So, few weeks ago I was in hospital (DKA yet again) and a doctor was talking to me about the insulin pumps. Id heard of them before, but dont know alot about them. So after reading about them, I think that it would be a good option for me. Something constantly attached would definately remind me to take my insulin.
I was just wondering what they are really like? The good points and bad points to them? Or am I just best sticking to giving myself shots 4 times a day? Which do people think are best? HELPPP?!?!?!

Views: 135

Comment by Chris Miller on May 7, 2012 at 7:54am

I've been on shots for 38 years now. On June 5 I start training on an Animas Ping. I think pumps are a much better system. For one, you don't use any long-acting insulin. Of all the pump users I've talked to, 100% of them prefer a pump over multiple injections.

Comment by Maycri on May 7, 2012 at 8:15am

Me too! but only 8 years for me. I am going to miss the freedom of the injections, and lately I have been actually getting good at not only remembering but getting my dosage right. There are pro's and cons to both.

For example with MDI (multiple daily injections) you don't have to sleep with your insulin on, you can wear tight dresses without anyone pointing at your extra bulge, bikinis, less stuff to carry on trips.
On the other hand with pump diabetes is on you at all times (less likely to forget), don't have to lift up layers of clothes to inject, it helps with math and gives more precise dosage.

So is up to you! My nurse gave me wonderful advice that made me look at the decision differently: "pump or injections are just an insulin delivery method, if you are not comfortable with one you can switch to the other anytime"

Now there is something I don't understand myself, why do people get off long acting as a base and switch to rapid as the only insulin to control BG. Isn't it better to always have back up insulin in your system in case your pump malfunctions or you wanna take a loooong swim?

Comment by Chris Miller on May 7, 2012 at 8:40am

Another benefit, I think, is when you sit down to eat. With injections, you give your insulin and must eat according to the dosage. If you decide that you want another slice of pizza, you need another shot. With the pump, that's just a simple push of the button. Also, at times I give my insulin and later wonder whether I did or not. With a pump, there's a record of it. Therefore, no missed shots or double doses.

I don't have to worry about the tight dresses :) ...Women seem to have an advantage for where to keep their pump. It sounds like many women keep their pump in their bra. Guys don't have that option.

The tiny doses of NovoRapid (or Humalog?) are supposedly a better way to basal than long-acting insulin. It seems more convenient, for sure.

Comment by Holger Schmeken on May 7, 2012 at 9:12am

The real question is: why is your current A1c that high? Are you really sure that your basal insulin is covering 24 hours for you? Have you read "think like a pancreas?" to get an understanding of the mechanics of D? Are you really sure that you are not in denial to some degree?

The pump will not remind you to inject insulin before a meal. It can calculate the dosage after you have entered the amount of carbs to eat. It will not know the correct I:C ratio. This is something you have to find out for yourself - like with MDI. It will not fine-tune the basal profile. The basal profile is a steady stream of insulin delivered by the pump - the equivalent to the basal insulin in MDI. You will have to fine-tune it and this is a great chance to find a better basal setting than with MDI.

Chances and responsibilities at the same time. The pump is just a blind tool. You will need the same basic skills for pumping. You should try to achieve good control with MDI first because the commitment is the key to good control. You can really get much out of MDI but there will be something left that is reserved for the pump. The little extra that has less to do with good control but more with quality of life. With the pump you can reduce the basal insulin for demanding physical activities. No need to eat and less lows. But you will also loose some degrees of your quality of life to the pump (scar tissue, self image, acceptance of partners). To weigh out the pros and cons is a very personal decision. So far I am prefering MDI but with the next 20 years this might change. This might be hard: If you see pumps as your way out of responsibility you are clearly on the wrong path. You can achieve so much with diabetes. All the bad things we hear are the result of uncontrolled diabetes. I find this video of Aimee Mullins very inspirational.

Comment by Kelly WPA on May 7, 2012 at 11:22am

Pumping is not a magic fix to your blood sugar problems. Sadly, people have to learn some of the things that could help them with MDI when they go for pump training. Holger has asked some good questions.

I used a pump for about 8 months of my 28 year diagnosis. My control was good but I was looking to do even better so got a Animas Ping in the summer of 2010. The first pump I had was defective and gave me too much insulin but fortunately, it didn’t kill me. The 2nd pump lasted for 2 months and the 3rd for 48 hours. You couldn’t pay me to get another Ping!

Besides all the pump failures, I discovered I was allergic to Teflon so could only use the steel sets. The Animas steel set (Contact Detach) feels like you are walking around with a knife stuck in you. Choices are very limited when you can only use the steel sets. I had a lot of site issues because my body just rejects them. You are supposed to change the steel sets every 2 days and I never had one last 48 hours. Even though I rotated sites like I was supposed to, I also build up scar tissue very fast. Because of all the problems, my A1c actually went up, not down.

If something happens to your pump, you are getting zero insulin in you because the pump acts as both basal and bolus. Depending on how much insulin you make on your own (some T1s still have residual insulin production) will determine how fast your BS goes up if your pump stops. It is very easy to go into DKA with a pump if your pump fails overnight or you aren’t paying attention to what is going on. At least with MDI, you have background insulin working.

Comment by Lora on May 7, 2012 at 6:07pm

I am a nurse pump trainer. You cannot imagine how great a pump can be! I have trained so many people and after 10 years of teaching, only one patient got off the pump. It is important to be sure to have your trainer work with you as long as possible. You will need to know how to adjust your basal rates, and bolus ratios. It will take commitment, but it is worth it. Good luck. I hope you decide to get on one. They are getting better and better.

Comment by Sam Iam on May 7, 2012 at 7:14pm

Agree with all comments above. Especially Hogar's. The pump is no magic bullet. More of a double edged sword. It can be a convenient, useful tool. It also puts you at greater risk for DKA and can be very expensive. Especially if you lose your insurance. If something goes wrong, it goes very wrong. You have to take more Blood Sugars, not less. That said, it feels great to wake up in the morning and not take a shot. I love my pump, but I've learned not to trust it.

Comment by Sam Iam on May 7, 2012 at 7:21pm

Sorry. I meant Holger not Hogar.

Comment by renka on May 8, 2012 at 12:32am
You have to be 100% dedicated to the pump and you have to have a really good nurse. If you are n to Bolger is correct. It doesn't remind you to take your bonuses. If your settings aren't right then it's no good. Junk in, junk out. I was on shots for 27 years and went on the pump 6 months ago. My a1c was always high and after 3 months it got down to 7 and is still improving BUT like I said you have to be dedicated. You must test your sugar and input all your correct numbers. Good thing is, you can always go back to shots if it doesn't work out.

Cosmetically, I thought I wouldn't like it and I don't mind it at all. It's so easy to hide. I clip it onto my bra or just on the belt of my pants. Only a couple times have people asked me about it and a couple diabetics came up to me. But it's easy to sleep with and you can unclip it when you shower.

I have the one touch animas ping and I love it.

I hope this is helpful.
Comment by renka on May 8, 2012 at 12:33am
Holger not Bolger ( Sorry my auto spell check did that)

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