Funnygrl
02-18-2008, 08:13 PM
I realized in an older thread Duck mentioned the need for a thread describing your "ultimate external pump." I can't remember if we've done this or not before, but it's actually been something I've given a lot of thought to lately, so I figured we'll do at it again.
I've actually considered "drawing up" a design for it, but I'm not quite that nerdy, so I'll just try and describe it best I can.
Please take this with a grain of salt. I'm EXTREMELY happy with pumps as they are now, I just always see room for improvements.
Having demo'ed an Animas in person and on the computer, used a 522, a Cozmo 1800, and a Cozmo 1700, demo'ed an Omnipod, used the Accu-chek Spirit virtual pump, and used literally every meter on the market, I have a fair bit of experience to go with from here.
For starters, my "perfect pump" would be shaped like the Paradigm and have a clip & cases like the Paradigm. I just think this shape is sooo much less obtrusive than the other pump shapes, and the clip is perfect. It would come in black, slate, clear, pink, purple, red, blue, silver, yellow, and orange. Lots of choices. It would be skinnable.
It would have a color screen and a dedicated back like button like the Animas.
It would hold 300 units, and could be set for U-50, U-100, or U-500 insulin so people who are very sensitive or very resistant don't have to deal with math or inaccurate insulin delivery history.
The home screen would display the date, time, battery level, reservoir level, current sensor bg, and any sensor arrows.
The status screen would show any information on active temp rates or boluses, the last bolus amount, the last bg (be it entered or from a linked meter), any up-coming reminders, reservoir volume, auto-off status, date, time, insulin type, IOB, delivery so far that day. The 800 number and the serial number would also be here.
The main menu would include bolus, basal, suspend, reminders, load, history, setup, and utilities.
The bolus menu would have 4 options- bolus manual, bolus calculated, carb database, custom boluses. Custom boluses would give you all of your custom boluses- ie, pizza for 45 grams, 70% now, 30% over 4 hours, or 2 units for "bedtime snack." You can name these, set them up (in carbs or units), or even create "meals" in the software, similar to the Cozmo's current set up. Grouping them in one category would give the main bolus menu a "cleaner" feel. The carb database option database would take you to the carb database, very similar to the Cozmo's, except no limit on 3 servings. Just like Cozmo's, touching the touch bolus would show more options. The other 2 would then give you the choice of a standard, combination, or extended bolus. It would not vibrate at every step of programming. When choosing whether or not to add a correction, choices would "Yes, use last bg," "Yes, use new bg," or "No correction." Once a bg is taken via connected meter, pressing the touch bolus button allows you to "tag" this reading based on activity level, time frame, and health, much like on the Ultrasmart. When programming a combination bolus with a correction, the correction portion will just be given right away (rather than not having an option for an extended bolus, like on the Paradigm, if a correction is included). Programming a combo bolus would show you the percent and unit split for now:later. If the calculator is used, when on the "recommended bolus" amount an astrix would appear next to the amount. The bolus screen would default to the recommended amount. The reminder will be set for any time from off to 6 hours after a bolus, in 15 minute increments, while programming. In the setup menu, you have the choice to let it not give you the option of a reminder at all. The boluses would be programmed in 0.05 u steps, and can be extended up to 12 hours in 15 minute increments. Multiple combo/extended boluses would be able ot overlap.
The basal menu would work much like the basal menu on the Paradigm now. The options would be "Set/Review basal patterns," or "set Temp Basal." Set/Revew basal patterns would work just like any other pump now. You could have up to 10 patterns, namable in included software, and with up to 48 rates in each pattern (by the 15 minute increment). The basal increment would be 0.025 units. Temp basal would give you the option to use a standard basal- in units, standard temporary basal- in percent of rate, or a custom basal (savable and namable via included software again). I'd like to see "complex temp rates" as an option, meaning you can lower basal a lot, then raise it later (like I need to do for exercise), or program a temp basal to start in a few hours. If weekly scheduling is turned on, you can change what basal you want on that day (ie, it's Monday, but you have the day off so you want Sunday's basal) here too.
Suspend would give you the option of suspending all delivery, a bolus, or a temporary rate.
Reminders would give you the option to set up missed meal boluses, set time reminders (with custom text programmable via software), low cartridge alert (in time basal can run left, or insulin amount left), site change reminder, and alerts to test after a high or a low. Further, in this menu you can see what reminders are coming up, and cancel them once, cancel all reminders for the day, cancel them for the week, or stop using the reminder all together. Reminders will also be programmable by day of the week.
Load is just as it sounds, and would work like it does on any current traditional pump.
