Living Well With Diabetes

I’m a believer in the value of an insulin pump and have been since 1996. Its precise and constant delivery allows a level of control of my blood glucose levels that I could never achieve using multiple daily injections of insulin. On top of that, there’s the whole convenience factor: dialing in a bolus on the insulin pump is much easier than collecting all the necessary equipment for an injection, especially when I’m in the middle of a six-hour bicycle ride.

I mention all this because the warranty on my current insulin pump (a Cozmo made by Smith’s Medical) recently expired. I was fully expecting to purchase a new Cozmo pump which I would happily use for the next four years. But then I happened across a report on a recent survey about insulin pumps:

Updated survey on insulin pumps and continuous glucose monitoring

(you’ll need the Adobe Acrobat Reader to access this report.)

In this report, they mentioned the OmniPod, a relatively new addition to the insulin pump marketplace. They entered the marketplace in 2005. Their product is unique (at least so far) because it doesn’t have the traditional architecture of other insulin pumps. In fact, Insulet, the manufacturer of the OmniPod, doesn’t like their product to be called an “insulin pump;” they prefer “insulin management system.”

In all other insulin pumps on the market today, a supply of insulin is stored in the pump itself and delivered continuously through a flexible piece of tubing and a cannula which is inserted subcutaneously.

The OmniPod, however, does away with the tubing which can be unwieldy, can get snagged on doorknobs and other objects (happens to me all the time), and is potential point of failure due to occlusion (happens occasionally) or being severed (happened to me once). With the OmniPod, the cannula, insulin supply, and all the mechanical and electronic components to accomplish insulin delivery are stored in a small device attached to the body (the “pod”). The pod receives instructions on insulin delivery via wireless communication from a personal diabetes manager (PDM). The PDM is a hand-held device about the size of a calculator. The pod, after it is attached to the body, delivers insulin for three days after which the pod is discarded.

So, I’m describing all this to you because I’m trying out the OmniPod right now. I’ve tried three pods so far and so far I like what I see. The PDM gives me roughly the same insulin delivery programming features as I have on my Cozmo insulin pump. So, the PDM itself doesn’t give me a good reason to switch. The pods, on the other hand, are very interesting. For the past 12 years, I’ve dreaded and struggled with the infusion site rotation process which is done every three days. It’s painful. At best, it’s only mildly so; at worst, it’s excruciatingly painful to the point that I’ve had to pull the whole infusion set out to make the pain go away. Perhaps I’m doing something wrong (I doubt it), but that’s my experience. Your mileage may vary, as they say.

So, instead of having to manually insert a cannula subcutaneously, the pods have an automatic insertion process. Given my painful history with infusion sites, I was especially leery of an automatic process. As I preparing to apply my very first pod, I braced myself for something very painful and you know what? It wasn’t. It was so unpainful that I had to laugh. I thought for sure it had failed to insert a cannula. But, four hours after insertion, my blood sugars were still normal, so it had to be working correctly.

Now, I’m at the end of a three-day run for this pod. It’s been through three bike rides, two of which were very sweaty rides on my indoor trainer. It’s still firmly attached, doing what I need it to do: worry-free delivery of insulin.

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Hardly a month goes by without the media covering some new study showing the importance of keeping blood glucose levels as close to normal levels as possible. And, hardly a month goes by that there isn’t some new technology to help people with diabetes in the never-ending and exhausting work of keeping their blood glucose levels as close to normal as possible. Continuous glucose monitors are all the rage right now and I can personally attest to the value of these products, despite their quirks, shortcomings, and expense.

This month’s offering in diabetes management technology is from Philips, a company I personally worked for back in the late 1990’s. They’ve got an idea for a non-invasive blood glucose monitor.

Quite a few companies have bravely ventured into the arena of non-invasive BG monitors. There have been a couple that have had non-invasive products make their way into the market — the Glucowatch comes to mind here — but it is difficult to say that any have been successful, at least not yet. Most past attempts have focused on using some kind of laser or light beam of some kind to detect the spectroscopic signature of glucose. As if this wasn’t difficult enough to do, it’s made more complicated by the unfortunate fact that there are other substances in our bodies with similar spectroscopic signatures. If you’re interested in the gritty details of non-invasive blood glucose detection, I suggest these for some light reading:

• Overview of Non-Invasive Optical Glucose Monitoring Techniques
• Raman spectroscopy for measurement of blood analytes

Those clever engineers at Philips are pursuing a non-invasive device to measure blood glucose levels by taking a sample of exhaled breath. A few years ago, scientists discovered a correlation between blood glucose levels and the amount of carbon monoxide in the air we breathe out and that’s the basis of their work. For the sake of all people with diabetes, I wish those people at Philips the best of luck and I hope I will soon be seeing their product on the market.

For details on this announcement, see Diabetes Breath Test and the glucose breath test patent application.

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The presidential election coming up later this year seems to be on everybody’s mind. If you’re reading this, or even if you’re not, you’re probably concerned about the state of health care in the United States. You’re probably also wondering where the candidates stand on various health care issues. I found this web site today:

Healthcare ‘08

On a related note, I recently found a “Select a candidate” survey on the web site of Minnesota Public Radio. It helps you learn which presidential candidates’ view most closely align with your own views:

Select a Candidate

Enjoy!

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I went on a hike with our dog Pearl today. I hiked about half the way up Grandeur Peak.

On the way back down, at the Grandeur Peak trailhead, I saw this sign for some dogs, free to a good home.

(Hint: Note the top line of the sign.)

Why am I suddenly hungry?

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