diabetes and the insulin pump
From our community blog:
I am a Type 1 diabetic since 1991. I have had two children and desperately want a third, but cannot face another pregnancy like the second due to severe hypoglycaemia that kept occurring.
I want to get a pump – my doctor did initially suggest it and I have asked for a referral to a centre that deals with pumps. I also would like to know what the chance of getting a pump on medical aid is if it is recommended by a doctor and if the medical aid is paying for CDE at the moment?
I am trying to control my sugars now but even tracking them 6-8 times a day, taking multiple extra shots when needed and tracking my diet closely is not helping.
The CDE has 5 pump centers in Johannesburg. 011 7126000. They also have an amazing 5 day course called DINE. Speak to Michelle Daniels.
I hope this may be of some help in resolving your control problems. I used a pump for 10 years and found it to be helpful particularly as you can control the long acting (basal) insulin for your individual requirements. You programme the pump to dispense whatever you need for each hour of the 24 hour day which will be exclusive to your needs.
A phone call to your medical aid should be able to tell you if they will support the purchase fully or partially. I stopped using mine because my levy on the consumables was increasing beyond reason.
It needs time and expertise to learn how to use the pump. I know we are all different but I believe that with the proper advise and treatment you should be able to get control before getting a pump. It will help your new doctor (it seems you need one) if you keep a record of insulin taken, food consumed, and exercise taken.
I’m a chairman of a support group, find one of these as they can also be very helpful.
If you met Shiara Pillay, a happy, healthy and confident 21-year-old who loves Art and is studying International Relations and Diplomacy, you wouldn’t guess that she had a chronic condition. But Shiara is a Type 1 diabetic. She just doesn’t let it get her down.
When did you find out you were diabetic?
When I was in Grade 4 and just about to turn 10. It wasn’t too horrible a diagnosis in comparison to some – my parents noticed that I was losing an extreme amount of weight, I was very dehydrated and waking up in the night to pee – all the classic symptoms.
Then one morning I threw up and they took me to the doctor. I was in hospital for a week and since then I’ve figured out how to live as normal a life as possible with diabetes. The hardest thing to get used to was not being able to eat sweets!
How has diabetes changed your daily life?
I think I’m obviously way more healthy than I would have been because I have to watch what I eat. I have a great diabetes team, and they’ve helped me to adjust my medication and my meals whenever I need to. I like the idea of being able to eat everything in moderation.
How does it help to have a community of fellow diabetics?
It helps to know that there are others in the same situation, it reminds you that you’re not alone. Youth With Diabetes really helped me to meet other people who have to think about the same things every day. I also think diabetes education is so important – new diabetics especially need to know what helps and what doesn’t, what you can eat, how you should exercise, how you feel when you’re low or high. It’s nice for me to share my experiences too. I do have bad days, it’s annoying to have to inject every day, but it’s just something you have to make the best of.
What advice would you offer to other diabetics?
Just do it – you can’t get out of it. If you look after yourself, it’ll be better for you in the long run, it’s for your benefit. And it makes you healthier too!
What makes your life sweet?
Just being happy – when things are going well and the sun is shining!
From the artificial pancreas to new ways of testing blood sugar and more, we take a look at the future for those with diabetes.
Diabetes is a rollercoaster ride of blood sugar ups and downs, and tight control can be hard work. But there’s good news: while some researchers are working on a cure, others are making life easier for those with diabetes right now, through technology.
Carine Visagie brings you a roundup of the top new technologies out there.
Continuous glucose monitoring (CGM) devices are soon going to take blood sugar control to another level.
With the help of tiny electrodes stuck beneath the skin, CGM devices allow for real-time glucose readings throughout the day. The results are sent wirelessly to a monitor you can clip onto your belt and access on the go, and some devices can even send results to your doctor. Normal finger prick testing is still required (for a double check and to calibrate the CGM sensor), but you can rest assured that a CGM device will alert you if your sugar spikes or drops below your limits.
Examples include the Flash Glucose Monitoring System (Abbott) and the Guardian REAL-Time Continuous Glucose Monitoring System (Medtronic).
Ask the expert: Dr Joel Dave, endocrinologist
“24-hour glucose monitoring is going to be very helpful in patients that have difficulty controlling their blood glucose levels, as it will provide a 24-hour 360-degree view of their diabetes control.”
Ask the expert: Dr Wayne May, endocrinologist
“I’m looking forward to the Abbotts Flash Monitor, as it will stay on for 14 days and doesn’t require calibrating with a second machine.”
Insulin pumps keep getting smarter: some of the latest ones sync with CGM devices, while others are incredibly accurate at giving just the right insulin dose at the right time.
One example is the touch-screen Tandem t:slim insulin pump, which shows the date, time, how much insulin is ‘on board’ (seeing this before you bolus can help you avoid stacking your insulin*), duration of insulin action, and the amount of insulin in the reservoir. It looks like a smartphone and data is easily transferrable via a USB port. Plus, it can deliver insulin in very small doses.
