I’ve often felt like a sorry excuse for a Type 1 diabetic. I’ve avoided joining in on activities or conversation with other Type 1 folks—I’m going to type “T1” from here on out, FYI—for fear that I’ve be outed as the one who doesn’t fit in. I’ve long struggled with diabetes and have never felt like I’ve become an expert on it, but lately that changed. My perception didn’t change because I began going to the doctor on regular intervals or because I’ve invested in more medical technology that will improve my health. No, my perception was altered by actually entering into conversations with other T1’s. As it turns out, no T1 is the same. Our struggles are similar and we have the inside scoop into our very challenging realities, but none of us are cookie-cutter and because of that, our treatments will vary based on a number of factors. All this time I’ve felt like an outsider, but I’m not. I’m one of the group.
I’ve long known that diabetes must achieve Hobby Status in my life. It’s got to take up as much time as anything else I’m engaged in—and I haven’t been a fan of that reality because I don’t like diabetes. Alas, how many of us like every aspect of our lives? Yeah, that’s what I thought. Sometimes you gotta go what you gotta do, like it or not. My endocrinologist has encouraged me to use a continuous glucose monitor (CGM) for years now, but I hated the last one I wore. She assured me the new model was far better; I still dragged my feet. It wasn’t until another doc joked with me about my hesitancy towards trying anything new medically that I became determined to prove my docs wrong and dive on in to the new tech. No school this semester, so it seemed the perfect time to try something new. And furthermore, this something new had potential to really improve my longterm outcomes health wise.
In October I received my new pump + CGM from Medtronic, and in November I was trained on how to use it. I’ve used an insulin pump for all but five years of my life as a T1, so I’m used to that therapy. It was this CGM—which involves a transmitter and a sensor—that I had to learn how to place on my arm, tape down with one hand, and then connect to my pump. This sensor is really something. It’s a teeny filament that goes under your skin, put in place by a needle you then remove, and it measures your blood sugar via interstitial fluid—basically the fluid between fat layers. It’s not as accurate as a finger prick (or blood glucose, BG) but it will trend up and down following my BG, so it’s pretty awesome. Even better, the transmitter wirelessly sends the sensor glucose (SG) to my insulin pump every five minutes. So in November I learned about the CGM, put it on (myself!) with the help of two nurses, and then breathlessly tried it myself at home seven days later with an open manual, a lot of sweat, and some prayer. For anyone who’s keeping track, the sensor is usually worn on an upper arm, abdomen, or leg, and it lasts about seven days. The insulin pump site, on the other hand, goes in my abdomen and is replaced every three to four days. What’s that you say? You don’t like needles? Me neither. But yes, I willingly poke my gut, my arms, and my fingertips all the time. I’m sorry to be a little unfeeling, but I don’t care that you can’t stand your yearly flu vaccine. Suck it up, buttercup.
A few weeks ago I went into the next stage of life with my new pump system, and that is something absolutely amazing called Auto Mode. This pump is basically a sweet little computer and I’ve heard the word “algorithm” thrown out more times than I can count. From what I understand, an actual rocket scientist designed this thing, and what is now happening is that my pump decides how much insulin I need between meals and gives it to me in microboluses. The other day I noticed it gave me 0.050 of a unit. Uhhhh, WHAT. Teeny teeny doses. My reality is this: every single carbohydrate that goes into my mouth must be matched by insulin. I’m still in control of counting carbs and giving a bolus of insulin (via pump) at mealtime. But between meals, this super rad little pump keeps track of my SG and then counters it with the smallest increments of insulin necessary. Sometimes the pump withholds insulin. If I’m exercising or gave enough at lunch to last me awhile or if my SG is dropping swiftly, the pump with not give anything. And the sweetest part of the deal so far is that if I’m crashing (meaning I’m experiencing hypoglycemia and could, yes, die) the pump will suspend up to a few hours. This is lifesaving stuff. Automode has kept my BGs in between 100-120 most nights while I’m sleeping and that just blows my mind.
Non-diabetics tend to get more excited about this tech than T1s do. The reality is that my new pump system is a lot to keep up with. My brain is pretty devoted to figuring it all out right now, and I really don’t think I could train for a new job or be engaged in finals season while learning the new system. But I have it on good authority that I’ll figure it out and eventually it’ll require less of me. I say non-diabetics are more worked up because they are, and because they really don’t know what’s required to keep up with diabetes (unless they’re a parent of a T1 or an endocrinology physician or nurse), so their enthusiasm for our potential good health should be tempered by the fact that they don’t have to poke themselves a ton or get up five times for an alarming pump or fish the pump out of their bras during a nice dinner just to get insulin. It’s a weird disease, if I’m honest. What we T1s want most is a lot of support and understanding. A hug, a celebratory chocolate at the right time, a word of encouragement, a well-timed question about how things work—all of that goes a long way. And if you know the carb count of the cookie you just made? Well, that’s the icing on the cake. So to speak.
All that to say, T1 is CRAZY TOWN but I’m feeling hopeful. Lord willing, the tech will get better and better. I’m hearing a new transmitter is coming out soon, one that will replace the current version which is sometimes glitchy and alarms for dumb reasons. For the first time in a long time though, I’m hopeful about growing older, feeling better, and having more energy. I feel like I’m on top of this game rather than chasing behind it, and for me at this moment, that’s enough.
