DexCom CGM: Buy 4 sensors get 1 free offer
DexCom is offering a free sensor with your next order of four. This buy 4 get 1 free promotion seems to be an effort to get customers introduced to their new online store. Looks like you just have to register and then place your order via that online store. The offer ends in March 31, 2012.
If you are an adult (users under 18 see below) DexCom user this is a no-brainer, we've all been waiting for the company to set up an easier way of placing an order. Now you'll be able to order online or set up a auto-reorder. You can visit the DexCom website and choose the link that looks like the image below (they banner rotates), it will take you to this link.
Now if you are the parent of a Dex user things get a little confusing but you can still easily take advantage of the offer and set up an auto-reorder (they call it 'Schedule Ship'). Since minors can't register to make purchases through their online store the form on the website is not going to help you. I had to call customer service, wait for a call back, etc. I asked my CSR if there was an easier way for the parents that read my site to take advantage of this offer, he and I came up with this...
Parents of minors that use DexCom can take advantage of the buy 4 get 1 free offer by simply calling...
Brian at 877-339-2664, extension 5561
Tell Brian that you were sent by Scott from Arden's Day, that you would like to set up a Schedule Ship and receive a free sensor as part of their offer. Brian will email you the 'Schedule Shipment' form, you send it back to him and you'll be finished signing up for their Schedule Ship program... getting your free sensor in the process.
Speaking of free stuff:
Apidra is free until 4/30/12
I have a 3 year supply of Spring's Universal Infusion Sets to give away
Trusted my instincts
Last night before bed, Arden's BG unexpectedly spiked up. I resisted the urge to play it safe and trusted my instincts to bolus. I covered the high BG and encouraged a small snack that I did not cover. We had an early dinner and while I didn't understand the spike I knew that the insulin without anything in her stomach would likely cause a low later. So I popped some corn and Arden had a few (of her) handfuls with melted butter to get some fat into the mix.
I must have been a bit unsure initially because I posted on FaceBook that I just bolused and didn't know what to expect. Two hours later her BG was in a good place and drifting gently to where she woke this morning, 85.
This morning she woke up in such a pleasant mood and immediately began talking about all sorts of funny stuff. She hopped out of bed when I asked her to, didn't linger in the bathroom or mess around while she ate... she didn't even complain about brushing her teeth! All of that makes me wonder just how much varied and fluctuating blood glucose levels effect her personality, mood and feelings.
Free* Apidra from now until 4/30/12
I just got my card. It only took a few minutes...
All you have to do is go to this link and answer a few simple check box questions. The system will then generate a printable card for you to take into your Pharmacy and just like that your Apidra is free! Visit the link to get your card now and for more details. There is a bit of fine print... I've included some of it below.
If you want to know about more offers in the future please follow me on Twitter, FaceBook and Subscribe to Arden's Day - links are in the sidebar to the right.
Please use the "share article" link just below to spread the word.
From now until April 30, 2012, Apidra® vials are free for patients with commercial insurance*. ACCESS also provides Certified Diabetes Educators for on-demand support and counseling.
*Offer is not valid for patients participating in Medicare, Medicaid, or any other federal- or state-funded benefit programs. Offer not valid in MA (except for cash-paying patients). Void where prohibited by law. Cards are the property of sanofi-aventis, and must be returned upon request. Both parties reserve the right to rescind, revoke, or amend this program without notice. Maximum offer value $250 per prescription. Cards valid through April 30, 2012.
I have not been compensated in any way for this post. Just good information for our fellow insulin users.
Apidra Blog ptII
Back in February I wrote about my experience with changing from Novolog to Apidra. This post is a continuation of that writing...
This part of the story begins in March. Arden had her endo appointment in March and though I knew we hadn’t been using Apidra long enough to see any improvement in her A1C, I was stunned when her test came back 0.8 higher then the previous quarter. Shocked is actually too polite of a word, I was devastated. Arden’s A1C had always been within .3 of her original test (after diagnosis). It’s not as low as I’d like but it is in the lower portion of the range for her age. Always room for improvement but not bad to say the least.
I promised our NP three months ago that the Apidra was working much better for Arden then the Novolog and I said that we would definitely see a better number at her next test.
Which brings us to yesterday...
