Insulin Pumps & A1C

I also target 100 and am using the Medtronic pump 3.5 years now changing from MDI for 20 years. The biggest advantages of being on the pump for me:
1.being able to micro bolus .025 units therefore micromanage.
2. The pump tracks insulin on board. Very important
3. Although A1C has always been good in either method of insulin delivery, my lines are generally less erratic with the pump and sensor.
I am also on Dexcom after switching from Medtronic Enlite sensor. I find Dexcom to be a lot more accurate and love getting the info on my phone and Iwatch. I would give up the pump before the Dexcom. The only thing I miss with Dexcom versus Enlite sensor is the direct integration with the pump with the Enlite sensor.

Also, I set my own basals, but that is up to you and your doc.

The majority of the effect wonā€™t be seen for 2 - 6 hours in my experience, but, most pump insulins begin to have some effect in as little as 10 - 20 minutes. When I am experiencing a low that is much more severe and/or I have insulin on board (IOB) that is likely to drive me even lower, Iā€™m going to set a 0% basal rate for a while, so Iā€™m not adding anything that will continue to drive my BG lower.

If the result is that I then go a bit high afterwards, so be it. I can correct and bring my slightly elevated BG down. I always try to remember that itā€™s the lows that have the potential to cause immediate damage.

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For me, the pump is way simpler and ā€œconvenientā€.

I work better having one type of insulin to think about. It gives me a better ability to understand the results I might see in the future and appreciate when and how I need to make some sort of correction when that future result doesnā€™t materialize.

Like @DrBB, my MDI nightmare had an fairly unpredictable basal insulin, and when I started pumping, it was like a veil had been lifted from my eyes.

I tend to think of pumping as simple with lots of options, others might call that complicated. The options let me use the pump as a tool to help me live the life I want (given the inherent D-limits).

Oh, and yes, I think the nurse was out of line with her attitude.

Wowā€¦talk about timely! Just now i was actually wondering what to do when I stumbled on this thread. CGM says 132 & i have 2.68u IOB. For me, one unit should lower my bg by 30, so i might get into the 50s. Your post is spot-on & i will set the basal to zero until my 3am profile change. Thank you!! :blush:

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Ha!

Timely indeed, not long after this post, my CGMā€™s low alarm sounded and I had 1.2U on board ā€¦ I went to 0% for an hour, ate a snack and bottomed out @ 41 mg/dl (no panic, btw!). Three hours later, I peaked @ 114. I have been mildly trending down for the last 4+ hours with a 70% TBR. 15 minutes ago, @ 83 mg/dl, I took a 4g glucose tab and I am mildly trending up.

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I have pumped for 14 years and just came off and never bee happier (well prior to dx would be better but I make lemonade out of lemons). My a1c went from 5.6 on pump to 5.4 on Tresiba. I would never go back. I also experience almost no lows and on the pump it was chronic. Itā€™s all personal. I dance and do yoga and with the movements I was effecting the infusion set (sure - T) and immediately go high after classes. I teach 18 classes a week so I was changing almost daily or multiple times in a day. I also tried the omnipod and a1c went to a whooping 5.9 on more insulin an higher rates.
Just thought I would share. We all have to make this disease work with us and everyone is different.

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Iā€™ll pop up to say I too have gone from an insulin pump to MDI and life is good. Everything thatā€™s been said here about the benefits of pumping is true and itā€™s a great tool. Until I started having chronic site problems I never ever thought Iā€™d be able to go back to manual injections. Never, ever. But, it is what it is. I was spending way too much time problem solving and dealing with pump-related highs. So I took all of what I learned from advanced pumping techniques, got some pens and nano needles, and much to my surprise, my numbers are stable. It does require a lot of injections to simulate what a pump does but the nano needles are painless and life is too short to make it one big pity party. But my advice would be to give a pump a try if one is available to you. Even if you donā€™t use it for decades youā€™ll end up learning a lot about how to manage your body on insulin therapy.

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I said the same thing! I used to say injections was for the Flintstones. The scaring to my stomach from my sets is awful. Iā€™m actively trying to break up the scar underneath. No luck yetā€¦ doing massage therapy, lymph drainage and some essential oils for scaring. I never realized what it was doing till now.

Oh my goodness!!! That is scary & frustrating! My lowest was a 51 & i felt beyond awful. Everything shaking, could barely get to a juice box. Canā€™t imagine the 40s. Glad youā€™re ok! :bouquet: I woke up at 162 but iā€™ll take that over waking up dead any day :wink:

Thanks again for your advice & take care!!

Thanks for letting us know how you did.

FWIW, I woke up around 3AM, with my BG @ 124 and trending up. I ended my TBR and gave a 0.3u correction. When I got up this morning, I was @ 98. Overall a pretty successful night diabetes-wise.

For me, this proves the value of the pump, the CGM, and my knowledge of how this chronic condition functions ā€¦ for me! YDMV!

Nice moves, @YogaO! Looking back, Iā€™m amazed that it took until 2015 for dynamic diabetes management (ala Ponder) to become a thing.

I added CGM (Dexcom G5 with an Android phone, no Dexcom receiver) to my Multiple Daily Injections routine 1 1/2 years ago. Have been considering an insulin pump but A1C has dropped from 7.5-7.8 before Continuous Glucose Monitoring to 6.5 with. I donā€™t mind mind the pen insulin injections. I canā€™t find any firm evidence that the switch to a pump would be of much benefit for me. I am 68 years old and insulin dependent for 43 years now. CGM was a life changer :+1:

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