Questions for Cozmonitor Users

[BrendaK]

I am having a heck of a time trying to log numbers. Between readings from the meter at home the meter at school and manually entering numbers in the pump, logging, even on the Copilot is a nightmare.

SO, the endo today strongly recommended going back to using the Cozmonitor hooked on the Cozmo to keep all the readings in one place and make it easy to download. We never really used it when we got the pump, too bulky, too hard to get out at night, etc.

For those of you who use it, can you give me any tips? Especially how you deal with corrections. From what I remember, it will automatically recommend a correction bolus if the bs is higher than the target. Do you do a correction EVERY time if bs is above target? What about IOB, I know the Cozmo factors that in, but how well does it work with Cozmonotir readings? I guess I'm asking if you trust all the pumps recommendations? Seems like a basic question, but we need to try something different!

Frusterating day, a high a1c at the endo visit, so we're changing meters and infusion sets!!!

[momofsingingdiabetic]

The pump will subract IOB for the correction if you use the CozMonitor, just like it would if you hand put the BS in the pump. Danielle has used her CozMonitor from the beginning as it was a big selling point for us.

It depends on how much above target she is. Her target is 120...if she's 150 I may not give a correction, but will for sure if she is over 200. If we've given a correction for a high, I try to remember to have her check again in 2 hours and her IOB is usually almost done by then anyway.

We trust all the figuring to the pump and have not had any problems at all. Make sure you get the CozMonitor extension from Smiths to work with the CoPilot. It's awesome.

[BrendaK]

Thanks, I figured it worked just as if you entered bs in the pump, but we don't manually enter every number in. (Which is probably why we're having some problems). I did get the extension and have been downloading the pump info and the meters seperately, also a problem, because I get overlapping numbers.

I think the Cozmonitor will be easier now that Carson wears his pump in his pocket instead of a pump pouch. It was a pain unzipping the pouch every bs check, but now he just has to take it out of his pocket.

Lots of changes for us!!

[momofsingingdiabetic]

Danielle carries hers in a cellphone case. It fits snug enough that it doesn't fall out, but it's easy enough for her to pull out to test and bolus. She's used several...with velcro, snap...this one is just open on top. Took me forever to find one that was cute (she wanted pink) that wasn't magnetized.

[Nelson]

As for the Cozmo's recomendations for correcctions, we generally trust them. If we have Derek's insulin sensitivity set correctly we don't have to worry about him going low because the pump always accounts for insulin on board. But, if Derek is over 300, we normally need to have the pump deliver a bit more than it recomends or we will have to give him more corrections later (due to insulin reistance occuring when BS is high).

However, we do not trust the hypo recomendations unless is is several hours since his last meal, because it will almost always tell us to feed him because it doesn't take into account the food that he has in him and is still digesting, it only takes into account his current blood surgar and IOB. For example, it will always tell you that quite a bit of food is needed to avoid hypoglycemia if you are testing an hour after your meal.

[kevin@diabetech.net]

The solution you are looking for is the GlucoMON-RT service that just last week became commercially available. Check out the current thread in the parents of type 1 section about 'my endo and new diabetes technology'.

[BrendaK]

The solution you are looking for is the GlucoMON-RT service that just last week became commercially available. Check out the current thread in the parents of type 1 section about 'my endo and new diabetes technology'.

I've read about the Glucomon, but I don't understand how it's that great if it is only measuring blood sugar readings and not meal boluses, basal rates, carbs eaten, etc.

The reason we're using the Cozmonitor is so that 1) he is measured on the same meter at home and at school and 2) so that we can upload that info to the Copilot which will analyze not only the blood sugar readings but also everything that the pump does. We can also upload the Copilot to a server and the endo can get on the server and look at all the info online. We're also using the Cozmonitor so the blood glucose readings are entered into the pump automatically and we will know when to correct and when not to based on IOB.

Am I missing something about the glucomon? It seems to be missing a huge chunk of the puzzle if it doesn't take pump data into account.

[Twinklet]

I don't get the GlucoMon, either. :confused:

We upload our pump info to Co-Pilot and transmit it to our Endo. The team can then see all the graphs, basal rates, carb intake and BG numbers. It's pretty cool.

Brenda, it sounds like others have given you great info regarding the Cozmonitor. We always use it and find that when we do have it off, Emily isn't as willing to correct a high because of that extra step entering numbers.

We have taught her to hit "correct" whenever the screen comes up asking her if she wants to--even if it's only a few points above her target. It will just give her a tiny bit of insulin and helps her stay in range a little better.

[kevin@diabetech.net]

I don't get the GlucoMon, either. :confused:

There are lots of ways to use data in management of type 1. People who use the GlucoMON have a way of doing this that is in some ways different than if you were using the Cozmonitor/Co-Pilot, Carelink, etc... The goal is shared in that people who review for trends and make adjustments can have better control than those who never or infrequently look at their data.

How do you use the bg/pump data? This would be a good discussion thread of its own.

[Twinklet]

There are lots of ways to use data in management of type 1. People who use the GlucoMON have a way of doing this that is in some ways different than if you were using the Cozmonitor/Co-Pilot, Carelink, etc... The goal is shared in that people who review for trends and make adjustments can have better control than those who never or infrequently look at their data.

How do you use the bg/pump data? This would be a good discussion thread of its own.

Hi Kevin,

I went to the Diabetech website, and the only explanation I saw on the GlucoMon was that it transmits BG readings to whomever you want to receive it. Does it do anything else, like transmit pump patterns or carb intake information?

