Diabetes Base Camp

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Grrrr, there is nothing more tedious than a sensor playing silly buggers, after one has already been without numbers for...
30/11/2025

Grrrr, there is nothing more tedious than a sensor playing silly buggers, after one has already been without numbers for 2 hours.
Somehow I always end up changing my sensor late on Sunday evenings, and did so again last night, around 2330ish. Dumb timing - possibly, but generally everything works ok.
Not this sensor change. “Updating sensor” was displayed after the warmup rather than a nice sensible number. So I am wide awake at 0215 being irritated, and knowing I will likely need to change it, but I must wait another 3 hours first to see if it comes to the party.
Seriously, sensor companies all really need to do better. Dexcom is under fire for dodgy G7s, Medtronic is being extremely slow in rolling out other sensor options (Simplera, Instinct, certainly within Australia anyway). Abbott seem to be winning the race right now, with Libre 3 being available for Ypso users as of today (officially). I am certainly looking very much forward to Instinct (Medtronic branded and tweaked Libre 3). Bring it on!
Ok, it seems that writing a snotty post has worked. My sensor has come to the party. We are 4.7 and steady, I have calibrated, and hopefully Smartguard will kick in soon and I won’t drop further.

13/11/2025

It is World Diabetes Day today, my 47th with T1D.
I’d like to have a bit of a chat about the “other” forms of diabetes we don’t think about much.
We all (well, certainly on this page anyway), know about T1 (autoimmune Islet cell destruction and lack of insulin), and T2 (insulin resistance and elevated production of insulin in response, with eventual pancreatic exhaustion in some cases), and some of you might know about T3c (surgical or physiological destruction of the pancreas including the islet cells - cystic fibrosis related diabetes could fit under this classification).
There is a decent sized group of people with diabetes who are tricky to categorise.
Not antibody positive, not insulin resistant. Some of these folks are diagnosed in infancy, and a genetic cause is quite clear, but others are very commonly misdiagnosed as T1 or T2, depending on their age and body type.
These folks may well have monogenic diabetes or “mature onset diabetes of the young”.
Some of these people might in fact not need insulin, and may do very well on an older sort of medication (sulfonylureas), or may not need treatment at all, because their glucose is only slightly elevated and it never progresses toward complications.
The actor Halle Berry probably has a monogenic form of diabetes, as she does not always need insulin, and was diagnosed as a young woman in excellent physical shape. It has been postulated that she may have “Flatbush diabetes”, which is unique to people of African ancestry, and named after a region of New York. Sometimes they need insulin (illness, stress), often they do not.
My gripe with all this classification is that it allows governments and health systems to withhold potentially useful technology and medicine from entire groups. Would most people with T2D benefit from CGM - absolutely! Would adults with CF related diabetes and T3c benefit from subsidised CGM? Absolutely. Would folks with atypical T1 or T2 benefit from Medicare funded genetic testing? Absolutely.
Many of us (mostly T1s) are in a good spot with regard to accessing tech, and T2s are in a good spot regarding medicines (yay Ozempic - for many this is a game changer), but we still have lots to do.

05/11/2025

I am closing early today, as not many bookings and I have plenty of professional development to be getting on with.
Have a lovely Wednesday people!

30/10/2025

Some people might be getting all excited about the Medicare changes that start tomorrow.
Unfortunately, all the hype about “You will only need your Medicare Card to see the doctor” is just that - hype.
The Medicare rebate that the government pays *you* has not increased, unless practices agree to bulk bill everyone. Then we get a small grant.
The new Medicare rules might work for “fast medicine” or “6 minute medicine”. Longer appointments attract proportionately less rebate per minute.
And slow medicine is what we practice here at DBC. No rushing people out the door at 6 minutes!
Many of my appointments are over 30 mins (except for prescriptions and Med Certificates).
So we will continue charging a gap, so we can afford to keep the lights on and pay the lease.
Trust me - I am not a greedy rich GP! I have not had a holiday in nearly 4 years, and have to think very very carefully about purchases. I was thrilled to buy a leotard a few weeks back for $10!
I want to keep DBC open and providing excellent medical care, to the best of my ability, so the gap payment needs today stay for most people.

The end of this week is very busy for me - engineering inspections at DBC before roadworks and demolitions start (DBC is...
30/10/2025

The end of this week is very busy for me - engineering inspections at DBC before roadworks and demolitions start (DBC is unaffected, but the government wants to prove that they are not destroying heritage buildings).
Then I have a Saturday performance with my ballet buddies from Dragonfly Dance, 2 performances actually - the dress rehearsal is ticketed. I am dancing in 2.5 dances, and playing bagpipes for 0.5 dances.
This morning I have been making sure I have 2 pairs of pointe shoes with very firmly sewn elastic and ribbons, and Fluff the giant tuxedo came to help (Moodle the ginger girl also helped, but very energetically and I did not get a picture). I think he likes the smell of satin, leather and foot sweat. Weird cat!

In conjunction with Attune Hearing, we are able to offer quick, simple hearing tests, using a fun little iPad based audi...
20/10/2025

In conjunction with Attune Hearing, we are able to offer quick, simple hearing tests, using a fun little iPad based audiometer.
Attune has loaned us this device long term, and I am very excited to be able to offer hearing checks.
I tried it out and passed, even though I had played my bagpipes about 30m prior!
Demonstrating the setup is our lovely model Maree, who also passed (yay).

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.

When you really, really stuff up your breakfast bolus……I was low at breakfast time, so did not bolus immediately for my ...
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.

I had a fairly tedious diabetes day yesterday. I was stressed about a planned power outage (glucose higher than usual a...
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.

Address

Everard Park, SA
5035

Opening Hours

Monday 9am - 5pm
Tuesday 12pm - 5pm
Wednesday 9am - 5pm
Friday 12pm - 5pm
Saturday 8am - 12pm
Sunday 4pm - 6pm

Telephone

+61881662418

Website

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