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Source: (consider it)
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Thread: Diabetes, Revisited
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The5thMary
Shipmate
# 12953
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Posted
Hi, all. I was hoping to spur a new discussion about diabetes since I have "fallen off the wagon" as of late and am getting back to the serious business of taking care of myself. I just visited my new endocrinologist last Thursday and sort of lied to him about how my blood sugar numbers have been. They're not horrible but they could be a lot better. My last A1C (February 2011) was 5.4 but my overeating is still a problem. The endo suggested I go on Byetta, a.k.a. "Lizard Spit" and said that I would lose a lot of weight and it would suppress my appetite so I could live without constantly craving food.
Any Ship mates using Byetta? I'm still rather needle phobic and want to know if injecting it hurts?
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God gave me my face but She let me pick my nose.
Posts: 3451 | From: Tacoma, WA USA | Registered: Aug 2007
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Sober Preacher's Kid
Presbymethegationalist
# 12699
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Posted
Your A1C was 5.4 and your readings were off? ![[Confused]](confused.gif)
I'm Type 1, so frankly I'm far more variable.
Though I suck back insulin in the morning and hardly need a whiff of it in the afternoon. Crazy body.
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NDP Federal Convention Ottawa 2018: A random assortment of Prots and Trots.
Posts: 7646 | From: Peterborough, Upper Canada | Registered: Jun 2007
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The5thMary
Shipmate
# 12953
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Posted
Sorry, Zappa. Do what you must. I hope you don't kill this thread entirely, though.
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God gave me my face but She let me pick my nose.
Posts: 3451 | From: Tacoma, WA USA | Registered: Aug 2007
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Uncle Pete
Loyaute me lie
# 10422
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Posted
It wouldn't be killed; it would just be moved.
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Even more so than I was before
Posts: 20466 | From: No longer where I was | Registered: Sep 2005
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Uncle Pete
Loyaute me lie
# 10422
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Posted
And I'd kill for 5.4. That's high-end normal (i.e. watch it!)
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Even more so than I was before
Posts: 20466 | From: No longer where I was | Registered: Sep 2005
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The5thMary
Shipmate
# 12953
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Posted
Well, yeah, my A1C is great and the 500 mg of Metformin is keeping my blood glucose fairly normal but I'm still fat to the tune of 100+ pounds and my endocrinologist suggested Byetta. He says it curbs your appetite and just helps you lose weight quickly. But it's an injectable medicine, so I'd have to revisit my fear of needles and the side effects of Byetta can be pretty bad, from what I've read.
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God gave me my face but She let me pick my nose.
Posts: 3451 | From: Tacoma, WA USA | Registered: Aug 2007
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The5thMary
Shipmate
# 12953
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Posted
Okay, so in order not to violate any more Ship commandments, I'll just ask: Does anyone inject diabetes meds and if so, did it hurt like hell when you started? I've heard it hurts less than pricking your finger to test your blood sugar but I don't test on my finger, I test on my arm. And it only hurts on my arm when I can't get any blood and I have to repeatedly lance it or when I hit a nerve.
Needles, needles, needles, I hate 'em!
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God gave me my face but She let me pick my nose.
Posts: 3451 | From: Tacoma, WA USA | Registered: Aug 2007
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Evangeline
Shipmate
# 7002
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Posted
Hi Paddy'O.
Like SPK, I'm a type 1 and would "kill" for an a1c of 5.4 without hypoing severely 5 times a day. My sugars have been baad lately-I expect an a1c of about 9-ooops I've managed to keep around 7 for years now but have falled off the wagon of late-not really doing much differently but just having more highs.....oh well back tot he question.
I've not heard of Birretta. I of course inject insulin (well I'm on a pump now but was on multiple daily injections for about 30 years before the pump)-insulin's not painful and it's a small needle just under the skin, although sometimes you get an "ouchy" spot. My motto is if it works do it-so if this new med is going to work, then I wouldn't let a needle prevent me from giving it a go.
Posts: 2871 | From: "A capsule of modernity afloat in a wild sea" | Registered: May 2004
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Firenze
Ordinary decent pagan
# 619
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Posted
Wafting Saintwards.
Firenze
Heaven Host
Posts: 17302 | From: Edinburgh | Registered: Jun 2001
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Darllenwr
Shipmate
# 14520
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Posted
You probably won't thank me for this thought, but if patterns of treatment on your side of the pond are in any way similar to ours, you may well have to come to terms with needles in due course.
I am taking it as read that you are type 2 on tablet treatment. I have a number of friends who were in that position, but who are now injecting insulin. The logic of this move was that they achieved better sugar control by injection than they could with tablets. One, in particular, has stated that he wishes he had gone to injection years ago - he feels better in himself now that he is injecting that he had for a very long time.
