Thread just for us old Type-1 diabetic insulin pump wearing Spyder Ryders

[Bob Denman]

Something that I have learned in the past two days:
The 670G DOES take over a whole lot of the decision-making...
When setting up a bolus with prior pumps: you could make the decision to have either a Normal, Square-Wave, or Dual-Wave delivery.
(For those non-diabetics who are still reading
A bolus is just a delivery of insulin. You decide how much you want (Based upon your caloric intake and/or blood glucose level, and have the pump deliver it.
A Normal delivery simply pumps in the amount of insulin that you have asked for
A Square-Wave will take that amount of insulin, and delivers it over a period of time that you specify.
This can be up to eight hours. I normally never went much beyond a three hour square-wave
Dual-Wave deliveries are really cool! You take the amount of insulin that you want, and break it down into a n amount that you want delivered "Normally", and the rest of it is then delivered in the Square-Wave manner.

Anyway: When you're in Auto-Mode with the 670: you can only bolus in the Normal manner.
Since the pump is handling the basal deliveries: it just watches your BG levels, and will add extra insulin, as your BG rises...
In effect: it has taken over the Square-Wave delivery feature of prior pumps!

What I have found; is that it doesn't seem quite capable of keeping up with my meals. I sort of have to "trick" it into giving me extra insulin, by telling it that I'm taking in more food.
So far: so good!

[tobor9]

Please consider going to the CGM if you can...
Here's why I think that it really helps:
Assuming that you test your BG four or five times each day: that gives you a "snapshot" of what is going on at that moment.
But it doesn't tell you anything else!
With the CGM: you'll need to calibrate it three times daily (I do mine when I get up, in the mid-afternoon, and at bedtime) You simply do that by testing your BG, and making sure that the value in entered into the pump.
By doing this; your pump will keep track of your BG values 24 hours a day, and it will be able to give you those values.
EXAMPLE:
Under your current setup, you have just tested your BG, and get a reading of 115 ()
But where is it going? Up or down? Should you be grabbing a snack to prevent a low, or throwing in some insulin to prevent a high?
The pump will keep running graphs available for you, so that you can see where the numbers have been... and where they are going.
And your 630 will do a GREAT job of providing this information to you!

Please consider it...

Thanks Bob,but i'm T2 and it would not be as useful for me as it is for a T1,and the cost(don't know if Humana would cover) is too high!

[OverHillAndDale]

What I have found; is that it doesn't seem quite capable of keeping up with my meals. I sort of have to "trick" it into giving me extra insulin, by telling it that I'm taking in more food.
So far: so good!

Bob - I just want to make sure that I'm following you as I not yet blessed with the new pump.

Are you saying that you can't bolus for a meal, OR that it doesn't do a good job of quickly adjusting if you DON'T bolus?

[Bob Denman]

Bob - I just want to make sure that I'm following you as I not yet blessed with the new pump.

Are you saying that you can't bolus for a meal, OR that it doesn't do a good job of quickly adjusting if you DON'T bolus?

What I think that I'm trying to say, is that the pump's algorithms seem to be aiming for blood sugars that are high enough to keep us safe.
I have mine set in "Auto-Mode"
(So Dr. Daystrom has programmed the Enterprise to pilot itself! )
When I want to bolus for a meal: I get to the bolus screen, and it asks me for a BG reading, and a carb count. It will then figure out how much of a bolus is needed. (based upon insulin sensitivity, active insulin time, and carb ratio)
It doesn't use the dual, or square wave bolus feature in Auto-Mode: it just seems to be constantly inputting tiny correction boluses. (.05, to .15 units at a time). This "sort of" keeps me close... I just need to add in some extra boluses, to aim for my much lower BG targets.
I've got a call in to Medtronic Support right now, to discuss some of this. I'll let you know what I learn!

[OverHillAndDale]

Sounds like like the bolus calculation is still intact.

I'm bugging Medtronic again about offering a higher-resolution screen for their phone app so I can better read my blood sugars while on the Spyder. I know you avoid this technology, but I find it extremely useful to be able to monitor while I ryde.

Looking forward to watching your regular reports on the new pump technology.

Dale

[Bob Denman]

When I'm riding: I'll take a peek at what's going on, whenever we stop for fuel, food, or pit-stops...
Every couple of hours seems to be enough!

[Bob Denman]

I just got off the phone with Tanya at Medtronic:
The reason why the pump seems to be letting my BGs go higher than I like right now: it's learning what it can about the idiot that it's hooked to! It starts out with smaller amounts of insulin, and will ramp up the delivery as it sees what I can take without "crashing".
This thing is leaning all the time that it's hooked up to you!

[OverHillAndDale]

Since I'm a simpleton, I suspect the device will outsmart me in the first 5-10 minutes. I'll be breaking mine in during August of 2018. Can't wait!

