Medtronic or Animas Insulin Pump

My Medtronic Pump

I have been using a Medtronic Minimed 715 insulin pump for the last 5.5 years. I believe the warranty is only for 3 or 4 years, which means if mine breaks now I need to pay for a new one (insurance copay). If it was under warranty I would probably be able to get a new one from Medtronic at zero cost. The Rep for Medtronic told me that it’s beneficial to have the pump under warranty in the event it breaks I can get a new one a little quicker due to paperwork that will be needed. I get that and haven’t wanted to spend the money on a new pump since mine works perfectly fine and it’s over a grand for a new one.

Decision

I am starting to plan for 2012 and potentially using my Flexible Spending account to get a new pump. I’ve really been thinking through what pump I want to get and it hasn’t been easy. For the record, I’m still undecided and don’t know which way I will go at this point. Here are the features that I like/dislike about each that are factoring into my decision.

Animas Ping

I’ve really been looking hard at the Ping. The big features I like about the Ping is that A) It’s waterproof – like really waterproof to the point where I could jump in a pool fully submerged without issue. B) It’s pretty cool looking with a color screen (lower on my priority list) and finally C) They are working on integration with DexCom a leader in the continuous glucose monitor (CGM) market. I might take the plunge down the road on a CGM and I think I would prefer a Dexcom over the Medtronic CGM.

I know it sounds weird, but the waterproof feature is almost a game-changer for me. I don’t go on vacation or to the pool often, but it would be SO NICE to not have to disconnect my infusion set each time I went in the pool. That also means more checking, tweaking of bolus/basal for time disconnected. The waterproof feature is big to me. Note, the Medtronic Rep made a good point to combat the fact that their pump is NOT waterproof. He said, do you really want to take the chance with a $6,000 medical device? They focus on features that will help patients manage their diabetes versus making it waterproof.

Medtronic Revel

Now with Medtronic, I get a company that is focused and built a strong reputation with it’s insulin pump. My pump has worked very well for 5+ years and when I did have an issue, Medtronic responded quickly and resolved the situation perfectly. I also have CareLink, my web-based program that has tracked my diabetes data for a long time now and works well. My doctor likes the reports it produces and I like studying them for potential changes.

I have all the infusion sets and reservoirs that are for Medtronic, which isn’t a huge issue but a pain for timing a change. The downside is that the Revel and CGM from Medtronic is not as good as the Dexcom from what I’ve heard. They are working on changes and making the sensor more comfortable for insertion, but not there yet. With a somewhat lean body type and goal of getting leaner, the size of the needle can be an issue.

Summary

As I previously wrote, it’s difficult to get an unbiased comparison from a pump manufacturer. This is a pretty tough decision because it’s one I will have to live with for probably at least 5 more years. Which company do I think will be better over those 5 years, what product will have better support and what will I be happier with? Basically I am weighing the waterproof and change aspect of the Animas Ping against the proven support and product quality of Medtronic. It’s a tough decision that I will continue to think through over the coming months.

Ping
+ Waterproof, CGM Integration coming and looks

– Untested/unknown customer support, change from what I’m use to, 2 devices if I want a CGM now

Revel
+ Proven performance, customer support, Carelink reporting, CGM integrated with pump

– Not waterproof, CGM inferior…

World Diabetes Postcard Exchange

This is super cool and I’m excited to participate in Lee Ann’s postcard exchange for this year’s World Diabetes Day. Below is the rules for the exchange and a little bit about why Lee Ann wanted to start this for WDD. I find it really nastalgic to think back to grade school (WAY BACK) before there was e-mail and writing to pen pals. I wonder what kids do these days, e-mail pals??? Anyway, this exchange will be a fun way to share a little bit of your diabetes with someone who gets it. The greatest thing I have related to diabetes is the on/offline community that shares, doesn’t judge and just understands. As of writing this, a TON of people have signed up so let’s all join together. I signed up!

Please take a moment to let Lee Ann know you want to be involved.

Lee Ann’s Postcard Exchange

Here are the rules (as displayed on The Butter Compartment):

  • Email your postal address to Lee Ann: [email protected] If you would like to be matched with an adult, child or family, another type 1 or type 2, or if you are a type 3, spouse, sibling or parent, please indicate that. I will do my absolute best to match you with someone who is similar. Otherwise, your assigned recipient will be random in that regard, which isn’t necessarily a bad thing! We’re sending old-school post office-delivered postcards, so I need your snail mail address.
  • Expect to receive an email with the name and address of your postcard recipient. I’m trying to collect a nice list of participants from many different places, and as soon as the list fills out, I’ll be sending those emails.
  • Use the WDD Blue Circle and all the creativity you can fit on a 3.5”x5” piece of cardstock.
  • On the back of the postcard, complete this mini D meme, in addition to anything else you’d like to share with your recipient:
  • Your name:
  • Where you live:
  • Your connection to diabetes:
  • Type of diabetes:
  • Year of diagnosis:
  • One thing you do to Act On Diabetes:
  • One Word:
  • Mail it, ideally in time for the recipient to receive it by November 14th. If you’re unable to do that, please at least have it postmarked by then.
  • Check your mailbox for a postcard from the person who was assigned your name and address.
  • If you like, post a photo of the postcard you receive on the World Diabetes Day Postcard Exchange Facebook page.

