Tuesday, October 29, 2013

Before the Return of the Shell

Since I've been on an insulin pump for several years now, I have been lucky enough to see some of the diabetes technology devlop. All in all, I think (because my memory is too fuzzy to really remember) I've had at least 3 different Medtronic Minimed (MM) pumps. The latest and greatest 530g just came out as the successor to the Revel. I never got to experience the Revel first hand but one of the improved features was predicted alerts for the continuous glucose monitoring (CGM). I'm going straight from the MM Paradigm to the MM 530g, who's updated features included the linked CGM that allowed you to see your bloodsugar on the screen of your pump. If I'm wrong about this, I'm sure someone out in the DOC interwebs (because we're usually brighter than the average bears) will correct me. The funny thing about this whole experience is that while the Paradigm had the CGM ability, I only used it a handful of times before being so frustrated that I nearly pretended it never existed in the first place (which is saying quite a bit for someone who has the patience of an educator).

Regular readers will know that I've grown very attached to my Decom CGM that I lovingly call Eggy. I switched from MM to Dexcom two years ago because of that silly shell shaped transmitter. The transmitter would never stay put even with the assistance of every type of tape under the sun (that I could get my hands on at the time). The sensors were also crazy innacurate, and I could never get the calibration to work with my insane college schedule (really, who is stable for two hours when there are hormones and caffiene raging through you?). I held out for 4 months before deciding not to order another 3 month supply.

One of the other major things that bothered me was that the transmitter need to be recharged for EIGHT hours once a week. Add on the two hour calibration for every new sensor and replacing a sensor every three days. There goes 12 hours of glucose monitoring for your week.

In my mind, I expected that Minimed would change this as the technology improved, because this continuous monitoring thing was too new still. Or at least realize that they should send people two transmitters for the investment. That kind of logic is entirely false apparently. Even with a newer sensor that is FDA approved for SIX days of wear (the Enlite), you still lose eight hours of calibrating (ten if you add the two hours of calibration). This is all extremely perplexing when you add in the benefits of CGM plus low glucose suspend. If I chose those ten hours to be overnight while I'm sleeping, there goes the necessity of that feature. If I chose those ten hours to be during the day, I lose the ability to track my meal bolusing. I know that we're still miles away from "true" continuous monotoring but losing eight hours to charging the shell shaped transmitter seems asinine especially when compared to Dexcom system. All you lose is two hours a week for new sensor calibration if your efficent. Switching over has been a hard sell, my friends. But for aomeone who's struggling with perpetual hypoglycemia, I couldn't say no to a system with low glucose suspend and the timing for an upgrade just worked out.

I'm being adventurous and faithful to a company that  has served me for over a decade. I'm also trying to keep an open mind. Maybe it won't be as bad as last time. My CGM training is tomorrow afternoon so hopefully I can throw in a new sensor before bed. I will try the dual Dexcom and Enlite for a little while since I've got the mother load of Dexcom sensors left...

If you have any specific questions about the system, let me know in the comments!

Friday, October 18, 2013

Running High

Not literally. Only in the blood sugar sense. Waking up high should not be the norm. It's making me grumpy.

Two things I need to do: Basal testing and some light exercising.

And in all that extra free time I have: Postprandials to test my insulin to carb ratios and learning how to relax.

Sunday, October 13, 2013

October Bits and Bytes

I've been hiding in the real world diabetes community and my twitter feed and blogging reflects that with silence. So in lieu of skipping all the fun stuff, here's some of the major highlights:

I volunteered at a JDRF Walk for a Cure on the Jersey Shore. My friend and I were in charge of signing up Government Relations Advocates. I got 3 actual signups but I spoke to several dozen people who were already advocates. Warmed my heart. Only down side to the day has been the perpetual gluco-coaster I've been riding. My bloodsugar hasn't been this high in a while. I think someone swapped my insulin for water. I may also blame the bagel I ate (avoiding carbs is so difficult with free food)
Late September:
Since I've hit 4 years with my Paradigm 722, I got a call a few weeks ago about upgrading. A week later, I was notified about the latest FDA approval for the Minimed 530G (aka the fancy closer to artificial pancreas pump). I'm a little skeptical but trying to be open minded. So far (before actually having it on my doorstep), my only big complaint is that Minimed's CGM transmitter is still shaped like a seashell. I've been spoiled by the relatively well adherence of my Dexcom sensors, but maybe this time I'll figure out some D-ninja skills for taping it down. The ETA for my new pump is another week or two.
Late September:
I lost my Dexcom CGM receiver, Eggy, on campus one night. After retracing my steps, inspecting the lecture hall, and tearing apart every possible spot, I dishearteningly gave into his permanent disappearance. I'm still convinced he's stealthily hiding in my car or room, but I called Dexcom up to have them send me a new receiver.  I have enough sensors in stock that it was silly not to follow through with that option. Now that I may be transitioning to a MM CGM, I feel EVEN more silly. Oh well.
Late August:
I'm not in love with my new doctor but I don't have any reason to be offended by her. She's very matter-of-factual. I was a little turned off by meeting/reviewing my history with a med student before I met her but that's the blessing/curse of teaching hospitals. I love helping students, but for a doctor I'm going to see 2-3 times a year, I wish she had built some of a rapport with me before inviting a student in. We discussed stuff. She filled my prescriptions. Very transactional. We'll see what happens in 6 months.