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    • 46 minutes ago
      Wanacure likes your comment at
      If you were to request the next available appointment with your T1D healthcare provider, when do you estimate the next available appointment would be?
      Being on Medicare and required to see my Endo. every three months, my next appointment is made prior to departure from my Endo's office.
    • 46 minutes ago
      Wanacure likes your comment at
      If you were to request the next available appointment with your T1D healthcare provider, when do you estimate the next available appointment would be?
      If I were not on Medicare, it would be difficult to get an appointment within 3 months, even in an emergency. In an emergency, they would assign me a nurse practitioner to see. It is possible to contact them through their "portal." Whether I get a timely response depends on whether there is a reliable nurse to respond.
    • 1 hour, 2 minutes ago
      Wanacure likes your comment at
      If you were to request the next available appointment with your T1D healthcare provider, when do you estimate the next available appointment would be?
      When I saw my endo a year ago, I wasn't able to make an appointment 6 months later because all available appointments were fully booked. I have to see her CDE who has more availability in order to meet Medicare requirements for quarterly visits. Many, many healthcare providers in my area burned out and quit during Covid. I injured my knee badly last June and can't get a consult with an orthopedic surgeon until May due to the backlog of people needing help. I'm on crutches until then. My sports medicine doctor stopped practicing medicine last month. Our healthcare system is in crisis with no solution in sight.
    • 1 hour, 3 minutes ago
      Wanacure likes your comment at
      If you were to request the next available appointment with your T1D healthcare provider, when do you estimate the next available appointment would be?
      On hold or actually talking about the issue and calling back to ensure someone follow's up as everyone seems to be over their head. Honestly, it varies. It can take considerable time just to raise the visibility of an issue, then the follow up can take weeks/months and patience to resolve. Another problem is patients without the cognitive skills for follow-up. These days i doubt anyone pays attention to them.
    • 3 hours, 23 minutes ago
      Wanacure likes your comment at
      If you were to request the next available appointment with your T1D healthcare provider, when do you estimate the next available appointment would be?
      I try to make my appointment for my next appointment when I check out. The scheduler always asks maki g it easier to remember. If I was to forget there would be a wait to get back int the rotation.
    • 10 hours, 32 minutes ago
      Greg Felton likes your comment at
      If you were to request the next available appointment with your T1D healthcare provider, when do you estimate the next available appointment would be?
      Before the onslaught of Type 2 Diabetes, I, as a T1D, could get an appointment almost anytime I needed one. Now, I cannot get an appointment within 3 months, which is the time within I must see rhe doctor for Medicare benefits. My doctor cancelled 2 (half ) of my sppointments last year. Caused ma a lot of problems. I live in Florida, a place where modern medicine does not seem to have reached yet.
    • 10 hours, 32 minutes ago
      Greg Felton likes your comment at
      If you were to request the next available appointment with your T1D healthcare provider, when do you estimate the next available appointment would be?
      I routinely see my Endo every three months. At the end of my appointment I schedule the next quarterly meeting date. But if I ever have to reschedule it, then it takes anywhere from two to four weeks to find a time that works for us.
    • 12 hours, 29 minutes ago
      Mike S likes your comment at
      If you were to request the next available appointment with your T1D healthcare provider, when do you estimate the next available appointment would be?
      It all depends on the urgency of my needs. I’ve gotten in the next day before, but those days may be gone! It also depends on who I see. But these days, even the PA is often booked. Of course, cancellations happen, so that can be a factor as well.
    • 12 hours, 45 minutes ago
      Jeff Marvel likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      The beginning of the year is always a bit iffy when you're on Medicare. Even though I've already paid my annual deductible, my pharmacy can't see that, so I must wait until it shows up on my Medicare account before I order new insulin. I always try to have plenty of insulin on hand at the end of December so it's not an issue. The organization I get my pump equipment from has a lot they must do because of Medicare, as well, and that can get time consuming. All-in-all, I'm lucky to have the time, energy and patience to deal with it, and I know up front these time-consuming moments are to be expected. If I wasn't retired, it'd be more of an issue.
    • 23 hours, 55 minutes ago
      Gerald Oefelein likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I selected 6 hours. So far, I have spent 6 weeks trying to get a new pump. I decided to look for a new pump in mid-December as my 770G warranty expired on January 3. I wanted to go hoseless with the Omnipod and the Dexcom 6. I contacted Dexcom and they sent me to the medical distribution company ASPN, and they could do the Omnipod but only with pharmacy part D with the Dexcom 6 sensor on DME My part D pharmacy plan had Omnipod as tier 6. $155.56 co pay and $150/month. The omnypod is not available as DME. I called INSULET the mfgr of omnipod. They told me they only supply via pharmacy plan to get more T2d's to sign up. Verses 100% DME coverage, part D coverage that was a non-starter. I contacted another supply company CCSmed. They could do both Dexcom 6 and tslim x2. Ineeded a Endo visit to get the notes and Rx. I had my Endo visit on Jan 20. Still waiting for CVSmed. Been waiting for 5 weeks now. Just called CCSmed and they got the endo notes and Rx but Medicare wanted to know who paid for my 770G 4 years ago. Fortunately, that was private/company. My new pump should now ship tomorrow. Finally.
    • 1 day, 3 hours ago
      Wanacure likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Most of the 3-4 hours is way ting on a phone
    • 1 day, 3 hours ago
      Wanacure likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I answered "No time," but I live in France, where we have a single provider. I receive a prescription from my doctor and go to the pharmacy monthly to have it filled. (Pump peripherals are provided by a separate supplier.) "Appeals" do not exist here since the doctor will only prescribe medicines that are reimbursed. And no, I have never needed a treatment that wasn't covered.
    • 1 day, 4 hours ago
      Wanacure likes your comment at
      When you experience an illness that makes your blood glucose levels more difficult to manage (whether because you are unable to eat, the stress of being sick, or any other reason), what resources do you refer to for help managing your blood glucose levels while sick? Please select all that apply to you.
      The resources I use in managing my glucose levels once sick is my own personal experience after living with t1d for 46 years
    • 1 day, 4 hours ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Switching to Medicare has created (seemingly) endless hours and day making this transition with all things diabetes related. We’re still in the midst of making this ā€˜delightful’ change. This week we learned that Medicare covers Either CGM stuff OR glucose test strips. Thank goodness that God is sovereign over all these details. He helps me walk through these challenges without despair.
    • 1 day, 4 hours ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      The last 3 months have been filled with frustrating phone calls now that I switched back to traditional Medicare from a Medicare Advantage plan. I have been fighting to get strips authorized in addition to CGM- they did not authorize them because I had no proof that I had a meter!! Crazy making! I had to write an appeal letter in order to get them, but finally got it worked out. I also had some pump replacement issues, trouble getting insulin, etc.
    • 1 day, 4 hours ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I answered "No time," but I live in France, where we have a single provider. I receive a prescription from my doctor and go to the pharmacy monthly to have it filled. (Pump peripherals are provided by a separate supplier.) "Appeals" do not exist here since the doctor will only prescribe medicines that are reimbursed. And no, I have never needed a treatment that wasn't covered.
    • 1 day, 4 hours ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Much too much time! Part of it, I know, is my own fault, for not keeping anxiety at bay when I have to sort out which plan will work best, annually. But it is something I dread, every single year. When I call to get some help understanding, the people are almost always very nice, but I have had times when the information was incorrect or not explained clearly. I usually commiserate with the person on the phone for having such an annoying system, and agreement seems to rule the day. But I never chose to make sorting out insurance management a career!
