I would be lying if I said that this isn’t the definitive time to be alive with Type-1 Diabetes. Treatment options, medications and education that definitely weren’t there even 50 years ago are a Godsend and reinforce the possibility that the lifespan of someone with condition is much more assured than it used to be.
Prior to the creation of insulin, the average person with type-1 Diabetes would typically die after 7 to 10 days, usually due to complications such as ketoacidosis. But despite all the benefits and available resources (which are not necessarily available to everyone, FYI), there are still significant difficulties that come with living with T1D. If I had a dollar for every person who told me how lucky I am to have an insulin pump, I could likely retire.
And while they’re quite right about how lucky I am, most non-Diabetics don’t realize the amount of work and effort required in order to maintain our health, despite all these benefits. Because I’ll tell you right now, even the best technology is NOT all it’s cracked up to be!
Let’s take the overnight odyssey I suffered last Monday as an example. Last Monday was a pretty typical day for me; work and errands in the morning, time with my son in the afternoon and some television and R&R during the evening before bed. I used Monday as a rest day, since I foolishly did a marine workout on Sunday evening that pretty much slaughtered my legs.
We had dinner, and as is often the case I miscalculated and boluses too much for the amount of food I ate. The end result was a low, which I treated but overcompensated. What followed was to be a night of sweats, nausea and lack of sleep…
Here’s the logbook entries for the end of Monday night, as taken from my Freestyle Libre. My family and I had dinner around 5 p.m., which would explain why my slightly elevated blood sugars started to go down within the next hour. At 6:38, I realized my blood was starting to drop. I retreated to me basement office, where I indulged in a handful of fast-acting carbs.
Usually, it works like a charm so I gave it time and thought nothing further of it. About forty minutes later, I checked my levels again, only to realize that I was sitting at 3.8! It had tapered off, sure, but it was still too low to safely sit at. So I suspended my pump and wolfed down more fast-acting carbs, uncertain of how much insulin beyond what was required I may have coursing through my system.
At 9 p.m. we were getting ready to crash for the night, so I checked my levels again and realized that I overcompensated and was now at 14.2, with the indicator arrow telling me that I was still climbing. I bolused accordingly and hit the sack, confident that my pump would bring my levels under control. I mean, why wouldn’t it? That’s what it’s for, right? Unfortunately, as convenient and effective as my pump may be, it’s still a mindless machine and requires direct human intervention to function. Adding to the fact that it’s prone to malfunction like any other piece of technology, it can make proper balance of blood sugars rather challenging.
Less than an hour later, I hadn’t fallen asleep yet so I checked again. I had continued to climb to 15.2, but the indicator arrow showed that I was levelling off and I still had a lot of insulin on board, so I went to sleep confident that it would be fine. It would NOT be fine… I woke up just before midnight, feeling flush and nauseous and checked my blood sugars again. I was sitting at 14.2, which was odd considering how much I’d bolused. Concerned I may overdo it and slip in the other direction, I nevertheless instructed my pump to bolus in order to correct. The pump indicated I still had too much insulin in my system and did not provide any further. Fair enough, machine! Take the wheel, I’m going back to sleep!
I tossed and turned for a few hours and may have slipped in and out, but I didn’t really get much sleep. I was awoken by the violent spasming of my pump and checked the alert, which indicated the worst message a pump user can see: “NO DELIVERY”. What the hell? I resumed my pump’s normal function and checked my blood, to see that I was still sitting in the high 14’s. I requested a bolus to correct. The pump began to comply.
Then, 2 units into the bolus, the pump vibrated once more and still provided the message “NO DELIVERY”. I wasn’t due to change out my set until the day after, and I still had a LOT of insulin in the pump. I made several attempts to get the pump to comply. After three attempts at trying to get insulin into my system, I finally surrendered and took a manual injection, the old fashioned way.
I performed a “FILL CANNULA” to see if insulin would drip freely from the infusion set, which it did. I reset the pump to continue with its normal basal rate and tried to get back to sleep. I tossed and turned, washed some Netflix on my iPad and got up for the dreaded Diabetic cycle of drink, pee and repeat. I may have snoozed off and on from sheer exhaustion, but I awoke at 8 a.m. and found my blood sugar to be sitting at 19.8! In the interest of preventing further complications and despite the waste of insulin and pump resources, I completely changed out my pump assembly and started a new infusion set.
I spent the next 8 hours (yes, you read that right) working on getting my blood sugars back down to a normal level. I was exhausted, parched and felt like absolute shit. I did a workout on Monday evening despite my fatigue, in order to help get myself balanced. The big problem is that I have no idea what caused the pump to stop delivering insulin, whether is may have been a bad site or bent cannula… who knows?
This simply goes to show that no matter the advancements, no technology is perfect and no two days for a T1D are ever the same. The challenges, issues and complications continue to pile up, even when one does everything as properly as they can. I’m hoping that my new pump system will help lessen and alleviate some of the issues, but until a cure is found, Diabetes is still a full time job. ☯