[Diabetes-Talk] Animas Vibe insulin limits

Wed Feb 15 23:28:03 UTC 2017

Thanks Tom! 

Sent from my iPhone

> On Feb 15, 2017, at 5:10 PM, Tom Ley via Diabetes-Talk <diabetes-talk at nfbnet.org> wrote:
> 
> Hi everyone, 
> 
> The Animas Vibe and the predecessors to the Vibe have various safety features you can elect to use or not when you first perform pump setup. Of course, they can all be modified later as well. Keep in mind that the Animas Vibe is approved for use in pediatrics ages 2 - 17. I found the Animas Vibe manual online as a PDF which reads fairly well. Hope the following helps. 
> 
> From the Vibe manual: 
> 
> Setup Advanced Screen 3 - insulin limits 
> You can program your pump to control the maximum amount of basal, bolus, daily insulin, and insulin 
> delivered in a 2-hour period. Your pump will alert you when you exceed these amounts. This screen allows you to: 
> . Set maximum basal delivery per hour 
> . Set maximum bolus amount 
> . Set maximum daily (24-hour) delivery amount. Your pump checks that total 
> insulin delivery each 24-hour period (running from midnight of the previous day 
> to midnight of the current day) does not exceed this limit.
> . Set maximum 2-hour delivery amount. Your pump checks that total insulin delivery over each rolling 
> 2-hour period does not exceed this limit.
> 
> NOTE: The maximum bolus amount you can deliver for any type of bolus (including Audio Bolus) is 35U.
> m WARNING:
> . Use caution when bolusing amounts greater than 25 units. Bolusing very large amounts of insulin
> can result in over delivery of insulin.
> . Insulin delivery limits should be determined in consultation with your HCP.
> . Caregivers should speak with the patient's HCP regarding maximum pump settings as a layer of
> security against inadvertent button pushing resulting in insulin delivery.
> 
> Tom
> 
> 
> -----Original Message-----
> From: Diabetes-Talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Veronica Elsea via Diabetes-Talk
> Sent: Wednesday, February 15, 2017 5:13 PM
> To: 'Diabetes Talk for the Blind' <diabetes-talk at nfbnet.org>
> Cc: Veronica Elsea <veronica at laurelcreekmusic.com>
> Subject: Re: [Diabetes-Talk] G5 question
> 
> Wow! How ridiculous! Can't wait to find out how much insulin the programmers think I should have. Sheesh!
> Veronica
> 
> 
> "Guide Dogs, First Hand", Veronica Elsea's classic album is now available on iTunes, along with other music from her and from the Guide Dog Glee Club. 
> To learn more, visit:
> http://www.laurelcreekmusic.com
>                 Veronica Elsea, Owner
> Laurel Creek Music Designs
> Santa Cruz, California
> Phone: 831-429-6407
> 
> 
> 
> -----Original Message-----
> From: Diabetes-Talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Bridgit Kuenning-Pollpeter via Diabetes-Talk
> Sent: Tuesday, February 14, 2017 10:57 PM
> To: 'Diabetes Talk for the Blind'
> Cc: Bridgit Kuenning-Pollpeter
> Subject: Re: [Diabetes-Talk] G5 question
> 
> The Animas has a set amount of insulin you can deliver through both basal and bolus each day. Depending on your individual and daily needs, you may need to raise this amount. While I was pregnant, my insulin needs rose, so we had to adjust this daily amount otherwise my pump would have stopped delivering insulin once I reached a certain amount and would not have started until midnight or if I over-rode it. I can't think off the top of my head exactly how to do this, but it is in the settings. It has to do with max daily amounts of insulin. Likely will not be a problem, but I discovered this little feature once after needing to correct a few times one day. My pump alarmed, and I knew it was not time for a prime and rewind, so my husband checked it, and it said it had reached its max daily amount of insulin. We went into the setting and just upped the amount, but still, something to be aware of.
> 
> Bridgit
> 
> -----Original Message-----
> From: Diabetes-Talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Veronica Elsea via Diabetes-Talk
> Sent: Tuesday, February 14, 2017 2:11 PM
> To: 'Diabetes Talk for the Blind' <diabetes-talk at nfbnet.org>
> Cc: Veronica Elsea <veronica at laurelcreekmusic.com>
> Subject: Re: [Diabetes-Talk] G5 question
> 
> I need to figure out what you guys are talking about with respect to insulin on board. All this feature does is to show you what insulin you have left and you should be able to over-ride it if you need more. Are you talking about a daily limit of insulin? I'm really puzzled here. The more info I have, the better questions I can ask when my pump comes in the next week or so.
> Thanks so much.
> Veronica
> 
> 
> "Guide Dogs, First Hand", Veronica Elsea's classic album is now available on iTunes, along with other music from her and from the Guide Dog Glee Club. 