Speaking for myself, when I was newly diagnosed (at age 35), I dreaded the possibility of having to inject - who wants to go sticking needles into themselves? (Barring an out-and-out masochist!). I was allowed to try tablets, subject to review after 3 months. Surprise, surprise, the 3-month review found that I needed to inject.
I found that I rapidly became resigned to injecting. With a very little care (and a sharp needle of the minimum size you can find) it does not hurt at all and, goodness knows, I am pretty pain averse. I find that, when the alternatives are taking a minimum 4 injections a day or having my next overcoat made by a carpenter, I can come to terms with injecting pretty easily. ![[Big Grin]](biggrin.gif)
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If I've told you once, I've told you a million times: I do not exaggerate!
Posts: 1101 | From: The catbox | Registered: Jan 2009
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Sober Preacher's Kid
Presbymethegationalist
# 12699
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Posted
I don't remember not being diabetic, I've had it since the age of two. So Paddy's question is quite beyond me.
I do get grumpy at injecting needles every once in a while, but getting angry it like howling at the moon, it doesn't do anything and I still have to take needles.
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NDP Federal Convention Ottawa 2018: A random assortment of Prots and Trots.
Posts: 7646 | From: Peterborough, Upper Canada | Registered: Jun 2007
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Lothlorien
Ship's Grandma
# 4927
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Posted
I've just heard that ex-MIL has gangrene in two toes. She's Type II but has never been reliable in diet or medication. She's now in a nursing home so is tested regularly and injected regularly. However she's been refusing to eat much. It was also discovered that she was browbeating maids into giving her morning and afternoon tea sweet goodies and hiding them away. She had her own stuff she was supposed to eat. Her long term tests show levels are far too high and erratic as well.
Many years ago, her brother with same stupid attitudes to exercise and diet died in an operation to amputate gangrenous leg. MIL is now 90 and somewhat demented, but gangrene is still an awful thought.
So, please take care of yourselves.
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Buy a bale. Help our Aussie rural communities and farmers. Another great cause needing support The High Country Patrol.
Posts: 9745 | From: girt by sea | Registered: Aug 2003
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The5thMary
Shipmate
# 12953
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Posted
quote:
Originally posted by Darllenwr:
You probably won't thank me for this thought, but if patterns of treatment on your side of the pond are in any way similar to ours, you may well have to come to terms with needles in due course.
I am taking it as read that you are type 2 on tablet treatment. I have a number of friends who were in that position, but who are now injecting insulin. The logic of this move was that they achieved better sugar control by injection than they could with tablets. One, in particular, has stated that he wishes he had gone to injection years ago - he feels better in himself now that he is injecting that he had for a very long time.
Speaking for myself, when I was newly diagnosed (at age 35), I dreaded the possibility of having to inject - who wants to go sticking needles into themselves? (Barring an out-and-out masochist!). I was allowed to try tablets, subject to review after 3 months. Surprise, surprise, the 3-month review found that I needed to inject.
I found that I rapidly became resigned to injecting. With a very little care (and a sharp needle of the minimum size you can find) it does not hurt at all and, goodness knows, I am pretty pain averse. I find that, when the alternatives are taking a minimum 4 injections a day or having my next overcoat made by a carpenter, I can come to terms with injecting pretty easily.
Well, my last A1C was a very good 5.4 but sometimes in my day-to-day living I don't take care of myself as well as I should. I don't test as much as I should either because my doctor only signed off on me being able to test 3 times a day and I would like to do at least 4. From reading posts on the American Diabetes Association website, it seems that Type 2's can expect to wind up having to inject Byetta or some similar drug even if their blood sugar is under control. And injecting medication is far better than losing one's legs, eyesight, other limbs... LIFE!
I saw an ad for BD brand needles--and the new BD "Ultra-Fine Nano" which is a mere 4mm compared to the original 12.7mm. So, I could handle that, I'm guessing.
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God gave me my face but She let me pick my nose.
Posts: 3451 | From: Tacoma, WA USA | Registered: Aug 2007
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Janine
The Endless Simmer
# 3337
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Posted
My doctor is happy I've gone from 6.4 to 6.2 in my A1C. 5.4 is, like, a goal for me.
And I'm gonna look up that appetite-suppressing injectable...
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I'm a Fundagelical Evangimentalist. What are you?
