Merry Christmas
Wishing you a very Merry Christmas...
from my family to yours...
With love,
Scott, Kelly, Cole, Arden, Indy and Basal
Glucagon Nasal Spray Effective for Hypoglycemia Rescue
Spray device easier for untrained people to use, experts say...
- Intranasal glucagon is effective and noninferior to injectable intramuscular glucagon for the correction of insulin-induced hypoglycemia in adults with type 1 diabetes, according to a randomized, cross-over study.
- Note that hypoglycemia was induced by administering insulin in a controlled setting, but this approximates the real-world setting of severe hypoglycemia occurring due to excessive therapeutic insulin with inadequate or absent endogenous glucagon response.
- An intranasal glucagon spray was as good as injectable glucagon for treating induced hypoglycemia in patients with type 1 diabetes, according to a randomized crossover noninferiority study.
- The effect of the nasal spray lagged a few minutes behind that of injections, but it met the study's pre-defined success criteria 74 out of 75 times, compared to 75 out of 75 with injectable glucagon, reported a team of investigators led by Michael Rickels, MD, of the University of Pennsylvania in Philadelphia.
- Currently, only injectable glucagon is available for treating hypoglycemic episodes, and it comes in a powder that must be reconstituted in a diluent before injection.
- The intranasal glucagon, developed by Locemia Solutions, is in phase III clinical testing. Eli Lilly recently announced that it acquired worldwide rights to Locemia's intranasal glucagon and plans to bring it to market.
Check out an episode of the Juicebox Podcast today...
Carb Wars: Going to the Movies with Type 1 Diabetes
Star Wars: The Force Awakens is breaking records at the box office in it's opening weekend. The film made 57 million dollars on Thursday and another 100 million on Friday and those numbers tell me that many of you will be in a theater something soon.
Trying to bolus for food that is carb heavy, nutrition light...
So there I was this morning sitting in a theater waiting for Star Wars to begin (it was amazing by the way) when I began to think about all of you and I decided to compile carb counts for popular movie theaters and include them in this post. That however turned out to be more difficult than I originally envisioned.
Of the big five theater chains, the two largest, Regal and AMC don't not provide nutritional information for their concession stands. Cineplex has a fact sheet online that I'd call "better than nothing", Carmike has a simple webpage that lists the values of their popcorn and Cinemark includes a partial list on their website. The thing is... there is no consistency between the theater companies and no good way to estimate based on the limited information that is available.
Blog post interruptus...
I wanted to provide at least a guideline to follow but from what I am seeing the variables between theater chains, package sizes, how full some theaters fill their bags and some significantly incomplete data; we're going to have to roll over guidelines and talk about strategy.
You're going to have to make some educated guesses. We could theorize that one nacho is between 2 and 2.5 carbs. I'd guess a pretzel bite to be about 4 carbs but that popcorn is just too wonky. How do you measure it? How many carbs, how much will they eat... ug. So here's what I'm going to do when we head back to the theater tomorrow afternoon so the family can see Star Wars, yea I went by myself today... what of it?
Arden has a Dexcom CGM so I'll be leaning on it heavily. I'll pre-bolus at least 15 minutes prior for food and try to time her food consumption with a diagonal down CGM arrow. From there I'll decide between either an increase temp basal or over estimating the carbs to combat effects of the crappy movie theater food. One way or the other I'd prefer to need to give a fast acting carb (Juicebox) for a low than watch Arden suffer with a high BG through the entire movie and beyond. When I estimate (guess) her carbs I won't only be taking my carb count into account, I'll also keep in mind the average amount of carbs Arden usually consumes at a sitting. For example if the food is 90 carbs but Arden usually doesn't eat more than 70 in a sitting; I'd probably pre-bolus for the conservative 70, set an increased basal (that I could always cancel if I need to) and watch the CGM for signs that it worked or didn't -- and then react appropriately.
May the force be with you...
Check out the Juicebox Podcast!
Yahoo: Internet pioneer now taking on diabetes
I reached out to Jeff yesterday and set up an interview with him for the Juicebox Podcast. I'm very interested in finding out more about what he has in mind for diabetes.
Excerpt From Yahoo Finance article:
Twenty years ago, in the early days of the World Wide Web, Dachis co-founded Razorfish, the digital marketing giant that later became part of Microsoft before being sold to Publicis Groups. He was subsequently involved in several other tech projects but his latest venture, One Drop, was started after beginning his own personal battle with the disease.
“Immediately, I started looking around for the best gear to get and the most interesting data sets to look at to help me manage my diabetes better,” said Dachis. “It turns out the technology from the ‘80s is still what people use for managing their diabetes. It seemed to me like a wide-open gaping hole in the marketplace.”
You can read the rest of the Yahoo article at this link.
How Would You Handle a 75 BG?
Always fighting rebound highs? Maybe you're over treating...
Click to Enlarge
There's not much text needed for this post, it's more for you to follow (orange numbers) and ask yourself, "What would I have done". Find the cause and effect that I created and use the information to help you make a better adjustment next time.
1. Arden's BG was 145 at 7 am. I bolused. .45 to try and get her as close to 90 as I could.
- It got a bit lower than I hoped.
2. The drift I caused with the .45 took her BG to 75 where it stayed steady.
- I may not have done anything if she was home but at school we wanted to bump it.
3. I set a temporary basal rate on her OmniPod, stopping insulin for a half hour and Arden ate one four carb glucose tablet.
4. No reason to panic, 75 BG is staying steady. Trusting that the temp basal and carbs will do what I expect. It does 40 minutes later.
- Temp basal can take 30-60 minutes to take effect.
5. Watching up arrow, don't want to get much higher.
6. Perfect landing! #A1cYaLater