A few weeks ago, I disconnected Sugar's pump for 24 hours because we were planning to spend a full day swimming and playing at a water park. Despite the fact that Sugar's pump is waterproof, she prefers not to wear it while swimming. Our usual pool visits last for about 2 hours, and we've figured out how to balance her activity level and disconnected time pretty well. But, on THIS particular day, we were planning to remain disconnected for 8 hours or more.
Well...your pancreas can't just take a day off!!!
Could you imagine that? "Well, Mr./Ms. Human Body, I just don't feel like showing up today. In fact, I think I'll just start showing up whenever I feel like it, until I finally decide that I want to leave this gig for good."
That's basically what happens when someone is diagnosed with Type 1 Diabetes. The Old Panc just calls it quits for no apparent reason.
And...if you didn't need a constant flow of insulin to convert food into energy to be used for pesky things like, say, BREATHING, BRAIN FUNCTION, or a BEATING HEART...well...then shutting off your pancreas for 8 hours while you decide to play in the water might be an option.
BUT...since it's NOT, then I suppose you need a plan to get the basal insulin your body needs.
Enter Lantus. (Or whatever long acting insulin you'd prefer.)
(Oh, wait...before I go any further, let me remind you that I am not YOUR doctor nor am I in charge of YOUR broken pancreas. Lantus is the 24 hour long acting basal insulin Sugar used prior to the pump. Whether for yourself or your child, be sure to consult your doctor before modifying the insulin regiment you are in charge of managing.)
Anyway, I reviewed her Total Daily Dose (TDD) from the previous 7 days and averaged them. Then I administered half of that amount via Lantus injection. Afterwards, I set a temp basal of 0 units/hour for 24 hours and removed her pump. For the next 24 hours, I used her pump to administer boluses for meals/snacks, and to keep track of the active Insulin On Board.
(Once again, let me remind you to consult your doctor before flying off the deep end and shooting yourself/your kiddo up with a random dose of a powerful insulin that lasts for 24 hours.)
It worked well, and she had a fun-filled day!
That being said, here's a few cons you should consider as well:
- What's your copay for a vial of long acting insulin? Ours is $40. That's an expensive one-time shot. An opened vial of Lantus only lasts for 28 days.
- Without a constant flow of insulin, the cannula under the skin could be at a higher risk of malfunction. The only way you'll know is when you see a wicked high about 2-3 hours after eating. BLECH!
- If you don't give the correct Lantus dose, you'll spend the entire 24 hours chasing lows or correcting highs. Once it's done, it's done. There are no temp basals to save the day!
So there you have it! A short review of our experience with untethered pumping.
(Here's another explanation, though it does vary slightly because the author uses 75% of his basal as a Lantus injection and keeps the pump on for the other 25%.)
Now get out there and enjoy summer :)