The Australian government announced yesterday an enhancement to the pumps subsidy program for children which could help in the path towards universal insulin pump adoption for people with Type 1 Diabetes.
In an article published in their regular newsletter, the Juvenile Diabetes Research Foundation indicates that the “Minister for Health, Nicola Roxon MP, has announced an expansion of the Type 1 Diabetes Insulin Pump Program, with a dramatically increased government subsidy of up to 80% of the purchase price of an insulin pump.
The program was first launched in 2008 and provides a means-tested subsidy towards the purchase of an insulin pump for children under 18 who do not have access to private health insurance.
In Australia insulin pumps can cost up to $8,000, making them a medically desirable but unaffordable option for many without private health rebates.
Children under 18 with type 1 diabetes will now be eligible, on the recommendation of a health professional, for a subsidy of up to 80% of the cost of an insulin pump, to a maximum of $6,400 and a minimum of $500.”
Interestingly, the JDRF has also created a form in the website so members from the public can send thank you notes to the Minister.
Shocking news have circulated the internet that Casey Johnson has died from Diabetes Ketoasidosis, a complication often associated with poor diabetes management. “Dr. Michael Baden, former chief medical examiner in New York City, said Johnson probably slipped into a diabetic coma, but people can usually be resuscitated from that in the first 24 hours.”
Johnson, the daughter of New York Jets owner Robert “Woody” is also the heir to the Johnson & Johnson health care products fortune. Of course, Johnson & Johnson is the owner of Animas corporation, one of the biggest makers of Insulin pumps.
One can only begin to imagine the effect this unfortunate event will have on Animas. Johnson lived a party life. In December, she announced her engagement to bisexual reality TV star Tila Tequila. Its very sad that someone with all the resources to have great control of the condition has ended this way.
I’m just back from a fairly long international trip, and thought I would share some of my experiences traveling with an insulin pump.
As I had an incredible number of connections during my flight, I had to go through Airport security a number of times. As I went through security the first time, I though I would save myself the inconvenience and take the pump off and put it through the metal detector. Despite the fear of some people that X-Rays may damage the device, the reality is that there is nothing magnetic in tha X-Ray machine, and I’ve been assured that puting the pump through it will not damage it.
After my second connection in San Francisco, I was told that taking the pump off was completely unnecesary. The officer said: “Is that an insulin pump?”… “you don’t need to take it off, the machine will not beep for it so you can go straight through with it”. So I decided to do that, after all, taking the pump off was a (very small) inconvenience and great if I could avoid it.
I left it on as I went through security in Newark. Given the temperature outside was welll bellow freezing, we had a significant amount of clothing on. We were asked to put coats and other outerware through the Xray machine. As I ended up with my Jeans and T-shirt I was asked by an officer again if that thing in my belt was an insulin pump. “Yep” I replied and then I proceeded to go through the metal detector, which as promised, did not alarm.
But thing had not ended just yet. I was then instructed to step into a flexyglass cabin for a manual inspection. As I asked what prompted the different process I was told that “We need to do an extra check because you are wearing an insulin pump”. Ten minutes later we where in our way, a bit disappointed that things did not go as smoothly as I expected.
So I made a decision. For the rest of the trip (another 6 or 7 flights) I disconnected my pump and put it in the little tray with the rest of my electronics. After all, pumps can be disconnected for up to a couple of hours, and pumps consumables don’t even show-up on the X-rays
Baseball player Dave Hollins is shares his story of being diagnosed with Type 1 during his professional career. He shares his first experience with going on insulin and how the earlier versions of a pump where not right for him. Today, Dave is in great health and uses an insulin pump to manage his diabetes.
Yesterday I was packing my diabetes supplies for an upcoming international trip, and though it may be useful to share some insights about what I’m packing. This is my first big trip since I’m on the pump, and must admit that my first impression is that there us a lot more “stuff” I need to carry with me compared with my last trip on injections. My kit looks like this:
Here is the list of what I’m bringing with me:
2 boxes of Paradigm Quicksets (20 sets total)
2 boxes of Paradigm reservoirs (20 in total)
4 boxes of test strips for my Freestyle Lite(400 strips total)
Spare Medtronic pump
Portable sharps container
3 vials of NovoRapid/Novolog (10ml each)
A few lancets
5 syringes (in case things o wrong)
3 AAA bateries + coin (for the pump)
Spare Freestyle Lite
Alcohol swabs
Ketone strips
Quickserter
Frio bag (to keep the insulin
Overall, my diabetes supplies will take about half of the space on my carry-on, and believe me, I want this stuff with me at all times. The last thing I want is for my diabetes supplies to be lost in one of the many connections I need to take, so puting it in checked luggage is not going to be an option.
