Loop and Learn posted a video presentation by long term T1D, author and educator, Gary Scheiner, about hypoglycemia and its current treatment regimen status. I think it’s a great summary and review.
His advice fits well with the general target audience whether they use MDI or a pump with or without an algorithm. I find it interesting that he mentioned that the professionals that work at his firm, Integrated Diabetes Services, all have a direct connection with diabetes and they include many who use DIY Loop, including Gary.
It’s a good idea to review your knowledge of important diabetes issues from time to time. His coverage of both relatively new glucagon formulations, Gvoke and Baqsimi, bring some good observations. Gvoke is injected and stings while Baqsimi is applied to the nose and stings a lot.
I was initially very interested in the Gvoke kit and the possibility of micro-dosing to treat garden variety lows but my insurance coverage makes that economically painful. I’ll stick with my glucose tabs for now.
I wonder if I should let me endo know about this. She’s nice, but doesn’t seem to understand T1D management very well, like someone with only book learning and no direct experience. She has the standard line: “stay under 160, don’t ever go below 70, and try to rarely if ever need to bolster blood sugar w/ extra carbs.” It’s so unrealistic, and seems to so severely misunderstand the ups and downs and unpredictable aspects of T1D (bolus timing, carb type, activity level, etc etc) that I don’t even bother trying to explain anything. I don’t want to ever have a low either, or bolster to prevent one–much more than any doctor could want on my behalf. But it’s just to hard to not go too high and not too low, or start trending low, and need 5 or so extra carbs. I definitely don’t always stay under 160 all the time/everyday, and I still can’t avoid low trends several times a week. I really wish I could, though. I don’t want the extra sugar either, but it just happens sometimes, even though I’m always trying my best and trying to learn lessons from past experience. My endo fortunately doesn’t freak out about lows, or think I’m doing poorly if I have some, like I’ve heard from others’ stories. And she gives me plenty of supply on my prescrips. That’s what matters most. But it’s just a little frustrating that she’s my doctor, and she doesn’t really get it (or seem to, from my encounters with her).
All endos are different and all diabetics are different in their education, management style, expectations, and determination of what is normal including deviations so the permutations and combinations are near endless. The real magic is finding an endo that is happy with you and your diabetes management while at the same time making you happy with your endo and endo’s recommendations.
This is a great review. Thanks for posting it Terry. I met Kathrine Gentile at a Diabetes Leadership institute in October. She loops and works with Gary and did a terrific discussion about exercise and D. To answer the question yes I have tried Baqsimi. I used it on myself. It felt like a gun going off in my head, but it worked quickly and effectively. I didn’t notice much in the way of stinging, but at the time my blood sugar was plummeting so fast, I probably wouldn’t have noticed it anyway. Baqsimi is covered by insurance and I have a few. It’s small, easily portable, and my friends and tennis teammates have all been instructed in its’ use. I feel a lot more comfortable asking them to give me a shot of nasal spray than I do an injection.
Thanks @Terry4 There were some nice tidbits in there.
@BKN480 I am of the opinion that someone, endos included, can’t completely get it unless they are a T1D or maybe have a kid with T1D. But there are some that have tried harder to actually understand it more.
