6 posts tagged “insulin pump”
Yay! We are live with insulin! Everything went really well at pump start today! Samantha has a kidney infection, so that complicates matters a bit as infection makes her more insulin resistant. But, we are doing good! Here are some pics.
This is Samantha's infusion set. She has 10 viable sites on each side of her tummy and 6 viable sites on each side of her upper tush. Having so many site options to rotate will greatly reduce scar tissue build up and site problems! The infusion set in this picture is a different type of set she will normally use. This one is called the Comfort Short and requires a manual insertion (using an introducer needle -- no cool little insertion device with this guy). We decided to give it a try so that we would know how to insert a different set if she does not do well on her prescribed sets. This set goes in at an angle and works great for kids without many fatty areas. You need fat for sub q insulin delivery! Luckily my kid has some padding so chances are the other sets will do just fine.
This second photo is the pump itself. We all started calling it Greenie before it ever showed up and the name just stuck. Although Samantha did inform us in the car on the way home that Greenie is in fact a girl pump. This home screen shows the name and current basal rate. Basal rate is the rate at which the small little doses of insulin are delivered over the period of one hour. This screen shows that she gets .7 units of insulin per hour this time of night. Since that .7 unit is split up into tiny doses delivered every 3 minutes, the actual doses delivered are insanely small.
Picture number three and four are her supply box and the typical supplies needed for one set change. The box is kept on the kitchen counter for quick access for treatment of lows and set changes. We decorated it together.
I guess I should mention what the insulin pump actually does for a person with diabetes for those not in the know. My pal, Jen, asked me about it on the phone tonight and I realized that in all of my postings I never mentioned what pumping is all about.
What is insulin anyway?
In order to accurately describe pumping, it is necessary to understand the basics of how insulin works in the body of a person without type 1 diabetes. For all of us without diabetes, our pancreas regulates our blood sugars by releasing two different hormones, glucagon and insulin. When going about your daily tasks, the pancreas lets out small doses of insulin constantly. It keeps the blood sugar range from going too high by increasing the insulin to turn food into energy. It keeps the blood sugar from dropping too much by releasing glucagon (this stimulates the release of glycogen from the liver), ultimately raising the blood sugar. The pancreas is a well oiled machine that keeps our blood sugar in really tight control. Even before we take a bite of food at a meal, our pancreas has already started delivering higher levels of insulin to balance with the food we take in.
Insulin is necessary to take every bit of food we consume and turn it into energy. But people who have type 1 diabetes no longer make enough insulin to turn food into energy. Without insulin the blood sugar rises to high levels and the body compensates by making you drink lots of water to dilute the level of sugar. When this happens no sugar enters the cells of the body and therefore it cannot be used as fuel. In response the body thinks it is starving because it has no sugar available for use in the cells. So it starts burning fat stores for fuel. The body literally starts eating itself. All of this makes a person with developing diabetes very sick. Without treatment this person would die in a very short amount of time (weeks, not months).
My daughter has been on insulin injections since she was diagnosed at the age of four. She doesn't just have one or two shots per day, she has more like four, and when she's sick you can easily double that number. I don't say this to complain or to make you feel sad, I tell you this so you'll understand what we currently are doing to keep her blood sugar in good control. For type 1 you cannot take a pill to treat diabetes. You can't just watch your diet and eveything will be oaky. You must take insulin or you will die ... soon.
The pump makes things so much easier. First of all, instead of getting poked with a needle four times per day, you only get a needle poke every other day. The insulin is delivered through tubing that connects to the body, called an infusion set. The other end of the infusion set connects to the pump, which is a small electronic device (the size of a pager or cell phone) that contains a reservoir with insulin. The computer inside the pump helps deliver small little bits of insulin throughout the day, very similarly to the way the pancreas does. So with the new pump, my daughter will get a super small dose (we are talking tenths of units here, folks) every three minutes. This function aims at keeping her blood sugars steady throughout the day. Because this is a machine and not an actual human organ, it doesn't work anywhere near as well as the pancreas, but it is much better than shots. In addition to the little bits of insulin delivered during the day (called basal dose), the pump also delivers a bolus dose.
A bolus dose is a dose of insulin that is delivered when the blood sugar is too high or at a meal (or snack) time based upon the amount of carbohydrates eaten. So right now if Samantha wants a couple of pieces of candy for a snack, she either has to take a pass and miss out on the Easter candy (because the insulin needed to cover that amount of food would be too small to administer via syringe) or she would have to eat a little more than a couple of pieces so that she could receive a bolus dose by shot. But once she starts on the pump she can have those two pieces of candy, enter them in the pump and the pump will deliver the right amount of insulin to cover those consumed carbs. When dinner time comes around we count up every gram of carbohydrate eaten and we input it into the pump. Based upon a bunch of calculations and definitions (I won't bore you with them) previously set up in the pump's computer, the pump recommends a meal bolus dose. We can accept the recommended dose or we can modify it. Similarly, when the blood sugar rises out of target range the pump recommends a correction bolus dose to bring it back into the preset range. Once the dose is accepted it is "pumped" out of the reservoir through the tubing and into the body.
