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. :)


  1. I have likely said below, that I love my pump. ( pumpee ). But I can see the point, to each ones own.

  2. I did the same switch and being free of a machine always tethered is very liberating!! I know exactly what you mean!!

    Still trying to work out how much "basal" I need daily, but I'm giving it my all because I am so much more comfortable now. Is there a group (facebook or other) you know of, that are doing the same??

  3. Oh good to know about Tresiba! I went on a pump break that lasted 4 years:) Lantus and I just don't get along so I'm back on a pump but I'm feeling tethered and summer is coming-heat makes me irritable about every single thing touching my body.

  4. Yaaay! Great to hear it's working out for you. Same here, though I'm a total slacker and so that's my own fault for not-so-good management in recent months. But when I'm on the ball doing what I need to, it's almost magical how well Tresiba does seem to work. I personally like the Afrezza combo, and I do use Novolog with it depending on my meals/time of day/stockpile of inhaled insulin left in the fridge. Anyhow, I do seem to do best when I stay within that 32 hour window, and see rising trends when it's longer than that. The only thing that bothers me is it seems like Tresiba "clumps up" a bit more under my skin, but that's not enough to change my love of it. And YDMV. Like you, not sure if I'll go back to pumping anytime soon or even at all, and am thinking about just waiting for a Dex-integrated closed loop. We shall see. Thanks for sharing, Kim!

  5. Hmmm...interesting. I've been pumping with Medtronic for 17 years now and have no intention of stopping. Actually, my warranty runs out in the fall, which should be just in time for me to get on the new 670G system--I'm kind of excited about that. However, if I ever want or need to go off of my pump I'll have to keep Tresiba in mind. Thanks for sharing! I miss your regular blog posts, but totally understand that you have more important things to do now--like keeping two tiny humans alive :-)