I'm picking up good vibrations.

Say hello to my new best friend, my Animas Vibe insulin pump with built in Dexcom G4 CGM.

For those of you that don't know, I am an insulin dependent diabetic. I was diagnosed with Cystic Fibrosis Related Diabetes (CFRD) shortly after my fifteenth birthday and I got my first insulin pump just before I turned eighteen. 

CFRD is a direct result of my cystic fibrosis ...hence the "CF related" part. Approximately 30-40% of individuals with CF will develop diabetes, most during adolescent or young adult years. CFRD is a rather peculiar disease. Doctors aren't 100% positive why it develops or what causes it to happen in some but not all patients, but the general idea is that it develops after years of pancreatic scarring. Some believe that genetics, outside of the those that cause CF to occur, can influence the outset of CFRD but who knows? 

Often, when someone says "I'm diabetic," people will ask are you type 1 or type 2? Let me just say, you get some really funny looks when you reply "Neither." Neither? How is that possible? Allow me to explain...

Before you can understand CFRD though, you have to understand first how the pancreas and insulin work, then the difference between Type 1 and Type 2 diabetes.

• The pancreas is responsible for producing a hormone called insulin, which allows the body to control how much sugar (glucose) is in your blood. Too much or too little glucose is bad. Too much and it begins to damage approximately 1293 different parts of your body (ok, not really but there are A LOT of complications from high blood sugar). Too little and well, you die considering that glucose is literally the "fuel" that every single cell in your body needs to function.  Ever tried to drive a car that has no gas in the tank? Yeah, that's your body without sugar. 
• In Type 1 diabetes, the pancreas is unable to produce insulin at all. This is typically referred to as juvenile diabetes and is actually an auto-immune disorder. Type 1 diabetics are always insulin dependent.  
• In Type 2 diabetes, the cells are unable to properly use the insulin the pancreas created. Most commonly, this develops in adulthood due to obesity. The insulin receptors simply become worn out and become resistant. While some Type 2s do require insulin, many are able to manage their glucose with healthy eating, exercise or even oral medications. 

My diabetes, however, is its own little breed. It's a combination of both Type 1 and Type 2.

The same thick that causes my lungs to suck at being lungs, causes my pancreas to not work either because the small pathway between my pancreas and my stomach is clogged with mucus. This pathway is normally used to allow enzymes made in the pancreas to get to my stomach, so that I can digest food. Since the enzymes can't get out of my pancreas, they just sit there and for lack of a better term, eat away at my pancreas itself. This causes my pancreas to scar and the tissue to die. Since my pancreas also makes insulin, these cells slowly die as well. Eventually, after enough insulin cells have died, my pancreas was simply unable to produce enough insulin to maintain normal glucose levels and I was diagnosed with CFRD. This is why my diabetes is kind of like Type 1, because my body not making (enough) insulin.

But it doesn't stop there!

My diabetes is also kind of like Type 2 because for most CFRD patients, the cells don't respond properly to the insulin it has. It's delayed. I don't really know why, and to be honest, doctors don't totally understand either because most CF patients are not obese so the cells aren't "worn out." I'm sure it has to do with the absorption issues that CF causes, but regardless of why, it happens. 

So that's it... Some insulin but not enough + some insulin resistance/absorption issues = a very sneaky and freaking annoying complication of having cystic fibrosis that I lucked out on because, you know, having an illness that only 0.00001% of the entire world's population has wasn't unique enough? 

Also, not to beat a dead horse, but CFRD is complicated even further by the fact that for most patients, malnutrition is a huge issue and they struggled to maintain a healthy body weight. It's pretty common for a person with CF to be told to keep a high-calorie diet. Unfortunately, with calories come carbohydrates, (aka sugar), so as soon as you try to eat "as much as possible," your blood sugar rises. Most people with CF eat 4-5 times a day, plus snacks. With CFRD, you have to check your blood sugar and give yourself an insulin shot with every snack and every meal. Which gets bothersome, to say the least. 

Now that I've given everyone a Biology 101 review, let's get on to the real stuff...

