Throwback Thursday: Thinking About An Insulin Pump

Almost two years ago, I attended an insulin pump information evening. Today I’m looking back at that evening, and some of the reasons why I began thinking about pumping.

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Last night, I attended an information session on insulin pumping.

I’ve been on Multiple Daily Injections since I was diagnosed five years ago. I’ve never seriously considered an insulin pump, and I can’t say that I know too much about them. I’ve thought about going to one of these information sessions over the years, but it was just one of those things that I never got around to. Okay, truth be told I procratinated on RSVPing to those events until it was too late. Over and over.

I guess what motivated me this year was the fact that I am now a part of the Diabetes Online Community. I think, talk and write about diabetes every day. I feel more motivated towards my diabetes managment, just from interacting with you. I see so many of you blogging, tweeting, screenshotting and instagramming pump stuff each day. I want to understand it. And I want to seriously consider it as an option going forward.

Representatives from a few of the insulin pump companies were there to chat to before and after the session. I’ve never seen such eager salespeople out there in full force, desperately wanting our business. When our fantastic host asked for some sample tubing to show us, it literally seemed like a race to see which rep could get to her first. As I asked one of the reps if a meal bolus was as simple as inputting the number of carbs into the device, she began hurriedly cramming in as much information as she could before the talk resumed. I’ve never seen anything like it.

The topic of Continuous Glucose Monitors came up briefly. As I have written in recent days, Continuous Glucose Monitors aren’t subsidised by the government here in Australia. The cost of purchasing a CGM device and its operating consumables is excessive. While having a CGM may not matter to myself, I know that it could make a world of difference to young children and parents out there.

I thought it was rather interesting to hear the representatives in the room quickly removing themselves of any responsibility for those excessive costs. They urged us to write to our Members of Parliament. They urged us to lobby the government for subsidies towards CGMs and diabetes devices. As though it’s out of their hands.

These companies are responsible for the excessive costs of these devices. I hardly got the feeling that these people genuinely wanted to help me make my diabetes management easier. I so badly wanted to know if they even had diabetes themselves!

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Excuse ranty, 2015 Frank. In hindsight, that evening probably could have been designed a little bit better. The good news is that on Thursday October 12, Perth Diabetes Care will be hosting a tech evening, designed by people with diabetes. I’ll be speaking about my own journey with technology, all of the highs, lows and everything I wish I was told on that evening. If you’re in Perth I highly recommend you come along, have a play with the tech and meet other people with diabetes. Details below.

Mystery of the Varying Overnight Basals

Last week was an exhausting week for many reasons that had absolutely nothing to do with diabetes.

Yet surprisingly, my blood sugars have been cruising along at the best they’ve been in weeks.

I’ve been struggling with my overnight basal rates in recent weeks. There have been some uncomfortable overnight lows, and then there have been other mornings where I’ve woken up frustratingly high. Alarms have been going off 2 or 3 times each night, instead of the usual one.

Things have felt rather inconsistent of late, so I decided to slap on a new FreeStyle Libre sensor last week to try and nut things out. I think I have finally cracked the mystery of the varying overnight basal needs.

If I go to bed sitting in the 7s or 8s, my overnights look something like this.


Looking at the gradual rise from around 4am, I’d be ready to make a basal change.

But when I go to bed sitting in the 5s or 6s on the same basal rate, my nights end up looking like this.

So it seems that my insulin sensitivity is far better when I go to bed in the 5s and 6s. I cruise along much more smoothly during the night, and my blood sugars get off to a much better start when my day begins in range.

So I’m now trying to be a little more bolder with my corrections at bedtime, in the hopes that I can replicate these levels and a decent night’s sleep more often.

Diabetes has so many little intricacies. It always keeps me on my toes, and I’m still learning new things about it after seven years.

One Year Pumping!

I’ve now officially passed the one year mark since I began using an insulin pump! It was a huge leap of faith at the time, but one that I knew I had to make for the sake of lower and more stable blood sugar levels.

The biggest reason I switched was because I never felt I could get my background insulin dose quite right. Some nights, particularly if I ate more than normal, my Lantus dose wouldn’t be enough to keep my levels steady. Other nights, it would be too much and send me low.

Today, that problem is all but gone. The pump delivers a basal rate of insulin that can be customised to the time of day. I have a higher rate running from 1am to mid morning to offset dawn phenomenon, and a flat rate running through the remainder of the day. Night time basals have been the most challenging, with upward tweaks needed every month or two. But thankfully, the remainder of my basal rates have remained unchanged since I first figured them out last year.

Before I started pumping, I was guesstimating a lot of my insulin doses. I guess I wasn’t very motivated to do otherwise. I wasn’t really thinking too hard about what I was putting into my mouth, and there were a lot of emotionally exhausting highs and lows.

I began diligently counting carbohydrates and weighing my food since starting on the pump, and surprisingly I haven’t slacked off since! With a properly tuned basal rate, insulin just worked when I bolused to cover meals, rather than staying frustratingly high. The pump’s bolus calculator was extremely helpful, and of course having the pump attached to me made bolusing a lot more convenient when out and about.

As anticipated, the pump was a huge learning curve. My biggest hurdle in those first few months was site failures. The 90 degree insets that I was using at the time continually failed on me, causing regular bruising and bleeding on the stomach. I’ll always remember one tumultuous night where I ripped out my infusion site to discover the cannula had kinked on the way in. I eventually switched to the comforts which sit on an angle and have a manual insertion. Today, site failures are rarely an issue. 

The insulin pump is hands down more work than injections. Infusion sites need changing every three days, insulin cartridges need to be refilled, pump lines need to be inspected for air bubbles, batteries need changing, and basal rates need adjusting for activity. You really need to be on top of your game with a pump, and that might not be a commitment everyone is able to make.

The insulin pump definitely gave me a renewed drive to better focus on what was some very lousy diabetes management.

From there, the rest of what I’ve achieved is down to my dedication to observing and learning more about my diabetes and the different variables that affect my blood sugar. So in this regard, I feel that I could just as easily have reached this level of management on Multiple Daily Injections as well.

I can’t express just how much of an investment this was – and I’m not sure I would have been able to do this if I were still at uni or had a more demanding job. But overall I now feel more knowledgeable, equipped and experienced to navigate my way through different scenarios. This level of management no longer feels like such a stretch.

While I don’t talk numbers on this blog, I will share that it took me six months to get my hba1c to where I wanted it to be. When I first hit that target in November, I really felt like I had squeezed everything out of myself to get that number. Today, I’ve been able to comfortably maintain that number – and hopefully even better it going forward.

It’s been a huge year for my diabetes, and one that I feel is definitely worth celebrating.

Happy pump-aversary to me!

(And here’s hoping diabetes is a bit easier on me this coming year)