Pump improvement ideas

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Pump improvement ideas

Postby piglet » Wed Feb 22, 2012 11:27 am

I’m currently on an Accu-Chek Combo and my daughter uses a Medtronic pump. I often wonder why some really basic features seem to be missing from pumps (the ones I am familiar with anyway) and have done a bit of blue sky thinking about some of the features I’d like to see in the next generation pumps (apart from the closed loop systems of course), but will probably never get ...... (sorry if this sort of stuff has been raised here before)

Basal profile based on weekday
Why can’t we have basal profiles switch automatically based on the day of the week – for instance a weekday basal profile and weekend profile? Such a simple thing to implement. As an example where this would have been really useful, in her early years my daughter’s school day basal profile included big spikes to cover morning tea and lunch, so no one had to manually administer a bolus. Guess what happened (too many times) on a Saturday morning! And for myself at work, I tend to

Super bolus
Why don’t we have a fourth type of bolus, known as a “super bolus”, built into the pumps, rather than having to do it manually like I do occasionally now? ie for high GI high carb we can ask the pump to add a couple of hours of basal to the bolus dose and then temporarily suspend the basal for a couple of hours. You get a bigger hit of insulin now which can help reduce post prandial highs (see http://www.diabetesnet.com/diabetes-technology/blue-skying/super-bolus)

Activity Monitor
Why can’t we have something like a simple pedometer built into the pump? With some obvious limitations, something like hourly pedometer counts could be a useful addition for basic trend analysis to pick particularly active times. I don’t keep a diary and can’t remember what I did yesterday, let alone a month ago, when I am sitting in front of the graphs trying to work out why I might have gone low or why I put myself on a temp basal and then a short while later been high (was that a post evercise high, or should I not have been on a temp?). Another example - we used to send my daughter of f to day care with her pump and we’d have no idea how active she’d been during the day

Location aware basal profile
With the addition of a GPS or even a static Bluetooth device or Wifi receiver, we could add automatic location based profile selection – "home", "work" and "other" for instance. I am usually far more stable at work (more predictable food and activity levels) and so could automatically set a tighter profile and BGL targets

Auto sensing disconnect
I disconnect every morning for a shower etc and probably like most, never suspend the pump. It just so happens that this is the time when I’m on the highest basal rate due to dawn effect. For me, a 30 minute disconnect can mean missing out on more than half a unit of insulin, which in turn can cause a 1.5 mmol rise. Wouldn’t it be nice if the pump automatically suspended (and within limits) gave us the missed basal when it was reconnected? Obviously if you’re disconnecting for sport you might not want this feature turned on. The reality of what happens now though, is the missed basal is generally built into the profile, so on the weekends when I get up later, I find I start the day a bit lower than during weekdays (of course with access to the pantry and fridge all day, this is soon compensated for!)

Just some thoughts . Really interested to hear if anyone has any other ideas
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Re: Pump improvement ideas

Postby kaito » Wed Feb 22, 2012 2:14 pm

Some interesting ideas, I found the super bolus a little tricky to get my head around, but I'm sure in time I'd get the hang of it!

I would love smartphone integration . I know the AccuCheck already has bluetooth, I'd love to be able to analyse my pump in my phone rather than my laptop, can allow for instant data input such as notes, food diary etc to really create a detailed logbook. Could also enable bolusing from phone as well as the remote! I can imagine this would come with a few "don't use your phone at the dinner table" lectures though!!

(ps: I hope the pump manufacturers are reading this thread! ;) )
Kait
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Re: Pump improvement ideas

Postby Catapult » Thu Feb 23, 2012 1:03 pm

My Cozmo 1800 had the weekday/weekend profile thing down pat I think. Also if you let the pump know you are disconnecting, it would suggest a quick bolus based on what you'd miss out in your time off the pump.

Cat.
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Re: Pump improvement ideas

Postby ali m » Thu Feb 23, 2012 2:23 pm

I'm not a huge fan of complete automation, I rarely even use the bolus wizard, but I would love MP3 and GPS facility on my pump. And of course, iPhone connectivity. Just because.
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Re: Pump improvement ideas

Postby Topcat » Thu Feb 23, 2012 3:33 pm

As a person who works daily with this sort of electronics/instrumentation and can therefore have a healthy distrust of it, my tendency would be to avoid any unnecessary extra features especially anything to do with radio (ie bluetooth) or anything that puts an extra load on the processing power or power supply in such an important piece of kit.

