My personal experience with iLet and putting the brakes on Diabetes burnout
Anna Sabino has been living with T1D for over 30 years and proudly offers expert emotional health counseling for children, adults, and families with T1D. |
I didn’t realize how burned out I was
Everyone’s definition of “burnout” is different. For me, the last few years have felt full of insanity parenting two littles, managing their every activity meal, snack request, and navigating my own diabetes management. As I reach for my pump, I will often quickly select ”32g” and say to myself, “Sounds right,” as I scarf down food to get them to bed at a somewhat reasonable hour.
I’m always rushing, yet never feeling truly satisfied with my bolusing decision. I just hope for the best result with the CGM graph to follow. I wait and see how things look, when I have time to take a second look.
My A1c hasn’t been over 6.5 in maybe 15 years. I know I could do better.
Even though I work from home, have all the resources in the world and access to the best healthcare, it is still “all on me” and my behavior to see the graphs and impact is of my effort. I know the input of the numbers (carb counts, BG values, ratios for food and correction) are really impacting my day-to-day more than I gave credit to.
Since math has never been my strong suit. I struggled with comprehension as a kid. Math involves multi-step thinking….and so does diabetes. When we bolus, correct, use our brain as it relates to planning (ahem ALL THE TIME), then we skip to the next thing. Yeah, yeah, correct and go, done. 2.6 units sounds great as my kid is screaming, gotta trust the pump, no time for diabetes today…. until you realize that today is becoming every day, and so on.
Until I met… the iLet.
I’ve been on the iLet pump now for 8 weeks. And of course, like any piece of technology, it has its quirks, but the mental and emotional guilt and feelings of “woulda coulda” aren’t there. There is no option for them to be there because the only time I give insulin is to say I’m eating a “usual amt, less than, or more than” and the algorithm of the pump determines the amount based off previous doses (the last 7 days) and aggregates them all.
I cannot correct a high blood sugar or input or change a basal rate. Some may cringe at the thought of not having that control, but after 36 years of doing it, it’s so freaking nice to have a break. There are also plenty of days when either I am planning to exercise or eating a low-carb meal that I don’t announce at all.
I will say I have had some lows and some annoying highs, but I trust the pump to bring me back down and bring me back up. I have no idea what my basal rates are and it’s not up to me to calculate anything. The math is hidden from the screen, and therefore my brain. AND I LOVE IT.
No rates or ratios to question, no settings to move around with. I can adjust the target (lower than which is 110, usual target which is 120, and higher which is 130). I can pause insulin if I need to manually (I do this approx. 30 mins before a workout).
I didn’t realize how much mental math and associated guilt around counting the carbs or trying to self-associate the shame was really impacting me. I can blame the pump not me. That’s powerful stuff.
A few things I have learned and want to share with you about the iLet Bionic Pancreas:
If I do see a trending higher BG, it doesn’t stay up for long. The ILet is SO fast at delivering insulin with both delivering a bolus and during the priming process. This means that even if I don’t pre-bolus by more than 5-10 minutes, my blood sugar immediately turns the corner. (I am using Humalog in the pump.)
Glass reservoir, not plastic, which I LOVE.
I can go 3 days without charging it. The pump uses a MagSafe induction charger that I can also use to charge my phone. It takes about an hour to charge the whole thing, which lasts a solid 4 days if not charging at all.
For the first few weeks, I was having a lot of lows. Not just sit at 70 and slowly come back up, but a LOT of lows, like 40s and symptomatic ones. I’ve learned to understand and work with the algorithm a bit and see within the phone app that each meal I announce is adjusting based on previous doses. This data eval has forced me to really try not to overtreat lows. For example, if my BG after a “usual meal” drops to 50 and then I overtreat and I spike to 200-all within a 4 hour period (the active insulin time in the iLet) it will think that because I was low but then also high that for my next lunch meal I will need the same amt of insulin if not more-which isn’t true. SO, I’ve really learned to not overtreat and then let the iLet do its thing. It’s helped A LOT.
One of the other main reasons why I was so excited about trying this was that I was involved in a clinical trial for this product back in 2013. I felt the same now as I did in that study long ago -the burden was stripped. I didn’t know or feel the responsibility and need to own all the decision-making. The saying that people with T1D make hundreds of decisions a day, yes, that’s true -but it’s not true with this pump. Some of those decisions are stripped away and I wonder if it’s helping my overall mood and level of anxiety just a little?
I’m unsure yet as to whether I will keep using the iLet long term.
As a Certified Diabetes Care and Education Specialist, I was given the opportunity to try this for up to 90 days.
If you are someone who only wants to bolus for a certain amount, or wants to enter a specific number every time you manually give insulin, this system may not work for you. If you often forget to bolus or correct, this may be good for you.
If you are not patient, need a break, and are burned out by all the data and options for shifting settings, I highly recommend giving the iLet a try.
