I’m curious, for the folks who pump, how long did you do injections before you transitioned to a pump?
I haven’t started injections yet (long story) but I will in two weeks. My Endo said I had to inject for a while and that at some point we would discuss a pump if it was something I was interested in. I don’t know much about the pumps but when my brother got his, it made his life so much easier. I’m all about easy so, I’m interested in one as soon as possible if I’m a candidate for one. Am I crazy?
My daughter started on the pump 6 1/2 months after dx. It might have been sooner but we didn’t have an endo for 4 months, then we had to jump through the required hoops (wait for an opening in the pump class etc).
My daughter loves her pump, but she misses not having to be attached to something 24/7. She’s considering a pump break for the summer.
If you’re interested in pumping I highly recommend Pumping Insulin by John Walsh.
I’m currently honeymooning and my pancreas is bi-polar. Sometimes it becomes manic and spills insulin all over and other times its so depressed I imagine it sitting on a tiny little couch, crying and unable to get up and do its job. Is a pump manageable with this type of behavior?
I did shots for 15 years before I started on the pump. First 13 years of R and NPH (two to three shots a day), and then two years of MDI with Humalog and Lantus. I’ve been on the pump for almost 10 years now. I wouldn’t say it makes things easier (in some ways it’s far more complicated than shots), but definitely allows for more flexibility in adjusting insulin (especially basal rates).
“Easier” is a relative term. To use a pump well you need to be knowledgable and conversant with some basic facts and characteristics about insulin. It’s a relatively small body of basic knowledge but when you first start it can seem like a lot to assimilate.You need to know about things like insulin onset of action time, peak time, and duration as well as your personal characteristics regarding these three things.
You’ll need to know how many units of insulin you’ll need to take to metabolize a certain number of carbohydrates. That’s the insulin to carb ratio, or I:C. Speaking of carbs, you need to learn how to count carbs and resources to use to discover how may are in the food you want to eat.
Knowing approximately how many points ( in mg/dl, if you’re in the US) your blood glucose will fall if you take one unit of insulin helps you to correct high blood sugar. This is called the insulin sensitivity factor (ISF) or correction factor. You should have a good grasp of the difference between basal insulin and bolus insulin.
Delivering insulin from a syringe and vial or using insulin pens can be a good proving ground to learn all these concepts. I don’t, however, think that holding off on starting an insulin pump is best for everyone. The pump itself adds some instruction but if you’re motivated, I don’t think you need to wait.
Using an insulin pump well is one of those things that will be easier once you acquire a certain body of knowledge and overcome the steep learning curve in the beginning. After that your life can become easier. In fact, it’s been a theme of my diabetic life that the more I learn about diabetes, the more complicated things become in the short run but in the end things do get easier.
Don’t fool yourself, though. It’s way easier not having diabetes at all. But if you don’t mind doing the work learning about this great tool then it can make your life easier and better.
I’m not a big fan of allowing the doctor to play gatekeeper for D-tech. If you’re willing to do the work then you should get a pump and not wait for some silly doctor.
To answer your question: I used multiple daily injections (syringe and vial) for three years before I started on a pump. My doctor was encouraging me for a full year before I decided to give it a try. In the end, the pump is just a fancy syringe. It’s your knowledge of how insulin works in your body that makes the biggest difference. The knowledge, curiosity, and persistence of the pump operator matter much more than the quality or brand of the pump.
I was diagnosed and started on MDI about 3 months ago, and right now I’m in the process of getting a pump. My Endo and I kind of went back and forth on it a few times (he thought I should wait because of my honeymoon), but I told him I wanted one as soon as I could get it, and he eventually agreed.
I think it would be even easier, as you can turn down basal insulin if your pancreas decides to work and turn up basal and bolus if your pancreas needs a break. If properly instructed, a pump can be a powerful tool and help you make fast decisions regarding your treatment.
I personally was on shots for 17 months before getting started on a pump. It really was a lifechanging decision, especially since i was on only 2 shots a day NPH/regular and my mom had a hard time reacting fast enough to my fast changing bg.
I’ve been on MDI for six years and still don’t have a pump. I have to say, in the end I think that it isn’t so much the tool but how you use it. And in my view, while a pump is great, it allows control of all kinds of things, in the end it isn’t going to “fix” my diabetes. And I actually believe that one should not move to a pump until you have demonstrated a strong competency in “driving” your diabetes management. You must be testing properly, before and after each meal, probably 8-10 times a day. And you should know “cold” all the stuff about what a basal and bolus is, how to count carbs and employ ratios and how to correct high and low blood sugars. And you need to do these things all the time at the right time with good consistent results. Even better would be to understand how to make your own adjustments to your basal and bolus ratios. While we may not all be ready to mess with all our pump settings if you are not going to actually use your pump to make finer and more detailed adjustments to your insulin regime (than you can do with MDI) then you might want to really consider whether you should move to a pump. In my case I have to ask myself some difficult questions about moving to the pump. It isn’t all positives.
Will it actually improve my control? Probably by a small increment, but I would be unlikely to get more than an 0.5% A1c improvement.
Will it make my life easier? Probably not, I would be tethered, I would have more insurance hassle and there are more logistics.
Will it save me money? No.
Will it make be "safer?" I actually don’t think so since pumps are more prone to site failures and you can go into DKA with a few hours, this doesn’t happen with a basal.
What about when I retire? Good luck with that Medicare stuff.
So I have been putting off the pump. And instead I’ve focused on getting all the foundation of my insulin regime tuned with my MDI.
