Sticky Stuff

Is it coming unstuck?

That’s the million dollar question that plagues me through the day. I often find myself prodding my arm, just to make sure that my FreeStyle Libre sensor is still there.

It’s pretty hard to tell whether that sensor is coming unstuck once those edges begin to fray. Sometimes it really is coming unstuck, while other times the edges are frayed but the adhesive game underneath the sensor is still going strong.

The warmer months of the year have definitely tested my sensors. I remember coming home from work after a warm day and the sensor literally fell off as I got dressed. Thankfully, FreeStyle customer service replaced the sensor for me with no hassles.

Without the security of winter thermals and jumpers, I’ve also found that I’ve got to take A LOT of extra caution not to knock that sensor as I go about my day.

I definitely find that getting the best position on my arm makes a huge difference, both in adhesive power and in sensor accuracy. Ideally I want to pick a flat space on my arm, as far up and out of the way as possible. 

This week, I’ve also been rocking my Rockadex Penguin patch. It’s a sticker that simply sits over the Libre sensor on my arm (or any other Continuous Glucose Monitoring device), holding it into place.

Honestly, it’s a lifesaver, especially during the warmer months of the year while I’m more active. As someone who always opts for the plainest or most invisible of colours, this is really saying something!

Yet what’s even better is the story behind it. Rockadex is an Australian business based in my hometown of Perth. It’s run by the mother of a young child with type 1 diabetes. The patches and diabetes accessories are sold solely for the purpose of funding a young girl’s Continuous Glucose Monitoring costs, which is not currently subsidised here in Australia. Anything more is given away. 

I’ve also splashed out on a silicone case for my Libre reader, which often slips out of my shirt pocket when I bend down.

 They’ve also got a bunch of international distributors for those outside of Australia. 

There’s stickers, patches and accessories available to match almost any diabetes device you might use. At the end of the day, anything that adds a bit of extra excitement to the monotony of diabetes is surely a good thing in my book.

Multiple Daily Injections, a Second Time Round

I definitely felt hesitant about going back to Multiple Daily Injections when I was contemplating a pump break.

I didn’t really have too many fond memories of managing diabetes prior to insulin pumping. Lantus was very uneven and inconsistent the last time I used it. I felt I could never get the dose quite right. I remember lots of carb guesstimates, and the wildly fluctuating levels that followed.

But at the same time I knew that I was armed with a lot more knowledge, and motivation compared to when I last did injections. I was actually curious as to whether I could apply these newfound skills into Multiple Daily Injections a second time round.

I gave 9 units of Lantus at around 9pm on the first night of my pump break, which was the sum of the 24 hour basal profile on my pump. I was pretty pleased to see that it did keep me fairly stable when I woke up the next morning.

I was definitely contemplating splitting my Lantus dose, but I wasn’t sure how best to go about it. The general consensus in forums seemed to be that Lantus lasted around 18 hours at best. After running high during the first two afternoons, I decided to experiment with a smaller second dose at 1pm to cover the final third of my day. 3 units seemed to be enough to cover, without sending me low overnight.

After months of diligent carb counting, I knew I definitely wouldn’t be able to survive without a bolus calculator. Although there were plenty of flashy diabetes apps to choose from in the App Store, many of them lacked a bolus calculator. I eventually found RapidCalc for $12.99. Although it didn’t have the flashiest interface, it fitted my needs nicely. I was able to set up my insulin to carb ratios, correction factors, insulin usage profile, and reminders for my Lantus doses.

This break definitely reinforced that to me that you tend to use less insulin on the pump. On the pump, I was using a carb ratio of 1:10g and a correction factor of 1:2.6mmol. On injections, I needed a ratio of 1:6g and a correction factor of 1:1.6mmol. Being off by even half a unit of insulin had a big impact on my blood sugar levels after meals.

What I loved most about injections was the simplicity of it all. There was instant relief from the lows, and far less thinking about where my blood sugar was heading. Small activities around the house had minimal effect on my blood sugar levels. I witnessed steady trend arrows on my Libre during afternoon walks, rather than downward ones. Using Lantus for my basal, rather than rapid acting insulin on the pump, made a BIG difference here. The only time I had to think about lows was when I had mealtime insulin on board.

Gotta say, it was also just awesome to sprawl out on the couch or in bed and not feel that chunk there in my pocket. And I loved having a little less weight in my pockets every time I left the house.

Overall, my blood sugar levels were just as good on injections as they were when I was pumping.

But shots were definitely a LOT of work. Although I carried my pen around with me in my pocket everywhere, I don’t shoot up in front of others. So I really had to make a point of finding a quiet corner to do so when I wanted to eat or correct a high blood sugar level. Speaking of, morning blood sugars were a LOT harder to manage. I didnt have the flexibility of increasing my basal insulin to cover the morning rise after I woke up. I often found myself giving at least 3 corrections after breakfast to bring me back into range. If I had stuck with injections for longer, I would definitely basal test with a few extra units of rapid acting insulin to cover the morning rise.

My pump break definitely reminded of something that Ginger at Diabetes Daily wrote recently. She says that neither pens or pumps were perfect, and that we were choosing between the flaws that bothered us the least. I couldn’t agree more.

For me personally, an insulin pump is a LOT more work than injections. Keeping on top of site changes, dying batteries and insulin cartridges, and having to be on my game in setting basal rates around my activity. It’s more careful thinking about what you’re doing. Not to mention the extra chunk in my pockets pulling my shorts down!

But a pump also offers me more convenience when I’m on the go, more precision in my basal rates and greater flexibility with insulin dosing to cover different kinds of meals.

For the time being, those benefits outweigh the flaws when managing my diabetes.