From MDI to Pump to CGM…

I was diagnosed with Type 1 diabetes in August of 1983. My CDE told me that 1983 was a good year to be diagnosed. So many positive developments and promises on the horizon. Well, nearly 29 years later much has changed and much has remained the same. I started out with 3 injections a day, multiple blood tests and lots of snacking. It was 6 small meals a day preceded with a blood test, an injection – if necessary – and the meal. As difficult and all-consuming as this was, in 1996 when my endocrinologist suggested that I would be a good candidate for an insulin pump, I resisted. It seemed that I had gotten into a routine that kind of worked and I didn’t want to change too much for fear the transition would be too difficult to adjust to and that I would lose time with family or work while I tried to adapt to my new paradigm (Medtronic pun intended!). So every 3 months I went to my endo and every 3 months he urged me to consider the pump and every 3 months I resisted. I didn’t want to be tethered to something 24/7 went my logic. I came up with every conceivable reason why the pump was a bad choice. I did this for 2 years and then finally in 1998 I decided I would give the pump a try.

I was so nervous the day I went to get trained on my new pump that I left the pump at home. My poor, ever-supportive wife had to bring it to me while I sweated out my nerves in the doctor’s waiting room. “This is a first!” my pump trainer said. All I remember is that she had tickets to see Springsteen that night and was anxious to get this pump training over with so she could get ready and go. I just wanted to stay with my multiple daily injections because that was something I was comfortable with. Well, as comfortable as anything to do with diabetes can be! In any event, I went through that training and almost immediately I began to berate myself for having waited so long to go on the pump. It freed me up in ways I would never have imagined. Counting carbohydrates along with bolus and basal was such a liberating way to deal with food. Before I felt so restrained to the “diabetes diet” that I tried to eat the same thing at the same time every day. No more! That was truly just a fantastic new way to control my diabetes. I embraced counting carbs, exercising, eating, adjusting basals, giving boluses and the best was that I didn’t have to do an injection except for once every two to three days when I changed my site. So I embarked on this new liberating way to deal with my diabetes. It was around this time that I had my first milk shake in about 14 years! Granted, eating all that was forbidden became a new challenge of carb-counting and experimenting but this was a way to figure out what worked and what didn’t. I still couldn’t really eat Chinese food successfully. Pizza is still a problem and Mexican food? Forget it. That is not to say I don’t occasionally indulge in these delicious temptations. The best part about a high post-meal blood sugar is the ability to do an extra bolus to bring that sugar down as quickly as possible. Through all of this, MDIs and the pump I have maintained an A1c of 6.5. I am proud of that number but still feel as though it should be lower and I should be able to do that.

  So the next hurdle to bringing that A1c down a bit is the Continuous Glucose Monitor. I have resisted that for a time as well. I don’t want to worry about two infusion sites. I’m thin and don’t have a lot of real estate on my body for two things to be poked into me. But I am over that now and soon will be wearing a CGM and I will tell you all about it!

Stay well, in control and don’t let the beast beat you down. It is a long journey and we must take it one blood glucose reading at a time.