I never thought I would weigh over 200 pounds in my life, yet I stepped on the scales one day and weighed 214 pounds!
Having type 1 diabetes for 16 years, I always knew that being obese was not a good thing for blood glucose control. I was also aware that weight gain is a common side effect of insulin therapy.
I vowed to lose the weight, so I consulted with my certified diabetes educator (CDE) and was started on a weight loss program that consisted of a 1500-calorie, low-fat diet and an exercise program. As my exercise level increased, we slowly adjusted my daily injections of long- and short-acting insulin. Despite the weight gain, my blood sugars had always been under control, with most readings less than 140 mg/dl and HbA1cs under 6%.
Dieting and exercising sent my blood sugars on a rollercoaster ride, and if I planned a day of heavy exercise, I would decrease my long-acting insulin by four units. For some reason, however, if I could not exercise on a certain day, my blood sugars would rise to 400 mg/dl. If I found extra time during the day to exercise, my blood sugars plummeted to 30 mg/dl and I would have to increase my carbohydrate intake. It became a frustrating and vicious cycle of high and low blood sugars, and my CDE couldn’t find a happy medium.
One day, however, my CDE introduced me to the insulin pump. She felt it might help me to lose weight by offering me adjustments with insulin in tenths of an increment, and get me away from unpredictable, long-acting insulin. In June of 1998, I started wearing an insulin pump, and the first six months were trial and error. We would adjust my basal rates to an appropriate setting, only to readjust it a few days later.
During my adjustment period, I had daily contact with my physician and CDE. When I was finally adjusted to life on a pump, I was given the go-ahead by my CDE to start the low-fat, 1500-calorie ADA diet, and begin my exercise routine. I had to document every blood sugar reading, every piece of food I ate, and all my exercise activity.
To coincide with my exercise program, I programmed my pump to fit my very active lifestyle. On the days when I would wake up early to run, my pump was programmed to decrease the basal rate by 0.2 at 5 a.m. so that while I was running, my blood sugar would not bottom out. I would often walk after lunch, so my pump was programmed to decrease one hour prior to my activity. During my exercise, I decrease my basal rate by one-half, and if my hectic schedule or the weather puts a damper on my activities, I program my pump accordingly. I have been known to go on for days without time to exercise so, once again, I adjust my pump accordingly. None of this would be possible if I was still taking injections of long- and short-acting insulin.
Today I look and feel better than I have in years. My BMI has dropped from a very unhealthy 37 to a healthy 25. I now step on the scales at 142 pounds, and on days when I am feeling stressed out, I can exercise more easily to relieve the tension. The insulin pump has allowed me to enjoy life and become healthier at the same time.
Lisa Buntain is an insulin pump user who lives in Defiance, Ohio