Could an Insulin Pump be the perfect accessory?

Emily Warner stops to reflect on a lifelong - and lifesaving - fashion choice.

https://nouse.co.uk/2022/01/06/could-an-insulin-pump-be-the-perfect-accessory - Published 06/01/2022

Image Credit: Tristan Truesdell

Nothing beats waking up, putting on a nice dress and then shoving a £4000 lifesaving machine down your bra. Yes, you heard me right. When your pancreas won’t produce insulin, you don’t have much choice but to incorporate an insulin pump into your outfit. However, if you happen to be wearing a small, tight-fitting, V-necked number, as I attempted on New Year’s Eve, you are left with limited places to subtly stash a pump (comparable to a small brick).

When I was diagnosed with type 1 diabetes at the age of five, my mum vowed not to let it stop me from doing anything. In retrospect, fitting into a size XS Pretty Little Thing dress is probably not what she had in mind. 13 years later I am still determined not to let my diabetes stop me from dressing a certain way. Just as it wouldn’t stop me from getting into university, climbing Mount Everest, or swimming the English Channel (the latter two of which I am yet to achieve).

I am sure you can imagine the discomfort of shoving an electronic device up your bra and then artistically arranging it to be invisible to everyone else. I think I deserve a gold medal for contortionism as I conduct my day-to-day business without bending over, moving too fast or breathing deeply to avoid upsetting the precariously balanced pump. Imagine how that discomfort intensifies when I make eye contact with a distant uncle across the dinner table and promptly try and retrieve the pump from its less than modest position to deliver a bolus for my meal. After years of experience, I can assure you there is no ladylike way to do this. Option one includes rummaging around under my skirt and looking like someone with a seriously misplaced itch. Option two consists of producing the pump and tubing from my bra with a flourish as I imagine a magician might pull a rabbit out of a hat. Neither is ideal and as I get older both options become increasingly frowned upon in public settings. Furthermore, the screen of my insulin pump lights up and, on several occasions, I have been informed (rather politely considering the situation) that my chest appears to be glowing, when a button has been accidentally pressed. Sometimes, at risk of appearing to have a severe continence issue, an opportune visit to the ladies is preferable.

However, despite the pump being a less than ideal addition to my outfits, it is a necessary one. This piece of technology which I desperately try to hide is saving my life every day. When my mum said that she hoped I could do anything 13 years ago, it was in a world where the only way for me to receive insulin was by injection, and the only way to check my blood glucose was through multiple finger pricks a day. Since then, advancing technology and extensive research, facilitated by incredible charities such as JDRF, Diabetes UK and DRWF, has revolutionised the treatment of diabetes worldwide.

I have seen insulin injections evolve into insulin pumps, through which insulin can be automatically delivered at the press of a button. I have watched finger pricks that measure blood sugar levels become almost unnecessary as CGM devices that permanently sit under the skin allow for continuous blood glucose monitoring on a mobile phone. Additionally, the NHS has recently introduced a hybrid-closed loop system in which the pump works in tandem with CGM devices, to control blood sugars.

The closed-loop system is a group of devices programmed to function similarly to a normal pancreas. In 1977 the first artificial pancreas was purchased in the UK and was the size of a filing cabinet – imagine trying to fit that up your bra! I’m suddenly less inclined to complain about my comparatively small insulin pump. In 2014 a trial showed that those using the system spent 13.5 percent longer with their blood sugar in the healthy range and one participant described the experience as feeling, “like [he] was on holiday for the whole month”. There are currently four artificial pancreas systems licensed for use in the UK, and research continues to improve the algorithms they use, making them even more effective at controlling blood sugars.

Any person with diabetes will tell you that concerns about severe low blood sugar and future health complications are constantly in the back of their mind. For most students, waking up with no memory of the night before is a sign of a good night out but for me, it could be fatal. The effects of alcohol, food and exercise on my blood sugars mean that I can never drift to sleep in blissful, vodka-induced unawareness. Most nights, in fact, inspire more anxiety than enjoyment and I fear waking up from a seizure in A&E as opposed to simply falling asleep with my head in a toilet. You can understand why a technology that could relieve this burden is not just revolutionary for the long-term health of diabetic people but a relief in the short-term as well; promising less time monitoring blood sugar and more time enjoying life.

Returning to my original dilemma of the incompatibility between a pump and tight clothing, the occasional fashion faux pas seems like a small price to pay in return for so many exciting new possibilities in the field of diabetic research. When I consider the vast advancements that have been made in the last decade I realise, perhaps it is time to stop hiding the treatment I receive and wear it proudly, as an accessory instead of a burden.