My D-Gear

There’s a series of questions that invariably come up when people with diabetes get together- “What gear are you using? MDI? A Pump? (which one? what style of infusion set?) CGM? Which insulins are you using? What meter? Do you like it? What do you wish was different?”

People with diabetes have intensely personal relationships with these devices, and it’s for a perfectly rational reason: WE DEPEND ON THESE THINGS TO STAY HEALTHY AND ALIVE.

So, I figured I should document my “kit”, and here it is, along with some color as to the reasons behind things:

  • Insulin: Humalog (Lilly). I don’t have any great emotional attachment to brands of insulin. For me, they all seem to be functionally equivalent. My insurance company has a contract with Lilly, so I use the insulin my insurer will pay for. Since I pump, I only use rapid-acting insulin, but I do have a box of Lantus pens to use in the event of a pump malfunction, or if I ever decide that I need a few days without a device attached to my body.
  • Pump: t:slim X2 (Tandem). I’m a tech guy. My day job is keeping web and database servers running. As a result, I appreciate thoughtful, forward-looking design. When I was selecting a pump, I sat in the CDE’s office at my Endo’s practice and played with all of the options, running through the everyday motions that would be required to use a pump, and the t:slim just spoke to me, saying “Hi- I’m the one for you”. It wasn’t any one thing. Instead it was the sum total of the little things. Rechargeable (no swapping batteries every few days). A clean, well-designed interface (I wanted to throw a different pump I tried across the room after the second level of menus). Touchscreen (which to the techie in me, means fewer parts that can break, but also means no scrolling to input carb counts or blood sugar numbers). Upgradeable software (this was a HUGE one). All pumps basically do one thing- they take insulin out of a reservoir and push it down a tube and into your body. The idea that the software that makes the decisions about how much insulin to deliver and when could be improved without replacing the entire device is a paradigm shift. Anyone who has upgraded the OS on their phone should be familiar with the idea, but doing it on a medical device is almost unheard of.
  • CGM: Dexcom G5. This little device is incredible. It doesn’t read blood sugar directly, but based on the glucose content of the fluid between your skin cells, it can make a pretty accurate assumption as to what your blood sugar levels are every 5 minutes. It’s amazingly accurate- I’ve done clinical trials where they measure your blood sugar (from the vein, not just a fingerstick) on laboratory-grade glucometers every five minutes, and the Dexcom was right there with the reference readings across a range of blood sugars from the 40s to 300s. It also can help identify trends, and has alerts which can help you proactively avoid problems rather than just react to them when they happen.
  • Meter: Verio IQ (OneTouch). No great reason for this other than the facts that it came with my pump (and uploads directly to the reporting software), and the fact that my insurance company covers the strips. I’ve used many different meters over the years, and I’m firmly in the camp of believing that the best meter for you is one that you can afford to use as often as you need to. Diabetes is ultimately (in my mind) a disease where managing is data-driven. Trying to manage diabetes without data is like trying to hunt while blindfolded. You might get lucky and hit an edible animal, but there’s also a decent chance that you’ll hit the guy next to you or shoot yourself in the foot.

So, there you have it. I’ll update this page with links and photos sometime soon, but I wanted to get all the “typing” done so that I can go eat lunch 😎