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While insulin pumps are a great piece of equipment, they are just that, a piece of equipment. They do not do ‘all the work’ for people with Type 1 diabetes.

Let me give you some background here before I get ahead of myself. People with Type 1 diabetes need to give themselves insulin to live. There are currently only two ways that the human body can receive insulin, other than from it’s own pancreas. People can either inject themselves with a syringe full of insulin or use an insulin pump.

The use of a syringe to administer insulin should be pretty self explanatory. A person with Type 1 diabetes takes insulin from a vial or cartridge, draws it up into the syringe, and injects it directly into their body. The amount of insulin, the type of insulin, the area of the body that the shot is given, are all particular to the person with Type 1 diabetes. All people with Type 1 administer insulin very specifically to them and their plan.

Like I wrote about before, my son receives 1 unit of insulin for every 21 carbs that he eats at breakfast. This is something I figured out from logging numerous blood glucose checks to determine his number 2 hours after eating breakfast, 3 hours after eating breakfast and 4 hours after eating breakfast. Once these numbers all look good, I know that the ratio that we have set for the breakfast hour is working fine. These ratios do change sometimes and the hourly checking happens again.

There is no difference with an insulin pump, other than the way the insulin is put into the body. Let me start by telling you what an insulin pump does not do.

An insulin pump does not check the blood sugar. That still needs to be done by the a finger prick 10 times a day.

An insulin pump does not count carbs. Yes, that has been said to me. “Oh, the pump must be so easy, it must count the carbs too.” No, an insulin pump is not smart enough to know if my son is eating a burger or not, sorry. Carbs can only be counted by a human, namely the person living with Type 1 diabetes.

An insulin pump does not figure out how much insulin a person should receive for each meal. Those ratios for meals and snacks are still created by the person with Type 1 diabetes by numerous blood glucose checks and taking copious notes.

An insulin pump does not know if a person’s sugar is running high or low, therefore it does not automatically give more insulin for highs and less insulin for lows.

Now, that’s all the things an insulin pump does not do. While it seems like I am knocking the pump for all it can’t do, that is not the case. To me the pump is a fantastic invention. There are some things it does do, but it does not ‘do all the work’ for us as some people suggest.

The insulin pump does hold 200 units of insulin, making it easier to go places without having to bring lots of syringes and vials of insulin.

The insulin pump does administer very specific basal rates at a continuous every few minutes for 24 hours a day, thereby making it easier to provide a very individual amount of insulin. This cannot be done on shots.

The insulin pump does store all the ratios entered by the user making it easier to administer insulin because the pump will do the math for the user. For instance, for my son I have programmed the pump to use the ratio 1:21 for meals between midnight and 11am. So when he eats 42 carbs, he can put in the number 42 and the pump will suggest that he dose himself 2 units. When on shots this math had to be done in my head (or on a calculator for more exact calculations).

And my favorite part about the pump, it allows my son to feel like a regular kid. While he still has to check his sugar while playing, and before eating, and whenever he feels high or low, it is still better to access the pump then give a shot in the middle of a game of tag. No one likes shots, a pump is way more outsider friendly.

A pump is an invention that makes have Type 1 diabetes a little easier. Just like a vacuum or a stroller makes cleaning or walking with a baby easier. A vacuum makes cleaning easier, but it by no means ‘does all the work.’ A stroller makes walking with a baby easier, but without the mom or dad taking charge, the stroller would do nothing.

The same with a pump, if the person with Type 1 diabetes or caregiver doesn’t take charge the pump would do nothing. It would be a useless piece of equipment without the person that really ‘does all the work.’

There are no medications to maintain level blood glucose levels for people with Type 1 diabetes. Avandia, Metformin, Januvia and Byetta are only for people with Type 2. The hormone insulin is the only option for people with Type 1 diabetes.

There are a couple of people in my life that have been recently diagnosed with Type 2 diabetes. Each have been put on one of the aforementioned medications and things seem to be going rather well for them. Their morning glucose numbers have been below 100, they have cut their testing down to at most twice a day, and they are feeling great. I, on the other hand, am not feeling so great. While on one hand I am happy for these folks that they are seeing success so quickly, on the other hand I am a green eyed, jealous monster. Yes, you read that correctly, I AM JEALOUS.

Not jealous, of course that they were diagnosed with Type 2 diabetes, but jealous that they can take a pill and feel better. My son doesn’t have that option. Yes, taking insulin 24 hours a day through an insulin pump attached to his body does make him feel better than if he didn’t have insulin. Especially without insulin my so would be dead, so yes, he does feel better with insulin, but imagine if his treatment were just a pill. It is this societal belief that my son can take these pills is the root of this jealousy.

There is a misconception in our world that these wonder drugs work for anyone with any type of diabetes and this is just not true. My son cannot take these drugs. They will do him no good, and definitely do some harm.

Insulin is his only option to live. People that we have encountered actually believe that my son has allowed his diabetes to get too out of control, so that is why they think he is on insulin. They think if he was more in control of his diabetes then he would be able to take a pill too. Like it is something that we are or are not doing with his care that prevents us from taking these pills. That is just not the case. My son needs insulin to live. He cannot take these pills, they were never ever an option for us. Insulin in the hospital when he was diagnosed, insulin now, insulin until he is dead (or there is a cure).

