If You Give a Mouse a Cookie

A while back, I started doing some videos about the usability of my new Animas Ping insulin pump.  It was a lot of fun, but the holidays and some other personal things sort of put a hamper on that.

However, the real reason I started doing those videos was that I was preparing for a presentation at a local usability conference called STLUX.

My emphasis in college was Human-Computer Interaction (HCI), but I am not a usability professional.  I do not doing anything related to that in my daily job.  However, it has always been a curiosity of mine, and I try to keep up with that world.

I’d been meaning to get back into HCI and thought that STLUX would be a great way to stretch my wings.  The obvious choice was my insulin pump and similar medical devices.

Since I’m not a usability professional, I tried to keep my talk light and interesting.  I’m not the best speaker, but I did have a few people come up to me after the talk to discuss things further.  I had a lot of support from my colleagues and it was a great experience all around.

My session was not recorded, but I have posted my slide deck on Scribd.  The first 13 slides are as the viewer would see it, and the second 13 slides contains my speaking notes.  You can Ctrl+click to visit the hyperlinks at the end of the document.

If You Give a Mouse a Cookie

In addition to my presentation, I was also volunteered to be the photographer for STLUX.  I’ve posted a bunch of pictures on Flickr already and I think there will be more from the secondary photographers up soon.

STLUX 2011 Flickr

Thanks to everyone who provided assistance and I hope you guys learn a little bit about the challenges of designing user-oriented medical devices. Now, where is that glass of milk? =)

Not all bad

I know I’ve ragged on my new Animas pump a little bit (lack of site reminders and I:C ratios and noise), but since it’s Thanksgiving week, I thought I’d talk about a couple things I really like.

I would never have been able to wear this dress with my old pump.  It is skin tight (although stretchy) with no pockets and nowhere to clip anything.  I am not exactly the most well-endowed, so the thicker Cozmo was pretty obvious if I tried to hide it in my bra.

Not so with the Animas.  There is just no way you can see it.  I could even tell you where it was and you wouldn’t believe me.  I am so excited for the fact that I don’t have to worry about where to stick my pump when I go shopping.

The other part to the hiding-in-the-bra trick is the Ping remote.  I can just whip this thing out, bolus for lunch, and tuck it back in my purse.  No one even needs to know what it was for.  The Ping has a food database in it, so I can look up carb counts without having to haul around a separate Calorie King book.  If I used One Touch strips, this could also serve as my meter, but I {heart} my Freestyle Lite too much.  =P

So thanks to Lucille, I have increased freedom and flexibility, which will certainly come in handy this week.  ;)

Ratios and rackets

A couple quick things this week.

I’ve really been trying to tighten up my control, so I’ve been playing around with my lunch and dinner insulin-carb ratios.  I prefer to sit at 1:6.5, but that isn’t an option on the Animas.  I know that others, particularly those with insulin resistance, might appreciate having a few more options once you get below 1:10.

Another issue is that the pump is LOUD.  I use the combo bolus a lot and every 3 minutes I will be reminded of it.  ><  My work is relatively quiet and when I bolus for my Lean Cuisines, everyone in the office can hear it.  It’s great that the Animas is physically discreet, but I would love for it to be aurally discreet as well.

6 things for 6 years

Happy D-blog Day!

To celebrate the 6th annual d-blog day, here are 6 things I think people should know about diabetes.

