Technology Breakdowns

Diabetes Technology
#1

Let’s review recent events:

  1. CGM transmitter fails 13 days after activation. Warehouse backlogged. Took 14 days to replace.
  2. Transmitter returned upon receipt of return package. Getting emails that item has not been returned. Once again, warehouse is backlogged.
  3. Sensor failure about ten minutes before calibration.
  4. Insulin cartridge leaking through O ring at base. When insulin pumps, some goes in, some doesn’t. Wonky BGs and finally the smell of insulin got attention, but still a couple of stressful days.

Can I please just get off this train? The recently unreliable tech only makes T1 more difficult, makes the patient more stressed, obsessed.

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#2

I hate it when that happens. And bad events seem to cluster in time. Don’t think of yourself as obsessed. It might appear that way to a casual observer but anyone who lives diabetes, all day, every day, gets it! What you’re doing is “due diligence.”

My least favorite part of the drill is managing prescriptions. I don’t have much patience for the lack of follow-through with many of the players. I hate to burden my doctor’s office with too many calls or emails. The pharmacy benefit managers can really screw things up or they can deliver as promised! You never know which way it’ll go and I detest double-checking on people but I am the one who suffers when I don’t get my stuff!

I can tell you’re a seasoned user of pump technology when you mentioned troubleshooting by detecting the smell of insulin. That’s definitely a pro trick.

Keep your chin up – tomorrow’s another day!

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#3

The biggest argument in favor of MDI as opposed to pumping is that there are very few failure points with the former and very, very many with the latter. Kind of an inherent problem with any advanced technology. In practice, what it means is that you have to balance the advantages of Pump + CGM against the occasional inconvenience–or at times, the sheer head-banging aggravation–of keeping the whole Rube Goldbergian thing running. For me the line was crossed with the 670G, which layered a whole new set of failure points onto a system that was already replete with same, thus ramping up the aggravation factor while falling short of the promised advantages–supposedly a pump that would be so smart it would do a better job of managing my BG than I could. Wrong.

But I know other T1s who draw the line at changing from MDI to a pump–they’re used to it, getting decent results, and it’s simple: you put the needle on the pen, click to your number, stick it in a nice fatty spot, sppppt! and you’re done. I can sympathize–my own transition to pumping had me close to throwing the thing against the wall many times (my very first set of reservoirs ended up being from a batch that was eventually recalled, speaking of failure points). But I did go back to my pens for a few days a year ago when my pump broke–going into a weekend of course–and that was enough to convince me I didn’t want to stick with MDI any longer than I had to. I do think that over all, CGM is a much simpler and therefore robust technology. If I had to choose between giving up my pump or my CGM, I’d definitely stick with my CGM.

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#4

Funny you mention the 670 in this manner. I actually put my order in for one, then changed my mind before I actually got it and went with the Tandem X2.

#5

I’ve been on the MDI-Pump fence for a very long time (still MDI), but I’m surprised that leaking plunger o-rings would be a thing after decades of pump technology development. Really? My greater concern is “soft technology” things like infusion site unpredictability/problems. Not to take away from real concerns like @T1Forever experienced.

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#6

I can sooooo relate to what you’re saying. The technology that we rely upon complicates our lives as much as it improves it. Just do your best, take a breath, and start again tomorrow.

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#7

And the flip side is when technology saves your *ss! :slight_smile: My Dexcom has saved me from countless highs and lows. And my pump just keeps on pumpin’. Sure, someone, somewhere may experience a hiccup now and then, but let’s not condemn all of tech. BE THANKFUL you have this stuff!

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#8

Sorry, but that is a simplistic view. Pump or pen. It’s all difficult. If you pump, it would surprise me.

Arguing MDI vs. Tech is a non-argument. It’s all kind of the same. Being on the train is key, but sometimes it gets really difficult, no matter which track you choose to ride.

Stay good.

#9

After 15 years of pumping, it was a first. Had O rings allow air in, but never before leak insulin out

#10

My personal experience with a pump was that it made my life way more complicated. There are way fewer technical difficulties related to the delivery of insulin when you’re on MDI. I use a cgm, and I can totally empathize with the frustration of ordering cgm supplies and the odd sensor failure (though this rarely happens for me). When I was on a pump, I had all sorts of site problems or inconsistent absorption. I don’t have those on MDI.

