Diabetogenic

Christmas detox

December 21, 2023 in Diabetes, Family, Food, Real life | 1 comment

Do yourself a favour this Christmas and holiday period and do a detox. And by that, I mean cleanse and purge anything that suggests people with diabetes need to change our behaviour or feel guilty for daring to enjoy sharing a meal with family and friends.

There are a lot of those stories out there and annoyingly, social media algorithms keep pushing ‘How to be a responsible person with diabetes at Christmas’ articles to me. I wouldn’t be worried if being responsible included making sure I ate enough of my mum’s divine zippoli or kept the Bellinis flowing, but instead, it seems to be all about restricting portions and sipping flavourless drinks (water), and making sure I don’t throw diabetes or weight management plans out the window. Apparently, Christmas is as good a time as any to reinforce diet culture, demand food restriction and push punitive portion policing on PWD. Such tidings of comfort and joy!

People with diabetes have every right to celebrate festive meal without being made to feel judged or that our choices are being scrutinised. Our diabetes; our rules including what and how much we eat (or don’t eat). If I want to eat panettone for breakfast every day for the next month, it’s no one else’s business. What I don’t want is suggestions such as: ‘Overcome the urge for a candy cane, by brushing your teeth with peppermint toothpaste. Twice!’. Or ‘101 Ways to Enjoy Ice Chips: The Ultimate Low-Carb Snack’. Or ‘Chew on a cinnamon stick. It’s all the flavour of a spiced cookie without the enjoyment!’ Good tidings…unless you have diabetes.

Another theme that I see is the patronising reassurance that it’s okay for people with diabetes to ‘overindulge’. Cloaking assurances in passive aggressive pats on the head about how we’re allowed a ‘day off’ is unhelpful and perpetuates guilt. How about instead we accept and recognise that people (ALL people!) may eat more when celebrations are centred around food, and normalise it rather than make us feel bad for doing what everyone else is doing?

If we must be forced to read articles about surviving the silly season, it would be great if there was some merriment in there. It is possible! I did it here. And also in the article I’m sharing below that I wrote for Circle Magazine a few years back. Just some authentic musings about real life with diabetes, embracing the season with comfort and joy.

Christmas Giving

Insulin for Life is once again running their Secret Santa campaign. All donations go to support the charities efforts in supporting people with diabetes in under-resourced counties. If you’re able to donate, please do so here.

Silenced voices speak volumes

December 19, 2023 in Advocacy, Community, Engagement, Lived experience | 3 comments

Ten years ago, Australian Prime Minister Tony Abbott appointed himself as the Minister for Women. Much has been written about the message this sent and what the government of the time really thought about women, despite the carefully framed rhetoric being spewed in press releases and at doorstop press conferences. But this post is not a lesson in Australian politics. It merely sets the scene for me to speak about the underhanded ways that those whose voice should be heard are silenced.

Diabetes advocacy sits in an environment that often resists the voices of those most affected by diabetes, at times in somewhat sneaky ways. A wolf in sheep’s clothing in advocacy comes in the form of anyone claiming to advocate by ‘being the voice’ of people with diabetes, which is problematic not least because we have our own voices and don’t need others to speak for us. Being adjacent to diabetes does not give anyone license to speak on our behalf. In fact, the very idea that anyone thinks that they can represent those who should be centred is offensive.

It matters, by the way. When our insights are not the ones being heard, we find ourselves in a cycle of misunderstanding and misrepresentation. Our perspective must be heard because it is inevitably comes with the reality of diabetes. When a person with diabetes is asked about why we need to invest in better diabetes care, have better access to drugs and technology or improve funding in diabetes research, we will speak of how improved care leads to better engagement with our healthcare professionals, reduced emotional load and the resulting increased time we can spend with loved ones and being productive at work. We will speak about how increased access can equal decreased burden for us and what that means in our real lives. And we will speak about how research is the gateway for us to have better understanding of our diabetes, helping us make more informed decisions, and speak to how research has changed our lives to date. We speak about hope authentically because we hold onto it with both hands.

