Checking back in, here at the end of my second week on auto. Thought it might be interesting to give a more experiential version of what it’s like.
First off, It looks the like a regular pump, but it ain’t. I’m just starting to get my head around that. At the macro level, the biggest difference is that you can’t wing it, the way you can with a regular pump. If you’re used to a lot of hands-on, stick ‘n’ rudder control over what your pump is doing, as I have been, this is a big adjustment. F’rinstance:
Bolusing for meals or corrections.
- This is a Wizard-only proposition. The system always needs a “why” for whatever you’re doing, in the form of carbs or meter BG or sensor values, so it can adjust itself accordingly, therefore there is NO Manual bolus. You *can’t just decide, “Y’know, I think I need an extra unit” for whatever reason and go plug that in." This has been especially difficult these early days where settings aren’t dialed in yet and I’m running higher than I want. It sets its own correction values and you can’t just hit the up arrow to make it give you more. The algorithm has to learn you need more, and what it is allowed to do to get you back on track is limited by your settings. This is especially frustrating at the beginning, because they want the algorithm to do its thing for a while before deciding, ok, you can change one of those settings and see if that does it. Means kind of a long haul getting it dialed in.
Basal doesn’t mean basal
- This is subtle and a bit elusive to get my head around. Those big square wave basals have been replaced by these little continuous blips, right? And at first you’re inclined to think of that as your basal rate, but on your old pump that was just a continuous increment based on an informed guess about what it’s going to take, meals notwithstanding, to keep you in a certain range. The pump doesn’t have any way to know if you’re in that range. In Auto, though, it does know where you are, and it’s continuously trying to pull you down to, or pause so you float up to, that magic 120. This is a different logic and impinges on a lot of things. Such as…
Sensitivity factor isn’t a factor.
- This one still perplexes me. You do have a setting for it, but it’s only operative in Manual Mode. In Auto, it doesn’t do anything. Drives me a little crazy because I want to adjust the ratio of how many BG points a unit insulin of insulin brings me down so I can force the thing to give me MUCH bigger corrections than I’m getting now. But instead, they want the algorithm to figure out what it has to do to reach the magic 120 (actually 150, since that’s what it targets when figuring correction boluses, then the microboluses are supposed to get you the rest of the way to 120). Well, ok fine, sez I, but when I do a BG check and I’m at 240, and the pump says “You need a correction!” and I sez “Yes, hit me with a big one!” and it blips out ~1 paltry unit when my experience tells me I need more like 8 - 10, it’s a bit maddening. I’m still trying to get more information on this one but the partial answer I do have is that the Algorithm (oh mighty Algorithm!) just hasn’t learned me yet. Which leads into…
Don’t exercise, just sit there!
- This is apparently a mistake I made, my first week-plus in Auto: I’ve been exercising down my highs, since the pump isn’t doing it on its own. The problem is that that prevents the pump from learning that IT needs to work harder, so some of the learning I was hoping it would do… it wasn’t doing. Therefore I’ve been deliberately not exercising the last few days, because I want the baseline to reflect what I need when I’m not going for a strenuous walk after lunch every day. Been also holding off biking for the same reason. Not for much longer though, dammit.
Bottom line is that I’m still curious enough to stick with the program and see if I can get out the other side to having the results I’m seeing from some of the more experienced people in the 670 user groups. So hopefully I’ll come back to report things going more the way I’d like next week.
BTW, if interested, my post about my first weeks (auto and pre-auto) are here:
I’ve also posted these on FUD, where there are some different questions/responses that may be of interest: