Readers with a memory slightly longer than your average goldfish may dimly recall that I before I started on my pump I made some predictions about how I thought a pump might benefit me.Â So four months after starting said pump, have these predictions come true?
I mentioned that like most of the pancreatically challenged horde, my insulin needs vary throughout the day. I used to put in about twice as much Humalog in the morning as I did in the evening. I hoped that a pump will ultimately allow me to up the basal rate early in the morning, allowing me to smooth off that irritating post-breakfast high.
And this is exactly what has happened. My pump automatically ups the background level of insulin that dribbles into me while I sleep and then tails off during the day. This means I wake up at a good level and carry on throughout the morning without having my traditional before-lunch-hypo. Score one to the pump!
Basal rates (again)
I mentioned that during the week I lead a relatively sedentary life, sitting in my office and only venturing out into the daylight to grab a sandwich at lunch time. However at weekends I am, sometimes, a ball of energy â€“ long walks in the Pentlands, cycling, working through the long list of chores Katie has given me and so on. Hypos at the weekend were therefore much more of a problem.
Lantus just didn’t have the flexibility to allow for on-the-fly adjustments. However, the pump allows me to temporarily reduce the amount of insulin that goes in when I’m out of the bike, walking round John Lewis (a notorious hypo spot) and so on. After a bit of practice, I’ve got the amount I need to adjust my basals down to a tee. Exercise hypos are now a thing of the past. Score two to the pump!
We all have our diabetic food nemeses â€“ fish and chips, Chinese take outs, pizzas. I hoped that I could use dual wave boluses and other fancy pump things to help take account of dietary misery.
I tend to use dual waves occasionally but they don’t seem to have made a wild difference to tackling difficult foods. Maybe that’s because I don’t tend to eat them often and so haven’t had much practice. So we’ll call this one a draw.
I muttered about the crudeness of injections â€“ the Autopen 24 for Lantus could only do double units and the finest control you can get with a Humalog-filled pen is a half unit. My pump goes down to 0.1 of a unit. When combined with the wonderful bolus-wizard, tiny units really come into their own. You can really, really fine tune things. A definite score for the pump.
The cyborg thing
I wondered whether being attached to something all the time would be a problem. It’s not. I got used to having the pump within a few days. Even in bed. Yay!
A few other benefits of the pump spring to mind after using it for four months. Firstly I have far, far, far fewer hypos. Instead of being an everyday occurrence they are now a rarity.
I used to expect to have a hypo before lunch and before dinner â€“ it was just part and parcel of having diabetes. Now I realise with a pump I didn’t need to have all these hypos â€“ I could adjust basal rates and carb ratios to keep my levels just right all through the day.
As well as avoiding the misery of hypos, this also has had the added benefit that I now consume far fewer fruit pastilles, Lucozade and so on to combat said hypos. This has meant I’ve lost nearly a stone in weight. Bonus!
I’ve also found that using a pump in public is far more discrete and convenient. I’ve never been shy with injecting in front of other people, but just dialling up a few units on the pump is three million times easier than getting a pen out, pulling up my shirt and injecting. In fact, because it’s so convenient I bolus for tiny things â€“ like apples, oranges and other snacks â€“ for which I wouldn’t have bothered before. This inevitably leads to better overall control.
So the pump has given me everything I expected it would do and more. It’s a brilliant bit of kit that has given me much more flexibility in day to day life and has genuinely improved my quality of life (it wasn’t bad before, it’s just better now). So all-in-all double thumbs up for Englebert Pumperdinck!