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!).

Wednesday, August 14, 2013

Where’s the site change reminder? Apparently with Waldo, wherever he is…

This is how it should be: If you fill a cannula a pump knows you’ve just changed your site. That should trigger a reminder that this needs to be done again in either two days, three days, or four days—depending on how sensitive your skin is and how bad your health insurance is.

It should be seamless and automatic. You shouldn’t have to do a fucking thing to make it happen. Furthermore, there should be a quick and easy place to double check when that impending reminder is going to happen. In short, there should be a site-change reminder screen so that when I get ready for bed at night I can check to see if I should leave out a new infusion set for the next morning.

So in a perfect world, a system like that would rate a ten on a scale of one to ten. How does the Snap pump fare in this regard?

I’d give it a one. Or maybe a zero. Or perhaps a negative three. And to add insult to injury, the Snap needs a good site-change tracking, reminder, and status system more than any other pump on the planet because the reservoir changes are completely independent from the site changes. It’s bad enough to try to remember anything that happens on a three-day basis (because it’s never the same day of the week from week to week), but now there are two schedules to take care of. Plus, if you use CGM, it will be in it’s own little site-change schedule, too. I’m surprised no one is getting rich selling diabetes day-planners.

So here’s what I’ve been doing on the Snap, and I hate, hate, hate, hate it. Did I mention that I hate it? I’ve been setting the “Pump Alert.” This is a feature that lets me manually set a countdown alarm. The range of the alert can be as little as six hours or as much as nine days and 18 hours. Don’t ask me how they came up with that range. The hours can only be selected in 6-hour increments.

But getting where you need to be to actually set this alarm is tedious, to say the least. Let me take you through the process. Uh….you might want to brew a cup of strong coffee first.

First, press any button to wake up the pump.

Then, select the “Menu” button.

Next, you need to skip over the following menus:
Log Book, and then:

Select the “Set Up” menu.

After that, you need to skip over all of the following menus:
BG Prompt
BG Units
Low Insulin
Notification Timing
Daily Alerts
Auto Off
Beep Volume
BG Log Target
Delivery Limit
Button Guard
Intro Screen
Screen Timeout

And finally, select “Pump Alert.”

That’s 24 button presses, just to get there. Ow. I have a cramp in my thumb. And now I still need to set the alert, both the days and the hours. At least the Snap remembers what I set the last time.

It is, by far, the greatest number of button presses you’ll ever need to do anything on the Snap pump. What the fuck were they thinking?

Now, I do need to mention one other (in theory) cool option. The Snap has a “notification timing” option. This lets you choose between having the pump remind you when the timer expires, no matter what, or choose to have it remind you when you next turn on the pump. This sounds great in theory—no one likes to have a reminder alarm wake them up if they are sleeping in—but using this feature screws up your timing. Once you acknowledge the alarm by telling the pump “OK,” the Snap resets and starts counting down again.

Well, I don’t know about you, but my life is not so precise. What if I get busy and don’t change my site until the next day? Now my site change timer is off. The only way to reset it is to follow that tortuous path laid out above and turn the reminder off, then turn it back on again. And once a timer is running, you can’t stack a second reminder on top of it. If you have a change of heart, or have your infusion set ripped out by a passing door knob, you have to cancel the old alert and then start a new one.

This lack of a proper site reminder sucks, sucks, SUCKS!! It should be automatic with the cannula prime. Or at least it shouldn’t be buried at the bottom of the set-up menu half way to hell, 24 button clicks downstream.

Twenty four clicks for something we need to do every two or three days?


Next time: On the other hand, there are areas were the Snap really shines


Blogger Sandi said...

Who designs these things??? That's horrible. It would be quicker and easier to just program a reminder on your phone.

We have always thought it ridiculous that on the Animas Ping, there is a place to input how often we do a set change, but nowhere to set it to remind us. At least the Dex tells us when to change (restart) the sensor.

12:59 PM  
Blogger Bernard said...

I wonder if the software developer was getting paid by the menu item? ;-)

Seriously that is messed up. They could make the second menu hierarchical and probably shave down many button presses.

I think designers/engineers should be required to choose each item 4 times daily. They'd soon realize the painful ones and figure out how to improve it.

9:49 AM  
Anonymous Mark Estes said...

Our bad, it was not anticipated that one would clear the alert and then wait a significant amount of time before acting.

It was intended to be something you set once and then rarely bothered with again. Thus the position at the end of a rather long menu (along with other items that are typically set once types of things).

It does reset when you clear the alert and when make the long trip to revisit this setting. It also resets when you attach a new or different pump body.(that may give the start of a workaround that trades having an old pump body on hand vs button pushing).

Anyway, I believe we can tweak this so that you are happier with this feature in the near future.

your boneheaded pal,


3:42 PM  
Blogger Sarah Kaye said...

I agree with you on this point. It should be a "set change reminder" automatically built into the "prime cannula" section. It would seem easy enough to just program the pump to automatically remind you in 2 days or 3 days after the cannula has been filled to replace it with a new one... and for it to keep a timer going on how long it's been since you placed the new one.

1:20 PM  

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