Replies to This Discussion

Permalink Reply by Cora on February 12, 2012 at 4:58am

I initially started pumping because I wanted the best control possible to take good care of my new kidney transplant. I didn't care if I liked it or not, I just wanted better numbers. And wow, did I ever love it! Sleeping in without worry, skipping meals (I had been on nph), only 1 shot every 3 days, tiny dosing in fractions of a unit, different basal rates to combat dawn phenomenon. It was fantastic. Don't get me wrong, it is a ton of work and if you're not willing to do it (test a lot, fast to work out basals,etc) then you will probably get yourself into a lot of trouble (it's easier on the pump). But with the work, you can get excellent control and feel a lot of freedom. I was also fairly low carb so being able to micro dose was very helpful.

Hope this helps a bit. Oh, and don't forget the expense. Even with insurance it is pricier than with mdi.

Cora

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Permalink Reply by acidrock23 on February 12, 2012 at 5:12am

I didn't like the idea of being attached to something *at all* and felt "I'm fine" w/ shots, although I was taking R/NPH shots (in 2008...medieval?) and, in retrospect, as *not* fine. I was always either low, going to be low soon, recovering from a low (going to be high soon, taking a huge CB to get low again...) or occasionally, OK. I switched to a pump and it was like night and day, a lot less work and, generally, much smoother control. More expense but totally worth it. I hardly ever notice the being attached to something business most of the time. I sort of don't like taking it off as it's kind of "precioussssss...."

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Permalink Reply by JohnG on February 12, 2012 at 6:10am

I love my pump

I never liked the idea of having some device hooked to me 24/7 but my lack of
low blood sugar awareness and fear of going to sleep at night finally wore me
down and I agreed to start using a pump and started using a CGM as soon as
insurance company's agreed to pay some of the cost. I have only had two significant
low blood sugar events in the past 5 years and they where both my fault.

The pump and CGM have completely changed the way I manage my BG.
My control is as good as it will ever be...It's all good.

Did I mention that I love my pump...;-)

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Permalink Reply by Brian (bsc) on February 12, 2012 at 6:31am

I'm on MDI (and am a T2) and although a pump may well have some advantages, I am really not sure they are a necessarily magic bullet for everyone. If you have not been diligent about testing, bolusing and carb counting, a pump won't do that for you. If you think it is going to be less work, that is probably wrong. You really need to test 6-8 times a day or more and you have to be a good carb counter (you can't just wing it). So if you meet this criteria, a pump could help, but there are some further things to consider.

Some people think that a pump can cause greater long-term scarring. Over ten years or more this may build up and if you are young, this is something to consider. Yes, you can manage this by being diligent about using a broad range of sites and rotation, but having a foreign object in your body 24 hours a day is more damaging than an injection for a few seconds.

Another thing to remember is that a pump is a brittle treatment and requires close monitoring and action. When you pump fails such as with a bad site, you suddenly get no insulin and you can have high blood sugars within hours and DKA within a day. With MDI, you have a slow acting basal that helps protect you and failures of a single injection or bad insulin affect have much less of an immediate and dramatic effect. You need to learn to identify these problems and correct them. ost pump users will tell you that it is not a concern, but when something goes wrong with a pump, often you get sudden high blood sugars.

And the final thing that makes me defer is that I have been able to achieve my goals with MDI. In the end, my goals is to achieve my health goals with the minimum effort and cost.

Everyone's situation is different. But be clear, the three biggest innovations that have changed diabetes are insulin, home blood sugar testing and the insulin pump. The insulin pump is the "gold standard" of care for T1. Unless you have compelling reasons to not have the best care, you should seriously consider it.

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Permalink Reply by acidrock23 on February 12, 2012 at 6:39am

A big part of what I've been able to do with the pump is, in fact, because my data tracking improved, just with the pump to keep track of what (or at least how many carbs...) I eat and when I eat it and, inevitably, what happens after I've eaten it. Logging sucks and a pump does enough to get by with it.

