UPDATE -** NOVEMBER 18TH 2013 ** - I HAVE FINALLY BEEN APPROVED TO USE THE I-PORT! Why it took my insurance company so long is beyond my comprehension - but now I'm so excited - especially when I take my next holiday!!!!
Okay, okay, don't get your nose out of joint - my fellow insulin pumping peeps - that I'm saying that the i-port is a mini-me insulin pump - but in away - when you look at it "logically" without any anger from my statement - I AM the "mini-me" pump - I am the brains behind what goes into my body - via the i-port - I AM IN CONTROL - not a machine - that I've programmed with best intentions to keep my diabetes health in control.
Yes, I still have to give a separate shot for my "basal" rate with long acting insulin - I do this twice a day - 12 hours part seems to work best for me. The basal rate is basically what your pancreas - if it's working - squirts out all the time - in order to keep your blood sugar in a normal range when your not eating, etc. With diabetes - your pancreas can be abit on the wonky side and either work when it feels like (e.g. Type 2) or like myself as a Type 1 - where my pancreas is dead as a door nail.
The recommendations of the i-port website is that only ONE type of insulin being put thru' the port via either a pen needle (no shorter than 5mm) OR a syringe (29 gauge is thickest - otherwise you will possibly punction the wall of the cannula) - and I'm fine with that. With a "real" insulin pump - which has an insulin cartridge (the i-port does NOT - you INJECT insulin via the port) - it's programmed to squirt out ""X amount" of rapid acting insulin - for your basal rate as well as your bolus rate (aka - if you have to correct a higher than normal blood sugar (BG) or for when you are eating a meal). If this has got you abit confused about the types of insulin - check out the link from Diabetes.co.uk that explains how injected insulins work in our bodies.
My messy diary along with box from i-port |
The good thing about the i-port - less expensive then the alternative of an insulin pump (I can purchase the i-ports at Diabetes Express for $149.99 CAD for a box of 10). This is bit less expensive then what I was paying for my infusion sets with my insulin pump - but the even bigger saving for me? I'm not having to pay for a pump which ranges from $5-7K depending on where you live - along with the other supplies that go along with the pump (insulin cartridges, batteries, replacement caps, etc.).
i-port put in place (really easy) |
I have submitted a predetermination form thru' my husbands workplace insurance in the hopes that these ports will be covered - hopefully at 100%. So wish me luck - since I'm really REALLY missing my little i-port right now - I felt very spoiled using the two I was sent. It's almost how I felt when I first disconnected from my pump - and went back onto multiple daily injection (MDI). After almost a month of learning how to stay in the BG zone with MDI - I can now say - that ANYONE can do it - if they put their mind to it - and now I'm not missing my pump as I go into my 4th month of being pump free.
It stands out about 1/2" or abit less |
My conclusion? For anyone without insurance coverage - dislikes injecting to the point of not wanting to inject (not good - tisk - tisk - who hasn't done that in their life time with diabetes?) - I really think this is the route to go - to keep a diabetic from suffering the effects of poorly controlled diabetes.
Where can I purchase the i-port? I live in NYC, USA.
ReplyDeleteIf you click on the i-port link in my blog post Joe - you will find the information in the Contact area probably. They are VERY quick with replying back to emails - and also I believe in the USA you can phone them via 1-800 number - again - listed on their site - if it's easier for you - here's the link to save you some work ... http://www.i-port.com/contactus.html
DeleteActually, their USA Toll-Free number is 1-877-763-7678.
DeleteOkay - thanks alot Anonymous - I guess the link didn't work for you - sorry if it didn't (it did for me - with the same number shown on the page). Are you thinking of going onto the i-port yourself? If you do - let me know what you think. I sadly never got permission from my company insurance company here in Canada to use them. So currently using insulin pump again - while it still works - when it dies - will go back to MDI (multiple dose shots) - until I can figure out what to do next. I did really LOVE the i-port - but just have to find a way to afford it - especially with limited income when I retire. Ducking fiabetes - it really can put a drain on your finances at times!!
DeleteWhat type of insulin does the i-port utilize? If it was stated in the piece I am sorry retinopathy plays havoc with my abilities left.
ReplyDeleteWebb1141 - don't quote me - but my undersanding is that it utilizes ALL insulins available on the market. I just know in my case - as written above - I use a slow acting insulin - that has to be injected in another part of my body (as it sort of becomes a "pool" from my understanding of how it works - and slowly releases itself to keep your BG's stable). I am only using the i-port for my rapid insulin. Hope this helps - if not - check out the link in my reply to "Joe Oh" above. Sorry to hear about your retinopathy. I have background myself - common among most long term diabetics - but now I only have to "report for duty" at the opthomologist every year now - instead of every 6 months - since the last 2 years have proven it's not changed (plus I've lowered my A1C's - which is supposed to help improve things for us - or so the medical authorities like to claim it does).
