Tag: Insulin pump

The itch that won’t quit

From time to time, when I change my infusion site it itches like mad. We’ve all had that itch that just won’t stop. For me, its the site where my insert has been stuck to my body for 2 or 3 days or even a freshly inserted infusion set. It itches and itches and I really have to try my best to resist the urge not to scratch it to death. From the moment it makes contact with my skin or from the moment I remove it, the itch becomes unbearable.

When removing the insert, it can also prove to be very difficult as the insert is extremely sticky. It clings to my skin for dear life and I sometimes find it difficult to separate it from my body. What makes it even harder are those awkward new sites you decide to try out. You transform into a performing Cirque du Soleil acrobat whilst manoeuvring your body to get it in the right spot.

As for a new insert, ripping it off a brand new site would be an absolute waste (especially since diabetes accessories are so costly) and for those old tatty insert’s that just won’t let go, you just want to tear them off!!

After removing the insert, the skin underneath reveals a raised surface, slightly irritated and now, finally, it is able to get some air and it just seems to itch even more.  A grey sticky adhesive coats the area where the insert once sat and resembles someone who hasn’t moisturised their skin for days.

I remember having itching issues from time to time when I was on multiple daily injections (MDI) but not as much since I’ve been an insulin pump user. I suppose when you introduce something foreign on to your body that isn’t supposed to be there, it can cause a number of potential of problems. Several aspects of insulin pumping can cause skin irritations or allergies for diabetics. Causes may include the Teflon cannula, the metal needle, the site adhesive or adhesive materials, and even the insulin itself. When I was MDI, my itching was mainly due to the overuse of certain sites and the metal needle.

When it comes to my itchy insert sites, the truth is it happens very rarely and I haven’t really been able to pinpoint the direct cause of the itch. So, for now, I think I’m just going to try my best to keep rotating my sites, moisturise those sensitive sites (after 22 years I’ve got quite a few) and just continue to keep my skin well moisturised and maybe even try a protective cream to create a barrier between my skin and the inserts to reduce any irritation. With everything that diabetes throws at me I try my best to work it out and make it work. Although I get an itch from time to time, I’ve accepted that it is a part of MY diabetes and that’s ok. I’m very lucky to have a pump and I can deal with a little itch now and again.

Amina xxx

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The curious Peanut boy

My 3 year has a very inquisitive mind and could absolutely drive you mad with the millions of questions he can come up with. isa scooterHe never wants to hear the straight forwards answer. He always wants the answer with detail. He loves learning about new things and is absolutely obsessed with everything from Space, to Volcano’s and the sea. His favourite subjects of discussion right now are the human body and my diabetes.

I’ve never felt that I have to hide my diabetes from anyone and it has never been a secret to my son either. He is very use to seeing me changing my inserts, playing with my insulin pump, pricking my fingers and he’s even found strips I’ve dropped in some place or another. If I’m guzzling down a sweet drink, he’ll ask me, “Mami is your sugar going low, low, low?” He’s very brave and has come to understand that in situations where my BG is dropping, that I need something sweet. He’ll run to my “special” cupboard of sweet goodies and bring a whole selection of foods and drinks. Of course he’ll wait patiently, smiling his biggest smile, waiting to get his sweet or sip of my drink hahaha! 

I guess right now he’s just taken a strong interest in my diabetes. Instead of just being an observer he wants to get involved and help me with anything diabetes related. He has even asked me a few times to test his blood glucose level and is starting to understand what a good number and bad number is. He’s even asked me if he can insert my insert. On many occasions he’s been with me at my diabetes appointments, taking it all in.

I recently made the decision to teach him how to dial my husband’s number, family members and even the emergency services. Just in case I may need any of them and he is the only one there. Thank god this has never happened and I pray I don’t need him to call anyone in an emergency. Surprisingly enough I ask him from time to time if he remembers and he recalled every instruction and number I gave him. He never ceases to amaze me.

Being a mother with diabetes I feel that it’s very important that my son knows about my condition and doesn’t feel ashamed or afraid of it, but instead that he knows every aspect of it. His recent curiosity and approach to diabetes makes me very proud. He has a great deal of awareness of what diabetes is and how it affects me. Now that he has taken an interest I try my best to include him in what I do on a daily basis. If he has any questions I always give him a good answer. He now knows that although he doesn’t have it the lady in his life (his mami) does. I’ve come to realise that although it affects my life ultimately it also has an effect on his life.

I really hope that other mothers and fathers with diabetes will be able to read my post and not feel that they have to hide their condition from their children. Include your children and don’t feel ashamed to share this aspect of your life with them.

