I use this term for a product that you may already like that then surprises you with a feature that you didn't even know existed. Like a car that turns off the interior lights before the battery runs dead, even if you'd left them on by accident.
I had one of those experiences today with my Cozmo. Yesterday my pump had started to complain that the battery was almost empty. And today I was running on voltage fumes.
I knew that I had to replace it, but I kept forgetting to. That is, until I was putting in a combination lunch and correction bolus. While the pump was delivering the bolus I decided to test what would happen if I removed the battery, essentially mimicking loss of power.
After replacing the battery I was pleasantly surprised to see a Bolus Interrupted message on my Cozmo. This is the kind of attention to detail that I've seen in other parts of the Cozmo pump. Those firmware engineers (the folks who write the code that runs the pump) really thought about this - good for you folks!
Dexcom delights
Another customer delight for me, this time from those great Dexcom folks. Today I got the new Dexcom CGM model to try out for a week or so (one sensor life). I'm going to replace my 16-day old sensor this evening and tomorrow I plan to try and use both receivers against the same sensor and see what happens. I'll use the OneTouch meter with the older receiver and my AgaMatrix WaveSense meter to calibrate the newer receiver.
What I'm hoping is that the newer receiver will show my readings to be higher that on the older receiver. If I'm right then it may prove my theory for my A1C being higher than expected.
The trial model also came with the slightly newer version of the Dexcom software. They've re-introduced the modal day view, which is very useful when you want to see recurring patterns in a number of days.
I'll blog about the new receiver and software after I've had a chance to play with it for a few days.
Note: I currently own shares in Dexcom, I try not to let this ownership influence what I say about the company or its products.
This last week started with the arrival of my newest diabetes gadget, a Cozmo insulin pump. I got it while at my office on Monday afternoon and opened the box to take a peek at it. But I didn't completely unpack it until I got home that evening. After dinner I headed off to a quiet spot and spent an hour or so programming it and 'plugging' it in.
I've already video taped the little guy once, when showing how to do a super bolus. I plan to do more videos in the future to show off some of the features that I really like on this pump. And now that I've done a second infusion set change and been wearing him for a week, living with him is pretty easy.
So the only thing left to do I suppose is to give him a name. I mean, I'll be living with this little guy for the next four years. I can't keep calling him 'my pump'.
Apart from toys, normally we only name cars in our family. (For example, Man the Van named after our favorite singer Van the man.) So I'm having trouble thinking about the right name.
Maybe you can all help me. I know some of you have named your pump. How have you gone about choosing the right name and what is it? Did having a name help in living with and using your pump?
Confession Time
My intentions were good. I signed up for NaBloPoMo, and I'm planning to write a post per day for the month of November. But yesterday I dropped the ball and missed posting. I can't believe it and I'm hoping the NaBloPoMo police don't go too hard on me.
I even started a long post on Symlin and how to use it. Maybe it was too long, because it's in my draft bin right now. I guess I've learned one lesson, keep them short and leave the long ones for a second post. Especially on the weekend.
I've mentioned the super bolus before on this blog. This is a technique that only works for people who are using an insulin pump.
According to John Walsh's original note about the super bolus:
A Super Bolus is created when some of the basal insulin delivery is stopped or partially reduced, and delivered instead as additional bolus insulin on top of a normal carb or correction bolus. This shift of basal to bolus insulin creates a larger bolus that can have more impact in situations where more insulin is needed quickly. These situations may include but are not limited to covering high glycemic index foods, larger intakes of carbohydrate, and speeding the return of an elevated blood sugar to normal.
The super bolus boosts the effectiveness of a regular bolus by taking some of your basal insulin and delivering it early. For example, if your basal rate is 0.7 units per hour, you can temporarily turn off the basal delivery for one hour and then take the 0.7 units immediately. The trick is how you take that insulin. If you took it as a bolus then it would affect your insulin on board totals, so instead you take it by using the prime features that you'd normally use to fill the cannula after inserting a new infusion set.
I shot three short videos that show how to do a super bolus on different insulin pumps. This gives you a chance to compare these pumps in action and see how to use this useful technique which helps correct high blood sugars a little faster.
Here's how to take a super bolus with a Minimed 512 insulin pump.
Here's how to do it with an Animas 2020 insulin pump.
And here's how to do it on a Cozmo 1800 insulin pump.
No, it's not a new Sam Beckett play. But today's the day my new Cozmo pump should arrive.
I'm so excited, it feels a little like my birthday with a really cool, geeky, present.
Once it's up and running I'll put up some video showing it in action. From trying one out in September I know that this pump can be customized a great deal. And I'm hoping to really take advantage of that.
I was baking some over the weekend and had lovely Irish brown soda bread as a result. Here's a picture of the results.
I can't easily get the right flour here to make this from scratch. So this is from an Odlum's mix that easy to put together. And in the US, there are several online sites that sell it.
Recently I was given a loaner Animas 2020 insulin pump to evaluate. My current Minimed 512 is out of warranty and is due for replacement. I evaluated the Animas and a Cozmo 1800 pump before deciding on a replacement that worked for me.
