Let’s talk about making life with Type 1 diabetes easier

I’ve been thinking a lot, lately, about the constant juggle of Type 1 diabetes. How wonderful it would be to just take 24 hours off and not have to think about it. Or to have someone next to me who could help me with the juggling. Here are a few examples…

Forgetting to take my long-acting insulin

I take my long-acting insulin once a day, in the morning. Also happening in the morning: making my kids breakfast, helping them with their lunchboxes, reminding them of the 17 things they need to take to school that day, taking my short-acting insulin, making my breakfast, taking my vitamins, getting ready for work. 

I remember when I was first diagnosed I didn’t think I could ever forget to take my insulin, because it was so incredibly important and loud. It’s still important (and loud) but it’s also surprisingly easy to forget…

Has this ever happened to you? 

Wouldn’t it be lovely to have a little reminder?

Forgetting to take my short-acting insulin

Also didn’t think I could ever possibly forget this one! But I’ve just finished making dinner, I’ve corralled the whole family to the dinner table, decided how much insulin I’m going to take and entered it into my CGM app, dished up the food, sat down to eat and… Can’t quite remember if I’ve actually injected or not.

I search my stomach for evidence of an injection, ask my kids and husband if anyone saw me injecting, but we are all so used to injections by this stage that it doesn’t register with any of us.

Has this ever happened to you? 

Wouldn’t it be lovely to have a log of every dose I’ve taken, so I could just quickly check? And better yet, not have to enter the dose into my CGM app because it automatically does it for me, and connects to my CGM?

And even better yet, if I do forget to take my insulin and forget to check, to be reminded that it looks like my blood sugar is rising fast… That would take away that awful moment of fear where I wonder if I’ve taken my injection or not, and whether it’s safe to double-inject. (If you know, you know!)

Misjudging insulin on board

Some days, I eat regular meals at set times and inject before each one, and then don’t eat in between. Other days, I am like a hungry impala, grazing all day long and injecting little bits as I go along. The trouble is, I am not so great at remembering how much insulin I injected the last time, and when exactly that was, and how much of that insulin is still active. (And by ‘not so great’ I mean I don’t take it into account at all).

So you know what happens, don’t you? After a few injections too close together, my blood sugar starts going down, and down, and down, because now I have far too much insulin in my system.

Has this ever happened to you?

Wouldn’t it be lovely to have a little calculator to tell you how much insulin is on board? And better yet, another little calculator that you can tell how many carbs you’re about to eat (or if it’s low carb / medium carb / high carb) and then it suggests how much insulin to take, based on how much active insulin you have on board?

Doing the maths wrong for a correction dose

I know that doctors like to think that the only thing people with diabetes have to do is have diabetes. We all know that’s not the case…

I am often rushing out the door to pick up kids or go to a meeting when I notice that my blood sugar is higher than it should be. So I take a quick correction dose. But either I still have some active insulin on board (which you know I haven’t paid attention to) or I misjudge how much of a correction dose I should take, and mid-school-pickup or mid-meeting, my blood sugar crashes.

Has this ever happened to you?

Wouldn’t it be lovely to have a sense-check of what your correction dose should be, or if you should just wait for the insulin already in your system to take effect? Ideally, wouldn’t it be lovely to have a little calculator telling you exactly how much insulin to inject to correct your high blood sugar, and to be able to tailor it to be as personalised as possible? If I’m aiming for 7.0mmol/l as my magic number, but you’re aiming for 6mmol/l or 8mmol/l, and our insulin to carb ratios are different, and our correction dose factor is different, I want all of that to be taken into account. I just don’t want to have to do that much maths as I’m rushing out the door because I’m actually (always) leaving home five minutes too late.

Correcting low blood sugar before it happens

Fun fact about me: I hate alarms. As soon as I put in a CGM, I switch off all the alarms, because I can feel my lows and I watch my CGM closely enough to spot my highs, and I don’t want to be disturbed by diabetes more than I already am or – the horrors! – be woken up by an alarm. (I recognise I’m very lucky that my body still wakes me up for low blood sugar, and I am very grateful.)