*Insulin stacking is injecting a second dose too soon after a first, without taking into account the insulin already in your system. This can result in low blood sugar.
Another insulin pump to watch is the MiniMed530G by Medtronic – the first pump to shut off when blood sugar goes below a predetermined level.
Ask the expert: Dr Joel Dave, endocrinologist
“Although an insulin pump isn’t the ideal way of administering insulin for everyone, many diabetics find a pump improves their diabetes control and quality of life. Since the addition of CGM, the use of this technology has improved even more, especially in children and patients with very erratic blood sugar.”
Bionic (artificial) pancreas systems are the next big thing in diabetes management. These systems, the first of which is still being tested, combine the latest CGM tech with the most advanced insulin pump tech and add a sophisticated computer programme to simulate the function of the pancreas.
The system constantly checks blood sugar levels by means of a CGM, and responds automatically by administering either insulin (to lower blood sugar) or glucagon (to raise blood sugar levels quickly) via two separate pumps. The system hooks up to a programme on your smartphone that makes decisions every few minutes, telling the pumps via Bluetooth how much hormone to deliver.
The bionic pancreas should be available in the next 5 years.
Ask the expert: Dr Joel Dave, endocrinologist
“The artificial pancreas has been the ‘holy grail’ for diabetes care for many years. The system has been vastly improved and early studies are showing great promise. Although not for routine clinical use at the moment, in the near future it will be a life-changing addition to the diabetes care of many patients.”
What about now? Smartphone apps for diabetes
If the future of diabetes tech seems too far away, keep an eye out for apps that can help you deal with diabetes right now, on your smartphone. We like:
Glucose Buddy: to track blood sugar readings, insulin doses, carb intake, exercise, blood pressure and weight, and
Diabetic Connect: helping you tap into trusted advice, friends, support and tips.
But be warned: many international apps use mg/dL, the US blood glucose standard, instead of mmol/l, the South African standard.
I am a Type 1 diabetic who for the first two years had perfect control. Then something happened… Life happened. I lost my control and actually started to feel like what’s the point? I gained ten kilos, my HbA1c is off the charts.
But I kept moving: running, yoga, spinning, aerobics, you name it. Eventually my lack of control or my inability to control my eating, my blood glucose and my life started to weigh down on me. I became depressed and burned out… And so I ate some more.
Over the past two months I have been on a journey into myself, I’ve read Deepak Chopra’s ‘Perfect Health’ and put my mind in a better place. I meditate daily and I believe that every moment, every challenge, every situation is as it should be. There is no reason why this shouldn’t be happening to me. This isn’t something that “happens” to people. I believe that I am my body and I am the energy I need to change things. I have started drinking water with two lady fingers and cinnamon every morning, eating according to some version of an Ayurvedic diet… And I am friends with my insulin pump.
The road is long but instead of asking why do I have to deal with this, rather I believe why shouldn’t I deal with it. I practice yoga and just last month I ran a total of 108kms. The path of least resistance is magical and as soon as we accept our circumstance, take ownership and responsibility, and instead of using our energy defensively by validating what people think of us, rather use that energy to liberate ourselves. We can create something beautiful.
My point – even though I really went off on a tangent there – is two lady fingers in half a glass of water, soak over night with some cinnamon. Drink it first thing in the morning. It is AMAZING!
This month, we welcome a new member to our Panel of Experts – Dr. Claudine Lee, a GP from Hilton in KZN. Find out more about her (as well as the rest of the experts) here.
Here are a few tips from Dr. Lee on how to manage diabetes well – and what advantages insulin pump therapy offers. Let us know if you have any questions for her!
Top tips for Type 1 diabetes good blood sugar control :
- Regular exercise – one sure way to keep things controlled (it must be a way of life).
- Correct food choices in terms of carbs, especially portion size and dosing correctly to “mop up” the carbs without any lows.
- Knowing if you are more sensitive to insulin in the morning or evening and adjusting your dose in connection with that.
- Knowing your numbers and testing, if you don’t know where your sugar is at you can’t respond to it.
- Being on the correct insulin to match your lifestyle/meals/exercise.
Advantages of insulin pump therapy:
- Getting rid of hypoglycemia (lows) especially bad lows.
- One prick every 3 days.
- Basal rate of insulin matched specifically to you, less insulin used (thus better weight control).
- Bolusing for meals is extremely simple and aided to control sugars exactly.
- Better control = better wellbeing generally.
- For the young: you can decide impromptu to stay over at a friend/function as all you have for the next 3 days for your diabetes is on your person.
I have extreme problems with high sugar levels. I was recently in Unitas Hospital where Dr Moolman recommended that I must get an insulin pump as soon as possible.
The problem is that I cannot afford one. I’m trying now to apply for one the Department of Health but are having problems there as well.
I’m 42 with Diabetes Millitus and its affecting my whole life.
Can you please give me some advice as to how to apply for a pump which I will be able to afford.
Thanx for your time,