Sure, there are other work arounds I need to use, but they tend to be more consistent and predictable.

I get that everyone is different and a pump is great for a lot of people, but I think it’s a valid point that MDI relies less on technology.

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#11

Was it a Dexcom warehouse that was backlogged?

I spoke with a rep there earlier today, and they said that once Medicare approves the G6, I won’t be able to order the G5 supplies anymore. He said the application was well under-way. Just curious.

Sorry you had a rough month! Hopefully the next orders run more smoothly!

#12

Not exactly sure what you’re getting at–should be pretty clear from what I wrote that I do use a pump–but FWIW: 20 years injecting R/N (syringes), 10 years on Lantus-Novolog (mostly pens), 5 years on a pump. I never had any problems with pen technology or syringes breaking down, but I have had any number of problems with various bits of the pump system failing. I think the advantages in control outweigh those problems, and controlling BG is never “simple,” so I certainly agree with that, but it’s simply a fact that in terms of technology there are fewer failure points with syringes and pens.

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#13

My biggest concern going back to MDI is that the pen units only come in whole units. Even before I started the pump, I had to have special ‘children’s pens’ that allowed me to use 1/2 units as the smallest amount and fill the pen from a vial myself. I still had to go under or over what I needed with my bg response as I am very insulin sensitive. With the pump my total daily insulin, including basal and bolus, are between 18 and 20 units. My meal boluses are never in nice whole numbers but percentages of numbers. I could never fine tune like this with MDI. Of course, the nice thing about MDI is that you do have a long acting basal insulin in the background so even if there is problem with dosing you almost never end up experiencing ketoacidosis between rapid acting boluses. It is always going to be a trade-off, I suspect.

#14

That’s an important part of pumping for me. My total daily basal is only 6.65, and all hourly doses are less than 1u, such as .150 and .275. Can’t do that with a pen. Also eat very low carb usually, so my daily totals are 10 - 11 units.

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#15

Wow, I just wanted to chime in and say how sorry I am. It sounds like the “perfect storm”of diabetes!
And while I have not had any of these issues and certainly not all at the same time, I have had a few issues over my 27 years pumping, but wow not all at the same time.
Technology is suppose to be our friend and made things easier but when it goes bad, it is so frustrating.
But as much as I dislike technology and how it has helped us isolate ourselves sometimes, I would be lost without my diabetes tech stuff.
I really do want to go back to urine testing or one shot a day or blood test strips that we read visually. Pumping does add another set of possible failures, it has many benefits. Just need to decide what is important to you.
I sure hope the full moon is helping make things run a little smoother for you now. Hang in there, this will past! And just think it will be another diabetes story you can share with people who get it!

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#16

Guess it was this part of the post that fueled my comment. Sorry

#17

I thought your comment was fine and I have appreciated this thread/topic. Thanks for starting it.

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#18

The NovoPen Echo doses in half units and, at least in Canada, they make cartridges for it for all Novo insulins (Levemir, NovoRapid/log, Regular) except Tresiba. It’s exactly the same as the NovoPen 5 except doses in half units.

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#19

If you are talking about calling Medtronic then I feel your pain. I called every week for 6+ weeks because my sensor went out before it was supposed to. I finally got a new transmitter and it seems to be working better, although, my sensor went out in the middle of the night last night. I was awakened to “Change Sensor” and it should have lasted 10 - 12 more hours. I called once when my sensor went out early and, since I never change late in the day because of all of the alarms going off, I had to wait until the next day. The tech. that I talked to the next day asked how my b/g was doing and I told him it was high because I didn’t have a sensor to tell my pump to give me small drops of insulin to bring it back down. I gave a smug reply of, “Well, actually the opposite is what happens when you don’t have the sensor.” That may be true in SOME cases but I don’t think it has to be in ALL cases. I think what upset me was the way he made me sound like I had no idea of what I was talking about. Grrrrrrrrrrr…

#21

Coming from the dark ages of diabetes, I’m so blessed to have access to all the new technologies. Yes they fail and are frustrating at times, but I can’t wait to see what the future holds.

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