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Monday, 24 August 2015

Forays into SmartGuard

The 640G: I finally managed to upgrade my pump and lay my grubby prick-marked fingers on one.

I fully intend to talk ramble about it. And all it's new features. Some people get excited about iphones. I get excited about mechanical pancreases.

But I'm saving that particular blog for later. Right now I'm a little sidetracked by the impressive Hylian Shield function (I'm talking about SmartGuard,for anyone who sadly grew up outside of the Zelda generation).

I didn't really think I'd get too much out of SmartGuard. I was pretty positive that I was just going to turn that function off, along with every other CGM alarm and notification setting. CGM has a unique way of driving me nuts so I usually just switch off any 'help' capabilities and use it as a trends-only tool.

For the sake of testing out a new product I enabled the 'Hey! Listen!' features of the 640G when I connected it up to CGM a few days ago. Smartguard, low & high limits were all set and ready to go.

Essentially, SmartGuard 'thinks' about your BGL trajectory, and if it calculates that you're going to hit hypo, it will suspend insulin delivery before you can hit a low level, and try to head off the hypo before it even happens.

It works. 

The 640G is whisper quiet on vibrate mode, so I didn't even know it had activated the first until I took out my pump to bolus for lunch to discover the exciting 'Suspended before Low' announcement. I was still quite skeptical, so I did a finger-prick to check the accuracy. It was spot-on.

I recently started a new job, and two weeks in, found out that one of the perks of working there was that there was another resident T1D. 

So when I got my exciting little 'Suspend Before Low' message I made a beeline to tell the only other person who could possibly appreciate what the heck I was raving about.

I didn't hypo. My BGL dipped to about 4.3 before leveling off and slowly climbing again. Once I had hit 5 and my BGL was holding steady, the pump made a decision of its own accord to restart my basal insulin flow.

Since then I have given my pump full reign to let the CGM run and do what it was made to do. The effect on my BGL has been amazing. It almost feels like a holiday. I have only had to treat 2 hypos since putting on my CGM last week, both of which were exercise-related, when I had my pump disconnected already meaning Smart Guard was not really able to be activated.

The new transmitter for the 640G seems to have more power, and I think that it somehow helps to calibrate better. Around 95% of the time my BGLs match the CGM to within a difference of 0.5mmol. The accuracy means I am able to give my fingers a well deserved rest. I have been testing only to calibrate or confirm unusual readings.

Not only is the Smart Guard preventing lows, but I haven't had a BGL over 12 since activating the CGM. One of the biggest reasons I would see BGL spikes is because I would be sick of hypos, and running a little higher seemed preferable to running low. Because I trust my Smart Guard to 'catch' me, I find that I'm dosing correctly for food - instead of under counting like normal to avoid lows. Dosing for all my carbs is helping to improve my post-postprandial glucose control. The result is a much straighter graph, with more time in the non-diabetic range.

(For anyone wondering, the orange sections are when SmartGuard activated)

I have also had 4 uninterrupted nights of sleep. In a row. For the past 2 days I have had enough energy to stay up until 11.30pm at night. Prior to this past week, I was so exhausted by hypos, nypos and self-management that I was falling asleep between 8.30 - 9.30pm at night. After scrolling back through my nights readings, I can usually see a drop at around 3am, which the SmartGuard is catching. It kicks in, I never become hypo, and I get to wake up fresh-faced and chipper in the morning. So the message I'm getting is that I need to fix my night-time basals, but in the meantime while I play around and adjust those, I can rest (and actually rest!) knowing that my pump is taking care of me. Extra bonus points for the fact that it doesnt make loud alarm sounds and just does what it needs to quietly.

Verdict? Shut up and take my rupees.

Disclaimer: Still not being paid by Medtronic or asked by Medtronic to write anything for them. Just a super excited T1D who likes playing with new technology and who cannot process her thoughts without writing them down and sharing them with the interwebs.

Wednesday, 5 August 2015

Pre-wedding conversations

The parmi in front of me looked delicious. A great last dinner for my last night as a single lady. My husband-to-be, myself, our Maid of honour, her partner and our best man had wandered to the pub across the road from our cabin for a warm meal.

 Without thinking I grabbed my meter, lancing device & strips and proceeded to do a BGL check. Something I do so often that its second nature. A normal part of eating.

As my Verio IQ counted down from 5 I absentmindedly sucked the blood off my fingertip before wiping my finger on my pants.

"Is that a habit?" Our best man asked concernedly.

"Yeah." At first I thought he was just being disgusted by my blood-sucking habits. He raised an eyebrow (Our best man has an unnatural amount of control over his eyebrows and often chooses to communicate through various combinations of raising and lowering them).

I understood what that eyebrow meant.

My maid of honour understood what that eyebrow meant. That's when we arranged that she would be keeper of the testing strips once I was in my dress. My biggest fear leading up to the wedding was that I would accidentally wipe blood on my wedding dress. Wiping blood off my finger onto my pants is habit. Not a habit I could afford to do the next day.


I went to clean my wedding dress today ready for selling. It survived. 

Tuesday, 4 August 2015

Fantasy Diabetes Device

Whenever Blog week rolls around, there always seems to be a topic on fantasy diabetes devices. I usually ignore that topic and run off to find a suitable wild card topic. There's never been anything that I needed a diabetes device to do that we don't have already. I mean, an app on your phone where you take a picture of your food and it tells you how much carbs are on your plate would be cool, but I don't really need it. I've got chocolate all figured out already, so really, I'm good here carb-counting my own meals.

But now I've thought of something. Guys - it's going to get a little girly in a second, so if that isn't your cup of tea - kindly click away to another, less feminine, post.

One of the awful truths about being female is that whether you want her to or not, your Aunty Flo wants to drop in every month or so for some female bonding time. You learn to live with it. My problem is that my diabetes loves Aunty Flo. He's always acting out whenever she comes to stay, trying to get her to notice him. But then the diabetes tantrums start once she leaves and he realises he's been left all alone again.

Its only a recent problem. Despite sulking objections from all my HCP's, a few months ago I quit taking the birth control pill after deciding I couldn't live with the side effects anymore. Best decision ever! Unless you talk to my HCPs who weren't too happy with the decision. Sadly for them, I don't care to listen to their opinions on the matter at all and am rudely ignoring their pleas to think about the possible unplanned children. I don't really plan on having any unplanned children, so I don't know what they're worried about really.

Since ditching the pill I have no idea what diabetes wants anymore. I know that I have a pattern that follows my menstrual cycle but by the time I can be bothered to change onto another pattern in my pump I've moved on from the low stage to the high stage.

So basically, what needs to happen is that someone needs to add a new kind of pattern to the pump that follows a set cycle of time before it loops back. Currently I have 3 different patterns set into my pump - 'nomal', 'A' & 'B' - normal for when my BGLs are behaving, A for luteal and B for follicular phases of my cycle. I'm ridiculously lazy and would rather spend a week hypoing a minimum of 5 times a day than simply switch my pump to my A or B pattern. And I won't even consider setting a temp basal every day. Its just more to think about.

My fantasy diabetes device is a pump, that upon set-up, asks if you're a female or male. You can select female and set a basal cycle length - i.e. 28 days. You can then set patterns inside a pattern - so tell it to have one pattern for say 5 days, before automatically switching to the next pattern, which may deliver less or more insulin, and so on and so forth, to follow your cycle.

Does anyone realise how much easier this will make my life? Why is this not a thing yet? Medtronic, are you listening?