    • 1 day, 4 hours ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I selected 6 hours. So far, I have spent 6 weeks trying to get a new pump. I decided to look for a new pump in mid-December as my 770G warranty expired on January 3. I wanted to go hoseless with the Omnipod and the Dexcom 6. I contacted Dexcom and they sent me to the medical distribution company ASPN, and they could do the Omnipod but only with pharmacy part D with the Dexcom 6 sensor on DME My part D pharmacy plan had Omnipod as tier 6. $155.56 co pay and $150/month. The omnypod is not available as DME. I called INSULET the mfgr of omnipod. They told me they only supply via pharmacy plan to get more T2d's to sign up. Verses 100% DME coverage, part D coverage that was a non-starter. I contacted another supply company CCSmed. They could do both Dexcom 6 and tslim x2. Ineeded a Endo visit to get the notes and Rx. I had my Endo visit on Jan 20. Still waiting for CVSmed. Been waiting for 5 weeks now. Just called CCSmed and they got the endo notes and Rx but Medicare wanted to know who paid for my 770G 4 years ago. Fortunately, that was private/company. My new pump should now ship tomorrow. Finally.
    • 1 day, 4 hours ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      The beginning of the year is always a bit iffy when you're on Medicare. Even though I've already paid my annual deductible, my pharmacy can't see that, so I must wait until it shows up on my Medicare account before I order new insulin. I always try to have plenty of insulin on hand at the end of December so it's not an issue. The organization I get my pump equipment from has a lot they must do because of Medicare, as well, and that can get time consuming. All-in-all, I'm lucky to have the time, energy and patience to deal with it, and I know up front these time-consuming moments are to be expected. If I wasn't retired, it'd be more of an issue.
    • 1 day, 4 hours ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I said 8+ and the reason, as for so many others, can be summed up in a phrase: transitioning to Medicare.
    • 1 day, 5 hours ago
      Wanacure likes your comment at
      On a scale of 1-5, how satisfied are you with your current insulin delivery method (pump, pens, syringes, inhaler, etc.)? 5 = the most satisfied, 1 = the least satisfied
      I’m a reasonably satisfied MDI user with Lantus and Fiasp. I’ve looked into getting a pump but honestly, until I find one that does everything I want, I’ll probably hold off. My wish list for a pump: 1) no tubes 2) works well with Fiasp 3) controls that allow me to stay at my target of 70-90 mg/dl all night long.
    • 1 day, 5 hours ago
      Wanacure likes your comment at
      On a scale of 1-5, how satisfied are you with your current insulin delivery method (pump, pens, syringes, inhaler, etc.)? 5 = the most satisfied, 1 = the least satisfied
      MDI for the past 60 years and do not see any alternative that I would prefer. The needles for my pens are so thin and sharp that they are painless (a far cry from the lancets I once used). chiefly, I am glad not to have to deal with setting up a pump and. Although I love my libre, I am not good candidate for having devices affixed to me. If my insulin delivery got interrupted they way i have interrupted my cgm service, I would have been in trouble. Furthermore, I have a track record of having both mechanicall and electronic things malfunction. (Seriously, I sometimes act as a beta-tester for technology folks. Maybe I push to many buttons?)
    • 1 day, 5 hours ago
      Wanacure likes your comment at
      On a scale of 1-5, how satisfied are you with your current insulin delivery method (pump, pens, syringes, inhaler, etc.)? 5 = the most satisfied, 1 = the least satisfied
      I've had Tandem x2 and Dexcom since September. Previously on Medtronic for around 15 years. Grew to HATE the sensors and switched before the warranty on my last Medtronic was up. So far, I absolutely LOVE the Tandem and the Dexcom. I'm disappointed, however, in the amount of waste and plastic that this pair creates. Of course there will always be plastic waste from any pumps/sensors, but the amount of non-reusable stuff for insertions is ghastly.
    • 1 day, 5 hours ago
      Wanacure likes your comment at
      On a scale of 1-5, how satisfied are you with your current insulin delivery method (pump, pens, syringes, inhaler, etc.)? 5 = the most satisfied, 1 = the least satisfied
      Have your doctor prescribe the syringes with .5 unit increments instead of the 1 unit syringes. Not quite a .1 unit which you are hoping for, but .5 is better than 1 unit increments.
    • 1 day, 6 hours ago
      Ahh Life likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I answered "No time," but I live in France, where we have a single provider. I receive a prescription from my doctor and go to the pharmacy monthly to have it filled. (Pump peripherals are provided by a separate supplier.) "Appeals" do not exist here since the doctor will only prescribe medicines that are reimbursed. And no, I have never needed a treatment that wasn't covered.
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    Do you think it would be beneficial to have an automated insulin delivery device that also measured your stress hormone levels, and used that in addition to your CGM readings to dose your insulin?