It’s probably also worth mentioning (you probably noticed in the list above) that I’m taking a second insulin pump with me. Medtronic has a program where you can get a spare pump when you are traveling. It’s probably not necesary if your destination is in a country where Medtronic has a significant presence. However if your trip includes more obscure places I highly recommend you consider borrowing a backup. My backup pump is Medtronic 515, a bit older than my current Medtronic 522, but considering is just a backup, it should be more than adequate. Kudos to Medtronic for puting this program in in place here in Australia.
Yesterday I received a letter from Medtronic, informing me of a new approval after some recent changes to their CGMS products. Medtronic has completed a study titled “An Inpatient Evaluation of Six-Day Subcutaneous Glucose Sensor Performance” which proved that sensors can be used for 6 days instead of 3. Additionally, sensors where also tested in alternate sites, instead of just the abdomen.
According to the study “The Medtronic MiniMed Subcutaneous Glucose Sensor was originally approved by the FDA for commercialization as part of the Continuous Glucose Monitoring System (CGMS) on June 15, 1999 (PMA 980022). The Sensor is composed of a microelectrode with a thin coating of glucose oxidase beneath several layers of biocompatible membrane. This same sensor is used as part of the Guardian REAL-Time System, the latest advance in continuous glucose monitoring, which is based on the CGMS. Similar to the CGMS, the Guardian REAL-Time System has been developed for use in conjunction with a standard home blood glucose meter. The Guardian REAL-Time received regulatory approval from the FDA in 2006. As currently used, the Subcutaneous Glucose Sensor is labeled for a maximum use duration of 72 hours, using only the abdomen area as an insertion site. Recent studies have shown that the useful sensor life could extend beyond three days, and it is reasonable to expect a significant percentage of sensors to last six days. It is the goal of this study to confirm sensor performance accuracy data from one of these recent studies. The sensor is also commonly worn in body areas other than the abdomen (such as the buttock). This study will also demonstrate sensor accuracy when used in an alternate site.”
This is a very positive piece of news that means that people here in Australia can now get Continuous Monitoring for about half the cost of what was possible previously. This is particularly important since insurance coverage for CGMS is not available here in Australia and patients wanting to use it have to pay out of pocket.
Now, a lot of people where reusing the sensors to achieve the 6 day mark, even if it was not officially approved. It would be interested if that same people will now try to get it to work even longer than 6 days…
This week I had the opportunity to attend the Insulin Pump Expo 2009. This event is organized by The local chapter of Diabetes Australia, and brings together the diabetes community interested in Insulin Pumps. There were two presentaton tracks on the day, one for prospective pumpers and an advanced one for those of us who have been pumping for a while.
In the introductory session they introduce the basic concepts of pumping, with the objective of helping people decide whether they may be interested in an insulin pump. There is also presentations by most pump manufacturers and it’s an interesting to see them competing with each other for patients attention.
I’m already on a pump and pretty much locked to it for the next 3 1/2 years, so for me, the advanced session was where the real value was. Cheryl Steele from the Diabetes Department at Western Health, presented a very comprehensive presentation on bolus options, handling tricky food and continuous glucose monitoring.
Particularly interesting for m was the section on takeaway foods. I’ve always had issues with some foods and had assumed that there was not much you could do… Naughty eating gets naughty BGLs…. It turns out that what I’ve been doing wrong is using the wrong type of bolus. I’ve been using normal bolus for everything while in reallity the fat content of the foods slows down the absortion rate.
Some of the recommendations were quite impresive… for a Big Mac, for example… 50% of the insulin immedicately and 50% over 3 or 4 hours… Pizza, 30-40% now and the rest over 6-7 hours. We were also told to include part of the fat content in the carb count as the liver will eventually turn it into glucose.
Overall was a great night and look forward to see whether I can used what I learned to get better control.
Today I bumped into the website of a company from Israel that is working with some incredible technology for insulin pumps.
NiliMEDIX seem to have created the first insulin pump without a motor. This will, in theory, help eliminate a lot of the risks and malfunctions inherent to using a pump in the first place, and may also make pumps cheaper.
Here is a video from the company describing the product:
The company is also working on a patch pump to compete with Omnipod and a disposable insulin pump, likely aimed a type 2 diabetics.
For me, and insulin pump is the best thing that could happen to me since becoming a diabetic. It has allowed be a level of flexibility and control that has never been possible before. With the pump I’ve been able to get as normal a life as a type 1 diabetic can have and I’ve been able to achieve nearly normal glucose levels with a fraction of the effort that it would take otherwise.
