Category Archives: Insulin pump
I woke up low yesterday morning.
Which, ordinarily, is no big deal. It happens. I’ve been pretty aggressive with my pre-dawn basal rates, actually trying to program a Super Bolus into my regular basal pattern (jack up my basal rate really high one hour, then cut it down to almost zero for the next) so I wouldn’t need to play those games every day at breakfast. That hasn’t been working too well, but that’s not why I woke up low.
This is why I woke up low.
Apparently, for reasons I can’t remember, I decided to give myself a shit-ton worth of insulin at 3:25 in the morning. Without entering a BG. Without entering carbs. Just straight, unjustifiable Novolog.
I am guilty of a scary borderline-serious low this evening.
I say borderline-serious because I was still fully aware of what was happening around me, and because I never reached that confusing haze, also known as Telltale Sign Number One.
I say borderline-serious because my CGM was, at one point, showing a 54 mg/dl with double-down arrows.
I say scary because I felt fine – I had no idea I was so low (and going lower, with a full unit of insulin on-board from an earlier high correction). I would not have known if not for my CGM alert, and even then, I thought it was a false reading until my meter confirmed it.
Then the sweat caused my shirt to stick to my back, and my hand to constantly wipe my oversized (thanks, receding hairline) forehead. Then I really believed it.
Though I’ve been doing a really good job of keeping by blood sugars on the lower-but-normal side in the eight weeks or so leading up to Thanksgiving (I’m targeting a monumental A1c improvement), I’ve pretty much fallen off the wagon since Thanksgiving, so much to the point that I’m feeling lows when they aren’t really low, which has led me to trust my feelings more.
Sometimes, trusting one’s feelings is a good thing. When it comes to hypoglycemia awareness, it is not
It’s been quite awhile since I made the decision to keep the 530G/Enlite (pump/CGM) system. If you followed me through the process earlier in the year, you know it was not an easy decision. Not by a long shot.
But I gave it every benefit of the doubt during my trial, and the Medtronic team tried really hard to get me to like it. And you know what? It worked. Over the past several months, I’ve really grown to like the system and have been very comfortable with my decision.
The sensor works well for me, and I understand how to make it well. The pump is comfortable and familiar, and talks to all of my other devices. The CGM is not as lumpy as its biggest competitor, and when I get out of the pool or ocean and back in range of the receiver-pump, it backfills the last 40 minutes of readings so i know what’s going on. The ISIGs give me a window into the CGM’s workings and lets me know if my sensor is performing well even if it’s got a bad calibration. The proprietary non-Luer connector makes the reservoir easier to fill than with the more common method. The pump’s raised blister-like buttons make it easy to operate without looking at it (don’t try this at home). And the clear/white case gives it a cool and modern look that I had never before anticipated – nor cared about. And CareLink!
Try to take it away and replace it with another pump or CGM, and you’ll be in for a fight.
And now, after all of the angst and turmoil of my trial, they’re telling me I can’t keep it.
They is my insurance company — an insurance company that has treated me fairly since I first got on one of their policies 17 years ago. I’ve changed employers, plans, and coverages, but always were fortunate to have the same company administering them. They, through my current (wife’s) employer-sponsored plan, have been really good at providing coverage to keep me healthy rather than simply keep me alive until the next open-enrollment period.
When I was first diagnosed with diabetes, I took one insulin injection a day: a little bit of Regular and a little bit of NPH mixed in a syringe before breakfast. That quickly shifted to twice a day: before breakfast and before dinner.
I had a glucose test kit that stayed in the school nurse’s office. In 1981 (1st grade, diagnosis), it was a urine test, in 1991 (11th-12th grade) it was a blood test. But it was there, not with me.
The only thing I carried around with me everywhere I went was a little box of Sun-Maid raisins, in case I felt low. Or maybe a roll of Life Savers, which always ended up permanently stuck to the paper wrapping (and each other) ensuring I had plenty of fiber with my low BG treatment.
At some point I switched to blood tests, first by holding the strip up to a color chart, and later by using a big, clunky meter. I took it with me on family outings, but I don’t remember ever taking it to school. All I took was the box of stale raisins to treat lows; or maybe a roll of Life-Savers, inseparably stuck to the foil wrapping and each other.
I don’t ever remember carrying a meter with me in school. In 9th grade, I had a late lunch period and consistently went low during my biology lab period before. But I fought through it like a
champ chump, traveling light.
I can’t remember if I carried a meter with me to class in college. Twelve years later after diagnosis, I was still on just two injections a day, each was a mix of Regular and NPH, taken before breakfast and dinner, with the Regular dose on a sliding scale that increased with my blood sugar. The scale matched the intervals on the old Chemstrip color chart: 180-240, add 1 unit. 240-300, add 2 units. 300-400, add 3 units, and so on.