Gary Scheiner MS, CDE

As a Certified Diabetes Educator and Type-1 diabetic for 20 years, Gary Scheiner knows and applies the latest techniques for achieving optimal diabetes control. Click here for more on Gary Scheiner

(10:00):Welcome to CGM Chat with Gary Scheiner!

Gary Scheiner, CDE says to (10:02):

Hi everyone!

gina says to (10:02):

me too

digammo says to (10:02):

Hey Gary

landileigh says (10:02):

hey gary!

bjphilly says to (10:02):

hey Gary!

pethridge@its.jnj.com says to (10:03):

good evening!

bjphilly says to (10:03):

hey Scott and Gina

gina says to (10:04):

Betty its great to see you

Gary Scheiner, CDE says to (10:04):

sstrumello, don’t I know you from somewhere?

sstrumello says to bjphilly (10:04):

Hey Betty

bjphilly says to (10:04):

thank you, same for you:)

Danny6820 says to (10:04):

Hello!

Gary Scheiner, CDE says to (10:04):

Betty! I should have known you would be here!

bjphilly says to (10:04):

of course

Sophia says to (10:05):

how many people here have and use a CGM?

bjphilly says to (10:05):

how’s the fam Gary?

Judy&Alli says to (10:05):

My dd has one

gina says to (10:05):

I use the Minimed CGM

PowerPumper says to (10:05):

no cgm

Gary Scheiner, CDE says to (10:06):

Everyone’s good. Even the teenager.

bjphilly says to (10:06):

no cgm yet

stark says to (10:06):

we have used dexcom with our daughter – didn’t like it

westinsmom says to (10:06):

my son used it for some time (MM) but we can’t afford to pay out of pocket anymore

gina says to (10:06):

Gary can you tell us the benefits of wearing CGM for the people that dont have one

Danny6820 says to (10:06):

yes please…

gina says to (10:06):

and want to know about it

Judy&Alli says to (10:06):

my dd has dexcom and loves it

bjphilly says to (10:07):

I’ve worn the dexcom

Gary Scheiner, CDE says to (10:07):

Benefits of CGM… that’s a lot to talk about! Preventing lows, spending less time high, improving sports performance, fine-tuning doses, etc, etc, etc!

bjphilly says to (10:07):

Hey Allison!

AMBlass says to (10:07):

Good evening, folks!

Sophia says to (10:07):

what are some of the bumps in the road people should expect with a CGM?

Gary Scheiner, CDE says to (10:08):

Stark, did you use the Seven Plus or the Seven? There’s a pretty big difference in terms of accuracy & reliability.

stark says to (10:08):

seven

gina says to (10:08):

gary do you recommend any one over the other? Which one do you use?

bjphilly says to (10:08):

what’s the difference Gary?

lee4031 says to (10:09):

My 12 year old hates to wewar her CGM – it is integrated with her Minimed pump, she just does not like the extra site. Currently, we make her wear it for sleep overs, but I don’t like forcing it down her throat…any ideas?

Gary Scheiner, CDE says to (10:09):

I use the Dexcom Seven Plus personally. With all the sports I play, the sensor holds on great and doesn’t get in the way at all. Navigator is a good accurate system too; has better on-screen graphics, but the sensor/transmitter are a bit large for me.

akoster says to (10:10):

Thats one of my big reservations about getting th CGM- the extra site

landileigh says (10:10):

i thought the Navigators were about the size of the omnipod, and it’s size is what discouraged me

westinsmom says to (10:10):

lee, that is another reason we don’t use it anymore. (I have a few in the fridge for emergencies)…it was just not appreciated by the 12 year old

gina says to (10:11):

I wore the navigator and the Minimed at the same time for a trial. I really liked the nav but it was very large

landileigh says (10:11):

what kind of patients do you recommend use the CGM?

Gary Scheiner, CDE says to (10:11):

Maybe your daughter would like having her blood sugar tested less if she wears the sensor. If it is working well, you should be able to cut back to 3 or 4 fingersticks daily.

digammo says to (10:12):

After 4 years, my 13-year old daughter just doesn’t understand the dangers of being high..so an extra site is a hard sell

westinsmom says to (10:12):

Gary, my son never wanted to rely on the readings and continued to check his sugar whenever he felt low

lee4031 says to (10:12):

We tried that reason with her, but she doesn’t mind testing, so it isn’t a big enough reason to convince her.

Gary Scheiner, CDE says to (10:12):

Landileigh, I recommend CGM to anyone with type-1 who wants better control, particularly those trying to avoid lows.

stacey says to (10:12):

My son, almost 18 wears the Navigator…. has had it for 1.5 years and loves it because I don’t have to nag him to check…:) He’s become very dependant on it.

westinsmom says to (10:12):

I should add, he usually wasn’t low when he checked

stark says to (10:13):

Does the Seven plus have a smaller sensor/transmitter than the seven? Does the sensor work better? We had a horrible time getting our 10 year old to go with the extra site & then the sensor wouldn’t last more than a day or so. It wasn’t accurate either

Gary Scheiner, CDE says to (10:14):

Westinsmom – CGM data is not always reliable, but it usually is… particularly if the last couple of calibrations have been close to what the sensor is showing.

gina says to (10:14):

Stark, a trick i learned is if you let the sensor soak in the skin for a whole day before turning it on the readings become really accurate

westinsmom says to (10:15):

I felt very comfortable with the cgms data. I could tell when it was working well and when it wasn’t…Westin just never got comfortable with it and he never paid attention to the alarms…I loved it at night but once I stopped using it and adjusted

stacey says to (10:15):

The only drawback to the Nav for us is that 10 hr calibration… hopefully the newer version will be out soon. We’ve found that its pretty darn accurate bwtween 80-300… over 300 he checks… and he hasnt had too many lows …

westinsmom says to (10:15):

to not having it, I don’t miss it too much.

Gary Scheiner, CDE says to (10:15):

Stark – the Seven Plus uses the same sensors, but the transmitter works much more efficiently. The hones to the calibrations immediately, and programming is much easier, with more customization options.

stacey says to (10:16):

Gary- do you have any clue wjhen the new Navigator will be available??

pethridge@its.jnj.com says to (10:16):

Gary – how do you feel about using the CGM for behavior modification – What i mean by that – if you know what you are about to eat and you bolus ahead of time so you don’t have the big spike

Gary Scheiner, CDE says to (10:17):

All 3 CGM manufacturers/systems have their pros & cons. I have a nice set of “real” comparisons at my website: www.integrateddiabetes.com; just click in the CGMS section.

Judy&Alli says to (10:17):

Gary do you have any idea when integration will happen with Dexcom and Animas?

landileigh says (10:18):

btw, this chat will be transcribed after it is over and up by tomorrow on this website! so if you miss anything Gary has talked about or a website he posts, you can catch it there!

gina says to (10:18):

Here is the direct link to Gary’s CGM page: http://www.integrateddiabetes.com/cg_home.shtml

Gary Scheiner, CDE says to (10:18):

Judy – I wish I knew. They have a national sales meeting next week, and new products usually follow those meetings. Hard to say for sure though.

Gary Scheiner, CDE says to (10:18):

Gina, you are TOO quick.

gina says to (10:18):

Judy&Alli says to (10:18):

ok thanks I was hoping you would have the inside scoop;)

art says to (10:19):

I use the Dexcom Seven but can’t get insurance coverage yet. Any advice on how to get them to approve it? I also find that the Dexcom is accurate when my blood sugars are stable and do not fluctuate a lot.

PowerPumper says to (10:19):

insurance is my hurdle too

Gary Scheiner, CDE says to (10:19):

Looks like the updated Navigator system will have a shorter warmup time, longer alarm shut-off options, and a few other programming advances. BUT, the sensor/transmitter will be the same size.

Gary Scheiner, CDE says to (10:20):

Art – My website also has details about securing insurance coverage. You have to be persistent… it will often be denied at first, so you have to keep appealing until they agree.

gina says to (10:20):

to be honest i think the longer calibrations make it more accurate

Wendy12571 says to (10:20):

I don’t have insurance coverage for the seven plus either, but also bolus off of it. ops don’t tell the FDA

westinsmom says to (10:20):

any tips on Medicaid?

gina says to (10:21):

I have tips at my other website on how to help people get covered for CGM as well: http://cgm-antidenial.ning.com/

Judy&Alli says to (10:21):

Michelle in Ohio they don’t even have a billing code for cgm’s.

Gary Scheiner, CDE says to (10:21):

I bolus off mine sometimes too, Wendy. But if my BG is rising or falling rapidly, I’ll do a fingerstick since there can be a substantial difference at that moment in time. If the BG is stable, it will be more precise.

art says to (10:21):

Thanks, Gary. I have been told that if your physcian indicates that you have hypogycemic unawareness (which I do), you have a better chance of getting it approved upon appeal.

westinsmom says to (10:22):

when we were on MIChild (which is for low income in MI but run through blue cross) we got reimbursement, surprisingly…but I have ot even tried to with straight Medicaid

stacey says to (10:22):

Jesse bolus’s off of it too.. because he’s a teen……….. and doesnt check

Gary Scheiner, CDE says to (10:22):

No specific Medicaid tips because coverage and terms vary from state to state. Medicare will absolutely not cover anything at this point.

lee4031 says to (10:23):

Gary, have you seen a significant drop in A1C’s in teens and young adults from using the CGMS?

stacey says to (10:23):

I got Jesse’s covered by GHI in NY… by calling and harassing them daily for 6 days… and on the 7th day he was approved.

Gary Scheiner, CDE says to (10:23):

That’s true, Art. Hypo unawareness is one of those “red flags” that insurance companies don’t want to mess with. That should be stated in your doctor’s letter of medical need.

Judy&Alli says to (10:24):

Gary do you find a 20 minute lag on the dexcom when coming up from a low?

Gary Scheiner, CDE says to (10:25):

Lee – My practice experience, and the recent JDRF-sponsored studies, show that young people who use the system on an regular basis and view the data regularly experience improvements in control.

gina says to (10:25):

i found that i have much better blood sugars when I am on the cgm and i like that i know what is going on

PowerPumper says to (10:25):

Gary, I have sites I don’t use anymore for insulin. After 34 years they just don’t work well anymore. Will these sites work ok for a CGM sensor?

DiabeticDiva says to (10:25):

Hey all

westinsmom says to (10:25):

Lee, Westin’s a1c dropped by almost a point and stayed there for a good year without using the cgms..now it popped back up.

Gary Scheiner, CDE says to (10:26):

That means: wearing the sensor just about all the time (not once a month or every other week), and viewing the data hourly or more to detect and fix/prevent potential problems. Those who don’t do these things don’t improve their control.

Gary Scheiner, CDE says to (10:26):

Way to go Stacey! Your experience sounds almost biblical.

lee4031 says to (10:26):

Is that reallt realistic for young adults in school? At what age is that an appropriate response?

randombetic says to (10:26):

I’m currently using an Animas Ping Pump. Any thoughts on their newly announced CGM system, and what to do in the meantime?

gina says to (10:27):

Gary, I would wear it all the time but, the alarms make me crazy any tips?

Gary Scheiner, CDE says to (10:28):

Judy – yes, there seems to be a substantial lag with all the systems during recover from a low. I believe it is caused by shifts in blood flow when the body is in a stressed state: very little new blood flow to the skin surface.

Gary Scheiner, CDE says to (10:29):

Power – all you can do is try. It might work fine, as long as there is reasonable blood flow to the area. Sensors seem far less affected by site selection than infusion sets.

Gary Scheiner, CDE says to (10:31):

random – when Animas updates their pump to link with Dexcom, it will use the current Dexcom sensors/transmitters, so it makes sense to get started on the sensor part now. When the new pump comes out, you’ll be ready to rock & roll.

art says to (10:31):

I am a triathlete and attended the Diabetes Training Camp last year with Team Triabetes. (Awesome program!) I was amazed at how many athletes now use CGMs when training. Only problem is that sweat tends to make it more inaccurate. Any advice?

Gary Scheiner, CDE says to (10:31):

Gina – which system do you use? There are ways to minimize the alarms.

gina says to (10:31):

MM

randombetic says to (10:31):

thanks Gary!

gina says to (10:32):

i minimize them but, it pretty much defeats the purpose of wearing it

DForce says to (10:32):

I have been wearing my CGM consistently since April, 2007, no days off. I love it, however I find that every few months, it gets crazy and say I’m 50 when I am in the 100s or I am 300 when I am in the 100s. I am an RN, CDE, CGM trainer, very experienced

DForce says to (10:32):

Any idea why this happens? Not a calibration issue…

gina says to (10:32):

Dforce that is awesome

Gary Scheiner, CDE says to (10:33):

Medtronic’s sensor gets a bit more cranky than the others. You can start by raising your high threshold and lowering your low threshold, and using a long snooze time for both. But there isn’t much you can do about cal errors.

PowerPumper says to (10:33):

I’ve not pushed for one yet because my control is pretty good. I’ve a 5.9% A1C and 16 basal rate changes. I’ve done lots of basal testing and meal profiling. But I am wishing I had some hypo protection. My hypo-sensitivity is pretty low.

PowerPumper says to (10:34):

My MM rep (at a session) said to insert sensors at 90 degrees, not 60. Also to calibrate less often.

Gary Scheiner, CDE says to (10:34):

Art- sweat should not affect accuracy, but it can affect the stability of the sensor/transmitter, which can cause error messages. Extra tape, careful placement (buttock works well), and use of Mastisol might help.

stacey says to (10:34):

Jesse’a A1C hovered around 6,8-7.1 for the first year of use… never really dropped.. BUT – we;ve just about eliminated the lows and highs… He had 78% of his readings betwn 80-175. His A1C last month was 6.5…..I’m pretty sure that puberty has ended

stark says to (10:34):

Dexcom’s sensor’s expire within a few months time. Can you still use them after the expiration date? Are they still accurate?

sstrumello says to (10:35):

Gary, have you thought about writing a CGMS book?!?!

gina says to (10:35):

that would be amazing!! WRite a book Gary!

stacey says to (10:35):

yeah !!

art says to (10:35):

Thanks, Gary! Great advice. Also did not know you could insert Dexcom sensor in back or buttocks!

Gary Scheiner, CDE says to (10:35):

DForce – I think you just have to expect an occasional problem. What the companies call “user error” I call “crappy sensor”.

Wendy12571 says to (10:36):

stark, i have been know to use expired sensors.

gina says to (10:36):

Art, I find that the arm is really accurate. Well, for me anyway

gina says to (10:36):

Gary LOL

gina says to (10:36):

Wendy, bad girl lol

Gary Scheiner, CDE says to (10:37):

Powerpumper – you could probably maintain a tight A1c but without nearly as many lows if you were using a sensor consistently and properly.

sstrumello says to (10:37):

I’m serious about a book; it would be helpful for anyone shopping for one, or trying to fine-tune one!

DForce says to (10:37):

Crappy in what way? The sensor itself has a problem?

Judy&Alli says to (10:37):

My daughter uses her arm for her sensors too. When the pad gets loose she uses sports wrap instead of tape and it works awesome!

art says to (10:38):

Gina…the arm works well for the transmitter (or the sensor)?

Gary Scheiner, CDE says to (10:38):

Congrats Stacey! That % in-range is my favorite statistic. THAT is what it’s all about.

gina says to (10:38):

Art, sensor

art says to (10:38):

Really! Didn’t know you could insert it there either!

sstrumello says to (10:38):

Its an almost unaddressed area in publishing

Gary Scheiner, CDE says to (10:38):

Stark – you should be able to use the Dexcom sensors a little after the expiration date; but if your first couple of calibrations are way off, I’d chuck it and start with a fresher one.

PowerPumper says to (10:38):

I have my lows pretty minimal. I really do understand my behavior. I’ve put a lot of work into it. But when I do go low, well, the lights might be on but nobody’s home

gina says to (10:39):

you can insert anywhere you take shots

gina says to (10:39):

powerpumper i hear you on that lol

stark says to (10:39):

Can you get free replacements for “crappy sensors” that cost a lot of money? In your experience can you get Dexcom to replace faulty ones? We were unsuccessful.

gina says to (10:40):

when i have problems with my Mininmed sensors i am able to call the hotline and get replacements

art says to (10:40):

Gina, I have only inserted it in the abdomen as they recommend. I get lots of bruises there, so it it great to know there are options. Thanks so much. ::)

Gary Scheiner, CDE says to (10:40):

Thanks for the vote of confidence, sstrumello. Maybe one of the sensor companies would hire me to write one.

gina says to (10:41):

Art, i use my side up in the ribs a lot too i get good readings there too

stacey says to (10:41):

jesse wears it on his left arm, in the same spot .. it drives me nuts… but at least he wears it. In the summer, he had a white rectangle on his tanned body…

landileigh says (10:41):

lol stacey! D-tans!

