Monday, November 16, 2015

Stick it to me..


Yeah, yeah..I know it's been awhile since I've blogged. I've been busy running a busy endocrine practice, raising two hoodlums and training all the dogs. Don't judge me. Just be thankful I have returned to the diabetes blogosphere AND during diabetes awareness month, because: timing. I'm a class act like that.

I have had type 1 diabetes for almost 24 years. I've had my ups and downs, ebbs and flows, "ohholyshitwhatthehell" a1c readings, and double back handspring with a twist results {disclaimer: I, personally, cannot perform said back handspring}. And you know what? Some of those results were on pump therapy, and some were while doing MDI {multiple daily injections}. Many in the diabetes world, both educators and endos alike, promote pump therapy, or CSII {constant subcutaneous insulin infusion}, as the gold standard and as the end all be all. Not going to lie, I used to be one of these educators. Pumps are great for better mimicking a physiologically working pancreas, and now with integration of CGM, they are getting better and better. Many studies support and tout the benefits of insulin pump therapy, and hey, I'm all for them...and wore one religiously for many years {my favorites are the Tandem T:Slim and Medtronic 530G...I also worked for Schmoni Plod as a Clinical Services Manager for a bit and wore one of their products}.

Close to 2 years ago I realized my weight had become an issue. I had given birth to two beautiful boys, gained close to 70lbs with each, took on the diagnosis of Hashimoto's, Celiac and Ankylosing Spondylitis following said pregnancies, and just really kind of let myself "go". Carbs weren't restricted, insulin flowed like a champagne fountain at your cousin's wedding, and I wasn't exercising. My glucose levels were good, but I was tipping the scales at around 235 lbs {see my pic with THE Gary Scheiner above at AADE 2013 Philadelphia}. I needed to get my ass in gear and I couldn't blame it on "the baby" any longer {he had just turned 3}.

Many of you are familiar with my love of Crossfit and low carb/high fat {LCHF} eating: it was these two things that helped me limit my insulin needs, which in turn lowered my insulin resistance and overall inflammation in my body. During my journey over the last two years I have lost around 80lbs, and I have never looked or felt better.


My weight hasn't been the only thing that has changed: so has my preference for insulin delivery. The more weight I lost and the more active I became, the less I enjoyed my pump. I wanted to wear more form fitting clothes, be able to do push ups without a device awkwardly poking out of my sports bra or stabbing me in the chest, I didn't like how insecure I felt about it at the gym and I didn't like having it on when wearing a bikini for the first time in years. So I made the switch to injections. At first I would flip flop between shots and pump, a couple of weeks here and there...then I would go for longer stretches. Now it's been almost a year since I took off my T:Slim, and I'm doing well on Toujeo and Humalog {I prefer the bouncy button of the Humalog KwikPen}. I do the best when I'm wearing my Dexcom, which I'm not the most compliant about, I'll admit. I have some pretty bad lows here and there, and they are stark reminders that this disease isn't going anywhere anytime soon, and that I can't, and shouldn't, ignore it.

I don't have to worry about bad pump sites, vampire cannulas, my dog ripping out my tubing, occlusion alarms, button errors, itching under sites or marks all over my body.
I don't have the bolus calculator {waaaaaa..maaaaath}, I don't have exact basal increments I can adjust, no temp basal feature, no extended boluses {this makes high fat/high carb cheat meals difficult} and no added benefit of utilizing 20% less total daily insulin.

So there you have it. The down and dirty of it. I guess I just get sick of the comments sometimes in regards to my lack of pump use {uhhhh, do you even pump, bro??} when I maintain my a1c goal just fine with injections. Some are just so judgemental and high and mighty when it comes to disease management. We are all just trying to win this fight the best way possible, and make it suck the least amount of suckage as possible. And honestly? Now that my boobs have shrunk so much, it's a lot harder to hide that damn pump..so lay off me!