Category Archives: economics

Libre flash monitoring – “freeing” you up to live life


What is flash monitoring ? Well it’s a button you wear on your upper arm (under normal sleeves) and use your phone (many compatible android and iphones) to swipe across the button and voila- a sugar reading. It then records on a graph on your phone.

We have come a long way since 1922 when without insulin type 1 patients essentially died. Crass but the truth sadly. And here we are in 2019 and we do not even have to rely on finger pricks. Yay! Progress and science and so much of happiness all around.

Flash monitoring does have a lag, and that is quite individual. Safe to say the “real time” sugar is ahead ie the flash is behind real time but the trend remains the same – I hope that makes sense. The beauty is being able to see where you have come from and are headed towards. So, if you are heading down you can snack or watch and wait depending on the circumstances : ie food, exercise, illness and same for heading up. And you can flash in 5 minutes to see.

So I very much advise against knee-jerk reaction to the blood sugar on flash monitoring but rather watching and waiting and “learning” from experiences of exercise and cake eating etc. As for adjustments in insulin doses and timing of insulin and what does what. For example stress affects certain people in one way and others in another and the beauty of the flash is that you get to learn what your body does and adjust to that.

In the UK this device is now relatively largely widespread and with great great results of way better control, time in range and very importantly better quality of life for type 1 patients. It is being funded by the NHS at large thanks to the Diabetes warrior doctors who have literally “gone to war” to get this funded.

In south africa we battle “the funders” to do what actually benefits them downstream but happy to say that I do feel that progress is being made in this arena too. Our “war” also slowly slowly being won for the betterment of both funder and patients.

Flash monitoring – glucose readings regularly not requiring finger sticks/pricks – accurate, timeous and life changing – allowing patients to live full lives rather than survive.

#abbottlibreflash a multitasking device that adds value at every level

670G medtronic – a lesson for all diabetic practioners in a very good way :):)


The new 670G medtronic pump is truely a wonderful amazing device.

What suprised me more than anything else is what an absolute pearl of a lesson it is in terms of how insulins work and the daily awful grind and variability of being a type 1.

Honestly congratulations to this development team, you have come up with a genius product. Genius!

It expertly and simply solves for so many of the dilemmas type 1’s face daily. And in a safe and perfect way.

Truely a product that answers so many of the questions that we have up to now not solved.

Thank you thank you thank you.

THe MARD was my biggest happiness on the sensor – 8.7- wow-Yay!

So many reasons that in my opinion as many type1 patients should get onto this technology in terms of cost saving in the long run for med aid schemes and longevity with quality for patients both old and young.

I nominate it for product of the year.

Problems it solves for :

1.) daily variability (automatic adjustments according to blood glucose)

2.) hypoglycemia – on a downward trend of sugar readings it keeps decreasing insulin as to prevent a low and then eventually suspending insulin so as to prevent the low from happnening, as soon as the sugar trends up it resumes insulin and keeps adjusting

3.) high sugars – on an upward trend it increases insulin (up to a preset SAFE) level with alarms and alerts so as to prevent the high sugar

4.) variability immediately improves as does TIME IN RANGE

5.) multiple layered safety catches in case of problems

 

Continous monitoring and it’s influence on control – a huge wonderful impact


If I could pick only one thing for all my type1s and type 2 s on insulin to have in their armamentarium of goodies it would be access to continous monitoring for sooo many reasons.

1.) they learn from it and figure out which foods spike them

2.) they learn what drops them and how quickly and how to rectify this, ie how long the rescue takes to kick in so to speak

3.) they are able to see that if they inject insulin correctly at the correct time that it actually controls the sugar

4.) they can see what a “missed” dose does to the sugar

and I could honestly go on to 100 things …

REcently prices have literally plumetted on these devices making them more and more accessible.

THe next question to ask is : ? accuracy.

It is imperative that the device have the lowest MARD possible.

All this means is that the reading you see on the device is actually a TRUE reading.

Sluce. Kapish. Simple

Accurate is everyting .

