Medtronic Minimin 508胰岛素泵与我的新型Paradigm 512胰岛素泵和血糖仪

This is a primarily technical blog, so I don't post pictures of pets (don't have any) or other personal bloggy things.  However, I am an Insulin-Dependant (Type 1) diabetic with an Insulin Pump and most folks know that, and I've blogged about Diabetes before: Scott's Diabetes Explained - The Airplane Analogy.

这是一个主要的技术博客，因此，我不会发布宠物图片(没有宠物图片)或其他个人博客内容。 但是，我是一名胰岛素依赖型糖尿病患者(使用胰岛素泵)，大多数人都知道这一点，并且我之前曾写过有关糖尿病的文章： Scott的糖尿病解释-飞机类比。

I've been diabetic for a decade, got it when I was 20.  It doesn't run in the family, nor do any of my relatives have Type I diabetes.  A few of the oldies have Type II, but these days who doesn't?  The theory is that I got the flu (possibly a coxsackie virus) and when it was all over I was left without a usable insulin-producing pancreas.

我患有糖尿病已有十年之久，我20岁时就患有糖尿病。它没有家庭成员，我的任何亲戚也没有患有I型糖尿病。 一些老歌有II型，但如今谁没有？ 从理论上讲，我得了流感(可能是柯萨奇病毒)，当流感完全蔓延时，我就没有可用的产生胰岛素的胰腺。

When I was diagnosed, my blood sugar was around 500 mg/dl and yours is probably 80 mg/dl.  (I currently aim for <= 150 mg/dl).  I had gone from 180 lbs to about 130 lbs because I was pissing away muscle.  We think I was uncontrolled as a diabetic for at least six month before folks noticed I was wasting away.  The weight came back on after I got under control.

当我被诊断出时，我的血糖约为500 mg / dl，而您的血糖可能约为80 mg / dl。 (我目前的目标是<= 150 mg / dl)。 我从180磅增加到了130磅，因为我小便了。 我们认为，至少六个月以来，我一直没有受到糖尿病的控制，直到人们注意到我在浪费时间。 我得到控制后，体重又恢复了。

Diabetes sucks egregiously.  It's the leading cause of blindness, kidney failure, and heart disease.  I have checked my blood sugar by pricking my finger between 5 and 10 times a day for the last 10 years (about 30,000 times so far).  Hurts every time.  Folks always ask "Does it still hurt?"  You get beaucoup callouses, but yes, it hurts. 

糖尿病太烂了。 这是失明，肾脏衰竭和心脏病的主要原因。 在过去的10年中，我每天要在5到10次之间拨动手指来检查血糖(到目前为止，大约有30,000次)。 每次都会受伤。 人们总是问：“它还疼吗？” 你会得到美丽的老茧，但是，很痛。

I check my blood sugar (glucose) then make a decision based on some training they give you when you're diagnosed, some equations and hunches.  I took shots 4-6 times a day for six years.  Ironically, I hate needles and giving blood.  Go figure. :)

我检查血糖(葡萄糖)，然后根据他们在被诊断出时为您提供的一些训练，一些方程式和预感来做出决定。 我连续六年每天拍摄4-6次。 具有讽刺意味的是，我讨厌针扎和献血。 去搞清楚。 :)

A month before my wife and I went on my first date I got an Insulin Pump, a Minimed 508.  It looks exactly like a pager with a clear tube coming out of it, except it costs $6000 US and delivers insulin.  (It does vibrate and have a remote control though.)

在我妻子和我第一次去约会的一个月前，我得到了一个胰岛素泵，Minimini508。它看起来像传呼机，上面有一个透明的管子，除了它的价格是6000美元，可以输送胰岛素。 (它确实振动并且具有遥控器。)

The pump doesn't know ANYTHING about my blood sugar, and there are no pumps on the open market today that can detect blood sugar either continuously or at an interval.  If you think your friend has one, you are either mistaken or they are in a clinical trial for something coming. I've done two clinical trials myself.