I would do anything for a cure. I would do anything for my son to be able to take a pill and not have to think about his diabetes until the next morning check. I wouldn’t do just anything for society to understand this, but if I knew I could make people understand, I would consider any reasonable request.

The medications out there are great, they are just of no use to my son.

People with Type 1 diabetes are constantly predicting, guessing, second-guessing, and evaluating blood glucose numbers. Nothing is ever written in stone.

Someone once told me that Type 1 diabetes is the thinking man’s disease, and that is because you are constantly thinking about numbers: blood glucose numbers, carbohydrate numbers, highs, lows, and the in-betweens. Some days are predictable, but even those are not predictable before hand. You only know it was a good day for numbers after you look back and see what kind of numbers there were. You can’t predict a day where every check will be in range, they just happen. They are great days when they do happen, but you never know when they will occur.

Then there are the days that seem like they are going to be predictable, and they make a u-turn and flip the other way. Those u-turn days are where the thinking, guessing, second-guessing, and evaluating come into play. Let me walk you through our day at the water park including my thoughts (IN BOLD) about the day. Be warned, you may get tired reading through my thoughts if you haven’t had your morning coffee yet.

Wake up the day of the water park, great number 103. Great, good start to the day, maybe our day will stay on track. Let me pack extra candy because with all the activity at the water park we may have some lows.

Arrive at the water park less than 2 hours after breakfast, great number 161. Great, still a good start. Let’s have a free snack to build up strength without adding any carbs and insulin. Snack on hard boiled eggs (it was the day after Easter after all).

Getting ready to swim almost 2 hours after last check. Long lines at the water park. Great number again, 148. That number is actually a little high for 4 hours after breakfast, but with the extra activity he may need the tiny bit higher number to hold him steady while he is playing so hard.

About 1 1/2 hours later check sugar again getting ready to eat lunch, ut oh, number not so good, 228. Ok, we are going up, maybe it’s basal? Maybe he needs an adjustment tomorrow when we are not here with his basal rate, should not be going up for no reason, especially with so much activity?
Correct the number and pre-bolus for pizza. Pizza is 75 carbs. I already looked it up on the internet the day before so I knew ahead of time what he was going to eat and how much insulin he would need.

About 1 hour after eating, not a time one usually checks sugar, and his number is 242. I’m ok with that number, he has over 1 unit of insulin working and he is going to be really active with his favorite cousin. Let that number go and check in while and see what is going on.

Another 1 1/2 hours go by, he must be going low by  now. He is crazy active, running around, jumping, going down water slides, let me grab him and check to see if he needs some sugar. Check sugar, 385!!! Ok, this is not good. Not good at all. What is going on? Could it be basal? Did I under bolus for that pizza? Maybe the nutritional information on the website was wrong, maybe I didn’t give enough insulin for the pizza. Correct, double check that he is feeling ok otherwise and move on.

Another 1 1/2 hours go by, he has to be in range by now, the boy has over 2 units of insulin coursing through his tiny body and he is having the time of his life. Expelling so much energy, climbing 5 flights of steps over and over to get to the highest water slide. Check sugar, 355!!!! Ok, this is awful. What is going on? Maybe his site is coming loose with all the water and I can’t see that it is not in correctly? Maybe it is basal? Maybe his adrenaline is keeping him up? Maybe he is getting sick, sometimes we see highs before he gets sick. Maybe this, maybe that? Ugh!!!

Ok, quickly go and take a shower, will reconnect pump after shower after I get a good look at the site. Check site out, it is coming up on the edges, but doesn’t appear to be affecting the actual cannula (part where insulin goes in). Change the site immediately and reconnect quickly. Do a big correction for that 355. Also, prebolus for dinner.

Check again in 1 1/2 hours, number down to 263. Ok, good sign. Insulin definitely working now, he’s even lower than before he ate dinner, so that original number is on it’s way down. Great!!

Check again in 1 1/2 hours, number down to 113. Looking good. Possibly a little too low, but not much insulin from the bolus working anymore, going straight on basal. Should remain pretty steady at this point.

Check again 45 minutes later, just had a feeling. Number down to 89. Aahh, not so good. Numbers below 100 at night (10:46 pm) scare me a little. Let me give him a glucose tab (4 carbs) just to turn this around. Maybe dinner insulin worked a little longer than normal? Maybe the correction was a little too much? Maybe the activity from today is catching up with him?

Check again 45 minutes later, another feeling. NUMBER DOWN TO 33!!!!!!! CRAP!! TREAT! Get this number up! Treat with 32 carbs.

Check again 1 hour later (12:30am), great number 136. Whew!

Check again a couple of  hours later, great number 127. Thank goodness basal held steady like it does most nights. Guess his night time basals are good. Now what was up with the day? Better check today to make sure basals and ratios are good.

This is one day in the life of living with Type 1 diabetes. Now you can plainly see the thinking man’s disease statement, you never stop thinking when you are dealing with type 1 diabetes. It is like Type 1 diabetes holds the key to a puzzle that you can never possibly solve, yet you wake up everyday ready to play the game.