Amina xxx

Get creative with Diabetes

Since, I didn’t get a chance to join in on the Diabetes blog week. I wanted to post this creative piece, which I had already prepared a while ago.

The moment I realised,

I RUN ON INSULIN

The Bond

Where would I be, without my insulin pump?

My constant supply, my night and day.

My everything, my all, the strength by my side.

My companion and I, we struggle, we stride, yet we continue to survive.

You who I can depend on, I will defend you, always on your side.

You endure, my highs, my lows, with no word, no sighs.

You are forever committed to me, for as long as I stay devoted to you.

What would life be, without your endless support?

Every day a new challenge, we fight, we fall, yet we’re still standing tall.

Oh How I envy you sometimes, looking all so poised and refine.

Memory takes me back, to when me and mine would work just fine.

Connected we will stay, till the end of my days

Me and my insulin pump.

By Sugar High Sugar Low

 

Work your sites

© Dmitry Lobanov - Fotolia.com

© Dmitry Lobanov – Fotolia.com

By sites I mean, injection and insulin pump sites. The site, where a needle must pierce the skin to allow insulin to be delivered into the body. As a type 1 diabetic, this is something which can’t be avoided. Whether you’re using an insulin pump or injecting, it’s really important that you rotate the sites you use.

“ROTATION IS KEY “

After many years of injecting, and now using an insulin pump. I must admit at times I do get comfortable with using certain sites on my body. It’s very easy to slip into the “bad” habit of using the same sites over and over.

Print“It gets comfortable! It’s easy to manage. It doesn’t hurt. If I try a new spot will it bleed? Will I have to redo it? Let’s just stick with the thigh today.”

No rotation = lumpy bumpy body

Over use of sites will stimulate the development of lumps. These lumps often seem soft and grape like at the site of injection. The proper term for these lumps are,

Fat hypertrophy also known as hypertrophy or insulin hypertrophy.

These lumps are a build up of extra fat deposits, due to the site being used too often. The Insulin injected isn’t able to flow around the body freely. The way insulin is absorbed is changed, and is unable to circulate as it should do. Therefore making it more difficult to keep blood glucose levels on target.

So what sites can we use?

Here are a few of the sites which can be used when attaching an insulin pump or when injecting with injections. Also refer to the picture below.

  • Stomach
  • Bottom
  • Waist area (love handles)
  • Thighs
  • Backs of upper arms

sites

When I use to inject 5 times a day, the frequency of lumps and bumps occurring were very common. I changed the size of my needles to the (novoFine 0.3 x 8mm needles) to help to prevent these lumps. Even though I was “rotating my sites”, and I now had “these finer smaller needles” I would still develop small bumps under the skin. I found that exercise helped to get rid of these lumps.

Now that I’m using an insulin pump the occurrence of lumps and bumps are far fewer. I try not to leave my insert on a site for more than 3 days ( *this also happens to be the maximum recommended time by the *CDC). After this point, I find that my skin does become raised and bumpy.

Site Rotation tips

“Monitor those blood glucose levels (BGL’s), because literally your life depends on it.”

As time goes by you will start to realise which sites are better for the best BGL control. Talk with your diabetes team and see if their suggestions are good for you.

  • Avoid injecting or placing your pump near your belly button, or near any moles or scars. Tissue in these area are usually a lot harder. Therefore insulin absorption will be a lot slower.
  • Try to use your outer upper arm, this part is a lot fattier. Placing an insert or injecting in this site is difficult, so when I put on an insert I press my arm against a wall to attach it.
  • Thighs – avoid inner thighs, because it could be more painful!
  • Change insert every 2 -3 days and change needles after every use!
  • Make sure the area you are going to inject or attach your pump to is clean.
  • Don’t get comfortable. Don’t use the same sites. Work that body! Avoid those unsightly lumps and bumps
  • Get your sweat on. Try to find an activity that you can maintain and most of all enjoy!

Which are my best sites you ask?

Well, the best sites for me have changed throughout the years. I try my best to avoid my thighs and stomach area (when I was on injections these were my favourite sites). By frequently injecting in those site it has left me with a few small lumps, but being active has helped to reduce and even get rid of the lumps. At the moment, I’ve found that the upper backs of my arms and my derrière region are great for the best blood glucose levels and my overall control. I have no idea why this is. It’s just right for me right now. Everyone’s best sites are different. It’s up to you to figure out which site is best for insulin absorption.

“Remember to rotate your sites, avoid those lumps and bumps on your skin, and find the best sites for you to be able to achieve the best blood glucose levels.”

Changing the “insert” before it needs to be changed

insert 1-This pictures to the right is a insert from different angles. The Picture towards the bottom is the piece that is inserted into my skin. The tubing is connected to my insulin pump.