泵对我的血糖一无所知，今天的公开市场上没有泵可以连续或间隔检测血糖。 如果您认为您的朋友有一个，则可能是您误会了他们的身分，或者是他们正在为某些事情进行临床试验。 我自己做了两项临床试验。

The pump is a one-way device - delivery of insulin only.  There is a small needle/canula that I stick in my side every 4 or 5 days.  I move it around; sometimes I feel like I'm putting holes in me faster than I can heal them.  It's a good thing though, as I used to have to stick a needle in me many times a day, now the needle and tube is in there all the time.  I keep the pump with me 24 hours a day, it can't be removed for more than a few minutes at a time (bathing, etc.) 

该泵是单向装置-仅输送胰岛素。 每隔4或5天，我会有一条小针头/套管贴在我的身边。 我四处移动； 有时候，我觉得自己在洞里打洞的速度超过了治愈它们的速度。 不过，这是一件好事，因为我以前不得不每天多次将针扎在我身上，现在针管一直在那儿。 我每天24小时都随身携带泵，一次不能超过几分钟(洗澡等)将其卸下。

Here's an example.

这是一个例子。

Let's say my blood sugar is currently 100 mg/dl.  FYI, 50 mg/dl would be dangerous.  30 mg/dl would be Emergency Room.  200 mg/dl or more for long periods is a bad idea also.  So the goal range is 100-200 mg/dl.  I know that (from a whole series of past calculations) that:

假设我的血糖目前为100 mg / dl。 仅供参考，50 mg / dl是危险的。 30 mg / dl将成为急诊室。 长期服用200 mg / dl或更高的剂量也是一个坏主意。 因此目标范围是100-200 mg / dl。 我知道(从过去的一系列计算中得出)：

• 1 Unit of Humalog Fast-Acting (starts in 15 mins, last 3 hours) Insulin will lower my blood sugar 50 mg/dl. 
  1单位Humalog速效(在15分钟内开始，持续3个小时)胰岛素将降低我的血糖50 mg / dl。
• 1 Unit of Humalog will "cover" 15 grams of Carbohydrates. 
  1个单位的Humalog将“覆盖” 15克碳水化合物。

So, ideally, if my BG (Blood Glucose) is 100 mg/dl and I want to eat a 30 gram Granola Bar, I'd take 2 Units of Insulin and expect my BG to be BACK at 100 mg/dl after about 3 hours.  Make sense? 

因此，理想情况下，如果我的BG(血糖)为100 mg / dl，并且我想吃30克的格兰诺拉麦片棒，那么我会服用2单位的胰岛素，并期望大约3个小时后我的BG以100 mg / dl的价格返回小时。 有道理？

Carbohydrates hit you fast - immediately and they spike blood sugar quickly.  If I ate that Granola Bar and didn't take any insulin, my BG would go to 200 mg/dl in short notice and likely higher.  Blood sugar is like a helium balloon, once it gets high, it likes to accelerate.

碳水化合物会很快打击您-并Swift使血糖升高。 如果我吃了那格兰诺拉麦片棒并且不服用任何胰岛素，那么我的BG将在短时间内达到200 mg / dl，甚至可能更高。 血糖就像氦气球一样，一旦变高，就喜欢加速。

Protein hits you slow - in about 3 to 5 hours. Fiber will also hit you slow.  This is all that talk about the Gylcemic Index of food.  For example an apple without skin would hit faster than one with skin.  White bread hits faster than wheat.  You get the idea.  (Rice Cakes are horrible for you, by the way)

蛋白质打击您的速度很慢-大约需要3到5个小时。 光纤也会使您感到缓慢。 这就是所有关于食物的血糖指数的讨论。 例如，不带皮的苹果比带皮的苹果命中得更快。 白面包比小麦命中更快。 你明白了。 (顺便说一下，米糕对你来说太可怕了)

OK, here's where it gets more interesting.  Let's say that I have lunch at Subway.  A foot long steak on wheat is 80 grams of carbs and 20 grams of protein.  That's ~5.4U of Insulin now and ~1.3U either over, or in, 4 hours. 

