Derek Helm’s transition from managing his type 1 diabetes with multiple daily injections (MDI) to using an automated insulin delivery (AID) system was far from simple, despite the promise of improved glucose control. While research consistently shows that AID can increase time in range, reduce A1C levels, and lower the risk of hypoglycemia, the real-world experience often paints a more nuanced picture. For Helm, the switch represented not just a technical change, but an emotional and physical journey marked by setbacks, moments of doubt, and eventual relief.
A Shift in Perspective and Health Priorities
Helm’s diabetes journey began when he was diagnosed at age 13. From the outset, he faced the daily grind of finger pricks and insulin injections. Over the years, his routines evolved, incorporating more advanced tools like insulin pens and continuous glucose monitors (CGM), but his management remained largely manual. Despite recommendations from doctors, he was hesitant to try an insulin pump, recalling an uncomfortable experience during a basketball game. As a jiu-jitsu enthusiast and surfer, the thought of wearing another device was a daunting one.
However, Helm’s work with diaTribe, along with a recent diagnosis of diabetic retinopathy, pushed him to reconsider. The compelling data surrounding AID systems and the visible success of his colleagues with diabetes opened him to the possibility that these tools could improve his long-term health. This shift wasn’t just about medical advice but a mental readiness to embrace change, moving past the stigma he had once felt and being more open to technology that could ease his burden.
Challenges During the Transition
The first month on AID was a period of adjustment. Helm found himself spending more time thinking about his diabetes than ever before. The transition wasn’t seamless; he had to wear the insulin pump 24/7, a stark departure from his previous routine. The pump, initially intrusive during activities like jiu jitsu, required creative solutions to keep it secure, such as using adhesive patches and compression sleeves. In the ocean, where low blood sugar could be dangerous, he switched the device to manual mode for added control.
Device glitches also added to the stress, and the conservative settings of the AID system, designed to protect against hypoglycemia, sometimes felt frustrating. However, as Helm adjusted, these hurdles began to feel less daunting. A key moment in his transition came after meeting with a nurse practitioner to fine-tune his insulin ratios and sensitivity. This session helped to reduce the mental load he experienced, marking the start of a more manageable routine.
Aiding the Mental Burden
Dr. Anne Peters, a leading diabetes expert and Helm’s endocrinologist, emphasized the importance of realistic expectations when transitioning to AID. While patients may enjoy better glucose control with less effort, AID is not without its challenges. Peters cautioned that the learning curve can be steep, and patients should not take device failures personally. “It’s not a reflection of skill or intelligence,” she said. “The system takes time to optimize.”
For Helm, the real breakthrough came after the first two weeks, when he began experiencing the true benefits of the system: stable glucose levels with less constant intervention. “When the pump works, it’s amazing,” Helm said. The reduction in daily mental effort was liberating, and the consistent time in range — once a full-time job with MDI — became easier with AID.
A New Era of Diabetes Management
Though the process of adapting to AID wasn’t without its setbacks, Helm’s story highlights the meaningful progress that comes with perseverance. While the system still requires fine-tuning and occasional adjustments, the long-term benefits are clear: less physical and emotional burden and better diabetes control. The key takeaway? When transitioning to AID, it’s crucial to be ready, have realistic expectations, and embrace the learning curve — because the rewards, over time, are well worth the effort.
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