My Meeting with the Pump Educator

[duck]

Well, I had my meeting with my pump edu-muh-cator yesterday, and I must say I was very impressed. She knew my Cozmo very well, and she straightened me out on a few things. She is both a trainer for MiniMed and Smith's Medical (makers of the Cozmo), so she had some good insight as well.

She pointed out to me that I was not proactive enough with my pump, that I needed to program some varying basal rates if I see a consistent pattern (higher or lower) during certain days/activities. So my homework assignment (that's what it amounts to) is to monitor my weekend sugars versus my work-week sugars--They don't seem to be that different, but as she pointed out *just* different enough that I may be able to knock down my A1c numbers a few decimals...The weekends make up almost 30% of our time on a pump...

I am also not being proactive enough with exercise and "yard work" temp basals...She pointed out that I am basically still in an "MDI" mindset inasmuch as I can rachet down my basals and NOT go low while doing yard work, and even though I don't go extremely low when working out, she said I could dial in that basal rate better as well...Her guidelines were to back down the basals to half and monitor from there.

She also told me my insertions sets (Soft-sets) are as ancient as my 508, and she showed me how wonderful the newer Quik Sets are--I may be calling MM soon to get a couple of samples (I may not be cutting my ties with MM after all).

We talked about other things: I mentioned that when I am really high (290+) that my correction factor does not typically work to bring my sugars down to normal. She said this was typical and that many studies have born that out. She was firmly of the belief that pumping is the best method of control for a diabetic, but she said with Lantus in the picture now, MDI has made a huge leap. SHE HATES NPH. She said when she sees NPH on a patient's chart, she does everything in her power to get them off of NPH.

She also programmed my Cozmo to allow me to enter the amount of carbs eaten as opposed to me doing the math in my head and then telling the pump how many units of insulin to give me...This has been something of a change for me! She also programmed it to calculate insulin on board, which is a neat function.

Anyway, that's my latest report on my transition to my Cozmo(re). Let me tell you how wonderful it was when I had to check my blood sugars for her to demonstrate some of the functionality that it came back at 126...Could you imagine if I had been 200 or something? LOL.

[Cinnabon]

<----- Cinnabon feels a lil jealous (LOL)

[Dewey]

Congrats, Duck! :thumbsup: Sounds like things are falling into place...I know what you mean about the 126...lol :D It seems like every time I go to the endo, my sugar just Has to be 70 or below (i.e. 65, etc. & they treat anything under 80)! Talk about embarrassing :o lol

[Clint]

congrats duck!

I have a MM 515 and I really like the bolus wizard where I tell it my BS, how many carbs and it gives me a 'recomended' dose and I can accept it or change it.

I too have started setting temp basals for certain instances and I have changed up my basals some as I saw a pattern of waking up high, or going low before lunch.. My dr hates that I do this without him, but oh well.

Hope it continues to go well for you!

[YouthIncJr]

Duck -
Certianly, a computer guy like yourself can appreciate the technology in these new pumps.

I was impressed with what all they do as well. The idea of "no need for math" is neat. along with the temp basals - still working out that one myself when I run.

As far as Clint's comment about his doc hating it when you change rates... Well, I am of the opinion that we should be trained and understand our disease well enough to do that. What better way to be proactive than that. Anyway, If I called them everytime, they would get sick of me, and we would still be playing with basal rates as my educator only looked at how much lantus i was taking and not TDD. Once I bumped my basal to accoutn for TDD and understood how my body worked along with the pumping insulin book. Things have been going much better for me. I say all that to say Way to take charge Clint.!!!

[Clint]

Thanks... being the technical type I am, I usually see patterns in myself.. and I am 'smart enough' to know how to fix it so that I am more normal more of the time. The last visit I had with my dr, he literally got upset with me because I had changed things and I didnt call to inform him. I said to that 'I have read the manual, I was taught what this pump can do for me, and based on that I have been trying different things which have made my management of my disease much better.' he didnt say much after that.

I agree that we should be educated to the point that we can manage this disease as much as we can and get input from our docs when we encounter something we dont have an answer to.

Along these lines, I have been developing software that will analyze my data and show me patterns so that I can see whats going on sooner rather than later. When I think its to a point that others can use it, I plan on releasing it for free to the masses.

anyway, sorry duck, didnt mean to hijack your thread. I am glad you got trained and are excited.