好的，这是更有趣的地方。 假设我在地铁上吃午餐。 一英尺长的小麦牛排含80克碳水化合物和20克蛋白质。 现在大约是5.4U的胰岛素，在4个小时或4个小时内约为1.3U。

Now, let's say that dinner comes around and my blood sugar is 200 mg/dl.  That's too high and I'll need a "correction" as well as enough insulin to cover dinner.  I want to be at 100 mg/dl, but I'm at 200 mg/dl.  That's 2U (Remember 1U = 50 mg/dl) to correct, PLUS whatever I need for dinner. But, if dinner is at 3 pm for some reason, then I've still got some fractional amount of "active" insulin in me from lunch!  If I don't take it into consideration I could over correct and crash later.

现在，假设晚餐来了，我的血糖为200 mg / dl。 太高了，我需要“矫正”以及足够的胰岛素来吃晚餐。 我想达到100 mg / dl，但我达到200 mg / dl。 那是2U(请记住1U = 50 mg / dl)，再加上我需要的晚餐。 但是，如果由于某种原因在下午3点吃晚饭，那么午餐中我仍然会有少量的“活性”胰岛素！ 如果不考虑这一点，我可能会改正并稍后崩溃。

Well, you get the idea.  Anyway, I got a NEW pump this weekend.  A Medtronic Paradigm 512 Insulin Pump with Wireless Blood Sugar Meter.  It's freaking awesome.

反正你懂这个意思。 无论如何，这个周末我得到了一个新泵。 带无线血糖仪的Medtronic Paradigm 512胰岛素泵。 真是棒极了。

When I check my blood sugar on this meter, it immediately wirelessly transmits the reading to the pump.  (I "married them" with a dance of serial number registrations and encryption as a first setup step.) 

当我在血糖仪上检查血糖时，血糖仪立即将读数无线传输到泵。 (作为第一步，我与一系列的序号注册和加密“结婚”了。)

The pump has a Wizard that I programmed earlier with all my details: Insulin sensitivity, type of Insulin, Carb/Insulin Ratio, etc.  The Wizard then keeps track of my blood sugar and active insulin.  If I count my carbs correctly, it will make a suggestion as to how many Units of Insulin to take.  Mind you, it's just a suggestion.  I have to make the final OK and/or adjustment for legal reasons.  God Forbid it should make a mistake, so I'm happy to be in the loop. :)

该泵有一个向导，我之前已对其编程，并详细说明了我的所有细节：胰岛素敏感性，胰岛素类型，碳水化合物/胰岛素比率等。向导随后会跟踪我的血糖和活性胰岛素。 如果我正确地计算出碳水化合物的含量，它会建议您服用多少单位胰岛素。 请注意，这只是一个建议。 由于法律原因，我必须做出最后的确定和/或调整。 天哪，它应该犯一个错误，所以我很高兴能参与其中。 :)

It works great.  Yesterday we went to the movies and I had an ENTIRE bag of Peanut Butter M&Ms (75g) and had perfect blood sugar afterwards.  This doesn't mean that I'll start eating crap.  Remember the Airplane Analogy - dramatic altitude changes are hard to control, steady and even is always the best bet.  But it was so much easier on the head to let a computer do the calculations that I've been doing 6 times a day in my head for the better part of ten years.  (Try not eating M&Ms for ten years, then see how YOUR demeanor changes. ;) )

效果很好。 昨天我们去看了电影，我拿了整袋花生酱M＆M(75克)，之后血糖很完美。 这并不意味着我会开始胡扯。 记住飞机类比-剧烈的高度变化很难控制，稳定，甚至总是最好的选择。 但是，让计算机进行计算非常容易，在十年的大部分时间里，我每天要进行6次计算。 (尝试十年不吃M＆M，然后看看您的举止如何变化。;)

For the next few years, the diabetic themselves will have to "close the loop" - but this pump and meter are a rockin' sweet next step and the coolest thing to happen to my diabetes in the last decade.

在接下来的几年中，糖尿病患者自身将不得不“闭环”-但是，这台泵和仪表是下一步的艰巨任务，并且是过去十年来我的糖尿病发生的最酷的事情。

翻译自: https://www.hanselman.com/blog/medtronic-minimed-508-insulin-pump-vs-my-new-paradigm-512-insulin-pump-and-blood-glucose-meter