Getting Used to an Insulin Pump

Posts tagged ‘Insulin’

Let’s Have A Party!

Xmas Pump

Xmas Pump

You might have noticed it’s getting a little close to the Crimbleton holiday period, which is nice, a week or two off work and food, drink, presents and family time for most of us. With this in mind I thought I’d just give a quick update on a few things.

  1. Don’t forget it’s the NottsType1 Xmas do at Fat Cat’s in the city centre this coming Saturday (the 15th of December). If you happen to be the sort of person who uses Facebook then you can tell us you’re coming here. If not just roll up and start imbibing. There will be the customary blood tests at ten o’clock, highest BG wins, plus we’ll probably have some kind of long drawn out discussion about the merits of drinking and bolusing.
  2. If you went along you’ll know this already but last weekend was the inaugural-probably-to-be-Annual NottsType1 Quiz Night at the The Willow Tree Pub in West Bridgford. According to those who attended the night was a roaring success. Personally I think it may have been some kind of set up as Sam won and she doesn’t even live in Nottingham, however the night managed to raise us £158.00 which isn’t bad and may go some way to allowing us to continue to hold our meetings and events and frankly do the stuff we would like to do.
  3. Web-Monkey attended a pump clinic yesterday, not as much fun as it sounds! The topic was festive eating and it mainly consisted of lots of Type 1’s guessing how much carbohydrate was in Christmassy fare like mince pies, etc. A useful exercise and handy because it meant Web-Monkey could invite all those people to Saturday’s knees up too so we might just get some unfamiliar faces turning up.
  4. The first “Travels with my pancreas” story has been submitted to Alex, if you have no idea what I’m talking about it was suggested some while ago that the NottsType1 group produce some kind of publication on holidaying in far flung places with Diabetes, without giving too much away the tale is called “How I Met Your Mother” and is about five thousand words long. If any of you are interested in doing something like this and becoming a famous writer, published author, target of others’ derision then get in contact with us and get writing,
  5. In case I’m too lazy to write anything else before the 25th, have a Happy Christmas.

See you all on Saturday.

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Toothbrush, Boots and a Memory Man

Boots The Chemist...and whatever else they do these days!

Boots The Chemist…and whatever else they do these days!

When I have a shower in the morning I tend to leave my insulin pump in my dressing gown pocket and then plug myself back in as soon as I’m dry and have something to clip it on to again. You may wonder why I’m telling you this, don’t worry hopefully it’ll become more obvious as the events of today unfold!

I was busy doing some important stuff at work this morning and I’d not bothered making any lunch as I thought I’d have a quick trip away from my computer to Boots in town to grab something. Because it had been busy I hadn’t done a  blood test since breakfast time.

So, one o’clock arrived and I headed out in to the frankly unpleasant weather, swiftly walking the five minutes or so in to try and avoid getting too damp. I got to Boots, picked a “”Delicious” Cheese & Pesto Pasta Salad”, a packet of healthy-ish crisps and a bottle of Diet Coke, then I headed over to the dental bit ’cause I need a new head on my electric toothbrush. I paid up and left heading in to the Victoria Centre to find somewhere to sit and have my lunch.

First thing I did was look at the food I had bought to see how many carb’s I needed to wind up on my pump, I was a little upset to find that Boots have re-branded their “”Delicious” Cheese & Pesto Pasta Salad” so it doesn’t actually tell you what the carbohydrate content is. After searching all over the packet many times I resolved to guess at the contents and adjust after getting back to a computer that I could look it up on (Web-Monkey without his own smartphone – funny I know!).

I did a blood test, as I always do before eating. I was a little surprised to find my BM was at 15.6mmol/l. “Hmm, that’s a little odd” I thought, that new bread must have a lot more carb’s in than it says on the packet. Anyway I wound up the CHO and hit the bolus button to which I was greeted by a “communication error” message. I cancelled out and tried it again and it did the same thing. Then I had one of those moments when you realise what the problem actually is. I patted myself down and realised that the reason I was getting a communication error was because my insulin pump was about two and a half miles away in my dressing gown pocket at home!

I ran back to work, carrying my carbohydrate-camouflaging salad, crisps, drink and toothbrush heads, grabbed my keys from my bag, excused myself and ran to get the bus home.

I got home in a little under fifteen minutes, which isn’t bad going, surprised Deanne who works from home on a Monday, plugged myself in and did a blood test, I’d dropped a little to 15mmol/l, which must have been a mix of the residual insulin and the running to get the bus. Gave Deanne a quick peck on the cheek and ran out the door again.

Getting back to work I looked up the “”Delicious” Cheese & Pesto Pasta Salad”, (56 grams in case you’re interested), wound up the total on my pump and bolused as quickly as I could.