There are times, when I attach my insert and it just won’t stay put, It doesn’t feel comfortable or it is stuck to me like glue. These all result in me having to change the site. These are a few examples of when I may have to change my insert.

  • Accidentally rubbing my hand over my insert and detaching it. I need to replace it.
  • Creaming my hands and skin and I start to feel my insert peeling.
  • As I attach the insert I get a sharp pain, followed by blood coming through the tubing of my pump. I need to replace it.
  • In the middle of the night, my pump has a fit, because there is an occlusion in the tubing.
  • Time to replace my insert and it just won’t come away from the site. AHHH!

Have you ever had lumps and bumps? Which sites are best for you? Do you get comfortable with certain sites? What do you do to stay active and get rid of those lumps?

*CDC – Centers of Disease Control

 

Test your sugar girl!

Blood glucose  levels = diabetes management

BE HEALTHY KNOW YOUR BGLA major aspect of being able to manage my diabetes is to regularly test my blood glucose levels. This involves inserting a test strip into a blood glucose machine, pricking my finger to draw blood and applying my blood to a test strip.

Testing blood glucose levels (BGL)  is a way for a diabetic to gauge what sort of  levels they are working with. For someone without diabetes this isn’t necessary,  as the body is able to keep the levels in a healthy range automatically. The body produces insulin and allows glucose to be released as energy.

What are the healthy ranges you ask?

In order for me to explain the levels a bit better. Please refer to my table below.

 Type Before Meal  2 hours After Meal
Non diabetic 4.0 – 5.9mmol/L Under 7.8 mmol/L
Type 1 4.0  -7.0mmol/L Under 9.0 mmol/L
Type 2 4.0 – 7.0mmol/L Under 8.5 mmol/L

For a person without diabetes, a normal blood glucose level usually ranges between 4.0mmol/l (72mg/dL)  – 6.1mmol/L (110mg/dL). After a meal, blood glucose levels may increase for a short period of time up to 7.8mmol/L (140mg/dL). With Type 1 diabetes there is the risk of blood glucose levels either raising (Hyperglycemia– this is when an excessive amount of glucose circulates in the blood) or dropping (Hypoglycemia – this is a  diminished amount of glucose in the blood.)

After years of testing, it’s something that you don’t really get use to. For me, it became something that I had to do, even though at times it can be painful, it can leave marks and has hardened my finger tips. The harsh reality is,  that it is a crucial part of being able to manage your diabetes.

How I manage my blood glucose levels

From the very beginning (at the age of 11), I tried as much as I could to take and record my BGL by myself. This was something which was encouraged during my time in the hospital and also at the diabetic clinic. However my parents supported me with this, but never pressured me. I felt comfortable to check my BGL and even inject in front of them and my siblings. They continued to except me for me, and never made me feel any different to them regardless of my condition.

Throughout my 19 years as a diabetic, I’ve gone through my fair share of blood glucose machines. There is such a wide variety of blood glucose machines out there. Most blood glucose machines work in the same way. In the sense that you get a blood sample and a blood glucose result in the end.My first blood glucose machine was big and bulky, required a large sample of blood and  took much longer to produce a blood glucose reading. I was advised by my diabetes team to test my glucose before and 2 hours after my main meals. My blood glucose levels (BGL) would then be recorded in a log book like this.

log book 3

The log book  allowed me to make notes of my insulin doses for that day, week etc. Also any general notes I wanted to jot down could be written in there. Now that I use an insulin pump my log books have changed and I tend to test a lot more frequently.

LOG BOOK

My blood glucose machines now are a lot more advanced and allow me to study the data a lot more closely. I enjoy formulating patterns and occurrences in blood glucose levels etc. (I think this is just the scientist in me). However, it does help me make changes or suggestions to my diabetic healthcare team during appointments.

The right machine

Here are the machines I’m using at the moment.

BGL MACHINE1

It’s always good to have a backup machine. Choosing the right machine is extremely important, because essentially it will allow you to know what is happening with your BGL and help  you to keep within a healthy range.  Personally, I prefer something that is small, easy to carry and requires a small blood sample.

Some insulin pumps, like the (Animas vibe) have the capability to continuously monitor blood glucose levels. These continuous CGM (Continuous Glucose Monitoring) glucose sensors are connected to the body and work with the insulin pump to retrieve blood glucose results. With the BGL’s retrieved, the CGM is able to formulate graphs. This comes in handy when it isn’t possible to test i.e. during the night, early morning, during a workout etc. The CGM is able to alert the user when blood glucose levels are increasing or decreasing. I hope to get my CGM sensor soon and will definitely share my experiences using one.