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Anna Sabino, MSW, CDCES

The overwhelming feeling to override pump settings

SO MANY DECISIONS!

I really do think people with diabetes make hundreds of decisions daily, I’ve never counted, and recently I’ve realized that something that really really overwhelms me a lot is the suggested bolus amount my pump spits out at me after I feel like I’ve carefully tried to count each carbohydrate, determine my level of activity both prior to and post bolus, and any other internal hormonal variable happening currently. BLAH! It’s like forcing me to second-guess myself with another piece of data….

And…whoa! Wait a minute, I`m eating xxxx and it only wants to give me…huuuuh? It is soooo overwhelming. Meet, the override!

Why is it so overwhelming? Either it’s not the amount of insulin I was expecting, or I really think it’s too much. Is it on par with what our gut is thinking? Do we go with what the pump says? Or do we override its calculations and use our own brain to make the decision?

This number has been carefully calculated based on OUR settings, ones we have inputted. Our targets, our ratios etc.

using insulin pump

When we override it means that we are….

  • second guessing the pump and its job
  • allowing our brain to be threatened by yet another decision to make and then to feel guilty about.
  • more data for our head to process, think about, stare at.

AND:

  • A chance to trust ourselves, that we are leaning on our other variables the pump can’t and won’t know when deciding to go against its suggestion. (it doesn’t
  • know that you just worked out for 30 minutes, or that maybe you’re sick, or about to sit on a plane for 3 hours).
  • A chance to trust our systems, and learn to rely on them for safety.
  • A chance for us to ultimately get to our physical and emotional health outcomes using the combined decision-making of us and our external pancreas :)

But what if it’s off? What if I go low? Is it that it is easy to just “blame” the pump’s calculation? Or is actually looking at the number the pump wants to give us really just more of a surprise?

Sometimes we will nail a bolus, and a lot of the time we won’t. Blood sugars rise for so many reasons that we can’t and won’t ever know the answer to why. People who don’t need to make these decisions 24/7 have the pleasure of making a natural amount of insulin and they never ever know exactly how much is secreted into their bloodstream! Fascinating how much we now know!

Some phrases to say to yourself as you give this insulin over and over are…

“I have the tools to adjust my settings”

“This is just a number, and I am ok with my decision.”

“I am changing my mind and overriding this decision, the calculations helped me figure this out.”

Overall, overriding the suggested dose isn’t a bad thing at all, and when we do it more often than not, or finding ourselves deciding to adjust the dose a lot of the time, it’s a good idea to review your data and perhaps make some adjustments so you can get your numbers where you want them to be. It’s all about trust, both in yourself and in the system. It takes time. You got this!

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