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Posts tagged ‘review’

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.

Shine On, You Crazy Pedometer.

I’ve spent a few weeks playing with the Shine fitness tracker from Misfit Wearables.  (Hence the title, which I’ve been itching to use since receiving the device.)

As with any pedometer/fitness tracker/new thing, I’m paying attention to this device and becoming immersed in the data.  I use it as intended; I wear it all day long and sync it to my iPhone when required.  And it’s not hard to integrate, as I’m still in the wicked techno-joy portion of using this fitness tracker.

Doesn’t hurt that it’s slick, design-wise.

Shine vs. a quarter

The Shine is about the size of a quarter, and looks like a spaceship.  Only more Batteries Not Included than Wall-E, which I’m fine with.  Already suited up with an insulin pump and a continuous glucose monitor, I’m grateful for the small, discreet design of this fitness tracker.  Especially since I view exercise as necessary in my diabetes playbook as insulin.

Right out of the box … well, I have to admit:  I had trouble getting this thing out of the box.  Literally.  The package design is streamlined and reminiscent of all-things Apple, and admittedly took me ten minutes to figure out how to pop the Shine out of the packaging.  (I had a photo of the box, etc. but it ended up lost down an elevator shaft along with my OCP [original cell phone] two weeks ago.  Don’t ask.)  But once the Shine was released from its factory packaging, all I needed to do was download the Shine application, put the battery in the fitness tracker, and sync that sucker up with my phone.

Pros?  Once I had the battery in, it took me about two minutes to set up my profile and assign fitness goals.  The Shine goal system is based on points, and I opted for 1000 points to start, which worked out to about 1.5 hours of brisk walking, according to the app.  It was encouraging, and informative, to see the patterns of my day.  Having worn the Shine for the better part of the last three weeks, I’ve seen that I’m lazy as eff in the morning, but by 1 pm, I’m already logging points and usually have my goal met by early evening.

I like seeing the progress build throughout the day, either through syncing-and-reviewing on the app, or tapping the device and watching it light up, clockwise, signalling how close you are to completing your goal.  That ‘around the world’ light show is very satisfying, once you’ve hit your goal for the day.

The detailed reports for each day are seen from the application, and while they aren’t as detailed as I’d like (I use RunKeeper to track miles, pace, etc, so I’m accustomed to that level of exercise detail, and I prefer it), it’s useful.  If I hit goal for a few days in a row, I get the “on fire” icon, showing that I’m on a good streak.  The device also tracks sleep patterns (see photo below).

And lastly, it can go through the washing machine.  Or you can sweat all over it.  Or wash your hands without fear of water-logging it.  Nice feature, considering what circumstances fitness trackers are put through (running, swimming, bathing toddlers, etc.)

Cons?  The biggest con is that the night I put the device on, I lost it about an hour later.  I used the magnet clip, at first, and it somehow came loose while I was giving my daughter a bath.  That sucked.  It’s so small and so slick that it hid from me, underneath the bathroom cabinet, for a long time before I found it.  I wish it had some kind of tracker built into it so that I could use my phone as a honing device.

I mentioned that the level of detail leaves much to be desired, for me, and I’m hoping the interface upgrades will eventually reach the RunKeeper level.  Also, there’s no way to track weight training, and no open data field to add notes, which would be really useful.  I’d love to be able to add notes about blood sugars, etc. to help make this useful in tandem with uploading my meter, etc.

Another issue is cost.  While this device was sent to me for review, at no cost to me, it’s not cheap.  (Which is why, when I lost it for a few days, I was spazzing, feeling like I lost $120.)  It’s a durable little sucker, but isn’t easily kept-track-of without accessories like the magnetic clip or the sport band.  You can splurge even further and go for the necklace option, or durable leather band, but you’re dipping into the $80 range there.  Overall, the design and functionality seems worth the cost, but it’s not a purchase I’d make without thinking through.

And the sleep tracker function?  I’m iffy on these sorts of things.  How does it know I only had two hours of deep sleep?  And why didn’t it notice I woke up to use the bathroom?  I have yet to find a sleep tracker app or device that seems to work for me, especially on days when they claim that I should feel rested when I feel more like I’ve been hit by a truck.  Tricky tracking there.