Sadly after being unplugged for about six hours my blood sugar hasn’t yet normalised and I suspect if anything I’ll get a sudden drop at about six o’clock this evening.

When I had sorted myself out to my own satisfaction I posted a message on the Boots UK Facebook page, and to give them their due they actually told me they would look in to a way of including all the details on the back of the packet, you can see my overly sarcastic posting and their responses here if you’re interested.

Anyway, it was a stupid thing to do and closely aligned with last weeks stupidity of bringing my insulin to work ’cause I knew it would run out before the end of the day but forgetting to bring a cartridge in which to put said insulin!

All in all I seem to be having a couple of slow brain weeks, I’m hoping it won’t last much longer!

Ooh, Pointy!

When I was at the clinic the other week for my annual pump check up I asked if I could try a different infusion set, because my stomach looks a little like it has a bad case of acne from the places where the needles have been. My pump is an Accu-Chek Spirit Combo and I’ve used the TenderLink infusion set since I got it because I thought having the bit that sticks in to me at an angle rather than at 90 degrees would be better for e.g. when I was playing volleyball and such like.

Anyhoo, I was given the only one they happened to have a few of laying around which was the Ultraflex, this one has a needle which goes straight in to you but is much shorter and (I think!?!?!) thinner than the TenderLink. Anyway I got four of them and so I used them over the previous couple of weeks, then last night I went back to the old standard.

I have put a picture of both below, the old one on the left and the new one on the right and I just wanted to say that the old one now feels like trying to stick Cleopatra’s Needle in to myself. Sadly I have about three or four boxes of the TenderLinks left and I don’t believe in needlessly sucking money out of the good old NHS so I’ll use them up first but when I next give those nice people at Roche Diagnostics a call I’ll be changing my standard order to the FlexLink infusion sets!

Accu-Chek FlexLink Infusion Set

Accu-Chek FlexLink Infusion Set

Accu-Chek TenderLink Infusion Set

Accu-Chek TenderLink Infusion Set

Ban(ne)d

Tomorrow night I’m trying out with a band, they want a guitarist and I kinda play guitar…badly, or at least I used to about four years ago. Here’s a picture to prove it:

Me, Playing Guitar!

Me, Playing Guitar!

As I say I’m a little out of practice and probably need a few go’s before I can actually play along with their music so I’m hoping they’ll be patient.

Anyway last time I lived the rock ‘n’ roll lifestyle I was using a pen to inject four or five times a day, I didn’t do carb’ counting and I frankly managed my diabetes by crossing my fingers and having a lot of hypos and highs so I’m hoping it’s going to be a bit easier what with all this modern technology I’ve managed to persuade the medical establishment to supply me with.

However What I do have now is of course plugged in to my belly 24/7 and also has a three thousand quid piece of kit hanging off me, this is why I’m going to have to think carefully about my set-up before I head out of the house tomorrow night. I think I’m due an infusion set change tomorrow night so I’ll probably do that before I go, this means I need to pick a spot…and a side of myself that will cause the smallest inconvenience in terms of catching cannula on sticky out bits of guitar or continually rubbing said guitar over infusion set and causing discomfort.

Further to this is of course the fact that I have experienced most things which come up in every day situations since getting the pump, however I haven’t stood up for a couple of hours with a frankly rather heavy guitar (I own one of these now) which weighs about nine pounds, that’s about four kilo’s if you’re a youngster! Also there’s the unpleasantness of hefting guitars, pedals and even worse amplifiers up and down stairs to practice rooms and back to your car afterwards.

So with all these things considered am I having second thoughts about going tomorrow night?

Don’t be silly,  I’ll just do a lot of blood test before, during and after and hope Im lucky enough not to stab a finger so it hurts when I press the strings down, if I do I’ll just have to live with the pain. I’ll just make sure they are all aware that if I play particularly badly it may be a mixture of nerves, not having practised properly for about three years and low blood sugar all combined in to an ear splitting wall of feedback and noise. Or maybe that’s what they want???

Wish me luck 😉

Wait for Me!

Some Food

Some Food

Today I am going to talk about something which nearly all of us Type 1 Diabetics have to endure, namely the discomfort that can be caused by eating with other people!

Some Plates

Some Plates

You meet your friends at a nice restaurant, or even just a pub or café for a bite to eat, you exchange pleasantries, hug kiss and generally try to think of funny things to say, you settle down at your table then pore over the menu until everybody has decided who’s going to have the crab, lobster or chicken nuggets. The waiter sidles over and takes everybody’s orders.

After twenty minutes and a couple of drinks you all breathe a sigh of relief as the food emerges from the kitchen, smelling like something you’d be quite happy to eat, of course the plates aren’t all brought out at the same time and invariably the last plate will be that of the Diabetic at the table.

