Blog Entries With Tag: ISF


Posted: Jul 18, 2013

When I first started to wear an insulin pump back in 2008, I didn’t realise that wearing one would restrict some of my clothing options.  Living in Montreal, the fashionista capital of Canada (okay – there’s Toronto – aka mini-me USA – but they just don’t have that French flair like we do ).

It was sort of nice since January, when I took a pump break, not to have to spend the extra time to pick out clothing that would not reveal a bulge of George Michael aka GM (pun intended there – remember – I grew up with Benny Hill) my insulin pump.  Now that I’ve been back on the pump for over a month now, I realise that I have to take extra time to figure out what to wear that will allow me easy access to George Michael.   Hmmm, should have I had added that time factor into my application for DTC?

I did the stint for almost a month of wearing the infusion set in my arms.  That was kind of neat – almost like I wasn’t wearing an infusion set except when I’d hit a muscle or nerve ending in my arm with the stainless steel infusion needle (found Contact Detach/Sure-T does this more than the Inset 2 sets). One thing I am going to try out if I can get some samples of shorter needle/cannula length for the infusion sets - just like I have done with the shorter 4mm pen needles I started to use back in April.  My absortion with the shorter pen needle created no change in my BG's - which I thought it would due to my not being a slim gal (as I had told the RN when she gave me some samples of the BD 4mm pen needles said skin depths for absortipon of insulin doesn't change in the human body).  Anyway, back to old GM, here  I was tucking him into a sports bra – where I couldn’t believe that despite how hot it gets inbetween the girls – the insulin would keep on performing 100%.  My fear, like other diabetics is that heat will deteriote our insulin – but after 3 days of using the same insulin in the cartridge – my blood sugars (BG) stayed stable.

Actually, stable isn’t the word I should be using here.  I’ve been experiencing hypos (low BG) more often - that almost reminded me of my days when I was MDI prior to going onto the pump (one of the reasons I went onto the pump in the first place was due to having frequent hypos.  I sort of didn't understand how to use my combinations of insulin properly pre-2008, I was trying to learn how to do the poor man's pump method - but not quite doing it correctly.  As I keep on telling pumpers who’ve never gone back to MDI since starting on the pump - being on the pump has taught me how to fine tune with ONE insulin and that with that knowledge - you can easily transferred over to using TWO insulins when doing MDI.  It really isn't that difficult - honest - you've just got to know how to use your insulin(s) - and their little quirks.

So, with the hypos I’ve been having – sometimes a few a day – the things I have planned to do – that usually involve some activity (even simple grocery shopping believe it or not) – have to be shelved.  I do NOT like to have my diabetes rule what I can or cannot do.  My poor DH has to put up with my having to tell him that I can’t do this / that – and he’s so far not really sad much – as I go “I’m so sorry, I’m so sorry” or “Get me some quick acting sugar NOW!!!”.  What a range of emotional outburst I put him through – that is so not me – that it makes me cringe if a fly is on a wall witnessing this (thank goodness they don’t have the ability to hold a video camera).

My basal rate has now been reduced by almost 20% - but I’m still needing to tweak it abit with some more basal testing since now I am going low in the afternoon (very rare for me).  If that doesn’t work and I’m still experiencing low blood sugars (hypos), then it’s looking at my carb ratio (I:C) – which I have slightly changed since I’m now understanding I’m insulin sensitive.  The other thing to look at is my Insulin Sensitivity Factor (ISF) - which to me is a trial and error type of test - since there are a few different formula's out there to deterimne what is best for "you".  

Ahh isn't diabetes control a fun puzzle or what?
 
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Tags: set (1) infusion (1) DTC (1) Disability Tax Credit (1) basal (1) pump (1) insulin (1) George Michael (1) GM (1) Ratio (1) Carb (1) ISF (1) Insulin Sensitivity Factor (1)
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Posted: Jun 14, 2013
Artwork from bunbunlandia on WordPress dated March 10, 2012                                   

For those of you wondering about my little SCREAM on Facebook earlier today - about removing an infusion set (Contact Detach) - from my arm - that could be a potential gusher (in my eyes I was thinking more of a geyser) according to some of my D-mates 3 days before and how I faired.  Well, here's the LONG low down (and this is aimed at some of the commentors saying that they'd never done an arm infusion site before - it can be done - even by yourself).  


