By Gary Scheiner, MS CDE
How does a pump mimic a pancreas?
The human body stores sugar in the liver. Throughout the day and night, the liver releases small amounts of sugar into the bloodstream so that we always have fuel available to burn for energy. To help shuttle the sugar into the body's cells (and maintain the blood sugar at a steady level), the pancreas releases insulin into the bloodstream every few minutes. When we eat food that contains carbohydrates (sugar or starch), the blood sugar level rises quickly and the pancreas releases a large amount of insulin to prevent the blood sugar level from rising too high. The insulin pump is like the human pancreas by automatically releasing small amounts of fast-acting insulin (in tenths or hundreths of a unit) every few minutes. This is the basal rate of insulin, and it varies from person to person. Most people need increased rates of basal insulin delivery at certain hours and decreased rates at other hours. It is important to work with your healthcare team to set and fine-tune the basal insulin rates. The basal rate keeps the blood sugar level steady between meals and during sleep. When food is eaten, the pump is programmed (at the touch of a button) to deliver a larger quantity of insulin very quickly. This is the bolus of insulin. The bolus is designed to match the amount of carbohydrate in the food. Boluses can also be used to lower high blood sugar levels. With a pump, you get large amounts of insulin when you need it, and small amounts when you don't need as much. With a pump, the basal rate of insulin holds your blood sugar steady between meals, so you can keep whatever schedule you like in terms of meals, activities and sleep. In other words, a near-normal life.
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Holidays are tricky, no? Between managing diabetes among massive amounts of junk food, managing stress to manage bloodsugar among (sometimes) massive amounts of family squabbling, shopping stress and the like, and trying to get enough sleep and exercise in the cold winter months - it's a lot to handle. So I've got a two tier plan to keep bloodsugars at bay this year. Tier one - diet and exercise. Typically, at this time of year I do what I call the nutrition and gym...