I’ve been on insulin injections since I was diagnosed in 2002. I started out on syringes, Humalog and Humalin. I still remember my instructions for mixing the two at breakfast and dinner, “cloudy before clear”. I still remember the first night I tried to take an injection with my newly received insulin pens and realizing I never got a prescription for the pen needles, “how do you get the insulin out?” I have the daily management of used and unused insulin pen needles to an oddly obsessive compulsive science. I’ve minimized my diabetes footprint so well when I travel that I’m more worried about packing enough socks for a short trip. I’ve got this stuff down.
But it’s time to switch to a pump.
The primary impetus for joining the pumping contingent lies primarily with the featured picture above, that recurring Dexcom graph, and a devious mistress called Dawn Phenomenon.
For the longest time I’ve always dealt with rising blood glucose levels in the early hours of the morning. I’ve tried various approaches to my Lantus dosage to combat this, but nothing seems to stick. When I took a full dose at night I would go severely low overnight if I didn’t supplement that injection with a snack. And the Lantus never lasted the full 24 hours despite the marketing. I’ve tried splitting my Lantus across mornings and evenings but the same super low occurs between 1-4am, followed by the same gradual climb from 4-7am. (All of this occurs without my doing anything, which is dependably frustrating.)
More often than not, I end up chasing these highs for most of the morning. Chasing highs often leads to sweeping lows. Sweeping lows often lead to overcorrections. And so on and so forth. This approach is a bit chicken and egg-y, but if I can solve the morning stuff I believe the rest of the day will fall in line.
The solution to the 4-7am part is obviously to take a correction injection of Humalog. But I’m not a fan of regularly waking up at 4am for a 15 second injection process. It messes with my chi.
In theory, an insulin pump should be able to handle the 1-4am bit (with a reduced basal rate), and the 4-7am bit (with an increased basal) like a machine. Because it is one. It should also help out with the minor corrections that I often delay because I still have a lingering hesitation with “wasting” an insulin pen needle on a 1 or 2 unit injection. It will also be a revelation to inject 1.5 units of insulin because that’s what I need, not 1 and wait, or 2 and cross my fingers.
There will be plenty of new to get used to, particularly the visibility of my diabetes far beyond what a Dexcom sensor on my arm can portray. And the idea of pressing some buttons and trusting a machine to do what it’s programed to do rather than hearing the click-click-click of an insulin pen hard counting each unit will take a lot of adjustment. But this change is for the better – I believe it.
I’m meeting with my endocrinologist at the end of August and one of my takeaways beyond learning her thoughts on social media and all that stuff will be a prescription for a T-Slim. I’ve already met with my local rep (they were in town for Scientific Sessions and I had some free time to explore the exhibit hall). The preliminary insurance paperwork has already been filled out and verified.
This is happening. I won’t lie and say that I’m not nervous, but this will lead to a healthier me. I know it.
More to come, naturally.