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Why the pump?

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James Robertson

Posts: 29924
Nickname: jarober61
Registered: Jun, 2003

David Buck, Smalltalker at large
Why the pump? Posted: Mar 9, 2009 9:35 PM
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This post originated from an RSS feed registered with Agile Buzz by James Robertson.
Original Post: Why the pump?
Feed Title: Michael Lucas-Smith
Feed URL: http://www.michaellucassmith.com/site.atom
Feed Description: Smalltalk and my misinterpretations of life
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Hi Michael. I've been a Type 1 diabetic for about 20 years now. I've been doing pretty well, with gycolsolated hemoglobins in the low to mid 6 range. I'm curious about what about what prompted you to initiate the move to using an insulin pump. My wife and mother have been pushing me to investigate this option. -- Richard

Hi Richard, thanks for your question. I was diagnosed with Type 1 Diabetes August 2006, I was 25 years old, soon to be 26. It was a rude shock to my life, as it is for every one who suddenly gets hit with this sort of problem. At first I was given a mix-tard, which was a combination of long and short acting insulins that had a profile that matched up with the eating habits of breakfast/lunch/dinner. You had to eat at exactly the right time and have exactly the right number of carbs or it didn't work.

People in the communicate quickly made me realize that this was an awful way to manage type 1 diabetes. It was very restrictive on my life style, very. Really super very. So I forced my doctor to move me over to long acting insulin with short acting insulin. At first, he dictated the dosages and it didn't work very well - then I went online and did some research and figured out my long acting insulin rate and then my short acting insulin dosage per carbs, learnt to carb count - so on and so forth and it worked pretty well. My HbA1C got down to 7.2 in the first year. The second year, I started traveling even more than I had in previous years.

Somewhere along the line, Levemir long acting insulin just wasn't working right over night. When I got it to work right, it'd over lap with the day, so taking it during the day would then cause a hypo, so I synced up in the day, then I'd get a hypo at night.. if I took the long acting insulin only at night, then managed the day time with short acting insulin every 4 hours, everything worked out just fine.

Here in the states, we swapped over to Lantus, which worked every better over night, lower bgl's in the morning was great, but I still had this overlap problem - both Lantus and Levemir were active for too long and too short. Too long being longer than 12 hours, too short being shorter than 24 hours. So I was back to managing the day time BGL using short acting insulin.

I do computations in my head for the short acting, plus the insulin for the carbs in the meal, plus any correction, etc.. it's a lot of work and when you're not feeling well from the flu, it can be a bit overwhelming.

Cutting to the chase, the techniques were working, really well - however, they were a lot of work. All that computing I was doing was grunt work, work that can be done by a machine - an insulin pump. So now I can tell the insulin pump how many carbs are in the food and it does the rest - including corrections. I take a BGL reading and it wirelessly gets transmitted to the insulin pump, which it then uses to compute corrections. It can even step back the insulin it would give for the meal as part of the correction factor.

It also has variable basal rates for sickness, exercise - it also has variable basal profiles for different times of the day. Same with bolus. In short, it takes all the grunt work out of managing my diabetes. We're a team, in theory - I tell it what my BGL is (well, I test my BGL and it tells itself wirelessly) and I tell it the carbs in the meal and it takes care of the rest.

That, in a nutshell, is why I decided to go to the pump. Quality of Life.

Read: Why the pump?

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