Tag Archives: diabete

COVID-19 and DIABETES

Although today the data are certainly not encouraging in general, I wanted in part to reassure T1D patients and family members with respect to the published images and tables that report a 35.5% mortality in Italy for subjects with DIABETES as co-morbidity. Today during the videoconference of the Istituto Superiore della Sanita I made an intervention asking specifically to clarify if there was an analysis available that differentiates between Type 1 Diabetes and Type 2 Diabetes. It has been confirmed to me that these are statistics related Type 2 Diabetes where the majority of patients are over 65 years of age and often have other co-morbidities.

Even among the 17 (data of 17 March) deceased patients who were under the age of 50 and in particular among the 5 deaths between 31 and 39 years of age, the subject with diabetes was affected by T2D and not T1D. Mortality among males is much higher than that of females, for reasons yet to be determined, but Type 1 Diabetes is not currently an increased risk factor. However, the rules of my previous posting on metabolic control and trying to keep an immune system in good condition, including diet and avoid smoking, apply, since hyperglycemia poor metabolic control can affect the immune system capability to fight infections in general.

Also today, in response to my comment / question, I have been told that an important emerging figure is the very high level of inflammation in the blood detected in these patients with Type 2 Diabetes, as detected for example by the very high levels of PCR (c reactive protein) detected in these subjects.

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Fonte delle immagini: Istituto Superiore della Sanità

NOTE: Omega 3 or Vitamin D if one takes them already for any reason there is no reason to suspend, but of course there are no specific randomized, controlled, prospective studies for COVID-19 and there is no rigorous research that indicates their possible use in curative terms for COVID-19. So keep staying at home and following the directions of the CDC in this direction.

Camillo Ricordi

Diabete e bambino. Cosa succede quando mangiamo? La vera storia del cibo dalla bocca agli zuccheri, grazie al lavoro di Fata Insulina.

Da Padre a padre, dico grazie all'autore per aver fatto sorridere la mia bambina. Ci ha relagato uno sprazzo di magia

Ho pianto nel vedere la mia bimba felice  di leggere di una bimba come lei
©Riproduzione riservata
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Vuoi parlare con le migliaia di amici che hanno già sperimentato le soluzioni proposte su DeeBee.it? Vuoi fare qualche domanda su un argomento specifico per conoscere le opinioni ed i suggerimenti di chi ci è già passato? Vuoi suggerire tu qualcosa dicendo la tua?
Non devi fare altro che iscriverti nel gruppo Nightscout Italia ed otterrai risposta ad ogni tua domanda! Nel nostro gruppo affrontiamo ogni tematica inerente il diabete (non solo tecnologia ma anche leggi, sport, alimentazione, accettazione, gestione quotidiana, L104, ecc., sia per adulti che per bambini).
Enjoy!

Solo, the patch pump that no longer leaves the OmniPod on its own

In 2019 the choice of insulin pumps in Italy will be expanded by the introduction of the Accu-Chek Solo (Micropump system) made by Roche. The device was awarded a CE mark in July 2018 and is approved for use by patients from 2 years of age. The pump is based on the design by Medingo. Ltd which was approved by the FDA in 2009 and purchased by Roche a year later.
Unlike the more well known OmniPod, the Solo has a semi disposable unit which is controlled via Bluetooth using a touchscreen handheld device with an intergrated Aviva Accu-Chek glucometer.

The part that attaches to the body is:

• An adhesive patch ( the pump holder) which has a plastic grafted inlay where the pump base and reservoir sit, this lasts up to 3 days.

• A pump base that contains the minimotor (with a piston system similar to that contained in conventional infusion pumps, and therefore different than the OmniPod system) and electronic components. It can be used for up to 4 months. The disposable reservoir part is inserted into this.

• The insulin reservoir, this can contain between 80 and 200 units of insulin and is replaced every three days. It is made of transparent material so that it is easy to see both the level of insulin as well as the presence of air bubbles.

It can be applied in four possible areas of the body: abdomen, legs, upper buttocks and arms.

Even though it looks very similar to its “cousin” the Omnipod there are a few important details that make the two quite different.

• The Solo micropump has two lengths of cannula available, a 6 mm and 9 mm these are made of soft teflon.

