I have a sticky button. I have lots of sticky buttons in my life. Of course, because of RA, I also have fat fingers. The problem is that I need my sticky buttons to work well.
The button is on my insulin pump. Now let me say right off: there is nothing wrong with the pump or the button. I blame the pump, but it is my fingers that are having difficulty working the pump today.
Living with diabetes and RA
When people ask me what is frustrating about living with diabetes and RA, they do not understand that sometimes, it is the oddest little thing like a sticky button. Unlike when I was diagnosed in 1974, type 1 diabetes is mostly a technology-oriented condition.
Even today, people with type 2 diabetes find that it is more and more a condition that relies on technology for day-to-day management. It is estimated that a person with type 1 diabetes makes approximately 180 diabetes decisions each day.1 That is about 64,000 decisions each year.
Using technology for diabetes management
While each of these decisions is usually routine, they are also potentially life and death decisions. Dose too much insulin, run the risk of low blood sugar. Too little, and one can trigger diabetic ketoacidosis (DKA), a condition in which the body uses ketones (acid) to break down fat for energy.2 This can be a deadly condition.
With all those decisions, no wonder diabetes has become a condition that is managed with technology. IBM has even entered the fray using Big Blue to apply artificial intelligence to the issue of diabetes management.3
Minding my diabetes after an RA infusion
Today, insulin pumps, continuous glucose monitors (CGM), glucose meters, and even smart insulin syringes give data, feedback, and direction to these decisions. A few days ago, I had two CGMs and a pump attached to my body, all to make sure I managed blood sugar following an infusion of Rituxan.
As my blood sugar soared after the infusion of Solu-MEDROL earlier in the day, I was sleepy having the infused Benadryl that I also had earlier in the day. For me, that could be a dangerous combination. Luckily, the combination of Sheryl, two CGMs, and remote monitoring kept me safe.
Fingers impacted by RA makes diabetes management challenging
All of these things are fantastic if your fingers can work them. I have been fortunate that, for the most part, I can accomplish this high-tech, high-adhesive world. But, I wear and use these devices despite RA.
Sometimes, it is challenging to peel the backing off these devices to get to the adhesive so that I can stick them on my skin. Sometimes, it is difficult to manipulate the buttons on the insulin pump. All of these things are required so I can have feedback, manage, and react to those many decisions each day.
Those 64,000 annual decisions about diabetes all involve one thing, my fingers, and it is not only pushing buttons. Many times, it is sticking my fingers with a portable lancet that draws blood from the side or tips of my fingers to test my blood sugar, something I do on average 4 - 8 times per day even with a functioning CGM. And before you say, "But what about that CGM? Will it not take care of finger sticks?"
Well yes, it does reduce the number of sticks. But frankly, it is always prudent to double-check the numbers reported by the CGM, especially at mealtime so I do not make a dosing error that could ruin the next few hours or, in an extreme case, cause my death.
RA and diabetes management requires support
After 46 years of type 1 diabetes and 20 years with RA, my fingers look like a war zone. It is no wonder sometimes I have stuck buttons. Or that applying my insulin infusion site every three days and the CGM every six days requires Sheryl's help.
The need for more finger-friendly devices
I wish it did not. I wish I were completely self-sufficient when it comes to diabetes management. But for that to happen, I need new and far more finger-friendly diabetes devices.
In a future post, I will review some of the finger-friendly diabetes devices and finding body real estate to hang these devices on when you have arthritis (it is not easy sometimes).
Has having RA put a hold on your ambitions?