So pick up something in your armementarium today for YOUR control 🙂

Accuracy data from ADA 2019 hot off the press praising CGMs’s at large 🙂

The data backs up the average clinician’s gut feel that seeing is the answer.

dexcom

“hybrid” Closing the loop …how divine :)


If you have an intact pancreas you already have a closed loop. That is to say you eat food and your pancreas automatically releases the perfect amount of insulin to “match” the carbohydrate you have just eaten so that the glucose molecule can travel easily into the cell, all cells require glucose for metabolism.

However if you are reading this and you are a type 1 diabetic you do not have B cells that are functioning and this is great news for you – a closed loop. It is in essence : an artificial intelligent pancreas.

It is here and for that we rejoice. It is not the full monty but at this stage each step is a win and this is a big big win. The algorithms get more and more accurate and detailed as time and data increase.

From march 2019 the alogrythms to close the loop will be available to all and anyone in the world.

For more info : 0832898351 Romae for a booking

It’s here and that is awesome. It’s hybrid and it’s not at its full potential as yet however it it more than we have had up to now and for that we rejoice.

Diabetes type 1 is no one’s fault, don’t be ignorant


Daily I hear very interesting “lies” about diabetes. I heard a classic last week. Someone’s mom who had had a stroke was told her mom has the kind of diabetes that CAN NOT be controlled. God’s truth!!!

Another common lie is that this is a disease “you do to yourself” i.e. you behave/eat in a certain way and your “punishment” is diabetes. Well I am afraid that is NOT TRUE.

Especially in type 1 diabetes. This scourge has been with us for a long time. However up until the 1920’s there was no “cure” or “treatment” so to speak i.e. you generally died from it. And the consequence being the “genes” or genetic inheritance died with that. Since the 1920 s we have had insulin and now one can live very “normally” yes ~I said normally with type 1 diabetes. Yes it involves checking sugars and injecting insulin but other than that you can eat mostly what you would like to and get on with life as you would like to.

So to the diabetes that can not be cured I say : Lord have mercy. There is so much lack of knowledge especially in public sector about diabetes. That added to the corruption. Ie meters, strips, insulin being sold on the black market meant for the poorest of the poor free as part of a the dismal service being provided is a scourge.

Any form of diabetes can be treated and controlled. Is it easy ? No but is it do-able even for the poorest of the poor. YES!!!

There is so much corruption in this country and it always affects the poor more. Let’s at grass roots level tackle this with the power of words, peace, and the truth. Join us to contribute to both awareness and funds for shap shap doing this very task daily excellently : roarin 20s party 27 oct 2018 …see Facebook drleethegp and shap shap

Silent heart attack


What is a silent heart attack. An acute myocardial infarct where the patient feels no pain whatsoever. Diabetics are very prone to this. Particularly poorly controlled diabetics. If the average sugar is consistently above 10 mmol/l then the nerves to the various organs actually stop working. Which means in essence you don’t feel pain like you should.

The problem with not feeling the pain is that you don’t realise what is happening. So generally the patient presents later. Sometimes with confusion (acute), sometimes with electrolyte disturbances or unfortunately death.

Control of sugar is key.

A1c – three month average of the glucose must be performed in diabetics at least every 6 months and attended to if too high.

Controlled sugars prevent heart attacks. Controlled blood pressure prevents them too 😉

Sticky mess 2


So when the sugar goes above 10 mmol/l (different values and way of measuring in the US and UK), the blood vessels : arteries and veins in the : eyes, heart, kidneys and feet and also EVERYWHERE (yes that includes the reproductive organs) SHUT – the sticky mess shuts them and so the cells can not get oxygen and they “starve” and can die.

That is when you have episodes like : stroke, heart attack or a black foot requiring amputation.

Or when you go blind, need dialysis or need to have a heart bypass/stent.

So what is the answer ? More meds, better meds ?? Maybe BUT mostly, more exercise, better eating habits, more exercise etc, consulting the team you know about re your diabetes : dietician, podiatrist, biokineticist, doctor, etc at least once a year.

If you keep the sticky mess away, did you know you live longer and better quality of life than your non-diabetic counterpart?