[Diabetes-talk] questions from a fairly new list subscriber

Chanelle Hill chanellemh at gmail.com
Thu Mar 5 22:40:15 UTC 2009 

Dear Mike,
Thanks for the information! I forgot about Calorieking. I will check out the
rest of the resources.

Chanelle

-----Original Message-----
From: diabetes-talk-bounces at nfbnet.org
[mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Mike Freeman
Sent: Thursday, March 05, 2009 4:16 PM
To: Diabetes Talk for the Blind
Subject: Re: [Diabetes-talk] questions from a fairly new list subscriber

Chanelle:

One of the best nutritional websites is http://www.calorieking.com; it's 
a bit busy but quite accessible. Also, if you're into fast food as I 
admit I am at times, a bit of sluething from Google will yield carb 
counts for the usual temptations. Ultimately, though, a sighted reader 
is extremely useful.

No, the KNFB Reader doesn't handle barcodes. That would require quite a 
database.

National Braile Press has an Atkins diet list of foods that has carb 
counts also and NFB used to sell an ADA exchange list. Hope Warshaw's 
guide to carb counting is available from RFB&D.

HTH!

Mike

----- Original Message ----- 
From: "Chanelle Hill" <chanellemh at gmail.com>
To: "'Diabetes Talk for the Blind'" <diabetes-talk at nfbnet.org>
Sent: Thursday, March 05, 2009 8:01 AM
Subject: Re: [Diabetes-talk] questions from a fairly new list subscriber


Hello Dave,
Thank you for explaining your process for using the bolis wizzard. I see 
my
diabetes educator in a few weeks so I will talk to her about it.
For the past several years, I have been meaning to use the Paradigm Pal
Software. Now that I finally got the right cable a few weeks ago, I 
should
try it. Unfortunately, the people atMinimed didn't know what I meant at
first. They sent me the meter to work with the Personal Care or whatever 
it
is called where people upload their pump readings online.
I have memorized the button pushing sequence for setting a temporary 
basal
rate, so if anyone needs the steps, please let me know. Of course, go
through the process with someone sighted first (smile).
I would definitely be interested in having the Paradigm Pal software 
made
more accessible with Jaws. I have always wanted to learn Jaws scripting.
Maybe someday when I get around to it, I can help with the Paradigm Pal
Software (smile).
Speaking of carbs, what ways have you or anyone on this list found to be
effective for reading nutrition labels or getting access to that
information. I have sighted friends read labels for me, but it is easy 
to
forget in keeping track of so many things. Since I am getting set up 
with
Services for the Blind, I am hoping to get a portable scanner or 
something
similar that would read barcodes. Does the K NFB reader do this? I also 
know
that there are websites that give nutritional information for certain 
foods,
but I have forgotten what those are.
I have been using my pump for five years, but I am feeling more hopeful
about using it more effectively since I have gotten responses to my
questions on this list.

Chanelle

-----Original Message-----
From: diabetes-talk-bounces at nfbnet.org
[mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of David Anspach
Sent: Wednesday, March 04, 2009 9:36 PM
To: 'Diabetes Talk for the Blind'
Subject: Re: [Diabetes-talk] questions from a fairly new list subscriber

Hello Chanelle,
I have successfully used the bolus wizard on the Paradigm series of 
insulin
pumps. It was much easier than I expected and requires just a few things 
be
set up in the pump itself first. Afterwards, it is just a matter of 
pressing
the button furthest to the left followed by pressing the far right 
button,
or activate, button. I haven't used this feature of my pump in quite a
while, but am planning on getting back into the habit once an insulin 
pump
trainer comes out to my home and helps me adjust my basal rates. From 
what I
remember, these are the steps:
1. Press the button furthest to the left. I think this tells the pump 
you
are ready to begin entering information into the bolus wizard.
2. Using the arrow keys, you enter the value of your blood sugar reading
that is over your target value. For example, my target value is 100. If 
I
check my blood sugar and I get a reading of 130, then I would press the 
up
arrow key 30 times.
3. You then press the far right, activate, button on your pump.
4. Using the arrow keys again, you enter the value of your carbs you are
about to eat. So for example, if you are going to eat 30 grams in carbs, 
you
would enter this value using the arrow keys. In my case, I chose to set 
the
up arrow to enter 1 gram per arrow press as it was easier and provided 
much
more control than setting it to 5 grams per press. So, I would press the 
up
arrow 30 times to enter the carb value.
5. Finally, you press the activate button, I think, twice to tell the 
pump
you are finished. The first press causes the pump to display the number 
of
units of insulin the pump has calculated you will need based on your 
blood
sugar reading and the carbs you will be eating. The second press causes 
the
bolus wizard to begin administering the insulin.

