Friday 27 February 2015

Episode 18: 64 Days on MiniMed 640G: Managing my type 1 diabetes: Week 2 SmartGuard kicking hypos Ass!


Welcome to the 2 week review of my 64 days experience of MiniMed 640G with SmartGuard.

 

See the video for full details but the highlights are here:

 

1.      SmartGuard prevented 2-3 hypos independently with no alarms! Lots of overnight hypos avoided! Another week of full sleep boom, see the three overnight examples!

 
 
 

 

2.       Smart guard prevented nocturnal  hypo after drinking wine see: http://www.mm640g.blogspot.co.uk/2015/02/smartguard-works-with-red-wine-check.html

 

3.      Enlite accuracy improved from 15% in week 1 to 11% in week 2 following the 7 top tips: with 80% spent in target of 3.5 – 9.0mmol/l: http://www.mm640g.blogspot.co.uk/2015/02/improve-enlite-accuracy-7-tops-tips.html

 

 

4.       SmartGuard works at its best:

a.       Overnight when only basal insulin in play causing hypos and no rebound hypers!

b.      2hrs post meal when bolus insulin is diminishing

 

5.      SmartGuard could not prevent hypos when over bloused in two hours post bolus.
 
 
6. When SmartGuard has worked a couple of times pre-meal there maybe a risk of post-meal highs. See the first graph when pre-lunch there has been very little suspend so a good amount of basal present pre-lunch bolus and no post-meal rise. The second graph shows two suspends pre lunch (great as hypo avoided) but  very little basal pre-lunch bolus and consequent post-meal rise. Therefore at meals when I look back and see the orange shaded area pre-meal I will add a bit extra onto the bolus!
 
 
 
 

 

6.       Change of SmartGuard setting required - See my shady diagram!

a.       Overnight set at 3.0 so MiniMed 640G will prevent going lower than 4.1 (1.1. above) – alarms off

b.      Two hours post-meal set at 3.4 (keep above 4.5) – alarms on to warm as may need extra carbs

c.       After two hours post meal back to 3.2 (keep above 4.3) – alarms off



7.       VLOGS to come:

a.       Carb counting and fibre using European labelling not US!

b.      Sensor accuracy explained – WTF is MARD?

c.       My top tips for getting Better Control
 
Enjoy your weekends!

 

Tuesday 24 February 2015

Episode 17: 64 Days on MiniMed 640G: Managing my type 1 diabetes: SmartGuard works with Red Wine? Check! Foggy head? Check! All in thename of Type 1 research debateable!

I thought I would put Smart Guard to the test with a little red wine tipple on a Tuesday evening, which seemed like a good idea at the time but now it's Wednesday morning and the red wine fog has emerged, I am not so sure!

I have just inserted my third sensor and this picture shows after inserting the new sensor it was tracking well. The first only lasted four days but the second sensor the full six days. Lets see how the third one goes.
 
The theory with alcohol is that each unit of alcohol takes 1 hour to be processed by your liver (detoxify the poison). Whilst the liver is detoxifying the alcohol it significantly reduces its output of glucose, the main reason why we have basal insulin. So in theory if the BG is stable before bed, your have some alcohol with no carbs and do not reduce your insulin (in my case the basal rate) you should have a hypo! So I decided half a bottle of red wine (5 units of alcohol with very little carb content) whilst watching the cricket world cup would be a good idea to see if Smart Guard stopping and restarting the basal would work!
 
 
This picture shows the morning calibration was pretty spot on with the sensor and looking back on the last three hours there had been no Smart Guard action. All I have to show for my troubles is a red wine fog!!!!
 
 
 
However on second look back over the night your can see here you can see between 01:30 - 02:15 there was a suspend before low and automatic basal resume preventing a hypo. As I had the wine at 22:00 I would have expected the liver to be producing little glucose from 10:00 to 03:00 (5 units of alcohol takes 5 hours to be processed), therefore a Smart Guard event at 01:30 is right where you would expect it to work. Sweet I do not need to worry about recovering from a hypo this morning BUT Smart Guard unfortunaltey does nothing for the hangover! URGH
 
 
It seems Smart Guard will help with a little mid week tipple! The bigger challenge will be the upcoming stag do to Prague! Anyone got any experience and suggestions.
 
Well the good thing is the alcohol will have been full processed by 03:00 so ready to drive for work, just hope these Paracetamol kick in quick time!
 