Arden’s A1C dropped .9 to 8.0, which is .1 lower then the test from six months ago and the lowest number that she has had since mid 2009, in fact, it ties her lowest number ever. and here is, in my opinion, why...
(For Arden) the Apidra has a shorter action time then Novolg but more importantly it doesn’t have a tail like the Nov did and it doesn’t cause accelerated declines. Here’s something that the CGM users will gasp at... Arden has only seen three, that’s 3, double arrow down readings on her DexCom since we switched to Apidra. For my money that’s a huge improvement because it allows me to be more aggressive with borderline BGs. I wouldn’t have had the nerve to bolus those numbers with Novolog.
Some more reasons why Apidra helped me bring Arden’s A1C down.
Shorter action time allows for quicker readjustments of poorly calculated meal boluses.
No significant BG declines allow for less overnight bolus stress.
Slower acting time allows for very aggressive pre-meal bolusing.
As mentioned above, adjusting borderline BGs is less frightening.
Fasting BGs are beautifully steady.
Our NP told us yesterday that even though the literature she refers to doesn’t show a statistical reason to suggest Apidra over Novolog, she just switch another patient based on Arden’s results. In the future if you are interested, I think I’d like to take each of the above bullet points and expand on them one post at a time. Thoughts?
The stuff at the end - I’m not nearly a medical person. I’m just a guy that takes care of a little girl with type I... I just happen to have an opinion, a keyboard and an idea about how to post a website. Please do your research, speak to others and then go over everything that you’ve learned with your healthcare professional. Please also know that this site is not supported by any ads, hand outs or pressure from any pharmaceutical company or device maker. I’m just trying to spread good information to the people that need it the most, as best as I can.
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The following are archived comments from this post. You can post new comments below.
Hi! Just popped over from D-Mom's Type 1 Tuesdays. So glad I did!
Bean (my 7yr old) has been using OmniPod for 9 months and we're on week two with the DexCom. I always 'knew' that she would spike after a meal, but to SEE those mountainous graphs are just plain yucky! I was figuring it might be that her basals are off or her ratios needed to be tweaked, but now I'm thinking it could just be the NovoLog. Her averages are pretty good, but those mealtime spikes are wreaking havoc on her, her A1c and me!! ;)
Thanks for sharing your experience. Apidra is definitely on the list for our next appointment!!
Tuesday, July 12, 2011 - 06:17 PM
We are indeed needed to change every 2 days now and it is decidedly because of the insulin change. I was very resistent to draw this conclusion as I know there are others, like Arden, who do not have this issue.
Caleb never did gets alarms though. Just unrelenting highs at the magical 48 hour mark.
It's definitely made everything "softer" though, like your point about calmer overnight corrections. I don't think Caleb ever had a lot, if any, double arrows down before, and I can't remember seeing double arrows in any direction in a while for that matter. :)
Tuesday, July 19, 2011 - 04:54 PM
Scott
How are things for Caleb since to 48 hour pod changes or did you switch back?
Friday, July 29, 2011 - 01:13 PM
Apidra v Novolog
I'm always saying that we (the parents of type I children) shouldn't make the mistake of becoming complacent when it comes to the methods that we use to manage our children's type I. I put my money where my mouth is last week and tried the insulin Apidra in place of the Novolog that Arden has been using since day one of her diagnosis. This is what I've learned after twelve days of using Apidra...
Our experience with Novolog was mostly good but I always thought that there was room for improvement. I knew what Novolog was going to give me and there was comfort in that, however the spiking and dips were just too severe at times.
Let me stop for a second to say this: I am not a doctor, in fact if you ask my wife I may be a moron. You should not take any of what I'm saying as medical advice and as a matter of fact, none of the steps that I took to come to my conclusion were scientific in any way. That aside, I know what I know, saw what I saw and I believe that you'd do well to speak to your endocrinologist and bring up what you've read here. I think that you'll be happy that you did.
Back to it...
Arden uses Novolog in her OmniPod insulin pump. After a bolus the insulin seems to begin working in around 20 minutes and it picks up momentum (like a freight train), peaking between the 1hr 45min mark and the 2hr mark. The trouble with the Novolog is that it sometimes drags Arden down over the third hour in a significant way.
