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Posts tagged ‘dexcom’

Animas Vibe: First (and Quick) Impressions.

Again, disclosure:  I work with Animas and have a sponsorship contract.  Here are more details on my disclosures.  I link to my disclosures more than I link to cat .gifs, which is saying QUITE A BIT.

As I mentioned, I’m testing out the Animas Vibe.  Here are my first, quick impressions after a few days using the Vibe.  (What, you wanted some long, flowery introduction paragraph?  I’m out of words.)

First things first. Change can be awkward and uncomfortable.  When I switched from Medtronic to Animas back in 2010, I had trouble with the switch not because of the pumps themselves but because of the change, in general. Wearing an insulin pump means being connected to a small box and tubing 24 hours a day, so you really get to know that box/tubing combination.  The curves and edges of the pump  became something I knew by heart, and wearing a pump that was even half a millimeter different than whatever I was used to made me grouchy.  It took me about three weeks to become used to wearing the Animas Ping pump, and about a month and a half to become entirely used to the differences in filling the reservoir, changing the infusion set, responding to alarms, etc.  (I experienced this all over again when I took the t:slim pump for a spin over the end of the summer.  The pump itself was fine but the different size/shape/process made me grumpy like this cookie and I was less accepting of the pump because it wasn’t what I was accustomed to.  This isn’t a comment on which pump is superior, but a commentary on why the learning/acceptance curve, for me, is a true curve.  It also illustrates my hate for change.)

I was set up on the Animas Vibe on 12/31, so I haven’t had this thing for more than a few days, but going from Ping to Vibe was simple in terms of learning curve because I’d already done that curve.  I have worn an Animas Ping since 2010, so the routine is familiar.  Keep that in mind as you read through my perceptions, as they are colored by familiarity.  And coffee.  (I had two cappuccinos with dinner.  TWO!!  Bees in fingers [h/t CSparl].)

CGM Integration.  I was unsure how I’d feel about integration, to be honest.  I like having my Dexcom separate sometimes, and things like CGM in the Cloud and Share are important to me because I most-often travel alone, so having my data streaming to the cloud is an important safety feature.  But, on the whole, I don’t stream my data (with overnight exceptions as noted).  Basically, I am the main person who needs access to my data.

However.  (And this is a big however.)  I like, and appreciate, options.  I don’t have the option of ditching diabetes, but I do have options on the tools and technology I use to make sense of diabetes.  I LOVE having the Dexcom data showing up on my pump screen.  Love, love, love.  Why?  Because I always have my pump clipped to me.  I didn’t realize, until a few days ago, how often I was keeping tabs on my external receiver, bringing it from room to room with me, and keeping it clipped to my purse while I was out of the house.  I went for a run the day that I hooked up to the Vibe and it was exciting to bring only one device with me.  With a tube of glucose tabs in my pocket and pump clipped to my hip, I was good to go.  It felt liberating.


The best part, for me, is that I can run my separate Dexcom receiver at the same time.  Yes, they can run simultaneously.  (No, I have no idea how that impacts the battery life of the transmitter.  Nor am I certain this is a sound idea.  But I’m doing it anyway.)  Both the Vibe and the receiver need to be calibrated separately, but for the times when I’m away for work, I’m happy I can still make use of the Dexcom Share without getting all weird. Options where there once weren’t any at all; I’ll take it.

(And I haven’t had a chance to test the accuracy of the receiver vs. the Vibe, but since I haven’t yet upgraded my receiver to reflect the 505 algorithm [we don't have a PC], I don’t know if my comparisons would be best.  Once I hijack someone’s PC and update my receiver, I’ll circle back on this.)

One concern I had about integration was whether or not I would hear the alarms on the pump.  In setting up my pump, I customized my alarms to reflect a vibration for any low blood sugars and a beeping for any highs, thinking that a vibration would be good for middle-of-the-night low warnings.  While I haven’t had much time to test the highs and lows (thankfully, numbers have been reasonable for the last few days), I did have one 2 am low blood sugar and the vibration woke me up.  I’ll have to wait a few more weeks/months to truly test how responsive I will be to the alarms.


Graphing it.