Gary Scheiner, CDE says to (10:42):

Stark – Absolutely… if your sensor poops out well short of its intended life, call the company. They will almost always replace it for you.

Gary Scheiner, CDE says to (10:42):

everyone — how much time do you get from your sensors? (and which system do you use?)

lee4031 says to (10:43):

We get 6 days, with a restart inbetween with our MM…

gina says to (10:43):

Stacey, that is funny happens to me all summer!

AMBlass says to (10:43):

I’m on the Minimed and I don’t wear it past 6 days. Not because the sensor is bad, but because I get infections.

Judy&Alli says to (10:43):

we use dexcom 7 plus. we get about 9 days typically:)

DForce says to (10:43):

Medtronic-6 1/2 days, although I have pulled off transmitter, popped in charger and reattached to old sensor for another 6 days!

gina says to (10:43):

Gary, I can get 7 days of use with Minimed

art says to (10:43):

I sometimes get about two weeks on my Dexcom sensors but they start to get erratic after about 12 days.

gina says to (10:43):

sometimes 9

Gary Scheiner, CDE says to (10:43):

Does everyone on the Medtronic know the trick for getting past 6.5 days?

AMBlass says to (10:44):

I don’t but even if I did – ouchy skin.

Gary Scheiner, CDE says to (10:44):

DForce just spilled the beans!

stark says to (10:44):

I guess we haven’t had much success with the this at all. . . we never got more than 1-2 days from Dexcom seven . . .uuggh!

gina says to (10:44):

Gary no ?

gina says to (10:44):

i did read Dforce that is a good idea

DForce says to (10:44):

If you train for the company, you better know the tricks!

stacey says to (10:44):

Navigator. 8-10 days… Then it usually falls off of his slimy skin… I have 100% coverage, and have a good supply ..

art says to (10:44):

Dexcom should certainly last for 7 days!

Judy&Alli says to (10:44):

1-2 days is unacceptable stark. I am sorry for you!

gina says to (10:44):

stacey you are lucky

sstrumello says to (10:44):

This seems to suggest why JDRF partnered with Dexcom, rather than Medtronic Minimed

Gary Scheiner, CDE says to (10:45):

After 6 days on the MM sensor, you have to remove the transmitter and charge it for 20 minutes, then plug it back in and do a fresh sensor start.

stark says to (10:45):

thanks Judy & Alli!

lee4031 says to (10:45):

After the 3rd restar, 6 days, how long does it stay accurate?

Gary Scheiner, CDE says to (10:45):

I like that, Allison. “Ouchy Skin”.

gina says to (10:45):

oh Speaking of the JDRF we will be having an Artificial Pancreas chat with Aaron Kowalski soon as well

Judy&Alli says to (10:46):

I hope dexcom replaces them for you stark!

gina says to (10:46):

GAry, how many more days can you get out of it then?

DForce says to (10:46):

Another tip. On day 3, enter a bg BEFORE going to “new sensor”. Then sensor will use CAL you just entered rather than having to wait a minute or 2 before entering it.

AMBlass says to (10:46):

Heh. Cute names don’t make it any painless. I don’t know how people can have something in their skin that long! Am I doing something wrong?

Gary Scheiner, CDE says to (10:46):

Beautifully descriptive, Stacey. What exactly does his “slimy skin” smell like? No… I don’t want to know.

PowerPumper says to (10:46):

Do you kno if this new JDRF/BD relationship will examine sensor improvement?

sstrumello says to (10:46):

Thanks Gary, Gina … I’ve got to cut out early now. I look forward to reading the transcript!

gina says to (10:47):

Scott see ya soon!

Gary Scheiner, CDE says to (10:48):

Yea, cute names just don’t cut it. Like infusion sets: “Sof Set”, “Silhouette”, “Tender”, “Comfort”. We need real names, like HARPOONATRON or BLUDGERMATIC.

gina says to (10:48):

LOL

PowerPumper says to (10:48):

lol

Judy&Alli says to (10:48):

lol gary

bjphilly says to (10:48):

lol

DForce says to (10:48):

I have gotten 12 days out of mine, however that was when my insurance wasn’t covering and I was desperate!

Gary Scheiner, CDE says to (10:49):

Most people I work with can get close to 2 “cycles” out of their sensors before the performance starts to croak.

gina says to (10:49):

wow!!!

DForce says to (10:49):

2 cycles of 6 days or 2 cycles of 3?

Judy&Alli says to (10:49):

can you go 14 days gary?

Gary Scheiner, CDE says to (10:50):

5-6 days w/Medtronic, 8-10 days w/Navigator, 12-14 days w/Dexcom.

Judy&Alli says to (10:51):

wow i think our record was 12 days. But she is so active they usually come out before they stop working.

DForce says to (10:51):

Do you find one brand more accurate than another? Which would you recommend to a new pt. with no preference?

Gary Scheiner, CDE says to (10:52):

I pay cash for my Dexcom sensors, so I put them on life support and do a few resuscitations before I rip it out.

AMBlass says to (10:52):

I definitely think I’m going to switch to DexCom once my supply of Minimed is done.

gina says to (10:52):

Gary that just made me laugh out loud

Gary Scheiner, CDE says to (10:52):

Usually get 15-18 days out of my dexcom sensors… also need to apply some extra tape around day 10.

art says to (10:52):

Gary…I am with you! When you have to pay out of pocket, you make them last!

PowerPumper says to (10:52):

ido cgms have to be matched to pumps — will only MM’s work with my MM722?

landileigh says (10:53):

Don’t forget everyone that you can check out Gary’s website at http://www.integrateddiabetes.com/

Gary Scheiner, CDE says to (10:53):

HERE’S THE RECORD FOR SENSOR LONGEVITY, at least from what I’ve seen. One of the dietitians in my office got 52 FREAKIN’ DAYS out of a single Navigator sensor. We framed the sensor and have it hanging on the wall.

says to (10:53):

I am up for a new pump…if I were to go with Medtronic, do people still recommend the Dexcom? Cons of Medtronic vs. Dexcom( aside from it being a stand alone device of course)?

gina says to (10:54):

WHAT!!!

landileigh says (10:54):

and of course the book that everyone must have “Think Like a Pancreas” written by Gary Scheiner will be linked off of this chat’s transcript

Judy&Alli says to (10:54):

52 days? OMG!!!

stacey says to (10:54):

52 days… thats scary- how did they get ot to stick so long…?

Ellen1456 says to (10:54):

Well my son can’t seem to get it not to itch after 4 days.

DForce says to (10:54):

52 days? And how was the surgery to remove it?

Gary Scheiner, CDE says to (10:54):

PowerPumper – CGM does NOT have to matched to a pump. I have patients on Medtronic pumps who use other types of sensors, and people on different pumps who use a Guardian system.

AMBlass says to (10:55):

Ellen, I am the same way.

PowerPumper says to (10:55):

cool, thanks

gina says to (10:55):

mine itches too

DForce says to (10:56):

Do not scratch it!! It is like poison ivy..once you scratch, you can’t stop! I find generally the itch goes away.

Gary Scheiner, CDE says to (10:56):

Thanks for the promo, Landileigh. FYI, my practice provides diabetes consulting via phone & internet all over the world, so if anyone is looking for some “coaching”, please let me know.

gina says to (10:56):

dforce i cant stop itching

gina says to (10:56):

LOL

Sophia says to (10:56):

I like your new website design, Gary. It looks good.

art says to (10:56):

I wish Dexcom would make the adhesive bandages flesh colored (beige or brown) instead of white. The transmitter is small but the bandage stands out like a billboard! Anyone else agree?

gina says to (10:57):

me too gary your new site looks really good! http://www.integrateddiabetes.com/

Judy&Alli says to (10:57):

i might be interested in some counseling for my 11 year old gary.

Ellen1456 says to (10:57):

Seriously, for the person who got so many days out of that Nav – what prep did they use? How many times did they have to retape it?

lee4031 says to (10:57):

Does insurance typically cover the cost?

lee4031 says to (10:57):

Of your counseling that is…

Judy&Alli says to (10:58):

good ? lee

Gary Scheiner, CDE says to (10:58):

Thanks Sophia. It just went up about 4 hours ago. Sorry there are still some “blank” pages.

landileigh says (10:58):

Everyone, it’s almost time for our chat to end tonight, Gary can take just a couple more questions.

gina says to (10:58):

Gary, I have been trying to get my a1c into “baby range” and it has been horrible

Gary Scheiner, CDE says to (10:59):

Art – at least the transmitter is no longer BlacK. fIRST time I wore it, my wife thought I had a bug on me.

gina says to (10:59):

i am about to give up how can i use my cgm to help me get there

gina says to (10:59):

any tips?

Gary Scheiner, CDE says to (10:59):

Lots of tape, Ellen. Lots and lots and lots of tape.

DForce says to (11:00):

Gina…just had baby #3 12 weeks ago. All normal weights, all overdue. This one was 3 weeks overdue! Doctor almost had a nervous breakdown but I refused induction/c section. There is hope..

Ellen1456 says to (11:00):

What kind of tape? Any antihistamine or barrier wipes to prepare the skin?

landileigh says (11:00):

Optiflex, I bet

landileigh says (11:00):

stuff is awesome

Gary Scheiner, CDE says to (11:00):

Lee – Our clients all pay us directly and then submit for reimbursement. Some get reimbursed, some don’t. But we get people the results they want, so they keep coming back!

lee4031 says to (11:00):

Thanks Gary – good to know!

art says to (11:01):

LOL! It does look like a big roach!

Gary Scheiner, CDE says to (11:01):

Gina – best thing you can do is set your high alert aggressively (160? 180?) and attack the high as soon as the alerts go off. If you spend very little time in the high ranges, your A1c will defintely come down.

Judy&Alli says to (11:01):

Goodnight all!! Thanks Gary!!

stacey says to (11:01):

gotta go, goodnight all (Tp)

gina says to (11:02):

Don’t forget to check out Gary’s website http://www.integrateddiabetes.com/

Gary Scheiner, CDE says to (11:02):

Thanks for having my on the “show”. This has been a lot of fun.

landileigh says (11:02):

Thank you everyone for coming! The Chat transcript will be up tomorrow.

DForce says to (11:02):

Try “mini bolusing”..as soon as you see bg creeping up into 130s, test and take 0.2…works for me!

art says to (11:02):

This has been great! Thanks!

Ellen1456 says to (11:02):

The new website looks good Gary.. Thanks for taking the time to chat.

Sophia says to (11:02):

Thanks Gary and thanks Gina – for all the great work you do!

AMBlass says to (11:02):

Thanks again Gary

gina says to (11:03):

Gary thank you so much for being a guest!

landileigh says (11:03):

Also, All of the links that Gary has mentioned will be listed with the chat

Ellen1456 says to (11:03):

Looking forward to reading the transcript – I arrived late.

Ellen1456 says to (11:04):

Thank you TDR!

*** (19:21):Welcome to The Charmr Project Chat , Mama Belle !
Mama Belle says to (19:22):
I’m early too. Just gonna wait
*** (19:23):Mama Belle quit the room
*** (19:24):Welcome to The Charmr Project Chat , bernfarr !
bernfarr says to (19:25):
Bernard here. I know I’m early but didn’t want to miss the fun.
gina says (19:26):
hey bernard
gina says (19:26):
how are u
*** (19:31):Welcome to The Charmr Project Chat , rjommp !
rjommp says to (19:31):
where’s the ballons and party hats have yeah missd me lol
rjommp says to (19:32):
website looks good Gina
*** (19:33):rjommp left this room, entered another room
*** (19:33):Welcome to The Charmr Project Chat , rjommp !
*** (19:34):Welcome to The Charmr Project Chat , 30ccsteven !
30ccsteven says to (19:34):
hello all
rjommp says to (19:34):
hello
30ccsteven says to (19:34):
have the night off, working days for a few days
rjommp says to (19:37):
I’m just in here for a little while. Wanted to let Gina and John know am still alive:P
bernfarr says to (19:39):
Gina, I’m well. My bike ride for Dr. Faustman’s research is this Sunday.
bernfarr says to (19:40):
On Monday I celebrate (!) the 35th anniversary of my Type 1 diagnosis. Yay, I’m still here!
rjommp says to (19:41):
Her research sounds hopeful. Don’years this Oct and still spry. lol
30ccsteven says to (19:42):
good to hear about your 35 years and still ticking.
rjommp says to (19:42):
Congrats on still being here
30ccsteven says to (19:43):
I often hope to make 5 more, and be glad to do more.
rjommp says to (19:43):
holy crap let me rewrite that don’t want you to feel young but have had type one 41 years 42 this Oct
bernfarr says to (19:44):
rjommp Good 4u. That gives me a stretch goal. lol. I’m looking 4ward 2 the Lilly medal in 15 years time
rjommp says to (19:44):
Are they making it in gold yet? lol
*** (19:46):Welcome to The Charmr Project Chat , Rachel Hinman !
rjommp says to (19:46):
Hello Rachel
Rachel Hinman says to (19:46):
hello!
*** (19:46):Welcome to The Charmr Project Chat , AllisonBlass !
rjommp says to (19:47):
Hi Allison
AllisonBlass says to (19:47):
Hey
bernfarr says to (19:47):
Hey Allison! U made it w/out running out of gas!
AllisonBlass says to (19:47):
LOL
AllisonBlass says to (19:47):
Oh that was a couple hours ago
AllisonBlass says to (19:48):
How is everyone?
rjommp says to (19:48):
doing well here
Rachel Hinman says to (19:48):
doing well here, too
bernfarr says to (19:48):
Pumped! Especially to hear more about the interest (if any) in Charmr.
Rachel Hinman says to (19:48):
yes – i have been looking forward to hearing your feedback
bernfarr says to (19:49):
Do u think a medical company might pick it up? Cause AdaptivePath is really in the concept space right?
Rachel Hinman says to (19:50):
well, our hope is to work with a medical company to pick it up
gina says (19:50):
hi everyone
Rachel Hinman says to (19:50):
since we posted the concept to our site, a number of companies have contacted us
bernfarr says to (19:50):
Can I tell u that I didn’t think the cover concept over the combined pump/cgm wouldn’t work.
bernfarr says to (19:51):
Because of the need to move the infusion set every few days, vs the need to move the CGM every week or so.
Rachel Hinman says to (19:51):
tell me more…
gina says (19:51):
hey Rachel! woow you are our earliest guest ever haha
*** (19:51):Welcome to The Charmr Project Chat , ArdRhi !
Rachel Hinman says to (19:51):

