I am totally OCD about my pump, CGM, A1C. I am 63. My obsession is causing problems. I maintain an A1C around 5.6. That would be fine if everything levelled out. I tend to be way up, then way down. I have rocked today between 218 and 60 several times, My sensor BG graph on my pump is scary…
This new 530 G is my fourth pump and third CGM.
I need to change. Thinking about going on a pump/cgm vacation. Back to shots. Lantus and Novolog bolus shots.
Sidebar: one day last week I turned off the sensor alerts on my pump until I got things stable. Forgot to turn it back on. Was below 40 on the CGM quite a bit. When it finally clicked in my brain, tested at 29. Helps understand my fear…
I have never taken a vacation from my own pump, but it’s never given me reason to consider it. A rocking of between 216 and 60 would have me doing some other kinds of changes. But as for a pump vacation, many have done this and here are a lot of experiences:
So, if I understand your post correctly, you are thinking that this won’t happen to you if go back to MDI?
That last part I’m a little sketchy on. Why would MDI and no CGM improve your stability? Or do you just want to not know that you are bouncing back and forth between high & low? Or is it some other reason altogether?
My blood sugar is up and down a fair bit, too, though much better since I’ve gotten a CGM. I don’t think 60 to 218 is all that terrible, more like average, though of course it could be improved.
Why are your numbers up and down? Is it because you’re burned out with the technology, or is it because there are other things you can improve (maybe pre-bolusing before eating, or checking your CGM more so you can “bump” up with a glucose tablet if you are drifting towards low, or adjusting basal rates, or figuring out how to prevent lows that occur at certain times of day or after exercise, etc.).
What I would do if I was burned out from the technology is take a pump vacation but keep my CGM and turn off all its alarms (it has one fixed low alarm at 3.1 / 55 that cannot be turned off). If your CGM doesn’t have a fixed low alarm, I’d leave that one on, that way you aren’t bothered by a bunch of alarms throughout the day but still have protection from lows. But I suppose it’s harder to do that if your pump and CGM are one and the same.
If there are other aspects of diabetes you could work on, or maybe you just need a new perspective to figure out some new strategies, then I don’t see how taking a pump/CGM vacation would help. What I would do then is pick one issue or time of day to focus on (so that it’s not overwhelming) and work to keep records around that and prevent that spike/drop, and not worry too much about the rest until you’ve improved that issue, then move on to something else.
I have only ever taken one pump vacation several summers ago. I planned on it lasting two weeks initially, but it lasted about five days. I thought my control was all over the place on the pump, but it wasn’t half as bad as my control without it. I couldn’t take the swings from 2 to 20 (40 to high 300s) every day, so I aborted the pump vacation. Despite it being short, it did renew my gratitude for my pump and made me more aware of how useful its features were.
It sounds like you’re too experienced in CGM to be falling into that thing of chasing your own tail by basing your insulin on the CGM rather than finger-sticks… but it sounds kinda like you’re chasing your own tail by basing your insulin on the CGM rather than finger-sticks. I totally sympathize with the OCD thing. One of the fallacies of all this technology is that it’s giving you a digital number that carries with it a sense of precision that isn’t really there in reality, and you can go crazy trying to nail things down–you can end up putting yourself on an over-correction high-low roller coaster trying to chase down a moving target that’s always just out of reach.
I think people underestimate the psychological dimensions to this disease. There’s a LOT more information and adjustment nuance available in the pump-CGM set up, but you’re getting hit with a lot of data and decisions to deal with. The downside is that it really rubs your face in the minute-by-minute reality of the disease and I think burn-out is a real risk. If it helps to just clear all that out and go back to MDI for a while, why not? It’s not like you’re burning any bridges–you can always go back to the pump when you feel ready to deal with all that again.
I have a new 530G pump and enlite sensor, since May. Yesterday was day 7 on the sensor. (I have always worn a sensor, even the 3 day version, for 7 days. I has always worked fine.) Over night, I was buzzed constantly as low. Finally got my tired self awake enough to test–pump said BG was failing to 60 (it read between 70 and 50 for several hours)…fingerstick was 182.
I am very careful and conscientious about my T1. BG test around 7 times per day, take care if myself, etc.
I am taking a deep breath, putting some new personal rules into place, and moving forward.
Yesterday was a hard day and difficult night. Just frustrated. Thanks for all the help.
Sue - That scenario would tire out anyone. When diabetes treatment tools turn on you, that truly adds insult to injury!
Does your pump/CGM combo work well most of the time? Is day 7 on your sensor often inaccurate, or does it usually work better?
Sometimes, this is the best thing we can do. We are not required to solve every diabetes puzzle. Some of them just can’t be solved. Good luck going forward!