[duck]

Thanks... being the technical type I am, I usually see patterns in myself.. and I am 'smart enough' to know how to fix it so that I am more normal more of the time. The last visit I had with my dr, he literally got upset with me because I had changed things and I didnt call to inform him. I said to that 'I have read the manual, I was taught what this pump can do for me, and based on that I have been trying different things which have made my management of my disease much better.' he didnt say much after that.

I agree that we should be educated to the point that we can manage this disease as much as we can and get input from our docs when we encounter something we dont have an answer to.

Along these lines, I have been developing software that will analyze my data and show me patterns so that I can see whats going on sooner rather than later. When I think its to a point that others can use it, I plan on releasing it for free to the masses.

anyway, sorry duck, didnt mean to hijack your thread. I am glad you got trained and are excited.

Hijack away...It's all good!

[duck]

Oh! I forget that the pump educator said that only Novolog was approved for use in pumps in the USA. That floored me! I've been using humalog until just recently, and she said most of her pumpers used Novolog (for many of the reasons we have stated here), but a good minority use Humalog and prefer it.

She said there was nothing wrong with Humalog in a pump, it was just that Novolog is the only approved insulin. Weirdness...

[JasonSmithMT]

Oh! I forget that the pump educator said that only Novolog was approved for use in pumps in the USA. That floored me! I've been using humalog until just recently, and she said most of her pumpers used Novolog (for many of the reasons we have stated here), but a good minority use Humalog and prefer it.

She said there was nothing wrong with Humalog in a pump, it was just that Novolog is the only approved insulin. Weirdness...

That used to be true until about a year ago (6/2004) when insulin lispro(Humalog) was approved. I also think insulin glulisine(Apidra) was approved about the same time. If I remeber correctly insulin aspart(Novolog) was approved in 2001.

I'm a little suprised a pump trainer wouldn't be up on that. If anyone should you would think it would be her.

Jason

[duck]

I was so incredulous (that's not the right word, suprised may be a better word) that she pointed me to Novolog's site...They claim to be the only one:

http://www.novolog.com/professional/devices/default.asp

I need to see if Lilly says Humalog is okay for pumps. In my experience it works great, it's just sort of amusing to me that it is not "approved" (maybe).

[JasonSmithMT]

I was so incredulous (that's not the right word, suprised may be a better word) that she pointed me to Novolog's site...They claim to be the only one:

http://www.novolog.com/professional/devices/default.asp

I need to see if Lilly says Humalog is okay for pumps. In my experience it works great, it's just sort of amusing to me that it is not "approved" (maybe).

Their website did used to say they were the only one ... however everything I've seen on the Novolog site now has change to say something like "approved since". Do you see it somewhere where they say they are the only one?


FYI ... here is the FDA approval letter (PDF document) (http://www.fda.gov/cder/foi/appletter/2004/20563se3-024ltr.pdf) for Humalog use in pumps.

Jason

[duck]

Where in the world did you get the approval letter? Isn't that classified? :p

From the link above:

This section provides information about NovoLog® FlexPen®. You can view an interactive demonstration of how NovoLog® FlexPen® works. Plus, you can learn about how NovoLog®, the first and only pump-approved insulin analog, can benefit your patients on insulin pump therapy. Then, find out about other insulin delivery devices for use with NovoLog®.

I wonder if they haven't gotten around to clearing that out yet, or maybe they have conveniently "forgotten" about it? Hmmmmm... :whistling

[JasonSmithMT]

Sure enough ... says it right there on their site. Seems a little funny they say "first and only". Wouldn't you just say "The only ..."

Jason

[YouthIncJr]

Along these lines, I have been developing software that will analyze my data and show me patterns so that I can see whats going on sooner rather than later. When I think its to a point that others can use it, I plan on releasing it for free to the masses.

Clint - maybe we should start a new thread on this one. Animas Gave me software with my 1250 pump. I am curious to see what you have. The Thing about the animas software is it seems like it would all be easier with a palm then just using a laptop/desktop. (animas did design for a palm). I am going to borrow a palm from my brother to trial the software the way it was intended. but let me know about what you have created.

[gettingby]

Duck,
Glad things are going great for you with the new friend. :D
I'm also glad to see that you didn't seem to suffer too much "seperation anxiety". ;)

[duck]

Duck,
Glad things are going great for you with the new friend. :D
I'm also glad to see that you didn't seem to suffer too much "seperation anxiety". ;)

Actually, the old pump is in my sock drawer clicking away...It's reassuring. :king: