i am a newly diagnosed type 1 diabetic and is wondering whether an insulin pump is worth buying, being so expensive I'm just curious yo hear other thoughts and whether i would save any money in the long term, with not having to buy the insulin pens all the time.
No, you won't save money, Dell. You still have to buy insulin (in vials) and you need to get regular supplies of infusion sets and cartridges. Going on a pump isn't a way to save money. But it does do two major things: Help us better control our blood glucose (because we can take the exact amount we need and use the basal doses that we need at different times of day) and improve our quality of life, not having to do shots five times or more a day. Do you have coverage for a pump and supplies?
thankyou for replying Zoe.
no i don't have coverage(costs?) to afford a pump, but buying supplies is fine.
Im not sure whether its because I've only just gone on the insulin shots, but i only tie 3 shots a day, will this be likely to increase?
I was very skeptical about pumps for years but got one in 2008 and, within about a day (maybe 2 hours...), I realized it was a game-changer for me. One thing I found very handy was the way it keeps track of everything for me. I ***loathe*** logging. It isn't really accepted by the medical community that we would blow off writing down dozens of numbers every day but I hardly ever did that (just for a month...to get a pump...and only because when I considered fictionalizing them, I realized it would be even harder than just writing them down...). The pump keeps track of things and amalgamates them int useful reports that you can use to consider what you can do to improve. That has been a huge thing for me. Things are rolling along now so I don't do it that much.
I don't really mind shots that much but the pump worked way better for me. Like a ton better.
I have to be honest. While insulin pumps can improve your blood sugar control and your quality of life, they are not a silver bullet. And frankly, if you can't properly manage Multiple Daily Injections (MDI) you won't do well with a pump. It is a little like driving, if you can't drive well, buying a Ferrari will not help.
And that is what I come to. You have just been diagnosed. There is still lots to learn. Your profile says your A1c is 14% which corresponds to an average blood sugar of 350 mg/dl. Many studies have been done which show that patients can improve their A1c by 0.5% to 1% by moving to a pump. A pump alone isn't going to get you from an A1c of 14% down to what we would define as good control. Maybe your A1c is dated and you are doing much better, I'm just saying to remember that a pump is not a silver bullet. You will see far more improvement in your A1c by simply becoming good at MDI.
So let me also be clear about what I mean about driving. If you spend the money on a pump (and as others have said it is markedly more expensive than pens) then you need to learn to be really good at MDI. Three shots a day isn't a full MDI. For full MDI you need one or two shots of long-acting insulin for basal and rapid insulin every time you eat and for when your blood sugar is high. For me that is 4-6 shots a day. You also need to test 8-10 times a day and you need to accurately carb count as these will drive your decisions on how to use rapid insulin. There is no point in having extra buttons and switches from a pump if you aren't ready to use them. The patients that do best on a pump are those that have learned all the fundamentals about MDI.
Some good books are "Using Insulin" by Walsh and "Think Like a Pancreas" by Scheiner.
There will be a time in the near future where a pump may really be a good move for you, but it is better to become a really good driver before buying the Ferrari.
It is worth it but it won't save you money in the short term. It will save you in the long run because it's easier to manage the disease using a pump and will almost surely help prevent complications from high blood sugar. I agree with what others have said maybe learn a little more before you get on the pump but don't wait too long like I did. I fought getting on the pump also but now I can't imagine not being on it. Between my pump and my continuous glucose monitor I feel much more in control of my health. I could kick myself for fighting getting on both of them for so long.
Most people on shots take three fast acting insulin shots for their meals,(called bolus) 1 or 2 long acting for background insulin (called basal) and perhaps more for corrections when high.(also bolus). When you are new to D you sometimes only need either basal or bolus for meals like it seems you do. Unfortunately, yes, that will increase.
It costs more but I prefer pumping. It has eliminated approx 3 lows a month due to my Lantus dose not metabolizing evenly. I customize my basal control to be higher during dawn phenomenon hours. I cover slower digesting meals with extended boluses and I offset activity with temp basals. That said, you can do very well on MDI.
Thankyou for all the replies, it seems to me that i should focus on learning to predict patterns and understand my diabetes further before i get a pump.
