Are you on the needle or on the pump?

At the start of my letter called "The truth about diabetes."I clearly state that with those on the pump the situation is somewhat different. However I have noticed that often letter readers only see what they want to see.

There really is not that much difference between pump people and daily needles people. I guess it has been sufficiently pointed out that some crying when one gets a set back in life often gets rid of the new tension brought on by a diabetes diagnoses. I didn't cry, but my wife did. It is a shocker to most if not all.

I just wonder , before one became diabetic was it not normal to eat your breakfast after getting up in the morning? Different times for some but if it was 7 AM it would always be around that time.
Same for lunchtime, you wouldn't have lunch in your office or other workplace just at anytime, but more at the dessignated time let's say 1 to2 pm?
For most people dinner would be around 6 pm. Not all of cause but there was a certain routine that worked because if you got late you felt the hunger eating away at you.
I guess that became the same time with people after getting diabetes. Your stomach would tell you that it was time to eat.

Being on the pump gives you more leeway and you can eat later (some) or sooner but is that such a benefit? Is that vitally important?

It is far easier to give a few clicks to take insulin than taken it with a syrinse everytime.
So why are not all diabetics on the pump?

Well there are some answers to that question.

There is the cost..... for me I have to shell out $ 8,000. in the hope that it will suit me to be on the pump. Not all people are happy on the pump. But the $ 8,000. is gone.
There are medical reasons. For me, I get ulcers if I use a very sticky bandages if I need them.
Particularly the tape pump users use because you cannot have the pump loosely on the belly, must use tape that really sticks. I have heard that there are creams one can put on before using the tape that may make things better. Maybe so.

If a person stays with the needle taking instead of being on the pump is he behind the times as some claim him to be? Maybe there are reasons for him to stay on the needles. Possible?
I think so.

We all have diabetes and we all should try to understand the other if he does things a bit different than he/she itself does. Again in my letter I started out saying that things on the pump are a bit different. I recognized that right off. I hope we can all work together for a better way of living with diabetes. I certainly appreciated all the replies I get. Only yesterday I got an email from a lady who stated that my letter made her realize that there is life after diabetes when she did read I'm at it for 50 years.

Thank you for reading,

JOHNBEN or JB.(that's me!)

I appreciate your points JB. I sometimes forget that only 20% (?) of us in the US are on a pump. Going online can make me think nearly everyone uses it and gets me wondering why I don’t. There are vastly more of us not pumping! I agree cost is #1 reason followed by significant other reasons like aversion to being tethered and a difficult learning curve. I have long wondered how many of us would pump if cost were not a factor. Maybe 50%? I am able to achieve A1C’s under 6 on MDI, so pumping is certainly not the only way. I pay a price with more lows but for now the cost and tethering are turning me away from pumping.

I just wish that anyone who wants to use a pump is able to do so without this huge factor of cost hanging over their head.

MDI here and ok with it. My last 2 a1c’s were 5.7 and 6.0, eat when I want and what I want. Of course it’s not like before (dx’ed type 1 at 52) I diet by insulin, that means what I eat has to be worth the shot!!! A lot of things aren’t,example, gave up fries for side salad, most of the time! LOL

See all your points here. Good for you!

Me? I’ve been pumping now for 22 years.

I could not lead my lifestyle on shots. I am loving life as an endurance cyclist and shots could not cover my required changes in basal. For me, and many other diabetic athletes, a pump provides a means to achieve physical challenges.

I am still doing pens but soon to switch to the pump (once I get all of the approvals and what not). I’ll be excited to be switching personally. More flexibility and I dont have to excuse myself from the table, etc. MDI does not allow me to achieve the A1C I need so I am hoping switching to the pump will allow me to do so

Yes, pumper, however I always have needles and insulin bottle on hand because of the unforeseen …I find it helps using the needle , when I have a HI BG ( unexplained or explained ) …and happy to report , I am much more aware of the lows I used to have … You are ready for the medal soon…50 years !! JB

I did MDI for a very long time, over 30 years. I was opposed to the pump because of the tubing. I have this real ick factor when I think about yanking my infusion site out. When I got the Dexcom by the time I was going in for my three week check, I told him I wanted the OmniPod.

