Tuesday, May 18, 2010

1 Year on an Insulin Pump


A year ago I started using an Animas insulin pump. It's been a great year as far as blood sugar control goes; I can't imagine going back to just injections and needing to use 2 types of insulin!

It took a few weeks to get basal rates (insulin given to me constantly, 24/7) figured out so that I could get rid of predictable low and high blood sugars. Now we're down to just the unpredictable ones. It also took about a month of trying different infusion sets, tubing lengths, and insulin delivery speed to avoid leaky or tender infusion sites. The nurses at the UW Diabetes Care Center were comfortable enough with my knowledge of the pump and type-1 diabetes that they didn't have a problem with us going to Maine last June, shortly after getting my pump.

Since then, I've learned a few tricks that help keep blood sugars a bit more predictable.
  • Use Novolog instead of Humalog insulin in my pump. The Humalog can form tiny little crystals in the tubing, making the delivery amounts unpredictable.
  • Change the infusion set every 3 days. It's tempting to stretch it to 4 if there's still insulin left in the pump reservoir. Leaving the set in longer means it gets tender and could lead to infection.
  • If I can smell insulin, it probably means it's time for an infusion set change because the insulin that should be in me has leaked back out around the tubing. (This hasn't happened too often.)
  • Take my food bolus (insulin to cover the amount of carbohydrate I'm eating) about 30 minutes prior to eating so that I don't end up with a blood sugar spike before the insulin is absorbed and starts working.
  • Use the combo bolus for foods that take a while to digest (high fat, high fiber). This setting allows me to calculate how much insulin I'll need for the food, but then lets me choose how many hours to spread the delivery over, and how much to take immediately and how much to delay.
  • Use a temporary basal rate for exercising. I can tell my pump to reduce my basal rate by xx% for any length of time so that while I'm exercising I don't have to worry as much about low blood sugars.
I had a bit of a hard time deciding between the Animas Ping pump system and the Medtronic pump. In the end I chose the Animas pump because it comes with a blood glucose meter that acts as a remote for the pump. I thought it would be convenient to not be needing to pull my pump out from where ever I've stashed it in my clothing. I'm so glad I did choose it! It also lets me program smaller amounts of insulin than the Medtronic.

The only problems I've had with my Ping system are analysis software related. For some reason, neither my pump nor my meter like to predictably download the data stored in them for myself and doctors to evaluate. So far Animas has been pretty helpful, sending new software, cables, and a meter replacement as we troubleshoot this.

For a long time I didn't think I wanted a pump because I didn't want something stuck to me all the time. Now I'm so glad I did get one! It isn't that much bulk to carry. In the past year my HBA1C (3 month blood sugar average) has gone from 8.0 down to 6.5 and I rarely have crazy high blood sugars anymore.

Monday, May 17, 2010

13 Week Update

Yesterday officially marked the start of week 13 for our baby! We had an hour-long ultrasound on Friday that showed a healthy and on-schedule baby. We also got to hear it's heart beat for the first time! The ultrasound tech said it looks like a girl to her, (at 10 weeks we had a doctor tell us he thought it was a boy) so now we're waiting 3 more weeks to find out for sure. The little black part you can see in the middle of the baby's abdomen below is its stomach. The tech said that because we can see it, that means the baby has started swallowing.
Today we had an appointment with our regular OB, who will be delivering the baby. She said so far she's happy with lab results and ultrasounds. She explained that because a type-1 diabetic's placenta tends to age faster she will induce me between 38 and 39 weeks which means an early November baby.

Tom and I spent the past weekend working to tidy and sort through everything that has recently landed in our second bedroom. In the process of moving furniture around, we discovered that the crib we were given 5 years ago has a recall on it. We were already a little scared of it because anything the finish on the wood touched (exercise ball, latex wall paint, fabric) would get sticky and smell funny. It turns out the recall is because they have had problems with the slats breaking, but if we don't have to deal with a crib that is still off-gassing, that's a good thing! We had to gather all of the hardware, it's model number stickers, and a few forms together and mail them into the manufacturing company who will in turn mail us a crib voucher for its value to use at Babies R Us. The wooden parts we broke and threw away. So now we're looking at crib options!