gina says (19:51):
officially we will start at 9pm for the others
bernfarr says to (19:51):
And because you can’t use the infusion set in the same place or you get tissue problems.
bernfarr says to (19:52):
Whereas you can leave a CGM sensor in place for 2 weeks (trust me) w/o any issues.
*** (19:52):Welcome to The Charmr Project Chat , mama2h !
Rachel Hinman says to (19:52):
where do you put the CGM sensor?
AllisonBlass says to (19:52):
Mel and I were talking about this on Saturday, and we both agreed that the overall machine was more important than having the two sets together.
bernfarr says to (19:53):
Currently mine is in my abdomen. Whereas my infusion set has been working across my butts for the last month or so!
Rachel Hinman says to (19:53):
interesting
gina says (19:53):
i had to move my pump site all the way up into my rib area because i had scar tissue problems
bernfarr says to (19:53):
I agree with Allison. Focus on the benefit of a combined controller/software.
*** (19:53):rjommp left this room, entered another room
Rachel Hinman says to (19:53):
that is good to know
*** (19:53):Welcome to The Charmr Project Chat , rjommp !
bernfarr says to (19:54):
Right and some parents are using the backs of arms for their kids because of the lack of available tissue elsewhere.
*** (19:54):Welcome to The Charmr Project Chat , Mama Belle !
mama2h says to (19:54):
We have no luck anywhere else but the arm
AllisonBlass says to (19:54):
The actual Charmr (not the site area) was what got people talking.
gina says (19:54):
bernard they wanted me to switch it there but i said NOOOO
rjommp says to (19:54):
catch yeah all later
bernfarr says to (19:54):
TTFN rjommp
mama2h says to (19:55):
Hailey has much better results there gina. We had terrible results on the abd and butt
*** (19:55):rjommp quit the room
Rachel Hinman says to (19:55):
so i am curious to hear what aspects of the controller were the most appealing to people
bernfarr says to (19:55):
My soapbox issue is that the software is key. Also the ability to get the data out of the system so you can load it onto sites like sugarstats, etc.
bernfarr says to (19:55):
Controller size was great.
gina says (19:55):
yea
bernfarr says to (19:56):
How about 2 different controllers with diff. form factors.
mama2h says to (19:56):
I liked the size and appearance
AllisonBlass says to (19:56):
I like being able to look at something and see stats right away
bernfarr says to (19:56):
One for configuration and control. The other for evenings when you might just want to carry a small one round with u?
mama2h says to (19:56):
That would be nice
Rachel Hinman says to (19:57):
when we conducted the research, i was very surprised at the size of current pumps
AllisonBlass says to (19:57):
they’re huge
AllisonBlass says to (19:57):
I have no idea what inside them…
mama2h says to (19:57):
They are huge
bernfarr says to (19:57):
Hah. Have u seen the size of the Dexcom? And you’re carrying that +pump +mobile phone. I need 3 hips.
gina says (19:57):
lol
*** (19:57):Welcome to The Charmr Project Chat , jon !
AllisonBlass says to (19:57):
yeah, I wore one. It’s ridiculous
mama2h says to (19:57):
lol
*** (19:58):Welcome to The Charmr Project Chat , scott m !
gina says (19:58):
the thing i really dont like is that huge patch looking thing on the body
AllisonBlass says to (19:58):
I like the idea of having the pump be the size of the resevoir… maybe a little longer for the computer chip.
mama2h says to (19:58):
poor Hailey’s pants sag now because of the pump and cell phone
*** (19:58):Welcome to The Charmr Project Chat , Abby-Dabby-Doo !
AllisonBlass says to (19:58):
and then having the conroller that I can put anywhere.
Rachel Hinman says to (19:58):
one girl we talked to is a marathon runner – she tried a pump for 6 months and gave up – it was just too difficult to carry it around and run with it
scott m says to (19:59):
Hey Room!
mama2h says to (19:59):
hi
Rachel Hinman says to (19:59):
hello!
30ccsteven says to (19:59):
hi
bernfarr says to scott m (19:59):
Agreed. It jiggles a lot. Why do they make the reservoirs round? If it were flatter, they might slim it all down. Hi Scott M.
*** (19:59):Welcome to The Charmr Project Chat , Ryanheroboy !
mama2h says to (19:59):
very true bernard
Abby-Dabby-Doo says to (20:00):
Greetings everyone!
bernfarr says to scott m (20:00):
Also. Why do we have to change both reservoir and infusion set at same time. If we had smaller reservoir, could change that daily and have a smaller pump?
gina says (20:00):
i love that the charmr looks like a jump drive
mama2h says to (20:00):
hi
*** (20:00):Ryanheroboy left this room, entered another room
scott m says to Abby-Dabby-Doo (20:00):
wow, I have no idea what Charmr is… I guess I’ll learn something new tonight
Mama Belle says to (20:00):
Hi Lanae
gina says (20:00):
well the whole poiont of the pump is to change it every three days
*** (20:00):Welcome to The Charmr Project Chat , sstrumello !
AllisonBlass says to (20:00):
bernerd, i don’t change them at the same time.
bernfarr says to scott m (20:00):
Hey sstrumello good 2cu
bernfarr says to scott m (20:00):
Allison, what do u do?
sstrumello says to (20:01):
Thx all … late day in the office, dinner and all that!
AllisonBlass says to (20:01):
well I accidentally bought too small of resevoir.
Abby-Dabby-Doo says to (20:01):
Scott your in for a treat tonight. I got supper done and the hubby is doing the dishes:D
AllisonBlass says to (20:01):
so I add new insulin about every 2-3 days and wear the set 3-4 days.
*** (20:01):Welcome to The Charmr Project Chat , Jill. !
gina says (20:01):
this is a chat about the charmr to see the video click here <a href=”http://www.adaptivepath.com/blog/2007/08/14/charmr-a-design-concept-for-diabetes-management-devices/”>http://www.adaptivepath.com/blog/2007/08/14/charmr-a-design-concept-for-diabetes-management-devices/</a>
mama2h says to (20:01):
No fair Lanae! Can I borrow him
Abby-Dabby-Doo says to (20:01):
This is a one time deal, and you know I’ll have to pay for it later
mama2h says to (20:02):
lol
bernfarr says to scott m (20:02):
I really liked the size of the charmr controller. And it looked good. Why does diabetes stuff have to look like a Model T Ford? Any color as long as it’s black.
ArdRhi says to (20:02):
I’m not sure why I was invited…I’m not insulin-dependent…*scratching head*
Abby-Dabby-Doo says to (20:02):
How are you Heidi?
gina says (20:02):
maybe they can make the charmr look like the new ipod
gina says (20:02):
rachel are you still with us?
Jill. says to (20:02):
what is charmr?
Rachel Hinman says to (20:02):
i am
mama2h says to (20:02):
No kidding! Pink is a must! Purple would be awsome, and not that dark purple, I am talking bright
Mama Belle says to (20:02):
Good, you?
Rachel Hinman says to (20:02):
so color is important – the external color of the product
Rachel Hinman says to (20:02):
that is good to know
Mama Belle says to (20:03):
PINK!!!
bernfarr says to scott m (20:03):
Making it more fun is important especially 4 kids.
mama2h says to (20:03):
It is for my 11 yr old!
gina says (20:03):
jill click here <a href=”http://www.adaptivepath.com/blog/2007/08/14/charmr-a-design-concept-for-diabetes-management-devices/”>http://www.adaptivepath.com/blog/2007/08/14/charmr-a-design-concept-for-diabetes-management-devices/</a>
Jill. says to (20:03):
k thanx
Abby-Dabby-Doo says to (20:03):
Tired, and we still have bath, site change, and getting stuff ready for tomorrow.
sstrumello says to (20:03):
OK, the kids colors don’t work for me, especially when I wear a business suit. Not everyone with type 1 is 8 years old!
gina says (20:03):
lol
mama2h says to (20:03):
If they have to wear it all of the time it needs to be “cool”
AllisonBlass says to (20:03):
*Variety*
Abby-Dabby-Doo says to (20:03):
Pink would look cool with a business suit!
bernfarr says to sstrumello (20:04):
My daughter (not a diabetic) wonders why the test strips themselves don’t come in diff. colors.
mama2h says to (20:04):
Fusia
Abby-Dabby-Doo says to (20:04):
Use it as a tie clip!
AllisonBlass says to (20:04):
One size fits all diabetes supplies is so 20th century.
Rachel Hinman says to (20:04):
our thought was that a lot of the customizaiton/color choices could be done on the screen
bernfarr says to (20:04):
Sorry got locked into talking with sstrumello only. My daughter (not a diabetic) wonders why the test strips themselves
don’t come in diff. colors.
mama2h says to (20:04):
that would be awsome too!
sstrumello says to (20:04):
I want this stuff to take a minimum of abdominal real estate!
*** (20:04):ArdRhi quit the room
Rachel Hinman says to (20:04):
the exterior of the product could be somewhat neutral but people could customize the ambient display -
mama2h says to (20:05):
yeah, make the set itself smaller
gina says (20:05):
yea the infusion set looks huge with that big patch
mama2h says to (20:05):
make it clear!
gina says (20:05):
not very nice when you are out in your bathing suit
Abby-Dabby-Doo says to (20:05):
And on a child, it would look even bigger
mama2h says to (20:05):
both the pump and the set
*** (20:05):Welcome to The Charmr Project Chat , t1p !
Rachel Hinman says to (20:05):
yeah – the infusion “soft fleshy thing” used in the movie on our site is big – too big
gina says to Rachel Hinman (private) (20:05):
rachel press the B to make your answers bold
gina says (20:06):
way too big
mama2h says to (20:06):
Oh yeah, I forgot about that! That would be great, my only issue is it would be hard to match every skin tone.
bernfarr says to (20:06):
I’d love to see software that would show bg readings and insulin taken (plus user comments) on one graph. Is that part of concept?
Rachel Hinman says to (20:06):
we used the strapless bra inserts that women use for strapless dresses as a model
Rachel Hinman says to (20:06):
the ones that “stick” to the skin
*** (20:07):Welcome to The Charmr Project Chat , duckfeetep !
Rachel Hinman says to (20:07):
we liked the material, but the scale was too big
sstrumello says to (20:07):
Another thing I would add is that the adhesives need to be top-of-the-line. When I wore my pump, I had to prep my sites with Skin-Tac H to get them to stay on after 1 shower.
AllisonBlass says to (20:07):
Oh.. so that’s what that was!
gina says (20:07):
i think its better to just keep it the way they usually look
Rachel Hinman says to (20:07):
yeah?
AllisonBlass says to (20:07):
Gary Scheiner had the idea of making sets flesh colored.
*** (20:07):Mama Belle quit the room
*** (20:07):Welcome to The Charmr Project Chat , Mama Belle !
AllisonBlass says to (20:07):
You know how they are usually white?
mama2h says to (20:07):
we prep the heck out of sites with two different wipes
AllisonBlass says to (20:07):
If you made them beige they might be less noticeable…
*** (20:08):Mama Belle quit the room
mama2h says to (20:08):
I would love to see them clear so I don’t have to worry about matching flesh tones
gina says (20:08):
the only time i had a site pop out was in the summer when the air at work was broken
gina says (20:08):
yea i agree mama
sstrumello says to AllisonBlass (20:08):
Yes, but whose flesh color … we live in a diverse society!
mama2h says to (20:08):
exactly
AllisonBlass says to (20:08):
I’m not the one who suggested it…
Rachel Hinman says to (20:08):
that is true, too
bernfarr says to (20:08):
Well the groovy patches helped (I think).
AllisonBlass says to (20:08):
Geez…
mama2h says to (20:08):
lol
Abby-Dabby-Doo says to (20:08):
I agree on the groovy patches
gina says (20:08):
clear is the way to go!
*** (20:08):Welcome to The Charmr Project Chat , chelsea !
Rachel Hinman says to (20:08):
interesting
gina says (20:08):
for me at least
*** (20:08):Welcome to The Charmr Project Chat , stacey !
Abby-Dabby-Doo says to (20:09):
Have more than one choice is the way to go
sstrumello says to gina (20:09):
Clear works for most everyone, I think
*** (20:09):Welcome to The Charmr Project Chat , Mama Belle !
mama2h says to (20:09):
could offer tones and clear, imho we would go for clear
stacey says to (20:09):
have I missed anything??
Abby-Dabby-Doo says to (20:09):
Mama B what are you doing goin in and out?
daddy says to (20:09):
too many choices may affect manufacturing costs
t1p says to scott m (20:09):
but isnt the point to hise it then clear wouldnt work?
gina says (20:09):
maybe the back of the charmr can be like a medic alert too
Abby-Dabby-Doo says to (20:09):
Haven’t missed too much
Mama Belle says to (20:09):
But flesh tones vary by race
bernfarr says to (20:09):
Yep. More colors, more configuration (with default easy approach) is best of all. More infusion set lengths, more more. I want it ALL:)
mama2h says to (20:09):
that would be a good idea gina
daddy says to (20:10):
so what is today’s topic?
Rachel Hinman says to (20:10):
so i am curious to know what you guys currently use – and the problems you have with what you currently use
stacey says to (20:10):
my son wants colored tubing.. to match the insets
bernfarr says to daddy (20:10):
daddy it’s the charmr
gina says (20:10):
daddy click here <a href=”http://www.adaptivepath.com/blog/2007/08/14/charmr-a-design-concept-for-diabetes-management-devices/”>http://www.adaptivepath.com/blog/2007/08/14/charmr-a-design-concept-for-diabetes-management-devices/</a>
daddy says to (20:10):
but i hought we were talking about the future?
Abby-Dabby-Doo says to (20:10):
Can’t get approval on CGMS- due to age (thanks FDA)
daddy says to (20:10):
sure, but what about the charmr are we talking about?
bernfarr says to daddy (20:10):
<a href=”http://www.adaptivepath.com/blog/2007/08/14/charmr-diabetes-management-research-%e2%80%94-theres-no-vacation-from-diabetes/”>http://www.adaptivepath.com/blog/2007/08/14/charmr-diabetes-management-research-%e2%80%94-theres-no-vacation-from-diabetes/</a>
Mama Belle says to (20:10):
The pump is too big and bulky.
gina says (20:10):
i use the paradigm 512
mama2h says to (20:10):
yes, too big and ugly
Mama Belle says to (20:10):
We use Cozmo
gina says (20:10):
its huge
Mama Belle says to (20:11):
But we love the intuiticve menus
Abby-Dabby-Doo says to (20:11):
MM 522
stacey says to (20:11):
Cozmo here too…
Mama Belle says to (20:11):
er, intuitive
mama2h says to (20:11):
we have mm 722 w/cgms and it is just ugly and not fun at all
daddy says to (20:11):
but the existing companies are continuing to make stuff smaller, so what is interesting about that?
bernfarr says to (20:11):
Cozmo is nice because of extra features. But I’m using an aged MM512
gina says (20:11):
i dont mind the sets on my body i just cant stand wearing the machine
daddy says to (20:11):
all tetchnology will get smaller over time
*** (20:11):Welcome to The Charmr Project Chat , chuck27 !
bernfarr says to (20:11):
daddy there are limits because of the size of the reservoir and motor to drive it.
mama2h says to (20:11):
yes, but the pump companies are just soo far behind the current technology
scott m says to Mama Belle (20:11):

