Going from pump back to injections

Hi all - apologising in advance for a long post!
I was wondering if any of you have made the decision to stop using an insulin pump and to go back to regular injections (MDI)?
I have been thinking a lot about this recently- I have had some issues with infections at cannula sites upon removal, some odd high blood sugars from not being able to pump much more than 6 units through my cannula, as well as some bumpy scar tissue and leaky cannula sites. (Using accu chek spirit wit plastic cannula)
I know I am incredibly lucky as I am in the UK and do not have to pay upfront for any of my healthcare, so I know I have the fortune to make this decision of my own free will and not because of funding.
I have been pumping since 2012 and started off very positive. My hba1c has never been above 60 and my pump and I have had a pretty good relationship for a number of years.
Recently, however, I have completely fallen out of love with my pump. It feels cumbersome, it puts me in serious pain with these infections, I am constantly checking for leaky sites, and I feel like I am relying on my Bluetooth handset rather than actually thinking about my dosages. It’s also partly got me into a bad routine as I am not eating as well as I should, and upon thinking about this I think it might be because there isn’t that physical requirement to inject and be conscious of it. I am aware that I’m incredibly stressed at work etc which is making this worse.
Anyway- the long and short of it is that I know I need to go and see my diabetic specialist before making a decision, especially as I don’t have much in the way of in-date insulin! But I would love to hear your thoughts on this.
Bx

3 Likes

I used a pump for many years and decided to switch back to injections about 6 to 7 years ago. The main reason for the switch was scar tissue forming from using the pump. I’m very happy with the decision and haven’t seen any difference in my blood sugar readings. I have no intention of ever using a pump again. For me, I just really didn’t like having something attached to me all the time and the scar tissue was a big problem. I’m pretty good about eating healthy and checking my blood sugar often. No regrets about stopping using a pump.

4 Likes

Some studies have shown that people can have better blood sugar results with MDI than with a pump, depending on which age group they fall into. Also, I have always been suspicious about the argument that pumping insulin in can somehow make managing blood sugars a trillion times more effective than pushing it in with a syringe, and oh, by the way, give me $6000 for the machine plus more and more money forever for the supplies.

The pump is a massive bother enhanced by the risks of infection and strange mechanical complications unique to it. I tried a pump for a while and had much worse control than without it, so I was happy to switch back.

I also remember that when I was first diagnosed in 1966, one of the physicians instructing us in the Joslin’s Clinic in Boston was trying to think of what was good about diabetes after having told us about all the bad things. “Well,” he said, “in contrast to most serious diseases, at least no one has to know you have it unless you tell them.” Now, with the pump, they’ve managed to invent a way to ruin that one advantage.

4 Likes

Over nearly four decades, I have been on four pumps, with sometimes long stretches of MDI in between each one. My decision to use one or the other form of treatment has usually been based mostly on “quality of life” considerations, rather than treatment (except the first pump, which I started on in 1981, when it was believed pumps would result in much better control). Much as I appreciate the flexibility that pumps provide – temp basals for activity are such a bonus; pushing buttons rather than injecting has its pleasures – there comes a time when I am just fed up with this thing constantly hanging off me, getting in the way, having to be accommodated, and costing quite a bit of money.

That nails it. Take a vacation. Use a treatment method you can love. You have nothing to lose.

2 Likes

Ok this is the pump lover in the group. I love my pump. I love the flexibility it gives me and the joys of not eating on that darn long acting insulin we used way back when.
I have been pumping for about 27 years and have never taken a vacation. Yes, I have had issues with kinked cannula which made me finally go back to metal. Never had infections but i’ve been very good about switching out every 3 days. And I rotate & use many body parts to try & stay fresh, arm, upper/lower abdomen, thighs, buttocks, just about anywhere.
That is my pump experience which has been great.
I have also meet quite a few pumpers who have made the switch to Tresiba & Afreeza or injectable short acting insulin with great success.
I just love the ability to turn it off or down and wow not eating or sleeping in! Yeah!
But I know the newer basal insulins are nothing like the old time ones. I was on ultra lente before I switched to a pump. Long time!
Good luck with your choice. It is whatever works for you.

That’s the perfect executive summary! YDMV

I was a huge pump proponent and started pumping ~3 months after diagnosis, so really didn’t know any other way. I never minded wearing it so much and contrary to what some people say, I felt it made it easier to hide my diabetes since I could bolus with the push of a button and never risked injecting in front of anyone. I was having a lot of site problems however and decided to try my first real pump vacation. So far my control is largely the same, sometimes worse and sometimes better, but I don’t expect my A1C or SD to be any different. There are definitely pros and cons of both regiments. I’d say I’m surprised by how well MDI is working and that it isn’t a big deal to take a pen injection wherever I am most of the time. I live in a big city and walk or take transit most of the time, so it can be annoying to find places to discreetly inject and that’s what I miss most about the pump - I haven’t worked up the courage to pull my pen out on the subway or a bus yet! I also don’t really seem to have much of any DP - my BG starts spiking when I get out of bed, but it did on the pump too and I can stop that by taking an injection immediately. I think MDI would be difficult if you experience DP. I also have little interest in going low carb, and it can be annoying to have to take multiple injections after slow-digesting foods, but it works pretty well (and sometimes better than square waving to my surprise). Some people swear by Tresiba and I’m glad it works well for them. I tried it for 3 weeks and could not get it to last throughout the day. I find a split dose of Levemir works wonders, so I’ll stick to that as long as this vacations lasts. I say go for it, you can always reconnect the pump if it isn’t working for you.

