Pumping Insulin

When I think about it, I'm surprised I haven't posted a photo of my insulin pump before now.  When it comes to things that are an important part of my day, I'd have to say my pump is at the top of my list, even above my husband, kids and pets.

The first thing I want to explain is that the fact that I'm on an insulin pump doesn't mean I have "the bad kind of diabetes", (there is no good kind of diabetes).  It doesn't mean that my diabetes is worse than some who isn't on a pump.  It means that I'm a Type One Diabetic who has decided to control my diabetes with an insulin pump rather than giving myself anywhere from 4 to 8 injections of insulin each day using a syringe or insulin pen.  It can also mean that I have an excellent extended medical plan, or that I'm willing to spend a lot of money on the initial purchase of the pump ($6,995 plus tax) and monthly supplies ($250).  I'm relieved to say it's the former and I have 100% coverage on pump and supplies (including batteries...and you go through a lot of batteries because you can't use rechargeables).  

The pump clips onto the waistband of my pants, or my belt, or sometimes I take the clip off and just tuck it into the side of my bra.  It has a long thin tube attached to it that hooks into an infusion set, which is a bit of plastic surrounded by sticky band-aid type fabric that holds the plastic in place, where it's attached to a small plastic Teflon coated needle, called a cannula that goes into my body.   The cannula is very small and flexible and I can't even tell it's there 99.9% of the time.  Every three days I remove it and put in a new one, to prevent infection.

I've been a Type 1 Diabetic since I was diagnosed at the age of 13, but I've only been on the pump since the middle of March.  It's really caused a great improvement in my ability to control my blood glucose (BG) levels. The pump supplies a continuous basal dosage of a small amount of insulin per hour, and then anytime I eat something I do what's called a bolus dosage.  I enter the number of carbs I'm about to eat, it calculates how many units of insulin I'll need to take, and I enter that amount and hit "go".  It also has an alarm that reminds me when to test my BG after I've eaten, to make sure I don't need a little extra insulin.  If I do, I can take a little more.  In the past, if I needed a bit more, the least amount of insulin I could take would be one unit.  Now with the pump I can take as little as 0.05 units.  It really allows for the fine tuning that keeps you from taking too much insulin and having to deal with a hypoglycemic reaction (low BG level that can lead to confusion, loss of consciousness and seizures).  

With my pump, you still have to prick your finger and test your BG many times a day but that may soon change.  In the states they have something that is able to test your levels continuously, through some sort of needle under the skin, as part of a pump system.  The few people I know personally that have used it find it painful at times and it has a tendency to wake you up with a false low in the middle of the night.  I'm willing to wait until they have things more fine tuned, but I do know of a very active young athlete in Kelowna who has found it to work well for him.  They would have no medical coverage for this however since it's not approved in BC as of yet.  

I can't imagine there will ever be a unit or "artificial pancreas" that will not have to be programmed by the user in some way.  For example I don't always give myself the full amount of insulin it suggests if I know I'm going to be going for a 1/2 hour hike right after lunch.  A pump that just gave you insulin based only on what your BG was wouldn't be able to take into account so many of the variables that affect the levels of someone without a healthy pancreas.

When i was diagnosed in 1975, Type 1 Diabetes was controlled by taking one dosage of long acting insulin every morning and hoping for the best.  The only way you could have your BG checked was to go to the lab.  You checked to see how you were doing at home by peeing on a piece of paper that would change colour to tell you how much sugar was spilling into your urine.  Really not an accurate way to predict BG levels.  Before the "discovery" of animal based insulin in 1921, Type 1 Diabetes was a death sentence with few people (mostly children) living no more than a year after their diagnosis, many of them starving to death.  

I'd have to say I'm pretty lucky when I think about it.  I'm very grateful for this technology that allows me to live with better control, one of the key factors in preventing life altering complications and I'm doubly grateful for my husband's extended medical plan that allows us to afford it.