Use it or lose it?

CalculatorThere was a time when the phrase “smart pump” did not exist in the diabetes world. There was basically one pump brand on the market and it did one thing: deliver insulin. But if you look at the pumps that have entered the market in the last five years, you’ll see all sorts of “smart” features. Things like a Bolus Wizard, carb count catalogues, insulin-on-board calculators, and tagging features galore. And I love that we have all of these options! It’s just that…I never use them.

Ok not never. When I test on the Freestyle meter built in to my OmniPod, I do use that BG as the suggestion for my bolus (plus a carb count). But let’s say I don’t do a finger stick and I’m bolusing on the fly based on my CGM data. Then I don’t use the calculator features. The reason being is that I usually feel like I’m  juggling too many factors for the suggestion to be helpful: yes my BG is 180 and I’m having 35 grams of carbs but what if I worked out? What if I was low just an hour before? What if it’s going to be a super lazy and sedentary Sunday in front of a Walking Dead marathon and I’m so grossed out by the zombie killing that I can’t finish my late breakfast (not that this has ever happened….except that it always happens)? When I factor in all of these variables, I’m convinced that I should just determine the bolus and forget about the calculators on my pump -I’m going to change them anyways, right?

Well, maybe. The problem is that skipping this step allows me to gloss over the whole process entirely. Even if I decide to change my bolus later, having to enter in a BG, a carb count, and confirm that suggested dose will push me to truly evaluate all of these items, rather than scan the dinner table and punch in a mostly-arbitrary “two units now more later if need ’em” type of bolus. Which is not using the features to my advantage. I’m missing a lot by not taking those crucial few extra seconds to actually think through what I’m doing (what a concept, eh?!).

Features on smart pumps were built around customer needs, and they only work if you use them. And although, as the saying goes, even a broken clock is right twice a day, having a little strategy and calculation on board is better than having absolutely none. Which is where we all tend to trend when we’re in a hurry or busy. I need to let the smart features on my pump offer a little guidance as I bulldoze through life these days. Hey, they might actually turn out to be helpful!


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Another reason to ignore them is when they are sort of wrong.

For instance, my late night correction bolus is lower than during the day (err.. or higher … 60mg/dl/I.E. instead of 50mg/dl/I.E). But when my pump tells me at 10.01pm that I should correct my 200mg/dl with a paltry 1,4 units, I’ll promptly go ahead and ignore it and use 2 full units.

And then have a low in the middle of the night. Because those correction factors were chosen for a reason. It’s just that they sometimes “feel” wrong.

And I’m no Jedi. I should use my targetting computer. That’s what it is there for.

I’m the exact same way as you! I think part of it comes from the initial training without all the fancy features of pumps and having to calculate everything ourselves. It just feels uneasy giving up the control/decision of how much insulin to do and relying on a machine (even though I have full power to override it). Plus it creates more work to have to actually count each carb and put in your BG, only to override and do what you actually want. I just had a convo with my diabetes nurse about actually counting carbs accurately. She suggested that I try the bolus wizard and I’m pretty sure I shot her a death glare!

Floh and Taylor – it’s such a function of the disease’s variability right? You know what actually happened that day and what you’re doing next – ie correction factors that change at certain times and those kinds of anecdotal knowledge that only you would know….and the calculator doesn’t. But sometimes I should “take the hint” and at least think about it….

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