Someone speaking ‘on our behalf’ will inevitably focus on reducing burden to the health system (which often makes us feel as if we’re to blame for overwhelmed and overrun hospitals and adds to diabetes stigma) or resort to listing diabetes-related complications, a familiar trope that sounds like a shopping list that does well to scaring us! I spent years being a spokesperson for diabetes organisations and always ensured that the reality of day-to-day diabetes was part of the discussion, not just the rehearsed talking points that tell nothing of the people behind the numbers. Even more importantly, I learnt very early on in my own advocacy when it was not my voice that should be heard and ensured I had a network I could reach into to find the right person. I estimate that about ninety percent of the time I’m asked to give comment, I point whoever is asking in the direction of someone far better positioned to share their lived experience.

This year brought with it a new role where it was essential that I step into the background. I now find myself in the incredibly fortunate position of working with unbelievably brilliant grassroots and community advocates doing truly life changing work with people with diabetes across India. I am not here to tell their stories or about their work. I wouldn’t do it justice – I have more than enough self-awareness to know that. I recognise that they are the protagonists of their narrative. They are the ones doing living the experiences, doing the ground-breaking work, and pushing for change. My responsibility is to be an ally and a supporter, doing what I can to amplify their voices rather than overshadow them. Perhaps this speaks to my own confidence in my abilities as an advocate that I don’t feel threatened by others who are raising their voices. Effective advocacy thrives on collaboration and shared leadership, and I admire those in the advocacy world who willingly take a step back. I think it’s fair to say that others also see those who do that; and also those who do not.

There are more insidious and damaging ways that our voices are silenced. Let’s go back for a moment to our former Prime Minister. I said earlier that he made himself Minister for Women. Except, he didn’t. In fact, he abolished the position and moved it into the Office of PM and Cabinet, removing the seniority and decision-making powers it had previously held. Sure, he appointed Michaela Cash as an advisor, but this was no more than an exercise in tokenism. The reality was that the PM would have final control over decisions affecting women. Abbott bristled when questioned about his decision, refusing to listen to the myriad women and women’s groups criticising the move, instead responding defensively.

I use this as an example when consulting organisations about effective engagement and how to address commentary from the community they work with and for. Receiving criticism can be uncomfortable. However, by being open to how community responds and the feedback they generously offer, it is an opportunity for improvement and collaboration, rather than a threat to be neutralised. It’s incredibly disappointing when organisations respond by attempting to discredit or question the motives and expertise of those with lived experience or suggest that negative comments are part of efforts underpinned with ulterior motives. It’s disheartening to hear implications that individuals offering critical perspectives are merely being influenced by others, disregarding their ability to form independent thoughts and opinions. This is simply another way that community voices are effectively silenced, and proves to the community that contributions from those who should be heard are not valued at all.

I speak a lot about allyship as a pivotal force in including and amplifying rather than excluding and silencing the voices of those with lived experiences. Allyship is an active commitment to placing people with diabetes at the forefront of conversations; featuring them in all levels of decision making; putting them in the rooms where things happen. True allyship involves listening to and acting upon the needs and concerns of people with diabetes, even when what is being said is difficult to hear. What it isn’t is fantastic window dressing. We see right through that.

I wrote this piece while listening to Black Oak Ensembles 2019 album, ‘Silenced Voices’. It’s stunning.

A BIG birthday and request

December 1, 2023 in #SpareARose, Advocacy, Community, Diabetes, Real life | Leave a comment

I had a BIG birthday this week. It was lovely – spoilt by my gorgeous family and friends, a beautiful dinner, calls and messages and special deliveries from friends in far flung places. BIG birthdays are weird. There seems to be an expectation that we have BIG feelings about them. Some people have BIG negative feelings about them. Some people freak out. Some go through a crisis and suddenly feel as though they are facing their mortality. I haven’t felt any of those things, but people have been asking. And I’ve been at a bit of a loss as to how to respond.

I don’t feel bad about getting older. I like that the cliché about women giving fewer fucks about others’ opinions as they age has been true for me. I like that I’ve become more confident, and with that developed the ability to recognise a bout of imposter syndrome and swiftly dismiss it, knowing I’ve absolutely earned the seat at whichever table I am sitting. I like that I easily stare down and call out misogyny and have become better at identifying the misogynists who cloak their misogyny in faux allyship. I like that I have a group of strong, sassy, spectacular women around me and that we build each other up and celebrate each others’ triumphs. I like the respect my work receives, and I especially like that I now walk away from situations where that respect isn’t afforded.

