Welcome to the fifth day of Diabetes Blog Week 2014.
Today's topic = Diabetes Life Hacks
Share the (non-medical) tips and tricks that help you in the day-to-day management of diabetes -- everything from clothing modifications, serving size/carb counting tips to the tried and true Dexcom-in-a-glass trick or the "secret" to turning on a Medtronic pump's backlight when it's not obvious on the home screen (scroll to the bottom of this post). Please remember to give non-medical advice only!
NEWSFLASH: FDA Clears Dexcom Share Direct
Dexcom gets regulatory approval of its 'on-the-go' mobile apps for CGM data-sharing.
State of the Union: It's Time to Cure Diabetes
President launching new precision medicine initiative to better treat, cure diseases like diabetes.
'Robotic Pancreas' Appears On American Idol
Carlos Santana's nephew Adam Lasher shows off Dexcom G4 during live performance.
We love this topic, especially since we're no strangers to going all MacGyver on diabetes tools (remember, those glucose meter batteries can serve multiple purposes!). For D-Blog Week today, we're taking a team approach with both Amy and I pitching in some of our favorite diabetes hacks.
Here they are, in no particular order:
Too Many Cables: Story of our D-lives, that ever-present array of connection cables for meters, CGMs, pumps... not to mention the cell phones, cameras and other devices from our "regular lives." Honestly, I get confused a lot. Particularly since many of these cables look the same, and many don't have (easy to read) words or symbols embedded to identify which one is which. So, I tape little labels onto my chargers and connection cables. Nothing fancy, just some paper or notecard taped on with the appropriate identifier scribbled on it. I use this with my Dexcom G4 along with my camera cord, as those two have the highest potential to confuse me on a regular basis.
Kick-Starting Insulin: I'd never thought of this until recently, but D-blogger friend Kerri Sparling wrote a post about kick-starting her insulin action by getting a little exercise. I struggle with the dawn phenomenon on most days, and it usually takes an hour or more for my correction doses to start working during those early morning hours. So after reading Kerri's post, I started taking the dog for a stroll around the block, or even riding my bike briefly to get the insulin going a bit quicker. And it works! Thanks for the shared life hack, Kerri!
Makeshift Sharps Jug: As mentioned in a past post, I use a thick plastic juice bottle as my sharps container. That way, I don't have to buy an official sharps container or worry about going out to get a new one every time it fills up. With my homemade sharps container, I write my own label that says "Sharps BioHazard" to make sure it's clear what's inside. Of course, as I've reported, there are some official rules and guidelines to keep in mind when it comes to using off-label sharps containers.
Tape & Breath Strips? Speaking of biking and being outside to get exercise, I was searching for some easier-to-transport options for my D-supplies last summer when training for my first-ever Tour de Cure ride. I use a finger-sized USB meter and a pinky-sized lancet device, so carrying those wasn't an issue. But lugging a circular test strip vial around, especially one with up to 50 strips, was just awkward. So I turned to those thin Listerine breath strip containers, putting 5 or so test strips inside so for a super-compact carrying option! At first, I was worried the strip-holder might have a residual minty smell or flavor that could impact blood sugar accuracy (who knows, right?), so I let an empty breath strip container "air out" for a while before using it. The trick works great and fits into my pocket perfectly with just the small supply of strips I might need while out -- for a max of about 4 hours. I also use a couple small pieces of tape on my lancing device cap so that it doesn't come loose and go missing during a ride.
Quick-Grab Airport Bag: Nothing annoys me more than being "that guy" at the airport who takes an unnecessarily long time and delays the rest of the line trying to get through the security checkpoints. I'm already expecting to cause delays when I decline the walk-through X-ray machine and opt for a pat-down, so I'd rather not add to everyone's misery here. I put all my D-supplies into a clear plastic Ziplock bag and toss my Medical Necessity Letter from my endo inside. That way, all of my gear is in one place and I don't find myself scrambling for my meter case, glucose tabs, medical ID bracelet, extra pump battery, and backup supplies when I get to the scanner belt. Usually it's not an issue, but if any TSA observers do get curious, all of my D-stuff is there in one place and ready for inspection.
No Wasted Insulin: It really bothers me to waste insulin (with the cost, how could it not?!), so I do everything I in my power to use every last possible drop. And I also like getting a full reservoir's worth of insulin -- if I'm told my pump holds 300 units, I want to start with exactly that amount and none less. So I try to remember to always leave 10 or 15 units in my pump before going through the site and reservoir change routine. That way, when I'm connecting new tubing, I can prime my pump and use what's left in the old reservoir to fill up the tubing before switching to a newly-filled reservoir.
Surprise Supplies: I keep a whole second set of D-stuff right in the suitcase that I use regularly -- in addition to the "go-bags" that I keep in each of our cars, and in my laptop bag. In the suitcase, I have extra pods, adhesive wipes, glucose tabs, etc., stuffed into the various zip pockets so that even if I forget to pack really well, I always have "surprise" extras on hand. It's kind of like keeping hidden "mad money" around just to cover for Murphy's Law, when it inevitably hits.
Site Change #BGnow Fix: If you use an OmniPod insulin pump, you'll appreciate this trick I got from Gary Scheiner's diabetes education group. Lots of OmniPod users find they run high for the first several hours after a pod change. To counteract this, you can leave the older pod on for about two hours, to let residual insulin seep into your skin, and set a temp basal on the new pod of around +20% for those two hours. Worked wonders for me! Also, to keep track of what happens during these site change periods, if you're Dexcom user: each time you change out your pump, go into the Dexcom "Events" tab and record the site change as "Stress." Whala! Your records will show what happened over that "hump"...
Exercise Temp Basal Hack: This one's specifically for spin class enthusiasts. Everyone's different, of course, but it took me a ton of trial and error to reach this formula:
• Cut your meal bolus by 50% if eating up to two hours before class. Also cut back your basal rate by 60% for 60 minutes BEFORE the class. (I tend to start this temp basal at my breakfast bolus so that I remember to do it.)
• For classes when starting with a BG level of 140mg/dL or higher, drink 8oz.of Gatorade or some other liquid carb at the start of class. Don't bother with solid forms of carbs for this because they just won't hit your system fast enough.
• Corrections after exercise — when eating shortly after exercise, use a 50% reduction of your pump's suggested correction bolus, to be sure you don't crash.
Sushi Hack: Finally, another from Gary Scheiner's group, the magic formula for covering sushi: one medium sushi roll = 6-7 gram carbs/piece; one large roll = 8-9g carb/piece; and to be sure you stay level, you should bolus for 30g of carb in advance when you hit the restaurant. Don't wait for the food to arrive! This hack has saved my sushi-loving #BGnow on many occasions.
So, those are our D-Life Hacks for now. We're always looking for more tips and tricks that might make life with this exasperating illness a little easier, so we can't wait to see what others in the DOC are sharing on this topic today.