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New T1D

Discussion in 'Introductions' started by AliciaM, Jul 23, 2013.

  1. Helenmomofsporty13yearold

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  2. AliciaM

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    Thanks for the links I will check them out for sure! I definitely am NOT going to give up cheer. I have had a few rough spots but its good that it's only summer and I can test lots at practice. May be a bit harder when competitions start. They are beyond hectic and I coach too so I'm always running around. I got an email from dexcom canada rep and he said the dexcom cgm will be out in september so I'm going to ask my endo about it. I know it doesn't replace finger checks but at least it can alert me more if I'm going low or going high ya know?

    And I'm not near trillium. My original referral to the endo was one who had type 1 also but her wait was SO long because she's the head of the dept etc big hospital so I got a referral for another one and see her in a few weeks. I'm in ottawa so we have a huge lack of specialists here and GP's for that matter..I JUST started seeing a new GP because was frequenting a walk in before and that's not convenient at all...

    Since you're in ontario do you know how strict they are with this whole 1 year wait for pump thing from OHIP?
     
  3. C6H12O6

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    I know of cases of them waiving the 1-year requirement, but it was for a baby.

    ADP is not OHIP, although it is part of the MOHLTC

    Do you have a confirmed appointment with an endo ?

    In some cases the CDE is actually the one who makes the decisions on insulin types and doses. Although, they are not the prescriber they fax the CDE faxes the dose and type to the GP and the GP signs off on it.

    This is even the case with some endos, the CDE sets the dose and type and the endo signs off on it.

    Not all endos can even prescribe pumps under ADP. You might want to check if the endo you have been referred to is even ADP approved. Likewise there are a lot of non endos (internal medicine doctors and paediatricians ) that are ADP approved to prescribe pumps.

    Example http://www.health.gov.on.ca/en/public/programs/adp/docs/adult/toronto.pdf here is the list of clinicians that are ADP approved for Toronto
     
    Last edited: Jul 29, 2013
  4. AliciaM

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    AH Yes that is what I meant ADP not OHIP. I am extremely well versed with ADP's process and procedures. I don't know if my endo is ADP certified..good question. I will ask and my gp said as soon as she gets the bloodwork back within a few days of it being done then the following week they would call to schedule the endo appt within a month. I got the bloodwork last week done for the referral so they should call me this week!

    I've used ADP for my hearing aids and assistive devices for the hearing aids. I also receive ODSP because I've had a lot of trouble with having to upgrade hearing aids 4 x in the past 6 years..gets expensive. I don't know if being on ODSP helps getting the pump quicker than having to wait the 1 year but I know ODSP usually only pays for stuff if ADP is partly covering ..so I doubt I can get by the 1 year waiting period...darn..
     
  5. C6H12O6

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    I was in touch with my local animas rep today and he said that is not at all accurate about the vibe, he confirmed that to the best of his knowledge the newest dexcom unit will be out in the fall and that is the extent of what he knows.

    But he made no suggestions about when the vibe will come out, he just emphasized that the dexcom as a stand alone will be a great alternative to Medtronic cgms and also said getting the blinded i pro unit from your clinic (on a temporary basis) is a good option too.

    I brought up that dexcom reps were talking about the vibe released and you could tell he was really not impressed that was the case and was wanting me to name names. I said I just heard this second hand.
     
  6. AliciaM

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    hmm ok good to know! and what is an i pro unit? And ya I've heard much better things about the dexcom than the medtronic cgm from people who've used both..well not heard but from reading on websites and blogs and peoples experiences ..the dexcom is favored much more from what I've seen than the medtronic.

    I definitely am going to ask my endo about the dexcom and this i Pro? I am finding it extremely aggravating the highs i go through at cheerleading and then the lows from coaching..
     
  7. C6H12O6

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    To the best of my knowledge I pro is a blinded cgm. I believe it is a Medtronic product.

    You wear it for a certain period, and then return it to the clinic and then they analyze the data and look at patterns.

    I have heard of cases of them using it for diagnostic purposes like to diagnose reactive hypoglycaemia, or say in situations like yours where the a1c is in the normal range but there is dysglycemia.

    Have you had any antibody testing done? Antibody testing is the norm now in Canada for anyone over 12 who present without ketones. It would probably be helpful to have these results in advance to your endo appointment.