    Home > LC Polls > Do you think it would be beneficial to have an automated insulin delivery device that also measured your stress hormone levels, and used that in addition to your CGM readings to dose your insulin?
    Previous

    If you have transitioned to Medicare from private insurance, did you at first have to go any amount of time without a pump or CGM because you did not meet all of Medicare’s coverage requirements?

    Next

    Do you usually suggest to your doctor what T1D devices/medications you want to use, or does your doctor tend to suggest to you which T1D devices/medications you should use?

    Sarah Howard

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    23 Comments

    1. ConnieT1D62

      Other. I am unsure what I think about an automated stress management feature as part of an insulin delivery device … Stress reactions and the release of stress hormones are highly individualized and unpredictable. Dealing with high and low levels of stress in everyday life is part of being human – do we need an insulin pump/cgm to monitor, measure and regulate the release of counter-regulatory stress hormones in us? Personally I think such a device feature could/would be unreliable and dangerous. People are better served learning & applying effective self-help stress management techniques to center, calm, and pace themselves in times of physical, emotional or psychological stress reactions.

      1
      2 years ago Log in to Reply
    2. Ahh Life

      ā„ā„ā„ Stress hormones I am not as familiar with as growth hormones. The sheer quantity of growth hormones that fluctuate by the minute would be tremendously helpful. Mine seem to elevate at 0530 in the morning and around 1300 or 1400 in the afternoon. Go figure? ā„ā„ā„

      2 years ago Log in to Reply
    3. Gary Taylor

      I am a pastor. I use Medtronic’s hybrid system. On Sunday mornings as I begin worship services my adrenaline kicks in and drives my blood sugars up even if I haven’t eaten anything. I often bolus phantom carbs to keep BG in range because the hybrid system cannot keep up. Something that accounts for the adrenaline would be very useful.

      5
      2 years ago Log in to Reply
    4. Anthony Harder

      I know stress affects my blood glucose, but it is very inconsistent. Sometimes raises, sometimes lowers, sometimes little effect on blood glucose. I sense this system is much more complex than a stress hormone level input and a blood glucose output. That said, we have to start someplace when figuring out complex systems. The initial model may be quite remedial, but it can be a knowledge building block.

      2
      2 years ago Log in to Reply
      1. Catherine Van Hove

        Anthony said exactly what I was thinking. At first I was going to say no I would not want to have a system controlling that decision but we do need to take a look at that if we are going to get better closed loop control. Well said Anthony.

        2 years ago Log in to Reply
    5. connie ker

      I have no idea because not only stress affects blood sugar #s. Lack of sleep, diet, exercise, all hormones, age, everything affects blood sugars for a T1D. It is hard to figure total coverage and automated insulin is still in the beginnings of clinical trials.

      3
      2 years ago Log in to Reply
    6. Philip Bunsick

      Lots of good comments. I said NA. To be honest at this point it is nothing but a hypothesis. I would have to see a lot of good data and animal and then human studies to be able to comment appropriately. For now I think it is challenging enough to manage my blood sugars on a day to day, hour to hour basis. But, if it can be proven that an algorithm and system can monitor stress hormone levels and it is proved it has an impact and I can improve dosing – of course I would go for it.

      3
      2 years ago Log in to Reply
    7. Sherolyn Newell

      First of all, thanks for adding the thumbs up and replies. I think I agree with pretty much everyone. But here’s a question. If stress starts making your glucose go up (or down), wouldn’t the closed loop system already be making adustments based on that? Isn’t there a possibility of too much insulin by adding for rising glucose and rising stress?

      1
      2 years ago Log in to Reply
    8. BARRY HUNSINGER

      I am not sure what benefit this would provide.

      2 years ago Log in to Reply
    9. Magnus Hiis

      I use FreeAPS from Loop, and i notice every now and then that I rise so much of cortisol and adrenaline that is hard to keep in range or even a little out of range.