You make a random guess at the amount of carbohydrates contained in your aubergine surprise, obviously failing to take into account the spoonfulls of sugar in the sauce, you grab your blood test monitor out of your bag, unzip the little case, attempt to prime the jabber, realise you need to put a new cartridge in, scrabble about in your bag again until you find another one, replace it then stick a blood test stick in to the monitor, only for the monitor to error out with some unhelpful message like “E3” or “LoTemp” or some such. Finally you get it working, stick yourself and bleed on to the blood test stick.

 

“2.3 mmol/l”

 

“Rubbish!” You go back in to your bag to find out your open packet of Jelly Babies has spilled and so you rub a couple of them on your trouser leg to get the fluff off before eating them. Finally you dial up the carbohydrate guestimate for what you’ve actually been served by the restaurant and inject/pump it in. You look up from your little world of Diabetes management and realise that at least one of your party has just finished a particularly amusing story concerning their trip to Beirut, another is just finishing their flambéed mushroom stroganoff and you’re just starting your meal.

Such is the life of the pancreatically challenged!

Of course this is a (possibly) exaggerated account of events as they often seem to occur but I’m sure I’m not the only one of us to always start eating after everybody else at the table. So what would I like to happen?

Well I’m not (that) selfish so I’m not after making everybody else wait until I’m done before they start eating, for one thing their food would probably be cold. I guess the main thing I want is not to feel like I’m always playing catch up, to be fair I could probably overcome a few of these problems by being better prepared and checking the state of my kit before going out, etc. however I’m not that well organised and so that is unlikely to happen.

What I would really like is not to have to think about it. “That’s never going to happen,” I hear you say but I’ve noticed a lot of articles on line recently about Continuous Glucose Monitors attached to insulin pumps and adjusting doses without interaction therefore I think it’s only a matter of time before my wish comes true and I’m able to just stick stuff in my mouth without having to faff about with little electronic devices.

Come on scientists, you can do it. If not for me then at least for my poor wife and son who have to eat with me at least once a day and endure my complaining and then watch as I try to inhale my food to catch up. To them I offer my most sincere apologies and keep my fingers crossed that the boffins get this sorted sooner rather than later!

90 Years and Counting

So, 90 years (and a few days) ago they managed to treat their first Diabetic patient with Insulin. Excellent! In honour of this I am not going to write very much myself but rather quote some other, more intelligent, people.

I thought it might be a good time to look in to how the discovery of insulin was made so here is a complete rip off from Wikipedia for those of you that can’t be bothered to type insulin in to the Wikipedia search:


An article Frederick Banting read about the pancreas peaked his interest in diabetes. Research by NaunynMinkowskiOpieSchafer, and others suggested that diabetes resulted from a lack of a protein hormone secreted by the Islets of Langerhans in the pancreas. Schafer had named this hormone insulin. Insulin was thought to control the metabolism of sugar; its lack led to an increase of sugar in the blood which was then excreted in urine. Attempts to increase the supply of insulin in patients were unsuccessful, likely because of the destruction of the insulin by the proteolyticenzyme of the pancreas. The challenge was to find a way to extract insulin from the pancreas prior to it being destroyed.

Moses Barron published an article on experimental closure of the pancreatic duct by ligature which further influenced Banting’s thinking. The procedure caused deterioration of the cells of the pancreas which secrete trypsin but left the Islets of Langerhans intact. Banting realized that this procedure would destroy the trypsin-secreting cells but not the insulin. Once the trypsin-secreting cells had died, insulin could be extracted from the Islets of Langerhans. Banting discussed this approach with J. J. R. Macleod, Professor of Physiology at the University of Toronto. Macleod provided experimental facilities and the assistance of one of his students, Dr. Charles Best. Banting and Best began the production of insulin—already discovered in 1916 by Romanian physiologist Nicolae Paulescu—by this means.


(Stop reading now if you’re squeamish!!!)

This is quoted directly from the Nobel Prize website:


In October 1920 in Toronto, Canada, Dr. Frederick Banting, an unknown surgeon with a bachelor’s degree in medicine, had the idea that the pancreatic digestive juices could be harmful to the secretion of the pancreas produced by the islets of Langerhans.

Banting and Best with a diabetic dog Banting, right, and Best, left, with one of the diabetic dogs used in experiments with insulin.
Credits: University of Toronto Archives

He therefore wanted to ligate the pancreatic ducts in order to stop the flow of nourishment to the pancreas. This would cause the pancreas to degenerate, making it shrink and lose its ability to secrete the digestive juices. The cells thought to produce an antidiabetic secretion could then be extracted from the pancreas without being harmed.

Early in 1921, Banting took his idea to Professor John Macleod at the University of Toronto, who was a leading figure in the study of diabetes in Canada. Macleod didn’t think much of Banting’s theories. Despite this, Banting managed to convince him that his idea was worth trying. Macleod gave Banting a laboratory with a minimum of equipment and ten dogs. Banting also got an assistant, a medical student by the name of Charles Best. The experiment was set to start in the summer of 1921.

