I have been bugging my dad to consider the pump for a while now. He has been on injections since his diagnosis at age 12 in 1955. He has decent control now (mostly 6-7 A1c) using Lantus/Log, but he has a lot of lows. I think he could get even better control with fewer lows if he tried the pump. He thinks that he would hate constantly being tethered to something and he thinks the pod is too bulky. I think he would get used to it. Today at lunch he asked me if I knew anyone online who had gone on the pump, but discontinued use because they didn’t like it. Anyone have any stories they would be willing to share, so I can pass them along? Basically I am trying to find out if discontinuing the pump is something a lot of people do, and if so why? Also I would love any other perspectives from folks who were worried about being “tethered” to the pump, whether they discontinued use or not. Thanks folks!
Thanks Amber. I appreciate the response!
My suggestion is for him to take a serious look at cleaning his liver. He has been on a very long path of imbalance in his life. The liver is the main filter for the body and he definitely needs to take a different path if he wants to have good years left. There is no reason for him to be tethered, let alone anyone else. I know these are heard as ‘extreme’ words, or confusing statements, for they go against the grain of what most have been taught. I do not go to any doctors, nor does anyone in my family, so I have many direct experiences with taking health into our own hands. I urge you to at least begin reading about liver cleansing, here is a link. Recently, a close relative passed over 100 stones she didn’t even realize she had. The liver, gallbladder, bile and pancreas work closely together, and all the D people here know the importance of all these in relation to D!
Heidi,
I went to the CWD pumping confrence in San Diego in April and i went to a workshop that explained the Unteathered way of pumping. It combines lantus with pumping. I know of one D Blogger who is using this to be able to go without her pump. I think she’ll explain it better than I will. Allison is on tudiabetes as well. Since she’s moving you might want to take a look at her blog: http://lemonlemonade.com/
Your dad might be more comfortable knowing that there are more options than just being stuck to a pump.
Awesome! Thanks, Amberthyme! This is exactly the kind of information I need to take back to him.
You can count me among the few former pumpers, and I am now, quite happily, no longer tethered to an insulin pump!
I was on an Animas IR-1000 for about 3 years, and finally, in 2006, I finally decided to return to MDI (multiple daily injections). No one can (or should) imply that a pump will or will not reduce the incidence of hypos, yet I frequently hear some pumpers, CDEs and pump salespeople all make the unsubstantiated claim that a pump will likely reduce the incidence of lows. Based on my own experience, I will tell you that this is not always truthful, and the reality is not quite so definitive. The key question is what his basal (long-acting) insulin requirements are, and whether this amount varies much throughout the day. Unfortunately, you cannot really answer this when someone uses Lantus or Levemir because the dosage is a fixed amount. The only way to really know is by using a pump in order to identify someone’s true hourly basal insulin requirements. But if the amount of basal insulin is relatively low as a percentage of the total, and varies little over the course of a day, my honest assessment is that a pump will not deliver much in the way of improvement.
You can ask some questions now that will provide a more informed decision. First of all, what is his approximate total daily dosage of all insulin? The prevailing belief is that about 50% of the total daily amount of insulin should be basal insulin, but this is certainly not true for everyone. What percentage of his approximate total daily dosage is Lantus? If its less (certainly if its a lot less) than 50%, then that’s kind of a strike against pumping. Factors that influence this is the secretion of glucose by the liver, and perhaps most notably, presence of other hormones in the bloodstream (for example, kids during puberty typically experience a dramatic need for basal insulin due mainly to various hormones that increase dramatically during this time. Also, many women find that during their menstrual cycle, their basal insulin requirements increase dramatically during that time, only to return to “normal” levels when their period is over).
Take a look at it from another perspective. His A1c is already pretty decent, so he’s unlikely to see a dramatic improvement (I certainly didn’t when I switched to a pump), so a pump will be a significant cost and learning curve involved, yet is unlikely to improve his overall “control”. He has already indicated a degree of discomfort with being tethered to a machine all the time, and I personally HATED that aspect of pumping. Some people get used to it, but my feeling is that they probably tolerate it because of the benefits that pumping provides, but that doesn’t mean its a minor concern. He’s probably pretty set in his ways, and has already achieved a pretty decent level of control, and now you’re pushing him to do something he’s not crazy about doing, based largely on the perception that it will dramatically reduce the incidence of hypos, which may or may not be true. I would start by having him “test drive” a pump (with saline) to see if he’s comfortable with wearing it 24/7/365. Don’t push him into it, be give him a chance to try it and assess honestly whether this is something he can see himself living with. It may be worth considering, but don’t push an old dog into doing something based on an unsubstantiated belief that it assures a reduction in lows; it can for some people, but that is by no means a guarantee!
Thanks for the info Scott. This is exactly what I needed to hear. It isn’t so much that I am pushing him to do this, as it is that I’ve kept it on his radar screen (asked him about every 6 months or so if it is something he would consider). His response has always been, “once the implantable pumps are available I would consider that.” Ultimately I just want what is best fro him, and I truly believe that he is the best judge of that. He is 63, well educated and very focused on taking care of his diabetes. More than anything I see the way he struggles with lows in the middle of the night and then highs in the day. He seems to have different basal needs at different times of the day, if I had to venture a guess based purely upon what we’ve tried to troubleshoot.
His basal dose is probably more than 50% of his TDD, I am not sure of his exact dosing, but I will check. One of his biggest issue is that his basal requirements in the morning are substantially greater than the rest of the day. He can eat nothing for breakfast, take a shot of Log and still end up high before lunch.
Anyway, thanks again for the great input!!!
20 years ago, I was diagnosed at age 13 and was never interested in a pump because it seemed too weird to be “tethered” to something – I was on Regular/NPH and then Humalog/Lantus for most of the last 19 1/2 years. After spending time around a new coworker a few months ago who was a Type I on a pump, I decided to give it a try. It’s really been great, and the stuff I was worried about before taking the plunge ended up not being any big deal. After one month on the pump my A1C dropped from 7.4 to 6.9. I’ll have my next A1C in about 3 weeks and am hoping for low 6’s, wish me luck.
You can let your dad know that the lower A1C’s are worth any early inconveniences, I certainly think they are.
Thanks for your input, Josh! I will pass along your thoughts.
To answer Scott’s question, my dad’s basal insulin is about 55% of his TDD.
I share your dad’s aversion to being tethered. I have considered and rejected pumping many times. My A1Cs are also decent and apparently my basal requirement is more or less level, so the benefit of pumping vs the trade-offs is less.
What about CGM? Has that ever come up with your dad? With lows, CGM can offer peace of mind that is hard to understand until you try it. It has a real learning curve (and is very different from bg sticks) but I really appreciate what it can do for me.