Travelling with Diabetes

February 15th, 2011

Diabetes control can be a trial, even when you are in a familiar location with all of your supplies at hand. Going to a foreign country, or even city, adds extra complications and can be daunting. With the proper planning, however, travel can be enjoyable and relaxing.

Before you go:

  • Get travel insurance
  • Check in with your health care provider to make sure that you are fit to travel, and get any vaccinations required for your destination
  • Fill any prescriptions you require (make sure you have twice what you need, just in case)
  • Bring copies of your prescriptions and a list of medications that you are taking
  • Research your destination for information on medical clinics and food options

En Route:

  • Check airline regulations concerning carry-on luggage
  • Keep prescriptions, diabetes medications and syringes on you at all times
  • Don't let your insulin or insulin pumps go through the x-ray talk to the security staff beforehand and ask for a manual search of your medical supplies
  • Make sure all insulin and supplies are properly marked with a professionally printed label from the manufacturer or pharmacy
  • Syringes must have needle guards and be kept with your insulin
  • Alert the security staff if you are wearing an insulin pump as they will need to check it in person
  • Take time to stretch or walk around

While There:

  • Remember to keep time differences in mind when you check your blood sugar level. Talk to your doctor, as you may need to adjust the dosage of your long-acting insulin, depending on how many hours you gain or lose in your travels.
  • Always bring extra water and snacks on outings
  • Keep your diabetes medication in two separate places, just in case anything gets lost or stolen
  • Never go on hikes or to remote places on your own, and make sure that your travel buddy is aware of your condition

Whether you are going away for a weekend or a month, to a new city or a new country, the proper preparation can ensure an enjoyable trip. Bring extras of all your supplies, keep snacks and bottled water with you at all times, and when in doubt, ask your health care provider.

Animus Issues Urgent Recall Notice to Insulin Pump Users

March 12th, 2011

In a rare development that all insulin dependent diabetics should be aware of, Johnson & Johnson has recalled around 384,000 cartridges for its Animus Insulin Pump.

To date, twenty-two injuries have been reported as a result of faulty insulin pump cartridges leaking at the side where the plunger is. The leaks can result in the diabetic using the cartridge receiving a lower insulin dosage than they intended.

Johnson & Johnson has posted an urgent notice on their Animus division website warning consumers to check their cartridge supply and to stop using any of the 2.0 ml cartridges in question immediately. It is also contacting insulin pump users, or as they refer to them, "insulin pumpers", that may have purchased the faulty cartridges, and shipping them replacement cartridges. The website notice reads in part:

Please note that under-delivery of insulin can cause high blood sugar and/or diabetic ketoacidosis. These are serious conditions that can cause severe health impact, including death. Symptoms of diabetic ketoacidosis may include nausea, vomiting, shortness of breath and excess thirst/urination. Contact your healthcare professional immediately if you are experiencing any of these symptoms.

Ketoacidosis usually develops slowly over 24 hours, starting with symptoms such as fatigue, mental stupor, decreased appetite, loss of appetite, headache, and fading consciousness. Other ketoacidosis symptoms all insulin dependent diabetics should be aware of include stomach or abdominal pain, a flushed complexion, and breath that smells like fruit or nail polish remover.

The insulin cartridge recall extends to the US and France. The recall applies only to lot numbers B201575, B201576, B201581, B201582 and B201583. The insulin pump cartridges in questions were shipped between November 30th, 2010 and January 4th, 2011.

Animas has provided the following instructions for insulin pumpers diabetics with a recalled insulin cartridge who need to disconnect their infusion sets:

1) Disconnect the infusion set from your body (failure to follow these important safety instructions can lead to unintended delivery of insulin).

2) Unscrew the cartridge cap, leaving the tubing connected to the cartridge.

3) With the tubing connected to the cartridge, pull the cartridge straight out of your insulin pump.

4) Disconnect tubing from cartridge, set the cartridge aside to return to Animas.

5) Fill a new cartridge from an unaffected lot not listed above, and attach infusion set tubing.

6) While still disconnected, rewind, load the cartridge and prime.

7) Connect tubing to site once prime is complete.

8)Fill cannula only if you have inserted a new infusion set.

Animas Customer Support can also be reached by phone toll-free at 877-937-7867.

