非糖尿病患者的糖尿病产品评论-Medtronic MiniMed范例“ Revel”胰岛素泵和CGM

This is a review for Diabetics. If you're not a diabetic, consider this and it might help you enjoy this review. This is a product that will never affect your life. You've probably not thought about how an insulin pump works or its features. Here's a nice analogy I use to explain how diabetes works. It's called Diabetes: The Airplane Analogy.

这是对糖尿病患者的评论。 如果您不是糖尿病患者，请考虑这一点，它可能会帮助您享受这篇评论。 这是一款永远不会影响您生活的产品。 您可能没有考虑过胰岛素泵的工作原理或功能。 这是我用来解释糖尿病如何起作用的一个很好的类比。 它被称为糖尿病：飞机类比。

I've just received an upgrade to my insulin pump and I'm thrilled. Products like this are as important to us (diabetics) as your phone, your fancy remote control, your new DVD Player. I touch this device as often as my phone. It's attached to me 24 hours a day, it's an "external organ" to me. I've worn an insulin pump every day, all day (except showers) for the last decade.

我刚刚获得了胰岛素泵的升级，我很高兴。 对于您(糖尿病患者)而言，像您的手机，精美的遥控器，新的DVD播放器这样的产品对我们来说同样重要。 我和手机一样经常触摸此设备。 它一天24小时都贴在我身上，对我来说是“外部器官”。 在过去的十年中，我每天都戴着胰岛素泵，(淋浴除外)。

If you find this interesting, please consider helping fight diabetes: http://hanselman.com/fightdiabetes or tweeting the link http://hnsl.mn/fightdiabetes  

如果您觉得这很有趣，请考虑帮助抗击糖尿病： http ： //hanselman.com/fightdiabetes或发推文链接http://hnsl.mn/fightdiabetes 

I've had Medtronic pumps since 2000. I upgraded to a Paradigm with a CGM "Continuous Glucose Meter" in 2006. Last week I upgraded to a new Paradigm "Revel" Insulin Pump with a number of new features. Insulin Pumps have come a long way since they were backpacks.

自2000年以来，我就拥有Medtronic泵。2006年，我升级了具有CGM“连续血糖仪”的Paradigm 。 上周，我升级到了具有许多新功能的新型Paradigm“ Revel”胰岛素泵。 自从背包问世以来，胰岛素泵已经走了很长一段路。

If you're not familiar, here's some diabetic equipment basics.

如果您不熟悉，这里是一些糖尿病设备的基础知识。

糖尿病基础 (Diabetes Basics)

I'm a Type 1 Diabetic. That means my body produces no insulin of its own and I need to get insulin from outside sources. When I eat food, the sugar in my blood goes up and isn't delivered to my cells and my body starves while marinating it its own sugar. When I take insulin, my cells unlock, sugar (fuel) is delivered to the cells, and my blood sugar values go down. Eat, go up, take insulin, go down.

我是1型糖尿病。 这意味着我的身体自身不产生胰岛素，我需要从外部来源获取胰岛素。 当我吃食物时，血液中的糖分会上升，不会传递到细胞中，而将其自身的糖分腌制后，我的身体会挨饿。 当我服用胰岛素时，细胞解锁，糖(燃料)被输送到细胞中，血糖值下降。 吃，上升，服用胰岛素，下降。

血糖仪有什么作用？ (What's a Blood Sugar Meter do?)

It does just that, it measures the level of sugar in my blood. I prick my finger, usually 10 times a day or so, and I put the drop of blood on a small gauze strip that goes into a machine and gives me a number. If it goes high too long, I'll die slowly. If it goes low too long, I'll die quickly. So, we need to keep that number as close to number as possible.

就是这样，它可以测量我血液中的糖水平。 我通常每天要刺10次左右手指，然后将一滴血放在一个小的纱布条上，该纱条插入机器中并给我一个数字。 如果涨得太久，我会慢慢死的。 如果下降时间过长，我会很快死亡。 因此，我们需要使该数字尽可能接近数字。

胰岛素泵有什么作用？ (What's an Insulin Pump do?)

I took manual shots for 5 years. Some diabetics take just a few shots, 3 or 4, using a mix of short-acting (take a few hours) and long-acting (spreads over 12 or 24 hours) insulin. Others use a MDI (Multiple Daily Injections) technique, as I did, taking as many as 6-10 small shots of insulin a day. This is not uncommon and is often referred to as the 'poor man's pump.'

我手动拍摄了5年。 一些糖尿病患者使用短效胰岛素(需要几个小时)和长效胰岛素(会散布12或24小时)，仅拍摄3针或4针。 其他人像我一样使用MDI(每日多次注射)技术，每天最多可注射6-10次胰岛素。 这并不罕见，通常被称为“穷人的泵”。

As a diabetic, once you've started taking that many shots, you get tired of taking shots. Enter the insulin pump. Once every 3 to 6 days, you poke a longish needle into your fat, then pull it out leaving a soft plastic canula embedded in you and held with tape. The insulin is sitting inside the pump and is pushed by a motor in the pump, slowly, through a long tubing and into you.

