Blog Entries With Tag: injections


Posted: Mar 30, 2013

Gotta love Mr. Bean

UPDATE -** NOVEMBER 18TH 2013 ** - I HAVE FINALLY BEEN APPROVED TO USE THE I-PORT! Why it took my insurance company so long is beyond my comprehension - but now I'm so excited - especially when I take my next holiday  - where I can't risk having my out of warranty insulin pump go wonky on me - this will make my MDI (multiple dose injection) regime so much easier!!!!

*******************

I posted this blog the other day at Blogger - and thought I'd share it here with you at Diabetes1.org! 

Picture of an upset

Okay, okay, don't get your nose out of joint - my fellow insulin pumping peeps - that I'm saying that the i-port is a mini-me insulin pump - but in away - when you look at it "logically" without any anger from my statement - I AM the "mini-me" pump - I am the brains behind what goes into my body - via the i-port - I AM IN CONTROL - not a machine - that I've programmed with best intentions to keep my diabetes health in control.

 


Yes, I still have to give a separate shot for my "basal" rate with long acting insulin  - I do this twice a day - 12 hours part seems to work best for me.   The basal rate is basically what your pancreas - if it's working - squirts out all the time - in order to keep your blood sugar in a normal range when your not eating, etc.   With diabetes - your pancreas can be abit on the wonky side and either work when it feels like (e.g. Type 2) or like myself as a Type 1 - where my pancreas is dead as a door nail. 


The recommendations of the i-port website is that only ONE type of insulin being put thru' the port via either a pen needle (no shorter than 5mm) or syringe (28 gauge is the thickest - otherwise you could ).  I'm fine with that that I can only use the port for one insulin.  With a "real" insulin pump which has an insulin cartridge that stores insulin (the i-port doesn't - you INJECT the insulin thru' the port) - we all know it's programmed to squirt out ""X amount" of  rapid acting insulin - for your basal rate as well as your bolus rate (aka - if you have to correct a higher than normal blood sugar (BG) or for when you are eating a meal).  If this has got you abit confused about the types of insulin - check out the link from Diabetes.co.uk that explains how injected insulins work in our bodies.  


My messy diary along with box from i-port


The thing I loved about my six day experiment with the i-port (I was only given 2 samples - boo! hoo!) - is that instead of my having to do the human dart board practise on my stomach for my bolus shots 5-8 times a day - I just did my insulin injections through the port in my skin.  It really is like an infusion set that we use with an insulin pump - except it has no tubing - or connections to a little machine that goes ping.   The port is changed EVERY 3 days - which is the recommendation for most infusion sets.  Usually in the past, I've had issues with the teflon coated plastic cannula that remains in my body for that length of time.  Luckily, with the i-port I had no such issues, removing the port left barely a mark in my skin. 


The good thing about the i-port - less expensive then the alternative of an insulin pump (I can purchase the i-ports at Diabetes Express for $149.99 CAD for a box of 10).  This is bit less expensive then what I was paying for my infusion sets with my insulin pump - but the even bigger saving for me?  I'm not having to pay for a pump which ranges from $5-7K depending on where you live - along with the other supplies that go along with the pump (insulin cartridges, batteries, replacement caps, etc.). 


i-port put in place (really easy)


One thing I did find was that I didn't cringe at having to give another shot of rapid insulin for a little sinful snack or a correction shot.  It reminded me so much of the insulin pump I used to use - where a simple touch of the key pad - squirted insulin into my body via the infusion set - except with the i-port - you are the brains behind what insulin you are injecting with.


I have submitted a predetermination form thru' my husbands workplace insurance in the hopes that these ports will be covered - hopefully at 100%.  So wish me luck - since I'm really REALLY missing my little i-port right now - I felt very spoiled using the two I was sent. It's almost how I felt when I first disconnected from my pump - and went back onto multiple daily injection (MDI).  After almost a month of learning how to stay in the BG zone with MDI - I can now say - that ANYONE can do it - if they put their mind to it - and now I'm not missing my pump as I go into my 4th month of being pump free.


It stands out about 1/2" or abit less


My conclusion?  For anyone without insurance coverage - dislikes injecting to the point of not wanting to inject (not good - tisk - tisk - who hasn't done that in their life time with diabetes?) - I really think this is the route to go - to keep a diabetic from suffering the effects of poorly controlled diabetes.  