> To learn more, visit:
> http://www.laurelcreekmusic.com
>                 Veronica Elsea, Owner
> Laurel Creek Music Designs
> Santa Cruz, California
> Phone: 831-429-6407
> 
> 
> 
> -----Original Message-----
> From: Diabetes-Talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Bridgit Kuenning-Pollpeter via Diabetes-Talk
> Sent: Monday, February 13, 2017 12:56 PM
> To: 'Diabetes Talk for the Blind'
> Cc: Bridgit Kuenning-Pollpeter
> Subject: Re: [Diabetes-Talk] G5 question
> 
> Jamie,
> 
> Duncan is doing well. Still in NICU, but medically, nothing is wrong; he's just working on eating orally. He's consistently doing 67% at each feeding, but they want him at at least 80%, so he's close. Hopefully it won't be much longer. This is usually what keeps people in the NICU the longest, the feedings, and for some reason, infants of diabetic moms can struggle more with eating orally. But Duncan is improving every day, and they are surprised how well he's taking to bottle feedings considering he was early and an infant of a diabetic mom. We try nursing when I'm there, but the majority of his feedings are bottles, so hoping once he's home and we are together all the time, he will be able to adapt to nursing as well. I'm pumping around the clock, which is tedious, but I want him to have breast milk even if we can't actually nurse. I'm producing a little lower amount than I should at this point, only about an ounce each pump, but something is better than nothing.
> 
> The insulin on board feature is annoying. I was not aware of it actually until I was pregnant, and we upped my basals, and I got an alarm one night because I had used my daily amount of insulin, but I needed more.
> Fortunately, my husband can sometimes use magnification for certain things, so he was able to change the amount. But yikes, 500 sucks. I've had a few of those over the years, and they really are not fun. Has your doctor ever written a script for an insulin pen just in case the pump has problems? I have pens on hand just for cases like this, so I can get my sugars down quickly. Fortunately, it rarely happens, but when it does, I want them down ASAP. And fortunately, I'm sensitive to insulin, so I usually drop quickly.
> 
> I do place my cannulas on my backside, but I usually stick around the tummy area. I place it all over, top and bottom and sides of my abdomen. I've never done my legs or arms, finding that placement annoying for me. Do you have scar tissue that causes problems? I know it happens for us diabetic lifers, but so far, in 31 years, I've yet to develop this problem. I use the inset, and my canula is a 3. I've played with a lot of infusion sets in the past 13 years, but it's been some time now. Wondering if anything new is out. I'm transitioning between my OBGYN endocrine and my regular endo, so once I do, I might take a looksy at sets again.
> 
> I plan to get a Dexcum too. Just waiting for things to settle around here.
> Hopefully in a couple of months I can initiate that process. I have Medicare, but also insurance through my husband, so hopefully it won't be a problem. I'm not super tech saavy, so hopefully I don't struggle too much with it, grin.
> 
> Glad you're figuring things out with the pump. I know how frustrating it is in the beginning, especially when switching to a new one. Again, if you ever need to speak with me or ask questions, feel free.
> 
> Bridgit
> 
> -----Original Message-----
> From: Diabetes-Talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Jamie Gurganus via Diabetes-Talk
> Sent: Monday, February 13, 2017 12:44 PM
> To: 'Diabetes Talk for the Blind' <diabetes-talk at nfbnet.org>
> Cc: Jamie Gurganus <jamielgurganus at gmail.com>
> Subject: Re: [Diabetes-Talk] G5 question
> 
> Hi!  How is the baby doing?  
> 
> I just came from a visit with my diabetic educator to review my blood sugars and go over my issues with the pump.  I think I almost have it down. We figured out where my confusion was and practiced going through the menu.  I also have the Animas rep visiting me on Wednesday, because I am having issues with the infusion sets.  For some reason, the Insets don't go in properly and leak on me.  I have given up using them for fear of having another 500 blood sugar.  I hadn't had one that high since going on the Dexcom almost three years ago.  My Dexcom kept alarming me in the middle of the night that I was high, I would give a bolus and then wait.  I should have gotten out of bed and checked my blood sugar, but I didn't.  By morning, I was over 500 and couldn't give any more insulin due to the Insulin on Board feature being on.  Fortunately, my husband uses a Novapen, so I was able to take 20 units to get it down quickly.  It still took all morning for that to happen.  And, I had my daughter turn off the IOB feature for now.  
> 
> So, I am using the Inset 30, but I can't twist around enough to insert one in my backside.  So, I am trying the Contact D  that is the little metal thumbtack looking thing with a pigtail.  I hope it works.  I wish I could continue using the Ultraflex set that I used for years with my Accucheck Spirit, but they may not be in stock in the near future.  So, I need to figure out how to make the Animas products work for me.  I really like working with Animas, and they have been so helpful with sending me replacement sets when I go through three just to get one to insert correctly.  I'm not sure what I'll do when I run out of Inset 30's and have just the box of Insets left though.  I ordered a three month supply with two boxes of 30's and one of the Insets.  Since they can't accept a return, I can't order new sets until I am almost out of the three month supply thanks to my insurance.  I'll see what the rep says on Wednesday.
