Is it really the pump?

Replies to This Discussion

Permalink Reply by John Smith on October 14, 2009 at 12:40pm

In my case, I had figured out my I:C ratio but never bothered with the ISF. I was always scared of lows and didn't particularly push for tight control. Getting the pump made it mandatory for me to learn my ISF and fine-tune my I:C ratio. And the biggest benefit is the variable basal rates that I set on my pump - impossible to do with any long-acting insulin. Couple this with a CGM (Dexcom 7+ in my case) and I feel like someone who has regained sight after many years of blindness.

▶ Reply to This

Permalink Reply by Scott on October 14, 2009 at 12:41pm

You need the better education because you have to tell the pump exactly what to do. With MDI, I could kinda "eyeball" it and do pretty well "Hmm, looks like about that much food so I need about this much insulin". I'd been trained on carb counting but after a while, you can almost do it on instinct

But to use the pump, you MUST have the education to really do well. I guess I tend to combine education and machine when I say "went on the pump"

▶ Reply to This

Permalink Reply by Jaclyn on October 22, 2009 at 1:40pm

This sounds like me exactly!

I even remember reading about people on the pump before I got one and hearing about how they would bolus for fractions of a unit...and I would find that absurd at the time. Since the pump, every .1 matters though!

▶ Reply to This

Permalink Reply by Dave   _ on October 14, 2009 at 12:51pm

Gerri, using a pump consists of many things besides just using cool technology (and "yes" you are correct that the knowledge a pumper has DOES affect the efficacy of pumping, as opposed to being on MDI)

1. No MDI can properly tame DP--it takes a pump with programmable basal rates to accomplish that amazing feat
2. Not having any long-acting insulin in one's body makes it much easier to deal with varying activity levels. Once you take a shot of Lantus, Levemir, or the older insulins like Ultralente, you were "committed" to the insulin for the entire day and had to take that into account should you want/need to increase your activity level above the level that the insulin dose was based upon at time of injection.
3. The ease with which one can take a "shot" makes it far more convenient to take additional boluses for snacks, extra portions, unplanned desserts, etc. One has to exercise restraint when pumping, to avoid gaining weight--think of pumping insulin as being "too" easy to bolus, in a manner of speaking.

NO other regimen can replace pumping.

Having said that, some people don't need/want to pump. Different strokes. For others it is literally ESSENTIAL that they pump (someone like me who has a strong DP).

▶ Reply to This

Permalink Reply by Gerri on October 14, 2009 at 1:06pm

I'm not disputing that pumps have distinct advantages, especially for DP & for increased activity. Just find it interesting how many people have stated that they didn't know ratios or other factors before pumping that they should know using MDI. They also didn't test as frequently on MDIs.

▶ Reply to This

Permalink Reply by Dave   _ on October 14, 2009 at 1:26pm

I didn't carb count or know about ISF or I:C until I began studying the pumping books.

▶ Reply to This

Permalink Reply by Mark Russell on October 17, 2009 at 10:35am

Right on, Dave....(refering to your original reply) I couldn't have said it any better myself!!

▶ Reply to This

Permalink Reply by Mommy and the monkeys on October 14, 2009 at 1:03pm

I think it is the intensive training. I am a mentor now to a friend who just recently started pumping. In 14 years of being on MDI she NEVER counted 1 carb and just did a sliding scale. I'm not sure if it is everywhere, however, I do think the intensive training may be due credit for the improved A1C.

▶ Reply to This

Permalink Reply by Gerri on October 14, 2009 at 1:28pm

The first time I noticed this was with a friend who's had diabetes for 33 years since he was three years old. He's my only Type 1 friend. Though he went to his endo regularly, he never got updated info. He was literarily shooting in the dark for three decades & ended up in the ER numerous times for lows. He guesstimated doses & never counted carbs. It wasn't until he got a pump that he was taught anything. I find it really disturbing.

▶ Reply to This

Permalink Reply by Dave   _ on October 14, 2009 at 1:30pm

disturbing and not all that uncommon, unfortunately.

▶ Reply to This

Permalink Reply by Mommy and the monkeys on October 14, 2009 at 1:31pm

I also find it really disturbing. I would ask her what her A1C was and she couldn't even tell me. I wish there was a way that those on MDI could receive the same training that the pumpers receive. I believe it would save lives.

▶ Reply to This

Permalink Reply by Karla J Sherer on October 15, 2009 at 12:40pm

I was on MDI 6 yr prior to getting my pump recently. I was sent home with a kit and a Rx for Insulin. The kit had a syring and pamplet explaining how to give an injection. No one showed me how or even talked to me about it. Luckily, I'd given injections when I was younger and worked at a small town hospital and I'd taken allergy shots. At least I knew what the pamplet was saying. I, of my own accord, called the ADA and asked for literature about eating. That's it. That is all I learned until I found this site. The first time I knew about carb counting was when I began needing a pump and started my research. The type insulins I was on prior to that were used like your friend's for the same "Shooting in the dark". I learned more on this site in 6 mo than I learned anywhere else in 6 yrs.

▶ Reply to This

• First
• Previous
• Next
• Last