The only one BIG feeling I have had is that ageing is such a privilege. I’ve felt that keenly this week as I’ve celebrated this BIG birthday. I’ve thought of friends who didn’t get to celebrate this BIG birthday for all sorts of devastating reasons, and of friends who have had some pretty serious medical emergencies of late. I flashed back to my darling sister being so, so unwell last year, noting that when it’s time for her next BIG birthday there will be fireworks to celebrate that she is with us. And I’ve thought about how if I’d been diagnosed with diabetes a few decades earlier, I may not be celebrating this week.

Diabetes has been a constant and unwelcome companion for over half my life now. I do have BIG feelings about that, none of them good. It entered my life and reshaped it in ways that I couldn’t have imagined, and even though my work – work that I love – is impossibly intertwined with my diabetes, I feel cheated that so much of my brainpower, my energy, my finances and mostly, my time has been sucked away by diabetes. I’ve never bought into the toxic positivity of diabetes superherodom, and flat out refuse to credit diabetes for the discipline and resilience I’ve been forced to adopt just to manage living. I get credit for that.

And I’ve thought this: Ageing is a privilege, but ageing with diabetes feels like a miracle, and believing that brings into sharp focus my diabetes brothers and sisters who might not get to celebrate BIG birthdays due to completely missed diagnoses, inadequate healthcare, or lack of access to drugs and technology. Over the last few years, we’ve heard more from our vast community about those experience and we need to hear more, and do more to help. And so, if I can be opportunistic on the occasion of my BIG birthday, an appeal to anyone reading. If you can, please make a donation to either Life for a Child or Insulin for Life; two charities doing so much to increase the chances of more BIG birthdays for people with diabetes in under-resourced countries. That seems like the best celebration possible.

D-Coded – diabetes research democratised

November 3, 2023 in Community, Diabetes, Engagement, Research | 1 comment

In a month where there is A LOT of great stuff happening in the diabetes world, stop for a minute and get to know D-Coded, a brilliant new resource which helps to break down diabetes research in an accessible, informative, and authentic manner. It simplifies complex research studies and contextualises information without losing any of the insights and provides people with diabetes a starting point to better understand research, and work out how to delve deeper if we want.

One of the challenges of communicating research is that it can be a lot of detail using specialised language and complex stats and data interpretation. There may be an assumed knowledge that people simply may not have. There are acronyms, jargon, abstract concepts and the details can be lengthy and overly detailed. And that’s if we can see it! Often research papers are behind a paywall, so we can’t event see it in the first place.

Diabetes research is the reason that we are all alive today and it gives us hope for the future. At any one time, the research agenda is advancing to find ways to prevent, cure and treat all types of diabetes in ways that give me so much hope. And so, it makes sense that we should have access to it in a way to keep us engaged and interested and wanting to know more.

One of the tactics I’ve employed over the years is to ask researchers to break down their research into a tweet (280 characters or fewer), or as an elevator pitch. Most find it impossible to do. There is a language to research that can be complex, confusing, and complicated – just as there is a language to lived experience that confounds others. (Don’t believe me? Throw HbA1c, #YDMV, CGM, DIYAPS etc. around and see how people outside our community follow what we’re saying!) D-Coded does that for researchers. Everyone wins here!

It comes as no surprise that this came from the team at Diabesties. Led and powered by Jazz Sethi and involving community, it’s a project that once again shows how lived experience innovation drives change, this time by levelling the knowledge playing field.

Check it out and share as widely as you can.

DISCLOSURE

I am a Lived Experience Advisor on D-Coded. I don’t receive any payment for my involvement and am honoured to have been invited to be part of this project.

Celebrate WDD by helping #EndDiabetesStigma

November 2, 2023 in Advocacy, Awareness, Community, Diabetes, Events, Lived experience, Peer support, Stigma, World Diabetes Day | Leave a comment

On November 14, the world will literally light up in blue to celebrate World Diabetes Day. And here in Melbourne, an event highlighting one of the most important issues in diabetes today will be held. The entire event will be dedicated to how the global diabetes community is coming together to work to #EndDiabetesStigma. And you can be there!

