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@everydayupsanddowns and
@Matchless
So firstly a bit of background I've been on camAPS for 18 months now at the time I was looking at pumps I had a choice between this Medtronic and T slim. I had originally wanted an Omnipod but this was not available at my clinic, only tubed pumps. I got some good very good advice on here about the importance of choosing the best pump for you on my criteria where a pump that was small, discreet, could be bolused from a phone and was loopable. I looked closely at the T slim and this was the pump that most people who attended the introduction to pumps meeting that I attended took. I ended up with a Dana pump paired with a Dexcom 6 and camAPS serving as loop.
I think the key thing with this (or any other loop) is the same as with any approach to management of T1D which is getting the basics right. You need to understand your insulin:carb ratios and the importance of pre bolus timing. Like any algorithm if you put garbage in you will get garbage out. I can't emphasise enough how important this is.
Overall, I really like the system as with anything else it has its downsides, so here are some of my reflections which of course are personal to me other people's experiences will vary:
Things I really like:
The camAPS system is (as I understand it) different too most other loops 'cause it works on an algorithm - the only information that this system starts off with is your total daily dose and your weight there's then a two week period where the systems is intensive learning what your insulin needs are at different times of the day. There is no setting of or changing to different basal rates for example and in that I think it is much more hands-off than other loops.
The Dana pump is as I hoped it would be small light and discrete, And I'm very grateful to be able to bolus from my phone and use this to quickly check what my numbers are and see a graph of the day.
The system will adjust/suspend insulin delivery if it looks like you are going low and of course ramp up if you are going high. I find it does a really good job of this particularly overnight and my overnight figures are almost always well in range.
There is a fall rate alarm for when your blood sugar is falling very rapidly. I've learned to never to ignore this and it will wake me up from even a very deep sleep and impell me to action.
The system is very good smoothing out bumps in the road
so long as it has good information to work from and I'm not doing anything unplanned for (for example sudden vigorous exercise).
Having a loop took a huge amount of the mental burden of diabetes away from me. When I first got the pump and loop I really had no idea how much of my energy was being taken up by thinking about everything and perhaps the best part of having camAPS has been the lifting of a large amount of the mental load.
The system brought my HBA1C down to 48 which I can't imagine being able to achieve on MDI.
Things I find more difficult:
The Dana pump is a little bit fiddly to refill. I can now do this pretty fluently but it definitely took some time to get used to.
Something I find the system does not handle well is a consistent moderate high. So if for example my blood sugar is at 10 and stays there for a couple of hours I find the system is not good at addressing this to move it back into range. It
will come down but probably not as quickly as I would like it to. This can be frustrating particularly as it ruins time in range for the day. I have learned that I rage bolus at my peril on CamAPS. For me, even a very small correction bolus can lead to my blood sugar falling very rapidly, even scarily on occasion, and then needing quite a lot of glucose to correct. Over time I have found it much better to go for a short walk or some other quick bout of exercise or to wait until I next eat before I consider manually adding any extra insulin to the system even if that means putting up with being a bit high.
For me I also find system is less good at handling unexpected bursts of activity there is an ease of function which reduces the amount of insulin delivered and this can be set in advance for a particular point in the day this works well if you have a predictable schedule, but I have sometimes found my blood glucose dropping just after a walk to the shops which is really inconvenient.
There is currently no ioS version, so if you are an apple person (I am), then is means you need two phones.
The system keeps learning based on the preceding 2 weeks data. As a woman who still has periods and whose hormones affect my insulin resistance, I find I need to be aware of this and to raise or lower my target glucose depending on what time of the month it is.
Finally I think the system was designed to be hands off and I think when everything is working well this works really really well however you do need to give the system accurate information and to let it (mostly) do its thing. If you have been used to managing your diabetes more intensively it's a bit of a big adjustment. I don't think I check my levels any less frequently than I did when I was on MDI but it certainly has removed a lot of the mental burden from my day-to-day management and I am hugely grateful for this. If you are considering or using CamAPS and have Facebook then I would recommend joining both the CamAPS Facebook group (camAPS users) which has someone from CamAPS in the chat and for those who do sports a similar group (Sporty camAPS users - peer support) both of which are really good.
I hope this is helpful. If you have any questions, please ask.