• The dispensing of insulin can take place by not only using the Personal Diabetes Manager, but also by pressing two buttons on the sides of the patch pump, thus avoiding inconveniences in case of loss or defect of the PDM (see below). By simultaneously pressing the two side buttons, after the audible confirmation, you can dispense insulin quickly in what is called a, “quick bolus”. Each time you press the buttons, it delivers insulin as needed, from as little as 0.20 to 2 units at a time.

• The pump part is water resistant but must not be immersed in water. It needs to be removed when having a bath or swimming. In these circumstances only the pump holder should be left on the body.

• The minimum basal rate is 0.0U / h (compared with 0.05U / time OmniPod), and the minimum bolus is 0.01U (0.05U compared with the OmniPod)

The Handheld Device

This is called the Personal Diabetes Manager (or “PDM”) it has a 4-inch colour display which can be locked preventing any accidental operation of the device. The display on the status screen allows you to see the time and date, the insulin level in the reservoir and the current basal rate. The battery is charged just like an ordinary smartphone, it features a display which confirms the bolus delivery and an integrated blood glucose meter port.
(The picture below shows the comparison in size between the remote control of Accu-Chek Insight and that of the Solo micropump).

Introducing a new Accu-Chek Italian User Group

With the imminent arrival in the Italian market, we reveal a new Facebook group dedicated to the new addition to the Roche family: This will be a place where members can exchange information, ideas and views on the new pump. As with all the other DeeBee groups, this will be a digital closed group , to protect the privacy of its members, please visit the group, we are waiting!

Diabete e bambino. Cosa succede quando mangiamo? La vera storia del cibo dalla bocca agli zuccheri, grazie al lavoro di Fata Insulina.

Da Padre a padre, dico grazie all'autore per aver fatto sorridere la mia bambina. Ci ha relagato uno sprazzo di magia

Ho pianto nel vedere la mia bimba felice  di leggere di una bimba come lei
©Riproduzione riservata
Print Friendly, PDF & Email

Vuoi parlare con le migliaia di amici che hanno già sperimentato le soluzioni proposte su DeeBee.it? Vuoi fare qualche domanda su un argomento specifico per conoscere le opinioni ed i suggerimenti di chi ci è già passato? Vuoi suggerire tu qualcosa dicendo la tua?
Non devi fare altro che iscriverti nel gruppo Nightscout Italia ed otterrai risposta ad ogni tua domanda! Nel nostro gruppo affrontiamo ogni tematica inerente il diabete (non solo tecnologia ma anche leggi, sport, alimentazione, accettazione, gestione quotidiana, L104, ecc., sia per adulti che per bambini).
Enjoy!

«My week with Libre 1, Libre 2 and xDrip+. That’s one I prefer»

First I would like to thank Deebee.it, specially Fabrizio Casellato and Irida Cami, the opportunity to test Abbott Freestyle Libre 2. Without them, this comparative test would not be possible.

Who am I?

My name is Sérgio Silva, I’m from Terceira island (Azores – Portugal), I’m 36 years old, I’m an IT technician and paraglider. My Diabetes appeared since I was 16 years old (1998). By August the 7th, 2018, I create the Portuguese Facebook group, entitled DiabéT1cos (www.diabet1cos.pt). I’m a user of an artificial pancreas (AndroidAPS + Accu-Check Combo) since August 2018 and I’ve recently collaborated in the translation into Portuguese of xDrip+ and AndroidAPS.

English translation by Sara Santos

What is the comparative test?

The objective is to compare Libre 1 with Libre 2, using official readers with the Libre 1 data, with Miao Miao and xDrip+ (with calibration plugin Dactrisae, recommended by the app development team for transmitters such as Miao Miao and Blucon). The Contour Next One meter is used to measure blood glucose with a capillary test.

It is important to note that since using the FreeStyle Libre (January 2018), it has been almost a general rule for the sensor to show lower values than the capillary test. So, most of the time, when it indicates that I’m in “Lo” when I can even be with 80 or even 90mg/dL. Let’s see how it goes now with Libre 2…

How will it be performed?