A photo posted by Kerri Sparling (@sixuntilme) on

One other concern I have is about the color indications for the different numbers.  I’m a creature of habit (see above bit about hating change) and I am used to the way that the Dexcom G4 receiver lays out blood sugars, in terms of color.  Ketchup and mustard, you know?  Highs are yellow, lows are red, and white means don’t touch anything because in range.  However, since companies cannot sync up their shit in a way that makes things easiest for end users (aka the PWD), the CGM graph on the Vibe is entirely different than that of the G4.  On the Vibe, highs are red, lows are blue, and in range is green.  For me, this has been a weird change because I like at-a-glancing at my CGM throughout the day, and now I need to readjust my mindset for what “red” means.

Screen Resolution.  This might seem ridiculous, but there’s a new feature on the Vibe that allows for the brightness to be turned up/down with a click.  The button on the edge of the pump with the little lock (or lightbulb, or whatever that icon is)  makes whatever screen you’re on brighter, or less bright, with a click. I like this more than I should, I think.

Food Database.  I haven’t used the Ping meter in a few years (I switched to the Verio when it came out, and am now using the Sync), so I haven’t done much with the food database in the past.  On the Vibe, the food database is built into the pump, so if I go in to give a bolus and use the EZCarb bolus, I can access a customizable database on the pump itself.  I haven’t had much time to play around with this feature yet, but I plan to as I fiddle around with the pump.  (One note:  on the “snack” screen, the food options are all junk food.  Chocolate cake, cannoli, donut holes, key lime pie, just to name a few.  Who categorized these as “snacks” instead of “junk food”?  Confused the small, rational part of my brain.)

To that same end about not using the Ping meter for a while now, it’s important to note that the loss of meter remote capability in the Vibe vs. the Ping did not matter to me at all. I haven’t used the meter remote option in ages, so not being able to use it with the Vibe made zero difference to me. Your preferences will vary, of course.

WearabilityFor better or for worse, this pump does not feel different on my body because it is essentially the same physical pump shape/size on my body.  Having worn the Ping now since switching to Animas, the Vibe feels the same.  But, for the record, I did try a blue pump this time instead of my time worn silver one, which feels sassy.  Also, not needing to carry the Dexcom receiver makes for a lighter purse.  (And when my purse holds glucose tabs, my meter, an insulin pen, car keys, wallet, gum, Batman, and a deck of Crazy Mates on an average day, one less thing is awesome.)

Battery Concerns.  Since it’s only been a few days, I don’t know how quickly running the CGM and the insulin pump will burn through the battery.  As it stands now, my Ping went through about one battery per month (maybe every 5 weeks), and my concern is that the Vibe will require more battery change outs.  Time, again, will tell.

Software Questions.  I haven’t uploaded my data to Diasend yet, but I’m excited to see what the overlap looks like for my pump, CGM, and blood sugar data.  My past experiences with Diasend have been good – I like the software – but I’m not the best at uploading data from my pump (read:  I never, ever do it because the process is annoying).  I’m hoping that future iterations of the upload process make it more plug-and-play instead of “hey, weird dongle.”

Overall, I’m excited about the Vibe.  (And even if you aren’t, let me be excited, would you please?  I’m appreciating the fact that this system has finally been approved in the US.)  I like carrying one less device while still using the CGM and pump combination that I trust and prefer (bias, bias, remember). 

I’m looking forward to sharing thoughts at the close of this trial period, and then moving forward with a Vibe of my own … even if the name of the product gives me a bit of a smirky smirk.

Bulk Solutions.

Due to adhesive change/skin sensitivity/dermis witchcraft, the Dexcom rash seems to be a now-reliable side effect of wearing a CGM (or anything else with adhesive ability, honestly.  Sometimes a bandaid gives me the scritchy-scratch).  I feel best with the Dexcom data streaming, though, so I do whatever keeps the sensor on and the itch at a minimum.

Which means ordering the ToughPads in bulk.


Necessary. And in bulk!

