I note that there was an earlier post on this same topic, perhaps moderators could combine the two discussions?
Longish essay here: how much time is spent actively treating T1DM a week?
Your thoughts are welcome!
Diabetes takes a lot of time and effort to manage well. I’m not asserting that I do it perfectly, but I do commit time to my health, wanting to be around and healthy for as long as I can.
Anyway, you may not be aware or keep track of the amount of time and energy that you dedicate to ACTIVE diabetes management. But I decided to review.
If I include awakening at night and treating, following up on Dexcom alerts (high OR low) reviewing diabetes supplies, ensuring that I’ve got documentation to maintain capacity directly related to diabetes management (this doesn’t include time spent exercising), reviewing glucose response to medication and to dietary intake, (excluding the counting of carbs of course) and assuring that adequate treatments are available for exercise such as cycling, hiking, and the like. — suffice to say it adds up to the 14 hours a week! I won’t say that none of this is multi-tasking but a substantial amount of my attention is goal-directed to management of diabetes that I believe it qualifies. As noted, I’ve done some tracking, and what I found may be surprising.
Where shall we start? Let’s consider a “standard week”. Starting with Monday morning.
Upon awakening, altogether each morning I spend 20 minutes on direct diabetes management, starting with checking overnight sugar tracing, reviewing response to insulin. I almost always wake up to 6.1 mmol/L. Which is thanks to Control IQ.
What else does this 20 minutes entail?
Part of my daily routing includes checking date and time for replacing glucose monitor or infusion set, and checking both sites for inflammation. I remove the infusion set for a shower, ensuring that insulin flow is stopped (and restarted again after it’s been reconnected), I program a breakfast bolus (depending on carb:protein ratios, for longer or shorter duration etc). Not to forget as part of your morning life-sustaining regimen: to check feet for blistering, cracks, infection etc. during or after the morning shower. Anyone who regards this as inappropriate care for a person with diabetes is missing the point.
During the morning I add another 10 minutes altogether, incurred during the five hours between breakfast and lunch, reviewing glucose tracing and intervening as appropriate (including treating lows or highs but EXCLUDING the actual time spent for example climbing/ descending stairs in order to treat a high. I think you MIGHT be able to count that time as it isn’t exercise per se, but treatment for hyperglycemia. But out of an abundance of caution, I’m not counting that time).
Then 10 minutes at lunch, preparing for injecting insulin via pump appropriate to the amount I’ll be eating after reviewing how the morning insulin has affected my glucose tracing and what I’ll be eating.
Review / treatment in afternoon, similar to the morning, considering another 10 minutes between 1PM and 5 PM.
After considering and counting evening meal carbs, I dedicate 10 minutes reviewing what my evening meal will require in terms of treatment — how many units, all at once, or delayed infusion? Similar to my breakfast calculations. Telling the pump to do it. Later, after evening meal, five minutes checking that glucose tracing is where it should be.
Later on in the evening: 15 minutes that includes reviewing my past 24, 48 hour, and past week time in range, average glucose, and considering factors that may have caused less than 100% of my time at 5.8 mmol/L. Considering pump programming changes to address that, do I need more basal? Should I change I:C ratio? How are my correction factors? I don’t change this every day, but I’m always aware. During this time I have my pump plugged into my computer so that the battery remains adequately charged for the next day.
Evenings: taking pump from pocket, adjusting and putting it in/on a belt so that I don’t strangle myself with the tubing. 5 Minutes.
That’s 80 minutes a day! Maybe not quite exact every day, some days more and some less, but often enough. So if you follow me, I’m dedicating over nine hours a week for just regular / routine management. 9 hours and 20 minutes to be exact, per week.
One or two nights a week I’m awoken, sometimes low, sometimes high, and I need to address. Carbs or insulin? How much? I figure it’s 20 minutes each time. Additionally, three or four days a week, on average, similarly, I need to address an out of bounds glucose, usually because it’s trending low. That adds 10 minutes “additional time” reviewing and treating my out of bounds glucose. An hour and ten minutes a week added here. So now 10 ½ hrs a week.
Preparing the pump: every three days, 30 minutes involves getting out the insulin, drawing it up into a syringe, measuring out how much I’m getting in the syringe, ejecting the bubbles, putting the insulin back in the fridge, checking my insulin supply and remembering to reorder when I’m getting low. Cleaning the area on my body where the infusion site will go. Drying said area. Preparing the injector, unwinding the tube, peeling off the protective tape, removing the needle protector, selecting site and firing it into place. Checking that it’s a good site. (Occasionally, having to go the whole thing over again because it didn’t go in properly). Then: loading up the new cartridge with insulin, switching out the old one, waiting for the pump to recognize the cartridge and all that jazz, filling the tubing with insulin, attaching the tubes, etc. and finally turning on and securing the pump where it needs to go.
This adds another 1 ¼ hours a week so we are at 11 ¾ hours per week on approved diabetes management time.
Changing the CGM: every ten days. 15-20 minutes that involves cleaning and preparing the site, getting the CGM ready, inserting, removing the old one and disposing of it; I’m including a single glucose finger stick during the two hours that your not getting readings. So that’s another hour a month, or 15 minutes a week, getting us to 12 hours. Occasionally, I need to calibrate or check my glucose on a finger stick, say three times a week at 5 minutes each time, so now we’re at 12 ¼ hours a week.
Exercise: I don’t count time spent actually exercising! I exercise more on the weekends than during the week and in general I’m active 10-12 hours a week. (Hiking, paddling, biking, skiing, etc). If I’m going to exercise, I need to prepare for the consequences so have adequate fast acting glucose to treat the downward trends that often occur. I also need to secure the pump and make sure that it and the tubing is adequately protected from the elements and the cold. If I spend 10 minutes addressing pump issues and preparing for treating hypoglycemia that occurs while exercising, and I do this four or five days a week, that’s another 45 minutes a week altogether. 13 hours.
If I treat hypoglycemia (while exercising) it can be a five minute process and sometimes I need to do so twice in an hour, other times not at all. But even if it’s only half the time that I need to treat, I’ve got 60 minutes actively treating a hypoglycemic event that occurs while exercising!
OK, this all adds up to 14 hours.
I’m applying for the credit.
I’ll let you know what they say.