To ensure a more reliable comparison:

  • The two Libres on the same arm, relatively close to each other since the readers only read the sensor corresponding to the version of the reader;

You might also be interested in:
Accessories and bands for MiaoMiao

  • Sensors with same expiration date: 2019-07-31
    • Libre 1: LOT 180909Q
    • Libre 2: LOT 3515698

  • Sensors placed and activated at the same time (unlike what I usually do). I did not put them in 24 hours before activating them, as this way it is possible to check the reaction of Libre 2 on the first day of use following what is officially recommended..
  • Software: xDrip+ build 22 febbraio 2019 withTicwatch E as”collector”.
  • Contour Next strips:
    • LOT DP7KPEC01A – Expiration date: 2019-10
    • LOT DP7FPEF03A – Expiration date: 2019-06
  • Readers:
    • Libre 1: 2.2.13/0.94
    • Libre 2: 1.0.0.12/1.03

Performed tests

  • Comparison of capillary test values with Libre 1, Libre 2 and xDrip+
  • Check the Libres readings when the blood glucose value is updated on xDrip+.
    • In situations where:
      • Stable Blood Glucose
      • Fast ascent/descent
      • Slow ascent/descent
  • Final comparison of sensor usage; average of 7 and 14 days.

Let’s start!

Sensors activated on February 22nd, 2019 at 11pm.
NB: Values in parentheses represent the difference between the blood glucose value and the capillary test result.
All values are in mg/dL.

1st DAY – February 23rd

First Reading 23/February at 00h

  • Capillary: 102
  • Libre 1: Error “Try to read again in 10 minutes”
  • Libre 2: 89 (-13)

Libre 1 presented the error “Try in 10 minutes”, I was testing for 30 minutes and the error continued. I thought it would be better to remove it and place a new sensor.
That way, there wasn’t much time wasted comparing it to Libre 2. When I removed the sensor I noticed that the tip of the flexible strip of the sensor was crooked (I did not have one with the same expiration date as the Libre 2). I activated the sensor around 00:30, taking the first reading and calibration around 2:00 in the morning… I fell asleep and could not do the test one hour after activation.

Libre 1 sensor data: LOT 329696964
Expiration Date: 2019-05-31

Libre 1 reading at 2:05 in the morning

  • Capillary: 74
  • Libre 1: 53 (-21)

Reading at 7:30.

  • Capillary: 95
  • Libre 1: 71 (-24)
  • Libre 2: 114 (+19)
  • xDrip+: 139 (+44)

Reding at 21:15

  • Capillary: 101
  • Libre 1: 98 (-3)
  • Libre 2: 101 (0)
  • xDrip+: 101 (0)

For me, the usually most critical day after activation of Libre, also on xDrip, given the calibrations.

2nd DAY – 24/February

Reading at 7:05

  • Capillary: 65
  • Libre 1: 47 (-18)
  • Libre 2: 53 (-12)
  • xDrip+: 83 (+18)

Reading at 11:00

  • Capillary: 91
  • Libre 1: 70 (-21)
  • Libre 2: 71 (-20)
  • xDrip+: 111 (+20)

Reading at 14:45

  • Capillary: 128
  • Libre 1: 124 (-4)
  • Libre 2: 143 (+15)
  • xDrip+: 150 (+22)

Reading at 20:50

  • Capillary: 131
  • Libre 1: 111 (-20)
  • Libre 2: 100 (-30)
  • xDrip+: 116 (-15)

3rd DAY – 25/February

Reading at 7:05

  • Capillary: 76
  • Libre 1: 61 (-15)
  • Libre 2: 63 (-13)
  • xDrip+: 79 (+3)

Reading at 11:55

  • Capillary: 94
  • Libre 1: 80 (-14)
  • Libre 2: 76 (-18)
  • xDrip+: 97 (+3)

Reading at 16:15

  • Capillary: 66
  • Libre 1: 57 (-9)
  • Libre 2: 62 (-4)
  • xDrip+: 74 (+8)

Reading at 22:25

  • Capillary: 146
  • Libre 1: 132 (-14)
  • Libre 2: 131 (-15)
  • xDrip+: 133 (-13)

4th DAY – 26/February

Reading at 6:50

  • Capillary: 93
  • Libre 1: 84 (-9)
  • Libre 2: 85 (-8)
  • xDrip+: 86 (-7)

Reading at 11:55

  • Capillary: 87
  • Libre 1: 73 (-14)
  • Libre 2: 73 (-14)
  • xDrip+: 90 (+3)

