Multiple Daily Injections

Taking a Break from My Insulin Pump

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I spent two weeks disconnected from my insulin pump last month. It was honestly the best decision I could have made for my diabetes management in the long run. Going back to the simplicity of injections gave me some much needed relief from the stress the pump was inflicting on me, as well as a lot of time to reflect on how I wanted to manage my diabetes going forward. With a much clearer head today, I will add some more to what I wrote about this pump break last month.


As we were heading into warmer weather and the festive season towards the end of last year, I was spending a lot more time being physically active. Watering the garden, Christmas shopping, setting up Christmas lights and activity around the house. Suddenly, a lot of what I had learned and experienced over the past few months from using an insulin pump had changed.

Being plugged into rapid acting insulin all the time felt exhausting. I was going low all the time. Even simple things, like watering the garden, would send my blood sugars spiralling downward. I felt like a single day without a hypo was rare. I often found myself eating my way out of impending hypos, and trying to predict what my blood sugar levels were going to do to me before leaving the house.

I felt really, really lost. I had very little confidence in my basal rates, or insulin to carb ratios. I had no idea whether it was my basal rates, or my insulin to carb ratios that were sending me low. I no longer felt safe leaving the house for half an hour without a meter and tonnes of skittles to fall back on. I’m pretty sure I had made the connection between physical activity and my lows, but I just felt far too overwhelmed at the thought of fine tuning everything once again.

I was nervously pacing up and down on a Friday night in December, deliberating over a site change or a Lantus injection. I was equally scared about going back to using Lantus, given how uneven and inconsistent it had been for me in the past. What finally got me over the line was telling myself that insulin pumping was no longer working for me. I knew that it was the source of all of this frustration, and that I didn’t need to use it if I didn’t want to.

The days that followed were quite honestly the happiest I’d felt in several weeks. The freedom from that annoying chunk of a pump, and the relief from not having to stress about basal insulin sending me low from a short walk. I was honestly so happy at the time, I was convinced that this might be the way forward for me. I was so relieved, I kept telling myself how much better injections were compared to the last few weeks I’d had on the insulin pump.

I went from having days like this.


To having days like this.


I anticipated I’d probably only last a few days without my pump. But injections were going surprisingly well for me. Everytime I stared at my pump, I just knew that I didn’t feel ready to hook back onto it. At the one week mark, I even stashed it in a drawer because I didn’t want to look at it.

My pump break gave me some much needed time to clear my head. I plugged back in for a few days over Christmas, because I knew that I would need the temporary basal rates and extended boluses to help me cruise through all of the food. I was fully prepared to take it off again after Christmas, but quite honestly I haven’t felt any desire to do so since.

I’ve been setting temporary basal rates around physical activity, and they seemed to do the trick from the get go with minimal hiccups. I’ve been setting a -30% temporary basal rate before I get into the car to go to the shops, and switching my insulin delivery to “off” for half an hour if I go for a short walk around the block in the afternoon. I think I’ve had about 2 or 3 hypos in the New Year, which is not only a big relief, but tells me that I must be doing something right. 

If it weren’t for Christmas, I’m not sure whether I would still call myself an insulin pumper today. In those two weeks, I was absolutely fine with the possibility of going back to injections permanently if that was what worked best for me. 

At the moment, things are travelling well with the pump. Things are making sense once again, and I honestly have not felt any desire to be without it since Christmas. 

Could this change again down the track? Who knows? This is diabetes, after all…

What I have learned, however, is that I absolutely will not hesitate to take a pump break if the need arises again.

My diabetes, my rules…

Pump-less in December

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I was staring at the infusion site on my stomach that needed to be changed on Friday night, and all I could think to myself was I really don’t want to do this. 

I thought about the stressful week I had just had. I thought about all of the running around I’ve been doing lately, and the hypos that accompanied the running around. Spontaneous activity is so friggin hard to plan for. How can I possibly guess when I’m going to get the urge to vacuum my bedroom floor, fiddle around with the Christmas lights that have fallen, or water the garden – and set a temporary basal rate an hour in advance to stop me from going low? This was hardly an issue on Multiple Daily Injections.

It was 37 degrees on Friday, and the pump just added to the hot weather discomfort. That lump in my pocket was a cozy comfort during the Winter, but now it just annoys me. Every time I sprawl out on the couch, or lay down in bed, its there. Every time I have to stop and tuck the excess pump line back into the waistband of my shorts, only to have it emerge again soon after. Every time it weighs down my shorts with all of the other crap I carry around when I leave the house, and I’m left pulling up my pants every five minutes.

I’ve definitely been cruising a little more than I would normally allow myself. Hello, December. I had two iced coffees last week. At 69g of carbs a pop, it’s not something I can usually justify consuming, especially being in liquid form. I’ve been treating myself more often than I would usually allow, and carb considerations cross my mind less often than they usually do. Maybe a break would give me time to refocus?