Take Me Home * My Heart * An hour with Rich Mullins *
Posts: 13788 | From: Below the Bible Belt | Registered: Sep 2002
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Darllenwr
Shipmate
# 14520
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Posted
I guess I'm about to be the pork pie at the Bar Mitzvah (or something ) but the length of needle that you use for your injections depends upon your physique. Being less eliptical, the less fat you carry, the shorter the needle you can use. I'm 5'10" and about 165 pounds (at 50 years of age) and use 6mm (1/4") needles. I doubt that I would be able to use a needle appreciably shorter than that.
The point that is important, from the pain point of view, is not the length but the thickness (diameter) of the needle. The smaller the diameter, the less likelihood of pain. My needles (supplied by Novo Nordisk) are 31 SWG (Standard Wire Gauge) and are about as fine as they come. I used to use 28 SWG needles (when I was first diagnosed) but went to the finer gauges as they became available. Just to be awkward, in SWG (and, I believe, in AWG as well) the higher number denotes the smaller diameter. It is probably something to do with the number per lineal inch.
I went to finer needles with no noticeable effects upon my condition. The amount of force needed to make the injection rose slightly but, other than that, the only significant effect was that injections hurt less. I have now reached the point (with 16 years practice) that I seldom even feel the injection at all. It could be a whole lot worse ...
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If I've told you once, I've told you a million times: I do not exaggerate!
Posts: 1101 | From: The catbox | Registered: Jan 2009
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Mr. Spouse
Ship's Pedant
# 3353
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Posted
quote:
I saw an ad for BD brand needles--and the new BD "Ultra-Fine Nano" which is a mere 4mm compared to the original 12.7mm. So, I could handle that, I'm guessing.
There is a good visual guide
here on recommended lengths. I have recently switched from 8mm to 10mm needles (29G) after putting on a bit of weight and find them good to use.
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Try to have a thought of your own, thinking is so important. - Blackadder
Posts: 1814 | From: Here, there & everywhere | Registered: Sep 2002
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The5thMary
Shipmate
# 12953
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Posted
Darllenwr: Well, for injecting Byetta, which is what I initially made this post about, one has options for where one injects it. I forgot about that until this morning when I read your post. I could inject it in my upper arm as well as my large stomach, so I think I could still use the shorter (lengthwise, not diameter) 4mm needle.
This is all just supposition at this point. I am still attempting to lose the weight by exercising and eating better. I have to give it a bit more time before I give up and try Byetta.
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God gave me my face but She let me pick my nose.
Posts: 3451 | From: Tacoma, WA USA | Registered: Aug 2007
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The5thMary
Shipmate
# 12953
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Posted
quote:
Originally posted by Mr. Spouse:
quote:
I saw an ad for BD brand needles--and the new BD "Ultra-Fine Nano" which is a mere 4mm compared to the original 12.7mm. So, I could handle that, I'm guessing.
There is a good visual guide
here on recommended lengths. I have recently switched from 8mm to 10mm needles (29G) after putting on a bit of weight and find them good to use.
Mr. Spouse: Thank you so much for including that wonderful link! Now I see that the 4mm probably would be too small for me, especially if I injected into my stomach. You've saved me from buying the wrong size needles, if ever I should go that route!
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God gave me my face but She let me pick my nose.
Posts: 3451 | From: Tacoma, WA USA | Registered: Aug 2007
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Darllenwr
Shipmate
# 14520
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Posted
Echoing Paddy O'Furniture - thank you Mr Spouse; I inject into the upper thigh and have had a couple of unpleasant experiences when, even using a 6mm needle, I have clearly hit a vein with my Lantus (slow-acting) dose of 24 units. The ensuing half an hour or so was fraught with activity as I fought to stave off coma. I don't recommend blood sugar levels down under 2 mmol/litre - very unhealthy. I noticed at the bottom of the linked page that they recommend that one always inject at an angle when using the thigh - wish I'd known that sooner!
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If I've told you once, I've told you a million times: I do not exaggerate!
Posts: 1101 | From: The catbox | Registered: Jan 2009
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Gee D
Shipmate
# 13815
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Posted
This is not any sort of medical advice, but a recounting of experience with needles etc. One of Dlet's mates was diagnosed with diabetes about 3 years ago when they were all 15 or 16. A change of diet, of course, and injections. He somehow managed those for a while, even at school and playing sport, but it became a bit hard on cadet camps. He had a cannula type device installed, and can "inject" quite easily. Matters are well under control.
These are matters which really need discussion with your specialist support - perhaps even a referral to dieticians to help with the sort of diet you need and also with any necessary and lasting weight reduction.
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Not every Anglican in Sydney is Sydney Anglican
Posts: 7028 | From: Warrawee NSW Australia | Registered: Jun 2008
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Taliesin
Shipmate
# 14017
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Posted
I don't think a pump is an option for type 2 diabetics though.
