670 G- the frustrating user experience

It’s now been about 9 months with my medtronic 670 G insulin pump. When it’s in automode, for the most part it’s pretty good. I’ve had less lows and less drastic spikes. I’ve also gotten better at pre-bolusing for my meals which has made a big difference.

In my current job, I’ve been thinking a lot about the users of our products. Thinking about the user’s needs and their experience using our product. I feel like I spend so much time thinking about other users that I forget that I too am a user. I am a user of the insulin pump product. Unlike the products I work on where we have to think about how we can engage the user and get them to come back, I have to use my insulin pump and continue using it (or I suppose switch to injections or switch companies). But there had to be people who thought about my experience using the pump, how to design the menus and buttons to make it as simple and intuitive as possible to use. And they needed to weigh the user’s needs and preferences against regulatory systems like the FDA and safety and compliance guidelines. It can be a hard line to walk. There’s a lot they did well, but yes, there is a lot of room for improvement.

There are certain features of this pump that continue to annoy and frustrate me. Maybe someone from medtronic will read this and can make recommendations for future versions.

Silencing alarms. To me, the point of silencing alerts is so that you do not hear or feel an alert. I understand the reasoning for not being able to silence low blood sugar alerts, that’s okay with me, but I would assume every other alert should not be vibrating if it’s on silent. This is not the case. From the user 670 G user manual:

“Alert Silence does not silence Auto Mode Exit, Auto Mode Exit
High SG, Auto Mode Off, and Low SG XX mg/dL (XX represents 50 mg/dL
or below) alerts. These are both based on set glucose thresholds and
cannot be silenced.”

Like I said, for safety reasons I understand why the Low alerts bypass the alert silence, but I don’t understand the auto mode exit. The pump is still working.

Automode exit. This brings up more frustrations with being kicked out of automode. For the most part, the reasons why you get kicked out of automode make sense. Although annoying, I do understand being kicked out when you’re over 300 for an hour or 250 for 3 hours. Being kicked out because you’re at your max basal delivery for 4 hours, I suppose I understand, probably good to check why the number isn’t coming down. But being kicked out for min delivery is an interesting one. I’ve been kicked out for running a blood sugar that was close to 85-90 for hours, I wasn’t requiring any basal insulin and so eventually it kicked me out, but my first thought was, why is having an amazing blood sugar kicking me out of the useful feature of the pump?

The sensor. I should be more specific about this one, really my biggest pet peeve with the sensor is that it only consistently works well for a few of the 7 days, and only lasting 7 days is annoying to begin with. But a more specific annoyance with the sensor is that I could have a sensor that is working really well on the 7th day and then the sensor expires. One would think that if the sensor was working fine before the expiration, that if you just restart the same sensor, it should work fine after. But it’s like the sensor sits there and goes “nah uh, don’t try to trick me, I know better” and will still tell you that it’s expired and needs to be replaced. A couple times I have gotten around this by disconnecting the sensor and charging it for a couple hours, and then reconnecting it as if it’s a new sensor. But even when this happens, it still doesn’t work as well as it did pre-expiration just a few hours earlier. Whether this issue is intentional or not, it makes me wonder if these companies could be designing a sensor that lasts significantly longer, but choose not to because it means we as patients and customers need to buy more sensors. Kind of how most electronics these days are not built to last, they’re built to last for a finite amount of time and then be replaced.

So any pump product designers and engineers and user experience people that stumble across this blog post, just a few things to keep in mind as you design and build your insulin pumps, especially as more and more turn to hybrid or fully closed loop systems. 🙂

The hypo hangover

30s.jpg

Replace four hours of drinking with 2 glasses of wine and you’ve pretty much nailed it. As my 30th birthday approaches, feeling the effects of a couple drinks the next day isn’t the only change I’ve begun to notice. When I get out of bed each morning, things crack and creak. I have more than just an occasional grey hair on my head. I get random back aches. Anything past 10 pm I want nothing to do with.

But the other change I’ve noticed is my low blood sugars. I have no idea if this has anything to do with getting older, but when I used to get low, I’d start to feel badly, I’d treat the low, and within 10 minutes I’d be back to feeling normal. A lot of the times I was able to power through and continue what I was doing, even if I was low.

Lately when I get low, the lows are more intense. They hit me head on and I often have to stop what I’m doing. But more than that, that low, awful feeling lingers! Even when my blood sugar is heading back to normal, I still feel awful- shaky, light headed, weak, and just generally out of it. It’s like the recovery from a low is taking much longer. And I’m stuck with a hypo hangover. It sucks! And a quick google search showed that I’m not the only one to have these hypo hangovers. There are forums full of diabetes talking about a similar phenomenon. Luckily, it doesn’t seem to be the case for all my lows.

There are so many factors that could have affected this longer recovery from my low. How much food I had eaten previously, the amount of active insulin I had, how quickly my blood sugar dropped, what I used to treat the low, how recently I had exercised, how many other lows and highs I’ve had recently, the amount of time I’ve had diabetes, my age, the frickin weather for all I know!

I’m looking forward to my 30’s, all the exciting changes, and even the not so exciting ones. And hopefully I can keep the hypo hangovers to a minimum. Cheers!