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!).

Sunday, January 15, 2006

Miscellaneous musings:

If you don’t have your shit together, and most of us don’t, you can forget that it is sensor change day. If you space it out, here is what the Guardian does to you: 72 hours after insertion you get an alarm telling you to replace the sensor. And then it shuts down!


That’s right. No more data. This is as insidious as Abbott's smart strips that won’t work one hour after their expiration date. If I were designing this system I either give a pending sensor replacement alarm in advance, or allow a six hour extension of operation after an alarm.

Can you imagine if your pump shut down after its “time for a new site” alarm?

Speaking of which, I have a window in my Cozmo that lets me look and see when the next site change is. Hmmmmm....Is that going to be tomorrow, or am I confused again? Well, let me see...oh yes next site change is ___________ (fill in the blank).

Why am I grousing about this? Well, I was out to lunch, in the intellectual sense of the word, on a recent sensor change. I forgot all about it until I was shut out. Unfortunately, It was right after a big, badly bolused meal. You can’t just plug back in. It takes two plus hours to spool up. That put my first cal stick on a steep slope above 300. Not the best footing to start out a new sensor. The unilateral shut down didn’t let me plan the best time for insertion of a new sensor.

Speaking of carbs and insulin, I forgot to tell you folks that a while back I adopted a new short cut. The Guardian has a way to enter both a carb value and an insulin bolus amount. However, it is almost a complete waste of time. Note that I said "almost," not "total" waste of time. The reason? The data isn't incorporated in any useful way by the software.

If you log in a meal, it will show up on the daily graph in "UnSolutions" (as I like to call it); but only as a graphic element. That's nice 'cause it says "at this point you put something into your mouth and took some insluin." Or, at this point you took a correction bolus. But....and there is always a "but" with is an act of Congress to find out how much insulin or how many carbs are involved. And we all know how slow Congress is, right?

Is there anything I like about UnSolutions? Hmmmm....Well, yes, as a matter of fact. The desk top icon. It looks like a miniature Guardian monitor. Very cute graphic. But that's about where my affection for the software ends....still better than nothing, and I do use it nearly every day. I spend a lot of time looking at the "traces" of the BG over a 24 hour period after I down load them. I just wish I had more flexibility in what I did with that data and how it is displayed.

But back to carbs and insulin, the data is there lurking under the surface of the software, but hidden and not readily available. First you have to close the graph; and second you have to open the log book, which takes foreeeeever to spool up. Then of course, you'd have to close the log book to re-open the graph. As there is no way to read the data while looking at the graph, I find it easier to just look in my food diary or pump log instead. That being the case, why am I wasting my time entering all this info in yet another place?!

Now, I do like having the little logo on the graph so I can quickly see when meals and insulin doses happened. My Solution? I just always enter the same insulin and carbs. That forces the software to leave me a logo, but takes me almost no time to do. The Guardian remembers the last entry so for a meal I just go to events press the ACT button five times and I'm good to go (once to confirm, once for insulin, once for insulin amount, once for carbs, and the last time for carb amount). If it's a correction bolus, same drill but three clicks instead. Maybe a few more buttons and a few less stacked menus would be a good addition to the next generation monitor.

By the way, as I predicted it would happen almost three months ago, the monitor's AAA batteries finally ran down. Readers who've been with me for a while will recall that one of my early bitches about the system was the lack of a battery strength indicator (which almost every other battery powered device on the planet both cheap and expensive have). Instead the Guardian gives you an alarm six hours before the batteries kick the bucket. I predicted this would happen in the middle of the night.

1:47 am last night... err... this morning. Yep. Damn, it's a burden always being right. ;-)

By the way, once that alarm goes of the back light no longer works, so if it is in the middle of the night you can't see what all the commotion is about.

Any way, quick process to change the two AAA batteries. I use the "Bunny Batteries." Energizer. I have no complaints. That was my original set. I got damn near three months out of them. And I use the monitor a lot, and most of the time with the back light too.

Oh well, replacing batteries by moon light four times per year won’t hurt me any....


Anonymous Anonymous said...

That is a hassle, but four mid-night wakeups per year is definitely better than even one mid-night untreated low. Nevertheless, it’s surprising that they wouldn’t include a battery life indicator (considering that even most of the batteries themselves have indicators)…

10:07 PM  
Blogger Ellen said...

What if one was to find out the sensor actually works for longer than 72 hours? This smacks again of MiniMed's greed to never allow you to find out whether or not it would continue to work. Of course it follows on the heals of MiniMed's requirement for everyone to use Paradigm proprietary infusion sets on the MM pumps too, rather than use a universal luer lock.

1:15 PM  
Blogger labrat said...

wish I could get one of these meters! Even if it'd wake me up for low batteries, at least I'd be woken up! Nightime lows are a hassle for me and I wish I had a better solution. With my husband out of town for two weeks, I wish I had someone like the guardian to watch over me... None available in SF. I can't believe that MiniMed forgot about us Californians...

9:26 PM  
Blogger labrat said...

btw wil, my blog is located at:

check it out...

9:36 PM  
Blogger Wil said...

T. Wolf-- I agree on both points.

Ellen--Of course it can work longer, just like an infusion set works longer. But the longer you leave something in, the greater the risk of infection. I think it is less of a direct greed issue than a keep-our-asses-from-being-sued issue.

I'm of two minds about the proprietary sets; it is one of the reasons I chose Cozmo over Mini Med when it came to my first pump. But since I made that call, I've had the chance to look at the MM locks more closly. They are quite a bit better engineered than the Luer Lock. So: greed or a love of superior engineering; or some of both?

LabRat--go back to the November Archives and scroll all the way to the start of the story. You can have one too if you want one bad enough!

They started sales in the seven cities where the previous "gold" system sold best. Makes sense, actually, the Docs in those cities were more acostomed to some sort of continous monitoring.

Good luck on your clinical trial, keep up in the loop as much as they allow you to!

10:26 PM  
Anonymous Anonymous said...

You can make the sensors last longer - much longer! When the Guardian shuts down at 72 hours, just start again wihout actually changing the sensor. When the Guardian searhes for a sensor, it doesn't know that it's finding the same one! Obviously you still get the two hour initializatin drop out, same as with a new sensor, but you'll save a lot of money.

3:30 PM  

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