 


NB
:  The i-port Advance has regulatory clearance in Canada, US and the European Union.  In the EU they currently have distributors in Germany, Italy and the Nordic Region and are in conversations to add some additional countries in the near future. India and Australia will be further down the road. 

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Posted: Jul 20, 2010

I know that there are a few people who are upset that I've gone off the pump - some of the private comments I've received I understand why you are feeling the way you do.  For myself, going onto the insulin pump in the first place was more of a push from a friend who told me that it was heaven sent to him being on the pump (though he's never revealed what his A1C's are with the pump - so it makes me wonder).   My control of my diabetes before the pump was fine, I just was curious to see what pumping was all about.

In April, I decided to take a pump holiday.  My intentions were to just do this until the next A1C - which I had written about last week.  My A1C has not really changed much as you can tell by that blog post.  So, for me, both methods of diabetes control works for me.  For other PWD's, they perhaps feel more comfortable with having a pump, that is programmed to deliver the correct amounts of insulin which I currently am performing by multiple doseage injections (MDI) and using my sponge brain to figure out the correct dose for carbs, IOB (insulin on board), etc.

So, the pros and cons of both methods are below -

  • Insulin pump does not allow you to FORGET to give you basal shot (been there/done that - but with no ill effects as I make it up later - and reduce the amount - but still - annoying that with the pump it's all taken care of - bing, bang, boom).
  • With MDI - when you inject your basal insulin (Levemir/Lantus/etc.) - you cannot turn back the clock like you can with the insulin pump where you can lower your basal rates if you need to reduce the flow on insulin into you body due to certain circumstances.  I have to know ahead of time what my activities will be for that day, with a child I think the pump is a better option, as they are all over the place as I'm sure D Mum's will agree on that one.
  • The insulin pump retains all the information that you require to check back late to see how much insulin you have on board (IOB) or have bolused for a meal with the carb amount.  I am bad (okay - LAZY) at keeping a journal with MDI. I was good in the beginning while I got my basal rates perfected, but then I slipped back into not keeping the journal (and I'd bought such a pretty one when I was in Boston).  Because of this, I actually had a very BAD hypo, which I'm trying to get the gutts to blog about, as I think it will cause quite an uproar from a few diabetics.  On the insulin pump, I doubt this would have happened as I would have had a record of what insulin had been given, etc.
  • The cost of MDI and insulin pump - that's where I find a big difference.  $300 a month average in supplies with the pump.  MDI is almost 1/3 of the cost (these figures do not include insulin - only the bits that are used for dart practise on our bodies).  Yes, I may now have to use two types of insulin on MDI, but it's still less expensive, and I'm getting basically the same results as I did on the pump.
  • Forgetting where you put your pen needle for my basal shots I do every 12 hours!  This happened to me twice since starting MDI. Wearing a pump, you can't forget where your insulin is - your plugged into the pump! 
  • When travelling by air - less to carry with you with MDI - and I don't get pulled over for pump inspection by TSA!

So, will I be going back onto the pump (Salvador Dali)?  Since only 80% of the pump purchased was covered by my husbands medical insurance at work, I probably will.  If I had bought the pump outright, then probably I may not have tried this test out with MDI.

Also, I am not sure when or how long I am willing to put up with the Levemir reaction I still have (my endo had me fill out forms for Novo Nordisk about this - but no reply from them). 

Remember, everyone is different with how they want to control their diabetes.  If pumping is easier and gives you better results then MDI, then go for it!  I am not putting down pumping at all with what I have done here as a guinea pig.  It's just nice having a break from the tubing, wearing dresses without trying to figure out where to put the pump so it's accessible to bolus.  I like the freedom, what can I say?




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Posted: Jun 3, 2010

 

First topic here is a semi-nonD subject to get you in the mood for what you about to read.  It involves a baby and stuffed toys (they weren't hurt seriously) – aka Iron Baby and with PWD blogger Kerri Morrone Sparling having popped a bun out of an oven recently I just couldn’t resist maybe suggesting her daughter call up Patrick Boivin (from Montreal) to ask him to put her in his next “flick”.  Even better, is the video he made of future of air travel – wait – where’s my pump supplies?

