2017 Reflections - a busy year

*DISCLAIMER - Please note in this article I am purely referring to Type One Diabetes and my personal views in relation to the Animas Vibe as well as my own personal experiences of NovoRapid and Fiasp. Remember Your Doses May Vary and all information found in this blog post is my opinion and is what works for me ONLY. It is not intended as medical advice. Please consult the relevant health care professionals before you make a change to your treatment plan in any way*

Well it's been a while hasn't it....

This year has certainly been one of ups and downs...and I'm not even talking my diabetes. There has undoubtedly been a lot going on with job changes, buying a house, family illness, house renovations to name but a few. Oh, and then of course there's the diabetes to throw into the mix.

Well after the HUGE transformation that the insulin pump made to my life back in July 2016, I would love to say that it's been smooth sailing ever since. In reality though - that just isn't diabetes now is it?

Despite my control being vastly improved from the 49 hypos a month.... (that’s right...49 a month!!) that I was having prior to starting Insulin Pump Therapy (IPT), I had still been having a few night hypos and some before meals. As a result, I trialled the Dexcom G4 sensor in the hope that the CGM link-up to my Animas Vibe pump would help with the night time hypos. Unfortunately, despite a number of attempts to use the Dexcom, for some reason I cannot get on it with. After seeing some amazing results from other people using it, I was sadly disappointed to have many false alarms and very inaccurate readings on every sensor, despite trying different sites. 

As a consequence, I intermittently used the Abbott Freestyle Libre to gain an insight into the patterns of my diabetes during those 2-week periods.

Although, as many will point out, it doesn't have the full features of CGM's such as the alarm functions or insulin suspension option, the accuracy that I get from using the Libre made it a much more reliable method of gaining continual, uninterrupted data.

I didn’t just look at the CGM/ Flash Glucose Monitoring options in isolation though. I also looked at the effects of how my recently developed (past 2 years) insulin-sensitivity affected my control. One major issue I kept facing was the difficulty of pre-bolusing at the correct time before a meal. This was particularly problematic when eating out at a restaurant or when eating at other people's houses. I would find that I would often hypo before the meal arrived, meaning a lot of explanation as to why I was eating just before we were about to eat. Step up FIASP!!!

Fiasp (a form of faster acting insulin) despite eliminating the vast majority of pre-meal hypos in a short space of time, it did take a couple of weeks to adjust to. One of the major adjustments I had to make was lowering the amount of insulin I needed for meals. It seemed, that with the differing profile of Fiasp and also not needing to pre-bolus before eating food meant that I didn't need quite as much insulin as I previously did. Conversely, I had to increase my basal rate slightly to keep my levels within the desired range. These adjustments were aided by the use of the Libre in the first few weeks of transitioning to Fiasp. Again, I am aware that a number of people have had difficulty adjusting/ using to Fiasp, however I have personally found it really beneficial.

And this was only half way through 2017...

Although some of hypos previously mentioned were still happening and my diabetes levels were erratic at times, progress was being made bit by bit. Pre-meal hypos had now been addressed!

Despite all the above, there was still another big step forward towards better diabetes management to come thanks to some hard work of a group within the NHS.

On 1st November 2017, the Abbott Freestyle Libre sensors became available on the NHS to those who meet the criteria. Despite some inevitable teething issues, as is often the case with new drugs and change, almost 2 months in there are a number of people around the UK who are benefiting from this prescription introduction. I am very grateful to be one of these people who has been massively helped by 6 weeks’ worth of data, patterns and invaluable information that I’ve seen already. What a way to end the year!

Therefore, although progress can be slow at times and it can often feel like things don't progress much from the research stage in some areas of diabetes, I would say that 2017 has been a year of fruition. This year has given us more choice in terms of the diabetes technology available on the NHS, a new insulin coming to market, trials of new CGM'S such as the Roche Eversense taking place as well as lots of pipeline developments (the DVLA changes for example) that I'm sure we will see in 2018.

Despite there also being some potentially negative changes with Animas pumps no longer being offered to new patients, I personally view 2017 as a year of advancement, with the progress still continuing into the year ahead. Additionally, and definitely on a personal level, 2017 has also provided me with the amazing opportunities to be part of formal/national diabetes events/ meetings, social meet-ups across the country and getting to know more local people with diabetes. All of these events, combined with new technology and differing approaches has certainly enriched my knowledge when looking at my diabetes management choices and decisions.

So, let me wrap up this post by saying that despite being optimistic, I am also not blinkered to the challenges that the NHS, people with diabetes and Health Care Professionals will face in the coming years as new technologies and approaches are introduced. I am yet to master the art of perfect diabetes blood glucose/ sugar levels as you can see from my Ayres Rock impression that happened before Christmas due to illness and festive eating (ooops!). However, I was able to see this thanks to the progressions of 2017 and to monitor my corrections and adjustments in addition to regular finger-prick tests.

Yet despite the challenges that diabetes throws our way...I am excited to see where we will be in a year’s time when we reflect on all that's happened in the world of diabetes in 2018! Bring it on...

Thank you to everyone who has read my posts and I have met in 2017. I wish you all a wonderful and safe New Years Eve and I look forward to sharing my 2018 adventures with you very soon.