I love my insulin pump. I love the added precision, and extra flexibility that it allows. Having an insulin pump has really motivated me to more actively manage my blood sugar levels and count my carbs. In seven months, I don’t think I’ve ever seriously considered abandoning my insulin pump.

But I was already daydreaming of being free from my pump. I was excited by the idea of shaking things up and doing something different, in the same, refreshing way that going Libre-less was.

I have learned so much about my insulin dose requirements since starting out on a pump, and I couldn’t help but wonder if I could apply this logic and newfound diligence into Multiple Daily Injections a second time around.

With Christmas just around the corner, I doubt that this pump break will last very long. But for a few days at least, I will savour the freedom of not having to feel for a flying pump every time I get up off the couch, and the extra space in my pockets.

Three Month Pump-aversary!

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The very first thing Gwen emphasised to me last year was that using an insulin pump would not be any easier than Multiple Daily Injections. Boy, oh boy, was she right.


These past three months have been by far the most challenging I have faced since being diagnosed with type 1 diabetes six years ago. I have gone through site failures, occlusions, ketones, frustrations and burnouts that have lasted for several days on end. It has required enormous patience, a commitment to learn, and it has seen me agonise over many a decision. I have been through it all. I have poured my heart onto these pages over the last three months.

There have been a lot of low points that I have talked about quite candidly over the past three months. There have been a few times where I’ve reached breaking point. Times where I have found myself pacing up and down my room, deliberating over whether to rip my pump out and take a break for a couple of days.

But every time I have contemplated removing my pump, I knew that I really didn’t want to say goodbye to that added level of precision. I have never truly felt ready to say that this wasn’t for me.

Stability during the night is miles better compared to injections. I felt that when I was using Lantus, I could never get the dose quite right. I felt that I needed to eat a similar number of carbohydrates each day in order to achieve that smooth coverage I needed during the night. I felt that if I ate more than normal, my basal wouldn’t be enough to keep me stable through the night. Then if I were to skip a meal the next night, my basal would likely send me plummeting at 4am.

For the first time in my life, I have confidence that my basal rate keeps me stable. When I give a correction at 1am, it actually works and sends me back into range by the time I wake in the morning. When I go low during the night, it’s only through my own fault.

I could never seem to get my breakfast insulin dose just quite right. In the months leading up to the pump, I noticed that I would end up frustratingly high after eating virtually the same thing for breakfast each morning. Now my pump delivers extra basal insulin to cover the extra glucose that my liver dumps when I wake up each morning, and my breakfast insulin dose actually does it’s job!

Highs are also so much easier to manage with the pump. I remember stubborn highs that were so resilient they needed multiple insulin corrections that didn’t make any sense. Now with the pump, I know that highs are a little less sensitive to insulin. When my levels soar into the 20s, I can set a temporary basal rate of +200% to get things moving a little more quickly. When i think about it, I don’t think my levels peak above 15mmol half as often as they used to. And when they do, they don’t stay there for too long at all.

On pump day, Gwen reminded me that I was the kind of person who wanted that extra level of precision. I knew that I wanted to be able to customise my insulin delivery to match the hour of the day or a specific activity. I feel that my insulin pump has given me that.

The pump has given me an added focus and drive with my diabetes. I am working my butt off with carbohydrate counting, pre-bolusing and watching my portion sizes (which I could easily do without the pump, too). I guess what I’m trying to say is that my diabetes goals seemed unattainable on injections. With the pump, they do. Hence, the drive to keep up the hard work rather than being lazy.

I’ll hopefully have an a1c result at the end of today. I have a good feeling that it will likely be around the same mark as it was in May, and I’m pretty content with that. Over the years my a1c results have been ridden with too many peaks and troughs, so I’m pretty pleased that those peaks are a little less peak-ey today.

As I reach the three month mark on an insulin pump today, I feel like I can finally focus on some of my other diabetes goals, which feel far more in reach than they ever did on injections.

Thanks for all of your support and encouragement over the last three months. I really couldn’t have done it without you all cheering me on.

Pump Doubts

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After a few infusion site failures of late, I’m starting to become really self conscious. After every new site change, I become really paranoid of whether it’s a failure or success.

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I poke my infusion site, trying blindly to detect a kinked piece of teflon that should be sitting underneath my skin. I prod around the infusion site on my stomach, trying to feel bruising and pain. I stand still while my pump is delivering an insulin bolus, waiting on edge to detect any stinging. I lift up my jumper compulsively, watching the colour of the skin underneath my site like a hawk.

I think about whether the skin tissue underneath my infusion site is strong enough to handle 3 days worth of insulin boluses. I frequently glance at my Total Daily Dose history on my pump, questioning whether it’s too high. I feel guilty for the carbohydrates I am consuming, for the sake of the subsequent insulin boluses that will have to go underneath my skin.