Artificial Pancreas Awaiting FDA Approval for Clinical Testing

March 26th, 2011

The artificial pancreas is a unique combination of three main closed-loop components:

1) A continuous glucose monitor for ongoing blood sugar levels and patterns

2) A programmable computerized insulin pump

3) An advanced computer algorithm (formula) that can calculate how much insulin the body needs, and when it needs it

Although just the "research and development first step" towards a fully functioning artificial pancreas, the insulin delivery system now awaiting approval for clinical trials is, according to Animas' Chief Medical Officer and director of Project Manya, Dr. Henry Anhalt, "leaps and bounds above technology that is currently available."

Anholt points out that current insulin pumps, which he calls "unintelligent", can monitor blood glucose and dispense insulin, but still require users to input and interpret a lot of data. While some decisions will still have to be made by users until the device is fully automated, Anholt says the new artificial pancreas can "assist the patient and in many ways, take over the decision-making process".

Once perfected, the new technology will have a monumental impact on the quality of life of insulin dependent diabetics. Not only will the new insulin delivery system simplify the constant challenge of controlling blood sugar, accurate insulin dosing and administering insulin injections, the resulting tight blood sugar control will help ward off a host of diabetes complications such as blindness, nerve damage, amputations and kidney and heart disease.

Frequently Asked Questions About Insulin Pumps

April 1st, 2011

insulin pump
About.com type 1 diabetes guide Gary Gilles believes that insulin pump therapy has changed the way people with insulin dependent diabetes handle their condition. Gilles, a health writer and diabetes counselor, has put together a helpful list of FAQ's on insulin pump therapy, answering inquiries from the basic "What is an insulin pump?" to questions about their safety, effectiveness and how to program and troubleshoot an insulin pump.

Click >HERE< to read Gilles' insulin pump FAQ's on About.com. Gilles' article links to related posts on the pros and cons of insulin pump therapy, types of insulin pumps, and the latest research.

Insulin Therapy Changing With New and Improved Insulin Delivery Methods

April 14th, 2011

An old insulin syringe
Not that long ago, being insulin dependent meant you had to carry around a syringe and a vial of insulin to deliver your insulin injections, making sure to keep them refrigerated. There are now a variety of methods for insulin delivery on the market, and some promising new developments on the horizon. These include:

1) Insulin pens. Most types of insulin are now available in convenient prefilled pens. Some insulin pens are entirely disposable when empty, and others use a replaceable insulin cartridge, usually containing 300 units. There is a dial on one end to set your desired dose. The pens offer discreet, push button insulin delivery. Some claim the injections are more comfortable than from a needle that has already been dulled by insertion into an insulin vial. Many people prefer to use an insulin pen if they are caring for a diabetic child or pet.

2) Insulin pumps. Insulin pumps are a device about the size of a pager that adhere to the skin and are worn 24/7. Insulin pumps contain an insulin reservoir, a battery powered pump, and a programmable computer chip that allows the user to control insulin dosing.

The pumps is attached to a thin plastic tube called a cannula, which is inserted just under the skin to deliver insulin subcutaneously and continuously. Insulin pump technology is constantly being improved upon. The newer pumps are smaller, and can "communicate" and interact with a continuous blood glucose monitor and computer software for state of the art blood sugar control.

3) Insulin jet injectors. Insulin jet injectors deliver a fine jet of high pressure insulin directly through the skin. The main advantage is that that the insulin delivery system requires no needles. The major disadvantage is that many diabetics find the force required for the insulin to permeate the skin is painful, and may cause bruising. Jet injectors have been on the market since 1979, but have yet to become popular.

4) Insulin patch. The FDA has just approved a new insulin delivery patch. The new device, Finesse, is a small plastic patch-pen roughly 2 inches long and an inch wide that is attached to the skin like a bandage. It can be worn under your clothes, and remains attached during routine activities like sleeping, exercising and even showering.

Patients use a syringe to pre-fill the patch-pen with a three-day supply of insulin, and simply push two buttons to dispense a dose of fast-acting insulin when needed. The insulin is delivered in seconds through a miniature, flexible plastic tube inserted painlessly into the skin. The manufacturer, Calibra is also working on a patch-pen that would deliver a .05 unit insulin dose for children.

