An Anxious Autistic's Trials of T1 Diabetes Management

Like many contemporary Type 1 diabetics, I treat my disability with an insulin pump. Specifically, it is a Medtronic MiniMed 670g that, though very outdated, has served me quite well across the years I’ve had it since 2018. I chose it because it was similar in functionality to the one it succeeded, so it took little to adjust to the new system.

Medtronic MiniMed 670g Insulin Pump (With CGM)

Many fresh additions to this pump elevated it above its predecessor. The accompanying Continuous Glucose Monitor (CGM for short) was at the forefront of these changes; it allowed users to monitor blood sugars with a far less hands-on approach. But the other change that caught my attention was how its insulin reservoirs carry double that of its predecessor’s. At the time, I assumed this meant I would have to change the cartridge far less frequently than ever before. Nothing seemed to be amiss; its design followed the same logic as the CGM: less maintenance for a high-maintenance condition, and who wouldn’t want that?

I wouldn’t have time to ponder whether this conclusion held up under scrutiny. In only a short time, I would plunge headfirst into a few quietly harrowing years that aggravated my anxiety like nothing else.

The CGM quickly turned out to be a clunky mess. Being one of Medtronic’s first, it ironically took more to maintain myself with it on than it did with it off. It was prone to failure, it consistently misread my blood sugar levels, it was awkward to attach, I had few viable locations to place it on my body, and the ones that accepted it were left with a nasty rash upon its removal.Soon enough, I elected to stop using it entirely, which was ultimately the right course of action… 

Medtronic MiniMed Mio Infusion Sets

But unfortunately, my annoyance would be redirected to another problematic aspect of this pump. The infusion sets I started with—the original MiniMed Mios—had the same issues, only tenfold more impactful to my overall health. Insulin flow was almost routinely obstructed, and I was left floundering about trying to regain equilibrium. My hatred for these things was far more visceral than the failed CGM; at least that device was ultimately optional. I was stuck with these other tools that did more harm than good.

Medtronic MiniMed Mio Advance Infusion Set

Luckily, only two years after I started with these infusion sets, their successors arrived—the Mio Advance, which used an insertion process that was far more efficient and led to more successes than losses. The moment these sets came into my life, I felt free. Sure, they wouldn’t be perfect every time, but they would be far easier to manage by comparison. I could finally go about my life as I wanted…

More time passed. I understood that, due to my disability, consistently perfect control was a pipe dream. But I couldn’t shake the idea that something still wasn’t right. For a time, I thought my diet was to blame. I rejected a plethora of snack food and even became a vegetarian, all in hopes of regaining control I so desperately needed. While I ultimately felt better after making these decisions, and I wouldn’t want to reverse them, I still felt off.

At the time, I was steadily losing my father to dementia (and still am, granted), I lost a pet, I struggled to find work, and many other awful changes relentlessly stormed into my life. I assumed the blood sugar issue was simply a repeat stress response. So many losses, and so little mental bandwidth to handle it. My body seemed to be suffering through a quiet meltdown.

Even still, I could still rise to meet those powerful negative emotions head-on. I would turn to my art to vent my frustrations with life, creating a loving tribute to my late pet, and later, a literal depiction of this figurative fight to regain my mental health. It felt cathartic and uplifting to accomplish what I had. I felt unstoppable. Each of these victories brought me closer to understanding how I could function in my adulthood!

… But eventually, time and time again, I would find myself dragging my feet. Why on earth was this blood sugar issue persisting after all that? I’d done everything right! I faced my demons! I took steps to improve my life at home! I’ve been seeing a therapist! But through it all, nothing I did for myself would stick. I would still ultimately slip back into being a tired, anxious wreck with unideal blood sugar control… All that hyperfixation on solving my issues seemed to be a wasted effort. Why?!

Just a few days ago, I visited a local endocrinologist to renew some prescriptions under him. I was eager to try out the Mio Advance’s successor: the Medtronic Extended Infusion Set. I figured, once again, that these current infusion sets were failing me, and I needed to try something that wouldn’t leave me feeling like a mess. Unfortunately, they could only work with a specific kind of insulin reservoir, wasn’t covered by my insurance.

We called a customer service agent for our prescription service to sort out the mess and rewrite the prescription for the Mio. During the conversation, they said something that, to them, was a casual observation, but to me, was the mother of all bombshells:

Medtronic 3mL Insulin Reservoir

My current insulin reservoirs were expected to be replaced every three days. Nobody, not even my doctors, had thought to tell me this. Either they expected this fact to be common sense, or they genuinely thought something else was causing my blood sugar inconsistencies like I did. If nothing else, I'd rather not assume they were actively withholding this information from me...

For nearly six years, I had been filling up these reservoirs to maximum capacity, letting each last across multiple infusion sets until they were finally depleted. However, upon this revelation, I researched and found that my routine had been causing insulin to crystalize within the reservoirs and the tubing of the sets, negatively affecting its flow into my body.

That was it. That was the one thing that was constantly troubling me throughout everything life had thrown at me. And thus, upon exchanging the current reservoir for a fresh one, my world brightened. 

No longer was I feeling exhausted by activities that wouldn’t have perturbed me before this pump. No longer did I start falling asleep midway through my nightly routine. No longer was I constipated by the most negative forms of nihilism when alone with my thoughts. What I first accepted as how my life would be from now on turned out to be a mere chapter in my story, and it finally ended. It may have been anticlimactic, but it was an ending, nonetheless. I am forever thankful for gaining an outsider’s perspective; sometimes, that’s exactly what an anxious diabetic like me needs to finally set things straight.

All told, and in a twisted sort of way, I’m somewhat glad I did not discover this self-imposed limitation until now. I’m certain things would’ve gone better had I addressed it sooner, but at the same time, I know now that I can manage myself through difficult situations, whenever they arrive again. The only difference going forward is that I won’t be left feeling weak after they end. I’ve come far within my restraints, and I can only imagine what I’m capable of now that I’ve shaken loose.