Insulin Pump Primer - Part 1

This morning I ran a great 10k.  Because of my recent race followed by a recovery week, it was the first time in a month that I went to Runners' Edge for my Saturday morning run.  It was gorgeous and sunny out this morning and, because the new running clinics have started, the place was overrun with runners of all shapes and sizes.  I'm not good at estimating but there must have been over 100 runners.  Crazy.

As I stood in the store waiting for the run to start, several people came up to me to say that they read Running on Carbs regularly.  Wow, thanks!  They also said that they had no idea how challenging running with diabetes could be.  They were surprised at how small my insulin pump is and how that blue thing clipped to my pants was keeping me alive.  They asked how it was attached and how it worked.

So I thought it might be time for an insulin pump primer.

First off, I apologize as there are no photos to accompany this entry.  I need to change my insertion site (more on that in a minute) in a day or two so I'll take some photos that might help make sense of the mysterious pump.

So, here's how it works.

My pancreas does not produce insulin.  Period.  My body (like yours) needs insulin to survive.  Think of insulin as a key that 'unlocks' muscles to let glucose in.  Without insulin, the glucose (or sugar) in the bloodstream will continue to rise to dangerous levels.  Worse case, with no insulin at all, the body could not survive very long (a couple of days at the most).  Not good.

Since my pancreas can't make the insulin I need, I use an insulin pump to get it. Other people use needles but I prefer the pump. The insulin pump is a small machine that delivers a constant stream of insulin into my body.

There are two words that are commonly associated with insulin (basal and bolus). I only take one type of insulin (Humalog) so the words basal and bolus are used to differentiate how it is used. Basal insulin is the amount of insulin my body needs to deal with regular physiological processes.  A slow, steady trickle is released from the pump and that is the basal insulin.

Bolus insulin is the insulin I take whenever I eat.  With every meal or snack, I have to figure out how many carbohydrates I'm about to eat. Then I check my sugar to see if it's high (over 8), in a good range (5-7)  or low (under 4).  I tell the pump what my blood sugar is and how many carbs I'm about to eat and it does a little mathematical calculation and tells me how much insulin I should take.  If I agree, I hit the button and it gives me the bolus.  There are other factors that affect the amount of bolus I will take (am I going to exercise after I eat?  How long and hard will I be exercising?) but that's for another blog entry.

So, the insulin pump looks like a pager and is typically clipped on to my belt.  When I run, it's sometimes tucked in my pocket.

The pump is connected to my body by a thin tube that is a few feet long.  The tube enters my body at the insertion site.  There is probably about an inch of the tube inside of me.  I know it sounds kinda gross but it's really not.

It doesn't hurt and I can lie on the insertion site without being bothered at all.

Every 4-5 days, I have to change the insertion site.  When I change the site, I also refill the pump with insulin. The entire process takes about five minutes and then I'm good to go.    

I can 'unhook' the pump to shower or if I want to go swimming but I really shouldn't have it off for more than an hour.  Typically, it's off for about 10 minutes a day (shower time) and that's it.  I'm hooked up at all times, even when I sleep.

If you haven't been exposed to the pump, it might sound like a very intrusive thing to be attached to all the time.  Having used it for over two years, I can assure you that it's not.  It keeps me alive and lets me do the things I want to do.  No complaints from this girl.

So folks, here's the deal. I write this blog to help people understand more about diabetes and to connect with others.  So, if you have any questions please don't hesitate to fire them my way.  I'll do my best to answer.