I'm a newer T1 (about a year into this) who has been using an insulin pump since July. It's incredibly expensive (I think $2-3K alone for the pump), but it has allowed me to tailor my insulin dosages closer to my body's needs and adjust for out-of-the-ordinary events.
An insulin pump is not going to be effective if you do not already know how to manage diabetes tasks. If you do not understand how bolus insulin works, then it will be a lot more difficult to understand why a pump is taking a reverse correction for a meal based off your BG and IOB. If you do not know how basal insulin works, then it will be hard to set a basal for the pump and know when it needs to be adjusted and how to approach adjusting it.
There's a few more additional tasks for an insulin pump than with MDI. With MDI, I don't remember needing to basal test, while I need to basal test regularly with my pump (in order to confirm that my basal rates are still accurate). If my BG is high, I do not have the long-acting insulin in me that will prevent going into DKA (only rapid-acting insulin is used in a pump), so I need to be more adamant about testing for ketones and making sure that a high BG is not from pump-related issues.
Interesting analogy.
Think a Citroen Coupe would be a better parallel, ok maybe an original VW Bug could be more accurate??? -lol-
that's very interesting, I didn't think there would be more testing with a pump. At the moment I am still managing my bg levels and have little knowledge of bolus.
I agree it is better to improve your control with mdi first, but I know someone who went on a pump very quickly and my endo wanted me to start one about a month after I was out of dka. I have resisted it for a long time but due to too much fluctuation etc. and difficulty controlling my bg I'm finally going to try one. The good thing about it is you can adjust your basal for exercise and dp which you can't do on mdi at all other than splitting your doses. You can also do extended bolus for certain foods and if you end up not eating something you can cancel them. If you don't feel hungry you can lower your basal and skip a meal. If you can get some type of insurance or help I would- many insurances cover 80% or more.
I have really good insurance through my parents but the pump still isn't cheap. However, we are fortunate enough to be able to pay for this luxury and it has made a huge difference in my quality of life. I got the omnipod about a year after I was diagnosed and I haven't looked back!
I taught my kids to drive with a 20 year old Crown Victoria. It was a boat but was safe and could not be destroyed. Once they learned to drive and parallel park the Crown Vic, other cars seems easy.
Wow, it really sounds like the pump makes everything a lot easier. I have being talking to my parents and we have decide to take out private health insurance, however i will still be on the shots for the 12month waiting period, which also means that i won't have it in time for my trip overseas, but hopefully i will eventually get one. Thankyou for replying.
I agree to an extent, but MDI has its limits. I've been experimenting with my insulin doses for months and I'm still having a hard time figuring out my basal rates and boluses. I'm applying for a pump because I think pump-specific features like programmable basals and combo boluses would really help me. Not sure if it's worth the headache to try and replicate that on MDI... or if it's even possible.
Yes, i agree with what you're saying Mimikins about understanding bolus and basil. However my diabetes educator said that i can spend a couple of days with this lady that specialises in pumps to learn about how everything works.But when i asked the price of a pump i was told that they were around $9000, i live in Australia so that may be why, but that seems incredibly expensive compared to 2-3 thousand, is that the usual amount to pay for a pump?
Excellent advice and analogy Brian.
I was as tightly controlled as I could be with MDI over the course of 24years and when I got the chance to switch over to a pump, it was an absolute game changer for me.
I always kept meticulous notes and tested often with 10 test per day being my average. (14 if I was having a sick day)
I think the fact that I was so aggressive in making sure I did my absolute best in controlling my Diabetes made it easier for me to get a pump and later a Dexcom unit once my insurance said they would cover them.
Even with these things helping me, I still test regularly and issue multiple minor corrections in the course of any given day.
Carb counting is HUGE.
I mean massive in regard to attaining better control. If I had one piece of advice to give someone, it would be to learn to count carbs and to buy a good quality food scale so that you can accurately measure servings. Especially for foods like chicken or vegetables.
For foods like cereal, having a set of proper measuring cups is a must.
Sorry for the book. Hope at least some of this helps. :)
- Mario
wow, you know so much information, i'm definitely going to buy a proper food scale and start trying to count my carbs and with a bit of help from my support team hopefully i will be one step closer to understanding the pump, thank you Mario for all the information.