My current diabetes treatment isn’t quite the same as when I was first diagnosed. I no longer take insulin injections, but rather use an insulin pump to administer insulin into my body. It basically looks like an old school pager with a funny tube hanging out of it. That tube is connected to my body via a small plastic catheter at an infusion site on my stomach. On the other end of that tube inside the insulin pump is a reservoir of Humalog insulin.
Humalog is a type of fast acting insulin, like R. However, it is more rapid acting. Within 5 minutes of entering the body, it begins moving blood glucose out of the blood to cells. Its “efficiency” peaks about 45 minutes after injection and ceases any function after about 3 hours. R on the other hand takes about 45 minutes after injection to begin functioning at all. NPH, being a slow acting insulin, takes about 3 hours to start its job.
The strength of the pump is that it basically allows me to give myself tons of injections of tiny amounts of insulin. It accomplishes this by keeping that catheter in me at all times. Additionally, since Humalog is a fast acting insulin, if need be I can program the pump to alter my dosage with almost immediate results. With an injection, you have to either hope the amount of insulin you gave yourself earlier isn’t too much to incite low blood sugar (ie: hypoglycemia) or hope that it wasn’t too little to cause high blood sugar (ie: hyperglycemia), which may mean another syringe and injection. Basically with the pump, I have a little more inflexibility by way of having something attached to me all the time, but I get a little more flexibility in how I can treat my diabetes.
Now, to mirror the basal and bolus treatment I outlined with injections in the previous post, I administer insulin two different ways with my pump. The basal is done by continuously giving me insulin at a rate I program into the pump (usually quantified as a unit per hour, where a unit is scientifically recognized as 0.001 mL). This is important because sometimes you need less insulin at night than you do during the day or vice-versa. But ultimately it’s kind of a like an IV drip.
The bolus is taken care of by having the pump deliver extra insulin whenever I sit down to begin a meal. I do this by counting how many carbs I plan on eating and then using a ratio of insulin to carbs to figure out how much insulin to administer (eg: at dinner I give myself 1 unit of insulin for every 10 grams of carbohydrates I consume).
In between all of these measurements of insulin doses, I also have to keep an eye on my blood glucose with my (aptly titled) glucose meter. Ideally, I try to keep my glucose between 90-130 mg/dL (that’s milligrams per deciliter). That’s considered a roughly normal range and keeps me feeling all right without any symptoms of hypo or hyperglycemia.
There are definitely a lot of caveats and changes I make to this formulation given circumstances (eg: using my pump to treat glucose levels above 130), but basically this is my life with diabetes. I promise it’s not as bad as it sounds. If anything, I promise I can tell you the nutritional facts on just about any food you can throw at me. And it certainly hasn’t kept me from living a normal life.
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