In order to assess your Loop's performance and more specifically your settings, having access to your historical data trends is invaluable. Seeing what your Loop was predicting, what actions were being taken, how blood glucose was reacting, and how insulin needs have been changing is critical when trying to assess any settings changes.
Problem with traditional methods¶
As a person with diabetes, you’re probably carrying around a lot of different devices that are holding a lot of different data; a blood glucose meter for your finger sticks, a pump for insulin delivery, a continuous glucose monitor for real-time glucose measurements, phone app for tracking meals, etc. When you go to your endocrinology office, you probably start the process by dropping many of those devices at the front desk to be individually downloaded and then having to pack all of them away 20 minutes later.
Then your clinic staff has the less-than-efficient process of trying to overlay all those different devices into some sort of cohesive strategy for how your diabetes may need some tweaks. Because of Loop use, a clinic currently has to look at separate reports from Medtronic pump, Contour Next Link BG meter, Dexcom CGM/Clarity, and our iPhone Health app, as a typical example. There are also a couple of issues with Loop when using this separate download method:
Medtronic’s pump gets so clogged up by the numerous temporary basal rate records being recorded that the clinic can only pull about 7 days of data from the pump at most.
Clinic basically lacks an overlay of basal rate/bolus actions with blood glucose from Dexcom, which really limits their ability to recommend any settings changes.
DIY solutions could fill some of the gaps as far as overall management, but the problem was with the actual gathering of the reports. It’s a little hard for the clinic to bring up reports live time, and sometimes remembering to print them out ahead of time just doesn't happen.
Manual notes the various tools are not the most streamlined experience (especially for young kids and teens to manage). This inefficiency can lead to people neglecting to note times of site failure or compression lows, for example. If the health care provider wants additional information about a particular blood glucose event(s), chances are good that there would be no notations to help explain the event without effort. If there was a note, it may be in Nightscout, Dexcom, or in text messages between caregivers...not really centralized and integrated.
The good news is that the community has some very useful tools to help address the shortcomings in the traditional data aggregation for Loop users. There are several tools available to help you and/or your endocrinologist evaluate your Loop data. Specifically, this section covers:
- Health app