Finding the chase and cutting to it

There’s a meme going round showing a young girl with a syringe in her body representing each of the injections she does a month.  She’s on multiple daily injections a month and conservatively the photo represents 120 syringes.

I am on a pump and this is what it is doing for me.

I have a microdose of insulin delivered every three minutes as a background or basal dose. (Each microdose of insulin, once given, is working in my body for the next four hours.)

If I were doing that with a syringe, that’s 480 odd injections a day.  On top of that (if nothing goes wrong) I then bolus for the food and drinks I have, call that 5 boluses a day.

So that’s equivalent to 485 injections a day and let’s say that are 30 days in a month, so that 14,550 injections a month.

That delivers between 57 and 87 iu (international units) of insulin or between 0.42ml and 0.67ml of 100iu/ml a day.  A month, that’s 18 – 30ml of insulin.

I use 3ml cartridges in my pump which deliver the insulin via a tube to a cannula inserted in my body.  The cannula is replaced every 3 days and the cartridge every 5th day on average.

On average, if I’m not using a Freestyle Libre, I do between 4 and 10 tests a day.  A month, that’s between 120 and 300 tests a day – I get 200 testing strips a month from the doctor.  Each testing strip needs a lancet.

If I’m using the Libre as a constant glucose monitoring system, that goes down to 20 tests a month on average.  I use two Libre sensors a month.

This is if everything works like it should.  My dose changes due to infection, stress, what I eat, how much sleep I get, how much exercise I take, if it’s colder, I need less insulin than when it’s warmer.  My period makes a big difference, not least to how my food is absorbed.

I was on injections for a long time, but when the pump and the Libre, I am managing a 4 hour window for how long my insulin lasts compared to 48 hours with long acting insulin.

I’m doing all this every day just to breathe.  No days off, no remission, no break.  When it goes wrong, I have to fix it.  Going wrong can be an air bubble in my pump cartridge or tubing due to changes in air pressure, a kink in the cannula underneath my skin, deteriorations in the plastic in the tubing, cannula or cartridge.  Temperature changes can damage the insulin (though my insulin is pretty tough compared to what I used as a kid).

I was diabetic from the age of 4, that means the majority of my time as a type 1 diabetic has been as an adult.

I have had prejudice, from being deemed not interested in career progression “because [I’m] ill” to people not wanting to be friends because of the responsibilities it incurs.

Some people believe:

• I shouldn’t have had my son because of the risk of passing it on (which is tiny by the way, compared to 0.2% risk of the general population having type 1, his chance of being type one is 0.8%).
• I should not have treatment because “it’s not natural”.  They believe I have no feelings because I inject and BTW, I shouldn’t do my injections at the table because it’s disgusting.  Or in the street or where anyone can see.
• It’s my fault my autoimmune system decided to knock out something critical.
• I should not talk about it because “it’s my health”.
• I’m not disabled because I can walk and talk.
• I’m not affected by high or low blood sugar outside of the inconvenience and distress it causes them.
• I’m in control of what’s happening to my blood sugar.
• It only affects me while I’m awake.
• I shouldn’t have free prescriptions, because I’m healthy.
• My doctor is constantly monitoring and making the decisions about my insulin.
• I’m too sick to do all sorts of things.
• I can’t live alone; I need looking after.
• I’m too busy with this to live.
• I need to concentrate on my health every second of every day (80% of the time, things just pretty much work.  When they don’t, it’s awful but most of the time, it’s OK).
• I should lose weight, not eat carbs, not eat meat, etc, and “[that] will get me off the insulin”.
• I’m too lazy at looking after myself properly (I get told that when I’m fighting the hardest to get things back to a normal keel!  Not by my family or friends who see what I do 24/7, but people at work do that a lot.)

I’m running a crucial part of my endocrine system on a four hour lag at best.  I’m doing really well but I am always reacting and always with that lag.

Even doing really well, there are consequences to the constant stress, medication and development of the disease.

This is what it’s like to live with diabetes.