Category: Technology

Insulin Pump Therapy Pros and Cons

Before I embarked on my journey, with an insulin pump, I had been on multiple daily injections (MDI) for almost 15 years.  It wasn’t until I began to learn about insulin pump therapy that I truly grasped how different the two were.

With MDI, I feel less training was given in order for me to manage my diabetes. I didn’t learn how to carb count or even have an understanding of what insulin sensitivity was. The main focus of my diabetes management was to administer my insulin (my doses were worked out by the doctor and diabetes nurse, based on my blood glucose readings) when I needed to take it and checking my blood glucose levels.

It was only with insulin pump therapy that I began to have a better understanding of my diabetes management. I had to undergo a process of training before I was given free reign with my pump.  I had to learn how the pump worked and in doing so, I had to develop my understanding of carb counting, insulin to carb ratios, insulin sensitivity, and basal rates. All of which, I have, to be honest, I had no idea what it even meant. I think this is because the nutrition and diabetes management were explained primarily to my mother but this information was very basic and she very much had to figure a lot of it out for herself. This then carried on into my transition from the children’s hospital to the adults clinic.

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The insulin pump, I think isn’t for everyone, it takes a lot of work to make it work. Diabetes management can be improved but it also takes the individuals being able to understand the ins and outs of their condition, how foods interact’s with their body as well as their sensitivity towards insulin.

There are many benefits, as well as problems which can arise due to wearing an insulin pump.

Some of these benefits include:

  • No more MDI: A sense of freedom from having to inject daily. At one point in my diabetes life I was taking 5 injections a day and I think that was one of the most challenging things I’ve ever experienced. It worked well with my sugars and control but it tied me down in so many ways. Let’s just say the insulin pump came at the right time.
  • Data Collection: The insulin pump is able to store a lot of data and when downloaded a clearer picture appears as to what blood glucose levels may be doing at certain times. With my pump (Animas vibe) it allows you to see how much insulin may still be on board in your system which on some occasions has helped me avoid a lot of hypos. There is also stored information on how much insulin is being administered daily over several days. If you can’t remember if you’ve bolused or not, then the pump also has a stored history bank which tells you when you last bolused.
  • Doses: Meal time boluses can be planned out in accordance with the amount of carbohydrates you may consume for that particular meal.
  • Sensor: The pump combined with a sensor, you can see blood glucose levels recorded every 5 minutes over a 24 hour period in graph format.
  • Ease of mind: receiving insulin doesn’t involve dialing up a pen and then finding the perfect spot to inject. It’s as simple as pushing a few buttons and insulin is delivered to you.
  • Cost: This only applies to my UK readers, but insulin pump therapy here is free! However, if you want to use a sensor then this is something that you will have to pay for yourself (which can get pretty costly).

Problems can also arise when it comes to being attached to an insulin pump.

Some of these problems include:

  • To Tube or not to Tube – I’ve been hooked to many a door handle and had my insert ripped from my body (Not nice at all). I’ve had to learn how to conceal my tubing in a way in which it won’t be affected by my surroundings. So the question is, do you choose a pump with tubing or not?  The decision is entirely yours. I suggest if you do choose a pump with tubing then take precaution, keep the tube concealed well under your clothes. There are so many cool diabetes undergarments that can be used to keep our pumps and tubing safe. One of my favourite undergarments for men, women and children is a Swedish company called AnnaPS

  • Wear and Tear – Protect your pump! I think the picture below explains my reasoning for this.

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  • Changes: The insulin pump does require that you change your insert every 2 – 3 days when the insulin cartridge is running low. This is something that you get used to, it has to be done so you get it done!
  • Ketosis: With pump therapy, long-acting insulin isn’t needed. Quick acting insulin is the only form of insulin used. I’ve had occasions where there have been occlusions in the pump tubing during the night and because there is no long-acting insulin available, it has caused my sugar levels to rise at a rapid rate. Acting and reacting quickly when the problem is spotted is essential to getting the blood glucose back in range and avoiding ketones in the urine.
  • Breakdown: Pumps are just machines and they can malfunction. I’ve had many a time when my pump has malfunctioned. One of the worst case scenarios was when I was on holiday, I noticed a crack in my pump and salt water had entered the pump, destroying the battery. My pump wouldn’t come on and was making all sorts of noises but thank god I took a spare (please remember to do that if you go on holiday).
  • Rotate: Remember to rotate you infusion sites as it can irritate the skin where the adhesive sticks to your body.
  • Control: Of course we want to have better control when we first start pumping. However, this doesn’t happen straight away. It took some time for me to understand more about the pump in relation to my body. Your control will start to improve but it won’t be immediate. You have to work on it to achieve better control.

If you are thinking of starting up on an insulin pump look at both the pros and cons involved in managing your diabetes with this technology. Be prepared to work hard at it and most of all be patient with it, you may not get the results you’re after straight away. Nevertheless, don’t give up on it, you’ll get there eventually.

Amina xx

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Whatever Next?

Hacking is something that has been in existence since the introduction of the first computer. In fact, it has been around for many centuries. As we’ve had more advances in technology, many hackers have also developed and broadened their hacking skills and techniques enabling them to target larger companies. They have even been able to access people’s private information, stealing it and sharing it with the world. Recently, Talk Talk Business were affected by hackers. Over 157 000 of their customers, information was accessed.