作为糖尿病患者，一旦您开始拍摄大量照片，便会厌倦拍摄。 进入胰岛素泵。 每3至6天一次，将一根长针刺入您的脂肪中，然后将其拔出，留下一根嵌入其中并用胶带固定的软塑料套管。 胰岛素位于泵内部，并由泵中的马达缓慢推动，通过长管进入您体内。

Now you can make tiny manual adjustments all day without shots. It's like the difference between making large, coarse movements of the steering wheel while driving and making those tiny back and forth adjustments you make just to say in your own lane on the road. Insulin pumps allow you 10-20x more precision over shots.

现在，您可以整天进行细微的手动调整，而无需出手。 这就像在驾驶时使方向盘大而粗略地移动，以及只是在自己的车道上说的那样来回微调之间的区别。 胰岛素泵可使您的注射精度提高10到20倍。

Everything inside an Insulin Pump is manual. It does nothing automatically other than a small background amount of insulin. My insulin pump gives me more control and means I get poked less often. But, it's not automatic. It doesn't cure or solve Diabetes.

胰岛素泵内的所有内容都是手动的。 除了少量背景胰岛素外，它不会自动执行任何操作。 我的胰岛素泵使我有更多的控制权，这意味着我被戳戳的频率降低了。 但是，这不是自动的。 它不能治愈或解决糖尿病。

So, to review. I did shots for 5 years, then a fairly standard insulin pump for 5 years. Then I got a CGM.

因此，进行审查。 我拍了5年，然后用相当标准的胰岛素泵拍了5年。 然后我得到了CGM。

什么是CGM(连续血糖仪)？ (What's a CGM (Continuous Glucose Meter) do?)

Pricking your finger and check your blood sugar tells you your sugar level now, but not 5 minutes ago, nor does it show the trend. Hey, my sugar is 80! Was it 200 a half hour ago? Or was it 50 a half hour ago. A single sugar value is about as useful as a single speed value or a single altitude value.

刺破手指并检查血糖可以告诉您现在的血糖水平，但不是5分钟前，也没有显示趋势。 嘿，我的糖是80！ 半个小时前是200吗？ 还是半小时前才50。 单个糖值与单个速度值或单个高度值差不多有用。

A CGM, or Continues Glucose Meter, is a transmitter that sits inside you body, usually inserted with a needle and a sensor then uses tiny micro-currents against your body's interstitial fluids to estimate (extrapolate) your blood sugar. It doesn't test blood and they are not typically very accurate. In fact, they have a little disclaimer that effectively says "don't make decisions using these values."

CGM或Continuous Glucose Meter(连续血糖仪)是一种位于体内的发射器，通常用针插入，然后传感器对人体的组织液使用微小的微电流来估计(外推)血糖。 它不能测试血液，而且通常不是很准确。 实际上，他们有一点免责声明，可以有效地表明“不要使用这些值来做出决定”。

CGMs do not replace finger sticks. They are not as accurate, but they provide valuable slope data that diabetics need. Accurate single value readings via finger sticks, combined with not-as-accurate slope information, combined with the ability to easily give myself small or large amounts of insulin without shots (I change the pump every 3 to 6 days, that does involve a needle) means I've got the information I need to maintain good control.

CGM不能代替指棒。 它们的准确性不高，但是它们提供了糖尿病患者所需的有价值的斜率数据。 通过指尖准确地读取单个数值，结合不准确的斜率信息，并能够轻松地给自己注射少量或少量胰岛素(我每3至6天更换一次泵，这确实涉及到针头) )表示我掌握了保持良好控制所需要的信息。

The Paradigm series of pumps are an Insulin Pump, but also a CGM receiver. They talk wirelessly to the CGM transmitter (see the picture above that is not my stomach) as well as wirelessly to a finger stick blood sugar meter. It's all one integrated thing.

Paradigm系列泵既是胰岛素泵，又是CGM接收器。 他们以无线方式与CGM发射器通信(请参见上图，这不是我的胃)，以及以无线方式与指尖血糖仪通信。 这全都是一件整合的事情。

Now, what's new in this new pump?

现在，这个新泵有什么新功能？

Medtronic MiniMed范例“ Revel”胰岛素泵 (Medtronic MiniMed Paradigm "Revel" Insulin Pump)

To review, insulin pumps are not automatic. They don't deliver without me saying so. While the pump talks wirelessly to meters and CGMs and stores values in memory, it doesn't act on them. There is no "closed loop" system. The delays involved are too great. However, the new "Revel" pump does add a number of cool new features that are making my life easier already. I think it's a great upgrade and if you have a MiniMed pump you should try to upgrade with their "Pathway Program." It's worth it.

