I’ve not been on here for a long time but have a few questions. I’ve been on insulin now for just over a year and my BG numbers are great. My last A1C a couple of weeks ago was 5.7. My Dr has suggested I’m a good candidate for the pump. He has made it clear that my numbers probably wont get any better but that most of his patients on the pump find it more convenient. I have forgotten to inject my Lantus a couple of times and sometimes I find it awkward in crowded restaurants so I’m considering the change.
I know this topic has probably been discussed before but do you think its beneficial for me to switch from daily injections to the pump? Also, I’m a very light sleeper so I’m not sure if it will affect that too.
the pump is great…it makes diabetes a bit more managable and less in forgetting. if you do forget your sugar levels will resplect that. it will be benificial and i know some people just like to stay with MDI but i like my pump. it has a name too. it wont effect your sleep. if you use the CGM part which is another great toola and can keep you on target it will wait you up with the alarms but it keeps you in good working order with the pump.
Well, you won’t give Lantus on a pump. Pumps use only short-acting insulin like Novolog. But it constantly drips in as a basal dose, so you won’t forget that anymore on a pump. And I find a pump easier in a restaurant. You just pull it out and punch in a few numbers. I find a pump much easier than MDI. It’s never impacted my sleep at all. After about two nights I forgot I was wearing it.
Well hello to you also and welcome! And pumps like everything diabetes related is very personal. I do love my pump and have been doing it for about 27 years. The flexibility is the best and when I first started , the joy of being able to sleep in and not have to worry about injections. It was great when planning on having babies! And I love the fact that I can turn it down or off. Comes in very handy when having medical procedures done.
That being said, it is also a lot of extra work. You might be someone like me that is adjusting basal rates more than most. You also might be one who has issues with the infusion sets. Many, many have problems trying to find one that doesn’t kink or cause alarms etc. And it might just be me, but I always have insulin and a syringe in case something goes wrong with the pump. Pumps are very personal and which one you like, the next might not. I suggest shopping around and see if the one you might like will let you try one out. Good luck and keep asking questions.
Hi Paul. I’ve been on insulin for a little over a year as well and my A1C was 6.1 at my last visit. My endocrinologist has also recommended pump therapy, but I’ve been hesitant for a few reasons. First, my A1C is pretty good and that’s a result of good control through MDI. Pump therapy will improve A1C, but not much given that MDI seems to work just fine for me. Secondly, most insurances cover pumps every 4 years (I think?). So, whatever pump you decide to go with will be a long term decision. Given the advances in CGM and pumps (and tech in general) within the last 4 years, I’m electing to wait it out and see what progress is made before committing to such a commitment. Lastly, I’m not a fan of being tethered (and the resulting worry of kinked tubing, etc) and what if something happens while you’re out and you don’t have a pen to administer insulin? I agree that the pump is a very personal choice, but for the reasons above I’ve stayed away (for now).
I’m really on the fence regarding this. I’m become accustomed to the daily shots and not sure how I will feel hooked up to a device all the time. What about swimming, showers etc etc… Is there a lot of time learning how to use the pump and are they safe? Do a lot of people choose the pump for better control or for convenience?
Thanks again and sorry to be a bother… Hope all of my neighbors to the south have a great Thanksgiving!
For what it’s worth, I am also a very light sleeper, and in fact gave up on tubed pumps because I seemed to spend half the night unravelling myself. After a dozen years on injections, I returned to a pump, specifically the Omnipod because it does not have tubes. And it does not interfere with my sleep at all.
In restaurants, on buses, in supermarket aisles, wherever, with the Omnipod you just pull out your PDM (your pump controller), push some buttons, and that’s your injection done. Most people will just think you have a slightly bulky phone, if they notice at all.
The Omnipod can be exposed to water for up to an hour, which means you do not have to disconnect from your insulin supply to shower, swim, use a sauna, stand in the rain. You might need extra adhesive tape if you are a frequent swimmer.
It did not take me long to learn how to use it, and the PDM interface is pretty simple. As for “hooked up to a device all the time,” the pod is very light and unnoticeable. As I type this I actually have to think about where mine is currently placed. I have worn a selection of tubed pumps, and remember always being sort of aware that they were there, so the “invisibility” of the pod is very appealing to me.
Most pump companies allow you to try them out. Omnipod in Canada has a 90-day money-back trial period. A number of provinces and territories have programs that cover much of the associated costs, which lessens that burden. There is tons of information and opinion on this forum.
I like the pump for convenience. I just disconnect for showers. You can disconnect for an hour at a time safely. I didn’t like doing injections in a restaurant. I’ve been pumping for 17 years.
I have to say, I’ve been pressured to move to a pump. After more than seven years I’ve been on MDI. I am doing fine. I have particular concerns about having more invasive treatment with a pump. I want diabetes to minimally impact my life. I’m not so clear that a pump will help me. And if I have a reasonable A1c before the pump it is not reasonable to argue that it will improve my A1c.
