A twofer

Friday, March 23, 2007 | 4 comment(s)

In the past two days, there were two separate (and completely independent) items/events that occurred where I thought to myself: "Hmmm, I should write something about this..." Rather than trying to choose which one to write about in my limited writing time, I've decided to just include both of these unrelated items here in this one post. As such, they are likely to each be given a half-assed treatment, but when put together... well, you get the picture.

So without further ado:
No Delivery
Say these two words to any non-diabetic, and I have no idea what the first thing that might come to mind
Thought experiment
It's actually an interesting mental exercise to try to pull off -- to abstract away from yourself and imagine what someone else might think about a certain situation, event, stream of words, etc. I almost never do things like this instinctively, and my failure to do so often gets me in trouble.

My initial guess would be that the first thing that comes to minds for non-diabetics would be something to do with pizza delivery.

close
for them would be. In fact, I'd imagine that these two words are relatively meaningless even for diabetics who are not on an insulin pump. But for those of us with insulin pumps, a quick beep-beep-beep-beep and a NO DELIVERY
I'm curious
I use a Minimed pump, so this is (obviously) the message that the Minimed pumps display. Are there similarly curt onomatopoetic noises and dread-inducing messages flashed on other pumps? I'm guessing, yes, but I don't know what they are, or whether they're any less fearful or more helpful or what.

close
message is a hassle and can even cause a good bit of anxiety depending on the situation.

I biked into work on Thursday. I wear my beloved rucksack while biking. This thing weighs a TON. I've got normal everyday diabetes supplies in there, plus clothes for the work day, a packed lunch, a book and/or a magazine, and for some reason, I've been carrying around a bottle of water that I just took out of my bag today. The pack has a waist band and a chest strap. I buckle these both down as tight as I can to help keep the weight off my lower back while biking. On the ride in, I could feel the waist band digging in pretty good on my infusion site.

I got into work, tested my blood sugar (155 mg/dl -- which had actually gone up from the 127 mg/dl I left the house at -- but I've noticed that that happens semi-regularly), and bolused for my breakfast of yogurt and a half cup of Fiber One cereal, per my usual routine.

But before the bolus was fully delivered, I got the dreaded "beep-beep-beep-beep" and I knew before even looking at the pump screen what it was going to say.

And so, sure enough, a quick wave of panic hit me.

Luckily, I keep a little dopp kit of extra supplies in one of my drawers. I pulled it out and opened it and wasn't sure I had the supplies I needed. I saw a few of these big bulky packages of Sof-set
It's ridiculous
I really don't understand why marketing firms need to bastardize the English language so. It's not as if it isn't a difficult enough language to learn without all these "cute" misspellings. Pisses me off.

close
QR® Infusion Set and a big blue Sof-serter® in there, but I hadn't used these in quite a while and couldn't remember whether I could connect my reservoir to it or not. Sure enough, I had thought about this situation before when I was packing this little back-up kit, and they fit just fine.

I know that there are times when we complain about how bad diabetes technology can be, or how much better it should be designed, but sometimes we forget to appreciate just how far things have come. And you don't realize how much an improvement something new is really until you are forced to go back to an old method. First off, the Sof-serter® is barbaric. It hammered the infusion set in with such force, I nearly cried. It's the infusion set equivalent to the external, swinging-hammer, blood-letting device that came with the first generation of glucometers.

I love my Quick-set® Infusion Sets and the little blue Quick-serter®. I don't think I've cried once since using them.

Head Slappingly Obvious
I received a copy of JDRF's Research Frontline ("The JDRF Research E-Newsletter No. 63") on Wednesday. There is an article (not sure if it's technically an article... a research summary?) titled "Glucagon May Add Another Dimension To Artificial Pancreas."

The hypothesis is brilliantly simple: to practically implement a closed-loop solution to the "artificial pancreas" quest, it might be a good idea to add glucagon to the mix.

I was struck by how logical this was and shocked that I hadn't heard it mentioned before or even thought of it myself.

Most plans for a closed-loop solution that I've read about includes an insulin pump, a continuous glucose monitor, and some mind-bogglingly crazy difficult to imagine software algorithms to safely administer insulin in exact enough increments to constantly maintain a near-normal blood sugar. I'm certain that there are numerous feed-back loops to hopefully prevent sever malfunction of this device, but the addition of glucogon as a counter-regulatory hormone added to the mix just makes perfect sense to me.

I've always been of the opinion that I would much rather prefer a molecular solution to this "diabetes problem" over a mechanical one. Mechanical things break, go hay-wire, wreak havoc. But, I guess, so too do molecular things. After all, that's how we got in this mess to start with. Perhaps I'll have to re-think my position on this issue.

4 Comment(s):

Blogger Scott K. Johnson said...

I used to use those Sof-sets too, and I agree - that inserter was just too forcefull. I guess they wanted to be sure that needle got in there!

On the glucagon thing - could you imagine having to BOLUS for a LOW? That would really play games with us "old schoolers"...

"Oops - 42 mg/dl? Guess I'll pump in a unit or two of Glucagon"

How weird would that be?

Anonymous Jana said...

Re: The Quickserter. I've never used the Sof-sets, but I'm not on entirely friendly terms with my Quickserter. Sometimes one of the little white buttons gets stuck, and then I have to re-"lock and load" (as I think of it). This sometimes steals away those precious seconds of time before the IV Prep is dry when you get maximum adhesion (important for me because I work out a lot and sometimes shower twice a day).

Blogger Chrissie in Belgium said...

I also have been a bit negative toward "mcehanical solutions". Although I love my pump, I am definitely familiar with that PANIC feeling when the pump beeps its alerts..... I also read that article about using glucagon in a "closed loop" solution, but what worried me is that I have also read that if your liver reserves are low or depleted then glucagon just does not work! This is one reason why you must always eat after tyou take a glucagon injection. If one has repeated hypos it is not unusual for the sugar in the liver to become depleted. Maybe they will be able to iron out these difficulties. But when will they really get a SOLUTION? Sometimes you get so sick of hearing about all the new progress...... Europe is SO far behing the US. I had to put in the catethers MANUALLY, and that is why I prefer my teeny little needles of 6mm which do not require any long insertion needle.

Blogger jill. said...

That glucagon concept is interesting, but I found it to be a little problematic. Aside from the fact that the protein would deteriorate weekly and need to be replenished, it simply doesn't work if you have depleted your glycogen stores. Plus, the pancreases of people with type one can still make glucagon, right? So our bodies would be making the glucagon for the low at the same time the "system" recognized it and that would result in a high. Maybe? Ugh, my brain hurts...

Post a Comment || Go Home