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October 22, 2016
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How Do You Want Your Insulin?

Over the last few months, I’ve considered going back on the insulin pump. Right now, I’m on MDIs with Lantus and Apidra and struggling more than normal. Years ago, I was on the Medtronic Minimed pump for 18 months and ended up going back to MDIs because of my frustrations. I absolutely hated the pump and the issues that I had on it. My A1c hit an all time low of 6.9%, but I was dealing with lows left and right and hypoglycemic unawareness that interfered with my daily life.

My other frustration with the pump was that I was attached 24/7 and couldn’t feel “normal.” I had a “beeper” on my belt or in my clothes at all times and couldn’t get away from that feeling that diabetes was following me everywhere. After having this disease for 20 years, I don’t want to feel like it’s stalking me. I want my freedom as much as possible. I don’t want people to ask me what that pager is for or stare at my infusion sets while I’m at the beach. The Dexcom is bad enough for that.

The pump that I’ve been considering is the new Omnipod. I received a demo pod in the mail a few weeks ago and played around with it on my stomach and on my leg. It’s significantly smaller than it was before, but it’s still bulky. Infusion sets really aren’t but the tubing always bothered me. For one, it got caught on things, stuck out of my pants or skirt, and didn’t allow me to feel as free as I think a tubeless pump would. However, I’m concerned that I won’t be able to wear the Omnipod in very many spots because of how my body has changed. I’m incredibly fit now that I’ve been teaching yoga and plan to keep that level of fitness up. My body is more muscle than fat. My pump real estate is limited. I’ve already seen some interference with my body change in the Dexcom. I wear it on my “love handle” area which is hardly any fat at this point. Certain sensors have gone in awkwardly and ended up causing me a lot of pain by pressing against my ribs or into other sensitive areas.

Today, I got all the insurance information on the Omnipod and determined that it’s in my current budget. But I’m struggling to make that final leap. How do I want my insulin delivered? Via syringe and bottle that doesn’t give me much flexibility and that I’ve forgotten in the past weeks since splitting my Lantus doses? That leaves me unattached and not concerned over real estate. Or do I want to try the pump again and give myself flexibility and constant basal? That requires extensive work (more than a unit here or there on Lantus) and attachment.

I honestly have no idea, but I do know that I can’t proceed in the way that I am as my A1c has jumped to 9.0% from 7.4% in the last three months. I’ve never seen that big of a jump and I have to say that my schedule change in the new job couldn’t come soon enough. My new schedule will require consistency in that Monday through Friday I’ll be working essentially the same schedule. I’m also cutting down my yoga classes to two classes per week rather than five to ten, which I think will help in some of my exercise induced highs and hypoglycemia fears. I want to maintain my practice and also start running again, which is a whole other post, but I know this will change my blood sugars.

My other concern in my new job is that I don’t want to feel restricted as far as boluses and necessary injections. I’d rather discretely dial up a bolus on my PDM or pump rather than pulling out the vial and syringe. For now, I do not want my employees to know about my diabetes. I have too much to overcome as it is. And I know that my schedule will include meetings, appointments, phone calls, and more that may prevent my timely injection of insulin. As an Executive Director, it seems better to have the pump and be successful in all efforts rather than risk my health for the job.

I continue to swing back and forth between my decision. I plan to sleep on it one more night now that I know the financial cost. If I start the Omnipod, I want to start it sooner rather than later and getting that ball rolling now is better than down the road. If you have any tips/suggestions/feedback, I’d appreciate it!

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