回顾一下，胰岛素泵不是自动的。 没有我不这样说，他们是无法实现的。 当泵与仪表和CGM无线通信并将值存储在内存中时，它不会对它们起作用。 没有“闭环”系统。 涉及的延迟太大。 但是，新的“ Revel”泵确实增加了许多很酷的新功能，这些功能已经使我的生活更加轻松。 我认为这是一次很好的升级，如果您有MiniMed泵，则应尝试使用其“通路程序”进行升级。 这很值得。

新的功能 (New Features)

Better charts. Previously the charts were either 3 hours or 24 hours. Far to zoomed in, or so far out as to be useless. Now you can zoom 3, 6, 12, 24. Here's some screenshots:

更好的图表。 以前，图表是3小时或24小时。 远至无法放大，甚至无法使用。 现在您可以缩放3、6、12、24。以下是一些屏幕截图：

It was amazing how this apparently small upgrade changes the experience with the pump. The 6 hour view is a dream.

令人惊讶的是，这次看似很小的升级如何改变了泵的使用体验。 6小时视图是一个梦想。

预测性警报 (Predictive Alerts)

This is the killer feature that has already helped me at least twice a day in the last week. The new Revel has a "rate of change" detection algorithm that is totally user-settable. If the pump decides that you will hit a high blood sugar if your current rate of change goes unchecked, it'll let you know via an alarm. This is the one feature I always needed and it works just as you'd wish it did.

这是杀手级功能，在上周每天至少帮助我两次。 新的Revel具有完全由用户设置的“变化率”检测算法。 如果您的泵确定您当前的变化率没有受到控制，则您会血糖升高，那么它将通过警报通知您。 这是我一直需要的功能，并且可以按您希望的那样工作。

This feature did initially cause me to stack insulin a bit and caused a few lows as I was acting extra aggressively to squash highs, but I am finding I'm getting used to it. I wish it hadn't taken 5 years to get it. That's the tragedy of medical devices. You're thrilled with your multi-touch color screen portable device and I'm happy if I get one firmware update every 5 years. The difference is, my phone crashed twice today. This pump has never crashed in 10 years. We sacrifice innovation for stability.

最初，此功能确实使我堆积了一些胰岛素，并导致了一些低点，因为我正在积极地采取行动来挤压高点，但是我发现自己已经习惯了。 我希望它花了不到5年的时间。 那就是医疗设备的悲剧。 您对多点触摸彩色屏幕便携式设备感到很兴奋，如果每5年更新一次固件，我将感到非常高兴。 所不同的是，我的手机今天崩溃了两次。 该泵十年来从未发生故障。 我们为稳定而牺牲创新。

细微但重要的改进 (Subtle but Important Improvements)

One of the most important numbers for a pumper is the amount of insulin that's "pending" or "active." Most insulin takes about 3-4 hours to get out of my system, so if I take 5 units now, and 5 more units in an hour, that's stacking doses. If I remembered or was told that I had ~5 units active, I might not have taken that second dose and could avoid a nasty low. The Revel automatically calculates the active insulin and shows you it in three new places. First, on the status screen, second in the manual bolus (dose) screen, and again on the Bolus Wizard. It was buried in the UI before, now it's front and center.

对于泵车而言，最重要的数字之一是“待定”或“活动”的胰岛素量。 大多数胰岛素需要大约3-4个小时才能退出系统，因此，如果我现在服用5个单位，并且在一小时内再服用5个单位，那就是堆积剂量。 如果我记得或被告知我有大约5个单位处于活动状态，那么我可能没有服用第二剂，可以避免讨厌的低剂量。 Revel会自动计算活性胰岛素，并在三个新位置显示它。 首先，在状态屏幕上，其次在手动推注(剂量)屏幕中，然后在“ Bolus向导”中。 它以前被埋在UI中，现在在前面和中间。

The motor is more precise now, letting you do basal rates as low as 0.025 units per hour, crucial for young people.

现在，电机更加精确，可让您的基准速度低至每小时0.025单位，这对年轻人至关重要。

结论 (Conclusion)

This upgrade, the Revel, makes a great pump better. It was totally worth the $399 Pathway upgrade. If you're on a Minimed pump, get the upgrade. If you're not on a pump, consider getting one, it'll change your life.

Revel这次升级使出色的泵更好。 399美元的Pathway升级完全值得。 如果您使用的是小型泵，请升级。 如果您不在泵上，可以考虑再买一台，它将改变您的生活。

If you found this interesting, please consider helping fight diabetes: http://hanselman.com/fightdiabetes or tweeting the link http://hnsl.mn/fightdiabetes

如果您发现这很有趣，请考虑帮助抗击糖尿病： http : //hanselman.com/fightdiabetes或发推文链接http://hnsl.mn/fightdiabetes

翻译自: https://www.hanselman.com/blog/a-diabetic-product-review-for-nondiabetics-the-medtronic-minimed-paradigm-revel-insulin-pump-and-cgm