I wear a Medtronic Paradigm 522, and trust it with my life. Is exactly for that reason that recent news published in the canadian newspaper The Windsor Star where someone got killed by their pump.
Steven Krueger used an insulin pump for four years after nine years of daily injections, and according to his parents “it allowed him to accomplish things he otherwise would not have been able to do as a diabetic. He received his scuba diving certificate, completed the Red Cross Lifeguard Program and earned his recreational pilot’s licence.
Steven’s pump failed by giving him a lethal dose of insulin and he died in his sleep three years ago at the age of 27, while living in British Columbia. The cause of death was confirmed by the B.C. coroner’s office. Dr. Phillip Neufeld at the Health Canada lab in Ottawa tested the pump and confirmed the failure and cited some additional interesting facts regarding the Medtronic Minimed Paradigm infusion pump, model MMT-511 that Steven used.”
Other deaths by lethal insulin doses have been recorded in the past, but the pumps have never been tested and therefore, a solid link can not be established. I must admit, however, that the thought of my pump having the potential of killing me makes me nervous.
I can only hope that Medtronics newer pumps have corrected any potential issues…
Many of my readers already know I live in Australia, and some may know that here the seasons are reversed, which means that instead of the middle of summer, we are about half way through our winter season.
A couple of weeks ago I spent a weekend skiing in the Australian alps, and decided to share some of the tips that others gave me and that made this incredible fun experience possible.
I’m on a pump, and that made a lot of difference. Skiing is quite a strenuous spot, so I initially set my basal at 50% of normal rate. I still ended up going lowish (not quite hypo but lower than I wanted) so I lowered to 20% and that worked better for me. (note, this is me so no guarantee it would work for anyone else).
Australian ski resorts are a bit warmer than those in Europe or the US, but still go subzero regularly. Skiing on these conditions means that extra measures have to be taken to prevent insulin from freezing. In my case, I decided to keep my pump on the inside of my jacket, in one of the pockets (mine has a ipod pocket, which is perfect). Having the pump in my jacket meant I could also feel the vibrations, which is easier than trying to listen to alarms while in a loud chairlift.
On one of the other pockets, I had a few muesli bars. I aslo carried my Freestyle lite meter, which behaved well in the cold. Also, beware you may test more than usual as sometimes being cold can be confused with the symptoms of hypo. I actually ran out of strips so beware.
Overall I had a great time in the snow, and will hopefully come back later in the season, hopefully better prepared.
The Australian government announced yesterday an enhancement to the pumps subsidy program for children which could help in the path towards universal insulin pump adoption for people with Type 1 Diabetes.
Posted by Henry 
According to the study “The Medtronic MiniMed Subcutaneous Glucose Sensor was originally approved by the FDA for commercialization as part of the Continuous Glucose Monitoring System (CGMS) on June 15, 1999 (PMA 980022). The Sensor is composed of a microelectrode with a thin coating of glucose oxidase beneath several layers of biocompatible membrane. This same sensor is used as part of the Guardian REAL-Time System, the latest advance in continuous glucose monitoring, which is based on the CGMS. Similar to the CGMS, the Guardian REAL-Time System has been developed for use in conjunction with a standard home blood glucose meter. The Guardian REAL-Time received regulatory approval from the FDA in 2006. As currently used, the Subcutaneous Glucose Sensor is labeled for a maximum use duration of 72 hours, using only the abdomen area as an insertion site. Recent studies have shown that the useful sensor life could extend beyond three days, and it is reasonable to expect a significant percentage of sensors to last six days. It is the goal of this study to confirm sensor performance accuracy data from one of these recent studies. The sensor is also commonly worn in body areas other than the abdomen (such as the buttock). This study will also demonstrate sensor accuracy when used in an alternate site.”
This week I had the opportunity to attend the Insulin Pump Expo 2009. This event is organized by The local chapter of Diabetes Australia, and brings together the diabetes community interested in Insulin Pumps. There were two presentaton tracks on the day, one for prospective pumpers and an advanced one for those of us who have been pumping for a while.
For me, and insulin pump is the best thing that could happen to me since becoming a diabetic. It has allowed be a level of flexibility and control that has never been possible before. With the pump I’ve been able to get as normal a life as a type 1 diabetic can have and I’ve been able to achieve nearly normal glucose levels with a fraction of the effort that it would take otherwise.
Many of my readers already know I live in Australia, and some may know that here the seasons are reversed, which means that instead of the middle of summer, we are about half way through our winter season.