Isn't the pump a Godsend?? Changed our lives. Both my sons went to scout camp last week and although I got one panicky phone call where they took him to A&E due to blood in the canula and tube (all very thin so a few drops of blood looks like a haemorrhage) everything was calm and under control. Incidently, I told them to bail out of A&E (emergency room?) get back to the campsite and just change the whole set, because the chances of finding someone who knew any more than basics about dibetes in general and pumps in particular were pretty slim.
Posts: 2138 | From: South, UK | Registered: Aug 2008
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Evangeline
Shipmate
# 7002
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Posted
quote:
He had a cannula type device installed, and can "inject" quite easily. Matters are well under control.
Ah, yes it does look easy and done and dusted from the outside and good on Dlet's friend for making it look so easy. It ain't that easy though. You have to insert the canula via a needle, yourself every 3 days or so, you have to take care of the site and be pretty vigilant in making sure your pump isn't empty, your sites not blocked etc and if you have a problem you need to take immediate action or you end up in DKA. It's a lot of work and you have to do all the thinking for the pump, it's still a pretty primitive device compared to a working pancreas.
That said I Loooove my pump but that's only cos it means I no longer have severe hypos as a result of peaky/unpredicatable long acting insulin and I can sleep in and snack if I want to. You don't get a pump just 'cos it's easier than needles-it's not and it's also about 10 times more expensive than needles. it's worth it when you are a type 1 but most medical experts do not recommend it for type 2s. In fact the Aust govt will only provide funding support for pumps for type 1s who also meet certain other criteria as well, as signed off by their endocrinologists.
Posts: 2871 | From: "A capsule of modernity afloat in a wild sea" | Registered: May 2004
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Taliesin
Shipmate
# 14017
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Posted
... the reasoning here is that although a pump costs more as a piece of equipment, it causes the diabetic to cost less over the years, as levels are managed better and self care is easier.
Unfortunately, a lot of families would apply for and get a pump, then find it was too much hassle (the setting up takes a long time, blood tests every two hours round the clock for the first 2 - 3 weeks) and then a lot of kids find the pump a bulky and annoying thing to have attached 24/7. So they'd go back to injections, but NOT give the pump back. So now the process of getting one has been made more complicated to weed out the uncommitted.
It really did make life easier though (SPK, have you ever considered one?) A few weeks after getting connected, my son went to a birthday party on his own for the first time - just when he was getting to an age when he minded having a parent tag along. He dialed up for every single cake and handful of cheesy things, and came home with a reading that was spot on amazing.
Course, now he's 11 and a bit of a wosit, he occasionally 'forgets' to test or dial up or whatever, and he doesn't exactly enjoy the set changes, and we battle with a higher-than-it-should-be A1C, but the pump itself is great.
He broke the clip on camp last week and I'm not sure how to go about getting a replacement, but it's lasted over a year and the pump itself should do 3, I believe.
[ 02. August 2011, 09:47: Message edited by: Taliesin ]
Posts: 2138 | From: South, UK | Registered: Aug 2008
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Evangeline
Shipmate
# 7002
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Posted
quote:
He broke the clip on camp last week and I'm not sure how to go about getting a replacement, but it's lasted over a year and the pump itself should do 3, I believe.
I broke the clip on mine-here in Australia I was able to phone the Minimed office and use my credit card and they sent me out a new clip. It cost something crazy for a bit of plastic-$80 or something but what can you do? I suspect that your pump manufacturer would have an office in the UK, you could ring them and I'm sure they'd tell you how to get a replacement clip.
Posts: 2871 | From: "A capsule of modernity afloat in a wild sea" | Registered: May 2004
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Sober Preacher's Kid
Presbymethegationalist
# 12699
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Posted
No, I have never given the Pump serious consideration. I have a deep-seated hatred of IV's and medical staff inserting them, same with venous blood tests. So I have never had one, nor do I plan to get one. I admit I am a stick in the mud.
I have lost a considerable amount of weight over the past five years and I'm now around my ideal weight for my height. I'm down to 21 units of Levemir per day which I find varies very proportionally to weight. If you lose a few pounds you'll find yourself having four low reactions per day.
No, this fuddy-duddy likes his needles.
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NDP Federal Convention Ottawa 2018: A random assortment of Prots and Trots.
Posts: 7646 | From: Peterborough, Upper Canada | Registered: Jun 2007
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Darllenwr
Shipmate
# 14520
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Posted
{Cross-pond confusion} And Levemir is what, exactly?
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If I've told you once, I've told you a million times: I do not exaggerate!