Okay now on to my continuing quest of the week as I figure out how to fix out my basal rate with my Lantus. I do love a challenge, oh yes I do!!!  I’ve been trying all this week to get help from my endo (endocrinologist).  Latest attempt today was sending a fax, trying to call a few times.  I’m getting his assistant saying a voice message, and no, they don’t take messages, just call back later.  I’ve tried this a few times, not succeeding.  I'm giving up, as I know they close up shop shortly, and on Fridays's they don't take calls.  Sigh.

During the night, as I did a basal test, pigging out abit on sweet things as I coped with BG’s in the 2-3 mmol/l (36-54 mg/dl) range.  My brain was just ticking away with how to figure out what to tweak with my Lantus shots I’m doing twice a day.  Many suggestions from people who presently are successful on MDI (multiple dosage injections), but alas, they use Levemir as they say Lantus gave them lows like I am experiencing.  Go back to my blog of last week and you’ll know why I’m back on Lantus again.  It seemed to be serving me well before, but now I’m facing these fun brain challenging lows.  Sometimes I think being high – 8-10 mmol/l (144-180 mg/dl) - range isn’t maybe so bad.

Today, I decided that there must be an overlap in when the Lantus meets up with the previous shot.  I’m not exactly doing 12 hour segments – it’s more like – 23h00 and 09h00.  As I type this up, my basal is not working; I’m in the 13 mmol/l (234 mg/dl) range.  I could handle 8 mmol/l (144 mg/dl) but 13 is a bit high for me, and it’s way past when I ate and gave my shot of NovoRapid.

So, today, I’m going to post this blog in all the D forums I belong to and see if I can get any help/comments from experienced MDI folks.  I know you are out there!  Any suggestion is helpful, as I try to figure out what’s up with these morning lows (and yes, I have a snack before hitting the hay – endo had told me to do this with Lantus – never did this when on the pump).  I swear I’m going to gain weight after going MDI – but it’s all for the cause man – all for the cause – as I figure out a way to make this MDI experiment of mine work.  I have to admit, I really don’t miss being attached to a machine 24/7 – just wish I could have as good control as I did with the pump!

 Help! I need somebody – anyone?

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Posted: Jun 2, 2010

I have been diabetic for a few years now.  I think sometimes, how I took care of my myself sometimes was maybe a shot in the dark  – and often look at myself in the mirror thinking … “Wow – you aren’t doing so badly” with the technology that took care of my diabetes from the 60’s and up.   Things are much better now but only if you can find someone who can take the time to go over all the nitty gritty details of how to keep your blood sugars in control, either with pills and/or insulin.  At the same time, we also have to educate ourselves on how to take care of ourselves, but not everyone can do that. I’m telling you it’s a complicated roller coaster ride we diabetics lead sometimes.

 My experiment with going back onto MDI (multiple dosage injecting) has had its ups and downs the past few months if you've been reading my dribbles here.   I’m enjoying the freedom of not being hooked up to a machine, but at the same time, I miss the ease of how I can remedy a situation with a few touches of buttons on my pump and I’m all set.  With MDI, I’m personally finding it a big challenge, to maintain those even BG’s that I can get with my pump basal settings.  I had to give up on the Levemir part of my “experiment” due to reaction to the insulin.  I am now having issues with low blood sugars in the morning.  Trying to figure out what I’m doing wrong – e.g. am I giving my 2 shots of Lantus at the wrong time, am I ???  This is making me seek help from my endocrinologist for the past few days as I deal with waking up to BG’s in the 2-3 mmol/l – 36 – 54 mmol/l.    

This morning I spent some time on the phone with various government services here in my province of Quebec.  First I tried my local health service centre (CLSC), and they had never heard of a CDE (Certified Diabetic Educator).  All they could offer me was a nutritionalist – but when I spoke to her – she didn’t even understand what a CDE was.  She then put me thru’ to Info Sante after we had both done some searches on the Internet together where she said they should be able to help me.  In the end, the Info Sante lady admitted that CDE’s are really a rarity in my province of Quebec (she had never heard of them – but again – perhaps due to my not knowing the French equivalent it didn’t help).  She said my best option was to drive to Cornwall, Ontario – which is a few hours west of my home – and seek help there. 