I’m delighted to be sharing the hosting seat with Dr Norman Swan, physician, journalist and host of Radio National’s Health Report. A veritable A-Team of people from the international diabetes community will be part of the event, sharing their experiences of diabetes stigma and why efforts to end it are so necessary and timely. There will be representatives from the global lived experience community, diabetes organisations and health professionals and researchers. You really don’t want to miss it!

For those able to attend in person, you’ll have a chance to catch up with diabetes mates. Any chance for opportunistic peer support is a great thing and I’m so pleased that I’ll be seeing diabetes friends that I’ve not seen for a very long time.

This isn’t only for Melbourne locals. There will be a livestream for people around the world to watch, share and be part of on social media. It’s free to attend and will be a great opportunity to see the diabetes world come together on a day dedicated to us!

Register right here, right now!

Time in Rage

October 30, 2023 in Advocacy, Diabetes, Real life | 6 comments

My Time in Rage over the past few days has been high; very high. That’s not a typo, I mean Rage (with a capital R). Since I published a post about airport security screening, a dozen people have messaged me with their tales of systemic failures that have left them feeling pretty damn overwhelmed. This is in addition to the myriad conversations I’ve had over the last twelve months. The situations may differ, but the underlying theme is consistent – this is a system that is not working, and people with diabetes are left exposed.

As systems break down, PWD are forced to deal with confusion, uncertainty, and a glaring lack of support. This is not confined to one specific area. I may have written about airports on Friday, but it spans across various aspects of our diabetes lives. The consequence is PWD in the firing line.

I’m forever thinking about the labour borne by people living with diabetes and how systems increasingly shift care responsibilities. Not only are we burdened with intricate care coordination and management, but also, we’re left exposed when navigating through systemic failures. Diabetes necessitates that those of us who live with the condition shoulder most of the care, but that burden shouldn’t then be compounded by systems that fail us – whether it be airport security checkpoints, or in healthcare settings.

Even worse, we know decisions are made around us, or without our direct input and when we highlight how things are not working, we are met with defensiveness and excuses. Inconsistencies, confusion, and a lack of clear communication may all be the reasons that things don’t work, but they are problems that are not ours to solve. It is not our role to make sense of chaotic labyrinths. We should not be expected to decipher the complexities behind systemic failures. Our focus should be on managing our diabetes, living our lives, and not on mitigating the fallout from systems that are supposed to support us.

I know that it can be argued that there are better ways to deal with matters than getting all rage-y. I agree with that; it’s counterproductive and draining. High Time in Range is often accompanied by distress, and hampered efforts to do diabetes well. It’s counterproductive and it’s draining. But sometimes, it really is difficult to keep that rage in check, especially when I believe that people with diabetes are getting a rough deal.

Australian airport security and diabetes

October 27, 2023 in Advocacy, Awareness, Devices, Diabetes, Pumps, technology, Travel | 3 comments

Australian airports seem to have become a battleground recently for travellers with diabetes. My own experiences since Australia opened back up to travel have been appalling and each week there are reports in online diabetes pages about some pretty horrendous experiences. Specifically, the problems are to do with full body scanners which have been rolled out across international security checkpoints nationally, and some domestic checkpoints.

This year alone in half a dozen international flights out of Melbourne Airports and a dozen or so domestic flights, all been much more difficult than any travel experience pre-COVID. I documented one particularly brutal encounter at Brisbane Airport last year in this Twitter thread. Sadly, since then, other instances have been just as awful.

It seems that the training modules for security staff have incorrect information about which scanning devices are safe for diabetes devices. In my experience, the messaging is consistent: staff have been told that the metal detectors (the older walk-through screeners) are unsafe while the newer full body scanners (the stand still and be scanned) are safe. This is at odds with information from device companies and health professionals and has resulted in a number of people reporting clashes at security checkpoints.

There’s so much discussion about this, as well as lots of confusion and some pretty dire misinformation across OzDOC socials, some of it coming from diabetes groups. Let me try to break this down with information that is based on advice from device companies and the Department of Home Affairs. This is what I have used to try to help me streamline my own travel experiences – with varying levels of success.