Posts: 1101 | From: The catbox | Registered: Jan 2009
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Sober Preacher's Kid
Presbymethegationalist
# 12699
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Posted
The Novo-Nordisk competitor to Lantus. It's a direct equivalent. I've been a lifelong Novolin user, that being the brand of Connaught Labs, the originators of insulin. Novolin in Canada was sold to Novo-Nordisk.
The main brands here are Eli-Lilly's Humulin line and Novo-Nordisk's Novolin line.
Lantus, a Sanofi-Pasteur brand, is an also-ran.
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NDP Federal Convention Ottawa 2018: A random assortment of Prots and Trots.
Posts: 7646 | From: Peterborough, Upper Canada | Registered: Jun 2007
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Evangeline
Shipmate
# 7002
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Posted
SPK, medical staff don't have to insert anything when you pump and there's nothing IV about it-the needle goes just under the skin, same as a normal jab, you pull the needle out and leave a little plastic canula.
Levemir and Lantus have slightly different chemical makeups-they're not exactly the same in the way that Humalog and Novorapid are the same thing-but they're both long acting/basal insulins.
Lantus & Levemir What's the difference?
Posts: 2871 | From: "A capsule of modernity afloat in a wild sea" | Registered: May 2004
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Sober Preacher's Kid
Presbymethegationalist
# 12699
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Posted
Still, I'm a Novolin user, Novorapid and Levemir. I used Lantus for a while but I wasn't happy with it. Levemir and Lantus are marketed head-to-head. I never got into the details because I was at university when they came out and had my head in other things. Canada was a laggard in approving them for release.
I'm not a fan of anything stuck inside me. I don't want a pump and I'm doing just fine without one.
It would cost me a considerable amount of money since Canada's health system is not what it's cracked up to be, particularly when it comes to drugs and equipment. But my primary objection is I don't want one on lifestyle and personal choice grounds.
Like many youths I fell into a gap when transitioning out of the youth diabetic clinics into the adult stream. My care had a gap. It now has another gap as I don't have an endocrinologist right now.
I'm praying that a job I really, really want and would be very good at (from what I can tell) comes through. If so I would be moving to Ottawa and I would have to get a new family doctor and they would refer me to the Ottawa diabetic clinic. There's only one in the city as far as I can tell due to hospital amalgamations.
Hehe, I already have an idea of the apartment I'd like, the clinic I'd go to for the family doctor and the endocrine clinic they'd refer me to.
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NDP Federal Convention Ottawa 2018: A random assortment of Prots and Trots.
Posts: 7646 | From: Peterborough, Upper Canada | Registered: Jun 2007
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Evangeline
Shipmate
# 7002
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Posted
Good luck for the job SPK. Yeah my care's had plenty of gaps-including trying to find adult care that is type 1 appropriate as opposed to type 2 focused.
Blah-sounds like Canada and Aust are pretty similar-I went on the pump initially because, for me it was cheaper than Lantus as my private insurance covered the initial cost of the pump but not Lantus and Lantus wasn't approved on the Aust Pharmaceutical benefits scheme-which meant you paid full price as opposed to about 1/10th of the full price of every other insulin cos the govt makes up the difference. Lantus is subsidised now-strangely enough Levemir is only subsidised for type 1s in Australia 'cos that's all that Novo asked for in their application-which I find sort of strange.
Posts: 2871 | From: "A capsule of modernity afloat in a wild sea" | Registered: May 2004
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Sober Preacher's Kid
Presbymethegationalist
# 12699
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Posted
Canada relies on employer-provided coverage for drugs. ![[Mad]](angryfire.gif) Medicare as we know it was implemented without drug coverage as it was the 1960's and they were trying to be a bit economical. Drugs weren't so expensive then.
Universal drug benefits are considered a provincial matter. Only Quebec has a universal plan for working-age people.
The Province of Ontario recently reviewed its drug plan for senior and poor people. It turns out that pharmacies devote 60% of their volume to provincially-covered patients, yet derive almost 100% of their profits from the remaining 40% of private-pay (emloyer plan or own pocket) patients.
The Government of Canada provides money to each province each year to implement a catastrophic drug plan, but fat lot it does. It is insane as my disease does not end when my employment does. It's not the 1950's anymore. But try telling that to Government.
Actually, that's part of the plan. ![[Devil]](graemlins/devil.gif)
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NDP Federal Convention Ottawa 2018: A random assortment of Prots and Trots.
