Pump up the insulin!

It’s been about a month now since I’ve gotten my purple Minimed and I can’t say I loved it from the start. Like anything, it takes a lot of getting used to and sheesh, the first time I had it on was a nightmare.

I didn’t expect it to be as nerve-wrecking as it was. I’m a patient at Mercy Hospital in Chicago and the diabetic nurse who’s been helping me through this whole process is Beryl Larson. She’s a great woman; patient, understanding and encouraging. Anyway, I got it put in on Nov. 20. Beryl and my doctor, Dr. Uy, told me not to take insulin the night before.

Let’s step back a minute so you can possibly understand what I was going through. If you’re diabetic, you will. So before the pump, I was taking two types of insulin. The first, that I would take in the morning and in the evening before bed, was called Lantus. This insulin is a slow-acting insulin. You take it, most of the time, once and it slows the rate of glucose that your liver produces. Because, yes, your liver produces glucose (or sugar). Now, take another step back and look at it from a “normal” experience.

Your pancreas makes a hormone called insulin (which is what I was taking through injection). The hormone allows for your cells to use the food you eat and convert it into energy. When your pancreas makes too much insulin, your liver intervenes and makes glucose, so it balances your body out. Unlike diabetics who have to calculate everything, in “normal” bodies everything is taken care of. The cause behind why sometimes “normal” people feel weak or shaky is due to too much insulin and not enough food or sugar. See? Easy as pie!

Now let’s go back to my insulins. The Lantus is slow-acting and does not peak, which means using it will result in less cases of low blood sugar (hypoglycemia) and would work throughout the day, up to 26 hours in my body. Humolog, is a fast-acting insulin and started working a half hour after taking it. I would take this when I ate to compensate for all the carbohydrates and food I was eating. I was acting as my own pancreas, which is weird and takes a lot of time and practice.

Basically, after all of that, I wanted to explain just how often I was on insulin (all the time!) and what it was like not to have it. Since I was used to taking Lantus the night before to help me out while I slept (my blood sugars used to run really high at night for some reason and result in a high blood sugar in the morning) my sugar was running on the high side. I didn’t have any insulin at all running through me.

I showed up at the hospital and I went through the whole process of changing and putting on the pump myself. Then we started it as the doctor had prescribed. Two units every hour, one unit for every 12 carbohydrates that I ate and that was it. Now, instead of taking two insulins, I am now only using one called Apidra. This insulin is another rapid acting insulin like Humolog, except that it works in half the time (15 min) after injection.

After starting up my little purple pump, I went to eat breakfast. I counted out my carbs and gave myself the appropriate dose, which by the way, the pump calculates for you. No more counting out unit to carbohydrate ratios! I then walked around the hospital and I could feel my blood sugar going up. This is when I begin to freak out.

I checked my blood sugar and it had gone up to the 300 range. A half our later it went up to the 400 range. Now, since I was used to just giving myself injections to control this up and down thing, that’s all I wanted to do. When you see yourself hitting those numbers, the first thing that comes to mind is, “Holy hell! Where’s my insulin pen!” The feeling is horrendous. I start getting headaches, my mouth goes try, I have to start peeing every 10 minutes and I get nervous. Mind you, the stress only adds to all of this.

So Beryl calls Dr. Uy. Dr. Uy says to just wait the two and a half hours for the insulin to be fully working. Beryl also reminded me that technically my body was catching up from the lack of insulin those hours before. After about five hours from when we first arrived, my blood sugar dropped to 245. Although it was high, I was never so happy to see a number like that before. “Ok, good,” said Beryl. “It’s dropping.”

From there on, I downloaded an app for my phone that allows me to keep track of carbs, medication, blood sugar readings and basically anything else I want. I’ve been back to see Dr. Uy and she changed my doses from what I started off with, which, I have to say, have worked a lot better.

From midnight to 9 a.m. I’m on a 1.7 unit basal rate.
From 9 a.m. to 7 p.m. I’m on a 2.0 unit basal rate.
And from 7 p.m. to midnight, I’m on a 2.1 basal rate.
I’m on a 12:1 carb ratio with a sensitivity of 40. Although I’m not always between 100-110, I may be at 120 or somewhere in the 90s which is exciting to see.

After getting used to it, I feel like I’m now at a new point of taking care of my diabetes and using this new (ok, new to me, old to a lot of other folks) is awesome.

Please let me know if you have any questions.