MDI… I feel behind the curve:P
Mama Belle says to (20:12):
But if we can make computers the size of our plam, can’t we make a smaller pump
daddy says to (20:12):
there are nano sized pumps that are coming
Abby-Dabby-Doo says to (20:12):
I’m interested in how LOUD the alarms re going to be.
daddy says to (20:12):
mems technology and other types of insulin.
daddy says to (20:12):
i know of several companies working on thhose
stacey says to chuck27 (20:12):
but how much insulin can a nano pump hold . I have a 15 year old who uses over 100U a day
bernfarr says to (20:12):
I think the big delays is because of need to clear FDA which means trials and results and long time periods.
mama2h says to (20:12):
and navigator was coming out last christmas. I am sick of hearing that it is “coming soon”
sstrumello says to daddy (20:12):
They have made the pumps smaller by cutting the reservoir sizes, not reducing the mechanics inside!
Rachel Hinman says to (20:12):
who do you guys feel is a progressive medical device company?
bernfarr says to (20:12):
But nano pumps could use highly concentrated insulin.
bernfarr says to (20:13):
Agamatrix , nice new meters.
daddy says to (20:13):
they have reduces teh mechanics (e.g. omnipod), but also other MEMS technologies (mm sized pumps)
sstrumello says to bernfarr (20:13):
I have an Agamatrix meter, but no test strips yet!!
mama2h says to (20:13):
never heard of it
AllisonBlass says to (20:14):
Omnipod is not that small…
AllisonBlass says to (20:14):
And you have to carry around the receiver, so you’ve just added onto it practically.
Abby-Dabby-Doo says to (20:14):
Medical device company?! We just go through the pump company.
mama2h says to (20:14):
at least it is tubeless
Rachel Hinman says to (20:14):
okay – a progressive pump company?
daddy says to (20:14):
look into MEMS and nano, there are very tiny pumps that are going into next gen systems (they are only a few MMs in size)
Abby-Dabby-Doo says to (20:14):
MM
gina says (20:14):
minimed
mama2h says to (20:14):
MM has the cgms, imho they are the front runners
AllisonBlass says to (20:15):
Minimed would be the top guys, I think.
bernfarr says to (20:15):
Not MM. They are the elephant. Maybe one of the newer ones.
Mama Belle says to scott m (20:15):
I dunno, I think Cozmo has put a lot into their pumps that MM doesn’t think of
mama2h says to (20:15):
they at least try to make it better with the skins and such
daddy says to (20:15):
<a href=”http://www.diabetesnet.com/diabetes_technology/insulinpumps_debiotech.php”>http://www.diabetesnet.com/diabetes_technology/insulinpumps_debiotech.php</a>
bernfarr says to (20:15):
Dexcom is at least up to MM by now. IMO
AllisonBlass says to (20:15):
Honestly, go with the one who seems the most willing to listen to your feedback, our feedback and make this thing work.
AllisonBlass says to (20:15):
If Minimed jumps all over it, who are we to say no?
daddy says to (20:15):
everything on the market is five years old due to FDA etc. new technologies are light years ahead, in the works.
*** (20:16):Jill. quit the room
daddy says to (20:16):
AllisonBlass you are right, it’s about the service really
*** (20:16):Welcome to The Charmr Project Chat , Jill. !
sstrumello says to mama2h (20:16):
Medtonic Minimed made a mistake by abandoning the luer-lock connectons to the infusion set and pump, you are obliged to buy Minimed’s sets, and I liked Disetronic (Accu-Check)’s sets better!
bernfarr says to (20:16):
What about Nilimedix? <a href=”http://www.nilimedix.com/index.html”>http://www.nilimedix.com/index.html</a>
Abby-Dabby-Doo says to (20:16):
In the end, I agree it’s service.
Rachel Hinman says to (20:16):
tell me more about the service
*** (20:16):Jill. quit the room
gina says (20:16):
i think MM has really great customer service
mama2h says to (20:16):
bbl kids
gina says (20:17):
if something goes wrong you get a new pump next day
sstrumello says to mama2h (20:17):
Animas used to have great service, too … I can’t speak for it currently
*** (20:17):chuck27 quit the room
scott m says to Mama Belle (20:17):
I’m impressed with the companys who will overnight a pump for replacement/repair issues. I think MiniMed does that as for as I know
gina says (20:17):
You can call them anytime
daddy says to (20:17):
great example bernard. so there are at least two interesting tiny pumps getting worked on
bernfarr says to (20:17):
MM owns the market at present. You need to look at the competitors to see where the innovation is. You won’t find it at MM.
Abby-Dabby-Doo says to (20:17):
Someone there that isn’t “bothered by” your call no matter what time of the day. Or someone acting like it’s your fault or not thinking your stupid for not understanding something. Willing
*** (20:17):Welcome to The Charmr Project Chat , sue !
sstrumello says to (20:17):
Their billing, on the other hand, was a nightmare!
Rachel Hinman says to (20:17):
well that is another quesiton i have
Rachel Hinman says to (20:18):
are most of your pumps covered by insurance?
bernfarr says to (20:18):
Any company will overnight something. Cozmo did that for me (extra infusion sets) and I was just trying it out.
gina says (20:18):
billing? i have never had a problem
AllisonBlass says to bernfarr (20:18):
I think considering MM is the first integrated CGMS/pump, that they are quite innovative.
daddy says to (20:18):
only pumps on formulary are covered
gina says (20:18):
my pump was fully covered
AllisonBlass says to bernfarr (20:18):
I disagree that MM is oldfashioned or at all a mountain that can’t be moved.
daddy says to (20:18):
MM is the most advanced on the market right now
Mama Belle says to scott m (20:18):
It varies from insurance to insurance and plan to plan
Abby-Dabby-Doo says to (20:18):
We didn’t have a problem- but for others it’s a battle.
*** (20:18):Welcome to The Charmr Project Chat , reese !
Abby-Dabby-Doo says to (20:18):
CGMS- is going to be a problem
bernfarr says to (20:18):
Coverage varies. Most pumps are covered by many plans. Some issues (I hear) with OmniPod.
sue says to (20:18):
We have minimed with CGMS..it’s awesome
Mama Belle says to scott m (20:18):
Our Cozmo was covered 100%
sstrumello says to gina (20:19):
They invoiced insurance, but didn’t code it right, and I’d get bills for infusion sets and supplies for $1,000. I guess it depends on your insurance!
*** (20:19):chelsea quit the room
Mama Belle says to scott m (20:19):
But other’s only get 80% coverage, it depends
bernfarr says to (20:19):
But CGMS is a different story. Insurance companies are looking for efficacy results.
daddy says to (20:19):
so do you guys like you CGMSs?
gina says (20:19):
what insurance do you have?
jon says to (20:19):
Kaiser would only cover Minimed or Animas
sue says to (20:19):
We’re in a study.
stacey says to (20:19):
Ins companies are just lloking not to pay
daddy says to (20:19):
Sue what kind of study
Mama Belle says to scott m (20:19):
Exactly
Rachel Hinman says to (20:19):
we spoke with a diabetic educator from kaiser
bernfarr says to (20:19):
CGMS are awesome. And my wife likes it too!
Abby-Dabby-Doo says to (20:19):
Correct, BUT anything NEW insurance is slow, you have to prove that it will lower there costs in the future
Rachel Hinman says to (20:19):
and she said that they only cover 1-2 kinds of pumps
Abby-Dabby-Doo says to (20:19):
HMO
sue says to (20:19):
Sensor is great.
daddy says to (20:20):
how did CGMS change things for you?
bernfarr says to (20:20):
Even if it is big and bulky. I’ve got Aetna, they’re not covering it universally yet.
gina says (20:20):
bern your pump or cgms
sstrumello says to Abby-Dabby-Doo (20:20):
What about avoiding a hypo-induced ambulance trip? Thats got to be at least a few hundred dollars?!
Abby-Dabby-Doo says to (20:20):
Anyone have an idea how much the charmr is going to run?
jon says to (20:20):
i really like the idea of adding features to the pumps such as mp3 players and video games
bernfarr says to (20:20):
CGMS made a lot of things easier. Can ‘test’ b4 driving just by looking. My wife can test while I drive by looking.
gina says (20:21):
thats really important
sue says to (20:21):
exactly
daddy says to (20:21):
cool bernfarr. is it accurate enought in your experience to do that?
bernfarr says to (20:21):
Pump is fully covered. Dexcom is not. I’ve yet to start the paperwork.
gina says (20:21):
pump companies should make the pumps affordable if your insurance cant cover
gina says (20:21):
i know thats probably not possible
bernfarr says to (20:21):
Absolutely. Unless it’s moving rapidly its remarkably accurate.
daddy says to (20:21):
that’s very good to hear
daddy says to (20:22):
so you do less fingerrstticks now?
Rachel Hinman says to (20:22):
cost? is cost important? would you pay for a cooler pump like the charmr if your insurance compay didn’t cover it or only partially covered it?
sue says to (20:22):
not always accurate..still need fingersticks but trending up and down you get alarms and can tweak basals
daddy says to (20:22):
do you does off of it?
reese says to (20:22):
do you feel better using it bernard?
bernfarr says to (20:22):
Not enough scale yet to reduce costs of these devices.
AllisonBlass says to bernfarr (20:22):
I probably would not pay for another pump if it was not covered.
daddy says to (20:22):
cost is everything
AllisonBlass says to bernfarr (20:22):
It just wouldn’t be worth it.
jon says to (20:22):
i would pay extra for a cooler pump for my kid
gina says (20:22):
cost is very important a mm pump costs i think like 6000 now
Mama Belle says to scott m (20:22):
I wouldn’t buy it if insurance didn’t cover it. D is expensive!
daddy says to (20:22):
yeah, i don’t have 5k laying around!
*** (20:22):Welcome to The Charmr Project Chat , t1p3285 !
bernfarr says to (20:22):
I wouldn’t pay extra 4 cool. I’d pay extra for convenience or data interpretation or better control.
gina says (20:22):
yea
Mama Belle says to scott m (20:22):
exactly bern
daddy says to (20:22):
bernfarr what do you see out there that is innovative?
scott m says to (20:22):
I only have acces to pumps that will be covered by insurance personally
sue says to (20:23):
ok, what’s the charmr
gina says (20:23):
sue click here <a href=”http://www.adaptivepath.com/blog/2007/08/14/charmr-a-design-concept-for-diabetes-management-devices/”>http://www.adaptivepath.com/blog/2007/08/14/charmr-a-design-concept-for-diabetes-management-devices/</a>
sue says to (20:23):
thanks
AllisonBlass says to (20:23):
It’s a pump that’s currently in concept.
bernfarr says to (20:23):
daddy not a whole lot of innovation right now. Just incremental improvements.
Mama Belle says to scott m (20:23):
So by the time it got approval would the tech be outdated?
bernfarr says to (20:23):
But I expect we’ll see more innovation within 2-3 years as next gen devices arrive.
daddy says to (20:24):
everything is outdated by the time it gets approved
*** (20:24):Welcome to The Charmr Project Chat , macksdaddy65 !
AllisonBlass says to (20:24):
Something is only outdated if something newer is available…
Abby-Dabby-Doo says to (20:25):
I don’t like it that my insurance won’t let me get something else for 4 years. It really makes you think before you get something, because something better might come out.
*** (20:25):stacey quit the room
daddy says to (20:25):
well, anything on the market is five years old, by definition of approval process. so it’s not like an ipod that changes every six months.
gina says (20:25):
abby but that is the same with anything even a new computer
AllisonBlass says to (20:25):
Since everything takes so long to be approved, I don’t think “everything” is outdated right away.
daddy says to (20:25):
yeah, insurance sure waits too!
sstrumello says to AllisonBlass (20:25):
There’s outdated by better technology, but most stuff is outdated by minor, insignificant design changes
daddy says to (20:25):
not true, compute dev cycle is months, not years
Abby-Dabby-Doo says to (20:25):
But we should be able to add to it like software or upgrade the memeory- not have to buy a whole new piece
AllisonBlass says to (20:25):
It’s not the same with diabetes.
bernfarr says to (20:25):
Rachel I think we all try to get the most out of what we’re using. Partly because insurance never pays for it all. Hence using 7-day CGM sensors for as long as possible.
AllisonBlass says to (20:26):
I agree in most tech fields, but not with diabetes…
sstrumello says to AllisonBlass (20:26):
Think about glucose meters, most strip designs are over a decade old now
daddy says to (20:26):
exactly sstrumello
AllisonBlass says to (20:26):
What makes that outdated though?
t1p3285 says to scott m (20:26):
yeah but if theres a flaw w/the newest computers it cant potentially kill you
jon says to (20:26):
you should be able to download alarm tones like you can with ring tones on a phone
daddy says to (20:26):
compare agamatrix technology and accuracy to one touch ultra for example
daddy says to (20:26):
agamatrix uses advanced DSP technology for more accuracy
daddy says to (20:26):
technological advance
daddy says to (20:27):
(same guys who invented the one touch by the way)
sstrumello says to AllisonBlass (20:27):
Nothing, I’m agreeing with you, most are not outdated, they merely look newer or have minor changes
gina says (20:27):
right
*** (20:27):t1p quit the room
bernfarr says to (20:27):
Plus agamatrix has done a nice job with user experience on the meter AND on the software. See my YouTube video. Even nice test strip design.
Abby-Dabby-Doo says to (20:27):
Like on the MM it doesn’t show IOB- couldn’t you buy software to make it do that
Mama Belle says to scott m (20:27):
So with a feature like a touch screen, how would you prevent accidentally accessing and changing menus or dosing insulin?
daddy says to (20:27):
yeah they are doing a good job
Rachel Hinman says to (20:27):
i know there are a lot of challenges that have some up – cost, size/bulkiness, accuracy…i’m curious to know as a designer, if there was one thing we could change to make managing your diabetes easier, what would it be?
daddy says to (20:28):
cure!
macksdaddy65 says to (20:28):
how many people in this chat are using the hot new agamatrix technology?
gina says (20:28):
after a cure…
bernfarr says to (20:28):
Reduce the amount of time we spend every day trying 2 control it.
gina says (20:28):
haha
Abby-Dabby-Doo says to (20:28):
personal choices
gina says (20:28):
bern yes
daddy says to (20:28):
yeah easier data management and more saffety. and accuracy.
bernfarr says to (20:28):
I’m use agamtrix as my backup. Have 2 use OneTouch because of my Dexcom.
Mama Belle says to scott m (20:28):
“Reduce the amount of time we spend every day trying 2 control it.”
Exactly
sue says to (20:28):
artificial pancreas
scott m says to (20:28):
Wireless control of pump is exciting to me…
sstrumello says to Rachel Hinman (20:28):
All the stuff we have to carry around to manage it 24/7/365. We guys have to carry around a diabetes purse, not very cool.
Mama Belle says to scott m (20:28):
CGMS and infusion set in one site
gina says (20:29):
lol
bernfarr says to (20:29):
Look most devices now just help us in short term.
sue says to (20:29):
yeah mama
bernfarr says to (20:29):
What’s my blood sugar right now. What do I need to take for this meal.
bernfarr says to (20:29):
But where are the devices/software telling me what happens every other day when I exercise, or every time I’m sick, or have my period.
30ccsteven says to (20:29):
but we have the help!
sue says to (20:29):
ditto
bernfarr says to (20:29):
We need stuff that helps witht he longer term also.
bernfarr says to (20:30):
30ccsteven what help?
Mama Belle says to scott m (20:30):
yes!
Rachel Hinman says to (20:30):
i’m curious also o know hat aspect of the charmr concept was especially appealing to you guys
*** (20:30):Mama Belle quit the room
*** (20:30):Welcome to The Charmr Project Chat , Mama Belle !
t1p3285 says to (20:30):
the size
daddy says to (20:30):
i like the touch screen
t1p3285 says to (20:30):
or lack of
daddy says to (20:30):
and it’s pretty looking
*** (20:30):sue quit the room
Mama Belle says to (20:30):
Size
Abby-Dabby-Doo says to (20:30):
size
Abby-Dabby-Doo says to (20:30):
beat ya
scott m says to (20:30):
I like the compact size of the charmr and expecially the ease of use/user interface
gina says (20:30):
size
bernfarr says to (20:30):
Size and concept of integrated control interface. Tho I guess the MM has that in a way.
30ccsteven says to (20:30):
the change that has allowed us to enjoy the benifits of better BS control.
daddy says to (20:30):
has anyone used it? is it really easier?
AllisonBlass says to (20:31):
It looked like something I could tuck into my bra and wouldn’t at all ever show.
AllisonBlass says to (20:31):
even with something lowcut and sleezy!
AllisonBlass says to (20:31):

bernfarr says to (20:31):
Allison, you’re a bad diabetic
Rachel Hinman says to (20:31):
it’s stil a concept – so no one has used it *yet*
AllisonBlass says to (20:31):
I am not!
Abby-Dabby-Doo says to (20:31):
I hope the alarm can be turned loud. That would be great for kids sleeping in the next room or heavy sleepers
Mama Belle says to (20:32):
YES!!!
sstrumello says to Rachel Hinman (20:32):
Just sleazy … LOL!
daddy says to (20:32):
well i don’t see what is so innovative about it really – other companies already are working on compined pump cgms
AllisonBlass says to (20:32):

