The Family Centre’s Adult Community Coordinator Gabby Lane has lived with type 1 diabetes for nearly nine years. In that time, she has used numerous blood glucose meters, two insulin pumps and three different types of continuous/flash glucose monitoring devices, so it’s fair to say she has experience in the diabetes tech department. Here’s her story about her recent ‘tech break’ and what she learned.
Gabby Lane wearing her CGM loud and proud with her friend Annie
Like many others, I found the sudden and massive changes to the way we live and work that came with COVID-19 quite overwhelming, and the frequent scary updates about how the virus could affect people with underlying conditions like type 1 made me feel very anxious. At the time, I was wearing my pump and CGM, and the constant need to pay attention to my diabetes tech, respond to CGM alerts and attend to set change reminders started to make me feel even more stressed. In response, I withdrew. I stopped responding to the alerts and alarms and my diabetes management went haywire. I have been in this situation once before, and I know the solution to getting back on track: take a short break from diabetes technology, clear my head, and reset.
I wanted to make sure my technology break was safe, so I checked in with my diabetes educator to convert my pump basal rates into a long-acting dose and have my carbohydrate ratios and insulin sensitivity factors reviewed. Then, I took my insulin pump and CGM off, picked up my insulin pen and glucometer, and started doing diabetes manually.
Here are the 9 things I learned from my diabetes tech break:
1. The next injection comes around much quicker than ‘set change day’
I used to think that ‘set change day’ came around quickly, but I soon learnt the next injection came around even quicker. After a short time on pens, I remembered that I preferred one time-consuming set change every three days to having to prepare and do four or five injections every day.
2. I’d rather have annoying alerts than the realisation that I forgot to check my blood glucose
Realising you forgot to check your level for ages or forgot to bolus for a meal is a horrible feeling! I probably would have gotten better at remembering over time, but I really missed the alerts from my tech giving me little reminders to check on my level or complete a bolus.
3. My medical expenses were reduced significantly
Not having to pay for insulin pump and CGM consumables, which aren’t generally subsidised for people over the age of 21, was a relief for a few weeks. Over a year, I need to spend around $7500 on consumables alone; with the private health insurance I need to cover my pump on top, my tech bill is over $8700 a year.
4. My insulin pump is a much better calculator than my brain, but I liked manual calcs too
The insulin pump is a marvellous machine – its in-built bolus calculator relieves much of the burden of complicated insulin dose calculations. Going on a tech break showed me how much I rely on my pump, and was a good test as to whether I could still do dose calculations ‘manually.’ It was hard having to calculate everything in my head (note, I could have used a standalone bolus calculator but chose not to), but I found I actually enjoyed the opportunity to own my diabetes calculations – it felt like taking my power back.
5. Stick to the status quo if it works for you
I often get the urge to ‘change things up’ with my diabetes management, but you know what? If it ain’t broke, you might not need to fix it. My tech break was a great reminder of why I went onto the technology in the first place. I quickly realised why I moved away from long-acting insulin to the much more flexible basal rate settings of an insulin pump. My basal needs change at different times of the day, and being committed to a set once-daily dose of Lantus felt inflexible and frustrating.
6. My time-in-range improves significantly with a CGM
Alongside the power of peer support, starting on a CGM was the game-changer for my diabetes management. A break from CGM reminded me of the value of the information it provides and how much I have come to rely on the ‘trend arrow.’ Having a CGM keeps me more accountable, I have more time in range and, despite the alerts and alarms, I have more mental clarity. Plus, finger-pricking multiple times a day hurts!
7. My diabetes management is more finely-tuned with an insulin pump
Having the ability to modify basal rates and to microdose insulin with my pump allows me more finely-tuned dose accuracy compared with injections. Overall, I have better blood glucose levels and more time in range when I am wearing my insulin pump compared with injections.
8. A tech break is a great opportunity to re-evaluate your diabetes goals
When I decided to go on my tech break, I thought the main outcome would be some more headspace and time away from the alerts. However, the break made me reflect on my diabetes goals. I found it wasn’t just the technology that was making me anxious and jumpy – I had some work to do to set myself up for success. I asked myself whether what I was doing in relation to food and exercise was working for me. I realised I needed to carb count more accurately, pre-bolus more, get more exercise and relax a bit on food. I also needed to connect more with my type 1 tribe. I’m working on those things and I feel a whole lot better now as a result.
9. Go back to your tech when you're ready
I know that when I utilise diabetes technology to its full potential, my life is significantly easier. I made sure I only plugged back in when I felt ready though, and I know the option of taking another break is always there.
I'm glad I took a technology break: I had a break from the alerts and I learned a lot about myself and my type 1 diabetes in a short space of time. Diabetes tech can have profound benefits – it’s been shown to improve HbA1c, time-in-range and overall quality of life in many users – however, others report that the intrusive alarms, constant stream of information about glucose levels and the feeling of being tethered to a device feel overwhelming. We need to feel confident and comfortable to deploy our technology to its best effect when we want to, and also to put it in a drawer when it's too much.
If you need support to go on a tech break, or you’re keen to explore trying diabetes tech, contact the Family Centre on 9446 6446 or hello@type1familycentre.org.au – our community and clinic are here to support you every step of the way.