Reading at 22:15

  • Capillary: 123
  • Libre 1: 110 (-13)
  • Libre 2: 121 (-2)
  • xDrip+: 122 (-1)


5th DAY – 27/February

Reading at 6:55

  • Capillary: 99
  • Libre 1: 79 (-20)
  •  Libre 2: 81 (-18)
  •  xDrip+: 98 (-1)

Reading at 12:10

  • Capillary: 105
  • Libre 1: 88 (-17)
  • Libre 2: 104 (-1)
  • xDrip+: 100 (-5)

Reading at 22:15

  • Capillary: 113
  • Libre 1: 121 (+8)
  • Libero 2: 127 (+14)
  • xDrip+: 113 (0)

6th DAY – 28/February

Reading at 6:45

  • Capillary: 91
  • Libre 1:75 (-16)
  • Libre 2: 82 (-9)
  • xDrip+: 93 (+2)

Reading at 12:45

  • Capillary: 88
  • Libre 1: 79 (-9)
  • Libre 2: 85 (-3)
  • xDrip+: 95 (+7)

7th DAY – 1/March

Reading at 7:10

  • Capillary: 113
  • Libre 1: 72(-41)
  • Libero 2: 130 (+17)
  • xDrip+: 82 (-31)

Reading at 9:20

  • Capillary: 78
  • Libre 1: 46 (-32)
  • Libre 2: 66 (-12)
  • xDrip+: 74 (-4)

Reading at 11:35

  • Capillary: 69
  • Libre 1: 43 (-26)
  • Libre 2: 64 (-5)
  • xDrip+: 80 (+11)

Reading at 16:10

  • Capillary: 97
  • Libre 1: 46 (-51)
  • Libre 2: 88 (-9)
  • xDrip+: 91 (-6)

Reading at 21:45

  • Capillary: 71
  • Libre 1: LO 40? (-31)
  • Libero 2: 65 (-6)
  • xDrip+: 77 (+6)

Values after 2 xDrip+ rapid ascent readings

  • Capillary: 124
  • Libre 1: 92 (-32)
  • Libero 2: 87 (-37)
  • xDrip+: 100 (-24)

Values after 2 rapid descent readings on xDrip+

  • Capillary: 85
  • Libre 1: 101 (+16)
  • Libre 2: 126 (+41)
  • xDrip+: 109 (+24)

And at the end of the 7th day, Libre 1 ends up dying, the readings were already strange on the 1st of March, and then it ends up giving a reading error, so that the reading is repeated in 10 minutes and after a while there is an error so that the sensor can be changed. There was supposed to be a second part of the test, with comparison of the 14 days, but in this case I end up staying only for the first 7 days.

Statistics for the first 7 days

Averages of the difference between the finger test and the values presented in the 26 tests performed (not counting the first test, since Libre 1 did not present values in the first result):

  • Libre 1: -17.12
  • Libre 2: -6.12
  • xDrip+: -0,73

Average of 7 days

Libre 1: 87
Libre 2: 98
xDrip+: 105

A1c

(converting the average of the Libre readers as an estimate)

Libre 1: 4,83%
Libre  2: 5,44%
xDrip+: 5,3%

xDrip+ calibration chart for the 7 days of use

TIR (Time in Range)

Range of the target: 70-170

  • Libre 1: Above: 2%. In range: 67%. Below: 31%
  • Libre 2: Above: 1%. In range: 75%. Below: 22%
  • xDrip+: Above: 2%. In range: 91%. Below: 5%

Patterns of 7 days

My conclusions

In my opinion, Libre 2 behaved much better than Libre 1 and I noticed this in the first 24 hours. As I said before, they end up being the most critical hours in relation to the values presented. After the initial 24 hours, and as usual, Libre 1 always showed much lower values than the test result on the finger and xDrip+. In turn, Libre 2 indicated higher values than Libre 1 and closer to the capillary test. Observing my results, Libre 1 would spend most of the time in hypo, which does not correspond to the truth. Therefore, if I trusted only Libre 1 (without capillary tests) I would always be correcting a non-existent hypo, which in turn would increase the laboratory test of my A1c. I still trust the values of xDrip+ and if I didn’t, I wouldn’t be able to use artificial pancreas. After all, all decisions regarding the amount of insulin are analyzed at each result received, every 5 minutes.

