LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Monday, July 22, 2013

Let’s eat. NOW!


You’ve been staggering around, lost in the Sahara for four days, ever since your plane ran out of fuel high above the dunes and ditched in the arid sands. Luckily for you, the good folks at Hilton have just opened the Moroccan Sands five star resort, and, stomach growling, you stumble into the all-you-can-eat buffet.

By some miracle, you’ve kept your insulin cool all this time and it’s still good. Wanting to maintain that stellar A1C that made your crusty old endo smile, you take the time to enter a bolus into your pump before you dig into the mountains of mouthwatering food that await you.

Trivia question: Just how many steps does this take on a Tandem pump vs. how many steps does it take on a Snap pump?

Are you fucking sitting down? Tandem: 14 steps. Snap: 6.

What???? Yep, that pretty, shiny, high-tech t:Slim makes you go through more than twice as many steps and “are you sure” screens before you take your first bite.

Maybe the Snap really is a snap, after all.

Now, because the flamers are cracking their knuckles and saying, “No frickin’ way,” let me bore you with the steps to prove my point.

Tandem:
1.) Wake pump up with silver button on top.
2.) Touch target 1.
3.) Touch target 2.
4). Touch target 3 (the pump is now unlocked).
5). Select Bolus.
6). Press Add BG to enter your BGL (or you can do carbs first, it doesn’t matter).
7). Enter your BGL. Although this probably takes three key strokes, I’ve counted this as one step.
8). Press Done.
9). Tell the little fucker that, yes, of course you want to correct your blood sugar, if you didn’t why would you embarrass yourself by telling it what your sugar is in the first place??).
10). Select Grams to enter your carbs. Now, I again counted this as one step, even though there is no saying how many key strokes it could take. You can also use the “+” key to enter multiple carb-counted items that build your meal. If you do, you must now however press “total” to add them up.
11). Select Done.
12). Select Next.
13). Confirm your request. If you choose to do a combo or extended bolus you’ll add a few more steps here.
14). Press Deliver.

Snap:
1). Press the bolus shortcut button, the one on the far right, to wake up the pump and take you to the bolus screen.
2). Enter your BGL. This does require scrolling, which depending on your BGL may or may not take as long as typing a blood sugar value into the Tandem. The higher your BGL, the longer this takes. Bear in mind that neither system has a meter that “talks” to it. Yet.
3). Press Next.
4) Scroll in your carbs. Note that you can also add the components of a meal. Just like with the Tandem, all you need to do is hit the Next key again and the Snap keeps a running total. Unlike the Tandem, however, you don’t need to press yet another key to total all the numbers.
5). Hit Next again. The Snap shows you the total insulin bolus. If you want details, you call scroll to the side to see them, but it’s not required.
6). Hit Start to deliver. And that’s it. It’s time to eat.

What? The Tandem user has fainted from hunger at step ten? OK, let me eat one more lobster tail, then I’ll go help him.

Now, the Tandem people have been telling me that all the “are you sure” and “are you sure you are sure” screens were required by the FDA under the new pump guidelines, and that, going forward, all new pumps will be designed for the stupidest diabetic on the planet. But… wait a sec. The Snap is approved by this same FDA, under these same new guidelines… Hmmmm…

I suppose some of the extra steps might be because of the Tandem’s innovative touch screen (certainly that’s true of the first four steps), but I wonder if Tandem was being straight with me. Even without the touch screen unlock, the t:Slim would have four more road blocks between me and my insulin than the Snap does.

Today I’m liking Snap a lot. She’s not as pretty, but she loads fast and lets me eat faster. But the honeymoon has just begun.


Tomorrow: Are there things I DON’T like right out of the gate? Oh, yes. Yes, there are.


14 Comments:

Blogger Leighann of D-Mom Blog said...

The new OmniPod had a ton more confirmations that must be given. What's really annoying, given that there is only one person with diabetes in our house and at our school and most places we go, is that we have to confirm it's our daughter. Each. And. Every. Time.

7:09 AM  
Anonymous Kerri. said...

I've seen the Snap a few times in the wild, but haven't tried it out myself yet. Thanks for sharing your thoughts, Wil.

7:09 AM  
Blogger Scott E said...

Anything that makes the process easier is a good thing, and I've been thinking a bit more about the Snap lately. But I just did a comparison with my Medtronic pump to see how many steps it takes... and it seems to be the pretty much the same, maybe one more. Subtract one step if the meter beams the BG to the pump, add one step if you have the Square/Dual-Wave options enabled (both are the case as I use it). Then, the one additional step is verifying, and changing if desired, the number of units delivered from the estimate, which is really helpful when doing a Super Bolus. I imagine the Snap allows the actual bolus to deliver to be changed somehow, too.

I wondered about the confirmation screens too, and how Snap avoided them.

Looking forward to your continued posts on this!

8:17 AM  
Blogger laura said...

Thank you so much for all the testing and sharing you do! #dblogcheck

9:07 AM  
Blogger Laddie said...

I am using a Ping as I wait for the Vibe to be approved. All of the extra steps drive me crazy and it sounds as though the Tandem might be worse. I think with the Ping that the extra steps make it more likely that I will make a mistake. I miss my Revel, but couldn't live with the Medtronic CGM.

The Snap seems to understand that we're not stupid and we want a streamlined way to handle our pump.

#dblogcheck

10:27 AM  
Blogger Emily said...

Happy #dblogcheck Day! :)

10:32 AM  
Blogger Melissa Eagan said...

Checking in! #dblogcheck

11:54 AM  
Blogger Mike Hoskins said...

As always, thanks for not only sharing your honest opinions but doing it in a way that keeps us captivated and WANTING to read more. I'm currently considering the t:slim and wasn't much thinking about the Snap, but I find myself easily annoyed by these extra steps that aren't really needed. Might have to add the Snap to my list of items of interest to explore... Thanks for this, Wil. Looking forward to hearing how the rest of the honeymoon plays out.

2:06 PM  
Blogger Lesley said...

Wil - I love that in your blog & your "Ask D'Mine" columns you tell it as you see it. Diabetes isn't really a beat around the bush, prettied-up kind of disease to self-manage and I think most of us appreciate that you just cut to the chase.
I am AMAZED that the t-slim has 14 steps to the Snap's 6. I use the omnipod and the new pdm (as leighann mentioned) has a bunch of new "extra" steps and they are making me somewhat crazy [even though the smaller pods are making me deliriously happy]. When choosing a pump for my daughter, I really don't want to have her teachers facing any more pump work than is really necessary. Thanks for these posts - they are really helpful.

2:19 PM  
Blogger Karen said...

Very interesting. I enjoy a pump that looks snazzy and high tech as much as the next girl - but in the end it comes down to user-friendliness to me. And it sounds like when you compare the Snap to the T-Slim, the Snap wins the user-friendly contest hands down!

4:06 PM  
Anonymous Anonymous said...

I'd be interested to see a time comparison between the Snap and the Tslim, not just the button presses. Although I do need to press a fair number of buttons to program a bolus, I am able to do it very quickly. In my opinion much faster than I could with my non-touch screen pump. Has this been your experience?

4:22 PM  
Blogger Sara said...

"The Snap shows you the total insulin bolus... Hit Start to deliver. And that’s it."

Has MiniMed sued yet?

9:43 PM  
Anonymous Kathleen WEaver said...

Snap sounds interesting but I'm loving my Medtronics pump and CGMS (just got the transmitter two weeks ago).

9:59 PM  
Anonymous Hyman said...

This is great!

3:39 AM  

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