Tag Archives: Diabetes and pumping

What Diabetes Technology Can’t Replace

v66n01_p30

If successful diabetes management is based upon a multitude of decisions we make during the day, why is technology often regarded as the number one asset in our diabetes management arsenal?

It can’t possibly be.  Take some important daily decisions that all impact diabetes:

-what to eat

-when to eat

-how much to eat

-how much insulin to give

-when to give insulin

-when to exercise

-what type of exercise to do

-how much to exercise

-when to test blood sugar

-how often to test blood sugar

And on and on!

Now basic technology like a meter is huge.  But, only if we choose to use it.  And a pump, for many of us, makes it easier to eat and deliver insulin as needed and to do a wide variety of exercises, as long as we choose to use it properly.  A CGM gives us information about trends and helps us catch highs and lows before they get too high or low.  Not to mention it can help save our lives by alerting us to dramatic blood sugar levels. 

So technology is awesome!

That’s indisputable.

It would seem that those using all of this technology would always have better diabetes management than those who only use a meter and syringes, right?  And yet, in my personal experience, I’ve met many people who use a meter and syringes and do very well and people who use all the technology available and don’t do very well. 

There are other important variables that always need to be considered.  So when a person is struggling with their diabetes management, often times more questions need to be asked than what is often asked.  Most likely, a person who can do well with a pump, can do well without one.  And CGM’s are most dramatically beneficial to those who can’t feel their lows or have young children with diabetes. 

My cautioning is really about avoiding the conclusion that, “If I had a pump, my diabetes would be controlled” or “I probably just need a CGM to have controlled blood sugars” without considering other factors. This isn’t to say these tools won’t dramatically help one’s management.  There is no guarantee and the decisions a person takes throughout the day is a better indicator of how a person will do with diabetes technology.

So if you’re struggling with your diabetes management, assess the root of your individual struggle.  Some people’s issues are best addressed with technology, but many issues are addressed outside of technology and skipping this facet of diabetes management can prove extremely frustrating and detrimental. 

I know because I’ve been there, done that.  Address your personal needs and let your blood sugars be your guide.  What technology can’t begin to replace is you and your knowledgeable decisions, which require knowledge about your diabetes.  Make sure your bases are covered before relying on gadgets.

My Biggest Worry about Pumps

561431_328756620514808_1838768377_n

“Ketones” by Ana Morales

 

I’m all about people using pumps if they like them (or don’t like them but find they manage their diabetes well with them).  It’s a wonderful device and I’m happy technology like that exists for us.  I used a pump for 7 years, which is plenty of time to experience just what pumping is all about.

So I want to talk about something I noticed during my pumping years and after them.

It occurred to me recently that my numbers rarely go high enough to induce DKA.  I can count on one hand the occasions in the past 5 years where my blood sugar has gone over 350 and it hasn’t been over 400 in 6 years.  I’ve been off the pump for 6 years and find I can’t go back, yet.  One of the most dangerous things in my mind is DKA and very high blood sugars.  I experienced super high blood sugars enough as a teenager to know I never want to go through that again.

When I was on the pump, it was a regular monthly occurrence to have a 400+ blood sugar reading and it was almost always due to a pump or tubing or pump site malfunction.  I knew that my being human provided sufficient variability and error to my diabetes management and I began to seriously resent the pump for adding to that risk simply because I didn’t have the energy to keep up with it’s extra requirements.

What I mean is people who don’t endure these pump issues have very good discipline when it comes to changing their pump site and checking their tubing and changing the site when they suspect they need to.  However, I know that many of us don’t do this.  I completely understand why-it’s hard to keep up this kind of diligence, especially if it means inserting a painfully long needle more times than we’d like.

Those who use pumps should probably be in a very good place when it comes to their motivation to do all that is necessary to successfully use the pump.  I was not one of these people because I resented wearing the pump and as a result, kept my site in too long sometimes and suffered the consequences.  Of course, sometimes, we can do everything right and something wrong can still happen with the pump though the likelihood is very much decreased if we keep up the right routine.

I love using syringes because I get piece of mind each time I give insulin, knowing I don’t have extra variables to contend with (there are SO many as is).  And mostly because I never have a high blood sugar surprise that is a result of my not receiving any basal insulin for a mysterious amount of time.  The danger of very high blood sugar isn’t just that, it’s also the lows that can result from giving insulin over and over again in an effort to push that really high and resistant blood sugar down.

Obviously there is more involved in keeping blood sugars stable.

Reducing my carbs and using shots has made my blood sugars so much more stable, with little extra effort involved.  And to me that’s practically miraculous in terms of gains to my quality of life and health.  So while I don’t mean to say that people shouldn’t use a pump I just think we should each be honest with ourselves about how it works for us.  I realized I was no longer a good candidate and got off the pump and there is nothing wrong with that.  And there is a good possibility that one day I’ll get back on a pump.  They are making wonderful improvements to pumps each year and I’m becoming a more responsible and disciplined person each year.

Very well meaning people tell me all the time, “but don’t you miss being able to sleep in and eat when you want?”  News flash my friends, there are now long acting insulin such as Lantus which serve as a basal insulin.  The NPH and R insulin of the past are just that.

I guess what I’m saying is, are you having a lot of extremely high numbers due to pump issues? If so, work to reduce them with your healthcare team and if you know in your heart that you aren’t keeping up with site changes and all the pump requires, think about your options.  Whatever you do, do it in favor of your health.  Everything else will surely fall into place.

Copyright © 2017. Powered by WordPress & Romangie Theme.