 


Sunday 22 February 2015

Episode 16: 64 Days on MiniMed 640G: Managing my type 1 diabetes: Improve Enlite Accuracy: 7 Tops Tips


Improve Enlite Accuracy: 7 Tops Tips

 

1.       Insert Sensor vertical NOT horizontal and on an area of little twisting and turning

2.       Press the inserter GENTLY on the skin

3.       Try products such as Skin Tac to prevent sensor pull out

4.       Connect the guardian Link/Minilink ASAP – waiting = peroxide build up

5.       Gently pull the security tape over

6.       Double tape after attaching the Guardian Link/Minilink

7.       DON’T WAIT TO CALIBRATE

 

I have used all these tips and will see if I can get the MARD from 15% below 10%!

Results to come after 6 days

 
 

Saturday 21 February 2015

Episode 15: 64 Days on MiniMed 640G: Managing my type 1 diabetes:MM640G vs VEO: 1 week CareLink Analysis for the Diabetes Geeks like ME!


This video shows the first 5 days of MM640G vs VEO and the difference in user experience. It shows how SMART GUARD works in real life and where it works amazingly well and also its limitations.

The diabetes geeks like me will like but if not a diabetes geek it may be a bit heavy!

 

Episode 14: 64 Days on MiniMed 640G: Managing my type 1 diabetes: MM640G vs VEO First week: Volvo vs Porsche: Plain Jane Vs Cindy Crawford


This video is a summary of the first week where I compared the MM640G vs VEO.

In essence:

1. I have gone from 14 low alarms per day to 1
2. SMART GUARD prevented 3-4 hypos per day without needing my attention1
3. Got an extra 1-2 hours sellp than normal and 2 hours per day less spent on my diabetes

I feel like I have upgraded from a Volvo to a Porsche and from plain Jane to Cindy Crawford!

 

Episode 13: 64 Days on MiniMed 640G: Managing my type 1 diabetes: Day 4: Hitting the Gym followed by dual wave for Chilli

New sensor tracking well so time to test with a weights session at the gym followed by a Chilli Con Carni Dietitian style with Dual wave.

For me no adjustment needed when doing weights as adrenaline release counteracts the usual BG drop from exercise.

I am guessing not many people use vegetables as their base for a Chilli Con Carni! Deitiitans are strange animals though!

 


Friday 20 February 2015

Episode 12: 64 Days on MiniMed 640G: managing my Type 1 Diabetes: Day 4: SMART GUARD prevents hypo overnight and whilst driving, then sensor failure!

SMART GUARD prevents hypo again overnight and then whilst driving! Works really well 3 hours after a bolus.

Then sensor failure, discussion about why and potential implications.

Meet my work colleague Kirsty!


Episode 11: 64 Days on MiniMed 640G: Managing my Type 1 Diabetes:


SMART GUARD prevents overnight hypo and hypo during exercise. I was only alarmed once in the day compared to 5 times with the VEO! I spent hardly any time managing my diabetes with the MM640G but would have had to have a lot of interventions with the VEO.

SMART GUARD works at best over night and when last bolus three hours prior!

SMART  GUARD could not prevent hypo when significantly over bloused at lunch time - key learning count your carbs right you fool!

There is more to learn but so far SMART GUARD is kicking ass!
 

Thursday 19 February 2015

Episode 10: 64 Days on MiniMed 640G: managing my type 1 diabetes: Day 2: SMART GUARD during the day and managing exercise


Day 2 review of SMART GUARD kicking in. At first I thought this was a bad thing but then realised people without type 1, their pancreas significantly slows down insulin secretion when BG starts to fall. Therefore SMART GUARD is making Type 1 more naturally physiological.  However, this requires a change of mind set by the people using it and almost as importantly the Clinicians prescribing it. In my view a few suspend before lows per day is actually beneficial as it allows you to run tight control with a much lower fear and chance of hypo!

Really put SMART GUARD to the test with exercise! Worked really well as I had no active insulin onboard. mixed activity of circuit class then yoga!

Chilli Con Carni carb counting with Dual Wave!


Episode 9: 64 Days on MiniMed 640G: Managing my type 1 diabetes: Day 2: SMART GUARD Hypo prevention and pre-bolus breakfast

SMART GUARD kicking ass overnight!

Pre-bolus for breakfast and think I need to work on my maths skills! 40 + 10 does not equal 60!

Monday 16 February 2015

Episode 3: 64 days on MiniMed 640G: managing my type 1 diabetes: Preset basal and bolus, set change reminder


 

Episode 2: 64 days on MiniMed 640G: managing my type 1 diabetes: Setting Up MM640G: battery, Active Insulin

 

Episode 1: 64 days on MiniMed 640G: managing my type 1 diabetes: Why 64 days on MiniMed 640G?


Welcome to My VLOG of my first 64 day experience on the MiniMed640G System.

Lots more videos to come on set up and then a head to head comparison of VEO + Low Glucose Suspend vs MiniMed 640G with SMART GUARD.

It's by a person with Type 1 for patients with Type 1!