Firstly, let’s start with the Department of Home Affairs. This page has the information you need, but specifically, under the section Travellers who have a mobility aid, prosthetic, medical device or medical equipment is this: ‘If you have a medical device or medical equipment, it may streamline the screening process if you have a letter or medical identification card from your doctor or healthcare professional that describes the device or equipment. It is also recommended that you talk with your doctor, healthcare professional or check the manufacturer instructions for guidance on whether the medical device or equipment is suitable for screening by body scanner technology or X-ray technology, and if not, make the screening officer aware of any restrictions before beginning the screening process.’

Device companies all have their own advice, so familiarise yourself with what their recommendations. I wear a Dexcom, and carry a printed copy of security screening advice. At the end of this post you’ll find links and relevant information about the different devices available in Australia.

Knowing how tricky things are likely to be, I am super prepared for security checks now. I carry a letter from my endocrinologist that states I’m wearing diabetes devices that must not go through the full body scanner, and that my pump cannot be removed (not so relevant these days as I wear Omnipod). In a sign of just how much the times have changed, I now need to show that letter about 80% of the time at Australian airports. Pre-COVID I maybe needed to produce it twice in hundreds of journeys.

I always remain calm and clear about what I need: ‘I am wearing medical devices and cannot go through the fully body scanner. I can go through the metal detector, or I need a pat down. I’m happy to wait out of your way.’ I stand firm with this request, remaining polite and calm even when there is increasingly aggressive pushback. In most cases, security staff will tell me that the training says body scanners are safe and metal detectors are not. At this point, I offer the letter from my doctor and the printed out advice from Dexcom and mention the relevant information from the Department of Home Affairs. If there continues to be pushback, I’ll ask to speak with a supervisor. I truly hate doing this.

While this isn’t applicable to me now, at no point ever would I remove my insulin pump and hand it to security staff for inspection. Disappointingly, some of the device companies’ travel advice (and today I saw advice from a diabetes centre) suggests this. Don’t do it. I am happy for them to swab it while I hold it, but I won’t disconnect and hand it over. Items go missing and handed to the wrong person or could be damaged at busy security checkpoints.

I know others with diabetes are happy to go through whatever scanner they are directed to and have had no adverse issues and that’s great. But this isn’t about individual experiences so much as about how to manage situations according to manufacturers’ advice and knowing what official information from the relevant Government department is. It’s also about being treated respectfully and having our own lived experience and knowledge respected by security staff; something that sadly seems to be repeatedly forgotten.

If you’ve had a lousy experience and have the emotional labour to write a complaint to the airport, please do so. There are online forms you can use.

It would be really great if this additional work didn’t fall to people with diabetes. Device companies could step up here and provide cards to use at security checkpoints, similar to those that have been developed for people with pacemakers and knee and hip replacements. Simultaneously it would be great if there was a form that could be personalised and printed out or a card issued via the NDSS when people register for pump and/or CGM access (this wouldn’t serve people who are self-funding, but it would reach the majority of Australians affected). While I am sure that there are efforts underway to address it, there’s no time to wait and a temporary fix is needed immediately. And any other advocacy groups who are addressing this issue can make sure that the advice they are providing on behalf of their diabetes community is accurate and best serves the needs of people with diabetes.

A photo of the Melbourne sign in the departures hall of Melbourne Airport. — _{The departures hall at Melbourne Airport (before heading to the nightmare that is security screening)}

Advice from device companies in Australia

AMSL has this advice for Dexcom users: ‘Use of AIT body scanners has not been studied and therefore Dexcom recommend hand-wanding or full- body pat down and visual inspection in those situations.’

Insulet Australia has this advice for Omnipod users: ‘The Omnipod DASH®PDM and Pods are safe to go through the x-ray machine and the Pods are safe to be worn through airport scanners.’

AMSL has this advice for Tandem T:Slim users: ‘your Tandem Diabetes Care insulin pump should NOT be put through machines that use X-rays, including airline luggage X-ray machines and full-body scanners.

Medtronic has this advice: ‘Your pump should not go through the x-ray machine that is used for carry on or checked luggage or the full body scanner.’

Abbott has this information for FreeStyle Libre wearers: ‘The FreeStyle Libre reader and the FreeStyle Libre sensor can be exposed to common electrostatic (ESD) and electromagnetic interference (EMI), including airport metal detectors. You can keep your FreeStyle Libre sensor on while going through these. However, the FreeStyle Libre reader and the FreeStyle Libre sensor should not be exposed to some airport full body scanners.’