DeleteLooks cool!
ReplyDeleteThanks Scott - it's a good alternative for me - since I really enjoyed the pump while I could use it - and this is "almost" the same - but like my blog says - I'm the brain behind the programming portion of the "mini-me pump". I've already had a few long term pumpers (20+ years) contacting me wondering if they could do what I do with this "old fashioned futuristic" way of MDI. It might take them abit longer to adjust - since I was only pumping 4 years prior to over MDI of 40 years - so it's abit easier for me to adjust from one to the other. Have you ever taken a pump break? Curious - remember - I'm a cat!!!
DeleteI saw this a couple of years - just before it was mass distributed -glad to hear...
ReplyDeleteHey Dr. Mike!!! Anything to help some of the T2's who have to go onto insulin - and dread the multiple shots they have to take. If this can make them take control of their diabetes - to avoid complications further down the road - more power to them. Let's hope endos/educators become aware of this product (not in Australia yet - but if it's anything like Health Canada - give it a few years to pass approval - hopefully faster).
DeleteGreat post, but when you said (where a simple touch of the key pad - squirted insulin into my body via the infusion set)>>>did you mean that as any other instrument could fail somehow, someway, the pump also could cause a severe problem>>>>>is that what you meant as I can read that between the lines and as an engineer I agree that this may happen....please explain
ReplyDeleteHi Ahmed - just attempted to search my blog as to where I put that "severe" statement - and realise ... it's your words not mine .
ReplyDeleteOkay - if you've read some of my blogs about Animas 2020 issues here and at Diabetes1.org (with s/w end date - where pump no longer will deliver insulin after X date) - perhaps I'm being abit overboard with saying that a pump could cause severe problems. Yes, there have been cases where a pumps program has gone wonky - delivered a load of insulin into the body - causing death (case in point - forum and blog post at Diabetes1.org - http://www.diabetes1.org/forum/News/Insulin_pump_gives_lethal_dose_to_27_year_old_man_in_Canada-18704 ). Things sometimes do go wrong with a pump ... BUT ... a human can easily do something similar. E.g. - if using two types of insulin like myself - if the user is NOT careful - they could inject their fast acting insulin instead of their long lasting insulin. One thing with pumps, MOST of the time, the "simple touch of key pad" has confirmations that don't allow you to proceed with the bolus of insulin just like that - it is written in the program - but it has been known that some diabetics - in their sleep - have bolused - without being conscious of what they are doing - and allowing the insulin to go into them (scary stuff - but I believe extremely rare).
Now, in most diabetics on the system of MDI, Lantus tends to be the larger dose of insulin (e.g. I take 12 units in the AM - which if it was a fast acting insulin - my Carb to Insulin ratio - aka I:C - would mean I'd have to stuff abit of sugar into my face to not go into la la hypo land). Luckily, I have yet to do this, but have heard of a diabetic doing this by accident - very scary - especially if you are alone.
So, yes, even a human can bugger up things on MDI - can't put ALL the blame on an insulin pump. Does this help explain it a bit to your engineering side of the brain - if not - ask away again!
Great Answer, thanks a lot, still that means in such life or death staff, the manual is better than machine work.
ReplyDeleteI have a question for you that confuse me a lot, it is regarding splitting the dose of levemir>>suppose that I am taking 30 levemir at 9 pm and I wake up with good numbers, is split here means to split the 30 units to 2 units 15 each taken 12 hrs apart or take another 30 in the morning. of course I tried that as my dose 30 at 9 pm and 12 at 9 am and I am doing fine, some one in TU diabetes told me in a post that 30 could be splitted to two doses taken morning and night, I did this and since then it is bad (my readings) , so I came back again yesterday to old pattern...what you think of this
Hey Ahmed - I know of a few diabetics who actually split their Levimir THREE ways. These are T1D's that have an A1C below 5% - something don't think I want to aim at - figure that number will correlate to having a few too many hypos (low blood sugars) - but could be wrong.
ReplyDeleteAll I can say about your question is ... you had tried splitting the Levemir dose 50/50 every 12 hours - if I understand you correctly? If you did - and it didn't work - perhaps it was due to stress, etc. Only you can tell (are you keeping written/typed notes on what you are doing - that can help). Also, usually give it a week to find if it works - take notes of when you have to correct with rapid (do you do that?) - yadda, yadda, yadda.
