Diabetes Tech and how it hangs together for me

 As some background, I have the following bits of kit helping me manage my T1D:

• Medtronic 640g Insulin Pump
• Contour Next Link USB Blood Glucose reader
• Tidepool
• 600 Series Uploader
• Nightscout
• Freestyle Libre 1 and Freestyle Reader
• 2 x MaioMaio 2
• Google Pixel 2 XL (Android 10) Phone
• xDrip+ Nightly build
• Pebble Smartwatch

Medtronic 640g Pump

This replaced my Animas pump, when Roche pulled out of supplying Insulin pumps in the uk.

Not a great gadget - it does everything fine, and has all required settings / programs, however the level of support is not as good as Animas, and the essential products that were supplied as standard with Animas are not available.

The Canula design was changed a few years back, so they shatter when removing them from the reservoirs (to prevent re-use) which can be annoying when parts of the cannula fail and you're stick int he middle of no-where and just need to do a quick fix.

Battery life is approx 10-15 days

Belt clips wear out quickly, and although replacements are available (as long as its within 1 year of supply) they don't last well. In addition to this, after 3 years of wearing a pump, the pump itself is work on the belt clip, so new clips do not stay on well. Roll on the 4 year renewal!

Contour Next Link Blood Glucose Meter

Works well, although the lance isn't to my personal comfort. Accuracy of the blood strips was questioned in the UK - although never noticed a problem myself. I tend to use this only to upload data to Tidepool and into xDrip+ / Nightscout

Tidepool

On-line application that gathers data from Nightscout and xDrip+ along with readings from your pump and Libre scanner, and displays it in graphs and detail to help you plan your changes and review 'what went wrong' and then give you the info to go fix it.

Data can be loaded directly from your devices (pump and blood test machines), or by sending it all directly from xDrip+

600 Series uploader

Pulls the info directly from your Medtronic pump (basal/bolus settings, CP amounts, insulin delivered etc) and sends it to xDrip+

Once installed on your phone, you plug a OTG USB cable (On-The-Go is a special USB cable type, but widely available) between your phone and the reader, and it sucks the data off the pump and into xDrip+

Nightscout

This allows you to create your own website that shows your current Blood Glucose and the events (boluses, food intake etc) that constantly updates in a graph form. Great if family need to keep an eye on you and check you're safe

Freestyle Libre 1 and Freestyle Reader

One of the great steps forward -  A flash glucose monitoring system (from Abbott) which measures interstitial fluid glucose levels. The system comprises a sensor and a reader. ... At each scan, the reader displays current glucose levels, levels over the previous 8 hours, and whether glucose levels are trending upwards or downwards (and how fast).

Works really well with the following things to be aware of:

• BGs displayed are approx 20 minutes behind real time. You may need to check using a Blood test if you need a 'whats happening now' test
• When inserted it takes 1 hour to activate after you first swipe it with your reader. This is supposed to git it time to settle down with your interstitial fluid and calibrate itself. If you can do it, insert it a day or maybe 2 days before activating - the readings are more accurate
• They tent to come off in hot weather - I use 3M Tagaderm film to stop that happening (also means when you walk into a door frame they stay put (that happens more than you realise, till you start wearing one of these things
• From time to time they don't start up - usually due to blood getting in the sensor when you insert them. If this happens they are replaced by Abbot, usually take 1 week to get the replacement, so worth keeping a couple in stock if you can

MaioMaio 2

 Another great leap forward - AS bluetooth transmitter for the Libre - sends the data to xDrip+ on your phone, is rechargeable (mine lasts about a week between charges) and can be held on by simply sticking it to your arm on-top of the libre using a larger 3M Tagaderm. You don't need the self adhesive strips they send with the MaioMaio that way - and you can remove it for charging

Google Pixel 2 XL

Seems to work ok with the above kit - Google don't put additional software enhancements in the way of the basic Android O/S (like Samsung can do) and this one seems to work ok for me. Battery life is impacted by xDrip+ (lots of bluetooth activity) so you'll end up charging it up more than usual.