AllisonBlass says to (20:32):
hehehe
bernfarr says to (20:32):
I think you need an audio output for the alarm. That would help with kids.
Abby-Dabby-Doo says to (20:32):
how about loud and vibrate at the same time
bernfarr says to (20:32):
Abby-Dabby the Dexcom has that. And it’s annoying sometimes.
gina says (20:32):
and a parental remote
scott m says to (20:32):
Vibrating alarms are a must
Abby-Dabby-Doo says to (20:32):
at 4am I wouldn’t be cursing it
Rachel Hinman says to (20:33):
i am also curious to hear how you guys currently keep track of your data – is it stored in your pump? do you write things down?
bernfarr says to (20:33):
More customization about when it’s loud and when it reminds you and how often it tells you that you’re high.
Rachel Hinman says to (20:33):
keep a journal?
Mama Belle says to (20:33):
Stored
t1p3285 says to (20:33):
maybe I missed this part but any thought to given to an alarm system of the unit being separated from the person?
Abby-Dabby-Doo says to (20:33):
I write EVERYTHING done
scott m says to (20:33):
excell spreadsheet
bernfarr says to (20:33):
Downloaded from my 3 devices onto my PC.
AllisonBlass says to (20:33):
download… sometimes….
gina says (20:33):
i write down first then put it into the computer
bernfarr says to (20:33):
But my endo doesn’t use the software.
sstrumello says to (20:33):
We need standardized data outputs, that can be merged together from multiple sources
Abby-Dabby-Doo says to (20:33):
I’d like to wake up and see her number not so see what her number is.
Mama Belle says to (20:33):
Yes, we download all of our devices into seprarte programs … annoying!
jon says to (20:33):
writing it all down sucks
Abby-Dabby-Doo says to (20:33):
*not get out of bed to go see her number
bernfarr says to (20:34):
Stuff like <a href=”http://SugarStats.com”>http://SugarStats.com</a> is going to be the future there I think.
daddy says to (20:34):
we need systems that are complete and cohesive. so far minimed is closest, but others are working to that also.
jon says to (20:34):
the minimed pump keeps track of most data
bernfarr says to (20:34):
jon yes it does. But you ahve to use the lousy BD meter to get at it.
macksdaddy65 says to (20:34):
so I guess that’s only one person using the hot new agamatrix meter and only part time? and that is the newest and most innovative meter. hmmm?
Rachel Hinman says to (20:34):
so what do you guys do with the data your write down/put in excel/download
jon says to (20:34):
but downloading minimed is a pain
Rachel Hinman says to (20:34):
how is that data helpful to you?
Abby-Dabby-Doo says to (20:34):
but I don’t want to have to push buttons to see the IOB
daddy says to (20:34):
sure it is
daddy says to (20:34):
it’s not automatic
sstrumello says to (20:35):
Can we say comma separated values?!
bernfarr says to (20:35):
Rachel data is not much help to me, because I can’t analyse it. And you can only look at pretty graphs for so long.
jon says to (20:35):
the diabetes educator downloads the pump to see how my son has been doing and make adjustments
Abby-Dabby-Doo says to (20:35):
Can’t it pick out a trend for you that’s out of range instead of having to look for it
Abby-Dabby-Doo says to (20:35):
Same here Jon
scott m says to (20:35):
I use the data for averages/ patterns/ overall record for future comparison
Abby-Dabby-Doo says to (20:36):
Did I get thrown off?
sstrumello says to Abby-Dabby-Doo (20:36):
I agree, the averages are useless, and you need to scroll through them to give us our last reading!
reese says to (20:36):
i don’t log as my outcomes are not that consistent, to many variables
daddy says to (20:36):
yeah, most of the stats are not meaningful
Mama Belle says to (20:36):
I use trends all the time to figure out adjustments
Rachel Hinman says to (20:36):
i am wondering if they could be more meaningul
jon says to (20:36):
the averages might be more useful to those with type 2, but are usuless for type 1
Rachel Hinman says to (20:36):
meaningful, i mean
Rachel Hinman says to (20:37):
if there was a way to visualize the information better
scott m says to (20:37):
When I test alot during the day I feel the graphs I get from the data entry is very helpful. Like seeing trends without a CGMS
Rachel Hinman says to (20:37):
i agree – you can only look at graphs for so long
reese says to (20:37):
but it is hard to tell if the adjustment should be to the carbs, the bolus, or the basal, or the fact you used the stairs versus the elevator
daddy says to (20:37):
right, too many variables
sstrumello says to (20:37):
Perhaps having a slope of the increase or decrease in CGM values, as the actual value is less important than how fast it is changing
daddy says to (20:37):
very difficult to do real analysis w/o enought information
jon says to (20:38):
if the pump could wirelessly connect to the computer or printer, it would be easier to print out the info
Mama Belle says to (20:38):
I agree that there needs to be some way to integrate lifestyle info into the results. If you can’t see which BGs or setting coordinate with hormones or stress then you can’t use that information to make changes in the future
Abby-Dabby-Doo says to (20:38):
I would like school time on there. I can control what time PE is. Sorry I know this is usless for adults.
bernfarr says to (20:38):
Without helpful analysis software, the data quantity will increase and our ability to use it meaningfully will go down. One of the things in my paper on the need for diabetes data standards. <a href=”http://tinyurl.com/33ewtt”>http://tinyurl.com/33ewtt</a>
reese says to (20:38):
now the cgms giving me realtime data would be a gift and something I could address immediately
jon says to (20:38):
minimed pumps already communicate wirelessly with the bd meter, so it shouldn’t be hard to connect them to a computer
gina says (20:38):
sorry guys and menstrual cycles
Abby-Dabby-Doo says to (20:38):
The BD meter is JUNK!
Abby-Dabby-Doo says to (20:38):
IMO
jon says to (20:39):
yes and i think bd has been discontinued
jon says to (20:39):
i don’t know how minimed is handling that
bernfarr says to (20:39):
Yep. BD will be replaced with OneTouch next year.
bernfarr says to (20:39):
Overseas will be replaced by Bayer meter.
Abby-Dabby-Doo says to (20:39):
Thank goodness. It doesn’t even have a back light for goodness sakes
jon says to (20:39):
i think the meters could be improved too
macksdaddy65 says to 30ccsteven (20:39):
I think meters have been improved
Rachel Hinman says to (20:39):
so how many of you would get a CGMS if they were more accurate?
Abby-Dabby-Doo says to (20:40):
Raising hand
daddy says to (20:40):
ultra2 is improved ove ultra (data marking)
Mama Belle says to (20:40):
I would get one now if insurance would cover it
bernfarr says to (20:40):
I have one and I’d replace it if it were more accurate and needed less feeding (sync wiht a meter).
daddy says to (20:40):
agamatrix is improved
jon says to (20:40):
there was a pocket pc that had a glucose meter attachment, maybe they could do that with a cell phone or pocket calculator
macksdaddy65 says to 30ccsteven (20:40):
cgms is about reimbursement first and usability (simplicity) second
scott m says to (20:40):
, if insurance would help pay for it
sstrumello says to (20:40):
I like the backlight feature on meters, I’m thinking Freestyle Flash, for example, with lighting of the test strip as well … great for using in movie theaters or in the dark
bernfarr says to (20:40):
How about a system (CGM/Pump) that has a bluetooth interface and have the controller software on your mobile phone?
daddy says to (20:40):
doesn’t ultra2 have a backlight now? or no?
Abby-Dabby-Doo says to (20:40):
We can ONLY use Lifescan strips PER insurance.
Mama Belle says to (20:41):
It has back light but nothing for the strip
Abby-Dabby-Doo says to (20:41):
Yes Ultra2 does
jon says to (20:41):
nice bernfarr!
daddy says to (20:41):
my phone dies enought as it is
sstrumello says to jon (20:41):
That would be really cool, a pocket PC in my cell phone with a built in meter
daddy says to (20:41):

Mama Belle says to (20:41):
The lighted strip for the flash is so helpful with kids
jon says to (20:41):
and put an mp3 player in there
macksdaddy65 says to 30ccsteven (20:41):
insurance does not prohibit you from acquiring the tools you need.
bernfarr says to (20:41):
Yeh, but without the other gizmos, you’d have more room for BIGGER BATTERIES. ^o)
Mama Belle says to (20:41):
Yes it does
daddy says to (20:42):
haha there you go
Rachel Hinman says to (20:42):
<a href=”http://www.medgadget.com/archives/2007/08/glucophone.html”>http://www.medgadget.com/archives/2007/08/glucophone.html</a>
jon says to (20:42):
they could put those rechargable lithium battery packs in there like the cell phones
Abby-Dabby-Doo says to (20:42):
Not if your wealthy
Mama Belle says to (20:42):
Which I am not
Mama Belle says to (20:42):
NOr do I know anyone who is
Abby-Dabby-Doo says to (20:42):
8-| I haven’t found that money tree yet
bernfarr says to (20:43):
Rachel I wonder how the glucophone will look after 6 months of bg testing with drops of dried blood all over it. :-}
Abby-Dabby-Doo says to (20:43):
what is free with diabetes?
bernfarr says to (20:43):
The aggravation?
Mama Belle says to (20:43):
Sleepless nights!
reese says to (20:43):
ding ding ding, bernard
scott m says to Rachel Hinman (20:43):
What a great concept
Abby-Dabby-Doo says to (20:43):
other than emotions or feelings
sstrumello says to Rachel Hinman (20:43):
I like the Glucophone concept, but don’t want to send the data wirelessly, I’m already having my hemoglobin A1C test results seized by the NYC Health Dept. without my consent, I don’t want anyone else to get to it!
macksdaddy65 says to 30ccsteven (20:43):
highs are free ;(
reese says to (20:43):
has your aggravation lessened by using the cgms bernard?
bernfarr says to (20:43):
Good. And lows (BG or caused by stress).
bernfarr says to (20:44):
reese it has been reduced enormously.
*** (20:44):Welcome to The Charmr Project Chat , sixuntilme !
bernfarr says to (20:44):
Hey kerri where were u?
jon says to (20:44):
you could store info on an 8 gb memory card and stick it into the computer for download
sixuntilme says to (20:44):
Hey sorry I’m late. But I’m here now.
Abby-Dabby-Doo says to (20:44):
Evening!
bernfarr says to (20:44):
reese I also saw my a1c go from 8.2 to 7.0 in 3 months at least partly because of CGMS.
sstrumello says to jon (20:44):
Much better idea!
jon says to (20:45):
thats how my cell phone works
Abby-Dabby-Doo says to (20:45):
Why wouldn’t insurance pay for just that! Lower A1C…
daddy says to (20:45):
so tell us more aobut charmr
macksdaddy65 says to (20:45):
tell us more about the chrmr
jon says to (20:45):
i can transfer pics, music, and whatever else that way
Rachel Hinman says to (20:45):
what would you like to know?
daddy says to (20:45):
how long until it’s developed?
reese says to (20:45):
because insurance companies don’t get it they just look at cost
Abby-Dabby-Doo says to (20:45):
How far out?
daddy says to (20:45):
what kind of cost?
scott m says to (20:45):
Is there an expected launch date for the Charmr, or financial support for it yet?
daddy says to (20:45):
will it use normal consumables?
jon says to (20:45):
you could keep pictures on the pump and even have them pop up as screen savers
Rachel Hinman says to (20:45):
originally – we though2-3 years out
macksdaddy65 says to (20:45):
what kind of sensor is it?
Mama Belle says to (20:45):
Can you lock out the touch screen?
daddy says to (20:45):
oh
Abby-Dabby-Doo says to (20:46):
Need guinea pigs?
daddy says to (20:46):
well isn’t MM going to have something out before that though?
Rachel Hinman says to (20:46):
yes – you can lock the touch screen
daddy says to (20:46):
they are working on artificial pancreas right now w/ JDRF
Mama Belle says to (20:46):
Thanks
bernfarr says to (20:46):
I think all the charmr parts/pieces are already available. Right? So is it just that you need a company to take the concept and run with it?
Rachel Hinman says to (20:46):
we are looking to find a company to partner with to see what can be done to develop the concept further
Abby-Dabby-Doo says to (20:46):
What is the best feature? The selling point?
Mama Belle says to (20:46):
Approx dimensions?
daddy says to (20:46):
has anyone offered to fund the effort?
Rachel Hinman says to (20:47):
the approximate dimensions are slightly larger than a thumb drive
macksdaddy65 says to (20:47):
what is unique about charmer that a company would want? that isn’t already available?
Rachel Hinman says to (20:47):
and slightly smaller than an ipod nano
gina says (20:47):
i said before it looked like a jump drive
Abby-Dabby-Doo says to (20:47):
Is it possible to get ONE stick out of the deal?
reese says to (20:47):
Get in touch with Lee Ioccoco
bernfarr says to (20:47):
My concern is that your concept in the hands of a current company will be like the parody of Microsoft redesigning the iPod package. <a href=”http://www.youtube.com/watch?v=aeXAcwriid0″>http://www.youtube.com/watch?v=aeXAcwriid0</a>
Rachel Hinman says to (20:47):
yes – we would like to avoid that
daddy says to (20:47):
the nanos they came out w/ today or the one’s from six months ago?
Rachel Hinman says to (20:48):
either seems as though it would be better than what diabetics are currently using
daddy says to (20:48):
yeah, hopefully not microsoft eh!
t1p3285 says to gina (20:48):
is there WORKING PROTOTYPE or is this just a concept on paper??
Rachel Hinman says to (20:48):
to manage their condition
Rachel Hinman says to (20:48):
it’s a concept on paper
macksdaddy65 says to (20:48):
what kind of data does the chrmr consider? bg, insulin?
Rachel Hinman says to (20:48):
some aspects we have prototyped physically
gina says to t1p3285 (private) (20:48):
chris?
Abby-Dabby-Doo says to (20:48):
Where can we follow your progress?
Rachel Hinman says to (20:49):
but we really need a company to work with for funding
t1p3285 says to gina (20:49):
sup
t1p3285 says to gina (private) (20:49):
oops sup
bernfarr says to (20:49):
I like the food database on the Cozmo and Animas pumps. Does the charmr have a similar idea?
sstrumello says to (20:49):
Consider licensing the concept to multiple companies, or negotiating with JDRF to buy the patent rights as they are with some new drugs
Rachel Hinman says to (20:49):
the project started as an internal R&amp;D prpject
gina says to t1p3285 (private) (20:49):
how do you like this cool right
Rachel Hinman says to (20:49):
that was sponsored by our company
macksdaddy65 says to (20:49):
what about the whole patent thing like what happened between Smiths and MM?
daddy says to (20:49):
sounds like a neat project to work on. has it been fun?
t1p3285 says to gina (private) (20:49):
yeah- wich some people wouldve done theior homework though
t1p3285 says to gina (private) (20:49):
having no clue- ya know?
gina says to t1p3285 (private) (20:49):
what do you mean
Rachel Hinman says to (20:49):
we are thinking of trying to do what debra adler did – with the target pill bottle concept
gina says to t1p3285 (private) (20:49):
oh
reese says to (20:50):
diabetes and fun should never be in the same sentence
t1p3285 says to gina (private) (20:50):
I did send a newsletter out last night to hype this !
macksdaddy65 says to (20:50):
haha
Rachel Hinman says to (20:50):
she talked to a lot of companies – walgreens, cvs
gina says to t1p3285 (private) (20:50):
oh nice thanks
bernfarr says to (20:50):
That Target pill bottle was just a lovely piece of work.
Rachel Hinman says to (20:50):
then she met target – and they made it happen
bernfarr says to (20:50):
So have Target take it and run with it.
Mama Belle says to (20:50):
I also loke the food database. Have you considered this?
daddy says to (20:51):
yeah food database, very handy
Rachel Hinman says to (20:51):
well, that is why i am wondering who is the “target” of the pump/medical device world
sstrumello says to Rachel Hinman (20:51):
The only issue is that until it is widely adopted by CVS, Walgreens, etc. it fails to reach the masses
daddy says to (20:51):
insurance company reimbursement, then companies follow
daddy says to (20:51):
nothing is done w/o reimbursement
Abby-Dabby-Doo says to (20:51):
Who makes the luer locks for the MM pump? Anyone know?
macksdaddy65 says to (20:51):
how much do you think it will take to commercialize?
bernfarr says to (20:51):
I think part of the challenge is that FDA has stuck with the reliability and functionality tiers of the design hierarchy of needs. And so the device companies are there also.
Rachel Hinman says to (20:51):
true – but it shows what is possible
bernfarr says to (20:51):
Rachel what do you mean by target?
t1p3285 says to gina (20:52):
ant thought into a separation alarm? What happens if the person forgets the accessory piece?
Rachel Hinman says to (20:52):
i mean Target – the retail chain
bernfarr says to (20:52):
Ooops. Sorry.
Rachel Hinman says to (20:52):
np
Rachel Hinman says to (20:52):
sorry i wasn’t more clear
reese says to (20:52):
i was confused too bernard
*** (20:52):Welcome to The Charmr Project Chat , paula !
Abby-Dabby-Doo says to (20:52):
Well, you just made me want to shop there more!
Mama Belle says to (20:52):
Yeah, what does happen if you forget the charm?
bernfarr says to (20:53):
Sorry about my short-term memory. I’d talk with JDRF and see who they think are most innovative and deep pocketed for the artificial pancreas work.
t1p3285 says to gina (20:53):
i personally would like alil shock device- to teach my son to remember it
daddy says to (20:53):
JDRF is already doing this w/ MM
daddy says to (20:54):
they are doding artificial pancreas w/ them which does all this suff. packaging will be an all in one unt.
t1p3285 says to gina (20:54):
he forgets it and ZAP!!!
daddy says to (20:54):
haha ouch t1p!
bernfarr says to (20:54):
But I think the ‘obvious’ answer is MM. Look at some of the early stage startups like Nilimedix and MichoChips. Maybe there VC companies would commit to this.
daddy says to (20:54):
i bet FDA would love that hehe
sstrumello says to bernfarr (20:54):
The (relatively) new CEO is really pushing to have the JDRF organization serve the role of filling in the gaps in terms of scientific and/or commercial development, and considerable progress has been made just in the last 12 months
*** (20:54):paula quit the room
macksdaddy65 says to (20:55):
art panc progress w JDRF $s is great but how does that make people feel who donated for a cure? maybe better question for another chat.
bernfarr says to (20:55):
The other challenge is that this is not a normal consumer device with a market of millions. If you make it more approachable/usable then the market is in the 100’s of thousands.
Abby-Dabby-Doo says to (20:56):
I wish someone would focus on the little ones for something someday- IMO it’s all focused around adults.
bernfarr says to (20:56):
So getting the costs really low is not possible. And unless it’s approachable getting the average person w/diabetes to adopt it is not that easy.
bernfarr says to (20:56):
We’re the noisy minority in this room.
sstrumello says to macksdaddy65 (20:56):
Its probably a question for another chat, but I think the perspective is that treatment has fundamentally not changed in 90 years, and its no worse than pushing stem cell research on some who don’t support it.
macksdaddy65 says to (20:56):
yep
Abby-Dabby-Doo says to (20:57):
I can’t even buy a decent thing to carry the damn pump in on MM website.
daddy says to (20:57):
yeah, i guess bayer is doing some stuff too
daddy says to (20:57):
around better meters
reese says to (20:57):
i agree abby
AllisonBlass says to (20:58):
What do you mean?
bernfarr says to (20:58):
Abby-dabby one day your kids will be grown-ups and you’ll find that a lot of it is focused on kids. For example, no T1 conference for adults and relatively few endos that work with adults.
AllisonBlass says to (20:58):
Like a holder?
Abby-Dabby-Doo says to (20:58):
Anything.
AllisonBlass says to (20:58):
I have a clip for the pump
AllisonBlass says to (20:58):
that I bought on their website.
Mama Belle says to (20:58):
Kids don’t wear clips
Abby-Dabby-Doo says to (20:58):
Nothing appealing for the younger generation. I mean can we get anymore boring with black and blue
AllisonBlass says to (20:58):
PumpWear Inc.
AllisonBlass says to (20:58):
try there
t1p3285 says to gina (20:58):
my son does
reese says to (20:59):
but it sticks out allison with a shirt over the waist, tucking in is not cool
bernfarr says to (20:59):
abby I’m surprised the pump makers don’t follow the phone or ipod form factors. Then we’d be spoilt for choice in terms of carriers and accessories.
Abby-Dabby-Doo says to (20:59):
That clip would last us less than a week, and pull her pants OFF in the process of wearing it.
Mama Belle says to (20:59):
So does mine, but in general they don’t especially the wee ones
AllisonBlass says to (20:59):
But no clip?
AllisonBlass says to (20:59):
Sorry I guess I don’t understand the question….
Abby-Dabby-Doo says to (20:59):
Why do I have to go to pumpwear? Why can’t the damn company come up with something? Don’t they give a rip about the little ones?
Mama Belle says to (20:59):
Accessories aren’t kid oriented, that is what she was getting at, I think
Abby-Dabby-Doo says to (21:00):
Yep
sstrumello says to Mama Belle (21:00):
Animas’ clips (at least early generations) were screwed in with a screwdriver … your kid would have to be pretty destructive to remove it!
AllisonBlass says to (21:00):
MM has those new skins for the pumps.
AllisonBlass says to (21:00):
Those are pretty cool.
bernfarr says to (21:00):
Agreed. Look at the buzz over the OneTouch Mini.
Mama Belle says to (21:00):
My daughter is older and wears jeans and stuff with pockets a lot, but when she was younger she wore no pockets with cotten knit stuff. That doesn’t work well with a clip
bernfarr says to (21:00):
How innovative was that?
macksdaddy65 says to (21:00):
what about the chrmr sensor/longevity and how that relates to frequency of change outs and usability, etc… if you swap out every week vs. every month that makes a big difference in the design, yes?
AllisonBlass says to (21:01):
I have the jellybeans one. Just yesterday when I was at the doctor’s, I had a 4-year-old girl tapping at my pump because she saw the jellybeans on it.
Mama Belle says to (21:01):
One touch mini is crap IMHO
AllisonBlass says to (21:01):
I love the mini.
bernfarr says to (21:01):
Agreed. But the colors are pretty!
daddy says to (21:01):
why is it crap?
AllisonBlass says to (21:01):
what’s wrong with the mini?
bernfarr says to (21:01):
And when they add a download it’ll take off
Mama Belle says to (21:01):
It does way less than the flash and is bigger!
bernfarr says to (21:01):
Coz the size is hard to beat.
Rachel Hinman says to (21:01):
i think we were thinking every 3-4 days/week
sstrumello says to (21:01):
I like the Mini too, its tiny … the only downside is that the data can’t be downloaded (yet)
Mama Belle says to (21:01):
I don’t see what the big deal is about it. You can’t dload it
daddy says to (21:02):
good point mama belle
Mama Belle says to (21:02):
It has no light
bernfarr says to (21:02):
dload is coming later in year.
scott m says to sixuntilme (21:02):
The biggest issue I have with the Mini is the small BG history it keeps
AllisonBlass says to (21:02):
Oh well.
AllisonBlass says to (21:02):
Ok, well, I’m going to go.
AllisonBlass says to (21:02):
Bye everyone.
Mama Belle says to (21:02):
BYe!
bernfarr says to (21:02):
Hey Allison. Nice blog post. TTFN.
Mama Belle says to (21:02):
(})
Rachel Hinman says to (21:02):
hey folks – i am going to have to sign off, too.
scott m says to sixuntilme (21:02):
Bye Allison
Abby-Dabby-Doo says to (21:02):
Ya, and you can’t download it, no back light. It’s pink and that’s all my dd likes
Mama Belle says to (21:02):
BYe! Thank you!
*** (21:02):AllisonBlass quit the room
Rachel Hinman says to (21:02):
it’s been great chatting with all of you!
sstrumello says to Mama Belle (21:02):
Try being a guy and carrying a purse to carry all of this crap around, and then you’ll see what the big deal is!
daddy says to (21:03):
yes great chat
bernfarr says to (21:03):
Rachel good to talk with u. bernard.farrell@gmail.com
gina says to t1p3285 (21:03):
thanks for chatting rachel
scott m says to (21:03):
Thanks Rachel
Rachel Hinman says to (21:03):
please feel free to email me with any more comments: hinman@adaptivepath.com
Abby-Dabby-Doo says to (21:03):
Thank you for your time Rachel!
Abby-Dabby-Doo says to (21:03):
BEST OF LUCK
Rachel Hinman says to (21:03):
thanks!
sstrumello says to (21:03):
Thanks Rachel, you’ve been great and very gracious considering how vocal we all are!!
*** (21:03):Rachel Hinman quit the room
bernfarr says to (21:03):
We should start a Charmr pool. Money pays for the first one!
gina says (21:03):
lol
scott m says to (21:04):
Wow, very ambitious project. I hope some headway is made on this one
Mama Belle says to (21:04):
“Try being a guy and carrying a purse to carry all of this crap around, and
then you’ll see what the big deal is!”
I promise you, as a parent I carry around more than you do. Also, again the flash is smaller!
bernfarr says to (21:04):
Night night everyone. Good talking with y’all.
Abby-Dabby-Doo says to (21:04):
Go mama
daddy says to (21:04):
yeah, but he still has to carry a MAN PURSE!
bernfarr says to (21:04):
Gina thanks for organizing.
Mama Belle says to (21:04):
Awww, buck up!
scott m says to (21:04):
Let’s hear it for the Freestlye Flash! Yea
Mama Belle says to (21:04):
Yes, thanks Gina!
sstrumello says to Mama Belle (21:04):
Yes, but the downside is the Flash uses those awful test strips
Mama Belle says to (21:05):
What’s wrong with the strips?
gina says (21:05):
no problem guys!
Mama Belle says to (21:05):
We have zero strip issues
reese says to (21:05):
why awful
bernfarr says to (21:05):
If anyone is in Connecticut on Sunday drop by and cheer for us. <a href=”http://bikethemiles.com”>http://bikethemiles.com</a>.
scott m says to (21:05):
aweful?
gina says (21:05):
if there are any other chats you guys think you want to have let mem know
t1p3285 says to gina (21:05):
Gina- I was just typing when she left but what type of credentials does the company Rachel works for has for making this a go?
reese says to (21:05):
good luck bernard
gina says (21:05):
<a href=”http://www.adaptivepath.com/blog/2007/08/14/charmr-a-design-concept-for-diabetes-management-devices/”>http://www.adaptivepath.com/blog/2007/08/14/charmr-a-design-concept-for-diabetes-management-devices/</a>
reese says to (21:05):
insurance companies and payment for cgms, gina
30ccsteven says to (21:05):
BYE
sstrumello says to (21:05):
Good luch, Bernard!
*** (21:05):30ccsteven quit the room
gina says (21:05):
ok reese good idea!
Mama Belle says to (21:06):
Yes, what reese said
bernfarr says to (21:06):
t1p3285 Adaptive Path is way up there. In the same level as Frogg design who helped on several Apple devices. Good company.
scott m says to (21:06):
Good luck with biking those miles!
gina says (21:06):
hey guys
gina says (21:06):
if you all sign up to my diabetestalkfest.ning.com page you will get updates on the latest chats
gina says (21:06):
and past transcripts
Mama Belle says to (21:06):
Already on it
gina says (21:06):
great
*** (21:06):bernfarr quit the room
sstrumello says to (21:07):
Plus, the chatroom is accessible from that page, too!
sixuntilme says to Abby-Dabby-Doo (21:07):
Sorry I was so late. But great seeing everyone here.
Mama Belle says to (21:07):
Bye Kerri

