Artificial Pancreas with current CGM technology?

September 21, 2009

My doctor has lately been telling me that Minimed/Medtronic is going to close the loop very soon now in providing an artificial pancreas based on today’s CGM and pump technology. Given my own experience, as well as the responses I’ve gotten to my post Continuous Glucose Monitoring with Medtronic/MiniMed Updated, I find this rather difficult to believe. I’m curious whether anyone reading this blog would actually trust their lives to CGM technology telling your pump how much to pump, removing yourself from the loop. However, this peer reviewed article seems to confirm his comments.

Personally, even if I have a way to override this, I would be very uncomfortable with it. For starters, I find the device to accurately track my blood glucose about 80-90% of the time at most. Then, there’s the issue of the 15-20 minute lag. Further, I sometimes have issues with slow insulin absorption, especially during long drives. Unless they combine this with their old implantable pump technology that delivers insulin into the renal vein and unless they find a way to continuously monitor blood glucose rather than interstitial glucose, I think I’m going to have to pass on this.

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Insulin Infusion Set First Day Blues?

August 28, 2009

I’m curious if anyone else is having trouble with high blood sugars on the first day of a new infusion set. I have noticed an issue with this, despite gradually increasing my fixed prime over time. I notice that on the first day of an infusion set it appears to take some time for the site to really begin to absorb the insulin.

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Continuous Glucose Monitoring with Medtronic/MiniMed Updated

December 5, 2007

I decided to create a new post for this so that my initial reaction to continuous metering would remain untouched and available for review. If you would like to see my first reactions to this device, please refer to my original post on the same topic.

I am now at the point where I am satisfied with the sensor glucose readings about 75% of the time. This has taken me a number of months, despite the fact that I consider myself quite technical and quite good at caring for my diabetes. Thus far, the sensor has helped my go from an A1C of 5.8 to 5.3, an improvement of about 9%. I do not know yet whether my next A1C will be as good. My doctor has cautioned be about going low too often. Being even more careful about lows than I had been may raise this slightly.

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Diabetes Tight Control

September 27, 2007

I have had Type I Diabetes since 1988. I have been pumping Humalog since 1998. My hemaglobin A1C tends to be in the 5.5 – 5.9 range. I have had A1Cs as high as 6.3 and as low as 5.4, not counting my long honeymoon period.

The reasons to maintain tight control and to improve whatever level of control each of us has have to do with the Diabetic Control and Complications Test (DCCT) that was performed years ago. That long term test of varying levels of control proved the intuitively obvious. Better control reduces diabetic complications. It also quantified it. Those in the tight control group saw a 50% reduction in all diabetic complications except one. For retinopathy the reduction was 60%. Tha’s a 60% reduction in the chances of going blind. That’s huge. It also proved that it was not a simple tight control yes or no type question but that improvements in control at all levels reduced risks of complications. So, that’s some serious incentive for maintaining the tightest control we can, whatever that is for each of us.

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Continuous Glucose Monitoring with Medtronic/MiniMed

September 13, 2007

UPDATE: THIS THREAD IS CLOSED AND NOT CURRENT. For an updated view of my experience with this product, please go to my more recent post, from 12/5/2007, on the same topic, just click this link.

First I should state that I have not yet been using the continuous glucose metering from Medtronic/MiniMed for long, less than one month. The learning curve appears to be quite large, even for someone with a strong technology background and competence with other electronic devices, even for someone already in tight glucose control.

I would also like to state that even at these early stages and with the lengthy laundry list of issues I’ve had, I have also gotten some very good information from the continuous monitoring, even at this early stage. I have already adjusted my basal rate for a much more even reading throughout the night. I have already learned that I was under-bolusing, especially for breakfast and lunch. I have also had times when the alerts have told me my blood sugar was either high or low that I would otherwise have remained unaware of.

These hint at great things to come as I learn more about the proper use of this device. I would hope that this page will serve to help others set realistic expectations for what they can get from this device and shorten their learning curves to avoid some of the pitfalls I have made. As I get better with this device, I expect to post more threads with pointers for improving results. I will be more likely to do so if others respond on this thread to let me know that it is being read.

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