what i know:
the algorithm does not work like the Bolus Wizard  with a straight correction ({[bg-target bg] / [correction factor]} - iob)
the algorithm for basal and correction decisions looks at total daily dose, SG, and rate of change
max/min auto basal rates are determined by the algorithm and cannot be adjusted
changes to carb ratio and active insulin time are the only settings i can control to impact immediate control
the algorithm learns from me using it

what i don't know:
how it does all this and how long it takes to learn, though i do think it is getting better!

i'm two weeks in to Auto Mode and i think i  can begin to make some observations.

pros:
not adjusting basal rates since they are automatically calculated!
keeping blood sugar relatively steady while fasting
predictive low suspend (basal rates cut off when blood sugar starts dropping)

cons:
can only correct to 150 while in AutoMode, although my target blood sugar is 130 and the standard range is 90-140
no manual boluses to correct blood sugar; must use the bolus wizard and enter high blood sugar or carbs to get insulin
can not override suggested bolus amount: it's all or nothing
although the targeted blood sugar is 120, i'm finding that the pump is keeping me closer to  150 fasting
the pump is having trouble in the mornings, and my blood sugar is shooting up to 230 even though i'm fasting
the automatically calculated maximum basal rate does not help with underestimated carb counts, or  high fat meals
no extended, dual, or square wave bolus features are available in Auto Mode
basal rates suspend after a meal bolus but before eating, although bolusing 15-30 minutes before eating is suggested

lots of adjustments being made since i entered into SmartGuard Auto Mode sunday evening!   i'm not sure if i knew exactly how it would all work!

in effect, when in Auto Mode, the 670g targets a blood sugar of 120.  although suspending the pump is still an option, there are no temp basals, only a temporary blood sugar target of 150 that you can set the pump to.   in essence, there are no. basal rates.  the pump just automatically gives microboluses of insulin (represented by pink dots at the top of the glucose screen) to target a blood sugar of 120.

some odd things that i've had to change since going into Auto Mode include my insulin to carb ratio (previously 1:4 and now 1:5) and my active insulin time (previously 2 hours and now set to 4.5 hours).  while i am confident that these numbers were correct for the 670g in Manual Mode, in Auto Mode i've had to make these changes.  i have no scientific explanation, and i'm still testing to see if these changes will work out.

meanwhile, though, know that the robot pump did not take my life.  please send me any questions that you have!

just got the phone call from the clinical research coordinator.  
SmartGuard Auto Mode has been turned on!  

​let the fun begin!

​

for the run-in-period

things i like about medtronic's 670g with enlite sensor:
-insulin to carb ratio is  adjustable by TENTH of units, a HUGE help as my I:C ratio is very high  at 1 unit  to 4 carbs
-basal rates are adjustable by .025 units

things i like about my omnipod/dexcom:
-no tubing to get caught on doors &  easy to wear anything i want without considering my insulin pump
-the dexcom can be calibrated at any blood sugar, any rise rate, and remains very accurate  if <225 mg/dl


for the start of the study (no SmartGuard Auto Mode yet)

things i love about medtronic's 670g with enlite sensor:
​-predictive low suspend is AMAZING; the pump automatically turns off (can be overridden) and automatically turns back on when blood sugar is back into a safe range


although the  pros and cons of every insulin pump/cgms are highly individualized, i'm interested to know what pros and cons other persons with diabetes see with  these systems or others.   please feel free to comment below!

we left home sunday afternoon, driving halfway to charlottesville and arriving in charleston,  west virginia around nine pm.   as we often now do since becoming airbnb hosts ourselves, we stayed in an airbnb overnight (i even got some ideas that i may implement).   we slept really well and on monday morning, we drove the rest of the way to charlottesville (4 hours) and arrived about an hour before my 2pm appointment.

straight away, i met the clinical research coordinator and began filling out paperwork.  a nurse came to draw my blood and collect a urine sample.  the nurse also hooked me up to an ekg machine (there's a first time for everything) and printed results for the doctor to read the next day.  we waited for about an hour, then, until my test results came back indicating that i'd passed the screening.  

​
!!!YAY!!!

supplies laid out on the counter, a diabetes educator came to teach me about the new system.  having been on a medtronic insulin pump from 2006-2011, it didn't take long for me to get the hang of the 670g and enlite sensor.   after practicing uploading (i'll upload weekly to medtronic's website), we packed up the bag that i'd brought with test strips, glucometers, a blood ketone meter, infusion sets, reservoirs, sensors, batteries, and the like and before i knew it -- i was on my way out the door!   next visit scheduled two weeks later, and a week after that on 11/16 the new auto feature, SmartGuard Auto Mode (what all of the hubbub is about),  will be turned on.   just in time for thanksgiving.  

​#imightpeemyself

hybrid closed loop  pivotal clinical trial in type 1 diabetes


it all happened so fast!   the past two weeks have been a whirlwind. 

on october 15, i learned via facebook that a friend had been accepted to  the above clinical trial out in colorado.   i clicked on the  link she'd posted to learn more, and i found out that there were several sites still recruiting (according to the clinical trials website).    i've never participated in a clinical trial before but without hesitation,  i wanted to know more.   i emailed a few sites that would  be easy to get to from  indiana: colorado and  georgia.  

we went camping that weekend with friends and  i mentioned the clinical trial.   i was excited about the possibility of a hybrid closed loop system and my friends and, most importantly, husband urged me to follow up with a few additional sites on monday.  

 within 2.5 hours of taking action monday morning, i'd had a few responses, most saying that recruitment had completed but one response from UVA in charlottesville, virginia -- they had an opening as a  participant had just recently failed his screening,

after several emails back and forth with the clinical research coordinator, i scheduled a phone call for that afternoon (monday the 19th).  during the phone call, the coordinator and i went through the exclusion criteria and scheduled a screening on monday, october 26th (this past monday). 

we were going to virginia!