Fiasp still on the PBS (in new packaging)

September 19, 2023 in Diabetes, Real life | Leave a comment

What great news for Aussies with diabetes yesterday with the announcement that Fiasp will remain on the PBS! Such an excellent way to start the week. The media release from the Department yesterday referred to a ‘new form of fast acting insulin’, but that’s really not correct. It’s still Fiasp!

The bottom line: if you’ve been using Fiasp, you can continue to do so after 1 October via the PBS. The difference is how it is being packaged up. (Think of it like when you go to your local Woolies where you can buy the same brand of juice in small and large bottles, glass, and plastic bottles etc. Different vessel; same product inside.) It’s exactly the same drug, but now, it will be available only in Penfills. Up until now we have been able to purchase Fiasp in vials or FlexTouch disposable pens. Those options will not be available any longer.

This is not new. Twenty-five years ago when I as diagnosed with diabetes, this was the only option I knew! I was given two rather swish looking matt silver pens in grey boxes that housed the pen and three pen tips. I then picked up 5 boxes of insulin and inside each box there were 5 cartridges and those cartridges popped directly into the silver pen.

That’s how Fiasp will be available from the pharmacy now. If you use injections, the Penfills fit directly into a reusable NovoPens (for those using injections); if you’ve been using vials to fill pump cartridges, it’s still possible (and easy enough) to do so from Penfills.

It’s annoying when the language and words used to describe different diabetes products gets messed up, because it causes unnecessary confusion. And there was some confusion yesterday about what this ‘new form’ of insulin meant. This is why having people with diabetes involved in messaging is so important – we get the language, the jargon and the words right!

In case you missed it, here’s the JDRF Australia announcement which very clearly outlines exactly what this is about, using accurate language. (Disclosure: I work for JDRF International, not the Australian affiliate. Sharing this from yesterday because the comms from the organisation across all socials were super informative and used all the right language.)

And of course, the Bionic Wookiee was on top of it with this great blog post which outlines what it all means – also super clearly.

So, it’s good news really for the community, really. And an example of a united community response I’ll be pointing to for some time! Great work, OzDOC!

Photo of my hand holding a vial of Fiasp insulin. — The first time I used Fiasp (2018). I’ll be moving from vials to Penfills now.

New tricks

September 18, 2023 in Devices, Diabetes, Pumps, technology | 1 comment

Because our little diabetes community is about sharing and caring, a sharing and caring friend of mine gave me a few Omnipod Dash pods to try. I’ve been Open-Source looping with an old (small size) Medtronic for the last 6 years, and the recent news that the 1.8ml cartridges were coming off the market sent me into a spin of despair. I probably wailed ‘Why do things keep changing?’ at some point.

I am firmly of the ‘If it ain’t broke, don’t fix it’ school of thought, and needing to re-evaluate my current, very-not-broke Medtronic Loop set up was not something I was particularly keen to do. But it seemed that the decision was being made for me, and switching to Omnipod seemed to be a not-too-stressful way to keep using Loop.

Of course, between my panic, wailing and fury (alongside talking myself off the ledge of stockpiling every box of 1.8ml Medtronic cartridges available in Australia), a DIY fix was already being created that involved cutting down the larger 3.0ml cartridges to safely fit the smaller pump.

But the seed had been planted. Maybe Omnipod could be the easy solution. Pods are easily available. I have private health insurance that hasn’t been used to get a pump since 2013. And, most importantly, I won’t need to stop using Loop, or lose any of the beautiful ease it has brought into my life. This has been the reason I’ve not switched to a commercial system. I’m not willing to consider anything that requires what I consider to be a step back. Not being able to bolus from my phone or smart watch, needing to carry another device to drive whatever I’m using, and less customisation are all a step back in my mind.

So, I bribed my sharing and caring friend with lunch, and he came over my way to deliver some pods for me to try and since then I’ve been on and off Omnipod since the beginning of August, including for ten days travelling in India for work.

