Quinte Insulin Pumpers Meeting Minutes November 16, 2005


On Wednesday, November 16, 2005, sixteen persons and their support persons
concerned with the delivery of insulin by means of insulin pumps gathered at
Holy Trinity Lutheran Church, 516 Victoria Avenue, Belleville, Ontario, 7:00 to
9:00 pm.  Those in attendance included health professionals, long term
experienced pumpers seeking and giving support, a person making inquiries about
potential pump use, and family and friend support persons.

Important Question

"Whom should you believe?"

It is up to the diabetic or the caregiver to study andÊgather informationÊabout
the disease and aboutÊindividual body reactions so that you are equally or
better informed about diabetes than the health professional with general
knowledge.  You must be your own best expert!

Special Guest

NicoleÊhad driven from Peterborough toÊattend.  She has been selected to be the
spokespersonÊon behalf ofÊdiabetes for the Medtronic Corporation.  She will
participate in the Minneapolis December internet presentation to 30,000 viewers
world-wideÊexplaining how the devices have helped her to manage her diabetes.

The MiniMed Paradigm REAL-Time Insulin Pump and Continuous Glucose Monitoring
System

Jill Milliken, RN CDE, presented the latest advances in diabetes management.

Continuous glucose monitoring is a method of assessing glycemic control, thus
enabling informedÊ therapy adjustment.

The technology of the CGMS systemÊwill soon be available in the Guardian RT
System to individual patients, giving them access to real-time glucose readings
and alarms around the clock.

A sensor is attached with an insertion device to the body at a site that should
be changed every three days.  Information about current glucose readings is
transmitted wirelessly through radio frequency to the insulin pump monitor.

Every five minutes, around the clock, an updated glucose valueÊwill beÊavailable
on the Medtronic 722 pump screen. You can alsoÊcheck glucose values during the
last eight hours.  Long termÊdata can be downloaded to a computer as well.  As
one personÊchuckled, "You won't be able to fib to your doctor anymore."

Real time alarms use either vibration or sound with adjustable volume to
indicate potential hypoglycemia or hyperglycemia. We heard that ascending or
descending notes in the alarms indicate if blood sugar levels are going up or
down.

Trend arrows on the screen indicate if glucose levels are going higher or lower.
Ê

Do a fingerstick test to confirm that action is required.

The patient remains in control.  The pump must be told what to do.

WithÊthe Guardian RT system,ÊtheÊwearer will make more frequent adjustments
ofÊinsulin delivery i.e.Êyou will bolus more often but in small increments. 
Basal rates can be set with improved accuracy.  Glucose levels willÊhave better
control. Diet and life-style will be adjustedÊas youÊcan see theÊgood effects of
these changes in the trend
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It's all about food.  Even the fragrance of dinner cooking can stimulate a
hormonal response in the body althoughÊno carbohydrates have been injested.

Be informedÊbefore purchasing an insulin pump.  Talk to other pumpers. Be
specific about which options you prefer. Negotiate.

Name Change

Disetronic is now Roche.

Newspaper Coverage

It was noted that in both the Ottawa Citizen and the Toronto Star,Êrecent
feature articles confused type 1 diabetes with type 2.  When we see such errors,
we should write letters to the editor to clarify the issues related to cause,
effect and management of diabetes.

Professional Development

Debbie Moffat , Shopper's Drug Mart Trenton, attended the Canadian Diabetes
Association meeting in Edmonton in October.

HealthÊprofessionals only from the Quinte Health Care Corporation will meet to
study diabetes care on November 25, 2005.

"Time Capsule" Approach for Insulin

To learn about a new form of insulin currently being developed, click on
<http://www.smartinsulin.com>www.smartinsulin.comÊ

Observation

High sugar levels can result in blurred vision and drowsiness.ÊÊ

Canadian Diabetes Association, Southeast Ontario

November 16, 2005, Joan Coyea  attended aÊmeeting at which, in honour of
NovemberÊbeing Diabetes month, David Townsend of the Canadian Diabetes
Association office, Kingston, was the guest speaker.Ê

Mr. TownsendÊis Regional Director of the Southeast Region, extendingÊfrom
Brighton, in the west, to Cardinal, in the east, north to Highway 7 and
including Kemptville, Ontario.  Kingston happens to be central.  There isÊno
money in the budget for a Belleville office, but if a cost-free site could be
located, a Belleville branch might be considered.Ê

David Townsend has a staff of four plus 600 volunteers.  There will be a
door-to-door canvass in November.

He stated that in the Hastings-Prince Edward region, there are 10,000 diabetics
of whom 1,000 are type 1. (Meeting Comments:ÊWith this population base, and
problems of distance, our area is severely under-serviced.  We lack a local
endocrinologist. When newly diagnosed, diabetics needÊto have easy access to
information and support such as are available from the Canadian Diabetes
Association in other centres. Potential diabetics require information on diet
and life-style to avoid diabetes and its complications.  A letter should be sent
by Quinte Insulin PumpersÊrequesting assistance from the national office of the
Canadian Diabetes Association.)Ê

According to the speaker, in Kingston alone there are forty youngsters with
obesity-related type 2 diabetes.

He said that the Canadian Diabetes Association is concerned with prevention,
management and ultimately a cure for diabetes.

The group was told that a  summer camp, Banting, is subsidized by the Canadian
Diabetes Association.  It accommodates 84 children so they can learn to manage
their own diabetes. (Meeting Comment:  Many children from this area choose to
attend Camp Huronda because ofÊits greater variety of facilities and extended
time availability.)

He said that diabetes is a killer, not just a "condition", andÊa major factor in
50% of heart related deaths, 75 % of amputations, 75% of kidney failure
requiringÊdialysis, as well as vision problems and erectile dysfunction.

Mr. Townsend stated that type 1 has an onset, usually in youth, as a result of a
viral infection at some point in the person's past.

According to David, 4Êout of 10 cases of type 2 diabetes are genetically
related. It used to skip generations; now, there is a direct diabetes link
between generations.  Aboriginal persons are particularly vulnerable.

He stated that for 6 out of 10 persons, type 2 diabetes is a preventable
disease.Ê

He advocated three balanced meals plus snacks, exercise and a reduction in waist
size. People with a waist size 40" or greater areÊprobably proneÊto type 2
diabetes.Ê(Meeting Comments:  Waist size for women should not exceed 38 inches.
ÊPhysicians will have to get over being shy about embarrassing their patients.
Waist size has replaced the BMI as a predictor of vulnerability to diabetes.)

According to Mr. Townsend, the Canadian Diabetes Association is supporting Bill
15 in the Ontario Legislature. This legislation, if passed, would
provideÊfunding for insulin pumps. (Comment:  The Yukon Territorial Government
has funded three insulin pumps to date.Ê)

Mr. Townsend observed that In Canada $13.2 billion is spent annually on
diabetes; Êthat's more than the entire military budget.ÊÊ

He reported that an amputation costs $74, 000; dialysis $50,000 a year.ÊÊÊÊÊÊ

Mr. Townsend stated that concerns have arisen with the Edmonton protocol.  After
3 years patients must return for a second islet transplant and after five years
only 15% are not insulin dependent.ÊÊÊ

The Regional Director referred interested persons toÊthe site
<http://www.diabetes.ca/getserious>www.diabetes.ca/getserious

Upcoming Events

Wednesday, December 21, 2005, 7:00-9:00Êpm Pot Luck Dinner January, 2006  No
meeting February, 2006 Family Skating PartyÊ