Companion Medical InPen - Field Test
The Project 50-IN-50 team was lucky enough to have the support of Companion Medical for the duration of our prep and expedition. Over the last 6 months, I’ve given their product, the InPen, the mountain test and can confidently give it the thumbs up as a therapy system for backcountry adventures. Here are my thoughts!
First off, what exactly is the InPen?
The InPen is the first FDA approved “smart” insulin delivery system. It works by pairing with a phone-based app to record insulin delivery as well as provide a ton of other tools to help simplify and better your diabetes management. Pairing it to your phone takes a few minutes and then you’re set for six months (the life of the pen’s internal battery). It takes 3mL insulin cartridges and operates exactly like any other insulin pen with standard pen needle caps and dosing up to 30 units at a time with half-unit increments. The phone app displays active insulin, your last dose, and blood glucose when you enter it. It’s much along the lines of an insulin pump without the cord or bulkiness.
What I like about it:
The biggest thing I enjoyed about it was the simplicity of the app. Opening it, I was able to instantly understand the data presented in front of me. Last entered blood glucose, last insulin dose, as well as active insulin, are all displayed on the home screen. This gave me a quick synopsis on where I was at and heading blood glucose wise. More importantly, it let me decide whether to dose or not. When I use multiple daily injections, I’m prone to insulin stacking and seeing my insulin on board (something no other pen has done) helped stop that.
The other tool I really liked was the dose calculator. Type in your blood glucose and carbs and it’ll shoot out a recommended dose. It eliminated the need for mental math and you could get you an accurate dose based on your predetermined therapy settings. A small but beneficial part of the dose calculator is its ability to tell you if you need to eat rather than dose, based on your active insulin and current blood glucose. I used this more than expected, especially at night and right before bed.
The Mountain Test
If it doesn’t work around my activities, then it doesn’t work for me, plain and simple. To put the InPen to the test I took it on a climb to the summit of Mt. Hood, Oregon’s tallest peak, during a cold, windy, and snow-filled day.
In mountaineering, there are two major factors that I take into account when managing my diabetes - exercise and environment.
With steep and sustained climbing, I use a ton more glucose and overall energy to get to the summit. This generally adds a challenge of insulin dosing when out on the mountain. Combining the dose calculator on my InPen with data from my continuous glucose monitor and the fuel I was eating made the trip quite a bit simpler compared to a standard pen. Knowing how much active insulin on board prevented me from overdosing, something that could have led to some severe hypos while climbing.
Alongside exercise comes an equally challenging environment and its effect on blood glucose. Cold can wreak havoc on diabetes management and that day on Hood was no different. We climbed up with sustained gusts of 40MPH and got chilled to our bones. So did our insulin, and I only knew that due to the temperature alarm on the pen (which made me pack my pen closer to my skin, rather than to the outside air!).
Altitude is also something that plays a role in diabetes management and mostly in decision making. As we get higher, our brains tend to work poorly. When you combine exhaustion, cold, hunger, exercise, and altitude while trying to manage diabetes it can get very challenging. On Mt. Hood, we rolled onto the summit after 8 hours of tough climbing and my blood sugar was 226. I was too tired to try to estimate a dose but didn’t want to overdose so I just popped open the app and boom, the app gave me the info I needed. This is where I found my two thumbs up for the InPen. It’s a smart pen that allows you to simplify your daily diabetes decisions.
A common rule to follow in the backcountry is “keep it simple” or the more well know KISS (“keep it simple, stupid!”). With diabetes management in the backcountry, I feel the same way. The InPen allows you to record the important data, make management decisions with a intuitive app, and is a simple, straightforward system. To keep it simple: I really like it.