*This was posted on my personal blog yesterday, Silver-Lined, but I thought I'd cross post it here. Also, why can't I make the font black? Also, sorry for the screwy font business!


Yesterday was my quarterly endocrinologist appointment and it went really well! As I mentioned here in the
past, I've become increasingly interested in getting both an insulin pump and a continuous glucose monitor (CGM). I got to discuss this with the diabetes educator whom I see every visit.


Side question for other PWDs: Do you spend most of
your endo appointments with a CDE instead of the doctor? I've only spent a big
chunk of time with Dr. L on my very first appointment. I've been back twice now
where I spend nearly an hour with her CDE (whom I LOVE) and then Dr. L comes in
for a few minutes to review what the CDE has determined. Is this typical?
Should I not like this? Basically all of the new treatment plan I'm about to
discuss was formulated by the CDE and then OK'ed by the doctor.


Ok, back on track. Of course the first thing I
wanted to know was my most recent A1C. This was my best number ever: 5.7! While
that shows tremendous improvement from my original diagnosis (12.5) and even my
last A1C from mid-April (6.3), what it doesn't tell you is that it's a result
of glucose levels ALL OVER THE PLACE. I had been waking up nearly every day
with a low, especially since I started my new exercise plan. Almost every
single one of my post-lunch finger sticks showed me too high. While I am
thrilled with a 5.7, I would much rather have consistent glucose levels with a
higher A1C. So, we're adjusting my treatment plan to make my everyday life a
little safer.


I had been taking 12 units of Lantus a day, at
bedtime, and that was it. This easily explains my high postprandials since I
hadn't been taking anything for my meals. I really preferred this one shot a
day thing to what I'm doing now, but I know that it's better for me this way.
Now, I'm taking a 6 unit dose of Lantus at bedtime and a 1 unit dose of Humalog
before every meal. This means 4 shots a day now. Ouch.


I started this new plan last night and woke up
with a much better number of 93 instead of my usual 60-65. I gave myself my
first Humalog dose before breakfast. This is such a small dose that it seemed
like I was injecting nothing. Trust me, the needle still hurt like always, but
it's hard to believe so little fast-acting insulin can counteract my 45
g/carbohydrate breakfast. Plus there was a fairly sizeable drop left on my skin
at the injection site. I suppose when I test in about a half hour, we'll see
how well it worked.


So, even though the shots are not my friend, my
CDE and endo both promised me this was the next step before getting a pump.
They want to see how these doses work for me. I was sent home with brochures
for three different pumps to try to figure out what I might think works best
for me.


Here are my choices:
OneTouch Ping

What I like about the OneTouch Ping: separate
remote for dosage, completely waterproof, very small basal increments
available.


Medtronic Minimed
What I like about the Medtronic Minimed:
integrated CGM system, the company has been in business for a really long time.


Here's the final one, the OmniPod. Although this
one didn't come with a great deal of information, it did come with a sample pod
(no insulin, no needles).


What I like about the OmniPod: no tubing! I know I
didn't say what I didn't like about the other two, but this one is easier since
I've been able to attach it to my body. It's big. It seems like it would be
trickier to conceal. I've read some reviews that mention if anything goes wrong
with the cannula (the catheter under the skin) you have to replace the entire
thing.


I put it on yesterday evening and so far it hasn't
been too bad. I have run into door frames with it a few times. It didn't
interrupt my sleep at all on my arm. It kind of hurt at first immediately after
I applied it. I guess my arm just wasn't used to an extremity like that. It's
not incredibly heavy, but I can definitely always tell it's there. Plus, it will
be heavier when it actually has insulin in it. I haven't showered yet or worked
out since I attached it, but so far the adhesive is working really well. Nick
has decided it's my on-off switch and he's not sure how he feels having a robot
for a wife.


At this point I think I'm leaning towards the
OneTouch. I've read several comparisons and reviews and lots of marketing
material. I'll still be doing more research between now and my follow-up visit
to the endo in two weeks. I know that two weeks from now I'll be so ready to
stop the four shots a day and just hook myself up to my new artificial pancreas.

Views: 10

Comment by Linzie Wohletz on June 30, 2010 at 9:15am
Congrats on soon to be getting a pump, its very exciting. I have been on my omnipod for almost 3 years and I love it, I cant really say anything negative or positive about any other pump as the omnipod is the only pump I have ever used. I have been D for almost 19 years and never wanted the tubed ones I felt they would get in the way of my life. Once I found out about the pod I jumped and was in like 3 weeks on the pump and on to a better stronger me. Never been better, but congrats to you again. I hope everything work out wonderfully for you!!!!

Linzie
Comment by Bradford on June 30, 2010 at 9:23am
Congrats on your lower A1c. But I understand that having a higher A1c with less "peaks" and "troughs" would be better. Or go for the best of both worlds and lower your A1c and decrease those peaks and troughs ;-)

As far as the pumps are concerned, I'm using the omnipod and love it. And on a side note, the sample pod is actually weighted to feel like it's got a full 200 units of insulin in it...so what you've got on your body is actually as heavy as it would ever be.

Every pump has pros and cons. I would suggest getting w/ your CDE to see about scheduling an appointment with all 3 of the reps (one at a time, of course). They should all have working models to let you play with the buttons, listen to their sales pitch, etc. I would just take the opportunity to see how you like each user interface, how you like the size/weight and the way each one would attach to you and/or your clothing, etc.

I think the pump will help you control your "swings" a little better because you'll be able to adjust your basal rates throughout the day, and then bolusing is super easy with any of the pumps, and takes away the issue of needle discomfort as well. Good luck!
Comment by Jasmine on June 30, 2010 at 11:19am
Thanks for the comments, Alan, Bradford, and Linzie! I really appreciate your input!
Comment by Richard P Cosgrove on June 30, 2010 at 4:46pm
Jasmine, sounds like my Endo's office. I started with the Dr on the first meet and greet and was shifted over to the APRN who has managed my D for the last two or more years. Last year I started on MDI, Novalog and Lantus only no oral meds for about six months and then was asked if I would like to go on a pump. Beginning this year I am seeing the Dr only and not the APRN. Not sure why maybe that's the way the do it or the Dr is not happy with my progress. I have my quarterly Endo visit in three weeks. I been trying to lose weight and my numbers have been much more in the target zone. Keep up the good work and good luck on your quest for a pump.

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