1 Like

I had this since I’ve been 5years old I use to do needles I miss it I got the pump 2012 I hate it I switch spots and it leaks I had to throw out 3 boxs they all been leaking. Its been hell.

What pump and sets were you using that leaked ? Was it the minimed sets that were recalled ?

I just returned some that were recalled, and they will be sending replacements.

I was also diagnosed at age 5, but no pumps or pens available at that time. I started pumping in 1996, and so far has worked well for me.

If you hate it, try going back to MDI. It’s a good age to be in with multiple basal options (Levemir, Lantus or Tresiba), half-unit dosing pens with memories, apps, etc. The worst that can happen is it makes you appreciate the benefits of pumping, even in spite of the infusion problems, if it doesn’t work for you!

2 Likes

Excellent point !!!

Beckarini, I understand what you are feeling. I switched from the pump to MDI in March and my Endocrinologist’s PA made me feel like I was crazy for wanting to do that! I persisted and I did it and I’m glad .I’m enjoying MDI and the feeling of not having something hanging off of me! The joy of just injecting and being done-makes it worth it !! I pumped for 5 yrs. and was totally disenchanted with all things ‘pump’. Instead of honoring my decision to do what I thought was best for me, I was labeled as being non-compliant. There is more than one way to achieve our diabetic goals. Yes, I was experiencing diabetic burn out, but it didn’t mean I no longer had a brain!!

2 Likes

I have been a Type 1 diabetic for over 59 years. Lots and lots of shots. Became needle phobic. Just couldn’t face taking any shots. Long story short. I now use AFREZZA inhaled insulin. Spent 5 1/2 years in a study trial. This AFREZZA has been on the market a few years. Ask your doctor to request a sample from Mannkind Corp.
To me it is a miracle drug. I no longer have to take ANY shots. Still follow my diabetic diet - count carbs for every meal. Good luck. Mary Lou

2 Likes

I used the pump for 3 years but unfortunately from day 1 and I do have infusion spot issues all the time, I never was able to put more than 1 unit of bolus by the pump, insulin accumulation irritates my skin only when using pump but never when externally inject it !!! so during the three years of pumping I was using it only for basal and all bolus was by external insulin pen…
I had to switch to sure T infusion set, so I can switch site daily for three days to avoid infections but even though it creates issues with sure T is less than 24 hrs in site… I switched the insulin from Novolog to Humalog but still had the same issues… to be honest I liked a lot being able to change my basal rate during the day as per my body needs and I also like using temp basal when I exercise but the bump and infection issues were bothering me big time so I switched to MDI using Trisiba and Humalog and I do just fine and best thing of it is that no bumps or infection and nothing attached to me…

If I were to go back on injections for a pump break, how do you correct a high bloodsugar, say through the night when my dexcom goes off? How do I know how much insulin is left in my body before I do another injection.? I am very confused on how to manage if I go back on MDI. Please help me!!!. Grrrrr!!!

1 Like

There are various “smart pen” options now that help you keep track of all this stuff, much like what you can do with a pump. Might try searching here or on Google for InPen Smart Insulin Delivery and the like.

I have never been on a pump as it is too inconvenient with my regular travel schedule crossing the international date line and other issues so only know MDI. I dose, exercise and eat based on the trends of my G5 Dexcom receiver and my digital scale. There is a direct relationship between my weight first thing in the morning and my standard deviation for the day.

In order to avoid night time variations I basically eat OMAD (One meal a day) at lunch time. That way by bed time my BG trend is steady and if it is a little high, I know from experience how much insulin to take at bed time to come back down to normal and not go low.

When I do need to eat dinner at a business or other function, my Dexcom will go off high during the night and I need to take insulin to correct. Unfortunately it takes 26 minutes for my insulin to kick in and that means waiting through an additional 5 alarms (alarm goes off every 5 minutes) which is quite annoying. In order to keep alarm as quiet as possible, I bury the receiver under my foam pillow. I have also put thick screen protector over the alarm holes of the receiver to reduce alarm volume.

I have been using Pendiq digital pens for well over a decade and they allow to fine tune delivery down to 0.1u. Pen is not approved in US by FDA but it has worked for me. The digital pen keeps track of everything and has alarms available as well and is bluetooth so will talk to other hardware.

I live in Canada. From what I read it’s not available here. Now what?

The great thing now is you have a Dexcom I believe? And I have a feeling you didn’t have a CGM before you started on a pump.

So you got by without a pump at one time and managed, so you can again. But I would say the first thing to make sure of is to get your basal rate right as it will probably be a little different than the one set on the pump.

A lot of people do a basal shot twice a day, it gives you a more even level and can be adjusted easier. But start with back to basics. Basal, dosing to what you eat, then corrections if needed.

@Marilyn has very good control and has never been on a pump. I don’t think she uses a smart pen, I’m not sure though. I think the newer pens do keep track of dosing you have recently done. Plus there are some aps that I think do the work for you in computing dosing.

I don;t know anything about the aps, but here is a link of some of the different ones and I bet some people can give you recommendations.

I find I just don’t worry about things like insulin on board and duration on MDI, as opposed to using a pump when I spend so much time trying to get all those settings so right and they’re always wrong anyway. If I’m going high in the night, it’s usually due to delayed carbs/fat/protein or basal dose too low, so insulin on board wouldn’t be something I’d consider. Personally on MDI I just go with my experience/gut a lot more, and if I’m wrong can correct with glucose or more insulin. I find paying attention to and dosing off of the CGM the most useful thing.

1 Like