I’m very fortunate that my insurance coverage is very good. My stuff is covered at 90%. There are reasons for each of our choices. I’m finding a bit more flexibility with the pump and not having to do any long-acting makes this a little bit more predictable. With MDI I had great A1Cs but I had great fluctuations. My 6.1 wasn’t because I was steady at 120. i don’t want to think about what my deviation was. The CGM was the best thing I could do. Using it with MDI really helped me. The combination of the pump and the CGM has helped me to stay more even. If someone doesn’t pump and doesn’t want to, they can. That’s what makes this country great. :slight_smile:

I like my pens but wasn’t diagnosed as a child or teen. Everybody’s different and that’s ok

Have you picked a pump yet? There are many pros and cons.

Syringes and then pens for the last 34 years. A1c’s under 6 and managed just fine. Tubing is not for me and I figured why fix if it ain’t broke. I finally broke down and went on the Omnipod 4 days ago. Main reason was I was tired of consuming 200 calories in OJ or candy or Glucostabs every time I worked out (4 times a week) Money was never the issue, insurance covered it all. Started with a CGM a couple of months ago and that was almost better than the pump. Needles were never a problem and taking shots was just a way of life for me. It’s only been 4 days but I think I’m already in love. I ran for an hour the other day and my BS stayed perfect the entire time! I was happy on the shots and I think I’ll be happy on the pod but I had a need that needed to be filled and I was able to try something else.
You have to do the best you can and work with what you’re comfortable with.

MDI for now. It’s ok so far. I’ve only been type 1 since June of this year.

MDI here & fine with it. No set problems, delivery failures, infections, expensive supplies or waste. A big concern of mine is scar tissue with pumps. I use syringes because I hated the bruising from pens. I’m as low tech as they come:)

I have had the option of a free pump and supplies for the last 7 years but I prefer syringes Thanks. I did use the pens before but I didn’t trust them plus they leaked. I see too many problems with the pumps. I don’t normally swear but I have a feeling I would be with a pump. I don’t have enough patience to be a Pumper.

My A1c’s have been Good and stable(except for the last one because of drug reactions), I have no complications worth mentioning and all my tests usually come back in the normal range(Touch Wood). Maybe in the future for a pump when they are less problematic.

There are good arguments pro pump like Barb and Joe wrote. What I have a problem with is the glorification of pumping. People seeing the biggest improvements when switching from MDI to pumping have had poor control with MDI. So the real question for me is: why was the control so poor then? What has changed with the pump? I am convinced that the better basal profile of the pump did the trick. So this boiles down to: why was the basal insulin not doing its job on MDI? And here we come to a very unpleasant reality: basal insulins for MDI are rarely questioned in their effectiveness and application scheme. But there are huge differences from individual to individual:

-get rid of NPH basal insulin and replace it with Levemir. Dosage can be transfered 1:1. The improvement in life quality will be breath taking (if Levemir is applied twice a day).

-will one shot of Lantus cover 24 hours? If your I:C ratios show a high variation your coverage may not be perfect. Alternate: two shots of Levemir or two shots of Lantus (although this is less recommendable because of the insulin stacking effect).

-will one shot of Levemir cover 24 hours? Definitely not! Distribute your dosage on two shots every 12 hours.

These methods do not guarantee success but if you are struggling with bad control these are good points to try before switching to a pump.

I am on MDI since 1987 and I dislike to be attached to something so my opinion may be biased :wink:

Holger, when I switched from MDI to pumping in 2001 , both Levemir and Lantus unavailable in Canada then . Had those choices been available , who knows .I and my Team were aware, that NPH did me in , so to speak .
For me at my age ( 70 ) I am " used to" pumping and the pluses that go with it ( travel through time zones, travel by myself etc. etc. ) One day , when in " the home " I may have no choice but be back on MDI and may need the help from the Staff to inject . Fortunately I don’t think about this too often .

I like to thank all you many repliers (Is this a word?) for your so interesting replies.

JB or Johnben.

Just switched to a pump after nearly 25 years, all MDI, the last 8 using pens. As with others who have commented, the idea of being tethered kept me off the pump. The Omnipod was the only option for me and, so far, I’m glad I switched. Ultimately, I want equal or better control than with MDI. That will determine my long term satisfaction with pumping. For now, I’m content with the convenience and I’m just constantly amazed at how different life is now that I have the ability to adjust basal rates.

Two more yet! Thank you!