As I stated above, I'm not 100% sure my steps are accurate, but, I think
they are close. So, don't try this at home <smile>. In any event, you 
will
need to have someone sighted give you a hand in the initial set up of 
the
bolus wizard. You will need to set your target blood sugar value, the 
number
of carbs each press of the up arrow key represents and I think that's 
it.
The nice thing about using the bolus wizard is that it shows your health
care provider what your blood sugars have been running and your average 
carb
intake.

Someone also mentioned the software that you can purchase that allows 
you to
adjust various settings on your pump, including basal rates. I believe 
this
software is called something like Paradigm Pal, but I'm not totally 
sure.
When I first got my pump back in 2004,  I took a look at this software.
Unfortunately, it was written totally in Java and was basically 
inaccessible
using a screen reader, such as JAWS. I tried working with their software
developers to get it to be more accessible, but, my efforts didn't pan 
out
as I had a lot of trouble getting the Java run-time environment and 
access
bridge set up correctly on my PC. Once I did, I lost their contact info 
and
sort of gave up. I have a newer copy of this software around somewhere 
that
I received after getting my new 722 last spring. I have been looking for 
it
as I want to see if it is any better now than it was nearly 5 years ago.
Since I also work for Freedom Scientific, I may end up taking it into 
our
development team and asking them to see what might be done on the JAWS 
side
of things to help access the software. I think that in order to 
actually
get changes made to JAWS, I will have to show project management that 
there
is enough need for changes in JAWS. If you or anyone else, for that 
matter
is interested, then please let me know. The more interest in the use of 
this
software by blind diabetics who use Minimed pumps, then the better the
chances we will have in getting changes made. I also have a contact at
Minimed that I am going to try and use to see if I can get back in touch
with their software development team. I truly think that if we cannot 
get an
accessible pump, then having software that is accessible that allows us 
to
manage our pumps will be just about as good.

Sorry for the long post, but, I am very passionate about making life for
blind pumpers  that much easier.

Have a great Thursday,

Dave

-----Original Message-----
From: diabetes-talk-bounces at nfbnet.org
[mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Chanelle Hill
Sent: Wednesday, March 04, 2009 12:04 PM
To: 'Diabetes Talk for the Blind'
Subject: Re: [Diabetes-talk] questions from a fairly new list subscriber

Dear Mike,
Thanks for replying to my message. I will check out the Braille Monitor. 
I
subscribed to Voice of the Diabetic about a month ago and haven't 
received
an issue yet. I opted to receive the publication via email.
The CD I received from Blind Inc., seems to be a few years old since 
some of
the articles date back to 2004, 2001, and those reprinted from the 90's.
I would like to get connected with diabetes educators who have had
experience working with the blind.
That would be great if Prodigy made a talking pump!
Minimed pumps have software that allows one to make changes to basal 
rates,
the increment for easy bolis, time and date, and other items that are 
set
through the pump menus. It would be nice if one could also use the 
software
to program a bolis that would be delivered as soon as the pump was
disconnected from the computer. For example, I think that the pump has 
bolis
wizzard--a feature to calculate insulin needed for carbs eaten and high
blood sugars. These calculations can easily be made manually, but I 
think
the pump also keeps track of active insulin.
I will figure out who I could speak to at Minimed about this or pump
accessibility. I appreciate your efforts to advocate accessibility with 
the
insulin pump companies.