I check my levels like crazy after a site change, impatiently looking for signs that the insulin is heading successfully underneath my skin. I keep an eye on glucose movements like a hawk. In a moment of paranoia on Saturday, I even ripped out a perfectly good infusion site because the correction was taking too long to work it’s magic.

I draw dots on my stomach in permanent marker, in a desperate bid to keep on top of site rotations. I stare persistently at the real estate on my stomach, deliberating over just the right spot to place my new infusion site. I worry about how soon I will be able to re-use an area of real estate again.

In moments of site failures, I question whether this is really worth it. I think about results around my diabetes, and I’m almost certain that I won’t see any improvement yet. I’d be lying if I said I haven’t had fleeting thoughts that maybe this is not working for me. I worry that I won’t be able to make this work for me. I stand in my room for minutes on edge, pacing, deliberating over a site change or a shot of Lantus.

But when I think about going back to Lantus, I think about the level of control I will lose around my basal insulin rate. I think about how unfocussed I was on injections, blindly guessing and correcting all the time. I think about all of the time and investment I’ve put into this insulin pump, and I know that I’m not ready to pull away from it just yet.

Goodbye, Gwen

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A diagnosis with type 1 diabetes back in May 2010 changed my life.

I remember how awkward I felt around my new condition at the time. Carefully finding a spot on my stomach and willing up the courage to insert the needle and administer an insulin injection. Standing in the kitchen eating a white bread sandwich at bedtime, feeling uncomfortable as soon as someone walked in and saw me. The way I tried to carefully follow the very vague instructions I had been given upon my discharge from hospital – 20 units of Lantus at dinnertime, 5-10 units of Novorapid at meal times, and a white bread sandwich at bedtime to stop me from going low.

I remember how “different” I felt at the time. The reality that this condition would be around for the rest of my life was still sinking in. Nervously walking into diabetes clinic for the first time, and seeing other patients there reminded me that I was now a “diabetic” – something I felt very labelled by at the time.

It was there that I first met my diabetes educator, Gwen, a straight talking woman with plenty of diabetes knowledge and experience. My Mum was there with me at my appointments, and Gwen made her feel very much included as well. I’ll never forget her famous diagram of the mouth, the liver and the pancreas, as she demonstrated the role of a functioning pancreas when food entered the body. A diagram that she still uses to this very day.


In the months that followed, Gwen went on with helping me to fine tune my insulin doses, so that I wouldn’t need that white bread sandwich at bedtime. When she saw how complex and spontaneous my meals were, she taught me how to carb count. She always made herself available to me outside of appointments by phone and e-mail, despite how busy she was. When my first endocrinologist told me that I had very poor control, Gwen was the first to see the look of disappointment in my face. She was prepared to go and have a word with him, and she made sure that I didn’t see him again in future.

Gwen often reminded me that the first year was biggest hurdle to get through, in terms of education and clinic appointments. Her job was to make her role as my diabetes educator redundant. After the first year or so, I went on managing my diabetes without regular education sessions.

As I began to consider insulin pumping last year, I felt that it was time to touch base with Gwen again. Nerves after such a long space of time were immediately relieved, as Gwen proceeded as though our last appointment was only yesterday. She approached the matter with the seriousness it deserved. She never sought to influence or sway my decision either way, and respected the decision that I eventually made.

It’s hard to imagine starting out on an insulin pump with anyone other than Gwen. Nerves were eased going into it with someone I was so familiar and comfortable with. It was fantastic to be able to chat with Gwen over the phone every day during that first week. I was very comfortable uploading all of my data to Diasend for her to see.

Last week, I had my final education session with Gwen before she retires at the end of the month. Even though there has been considerable distance between our sessions over the years, I still find it hard to say goodbye to someone who’s been there since the very beginning.

Gwen has been a huge part of my diabetes journey. She is the professional who has the time for me. Who sits down with me, and has my undivided attention for a whole hour. Who knows me, and the very hands on approach I take towards managing my diabetes. My GP, although excellent, doesn’t often have the time for me and is quick to dismiss my concerns. I don’t always see the same endocrinologist on clinic days. Too often, they are quick to sign off on my six monthly checkup and move on to a higher priority patient.

There have been a lot of changes over the past six years.

Back in the beginning, I managed my diabetes with a meter, insulin pens and a paper logbook. Today marks four weeks since I first started using an insulin pump. I also have access to a logbook meter, Diasend software to analyse my data electronically, and a FreeStyle Libre.

Back in the beginning, I was a nervous newly diagnosed teenager who used to shy away from his diabetes. Today I am a confident, passionate and knowledgable person who is empowered to make his own diabetes decisions.

In some ways, I feel as though I am reaching the end of a chapter in my diabetes journey. And it feels nice to have been able to close that chapter with Gwen.

Goodbye, Gwen. Wishing you a very happy and fulfilling retirement that you deserve.