History would give you the option of Bolus history (which would be just like the Paradigm's- click on any bolus to see details that led to it's calculation, and information on the type of bolus, clicking again will show you what foods were programmed if the carb database was used), TDD history- which would show your TDD and the basal/bolus percentage, Bolus breakdown history- which would show what percentage of your bolus was manual, correction, food bolus, both, and how many boluses you are taking a day. BG history would give you the option to see all bgs, bg's with a certain label (after exercise, after lunch, before all meals, fasting, etc). You would even be able to filter to show all readings with these three labels- ie, all hypo readings before lunch. BG breakdown would should you percent low/high/in range by category, or for all readings. BG average would should you tests/day, standard deviation, average, and number of tests included in average for a certain time frame, in a certain category or all categories. Insulin delivery averages would should you average tdd, average bolus size, average boluses/day, average basal/bolus split, average bolus breakdown, average carb intake, etc. Temp basal history would should you the history of when you suspended or used a temp basal (clicking would show you details of programming). Alarm history would show you alarms (and clicking would give details, including how long it took you to respond to the alarm). Prime history would give you the history of priming events. Finally, a basal history will let you click on any day and see exactly what your basal was that day, in graphical or list view.
Setup will allow you to set up if you want the carb database or bolus calculator to be options, whether you want the "touch bolus" to be programmed in carbs, units (and what increments), or be used as a short cut to the bolus menu, or serve no purpose at all. You can also program how long until the screen times out, if you want extended/combination boluses to be an option. Date, time, 24 vs. 12 hr clock, and language would further be set from here. You would also set up alert settings here. You would be able to program volume (or vibrate, or both) by alert type and time of day. Bolus calculator settings would also be programmed here, including how long you want a bolus delivered over. You could also program contrast and backlight brightness from here. Of course, all programming could be done via computer.
Utilities would include basal testing, child lock, disconnect option, and a plain old calculator.
The pump would have a remote with an LCD screen that could be used to program a bolus or a temp rate or suspend the pump. The remote would also show bg info from the sensor on it, so a parent can see it without even being in the same room as their child.
The pump would also have an external speaker that could be set next to the person's bed (or their parents) so alarms could be heard at night.
The pump could be programmed to text message a bolus amount, bg, or alarm info automatically by incorporating a SIM chip.
The pump would ideally be able to communicate via RF to your choice of 3 different meters or so. And more than one meter could be set up, so one could be at home, school, grandma and grandpa's, etc. If the meter has an option to mark a bg reading as pre/post prandially on meter, this will be applied to history in pump. Also, if the meter can remember insulin doses and carb intake, the pump will communicate this to the meter. So in other words, the history would be in both places.
The pump would be waterproof, and take 1 rechargeable AAA battery. A charger and 2 batteries would be included. In a pinch, it could take a standard AAA battery, as well. And 2 month battery life minimum.
I've actually considered "drawing up" a design for it, but I'm not quite that nerdy, so I'll just try and describe it best I can.
Please take this with a grain of salt. I'm EXTREMELY happy with pumps as they are now, I just always see room for improvements.
Having demo'ed an Animas in person and on the computer, used a 522, a Cozmo 1800, and a Cozmo 1700, demo'ed an Omnipod, used the Accu-chek Spirit virtual pump, and used literally every meter on the market, I have a fair bit of experience to go with from here.
For starters, my "perfect pump" would be shaped like the Paradigm and have a clip & cases like the Paradigm. I just think this shape is sooo much less obtrusive than the other pump shapes, and the clip is perfect. It would come in black, slate, clear, pink, purple, red, blue, silver, yellow, and orange. Lots of choices. It would be skinnable.
It would have a color screen and a dedicated back like button like the Animas.
It would hold 300 units, and could be set for U-50, U-100, or U-500 insulin so people who are very sensitive or very resistant don't have to deal with math or inaccurate insulin delivery history.
The home screen would display the date, time, battery level, reservoir level, current sensor bg, and any sensor arrows.
The status screen would show any information on active temp rates or boluses, the last bolus amount, the last bg (be it entered or from a linked meter), any up-coming reminders, reservoir volume, auto-off status, date, time, insulin type, IOB, delivery so far that day. The 800 number and the serial number would also be here.
The main menu would include bolus, basal, suspend, reminders, load, history, setup, and utilities.
The bolus menu would have 4 options- bolus manual, bolus calculated, carb database, custom boluses. Custom boluses would give you all of your custom boluses- ie, pizza for 45 grams, 70% now, 30% over 4 hours, or 2 units for "bedtime snack." You can name these, set them up (in carbs or units), or even create "meals" in the software, similar to the Cozmo's current set up. Grouping them in one category would give the main bolus menu a "cleaner" feel. The carb database option database would take you to the carb database, very similar to the Cozmo's, except no limit on 3 servings. Just like Cozmo's, touching the touch bolus would show more options. The other 2 would then give you the choice of a standard, combination, or extended bolus. It would not vibrate at every step of programming. When choosing whether or not to add a correction, choices would "Yes, use last bg," "Yes, use new bg," or "No correction." Once a bg is taken via connected meter, pressing the touch bolus button allows you to "tag" this reading based on activity level, time frame, and health, much like on the Ultrasmart. When programming a combination bolus with a correction, the correction portion will just be given right away (rather than not having an option for an extended bolus, like on the Paradigm, if a correction is included). Programming a combo bolus would show you the percent and unit split for now:later. If the calculator is used, when on the "recommended bolus" amount an astrix would appear next to the amount. The bolus screen would default to the recommended amount. The reminder will be set for any time from off to 6 hours after a bolus, in 15 minute increments, while programming. In the setup menu, you have the choice to let it not give you the option of a reminder at all. The boluses would be programmed in 0.05 u steps, and can be extended up to 12 hours in 15 minute increments. Multiple combo/extended boluses would be able ot overlap.
