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I’m lying in bed, cringing

listening to Radio 4 happily announce the launch of “the artificial pancreas” in the NHS.

I realise, I’m one of the 900 trialing this approach in the UK and it’s far from the freedom being touted in the article.

I got my new pump, a Tandem TSlim X2 with “Control iQ” on the 13th January and on the day I got it, my HbA1c was 5.6% which in layman’s terms means an average of approx. 6mmol/l.  Over the past few weeks, using my Dexcom, I have tuned my basal dose in my pump and my boluses to keep my glucose between 4 and 6.7mmol/l 80% of the time and between 3.8 and 10mmol/l 97% of the time quite often.  I still get highs, I still get lows but I’m in amazing shape.

This is not the same as being non-diabetic; the average non-diabetic is ranging from 3.5 to 6.8mmol/l > 98% of the time.  But I’m reasonably close with a target blood glucose level of 4.8mmol/l for corrections etc.  If I’m bolusing, that’s my goal 75% of the time (exercise changes it as does driving).

What am amazing thing to be doing, with the trial, I mean

I was looking forward to it.  I knew it wouldn’t be running as low, in “normal mode” as I do, but I was expecting it to spot when I was high (getting my boluses wrong) and correct round the edges and more importantly, pick up if I’m dropping a bit low.

Well, it’s done that for you, hasn’t it?

Not really.  First, I had that great HbA1c on a completely different insulin, which didn’t work with the algorithm.

So, a new insulin.  Which meant my basals didn’t work.

Shouldn’t be an issue, it will tune on top of the basals.  Only it didn’t.  After 7 weeks, I’d ditched it for running over night from about 9pm.  After 9 weeks, I’d ditched during the day too.

Why?

I don’t like running that high.  Full stop.  More importantly, I don’t want my insulin to be shut off when I’m above 7mmol/l, because it believes I’m going to be low in 3 hours time leading to my blood sugar being above 10mmol/l regularly.

It reducing my evening basal regularly meant I was being hyper more times than I could mention with blood sugar high enough to wake me in the night needing the loo and that’s when I could persuade it that my blood sugar needed to be below 7mmol/l to allow me to sleep!

It decreased my time in range against the levels I was given as a 7 year old and just left me feeling tired all the time.  A thoroughly miserable experience and that’s ignoring the fact it didn’t cope with different stages in my menstrual cycle – I had to manually programme them.

Did it at least protect against any hypos while running?

No, it was more cautious about correcting highs but that just meant I had to turn it off – the classic was when I’d got a bolus wrong and it shut my insulin off when I was above 9mmol/l leading to me being above 13mmol/l and fighting a hyper at 3am.  When I got it below 8mmol/l I turned on the closed loop only for it to not start “tuning” when I got to 6mmol/l which would have saved me from dropping below 3mmol/l an hour later because it deemed 6mmol/l as being “perfect”.

And that was before I caught Covid-19.  I thought it might at least help with that.

No?

No.  I tried for the first couple of days but it wouldn’t keep my blood sugar down enough to allow me to fight the infection.  That’s when my non-diabetic husband suggested I give up the fight and turn off the loop.

A failed experiment then?

Pretty much.  The worst bit is being on an insulin that is harder to correct highs with because it has a slower acting rapid onset.  Having spent the past 6 weeks tuning my basal, I’m pretty much I still bereft of losing my old pump and the freedoms it gave me.

 

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