      2 years ago Log in to Reply
    10. Carole Ludwig

      yes. It would be very helpful as I find that when I am stressful situations my blood glucose numbers go much higher and is hard to bring down. I can follow the graph on my Tandem pump and can correlate when the stress occurs.

      2 years ago Log in to Reply
    11. Janis Senungetuk

      Yes, I think it would be helpful. All efforts to personalize generic AID algorithms will increase the value of using a closed-loop system.

      1
      2 years ago Log in to Reply
    12. Sally Numrich

      It might. Problem for me over the years, sometimes stress drives my blood sugars up & wow some wicked lows due to stress. This was before CGMS. Now with a CGM it might not be an issue. The reality to blood sugar management, the human body is very complex. Everything ties together, if one thing is out of sync, it will cause other things to be out of sync.

      2 years ago Log in to Reply
    13. Michelle Litzau

      This would be a game-changer in the way the pump and CGM were when introduced. Many T1Ds have Schmidt’s Syndrome, a combo of T1D + Hashimoto’s + Addison’s (Primary Adrenal Insufficiency), requiring us to not only estimate and dose insulin 24/7, but also replacement steroids for our inability to make cortisol. Unlike T1D, there’s currently no testing option for making educating stress dosing, treatment is similar to how we dosed insulin prior to the invention of quick-acting modern types available today; standard dosing at standard times of day as a baseline treatment, and up-dosing for stress based on situation and interpretation of symptoms. If we had the ability to measure stress hormones on board, it would change the quality of life for many – especially those of us who rely on guesswork to dose steroids, which significantly impact bloodsugar levels in both directions.

      2 years ago Log in to Reply
    14. Donald Cragun

      Sometimes stress raises my blood sugar and sometimes it lowers my blood sugar. I would hope that tracking the changes in blood sugar would trigger the correct response by an AID no matter what caused the change (without needing to add another sensor to the equation).

      1
      2 years ago Log in to Reply
    15. Amy Nance

      Only if it measured estrogen-testosterone. Women have a much harder time than men due to the fact of fluctuating hormones every. Single. Month. A man definitely wrote this question.

      2 years ago Log in to Reply
    16. KarenM6

      Just on Monday i said to a nurse preparing me for surgery, “I don’t know how to bolus for stress.”… so, yes to the hundredth power, that would be helpful!!

      2 years ago Log in to Reply
    17. Retired and glad

      I don’t currently have an AID, just my insulin pump and a CGM. Therefore I don’t know much about the theory of closed loop systems. However, it seems, as others have stated, that the system should be monitoring for highs and lows, and compensating, regardless of what are causing them. Is that too simple of a theory?

      2 years ago Log in to Reply
    18. Randi Niemer

      I really don’t know. My gut says no, but maybe it would be good for some people.

      2 years ago Log in to Reply
    19. Britni Steingard

      I don’t know. I don’t really understand how stress affects my blood sugar. I’ve noticed my blood sugar level going low in high stakes situations in the past, but the literature says stress leads to a rise in blood glucose.

      2 years ago Log in to Reply
    20. Mary Ann Sayers

      YES of course! (I laughed at Amy Nance’s comment that the question had to be written by a man)! When I
      had my periods, my bgs were on a constant rollercoaster.
      Today, 66 years of T1D has taught me the effects of hormones and of STRESS. When I eliminate the amount of food, possible illness, or lack of exercise as the cause of elevated bg, the ONLY element I think I can’t is STRESS!!! I would love to see a device that could do that!!!

      2 years ago Log in to Reply
    21. Nicholas Argento

      The effects of stress are far too variable and unpredictable to be able to effectively change insulin pump programing, in my view.

      2 years ago Log in to Reply
    22. Sahran Holiday

      Need to see the what hormones are measured and how. Am aware that severe hypoglycemia increases adrenalin and subsequently might require higher insulin doses. Have not seen the research.

      2 years ago Log in to Reply

    Do you think it would be beneficial to have an automated insulin delivery device that also measured your stress hormone levels, and used that in addition to your CGM readings to dose your insulin? Cancel reply

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