The following story tells the individual experience of someone using insulin pump therapy and frequent blood sugar monitoring to manage his/her diabetes. As you read, please remember that the experience is specific to the individual. While clinical studies support pump therapy and frequent testing as effective tools for controlling blood sugars, results may vary, and not every response will be the same.
MiniMed and Mt. Mitchell: A Diffierent Kind of Fun
By Richard Entrekin for Medtronic Diabetes
I'm a husband, a father, an engineer, a cyclist, and I have had diabetes for 28 years. I've been pumping with a MiniMed 508 for three years, and this story is one more data point about the wonderful flexibility of the pump. This story is about an extreme event. In no way am I suggesting that any person needs to go to such extremes to be healthy, although I do feel that a regular exercise regimen has significantly contributed to my good health.
More than anything, the following is a tale of the spirit and the will that it takes to live well with diabetes. It's one part clinical (my insulin pump strategy) and one part psychological (my "anything is possible" attitude). Of course, people may say that the only part is that I am "nuts." However, it depends on your perspective: A very good friend of mine characterizes challenging situations as a "different kind of fun." Read, and you will understand.
In the early spring of 2002, I decided to do a bike ride in the east called The Assault on Mt. Mitchell. It's 103 miles of strenuous riding with 11,000 feet of vertical climbing. This ride perennially makes the list of the 10 toughest rides in the United States. Ugh! While I have done this ride eight times previously, those were before I converted from MDI to the pump. So based on the remarkable results I was getting in everyday life, I wanted to see how much difference the pump could make in such an extreme event.
The first challenge was to figure out the right dosing regimen that would allow hours and hours of ride time without "bonking." As many of you other athletes know, the extra hurdle we face (relative to the average weekend warrior) is achieving the fine balance between food, exercise, and insulin. It turns out it was much easier with the pump than the elaborate schemes I used to use while on MDI.
If you are on the pump you have already learned how to find the balance. The same concepts you employed to determine your basal rate and bolus calculations can be applied to exercise activities. I used a simple strategy of fine-tuning a basal rate that kept my blood sugar stable during a ride of two hours or more while ingesting a fixed number of carbs per hour. Sure, I used my meter a lot while training and kept meticulous logs of blood sugar, basal rates, and carb intake. It wasn't any harder than the routine we all go through in initially setting up the pump. I found the steady carb intake with a reduced basal rate worked much better for me than trying to find a bolus for every snack and energy drink. On the bike you are constantly eating and drinking small amounts rather than periodic inputs of food and drink, so fiddling with the buttons didn't seem like a good option while riding amongst hundreds of other riders. Of course, you have to experiment to find what's best for you. I think this approach would work well for long walks, runs, hikes, tennis matches, and other sustained physical activities.
After training steadily for a couple of months, I drove from Texas to South Carolina to meet up with some old cycling buds. The night before the ride we met for dinner, and that's when the fun began. I didn't feel well. At all.
That's a bummer, I thought: I couldn't be sick now, right on the eve of the big event. Maybe if I just walk around the parking lot for a second, I'll feel better. Hmm. No, it was getting worse. . . .
I didn't think I could stay in denial much longer, and so I admitted to myself that this was a "for real" kidney stone attack. Ouch!!! Well I didn't want to interrupt my friend's dinner with such a trivial thing as a kidney stone (!) so I just performed war dances in the parking lot until they were finished. An ambulance was summoned, and we visited the local emergency room, where I continued gyrations and audio effects while insurance info was verified. Never mind that I was a raving lunatic by then. Brothers and sisters of the stones, you're laughing because you know it's true. The rest of you don't want to know.
This was a disaster. This couldn't be happening, I recall thinking. I writhed in agony for several hours while the ER doc sewed up some drunks, and low and behold . . . just as the doc enters the room, the pain stopped. Completely stopped. "Hey, bring me a cup," I asked, in shock. Plink. There the devil appeared, right in the bottom of the cup.
Well, I told the good doctor that I had to leave, that I had a bike race in a couple of hours. Of course he said I shouldn't be doing that, that I should take it easy. Doc, you should never underestimate the human spirit.
We lined up on the start line, and it was cold and raining. A miserable way to start a ride, but a lot better than I had felt a couple of hours before. It was pretty uneventful for the first 70 miles, until we reached the big mountain. I was eating according to plan, and checking my blood sugars on the hour. Everything was between 100 and 150, and I was riding surprisingly well by my personal standards.
Then, the previously nasty weather turned even fouler. "Oh yeah," I remember thinking." This is a different kind of fun." . . . .Fun is, of course, defined by riding uphill - a steep uphill - for 27 miles while its 40 degrees, 40 mph wind, and occasionally raining. "And why was I doing this?" my private dialogue continued. "Oh yeah . . . . To prove that I can."
Despite everything, I finished the ride in eight hours and 20 minutes - a personal record for me. No bonks, and no nausea from overeating to feed the insulin. Thanks, Mr. Pump. Take that Mr. Diabetes.
The point that I've tried to make here is that I am an average guy, and if this tale helps you to tear down your self-imposed limitations . . . well, then we all win.
Oh, and one more thing: I'm going back next year.
Information on this site should not be used as a subsitute for talking to your doctor.
To find out if intensive diabetes management using insulin pump therapy and frequent blood sugar monitoring is right for you, call 800-MINIMED (800-646-4633) or 818-362-5958 for a referral to a diabetes specialist.