Overall, I think the design of this device is excellent, and integration is easy (that is, providing I don’t lose it again).  With time, I hope the interface evolves to customize more details.  So far, it’s been fun to use.  What I really want to do is stick this pedometer – or any pedometer, for that matter – to my three year old and confirm that she logs over 20,000 steps per day.  I’m sure she’d kick the crap out of the goal system.

[Disclosure:  Misfit Wearables sent the device to me to keep and review.  I was not asked to blog about it, and my opinions are all mine. ALL MIIIIIIIINE.]

Guest Post: I’m Going to Pump *CLAP* You Up!

Today’s guest post is from friend, fellow PWD, and creator of the glucose tabs I stuff into my face for those lovely 3 am hypoglycemic events, Christopher Angell.  These are his first impressions of life as a cyborg as he gives pumping insulin with the t:slim a run.

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I put off pumping for a long time. When I was first diagnosed, at age 30, I wanted to get a pump right away, but my insurance company decided that my [newly diagnosed] diabetes was in fact a pre-existing condition that they declined to cover, despite my appeals. So the economic reality of getting a pump quickly squelched my desire to have one.

Faced with the reality of using MDI (pens) to manage my diabetes, I did the best I could, and got used to it (and pretty good at it). When I finally got new, better insurance over a year later, and finally had DME coverage, the first thing I did was get a CGM (Dexcom Seven+). I knew how to give myself insulin, but I wanted more info about when/how much to to give, not to mention some chance of getting a jump on my more aggressive lows. Once I had the CGM, I lost all desire for a pump. I just didn’t see how I would benefit from it enough to justify the expense/extra supplies, and all the accounts I read online about bad sites, occlusions, ripped off sites, forgetting to reconnect etc had me nervous. Sure, on MDI I might screw up a bolus and wind up in the 200s, occasionally eve the 300s, but the only way I’d end up in the 400s is if I was drunk, very sick, or just completely forgot I had diabetes. I’d gotten my A1c under 6 and I didn’t want to change anything.

Fast forward to earlier this year. That sub-6 A1c had crept upwards at each of my last four or five tests. I was having more noticeable highs (which tend to lead, one way or another, to more lows). I was traveling and exercising more, and having trouble managing my basals across time zones. I was ready to try something new.

Another reason I’d resisted a pump is that I didn’t feel like I had any more room in my pockets, and I’ve never been one to wear things on my belt. In my pockets, I was already carrying a phone, a Dexcom, a credit card case, cash, and often keys. At minimum. There was definitely no room for a pump. But within a few months of each other, Dexcom released the Platinum G4, and Tandem launched the t:slim. Put together, they were still smaller than just my Seven+ receiver. So there went that excuse. I took the plunge.

1st day – 3/27-28/13

Minimal pain/discomfort w/ insertion
Surprised by length of needle! (comfort short manual insert)
Some burning with first bolus
Occasional burning at site throughout the day
Used to bolusing carbs + protein/meal size, so carb-based bolus feels awkward. Want to feel empowered but still take advantage of new technology
Because I wasn’t using basal first day (had taken morning Lantus after forgetting it the night before) I disconnected for sleeping, which put off that adjustment.
Tubing novel (23″). Can see potential for many mishaps, but so far nothing.
Pleased with size of pump, but means it slides down deep into pocket. (selected largely based on pocketability).
Never had to think twice about how to operate it once I left training. Did extended bolus without any difficulty.
Looking forward to experimenting with different ways of wearing it.
Definitely lots of curiosity about t:slim from people once they learn I’m using it.

Day 2 – 3/29/13

Ran with it in Diabetic Lifestyle shorts pocket. Didn’t notice it at all.
Slept with it. Also not very noticeable.
Bolusing definitely easier. Not yet taking full advantage of the precision of the pump because carbs are only part of my bolus calculation, so still tend to bolus for meals in .5 unit increments, but use full wizard for corrections with good results.