 There are now mounting concerns over the threat of medical devices being hacked. Kaspersky Lab a security firm announced in February 2016 of their success in hacking into a hospital’s I.T infrastructure, which gave them full access to the hospital’s MRI device (magnetic resonance imaging).

The pharmaceutical company, Johnson and Johnson, who produce many types of insulin pumps, from the Animas Vibe, The One Touch Ping and the 20/20, have recently warned that one of its pumps, The One Touch Ping is at risk of being hacked, which can result in an overdose in patients using the device. They have reported that although these pumps were vulnerable, the risk of hackers entering the pump data was very low.

However low it might be, this is an extremely frightening prospect. We have enough worries when it comes to managing our condition. This is just another extra burden to carry. I have a great deal of trust in my pump but to my diabetic friends who are users of the One Touch Ping, I can imagine that this will affect their relationship they have with their pump. Being able to rely on it as you once did before will be difficult. Yes, the risk is low, but the fact that a risk even exists is extremely unnerving.  

Johnson and Johnson said, “It would require technical expertise, sophisticated equipment, and proximity to the pump” before the pump could be accessed.

As this pump is only produced in the United States and Canada, all patients using this pump were contacted on the 27th September 2016 and warned of these possible risks.

The One Touch Ping works via a Wi-Fi remote and enables diabetic users to administer insulin without having to take out the pump from underneath their clothing.

Johnson and Johnson have also said, “That the pump was not connected to the internet or any external network.” 

A diabetic and researcher with a cyber security firm Rapid 7 said, “He had discovered it could be hacked from a distance of 25 feet. Communication between the insulin pump and its radio frequency remote could be hijacked- in theory allowing a hacker to administer unauthorised injections.”

Whhhhhhhat!!

Although Johnson and Johnson had confirmed these findings, they still insisted that the pump was safe to use. They also stated that concerned patients “could take precautions, such as not using the pump’s remote and programming the device to limit its maximum dose.”

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This report was a few weeks ago now so,  what are your thoughts on this finding?  Existing users, what precautions have you taken since this information has come to light? Please feel free to share?

Amina xx

The beeping D ……

As you may know I recently started a sensor trial, which started off really well. I got my sensor fitted everything was running smoothly until I decided I was going to go to the supermarket.

First supermarket trip

The moment, I stepped into the supermarket doors.

BEEP, BEEP, BEEP, BEEP, BEEP! (Anti-theft alarm)

Of course I totally ignored it and kept walking, there were so many people going in and out of the supermarket.

Major Side note: I was coming into the supermarket and in any case it’s not in my nature to shop lift.

I continued with my shopping, arrived at the till, paid for my goods and went through another set of alarms (WHICH WENT OFF).  I looked around because, that surely was not me! So I kept on walking. I reached the exit and walked through the doors with a herd of other people (YES the alarm went off again)! Still oblivious I continued to walk towards the car and go home.

“Wow those alarms were going off a lot. I wonder why?”

My second supermarket trip

Off I go to the supermarket nice and early to pick up a few things.

Side note: I love going to the supermarket nice and early. Its empty and I can just pop in and pop out. Job Done!

I reached the entrance and BEEP, BEEP, BEEP, BEEP!  OK I was the only one walking through, was that me? The guard just nodded and smiled so I smiled back and continued walking in. Shopping done and paid for. I approached the first alarm, BEEP, BEEP, and BEEP! No that was definitely me that time. I decided to turn around and go back to the lady at the till to make sure there were no tags in my bag. The lady checks and finds no tags. She encourages me to just go through. BEEP, BEEP, BEEP! That now confirmed that it was me beeping.

So embarrassing! I had a feeling that perhaps it was something to do with my sensor. I was totally dreading going through the exit alarms so I decide to let the guard know I was wearing a sensor and it might possibly go off as I go through the alarm. I showed him my receipt and my pump just in case he didn’t believe me. Off I went!

BEEP BEEP BEEP BEEEEEEEEEEEEEEEEEEEEEEEEEEEEP!

I continued to use the sensor but I just felt that whenever I tested my BGL it wasn’t even close to the numbers on my pump. After 12 days the sensor totally failed and produced an error message that read ERROR 0.

sensor fail

After 5 hours the sensor remained like this so I decided to call Animas (they are so helpful) and I ended up having a lengthy conversation with them. The lady I spoke to asked me several question and tried to get the sensor running again. However she finally said, that the sensor had failed and that I should remove it all together. When I removed the sensor it was bent and had barely pierced my skin. I also mentioned my beeping every time I went through the supermarket alarm. She said that it’s possible that the transmitter may have been faulty. I gave her the codes on both the sensor and transmitter and I was sent new replacements the following day.

I then restarted my sensor trial and I’m now on day 5, no errors or false readings. My BGLs have been spot on when I cross reference them with my BGL on my BG meter. I’m starting to see a clearer picture of what my BGLs are doing and have been able to make adjustments in my basal rates. It still needs some fine tuning but I feel I’m finally starting to iron out all the lows.

Has this (the beeping) ever happened to anyone else? Or have you ever had a faulty transmitter or sensor in general?

 

Amina xx