Extra alarms/timers would be useful, such as when next cartridge change and infusion set change are due, with the ability to adjust the default time periods and not settle for the manufacturers recommended intervals.

Bolus and BGL test alarms would be good, with a little extra adjustment built in.

The ability to insert when an external bolus has been made with a pen/syringe, would keep the pump aware of insulin on board in those circumstances.
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Re: Pump improvement ideas

Postby kaito » Thu Feb 23, 2012 4:00 pm

Topcat wrote:The ability to insert when an external bolus has been made with a pen/syringe, would keep the pump aware of insulin on board in those circumstances.

I do that by disconnecting and running a "normal bolus" (no wizards) of my injection. But a less insulin-wasteful way would be nicer!
Kait
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Re: Pump improvement ideas

Postby cazza » Sun Feb 26, 2012 1:39 pm

MP3 and being able to program different songs for the pump requirements. I would love to have "American Idiot" play every time I need to check BSL. I have it on my phone and the looks you get in the supermarket are a scream. lol
It's mind over matter, I don't mind so it doesn't matter.
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Re: Pump improvement ideas

Postby summerdays » Sun Feb 26, 2012 3:24 pm

piglet wrote:I’m currently on an Accu-Chek Combo and my daughter uses a Medtronic pump. I often wonder why some really basic features seem to be missing from pumps (the ones I am familiar with anyway) and have done a bit of blue sky thinking about some of the features I’d like to see in the next generation pumps (apart from the closed loop systems of course), but will probably never get ...... (sorry if this sort of stuff has been raised here before)

Basal profile based on weekday
Why can’t we have basal profiles switch automatically based on the day of the week – for instance a weekday basal profile and weekend profile? Such a simple thing to implement. As an example where this would have been really useful, in her early years my daughter’s school day basal profile included big spikes to cover morning tea and lunch, so no one had to manually administer a bolus. Guess what happened (too many times) on a Saturday morning! And for myself at work, I tend to

Super bolus
Why don’t we have a fourth type of bolus, known as a “super bolus”, built into the pumps, rather than having to do it manually like I do occasionally now? ie for high GI high carb we can ask the pump to add a couple of hours of basal to the bolus dose and then temporarily suspend the basal for a couple of hours. You get a bigger hit of insulin now which can help reduce post prandial highs (see http://www.diabetesnet.com/diabetes-technology/blue-skying/super-bolus)

Activity Monitor
Why can’t we have something like a simple pedometer built into the pump? With some obvious limitations, something like hourly pedometer counts could be a useful addition for basic trend analysis to pick particularly active times. I don’t keep a diary and can’t remember what I did yesterday, let alone a month ago, when I am sitting in front of the graphs trying to work out why I might have gone low or why I put myself on a temp basal and then a short while later been high (was that a post evercise high, or should I not have been on a temp?). Another example - we used to send my daughter of f to day care with her pump and we’d have no idea how active she’d been during the day

Location aware basal profile
With the addition of a GPS or even a static Bluetooth device or Wifi receiver, we could add automatic location based profile selection – "home", "work" and "other" for instance. I am usually far more stable at work (more predictable food and activity levels) and so could automatically set a tighter profile and BGL targets

Auto sensing disconnect
I disconnect every morning for a shower etc and probably like most, never suspend the pump. It just so happens that this is the time when I’m on the highest basal rate due to dawn effect. For me, a 30 minute disconnect can mean missing out on more than half a unit of insulin, which in turn can cause a 1.5 mmol rise. Wouldn’t it be nice if the pump automatically suspended (and within limits) gave us the missed basal when it was reconnected? Obviously if you’re disconnecting for sport you might not want this feature turned on. The reality of what happens now though, is the missed basal is generally built into the profile, so on the weekends when I get up later, I find I start the day a bit lower than during weekdays (of course with access to the pantry and fridge all day, this is soon compensated for!)

