Category Archives: continous monitoring

Innate


http://innatehilton.wix.com/innate

Holistic integrative medicine

Pump for me or not for me?


Report back : We had a marvellous discussion about pumps on wednesday evening. Highly enjoyable and informative, even our pump patient learnt something.

JOIn us today : On wednesday night 530 pm in Hilton Pietermaritzburg we will be holding an informal hour discussion about pumps -insulin pump therapy. What is pump therapy ? Who “qualifies”? What is the benefit. Is it for everyone who injects insulin?

Feel free to join us for free for an hour to explore the “pump market” in south africa and get first hand feedback from “pump” patients 😉

Diabetes cure?


There are various teams around the world – dedicated scientists and enthusiastic people working on all aspects of diabetes – trying to find prevention, cure, treatments – better, onwards and upwards. The diabetic scientific community at large strive for better quality of life.

There are also many snake juice paddlers as there are fake news folk. Do not be duped or sucked into some scam.

It’s a pity that in the light of such a huge and devastating epidemic there would be folk peddling snake juice and basically lying to a vulnerable subset of people. But that is life and ours the task to engage the brain and always question.

New treatments, closed loop technology and cures are on the horizon and I salute the many people working around the clock to accomplish that. Please the internet if FULL of rubbish – surf wisely.

Success !


It’s a brand new year and great excitement after a really good rest and break.

I started using ryzodeg as it hit the shelf (I had been anxiously awaiting its arrival for months). I have reviewed most of the patients started on it now and wow!! incredible results. Even more incredible when combined with a libra pro sensor!!

This is cost-effective, accurate and well tolerated treatment for type 1. Most patients have stopped having hypos and certainly all have stopped having bad hypos. All of the patients average sugars have dropped significantly and variability come back to a much more acceptable range. Patients are happier, have better quality of life and generally walk in with a smile on their dial.!! Yay!! Yay yay!!!

I could not ask for a better way to start the year 🙂

This is a video link of how the new long-acting insulin works: on youtube: Tresiba® (insulin degludec injection 200 Units/mL) Pharmacology

Ryzodeg  (avail in SA) is part (1/3) short acting (novorapid) and part long-acting (48hour half life) degludec as in the video.

 

Carb : Insulin mismatch?


Are you matching your carb intake to your insulin intake? What is your specific and individual insulin sensitivity and carb ratio – do you know?

If you are injecting insulin either long or short acting or both these “numbers” are important to know.

What complicates things further is that sometimes they are different for different times of the day as well as different states of health.

Injecting insulin is a very tricky business if you are aiming for “perfect” control – i.e. glucose between 5-9 mmol/l (this is my personal goal post). Overshooting and under dosing happens most days.

In order to try and get it right most of the time it helps a lot to KNOW your body and your numbers. So what is carb ratio ? This is the amount of insulin you specifically need to cover 15 g of carbs – that is roughly one slice of bread. Most patients are in the region of 1-2 u units per 15 g/one slice bread. Children/babies however are more usually 1 u for 30g or more and in terms of sensitivity 1 u dropping sugars by 10 mmol/l (vs adults usually 1 unit dropping sugars by 2-3 mmol/l).

This information/calculation needs to be worked out by yourself, your doctor as well as your dietician. It is really important to understand and apply this in order to get better control.

Then bear in mind that on sick days you usually need a bit more. When exercising hard a little less (sometimes a lot less). And so it goes : hot weather, cold weather, different foods, stress, etc all influence the sugars and how they react to insulin.

Don’t be caught high or low this festive season – stay jolly and even.

 

 

 

 

Guardian connect – a step in the right direction


Ok so south africa’s latest CGM is here and available. We have a few on the market and this is the newest addition.

It currently “talks” to iPhone and from next year will also “speak” to android phones.

The great great benefit of this device is that the sensors are relatively “cheap” and the device is simply a sensor contraption that attaches to the body and then “speaks” to the iPhone. From that iPhone to the cloud where a healthcare provider, mom or dad or care-giver can access the “data” – a blood test every 5minutes that is 288 tests per 24 hours !!

The data is reliable with an MARD of 9 and thus insulin can be titrated using the readings.

The cost of the kit is 13k (R13828.20) and the sensors are R1695 for 5 – they last a week each, that’s 399 per sensor.

The benefit of “knowing” your sugar is fairly obvious but is in actual fact revolutionary and life changing for an individual diabetic.

You simply can not compare 6 tests a day to 288. The maths of that in itself is a mindblow.

NOW is a great! time to order one at the end of the year before a brand new year on med aid benefits.

email me if you have questions : drleethegp@gmail.com

Knowing your number is honestly the single most effective way of getting control.

Continous monitoring cleared up


Ok so what is available currently in South Africa for continuos monitoring – and what is that any way? Continuous monitoring is the single most effective tool in controlling sugar in my practice.

Instead of 4-6 finger pricks a day to see where you are at for a sugar level continuous monitoring is essentially a device that resides subcutaneously (under the skin) for a period of time and “reads” the sugar on a 5 min or 15 min interval and gives a reading on a graph format of the sugars.

It is a life changing and diabetes management miracle. I find that with just this one intervention we can stabilise the sugars.

So in SA we have from cost-effective to expensive : libre-pro, guardian-connect, dexcom G5 and soon to be G6 as well as medtronic’s continuous monitoring that accompanies their pump.

For those needing a cost effective yet accurate solution the libra-pro is the way to go. Please do be aware that the device in SA is DIFFERENT to the one overseas.

Guardian connect is about to launch, it is a great CGMS that is both accurate and affordable. This device has a “monitor” on which the graph of the glucose readings appears.

Dexcom is an expensive but amazing CGMS, the G5 now communicates primarily with an iPhone and soon to be android. This means carrying less devices around. It is supremely accurate and easy to use.

The CGMS that accompanies the medtronic pump is getting more accurate but only available with the pump.

Any queries will happily be answered : shoot your questions : drleethgp@gmail.com