Ratios and rackets

15 11 2010

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.


Data and what to make of it

2 11 2009

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.

Well, it works…

3 09 2009

In a never-ending quest for lower and more stable blood sugars, I’ve been making some tweaks.  However, looking at the data, I’m less sure I’m doing the “right thing.”

I’ve done overnight, morning, and afternoon basal tests (evening still eludes me), so I know those are good.  My insulin:carb ratios are such that I am taking quite a bit of insulin with meals.  Result:

  1. I rarely go above 200/220 after meals.  And if I do, I almost always come right back down.
  2. My basal % of TDD is 30-35%.  Very very low.
  3. Because of the reduced basal, I have to bolus for Every. Single. Piece of Food. I put in my mouth.  i.e. if I treat a low with 2 Starburst instead of 1, I have to bolus for that 2nd Starburst.

I’m getting a little concerned about #2.  Early recommendations are for basal % TDD to be around 50%.  Pumping Insulin also has recommendations for basal % TDD to be around 40%.  Additionally, some studies have shown that the people with the least variability have basal % TDDs of around 40%.  So, I’m not way off base, but 30%?  Really?

HOWEVER!  My last A1c was 5.9% with almost no lows and less time spent high.  My % in range has continued to go up, even as I am lowering my basal.  Should I be worried that I’m not following the “correct” recommendations even though the end results show it works?

Diabetes misinformation in comics

16 01 2009

I don’t know how many of you read xkcd, but it’s a really great math/geek/romance/stick figure comic (yes, you read that correctly).  Today’s comic mentions diabetes, so I took extra notice.

(make sure to click through the image to see the comic page, and then mouse-over to read the alt-text)

As you probably guessed, I got a little miffed.  Yet another inaccurate portrayal of diabetes.  /sigh

There are forum threads dedicated for each comic, so I went there (login not required to view) to inform other readers that this isn’t how it works at all.  But, it seems that others had beat me to it.

I am glad that people jumped on the fact that Type 1 and Type 2 are different diseases and the comic is not an accurate portrayal of either.  Unfortunately, most people don’t bother to read the forums, so all they would see is the misinformation in the comic itself.

However, I think we can all understand that the comic is more about Jurassic Park and parenting than it is about diabetes.

P.S.  For more information about my serious lack of posting, see my general blog post here.

Anyone want some IV-3000?

17 11 2008

After my horrible experience with IV-3000, I decided to give it another try, in case the first case was a fluke.

It wasn’t.

As a result, I have 48 IV-3000 thingies that I no longer need.  If you would like some (2, 10, all of them), just let me know.  I’d like to get some of my money back on it, but I am not opposed to giving them away either.  You can email me at amalasblog[AT]gmail[DOT]com.

Diabetes terminology

27 10 2008

I am thinking of getting a medical tattoo, and I am wondering what the best text would be.  I am hesitant to put “type 1 diabetes” because I fear that they will rename it in the future (see: “juvenile diabetes”).  “Insulin-dependent diabetes” is more accurate, but longer.  “IDDM” is shorter, but more cryptic.  What do you think?

Questions about Animas pump

6 10 2008

I know at some point, I’ll need to replace Lucy.  I was poking around Animas’ website, and they have a GREAT demo of their pump.  I played with it a bit, trying to see how the things I do with Lucy would translate to the Animas.

One thing I noticed overall, is that there are WAY fewer customization options.  For example, when I want to do a meal bolus based on carbs, I can customize the scrolling amount (1, 2, 3, 4, 5, 10, 15).  However, I didn’t see that option on the Animas.  There are a lot of other things I didn’t see, which kind of surprised me.

The major thing I found, though, is with the meal bolus itself.  I entered my carbs, entered my blood sugar, and it gave me a suggested amount (based on carbs, BS, IOB, etc).  HOWEVER, the amount to deliver defaults to ZERO, NOT the amount suggested.  In fact, the default button is the “Go” button.  If one were just to hit “OK” through all the prompts after entering your info, you would in fact deliver NO insulin for your meal.  This seems like a bad idea.  I would hate to take the time for every single bolus to scroll up to the suggested amount.  Is there a setting somewhere to change that?  I couldn’t seem to find it.

Relatedly, after you hit Go to deliver, it shows that your insulin is delivering and you hit any button to cancel.  Are you just supposed to sit there and wait for your bolus to finish delivering before touching anything else with your pump?  What happens if you accidentally press buttons?  All this seems like a sure recipe for accidental highs.

I am also frustrated with the interface for changing inuslin/carb ratios, correction factor, etc.  Each segment has its own screen, so it’s hard to see the big picture.

Anyway, I’m sure people who use the Animas all the time have a better idea of how to use their pump.  But for now, it looks like I’m sticking with my Cozmo.