The only reason I split my Lantus dose was I was having hypos at night time. For example, I currently take 20 units TOTAL a day of Lantus. i don't go 50/50 tho'. In my case, thru' tweaking, I found that giving a larger amount of my Lantus in the A.M. and smaller amount in P.M. - no more hypos over night. The only thing I will be maybe adjusting will be my A.M. shot - since I find I am getting hypos around 15h00 oncein awhile - so probably it's the A.M. shot - maybe I'll reduce it by 1 unit to begin with - test it out.
I do know when I was on the pump - I used 14 units of NovoRapid for my basal insulin (remember the pump uses fast acting insulin 24/7). I find with the Lantus - I have to use abit more to keep my body functioning in a good BG zone.
The only way really tho' to find out how your basal rate is doing - is to do tests - which I'm sure the folks at Tudiabetes and/or your endo has told you to do (mine never has - but I followed advise of others at TuD and other forums). It all depends on how you feel about taking the bull by the horns and doing this yourself - along with tips like mine - but remember - I am not a medical authority - just a Dgal that's been living the past 48 years as a human dart board - wish I could hit that bulls eye more often with my control if you get my drift.
thanks a lot for your reply, yehh I got it, yes I write every thing to learn from, but I have a problem that I could not fix is that I wake up middle of the night around 2 am or so and always eat something fast or drink some milk, so I think that my readings in the morning is not a real indication for the Levemir dose.
ReplyDeleteOf course my endo know nothing about what you say, I am educating myself through books like Dr bernstein, using insulin or think like pancreas.
Allow me please to rephrase my question some guys in TU Diabetes says if I take 30 unis once in 24 hrs (night time)and this dose get me good reading in the morning then I can split this 30 units to two doses 15 each taken 12 hrs and that suppose to give me same good results>>>>I tried that but it did not work for me but still I am confused because if I reduce 2 or even 5 units of night dose still I get the same reading in the morning???
Ok - can't really say too much about what TuD is telling you - that if the full dose of 30 brings you good results - then it's okay to split in 1/2. If that's the case - why change what you are doing? Just keep it at the full dose of 30 :)
DeleteOnly reason I went the route I did - splitting my dose - with larger amount in A.M. is I need more basal insulin during the day time ... that is what works for ME - and maybe not work for YOU. Make sense?
My P.M. shot is smaller - as I do not need as much - due to trying to avoid hypos at night.
Like yourself, we have to be our own doctors when we don't have a team that "gets diabetetes". Maybe one day - you and I will luck in on a GP or endo that understands how to manage diabetes - but until then - I'm like you - with doing my own research - reading books (great choices by the way). Tho' Dr. B is abit too technical for me to understand fully - but he does makes some good points. Except I don't do low carb like he suggests - this could make for a another big discussion between us and Dr B fans. I average about 40 grams per meal- he stipulates much less than I am happy to eat I'm afraid to say - but there are D's that swear by it for their control - whatever works is the best route to go in anyones health mangement - right?
reply to Ahmed...are you checking your BG's at 2am or before...you may be dropping that's why you're waking up and eating, even a small drop sometimes can induce a hypo feeling. i do this too sometimes, wake up and eat, and it's always around 2am. i was actually taking too much PM insulin, it was dropping me, I'd wake up and eat and then wake up high, check your BG's like every few hours over night
Deletethanks a lot, I will do that because this is exactly my case just like you were before, wake up eat, then wake up in the morning high>>>I will check up during the night.
DeleteThanks for the great help and it is very nice to know you indeed, please keep in touch
If I ever went back to MDI, THIS is what I would use! No multiple shot sites per day for me! Thank you so much for your review!!! :D
ReplyDeleteSarah - this is the reason why I'm going this route after being on the pump for past 5 years - still waiting patiently to hear from IA - insurance company - it's over a week now since I faxed in all the required paperwork - put EMERGENCY on it - as the agent had stated it would get seen to quicker. I have heard from others on Tudiabetes that sadly from the USA, where most of you have private medical insurance unlike Canada - it seems the i-port is not something that is covered - sad to say. It's all to do with that money thing I think - with pharmacy's / insurers - etc. - sad to say.
ReplyDeleteThis is good news! Insurance companies take time for these things, and you were fortunate that they approved your request. Who knows how much longer it would have taken if "EMERGENCY" wasn't stamped on it? This looks like a more user-friendly way of medication, unlike earlier methods, so you must've been pumped to get word of its approval.
ReplyDeleteSeason Reza @ InsuranceAdvantage.ca