[Bob Denman]

Since this thing is always learning: I'm half-expecting this to happen:

[Bob Denman]

Basal Rates:
This thing is getting smarter... and I think that I am also!
When it's running in "Auto-Mode"; it makes continuous adjustments to the amount of insulin that you receive as a basal rate...
The micro-boluses are based upon what your maximum basal rate is set at.
When you get these rigs: that maximum basal rate is set at 2.5 units per hour.
That would be about two-tenths of a unit delivered every five minutes...
that wasn't high enough to keep my BG levels from rising...
Rather than just pumping in correction boluses constantly: I've been adjusting the max. basal rate upwards...
I've currently got it set at 4.0 per hour maximum, and may even go higher...
(This level is beyond what they suggest, but you CAN exceed the limit! )

[OverHillAndDale]

Bob - you and I have been Type 1 for 52 years, so I'm sure you're as insulin-resistant as I am. My maximum bolus and maximum basal are both WAAAAY beyond the suggested limit.

[Bob Denman]

Yup! Ain't it fun?
I found that even with some really careful carb counting: I was still going sky-high after meals. Since the auto-mode doesn't allow for square-wave boluses: I'm moving the max basal rate up to allow for more insulin delivery after meals.

(I STILL haven't figured out how to beat the maximum bolus amount of 25 units...
I was told that was hard-wired in, so that none of us would "suicide by insulin"

[jmnels]

Maybe I am a bit of a newbie type 1 - 38 years, lol.
I've been using pumps from Medtronics for years and now do CGM with the Enlite sensors.

Great explanations Bob.
Do you work with a dietician or nutritionist through your Endos office?
Perhaps some of the lag in BG corrections can be due to what you eat, as you know the impact of various foods on you. Adjusting the make up of the meals or timing could be part of the answer.
I know various Docs have different approaches.
As much as I enjoy pizza it takes about a pint of insulin to bring my BG back under 300 after eating 2 slices at the local pizza joint. So if I can't resist I make my own that way I know whats in it.

Not real strict with my intake and not an organo-nazi but I know foods can affect us all differently. No matter how much we like them....some don't like us!
Just my .02
Jim

PS keep up withs your posting of the good info

[Bob Denman]

Hi Jim!
Regarding the delayed absorption of food:

Ned.jpg

For years: I have been arguing that protein and fat intake has to affect the insulin requirements. But nobody has ever been able to tell me how to do it!
So I experiment, tinker, guess, throw sand in the air, squint at the Sun: and punch more buttons!
Nutritionists and Endocrinologists? I don't bother with them anymore...
I'm going to eat what I eat, and figure out the boluses on my own.
I use my Primary Care Doc to write me some scripts, and suck out some blood for testing: that' all....
Oh! I also let her yell at me about my weight...
I figure that since I'm paying for the Band: it's my Dance Party, and I'm calling the shots!

[OverHillAndDale]

If you're eating some high carb stuff mixed with fats like pizza, I find that the square wave or dual wave bolus works best. For me, about 8 units spread over and hour (Spyder people - how we handle as we ryde IS relevant to this forum!)

Proteins and fats DEFINITELY affect how carbs are managed. If you eat a LOT of protein, primarily meat proteins, they will raise your blood sugar (not sure of they become carbs or what).

Proteins and fats both interfere with insulin usage rates. If I have a meal with lots of fats, often it takes 2-3 hours before the meal starts raising my BS. So, add some of this, wait on that, bolus this way, don't do it the way it did before.... As a Type-1 friend of mine said, "There is never a moment in the day where I can just ignore that I'm a diabetic." So true!

[Bob Denman]

I think that we've got the same Dad...
Your explanation of how the meal type affects the digestive rate tracks EXACTLY with my experience.

[Bob Denman]

In today's News:

http://www.bbc.com/news/health-40876438

This is kind of exciting! I hope that this research hits on a useful solution!

[OverHillAndDale]

Houston is desperately looking for help with diabetic supplies including insulin, alcohol swaps, syringes (in unopened boxes), pump supplies, etc. Steve Ponder who wrote "Sugar Surfing" has people assisting in the coordination of this effort, and you can look for him on FaceBook. There are people in or close too DKs due to doing without insulin. Not sure, but I believe the greatest needs right now are insulin, syringes, alcohol swabs, and lancet devices (not the lancets themselves), glucose meters and strips.

I have a contact, Anne Imber who is managing some of this effort.

Anne Imber.JPG

[Bob Denman]

Thanks! Let me go see what I can dig up!

[Bob Denman]

I saw this on the news feeds this morning. It sure seems interesting!

http://www.denverpost.com/2017/09/28...ests-diabetes/

By the way: a VERY good friend suggested that I read "Sugar Surfing", by Steven Ponder...

It is an EXCELLENT book, and I have to pass along his suggestion to everyone!! Thanks!