Video Blog – Diabetes irritations

By | 19 April, 2011

Alison and Tim burble on about the things that really irritate us about diabetes.

36 thoughts on “Video Blog – Diabetes irritations

  1. Nig

    @alison – completely agree about the amount of “stuff” we have to carry and I am not even on a pump yet, when, I suspect, the quantity of “just in case” will double?

    @tim & @alison – also completely agree about the 24/7-ness of it!

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  2. Dave

    All good. My personal bugbear is not being able to easily just stay over after a night of too many beers at friends if I hadn’t thought ahead to bring the Levemir. And chuck in late-night night time activities that occassionally need to be preceeded with a mood-killing big glass of orange if the body is not prepared for ‘exercise’ at that time of night.

    Anyway, onto more important things…. @tim @alison – Where are the ducks? The addition of random glucose has been noted but replacing the ducks with a D shaped lamp is a definite downward step in production quality and I demand their return immediately. Unless of course they are now ex-ducks following an encouter with some orange sauce?????

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  3. Tim Post author

    @seasiderdave – the big D came from a video blog we filmed earlier in the day but which is going up on YouTube later. We’re real sticklers for continuity! I think the ducks may return, along with with random booze, flowers and misc. other – @Katie and Geoff were in charge of set dressing!

    I always lugged my Lantus about with me when I was on MDI – just so we could stay out or whatever we were doing. It weighs nothing, so why not?

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  4. Tim Post author

    @nigho – I possibly carry slight more stuff around now I’m on the pump. I have one pencil case which carries my everyday stuff – meter, strips, Fruit Pastillles, etc. and I have another pencil case with “emergency” stuff – a spare set, reservoir, QuickSerter, etc. The second emergency kit just gets shoved in the bottom of whatever man bag I’m carrying, so it’s quite handy really.

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    1. Nig

      @Tim – no, sorry, I just cannot get my head around the idea of a “manbag” – I mean, that in itself is just more “stuff”! Carrying more “stuff” to put your “stuff” in just sounds hideous to me! I accept that you then just have one large item of “stuff” instead of several smaller, more easily misplaced, items but I think I’d rather be more selective/creative with the “stuff” I carry. That is part of the reason I am investigating the Omnipod as my pump of choice; apparently less “stuff” required for emergency backup? I could be wrong of course! Does anyone have any views on the relative quantities of kit required with the Omnipod vs “normal” pumps?

      Having said all that, if/when I get a pump I could be forced by sheer volume of kit to resort to a manbag instead of just wearing/carrying a jacket with multiple pockets wherever I go! What is your “manbag” of choice Tim?

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  5. Alison

    @seasiderdave I had to miss out on an inpromptu sleepover at a friend’s house aged 9 because I didn’t have my Ultratard with me. Since then, I always carried it as I was loathe to miss out on any fun just because of the diabetes.

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    1. Donald Thomson

      I sometimes deliberately don’t come prepared for an overnight stay just so I have a good excuse get back home to my own comfy bed at the end of the evening. Call me an old fart, if you will . . .

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  6. Alison

    @Nigho I don’t see why the Omnipod should require less junk. With a pump you’d probably carry a spare infusion set and reservoir, plus insulin. With the Omnipod the infusion set is built into the pod so you’d just carry that plus insulin, but size-wise I don’t think there’s much difference between a pod and a infusion set + reservoir. Plus, from what I’ve read about issues with pods failing, I’d think you’d need to carry a couple to be safe. Whichever you had, I’d always carry a syringe too so if it comes to it, you could get insulin out of the pump and inject it.

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    1. Nig

      @alison – To my way of thinking (so far – I am still new to all this, and still undecided) the choice between carrying a spare pod or carrying a spare cannula, tubing, insulin reservoir and insertion device seems like a no brainer. Your view on insulin and syringes is interesting. My assumption on this was that I will be carrying a loaded pen and so can fill a fresh pod if required or revert to MDI temporarily rather than extracting insulin from a failed pod with a syringe. More questions for the Omnipod rep when we meet. Thanks Alison.

