PUMPED: A Diabetic’s Analysis on Her Trusty Sidekick

Today’s Guest Blog brought to you by Brooke Stewart, SPT. Not only is she a PT Student, but she is a Type 1 Diabetic. No better way to get information than directly from somebody living with Type 1 Diabetes. Its titled PUMPED: A Diabetic’s Analysis on Her Trusty Sidekick.

The other day I was PUMPED because this happened:

Here is my pump and its trusty sidekick, the blood glucose meter. In this picture, they are reading the same blood sugar values. Why is this such a marvelous sight to see you might ask? Because in a realistic (diabetic) world, this beautiful thing rarely happens.

The two devices work side-by-side to fight against pesky stressors to help keep my blood sugar in range throughout the day. Their job isn’t easy and for that reason alone, I’m forever grateful for this dynamic duo.

MY STORY

Most diabetics go through what I like to call the roller coaster effect.

This is where blood sugar likes to go on a wild ride from high-low-high-low with no consistent balance. It’s usually due from under or overcorrection of insulin, but many other factors can influence this fluctuation, including stress, lack of sleep, diet, and exercise.

I experienced this roller coaster effect for twelve years of my diabetic life. During this time, I was using injections for my insulin therapy and my average A1C ran >9%, giving me an average blood glucose of >200 mg/dL (YIKES!).

As my life became more unpredictable, the harder it became to manage my diabetes. With the combination of poor college eating habits, travel-induced stress, and a lack of exercise and sleep from school, it became nearly impossible to sustain balance in my blood sugars.

There became a point where I was done. I needed a change.

My pump is my personal sidekick.

There are many great pumps out there, but I needed something that could keep up with my ever-changing lifestyle. I’m a student, a traveler, and a young professional who is constantly on the go. My pump is always on my side (literally), adjusting and correcting so I can keep moving.

The Medtronic MiniMed 670g pump is the first of its kind. Being the first hybrid closed loop system on the market, it provides users with a semi-automatic way to managing blood sugars.

Coupled with a glucose sensor, this system contains “smart guard” technology and a remarkable algorithm that adapts to the user’s insulin needs-automatically.

This technology mimics most of the functions of a healthy pancreas. It has the ability to provide the body with two ways of insulin delivery: one provided by the user and another way provided by the pump.

The bolus insulin administered by the user occurs when eating a meal. This requires carb counting and the occasional finger prick to calibrate the system. However, the 24-hour basal insulin is administered automatically from the pump itself. Using a special algorithm, it adjusts the basal insulin every 5 minutes based on glucose readings from the sensor and previous insulin deliveries. This allows the pump to compensate for miscalculations in carb counting and other outside factors that can cause the roller coaster effect. It’s constantly learning about my specific insulin needs and helping to reduce the variability in blood sugar levels (pretty neat-huh?!).

More important features:

The pump-sensor combo also has two features that make it unique to other insulin pumps. One being a suspend before low feature, which allows the pump to automatically suspend insulin delivery up to 30 minutes before the sensor suspects future low blood sugar. It will then automatically resume the basal insulin delivery when blood sugar levels are recovered. This helps to eliminate hypoglycemic events that occur (especially at night!) and provide the user with a more peaceful night sleep.

The other feature was already briefly mentioned but it’s worth further explanation because it’s one of the most important features about this pump. The automode feature allows the pump to increase or decrease your basal insulin delivery- automatically. This becomes extremely useful when the user has miscalculations in carb counting or has a sudden lifestyle change, such as a change in exercise, diet, stress or sleep. The algorithm targets a blood glucose value of 120mg/dL, so any deviation from that value will automatically trigger the pump to make the necessary adjustments to get the user back to baseline. This decreases the roller coaster effect and allows for a more concentrated control of blood sugars within the targeted range.

After a year with my pump, my A1C is now 7.2%, giving me an average blood sugar of 160 mg/dL. There’s still room for improvement, but this is a huge stepping stone in the right direction for my diabetes management. My health has improved, physically and mentally, and I spend less time worrying about my diabetes and more time focused on normal life.

PROS of having a pump:

• Maintains blood sugars within targeted range.
• Eliminates the stress from miscalculations in carb counting for meals.
• Improves concentration throughout the day by maintaining a healthy blood sugar level.
• Improves A1C value in majority of users.
• Eliminates lows at night to give you a more peaceful night sleep.
• Minimizes the roller coaster effect – super important!

CONS of having a pump:

As high-tech as this pump is, it’s still a machine and malfunctions can occur. It’s important to speak with your endocrinologist to come up with a backup plans in case the unexpected were to happen.

• Infusion sites can (and probably will) get yanked out. Door handles, kids, and pulling down your pants might have a part in this, but it’s important to protect your tubing and carry extra supplies in case this happens.
• Air in tubing, spoiled insulin, and kinked tubing can occur when changing your infusion site. Make sure to check your tubing and eliminate air bubbles before inserting a new infusion site.
• Some insulin delivery might not reach the bloodstream due to placement of infusion site or the build-up of scar tissue. It’s important to change sites and rotate regularly to reduce the risk of building up scar tissue.
• Traveling requires more planning. You need to plan ahead and bring extra pump supplies and have a plan in motion in case emergencies happen when traveling abroad or in a different country.
• Food, physical activity, stress, and sudden hormone changes can all affect diabetes. Most of the time, the pump can adjust accordingly. However, there are some instances where it’s beyond its control. This is where you take matters into your own hands. You need to fully understand how to correct your blood sugar levels and make the necessary changes needed to manage your diabetes effectively.

This has been my personal analysis and experience with my pump. My pump has tremendously improved my diabetes care, but there is a plethora of insulin pumps available out on the market. If you’re on the fence about getting a pump or want to explore more options of insulin therapy, talk to your endocrinologist. Your doctor can help guide you in a pump that best fits your specific lifestyle for effective diabetes management.

Nobody wants to be on the roller coaster forever. The good news is you don’t have to be-there are options for you. It’s important to find the right sidekick that will protect you day in and day out and be the perfect partner in crime against this fight with diabetes.

Together, you can be the dynamic duo.