This was originally posted to my blog, Diabetes Odyssey.
2015 was a year of new diabetes gadgets for me. From 1987 to very early 2015 the one and only electronic device I ever used for diabetes care was a glucometer.
Why did I wait so very, very long to come into the modern world with my diabetes care?
Money - As a child, I guess my parents just wanted to keep things simple. But as an adult I just didn’t have the money or resources to get a pump, etc. And I wasn’t so sure I wanted one anyway.
Insurance - As a child I always had insurance, but my parents were in control and although I haven’t asked my mom why they didn’t get me and my brother and my father pumps, I assume either our insurance didn’t cover it, it was too expensive, or they just didn’t warm up to the idea. As an adult I spent a lot of years without insurance and when I did have insurance I just was worried we’d lose it. A pump is very expensive and without good insurance you’re pretty screwed on the cost of supplies.
Interest - I was in my teens the first time I ever even heard of an insulin pump. Sure, they’d been around for a long time, but they were bulky and unpopular, so my doctors and parents, I assume, just didn’t bother to talk to me about it. Also, many doctors do not like to put their uncontrolled diabetic patients on pumps (at least this was how it was back then) until they could prove they were responsible enough to handle the initial extra attention a pump takes to get ‘settled in’. When I did finally learn about insulin pumps I was both turned on and turned off. I didn’t fully understand what a pump did, how it worked, etc. So both fear and intrigue filled me. Over time the whole money and insurance thing made sure to keep me from even thinking about getting a pump.
The step in to the modern diabetic world:
2013 was a year of change for me. Huge change. I finally got insurance again, and it looked permanent, not spotty. I had a ton of very serious health issues so I started on a journey to get things fixed and in order. I ended up having open heart surgery, so that put me down for awhile. Immediately after the initial recovery from heart surgery I spent all of 2014 having multiple eye surgeries (4) and spending weeks in between each recovering.
Although I got insurance in 2013, it wasn’t until early 2015 that I was finally able to get an endocrinologist. In the months leading up to this first visit I had been studying up on type 1 diabetes. I was quite aware that I had spent the last 10 years almost completely ignoring my disease and I was totally out of the loop on new technologies, treatments, medications, etc. This was when I first discovered the existence of CGM’s (continuous glucose monitor). I read up on them and became super excited.
“I need one of these!” I could see right away what a CGM could mean for better blood sugar control. I suddenly could see myself in perfect control. I wanted a CGM, I wanted it bad.
I also read up on pumps. I could see how far they had come, but I still wasn’t sure I wanted one. I was curious, though. My brother had had a pump for years by this time, but I had never had the interest to ask him about it and take a look up close. I now intended to talk to him about it. And I did.
The first visit with my new endo (actually a Diabetes Educator, not an endocrinologist) ended with me getting the OK for a CGM, within a month I would have it! The doctor also asked me if I wanted a pump, but I told her I needed to think more on it.
I got the CGM. There was no class or in person tutorial on how to insert it or use it properly or anything like that. Many people are reading this in serious confused concern, but let me tell you CGM’s are simple, easy to put on (insert) and virtually harmless. You don’t need to be taught in person, you don’t need a class to learn how to use one. They are made user friendly and safe. They come with a video tutorial and a step by step guide to get you started and let you know all the ins and outs. Then you are set.
And after your first insertion you’ll be thinking, “why was I so nervous?”.
Pumps are another story. A few months after I started using the CGM I got a pump. Getting the CGM and seeing how much easier it was to control my BG’s, and how easy it was to use the CGM, and how wearing it did not get in the way or hinder me in any way at all, I was able to make the final decision to get a pump.
I had to do an in person tutorial. The good thing was that the rep came to my house and worked with me one on one. She went through all the steps, explained all the functions of the pump, helped me do the math on figuring out my ISF (insulin sensitivity factor), I:C (insulin to carb ratio), basal and bolus settings, etc. And she walked me through my first insertion. And for the first few weeks I was using the pump I had to report everything (diet, BG’s, insulin bolus’ and usage, activity level, etc) to the rep so they could be sure I was getting the hang of it.
This may sound overwhelming and like a lot of work and involvement, and maybe it is to a certain extent, but we are talking about insulin going into your body 24/7, not just 3 or6 injections a day, we’re talking all day. It’s important to be doing it right.
It’s not difficult, though. It’s simple to learn, the pump is user friendly and comes with a million safety features to ensure you don’t end up pumping yourself full of 200 units all at once! It is a million times more convenient (in my opinion) than using syringes or pens.
It has been several months since I’ve been using a pump and CGM and I’m one of those many that think to myself on a daily basis “How did I ever survive without these things?”.
They aren’t all-important, that’s for sure. They do come with some mild annoyances like everything in life does. But what I mean by the above comment is that they make life so much more convenient, easy, etc. and sometimes convenience makes all the difference in the world.
Here are some differences between pumping and shot taking that I can list to help those of you who might be considering a change have a little better perspective:
When you are on shots you have to drop everything to go to the fridge (or wherever you keep your supplies) get your insulin and then inject. On a pump you just take a second to pull it off your belt and push two buttons, done.
On shots you have to remember to take your basal injection as well as all your bolus’. Your basal is done all at one time once a day (usually). On a pump your basal is programmed (you can adjust as needed) and injects you with a tiny amount of fast acting insulin every three minutes and you don’t have to even think about it.
You have to take a million shots a day. On a pump you only poke yourself once every 3 days (varies depending on insulin usage).
However, on shots you don’t have to deal with a cellphone sized contraption on your hip 24/7…with a pump line.
Some pros and cons of CGM’s are:
Yes, you do still have to check your BG several times a day. A CGM is not meant to replace blood sugar checking.
You will know where your glucose number is at all times and whether it is on the way up, down, or holding steady.
You can see a graph of what your daily activities, foods, and medications, etc. are doing to your glucose numbers, and can make the needed adjustments to your lifestyle.
You have the safety of an alarm to let you know when you are getting low or too high.
The only real con I can say is that when the transmitter gets to the end of its life (six months) it begins to act wonky and can be quite annoying until you replace it.
Really, CGM’s and pumps are very helpful. This is my own personal opinion and it is completely understandable that everyone is different. You may love a pump and CGM, you may not.
I do not by any means think everyone would benefit from a pump and CGM. But what I do encourage is that if you have the opportunity to give them a try, then try them! You don’t have to stick with it if you don’t like it. But it’s worth a test out.