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Permalink Reply by Jim on February 12, 2012 at 6:41am

Good reply. I would add CGM as the 4th biggest innovation. At this point in my life if I had to choose between pump and CGM, I would probably choose the CGM since it is very good at telling me what direction my BS is heading.

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Permalink Reply by Karen on February 12, 2012 at 6:54am

A pump is not a cure and either is a CGM. I was on shots for 35 years and pumping for 9. To me it is just another form of insulin delivery. With shots and a pump I still have lows, highs, and hypoglycemic unawareness.

The one thing is that I always hated shots and really struggled with the initial jab.

Now that I am on the pump, I feel like I did not have as many lows on shots (but I know this is not true). To me it is the syndrome of the grass is always greener on the other side. I think often of returning to shots, but then the convenience of the pump and bolusing whenever holds me back.

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Permalink Reply by JohnG on February 12, 2012 at 7:23am

I could do a good job with a CGM and MDI but my biggest problem started with NPH, fallowed by Lantus, levemir was a little better but I still had unreliable absorption during the night. The pumps ability to very my basal insulin has eliminated my low excursions at night. I still have low BG but it's just my fault when I fail to cover my bolus insulin with carbs or do not plain ahead for activity.

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Permalink Reply by T1Forever on February 12, 2012 at 6:50am

See answers below!

Hey All =)

I am currently using MDI's (not really that successfully to be honest) to manage my type one diabetes. Although lately I have come across low carb eating and I have been having some success with this in helping to keep my blood sugars more stable.

Anyway, what I want to know from people who feel like they have good control of their T1 diabetes:

How do you control your diabetes so well? Is it really possible through low-carb diet with MDI? The pump is the only way to go. MDI can work, but it is still not as good or as easy as the pump.

Do you use a pump or MDI? Pump for 10 years. I am on my third. I also use a CGM.

Have you gone on a pump, but found it unsuccessful? Successfully is a hard word to define. Does the pump miraculously make everything better? No, but it is a lot better than without it. I still have to be diligent.
Do you love your pump? YES! YES! YES! Greatest tool I have ever found.

I am going to try out a pump, as I don't think there is any harm in trying it. But it's just strange I have heard they are really good from most people, but then I have been reading on here that some people have started using them and then gone back to MDI's and find this better. I sometimes don't like the idea of being attached to something, but I guess that is something that you would get used to fairly fast if it's going to help with better control.
I think that the pump takes committment, but in the end is worth every bit of your time and trouble. I cannot imagine going back to 7 shots per day, carrying all that equipment, finding place to take insulin. It is such a drag. If you hang in there with a pump, you can be succesful. I thought that being "attached" would be a problem. I don't even think about that anymore. GOOD LUCK!

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Permalink Reply by MegaMinxX on February 12, 2012 at 8:25am

I currently use a MM pump and love it. Here are the key benefits for me.

- Can make corrections sooner with smaller doses - sometimes I do .2 - .4 with a BG of 140, where as with MDI, I would wait till a meal bolus, and add to correction. Meal bolus is more precise and not limited to .5 increments. (Important for me since total daily insulin is ~ 20-25.)
- Frequently use the temp basal for activity or basal testing.
- Frequently use the Square and Dual wave bolus for meals - not possible with MDI.
- Easier to deal with hectic / unpredictable work and 'life' schedules, especially travel and time zone changes.
- Easier to adapt basal/bolus during times of 'hormonal' changes.
- for me, improved BG, A1C and quality of life.

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Permalink Reply by Sarah Emily on February 12, 2012 at 11:40am

Oh wow. Thanks for the replies everyone. It looks like most people agree that the pump works best with T1 diabetes. I would love to hear from someone with type one (sorry I know there are t2's aswell) that the pump didn't go so well for.

I guess the thing I am most nervous about is being attached to something allll the time, but looks like you get used to that fairly fast. I really can't believe I didn't discover tudiabetes earlier!

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Permalink Reply by Cora on February 12, 2012 at 3:14pm

I personally found it not any more inconvenient than wearing glasses - but my pump didn't fog up when I came in from the cold. lol. You get used to wearing it fairly quickly.

Cora

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