Pumping 101

We get a lot of questions about V’s insulin pump. How does it work, exactly? Does it do everything by itself? Does it do our dishes too?

Meet the Omnipod:

IMG_2572 IMG_1811

It has a remote control, aka PDM (Personal Diabetes Manager) that acts as a meter, communicates with the pod, and is essentially the brain of the pump. The pod is attached to the body by an adhesive and delivers the insulin subcutaneously via a cannula. Check out this page that explains exactly how everything works, and make sure to click on the “Watch just how easy it is” link to see a brief video. The pod needs to be changed every 3 days, which is a huge improvement from having to give multiple daily injections. Is it virtually painless? Not according to V. She says that insertion hurts, albeit for just a few seconds. Still, one “shot” every 3 days is far better than a minimum of 4 shots every day.

I wish the pump would do everything by itself. One day it will, and it won’t be a pump anymore – it will be an artificial pancreas. But for now it goes like this: V checks her blood sugar. The pump asks her if she is going to eat and if yes, how many carbs. After that, the pump uses a formula determined individually for each person by their doctor to calculate how much insulin to deliver to cover the food or to correct for high blood sugar. Aside from bolusing or correcting for high BG, the pump delivers the basal (background) insulin via a continuous drip. It is waterproof, so V does not have to worry about removing it before taking a shower, swimming in the pool or when hanging out at the beach.

The pump does not do our dishes but it does make our lives a lot easier. Besides the obvious ease of giving insulin to cover for food, there are other options that we use often. We are able to suspend insulin delivery if V is low. We are able to change the amount of basal insulin based on her needs. For example, we often decrease it for physical activity and increase it on days she is sick or sedentary (e.g. on a 5 hr cross-country flight). For meals that are high in fat and protein we are able to give some insulin upfront and then spread the rest over few hours. When V is asleep we are able to manage her insulin without having to wake her up. We don’t have to keep a written log as all records are kept in the PDM. We can download the data and view the patterns that can help us better understand what is going on.

On the flip side, the pod leaves marks on V’s body. There may be a mild rash from the adhesive or a little bump in the spot where cannula was inserted. One time V developed a nasty infection at the pump site – that is something that occasionally happens to just about any pump wearer. The pod had gotten ripped out a few times. It starts beeping an hour before it needs to be changed and keeps beeping on and off until it is finally changed. When something goes wrong it alarms and the sound it makes is very loud and obnoxious. We are always hyper-vigilant about losing the PDM. And because the pod is usually worn in a visible place, it makes V’s Diabetes more visible too, to herself and to others.

All in all, for us the benefits far outweigh the disadvantages. V has been on the pump for 10 months now and there has never been a time we wished she were back on multiple injections.

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