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.
Posted: April 6th, 2022 under Diabetes.