The Road to an Insulin Pump
My way or the highway… that’s what I heard from my diabetes educator, although not in so many words.
I was diagnosed with Type 2 Diabetes in 1978, wrongly as it turned out some 30 years later. I’m actually what they call Type 1.5 or LADA – Latent Autoimmune Diabetes of Adulthood. It is like what they used to call Juvenile Diabetes (Type 1), but has a very slow onset. And like Type 1, and unlike Type 2, LADA has an autoimmune basis where auto antibodies destroy the beta cells that produce insulin.
Wind back to a few years ago when I started thinking about an insulin pump. How would I get one? I was still officially Type 2 then, and government subsidies for insulin pump supplies only stretched to Type 1s. Without this subsidy, it would be a monthly cost of around AU$200. Not something I could easily afford. Yet I still continued to explore possibilities.
Earlier this year (2009), I was talking to my endo about ruling out any possibility that I had anything other than Type 2. It involved having a GAD Antibody blood test. Much to everyone’s surprise, including mine, it was strongly positive.
Then came lots of questions – when had I acquired it? Because of the time-span, had I actually had Type 2 first and then LADA? No one really knows. 80% of LADA patients are insulin dependent within 6 years. I was below normal but still producing some of my own insulin. Was I on the longest diabetes honeymoon on record or had I acquired LADA within the last 6 years? No one can tell me.
More questions than answers really, but one answer did come. This new diagnosis now put me firmly in the Type 1 category. Insulin Pump here I come!
So, last week I got the letter from my health insurance that they had approved payment for the pump. And last week I was also the most frustrated I’ve ever been – my diabetes educator (DE), who has little experience in pump-starts, is putting the cart before the horse and asking that I have perfect blood glucose numbers before I go on the pump, or she wouldn’t ‘allow’ me to have the pump on my tentative start-date in May. While it’s possible to have good numbers, it’s almost impossible to have them all the time, every single time you test. The whole point of going on a pump is to improve the blood sugar readings. The mere command had me foaming at the mouth. It’s not usual protocol from the many forums I went to and asked.
It’s a long story, but one that is still making me extremely angry that someone is holding me to ransom like that. There’s not another DE for miles around.
Be that as it may, I’m still on my way to a pump-start date.
After weeks of doing research, I settled on the Animas 2020 Insulin Pump. While I’m a tad worried about the capacity of only 200 units (as opposed to 300 in the rival pumps), the deciding factor for me was the hugely superior screen, and the luer locks on the insets.
My blood glucose numbers have been reasonably ok of late, but that hasn’t been without a great deal of hard work on my part, and severely restricting the carbs. It’s really the only way to keep on top of it. Dr Richard Bernstein explains it very well on his website and in his books. And despite his being against insulin pumps, I’m still quite a fan of his theories.
If you don’t eat huge amounts of carbs, then you’re only correcting small spikes in blood sugars. Less room for error, and less chance of hypos or not correcting properly. Least that’s the theory and is borne out by many with diabetes who do lower-carb.
I’m not saying that good blood sugars aren’t possible if you do higher carb. In my experience, it’s just not possible for me.
So, I’m testing and testing some more. I have my basal insulin just about right, and my mealtime insulin is right about 85% of the time. The other 15% is governed by who knows what? Definitely not by logic or any science that I know about. Some days I get it exactly right – insulin to carb ratio is spot-on. Other days, the ratio and my body, refuse to cooperate! I think the Sugar Fairy picks on me from time to time. I wish she wouldn’t!
