Nothing better than a little football in bed while its raining outside, right? They only show the New England – Buffalo game here at MGH. Their all die hard Pats fans. Gotta appreciate that!
7:30am – BG was 115. It then spiked in the 340’s after my meal of oatmeal with raisins and syrup, toast and orange juice. I am back down now to a BG = 90. Do not be frustrated with the after meal spike. Remember the following:
1. I was randomized in the group of the study that gets no pre-meal bolus. The AP has to chase the carbs, and
2. Since there is a delay in the insulin absorption, it lags behind. And,
3. There is a delay in the CGM readings as well, and since the AP reacts based on the CGM, there is delay in the reaction.
They are testing the system in this part of the study based on worst case scenario, i.e., if I am the type of T1D that plugs in my AP and then does nothing with it. They want to know that it is still safe and that it will work.
Pre-meal bolusing and some other things, I can already see how the AP will make my life better.
I am curious, how would the AP play out in pregnancy? (I am currently and one thing that makes it hard is the ever changing insulin need/ resistance.) The AP would be learning new algorithms daily and could it comp for the resistance adequately? Also where do you put all hose pads when your belly is ever expanding? 😉
Great questions, Jen. Let me answer the easy one first: The next generation AP will be running off of the T-Slim (http://www.tandemdiabetes.com/products/t-slim/) and will have normal capability with infusion sets offered for the T-Slim. It will actually work with 2 T-Slims, one for insulin and one for glucagon. The 3rd generation will have a duel chamber T-Slim with one infusion set. Cool, huh?
Q2: So, I understand that pregnancy effects hormone levels constantly (I have never experienced this first hand, however, I have been told this happens) and it will be a challenge to address blood sugar levels regardless of the method you choose. What you have to keep in mind, no matter what, is that no insulin therapy methodology is perfect, and you will have to find the method that works for you. Study coordinator Kendra, who is T1D and pregnant, feels that it will adjust well to get the Basel doses right. You would have to figure out the boluses for meals. Officially, though, it has not been tested.
Oh, and where do you put the pads? I have used my hips, back of my arms and lower back. By the time it is on the commercial market, there should only be one, so it shouldn’t be tough.
Ha ha. Try reaching your hip when you have a watermelon in the way! Suppose the husband could do it which means being extra nice every 3 days right? I forgot you were the control group who didn’t have bolus coverage. So that would nix the spikes entirely. This is not really an option for me since this is it(I hope!) But it is encouraging to hear all of this info. I still live in a 2cow town and have heard nothing of these studies. Following your blog this weekend has been enlightening. Keep up the great work!
Wow!! Knock me down to a 1 cow town! I have never even heard of these pumps. Medtronic and animus are the only 2 I’ve ever seen. Fascinating!