[Ariel22]

hi i'm new to the site, but i'm 22 and have had type 1 since i was 12.

lately i had a couple of bad lows that happened for no reason as a far as i could tell. (i had just eaten). it's made me feel paranoid and anxious all the time, and i think i've let my blood sugar become higher because i'm so afraid of it going low, or having a big drop.

whenever i see it in the 100s now, i worry about how fast i'm going to drop, and i know i shouldn't be doing that.

i also get nervous about food now and feeling pressured to eat has made me nauseous and just not hungry.

i told my doctor about the nausea and he's having me checked for some sort of nerve damage but he says it could also be stress. the only real stress i've had lately has been just worrying about this, though.

he also told me i should probably get on the insulin pump. does having a pump improve wildly unpredictable blood sugars? and does it prevent you from going low?

i almost got one in high school but i never followed through, i can't remember why now. it seemed like a bigger hassle, but the doctor says that's what everyone says but then they love it when they go on it.

what should i do?

[HollyB]

Hi,
Sorry to hear you haven't been feeling yourself lately. I'm sure people more knowledgeable than I am will chime in, but I just wanted to let you know that my son (turning 17) would HATE to give up his pump and go back to shots.

The pump won't prevent you from going low, but it will allow you to give more precise doses (like a tenth of a unit at a time) and change the way the dose is delivered for foods like pizza that tend to "hit" later (which might make you go low first, then high in a few hours). It also helps you calculate how much insulin is still working in your body when you do a correction so that you don't give too much.

This precision comes with a price -- you need to make the commitment to learn to use the pump's features to get its full advantage. And yes, my son still has high highs out of nowhere and lows (though no bad ones yet, knock on wood!).

If you are stressing out a lot about going low, you might also look into a CGM (continuous glucose monitor), especially if you have insurance that will pay for it. It will alarm when you are heading towards a low and also show you if you are dropping fast, which could increase your peace of mind.

Good luck with your decision, and I hope you're are feeling confident again soon.

[genie86333]

When you say you worry about your #s dropping to fast in the "100s" I hope you meant that as in between 100 & 110...not between 100 & 200! Because if you're keeping your numbers above 200 to avoid going low you may be doing serious damage to your body - that could cause serious issues MUCH worse than going low on occasion.

Yes, lows are scary/incovenient/yes even dangerous, but I'd say going blind, or losing a limb is even worse.

I know you said you've talked to your doctor about nausea & I hope he/she is able to help you out with that. You might want to talk to him about your fears of going low. He might be able to help you find a healthy balance. Maybe even the pump will help with that if you learn how to use it to it's fullest ability.

[mortis505]

Hello and welcome to DF!

What do you define as a low?

[Ariel22]

i guess below 60 is when i get spooked. that continuous glucose monitor sounds interesting. i haven't been told about those.

[Subby]

The CGMS is not so common to be covered by insurance/other plans to be affordable (hopefully that's changing), so it's important you work out if it's affordable first.

As for the pump, I echo sentiments here that a pump could be great, if you are prepared to "work with" your pump (it is not automatic, it just gives you a whole lot of ways to deliver yor insulin more effectively).

To answer your question does it improve wildly unpredictable BG's. Chances are it will make a substantial difference if you spend some time and effort to set it up correctly (meaning, some guessing, trial and error, to get the right settings for your body). For a start, you are currently on a long acting shot for your basal needs (between meals, overnight)? Your body probably does not have an entirely "flat" basal requrement through the day. In other words long acting can cause ups and downs because it is one rate through the day.

On the pump you can change that rate every half hour, if you wish. Most people find that at least 3 or 4 different rates through the day avoids problems that they could not get away from with long acting insulin. There is a straightforward way to work out good basal rates that will help, called basal testing.

Another thing about the pump to really help avoid lows and highs, is that you use carb counting to determine any dose any time. Do you know what I mean by carb counting? And of course it is easy to take many small doses through the day to cater for exactly what you eat, rather than a big flat mealtime dose. You can also easily take a correction dose if you are say very high. This is based on a "sensitivity factor" you put in that works for you (it might be, 1.2 units to come down 1 mmol/l or 18 mg/dl) and it can work how big an insulin dose is needed to get you back to normal levels again, you just give it your lcurrent level, it does the rest.

I know all this might sound confusing. They are examples of how a pump practically lets you control your BG better thank injections often turn out. It does bring it's own set of pains and trials and tribulations, but it's true that many find it really helps especially to irom out troublesome BG's like yours. Ask any questions you want, we'll do our best to answer.

[Ariel22]

thank you all for the information. i think i've decided that i really want to start the pump, but i have another question now.

about how long does it take to get really started and into this? i'm in my last year of college, but i have a feeling getting into this process is going to require me to miss a lot of school. especially because i commute to school from home, which is about a 30-40 minute drive each day.

the doctor's appts are all going to have to be during the week obviously, so i'm wondering....since i haven't been feeling well and it's probably important that i start on this right away...should i take a quarter off from school to work on this?

will it require that much time and attention? probably, huh?

[Psycho Penguin]

It depends how busy your school schedule is. Do you take a lot of classes? Can you work doctors appointments around the school?

Or, maybe you can hold off on it until you finish school, if it's a concern? It doesn't sound like you absolutely NEED the pump right now..

[HollyB]

There is a lot of fiddling to get the pump set up just right, but most of it you can do (after training) on your own while you work or go to school. My son started on his pump midway through March break, so he had about 4 hours of training, then 4 days at home and then was right back to school. You will have to spend more time than usual testing, recording, and analyzing your numbers, then making changes and testing again, till you get things nicely set up... so I wouldn't do this in the middle of exams or anything.

Pumps are also very expensive so if you are, for example, covered under your parents' insurance while you're in college, that would be a good time to make the switch.

If you're interested in this option, do some research on the features and how they work (the different companies will also send you info kits), look into your insurance options and talk to your endo about how to get the ball rolling. They may have a class they want you to go to or other training process. Are you counting carbs now? If so, the switch to pumping will be easier.

[Meghann0409]

I just started the pump (MM 522) on 12-29-08. I went to the Dr. that day, then 3 days later for the first site change. I have the next appointment 2 weeks out from the first day.

When I got the pump I "wore" it (without insulin of course) for a weekend to get used to the features and get used to using it.

Days 1-4 I called in numbers daily, then about 3 days later, and now I will call in again in a week.

Overall, its not been a bad adjustment at all. That said, I may be the odd ball out.

Just thought I'd share!