Got questions about navigating life with diabetes? You've occur to the right place! You know… information technology's Call for D'Mine, our weekly advice column, hosted by veteran typewrite 1, diabetes author and pedagog Wil Dubois. This week, Wil's offering some advice about new pumps and their little-read program line manuals, as well Eastern Samoa insights almost wrist-style blood insistence cuffs and what they signify for mass with diabetes who are prone to circulation concerns.

{Got your own questions? Email us at AskDMine@diabetesmine.com}

Jody, type 1 from California, writes: I was indication the non-automatic for my calendered new t:slim insulin heart and came across the following: "Always dispose of used cartridges and infusion sets pursual your community's regulations. Insulin can be absorbed through the skin, so wash your hands soundly after handling any insulin-holding device." Is this true? The part virtually the insulin and skin, I mean, not the part about the disposal regs.

Wil@Ask D'Mine answers: Get outta' town! You actually read the manual? Hell, I don't even remember acquiring a manual with my vitreous recently t:slim. (Alert for readers living under a rock: All t:slims are revolutionary. All t:slims are shiny.)

Oh… wait a sec. Here it is! The manual is on one of those funky how-do-you-do-tech USB line of work cards. Appropriate for the advanced Applesque pump, I suppose. Let me check. Delay connected a sec while I connect my User Guide… Oh how playfulness! You can turn of events the pages barely like a factual book. But better, because it's searchable, and you are right. On page 15 they warn us to moisten our paws if we happen spill insulin on them.

What? You didn't live I had returned to pumping? Ohio yes, and seek an in-the-trenches reexamine of the t:slim right here at the 'Mine in the coming weeks. I just want to get a petty time under my belt… fortunate, connected my belt out… before writing astir it. But I'll tease you away expression my first impression was that all the things I sentiment I wouldn't like-minded about it are not-issues, and that it's great for acquiring attention from the ladies—at least the ones with diabetes. I've never had and then many women want to press my buttons earlier. 🙂

Life is good. Simply we've gotten off give chase.

Can insulin be absorbable directly through skin? To be honest, I'd never heard that before. Nor could I find any time-tested sources that mention this possible action. After all, skin is a really tough barrier. Its job is to keep stuff outside of your body. Wait a sec, you say, what about wholly those medicine patches? They deliver meds through the skin, right?

True, all kinds of slim-speck meds lavatory cost delivered through the skin, what's called transdermally, via patches. The best example is the nicotine patch for those of you having trouble with your New Year's quit-smoking resolution. There are also patches for hypertension, Alzheimer's, ADHD, economic crisis, and motion sickness. Vitamin B-12 can be had in a patch, every bit can the coercive opioid pain killer Fentanyl.

And in that respect's a testosterone patch, excessively. I only cite this because, like insulin, testosterone is a hormone. Testament we someday go steady an insulin patch? Maybe. The problem is that insulin is a pretty big-ass molecule. Most transdermal drugs have a relative molecular mass (a.k.a. "sized") of less than 500 Daltons (a unit of relative atomic mass). Insulin has a large weight of 6,000 Daltons.

Acquiring insulin through with the skin is kinda like trying to ribbon a rope through the eye of a needle.

Only there would be very much of money to be made if you could figure out how to know, so the Pharma common people are working on IT mean solar day and night. One of the insulin patches in development is genuinely more of a skin-worn reservoir that requires a "blast" from a audible applicator to pioneer skin pores. Sounds equal a tool right out the the Brit Sci-Fi computer program Dr. Who. Some other company has developed a different approach that works on pigs to piggy-game (pardon the pun) bigger molecules through the skin aside hiding the insulin inside a specialized form of tocopherol—but this is some solid scientific black magic. It's a far cry from spilling whatever Novolog along your laurel wreath.

Now, if you had a bracing, open injure, and poured insulin into information technology, that would exist a Equus caballus of another color. It would be an extremely crude mode of pickings intravenous insulin. I bet it would sure as Hell lower your blood glucose, but I don't think this will get along the standard of care anytime soon.

So I have no idea what the Tandem common people were thinking when they put that into their slick, how-do-you-do-tech manual. Maybe it was written by the same folks who wrote the original return policy. Serves you right for reading the hand-operated in the first place, Jody. Hopefully, the rest of the advice in it is better.

Anyway, it would seem that the worst thing that will happen if you get insulin connected your hands is that you'll smell like Band-Aids for the rest of the day. But, of course, you should hush up wash your hands before checking your blood line kale, for accuracy reasons.

Moving up the physical structure to the articulatio radiocarpea, I found this query in my inbox at the clinic from one of the nurses early day:

Kristy, nurse type from New Mexico, writes: I read somewhere that we shouldn't use the carpus-style pedigree blackmail cuffs for diabetes patients because reduced peripheral device circulation will throw off the results. Is that true ?

Wil@Ask D'Mine answers: For Divinity's sake, we don't totally have complications! And eve if we did, how much decrease in circulation could there possibly be between the upper subdivision and the wrist?

I couldn't find the place she read that, and she didn't remember where she'd seen it, either. I scoured the Cyberspace until I ran taboo of caffeine, and then eroded some more until I drank overmuch whiskey and fell drowsy at my keyboard. I didn't find much.

Only here's what I learned: Blood squeeze machines in general are suspect when it comes to truth, compared to the manual method done well, and wrist machines even more so. Apparently, the echt key to an accurate version on a wrist unit is to get the damn thing right deep down level, something historically problematical to do with radiocarpal joint models. The newer ones have a sensor that lets you know when you've got it in just the right position, and this is said to do much to upwardly the accuracy of the wrist-style design.

As for the arm type automobile-cuff, it's important to use this kind right, too, and virtually the great unwashe plain wear't, as acquiring it onto the arm right is a challenge. I could see where a so-so wrist unit exploited aright could easily trump the accuracy an arm unit exploited poorly.

Today you might have noticed above that I said "when done well," when I was talking about the Gold Standardized of manual blood pressure reading. You know, the kind using a stethoscope, a good venerable-fashioned dial, and through with by a somebody wearing scrubs. But guess what? Between equipment errors, mistakes made by the somebody taking the parentage pressure, wrong cuff sizes, and white coat syndrome—a great percentage of rakehell pressure readings in clinical environments are but plain wrong.

As a matter of fact, the only place I found anything that even came close to beingness virtually US D-common people and wrist blood squeeze cuffs was in the extremity for one of the more hi-tech wrist monitors, the Omrom Series 7. IT states, "If you have a condition that English hawthorn via media circulation, you may get an inaccurate reading with this twist." Of course, on the same page it says, "If battery fluid should render your eyes, immediately rinse with plenty of unsoiled water. Contact a physician now." Ya think?

At the same time, these kinds of systems are sold past Earth Diabetes Wholesale, Diabetic Care Services, Typefree Diabetes Superstore, and everyone other who makes money murder us. An turnout called Diabetic Supply of Suncoast, Inc., even makes a wrist unit.

So what does all of this mingy? Equivalent so many different things in diabetes, it's all quicksand. If you are going to use a carpus model, spend a little extra and get a really good ace, read the manual of arms, and so use it "just."

In the end, I think that oftenness trumps accuracy. You'll learn much at home from frequent readings that are less than perfect, than you will from a perfect reading four times a year at the doctor's office.

"This is not a medical examination advice tower. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. Only we are non MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Penetrate line: we are merely a teensy part of your total prescription. You still need the white-collar advice, treatment, and care of a licensed medical professional."