In October 2014 I was formally introduced to the insulin pump and CGM. Up until that point my 18 years with type 1 diabetes was based around 1,000’s of finger pricks and injections. There was no real reason why I hadn’t investigated these amazing technologies earlier but I guess up until that point I was managing OK and just thought that managing diabetes was meant to be challenging. In saying that, my insulin pump and CGM technology has had an amazing positive impact on my life and I now find it hard to believe that I ever lived without them.
My journey onto an insulin pump and CGM started with my utter frustration that I was unable to target my insulin levels and BGLs around my increasing triathlon training loads and this difficulty and subsequent variability in my BGLs meant that I was unable to get the most out of my training sessions. Trying to get BGLs right over night for morning sessions, for recovery after sessions and then for evening session was really difficult when I was using injections at meals and before bed only. The daily variations in training, recovery and food needed a much more flexible approach. I was very lucky to be put in touch with another diabetic triathlete who also worked for a diabetes tech company. She put me in touch with a fantastic diabetes educator whose passion and knowledge for sport and exercise gave me great confidence in her advice. Having managed my diabetes on my own for so many years, thinking that I knew everything that I needed to, it was humbling and fantastic to get advice which nearly instantly changed my diabetes life.
Over the past two year I have achieved many things that I am really proud of as an athlete but especially as a type 1 diabetic. Some of my proudest achievements on my insulin pump and CGM have been:
- First Ironman Triathlon in 2015 at Ironman Melbourne (Asian Pacific Championships) in a time of 9hrs 28mins
- 600km unsupported ride through the Victorian high-country (one week after starting on the pump)
- Multiple Ironman 70.3 triathlons and personal best times
- Several open water swims
- Cycling Gran Fondo’s including L’Étape du Tour (Stage 16 of the 2015 Tour de France)
- First road marathon at the 2016 Melbourne Marathon in a time of 3hrs 1min.
Although I may have still achieved all of this if I was not on a pump or using CGM, using these devices has allowed me to train and races more closely like a non-diabetic athlete and have a far greater understanding of my physiology and why things happen (hypos, fatigue, poor performance, etc.).
For all of these great achievements there have been plenty of difficult and challenging times which have taught me a lot about managing my type 1 diabetes. Starting on the pump has also been the catalyst for me starting Type1Athletic and blogging about my experiences. Some of the great things which I have learnt from since starting on my insulin pump have been:
- Able to maintain very stable BGLs overnight including accounting for a BGL rise when I fall asleep and the dawn effect
- Achieve stable BGLs before, during and after training sessions including morning, afternoon and longer weekend sessions; all require different basal insulin rates and carbohydrate consumption
- Allowed for finer insulin adjustments at any time to account for meals and activities; the change from single unit pens to 0.05 unit adjustments on the pump has been significant
- No longer needing to carry around injections or pens
- With the need to understand carbohydrates (carb counting) I have learnt more about what I eat and what is actually in my food; I believe that my diet is now healthier
- With the need to adjust basal and bolus setups in my pump I have learnt a lot about how insulin works with my body and with the food that I eat
In terms of managing my day to day diabetes I believe that the development of CGM technology has had the greatest impact on my diabetes control. Prior to CGM I was testing my BGLs up to 30 times per day to provide me with the understanding that I needed to keep my BGLs stable throughout the day, especially when training. I started on the Dexcom CGM and have since started using the Freestyle Libre Flash Sensor, both sensors have provided me fantastic insight into my BGLs and made my day to day diabetes management a lot easier. Some of the benefits which I have found from using a CGM are:
- No need to finger prick test!
- Easier to check levels with the bonus of history and trends
- Provide far greater understanding of BGL variations including from physiological processes, psychological states, high and low GI carbohydrates and exercise
- No need to carry around a bulky blood testing kit any more
- Improved athletic performance by making testing and tracking BGLs far easier (finger prick testing on the bike is certainly a challenge)
- Some CGMs provide real time feedback which allow for trends and warnings to be setup; I see this especially being beneficial for young children who rely on their parents to check their levels, and people whose BGL awareness is not effective
Apart from a couple of years at University I believe that I have always had pretty good control of my diabetes. Before my insulin pump and CGM I thought that I had everything under control and I was satisfied with how I managed my diabetes day to day. Since starting on my pump and using CGM devices I now have better control and BGL stability, my understanding of how insulin, food and exercise effects my BGLs and physiological processes is far great, and I am far more educated about type 1 diabetes and exercise in general.
An insulin pump may not be for everyone but the development of CGM’s has been game changing for diabetics. Easier testing, BGL history and trends, along with warnings provide the best possible information for a diabetic to manage their BGLs. They can be expensive and this can certainly be a turn-off, but even using a CGM sporadically will provide you with a greater understanding of your diabetes. It is fantastic that technology is advancing so quickly now and I am excited to see what the future holds including advanced trails of a CGM closed loop system which is due to occur in 2017!
#All the information provided in this post is from the authors experience only and the opinions expressed are the authors only. See Disclaimer.