Pumping vs. MDI

When I decided to stick with MDI in March after my pump broke, I said I would write more about the comparisons between MDI and pumping. I never did that so thought I would do that now.

One big plus of pumping is the multiple basal rates. Most people take one or two shots of Lantus or Levemir. Some people need more variety and they can have more basal rates with a pump. I take three shots of Levemir per day. I was always able to get fairly flat coverage with the three shots, but lately, my basal needs have changed. If I take enough Levemir to stay flat in the mornings, I end up going low after lunch. If I were on a pump, I could just set the pump to change basals rates when my body needs more or less basal.

You can also change your basals or suspend them on the fly with a pump. If your plans change for the day once you take Lantus or Levemir, that insulin is floating around in your body and you can’t take it back. You can change your basals with a pump or suspend them altogether.

Supply Company Nazis

I have been following a pump supply saga in the Animas Group on TuDiabetes. It first started with a delay in her e-store order from Animas then turned into a change in the amount of supplies that she received. She heard the usual finger pointing that we have all heard, “your doctor” and “your insurance company,” so she was making phone calls to both her doctor and her insurance company. What really put her over the edge was when she was told by Animas that her insurance company would only approve 3 boxes of insets and she was holding a copy of the insurance authorization for 5 boxes. Why is it that a supply company can override what our doctor feels is an appropriate amount for us and our insurance company is agreeable in paying?

I do think that there is a lot of waste in supplies and I even understand why there needs to be limits on supplies. I previously wrote that I think the auto-ship programs create a lot of waste. I often see people say, “the supply company keeps sending me …” and have to wonder why they don’t pick up the phone and tell them they don’t use that stuff. They seem to think it is free because they don’t have to actually write a check for it. After I first started using the Multiclix lancets, I was good about turning the little knob every day but I am back to my old habits. When I call to order test strips, they always ask if I need lancets and my usual answer is no. I went over a year without ordering any and if I keep going at the same rate, it might be another year before I order another box.

Pump Hackers Revisited

Back in June, I wrote about the MSNBC article on wireless pumps being hacked. You can read that article here. Last week, the Washington Post also wrote about it. Since then, there has been a lot of discussion about it and several of the other diabetes advocates have written about it. Keep in mind that this is not just insulin pumps involved, but insulin pumps seem to be what is getting all the attention. It involves Continuous Glucose Monitors (CGMS), pacemakers, defibrillators and any other wireless medical device out there. I will make a list at the end of the other articles so you can read more thoughts on the subject and I will update that list as I hear about more.

When I wrote my original article, I wrote, “It is pretty scary to think that someone can deliberately take over your pump and inject insulin into you without your knowledge.” In one way, it is scary, but what is the likelihood that would ever happen? Just because something is possible does not mean it will happen. You have a greater chance of being killed in a car accident than someone killing you with your pump – I sincerely doubt that you will quit driving or being a passenger in a car just because you could be in a bad accident. Do you really believe that someone is going to sit at the mall picking off every pump user that walks past? Honestly, if someone really wants to do you in, there are a lot easier ways to do it.

Animas Ping Combo Bolus Feature

I thought I would share this here just in case anyone else was told something wrong during their training.  It is not exactly that was I told was wrong, it is just that there is an easier way to do something!

I have been playing around with using the combo bolus feature (extended bolus for you non-Animas users).  Getting interested in the TAGgers group (see my post on Total Available Glucose) has me playing with the combo bolus feature more than I had been. 

If you select “Combo Bolus” on the bolus menu of the Ping, you enter the number of units, the duration you want those units and the percent that you want extended.  When I had my training, I was told to first go to “ezCarb” on the bolus menu and enter the amount of carbs I planned to eat, and then click “show result” to find out the amount of insulin calculated for those carbs.  What I was told to do next was cancel out of the “ezCarb” section and then to go to “Combo Bolus” to enter the insulin, time and ratio that I wanted.  I thought that seemed kind of stupid to have all these automatic calculations for me on the pump and then I have to calculate on one screen and then remember the calculation to enter on another screen.

I have been trying to use TAG and have been playing with using the combo bolus.  The other day, I selected the ezCarb menu to calculate the units of insulin I needed.  I went to move the cursor down to the bottom of the screen to cancel out before going to the combo bolus.  I did not realize that the cursor landed on the line that says “Type Normal.,” and more specifically, the cursor landed on “Normal.”   I accidentally clicked on “Normal”, and that “Normal” changed to “Combo.”  When you change “Normal” to “Combo” by using the up arrow, you then go to the line above where it says “Go” and that will take you to the “Combo Bolus” menu with the recommended units of insulin for the amount of carbs you are going to eat.  You can change the units there if you want and also your time and ratios, then select go to get your combo bolus!

 

The trainer I went to was at a diabetes center near here and trained on different pumps besides Animas.  I understand they can’t necessarily know every single feature on the different pumps that they train on.  Also, the training is meant to be a start and not necessarily some in-depth training about everything on your pump.  But if you are going to touch on the Combo Bolus feature, you should at least know how it works!   I just wanted to post this just in case someone else was told the same thing as me.  And sometimes if you think there should be an easier way to do something, there might be!