I sometimes sit and reflect on the changes that have occurred over the last 25 years and there has bee only a few times over that period where the control of my T1D has become enhanced and the way I felt directly relates to the management method.
On MDI, I lived and I had control but I never felt as though I was in control. There were so many unknown's. For example over night and even during the day you have an insulin that releases throughout a 12 hour period. As well created as the insulin is it is extremely difficult (if not impossible) to fit the release times to what the natural body needs.. I would have half of my long acting insulin at night before bed and half in the morning. Unfortunately my body didn't need a standard flat line of insulin and I would have highs and lows through out the day and night. The way that those highs and lows would make you feel is just a constant level of tiredness and even cloudiness. It would be difficult to get out of bed because of the dawn phenomenon.
From here, and probably the first time in 16 years I felt I had control by moving from MDI to a pump. This allowed for the variable rates of insulin to be set and changed for what my body needs. It also allowed me to give insulin for the food I ate rather than feed the insulin I gave myself. This in itself is a major change and advance that saw you be able to make choices around eating and even missing a meal in specific circumstances. I remember the thought of being able to sleep in and not to have to worry about getting up at a specific time to give my injection and to eat. The pump gave me the ability for be flexible, change the way I was living, and start to take control of what was happening to me each and every day. As much as you can say that even on MDI that this is possible I felt from a mental point of view that the pump allowed me to cope and really understand cause and effect and give me the means to change.
Through out the early days of being on a pump my Endo informed me that they had a device that could monitor your blood sugar on a regular basis (every 5 mins) and then at the end of a few days it could be taken off and downloaded to see the peaks and troughs of how the insulin settings were preforming. This was another tool that allowed greater confidence in my life with T1D. It was well and truly something that I could only use on a vary rare occasion to check how things were going and make some adjustments but it was another step in control.
If all of this isn't enough I then started on a journey were we were introduced to the Medtronic 640g pump. Fundamentally it has the same functions as my previous 2 pumps however this would see the first real step into automation.
Let me set the scene before I go any further, I like to have tight control and I like my HBa1C to be between 5.5 and 6.9. To be able to do this unfortunately I was having a number of lows through out the day. Some days I would wake up low and other days it would happen in the middle of the day. Now when I say lows this is when my BGL goes into the 2's. I can manage and get through high 3's and 4's without any effect (and yes it meant treating) but the 2's would make a difference and I will go into that later. The lows were not welcome however I needed the control and after having T1 for 25 years it had been working well and I have no other complications due to T1D (I am tapping wood right now as I say this).
Anyway back to it, yes fundamentally it was the same however combined with a Continual Glucose Monitor it now had the ability to predict a low and shut the pump off so that you change the curve of the low and stop the serious lows from happening. As with all technology it would take time to trust that what they were saying was in fact true however after only a day or so where both my daughter and I stopped having any lows in the 2's it was the next stage in my life that significant changes have had a dramatic effect on the way I feel and the way we can have confidence that both my daughter and I will be safe.
Without the 2's that I was having I finally realized the effect that they were having on me. Thinking would become easier and the tiredness would ease. I realized that for hours after a low the cloudiness within the brain would act like a dulling agent when trying to process everything. With the 640g and without the lows the fog was lifted. This is not to say the going into the 2's is impossible because it just isn't. You can still miss calculate and you can make mistakes however the frequency of this happening is dramatically less for both me and my daughter.
The other thing that helped in making this change is that the pump moved from being a simple medical device that would be difficult for everyone to understand and operate to a device that almost acts like a user friendly device that you need to know just a few key words and then follow the directions that it gives you. We put this into practice when training my daughters Kinder teacher who had never had any exposure to T1D at all. After a 2 hour basic session with our diabetic educator to understand what it was and what it meant if it wasn't managed we then introduced the pump. Reponses from the teacher and the assistant was that it was easy to see what is happening at any one time and that they had confidence that managing our daughter's condition would be simpler knowing that this pump was in place. We would continue to hold the teachers hands over the coming weeks however that is always going to happen. We send our daughter to kinder now knowing that the pump will alert people if there is a problem and that we can rest assured that things will be ok and she will be home at the end of the day having a great time at kinder.
This has been a unexpected change that is extremely welcomed because the quality of life has and will continue to get better. I know it isn't the last change that I will see a however while on this journey I am now dedicated to finding the solutions that will make my life and my daughters life better.
Here's to the next 10 years and beyond.
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