something on your skin for long periods of time – but I guess you’d have to try it to see how it works for you.
  • Getting started: when you strap on the system, it should be up and running in around 15-20mins and need one blood test to calibrate (it basically has to warm up, so if you’re hot it’ll be quicker, but will take a bit longer if you’re cold). The only time it should take longer is the very first time you use the device, when you’ll have a 45-60min warm up. This compares very favourably to around a 2 hour warm up for the invasive models.
  • Monitoring the results: the C8 device has no separate monitor, instead it transmits its results to an app on your smart phone. The app currently works on Android phones, with an Apple version planned.
  • Alerts: high/low alarms will sound on your phone, not on the device itself – this might help with the perennial CGM problem of the alarms being too quiet – on a phone they should be easier to tailor.  At the moment there are no rate of change or predictive alerts, but they are a future possibility.
  • Battery life: Around 10 hours, with 2 batteries provided as standard. So you’re going to need to recharge daily, compared to weekly at the most for other CGMs. Powering your own laser beam takes a fair amount of power.  Plus you need to make sure you keep your smartphone fully charged, as that’s how you view your results.
  • Sex appeal: the device and battery are pretty bulky and are worn strapped to the stomach via a material belt. Compared to the tiny Dexcom and Medtronic transmitters, which are just a bit bigger than a 50p piece, it’s a major difference. They are working on improving this for future versions.
  • Exercise: the laser does like to be snuggled up close to the skin, without too much jigging around. So at the moment C8 recommend you don’t use it while exercising as it might give erratic readings. I think this’ll be one of those things that users will have to play around with to work out for themselves. On the plus side, it is easy to take the belt off and on and start up time is very fast.
  • What about the kids?: at the moment its only been tested for use for those over 18, so although theoretically ideal for kids it isn’t officially approved for them to use.

And of course, who wouldn’t want to be able to say to their friends in the pub “Did you know, I have the world’s smallest Raman spectrometer strapped to my stomach?”.

I think this has the potential to allow many more people to take advantage of using CGM as it reduces the big stumbling block of cost, and removes the issue that some have with painful sensor insertion. As someone who already uses standard CGM, I’m not tempted to switch at the moment – the battery life and size of the device wouldn’t fit with my life. But if I didn’t already have CGM, I’d be looking at this with interest when it comes out.

For more info, take a look at a video of the C8 in action.

As you’d expect, I didn’t spend my own hard earned cash to go and see this, C8 lured me to their offices with promises of expenses, nice sandwiches and an interesting product, which they delivered on.

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by Alison

Making life more boring with Timesulin

15 February, 2012 in Kit & equipment, Living with diabetes, news

Things would be much easier if diabetes was the only thing on my mind. If the only challenge in my day was to calculate my carbs and stick in the right amount of insulin. That would also be quite a depressing way to live, I admit. So, in the interest of preserving sanity, we diabetic types tend to introduce something else into our existence, commonly known as life.

Life is fun. But it does tend to take up brain space. Unbelievably for those not reliant on stabbing themselves daTimesulinily to stay alive, it is possible to have an injection without spending the whole morning fretting over it and the whole afternoon talking about it. It’s like brushing my teeth, it happens regularly but often while my brain is thinking about something else entirely.

When I started on the pump, one of the unexpected pleasures was the discovery that I could check the screen to see when I’d last bolussed. This has removed hours of frustrating conversations with the husband – did I inject for dinner? I can’t remember. Did you see me inject? Well I saw you take your pen out, but I’m not sure if you actually used it. Or maybe that’s yesterday I’m thinking of. All these injections tend to merge into one, you need to make each individual injection experience memorable and unique in some way, so we can clearly remember them. Did I inject? Ah yes, that was the one with the goldfish, I couldn’t forget that. What about breakfast. Well of course, that was when you stood on one leg and pirouetted as the needle went in.

Apparently there is now a duller alternative to the unique injection approach. A clever pancreatically challenged type has invented Timesulin – a handy little cap you can fit onto most insulin pens that records when you last injected. So rather than spending hours trying to rewind and replay your life to remember if you injected, you can simply look at the cap of your pen.

If such a boring form of existence appeals to you over the living by the seat of your pants, did I inject, I don’t know, let’s explore it through the medium of shared recollection and then conclude we’ve no idea approach – you can splash out 25 of your hard earned pounds to purchase one.

I have no idea if they’re any good and I have no intention of stopping using my pump just to try them out. But I really like the idea and their website tells you everything else you need to know.

Avatar of Alison

by Alison

Ingenious infusion set removal

8 February, 2012 in Living with diabetes

Now of course the easiest way to remove an infusion set is simply to pull it off, like you would a plaster. But here at ShootUp we say where’s the fun in that? There are far more entertaining ways of separating a set from your skin.

  • Buttock and thigh sets can be conveniently ripped out by over-enthusiastic trouser removal when going to the toilet. This is always a pleasure.
  • Pumps have been warned before by ShootUp about their door handle fetish. But to little effect. Handles of any form – door, cupboard, drawer – act as a handy extraction device. And have the added joy of allowing you the experience of horizontal bungee jumping when you discover just how far your tube can stretch as you continue walking past the handle you didn’t realise you were attached to.
  • Door frames can also be a useful tool. Mostly I manage to just ram the pump into them as I walk through, chipping the paintwork as I go, but occasionally you can hit them at just the right angle and remove an infusion set.
  • My most exciting infusion set removal was on a boat in a storm whilst trying to get the life jackets. I wouldn’t recommend that one.
  • Dropping the pump so that it hangs from your infusion set is surprisingly ineffective. I have done this many times – mostly because it seems to make non pumpers a bit queasy when they see it happen and is therefore entertaining – but have never managed to pull a set out this way.
  • Applying a set after having had a bath seems a sure fire way to mess it up. It goes in ok, but generally falls off within a couple of hours – something to do with hot, damp skin and a residue of bubble bath I think. There is plenty of skin cleaning gunk on the market to avoid this problem, but where’s the fun in that?

Any other exciting ways to remove an infusion set?