Posts: 7646 | From: Peterborough, Upper Canada | Registered: Jun 2007
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Darllenwr
Shipmate
# 14520
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Posted
A curious article appeared in Metro (free newspaper distributed on public transport) this morning, claiming that diabetics using insulin pumps were at risk from computer hackers. The article claimed that insulin pumps use WiFi to connect to the internet, enabling health care professionals to monitor their use. It then went on to claim that the links in question could be hacked, enabling the hacker to kill diabetics.
My immediate reaction was along the lines of, "Yeah, right, pull the other one. Just another silly season scare story, picking up on the current preoccupation with hacking." But, second thoughts raised the question, "Is this possible? Could it be true?"
Anybody any better informed than I am?
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If I've told you once, I've told you a million times: I do not exaggerate!
Posts: 1101 | From: The catbox | Registered: Jan 2009
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Moo
Ship's tough old bird
# 107
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Posted
I came across this article. The author appears to be well-informed.
Moo
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Kerygmania host
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See you later, alligator.
Posts: 20365 | From: Alleghany Mountains of Virginia | Registered: May 2001
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Evangeline
Shipmate
# 7002
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Posted
That's a very interesting article. I've always felt uncomfortable about the remote control feature of the pump-I mean do you really need it? The remote control features were banned for some time in Australia because of an issue with frequencies-the problem was other remote control devices interferring with the signal. I was afraid somebody opening their garage door would give me a bolus.
It's a scary thought. I must say it wouldn't be silent though, I always hear the alarms and vibrations my pump gives when it is off, or bolusing or "doing something".
IMO it's easily fixed, just by getting rid of the remote control function on pumps-I've never even used my remote.
Posts: 2871 | From: "A capsule of modernity afloat in a wild sea" | Registered: May 2004
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Sober Preacher's Kid
Presbymethegationalist
# 12699
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Posted
There was a Law & Order episode 15 years ago where somebody hacked a diabetic clinic's glucometers to cue an insulin overdose in the patients.
Life imitates Art?
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NDP Federal Convention Ottawa 2018: A random assortment of Prots and Trots.
Posts: 7646 | From: Peterborough, Upper Canada | Registered: Jun 2007
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Taliesin
Shipmate
# 14017
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Posted
what is this 'root' thing? getting/taking?
apart from that:
Any technology that proposes doing all the thinking for a person is a bad thing, and if sci-fi speculation like this means an extra safety check is left then hurrah.
Certainly, there's no way my son's pump could take any action without his knowledge and consent - it makes suggestions, but have to be confirmed manually, and can be overridden.
When he removes his pump for washing or wet/dirty activities, we let it continue to drip as if still attached - we were advised at the beginning not to 'suspend' the pump unless it's still attached to him, as the alarm that goes off after an hour would advertise the presence of expensive medical kit in a sports locker. We'd suspend the pump if he was hypoing badly, and it would alter him if it was still off an hour later.
So, I think there's minimal danger for diabetics as it stands, since they understand their own condition, but it's a good warning for the people who like to tinker with technology and probably have less understanding.
Posts: 2138 | From: South, UK | Registered: Aug 2008
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Evangeline
Shipmate
# 7002
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Posted
quote:
it makes suggestions, but have to be confirmed manually, and can be overridden.
The article claims that the hacker-using the remote control function, can from within about half a mile radius, actually turn the pump off and/or deliver boluses etc. So the manual confirmations etc are actually being done by the hacker.
it's all a pretty unlikely scenario but from what this guy is saying it's possible.
Posts: 2871 | From: "A capsule of modernity afloat in a wild sea" | Registered: May 2004
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Darllenwr
Shipmate
# 14520
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Posted
I find that pretty disturbing. OK, so the individual in question is, if you like, a *professional hacker* - it's his job to hack his way into things to determine their vulnerabilities and it was his own insulin pump he hacked into - but it is disturbing that it could be possible (and this could include inadvertantly) to kill a pump-using diabetic remotely by tampering with their pump settings. The joy of killing somebody in this fashion is that it would be the perfect crime - almost impossible to determine who was responsible, if it were even determined how the victim had died. To my mind, it is a great pity that a garbled version of this story appeared in Metro - it will certainly give some people ideas.
As all will have gathered, I don't use a pump and don't anticipate ever doing so, but I am concerned for those who do. I hope that the pump manufacturers have been taking notice ...
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If I've told you once, I've told you a million times: I do not exaggerate!
Posts: 1101 | From: The catbox | Registered: Jan 2009
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Sober Preacher's Kid
Presbymethegationalist
# 12699
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Posted
About the thing that dare not speak it's name: cure.
I have kept my eye on an interesting line of research out of Harvard which is summarized here.
They have some some excellent research and are now into Phase II trials, the do-or-die phase. Phase II determines if the therapy works and the therapeutic dose.