I can't get xDrip Vehicle mode working any more (google updates stopped that) so maybe another phone would be needed to get that working

xDrip+ Nightly build

Awesome - pulls all your tech together and give a detailed way of gathering the data in one place. Graphs whats going on with your Blood Sugar, and allows you to set alarms for highs and lows, and predict when they might hit you. If you've not seen it - go have a look, it can be challenging to set up first time, but its incredible.

I use the Nightly build to keep up to date with new features - usually wait a couple of days after its published in case there are issues

Pebble Smartwatch

Best I've found as an all rounder, but getting older now - means you always know your blood sugar levels and are warned when they drop.

Doesn't work as an xDRip collector (where the watch talks directly to your MaioMaio when out of reach of your phone, but I'm not sure what watches do work - the info out of the xDrip community is a bit 'scattered' and I'm not sure what works or doesn't at the moment

XDrip+ and Watches

If any of you work in IT, you know that developers very seldom write documentation for the rest of us.

The xDrip team write some incredible software, that gives my diabetic life a massive leap forward in manageability, sometimes its hard to find up to date info on how parts of the system work (thats up to date at least).

The official info is here and has some great reference info: Nightscout cgm-watchfaces

Its possible using xDrip to get the display and high/low warnings etc on a bluetooth enabled watch, there are several types supported:

• Android Wear OS
• Pebble (all types)
• Amazfit
• Bip
• GTR
• BlueJay
• Lefun band
• MiBand

I initially bought an old Pebble Time (ebay £10) as these are now legacy, but after wearing it while fixing the car (it got covered in brake fluid) it fell to bits and I had to superglue it back together as a temporary fix.

I then started looking at the Android alternatives, as this is mainstream tech and seemed to be the easiest to get running, plus should have support going forward.

The watch I picked was a 2018 Ticwatch Pro - again from eBay (about £110 I think) which has been fine for the last 18 months or so. Then Google started changing the way Apps can be loaded onto a WearOS watch - they look to be forcing developers through the Playstore, which is difficult for an open source app and development team.

So for the moment there is a question on whether we will be able to load xDrip onto Android for updates etc without jumping through (IT) hoops, which lots of us find difficult to do.

I started to look back at the old Pebble watches and see if there was something I could pick up cheaply that would do the job, as Pebble was bought out by Fitbit in 2017 (and then shut down) the watches are getting old, and batteries in them starting to fail.

To get a Pebble to work, you need to load the Pebble app from the Playstore, then patch it using http://rebble.io (google 'pebble rebble' to find them)

Once thats done, you have the Pebble app with the associated store of watch apps/watch faces etc.

Here is what I've learned from looking at the watches themselves:

• Original Pebble Model 301BL (BL is black)
• Old and batteries usually failed by now, unless replaced.
• Essentially 2 types
• original kickstarter one, thats glued together
• the newer one, that has 4 screws on the back (screws are T3 torx)
• Batteries can be replaced (£15 quid on ebay) but its a reasonable bit of work to strip them down and solder the very small connections - not for the faint hearted.
• Monochrome screen
• Pebble Steel Model 401B
• Some working ones about on ebay if you keep looking (£15-£20)
• Lots suffer from Screen Tearing - the connector in the watch goes loose, so you have to take it to bits and jam something (toilet paper works fine) in the back over the connector and screw the back on again (T4 torx screws), lots of Youtubes on how to do this
• Monochome screen
• Strap is a stepped connector on the watch - special for the Pebble steel, so if you need one expect to pay £12 on Amazon or £20 on ebay
• The strap pins are screw in - not sure what the sizes are, but if you buy a working watch without them (I did) its probably easiest to buy a broken one an use the pins for spares
• Battery life 3-4 days using xDip
• Pebble Time Model 501
• Colour Screen (yay!)
• Battery life is usually 'ok' but mine lasts about 1.5-2 days before needing charging as its getting older
• Case is glued together so if you need to get into it - its a 'warm up with a hair dryer' job
• Pebble 2 Model 1002
• Newest (the last of the line) of watches before being shut down
• Heartrate monitor
• Colour screen
• Buttons on the side wear out (you can buy these 3D printed if a replacement is needed)

Pebble sold best in America - so lots more on ebay.com if you can stomach the postage costs to the UK