I am regularly praised for how well I handle my diabetes. At my last clinic appointment the team were quizzing me on how I do it and saying how disciplined I must be. And I am – of course I am, otherwise I wouldn’t be in the position I am now medically.
To those outside of the diabetes bubble though, my self care seems effortless. There is little understanding of what goes on behind the scenes (or the thoughts that are constantly at the back of my mind). To those people I apparently appear “perfect”. Any mention of diabetes is countered with “oh but you cope with it so well” or “but you don’t let it affect you”. But I am not perfect, I make mistakes just like everyone else.
The type of treatment I use to keep my blood sugars in check is an insulin pump. It is injecting insulin 24 hours a day via a cannula. It is an amazing piece of kit, but it does rely on regular human interaction to keep things ticking over. I have to do various things with it, such as put in the insulin in the first place.
When I woke up on Saturday morning I discovered my pump had been alarming overnight. It told me it was low on insulin, but I silenced the alarm as usual. It will first alarm when there are 20 units of insulin left, but as I use approximately 25u per day it is not urgent for me to replace the insulin reservoir immediately. As a general rule, I wait until I get the second alarm at 10u to go before taking action.
I bolused (took insulin) for brunch and didn’t think twice about it. We went about our day as usual. Mid afternoon I checked my blood glucose levels again and they were 9.4, slightly above my target range ( 4.5 – 6.5) and so I told the pump to give me a little extra insulin to bring me back down. I didn’t really think much of it as 9.4 is not really considered a high reading.
We had a busy afternoon and I was on my feet a lot. Often that would mean I end up with a low blood glucose (activity makes my blood sugars drop) but I just figured I’d gotten lucky. After Piglet’s dinner we took him over to the park to give him a chance to burn off some energy before bed. It wasn’t until we were there that I noticed the familiar dry mouth feeling, and a stiff jaw – a tell tale sign in me that my blood sugars are high.
I checked my blood sugars when we got home and found them to be 14.2 – well above target but thankfully not dangerously high. Before telling the pump to give me my correction I thought I’d double check how close I am to the 10u left threshold.
There was none left.
Not a drop. 0u available.
It turns out that the alarm I was receiving when I woke up in the morning was the 10u left alarm. By my estimations of how much insulin I’d use I must have run out when I was bolusing for brunch.
Basically – I’m a muppet.
It’s probably a fairly big design flaw that the pump doesn’t alarm again once the insulin has actually finished, but I can’t blame the pump for my error. I made a mistake, and I’m very lucky that I didn’t end up with very high blood sugars as a result.
There’s no excuse, I should have checked my insulin level and changed the pump first thing in the morning.
It’s not the first time I’ve made that sort of mistake. I once went away for the weekend with no testing strips for my blood glucose meter. And just last weekend I thought I had left my whole testing kit in Aberdeen when we were in Glasgow (I hadn’t – it was under the seat in the car).
I am not perfect. I try really bloody hard, but I make mistakes just like everyone else. I do try to learn from my mistakes though – so since my pump has just alarmed for low insulin again I’m off to change it!