A photo posted by Kerri Sparling (@sixuntilme) on

The extra cost isn’t fun, but my sensor is currently rolling through it’s second start-up cycle, so I won’t complain.  Whatever frigging works, right? (Besides, a tattered Dexcom sensor feels like a diabetes Girl Scout badge. Next, I’m going for my “pile of test strips NEXT to the garbage can instead of IN it” badge.)

Hypo Management.

“Ninety-five percent of the time, I’m fine.  The lows are ones I can treat myself, even if the number is really low.  Usually my symptoms are shakiness or like this brain fog.  When the lows are really gross, I usually cry at random.  Or I throw things.  No real in between.  But the majority of the time, I can take care of things myself, and then it’s over.  Like nothing happened.”

I tried to explain this to a friend who was asking when it’s necessary to intervene during a low blood sugar, but explaining the slide from “fine” to “holy effing low blood sugar” sounds confusing when I say it out loud.

That’s the weirdest part, for me, that whole panic-then-peace part of severe hypoglycemic events.  My lows have historically come crashing in at a breakneck speed, which is part of why using a CGM has been a pivotal change for me.  Getting a head’s up on when a low is happening, or being able to treat it even before it becomes a problem, has helped me feel safer in the face of hypo unawareness (a lack of low blood sugar symptoms) and fast-dropping numbers.

My endo suggested that I raise my low alarm on my Dexcom from 65 mg/dL to 80 mg/dL in efforts to catch lows earlier, and in the last month or so, I’ve had far fewer chaotic hypos.  Instead, I’m grabbing the lows before they even become low, snagging a 70 while it slides versus waking up in the trenches of a 40.


Low alarm at 80 has been the best suggestion in a long time. #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

Small little tweaks here and there make differences I couldn’t have imagined. … that, and I’m burning through my supply of glucose tabs with a little less vigor.

 

Animas Vibe APPROVED in the US!

Oh YAY!!!

[Disclosures first:  I have a sponsorship relationship with Animas and have since early 2010, so everything said here is colored by that bias.  For more information on my disclosures, you can read my disclosure page.]

I was really excited to see in my inbox this morning that the Animas Vibe insulin pump has been approved for use in the USA for adults.  This device integrates my insulin pump and my CGM into one device, giving me one less thing to lose and one less thing to carry (and one less expensive thing to throw when frustrated).  As a human being who is not a kangaroo, this is a plus for me.  And integration with the CGM product that I know and trust (and also have a disclosure about – bias!) is an even bigger plus.

Worldwide President at Diabetes Care for LifeScan/Animas, Val Asbury said:  “We are excited to celebrate this significant milestone in our efforts to expand Animas® Vibe’s™ global footprint and our insulin delivery offerings to adult patients (ages 18 years and older).  Animas® Vibe™ is an important addition to our product portfolio because we are now able to offer patients in the US a solution that allows them to view glucose data and administer insulin right from the pump – simplifying and aiding in their ability to make more informed decisions and fine-tune insulin delivery.”

(For the record, Val and her team added their own little R-in-the-circle thing because they are official.  I am not as official.  I’m just excited.)

I asked the Animas team about upgrades for folks who are using an Animas pump but are still within warranty, and the response I received from Dave Detmers (Director of Communications) was:  “Once Animas® Vibe™ is commercially available in the US, we will provide an EZAccess Upgrade program, which offers patients who qualify the opportunity to upgrade to our latest technology. More details will be available surrounding the EZAccess Upgrade program once the program has launched.”  Like you, I am not sure how that will shake out, but once I have more details, I’ll share ASAP.

For now, I’m thankful that the Vibe has finally been approved by the FDA, as this moment marks progress.  I like progress. And I’m excited to see it happening.

When Good Insulin Goes BAD.

Ninety percent of the time, my high blood sugar has an identifiable reason, and there’s a cluster of common causes.  Did I under-estimate the carbs in a snack and therefore under-bolus?  Did I over-treat a low blood sugar?  Did I eat without bolusing at all (it happens)?  Is there a lot of stress floating around that I’m responding to?

Most of the time, those questions cover the why.  Once in a while, my highs are for rogue reasons, like an air bubble in my pump tubing.  Or when I eat something carb-heavy right after an insulin pump site change (it’s like that first bolus doesn’t “catch” somehow).  Or I forgot to reconnect my pump.  Or if the cat bites through my pump tubing.