Every time Arden eats we pre-bolus, eat, watch the BGs spike or gradually rise, then watch them level off, later the BG drop occurs and then the gradual decline over the third hour finishes the ride. This all makes eating a meal a three + hour process and since there are three meals a day, well you can do the math. Even worse, if I miscalculate the carbs, more insulin may be needed and you can't bolus with any certainty until the three hours has elapsed. You all know the feeling - do I live with the high a little longer or bolus and catch the low later? There is nothing fun about this...
By it's nature Novolog also makes a pre-bedtime correction a very scary proposition because you can't be 100% sure that the third hour of the bolus (most call it the 'tail' of the insulin) is going to happen, and if it does happen - will it be severe, gradual, take the user too low... it's a mess I tell ya.
Now of course man made insulin isn't perfect and Novolog is very good and I am grateful for it but in my opinion the Apidra has a slight edge over it in two ways. Here is how...
First, Apidra is gradual. I can watch Arden's BGs on her DexCom 7+ CGMand the Apidra is smoother then Novolog. After a properly pre-bloused meal Arden's BG rises gradually, not sharply like with Novolog and the decline is the same. Her CGM line now looks more like a rolling hill then a mountain range at meal time.
Second, there's little to no tail and Arden is experiencing a much shorter insulin action time with Apidra (two hours) vs. Novolog (three hours). Apidra seems to be finished doing it's business in two hours and if there is a decline in the third hour it's so gradual that the DexCom can't report it as an arrow diagonal down. The CGM maintains a horizontal arrow as the number drifts lower but generally the Apidra seems to be finished after two hours. She may get lower in the third hour but the decline is not dramatic and therefore not scary and easier to manage if necessary.
Switching from Novolog to Apidra was fairly painless but it did take a few days to make adjustments to basal rates and insulin to carb ratios in Arden's pump. The process was made easier with the DexCom but would have been possible without it. It's important to remember that everyone may not respond the same as Arden did but I think that it's important to keep our minds open and not get stuck in today's methods in regards to our children's therapies. Over time treatments will change and I believe that changing with them, when changing is warranted, is important.
I had a close friend when I was younger that was diagnosed at age 18. Back then meters were huge and humolog was the insulin de jour. My friend would get up in the morning, decide how active the day would or wouldn't be and then approximate how much insulin he needed. He injected, ate and went about his day. He would have lunch when he felt light-headed and inject at dinner. He didn't count carbs, test or even visit an endo with any frequency. By today's standards he was barely taking care of himself. However, 20 years ago he was doing what he was supposed to based on the best medical advice available to him. He didn't fall behind because he didn't care, it's just human nature to find something that works and stay with it. I say to resist that urge, pay attention to advancements and after careful consideration take a chance when something looks interesting. I wouldn't change for the sake of changing but please learn the lesson that my friend's story teaches. When he finally tried Multiple Daily Injections two years ago the therapy almost killed him. It was too different and he was too set in old ways. One Saturday he stopped at a store to buy a book before lunch, as he did every Saturday. At some point he pre-bolused for lunch while he shopped just as he'd always done and then drove for two hours in his car before crashing it into a tree - all because he took his shot too soon before lunch. He has no memory of the two hours, the last thing he recalls is leaving the book store and saying goodbye to the guy behind the counter. Something that simple almost ended him. Treatment had passed him by... Now he is scared of the "new" and will never experience the stress relieving goodness of the OmniPod or the security of the Dex. His care is frozen in time and his inability to adjust may very well cost him at some point. I can't imagine what is to come in diabetes management but I'm sad that my friend will never experience it.
Not being complacent won't just benefit our children, it will also keep the people and companies that we all rely on focused on innovation. We absolutely love Arden's OmniPod and her DexCom 7+ but those products have to continue to improve if they want to keep us as customers. We shouldn't become complacent and we shouldn't accept complacency from the products that we count on to keep our children alive and healthy.
Having allegiance to an insulin is actually silly right? I mean I only use Novolog because a doctor gave it to us. I never looked into it, I was too stunned at the time. Moving forward, no one ever told me that there were choices, I only have the internet and the Diabetes Online Community to thank for my awareness about Apidra. When I asked my NP about it (and this is important) she hadn't seen any data to suggest that switching was warranted but she still supported my trying. Please don't let your doctors limit your choices, you may only be using Novolog because the reps from Novo Nordisk have better deli platters then the girls from Sanofi-Aventis.
