Happy Saturday! Welcome to Ask D’Mine, our weekly advice column hosted by veteran type 1, diabetes writer and community educator Wil Dubois. This week, Wil ponders time itself… especially considering we’ve once again struck that twice-a-year clock altering time. On that note, Wil also explores how diabetes has changed over the years.
Tabitha, type 1 in Maine, writes: Hey Wil, when I flipped the calendar page to the month of November I found that it’s time to “fall back” and change our clocks from Daylight Savings Time to Standard Time. Only I don’t need to, since apparently I never “appeared forward” in the first place. Does an hour matter for our D-devices? And what about travel? If time zones are respected by us or simply let it ride? Thanks, and understand that regardless of what time it’s, I always make time for the own column!
Wil@Ask D’Mine replies: Thanks for taking the time to make time for me, and for taking the time to write! Now let’s dig into this question that is timely.
As I’m writing this, the time is 7:03 am Mountain Daylight Time, according to Google. The clock on my library believes it is 7:07 am. My watch says 7:04 am My pump states 6:58 am, along with the CGM’s opinion is that the time is 6:54 am. All four of these devices were synchronized to the minute 342,720 moments past at the night of March 13 as we jointly (except Arizona) sprang forward. This is proof positive of one of the more annoying aspects of contemporary electronic equipment: Most of these are crappy when it comes to keeping track of the time. They are inclined to lose time, at least over time. However, is keeping them in sync only a waste of time?
But what was that? What about my blood glucose meter, you ask? Oh, it states the time is 10:53 am.
Additionally, it believes today is May 5, 2006.
I could re-set it, but I can’t take be bothered to the time. Why? Since I use my plate to tell me what my blood sugar is, to not tell me what time it is. And this is where we reach the heart of which D-devices will need to be “in the know” about what the time really is from the external atmosphere. I utilize my meter only twice each day, on average, and its only purpose is to calibrate my CGM. It doesn’t need to understand the opportunity to do that. And since it records only two blood glucose measurements each day, while my CGM records 288 readings, it would be nuts for me personally to take the opportunity to download the tube.
And downloading is 1 place where time matters.
Some time ago I downloaded an individual’s meter in the practice. This specific person tests four times every day. The readings were very elevated in the morning, and generally got better throughout the day. The plan of therapy was obvious, and if I’d been more rushed (like the typical physician) I might have made a vital error. Because, as it was, the meter has been exactly 12 hours away. At 10 in the morning it was set for 10 at night time. The blood sugars have been climbing throughout the day, not decreasing, requiring a completely different therapeutic approach.
This well illustrates Time Rule Number One: Any device that either you or your doc downloads to make therapy decisions had damn well better have the ideal time on it. It has to be appropriate, maybe not to the moment, but close. This 12-hour error is a stunning one, but even a meter that is an hour or two off may create an erroneous belief.
I had another patient who was excited about his new Animas Vibe that he couldn’t bide his time and wait for the pump coach or for me to help him set it up. He, like the person, captured his AM and PM perplexed and ended up with a Devil of a time controlling his blood sugars. The pump has been providing the maximum basal insulin when it ought to have been providing the least, and vice versa.
Luckily I figured it out in the nick of time.
Time is also of the essence when you have two interrelated devices that are linked on your therapy. For Example, I’m still using the ahead-of-its-time Asante Snap along with a Dexcom CGM. Both of these devices can’t talk to each other directly, but they nevertheless need to be on the same webpage, time-wise.
Why? Since I use you to correct the other.
About once a month I make the time to get my CGM and examine the wave forms of my blood sugars. I look for times of day that I’m running either above or below target, I make adjustments to my pump settings, frequently tinkering with the basal rates. I don’t usually get it right the second or first tries; the third time is usually the charm. However, if my CGM were to be to be an hour off, and I wasn’t keenly aware of that, then any adjustments I made to the pump’s delivery configurations wouldn’t be timely.
But independently of CGMs, an insulin pump should be to the church on time, so to speak. If your pump is even an hour off, it may make a mess of your blood sugar. If you leave your pump when the world around you drops back or springs forward, any configurations to deal with things like the sunrise phenomenon will be ineffective. The insulin will be delivered late or early. You are going to end up low or high. Likewise, if you have varying insulin-to-carb ratios and various correction factors through the day, obtaining the pump clock away will result in the wrong levels of insulin in the right times. All the time.
So that is Time Rule Number Two: Give on time. (Like FedEx’s old commercials When it absolutely, positively has to be there overnight! )
Speaking of getting somewhere overnight, that leads us to journey. Should you change all your devices when traveling? First and foremost, I wouldn’t bother to modify time on any tracking device for traveling. Blood sugar info from travel is a mess anyway. Nonetheless, it’s another story when it comes to an insulin delivery device, in other words, a pump. Of course, it still depends on the trip–especially how far off you’re going and how long you’ll be gone.
If you are flying across a couple of time zones to get a weekend, then I wouldn’t bother. Sure, your basal rates will not match your new wake times, along with your insulin-to-carb ratios may not match your meal times, but traveling so screws up many people’s blood sugars that it will hardly matter. And besides, placing and re-setting devices is not only time-consuming, but dangers introducing errors. Big time. You may receive your AMs and PMs blended up.
On the other hand, if you’re flying around the planet like fellow D-peep and pilot Douglas Cairns did, you need to adjust your gear as you go.
A fantastic rule of thumb is that if you are going to be somewhere for more than a week, then it is a fantastic idea to synchronize your D-delivery gear with the local time. I’d also say that it is worthwhile to take the time to set the local time if you’re more than just four time zones from home. Your sweetie is taking you to Paris? Yeah, even if it’s only for a couple of days, alter the time on your insulin-delivery device.
In conclusion, I believe the rules that will stand the test of time are: Time matters to insulin delivery devices at home, and to any devices that you or your medical team download to help make therapy decisions. Otherwise, unless you have a great deal of time on your hands, I find no need to worry about putting time on your other D-devices. When traveling, alter only time on pumps, and then only if you’re going to be in a different time zone for more than a couple of days, or if you’re going far, far, from home.
And that is all we’ve got time for this week!
This is not a medical advice column. We are PWDs freely and publicly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a little part of your total prescription. You still need the professional guidance, therapy, and maintenance of a licensed medical practitioner.
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This content is made for Diabetes Mine, a customer health blog concentrated on the diabetes community. The content is not medically reviewed and doesn’t stick to Healthline’s editorial instructions. For more information regarding Healthline’s venture with Diabetes Mine, please click here.
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