In this test, we can also see that many of the irregular values of xDrip+ have an influence on the malfunction of Libre 1, which ended up dying after 7 days.

In order of preference:

  1. Libre 1 + Miao Miao + xDrip+ solution
  2. Libre 2
  3. Libre 1
Is Libre 2 an alternative to Miao Miao with xDrip+?

My answer is no! It is not an alternative, neither far nor close, who was waiting for the Libre 2 not to have to buy the Miao Miao, in my opinion was a waste of time.

Libre 2 is a FGM (Flash Glucose Meter), instead of Miao Miao that converts a Libre into CGM (Continuous Glucose Meter), which makes it necessary to pass the reader through the sensor to have the value in an episode of hypo or hyper.

It seems that the only data that is transmitted by Bluetooth is the information to trigger the alarm. A curious thing happened to me only once and I don’t even know how I did it, I could see in my mobile phone, in the Bluetooth menu a device called “ABBOTT56456” (the numbers weren’t these, because I couldn’t memorize them), but right after that it disappeared. Is there anything planned to connect to the mobile phone, when near the reader, as a warning for hypo or hyper?

The alarms on the xDrip are silenced for a certain time, by default 30 minutes in the hypo and 2 hours in the hyper, the time that supposedly takes us to get out of a hypo and the insulin acts in case of hyper and, in case we continue in hypo or hyper, the alarm rings again. In the case of Libre 2, it is played only once in each episode, that is, if you have hypo and silence the alarm, it will only ring again when you leave the hypo and enter it again, which in a night hypo and in the middle of tiredness and sleep, may not have great effectiveness in preventing serious episodes. On the other hand, I understand how it is not possible to calibrate Libre 2 and how it happens to me to have values always lower than the capillary test, Libre 2 would be beeping for most of the day. Another available alarm refers to the distance of the reader in relation to the sensor for more than 6 meters, which really must have the idea of alerting that we may not be being monitored, in cases of hypo and hyper, but I keep thinking, if I get so far away, how will I hear the alarm? If I leave home and leave the reader behind by forgetting, how will I hear the alarm?

And how will remote monitoring of glycemia be done? As far as I can see, to date, it will be just like in Libre 1, using LibreLink on an NFC-enabled mobile phone to pass the phone through the sensor to read the value and then transmit it to the follower, who uses LibreLinkUp, but without receiving the graph of the day and only the value seen at the moment.

It’s curious that Libre 1 was released more than 2 years ago in Portugal and the two apps are not available for download at Play Store (Google) or App Store (Apple) in Portugal.

What about the calibration?

It’s unavailable in Libre 1 and 2… as seen in this test and by the average of the tests performed at some time of the day, the xDrip+ with calibration is much closer to the value of the capillary test and the Libres are not.

We remember that these are not absolute conclusions, but relative to the experience of the writer. To draw safe conclusions, Diabetes Technology Society tools to calculate risk around MARD need more data points (this article reports 26).
The values presented by xDrip are more often higher than capillary glucose: this, especially when used with an AAPS system, could create a risk of overdosing insulin.
Thanks to Tim Street for the precious feedback.

Diabete e bambino. Cosa succede quando mangiamo? La vera storia del cibo dalla bocca agli zuccheri, grazie al lavoro di Fata Insulina.

Da Padre a padre, dico grazie all'autore per aver fatto sorridere la mia bambina. Ci ha relagato uno sprazzo di magia

Ho pianto nel vedere la mia bimba felice  di leggere di una bimba come lei
©Riproduzione riservata
Print Friendly, PDF & Email

Vuoi parlare con le migliaia di amici che hanno già sperimentato le soluzioni proposte su DeeBee.it? Vuoi fare qualche domanda su un argomento specifico per conoscere le opinioni ed i suggerimenti di chi ci è già passato? Vuoi suggerire tu qualcosa dicendo la tua?
Non devi fare altro che iscriverti nel gruppo Nightscout Italia ed otterrai risposta ad ogni tua domanda! Nel nostro gruppo affrontiamo ogni tematica inerente il diabete (non solo tecnologia ma anche leggi, sport, alimentazione, accettazione, gestione quotidiana, L104, ecc., sia per adulti che per bambini).
Enjoy!