The reason I had written this - was my tubing the next day after putting the infusion set in (my 2nd arm installation - yes - I'm no longer a virgin) - had a very very weak pinkish tinge to it - though I couldn't tell if it was inside (from rubbing on a red top - which I hadn't) or from a broken blood vessel when putting the set in.  The funny thing is - it was not at the infusion site where the needle was inserted - but further past where the detachment area is on the tubing (managed to luck in on finding a 31" tubing from the Comfort sets I used to use in the beginning).  The longer tubing is much better so I can also clip the pump onto my usual waistband of my pants - before that - it was impossible unless I had no long neck/torso.  Having that extra 10" really makes a difference (oh this sounds like a Long John Silver movie).  And yes, for those dudes out there - who asked the question - where does the pump go - check my previous blog.

Many comments on my post at the Facebook group page of Insulin Pumpers gave varied responses to my plea of "help"!  Due to being self taught on the insulin pump - and not having an endo or diabetes team I can go to for help - in person - I've had to be my own human guinea pig in many things I do - of course - along with the bible from John Walsh - Pumping Insulin (5th edition was released last year) and various other books I've recommended over the years here at Diabetes1.org.

Just a joke but Duck tape is VERY handy

So, here I was prepared - armed with my medical kit - pads & tape to soak up this potential pouring of blood when I remove my infusion set.  I actually thought I was having a low blood sugar at the time, except I wasn't.  I thought I should pop one of my Ativan aka "happy pills" I was given earlier in the year by my GP when I went away on my 2 week sailing holiday - but resisted the urge due to my fear  of becoming dependent on them (insulin is ENOUGH thank you very much).  My GP was a smart cookie - as she only gave me 20 - and I still have 9 left six months later.

I gently pulled out the infusion set - all set to put the padding/tape in place - prior to hitting the floor - NOTHING ... I mean .... NOTHING - all I see is a little teeny tiny hole where the infusion needle was inserted - that's it! Phew!  At that point I knew thare was higher life above us - that is looking down  - knowing that I didn't need any drama in my life (hmmm, what's this blog all about??). 

Today, for my third try at an arm infusion site - I've decided to use the mini-wanna-be Omnipod (humour me John as the wanna-be-Princess) - aka Inset II.  The tubing is turned the right way - and as usual - pump is sitting in it's normal happy place (BTW, it gets REALLY warm there).  Sadly, the tubing on the Inset II I use (I've got 2 more boxes before I can reorder longer tubing of 43") - isn't as long.  I liked having the option of wearing in either places the last 3 days.

And yes, to some of those on Facebook who asked the question about absorption of insulin being better or worse in the arm, than my usual stomach, legs, lower back sites - I'm wondering if it's better - due to never having been used for infusion sets that stay in place for 3 days.  I did find I had a few interesting low's with this past infusion set - that aren't quite explainable - except at the time I thought perhaps it was due to hitting blood vessel.  It could be due weather - since I tend to use less insulin when it's humid AND warm.  It also could be due to the fact the set was in part of my muscular part of my arm - which can cause faster absorption of insulin.   Lots of scenarios here as to "why".
Back of arm for latest infusion site
Luckily, the latest infusion set is now in the back area of my arm that you see above - in the fatty portion of my arm - not up front in the more muscular area that I had just removed.  I just know I'm sensitive to insulin (I use less insulin than a person of my weight should use according to books I've read) - so wondering if I've become more sensitive.  Questions, questions, questions.  Who knows - but in the meantime I'm back to keeping a written log during this arm infusion test and see if perhaps I have to make some changes on my programming (either basal / I:C / ISF).  One step at a time of course - starting with basal testing first if my blood sugars (BG's) continue wonky.  Otherwise, things get even more complicated with too many scenarios that can overwhelm what you are trying to accomplish.

I am a contented cat

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Tags: insulin (1) Animas (1) contact detach (1) BG (1) blood sugar (1) ISF (1) basal (1) log (1) muscular (1) Ativan (1) infusion set (1) Inset II (1) mini me (1) pump (1) Omnipod (1)
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Related posts:

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