Replies to This Discussion

Permalink Reply by Kelly WPA on June 11, 2010 at 11:44pm

If you don’t check, how do you know if you have a problem with your pump or not? When you did MDI, unless you forgot to take your shot, you usually had some basal working in your system. If your pump dies, you have nothing and it is very easy for your BS to skyrocket in a few hours. Besides stuff like a bad site or other things with the pump, other things can affect your BS besides food. The only way you will know exactly what your BS is will be to check.

Permalink Reply by gw on June 11, 2010 at 11:57pm

you have to check your blood sugar or you will have poor control, no matter what method of insulin delivery you use. also, for me anyway, if i dont check my blood sugar 5-7 times a day, my insurance will not cover it.

the whole question doesnt really make any sense when you think about it; how would you know your basal rates and boluses are working if you dont test your blood sugar? this is not a "set it and forget it" kind of machine.

blood sugars can skyrocket in a matter of hours if your infusion set fails for instance. it is up to the diabetic to do what they can to prevent these emergencies, as so many diabetic emergencies can happen, and many are preventable and treatable with blood sugar testing.

also many factors influence blood sugar levels; diet, excercise, stress, hormones, etc, its not entirely exclusive to the insulin you take.

(i thought it was not necessary to check about 15 years ago, and my A1C levels hit a high of 13.5)

finally, insulin pumping is more work than shots in some ways, requiring closer monitoring of your blood sugars, and the reward of better control, and for the most part a better and hopefully longer life.

i can attest to this; much more than the conveninence of not taking injections 5 or more times a day, a more stable blood sugar means more stable life, emotions, and energy, but it is not the pump that does it! It is the person that DRIVES THE PUMP, like any machine.

not to mention the evidence that good blood glucose control is the only way us diabetics can have any chance at preventing the myriad of complications that go along with this disease.

in many ways, its a more complicated system that requires more focus, but its definitely worth it. frankly im surprised that anyone who has an insulin pump wouldnt have already known what it means to manage diabetes with one; didnt your doctor or CDE already take the time to explain this to you?

Permalink Reply by Jason K on June 12, 2010 at 12:10am

Because you're still diabetic.

That's really the bottom line. The pump is a totally imperfect, albeit high-tech, tool. It's not a cure, unfortunately. Until our bodies function properly on their own without intervention, testing is necessary.

Permalink Reply by Tom Gohl on June 12, 2010 at 9:09am

Robert-
Think about it this way. Before you became diabetic, your islet cells did two major things for you. 1) They sensed the glucose concentration in your blood stream continuously, 24/7. 2) When they detected a rise in glucose concentration, they immediately responded by secreting the exact amount of insulin required to maintain your blood glucose concentration within a very narrow range, about 75-105 mg/dL.
When you became diabetic, you lost the ability to secrete insulin and now must replace that lost ability with your pump. So your pump takes care of #2. However, you, with your eyes and brain, are responsible for #1. You need to measure your own blood glucose concentration so you can tell your pump how much insulin to deliver, in the same way that your islet cells formerly sensed glucose concentration and regulated their insulin secretion accordingly.
As is stated in other posts here, many things can affect this closed feedback loop. The primary problem I experience is infusion site absorption variability. From one day to the next, a given amount of insulin can have a widely varying ability to lower blood glucose concentrations. Also, hormonal variations with time of day, month, etc. can have an effect. Your level of physical activity may also greatly affect your sensitivity to insulin. Because of all these variables, there is just no possibility of an open-loop, pump-only system taking care of the entire problem. You, with your data collection and brain engaged, have to close the loop and make the necessary pump tweaks to keep the glucose concentration as centered as is humanly possible.

Someday, it may be that the pump and the sensors will communicate well enough, and bright minds will invent the technology needed to duplicate what our awesome insulin cells once did on their own. Until that day, our brains must close the loop!

-Tom

Permalink Reply by Robert on June 13, 2010 at 12:37am

Hmmm, Thanks for the informative responses people. In closing, I did not state not checking just the amount of checking is what I was referring to. I have checked my sugar three times a day (morning, afternoon & night) for the last month now since using this pump two months ago and my readings have hovered around (95mg/dL). I will check my blood glucose more frequently now thanks to the info, Have a Great Day!.