Managing Type 1 diabetes involves more than just giving myself an insulin injection before I eat. It’s a basal-bolus routine.
A basal-bolus routine involves taking a longer acting form of insulin to keep blood glucose levels stable through periods of fasting and separate injections of shorter acting insulin to prevent rises in blood glucose levels resulting from meals.
It gets more complicated. My basal rate – the amount of insulin I take in between meals – changes from week to week, day to day and hour to hour. This can depend on my schedule (weekend vs. weekday vs. traveling), hormones, exercise and even stress.
Here’s a breakdown of the basal rates I have preset within my personal diabetes manager (what I use to administer insulin via the pod attached to my skin). Continue reading
If the world ended, and I somehow managed to be one of the few survivors in the new post-apocalyptic world, this is all I would need to manage my diabetes.
When I was diagnosed with T1D I depended on these bad boys to survive.
The world hasn’t ended. And yet this past month, I learned firsthand what life would be like without all of the technology that helps me manage this disease.
Back to Finger Pricks
First, my prescription for the wireless transmitter component of my continuous glucose monitor (CGM) expired. My health insurance company requires a letter of medical necessity, certified from my endocrinologist, every year (you know, because I may be miraculously cured in that time span). For some reason, medical supply companies and doctor offices still communicate by fax (archaic!). Fast forward three weeks from when I put in the order for a new transmitter (I documented the whole saga on social media, by the way), and my transmitter dies. Continue reading
April 24, 2009… diagnosed with Type 1 diabetes
October 21, 2011… first seizure as a result of hypoglycemia (low blood sugar)
January 26, 2012… second seizure as a result of hypoglycemia
March 31, 2018… Many of you have heard this story a million times. I have Type 1 diabetes (T1D). It’s an autoimmune disorder where I must inject myself with insulin on a daily basis to live. I’m lucky to be alive. I’m lucky this is something I can manage.
And yet part of the story you probably haven’t heard is how research and technology saved my life. In the span of four months back in 2011 and 2012, I experienced two seizures – one at the Baltimore/Washington International Airport and another at the Orlando International Airport (at least I’m consistent). I’m not only thankful for the TSA officials, EMTs and strangers who looked out for me on days when my troubles could have easily been dismissed, but I am thankful I had these experiences.
Because they led me to Gizmo. Continue reading
His name is Gizmo. He’s a small thing, about the size of a pager, with charcoal skin…. Gizmo and I are attached by a long string, like an umbilical cord. He’s constantly pumping insulin. Sometimes, he moves to the comforts of my small stomach rolls. Sometimes, he rides along my back. He doesn’t enjoy the hard surface of my legs, and it feels uncomfortable when I tuck him under my arm.
Many of you may remember when Gizmo and I first met or you may remember this short introduction from my book Sugarcoated. But I first met Gizmo back in March of 2012 when I went from injecting myself with pens and needles every day to the transformative wonders of an insulin pump. With Gizmo I never had another hypoglycemic seizure, and I was better able to function on a daily basis without diabetes getting in the way.
But recently I wrote about possibly saying goodbye to Gizmo and introducing a new type of insulin delivery system into my life. Well just a few days ago I took that step. Continue reading
As much as I love Gizmo, I’m kind of tired of my insulin pump. I know, I know, I shouldn’t complain. Having a $6,000 piece of equipment attached to me 24/7 has been an immense help in the management of my disease over the past four years.
But I am starting to understand why fellow Type 1 diabetics take a break from the pump every now and then and sometimes forever. It’s not easy having something attached to you 24/7. Right now I carry three devices around with me to manage my disease: my insulin pump (aka Gizmo), my continuous glucose monitoring receiver (aka Cosmo), and my glucometer. That doesn’t count my phone.
Gizmo is about the size of a pager. I usually conceal it clipped to my bra strap or waistline of my skirt or pants. The clip is currently taped together with duct tape, and the Medtronic label is practically worn away. I’ve had Gizmo for four and a half years. I’ve only had to replace it once when the battery container froze shut. For the most part I have no complaints.
But lately I’ve been more annoyed with Gizmo than happy. Take for example: Continue reading
I stare at Gizmo, my insulin pump. I review its user settings, and basal and bolus rate set-up. But nothing within this gadget tells me how to change my reservoir numbers.
Yes my body is no longer producing enough insulin. And yes that means I must use more insulin to function on a daily basis. My basal rates have increased from .325 to .900, and my bolus rates have increased from 1 unit of insulin per 20 grams of carbs to 1 unit of insulin per 13 grams of carbs.
When my roommate a few years ago told me her basal rates were 1.000 unit, I scoffed and hoped I would never reach that level, at least not for another five years. But now having only had diabetes for six years I am now almost there.
The downside? I’ve been switching out my pump’s reservoir every two days. It used to be that 100 units of insulin would last me three days, if not four. And in the past month, it’s only lasted me two days. Continue reading
The other day I was replacing my insulin pump reservoir. This requires a series of steps that I will reiterate for those who have never had to replace their insulin pump supply (as a side note, manufacturers, physicians, and researchers alike recommend switching this supply every three days although I sometimes stretch mine to four).
Replacing my Insulin Pump Reservoir
The first thing one needs is an alcohol swab, reservoir, infusion set, a blue cylinder-shaped device to inject the infusion set underneath the skin, and of course the insulin and pump. So after wiping the spot on my stomach with alcohol and then the top of the insulin vial, I use the reservoir to fill the plastic insulin container with insulin from the vial (it’s important to make sure you remove all air bubbles from the plastic container). And then of course my cat knocks the vial from my desk (it’s small enough this is harmless).
I then twist the reservoir into the end of the infusion set. I rewind the insulin pump so that it knows there is zero insulin inside and can essentially start to recount my usage (I tell it I use 100 units per new supply). I place the new reservoir into the insulin pump and then fill the 23-inch thin plastic tubing of the infusion set so that I know insulin will safely travel through the cannula from the pump to underneath my skin (this usually requires 6-9 units of insulin per fill). Continue reading