While I had the Animas I took some video that demonstrates how to use the Animas to take a bolus. I hope it gives you some idea of how this pump is to use.
Please note that in the video the screen flickers. In real life I found the screen bright and easy to read even in direct sunlight.
I really liked the built in food database that helps you when bolusing for meals. The Animas lets you bolus in 0.05 unit increments and set basal rates in 0.025 unit increments. So it's great for anyone who's really sensitive to insulin. It's fully waterproof, the O-rings on the battery cover and the insulin reservoir really emphasize this. It also delivers the insulin boluses very quickly compared to my old Minimed. And despite the bright screen it doesn't seem to drain the single AA battery too quickly.
On the down side. I didn't like the speed at which the up and down arrows worked. The numbers scroll extremely quickly and it's hard to stop at exactly the right spot. I also missed seeing the carb information on the summary screen that's shown just before you get a chance to take a bolus. The history on the pump is very insulin centric, with no information about carbohydrate consumption or blood glucose values. I also wish the daily summary showed the ratio of meal boluses to correction boluses. Finally the accompanying software has a very dated feel, the reports are pretty basic and there is no data export capability.
Even though I was just trying out the pump, Animas was very supportive any time I had a question. This was very refreshing when compared to some recent experiences I had with Minimed.
In the end, I chose the Cozmo 1800 pump and look forward to starting on it early next week.
I'm looking forward to a last bit of R&R before school starts for everyone.
On Monday I'm looking forward to lunch with Allison and Mel in Cambridge, MA. If any of you d-bloggers are local to Massachusetts drop me a line if you'd like to join the fun.
And next week I'll try and post some thoughts on the Cozmo insulin pump that I just returned today. Overall I liked it with a few reservations.
My aging Minimed 512 is due for replacement in September. This time, I'm planning to evaluate up to three models before deciding on the right one for me.
And tomorrow, I'm going to be fitted with a Cozmo 1800 insulin pump for a trial run. I'll be wearing it for a week or two with saline and testing it out.
What I've already heard about the Cozmo from friends is that it's a little bulky but very easy to customize.
I've also asked for the software that goes with it. And I'll blog about my impressions with both.
Because I don't see the software as an add-on for the insulin pump. It's an integral part. After all, what use would your iPod shuffle be if you didn't have iTunes? Probably you could use it as a door stop. Otherwise it wouldn't be worth all that much.
I'll post tomorrow about how the 'training' and first priming goes for me.
Sometimes I'm a bit of a perfectionist. I demand a lot of myself and expect it from others. I'm telling you this because maybe I just have unrealistic expectations.
In September my current insulin pump (Minimed 512) will be 4 years old. At that stage it will be out of warranty and I can get a new pump and expect that insurance will cover most of it.
Insulin pumps are truly a marvel of technology. This is a small pager-sized device that I will wear 24 hours a day, 365 days a year. It helps me to keep my blood glucose levels close to normal and it's something that I'll probably actually use and interact with at least eight times a day, every day.
So why are pump companies making it so hard to try one out for a short while? Yes, I can read the instruction manual and get some feeling for how the pump will behave and feel. But that's not the same as wearing the thing and using it for a week or so.
My original plan was to contact a few pump makers and ask them for a one or two week loaner. I'd fill it with a saline solution and wear it together with my old pump for that period. That way I could gauge its accuracy and usability and see if it was right for me.
So far I've contacted three different companies. One (Cozmo) has told me they don't have a loaner program. And the other two claim to be working on it, but I'm not holding my breath.
Pump companies (Minimed, Animas, Cozmo, and others) - WAKE UP. These are complex devices that are essentially extension of our bodies and our brains. There is no way I'm going to purchase a new one without trying it out first.
I don't want a 30-day money-back guarantee. I want to be able to try out the pump, with its software for a week or two. I want to know how it will work for me.
Will I be able to use it when I'm exercising? What are the insulin on board calculations like? How easy is it to bolus? What do I need to do to set a temporary basal? Can I easily calculate meal requirements? What kind of extended bolus options are there, and can I use them?
Maybe I'm crazy. Maybe I should just look at the glossy brochures with pictures of happy people and just pick one at random?
Diabetes: technology, devices, software, and other stuff.
About Me
Name: Bernard Farrell
Location: Massachusetts, United States
I was born in Ireland and now live in the US.
I have had Type 1 diabetes for over 35 years. I struggle with my blood sugar, the same as most people with diabetes.
I wear a Cozmo 1800 insulin pump and a Dexcom SEVEN CGM to track my blood glucose levels. I also take Symlin to help control my post-meal blood sugars.
I'm blessed by God, and every day brings the possibility of a cure.
I had one of those experiences today with my Cozmo. Yesterday my pump had started to complain that the battery was almost empty. And today I was running on voltage fumes. 
Today I got the new Dexcom CGM model to try out for a week or so (one sensor life). I'm going to replace my 16-day old sensor this evening and tomorrow I plan to try and use both receivers against the same sensor and see what happens. I'll use the OneTouch meter with the older receiver and my AgaMatrix WaveSense meter to calibrate the newer receiver.