The benefits of pumping over injections are many. First of all, there is a reduced risk of low blood sugars (which happen regularly with injections). Second, it keeps the blood sugars from fluctuating so much and if everything is set up correctly, it can lead to much better blood sugar control. Good blood sugar control reduces the risk for complications (blindness, heart disease, amputation, kidney failure, etc.). Anything that does that and allows my daughter more freedom with food and fewer needles, makes me a very happy mom!
This is a cute little video that helps illustrate what it is like to be a kid living with type 1 diabetes these days. I'd like to point out that this kid, Calvin, is on the pump. Not all kids with type 1 are on the pump, some kids, like my daughter still take insulin via injection. This means that most days my daughter will get 4 shots. When she is sick, she may end up getting as many as ten shots in one day. Luckily, we recently made the decision to start Samantha on the pump. We should be pumping in the next couple of weeks. Calvin has the same type of pump that my daughter Samantha will be starting on.
I love the way Calvin describes insulin as being a drawbridge. He really seems to "get it". Anyway, for those of you who know someone with type 1, or who mistakenly think that all types of diabetes are the same, or who are just plain interested you should watch this video, it is informative and cute and really well done.
Our beloved mean, green insulin delivery machine showed up today!!! I am so excited! I can't wait to show Samantha! I promised her that I would bring it up to show her at After School today. She is headed to her Dad's house tonight for the entire weekend so we agreed that she needed to see it before Sunday when she comes home.
I knew this thing was small, but I really had no clue how small until I held it in my hand. It just looks so much bigger in pictures! For comparison I took these pics on the left. I thought my cell phone was relatively small, but the pump is even smaller!!
One of the coolest things about this pump is that it has a glucose meter that attaches to the back of the pump and the two communicate with each other through infrared technology. When she puts a test strip into the meter slot the pump screen automatically converts to the glucose meter screen. Once her blood sugar is tested and the reading appears the pump then takes her blood sugar number and based upon pre-set guidelines it suggests insulin treatment if necessary. When she does this at mealtime all she needs to do is enter her total carbs consumed and it automatically calculates a suggested meal bolus based upon her food intake and blood sugar! I so can't wait to get her going on this thing!
Of course we now have to wait until April 6th to attend pump class where we will learn how to use the thing. It came with this GINORMOUS book, so I am sure there is quite the learning curve. Hopefully within the next month Sammy Sue will be a full-fledged pumper!
We decided on the Deltec Cozmore. It is a glucose meter/pump all in one and has so many awesome features that will make Samantha's life that much better. This pump comes in three colors: blue, green and black, she's going green. The pump should be here next week, so I will be posting pictures of the real deal then. I guess this means that I should get busy creating a pattern for a hip little pump case!
YAY!!!
So, we have set a goal this year to get my daughter started on the insulin pump. She was diagnosed with diabetes 4 1/2 years ago and it is about time we make life a little bit easier for her. We went to a pump basics class last night and after the class met with the pump reps. We've narrowed it down to two pumps:
The Deltec Cozmore: The Minimed Paradigm:
Aside from looks the pumps are pretty similar. They have most of the same features. A few of the features offered on the Cozmore are not offered on the Paradigm and these are features we would probably use a lot. Cozmore also has an awesome 24 hour replacement policy so that if your pump breaks, you are guarantied a new one within 24 hours. That's 365 days a year, holidays included. None of the other pump companies offer this guaranty. However, with the Minimed, you can upgrade your pump within four years if new/improved technology comes out. So if a new pump comes out with improved features we could trade our old one in and get the better pump. The other companies do not offer this option. Another purely asthetic thing that the minimed has going for it is that they make skins for the pump. This is pretty appealing for my third grader who doesn't necessarily like the boring colors the pump is offered in. Obviously we won't choose a pump based purely on aesthetics, to me the important thing is reliability and versaitilty, which both of these pumps offer in their own way.
I guess the only thing left for me to do is some research into user feedback to determine which pumps users seem happier and to learn about potential problems with each pump. This kind of thing is so frustrating for me because I know they are both really good pumps and in the end we will probably be happy with whichever we decide upon. But, this is a really important decision, too, and should not be taken lightly. Once you get a pump you are stuck with it for four years, so the decision better be an educated one. Her next appointment isn't until February 13th, so I have some time to investigate and work with Samantha and her dad (& step parents) to make sure we are selecting the right pump. Hopefully, I can find some good information from users to help me in my decision making. If anyone has any experience with pumps or knows of anyone with pump experience, please post a comment or forward my post along to friends that pump. All input is welcome!