If not, I guess I don't understand the benefit.:confused: Some use the GlucoPhone to send BG numbers to others, and some use text messages on regular phones.

We haven't found the need to do any of the above, as we download all pump data weekly and analyze trends and patterns. We transmit information via Carelink or Co-Pilot to our Endo prior to appointments. If our daughter has a problem number, either she or her teacher calls us from the classroom.

How would a GlucoMON benefit me, other than knowing what my child's BG was at any given time?

I'm really trying to understand this device....

[kevin@diabetech.net]

Hi Kevin,

I went to the Diabetech website, and the only explanation I saw on the GlucoMon was that it transmits BG readings to whomever you want to receive it. Does it do anything else, like transmit pump patterns or carb intake information?

I'm really trying to understand this device....

Hi Twinklet,

You might want to go to challengediabetes.com, a clinical blog that talks about how patients, families, endos and behavioral psych people use our various technologies incl the GlucoMON.

What's missing from your understanding so far I think is the effect of totally automated vs manual steps. I told someone recently that it's like having a garage door remote in the Winter in Chicago vs. getting out and opening the garage door by hand ;) Sure you can do it but wouldn't you rather have it open automatically?

Each night at 7pm, GlucoMON subscribers receive a day over day blood sugar logbook that is color coded to highlight highs and lows. The picture illustrates trends and these trends are discovered typically in about 15 seconds vs the manual efforts required to upload and remembering to upload. People look at their ADMS logbook more frequently than people who aren't on our system - simply because it's easy and fast.

Given that we've worked with hundreds of patients over years with this system, we have found a method of pattern management that doesn't rely so much on carb/insulin logging as a first step toward better control. The indicator is always blood sugar trends first - then drill down into other data that might impact decisions. Done frequently, most of that info is top of mind anyway. Also, nobody starts to change a dose/ratio from scratch - you only adjust typically up or down by 10% at one time of day then run with the new setting for a few days and see if the trend has been fixed... so tons of effort to collect and analyze insulin is secondary to verifying the bg trend and typically not necessary.

So not only does it give you the ability to intervene with your remote child (based on a highly accurate meter w small sample size strip), it uses an every day meter not a special case meter, ALL data from multiple meters are connected and data is collected and trend reports are automatically distributed to patient, care team, physician, friend, as defined by the subscriber including risk algorithms to detect trends.

Finally, your meter's clock is also managed by this system. 50% of meters have the wrong time setting and they all have a way of getting off track (meter's are cheap computers). We compare meter time to the atomic clock and then reset the clock to match the atomic clock if it's off. This ensures accurate reporting that people can rely on.

We focus on simplifying diabetes mgmt for the family and if you look at what people say I think we've accomplished that to a great degree already with more on the way.

I'm still interested in hosting a conf call if anyone is interested. Just pm me and we'll set a time.

[ecs1516]

I have a question for Cozmonitor users. We use the Cozmonitor and the Flash. I use the FLash at night and sometimes at other times. When I download (the Flash and the pump)into Co-pilot any number I have entered into the pump and took it on the flash it will of course go in twice in reports. Is there any way to get rid of duplicates?

[kiwikid]

I just right click one of them and 'hide data' ? That may not be the correct way though :o

[ecs1516]

Jane,
Thanks! I will sure give that a try!

[ecs1516]

Jane,
I hid a duplicate number in the diary data in Co-pilot. Does this take that data out of every report? Will the number no longer go into the statistics page like in the standard deviation?

[toohughey]

I don't get it. Do you just test and not enter the number into the pump and store it that way. When our Cozmonitor went bad, DD will check her BG and no matter what the number, she entered it in the pump to save the number. Then I have the BG in one place.

TRACY

[ecs1516]

If we test on the flash and it doesn't need a correction or is low, we don't enter it into the pump. We thought that was the benefit of Co-pilot, it would combine it all together. It downloads Flash, Cozmo, and soon our Navigator.
If we checked all the BG on a Flash then entered into the Cozmo then every BG would be duplicated and make the reports and data(in Co-pilot) look strange I thought.

[toohughey]

Oh I see. I have not tried the Co-Pilot because I cannot get the IR to work on my Computer--I think it is Vista related. So everything goes into the Cozmo and I have one download onto my old laptop where the IR does work.

TRACY

[ecs1516]

Tracy,
I see your only downloading your Cozmo , not your Flash right? If all your numbers are in your pump that should work great and you'll have no dup numbers.

Also, we called Cozmo and they sent us a new IR device free of charge. That might help you.
Also, I had to get the exterrnal from Cozmo to work with Copilot and download the new software for Copilot from Abbott(I think I downloaded new, not sure)
I love the combination report which shows the BG reading with the insulin on the pump. Neat. I could post this (I think) if you want to see it.

Also , I loaded all of this on our new Vista laptop and it worked .I just had the new Cozmanager 2.0, the new external for Vista for Copilot from Cozmo and the latest Copilot software and the new IR device from Cozmo(Smiths).

[skimom]

Call the cozmo people and be sure they send you the compatible software for Vista- our cozmanager software wasn't compatible. They sent next day for me (free of course)Also, make sure your computer is recognizing the IR adapter. Call that rep - that's what they are paid the big bucks for if you are still having trouble,

[ecs1516]

The Cozmonitor makes it easier that all the numbers can go into CoPilot and you don't get duplicate numbers. The pump combination report I think is wonderful. It shows all the blood sugar reading on a graph combined with the insulin basal and boluses. Can't ask anymore than that. I use it to make basal changes and to give the the endo. The only think I don't like about the Cozmonitor is that I have to take it off to download my pump.