A few weeks ago, I attended a fantastic seminar hosted by Diabetes Australia – Victoria, sponsored by Medtronic. They had brought in Gary Scheiner, creator of Type 1 University to talk about old technology versus new technology in diabetes management. Covered in his talk were the comparisons between multiple daily injections and insulin pump therapy as well as using Continuous Glucose Monitoring (CGM) devices in conjunction with the pump. Now that I’m actually eligible for the pump and sorta starting to learn to carb count, this topic was certainly very relevant to me.
But before I go into what Gary spoke about and the impact it had on me, I feel like I should probably explain what these fancy diabetes terms actually mean. I’ve had friends with diabetes who don’t even know what the different things mean! We get so caught up in diabetes technology that we forget that others who may be new to this have absolutely no idea what we are on about! So here’s a quick summary of what each management type involves:
Multiple Daily Injections (MDI)
Exactly as it is called, MDI involves having several insulin injections a day, from one to at least four a day. There are SO many different types of insulin on the market. Each insulin has different peak rates but are broadly categorised to short-acting and long-acting insulin, which is pretty self-explanatory. As I decided to start on basal bolus, I was using two different types of insulin. I had a long-acting insulin which is supposed to cover me for 24hr and is my basal insulin. Then I had my short-acting, which I only took when I had my meals. So each time I injected for a meal, this is called a bolus (or bolusing for food).
Insulin Pump Therapy (or…the pump…)
The pump is basically a little machine that calculates how much insulin you need to the amount of carbohydrates you eat and delivers that to you via a cannula. It gives you a much more control and flexibility over the food you eat (hence why carb counting is vital). You wear the pump 24-7 and can take it off for two hours if you’re doing vigorous sport or if your pump isn’t waterproof and you’re getting in contact with water. When I say you ‘wear’ the pump, it’s physically attached to you via the cannula, a sturdy thing tubing that delivers the insulin directly to you and the pump device itself. From there you can already see one of the largest deterrent of choosing the pump – being attached to a machine 24-7. Granted it’s a small thing compared to its ancestors, however there are some benefits that far outweigh being attached. (I’m basically attached to my phone 24-7 anyway!) One of the greatest benefits is that rather than having four injections a day, I would only have to do a site change (equivalent to one needle shot) every three days.
Continuous Glucose Monitoring (CGM)
CGM has been around for a while but it’s starting to gain popularity, particularly with the special promotions and trials going on at the moment. As its name suggests, CGM is another device involves having a little sensor attached to you, like a pump site, and it measures your blood glucose levels every 5mins. The importance of this comes in the trends you are able to detect from the data. Rather than having a single value when you test your BGL, you can see if you’re dropping from a high or rising up. This is also a great tool for those using the pump because it lets them adjust their insulin levels accordingly. Whether or not they should put a temporary basal rate to increase their insulin if their BGLs are rising or the opposite for dropping BGLs. It certainly plays a vital role in helping people stay within their target range. Similar to the pump, you wear it for 24-7 even during water contact activities and it’s advised that you change the sensor every seven days. Well worth the extra prick, however the costs of these are ridiculously expensive, which is the biggest deterrent for most of my friends who have trialled the CGM.
And so this sums up part 1 of the Old Technology Versus New Technology seminar. Stay tuned for part 2, where I talk about how Gary’s talk left me in deep thought and even a nightmare!