CHAT TRANSCRIPT – The Artificial Pancreas Project with Dr. Aaron Kowalski (December, 12, 2006)

Want to be a guest speaker contact: Gina

LIVE CHAT SCHEDULE 2006 | CHAT ROOM | PAST CHAT TRANSCRIPTS

Gina says (17:55): Hello Aaron!

periwinkle says to (17:55): Good evening, Dr. Kowalski

Jon says to (17:55): Hi Aaron!

Aaron Kowalski says to (17:56): Hello Everyone!

Aaron Kowalski says to (17:57): I have my diet coke and my CGM by my side – life is good

periwinkle says to (17:57): I am most excited about the development of the continuous glucose sensor. My question to you is this: I often take baths as opposed to showers and am wondering if this will be possible with the sensor, especially if I bathe in very shallow water?

periwinkle says to (17:58): Has my question been received by Dr. Kowalski?

Julie says to (17:58): So, let’s cut to the chase – when will we have a completely closed loop pump?

Aaron Kowalski says to (17:59): I’m wearing the STS and the Paradigm Real Time right now. The Paradigm is waterproof and I believe FDA approved as such. While the DexCom STS is not FDA approved as waterproof, I’ve shower with it on and uncovered and I’ve gone swimming with it w/o issue

christine says to (17:59): julie, do you think anyone knows that?

christine says to (17:59): it seems like there are a lot of issues to overcome

Aaron Kowalski says to (17:59): I believe a closed-loop is sooner than we expect

Gina says (17:59): how soon

Gina says (17:59): like tomorrow

Allieb2 says to (17:59): really?? sooner!??

Gina says (17:59): haha

Gina says (18:00): Jk

Aaron Kowalski says to (18:00): There are obstacles, but we’ve (JDRF) funded research in real people that shows it can be done now with today’s tools

Aaron Kowalski says to (18:00): Not tomorrow

Gina says to (18:00): i know im just kidding! Haha

christine says to (18:00): how will the issue of insulina ction time be overcome?

Rmhb1126 says to (18:00): Hi Aaron – it’s Renee….any updates on insurance covering the CGMS? I know lots of families who would like to access this technology but can’t afford the out-of-pocket costs

christine says to (18:00): will it require some form of access to the portal vein/artery?

Julie says to (18:00): Is there a sensor that’s measuring blood glucose instead of interstitial fluid glucose? Is JDRF also working with Animas and their technology for a sensor?

Aaron Kowalski says to (18:01): That is an issue – but I like to say (got this from Dr. Buckingham at Stanford) don’t let perfection be the enemy of the good

Aaron Kowalski says to (18:01): Even with today’s insulin’s there is so much room for improvement

Gina says (18:01): PLEASE GIVE AARON A CHANCE TO ANSWER AFTER EACH QUESTION… THANKS

Aaron Kowalski says to (18:01): It can be done sub-q – with very good results

Johnboy says to (18:02): cool

periwinkle says to (18:02): Well, Dr. Kowalski — it remains an issue with me with regard to the baths vs. showers — I’d sure like to have a positive answer about that !!!!

Aaron Kowalski says to (18:02): Right now most sensors are measuring interstitial fluid

Aaron Kowalski says to (18:02): Medtronic has an implanted IV sensor – but I think that is a while away

periwinkle says to (18:02): That would be great for me for sure —- bathe away !!!!

Aaron Kowalski says to (18:02): We are working with most all of the companies -to different degrees to try to close the loop.

Aaron Kowalski says to (18:03): I was excited to see Lifescan join with animas

Gina says (18:03): Can you give us a little background on The Artificial pancreas, in case some people dont know.

Kit says to parrotletzoo (18:03): yes please!

parrotletzoo says to (18:03): will systems with closed loops incorporate glucagon into the pumps?

periwinkle says to (18:03): I am so very very hopeful that I’ll be able to enjoy the sensor and still bathe as I have been accustomed to !

Aaron Kowalski says to (18:04): I oversee research that the JDRF funds on the Artificial Pancreas

Aaron Kowalski says to (18:04): We just launched a major – multi-million dollar initiative to try to make this a reality – Sooner!

Julie says to (18:04): What part is JDRF funding in this research and how many $$ are going from the donations towards this?

Aaron Kowalski says to (18:05): We’re using a variety of different approaches to do this – including glucagon as counterregulation – partnering great diabetes docs with world class engineers

parrotletzoo says to (18:05): nice

Julie says to (18:05): Is Symlin being used too?

Aaron Kowalski says to (18:05): Right now we’re about to launch a large CGM trial – over 500 people and we just announced six sites working on closed loop

christine says to (18:05): how does one apply for this trial?

periwinkle says to (18:06): Truthfully, Dr. Kowalski, do you believe that I should even consider the sensor in as much as I continue to bathe instead of showering??

Gina says (18:06): how can people be 1 of the 500

Aaron Kowalski says to (18:06): Symlin is going to be plugged in at some of the sites and is a logical approach to the post meal highs we face

christine says to (18:06): interesting approach

Aaron Kowalski says to (18:06): We have info about enrollment on our website – also a clinicaltrials.gov

Aaron Kowalski says to (18:07): meant to say clinicaltrials.gov

Julie says to (18:07): Respectfully, shouldn’t the meter, cgms, pump…companies be funding these trials rather than JDRF?

Aaron Kowalski says to (18:07): This is a common question I get

Aaron Kowalski says to (18:07): What we want to do is fill in the gaps

Aaron Kowalski says to (18:07): Will there be an artifical pancreas without JDRF funding – probably yes

sstrumello says to (18:07): Exactly how much of a “gap” is JDRF funding?

Aaron Kowalski says to (18:08): will it happen SOONER with JDRF – I think certainly yes!

Aaron Kowalski says to (18:08): We’re funding about $11 million over the next two years

sstrumello says to (18:08): thanks!

Aaron Kowalski says to (18:09): There are many obstacles that an independent foundation like the JDRF can address

Aaron Kowalski says to (18:09): FDA, health insurance, etc…

Kit says to (18:09): Is this a worldwide thing, or the US atm???

Julie says to (18:09): Is JDRF moving in a different direction now, and not focusing on cure-focus research? I still see the closed loop pump as a mechanical device that can fail. …not a cure.

Aaron Kowalski says to (18:09): We need all people with diabetes to have access to these tools. Right now I have to pay out of pocket to get my cgm sensors

Gina says (18:09): dont you think that the artificial pancreas closed loop system is just another way for companies to make money instead of putting money toward a cure.

Aaron Kowalski says to (18:10): Both my brother and I have type 1 (many years), the closed loop is not a cure (in my mind) but an important step forward

Aaron Kowalski says to (18:10): We need to prevent complications, ease the burden of diabetes, while we get to a cure

christine says to (18:10): will any trials include people with type 2?