1. Yes I can eat that! With the advent of insulin pumps and CGMS, there is no real reason I can’t eat whatever I want.  Not to mention that sugar-free stuff just plan tastes nasty.  If I’m going to eat the carbs anyway, it might as well be something delicious.
2. Taking insulin is not “bad”. I do not have it “really bad” because I have to take insulin. My body simply doesn’t make insulin anymore, so I need to replace it manually.
3. I’ve got it, but sometimes I need help. Most of the time, I am super aware of all the intricacies of what’s going on in diabetes-land.  I know that my blood sugar is going up, but it’s okay because I just ate and I know I bolused accurately, etc.  Or that I may be dropping, but that’s good because I was high before.  However! Sometimes I am low and I don’t know why and I need someone to cut me some slack and get me some Starburst.
4. My CGMS is amazing. This thing catches everything.  It tells me when I’m high; it tells me when I’m low; it tells me when I’m going up or down too fast; it will remind me later if things haven’t improved.  Because of this device, I have kept my A1c at 6.2% or lower (below 6.0% is NORMAL) for 2 years.
5. Diabetes is expensive. 4 endo visits, regular doctor, OB/GYN, eye doctor, dentist.  6 test strips per day x 365 days = over 2000 strips per year.  New infusion site, pump cartridge, and tubing every 3 days.  A CGMS sensor is $135 before insurance, which is only supposed to last 7 days.  The pump itself is over $6000.  I just started with new insurance, and next year I will EASILY hit the out of pocket maximum of $2500.  Probably by May.
6. The D-OC is awesome. George, Kerri, Scott, Bernard, LeeAnn, and Allison are all household names.  You are all my friends.  And not qualified with “diabetes online friends”.  Just “friends”.  <3

I’m back!

Hey everyone in the D-OC! Loooong time no blog.  Last we spoke, I was busy living my IRL, and while that is still the case, it’s time for me to get back into diabetes-land.

I recently got involved with a local usability group and it has inspired me to apply that knowledge to my diabetes.  I plan on putting together a number of videos about my experiences with my various diabetes devices.  Below is the first, introducing my new insulin pump.  I hope you enjoy it and I look forward to being a part of the blogosphere again.

Disclosure:  I am not affiliated with Animas or Dexcom in any way, shape or form. I am simply a user who would like to see some improvements.  All opinions expressed in this blog via text or video are mine and mine alone.

Oh, insurance… What are you doing?

I got a letter yesterday from my health insurance stating that they are no longer covering my Dexcom sensors, starting from August. I was confused because they’ve covered them in the past. Based on the code they listed, I assumed I had hit my DME cap for the year (this was my first full year on the sensors) and would need to appeal.

However, after spending 1 hour talking to 5 reps, I found out that the health insurance has randomly decided they are “disposable” since I throw them out after 7 days and they don’t cover “disposables”.  I imagine that “disposables” is intended to cover things like alcohol wipes and cotton balls, which they should rightly not cover.  However, 7 days is hardly “disposable”.

Edgepark (the company that provides the sensors) is already working it and their argument is that they’re not considered “disposable” since they are used in conjunction with a Durable Medical Equipment (the receiver).

I won’t know anything for at least 5 business days, but it is good to know that Edgepark is trying to regain my coverage.  I really cannot afford to either a) pay full price for the sensors or b) limit my use of them to every other week or similar.  I just hope this gets straightened out.

Data and what to make of it

I just downloaded data from my Dexcom and have been taking a look at it.  There’s so much data and so many different ways of looking at it; it’s hard to tell what to make of it.  There are a few items I like to focus on:

Modal Day screen

• average blood sugar for the month
• average blood sugar for the past 3 months
• standard deviation

Glucose Distribution screen

• % in range for the month
• % in range for the past 3 months

Success Report screen

• compare data montly
• compare data quarterly

The average will tell me about what my A1c will be.  I use this chart and I have found that comparing my Dexcom average to this chart is very close to my actual A1c.

The standard deviation will tell me if I am doing too much of a rollercoaster.  Lower is better.  I will confess, mine is not as low as I would like, so I know that I need to level it out.

% in range is very important to me.  Knowing that I am in range 75% of the time is greatly empowering.  Knowing that I am 95% in range upon waking is even more empowering.  Of course, knowing I am only 50ish% in range after lunch tells me that I need to work on that area.

Comparing the data from month to month is great for trends.  I can see that my average in October was less that what it was in September, which is great.  I can also see that my average for the last quarter is lower than the previous quarter, so I imagine that my A1c will be lower as well.

Using the Dexcom software can be a little overwhelming (there’s so much more data available than I even mentioned), but if I focus on these few things, I feel like I have a pretty good handle on my diabetes control.