Step by step, little by little, the machines are taking over my diabetes.
It started in the mid 1980’s when the traditional family pre-bedtime routine of passing round the test strip came to an abrupt end. For anyone who hasn’t had the pleasure, before there were meters there was a great family game of passing the test strip round so everyone could give their own opinion as to which colour it matched on the bottle. You took everyone’s opinion, usually in a range from about 6-10, this wasn’t an exact science in those days, divided by the number of people and came up with a blood sugar reading. What larks. Those fun days ended with the invention of the meter.
More recently, the machines have been encroaching more and more into my diabetes world. First the pump, automating insulin delivery at the push of a button and working away in the background drip-feeding insulin without me giving it a second thought. But the really clever bit for me is the bolus wizard. Modestly I thought I had no need for such artificial intelligence. I could look at a meal, guestimate the carbs and pluck an insulin dose out of thin air accordingly. But it turns out the pump is rather better at it than I am. It doesn’t do quite so much rounding (“I think that needs about 8, but let’s round up to 10 as that’s a nice neat number”) and its opinion is less impacted by its mood and whether its distracted by other more interesting things.
Then the CGM came on board, tracking my blood sugar, creating monumentally impressive graphs I never bother to download or analyse (bad diabetic) and alarming helpfully whenever my blood sugar meanders off into places I don’t want it to go.
By this point I was starting to see the machines as helpful assistants, useful tools that helped me do the job more precisely and efficiently. But then they got cleverer. They starting acting independently of me. My Medtronic 640G pump and CGM comes with SmartGuard technology. This is more than just responding to a button press or making a noise to alert me of a problem. This is full on, taking control, making decisions by itself machine autonomy.
If the CGM predicts I’m going to drop beyond a certain level (that I’ve set, I do still have some input to all of this) it suspends my basal insulin. Once it senses I’m starting to rise again it restarts my insulin. If I like I can disable the alarms so I know nothing about any of this, it just does it quietly in the background. And after a couple of weeks, I did disable the alarms, because generally it gets it right. In the early days I watched it suspend insulin when I was convinced it wasn’t necessary, but let it do its own sweet thing and hours later was pleasantly surprised to see a flat line on the screen, that would otherwise have been a hypo. I didn’t have a massive issue with hypos, but Tesco’s profits have taken a massive hit as I’m buying far fewer juice boxes to ward off lows, especially overnight and while shopping.
I’m now at the point where I’m irritated when I notice I’m high and the pump hasn’t taken it upon itself to sort it out. They are working on it, but I’m ready for it now. The machines are slowly but surely taking over my diabetes. And you know what? They’re very welcome to it.