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Jason Winters has been living with type 1 diabetes (T1D) since he was 21 years old.  After 10 years of uncontrolled blood sugars, his primary care physician referred him to the UMass Memorial Diabetes Center of Excellence (DCOE).  He arrived with a dangerously high A1c of 12.3% in 2011.  His care team consists of endocrinologist Dr. Samir Malkani, nurse practitioner Nancy Sidhom & certified diabetes care and education specialist (CDCES) Cheryl Barry.  Together, they lowered his A1c below 8.5% which he has maintained until they finally convinced him to try an insulin pump and continuous glucose monitor (CGM).  For years, Jason preferred to inject himself with insulin throughout the day and check his blood sugar by pricking his finger using a meter.  “I’ve had severe incidents of low blood sugar over the years and needed glucagon shots, so I was deathly afraid of getting too much insulin and going low,” he said.
He needed a back operation, but the surgeon wouldn’t perform the surgery until he lowered his A1c to 7.2%.  That was the motivation Jason needed to agree to wear an insulin pump.  “I finally had enough of the highs and was tired of how sick it made me feel,” he said.  “I decided to try a pump and it’s been great. The technology has gotten so much better, even within the past two years.”
“Jason’s A1c is now in the 6’s and we are so proud of him,” said Barry.  “He overcame his fear of hypoglycemia to try a pump and he contacts us for dosing changes and tolerates glucose levels close to target.  I’m pleased to be part of the team that helped Jason achieve these major improvements.”  
His glucose control improved significantly since he began using Tandem’s t:slim insulin pump with Control-IQ technology.  “My time in target range is now 75% or better.  It was 30%.  Now the pump predicts my blood sugar in advance and automatically adjusts the insulin delivery.”
Jason was first diagnosed with T1D after going into a diabetic coma.  His parents found him passed out at their home in Springfield.  A Life Flight helicopter transported him to the emergency room at UMass Memorial Medical Center in Worcester with diabetic ketoacidosis (D.K.A.).  He was hospitalized in a coma for a week.  “A year before that, I was misdiagnosed in Springfield,” he said. “They tested me for hepatitis and all kinds of diseases.  Everything except diabetes!”
Years of uncontrolled blood sugars resulted in health complications including neuropathy in his feet, and his eyes have been affected by diabetic retinopathy.  “I wish I had started on the pump 20 years ago,” said Jason. “However, since lowering his A1c, my neuropathy has improved, and I feel better in other ways too.”  Jason also has a rare disease called gastroparesis in which the stomach can’t empty itself of food in a normal way.  Those symptoms have also improved.
“I never had a proper treatment plan or was taught how to manage diabetes until I met the team at the UMass DCOE in Worcester,” said Jason.  “Dr. Malkani is very knowledgeable.  I liked him right away, otherwise I wouldn’t have continued to travel from Springfield to Worcester all these years.  Nancy taught me a lot, and Cheryl and I communicate regularly to adjust the pump as needed.  She knows the pump inside and out.  They’re all wonderful!”
He appreciates the diabetes education that he received including nutrition and carbohydrate counting.  Jason’s blood glucose was high for years because “I was chasing my sugar all the time” by eating before injecting insulin.  Instead, he learned to stay ahead of it by giving himself enough insulin for what he was about to eat.
“But now the Control IQ recognizes when I eat and it provides the necessary insulin,” he said.  “I don’t have to tell the pump anything which is great.  Especially when meals are prepared for you.  No longer do I have to guess how many carbs are in the food.“ 
Jason’s advice to anyone who is scared about using an insulin pump is “definitely try it!”  He says it’s the closest thing to a working pancreas and would recommend it to anyone living with type 1 diabetes.
   

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