A Type 1 diabetic of 5 (I can't remember the date now) years or so here, an expensive hobby being a diabetic

Using Levemir + Novorapid here

Most important is to get the basal insulin dosage correct - if you're taking too much and always going low, having to snack to top-up will for sure make you increase weight

Yup, but no matter how - sometimes highs / lows are unavoidable unless you stick to the same routine day in day out (with regards to food, sleep, excersize)

I'm going to be investing in a CGMS (constant glucose monitor) soon to help me improve control, especially overnight levels which are the trickiest ones for me.

http://www.dexcom.com/dexcom-g4-platinum

This post has been edited by rjb123: Jun 12 2013, 11:37 AM

Nope, it's like your normal glucose monitor - but you attach a sensor to your arm and it reads your BGs 24 hours per day. Although it does still need to be calibrated a few times per day with a standard reader.

I'm on injections and not planning to change to a pump - I think being able to read BGs 24 hours per day will be of more advantage to me than a pump

Also the constant monitoring system is expensive enough, not sure how much adding a pump into the mix will add.

That's one upside of being a Type 1 on insulin is you can get away with eating some things as you can bolus / inject for it extra

Just checked the price of the CGMS unit I mentioned (needs to be bough from UK)- damn expensive but probably a worthwhile investment to give more detailed information on BG readings

When living in the UK all my test strips etc. were free, since moving to Malaysia nothing more for free - I buy them in bulk in UK and send them by courier.

I tried to get a medical card here but as you can imagine , none are interested in covering existing conditions (understandably!)

The cost for CGMS comes to (in RM) 4600 for initial unit, 950 for 4 sensors , one sensor guaranteed to last 1 week but can often last up to 2, transmitter 1560 guaranteed for 6 months but works up to 12.

So total for a year excluding the initial cost is around 12-13k

Yep that's one benefit

But means (for me at least) all the strips + insulin have to be paid out of my own pocket.

This post has been edited by rjb123: Jun 12 2013, 05:45 PM

I'm not Malaysian so I don't think will be eligible to discounts / using gov. hospital.

I import my strips from UK - cost is approx RM60 for a pack of 50, most pharmacies I see here are selling at this price for only 25 pcs. The meter I use isn't available here but can buy it in UK too for cheap (RM70 around only)

Needles I buy a few hundred at a time - normally RM40-45 per box of 100

My Dexcom G4 is due to be delivered on Monday by DHL (unless it gets held up at customs)

Yep, I'm using the Accu Chek Aviva Nano meter from UK - you can buy the meter there for less than RM50 as they make the money from the strips (NHS in UK will give a Type 1 1 box of 50 per week FOC). Unfortunately the model is different to the ones available in Asia so I also have another meter I bought here for emergency.

Now I'm using the same meter, and buy strips from eBay in UK - last time purchased 30 boxes or so and send over all together by courier

Looks like my CGMS should be arriving by tomorrow, will need less strips and get a reading every 5 minutes

Durian has a lot of carbs actually - Low GI or High GI, still a lot of carbs

And I've fitted my first sensor just now - approximately 2 hours before I'll start to get first readings / calibrate

Yeah but you don't eat crabs dry - I mean 100g of Durian isn't much

Cooked rice has around 25g / 100G, raw rice 70-75g / 100G, 100G cooked isn't enough for a meal

Well in effect cooked / raw is the same , just the cooked one has water inside hence less carbs / 100g

If I eat brown rice I normally have a 100g raw portion, equates to around 300g cooked - for me 5-7U of Novorapid depending on time of day / activity level

The insertion needle on the meter is fairly long , after that the needle that goes inside is tiny (don't even get to see it, as it's inside the insertion needle) although the tool looks a bit scary at first - it's the packet on the left



You keep the sensor / transmitter on the whole time - it's waterproof. Once taken off you need to replace with a new sensor - sensor guaranteed for 7 days - although some people report getting up to 4 weeks out of it, hope I get as long as possible as they're not cheap to say the least.

Will update over the next few days how I get on ... today not the best start as woke up with a high BG (10.2) Unfortunately the first sensor I inserted had an error, so need to get that replaced

This post has been edited by rjb123: Jun 18 2013, 12:00 PM

I can only feel the adhesive / tape sticking the transmitter / sensor on to be honest - don't even notice the needle inside

Then again being a Type 1 I've injected myself so many times over the years I don't really feel those either anymore

It does feel a bit unsual to have something stuck to you though - I'm sure I'll get used to that part soon ...

This post has been edited by rjb123: Jun 18 2013, 12:10 PM

Yep, you get used to it

Good on you, but as a T1 unless there's a major breakthrough I'll be stuck on needles for a long time - or I invest in a pump but that is REALLY expensive

US coverage is more likely - but I doubt you'd get insured as a pre-existing condition unfortunately.

UK coverage only in some cases you'd get a pump - I was only ever eligible for the needles / insulin / strips , normally you'd only get a pump if your control wasn't that good as far as I know, or you had a phobia of needles. Same with CGMS like I just got, you'd only be eligible in UK if you were hypo - unaware.

I checked with Animas UK the cost of their Vibe pump (with built in monitor) - the unit comes to RM15K (double this price in US) and of course excluding all the consumables.

In the first year after initial diagnosis I thought the same too (although I wasn't overweight at all) as the BG levels seemed to control themselves pretty well, even if I forgot to inject after a meal by accident

Turns out it was just the "honeymoon period" unfortunately.

I noticed - I tried to apply for a medical card once which was rejected , they won't cover me at all.

There's a company called Interglobal that do offer insurance and include pre-existing conditions but the cost is high. Around 8-9K per year, and of course that would only cover emergencies etc. and not medication/supplies for ongoing conditions

First full day (well nearly, in 1 hour) of using CGMS - and it's proving to be useful.

Not missed a single measurement (12 per hour) and plots them all on a graph on the device / syncs to PC when connected

Woke me up beeping at 9AM this morning as BG was high (11.1 ) - it seems from looking at the graph my basal insulin drops me too low first which makes me have to top up before sleep ... then keeps rising from around 5-6 AM or so

Time for changing that - main reason I got this

Yep I'm on Levemir - it used to be perfect for me , 12U per day at first, and hardly any highs or lows - I guess that was my honeymoon period making things easier. A lot of people report having to split their dose in 2, in some cases even 3 during the day. If I take only a single larger dose either it drops me too much after a few hours, or will rise like crazy for the last 6-7 hours before the next dose is due

Due to that rise I decided to increase Levemir by 2U and move it along 3 hours earlier to 9PM so the initial low BG comes on earlier - that plan didn't work - got woken up to Low BG alarm at 4AM (around 3.4 or so)

Today going to reduce to 10U and see how I get on overnight. Very useful being able to see on a graph exactly what your BG has been doing , in the past was always guesswork!

This post has been edited by rjb123: Jun 21 2013, 04:22 PM