> 
> 
> I did get discouraging news today from my Dexcom supplier.  Insurance won't pay for an upgrade to the G5 until my receiver is out of warranty in August.
> And, since I just replaced my transmitter  on Feb. 3, I can't even get the
> G5 transmitter.  So, I guess I'll do what I am doing now for six more months.  I really wanted to be more independent with the Dexcom than I am now.  I have to rely on my kids too much, and their busy schedules has me planning when to do a quick blood sugar to calibrate it or change the sensor.  Insurance companies really cause us a lot of headaches, but I know that we can't afford to be without them.
> 
> Take care.  I hope Duncan is doing well and home with you.
> 
>                Jamie
> 
> 
> -----Original Message-----
> From: Diabetes-Talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Bridgit Kuenning-Pollpeter via Diabetes-Talk
> Sent: Monday, February 13, 2017 8:37 AM
> To: 'Diabetes Talk for the Blind' <diabetes-talk at nfbnet.org>
> Cc: Bridgit Kuenning-Pollpeter <bkpollpeter at gmail.com>
> Subject: Re: [Diabetes-Talk] G5 question
> 
> Jamie,
> 
> How are things going with the pump? I can still call you at some point if you wish, things are still just a little hectic around here. Is the prime and rewind going better? Let me know if I can do anything else or answer other questions. Will do my best.
> 
> Bridgit
> 
> -----Original Message-----
> From: Diabetes-Talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Jamie Gurganus via Diabetes-Talk
> Sent: Monday, February 13, 2017 6:03 AM
> To: 'Diabetes Talk for the Blind' <diabetes-talk at nfbnet.org>
> Cc: Jamie Gurganus <jamielgurganus at gmail.com>
> Subject: Re: [Diabetes-Talk] G5 question
> 
> Tom,
> 
>     Thanks!  This does seem like it can be managed!  I have my high alert set at 180, because I feel awful if it is in the 200's.  So, mine does go off more than usual, but I do watch what I eat.  I will get it all figured out, just like the Vibe.  I'm still working on mastering that!
> 
>                Jamie
> 
> 
> -----Original Message-----
> From: Diabetes-Talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Tom Ley via Diabetes-Talk
> Sent: Sunday, February 12, 2017 7:21 PM
> To: diabetes-talk at nfbnet.org
> Cc: TALey at ups.com
> Subject: Re: [Diabetes-Talk] G5 question
> 
> Hi Jamie,
> Glad you had success with your upgrade request, and very quickly, it seems. 
> 
> At church I make sure I plug my ear buds  into the iPhone, even though I may not have them in my ears, to prevent unexpected alarms and Voice Over announcements disrupting the people around me. The alerts still play but just through the ear buds, not on the iPhone speaker. This also works when sleeping. I think the below 55 alert always plays over the speakers, even if you have your ear buds plugged in, the same way the alarm clock on the iPhone works. But, if you are really 55, you need to be disrupted (smile).
> That is a serious low, at least for me. 
> 
> The alarms options such as sound and vibrate, sound only, etc. on the Dexcom
> G5 app can be changed any time, as well as the level when the alarm is triggered. , and this is separately controlled for each type of alarm. I think all of us probably have our alarms configured differently, to fit our lifestyles and diabetes health and safety needs. So, you will need to work with the alarm settings over the first few days or weeks to find what works for you. 
> 
> One time I chose to set my high blood glucose alert to 220 to avoid so many disruptions from the alarms. That worked to prevent so many alarms, but my A1C was not as healthy when it was next measured. So I lowered it back. I decided it was up to me to behave differently to keep the alarms from going off, as if that wasn't obvious to everyone. Sometimes though we just need a break from having to think like a pancreas! 
> 
> Hope this was helpful.
> 
> Tom
> 
> 
> 
> -----Original Message-----
> From: Diabetes-Talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Jamie Gurganus via Diabetes-Talk
> Sent: Sunday, February 12, 2017 8:53 AM
> To: 'Diabetes Talk for the Blind' <diabetes-talk at nfbnet.org>
> Cc: Jamie Gurganus <jamielgurganus at gmail.com>
> Subject: [Diabetes-Talk] G5 question
> 
> Hi all!  My insurance has approved an upgrade to the G5, since I really want to be able to input my own blood sugars via the phone app.  However, I am quite concerned about the negative reviews that I am reading about regarding the inability to silence the alarms.  From what I read, it is with the latest update that took away the mute feature for the alarms.  As much as I want to be able to independently manage my Dexcom, is it worth having the alarms going off with no way to silence them at night or in church or meetings.  Thanks for your experiences.  I may consider staying with the G4 unless they change the alarms.  I can't close the app during church or meetings like many do, since I need the Dexcom to notify me of lows that I don't feel anymore.  
> 
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