But there is one alert I will put on if it is available to me, and that’s the ‘low blood sugar soon’ alert. This is a miracle alert, in my eyes, because it helps me avoid a low – it helps me predict that low blood sugar is coming while I can still do something sensible and fun about it. (And by that I mean, eat a piece of fruit instead of a spoon of sugar!) More importantly, it helps me avoid the awful effects and after-effects of low blood sugar, and keeps me more in range all day.

Has this ever happened to you? 

Isn’t it lovely when you manage to avert disaster before it hits? It makes me feel like a superhero!

Having a temperature sense-check

I know that insulin is apparently heat stable up to 30 degrees Celsius, and I do not believe it. My lived experience is too many weird unexplained days of high blood sugar that are magically fixed as soon as I switch out for a fresh insulin cartridge.

Has this ever happened to you?

Wouldn’t it be lovely to have a teeny-tiny little thermometer next to your insulin that could alert you if the pen has potentially been in temperatures that are too hot or too cold, so you can be on the alert for unusual blood sugar? What a relief that would be!

Making doctor’s appointments easier

We all know how much doctors love looking at our data and asking what specific thing we were doing on one specific day at a specific time, several weeks ago… The only time I have been able to adequately answer this has been the day of the World Cup opening game in Cape Town, where my blood sugar was perfect because I walked around all day!

Has this ever happened to you?

Wouldn’t it be lovely if all your CGM data, and your food data (timing and size of meals) and your insulin data (how much and when you injected) were all seamlessly part of one report, without you having to manually input anything, or your doctor having to open different programmes? Imagine how much easier doctor’s appointments would be? (For everyone!)

Making life easier

My primary goal for my diabetes is for it to take up less space inside my head. I don’t need perfect numbers, I need to not have to think about it so much. That’s why I eat the same thing for breakfast and lunch every day, because then I don’t have to think about how much to inject and what my blood sugar will do. That’s why I try to do the same type of exercise at the same time each week. But with 42 factors that affect blood sugar, that’s not enough… (Alas!)

I tried out the MiniMed Go system and it made life with diabetes so much easier.

• It reminded me to take my long-acting insulin.
• Logged every dose of my short-acting insulin, so I knew I’d taken it.
• Reminded me if it looked like I’d missed a dose.
• Told me how much active insulin I had on board – without me having to do anything, because every dose had magically been logged already! – and suggested how much insulin I should take for my next meal.
• Took the guesswork out of insulin doses for every meal.
• Guided me in how much insulin to take to correct high blood sugar.
• Alerted me 20 minutes before my blood sugar was likely to go low.
• Kept track of how warm or cold my insulin was getting, and warned me if the temperature was potentially getting dangerous.
• Collated all my data for my doctor without me having to do anything.
• Made my life easier.
• Made me like Alexander Zverev, who uses the MiniMed Go!

CGM alone is not enough to make it easier

I suppose I thought that just getting the data from a CGM would make life with Type 1 diabetes easier. But the reality – as all of us who have been lucky enough to try a CGM know – is that just the numbers can be overwhelming. It turns out there’s a lot of research that has been done about this too: HbA1c doesn’t necessarily improve if you have a CGM, missing 2 doses a week can increase your HbA1c by 0.4%, up to 60% of people need help calculating their insulin doses and, unsurprisingly, lack of accurate data is a significant barrier to optimizing glycaemic control.   

This isn’t saying that CGM isn’t amazing – it is a wonderful tool! But how do you take that tool one step further, without an insulin pump? What this system does is offer the perks of an insulin pump while on injections. It synthesises the data from your CGM, your insulin doses, and the meals you log, and offers a cohesive set of suggestions. It minimises the need for high alarms by letting you tailor the alerts to suit your lifestyle, and then when it does offer an alarm, it offers a suggestion too – not just noise, but advice that comes from seeing the whole picture.

Life with Type 1 diabetes is a constant juggle. But it has been such a relief to know that I don’t, actually, have to do it all on my own. It is possible – with the remarkable tech currently available in South Africa – to have someone to help me.

Find out all about the MiniMed Go here.

What would make your life with diabetes easier?

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