Diabetes Upgrade: New Pump and CGM

After several months of back-and-forth with the insurance company, medical supply company, and my doctor’s office, last week I went in to get set up on a new Minimed 670G insulin pump. The thing I’ve been really excited about is that this pump links to a continuous glucose monitor (CGM).

For the past 20 years, I’ve checked my blood sugar by pricking my finger about six times/day and putting a drop of blood onto a test strip. The CGM checks every five minutes, and gives me something close to a real-time graph showing my blood sugar levels and how those levels are changing.

I still need to do the finger-pricks, since the CGM isn’t quite as accurate, and needs to be calibrated. But this means I get much quicker warnings if my sugar starts to go high or low. It also gives me a lot more data to better refine how I take insulin to keep things under control.

Ironically, this came up as I was working on this blog post. I think there was an issue with the site where I plugged the pump into my body, which was causing me to not absorb insulin as well as I should. As a result, my sugar was high. It’s currently 255, to be exact.

Thanks to the CGM, I’d been alerted that it was going high, and had been able to monitor the rise and decide to change the set. Without it, I’d have waited until my next finger-prick.

You can see I’ve already come down a little bit from the peak when I changed my site. Theoretically, that line should keep coming down until it gets into the green-shaded area between the two horizontal red lines.

The only problem so far is that I tend to overreact. It takes time for the body to process insulin or digest and process food. If I take insulin now, I won’t see an immediate effect. Likewise if I eat, say, a chocolate bar, it could be 15 minutes or more before my sugar starts to rise. So if I’m high, I might take a correction dose of insulin. Ten minutes later, I’m still high! What the heck? So the temptation is to take another dose. Unfortunately, “stacking” insulin like this can result in an overcorrection, and suddenly my sugar is too low.

But I’m getting used to it, and I haven’t had any severe problems.

The other inconvenience is I now have not one but two things plugged into my abdomen: the insulin pump site, and the CGM sensor.

Warning: pale belly pics behind the cut.

The pump site is a small (17mm) flexible catheter connected to a tube running to the insulin pump. Pump is delivered through the tube, and life is good. This is much, much better than having to take 5-6 injections every day, which is what I did in my pre-pump days.

You can also see a few red dots from previous sites. Those heal with time, but it means my belly tends to be polka-dotted.

Now I also need to wear a sensor, that looks like so:

The small gray part on the left is the actual sensor. It has a tiny filament that goes into the skin to measure my blood sugar. The larger whitish piece is the transmitter, which relays the sensor readings to my pump. The whole thing is held in place by three layers of thin, flexible tape.

That’s a lot of tape. Far more than I’m used to with the insulin catheter. I discovered that removing said tape, while it’s not as effective as waxing my stomach, still removed about 50% of the hair. So…yeah, I now have a shaved belly.

I go back next week for more training on additional pump features, but so far, I’m really appreciating the CGM. It beeps and buzzes at me a lot more than my old pump, but it should give me better control. And it’s one step closer to becoming a cyborg superhero.