5) Inhaled insulin. The FDA approved the first insulin inhaler, Exubera, in 2006. It was a short-acting insulin delivered to the lungs through a device similar to an asthma inhaler. But it never achieved market success, and was discontinued a year later.

But research on inhaled insulin continued, and two new forms are poised to hit the market. One is an insulin inhaler, AFREZZA, which is awaiting FDA approval. The other is an insulin spray which is absorbed through the mouth, called Oral-Lyn. Oral-Lyn is in Phase 111 clinical trials in Europe and North America.

Despite some obvious advantages to the new insulin delivery methods, tried and true insulin syringes remain the most popular way to deliver insulin injections with most insulin dependent diabetics, who no longer consider injections a big deal.

Insulin pens, insulin pumps, and insulin jet injectors are all more costly than insulin syringes, and not always covered by medical insurance.Not all types of insulin are available in insulin pens, and you can't mix insulin types in a pen.

Insulin pumps can kink or otherwise malfunction, posing the danger of inaccurate insulin dosing, and are just too "high tech" for some diabetics. Many diabetics remain skeptical of devices like insulin inhalers and sprays after Exubera's spectacular lack of success.

Still, with the advances being made in insulin pumps, and the pending introduction of an improved inhaled insulin and the insulin patch, the world of insulin therapy is definitely changing - and most would say for the better.

Artificial Pancreas Performs Well in British Trials

April 15th, 2011

model of a pancreas
Pancreas model. Photo: Suleyman Habib
There's good news coming out of Britain for type 1 diabetics. Researchers conducting tests with a closed loop system artificial pancreas were able to better stabilize blood sugar in two groups of study participants than with a conventional insulin pump and - most importantly - to keep their blood sugar from dipping overnight.

An artificial pancreas combines an insulin pump, a continuous glucose monitoring system, and a high tech that provides sophisticated instructions to the insulin pump and glucose monitor depending on blood sugar readings. For example, the computer algorithm computes insulin doses according to rising or falling blood sugar levels, and sends instructions to the insulin pump to deliver the optimum dose. The goal is to have the system act as much as a normal pancreas as possible.

The researchers tested the artificial pancreas in 24 insulin dependent diabetics in two real-life scenarios - an evening meal eaten at home, and a dinner eaten out, including alcohol. Half of the diners were given the artificial pancreas system, while the other half used conventional insulin pump therapy.

To read more on this story online at WebMD, >CLICK HERE.<

High Tech Tools for Diabetes Control

May 11th, 2011

insulin pump
It's hard to believe that insulin has only been around as a diabetes treatment since 1922. A pair of Canadians, Dr. Frederick Banting and Charles Best, discovered how to extract insulin from animal pancreases, and then used the insulin to treat diabetes in humans. Stories are told of how they went to hospitals and, with a single insulin injection, resuscitated diabetes patients who were already in a coma.

Originally, all insulin was extracted from animals. In the 1970's, researchers started using recombinant DNA technology to produce pure analogues of human insulin. In the last century, diabetes medication and management has progressed by leaps and bounds, including the introduction of long acting insulin in 2003.

The first FDA approved insulin pump hit the market in 1983, and dibetes management technology has greatly advanced in the last couple of decades. WebMD has researched four noteworthy high tech tools for insulin control, including continuous glucose monitors, insulin pumps, a combination of a continuous glucose monitor and an insulin pump, and diabetes information management software that allows the monitor and pump to operate much like an artificial pancreas.

To read the entire article on WebMD, >CLICK HERE<.

Oil Refining Expertise Being Applied to Closed Loop Artificial Pancreas

June 15th, 2011

Engineers from the Rensselaer Polytechnic Institute are building on automation techniques used in oil refining to create a closed-loop artificial pancreas for type 1 diabetics. The Institute's Professor B. Wayne Bequette, whose sister developed diabetes early in life, has been fine tuning an increasingly advanced diabetes control system for six years.

The pancreas of a type 1 diabetic produces little or no insulin, leaving them dependent on insulin injections. Blood sugar and insulin levels rise and fall normally during the day, responding to factors like meals, the type of food eaten, stress and exercise. Diabetics must monitor their blood sugar levels frequently, and adjust their insulin dose accordingly.

