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Diabetes Base Camp

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Diabetes Base Camp

General Practice, Diabetes Education and more.........

25/09/2025

Lots of bad medical news in the media right now (Trump, RFK spouting untruths and outright silliness - please ignore all of their rhetoric).

However, in the UK, researchers have developed a very exciting treatment for Huntington’s Disease.

Huntington’s is a devastating neurodegenerative disease that runs through families, it is genetic, and is autosomal dominant, which means only one copy of the faulty gene is needed for a person to be affected. Usually it is detected in middle age, AFTER potential children have been born.
It is fatal, a horrible way to die, and thus far has been untreatable.

Researchers have found a reduction in progression of symptoms by 75% for people with detectable Huntington’s. This is really, really exciting for those affected but who are not showing symptoms (usually young adults in their 20s and 30s who have seen a parent affected and are rightly terrified).

This is not a “cure” as such, but if given to affected but asymptomatic patients, it may well be.

These researchers deserve a Nobel Prize. Not an orange muppet and his leather faced sidekick.

23/09/2025

Apparently I am unable to see recent Messenger messages and respond. This is a technical/FB/Messenger/Meta issue. I am working on it.
Please don’t use Messenger as a primary means of contacting me. Please either book an appointment on HotDoc, or email or ring. I cannot always respond to calls during consulting times though, so please leave messages.

19/09/2025

When you really, really stuff up your breakfast bolus……
I was low at breakfast time, so did not bolus immediately for my 2 slices toast plus PB, jam and cheese. I *did* partially bolus when I was about to drive back to the city (1 hour drive). Clearly too late and not enough. I also could not easily stop to bolus properly, nor do it while driving (fines ++ for touching a portable electronic device).
But I can feel it heading down now, thankfully. Normally the algorithm gets on top of things before I hit 15.5mmol/L, but whatevs.

06/09/2025

Just a heads up that AI is everywhere.

One of my patients informed me that DBC is being touted as an endocrinology clinic somewhere on the internet (we could not find that page again).

I noted that the clinic is being slightly misrepresented on Zable, with “lots of experienced clinicians”. Um, yeah, that would be me, and Kirrily the very experienced CDE.

The only things *I* have published are on Google Business and the website for DBC. Nothing else.

We are a GP clinic with a special interest in diabetes. Nothing more, nothing less. Not pretending to be an endocrinology clinic at all!

GPs can absolutely have special interests, but as we have general training, and are theoretically capable managing any condition, we may not advertise ourselves as body system specialists.

Additionally, GPs have a specialist qualification in General Practice. We refer to organ system specialists as “non GP specialists”. General Practice training can be as intense as organ system specialty training.

A common misconception is that GPs are untrained doctors who have just flunked out of the hospital system. Yeah nah! Loads and loads of training happens in general practice.

21/08/2025

I had a fairly tedious diabetes day yesterday. I was stressed about a planned power outage (glucose higher than usual as I tried to make sure my vaccine fridge would stay nice), then I also spent a lot of time running around the building speaking firmly to electrical people, repositioning my huge power banks etc.
After all that I kept mistiming my insulin and going low then high. Ugh. Just getting things wrong. It happens.
But my current (trial) Medtronic 780G still did a bang up job of things. Am thinking I might need to keep it. It works far more harmoniously with my diabetes than my Ypso/CamAPS.
Below is my *worst* day using Medtronic 780G…….
Range is 3.9 to 10mmol/L.
I reckon I would have been lucky to score 65% TIR on Ypso/CamAPS yesterday.
I realise I am lucky to have less temperamental diabetes than many, so this is honestly not a humble brag.
But this algorithm, cannula sets and tubing just work really well for me.
I could live without the clunky sensors and transmitter, but hopefully Simplera then Libre 3+ will be on NDSS soon.

20/08/2025

Parking is getting quite tight in the DBC carpark. Wednesday mornings are the most tricky right now.
Please try and use the allocated DBC carparks, the first 4 on the left as you drive into the carpark.
I may adjust clinic hours if my foot injury recovers, as I will likely want to attend an 8pm ballet class on Wednesday, so possibly I will start clinic later and run it a bit later.

19/08/2025

I just attended ADATS (Australasian Diabetes Advancements and Technology Summit) 2025, and while I missed a couple of afternoon speakers to see patients, so have a couple of talks to catch up on, my take aways are this….
1. An explosive decompression at altitude (ie a window blowing out at cruising altitude) will result in a pump delivering ~5.6u of insulin (rapid expansion of any air in the reservoir). Certainly enough to send me properly low. While this is a 50x a year event across the thousands of daily flights worldwide (very rare), it has happened to my old boss (Dr Don Bowley OAM) while on an RFDS retrieval flight, so during my work with RFDS, it may have occurred. Dr Don ended up with an ear perforation and the flight nurse got a dislocated shoulder, and we were warned about it during training.
2. People with T1 diabetes rarely if ever get liver fibrosis (far more common in T2 diabetes and obesity in general). One reason postulated is that there is little portal circulation of insulin in T1, but possibly elevated levels in T2. Very interesting!
3. Testing has shown that insulin delivered on descent while flying is 1.2u, possibly explaining the “baggage carousel hypo”. Then a high later as insulin is “sucked up” by the pump as the air bubbles resolve after landing. I did not EVER notice this while flying at work, but I did notice this while flying on commercial flights home from work. The difference? Me running like a mad woman to get first in line for a taxi when arriving home. I rarely did that when traveling TO work, as I simply needed to amble across the carpark and get in the work vehicle.
Do with this information what you will. I personally would not routinely disconnect while ascending and bolus after descent, but people very sensitive to insulin might want to.

