InsuCalc: My Favorite Gadget from the ADA's 73rd Scientific Sessions
I’m just home from attending the ADA Scientific Sessions, which is a huge international event focused on diabetes. Approximately 20,000 people attended the conference and it is wall-to-wall diabetes. I feel like I have a diabetes hangover due to the intensive learning, sampling and networking.
Probably the coolest thing about this conference is the vibe and chatter everywhere dedicated to diabetes. It’s lots of science, but it is also wonderfully emotionally supportive, especially when you step into the exhibit hall.
The ADA exhibit hall is huge, with hundreds of vendors, ranging from the major pharmaceutical companies to small start-up businesses. This year, I skipped out on lectures in favor of walking the exhibit hall and talking to vendors until I couldn’t take anymore in.
The exhibit hall is designed to encourage communication and meet-ups by having charging stations for computers and phones, free wifi, coffee and food vendors for grabbing lunch or a snack (or to ward off that pesky low blood sugar). Speaking of, Cherise Shockley and I seemed to suffer from low blood sugars the entire time we were there! Our Dexcom screens looked like a mirror reflection. Twitter was a great way to shout for help if you needed a glucose tab, or suggestions for which booth had samples for just such things.
In the exhibit hall, there was BioRad, where you could get a free A1c test, a podiatry booth for foot inspections, and, of course, products of all kinds. Some of the companies were showing future products for people to look at and discuss.
While wandering around the ADA conference, I ran into a friend who is a pediatric nurse and CDE, and she asked if I knew of an app that would help calculate bolus rates. One of the advantages of using an insulin pump are the programmed calculations in your pump. Insulin sensitivity, basal/ bolus rates, bolus wizard, and my personal favorite “insulin on board.” When you go off the pump, you have to teach yourself all those calculations and then either keep them handy, or memorize them. There is the potential for human error, which is frequently the problem for non-pumpers.
Why is it that a medical device company can plan this into a pump and make it meaningful to people with diabetes, yet pharmaceutical companies, who make insulin, don’t support people using MDI, multiple daily injections? Why not an bolus app for people using MDI? Wouldn’t it be great if we had an app that would let a doctor and/or CDE program their patient’s personal calculations into the app to help teach patients how to avoid those screaming lows from the over-bolus trigger monster that sits in your fingers? That would be a step in the right direction, since, after all, they make the insulin that causes the hypoglycemia in the first place!
However, there is a work around to this problem. I met Dr. Doug Nelson, a pediatric endocrinologist, at his booth featuring a product called InsuCalc. What a treat this concept is. Insucalc is a pocket-sized insulin bolus dosage calculator for bolus insulin regimens.
This cool little wheel sets up your mealtime calculation by using the amount of insulin needed based on your blood sugar reading, against carbs to be eaten and your sensitivity. There are 12 separate combinations of wheels to meet everyone’s sensitivity requirements. The only caveat is that this calculator needs to be sold through your doctor’s office.
In the few days that I've used the calculator, I have noticed how many times I was about to over-bolus. In fact, the first time I used it, I thought it was wrong and so I paid the price. The second time, I was spot on with hardly any post-prandial spike. I tend to worry about a huge spike, so this little wheel of good fortune has brought my awareness into check and I’m much better at thinking through my calculations.
I hope that doctors will package these calculators into a starter kit for newly diagnosed patients who are using MDI, or those with type 2 diabetes starting on mealtime insulin. If the $36 cost of the calculator means tighter control with fewer lows, it's a worthwhile investment!