Just a few minutes ago, I was finally able to reach my endocrinologist’s secretary – and as usual – she’s finding it strange that because I work as a diabetic mentor – I don’t know what to do.  When it comes to pumping, I’m a whiz semi-kid, but MDI, despite doing it for 40 years; I didn’t really understand how insulin worked, etc. before going onto the pump.  She then told me that my endocrinologist has 10,000+ patients – these are open file patients – meaning – he is BUSY - so basically - no time to see me.  These patients are not just diabetics, but other patients with endocrine disorders.  He is overwhelmed.  The fact that she runs the office on her own is another story (I keep on telling them to hire me – but it’s my darn lack of fluent French again).  She also told me, that going to Ontario won’t help, that they have patients coming from that province since there are just not enough endocrinologists to serve them!  Again, CDE’s, why don’t we have them here in this province is what is going thru’ my head which would take the pressure off the endocrinologist? 

She did say that big changes were happening in the Fall time here in the area I live in for a clinic that will be set up just for diabetics (she was vague about what it all entailed).  All I know is, that as a new diabetic, in my situation, I would be very scared, not being able to have some sort of help when I need it.  To be told to go to ER is not something I feel we should do if we are having issues with our insulin regime.  Are Quebec and the rest of Canada ready for the amount of diabetics that are being diagnosed and needing help?  I hate to say this, but I don’t think so. 

Back to research on Lantus again (hopefully Tudiabetes is working again) until I try my endocrinologists office again tomorrow (this is all his assistant could offer me).  Diabetes right now seems to be taking up much of my time lately, as I try to find that magic combination to having level BG’s.   Yes, Dianna, my pump, aka Salvador Dali keeps on looking better and better to me these past few days, but I must resist the pull of his twirly moustache, and hang in until my next A1C in July.  I can do it; I can do it … with a few gripes here and there from the peanut gallery.

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Posted: May 5, 2010
Not only did gas prices shoot up here on the Island of Montreal (from $1.03 to average of $1.16 a litre) - my blood sugars (BG) shot up.  Not like they did about a month ago, where  my BG was 15 - 22 mmol/l (270 - 400 mg/dl) for a few days - but today I'm hovering around 9 - 10 mmol (162 - 180 mg/dl).

I thought that my high morning BG was due to my having a lousy sleep, tossing and turning all night with those oh so sweet menopausal sweat sessions.  Apparently according to an article I came across today - Type 2 diabetics BG's can be affected by bad sleep - so I'm thinking it's probably the same for Type 1's like myself.  Oh joy!

So, I had my ususal espresso, a shot of NovoRapid to cover the sugar (yes - I use real sugar - do not believe in forcing more chemicals in my body then necessary).  All was good, as I went downstairs to tackle work where I'm slowly winding up my volunteer duties as "forced upon" President of the West Island Diabetes Association (WIDA) and handing over the reins to remaining two board members at the end of June  I'll still be helping them out afterwards for awhile, but I've got to let them get used to dealing an email account and running a simple website, etc.

Noontime, the church bells struck behind my house.  I was feeling hungry.  Time to eat my first meal of the day (not a big breakfast eater).  I'm going up the stairs from my basement office, and then it hits me ...... BOOONNNNGGGGG ..... forgot to take my friggin' Lantus shot this morning.  This is the 2nd time I've done this over the past cpuple of weeks since going back to multiple doseage injections (MDI) - but never this late!

Test my BG, it's 9.5 mmol/l (171 mg/dl) - not as bad as I thought (I felt thirsty before - should have taken that as a warning sign).  Injected a few units less of Lantus then I would normally due, injected some NovoRapid to bring my BG down.  Sigh, I've really got to get with the plan, and REMEMBER, I am not using Salvador Dali (my Animas 2020 pump) at the moment.  I must use my brain to remember to do the motions that the pump so quietly does in the background without much thought process.

Wish me luck for this evening (WIDA meeting) and during my Beauty Sleep (please let me sleep a full sleep) that no hypos occur.  Since the late injection of Lantus may cause me to have a hypo as both 12 hour shots collide with each other. 

 

WorldsCollide

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