Wednesday, June 18, 2014

6 months on the 530G

Well, my A1c is 6.4%.  That's higher than it's been for the last couple years, but not by much (my previous three readings were 6.3, 6.0 and 6.2).
So in terms of the A1c, I guess switching to a pump has not made any major change.

Switching to the 530G did not make a difference to my hypoglycemia in the first couple of months, as far as I could tell. However, in the last few months, there has been an extremely dramatic reduction in the frequency and severity of my hypoglycemia, particularly at work and also asleep. It has NOT helped with mealtime hypoglycemia, a major issue for me (where I bolus and go low due to food not absorbing).

I thought I was having a lot more, and more severe, highs. However, my A1c does not reflect that, so perhaps it's not as bad as I thought.

I have not been able to do as much site rotation as I would like. Neither of the types of teflon set worked for me, and the longest tubing length is not available for the "steel cannula" (I put that in quotations because really it's just a needle). So although absorption is fine in my arms, I can't, with short tubing, wear it comfortably there. The legs hurt way too much. That leaves the butt and abdomen. I've been using sites on the abdomen further up than I had before, which necessitates shaving the area, and still doesn't leave me with all that much available tissue.

My pump reports that my average TDD over the past 12 weeks is 39.5 units. For the 9 week period prior to pumping, I averaged 32 units. I believe that this is a significant increase in my TDD.

I gained four pounds since starting on the pump, which probably doesn't have anything to do with it. I'm happy about it anyways.

Features and symbols on the pump that I do and don't use:
Homescreen symbol showing how full the reservoir is... not useful. One bar means anything from 0 to 45 units, and everything beyond that is plenty.
Clock- look at and use a lot.
Communication symbol with sensor... ignore. I'm always looking at the graph anyways.
Battery bar- useful but it gains as well as loses bars, so I don't really know what to make of it.
Bolus wizard- don't use. I haven't been carb counting regularly in years, and the evidence suggesting that it helps is weak. I did have it set up at first but I just don't see it being helpful.
Square bolus and dual bolus- for the most part I have just set an increased temp basal instead, but I have occasionally used this feature. Right now it's turned off.
Audio bolus- used it at first, stopped. I never wear the pump in a way that I can't look at the screen, and audio bolusing is SLOW.
Bolus using the "B" button- rarely remember to use it.
Manual Suspend- I use this mostly when I disconnect, but occasionally to cancel a bolus in progress that I've thought better of.
Sensor is usually on, although not always. I generally have only the predicted low, predicted high, low suspend, weak signal, and calibration due alarms on.
I currently have five basal rates in my standard basal. I don't use the basal patterns, although I initially gave them a try. I would use them more if I could have more than two alternates, they would automatically switch on on particular days of the week, and they did not result in a "special status" circle on the home window.
I usually use temp basals where I set the rate. I change it to percentage, and set a temp basal percent, when I want a temp basal to run during periods where the basal needs would change. I would LOVE to be able to set a temp basal profile rather than one temp basal(ie, next two hours 0.5 u, following two hours 0.4 u). I probably use temp basals on about 4 days of any given week.
I don't bother locking the keypad. I tried that at first, to stop butt-basaling, but it unlocks itself when it alarms and that's just too useless.
I occasionally set the alarm clock. I wish it allowed one time alarms instead of repeating the 1:15 alarm everyday.
I often look at daily totals. I like to know where I stand.
I have had the alarm at various settings.
I don't use the connecting meter. Not gonna have insurance pay five times as much for test strips. Plus don't like navigating that meter.
I don't currently use capture event, because I rarely upload data.
I find the active insulin settings only slightly useful. I would like to program my own way to calculate IOB. I like seeing last bolus, but would like the status screen to show all boluses within the previous four hours. Then I can more easily calculate for myself a more realistic IOB.
I think it's really silly that the status screen shows me when I started my reservoir, rather than when I changed infusion sets. Those are the ones I'm much more concerned about.
I like seeing units left, but often use it past 0, because it's got quite a bit past 0.
I like seeing ISIG, and next cal is nice but would be nicer if it were accurate.
The backlight is nice. I forgot that there was a way to turn it on when you're not on the homescreen, and finding that again was great.

Friday, June 13, 2014


I read a  study that kept using the term insulin dependent diabetes mellitus to describe a group of people who seemed unlikely to be type 1 diabetics (they were on average 68 years old diagnosed at age 53, their average BMI was 30, and they were more than 1% of the study area's over-50 population). When I got to where it said they classified people as type 1 diabetics aka insulin dependent based on their answering yes to the question "Are you an insulin dependent diabetic" I was sure that the population was in fact mostly type 2s who were taking insulin.

So I fired off  an email to the study authors, telling them that their premise that insulin dependent diabetes has blah blah blah effect was not really valid.

Only then did I read the rest of the study. At the end of the limitations, the authors admit that their insulin dependent population seems unlikely to actually be absolutely insulin dependent because less than 10% of the "insulin dependent diabetics" were diagnosed under the age of 30.
They say that their group of "insulin dependent diabetics" is type 2s who are "relatively insulin dependent". Which, although I think it's a bunch of bull hookie, still means my email was not exactly news to them.

Wednesday, June 11, 2014

It's been six months pumping. I've got an endo appointment for Monday, and I'm holding out for the A1c and discussion with the endo before I weigh in on the pump.