The basal menu would work much like the basal menu on the Paradigm now. The options would be "Set/Review basal patterns," or "set Temp Basal." Set/Revew basal patterns would work just like any other pump now. You could have up to 10 patterns, namable in included software, and with up to 48 rates in each pattern (by the 15 minute increment). The basal increment would be 0.025 units. Temp basal would give you the option to use a standard basal- in units, standard temporary basal- in percent of rate, or a custom basal (savable and namable via included software again). I'd like to see "complex temp rates" as an option, meaning you can lower basal a lot, then raise it later (like I need to do for exercise), or program a temp basal to start in a few hours. If weekly scheduling is turned on, you can change what basal you want on that day (ie, it's Monday, but you have the day off so you want Sunday's basal) here too.
Suspend would give you the option of suspending all delivery, a bolus, or a temporary rate.
Reminders would give you the option to set up missed meal boluses, set time reminders (with custom text programmable via software), low cartridge alert (in time basal can run left, or insulin amount left), site change reminder, and alerts to test after a high or a low. Further, in this menu you can see what reminders are coming up, and cancel them once, cancel all reminders for the day, cancel them for the week, or stop using the reminder all together. Reminders will also be programmable by day of the week.
Load is just as it sounds, and would work like it does on any current traditional pump.
History would give you the option of Bolus history (which would be just like the Paradigm's- click on any bolus to see details that led to it's calculation, and information on the type of bolus, clicking again will show you what foods were programmed if the carb database was used), TDD history- which would show your TDD and the basal/bolus percentage, Bolus breakdown history- which would show what percentage of your bolus was manual, correction, food bolus, both, and how many boluses you are taking a day. BG history would give you the option to see all bgs, bg's with a certain label (after exercise, after lunch, before all meals, fasting, etc). You would even be able to filter to show all readings with these three labels- ie, all hypo readings before lunch. BG breakdown would should you percent low/high/in range by category, or for all readings. BG average would should you tests/day, standard deviation, average, and number of tests included in average for a certain time frame, in a certain category or all categories. Insulin delivery averages would should you average tdd, average bolus size, average boluses/day, average basal/bolus split, average bolus breakdown, average carb intake, etc. Temp basal history would should you the history of when you suspended or used a temp basal (clicking would show you details of programming). Alarm history would show you alarms (and clicking would give details, including how long it took you to respond to the alarm). Prime history would give you the history of priming events. Finally, a basal history will let you click on any day and see exactly what your basal was that day, in graphical or list view.
Setup will allow you to set up if you want the carb database or bolus calculator to be options, whether you want the "touch bolus" to be programmed in carbs, units (and what increments), or be used as a short cut to the bolus menu, or serve no purpose at all. You can also program how long until the screen times out, if you want extended/combination boluses to be an option. Date, time, 24 vs. 12 hr clock, and language would further be set from here. You would also set up alert settings here. You would be able to program volume (or vibrate, or both) by alert type and time of day. Bolus calculator settings would also be programmed here, including how long you want a bolus delivered over. You could also program contrast and backlight brightness from here. Of course, all programming could be done via computer.
Utilities would include basal testing, child lock, disconnect option, and a plain old calculator.
The pump would have a remote with an LCD screen that could be used to program a bolus or a temp rate or suspend the pump. The remote would also show bg info from the sensor on it, so a parent can see it without even being in the same room as their child.
The pump would also have an external speaker that could be set next to the person's bed (or their parents) so alarms could be heard at night.
The pump could be programmed to text message a bolus amount, bg, or alarm info automatically by incorporating a SIM chip.
The pump would ideally be able to communicate via RF to your choice of 3 different meters or so. And more than one meter could be set up, so one could be at home, school, grandma and grandpa's, etc. If the meter has an option to mark a bg reading as pre/post prandially on meter, this will be applied to history in pump. Also, if the meter can remember insulin doses and carb intake, the pump will communicate this to the meter. So in other words, the history would be in both places.
The pump would be waterproof, and take 1 rechargeable AAA battery. A charger and 2 batteries would be included. In a pinch, it could take a standard AAA battery, as well. And 2 month battery life minimum.