Do pumps help you not get so many lows or do they increase the risk of getting more lows since a computer is in charge? I am considering getting going on a pump. I like the tubeless ones:I am very physically active, live in the snowy mountains, eat super strict diet. I am currently on 15 lantus and bolus no more than 4 units 0-2 times a day. Do you think it is for me? Or should I just stick to the pens for now?

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i pump about 20 units a day to replace lantus and fast acting equivalent which totalled 30-35 units

the pump with CGMS is very very useful tool and if you are motivated the information will definitely help you get the level of control you will never achieve on pens

finally - the wireless system get so so reviews (omnipod) the minimed is a very well thought through and integrated system - the efforts of all our fellow pwds working out the bugs and refining the system and all the components really tells through and mikes the whole experience much more accessible and quickly positive

cheers

The pump can help people who are physically very active (and therefore need to change their basal rates to accommodate physical activity), have a somewhat variable schedule, are insulin sensitive (and thus experience differences between 1 and 2 units of insulin), and are really committed to D management.

In terms of lows, in my experience (as someone who is very physically active and insulin sensitive), the pump has decreased my lows and the severity of lows when I do have them. On MDI, I just could not work out without going low. And those lows were sometimes really scary. On a pump, I can turn down my basal rate before exercising and prevent from going low.

Also, when on a pump, you're only using fast-acting insulin, so that insulin clears your system faster when you do go low. On MDI, it would sometimes take 50g carbs to bring me up to an acceptable BG, but on a pump, I find that I can get my BG up faster when I do go low.

Also, the lows while pumping (for me) have been milder. I generally catch them faster and they aren't as bad.

Really do the research before selecting a pump. I know a lot of people like the omnipod, but they have a lot of issues and I know quite a few folks who have quit using the omnipod because of all the pod failures. I use a tubed pump (Revel) and love it. I am very active and the tubing doesn't get in my way. I use a Spibelt when I run or do other exercising and it works quite well.

I completely agree with "MyBustedPancreas" assessment - it was much better explained than I could have done.

One additional factor is that being human, we all make mistakes. When calculating a bolus I sometimes get the arithmetic wrong and realize I set the bolus insulin quantity too high which will inevitably lead to a low. After a shot your only "fix" is to add carbs and sometimes for me - especially when eating out - that can be easier said than done. With a pump you can monkey with the delivery if you are using a bolus that is being delivered over an extended period of time. One of the complications I have is delayed stomach emptying which means that instead of a quick bolus infusion I can get my pump to stretch it out in 30 minute increments. If I catch a goof in my calculation I have the means to fix it with my pump whereas that was impossible with a shot.

Best of luck and I'm sure that a pump will allow you to more easily enjoy your active lifestyle. I really envy your ability to be so active.

I recently switched from pens (and Lantus) to OmniPod and it's been helpful for when I'm sporadically active because I can set a temp basal rate. I've personally had fewer lows since starting with a pump because of how much more accurate the bolusing can be for my carb ratios because I had been going low after meals frequently.

I think there are less lows because if you need .85 units of insulin, you can bolus .85, you don't have to round up to 1.00.

But you say "a computer is in charge" and I think this is not a good way to think of a pump. Remember the old saying, "garbage in/garbage out"? Not only are you responsible for programming the data into your pump (I:C ratios, basal rates, ISF), but you should always look at what the wizard recommends with a practiced eye. I, for example, when I am on the low side find that if I bolus a reduced amount for my meal, I will go high. So I bolus the full carb amount and just do it closer to my meal, after my meal or treat the low first. Pumps are a great tool, but like any tool they are only as good as the person using it.

They also require more frequent (not less) monitoring. Since there is no long lasting insulin in your system, if the site is bad and you are not getting insulin you can quickly go high into the danger zone.

geez, zoe...this (the pump) is, or at least right now feels like a huge learning curve, at least from yesterday and today. we're not starting the pump today, as we thought..have to go back again for training next week. feel like i'm learning some foreign language all over again. it will kick in, I'll get it..but feels like a lot right now. the fear is there, the notion of easy DKA..but for those of us who test a lot, that minimizes that a bit.

What you describe, Type 1, is pretty much how I felt when I started the pump. It is a lot to learn and it is a real change from shots. Only, ultimately, all the skills you have from shots will become even more useful with the pump. Once you iron out your basals (which for me were more of a change than I:C ratios which stayed the same), and learn the technical aspects of the pump and the sets, you will find you have a great flexibility. And yes, testing a lot especially at first, will help you tweak the numbers and stay (feel) safe. I always think of learning curves as a huge hill you have to climb, and then once you get over the top you get to cruise down, laughing all the way!

true..! very true..thanks! :)

Hey Type1Gal -

I wouldn't focus too much on the "easy DKA". I've had exactly 1 bad site over the past 3.5 years and even that one was good enough to keep me under 250.

Maurie

ah..thanks so much, maurie. i was reading on here last night that some folks gave up their pumps, stating they kept having issues with their cannulas, bad sites, tubing because they're thin, insulin sensitive and take some amounts of insulin (as do I) which made the pumps not alarm with 'no delivery', etc..and they had problems with insertions, etc..which concerned me because i'm thin too. i'm in..i'm gonna go for it..for me, i just want to get rid of these rollercoasters and getting hit with these peaks and drops of levemir. i'm actually excited about it but it does seem like a lot to take in right now.

Maurie, are you actually saying that you haven't had any problems with sites in 3.5 except that one?? That every site you insert is fine for 3 days?? Wow!

Zoe - I've had a few insertions that had to be redone immediately and my share of what I call B- sites but only one really bad one.

Maurie

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