Aaron Kowalski says to (18:11): This is US based and we have a site in England

Kit says to (18:11): thanks

Aaron Kowalski says to (18:11): Right now we don’t have any type 2 patients – but we’re working with NIH to include people with type 2 in such studies

Aaron Kowalski says to (18:12): I want to make a comment about the thought about companies – profits – etc…

Gina says (18:12): why focus on 11 million toward another mechanical device just to make life easier… even with these devices we can still get complications

Johnboy says to (18:13): i used to say that i would wait to start pumping when the pump got smarter…it’s smarter, but still not smart enough…i finally have in and started…but now i can’t wait for improvements… a closed loop, if it works, would be a quantum leap forward imo

Aaron Kowalski says to (18:13): Ultimately, the JDRF, the NIH, ADA, etc.. are not going to be able to deliver a cure – whether it’s an AP, islets, regenterated beta cells, etc… we need companies to pick this up at some point – we need to partner with companies

Aaron Kowalski says to (18:14): Most every company i interact with has tons of committed people with direct connections to type 1

Julie says to (18:14): Will the companies give back to JDRF a share of their profits if they indeed do profit from this partnership?

Aaron Kowalski says to (18:14): I believe a robust AP could eliminate complications!!

sstrumello says to Gina (18:14): Dr. Kowalski, as JDRF research has revealed, hypoglycemia unawareness is due in large part to faulty counterregulation, something which a closed-loop “artificial pancreas” will not correct. What is JDRF’s position on this?

Aaron Kowalski says to (18:15): Right now we’re not funding the companies – we’re funding the academics at Universities, but when we do fund companies, we include language that if they profit, monies come back to fund more research to push forward

Aaron Kowalski says to (18:15): My brother has suffered terribly from Hypo unawareness – I’m all too familiar with this and oversee our hypo program

parrotletzoo says to (18:16): hypo unawareness is where glucagon would come into play in a closed loop system right?

Aaron Kowalski says to (18:16): I’ve given many glucagon injections and we nearly lost him more than once

Aaron Kowalski says to (18:16): Two points – the research suggests by reducing hypo you can regain some awareness – very strong evidence

Kassie says to (18:16): I arrived late, but did I read you correctly that there will be no cure? “Ultimately, the JDRF, the NIH, ADA, etc.. are not going to be able to deliver a cure – whether it’s an AP, islets, regenterated beta cells, etc”

Aaron Kowalski says to (18:17): And, with a robust AP, I think we could eliminate the VAST majority of hyop – even in those with unawareness

Aaron Kowalski says to (18:18): NO NO NO – I’m convince there will be a cure, but what I meant was that we may have a perfect cure in a lab but for us – people with diabetes – to benefit, we need to deliver them

Kassie says to Aaron Kowalski (18:18): thank you for clarifying that! {smile_smiley}

Aaron Kowalski says to (18:18): And – the JDRF, NIH, ADA, etc.. just are not set up to make devices, drugs, cells, etc.. put them through FDA, market them, etc..

Aaron Kowalski says to (18:19): We need companies to pick up the research and run with it

Kassie says to Aaron Kowalski (18:19): got it, thanks

Julie says to (18:19): Who exactly will get the $11 million from JDRF for this?

Aaron Kowalski says to (18:19): I’m more optimistic than ever there will be a cure

christine says to (18:19): can you comment any on the higher potency insulins, and what their involvment in the AP will be?

Aaron Kowalski says to (18:20): You can check out the research sites on our website – <a href=”http://www.jdrf.org/artificialpancreas”>www.jdrf.org/artificialpancreas</a> – hope I spelled that right

Aaron Kowalski says to (18:20): Joslin, Stanford, Yale, U.Wash, U.VIrginia, Cambridge, Sansum, Iowa, etc…

sstrumello says to (18:20): Can you tell us about the selection of clinical trial participants? Many studies focus on newly diagnosed patients or as your website noted, young patients, rather than a complete cross-section of patients with the condition.

Aaron Kowalski says to (18:21): The CGM study will be for people over the age of 8 years on shots or pumps

Aaron Kowalski says to (18:21): Not newly diagnosed

Aaron Kowalski says to (18:21): All types of people with diabetes

Rmhb1126 says to (18:22): Aaaron – any progress on getting insurance to cover the CGMS?

christine says to (18:22): so insulin dependant type 2s or 1.5s also?

jshirsch says to (18:22): Hi, Aaron.

Aaron Kowalski says to (18:22): Insurance coverage is a big issue – we have a great team of people working in Washington on this

sstrumello says to Aaron Kowalski (18:23): Thanks

LLL says to (18:23): Why over the age of 8 years? How is the age of participants determined for studies like this?

Aaron Kowalski says to (18:23): A tremendous advocate for people with diabetes is my colleague in DC – Cynthia Rice – she heads up the team that is driving this and she is fantastic – I’m confident we’ll get it done

Aaron Kowalski says to (18:24): We worked with the docs to make the protocol.

jshirsch says to (18:24): I’ve heard anecdotally that some patients using DexCom are struggling with the device, and sales are apparently soft. Is there any concern about whether CGM itself will work — let alone the artificial pancreas?

Aaron Kowalski says to (18:24): Over 8 was a tradeoff that we made based on some of the other clinical work going on in CGM – particularly DirecNet

Aaron Kowalski says to (18:25): I’ve been wearing a DexCom for nearly 8 months- I think it’s awesome!!

Aaron Kowalski says to (18:25): My brother is wearing one as well and its helped tremendously with his lows

Aaron Kowalski says to (18:25): THere is no doubt in my mind that this works

Julie says to (18:25): Wouldn’t encapsulated porcine islets that function well be an artificial pancreas we could all live with?

Aaron Kowalski says to (18:25): I’m also wearing the Medtronic Paradigm Real Time – also great

Gina says (18:26): Aaron lets be real here, do you really want to have another device in or on you… i mean arent you as a type 1 sick of feeling like a robot. I know i am as well as many others…im sick of all these freaking devices that come out TO MAKE MY LIFE EASIER

Aaron Kowalski says to (18:26): We’re supporting Xeno and Encapsulation research – likely down the road however

Gina says (18:26): im sick of the stupid commericials that say a blood montior is virtually pain free come on we know it hurts

Gina says (18:26): no matter how fine the needle

Gina says (18:26): get me a cure not another device

Aaron Kowalski says to (18:27): Wearing the CGM has made my life so much easier I cann’t even tell you. I do less fingersticks – wearing it has been no big deal – SO MUCH more peace of mind

Aaron Kowalski says to (18:28): Ultimately, I think we’ll see things easier to wear and smaller and that will be in the near future

LLL says to (18:28): I am the parent of a child with type 1 and changing sites on one device is hard enough….I’m not sure my child would go for two devices

parrotletzoo says to (18:28): peronally, i didnt mind the pump, i wouldnt have minded a cgms, I’ll take what I can get to give me optimal health until a cure is available.

Julie says to (18:28): Are you making dose decisions based on the output even though it’s not approved to do so?

Aaron Kowalski says to (18:28): Many kids are wearing the both and have similar reaction to me

Aaron Kowalski says to (18:29): the benefit far outweights the cost

Aaron Kowalski says to (18:29): I can not lie hear – I’m using my STS to make most of my decisions – and my A1c is way down – with no lows!

LLL says to (18:29): No doubt MY first concern is the best possible health for my child, but she has social issues to deal with

Jon says to (18:29): I am a parent also, and I would love having a device monitor my kid so that I don’t have to

LLL says to (18:30): One kid already called her a robot and she’s only in first grade

Kit says to (18:30): thats way harsh

Gina says (18:30): LLL that is what i feel like

Gina says (18:30): a robot

THE KAKSTER says to (18:30): can some one come to teen room

Aaron Kowalski says to (18:30): THe issue with the size of the devices agains speaks to why we need companies involved here – and the more the better

Gina says (18:30): i cant stand summer because of my pump… but i do horrible on lantus

Gina says (18:31): so when i switch to shots i sky rocket

LLL says to (18:31): Yep, first week of first grade – even after it was all explained to the kids – the nurse read them Taking Diabetes to School

Aaron Kowalski says to (18:31): The more competition, the better the devices … look at Insulet and how they have pushed the field forward for pumps

Aaron Kowalski says to (18:31): And dexcom has done the same on cgm

LLL says to (18:31): What companies are in the best position and the most motivated to back this type of research?

Rmhb1126 says to christine (18:31): what’s happening with the Navigator?

Aaron Kowalski says to (18:32): I hope the Navigator will be out soon – it seems like any day, but we’ve been hoping that for a while

Aaron Kowalski says to (18:33): I work with the direcnet group that has been testing the Navigator and it looks great

Julie says to (18:33): How long is the warm up period for the Navigator?

Aaron Kowalski says to (18:33): This is an issue – right now it looks like it will be 10 hours

Aaron Kowalski says to (18:34): The STS and the Medtronic devices are two each

jshirsch says to (18:34): aaron, many people have love/hate relationships with their pumps — powerful tools, but a pain when they break down. do you fear similar experiences with cgm, or is the technology appreciably better?

Kassie says to Aaron Kowalski (18:34): can you have one set warming up while you finish out another set? or do you go 10 hours without feedback?

LLL says to (18:34): Why doesn’t JDRF partner with other non-profits like the Lee
Iacocca foundation or even ADA for funding research?

Aaron Kowalski says to (18:34): So far, it’s been a pretty good experience for me with my CGM’s

Aaron Kowalski says to (18:34): I do think there are some features that can be made easier to deal with – particularly the alarms

Aaron Kowalski says to (18:35): What can be frustrating when using the CGM is the feeling that even with all the information in the world, it’s still tough to stay in target

Aaron Kowalski says to (18:35): Initially, the alarms seem to be going off all of the time
*** (18:36):basketballchich2011 quit the room

Aaron Kowalski says to (18:36): We need faster acting insulin – which is a priority for me on the research side

parrotletzoo says to (18:36): i had issues with my pump alarms not being loud enough, are the alarms on your cgm’s audable enough under clothing, or say burried in bedding at night?

LLL says to (18:36): I have issues with alarm volumes too

Aaron Kowalski says to (18:36): Interstitial glucose – 159 and steady {smile_smiley}

sstrumello says to (18:36): According to the October 24, 2006 JAMA, insulin remains the #1 medicine on file for the FDA for “adverse effects” requiring hospitalization, largely due to hypoglycemia. Might JDRF consider funding gaps for startup companies such as SmartCells, Inc.?

Gina says (18:36): i have issues period lol

Aaron Kowalski says to (18:37): The issue with the StS for many people is the alarms are too loud. I find them more than adequate to catch my attention

Aaron Kowalski says to (18:37): if not – my wife certainly hears them at night!

parrotletzoo says to (18:37): that is good to know, thanks

sstrumello says to (18:37): SmartCells’ key advantages would be reducing/eliminating the incidence of hypoglycemia, requiring fewer injections and less glucose monitoring, and control of both fasting and mealtime glucose levels. Their website is <a href=”http://www.smartinsulin.com/”>http://www.smartinsulin.com/</a>

Aaron Kowalski says to (18:38): There are many technologies – device, drug, and cell based that hold tremendous potential.

Julie says to (18:39): I’m more interested in vibrating alarms for adults/teens – they don’t want to call attention to themselves with audio alarms…but this is really a minor point IMHO, I think we need to know how we can count on such a device when we know all devices fail

Julie says to (18:39): at some point in time

LLL says to (18:39): Frankly I find it frustrating when non-profits compete with each other. If there is a clear direction that will help – why don’t the non-profits join forces?

Aaron Kowalski says to (18:39): I think we – as people with diabetes – need to understand that the regulatory challenges for cell-based therapies are considerable. This is a major focus of the JDRF

LLL says to (18:39): But maybe that’s naive.

Aaron Kowalski says to (18:40): I don’t care who discovers the cure – I want everyone to work together and I try to do just that every day at the JDRF

Aaron Kowalski says to (18:40): Not naive – this is how it should be and I’ve seen much better synergy between organizations of late.

Julie says to (18:40): What percent of the JDRF annual budget is now going towards research for complications and research towards the AP?

LLL says to (18:41): Good because the for-profit companies will follow suit if they see a clear direction I think

Aaron Kowalski says to (18:41): Complications – about 22% AP – about 5%

Aaron Kowalski says to (18:41): The AP budget is relatively small

Julie says to (18:41): Thanks.

Aaron Kowalski says to (18:41): Again – trying to leverage – not duplicate

Julie says to (18:42): What have been some of the frustrations you’ve experienced with the cgms?

christine says to (18:43): this may be a bit off topic, so correct me if i am wrong to ask

christine says to (18:43): but what is the jdrf funding in terms of islet transplant trials?

Aaron Kowalski says to (18:43): I think the main frustration I’ve had is what I’ve mentioned before – despite having all of this information it’s still so tough

Aaron Kowalski says to (18:43): But, I’ve learned quickly and it’s so helpful

Aaron Kowalski says to (18:44): I don’t have many really negative experiences – BUT I think that’s because I had the right expectations

Kassie says to Aaron Kowalski (18:44): how will the AP address that aspect – do you think it will be better at staying in range, better at using the CGM information?

Aaron Kowalski says to (18:44): CGM is different than blood glucose monitoring – and if you get the hang of dealing with interstitial fluid – it’s great

Kassie says to Aaron Kowalski (18:44): that aspect =&gt; tough to stay in range, despite the good info

LLL says to (18:44): How do you keep up with expanding technology, such as the explosion of Bluetooth, when only a few years ago everything was I/R?

Julie says to (18:44): You’ve had no negative experiences whatsoever? Usually there are some in any learning curve. How long are you using each sensor?

Aaron Kowalski says to (18:44): The power of the CGM is the trends

Aaron Kowalski says to (18:45): But, you need to look at the device to do something

Aaron Kowalski says to (18:45): You simply can’t look all of the time – we need automation

Aaron Kowalski says to (18:45): The approach the researchers we fund at Yale are taking is a “hybrid”

Kassie says to Aaron Kowalski (18:45): how will the AP account for things like stress/exercise/carb intake? or will it just respond to blood sugar automatically, and quick enough to account for those variables?

LLL says to (18:46): Hybrid?

Aaron Kowalski says to (18:46): The closed loop runs all of the time but the kids do a mini-bolus before meals – tremendously effective

Kassie says to Aaron Kowalski (18:46): so there’s still room for error (carb counting, estimating, ratios)?

Aaron Kowalski says to (18:46): This way the basal is essentially on autopilot and then you can get some insulin on board to compensate for the slow sub-q delivery issues

Aaron Kowalski says to (18:47): They get near perfect control overnight – not eating and not moving around – very exciting

Aaron Kowalski says to (18:47): During the day it’s significantly better than what they record the prior days open loop – and the subjects generally have A1c’s in the 6’s

LLL says to (18:48): How long does it take to figure out the best basal rates? With my daughter’s pump, we still haven’t figured it out? And how are the basals adjusted for growth, etc?

sstrumello says to Aaron Kowalski (18:48): What about those of us who, after 30 years with T1DM, still have a high c-peptide level? I use almost no basal insulin at all, only a small dose of N overnight covers my basal needs all day.

Aaron Kowalski says to (18:49): The alogrithm is developed by hardcore engineers and looks and many differrent factors – much more reactive than a person can be

parrotletzoo says to (18:49): will the AP address alpha cell exhaustion that some people with diabetes have?

Aaron Kowalski says to (18:49): Even for those with low insulin requirments – should be better – can also turn off insulin if you’re getting low

Kassie says to Aaron Kowalski (18:50): so the AP won’t adjust based on low blood sugars? you’d have to turn it off?

Aaron Kowalski says to (18:50): The alpha cell function may be improved in theory – much closer to “normal” insulin on board

Kassie says to Aaron Kowalski (18:50): and how the heck are you going to explain this to all us non engineers! {smile_smiley}

Aaron Kowalski says to (18:50): The AP will titer down or turn off if you are getting low

parrotletzoo says to (18:50): nice

Julie says to (18:51): IMHO it’s going to be a long time to work as a true closed loop pump – especially measuring interstitial glucose fluid with an approx. lag time of 20 minutes behind bg, and insulin that takes time to peak and varies per individual.

Aaron Kowalski says to (18:51): Don’t need to be an engineer really – as Dr. Tamborlane at Yale says “If the blood sugar is going up give more insulin, if it’s going down, give less”

Aaron Kowalski says to (18:51): Julie – I disagree – and the data really supports this.

Aaron Kowalski says to (18:52): We may not get to 100% closed righ away – but we can do much better than we as people with diabetes are doing “open loop”

Kassie says to Aaron Kowalski (18:52): hey if it were that simple, my current set up would work

Aaron Kowalski says to (18:53): With even a “semi-closed” loop, there should be no more A1c’s of 8’s or likely even 7’s – and if we can do this, without lows, we could put a huge dent in complications

Julie says to (18:53): I’m concerned that parents are already using the CGMS data to bolus their kids…rather than confirm with bg checks. I’m all for pushing the technology forward…just more concerned about relying on the technology at this stage.

