Adjusting to a new life with tech
We were lucky to be offered a CGM after a couple of weeks. Emmie couldn’t speak so had no way of communicating if she was feeling high or low glucose levels. She was very petite and lean so it was challenging to find places to insert the CGM, but it changed everything.
While we still carried out finger pricks, they were much less frequent and we were able to get some sleep – attending to her in the night only when the CGM alarmed. It also gave us a good idea on how to tweak her insulin doses and it soon became apparent to us and our team at the hospital that the minimum insulin dose of 0.5 units from a pen was often too much for her and would crash her into a hypo. As a result, we were offered an insulin pump which allowed to dose 0.05 units and allow us to much better control her levels.
Having a toddler carry around an insulin pump in a little belt bag with a cannula in one buttock and the CGM in the other was heart-breaking and difficult to accept, but it gave her more freedom and ultimately improved control of the condition.
Not long after Emmie started at nursery, even though the staff that looked after her were amazing, it was difficult for us as parents to pass her into someone else’s care. But with the CGM being able to send us her sugar readings in real-time, we were able to keep an eye on her and we were always a phone call or short drive away.
Hybrid closed loop: an enhancement to her glucose control
By the time Emmie reached 4-years old, despite having the technology, her control needed a lot of attention – often tweaking pump basal profiles and carb ratios more than once a week as she had growth spurts or picked up a cold. What worked one day may not the next and the static settings of the pump were restrictive.
We’d read online about “Hybrid Closed Loop” and despite Emmie being so young, we felt it was exactly what she needed for her constantly adapting insulin needs. We tried for a while with a DIY loop set-up with limited results, but as she was getting closer to starting school, we wanted her to be on an easy-to-use system that the various carers she would have a school could manage. After discussions with our team, we were approved to move onto mylife Loop powered by mylife CamAPS FX and it felt as much as an enhancement to her control as going onto the CGM and pump did initially.
No longer did we need to spend every night analysing her basal levels every hour, the algorithm did all that for us. While it was a rocky start while the system learned Emmie’s patterns, within a few weeks we were hitting 70-80% in target range most days – with the automated Insulin delivery system giving additional insulin when she’s high and cutting off insulin to avoid hypos.
Final piece of the puzzle – a new CGM
The final piece of the puzzle to enhance Emmie’s life was a different CGM. When it was announced that the FreeStyle Libre 3 sensor was to be compatible with mylife YpsoPump and mylife CamAPS FX*, we were instantly interested. At this point, even at 5-years old, the CGM she was using was still large on her small arms meaning she often knocked it off and it could sometimes give inaccurate readings during the nighttime if she lay on it – causing the algorithm to cut out insulin, thinking she was low when she wasn’t.
The FreeStyle Libre 3 sensor changed all that – tiny on her arm she instantly loved it and is much less likely to knock it off, meaning we tend to get the full 14-day life out of the sensor. We have no issues during the night thanks to the slim profile and she is more comfortable with the simple insertion, often doing it herself.
As parents we also love that it gives us readings after the one-hour warm-up time, any longer than that seems a lifetime in diabetes management and also, we get readings every minuteѰ!
In summary, the five-year journey Emmie has gone on with her diabetes management with the use of technology is amazing. I’d be lying if I said it was perfect, the algorithms can only help to a certain level with a growing child, illness, different levels of activity, but it massively helps.
Hybrid Closed Loop works, especially well during the nighttime, often allowing Emmie and us parents uninterrupted sleep. It also gives Emmie the freedom to attend the clubs mentioned at the start without us having to be there watching over her; we simply tell the people running the clubs if her phone alarms to give her a sweet to treat the hypo, and as we remotely get alerts, we’ll be there shortly after.
I describe it to people as a “helper” that helps manage around 50% of her insulin requirements, which is 50% less time and effort for her carers at school and us as parents to manage her diabetes. We look forward to what comes in the next 5 years!
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