I am not a good diabetic. To be frank, it is, in my opinion anyway, the absolute worst part of my health. I would rather take 100 pills a day than deal with my diabetes. I don't know what it is, but it's just a huge struggle for me. I don't always take insulin when I eat; with meals yeah, most of the time, but not usually with snacks. And I snack a lot. But a bigger issue I have is that I don't check my blood sugar as often as I should. I'm suppose to check it before I eat and two hours after I eat. This is so that I know if my blood sugar is too high and I can give myself extra insulin to lower it. You have to know what your blood sugar is because if you're too high (above 170), your body won't properly absorb nutrients from your food.

So, let's say I eat a cheeseburger that has 30 carbs in it and I take insulin for those 30 carbs, BUT because I didn't check my blood sugar before, I didn't know that my blood sugar was 200...  Even though I gave myself enough for my food, I didn't lower my blood sugar to a normal range to begin with, so I didn't actually absorb any of the calories that my delicious cheeseburger had in it.

For several years, my diabetes wasn't too bad and even though I, admittedly, wasn't super duper about taking my insulin, my A1C levels were normal. (A1C is a blood test that measures your average blood sugar for a 12 week time period. It determines how "good" your diabetes are). So it was okay, my pancreas seemed to be doing good enough. But recently, it hasn't been good enough. The last year or two, my A1C has been up and even though I'm really trying to be better, I can't seem to get a hang of it.

Don't get me wrong, I take full responsibility for where I fall short. I've told my doctors that and I am continually trying to improve and be more diligent. But it's not just that. CFRD is complex and just difficult to manage... Sometimes, I would take insulin.. a lot of insulin, actually, and my blood sugar just would not go down (per my insulin resistance). Then, even though for the last year, my A1C has been high (which implies that my blood sugar is too high on a day to day basis), I've had a lot of episodes of low blood sugar (meaning there was too much insulin in my blood). And it's completely random. I wake up in the middle of the night with lows. I get low during the day. Low less than 2 hours after I eat when I do take insulin. Low after I eat when I didn't take insulin. Lows on lows on lows. Yet, my A1C is still through the roof which means that I'm having highs too. And since the A1C shows an average, the highs are even HIGHER since they have to compensate for the lows. Go figure. Basically, my pancreas has some serious bi-polar tendencies. Some days, I feel like it doesn't even matter what I do, it's still going to mess with me.

My doctors and I have been working together to figure out what's going on but we weren't having much luck, so a little over a year ago, we decided it was time for me to get a continuous glucose monitor (CGM). These devices are a relatively new form of medical technology that uses a electrode sensor to measure the glucose level in your skin. It translate wirelessly to a small device about the size of the iPod Mini I jammed to in the 8th grade. CGM systems check your blood sugar every five minutes, 24 hours a day so that you track exactly what's going on with your body. These seemed like the best, next step in my diabetes care because it would allow me to know exactly when my blood sugar was going high and when it was going low, without having to prick my finger 100x a day.

Last summer, when we first decided that I needed a CGM, we applied for a standalone Dexcom device but had one problem after another with my insurance. I had almost given up that it would ever happen when in March, my diabetic educator at my clinic told me that Animas and Dexcom had just partnered together to make a new insulin pump, the Vibe. Animas is the company that makes insulin pumps (to deliver insulin to the body), Dexcom is the company that makes CGMs (to check blood sugars). And conveniently enough, I was eligible for an insulin pump upgrade (yes, like a cell phone). Needless to say, I was stoked. Not only was I finally going to get the CGM I needed without any insurance hassles, but I would have a 2-in-1 device instead of having to carry around two separate iPod Mini wannabes. Winning!

My new pump arrived a little over a week ago and so far it's been amazing.

One thing you learn very quickly when you live with a chronic illness is that no medication, therapy, device or crazy herbal supplement will ever be a miraculous, wham-bam, instant fix. They're just tools to make your day, and ultimately, your life, as healthy and enjoyable as possible, but tools don't just work themselves. If they did, it would be called a robot! No, tools require manual labor if you want to see results. With that said, I'm very excited and very hopeful that this will finally be the tool I need to see some results, and God-willing, some improvements!