A day in the life of a pumper
By Sandy Struss
Making the switch from multiple daily injections to a pump was a little scary at first, and a whole new way of thinking about managing insulin. But within a few weeks, I got the hang of it and totally "got" what all the hype was about with pumping. The freedom and flexibility of pumping lets me live life the way I want—and on my schedule.
Here's an idea of what I might do on a typical weekday to keep my blood sugars in line, which will also hopefully give you an idea of what it's like to manage diabetes on a pump and to provide some realistic expectations. Speak to your healthcare professional about your personal treatment plan and regimen.
- Wake up: Test blood glucose (BG)
- Take correction bolus (only if necessary).
- Make breakfast, count carbs, take pre-meal carb bolus. Drive to work (office).
- Mid-morning: Test BG
- Take correction bolus (only if necessary). One of the great things about pumping is that the pump's Insulin-On-Board feature tells me how much active insulin is still working in my body, which prevents me from "stacking" insulin, and thus avoiding a low BG later.
- 12 noon: Count lunch carbs, take pre-meal carb bolus
- Lessen carb bolus by a percentage if doing 20-30 minutes exercise or going for a walk after lunch.
- Mid-afternoon: Test BG
- Take carb bolus for snack (and include any correction bolus, if necessary, using the ezBG feature).
- After work: Test BG
- If exercising, lower temp basal rate in anticipation of exercise (at least 30 minutes in advance, in my case). Eat snack if needed. Pack blood glucose meter, glucose gel, and candy and head out for evening walk or hit the gym. Test BG at least once during workout.
- If not exercising, then keep basal rate “normal” and only do correction bolus if necessary according to BG result.
- Dinnertime: Test BG
- If exercising, test BG post-exercise. Check that basal rate is back to normal.
- Count dinner carbs and take carb bolus (along with any ezBG correction bolus that may be needed). Consider reducing carb bolus by a percentage if it was a hard cardio workout and BG is in normal range.
- If out for dinner with friends, then the bolus routine becomes something I like to call "munch & punch": eat a bit of food, punch a few buttons and take a bit of insulin. Eat some more food, take some more insulin. The pump is an ideal tool for "grazing"!
- Before bed: Test BG
- Take correction bolus (if BG high post-dinner) or have a snack (if BG low).
On a weekend, my schedule changes completely and varies depending on what I'm up to physically. Generally, I like to sleep in until my body tells me to wake up, and then I'll get on with whatever my plans are for the day. If I'm doing something active, I adjust my temp basal downwards. If I'm just lounging around and reading or watching movies, then I'll keep my normal basal rate and bolus for the amount of carbs I'm eating. With pumping, I'm the one in control of what I want to be doing, and I don’t have to schedule my meals around timing of insulin.
For me, the real beauty of pumping is having the ability to correct blood sugars with micro-doses throughout the day, and to know how much active insulin is still "on board" at any given time. Carb counting is challenging at the best of times, so a routine of "test BG, best-guess carbs, take bolus, then correct" is what works for me. And there are so many other factors that impact blood sugar levels that it's never going to be perfect, but the pump is a sophisticated tool that gives me more choices and the ability to respond quickly as blood sugars vary throughout the day.
I was less inspired to make insulin corrections on a multiple daily injection regimen because each time, it meant another needle. Now I can make insulin adjustments as needed with the push of a few buttons!
About Sandy Struss
Sandy Struss is the Global Marketing Manager for Animas Canada and has had type I diabetes since 1989. She was on multiple daily injections on a wide variety of insulin regimens for 18 years until she started pumping in 2007.
Read her blog, Sandy's Corner.
The information made available on the Animas Canada website is not intended to be used or viewed as a substitute for consultation with a healthcare professional. The information provided on this site cannot be the basis for diagnosis or therapy. You are advised to obtain professional advice and should always discuss your treatment plan with your healthcare team.