The real innovation here is in the principles than in the tools. The chief researcher, Dianne Faustmann, attacked Type 1 Diabetes as an autoimmune disease, not as an absence of insulin disease. It turns out the pancreas can recover once you get rid of autoimmunity. She attacked the cause, not the symptom.
Even better, her initial experiment was on natural, true diabetic mice rather than once with removed pancreases. She used a better mouse model.
And on top of that, her therapeutic agent is a drug called BCG, which has been around for decades. It's generic. However this is a completely innovative use and in far larger doses than in normal. To be fair to science, none of this would have been possible without the recent advances in genetics and computers.
To their credit the Faustmann Lab did a Stage I study where you inject a tiny amount of BCG and watch for any ill effect. Since BCG is decades old and well-known no ill effects or unexpected things were observed, but it does make the whole project more credible when it moves on to the Stage II phase where the rubber meets the road.
I'm simply delighted that something has got this far and will be cheap to administer. No expensive patented drugs.
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NDP Federal Convention Ottawa 2018: A random assortment of Prots and Trots.
Posts: 7646 | From: Peterborough, Upper Canada | Registered: Jun 2007
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Darllenwr
Shipmate
# 14520
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Posted
That's fascinating - maybe there's some hope for we Type 1's yet! I had always assumed that the condition was auto-immune and therefore irreversible, though I cannot remember where I got the idea that it was an auto-immune condition - it may be that my wife's auto-immune condition (MS) set me thinking along those lines. I shall watch the space with interest.
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If I've told you once, I've told you a million times: I do not exaggerate!
Posts: 1101 | From: The catbox | Registered: Jan 2009
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Sober Preacher's Kid
Presbymethegationalist
# 12699
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Posted
Doctors will frankly tell you Type I Diabetes is an auto-immune disease. But they long thought what was done was done. Faustmann's Lab turned the idea that the damage is permanent on its head and that is their controversial point.
I came across a website which said that Diabetes wasn't treated like other auto-immune diseases. Instead of trying to suppress the immune system and stave off the damage, things were allowed to run their course and then you got a replacement through insulin. It's an atypical therapy actually.
It comes from Banting and Co. groping around in the dark at the University of Toronto in the 1920's. By current standards they really didn't know what they were doing and they were flying by the seat of their pants. It took decades for science, especially genetics and cellular biology to catch up and let us really get a handle on what was actually going on in the pancreas.
Usual warnings about disappointment but they do have an innovative insight, they have used good models and have done everything in full so far as far as testing requirements go. It's clear they did this so that when the make-or-break test comes at the next stage their results are solidly grounded.
The fact that their therapy is based on a generic drug with negligible cost is a bonus, but delightful all the same, if not to you then to the Minister of Health.
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NDP Federal Convention Ottawa 2018: A random assortment of Prots and Trots.
Posts: 7646 | From: Peterborough, Upper Canada | Registered: Jun 2007
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Taliesin
Shipmate
# 14017
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Posted
Thank you for this. A family at church yesterday were in bits because their 4 year old grandson has just been diagnosed with type 1. They're upset about the needles and the 'no sweets' stuff, but more about the permanence and no hope of a cure. This might be something that lightens their load a bit.
Posts: 2138 | From: South, UK | Registered: Aug 2008
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Sober Preacher's Kid
Presbymethegationalist
# 12699
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Posted
There are the usual warnings about getting one's hopes up. But I'm amazed they have made it this far and are going into the make-or-break phase soon. So it is of interest but don't get too invested emotionally. But if it works then the UK Minister of Health should fall all over himself to dose every Type 1 in England & Wales.
Modern diabetes therapy for Type 1's is more into carbohydrate counting. Really fast insulins like Novo Rapide make this possible, so when the kid grows and can be more self-responsible they can get more freedom. The usual routine though is a healthy diet that everybody, the whole family *should* eat if dietitians had their way.
Scaling insulin off the carb count of food labels is actually pretty accurate. Fast Food restaurants here will actually post the nutritional information for their products on a poster. Add up the carbs, scale the insulin, and my blood sugar has been fine after a McDonald's Double Quarter Pounder with Large Fries. My blood was 5 mmol/L afterward, which meant the insulin worked.
Yes, I ate that heart attack on a bun.
If the dietitian and other medical team is not being so flexible, the family should look into a transfer. Type 1's lumped into clinics geared to Type 2's don't do well, the lifestyles and problems are just too different. They might do better at a clinic that specializes in Type 1's.
I know it's the NHS but there are valid medical reasons for asking, though they might have to go to London, Cardiff or another big medical centre for this.
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NDP Federal Convention Ottawa 2018: A random assortment of Prots and Trots.
