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  1. Overly Sensitive

    Saturday 29 May 2010

    I've made no big secret of the fact that I use very small amounts of insulin. My ratios are tiny. I use 1:25carbs in the morning, and 1:35 in the evening, with only 3u of Lantus. Quite often this gets a huge reaction of -cue shockface- 'Whoa, those are TINY amounts!'. Yes, I realise that.

    I've always put my small insulin requirements down to the honeymoon period. But the idea has been recently put to me that maybe the honeymoon ended whilst I was looking the other way, and I'm just incredibly insulin sensitive. 

    Now there's a thinker. So far I've been approaching this whole thing with the attitude of 'it's awkward and frustrating, but it will end.'. The frustrations of carb counting with massive ratios, and feeling like there's not much that I can do to make any sort of adjustments. Even with a demi pen, it's a bit like trying to crack a nut with a sledge hammer. Or getting rid of adorable truffling pigs for a JCB. At any rate, similes aside, if this isn't going to change any time soon, I might have to do a massive rethink, and possibly a bit of soul-searching. 

    My control generally isn't bad. I have a HbA1c that I'm happy enough with (6.2% at last check), and according to my meter, I'm mostly on target. But I'm working hard to keep it that way. You all know this, you never stop working. It's tiring. 

    I've also not really hidden that I'm not amazingly keen on the idea of pumping. However, there's a part of me that is thinking that the tiny amounts you can bolus by would be a good idea. But I just can't shake the fact that I don't want to be tethered to something 24/7. It would just feel like a constant reminder of diabetes to me. 

    This is awfully vain of me as well, but I don't know how sexy I would feel with a pump. I feel sexy maybe 10-15% of the time, so I worry about diminishing that 10-15%.

    If anyone has any opinions on whether pumping is something I should think over some more? I have an appointment with my DSN coming up in the next month or so - I can bring it up with her then. But I'd just love some thoughts on the matter.

  2. 8 comments:

    1. Siobhan said...

      it's possible that it could be ending, but some people honeymoon for a lot longer. it's also possible that you're sensitive to it because your pancreas hasn't given up the ghost yet. i'm not sure what the stance is on pumps + honeymooning. ask about it - see what the guidelines are for honeymooners and pumping, and if you fit the criteria x

    2. Siobhan said...

      eeeek also wanted to say, pumping has to be something you are 100% certain about - so maybe best to stick to MDI for the moment. hopefully pumps will be available to everyone at some point *fingers crossed*

    3. Anonymous said...

      The thing with my pump is, after a certain period of time I just stopped noticing it. I barely pay any attention to it being attached to me anymore. Much like how taking shots becomes second nature, the pump does too.

      My husband also doesn't notice it, and generally neither do my friends.

      People at the gym and the pool and people I don't know however, do notice the infusion sets but it has come to the point where I just use them staring or bringing it up as an opportunity to educate them on diabetes.

      For me, it makes life a lot easier but everyone is different. I'm not sure how it is over there, but here if I decided I didn't want to pump, I could go back to MDI, not a big deal. Michael over at The diabetic's corner booth (http://thecornerboothcc.blogspot.com/) is currently taking a break from it (to revive some sites.) So I think its a good investment, but that's just my personal opinion. Oh, and a big plus for me is that it calculates out the bolus for me depending on the time of day and the grams and my ratios. It just gives me one less thing to have to think about, diabetes wise!

      Good luck with whatever you decide!

    4. Anonymous said...

      I think deciding to pump is a very personal decision and one only you can make. I understand that it's not easy - there are pros and cons to both. You just need to decide what's important to YOU and make your decision from there.

      As far as insulin sensitivity, Caleb was on a TDD of less than 2 units (total bolus and basal) when he started pumping. It was reason for concern. Everyone is different, but his insulin needs increased quite a bit when he started pumping - the long lasting just seemed to "soak" things up and the fast acting works differently. I realize you have not stated that as a concern - you are looking more to the precise dosing that will help you, and I agree, that is a huge advantage of pumping. But also, the margin of error is much greater when pumping bc you don't have that long lasting to fall back on, so the precision in dosing is necessary.

      I tend to believe in going with your gut on this one. Listen to your heart. Good luck!

    5. Jen said...

      I recently started pumping, and like you, I have a low insulin need - about half of what I was even on with MDI of NPH (because we are trying to get pregnant - no Lantus or Levemir) and Apidra - I am currently using about 15 units a day total for basal and bolus. I love being able to use the pump to give fractions of a unit for meals, so I don't have to eat up to the next unit of insulin as I was doing with the pen. After being on the pump for almost 4 weeks now, I don't even realize it is there most times. Love having the insulin and the capability to bolus right with me - anywhere, anytime. No hassels. But as other people said - it is a very personal choice. I don't regret it at all.

    6. Alison said...

      Hi Becky. My first thought is what have you got to lose? If you try the pump and hate it you can always go back to MDI.

      That said, I've had my pump for 3 years, after 23 years on MDI and I wish I'd got it years ago. I hated the idea of being attached to something but it was never an issue for me once I started wearing it. It's made such a difference for me to be able to dose in 0.1 unit increments.

      For what they're worth, you can see some of my thoughts on the pros and cons of pumping here - http://www.shootuporputup.co.uk/2009/04/pumping-for-beginners/

    7. Anonymous said...

      Hi there,

      I have been a diabetic for over 20 years now and just went on the pump last October. It took me a long time to make that decision, for a lot of the same reasons that you have said. Now that i am on it, i love it.

      When I was trying to decide if I should go on the pump, I went to an informational session, and while there the rep offered to let me borrow a pump for a week to try it out-without the insulin-just to get a feel for wearing one. Maybe they would let you do that to? It is worth asking. Plus, including the CGM in there has been wonderful. I feel so much better now that I have my little CGM backup. I was testing upwards of 15 times a day, while I still test a lot, it isn't that much, and my fingers thank me for it!

    8. Unknown said...

      I think that it's good to check out pumping. It might help you with some of the sensitivity things - just in that you might be able to be more confident in the pump more accurately delivering small amounts of insulin.

      It can't hurt to talk more about it and learn, right?

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