Last week I was invited by Medtronic UK to come up to their head quarters, in the delights of Watford, and attend a meeting regarding their latest development in diabetes technology and the world of insulin pumps, the MiniMed 640G.
Personally I’ve always been a more straight forward type; for example in my days on the football pitch I was never the pink boots, twinkle-toes and make-up type of player… I was always the sleeves up and battle hard type, coming off the pitch drenched in mud and blood. And that’s the mentality I’ve always had in diabetes too really, to get stuck in and get on with it.
In the time I have lived with diabetes I have seen some major changes and developments in care come about, which continue to progress – this latest meeting with Medtronic being an example of that. There are insulin pumps as an alternative of the multiple daily injections I have always been on, continuing blood glucose monitoring systems, developments of an ‘artificial pancreas’ and all kinds of improved devices in terms of blood sugar meters and even insulin pens (check out Timesulin who have a simple but effective cap for insulin pens, so you don’t forget when you last injected insulin).
With all the diabetes ‘gadgets’ now in the world, I recall Alex Silverstein saying: “it is an interesting time to have diabetes!”
Indeed it is, especially when you consider once there was a time when people would take a slash (urinate) on an ant-hill and see whether their natural liquid was sweet enough, with high glucose, to attract the ants out to it.
In the modern world, personally, I’m not all that technically minded it is fair to say. I have some key skills in creating events and organising crazy challenges, as well as the heart to succeed in those challenges in my fight against diabetes; yet, I’m very old school for a young adult. An example, I prefer to listen to The Rolling Stones way ahead of One Direction. The fact One Direction now twice got a mention on my blog offends my pride. There’s simply no comparison between those two. None at all. In light of my old-schoolness, I have always remained on multiple daily injections, where in being an active diabetes advocate in the Western world, I have had opportunities to make a change in the past and go onto the insulin pump.
Last year with the United States tour for Marjorie’s Fund I had my first DiA-gadget taste. Firstly, I am absolutely delighted to hear that the funds we raised on that adventure will be used by Marjorie’s Fund to help support diabetes supplies in Gambia this year; with Dr Baker working with my IDF Young Leader pal Lamin on that!
In the U.S Tour I was on Dexcom’s G4 Platinum continuing blood glucose monitor (CGM). It was a good experience for me. The first time I wore the sensor I had an incident with some blood drops coming out, but after support from the #DOC passing on advice, it was easily solved. And I never had a situation like that with it since. What I really liked about the Dexcom was how it detected whether my blood glucose levels were rising or falling – I think that is key for anyone with type 1 diabetes.
It’s importance increased really for me given that I do not have very strong hypo-awareness symptoms. Once upon a time I used to have strong symptoms, which probably acted in a similar way to the CGM in terms of awareness: I’d get shakes and shivers when dropping low in blood glucose, and alternatively a quench of thirst and a regular need to urinate when rising high in blood glucose. In not having those symptoms come on too strongly anymore, having a device that beeps, vibrates and makes you aware of that is a great advantage. I successfully completed the 7 marathons challenge of running around Long Island and Manhattan, New York, and only had 2 hypos in the process, which isn’t bad considering 180+ miles of endurance…
I did kick myself for those two hypos though as they both came on the very last run! I injected my normal rate of Levemir basal insulin without thinking, where I usually lower my daily intake by 55% on a split dosage on run days (see, mathematical skills enhanced through diabetes..).
In travelling to Watford, home of the Hornets who Crystal Palace of course beat 1-0 in the 2013 Championship Playoff final, to attend Medtronic’s advocacy group meeting, I wasn’t sure what to expect. I knew all other attendees were on the pump and so I wasn’t quite in the know as they were. My technological terms are along the lines of “sticking the needle in” and so I had to quickly adapt! I guess what has put me off from going onto an insulin pump over the years has been two things really:
1. The idea of being attached to something
2. How will it affect me in sport?
From the latter of those two I know most in sport and exercise talk fondly of the pump – it is something that helps their control better for that. A few years ago I remember seeing Dr Gallon and he was strongly in favour that someone doing the level of endurance I was should be on an insulin pump. However, I have built many experiences up and have loved gaining the knowledge of control on injections – it is what I know and what I do. So why change? Has always been my question.
In the meet it was great to see numerous familiar faces and also meet people that I knew of through their online advocacy but had never met in person before. And Kyle Rose was there, of course, he is every-bloody-where I go! The Alps, San Diego, Melbourne, Watford…
In hearing all about this Medtronic MiniMed 640G, initially my thoughts were… who names these devices? Dexcom G4 Platinum, Medtronic MiniMed 640G… my assumption is J.K Rowling. The evidence is in the Nimbus 2000…
But actually from what I was hearing, and granted what I was hearing needs to be released (end of Feb in the UK I believe) and proven, I was really impressed. Their aim was clearly laid out to provide people with better health in diabetes, improving both the short term risks and long term control in health. What appealed to me the most regarding this device was the ‘SmartGuard’. Now I’d never heard of a SmartGuard before, it sounded to me like Stephen Hawking in a Red Coat outside of Buckingham Palace. The concept of the SmartGuard in this insulin pump of Medtronic really did intrigue me and seems a potentially great step forward in diabetes. And where I am concerned, a great step forward in sports and exercise for diabetes management too!!
It uses modern technology such as the cgm’s ability to predict the increase or decrease of blood glucose levels. It notifies you when dropping high or low, and this alarm can be altered, say if slightly hyper after dinner (as often expected) and turned to vibrate so you don’t have the annoying beeps continuing. Then this SmartGuard operates to keep your levels safer from hypoglycemia – stating that it will prevent 80% of hypos. When the blood glucose levels (in mmol/ls) are 3 mmol/ls above the level you put in for your HYPO mark (say 3.9 in most cases) and decreasing , it will automatically stop the insulin into the body to prevent the hypo. You don’t have to do a thing.
My question was: “What about in exercise where your levels might be dropping at a much faster rate than normal?”
And the answers I received suggested that this device will automatically adapt through the SmartGuard, calculating how rapidly the levels are decreasing and acting to prevent the hypo. I also asked about whether you need to tweak your insulin for the exercise and the response was that no you do not. The system works to prevent hypos in any way, shape or form and the further remark was that you wouldn’t even need to load up on carbohydrates beforehand to prevent hypos with exercise. Medtronic seemed very confident in this.
I made a suggestion at the other end. If this is effective and prevents 80% of hypos, brilliant! In terms of hypers, currently they are able to alert you through vibration that the levels are increasing and reaching your high threshold level. This allows for you to then act and stop the hyper yourself. The suggestion I made was whether they could also prevent hypers from happening, automatically releasing insulin at a certain level. This isn’t in the device, yet, according to Medtronic, that is the next step. They might owe me a few drinks on that one!
From what I understood in being at the meeting is that the DiA-Gadgets are so advanced now that anything is possible for the future. This MiniMed 360G really does appear a great way of bettering control of diabetes both short term and long term and I was really impressed by Medtronic’s ambition here.
Would I go on to the pump? Who knows… que sera sera!