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        1. Nig

          @alison – I do enjoy having my assumptions challenged; thank you. (I am being serious here, no sarcasm intended).
          I had assumed (without really thinking about it) that any insulin pump could be filled with a pen – I now realise that I had no evidence to support that assumption so I’ve spent the last couple of hours searching the web for any indication that it is possible. The results of this detailed research by Google’s web bots is that, yes, there are people out there who claim to have filled Omnipods, Medtronic and Animas pumps by “injecting” from a pen into the relevant pump reservoir. I found no mention of anyone doing this with a Roche pump but whether this is because it is not technically possible for some reason or just because Roche users have got better things to do with their lives I could’t say.
          Now I realise that this is the web and that you shouldn’t necessarily believe everything you read but at least it presents some (very limited!) support for my assumption. It should also be said that there were almost as many people advising that this was the worst possible thing you could do and would lead to the end of civilisation.. So, more questions for the omnipod rep!
          I accept that a syringe is smaller than a pump but for me there are limits beyond which “small” becomes “fiddly and inconvenient” which is why I have alway used Bayer’s meters that use their various 10 test discs (currently Breeze2) rather than meters which use individual (=fiddly and inconvenient) test strips.
          So, back to my original plan, as revised following Alison’s points and subject to my assumptions being supported by a greater authority than LizzieLou from Missouri; if I carry a pen as my backup device but also use it to routinely fill the pod then the pen contents will always be fresh and I can refill a spare pod should I need to. Alternatively, in Alison’s “one of those days” scenario, the injection would be simpler than having to retrieve insulin from the pump reservoir. Either way, less “stuff” to cart around 🙂

          /stands back feeling smug, but with feeling of impending doom as wiser pumpers shake their heads in disbelief at the sheer naivety of this late-comer to the pump party/ 🙁

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          1. Alison

            @Nigho Now this is getting complex! I’ve never used a syringe or a pen to fill a pump reservoir, they come with a great mechanism to fill from a bottle of insulin, far simpler. I don’t know how you fill a pod. The only time I’ve needed to use a syringe is when I’ve managed to pull out my infusion set (or in your case knocked off a pod) and can’t replace it immediately so I’ve withdrawn insulin from the pump reservoir and injected it into me. I might also use it if I suspected there was a problem with my infusion set (malfunctioning pod)and I didn’t have a spare. This has happened twice in 4 years.

            Your plan is probably theoretically possible, but seems a very complex way of doing a pretty simple thing. Definintely have a chat with the reps and a play with the pumps, you’ll have a much better idea after that.

            If I were you, I’d ask the Omnipod rep about their failure rates too. From what I’ve seen on forums etc people seemed to have lots of issues with pod failures in the early days of the product. This seems to have improved but is still around a bit. Just worth seeing what they say about that. http://www.insulinpumpforums.com have a fair few Omnipod users so they might be able to help with any specific questions too.

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          2. Annette A

            You can (I have) fill a cartridge from a pen (the top of a pen is exactly the same dimension as the top of a bottle,spongy bit and all) so the filling mechamism for a Roche pump cartridge (no, I had nothing better to do) fits perfectly. But that is filling a brand new cartridge from scratch with said filling mechanism still attached. Never tried with one ‘half done’, cant see how that would work. I just used all my existing pens to fill up my first few cartridges so I wouldn’t waste them before moving onto the bottles.

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          3. Nig

            Sorry. It should say “I accept that a syringe is smaller than a pen…”

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          4. Nig

            @alison – you said “I don’t know how you fill a pod”

            You get a syringe with each pod to extract insulin from a vial and to inject into the pod.

            @alison – you said “Your plan is probably theoretically possible, but seems a very complex way of doing a pretty simple thing”

            Reallly? I thought I was making it simpler! If I’m going to keep a pen as a back-up device, it seems simpler to me (subject to it actually being possible!) to use that as the source of insulin for the pump rather than the implicit expectation that you use a 10ml vial of insulin and the supplied syringe.
            So, only one size of insulin bottle (3 ml cartridge) to supply both the pump and to provide emergency backup in the pen.
            The alternative would be 10 ml vial for the pump via the supplied syringe plus 3 ml cartridge for random use in emergency in the pen (by which time it may well be out of date). Getting the correct insulin on a repeat prescription when there is a choice of two is hard enough; getting the correct size bottle of a single insulin may well overwhelm the admin systems of my local surgery!

            @alison – you said “From what I’ve seen on forums etc people seemed to have lots of issues with pod failures in the early days of the product.”

            I think this is a bit of a non-issue really and is really largely down to unrealistic expectations. I am not saying that those (very few) people who have had 10 consecutive pods fail on them do not have reason to complain; clearly they do. But those people who expect the same level of reliability from a bit of disposable kit with a 3 DAY lifespan as they would from a traditional pump with with a 4 YEAR lifespan are living on a different planet, probably in a galaxy far, far away!! I am not saying that the company should not improve the reliability of its products; clearly it should, if only to ensure it protects its reputation and survives long enough to provide a extra dimension to the competition between pump manufacturers. I can assure you that if/when I get my local hospital to fund it, any failed pods I have will be brought to the attention of the distributor very quickly!
            BUT, the fact that Insulet launched the Omnipod in the last quarter of 2005 and it is still the only patch-pump available anywhere shows how big a deal the technology is. A few failures in the first generation product are hardly a surprise.

            @alison – Yes, I know there are pump forums with groups especially for Omnipod but in general they do not have the same combination of intelligence, idiocy and wierdness as this one so I will need to take my time and find an appropriate source of reliable Omnipod wisdom.

            @annette – but did you use the pen needle and pen mechanism to transfer the insulin from the cartridge to the pump? That is the claim made for all the other pumps. Roche is relying on you Annette! 🙂 Interesting that you say “before moving onto the bottles” – should I infer that it is generally the case that if you are “promoted” to pump use, your back up options are simultaneously “relegated” to syringes instead of pens?

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  7. Tim Post author

    @nigho – I used to be like you, averse to the man bag! But I quite like them now; my main bag is a Visconti messenger bag (http://goo.gl/IhGyt) for every day use – it’s almost indestructible. For smart I have a tweed one that was handmade for me by @Katie (do check out stripykat.com for great bargains on handmade handbags and accessories! 😉 ) and a really funky Jake Spade one (http://goo.gl/BnrFR) also for smart; and I have a shitty Next laptop bag for business which I hate.

    I wrote about all this guff here too: http://www.shootuporputup.co.uk/2009/09/the-hidden-costs-of-diabetes/

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    1. Nig

      @tim – OK, I now see what sort of thing you are talking about but I just cannot imagine carrying something like that around with me. The closest I get to that sort of thing is my laptop bag but that is so full of laptop, cables, mice and paperwork that I don’t even keep any fruit pastilles in it. Besides, it only comes with me when I actually (might) need my laptop. I shall stick with multi-pocketed jackets for now but I will let you know if I am forced to admit defeat.

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    2. Alison

      @nigho I use a syringe as back up rather than a pen as it saves the hassle of having vials and cartridges. The pump reservoir fills very well from a vial, and a syringe means I can extract insulin from the pump or the vial in case of failure if needed. A pen is just surplus to my requirements, but I think everyone works out their own way of doing it.

      Re pod failures – I’ve had 3 infusion sets block over the years and the rocketing blood sugars they cause are quite something. Especially if it happens in the night and you don’t notice, it doesn’t take very long to get up into the 20’s without insulin (because you’ve got no Lantus in the background, if the pump stops, within a couple of hours there’s nothing in your system). The risk of DKA is high, therefore for me to use them, I’d want the pods to have a similar failure rate to infusion sets and certainly in the early days that wasn’t the case.

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  8. Annette A

    I dont think I carry much more junk with the pump as without – my case with spare pens (including lantus, always there just in case) and needles) has been replaced by a small ‘bag’ (its about the size of a large purse, was sold as a shoulder bag (for people who only carry a phone and a pound coin about with them, I think) and fits the entire emergency kit in (glucogel, infusion set, spare test strips and lancet drum, syringe, etc).
    I admit I carry alot of junk. But I carry less junk that other members of my family, who dont have diabetes – they have kids, husbands, a tendency to hoard, etc etc.
    The 24/7 bit is a pain. I’d like a day off once in a while…

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  9. Megs

    Huge irritation, losing driving licence after losing sight in one eye and partially in other eye. Buses are great but not when you have had the independence to go when you want to and not just when the 63 turns up. Also I get irritated with myself rather than diabetes when I start calculating carbohydrate values on other peoples plates when having a coffee. I find myself staring longingly at toasted sandwiches! Instead of a man bag try a justin case, thats where I put all my stuff.

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    1. Nig

      @megs – I know I’m going to regret asking this, but “what is a justin case?”

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  10. Donald Thomson

    @Tim I’m with you on the man bag question. They are a brilliant invention. Before then I had to carry everything in pockets. Only drawback is now my wife never carries a bag and just relies on me to carry all her stuff as well. Beast of burden. Re. the set dressing – I’m intrigued by the table piano you’ve always got in the background (more details please – I’m a professional musician) but must tell you off for putting a bottle of lucozade on top of a musical instrument. Slapped wrist. Liquids and pianos don’t mix!

