[Diabetes-Talk] Insulin on board feature.
Veronica Elsea
veronica at laurelcreekmusic.com
Thu Feb 16 19:50:52 UTC 2017
Hi Jamie and all.
Maybe I can make up an example to illustrate why I like this feature so
much.
First, I do not do my correction boluses at the same time as I do my meal
boluses most of the time. So let's say I calibrate my Dexcom and take a
correction bolus at 4:30 and I end up taking 2.5 units. Then I go about my
life and take 4.5 units at 6:00 for dinner. Then at 7:00 I realize something
was goofed up somewhere and I need insulin. Now I have two different 3.5
hour periods of insulin activity going on and I now would need to pay
attention to what I have left. With the insulin on board, I would enter in
my latest high number and if I could read the display, the pump would show
me what's left and automatically subtract it from the total I need to cover
my high. If I know something the pump can't know, here's what would happen
next. On my Cozmo, when the pump is displaying the number, if the pump
doesn't think I need any insulin, I hear no keypad beep when I hit the
up-arrow. So when I hit "next", I could then just hit the up-arrow once for
each half of a unit I think I require. Down-arrow would give me less if the
pump thought I needed something. During the past couple of weeks I've been
trying to figure it all out manually, in my head and compare it with what
the Cozmo does and over time, using the Cozmo's math I'd use noticeably less
insulin. What I will lose going to the Animas is any way to get a hint of
whether or not the pump thinks I need any more insulin. The only thing I'll
be able to do is go through the dialog and then listen for the pump motor
sound, and then add any if I think I need to do that. No take away possible
though. But nothing about me seems to come out in even numbers. <grin> I
always want the shoe size in between. My duration of insulin action is 3.5
hours. If I have to keep track of the time of each bolus and do the
individual pieces of math, right now it feels like I will always be thinking
about diabetes. I've sure enjoyed what I had for the past 12 years. Maybe
I'll find a creative way around this once I have the pump. But this feature
has really made a big difference for me.
Stay tuned and hope this made sense. <grin>
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
Jamie Gurganus via Diabetes-Talk
Sent: Wednesday, February 15, 2017 5:20 PM
To: 'Diabetes Talk for the Blind'
Cc: Jamie Gurganus
Subject: Re: [Diabetes-Talk] G5 question
Veronica,
I'm glad that you figured out how to navigate the insurance company to
get the pump. You must be one smart detective to have figured all of that
out on your own. Congratulations!
I feel very confident about my ability to master this new pump now that the
Animas rep paid me a visit. And, I know that I will be able to use the
Inset now. I like my Diabetic Educator, but she missed a few key details
that were causing me some confusion. And, she never told me to keep the
tubing unhooked from the notch until after I cock the insertion device. I
can't be upset with her, because she is teaching three different pumps to
clients. The Animas rep only does their pumps and knows them upside down
and backwards. What was super nice about the rep is that she brought me
full boxes of the sets plus gave me an extra lithium battery, battery cap
and cartridge cap. I bet I received hundreds of dollars worth of supplies
for free from her.
As for the Insulin on Board feature, the rep did say that by using the audio
bolus, I shouldn't have had this issue. I think the daily amount or hourly
amount went off. These pumps are just too smart now. But, can you help me
understand why you love the IOB feature so much? Why is it important that
you know it? I guess I don't see a purpose for it right now, but it must be
helpful if everyone likes it.
Oh, I found out what our pump is made out of too. It is Kevlar, the same
material that bullet-proof vests and Army helmets are made from. I'll be
anxious to hear how you like it.
Jamie
-----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 4:11 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
Jamie, as I said to you in a private email, I really don't get this on the
insulin on board. It's my favorite feature on my Cozmo. But if you decide to
eat, regardless of what insulin you have, you may want to cover new food.
And since the pump doesn’t know why you're taking a bolus, this doesn't make
sense to me. I know the insulin on board feature is there if you're
specifically doing a correction bolus from the menu item. When you took
extra insulin to try to get brought down, were you using the audio bolus
button? This just doesn't seem right. Weird!
As for me, I did finally get things sorted out. I had to do a lot of
sloothing to discover that there is something called a pier to pier review
that can happen between my endo and the insurance company. Not only did I
set one up but I then gave my doctor a script and said, read this! The
insurance company was behaving as if I were buying a Dexcom, not a pump.
Dumb! So then Animas dropped the ball and after hunting around, I found the
approval code numbers and sent them to Animas. Sheesh! So my Animas pump
will arrive next Monday. To save 500 bucks, I have to use my beloved Cozmo
as a trade-in and right now, boy that stings. But at least I have two months
before I have to send it in.
So we'll see how I get on with my new blue pump next week. And I am already
starting my list of questions. So thanks for the head's up bit.
I sure appreciate having this group and for the company as we all go through
changes in all of this tech. <grin> 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
Jamie Gurganus via Diabetes-Talk
Sent: Tuesday, February 14, 2017 12:47 PM
To: 'Diabetes Talk for the Blind'
Cc: Jamie Gurganus
Subject: Re: [Diabetes-Talk] G5 question
Veronica,
The insulin on board was new to me as well. My educator explained it to me.
So, when you take a bolus, the insulin has about 3 hours or so when it is
still working to lower blood sugars. If you take another bolus for a high
blood sugar, it will remember how much of the last bolus is still in you.
It may not let you take more, if it detects that there is still insulin on
board in your system. When I had a very high blood sugar due to the
infusion set not being inserted correctly the first time I used it, that
feature would not let me take enough insulin to get it down. I, luckily was
able to use my husband's insulin pen to take a bucketload of insulin to get
my blood sugar lowered. I had my daughter turn the insulin on board feature
off, since I am careful not to take too many boluses to get a high back
down. I believe it is called stacking when you keep taking a little more
and a little more and then finally crash. Some people like the feature, but
I didn't.
After almost 4 weeks on the Vibe, I am finally getting the menus memorized
and can change a cartridge without sighted assistance. The Vibe, to me was
the best option for a blind user, and I like how it just has three simple
buttons to use besides the audio bolus buttons on the side. My biggest
problem is using their infusion sets. I am getting the knack of them, but
they are a little more complicated to use than the ultraflex from Roche.
I'd keep ordering the ultraflex, but they will eventually be discontinuing
those just like they did their pumps. And, I really like the customer
service from Animas. They are so helpful and caring.
Good luck with obtaining a pump. Did you resolve things with the insurance
company yet? It is still unclear to me how and why they would deny you
getting a pump. I had to "prove" to Medicare that I test my blood sugars at
least four times a day to be approved for my new pump, but we kind of
cheated and used the results from my Dexcom. You have to supply them with a
print out of 60 days worth of blood sugars, unless another insurance company
like Blue Cross paid for your first pump. Then, you just need 30 days
worth. Lucky for me, that was the case.
Take care and keep me posted. Oh, I've been meaning to tell you that my
niece is in her sophomore year at UCSC and just loves it. My sister lives
in Irvine, which is a good seven hour drive to get her there. What do you
do in Santa Cruz?
Jamie
-----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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