Day 3 -  3/30/13

Prefer pump bolus to pen bolus overall. Not as fast, but overall more comfortable. I was not good at using new needles (always multiple days per) and feel like this is probably better for me.
Don’t love having an extra thing in my pocket, even something this small, but do love not having to carry a kit with needles, etc. at all times.
Tubing sucks. Not having a place to put the pump when changing etc is a pain (should just remove/disconnect whenever changing/undressing etc)
Wondering if there’s some sort of cable retractor device that would work with pump tubing…
As someone switching from pens, sometimes wish default bolus screen was just number pad for typing in units, still not relating to carb-centric paradigm (maybe it’s an option?)
Insulin On Board is something that I rarely thought about in a quantifiable way before. It’s now another thing to “worry” about. But, as someone who is normally data-hungry re: diabetes, I’m less engaged with this so far. But I have yet to encounter a stubborn high while on the t:slim that would cause me to rage bolus/severely stack insulin so I don’t know if my feelings will change in that situation.

Day 4 – 3/31/13

Legoland! More worry than I would have had w/ a pen in terms of riding rides etc. (losing it)
Am all for taking pump off whenever I feel like it. I assume that with time, I’ll grow accustomed to it much like with my Dexcom sensor, my wedding ring, or pants. For now, it’s foreign and at a time cumbersome, but, especially knowing I have some Lantus working no matter what, I just ditch it when it’s bothering me.
My favorite aspect is definitely corrections.  Correcting is much better, both manually and using the wizard.
Also, love the Quick Bolus. One of my concerns had been that, as a touchscreen, I’d always have to look at it to operate it. Not so with Quick Bolus feature.


Being sick brings up one drawback of the pump- there are now many more variables to test. Site? Tubing? Occlusion? Device?
Went to bed at 190->, gave a correction and a 20% basal increase (40% on pump due to split). Woke up higher.
In the olden days (2 weeks ago) if a correction didn’t work, I had one option: crack open a new pen/pen cartridge, shoot again, and wait half an hour (maybe drink some water and take a stroll). If that didn’t work, then I knew it was karmic retribution for not coming to a complete stop before making a right turn on red, or [took 4 puffs before passing/pressing every floor in an elevator/.…]

Testing all these variables feels wasteful. True, I could pull some insulin out of the tubing and give myself a shot with that, but honestly I only thought of that as I was writing this. As it was, frustration had me yank the site, pop the cartridge and its 38 units of insulin (enough to keep me alive for two days, three if I lived on nuts and lettuce) and start fresh (what I call “the scorched earth method”).

Thankfully, it worked. But WHAT worked? Was it the site? The insulin? A leaky cartridge? The universe deciding that my karmic debt had been paid at the precise moment that I hooked up my new rig? I’ll never know, so I don’t know what to try first the next time, assuming I actually have the time/supplies with me to go through this whole dance every time I have a stubborn high.

It’s been about four months now. It may not be obvious from those first few days of notes, but I kind of love it. I haven’t gotten new labs yet, but anecdotally I can see that my control has improved significantly. Between having a tethered pump and my faith in my Dexcom, I can now leave my house for hours with NO BAG, just my pump, my Dexcom, and glucose tabs in my pocket/car. It’s a revelation.

Though I had long ago stopped caring about being conspicuous when I bolused with a pen, my wife informed me that I no longer look like I’m taking insulin, I just look like I’m being rude and texting at the table. I guess that’s better?

I am bothered by all the extra waste from the pump, and I already have quite the visible scar posse assembling on my stomach from infusion sites I’m not too thrilled about. Sleeping with a tethered pump is not awesome, but I’m more adjusted to it than I initially thought possible. Tubing is cumbersome and unattractive. Itchy sites are itchy.

Still, right now, the pump is my weapon of choice.

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Thanks for sharing your first impressions as an insulin pumper, Chris.  For more from Chris, you can check out the GlucoLift company blog.  To taste test GlucoLift glucose tabs for yourself, you can purchase them on Amazon.  And for a quick video with questionable animation about how GlucoLift got started, click here.  Also, here’s a gerbil shirt, because you know you want one.


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