Before I proceed, let me respond to anyone who is skeptical about sharing their address. I’m very conscientious about people’s confidentiality in all realms of my life as a result of my professional responsibilities. Other than the one person who will be assigned your name and address as their postcard recipient, your address will not be distributed or abused in any way. It’s reasonable to be wary, but I want to reassure all that I have no nefarious intentions. The worst that will happen is you might get a Christmas card from me IF I get off my butt and start making some.

Lee Ann’s Vision

Creativity: Needless to say, there is some creativity required on your part. I’m predictable like that. I will have some follow-up posts here with ideas, inspiration, and just some basic practical suggestions for the making of the postcard. I know that the easier this is, the more people will participate, so I want to make it easy. If you want to get fancy-pants with your postcard, that’s up to you.

Connection: As a kid, I lived for diabetes camp. Camp Sweeney was the only place where the shame I had for having diabetes evaporated, and being able to shirk that burden for a few weeks in the summer was a gift and a life-saver. During the rest of the year, I lived to check the mail in hopes of finding a letter from my camp friends. We elaborately decorated envelopes and letters, postmarked works of love and art. Just writing about it is making me teary-eyed because long before the internet, that was my reminder that I wasn’t alone. Looking in my mailbox and finding a reminder that someone else with diabetes was thinking about me still makes my heart burst with joy. We all deserve that, and I hope you feel it too when you get your postcard.

Participation & Activism: Because of where some people are geographically, the options for connecting with others on World Diabetes Day are limited or don’t exist at all. My belief is that no matter where you live, you should be able to participate in World Diabetes Day by connecting to someone else with diabetes. It’s not the same as hanging out with people in person, but I feel like a postcard exchange will allow us all to celebrate together. Imagine postcards with bright blue circles spinning around the globe, connecting us to each other!…

Diabetes Management: Medtronic’s Carelink Reviewed

Effective this past Monday I learned that Medtronic’s Carelink (Diabetes Management System) was going to be supported on a Mac operating system/Safari (browser). I haven’t uploaded my data in quite some time because of compatibility issues and getting a new iMac last fall. So hearing this news rekindled my drive for better reporting and being able to analyze my blood sugar numbers. The issue I have yet to see solved by them or any company to my knowledge is the issue of having multiple glucose meters. My mini doesn’t update my pump like my UltraLink does and therefore leaves out critical pieces of data. How nice would it be to have the ability to use SMS or Twitter to upload data to CareLink? So Carelink isn’t perfect, but I do like some of the reports you can generate and print quite easily.

The CareLink system is 100% web-based and you don’t have to download a thing outside of maybe having the latest version of Java or something.

Here is a screen shot of the log-in screen where it shows the last uploads and what device I used to load the data. Right now I use a CareLink’s wireless USB to get the data from my meter/pump to my computer without any wires. As you can see there are tabs across the top for: Home, Upload, Logging Data and Reports.

Log-In

  • Below you will see the report options under the Report tab. The two that I’ve circled are the ones I use the most and have great information as long as there is a good amount of samples on your device to load. A small number of samples may lead you down the wrong path…
  • When you select the upload option, it will ask what device you want to upload from with the options being: Pump, CGM or Meter.
  • The Logbook option allows the user to load an entry manually such as carbs, exercise, A1c, etc. This is a nice area to keep track of past A1c results or to add in exercise to explain why there may have been a low.
  • The Summary report option can give a nice snapshot of readings by showing the average/high/low readings per day. The color coding represents what is in an acceptable range (green) and what is above or below. As you can see, I’ve got some work to do for improvement.
  • The distribution section below (Modal Day Hourly Report) shows a nice breakdown of what is in range (white), the numbers above (yellow), those below (orange) and the ones dangerously low (red). On the right side, the report shows the average, high, low and Std. Dev numbers for the time period selected. For those that may not know, St. Dev is a statistical term used to show variation from the average (mean). For the purposes of managing diabetes, you probably want the Std. Dev number to be low meaning there isn’t much scatter like you might see in my reports. An example of this would be a 200 and 20 that averages out to 110, but the variation from the 110 average is high. The Std Dev of these two numbers is 127. I would much prefer to have 120 and 100, that average out to 110 with a very low std. deviation. If you want to know more about this just drop me a message using the contact page.
  • This report below, Modal Day Periods is great because it segments out time periods throughout the day and provides the average, high, low and standard deviation for each segment. For example, you could have lunch set to any reading between 11AM and 1PM. The report will calculate the measures for any readings during that time. Really, it’s a nice way to see where problem areas may be and where you may want to focus. This is my favorite report and the one I use the most.