If you’ve forgotten your Lantus, another option would be switching to Tresiba, which has a much more forgiving injection window. I also really like the Timesulin caps, which help keep track of it, and I set an alarm on my phone to remind me. I would never switch to a pump if I had a 5.7 A1c on MDI, personally… but then I’ve never been in a restaurant I couldn’t give an injection in, since I do it through my clothes and usually, no one even notices.
Thanks everyone for the input. I think I’m going to stay with MDI for now because I’ve have good control and I just have concerns that it will be attached to me all the time. I went 4 years without insulin on an almost zero carb diet so right now injecting insulin doesn’t seem to bad.
There is a big push right now by the pump manufacturers to have the endos get PWDs on the pump. There are also a number of stories about some people dumping the pump and going Tresiba/afrezza will great results.
If you already have great control with Lantus I am not sure why you would switch. The “tuning” would be at meal time and if you can get the afrezza nothing is better for corrections or the occasional times when you have forgotten you basal. The problem with afrezza is getting insurance coverage.
I think this discussion would’ve been different before the development of insulin pens and insulin analogues. It’s mostly personal choice now, unless you are having specific issues that a pump would best address (extreme dawn phenomenon or variable basal needs, exercise lows or a need to extend boluses for slow-digesting meals).
I’ve been using pumps for 30 years now with only one five month MDI break I took last year. The biggest advantage I find with pumps is the ability to vary the basal rate according to current factors. I’ve made extensive use of temporary basal rates to coax my blood glucose CGM trace into a better range. I think of it like driving a car. If I need more insulin due to holiday treats, I can boost my basal rate by 20% or more. If my exercise is driving me further down toward hypos I can set a temp basal rate -100% or zero units/hour. This is like applying the brakes in my car metaphor.
You just can’t do this with any of the injected basal insulins. Once you inject, you’re committed. You have to live with whatever profile it will draw.
I’m a big fan of Ponder’s sugar surfing techniques. While the MDI regimen allows you to take corrective boluses, you likely can’t inject anything under 0.5 units. And for that small dose of insulin you may be inclined to forgo the trouble. With a pump, delivery micro doses is relatively simple. Just punch in the does and fire. You can get on with your life while the pump slowly delivers its payload.
I’ve had a front-row seat to the tactic of using variable basal rates. I use the Loop artificial pancreas. A few years back, I was skeptical that changing basal rates could deliver its effect soon enough, given the time for insulin to peak. I’m a believer now. Tiny changes in basal rates can deliver excellent results.
I know MDI can deliver excellent results; my five month MDI break last year only ended when I had the chance to experiment with my current closed loop system. I was happy with my MDI results in terms of the effort it took. One of my biggest difficulties was remembering whether I took my basal or bolus shot. Pens with memories are something I would try to get if I ever committed to MDI long term.
In summary, I think MDI vs. pumps are an individual preference. Good luck with your decision!
“…you likely can’t inject blouses under 0.5 units.”
The best part of pumping for me, on a low-carb diet, is the ability to drop my basal rate as low as 0.05 overnight to avoid hypos, then up to 0.5-0.75 for “dawn phenom”. I don’t take huge amounts of insulin, but my control is far superior to oral meds or MDI, and hypos are rare.
I did the whole pump avoidance thing, too. I have lap dogs! They’ll rip the tubing out! (Used OmniPod x4 years till my insurance stopped coverage.). Now happy with a Medtronic 630–easier to fine-tune dosing, pets don’t get tangled up in tubing, etc., and sleep is no prob, with reservoir/unit clipped to my MedicAlert necklace.
I did MDI for 27 years and now I would not trade my pump for the world. I love it. I think it is a personal choice and I do know a few who have started pump therapy and not liked it. However, I know many who have started it and love it.
As for the 4-year thing, it is true you can change pumps about every 4th years. But if you think about it how different are pumps? Not much. Yes, some improvements, and I love my Medtronic 670g system, but it is not that much different form my first pump in terms of the basics. In fact, I have an old 530g upstairs and would put it on if need be with little reservation. So, it is like not buying a house because you are waiting for interest rates to come down. You finally come to a point where you leap and know 4 years is quick and 4 years from now you will have the best again.
I have been a type 1 diabetic for 32 years. In my 32 years I have had a pump for over 12 years and love the convenience. I have used tubed and non-tube pumps, some companies not in business any longer. Today I use the Omnipod. I love the fact the pod injects the tube automatically. In the past when using the tube pumps I felt like I was on a leash. Sometimes difficult to sleep with it when turning in bed or if you drop the pump it can jerk on the setting in your leg or stomach depending on where you like to have it most. The first time I had the pump I was able to sleep in instead of getting up to test, take insulin and eat breakfast, and then go back to bed. I have seen the hardware change over the years and pumps are changing for the better. I will say the 24/7 blood glucose monitor (Dexcom CGM) should integrate with the Omnipod on the iPhone but so far it isn’t. The Tandem system does have the Dexcom integration so keep this in mind. The Dexcom reads your glucose level every 5 min and tells your pump where you are, then if you fall out of your “safety” range you are alerted and given the option to make adjustments accordingly. If I had known the Tandem was going to have the Dexcom first I would have gotten that instead of the Pod so may change again in two years. Live and learn.
