Pumping vs MDI - A Case for Both

VS

I have just recently reintroduced my "External Pancreas" back into my life. Well,  at least on a more permanent basis then before. We now have 100 coverage for pump supplies. Need I say more.

So, as you all know, my last A1C was, not desirable, at 8% which means my numbers were running in the double digits over the last 3 months(Canadian values eh) 

I really have been a bad diabetic, well, lets just say I needed to improve my record keeping and do some serious analysis. I need to measure more frequently and stop eating crap when ever I feel like it, I feel like a big hypocrite some days when I am telling people to do the opposite of what I am doing or "Do as I say not what I do"

In any event, here I am analyzing my numbers, and now I understand why my A1C sucked!!  Okay, too dramatic, but let's just say I did not meet the recommended target of 7%.

My fastings are above 8 mmol(multiply by 18 for US)---Not good.

So I analyse:  Why are they high? (Glimpse into my mind)

-Too much fatty food for evening snack or meal?
-Not enough insulin to cover the food?
-Inadequate Ratios?
-Inadequate Basal?
-Am I sick? Nope.
-Am I stressed? No more then usual
-Am I exercising? Yup, didn't last night.
-Dawn effect, rebound from a low?  Don't know. 
-Am I due for a site change?  Is the site a good one?

Man, these are a lot of variables to consider. "Pumping is sometimes more work then it's worth" --- to quote my direct thought.

Options:
-Switch back to the MDI(Levemir/Apidra) or Stay on the Pump? This is a Rhetorical question, just typing out loud so to speak?

My argument for the Pump:
-Once I do the work, skip breakfast, test the basals, analyse ratios, eat properly, tweak, test, etc....it works, less lows, more of a match to my physiologic profile.
-On the negative it is a whole lot of work, I am not sure if I am up for it.
-Obtain some CGM sensor sets for my pump and really figure out my basals.
-Freedom from Multiple daily injections, once it's(pumps) settings are accurate it is a major time saver in calculating corrections and ratio's, which is a major plus.

My argument for MDI:
-Don't mind injecting, and you know the amount you inject is the amount you will get, as with the pump you have to consider age of the site, site integrity, is the pump flowing like it should etc.
-Less variables to consider. For example, if my before lunch is high, then I need more Apidra, if my fasting is high, is it food, dawn, rebound, or my bedtime Levemir dose.
-Carrying around my Apidra Pen is a pain, but not really, since I would not have my pancreas clipped to my belt.

Other things to consider:
Daily routine:  My routine is stable, Monday to Friday job, predictable exercise patterns, week-ends are a little unpredictable.  Pumping is good for fluctuating schedules and eating patterns, I am a predictable fellow.

As you can see I can justify both methods to control my blood glucose level.  Which will I choose?

Still thinking about it.

Trev

Have your Cake & Eat it Too

Meet Dareian;  my older Type 1 in our  house of  Diabetics.  She is one amazing teen!


Dareian the baker!

This is her story, and how she has learned to manage her diabetes through carbohydrate counting, glucose monitoring, and MDI so she can live life how she wants, not how Mr Diabetes dictates. 
Sure she still occationally gets abducted by aliens (See post) but she usually returns the same day.

We partook in a study here in Edmonton called the Trial Net  to determine if any of our non-D kids had autoantibodies for diabetes. If  these autoantibodies are present  the risk of developing Type 1 D in the future is increased. So we took the remaining 4 children and had the blood drawn.  To our surprise, becasue you never really expect it, our oldest child(Dareian) had the autoantibodies.  Crap!

Anyhow, we proceeded with our day to day life, managing Rowan our youngest D and myself of course. Waiting, worrting, and uncertain if or when Mr Diabetes would attack. 

A little over a year later, after many random and fasting home glucose checks, he attacked! We went to the ER and had the blood work done to confirm what we knew.  "Your daughter has type 1 diabetes" There was that dreaded statement again. Once in a lifetime is enough but three times, come on already!

The next day we went through the same training we had with Rowan a few years earlier.  We felt like employees at the diabetes center since we'd spent so much time there.

Dareian was amazing, like her younger sister. She immediately caught onto to Carbohydrate counting, self injecting, I thought, man this kid is smart.  She took Mr Diabetes buy the horns.  We on the other hand felt overwhelmed, and once again went through a whole range of emotions, she was still our baby, even though she was 11 at diagnosis.

Upon arriving home, Dareian has her days, like all PWD where she is angry, sad, and in denial.  But she also has that essential quality or characteristic that I equate with success in diabetes management.  That is; she truly believes she can control it from the inside out.  She has learned and continues to learn about managing diabetes; what works for her and what doesn't. She is active and is a track star! I know I am bragging, but that's my job. She has learned, and managed well enough and knows that she can have her cake, and eat it too!  Great job Dareian!

The Cake she baked for her Moms B-day