Bequette's artificial pancreas marries an insulin pump with a continuous glucose monitoring system. The combination quickly and accurately identifies and responds to rapid variations in blood sugar and insulin levels, eliminating the need for frequent testing and guesswork.

To read more about Bequette and his fellow researcher's work on theEngineer >CLICK HERE.<

Online Diabetes Community Invited to Contribute to Video Project

June 17th, 2011

Kim Vlasnik, an insulin dependent type 1 diabetic since the age of six, found welcome support through the online diabetes community. She has been writing the cheeky diabetes blog Texting My Pancreas (a name inspired by her insulin pump) since 2010. "Living with diabetes feels much more bearable when I think of it as a team sport," she writes on her About Me page.

Now the ambitious Vlasnik has launched a companion video project to strengthen the online community and to lessen the isolation, depression, anxiety and frustration often caused by diabetes. The project, called You Can Do This, invites diabetics to create and share videos of their personal challenges to show others they can get through the tough times.

Vlasnik believes that everyone with diabetes struggles at one time or another, and that validation and community can lighten the emotional load. "Tell us your stories," she invites her readers, "Show others what living with diabetes is really like - no sugar-coating. Talk about the tough stuff. Show us how you've dealt with it. Let others see their own struggles and feeling through your words."

Launched June 15th, 2010, the site had almost fifty videos uploaded in its first two days, and numerous positive comments posted by grateful fans. Texting My Pancreas and the You Can Do This Project can be found at www.textingmypancreas.com.

More Progress Made Towards the Development of an Artificial Pancreas

July 7th, 2011

Researchers are continuing to make progress in the development of an artificial pancreas for insulin dependent type 1 diabetics. An artificial pancreas is an automated, closed-loop system consisting of a continuous glucose monitor, a glucose meter to calibrate the monitor, and an insulin pump.

With the help of a sophisticated computer system, an artificial pancreas produces insulin and controls blood sugar in a diabetic much as a normal pancreas does in a person without diabetes. The sophisticated system senses when the body needs insulin, calculates the dose needed, and delivers automatically, eliminating the need for insulin injections.

To read more about several recent advances towards the development of an artificial pancreas on WebMD, >CLICK HERE<.

Flying Can Cause Changes in Insulin Pump Performance

August 30th, 2011

Diabeticlive.com is warning insulin dependent diabetes planning to take a plane that changes in cabin air pressure while flying may alter the functioning of insulin pumps. The research arose out of an incident involving a young diabetic traveler using an insulin pump whose blood sugar levels dropped unexpectedly one hour into a flight.

After uncovering reports of similar incidents involving insulin pumps delivering incorrect insulin doses while being used on planes, a team of researchers from John Hunter Children's Hospital in Australia decided to perform some tests.

They placed ten insulin pumps on a commercial flight. When they analyzed them later, they found the pumps delivered 1 to 1.4 extra units of insulin after take-off, and that a small amount of insulin was drawn back into the pumps when descending for a landing.

To read the entire story on diabeticlive.com, including the researchers' suggestions for diabetics with insulin pumps who plan to travel byplane, >CLICK HERE.<

Should You Take a "Vacation" From Your Insulin Pump?

October 6th, 2011

insulin syringe

A veteran insulin pump user wrote a thought-provoking post for HealthCentral.com about "taking a vacation" from insulin pumping. It begins:

By Kelsey Bonilia

"One of the ideas I'd been mulling over in the weeks leading up to my endocrinologist appointment was taking a pump vacation.I'd experienced several frustrating pump site malfunctions (the cannula kept kinking during insertion) that left me with stubbornly high blood sugars for hours.It was maddening to have poor blood sugar control because of my insulin delivery system.Also, after nearly five years of insulin pumping, I just wanted the freedom of life without a little medical device tethered to me.

Upon discussion with my doctor, I made the comment "I know that the pump is best..." to which he replied, "For some people, but it's not inherently better." He knows that I eat a fairly disciplined diet and still test my blood sugar 10-12 times a day, so he agreed that switching to insulin injections would be fine for me. He prescribed Humalog and Lantus insulin pens, which I'd never used before.It was kind of exciting to open the boxes of pens and learn how to use a new device!"

Kelsey plans to update the pros and cons of switching to insulin injections after using an insulin pump for almost five years. To read this and future posts on HealthCentral.com, >Click Here.<