More Exercise Doesn’t Always Mean A Lower A1c

Almost a month ago now, I wrote that I was a little disappointed in my first 90 days with P90x as it relates to my A1C. I definitely saw results in my weight, body fat loss and all around health. However, this is only half the battle, right? Not only was my goal to lose some pounds and look and feel better, but I wanted to improve my A1C. You know, the dream to hover in the 6′s.

Challenge

With P90x or Insanity, they are both intense workouts that push you to the limit and burn calories. Don’t believe me? Check out youtube or search the internet for either and you will find a massive amount of videos showing great results and people soaked in sweat. When I would get ready to do a workout I would always check my sugar before starting. My optimal blood sugar was around 180 if I was going to do a more cardio intense workout. Now from one of my last posts, that 180 would translate to around a 7.4 A1C. If my goal is to get into the 6′s then bringing my sugar up to 180 isn’t helping.

My A1C

I posted the last 10 years of my A1C numbers in a recent newsletter article and got some great feedback. Most recently, I dropped my A1C by .2%. The frustrating part is that I literally busted my ass for nearly 3 months of working out around an hour each night. Sometimes I would be working out doing P90x at 11:30 at night. I could have done a bit better on my diet, but I was fairly strict. So to only drop my A1c by .2% with all that effort was definitely discouraging. Again, if your goal is to lose weight/body fat and gain muscle, then the programs are excellent. If your goal is to lower your A1C, maybe these workouts aren’t for you or at least the way I approached it.

Exercise Lower A1C

We all know exercise is good for us in terms of our overall health in so many ways. But killing ourselves to drop 10 lbs in 30 days will not help your A1C, I almost guarantee it. In order to burn enough calories, you have to simply run high on blood sugars too often, which I don’t recommend. A regular routine of moderate exercise is probably much better for staying healthy and maintaining a good average blood sugar or A1C.

Learning
Instead of me starting my exercise a little high, I think I would have done much better to add carbs during my workout. I could have done this by adding some regular sports drink, like Gatorade instead of drinking water. This way the sugar from the drink would help me maintain a level blood sugar instead of dropping low or starting too high. Remember, a smooth line (in range) is always optimal when it comes to diabetes. That line would have little dispersion unlike the image above and would look more like a line. So just because you may be hitting the gym hard, don’t expect to see a dramatic drop in your A1C just because you’re putting in the time and burning calories. Show me an extremely fit person with washboard abs and I could show you an A1C in the 9′s. So just because someone is in shape doesn’t necessarily mean their diabetes is in excellent control.

Final Word

Don’t let this article discourage you from working out, trying an extreme workout or exercising in any way. The benefits of regular exercise are just too important. I feel so much better about myself after working out and while maintaining a regular workout schedule. When I feel better and have more energy, I tend to eat less garbage, sleep better and be less irritable.…

Something Worse Than A Low (Hypo)

Hypoglycemic (Low Blood Sugar) Incident

Just last week I was up in the middle of the night with a 48 mg/dl (low or hypo) and headed for the pantry. During the next 20 minutes I came up with the idea for this post when two things collided. These two things are what I would call the “Perfect Storm” with diabetes. It’s actually not the first time this has happened to me and I’m sure it won’t be the last. In the diabetes community, they will probably say that a low blood sugar is the worst feeling in the world and something that scares the heck out of me.

Lowest Low

I can vividly recall my lowest blood sugar ever that was around 8-9 years ago. When I tested I was in the 20s and thought I wasn’t going to make it. I was literally crawling on the floor and hyperventilating to the point where I thought I would pass out. That was scary and something I don’t want to happen again, yet it probably will. To get that low I think I got complacent and took 20 units of Humalog (fast acting insulin) when I meant to take Lantus (slow acting). At the time I was pretty much in range, so that much fast acting insulin was a VERY BAD thing. Needless to say I never made that mistake again and I strongly urge you to highly differentiate between the insulin bottles. So what could be worse than a low?

2 Things Collide

Whenever I wake up in the middle of the night with a low there’s usually something else present. That thing is: HUNGER! When you are experiencing the scariness of a low and the shakes from lack of sugar in your bloodstream, it’s super scary. BUT, when you are low AND hungry at the same time it usually makes for the dreaded: ~40 t0 300 rollercoaster. This means you wake up low or let’s say 40 and starving. You head to the pantry with a laser-like focus on treating the low and getting rid of the hunger. Problem is that it can take 20 minutes or so for your body to absorb the sugar you ingest. That translates to about 15 minutes of gorging.

In talking to others with diabetes, I know I’m not alone here. It’s called over treating a low. I usually don’t have a problem treating a low without over doing it unless… I’m starving. Some in the Diabetes community refer to this as:

Treating a low while simultaneously treating the upcoming high blood sugar. This means eating/drinking carbs to correct the low and then taking insulin to correct the over correction.…