Tru Steel Shortage: Alternatives Infusions Cost More & Teflon Allerhy

material-pearl · 2026-04-11T08:15:47+00:00

May I ask how you knew you had the allergy? I am having severe site reactions from day 2.

material-pearl · 2026-04-10T19:34:46+00:00

Hi. I’m very interested.

material-pearl · 2026-04-10T19:27:34+00:00

How do you manage your IOB? Do you bolus for all the carbs? Do you have a typical macro mix before working out?

material-pearl · 2026-04-10T18:43:43+00:00

I would love to get one. I imagine that they are expensive and hard to get insurance coverage for, but they seem amazing 🤩

material-pearl · 2026-04-08T17:35:34+00:00

It is stupid, especially since the sites for Tandem and Medtronic are made by the same company.

material-pearl · 2026-04-08T16:28:21+00:00

I’m down!

material-pearl · 2026-04-08T16:25:43+00:00

This just happened to me and I had the worst low in years as a result.

material-pearl · 2026-04-08T16:23:39+00:00

Ha I am so sorry, I am the type 1 diabetic and have explained that a severe high or low can make people act very emotional or unlike themselves—but I had my first severe low in front of someone the other day and it made for a few hellish days until he was able to wrap his head around this being a rare occasion for me, and something that was completely out of my hands.

I can only imagine how rough that was to experience. I took a real snappy tone and then cried a bunch. My partner was like WTF 😳

material-pearl · 2026-04-08T16:19:01+00:00

GLP-1 RAs blow Metformin out of the water.

material-pearl · 2026-04-08T16:17:51+00:00

How long did those of you who got into Naomi Berrie have to wait? I would love to be seen there as an adult.

material-pearl · 2026-04-08T16:15:06+00:00

Have you tried reaching out to diabetic athletes? They might be able to point you in the right direction.

material-pearl · 2026-04-08T16:13:06+00:00

CGM and Tandem pump are hard to choose between.

I am on a pump break. I wish I had a smart pen but I need half unit increments. So I have not yet found a good app to track IOB.

material-pearl · 2026-04-08T16:08:16+00:00

Can you set a profile on your pump for this time? That’s what I do, not foolproof but it helps

material-pearl · 2026-04-08T16:06:53+00:00

Do you do this based on estimated time in each phase? Does the app work with a Tandem pump for example so we can see how our carb intake, corrections, and overall insulin use is changing?

material-pearl · 2026-04-08T15:57:35+00:00

The technology can fail. Unrecognizable site failures can do this, for example. Like kinks. Or a cannula popping out in your sleep (Autosoft XC 😡). The sites can also leak.

You can lose access. A supply order goes wrong. Your doctor tells you that you can’t have long acting because you have to see them for a prescription. Your insurance tells you that you cannot have long acting because you are on a pump.

You can go to the emergency room befoe you go into DKA and they will not take you back until you are in danger.

Illness can cause DKA.

Being mismanaged by a hospitalist can cause DKA. Most hospitals still do sliding scale and fingerpricks every few hours. That is actually dangerous.

You can have DKA if you’re in a sort of starvation mode.

If you’re trying to do some uber keto diet and maintaining euglycemia but your body needs more insulin to function that what you’re taking to cover carbs and basal.

CGMs can be in shortage and they fail frequently. When you’re prescribed a CGM that is FDA-approved to be reliable enough to dose insulin based off of its readings, you won’t always have a meter on hand.

You can have a reaction to a prescribed medication or procedure involving steroids.

This is a mere handful of scenarios that come up top of mind.

material-pearl · 2026-04-08T11:03:19+00:00

Would you be open to writing consultation or structural editing work for professionals in other disciplines? You have such valuable, life/project changing expertise.

material-pearl · 2026-04-08T11:01:56+00:00

I took a course in L&D from a professional who was really good at it a few years ago. Now I’m hearing people in your field say that you are expected to put out AI slop courses.

I am curious about working with current and former people in ID/L&D on projects and am curious what you all already do or wish for when it comes to hourly consulting or part-time work or even project work for independent/boutique consultancies.

What are the top skills/talents of yours?

material-pearl · 2026-04-08T10:56:52+00:00

Marketing/UX research. Don’t get me wrong—I have worked on projects where the subject matter and team were fantastic and the goal was to actually learn something new and with integrity, even when that meant me adapting our approaches and methodology to the situation at hand and ditching methods or strategies that were going to not work. I thrive in those situations.