Just some thoughts . Really interested to hear if anyone has any other ideas


Great ideas, any chance of you working for a pump company? ha ha!
Type 1 just trying to do my best
http://www.nicediabetes.com
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Re: Pump improvement ideas

Postby sammy » Sun Feb 26, 2012 8:42 pm

Totally agree on the pedometer and have often thought that since having my pump. Make it useful! My DE and I have discussed setting up a weekend and "office" basal scheduled into my animas pump and we are going to do that at the next appt. I no longer wear a watch, as I have the pump connected all the time and it has a clock on it, so the basic time is a feature I use now. I'm still trying to find and work with some of the features the pump actually has...
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Programmable basal rates?

Postby SallyMarchini » Mon Feb 27, 2012 5:01 pm

I wish I could program varying basal rates in advance, and then a series of basal rates for when I exercise. Eg program 55% to start at 6am (to kick in by 8am) for 4.5 hours, then 80% for 2 hours to finish the exercise, then 90% for a few hours before back to 80% for 8 hours overnight. I do this but manually and it couldn't be *that* hard to program...
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Re: Programmable basal rates?

Postby Catapult » Mon Feb 27, 2012 5:36 pm

I think there are some pumps that do this. What pump do you have?

Cat.
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Re: Programmable basal rates?

Postby yondi » Mon Feb 27, 2012 5:42 pm

What kind of pump do you have? I have an Animas it has 4 basal profiles. I have one for work days,one for lazy days,one for 6am run and one for arvo run.
The 6am run is the one i use most for exercise. The profile is the same as my lazy days profile except between 3am and 6am the basal is lower.
You just program it and then the night before you just change to the basal you want.
You can't do %'s though you have to do like 0:00- 0.65, 3:00- 0.3, 6:00- 0.75 etc
I'm not sure if other pumps also have this feature.
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Re: Pump improvement ideas

Postby piglet » Mon Feb 27, 2012 8:54 pm

Since I wrote the first post, I decided to have a look through some pump patents to see what they’ve patented but not yet put onto the market. It wasn’t really very enlightening. Skim read a number of them - they’re such a hard read, deciphering the dull language of patents with the innumerable numbered cross references to diagrams (see http://patents.google.com). Didn’t really find anything interesting.

Ali m – snap! The first thing I did with my Bluetooth enabled Combo was search for the Bluetooth signal on the iphone. Just because I wanted to. Alas, the iphone couldn’t even see it.

Topcat - I’d have to agree with you that any radio built into such critical things as pumps needs to be carefully balanced with things like battery life and security. You may recall it made the news last year when a guy hacked into his pump via Bluetooth. Re telling the pump about syringes, the Accu-Chek Combo can do that

Kaito – I’d love smartphone integration too. I understand some systems are currently under trial, (my daughter was hooked up to a blackberry for a while as part of a clinical trial) but the downside is they totally take over your phone and won’t let you do anything else with it (even phone!). The trouble is the pump companies cannot control the software environment on the phone otherwise, leaving it wide open to data corruption from other software on the phone doing unintended things, or even worse – hacking. It’s inevitable it’ll come one day though. I’d be ok with a **one** way sync from pump to my iphone to run a more complete diary as you suggest. Not comfortable allowing it to talk back to the pump though and do things like administer insulin.
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Re: Pump improvement ideas

Postby Kezza » Mon Feb 27, 2012 10:17 pm

What Sally said. After exercise I sometimes run 90% overnight, but I also use 30 min of 10% regularly to avoid oncoming hypos. I'd like to be able to tell my pump "do 10% for 30min then 90% for 7 hours". I know that's possible with alternative basals, but that's a lot of work and that "10% for 30min then x % for y hours" comes up for me a lot.
Ever tried to send a text message with your pump? It doesn't work!
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Re: Pump improvement ideas

Postby sammy » Tue Feb 28, 2012 8:36 am

Hi
This post made me read up on my animas workbook and user guide (amazing what you find out when you read the instructions) and as yondi said the animas pump has various settings for the basal for your different lifestyles. Can't comment on the other pumps. Perhaps give the reps a call?
Sam
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