Aaron Kowalski says to (18:53): AND ease so much of the burden of diabetes

LLL says to (18:54): tough crowd lol. But seriously, you’re not saying that everyone responds to insulin in the same amount of time?

Gina says (18:54): i havent had an a1c below 8 in over a year

Aaron Kowalski says to (18:54): I agree – it absolutely needs to be safe – and that’s our main focus. I have no doubt we can be more effective than open loop, but it needs to be safe

Gina says (18:54): safety first

sstrumello says to (18:55): What are the key safety measures you’re examining?

Aaron Kowalski says to (18:55): That said, personally, I think with the data I’ve seen we could close the loop tomorrow – eliminate most complications and PREVENT way more hypo then would ever be caused

Aaron Kowalski says to (18:55): The key is that the sensor doesn’t allow for overdosing of insulin

Aaron Kowalski says to (18:55): No hypo

Kassie says to Aaron Kowalski (18:56): which means no over treating and rebounding

Aaron Kowalski says to (18:56): There are many checks and balances that may be used to do this. This is the research the JDRF is funding right now

Gina says (18:56): even with the pump I have a fear of going low in the middle of the night

Julie says to (18:56): The sensor doesn’t allow you to overeat when you feel low? {flower_smiley}

Gina says (18:56): lol

Aaron Kowalski says to (18:56): Gina -that is what is amazing to me

Aaron Kowalski says to (18:57): Even with a pump – and even with a CGM alarming – if you don’t react – you can get very low

Aaron Kowalski says to (18:57): Right now, we should have pumps that turn off if people are getting low and not reacting – they shouldn’t continue to pump insulin into you

Gina says (18:58): I know this sounds nuts but I will eat a little something before I go to sleep… I am always afraid

LLL says to (18:58): not nuts

Aaron Kowalski says to (18:58): This is – in my opinion – the first step to the closed loop and we have great researchers working on this right now

LLL says to (18:58): We have a strict nighttime snack policy in our house

Gina says (18:59): I carry so much stuff in case I go low on the subway or the railroad… or some natural disaster o r terrorist attack

Aaron Kowalski says to (18:59): Not nuts at all – with fingersticks you never know – I use a slide in all of my talks that shows someone who went to bed at 120 – may have had a bed time snack – and was really dropping like a rock but didn’t know it – went into a seizure

Julie says to (18:59): How will the AP adjust to the sudden post exercise lows that come many hours after exercise?

sstrumello says to (18:59): or lows that come after drinking sometimes?

Gina says (19:00): ahh the after drinking lows lol

Aaron Kowalski says to (19:00): Julie- the algorithms are very sophisticated in picking up patterns of trending down glucose – will titer insulin down or off

Aaron Kowalski says to (19:00): We have two AP researchers who show glucagon can also be included – may be great protection

Aaron Kowalski says to (19:01): Another click – 166 – may need a unit before bed!

Julie says to (19:01): But if Glucagon is forcing the little bit of reserve left in the liver, will the person be left without any counter-regulatory mechanism for the next low if they exercise again in 24 hours?

LLL says to (19:01): And how does AP deal with carbs like Pizza – we do a combo bolus on my daughter but we’ve never gotten it right – we always miss the peak and end up with multiple corrections

Gina says (19:01): is having a closed loop system lets say going to save my life if I am stuck under some rubble for three days because of an attack on new york or what.

Aaron Kowalski says to (19:02): Pretty much the same as the going down idea – looking at trends, rates of change, and past experiences to compensate

parrotletzoo says to (19:02): forgive me if this has already been addressed I came in late, but are any of the research studies on AP using implanted pumps and cgms? Or are they all external?

LLL says to (19:02): There’s nothing that detects the peak and gradually compensates for it?

Aaron Kowalski says to (19:02): Gina – don’t know about that!!

sstrumello says to (19:02): Tough crowd … LOL

Gina says (19:03): hey we live in a crazy world, didnt hurt to ask lol

Julie says to (19:03): Gina, the closed loop pump won’t allow attacks on NY

Gina says (19:03): lol

Aaron Kowalski says to (19:03): Right now, they are all external – I think this is first. Medtronic has an implanted pump and sensor, but I think what’s first is what we call SC-SC — sub-cutaneous sensor and pump

rickinwacotx says to (19:03): I am confused by my MD……he says I am insulin resistant does that mean I have to take more than other folks

Gina says (19:03): now that is a machine I want lol

parrotletzoo says to (19:04): ah

Aaron Kowalski says to (19:04): Many people with type 1 also become insulin resistant – this may increase your insulin requirements

sstrumello says to Aaron Kowalski (19:04): What about reducing the size … and especially reducing all the tubes and wires required? Any ideas on timeframes for an integrated sensor/infusion set?

LLL says to (19:04): The SC-SC – that has to be changed like an external site?

Julie says to (19:05): Aaron we really do appreciate your time tonight. We just have to find a bit of humor. Are you working with the Omnipod too?

rickinwacotx says to (19:05): I take lantus 2 times a day 30 in am &amp; 50pm

Aaron Kowalski says to (19:05): I’ve been fortunate to see some of the high tech stuff coming down the pike – smaller will be hear soon

Aaron Kowalski says to (19:05): LLL – yes – just like today’s pump and CGM

rickinwacotx says to (19:05): plus novalog pre meals 30u

Aaron Kowalski says to (19:05): Julie – Omnipod is participating in some of the AP studies

Aaron Kowalski says to (19:06): I’m happy to stay on if people have more questions

LLL says to (19:06): owie – if changing a site externally hurts – internal must be a bummer!!

rickinwacotx says to (19:06): I can’t seem to get control

sstrumello says to rickinwacotx (19:06): Thats comparatively high … I’m a 37 year old man, and my total daily dose is usually less than your evening dose of Lantus.

Julie says to (19:06): Is Omnipod working on one insertion device that combines a sensor and the pump?

rickinwacotx says to (19:06): A1C 10,7

parrotletzoo says to (19:07): LLl I imagine that internal pump refills would be done under local anesthesia

Julie says to (19:07): I thought the AP you’re working on now is external.

Aaron Kowalski says to (19:07): I think everyone want to have the sensor and pump together – we may be limited a bit by just how close you can get the two, but it is likely possible.

LLL says to (19:07): Are there any concerns over long-term use of some of the wireless technology? I didn’t understand if AP was using bluetooth, I/R, or ?

bina says to (19:07): Aaron, when do you think it is coming on the market?

Julie says to (19:08): Is Abbott’s Aviator pump involved in the AP project?

sstrumello says to (19:08): I’d rather get a full pancreas transplant than go into surgery for an internal pump which has potential of failure

Aaron Kowalski says to (19:08): Julie – right nearly all of the JDRF funded AP work is external – we have one great researcher – Dr. Ken Ward – who’s working on small implanted approaches

Gina says (19:08): they both do scott

parrotletzoo says to (19:08): I’d take an islet transplant over either but transplants have their issues too

Aaron Kowalski says to (19:09): Right now the technologies are radio

rickinwacotx says to (19:09): I wanna say thanks for inviting me but your talkin’ way above me here………….the VA won’t even look into those

Aaron Kowalski says to (19:09): Abbott is a very active participant in the project and has been very supportive

LLL says to (19:10): I wondered why Minimed was sticking with radio when the world is going bluetooth….

rickinwacotx says to (19:10): so I will sadly say goodbye {shrug_smiley}

Aaron Kowalski says to (19:10): I’ll stay on, but if others need to leave – I’d ask you to check out the JDRF web site for more AP info and sign up to be diabetes advocates for the JDRF!! This makes a tremendous difference and ensures diabetes is a priority in this country!

sstrumello says to (19:11): Don’t leave on my account … just a personal opinion on internal pumps

Aaron Kowalski says to (19:11): Rick – email me if you have more questions!

Julie says to (19:11): I’m still hopeful for encapsulated porcine islets. Islets are the perfect AP. We need those without immunosuppression. We need islets that are glucose responsive and not rejected

rickinwacotx says to sstrumello (19:11): I would but I don’t have your e-mail

Aaron Kowalski says to (19:11): akowalski@jdrf.org

rickinwacotx says to (19:12): dang this is differante than yahoo LOL

Julie says to (19:12): You’ve been terrific about answering our questions Aaron. Thank you so much.

christine says to Dan (19:12): thank you Aaron

LLL says to (19:12): Yes, thanks for your time

Aaron Kowalski says to (19:12): Julie – we continue to fund lots of research in this area and this is certainly our goal – to walk away completely!

periwinkle says to (19:12): very informative session, thanks so much !

sstrumello says to (19:12): Thanks Aaron … I’m not convinced yet, but much closer than I was at the beginning of this program!!

rickinwacotx says to (19:12): yeah from me too

Gina says (19:13): haha me too scott

Aaron Kowalski says to (19:13): Great – I’m always available to answer questions if I can

Julie says to Jon (19:13): Gina/Jon will this chat be available in transcripts?

Gina says (19:13): of course

rickinwacotx says to (19:13): what can I do any dif than I am already?

B and M says to (19:13): Hope you come to JDRF in Bergen County.

Gina says (19:13): this chat will be available tomorrow sometime

rickinwacotx says to (19:14): I get so down and my wife gets ticked off at me

Aaron Kowalski says to (19:14): Rick – in my opinion it’s all about the glucose level – that needs to be priority number 1

rickinwacotx says to (19:14): I feel like I am on a roller coaster

Julie says to (19:14): Wishing you good health too Aaron.. Looking forward to hearing more in the future. Give everyone on your staff a raise this holiday season LOL.

Aaron Kowalski says to (19:14): B and M – I think I’m coming to the JDRF in Bergen in the spring – I live in Central NJ!

sstrumello says to (19:14): Thanks, goodnight everyone!

Gina says (19:14): NITE SCOTT

Gina says (19:15): Aaron, I am always on the diabetes rollercoaster as well, mentally a closed loop system would help me i think.

Gina says (19:15): anything to take the thinking out of it
Aaron Kowalski says to (19:16): I think that’s going to be the main benefit – relieve some of the mental burden

LLL says to (19:16): I’d love to see you in Bergen also. Keep us posted!

rickinwacotx says to (19:16): aaron I got your addy and thanks alot for your time……..VA won’t put me on a pump

Aaron Kowalski says to (19:17): I’m on a pump now – but did shots until recently – we’re working with the VA to try to help. But, in the meantime, do your best to go after those high sugars

Gina says (19:17): my worst time of the day is during the day

rickinwacotx says to (19:17): I am and I seem to have a lot of lows at nite

Aaron Kowalski says to (19:18): On the cgm I’ve found breakfast to be very very difficult

Gina says (19:18): i will forget to bolus, and check or correct while at work

Aaron Kowalski says to (19:18): I’ve used that information to modify my ratios and my basal in the AM which has helped

rickinwacotx says to (19:18): ya’ll are makin’ me feel like a real dummy

rickinwacotx says to (19:18): dummy opps

parrotletzoo says to (19:19): gah! i want cgms! lol

Aaron Kowalski says to (19:19): The CGM is great for pumpers – immediately see if you missed a bolus – or last week a picked up a kinked cannula very quickly

Julie says to (19:19): Aaron are you using the smaller sensors?

Aaron Kowalski says to (19:19): I’m using the currently available DexCom and Medtronic sensors

rickinwacotx says to (19:19): cya’ll God Bless

Gina says (19:20): wait, you are on two cgms ?

Gina says (19:20): nite rick

Gina says (19:20): thanks for coming

Julie says to (19:20): I assume you’ve tested the Navigator also?

Aaron Kowalski says to (19:20): I’ve been trying both lately – the STS and the Medtronic – haven’t had a go with the Navigator yet

Aaron Kowalski says to (19:20): But, I’ve seen it quite a bit and the data looks fantastic

Gina says (19:20): its like you have a tool belt of cgms lol

parrotletzoo says to (19:21): can i ask which you prefer?

Julie says to (19:21): I agree the data looks terrific. The 10 hour warm up is a “bummer”

Gina says (19:21): Aaron the diabetic tool man lol

parrotletzoo says to (19:21): sts or medtronic

Aaron Kowalski says to (19:21): My wife thinks I’m crazy – but I like to be able to have experience with what I talk about and its been super interesting

parrotletzoo says to (19:21): of course, makes sense

Gina says (19:21): yea

parrotletzoo says to (19:21): job research

Gina says (19:21): id say

Julie says to (19:22): So how close are the Dexcom and MM when you look at them both?

Aaron Kowalski says to (19:22): We’re hopeful the 10 hour piece will be addressed quickly

Gina says (19:22): which one has the 10 hr problem

Gina says (19:22): dex

Aaron Kowalski says to (19:22): the navigator has a 10 hour warm-up -

Gina says (19:22): oh oh

Gina says (19:22): we had a chat with Phil Southerland about the navigator

Aaron Kowalski says to (19:22): The STS and the MM both have been great – trend along very similarly

Julie says to (19:23): Have you had more problems with one brand sensor over the other?

Aaron Kowalski says to (19:23): Just say Phil in Atlanta a few weeks back – had on his Navigator

Gina says (19:23): maybe when you are done you can lend me yours lol…haha

Gina says (19:24): i have to tell you i struggle big time

Aaron Kowalski says to (19:24): I think they are both great – different

Julie says to (19:24): If you can convince Gina to use it, she’ll be living proof even the nay sayers can be swayed.

Gina says (19:24): lol

Aaron Kowalski says to (19:24): Gina – you’ll be on a CGM – I’m sure of it!

Gina says (19:24): if you are paying sure!

Gina says (19:24): lol

Aaron Kowalski says to (19:25): My brother will not wear a pump – but he loves the CGM

parrotletzoo says to (19:25): i loved my pump!

Julie says to (19:25): Does the cgm from MM have a vibrating alarm instead of an audible one?

Aaron Kowalski says to (19:26): The MM has a variety of alarms – which is nice – I keep mine on vibrate

Gina says (19:26): i have my pump on vibrate

Aaron Kowalski says to (19:26): The STS vibrates first – then beeps if you don’t react to it

parrotletzoo says to (19:26): that’s a nice feature

parrotletzoo says to (19:26): I work in a loud environment and don’t always hear pump alarms

Aaron Kowalski says to (19:27): Any other science questions?

Gina says (19:27): Hmm

Aaron Kowalski says to (19:27): Almost my bed time!

parrotletzoo says to (19:27): thank you for you time

Julie says to (19:27): How many fingersticks do you do now per day?

Gina says (19:28): oh yea do you have to calibrate

Aaron Kowalski says to (19:28): Truthfully – two – the two required for calibration

Gina says (19:28): lucky

Aaron Kowalski says to (19:28): And, as I said before, my A1c is way down and I have had significantly less lows

Julie says to Aaron Kowalski (19:28): Good night.

Julie says to Aaron Kowalski (19:28): Thanks again.

Gina says (19:28): I need to get my blood sugars down big time

Gina says (19:29): I am getting married and eventually would like to have children and that’s something that worries me

Gina says (19:29): that I won’t be able to be in better control

Aaron Kowalski says to (19:30): There was a great letter to the editor in the Journal Diabetes Care this month describing the power of CGM in a women who had struggled with her control and then was pregnant -

Aaron Kowalski says to (19:30): helped tremendously

Gina says (19:30): I don’t think I will be able to do it unless i have something like that

Aaron Kowalski says to (19:30): Will likely become the gold standard

bigainge says to (19:31): Thank you for your time Aaron, you have been most helpful. I bid you goodnite.

Gina says (19:31): Aaron, thank you so much for coming tonite

Aaron Kowalski says to (19:31): Good night bigainge !

Gina says (19:32): I will send you the transcript once we edit

Aaron Kowalski says to (19:32): Gina – everyone thanks – it was a lot of fun!

periwinkle says to (19:32): Goodnight and thanks again !

Aaron Kowalski says to (19:32): Again – sign up to be diabetes advocates at <a href=”http://www.jdrf.org”>www.jdrf.org</a>

Aaron Kowalski says to (19:33): And reach out to me if you think of any other questions at any point – I’m very optimistic = the future is bright!!

Aaron Kowalski says to (19:34): Good night everyone – I’m going to sign off

Gina says to Aaron Kowalski (19:34): Nite!