Why not low carb and pump? The two are not mutually exclusive.
I find that the lower dosages actually make it cheaper as insulin and sets last longer.
While I agree that the ease of dosing with a pump can lead to 'sloppiness' in eating habits, it isn't a tool solely for that purpose, and there are still benefits to be gleaned from it's accuracy and frankly it's IV like insulin dosing properties.
I don't see what you could gain through needles and long acting insulin other than instability and potential hypos.
Perhaps I'm missing something specific about your situation?
I've toyed with it for quite a while. I don't think infusion sets are agreeable with some of us. And that makes "real estate" hard to come by that isn't in a healing state or scar tissue. That's my case against pumps, at any rate. Plus pen delivery systems are super easy these days.
On the other side, breaddrink is right that the doses are smaller and can be delivered in multiple fashions, something MDI can't do. Plus forgetting your insulin isn't an issue when it's an IV-like drip.
I guess the question is, do you feel the pros of MDI outweigh the cons of pumping?
Never been a pumper so I can't comment on making the switch, but one of the reasons I stay away from pumps is that it forces me to really think about what I'm doing. Keeping it on "manual" control -- measuring carbs and calculating each bolus according to the specific situation -- keeps me honest. I can't just push it into the background and pretend not to think about it.
Of course, for some people that sort of detailed management and control is precisely what they hate. All I can say is, it works for me.
Oh, and I have to echo one earlier comment: low carb makes the insulin last a lot longer. And it obeys Dr. Bernstein's "Laws of Small Numbers" (the smaller the dose, the less risk of a serious mistake).
I have other issues with pumps, too, but they aren't directly relevant to your question.
Pumps are not as automated as you might think.
One of the main reasons behind not fully being backed b insurance is that it could be argued that they're not that different at all from syringes.
They're really no different at all from injecting in their essence, and the ease of dosing could lead to over-eating, etc.
This argument is somewhat oversimplifying the issue, and something pumpers have had to fight for with insurance companies, the same way we now fight over continuous glucose monitors.
I mean they're not THAT different from finger prick tests, right?
And stick tests aren't THAT different from urine tests...
You can regress the argument into oblivion.
I remember while injecting simply not being hungry enough to justify filling a syringe and injecting. With the pump it's three button presses away and therefore more likely to happen, but the advantages of pumping outweigh all the problems for me.
The pump is capable of an IV like effect, and can deliver tiny doses. Knocking a 130 down to 90 with tiny amounts that are near impossible to inject.
This goes both ways too, and when you remove your pump or turn it off, while you have to live with the effects of the insulin in your system, there's no long acting to mess things up and continue to run no matter what. The amount in your system stops dead right there.
While there are automated features on most pumps now (bolus wizards, etc) I don't use them. I feel they're more of use for people with a very high insulin sensitivity to avoid lows, rather than where I'm at, at the other end of the spectrum.
Watching a near straight line on the glucose graph from my pump from my continuous glucose monitor is all the proof I need. I've never been able to achieve that before low carbing combined with all this high tech stuff :)
I can dose .1's and .2's of units to gently steer things along.
There's no way I could get justify going back to syringes unless I was absolutely forced. It's a personal thing I know, but my numbers would suffer, and that's the bottom line.
Different strokes for different folks. I agree that I seldom hear pumpers complain about going low. But I constantly hear them complain about going high. There is always a "good, logical reason" -- didn't change the infusion set frequently enough, bad placement, scar tissue, a zillion others. The reason is always a good one -- there are just way, way too many of them.