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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.

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