Reasons I'm getting off the pump-and trying MDI for the first time - Ever.

Ahhh. Just got home from work. Walked in the door, said hi to the dog and bee lined for the closet to change out of my work clothes and get into my jammies. Its customary for me to do this routine as soon as I get home if I don’t have to go anywhere else for the evening. So comfortable.

Well, I meet with the CDE this week to discuss getting off the insulin pump and going to MDI. There are a couple of reasons for this-

1. The cost. Always high at the beginning of each calendar year until I meet my out of pocket maximum.
2. The adhesive is irritating to my skin.
3. I don’t always like having the visual “announcement” that I am diabetic. It is ALWAYS a conversation piece, whether I like it or not.
4. I don’t want the weird oval/egg shaped tan lines all over my arms/stomach/upper butt from wearing it all summer. The tan lines it creates are stuuuuuupid. Nothing like having white egg shapes all over. Or better- having to put a fresh pod with extra strong adhesive on sunburned skin.
5. I don’t like carrying all the pump junk around all the time.

Now here’s the thing. I’ve never done injections because I am afraid of needles. So two things might happen-

1. I might not be able to do the shots on my own out of fear of the needles.
2. I might not be able to manage my diabetes on MDI, because I use so little insulin at a time and the needles (even the kid ones) only administer insulin in either 1 unit or .5 unit increments. My endo previously advised me I would end up having to let my bg go higher and in turn, have a higher A1c. Because unlike a pump, where I can bolus in .05 increments, I wouldn’t be able to fix “small” highs, since I have a high sensitivity to insulin.
3. I like having the option of suspending the basal insulin when I am low.

So, it’s something I’m considering trying out for the summer and see how it goes. I can always go back to the pump if I change my mind. I’m a little nervous about the venture, because I am used to having really good control of my diabetes since its inception in 2010 and I give most of that credit to having the pump early on, which does most of the work for me.

I also need to briefly rant about my glucose meter. I am currently using a Bayer meter. I have both the Bayer Contour and the Bayer Contour USB. I am only using it until I finish up my remaining Bayer test strip stash (6 more vials). I started using the Bayer meter in October 2011 when I was forced to switch due to my new insurance only covering Bayer products (at that time). I had been using a couple different Freestyle meters for 2 years and LOVED them – everything about them. Extremely accurate, uses very little blood, doesn’t error out if you don’t put enough blood on the strip, and has a light at the test strip entrance so you can test in the dark-no problem. Well, I switched to Bayer by force and have disliked it. Everything about it is opposite of the Freestyle- the strips always error out, they are not accurate in comparison to my other meters (even the ReliOn brand I used for a while was more accurate), there is no test strip light, and requires more blood. Today was another example of why I can’t stand the Bayer meter. With clean hands (as always, I wash before testing), I tested my BG prior to eating a snack, which came in as 80. I bolused for 15g of carb. Literally 3 minutes later I felt LOW. I tested, and the meter read 65. I tested again, it read 60. I tested a 3rd time, it said 60. And my bolus insulin had not even hit my system yet. So I knew I was going to be in trouble. I treated the low with a juice box, then followed up with the snack I was planning to have.

This inaccurate blood sugar reading has been an issue with Bayer since I switched to it. I have been sent 2 different meters by Bayer because the two I had were so inaccurate that I thought they were broken. Too many times I would test- get one reading- then test again right after because it doesn’t match how I felt- and get a completely different reading. This didn’t happen with my Freestyle, at least not enough for me to ever remember or ever complain about it. I loved my Freestyle the 2 years I had it.

Luckily, when my insurance changed last October, it began to cover both Bayer and Accu-chek products. So I immediately switched to the Accu-chek Nano. I’ve had no issues with it. Unfortunately, I still have Bayer strips I need to use up, so I’ve had to go back to the Bayer for a while. I cannot WAIT to finish these off.

I sure wish my insurance would cover Freestyle… Oh well, Accu-chek is ok.

Forgive my rant but I think when you are making important decisions (with your insulin) based on your bg readings, those meters need to be accurate. And I’m sorry to the Bayer meter lovers out there. Your experience may be different than mine.

I haven't been using the Dexcom for while, either. I was wearing the Dexcom Seven, then I upgraded to the new one, the G4 last fall. But the cost is high and I really don't want to wear yet another device. And carry around another device. How many things can I wear on my belt clip before I'm considered a nerd? Anyway, for some reason, the CGM doesn't work great on me at night time. During the day, it works like a champ. But every night, even though I calibrate it according to Dexcom's guidelines, it goes haywire at night with crazy high (wrong) readings. All night, every night. I was turning it off at night and re-starting it in the morning, but it just got to be too much so I stopped wearing it. And again, I don't want the tan lines for summer. I have 12 sensors still so if I have the desire to put it back on, I will. And I have to be mindful that those sensors expire in kinda short period of time so I will need to use them up at some point.

I'm lucky to have these complaints- poor me, my diabetes is so well controlled right now that I don't need the pump or the CGM- wahhh wahhh. I hear ya. It goes in phases, just like yours, where it behaves for awhile. It's been pretty good for a while now, since I switched to the Paleo Diet last November. It made a HUGE difference in my bg trends.

Ok well, I'm off. I have some work to do and I need to watch Mad Men from last night.