But rarely, if ever, is one of my high blood sugars the result of bad insulin.

Except it totally happened last week, when two days of bullshit high numbers had me mitigating every possible variable … other than swapping out the insulin itself.  (And clearly I’m stubborn and/or in denial about the quality of my insulin’s influence on my blood sugars?)  I rage-bolused.  I exercised.  I low-carbed the eff out of an entire day.  I did a site change at midnight to take a bite out of the highs.  Nothing.  The downward-sloping arrow on my Dexcom graph had gone on hiatus.

(Always a punched-in-the-gut feeling to see the word HIGH on a Dexcom graph, accompanied by an up arrow.)

But ditching the bottle of insulin entirely and swapping in a new Humalog vial?  That did the trick in a big way.  For once, it was the insulin.  Next time, it will surely be the cat.

LOW.

BEEP!BEEP!BEEP! from the Dexcom receiver on the bedside table.

I heard it beeping for a long time.

Woke up with sweat pouring off my forehead and running down the side of my face, pooling up in my ears and in my collarbone.  The pillow was soaked.  My hair was soaked.  An outline of me underneath me, the line drawn with the panicked sweat of hypoglycemia.

Panic.  But tempered panic, since I was so deep into the low that I was slow in recognizing anything.  My status updated slowly:  This is a low.  This is a bad, bad low.  Eat something in a hurry or you’ll probably die.

The juice box on the bedside table was hard to assemble.  Plastic sleeve around the straw, poking the straw through the foil hole … all actions I’ve done before but it took 30 seconds apiece for me to figure out how the whole thing worked.  I drank the juice as fast as I could, in just a gulp or two and then I settled back into my self-made sweat lodge.

A few minutes later – maybe two, maybe twenty – Birdy arrived fresh from a nightmare, clutching her blanket and asking to sleep in our bed because she was scared.  I don’t remember gathering her up, but I do remember putting her on the outskirts of my dampness, snuggling her up against her still-sleeping father.  I was scared, too, still arranging blankets, trying to find a cool, dry section.  I looked at the Dexcom, and it only told me I was LOW and had been LOW for a long time.

Normally, I get up and brush my teeth after a low blood sugar.  Sometimes I use the hairdryer to dry my hypo-damped hair.  This time, I couldn’t move my ankles without feeling the dizziness flooding up to my hairline.  I used the edge of my t-shirt to mop the sweat from my ears.  So gross.  But necessary.

This morning I woke up chilled to the bone, the result of falling back asleep soaked to the skin and then drying off in the cool, fall night.  The Dexcom told me I had risen up safely to 109 mg/dL, and my meter confirmed that result.  My family bounced up and was ready to start their day, and I followed behind them, nursing the hypoglycemic hangover, grateful for technology that woke me up and for portion-controlled hypo treatment, but pretty fucking pissed off that diabetes was the nightmare last night.

 

Diasend: Now With More CGM!?

Is it a glitch?  A misfiring Internet tube?  A mistake that they haven’t realized yet and now I’m that jerk for pointing it out?  WHEN DID THIS HAPPEN?!!

Dexcom data, now available for upload on Diasend.  I don’t know when this changed (last time I looked was over 18 months ago), but it’s working now.  Even here, deep in Rhode Island (can’t go too deep, actually, as it’s a very small state).

After digging through the box of diabetes-related cables that lives in my bathroom cupboard, I can easily upload my glucose meter (Verio Sync), insulin pump (Animas Ping – actually not the easiest upload because it requires dongle dexterity and I can barely say “dongle” without losing it, so being dextrous is extra difficult), and continuous glucose monitor (Dexcom G4).  All my data garbage, dumped into one source.

It’s not streamlined, but it’s closer, and I’ll frigging take it.

(For a list of supported devices, check out this link.  And if you knew Diasend worked with Dexcom for US accounts a long time ago, sorry for being late to the game.  Also, why didn’t you tell me?  I am now VERY EXCITED and the CAPS BUTTON is sort of STUCK.)

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