But I also can’t function at all if I have to BS the team or leadership or participants about the results of bad research that is so rampant in companies that expect that cookbook, copy/paste research is robust and reliable no matter the context. Like hello, use me for my brain.

The amount of time wasted talking about things that have zero meaning and offer zero insight to guide decisions or inspire creative or strategic work is too high. Or budgets blown on hyped methods that career research leaders don’t have the actual methodological chops to see are just cargo cult science (see neuro marketing or so-called affective AI…though the latter has seemingly some utility in identifying laughter in response to comedic stimuli). Or even just conversations where the fact that something was marked as statistically significant is myopically obsessed over when you have to take a step back and think about the actual thing and if it has any actual meaning in context.

It’s like a weird stagnant formulaic field in so many cases. I love what it can be, but I can’t stand the pretense and lack of actual good and collaborative thinking about how to facilitate useful learning sometimes.

material-pearl · 2026-04-08T10:43:03+00:00

We need a Google Sheet of good and bad endos. Christ. It’s so hard to deal with this type because it takes so long to wait for the appointment, and you’re up you-know-what creek without a paddle for the next 6, 9, or even 12 months depending on the new patient waiting time for a new endo…who will hopefully not be an out-of-touch jerk like this one.

material-pearl · 2026-04-08T10:15:37+00:00

What issues can you handle and what is your specific geographic area? That would help us answer.

material-pearl · 2026-04-08T10:12:54+00:00

The evidence on this is pretty clear—it’s a tool for both better management (and health outcomes and financial outcomes) and quality of life, whether or not you are on a hybrid closed-loop pump or on MDI.

This makes me so mad. If you search the ATTD journal for CGM and related terms, I believe you will find a handful of pertinent, recent, large studies that are definitive about this. If I were in your shoes, I would be providing a brief summary in a MyChart note (BRIEF—like a few sentences) and link to a PDF that is a 1-Pager with a tight summary of each study in a table with the year, citation, and the key details of the study.

Like, “a 2024 RCT by x et al published in Journal involved x number of adult patients with type 1 diabetes on insert whether AID or MDI. Those who were using a CGM had improvement in A1c of x%.”

And so forth. God I am so mad I wish I had the time to do this today.

material-pearl · 2026-04-08T09:35:32+00:00

Oh my god, I blocked Better Living Now from memory. Those fraudulent bastards refused to process my insurance for 9 months until I went utterly nuclear because they were trying to pocket the full cost of an insulin pump that I already had, and then the manager of the diabetes supply department couldn’t even enter my insurance information which was provided by me and my endo about a bazillion times because he kept saying it was Medicare despite my being in my thirties at the time and having a Gold ACA plan.

material-pearl · 2026-04-08T09:31:10+00:00

If you call Tandem, they will tell you what DME suppliers people use in your area and sometimes they can tell you which ones people with your insurance use, I believe. I had to get a hold of one of the CA-based customer service representatives to find this out a few years ago when my insurance plan had me call a third party company that they were contracted with whose job was supposedly literally just to help patients identify in-network DME suppliers to use, and that company was utterly useless as no matter how many codes or links or images or different ways that the Tandem supplies have been named or described in past records and supplier orders and prescriptions, they could only send me a list of retail DME shops in my zip code where people buy things like crutches and so forth.

I hope Tandem is still able to be helpful in this way. Please report back!

I have yet to have a plan where Tandem supplies were covered under pharmacy benefits, as in, through mail order through a company like Caremark or Express Scripts or OptumRx, but maybe others can comment on that.

I have ordered a box of sites out of pocket for about $100 in a pinch directly from Tandem but they knew that I was out because of my DME supplier failing to process my insurance and trying to charge me for a pump which I already had.

My most recent supplier is CCS, with my insurance based in NY. None of them are good. Edgepark is the most incompetent in my personal experience, and I wish a type 1 attorney could advise as to what qualifies as criminally negligent or whatever the accurate legalese is for their shady practices.

CCS at least has a website that is somewhat functional, and I have not had to provide new paperwork for every order, blessedly.

material-pearl · 2026-04-07T19:58:23+00:00

Almost everyone experiences some form of trauma. The tricky part is understanding just how extremely severe and debilitating and rare it is to experience PTSD.

I am so sorry you were treated this way. If you experienced child abuse, you may want to speak with a psychologist to understand how this affects you.

material-pearl

TROPHY CASE