Posts: 7646 | From: Peterborough, Upper Canada | Registered: Jun 2007
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Taliesin
Shipmate
# 14017
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Posted
Thank you, yes, my son has total freedom within sensible, normal-for-everyone limits, and he is on a pump, and carb counts.
Little just diagnosed 4 year old at church is starting on long acting insulin, fights every injection and every blood test and is still having the diabetic team come to adminster insulin.
(I was surprised at this new service - when my son was diagnosed at 4, they just gave us a bag of needles, insulin cartridge, prescription for more of same, and a pen. And a BM kit with a few test strips and a prescription for more of same. And a book of FAQ. Actually, I'm very glad people didn't keep coming round to do it for us - I think people are better left to their own devices to figure out their new kind of normal. But YMMV)
Posts: 2138 | From: South, UK | Registered: Aug 2008
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Sober Preacher's Kid
Presbymethegationalist
# 12699
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Posted
My parents had the same experience with a screaming two-year-old. In Northern New Brunswick. I had the first glucometer on the whole North Shore.
I do Novolin Levemir with Novo Rapide, but to each his own.
The fact of being stuck in a Type II clinic with people unable to follow their diets vs. a more Type 1 clinic where the question is "how to I make this work 'cause I want a life" is a major issue of youth diabetic care.
The fact is insulin gives you more freedom IF you can count carbs and use some sense and moderation.
When I was diagnosed you were handed a diet and told to follow it, the doctors nurses didn't care what your previous diet was and you were told to forget your old routine.
Diabetic care has made quantum jumps in attitude, accommodation and use of dynamic insulin adjustments but you have to be in a clinic that embraces those principles. Type II clinics have different fish to fry.
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NDP Federal Convention Ottawa 2018: A random assortment of Prots and Trots.
Posts: 7646 | From: Peterborough, Upper Canada | Registered: Jun 2007
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Evangeline
Shipmate
# 7002
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Posted
quote:
Diabetic care has made quantum jumps in attitude, accommodation and use of dynamic insulin adjustments but you have to be in a clinic that embraces those principles. Type II clinics have different fish to fry.
Absolutely! I find it irritating that in Oz and I think other places, there is this talk about helping type 1 young adults transition to "adult care". The problem is that the "adult care" is type 2 centric and completely unhelpful to type 1s They need to improve care for adults with type 1-we are the forgotten ones when we turn 18.
Faustman is quite controversial SPK, although so were Banting and Best. I suspect that if there is a cure or a massively improved treatment for type 1 it will come from somebody out of the mainstream. I don't expect a cure anytime soon (like within 20 years) something would have to be close to a human clinical trial but we're years away from that-but perhaps the 18mo diagnosed tomorrow will be cured before they're 40. I doubt it, but perhaps....
Posts: 2871 | From: "A capsule of modernity afloat in a wild sea" | Registered: May 2004
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Darllenwr
Shipmate
# 14520
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Posted
[Cynicism alert]
Bear in mind that it is very much against the interests of the drug companies that a cure should be found for any chronic condition. Paliatives make for much better sustained profits than do curatives. So, whilst it may well be that the use of the indicated generic can offer a genuine cure for Type 1's, I anticipate that Big Pharma will do their best to suppress this information or to rubbish it - it is very much in their interests that diabetics (of whatever hue) should not be cured of their condition.
Which may very well explain why diabetes is not treated in the same way as other auto-immune conditions - there is good money to be made by life-time treating diabetics ... ![[Paranoid]](graemlins/paranoid.gif)
[/Cynicism alert]
Bear in mind that I worked in medical device R&D for 6 years - I know of what I speak.
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If I've told you once, I've told you a million times: I do not exaggerate!
Posts: 1101 | From: The catbox | Registered: Jan 2009
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Sober Preacher's Kid
Presbymethegationalist
# 12699
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Posted
I know she's controversial. I've been disappointed by research before (the laser-based bloodless glucometer, next best thing for a six year old) so I'm cautiously enthusiastic.
She's using well-studied decades old drugs as the therapeutic agent, she put her therapy through every test demanded including ones that might be dispensed with as extra, and she does have enough money to run a Phase II clinical trial in the next two years. The fact that she isn't inventing a new drug helps stack the deck in her favour.
I will give her the benefit of the doubt and wait for the test results to come in, though I won't hold my breath. The next two years will mean Faustmann is either totally discredited or she gets the Nobel Prize.
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NDP Federal Convention Ottawa 2018: A random assortment of Prots and Trots.
Posts: 7646 | From: Peterborough, Upper Canada | Registered: Jun 2007
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