Until next time, keep injecting 💉 or pumping 📟 insulin!

Ros x

Life on an Insulin Pump - the only way for me...

*DISCLAIMER - Please note in this article I am purely referring to Type One Diabetes and my personal views in relation to Insulin Pumps and in particular the Animas Vibe. Remember Your Doses May Vary and all information found in this blog post is my opinion and what works for me ONLY and is not indented as medical advice. Please consult the relevant health care professionals if you feel the need to make a change to your treatment plan after reading this post*

As I've only been on an insulin pump for just over 9 months, in the world of diabetes I would consider myself a 'newbie' when it comes to this area of diabetes treatment. Nonetheless, despite this limited time-frame, I can honestly say that it has been the biggest and most life-changing decision of my diabetes adventure to date and I'm defintely not looking back!! 

I had never really considered myself to have any major issues when it came to injecting insulin, but after 16 years of Multiple Daily Injections (MDI), this was no longer the best, nor the right treatment method for me.

I will never forget the moment in July last year when I was handed my Animas Vibe Insulin Pump in a box. It was a huge moment for me. Due to the urgency of me needing to start on a pump, I didn't get to choose the colour of my Animas Vibe. Although I would naturally have chosen the blue one as I don't consider myself to be much of a pink person, the baby pink colour of the Animas Vibe I was given has really grown on me.

During my training sessions with the pump, and seeing the functions available to me in terms of Temporary Basal Rates (TBR) and the tiny increments of insulin I could select, it was clear to me that the Animas Vibe was the answer for the 'insulin-sensitive-erratic-bloods' person that I had become over the last few years. The Animas Representative was great in answering my many, many questions and continued to check in on me throughout my initial six months and still does in clinic appointments. Equally, I must say that the Animas Helpline have also been fantastic for those 'out-of-the-blue' queries that I've had too.


So what is the Animas Vibe like? Well aside from having the many wonderful and essential functions that other insulin pumps share, such as varying basal profiles throughout the day, extended bolus waves and TBR, one thing I certainly didn't expect to be doing a month after starting it was swimming while my pump was still attached to me! I had thought that all pumps needed to be removed for things such as swimming so was very pleasantly surprised to find out the Animas Vibe didn't need to be. Personally I felt strangely liberated by this in terms of reducing my basal while I was in the pool and then increasing it again after swimming. The whole unit is waterproof so I don't need to be concerned about it when changing my doses in the water.
 

I also love the cannula sets and how everything is ready to go and easy to carry around. Unlike many insertion kits, namely the manual ones, I found the Inset II sets to be the easiest to use and to transport around with me. The cannula adhesives are also really strong and despite having got occasionally acquainted with door handles where your tubing gets caught, I have found that the cannula has stayed put completely with only two accidental removals to date where it was completely my fault! the adhesive also comes off easliy after removal and has not caused any unsightly marks or irritations either which is great.

The other great function of the Animas Vibe is the ability to use the in-built CGM function with a Dexcom sensor. This allows you to monitor your blood sugar levels at a click of a button on your pump, to review the graphs of your levels during downloads and on the pump itself and to use the alarm functions to try and prevent hyper and hypo blood levels. For many people, this is the reason that they choose the Animas Vibe, due to the seamless connectivity between the the Dexcom and the pump. I have only trialled the Dexcom a few times and have seen the benefit of the alarms and the ease of accessing the readings all in one place on the pump. However, I have not had a full and successful trial with the sensor as yet and so do not feel that I could personally comment on this function beyond what I have. That does not mean though that I am not eager to use this great feature of the Animas Vibe without the need of an additional handset.

So is there anything I would change? Well yes, like most things there are elements that you would like to see developed in the future, and for me the main one would be the introduction of a handset. I don't find wearing the pump at all uncomfortable and I can hide it away discretely under most clothing, however the fact that you need to access it to input into the pump means that this can sometimes be a bit more tricky! Thankfully, I have discovered the wide variety of waist and thigh belts out there that have helped make this less of an issue. Nonetheless, a handset that could be kept in a handbag would make life a bit easier.

The only other thing I would mention would be the screen. Despite having an easily accessible option to dim and brighten the screen, during sunny days the screen can be a little difficult to see and so you might see me trying to block out the light to get a proper view of the screen...

Overall though, I think the two areas that I've raised as 'future developments' are for me, pretty insignificant compared to the diabetes control and improved daily life that the Animas Vibe has given me. I am sure that many other pumps could have done this or similar, but the ability to increase my insulin rates by increments of 0.025 on the Animas Vibe mean that I can radically reduce my insulin intake per hour whenever I need to. It has also given me the confidence in falling asleep comfortably and without the fear of waking up on a drip and in a hospital bed after a severe hypo as had happened so many times before I started on an insulin pump.

As you can probably tell from my smiles and enthusiasm about the Animas Vibe in this blog, I am really happy to be on this insulin pump and the features and freedom that it gives me. To sum it up, I'd say that you would have to wrestle it off me in order to get me to give it up as it really has been the answer to my diabetes-control prayers...

Thank you once again for taking the time to read my blog post.
Until next time, keep injecting 💉 or pumping 📟 insulin!
Ros x


For further information about the Animas Vibe, please visit https://www.animascorp.co.uk