Life with a pump
Understanding diabetes and alcohol
For many people, having diabetes does not stop them from living a healthy and active lifestyle. Whether it is going out with friends, grabbing a bite to eat or enjoying the occasional alcoholic drink, it is important to be prepared and pro-active when it comes to diabetes management.
When it comes to alcohol, it is important to understand the effects it can have on glucose levels to better understand the body’s insulin and carbohydrate needs when drinking.
Some alcoholic drinks contain quite a lot of sugar and make it difficult to maintain good blood glucose levels. So, when I was on multiple daily injections, I had to give myself an extra shot or choose not to drink with my friends. The side effects of the alcohol can also hide the symptoms of a hypo. My MiniMed Veo insulin pump makes it possible to enjoy a few drinks with my friends while staying in control.
Keeping Blood Glucose levels under control
After eating, food is broken down into glucose which is needed to give the body energy for all daily activities. Our bodies also need insulin to help transfer glucose from the blood stream to the cells and this insulin is normally produced by the pancreas.
When the pancreas does not produce insulin the glucose will remain in the blood, leaving cells without any energy. These high glucose levels in the blood cause the more acute clinical signs and symptoms of diabetes. To treat diabetes it is important to take into consideration many factors in its management, including blood glucose monitoring, carbohydrate intake, physical activities and insulin requirements to ensure good blood glucose control and to reduce the risk of complications.
Alcohol can alter blood glucose levels, or potentially increase the risk of hypoglycemia. It is important to understand the amount of carbohydrates in each drink, as this can vary depending on alcohol type and mix. It is important to monitor glucose levels before, during and after drinking alcohol.
Hypoglycaemia (“hypos”) refers to when the blood glucose levels go below 3.5 mmol/L, but can vary depending on the individual. Hypoglycaemia can be mild, where its symptoms are felt and action can be taken by eating or drinking something with carbohydrates. Severe hypoglycaemia requires assistance from another person and may need treatment at a hospital.
By understanding the body’s needs and learning how to keep blood glucose within recommended levels, it is possible to manage diabetes effectively. It can be a challenge to reach and maintain the HbA1C goal whilst minimizing the risk of hypoglycaemia.
HbA1c: an important measure of how effectively diabetes is being managed using a measure of the amount of glucose that has attached itself to each red blood cell over the preceding 2-3 months to assess the level of diabetes control.
So, as someone living with Type 1 diabetes, how can I better manage my glucose levels whilst drinking alcohol?
Diabetes, Alcohol & Insulin Pumps
To deal with the challenges of keeping blood glucose levels under better control, many people with Type 1 diabetes rely on insulin pumps to achieve better glucose control.
An insulin pump is a small device, about the size of a mobile phone that can be easily carried on a belt, inside a pocket, or even attached to a bra.
An insulin pump can help you and your healthcare team to more closely mimic the way a healthy pancreas delivers the basal insulin to the body by providing small amounts of rapid acting insulin during the day and night. It can help to better manage the need for insulin dose adjustment, particularly after meals and overnight and can thus help to achieve better glucose control.
Instead of frequent injections, all that is needed on pump therapy is a change of infusion set every few days. Clinical studies* confirm that many Type 1 patients of various ages who switch from MDI to insulin pump therapy report improvements in their quality of life and increased satisfaction with their treatment.
Without the pump, I would have preferred not to drink rather than to add an extra injection in the evening. Now, however, with the pump, nothing is really off limits to me.
How does the MiniMed® Veo™ help control glucose levels?
The MiniMed Veo allows for better glucose control due to the ability to adjust insulin delivery, reducing the risks of hypers and hypos. With insulin pump therapy users can benefit from:
Calculating insulin requirement can be a complex task with many different aspects to be considered. In the MiniMed Veo, the built-in Bolus Wizard® feature helps to ensure accurate dosing by taking into account the insulin already in the system, the current glucose levels, carbohydrate intake and personal insulin settings to determine the right dose.
Precise amounts of rapid acting insulin are delivered throughout the day by the infusion set which is easily removed and replaced every 2 to 3 days.
The MiniMed Veo can be instantly adjusted to allow for exercise, during illness or to deliver small boluses to cover snacks. This can be easily done with a touch of a button, rather than with another injection. There is even a temporary basal rate option to proportionally reduce the basal insulin rate, an option that can be used during exercise, for example.
The MiniMed Veo offers the additional convenience of a wirelessly connected blood glucose meter. This meter automatically sends blood glucose values to the pump, allowing more accurate Bolus Wizard calculations. It also stores this information in a digital diary along with your insulin doses.
Is an insulin pump right for me?
Many people with Type 1 diabetes may benefit from an insulin pump without even knowing it. In general if they experience any of the following, they could get better control with an insulin pump:
- Concerns about long-term complications
- The first symptoms of long term complications
- Fear of needles
- Difficulty in managing highs and lows
- Fear of hypoglycaemia, especially at night
- Outside targeted HbA1c levels
- Reduced hypoglycaemia awareness
- Seeking more flexibility in everyday life
The best way to stay within a healthy glucose range is to test blood glucose levels (SMBG) at least 4 times per day and make adjustments to the therapy as needed. The MiniMed Veo with the use of the Bolus Wizard can make these calculations and adjustments to help improve glucose control.
Since I began using the pump my HbA1c has dropped significantly: from 15% (140 mmol/mol) to an average of 7% (53 mmol/mol). As I gradually became more confident and expert in using the pump I began to get the real advantages from all the pump's functionalities. With the pump and sensor, for continuous glucose monitoring, I reached an optimal level of control.
Additional options available with the MiniMed® Veo™
The MiniMed Veo is also available with the additional integrated options of Continuous Glucose Monitoring (CGM) and CareLink™ Therapy Management Software.
The MiniMed Veo when coupled with CGM is the only insulin pump with a feature which can help reduce the impact of hypoglycaemia*. If glucose levels fall dangerously low, the MiniMed Veo can turn off insulin delivery for up to 2 hours. It can also advise if glucose levels are rising or dropping quickly. This can be a big advantage compared to SMBG as the MiniMed Integrated System alerts when crossing pre-set threshold limits and shows current glucose trends.
*References are kept on file and are available on request; please contact your local Medtronic representative for copies.