Chanelle
-----Original Message-----
From: diabetes-talk-bounces at nfbnet.org
[mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Mike Freeman
Sent: Tuesday, March 03, 2009 9:58 PM
To: Diabetes Talk for the Blind
Subject: Re: [Diabetes-talk] questions from a fairly new list subscriber

Chanelle:

With respect to BLIND, Inc., it's a great rehab center. I know some of 
the
personnel who teach there and they're great folks and know what they're
about. If you go to http://www.nfb.org, thence to the "Publications" 
link
and thence to "The Braille Monitor", you can read a review and 
description
of
the BLIND, Inc. program in a recent issue.
Just do a search for "Blind, INC." and you'll find it or just peruse the
tables of contents for the past few issues.

BLIND, Inc. had someone who specialized in diabetes management but don't
think there's one there now. However, there are a number of persons 
there
who have diabetes and who can probably put you in touch with 
blindness-savvy
CDEs. Additionally, there's a lot of practical expertise on this list.

Insofar as pump accessibility is concerned, I and several others from 
the
Diabetes Action Network are working on the problem. However, the 
situation
isn't much different than that which you described from an article 
several
years ago. Although at first blush it would seem that it would be easy 
to
make an insulin pump talk, it isn't quite as simple as one might 
suppose.
One has to determine what must be spoken when and in what form (for 
example,
if one is using a pump with a CGMS system, often the information is
graphically displayed, not numerically displayed and one must figure out 
how
to convey this verbally). WE have had some communication with one pump
manufacturer which has showed a bit of interest. However, if truth be 
told,
despite what we might think, the blind (and yes, I mean the visually
impaired also) are a pretty small segment of the market so pump
manufacturers have to be shown a good reason for making the investment 
in
access technology. AS I say, we're working on it. I doubt anything is in 
the
immediate offing.

AS to the Clevercheck, I've not seen one but suspect that it is like the
Prodigy Autocode or the Advocate in that it would speak a bg reading --  
once
-- but that all other functions would be inaccessible. But I emphasize 
that
I'm going on a hunch, not on knowledge.

We'll keep working on the pump problem, though!

Mike Freeman, President
Diabetes Action Network
National Federation of the Blind

----- Original Message -----
From: "Chanelle Hill" <chanellemh at gmail.com>
To: <diabetes-talk at nfbnet.org>
Sent: Tuesday, March 03, 2009 1:27 PM
Subject: [Diabetes-talk] questions from a fairly new list subscriber


Dear List Members,

I read an article about insulin pumps that someone from NFB wrote
several
years ago, and so I thought I would join this list to see if anyone has
had
improved accessibility with the pump and for other diabetes issues. I am
a
Type I diabetic, and I have been using the Minimed Paradigm 512 insulin
pump
and the Prodigy Voice meter. I know that NFB is heavily involved in
advocacy, but what has been done to inform insulin pump companies of the
need for more accessible pumps? Is there any way to become involved in
advocating for better accessibility? It would be wonderful to use the
new
Minimed Continuous Glucose Monitoring system, but the meter needed to
calibrate the pump doesn't talk. It seems like that could easily be
fixed
since there are already talking glucometers. I spoke with a rep from
Minimed
about upgrading my pump and asked if Minimed was working on a pump that
would be more accessible. She thought that the company was, but no one
has
gotten back to me.

It sounds like someone is having problems with the Prodigy Voice meter
on
this list? After calling and waiting a few weeks to get some more
strips, I
found out that Homecare Solutions is no longer carrying the strips for
Prodigy Voice and that they are carrying a new meter that is supposedly
like
the Prodigy called the Clever Check. Have any of you heard of this new
meter? Hopefully it has all of the audible features and more accessible
software (that's almost too much to ask :-) ).

Finally my last question. I am checking out state rehabilitation centers
in
Minnesota-one of which is Blind Inc. On the CD that SSB sent me
containing a
BLIND cyber brochure, a class for diabetes management was mentioned. Do
you
know if that is still taught? Apart from that, have any of you had
experience with the training programs at Blind Inc.?

Thanks in advance for answering my questions.



Chanelle

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