10/08/2025

Next week is going to be a bit messy - there are lots of disruptions to clinic hours, mostly due to planned power outages (for the interminable roadworks), and me needing to do professional development (yay 🙄 - but I am attending the Diabetes and Technology conference, virtually, so might get some info about new sensor and pump availability).

HotDoc is updates with all the available booking times.

05/08/2025

It is becoming increasingly clear to me that cannula choice is far more important in selecting a pump than the algorithm or even CGM.
I am lucky enough to be very insulin sensitive, so tight control is not especially difficult for me (unless we are talking about avoiding those pesky lows - I am pretty good at having those due to mistiming insulin, a tiny bit of unexpected activity).
But after experimenting with Medtronic 780G vs Ypso/CamAPS, I have discovered one thing.
With Medtronic, I know if my glucose is high it is likely a carb issue.
With Ypso, it could be carbs, a kinked cannula, a blood filled needle - anything really. The cannulae (both sorts) do not work well for me, and will stop working properly after 36 hours, or they might work for 72. Who knows?
Needles I actually occlude more, due to bleeding.
When I first started pumping, in 1999, I used Medtronic SoftSets. They were ok, but not great. Then I used Quicksets, and for me, they are magic. Probably 18 years using Quicksets, and maybe 1 occlusion? If that. I honestly cannot recall an issue with a Quickset. Maybe 1 bad bruise?
I am playing with the extended 7 day sets now. They work really well for me. They last about 9 days for me, which of course is less naughty, but it works.
I dislike Medtronic CGM, but I might be prepared to put up with it for the reassurance of actual insulin delivery. Maybe not with the G4 sensor, but if Simplera happens soon, I might be needing to have a hard think about things…..

28/07/2025

My dear friend Mags Hussey reminded me that today is my 47th “Diaversary”.
I had forgotten, of course.
This is a day that some people with T1 diabetes celebrate or mark in some way.
Until earlier this year, I did not know my exact diagnosis date - nor did my parents.
But as my 50 years with T1 is approaching, I submitted a Freedom of Information request last year for at least the date of my diagnosis back in winter 1978.
I got the whole medical file!
And my official diagnosis date is 28/7/1978.
Technically, it was probably the day before, when I had a 2 hour glucose tolerance test (which clearly I failed), but all the letters are dated 28/7/1978.

27/07/2025

I have been really enjoying most aspects of using the Medtronic MiniMed 780G pump and G4 sensor. Really good TIR, sometimes 100%. Cannula does not block, so I know if my glucose is rising, I have stuffed up my carbs (rather than getting no insulin, as is common when I use Orbit sets, both cannulae and needles).
And I was getting on better than expected with the sensors. Until 0130 last night. Two tedious alerts from the pump, stating that the sensor was updating. Yay. But it got back to normal and continued until about 15 mins ago. The 7 day sensor that was inserted less than 2 days ago decided it was done. 0 days, 0 hours left. Change sensor. FFS. Not amused! So I am no charging the transmitter again and will do a fresh sensor. With a 2 hour warm up. 🙄🙄🙄

19/07/2025

The everyday frustrations of diabetes (yes, first world issues, but still, nothing that gluconormals have to even consider).

I love Saturdays - I have a sleep in, watch a lot of crap on my iPad, read a bit, then get ready for ballet classes.

I ate some random stuff for breakfast - marzipan, a few chips, some dark chocolate. Glucose was all good.

Nice hot shower, then start getting ready with all my ballet layers - leotard, tights, some sort of skirt or shorts, long sleeved bolero thingy over my leotard for warmth, leg warmers, tshirt, jumper and giant denim dress.

Am a bit low by this stage, so probs could have dressed without my pump on, but I was low, so did not think that through.

My pump gets tangled and tries to pull out when I take my towel off. Then I nearly drop it while trying to hang my towel up one handed. Get both feet caught in the lining of my leotard while trying to hold my pump and feed it through. Tights waistband gets caught on the clip of my pump and tears a bit. Have to select shorts rather than a pretty, filmy ballet skirt so I can wear my pump in class (2+ hours is a bit long to unclip). Shorts elastic has died so I need to tie the drawstring up really tight (MiniMed pump is heavy - normally I use Ypso, which is less of an issue, but am playing with the 780G currently).
I am using a 7 day MiniMed set, which is great, except I prefer 110cm sets, and this only comes in 80cm. It is hard to feed the tubing through all my Lycra layers.
My Lycra bolero sleeves cover my sensors, which is helpful, and stops them catching on anything else. So that is a win!
Tshirt does not fit smoothly over my sensors, but what evs.
My denim pinafore is lovely and warm, but does mean I can’t reach my pump easily.

Finally, I am ready to leave the house, but after all this, I am properly low and can’t drive to do an Aldi run before class. So snacks, and sitting down nicely until I am “above 5 to drive” and writing this little rant.

Most of us living with T1D or insulin using T2D will relate I suspect.

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Everard Park, SA
5035

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Tuesday	12pm - 5pm
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