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!).

Tuesday, July 23, 2013

Not a pump paradise

So in many ways the Snap is pretty Snapalicious. What I like about it best so far is that it lets me do something that I love to do quickly: eat. As we covered yesterday, the Snap is practically a speed demon, compared to other modern pumps, in this regard. To recap, there are a minimum of steps involved in getting the BGL and Carb info into the damn machine, so that the insulin can get into my shitty body, so that I can eat the frickin’ food.

Now, for you non-dFolks, the reason this matters to us is that by the time we’ve figured out our carb counts in the first place, our food is already cold and the rest of the dinner party is starting dessert. Adding any slow-down on the pump end of the business makes eating practically not worth the effort.

I also like the fact that the Snap requires fewer oil changes than my old car. And by that I mean, of course, that I enjoy the fact that I only need to slap an infusion set on my body every three days rather than do the whole fill-the-pump/fill-the-tubing thing every 72 hours. But that leads us nicely to the first thing on my list of things that drive me batty about the Snap. Asante’s menu design slows down one of the fastest feature of the Snap.

Just for the sake of argument, let’s say that you’ve had a back-alley encounter with a sword-wielding Japanese mafia hit man who’s just cut your infusing tubing while trying to eviscerate you. Hey, it could happen. And it’s just about the only scenario I can imagine where you’d even need to fill your tubing using a Snap pump. Recall that when you assemble a pump body, penfill, and tubing set every week or so, the tubing fills itself.

Of course, the pump still has to have a tubing fill menu because we dFolks do sometimes encounter Japanese mafia hit men, sharp doorknobs, playful cats, dropped razors, and insulin pump tubing-eating seatbelt latches. So in an emergency, you do need a way to replace the tubing without sacrificing the pump body or the expensive insulin penfill inside it. Try that with an OmniPod or t:Slim. So there is a tube-fill menu, and I’m glad to have it, but it really should be at the bottom of the glove box.

But noooooooooooooo….. It’s high up on the menu structure, while on the other hand, buried below it, is the menu that lets me fill my cannula: an operation I need to do every three days. So on a Snap, every three days you need to scroll past the tube fill menu you’ll probably never use, to get to something you use all the frickin time. It’s not that big a deal, but it’s an extra button press. And extra button presses add up to God only knows how many hours/days/weeks/months/years of my life that I’ll never get back.

I have a low tolerance for extra button presses. Life is short and I have better things to do.

And this is an unnecessarily bone-headed extra button press. Someone at Asante should have realized that we almost never need to prime our tubing, but we have to fill the cannula every couple of days. What happens most often should have priority in the menu structure, while what happens almost never should be at the bottom of it. I suspect this is a legacy of engineers thinking inside the old pump box, not outside it where they created this baby. Back in the day you always had to fill the tubing before you could fill the cannula. Still, you’d think someone would have noticed how stupid this is. Maybe Asante doesn’t have enough dFolks on staff. Maybe they should hire some more. I urge all of you to fill their inboxes with your resumes.

But Snap’s exacerbating features don’t stop there. Chief among other things that piss me off about the Snap is how damn long it takes to correct a high blood sugar. Getting to the place to correct an unexpected high is a Snap, but then you need to scroll in your blood sugar. Yesterday Debbie brought me a diet cherry lime from Sonic Drive-In. Well, actually, that’s not correct. She ordered me a diet cherry lime. She brought me a regular one. I couldn’t taste the difference, but my CGM sure could. In no time, I had two arrows up and the sensor glucose was rocketing past 350. Guess how long it took to scroll from the default setting of 100 mg/dL to 350 on a Snap?

Twenty seconds.

Assuming one snap per second, it took 20 snaps. So it’s hardly a snap to fix a high.

♪♫♪ Scroll, scroll, scroll, your pump gently down the (blood) stream…♪♫♪ But there’s nothing fucking merrily about how long this takes. I think the Snap is the slowest scrolling pump I’ve ever worked with, and infinitely slower than a linked meter or the t:Slim that lets you enter a blood sugar as simply as dialing a phone number. Well, simpler, actually. When was the last time you called a three-digit phone number?

Why on earth don’t these pump companies set the blood sugar correction scrolling at 5mg/dL intervals? The damn meters are so inaccurate in the first place, it’s not like there’s a real world difference between a blood sugar of 273 and 275. But like the movement to remove the penny from US currency and just round sales up or down, I suspect many people would cry foul if a pump scrolled in fives. But it should at least be an option.

Do my complaints stop there? No.

Tomorrow: How the temp rate menu drives me temporarily insane


Blogger Scott E said...

Can't you just skip the BG scroll and enter a number of units of insulin? If you correct for a 350 while you have double-up-arrows, chances are that calculated correction won't be enough. (Not that you'd have the patience to have it calculate a correction for a 500 or anything!)

6:11 AM  
Anonymous Tiffani said...

This is awesome!

4:41 AM  

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