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  11. Tim Post author

    @don172 – the piano is an 1822 John Broadwood and Sons square piano. The frame isn’t strong enough to support the horizontal strings, so they’ve been slackended off to stop the frame splitting any more than it already has. So it’s not playable at the minute. 🙁

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  12. Megs

    Its also known as my big handbag where I shove all my extra pump stuff just in case. Yes, I know, its really sad!

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  13. lizz

    Went off to look up ‘Justin Cases’. First website I came across was little boxes to hold condoms. Ahem.

    I would like a day off. Once a month would do…

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  14. Bennet Dunlap

    The piano that is almost as old as our country is cool.

    Man bags? Who are you kidding. What would Jeremy Clarkson say if he knew you were representing country and crown around the world with a man bag?

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    1. Tim Post author

      @bennet – there’s nothing wrong with man bags; I’m comfortably metrosexual 😉

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      1. lizz

        @Tim – don’t listen to them. All the youngsters nowadays have them – my own 18 yr old son has several bags. You are just way ahead of the pack.

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  15. Lesley from INPUT.me.uk

    The only extra stuff I carry as a pump user is a spare infusion set and battery. The rest – jelly beans, spare insulin, syringe, id – I used to carry around before the pump. However I do have to carry spare subcut and spare DiaPort infusions sets at the moment (damn DiaPort).

    My Man used to carry a backpack (he’s not got the D) but now he keeps his stuff in a van…

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    1. lizz

      Well, that has to be ultimate in one-up-manship. Not enough room in my pockets, I had to get a van…

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  16. Cecile

    @lizz: The van’s needed to cart around all those plumber’s tools that are needed when her DiaPort becomes blocked (I’ve cyber-spied a bit on @lesley1966’s implanted-in-her-innards insulin delivery system – how often does it become blocked because of insulin crystalization?)

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  17. Annette A

    @nigho – no, you use the filling mechanism which has a needle in it which inserts into the top of the pen, then you use the plunger on the cartridge (only available at first set up of cartridge, you then remove and dispose of) to pull the insulin out of the pen (rather than using the pen mechanism to push it out).
    Once your cartridge is emptying, the plunger mechanism in the base of the cartridge moves up to push out the insulin, and hence you couldn’t refill it (because there’s no space to refill, as the cartridge volume decreases with use – I hope that makes sense) using the pen mechanism (unless you took a full cartridge, emptied the contents laving an empty cartridge with the plunger at the base, then you could fill it up. But I dont see why you would do that. Or unless you had a fresh cartridge to fill – in which case you’d have all the filling mechanisms with the fresh cartridge, so you’d use that.) The cartridges are not sealed at the top, so you couldn’t put any pressure on the plunger using the force of liquid from the pen mechanism – it would just overflow out of the unsealed end. (It is sealed by the tubing being added.) (Is the Medtronic cartridge sealed at the top end? Could you fill it just by the pressure in a pen?)
    I don’t know about generally, but my DSN, on my getting a pump, gave me a change of prescription form to remove the pens and replace them with bottles. I get the feeling that it is cheaper to supply bottles than pens (makes sense that they would be) so if you dont ‘need’ pens (ie to inject with on a daily basis) why should you get them? (I guess that was the logic behind it, anyway. I didnt question it, as I had no problem with moving to bottles.) But I guess its down to you and your prescribing Dr, really, what your backup is (I still have a lantus pen on my prescription that I always have as back up – just in case it all goes massively wrong. Reminds me, I must check its expiry date and get a new set.)

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    1. lizz

      I agree – you couldn’t refill ANY pump cartridge because the plunger is pushed forward by tiny increments by a mechanical rod. Once the rod is at its fullest extent, and the cartridge empty, the only way of getting it back down is by rewinding it into the pump, and that is a mechanical procedure. You couldn’t ‘push’ it back into the pump by refilling the cartridge because the rod isn’t a simple plunger, it’s on a very precise ratchet. You’d break it.

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  18. Nig

    @annette & @lizz – sorry. I shouldn’t have said “REfill” it should just have been “fill”.

    I must be more careful when I type.
    I must be more careful when I type.
    I must be more careful when I type.
    I must be more careful when I type.
    I must be more careful when I type…………………

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