I’ve been pumping for over twenty-two and a half years. I’ve never taken a pump break. When I say having an insulin pump hanging from my body is my normal, I mean it. It was with me in the delivery room when my kid was born and has travelled the world with me. I have worked out how to tuck a tubed pump away in my clothes so that it doesn’t cause any sort of unsightly bump and other than my constant (sadly losing) battle with door handles, the tubing really hasn’t bothered me.

For these reasons, I’d never understood the deep-seated position some people hold at not wanting to use a tethered pump, or the overall appeal of a patch pump. That’s not to say that I don’t think they’re a good option. I just wasn’t drawn to one the way that I know others have been. To be honest, I’ve been kind of ambivalent about the benefits of no-tubing. That was all 15 pods ago ago, and now I get it.

Here are some of the thoughts I’ve had since using Omnipod:

⊙ Oh my Lordy! Phantom-pump is a real thing. I spent the first week of wearing a pod groping around for my old Medtronic pump. I’d go to grab my pump if I got up out of bed overnight, or first thing in the morning. One night, I thought I’d ripped out my pump and after groping around for a few minutes, woke Aaron, thinking it was under him. Half asleep, he said ‘It’s on your arm.’ I still do ‘the pat down’ before walking out of the house each day, gently tapping the middle of my chest to reassure myself that my pump is there. It’s redundant these days!

⊙ I don’t know why I thought it might be more complicated to use than it is, but I was really pleasantly surprised by ease of it all. The clunk of the cannula going in is slightly startling the first time, (but no more so than putting in a sensor). I’ve not found it painful at all.

⊙ That tape sticks! After three days, the tape has still been firmly adhered to my skin and looking pretty pristine. This was even in India where it was hot and humid. This bodes very well for the warm Aussie summer we’re being promised!

⊙ I thought that the Pod would feel more obtrusive on my body, but I have absolutely not once had a moment of ‘Ooh – that’s uncomfortable’ when I’ve rolled over in bed.

⊙ I’ve worn the pod on my right arm (Dex is always on my left), sides of my stomach (low and high), thighs (and didn’t rip it off when pulling down my jeans to race to the loo!), hips, lower back and all have been fine. No pain or discomfort at all.

⊙ Not needing to wear a bra if I don’t want to is liberating! Not needing to consider housing my pump and Orange Link is one fewer thing to think about!

⊙ I feel lighter because there is one fewer pieces of diabetes kit I need to worry about now that my Orange Link is redundant. This is a big win!

⊙ I’ve had two faulty pods which isn’t great really and the ‘replace pod’ alert came after three hours of inexplicable high glucose levels that were not responding to adjustment boluses. I’d really like to know if a problem is detected with the device before three hours of low teens numbers. The two faulty pods have happened in the last four days and I’m actually back on my Medtronic right now because I am a little thrown right now, but I’ll go back onto a pod later in the week when I head to Sydney for work.

⊙ Sorting our replacements with customer service has been a slight rigamarole, requiring far more calls and questions than seem necessary, and requiring a lot more emotional labour that, quite frankly, I don’t have to give.

⊙ Door handles are friends again. (Door jambs on the other hand, are now potentially double trouble if wearing a Pod on one arm and Dex on the other!)

⊙ I don’t love the waste and the thought that I am effectively using a pump every three days. Insulet offers a super neat recycling program which goes someway to alleviating my concerns about this. I love that my delivery came with a labelled box, zip log bag and clear instructions for the recycling program. This is outstanding and I wish other device companies could be this forward thinking.

⊙ The three-day hard cut off annoys the crap out of me. And yes, I’ve been using the 8-hour grace period every single time. I know that we are meant to change cannulas (tubed or otherwise) every three days, but many of us extend by a day or two when we know it’s safe to do so. And twenty-two years of pumping, not a single site infection, and knowing when I’ve extended to my limit would suggest that I am able to safely decide to keep a pump running for a few more hours without having it screaming incessantly at me. Alas, that’s not possible here. (And how has the DIY community not figured a work around this yet??)

⊙ Cost is, of course a consideration. I’ve not used my health insurance yet, so I have paid the NDSS + Insulet cost which is $29.30 (NDSS cost) + $168.27 (Insulet cost) per box. It works out to just under $20 per pod which is not cheap. If I make the decision to use my private health insurance and start using Omnipod on an ongoing basis, I will only have the NDSS contribution, bringing the cost down to $2.93 per pod – way nicer!

