I most DEFINITELY sang the “Barbie Girl” song when I wrote the title (not sure what the name of the song is). So… now it’s stuck in my head of course.
I LOVE POLI.
This also needs a disclaimer- please remember I am NOT a medical professional. Please do not just make changes before talking with your care team- I spent several years working with them until I really got the hang of this. I’m not saying to switch or what is right for you (because everyone is different and has different preferences). Please do not take this post as medical advice- I’m sharing my experiences based off of all of the questions I have gotten regarding POLI- Thanks! 🙂
What’s POLI? It stands for Pumper on Long Acting Insulin. AKA one of my favorite Diabetes Management Tools I use. Some might remember it as untethered (or still refer to it as that). But the more common term has become POLI- (which is more fun to hum to because you think of barbie girl).
So the basics first, right?
(Then I’ll get into the journey I’ve had with POLI).
POLI is using your insulin pump and using long acting insulin (yay for the name change- it explains itself a little better).
I opt to stay on my tslim insulin pump while using Tresiba. (Disclosure- I take my Tresiva in the AM because I kept having lows at night- helps with my dawn phenomenon too).
Typically, the long acting insulin covers about 70% of “basal” while the pump covers about 30% of “basal.” (something to keep in mind- if your pump isn’t still delivering a basal insulin, it can get “blocked.” So no to 100% long acting and then only use for bolus- won’t work so well…). It’s also nice because I can tweak specific times with my basal rate which I cannot do when I take pump vacations. I started with a basal rate that is the same all day and then tweaked it over the following days as I figured it out.
Reasons I love it?
I get a lot of confusion or people questioning why I would want to do this?
- My body LOVES long acting insulin pens, but it’s not a fan of short acting insulin pens (long story).
- HELLO something to help with anxiety– I would always be nervous about pump sites failing- especially in the middle of the night- now even if that does happen, I am still getting background insulin- which helps with my fears of DKA. (But it does make it more difficult to detect pump sites that aren’t working well.
- Summer anyone? Being disconnected, the heat, dresses, etc.
- Since I’m already on long acting insulin, if a situation arises where I don’t need (or want) the pump for some reason, it’s now easier to switch. (or something bad happens!)
The first time I tried POLI was at diabetes camp when I was about 14 or 15. We are disconnected from our pumps often because of water activities and pump sites also fall off because of water and sweat (and believe me, I am a SWEATY person). I tried it once there- the people talking about this at camp? Members of my pediatric diabetes care team! 🙂
About a year later, I was talking about band and theatre. Using my pump was difficult with those activities. I also didn’t want to have figure out my pump for theatre- where would I hide it? No way would I wear it in an era type show- insulin pumps don’t go far back into history- it’s not like we are in Doctor Who or anything yet. So the idea of my pump vibrating or going “tick tick” on stages was OUT of the question.
So my endo suggested I try POLI (known as untethered at the time) for band and theatre- so I could disconnect and not go high later.
Let’s just say… it worked wonderfully!!!!
By this point, I didn’t spend a lot of time at the pool, and I wasn’t in sports anymore- but golly… I wish I had had that then- because no way was I wearing my pump playing soccer or basketball and forget taking it in the water…
My junior year of college, all of the sudden I decided I’m going POLI full time– this was during Diabetes Burnout, and I was trying to do things to spice up management or try and make things a little easier– My pump sites were failing all of the time (I do have to say that the pump companies and healthcare providers do have a point when they say rotate!!!) I was able to justify going on POLI with my healthcare team (plus I had just had a pump vacation so I had long acting insulin anyways).
I haven’t looked back since, and I LOVE it. I don’t see myself changing this up- unless I take a pump vacation.
A lot of healthcare providers and my insurance company are not a fan… I often have to fight or advocate for it.. Especially each time I switch providers. (which I’ve heard is common for people who want to try it- doctors don’t want them to even try it… that’s a shame..)
They both suggest- I pick something. Or ask why do both? What’s the point?
I listed reasons above, but I immediately go “I have anxiety and diabetes“ soooo- it’s kind of nice that there is something I can do that benefits both- right?
I do have an occasional healthcare provider who gets excited or wants to learn more because they haven’t had a lot of people who use both.
But overall, no one is super excited about it- so I have to advocate for myself. Remember, sometimes advocacy is “the little things.” (Check out my post about advocacy on the CDN Blog- talking about the big and the little things regarding advocacy, here.)
I haven’t been denied to continue this yet- but it’s after a lot of convincing. An example of why I like conversations with my healthcare team and don’t want to be talked at. I don’t just sit there and get talked at- and luckily I don’t allow it either. If they had it their way, I wouldn’t be on POLI- but I’m persistent and stubborn.
So there you have it- I’m a POLI girl in a not so POLI world, but I wouldn’t have it any other way. 🙂
POLI Girl in a not so POLI World
Editor’s Note: This was originally published in January 2016 and was updated for clarity and accuracy in August 2018.
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18 thoughts on “POLI Girl in a not so POLI World”
I’ve been awaiting this post! Hits the nail on the head with the anxiety lessening regarding DKA. Will probably send this to my HCPs if and when the POLI leap of faith happens for me. Thank you!
Thanks Ally!!! It definitely helps with my anxiety, a lot.
HCPs can be stubborn. Haha.
Mindy – I am fascinated by this concept. I’ve heard of using the pump for basal and then injecting bolus doses (I’ve done that because of lipoatophy), but never the opposite! Makes sense for DKA worry mitigation. I’m glad this is working so well for you! I will definitely spread the word about POLI to students in the program where I teach (it’s a Master of Science in Diabetes Education and Management, so a very interested audience) and hopefully more and more health care providers will learn about and support it.
Jane- thanks for reading and commenting! (And for spreading the word). I’m glad it’s working too- peace of mind works wonders!!!
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