Tuesday, April 4, 2017

Update: The Pump Break Continues.

If you were to ask me what sort of insulin therapy routine I'm using these days, I would likely tell you I'm on MDIIIII... may never wear my t:slim again.

I'm just really, really loving not being tethered to a machine right now.

Before I first started on an insulin pump 11 years ago, I had been using Lantus for my basal (long-acting) insulin. My insulin resistance while sleeping, combined with some lovely dawn phenomenon, made for quite the challenge; one that Lantus never really met head-on for me - which had made me a little hesitant about ditching therapy that could be so easily tailored with custom basal rate patterns.

Tresiba, on the other hand, has been working really well for me. And when I mean "working really well", I don't mean that my blood sugars are always in range - they aren't. It does mean, however, that they seem to swing a little less violently than I remember in my pre-pump days.

  • My overnight readings don't see that gradual rise in the early mornings; if I'm in range, when I go to bed, I generally stay there (high-fat foods and/or alcohol still in my system, pending). If I'm high when I go to bed, I stay just that high. I marvel when reviewing my Dexcom graphs each morning. WHAT IS THIS WITCHCRAFT.
  • Previously when eating a higher fat meal, I'd use the extended bolus feature on my insulin pump to deliver a larger percentage up front, with the remaining dose spread out over a large period of time (two or three hours). On MDI, there are really just two options: give all of your dose at once up front and cross your fingers, or split up the dose and take it in two parts (one now, one later). Previously, I would have had to do the two-dose method... but on Tresiba, I've been just taking all of it up front, and somehow... it just works out. I don't know how. It just does. YDMV.
  • I'm not chained to the clock with my basal insulin, which had always been a struggle for me to remember (and then take the time to actually dose it). Because of some version of sorcery, Tresiba doesn't have to be dosed exactly 24 hours apart. They claim you can actually go up to 42 hours between doses... a claim I haven't fully tested, but I've certainly gone 28 hours in between, and didn't notice any ill effects from the delay.
  • And after 31 years of T1D and approximately 67,000 needle pokes, a few more each day really doesn't faze me. 

Insulin pumps work really well for some people - and they did for me at one time. I've always been a fan of "do what works for you", and not everyone with diabetes can (or should) use the same treatment. Options are healthy - both physically and mentally. :)