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, July 24, 2013

Temporary insanity

I’m annoyed at the location of the temporary basal rate menu in the Snap, but I don’t know if this will bug anyone else. You see, I use temp rates a lot, which means either that I’m a “super user” or that my pump programming is less than perfect. (The truth probably lies somewhere in between.) But anyway, I frequently use temp rates during CGM drops, and always use them to shut the pump off in a low. Yes, yes, yes. I know. I know. You can suspend a pump when you are low, but then you have to remember to turn the little fucker back on again. When I have a hypo, I follow a simple three-step battle plan. First, I set a temp rate of zero for 30 minutes, as there’s no point in throwing fuel on the fire. Second, I consume 16-18 carbs. I usually use Dex 4 liquid at night and Nipro’s Shot during the day. The Shot has 400 IU of vitamin D, as well as glucose, to help me recover the physical energy I lose from the low. I don’t care if I’m peppy or not after a nocturnal low, but during the day this really helps me get back on my feet quickly. Third, I use colorful, explicit language about food, diabetes, insulin, technology, and how the sucky universe is in general.

This procedure works well for me.

Now, it was not my intention to spend the next month doing nothing but comparing t:Slim to Snap, but I’m sort of forced to. It’s been years since I wore the OmniPod, and talking about the extinct Cozmo is moot. Of course I wore a Revel last year. Well, that’s not quite accurate, is it? As veteran readers will recall, I actually wore five of them over the period of a few months. All the gaps in between these pumps were filled with pens and syringes… and what the hell, I think most of the reader interest out there is in t:Slim or Snap… so I guess I’ll just go right on comparing. If you don’t work for either pump company and you get sick of it, let me know.

So on the temp rate front, t:Slim mops up the floor with the Snap. Once either pump is turned on and at the main screen… Hold on a second. We need to clear something up before we go on. To wake up the Snap takes a single button press—unless you have the optional screen lock on, and why would you? To wake up the Tandem, it takes four button presses. But please remember that unlocking the t:Slim isn’t hard, is kinda fun, and it becomes very automatic, so it’s not the pain in the ass that it sounds like. But to try to keep the playing field level, I think I’m going to start counting steps from main menu. Just try to remember that getting to the main menu on either pump is a quite different operation, OK?

Now where the hell was I? Oh, yes. I’m dropping like a stone because the Amaretto Sour had a lot fewer carbs than I thought it did, so I overdosed myself with insulin. How many steps does it take to get to the temp basal control screen on each pump? Tandem: two. Snap: six. I find that really annoying on the Snap. And of course, I’m trying to do it quickly, because I’m low. And neither pump will remember the last temp rate I ran, damn it. Once you get there, the Snap requires some scrolling, and the t:Slim some typing.

Actually, once I do eventually get there, I prefer the Snap’s way of getting the rate programed and set: I just hold down the left button for about five seconds to scroll it to zero, and hit next. The pump does not advise me (and make me acknowledge) that I have set a temp rate of 0.0 u/hr. and basal will not be delivered for the duration of the temp rate, like some other pumps do. Next, on the Snap, I scroll for time. The pump’s default temp rate time is one hour, but it scrolls in 15 minute blocks so it takes only two left button presses to set my half hour. I don’t recall if 15 minute intervals is the pump’s default, or if I set it up that way. Hit the middle button  (labeled Start) and you’re done. A screen pops up to tell you the temp rate has started, but you don’t have to acknowledge it. You can just drop the pump back in your pocket. When it times out in a few seconds, it will return to the main menu.

Now on the t:Slim, the default settings on the temp rate control menu are 100% and 15 minutes—two settings that no one on the planet will ever use. So that requires you to access both menus separately and enter numbers. If you are low and shaky, you’ll be amazed by how hard it is to get your fingers to press the right part of the touch screen to enter the numbers you are after.

I must confess, however, that I’m sort of old fashioned. I’m a steam gauge and button kind of guy. I really prefer analog displays over digital. Debbie’s new used car, Duke the Juke has a digital gas gauge that just doesn’t “talk” to me. It’s too fancy-pants. I’m always getting myself into trouble and don’t know it until the low gas alarm goes off. My trusty old Jeep, on the other hand, has a needle that drifts between “F” and “E” and a quick scan of the dashboard tells me all I need to know. I also prefer buttons that really press over these touch screen things. I admit, they are kind of cool, and our house does have several of them, but I’ll take a button over a touch screen any day. Especially on a diabetes device. If you are younger, and grew up with this technology, you’ll probably feel the reverse of how I do.

Anyway, so the bottom line here is that I actually like the Snap’s control interface for temp rates much better than I like the t:Slim’s; but I hate where Snap buried it in the menus—temp rates are much easier to get to on the t:Slim—a fact that may come from the crowd-sourced design model that developed the t:Slim menus.

And there are a few menu items that are just in plain stupid places. But I’ll save those for another day.

Next time: The difference between unsnapping someone’s bra and unsnapping someone’s pump


Anonymous StephenS said...

Wil, I'm really enjoying reading about the Snap. I'll probably come back to this series of posts again when my latest warranty is up. Can't wait to see what that next post is about...

7:56 AM  
Blogger Scott E said...

I just love the teasers you use to keep us interested in the next post!

Question: Does the Snap wrap from 0% back around to 200% (or whatever the max is?). My MedT revel does, and it's annoying as all hell. I use 0% a lot, and missing it by one tick could be disastrous -- and there's no reason for anyone to want to wrap around like that.

3:30 PM  
Blogger Judi said...

Wil, I do what you do when I'm low, which is to start out by setting a temp basal of 0% for a half hour. I so wish that the t:slim would let you store a few temp basals like the Cozmo did. It was so much easier to just go to the per-set temp basal and not have to figure this out when I was low. It looks like the Snap doesn't have that ability either. Too bad one of these companies didn't pick up this great feature.

8:05 AM  
Blogger Wil said...

Scott E--

Rolls down to 0% and STOPS. Yay!

2:48 PM  
Blogger Mike Hoskins said...

It will be interesting to see if Tandem weaves into future generations this temp basal rate feature that the Cozmo had - especially since they gobbled up some of those patents and IP items earlier in the year. Also, very interested to see where and how soon we get some integration on the t:slim front...

1:39 PM  

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