⊙ Omnipod currently has a new user deal on. You get 90 days of Omnipod for $149.40. Really annoyingly this is only available to new customers. I tried to see if I was eligible for this (after all, I’d consider having bought only one box would classify me as ‘new’ to Omnipod, but alas, I was not eligible). This is actually very disappointing. I’ll never understand why companies ‘punish’ their existing customers. But, if you’re brand new to Omnipod, this is a great deal and I’d encourage you to get onto it now! It’s a great way to try before you commit to using your PHI.

⊙ The best thing? Choice! Having a tubeless pump available here in Australia means Aussies with type 1 diabetes have another pump choice and that is only ever a good thing and should be celebrated. I now get why people are determined to only use a tubeless pump and if that is their choice, it should be available to them, and they should be supported to make that choice. I’m hearing that there are some centres that won’t use Omnipod and that’s absolutely not okay. If anyone is in that situation right now, reach out if you’d like some suggestions about advocacy to change the situation.

It’s exciting to try new things and this really is the first significant diabetes device change for me in some time. It is energising to have something different to play with. If you’ve been thinking of trying something new, this is a good thing to try!

Photo of me standing in my kitchen with an Omnipod insulin pump on my upper arm. I'm wearing blue jeans and a striped top and holding a yellow mug. A little black dog in a striped jumper is jumping up towards me.

DISCLOSURE

None! I was given a few pods to try from a community member (who has no affiliation with Insulet or Omnipod) and bought a box myself. I have done some consulting work with Insulet before, but not in the last two years.

Reaching out

September 14, 2023 in Community, Diabetes, Mental health, Real life, Wellbeing | 2 comments

It’s RUOK? day and while I am ready to jump on any worthwhile bandwagon, this one, today, seems especially important. A (non-diabetes) community of which I am on the periphery is grieving today after the death of a much-loved friend and colleague. I’ve been reading beautiful tributes to this person and messages of love and support to their family. I can’t begin to grasp what their loved ones are going through today.

RUOK? is more than a single day. It’s a movement that emphasises the power of human and social connection and having conversations about difficult things. If you’ve not looked at the website, there is advice about building the capacity of support networks (the very foundations of diabetes peer support groups for decades now) and developing skills to have meaningful discussions with someone who might be struggling.

It’s applicable to everyone, including those who may appear to not necessarily need it. Undeniably, it’s very relevant to diabetes. (This article outlines the increased risk of suicide in people with diabetes.)

Diabetes and mental health may be a topic on the agenda at most conferences and we’ve certainly seen an uptick in mental health and diabetes research over the last decade. But the strides that have been made are not enough. The pathway to genuine support and treatment for people with diabetes remains elusive. Simply telling people to seek help falls short when the help they need is not available.

Our peer networks go a long way to offering support, empathy, and love, but we’re not equipped to handle complex mental health issues. While we can assure people that they are not alone and perhaps offer suggestions for where they may find help, this does not go far enough in addressing mental health care, especially in critical situations. Accessing mental health professionals that have knowledge and training to support people with diabetes is what is needed. And it needs to be easily accessible. Easily affordable. Easily available. Right now, that’s not the case.

On RUOK? Day implores us to tap into our social circles and genuinely check in. (Do it, please; just do it). But there is a braider landscape of mental health in the diabetes landscape that needs real transformation. And while it seems unreasonable to add extra burden to those of us living with diabetes – after all, we are already expected to do so much of the physical, emotional, social, and political labour just to get by – community action drives change so often. We have had successful and coordinated community efforts to increase technology funding and access. Is our next frontier turning our attention to increasing funding and access to mental health care for people with diabetes? I know that some diabetes organisations have this in their sights, but without people with diabetes making noise, the campaign is only half-baked. Our voices amplify the urgency of the issue.

Today is just one day, but if RUOK? Day is what provides the gentle nudge to initiate these conversations, it’s a step forward. The tapestry of personal narratives, community connections and shared experiences form the basis of peer support. But not everyone has a safe space where they can share or the people to share with. Sometimes we need to reach out, extend a hand and signal we’re ready to listen. Keep reaching out. Today. And tomorrow. Every time you can.