I was MDI for 3.5 years before I got my pump. For me (not universal, but for me) the saving grace of the pump is the variable basal rate; most especially that I can lift my basal when I’m asleep and virtually avoid the dawn phenomenon. I just couldn’t do that with MDI. Although now that I think on the answer that @Brian_BSC gave, I probably could if I set an alarm and gave myself a bolus at 4AM.
Thinking back, I’m pretty sure I could have learnt the same things about blood sugar, food, activity, and insulin if I’d started with a pump. I think this statement runs counter to most people’s perception, but it’s very easy to set the pump up to emulate a flat 24h Lantus basal and give yourself manual boluses for each meal - exactly as if you needle yourself 4 times a day with MDI. Except it’s one jab every 2 or 3 days.
I think that doctors might think we’d be overwhelmed as new diabetics if we had to learn to count carbs, calculate boluses, account for activity, fingerstick, fingerstick, fingerstick - where did that number come from? and learn how to manipulate a pump all at the same time. A pen is ‘dial, point and shoot’ and a syringe is just as easy. But the current digital generation may not have as much difficulty pressing buttons as the preceding generations, so perhaps this should be re-considered.
As for me, I’m going to think about a pump vacation and see how I can actually deal with that dawn phenomenon because learning never stops!
Had to be a good 23 years, from 1979 til about 2003. I actually did alright on 2 shots a day with NPH and REG mix. Some people had a hell of time with it but for some reason it worked OK for me. Went to pump once I got divorced and living alone had me spooked as my hypo’s started happening with very little warning and at night. Pump has taken care of that as I feel them coming at much safer readings and love that just suspending pump slows them down a bit giving you time to get glucose in bloodstream. As a side note, the Pump gives you a bit more freedom of choice and helps your timing but as others have said is by no means easier, lol.
I am 28 years old. I was diagnosed in 1994 at the age of 7. Back then it was 2 shots of “clear and cloudy” insulin a day (R and NPH). Stricter eating plans, less wiggle room. Then in about 5th grade, Lantus came out, which the odd thing was it went from 2 shots a day to about 6. Not sure how that’s “better” but the sugars were better because the insulin was stronger. Finally I got a pump in 2001 when I was a freshman in high school and I felt that it was a useful tool. But do keep in mind that kids can be cruel. Anyway, I don’t think I would have wanted a pump between the ages of 7 - 13 because it would have been difficult to play and rough house. I have worn my pump since 2001 with maybe 2 MDI breaks in between lasting no longer than a week because it was just too much to put up with. I currently am happy with pumping and it gives me greater piece of mind than just injecting a bunch of insulin with a needle. By the way, I never did pens. I had always done syringes in those 8 years. And that was before I drove so I never was challenged how to carry my supplies with me when I drove somewhere. Still not sure how I would. What I like about the pump is that I can eat next to nothing and my sugars stay about the same all day long. And it makes exercising easier. What I don’t like about it is that I think it makes me look like there is something wrong with me and women do not particularly care for it. I have switched to injections for a few women who I were dating who felt that the pump got in the way of intimacy (and it kinda really does) You can disconnect it for play time but the sticker is still there and if you’re not careful if you stay disconnected too long, your sugar will sky rocket. Anyway, I’m 28, I’ve had it since 14. If I can lose 50 lbs, I will try MDI again on my own terms and not some girls’. And I’ll probably give it up for good after I’m 34 because that will reach the 20 year mark and 20 years is too long to be attached to anything.
Sounds like another sterling example of YDFLNCA, which is what kept me bound not merely to injections but to R/NPH far past the point when that treatment had been superseded by what we now mean by MDI.
1983-2003 for me. I don’t feel so bad now knowing I wasn’t the only one who stayed on it that long! Only I’m a member of the “had a hell of a time with it” group. I switched to Lantus/Novolog MDI first, and THAT was like being let out of prison after 20 years. I was on it for ten years before moving to a pump in 2013. For me the pump is a convenience–I definitely prefer it–but only an incremental one. MDI was the real life-changer.
I have had T1 for 32 years and did injections for the first 19 years, have been pumping for the last 13. I love it and would never go back to shots unless I had to. The flexibility is huge - you can bolus (dose) for even the smallest amount of carb, adjust basal (baseline) rates during exercise and stressful times, and run different basal rates and insulin-to-carb ratios for different times of day. Just wonderful. I think it’s best to do shots for at least a year just to learn how insulin, BG monitoring, and carb counting work to get the hang of all that drama first. During that time you can start keeping logs of your BG’s and eating habits, which the doc and insurance company will want to see before they recommend a pump for you. The only down side to pumping is that you are only using fast-acting insulin and if your infusion set is in a bad spot, you won’t know it until your BG gets high, so you can imagine that things can get badly out of control if you are not checking your BG several times a day, each and every day. And they want to know you are in a good pattern of that before they switch you to a pump, because it is a lot more responsibility. All in good time, and you will love it!
I was on injections for 28 years before starting pumping 12 years ago. If you only consider A1c numbers, you would say that pumping hasn’t helped me because my A1c’s have not changed. However, my time in range has greatly increased. I have fewer severe lows and fewer extreme highs. My diabetes is easier to deal with and a pump makes it much easier to do multiple micro-corrections through the day. I have never gone on a pump break although I currently am on the untethered regimen where I take an injection of Lantus for 50% of my basal. It helps smooth out pump disruptions such as set changes and allows me pump-free time when I swim.
I have never hated my pump. I find it convenient and I use advanced features like temporary basals and extended boluses almost every day. I am very insulin sensitive and appreciate the exact dosing that a pump allows.
I have had T1D for 42 years.
I went on the pump in 2000 - (need to get my calculator…) so, 26 years.
In 2000 there weren’t many options, and the pump I had didn’t have too many features but it was life-changing, for the better. I haven’t been off it since!