If my eligibility date for my insulin pump upgrade wasn’t Thanksgiving Day (easy to remember and very apropos because it involves both food and being thankful) I would have marked my calendar. Leading into the holiday I started to research what I would need to do if insurance denied me coverage (file this paper, write this letter, etc). In the end, thankfully, none of it (well, almost none of it*) was necessary.
I have a few friends and family members who have shown interest in understanding, so today I’m going to explain how my new gadgets work.
Above are the devices I’ve been using for years now. On the top left is the insulin pump which delivers the insulin through a catheter (bottom illustration) into my body. The insulin goes into my fat cells, not into a vein. This temporary catheter is moved every three days so that you don’t build up scar tissue from your body trying to “heal” around the foreign object/catheter. Also, scar tissue would make it harder for the insulin to get absorbed into the body so it’s healthiest to remove it and reinsert another one elsewhere.
On the top right is the glucometer. I use a spring-loaded lancet (not pictured) to prick a small amount of blood from the heel of my palm (many people use their fingertips but holy good lord it’s painful!), add the blood sample on the little, grossly-overpriced test strip, and the glucometer tells me where my sugars currently are (ideally between 90 and 120).
That number is sent to the insulin pump by some technical wizardry, and I then use various buttons on the pump to tell the pump how many carbs I am about to consume. The pump will then combine the sugar level number with the units of carbs and come up with the right amount of insulin to administer (this equation is specific to each diabetic depending on their insulin sensitivity). I then hit a button to tell the pump to go ahead and administer that insulin.
I would also do this mathematical and button pushing process if my sugars were too high and I simply needed to administer some insulin to get that sugars down a bit. This is called bolusing.
Also important to note is that the pump gives me a microscopic amount of insulin at all times because that’s what a real functioning pancreas does. The extra insulin is required when I eat to keep the sugar levels in the right range (because every carb turns into sugar in your body).
I check my sugars every morning, almost every time I’m about to eat, and other times too, like when I’m about to work-out (if I’m not at 180 or above, I can’t work out because working out burns off sugar naturally and my sugar level is bound to crash), or I’m not feeling well and I want to know if my sugars have dropped or are really high so I can make adjustments.
On a typical day I draw blood to check my sugars three to eight times.
As mentioned, in order to administer insulin, I have to physically remove the pump from my waistband so I can access the buttons, etc. When I’m wearing a heavy coat and all my camera gear (which I wear on a belt pack), this is a real hassle.
Above are my newest gadgets. The black device in the waistband (which is not my waist, unfortunately) is the shiny new insulin pump. The little white piece that looks like a seashell is the CGM. The device on the right is a new and improved glucometer.
I check my sugars in the same manner with this new glucometer. It sends the info, the pump does the math, I tell the pump to go ahead and administer the insulin. One important difference between this glucometer and my old one is that I can use this glucometer to tell the pump to administer insulin remotely! Just last night I was driving and knew that my sugars were very high (because I’d checked a half hour earlier). I wanted to take a correction bolus and was able to administer it simply by pulling out the glucometer and pushing some buttons! It’s so much more convenient now.
The CGM, the thing that looks like a seashell, which reads my sugar levels from my cells instead of from a blood sample, is worn for a whole week straight (the pump catheter still has to be moved every three days). Once you put the CGM in using, basically, a spring-loaded stapler (try not to think about it), you have to check your sugars the “old-fashioned” way to calibrate the CGM. After that you calibrate it only once or twice a day, always once in the morning.
Once wearing the CGM, I won’t have to check my sugars as frequently as before. Why? Because the CGM is, you guessed it, continuously checking my sugars and sending the number to my pump. When I eat, I will still tell the pump how many carbs I’m about to consume and the pump will do its little mathematical equation and I will hit buttons to tell it to administer the insulin.
However, (and this is the game changing part) if my sugar levels suddenly drop (in my sleep for example, which does happen), or suddenly rise (maybe I’m stressed, or I eat something and forget to administer the extra insulin) the CGM communicates this sugar level change to the pump and the pump automatically gives me insulin or lessens the amount coming in according to what my sugars are doing. It’s like a real pancreas you guys! I haven’t had one of those in twenty years!
I’ve come a long way from putting insulin in a syringe and “shooting up” through my pants and into my leg (leaving behind tiny spots of blood sometimes) at a restaurant, that’s for sure. Science is amazing, and if anyone tries to tell you otherwise, they are simply wrong. And also, they’re not really worth talking to because WHO DOESN’T THINK SCIENCE IS AMAZING?! Idiots, that’s who.
Merry Christmas to me!
*I had to get a Prior Authorization to get my glucometer’s test strips covered.