    - have you been able to get you endo appointment yet ?

    Btw if there is suspicion that the a1c is not accurate there is also a glycated albumin test available
     
  8. C6H12O6

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  9. AliciaM

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    thanks for the link :)

    Met with my nurse practitioner at my GP's office and went over my meds I was on for my endometriosis and then went over my meter as well. She agrees that I've had WAY too many highs. I've had over 25 highs since last friday and only 18 in targets and 3 lows. So she is putting in the request to my endo to prescribe the dexcom when it comes out (I see endo oct 4th) and she also made a note for my to start a long acting as well. So I start either levemir or lantus on tuesday and hoping I get some better bg's in the next few months. I had another bad low today that I didn't feel again ..starting to really frustrate me that I don't feel the lows. The nurse also prescribed me glucagon :)
     
  10. C6H12O6

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    How many times a day are you testing ? Just so you are aware they are going to cap the number of test strips you can get to 3000 per year if you are on a government funded drug plan

    I would not go off of the advice of an RN EC unless she is also a CDE. CDA targets for a post meal BG is 10 / 180. So if you are defining 10 as a high it gets a little bit tricky

    Also, if your B12 is low is your iron low ? bc meters are not accurate if your Hematocrit is low
     
  11. AliciaM

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    I have my ODSP coverage and I have work coverage for strips. My b12 is good now according to my GP and my iron was not a problem before no, just my b12. I test anywhere between prob 5-8 times a day. The RN I saw is also a CDE yes, my office has a dietitian and endo in it as well so they wanted a dual RN/CDE instead of having two separate ppl I'm guessing. I also got a cancellation so I see the Endo I originally wanted to see for tomorrow so that's nice :)
     
  12. C6H12O6

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    please keep us posted on what the endo says, and what extra tests they order.

    with your hearing impairment there could be other stuff at work here. I guess the endo will know more about the a1c being 5.8 and why that would be

    good luck at your appointment

    - I think once the gov't says 3000 a year is acceptable then private insurances will follow (considering a lot of drug plans follow the Ontario drug benefit formulary)
     
  13. Megnyc

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    I would request a fructosamine test.

    http://labtestsonline.org/understanding/analytes/fructosamine/tab/test

    Also, you should make a seperate post about how you are getting insurance coverage for the dexcom. We have several posters here from Canada who haven't been able to get CGM coverage and I'm sure they would be interested.
     
  14. AliciaM

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    Well the dexcom canada rep said when they launch the G4 there will be an insurance verification set up like animas does. They'll contact your insurance for you etc. I doubt it will be covered because like you said a lot of ppl have trouble getting it covered. If it's not covered (i have GREAT coverage through the bank) I will pay out of pocket for the CGM.
     
  15. C6H12O6

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    how did your endo appointment go ? :cwds:
     
  16. AliciaM

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    It went great :) have another appt in 2 months. She ordered a full round of antibodies and c-peptide and a1c.
     
  17. C6H12O6

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    great :cwds: did she prescribe basal insulin ?
     
  18. AliciaM

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    ya I put it in my signature I'm now on lantus :)
     
  19. C6H12O6

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    That is great I hope you are feeling better. :) How many units of lantus ?

    Feel free to join into the message board more often (I am sure you have a lot of insight as a young person navigating type 1 on her own).

    Like Meg said a lot of Canadians will be interested in your experience getting the cgms through insurance bc it is not that common to get coverage here.

    I am also going to be looking at funding options for the dexcom in the fall. I hope the dexcom release date that has been proposed is accurate, because as you will learn in the diabetes world these dates are often not as accurate.

    I will wait until the fall and then look into the standalone guardian, bc I am in the process of getting an animas pump (after 8 years 13 years on another pump)
     
  20. AliciaM

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    well I don't think I'm going to get it through my insurance for sure yet. I will need to wait and then I'll get dexcom to do the insurance verification. I will still get the dexcom though even if my insurance does not cover it as I would just feel more comfortable having it.

    I'm doing 4 units if lantus but I had to split the dose. I tried for the first few days but it wasn't lasting all day and someone suggested splitting the dose and that seems to work better so I take it at 11 am and 11pm.

    I will start posting more but I'm just worried as someone new I'll say the wrong thing or something! But I will start to participate more..so far I read a lot! :D
     

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