The Experiment Begins

Banting and Best began their experiments by removing the pancreas from a dog. This resulted in the following:

  • It’s blood sugar rose.
  • It became thirsty, drank lots of water, and urinated more often.
  • It became weaker and weaker.

The dog had developed diabetes.

Banting and Best's laboratory Banting’s and Best’s laboratory, where insulin was discovered.
Credits: University of Toronto Archives

Experimenting on another dog, Banting and Best surgically ligated the pancreas, stopping the flow of nourishment, so that the pancreas degenerated.

After a while, they removed the pancreas, sliced it up, and froze the pieces in a mixture of water and salts. When the pieces were half frozen, they were ground up and filtered. The isolated substance was named “isletin.”

The extract was injected into the diabetic dog. Its blood glucose level dropped, and it seemed healthier and stronger. By giving the diabetic dog a few injections a day, Banting and Best could keep it healthy and free of symptoms.

Banting and Best showed their result to Macleod, who was impressed, but he wanted more tests to prove that their pancreatic extract really worked.

Extended Tests

A dog and a cowThe new results convinced Macleod that they were onto something big. He gave them more funds and moved them to a better laboratory with proper working conditions. He also suggested they should call their extract “insulin.” Now, the work proceeded rapidly.

For the increased testing, Banting and Best realized that they required a larger supply of organs than their dogs could provide, and they started using pancreases from cattle. With this new source, they managed to produce enough extract to keep several diabetic dogs alive.

In late 1921, a third person, biochemist Bertram Collip, joined the team. Collip was given the task of trying to purify the insulin so that it would be clean enough for testing on humans.

During the intensified testing, the team also realized that the process of shrinking the pancreases had been unnecessary. Using whole fresh pancreases from adult animals worked just as well.


So apparently it was a fairly gruesome bunch of experiments that gave all of us Type 1 Diabetics our lifeline!

Of course science has moved on a lot in the intervening years, for one thing most insulin is synthetic now and cultured in labs rather than being harvested from animals, thankfully most of the changes have brought enormous leaps in understanding and control for those of us sans-insulin. As the saying goes things can only get better!

Here’s Looking at You Diabetics!

Looking Ahead

Looking Forward

Well, new year new me! Actually that’s a lie I’ve not made any kind of resolutions and I don’t intend to change anything in particular, however I am quite excited as to what the next 12 months might hold for myself and all the other Diabetics in the world.

Personally I think the most exciting short term news is the fact that there are some serious jumps being made in CGM, that’s Continuous Glucose Monitoring, technology at the moment, I’m hoping that by the end of this year or not long  after we are going to be seeing the first commercially available CGM enabled Insulin Pumps, that is Pumps with a continuous feedback loop that monitors your BM and adjusts your insulin intake to compensate.

Of course like most scientific developments this could actually take a lot longer than it should and will need proper sign off by whoever the governing bodies are, however it will certainly be a big step, when available, to giving us Type 1s a fairly normal life (minus the obvious infusion set changes and being woken up in the night when your pump battery runs out, etc.)!

Next of course are the ongoing promises of some kind of genetically engineered “cure” for Diabetes, as far as I can make out at the moment the scientists are looking at a number of ways of doing this, for instance putting beta cells in one way membranes which carbs can get through but white blood cells can’t so they pump out insulin without getting destroyed. Another one is fiddling about with your existing biology to regrow the cells in your pancreas that do all the hard work (that they don’t at the moment). This is much further off and I think of all the things happening the First thing I mentioned here the “Artificial Pancreas” is probably most close to fruition and also most exciting for all of us.

The Notts Type 1 Diabetes Group is also steaming on with various members doing various exciting things, the next of which is apparently some kind of video performance thing (sic.) by the committee members prior to the next meeting but I’ll tell you more about that when I’ve had some more details myself. Also just a quick aside, I apologise for not updating the web pages, however it does tend to be a darn sight easier and less disruptive updating Facebook and Twitter so I tend to do those most often and leave the website for if there is anything specific that is worth putting on it!

Personally this year is quite a big one as Deanne and I have a trip to Australia for a month coming up in the not too distant future, the reasons behind this are several-fold but it’s mainly to show the Little-‘Un off to the in-laws, but while I’m there I think I might look in to what’s going on Type 1 Diabetes wise as it is always interesting to get a different perspective on things.

Other than that it’s business as usual, work is busy, life is packed with things to do including childcare, housework, open mic’ nights and attempting to write a novel. Apart from that of course it’s a breeze.

Look after yourselves in 2012, do lots of blood tests, eat well, drink well and most importantly have lots of fun!!!

🙂

Happy (ever so slightly belated) new year!

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