Final thought - If Arden's NP is reading this (and I know that you are) please get your script pad out because we are switching insulin. Switching wasn't exactly fun and I'll admit that I had to rev myself up to go through basal testing but that little bit of effort and a tiny bit of patience bore some nice rewards. No fast spikes, no fast falls, shorter insulin action time and a steadier fasting BG. Also, I didn't get a chance to speak about it but Arden's overnight CGM line is excitingly flat.
See ya Novolog, it's nothing personal... I have to keep up - for my daughter.
Be well, you and your children are all in my thoughts!
Read the follow up to this post, 'Apidra Blog ptII' here.
The stuff at the end - I already said that I’m not nearly a medical person. I’m just a guy that takes care of a little girl with type I... I just happen to have an opinion, a keyboard and an idea about how to post a website. Please do your research, speak to others and then go over everything that you’ve learned with your healthcare professional. Please also know that this site is not supported by any ads, hand outs or pressure from any pharmaceutical company or device maker. I’m just trying to spread good information to the people that need it the most, as best as I can.
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The following are archived comments from this post. You can post new comments below.
Joel
Apidra is not keeping up with technology for those that choose MDI.
They, unlike Novolog, do not offer a pen that allows for 1/2 unit dosing. The ability to give a 1/2 unit dose is a big deal for those on MDI.
They are lacking in the technology area for sure.
Wednesday, February 2, 2011 - 12:17 PM
Penny
Hi Scott,
I just tried to comment on your blog about Novolog vs Apidra, but I cannot leave a comment. I can get to the comment section and complete it all, but clicking on comments does nothing.
So, here is my comment:
Thank you for this information! I do appreciate it and I swear, will NOT take it as medical advice!!! I spoke with Lorraine over at This is Caleb about Apidra a few months ago when she tried it with Caleb and there, in my frig, sits a bottle of Apidra, scripted from our endo at DuPont. We are still using Novolog in her OmniPod, but I am tempted to go ahead and try it. I do want to try it when I am around to watch whats happening - Spring Break to be exact, cause having a girl active at school with a new insulin will not be fun times for all.
I'm interested in the insulin action. We get a spike, not very large, but enough to sometimes cause a crash from the long actingness of Novolog. I'm also liking the finishing in two hours, for Arden at least, in a shorter amount of time. We have so much of a tail of Novolog at times, we end up with IOB for a high correction, coming down within perfect range within an hour, but overshooting our target, resulting in a low. These at bedtime, as you said, well, they suck.
Thanks again, I appreciate you sharing your experience. Glad it is going well for Arden and for you too.
Thanks so much!
Penny
Wednesday, February 2, 2011 - 01:03 PM
Scott
If comments won't work please try deleting your cookies... That sounds funny!
Sorry, thanks!
Wednesday, February 2, 2011 - 01:05 PM
I've heard so many people that get better results with Apidra. I, unfortunately, am not one of them. I tried it twice some time ago and although I didn't get to catalog every detail as well as you did (wish I had!), I believe it was the shorter action time that just didn't work well for me. It was a bit disappointing too. But I'm glad you got good results and found something to improve Arden's bg, even if just a little bit =)
Thursday, February 3, 2011 - 04:00 PM
Anna
Hi. We have an almost 3 yr old daughter w/Type 1. We use Dex and Pod (just started) and found your blog when searching for info on Apidra. A FB D mom friend suggested it. Thanks for your input!
Wednesday, March 9, 2011 - 01:24 PM
hockeymom
Thanks for sharing your experience. We are just starting our 2nd week on Apidra and ran high the first week--made some basal adjustments today and will see how that goes before making carb ratio adjustments. Waiting to get our new sensor transmitter--would LOVE to see some of those flat lines you describe. Have had too many seizures on Novolog so hope for some more stability and sleep at night!
Saturday, May 14, 2011 - 10:07 PM
Scott
Hockeymom,
It took me a few weeks to get it all together. I wish you luck! Please let me know how you make out.
Scott
Wednesday, May 18, 2011 - 11:15 PM
Update
on 2011-09-26 13:29 by Scott Benner
Read the follow up to this post, 'Apidra Blog ptII' here.