So I spent the morning on the phone with my insurance company trying to decipher some changes made to my policy recently.
What I found out is that they are now adding insulin to the diabetic coverage section of the policy. Meaning I can now get my insulin 100% covered instead of my normal copay. At this point, When I figure out & switch to all the preferred brands, the only supplies they won’t cover are my pump supplies.
This has me thinking. I absolutely love my pump & am intimidated by the thought of going back to MDI, but if I were to switch I’d get all my supplies free. (with the exception of the monthly insurance premium.) I’ve got a bit of debt at the moment, so even a short-term switch would help me to play catch-up on my bills.
I’ve learned a lot since switching to a pump 6.5 years ago & I think I could manage MDI much better now than I did before but I’m still nervous at the thought.
I should also mention that I have about 1 month’s worth of pump supplies left & will have difficulty making the payment required to release a new shipment.
Has anybody else been in this situation? What would you do? Any tips for a smooth transition?
Thanks in advance. 
MDI for me was much easier post-pump than before… but I have to ask, if they’re covering insulin under “diabetes supplies” why are they not also covering pump supplies?
Money saved is money saved. i too have a pump and as of right now i have met my deductible for the year and all my suplies are free. but next year when they are not i will take into consideration what will be cheaper and easier for me to handle. i would switch even for a little bit. it’ll help your pocket book then get back on the pump later. free supplies are hard to find, take advantage!
I switched from a pump back to shots. But I never used my pump properly, so it wasn’t a big deal for me. I would agree with Sarah, though, that MDI is easier after you’ve used the pump, it seems like you understand more of what’s going on or something.
Exactly… I felt like after having been on a pump for a while, I understood how to “make” the insulin work for me better than I had before
I had actually grown frustrated with pumping… and constant site failures (I was going through a particularly bad stretch) and opted to go back to MDI for a few months… I was not a happy camper when I wanted to use my pump again and it was not working and out of warranty - finances didn’t allow me to upgrade at that time so I ended up staying with MDI… for over 3 years. I’m happy to be pumping again for now, and more successfully too.
Well technically they DO cover pump supplies, but not at the $0.00 copay. I pay MUCH more out of pocket for them.
Thanks for the replies everyone! It’s definitely a blessing at this point to have the option of free supplies. I’m almost afraid to believe it. I’m thinking I can’t afford NOT to take full advantage at this point, even if it is just temporary.
I think I’ve gained a better understanding of D management & that I’ll manage MDI better now than I did before, but I can’t help feeling nervous. I know I will miss my pump . I did have a few site failures recently that made me pretty frustrated. It will be nice not to have to deal with that part.
To those of you who’ve switched from pump to MDI, do you have any helpful advice/ tips?
I am on the pump and have no intention of changing. I was thinking of it … sort of! I had to go off for the weekend when I went into the hospital and the ambulance driver forgot the bag I put my supplies in. They were jacka**es at the hospital and couldn’t get me under control in any way. Two units, four units, etc.! My stars! Right after I got back to the home I put myself back on the pump at almost 400! By morning, I was 101. Goes to show you that not everyone is having problems.
As for financing, I know what it’s like trying to keep up. What I did, fortunately for me, is to apply to Medtronic for special financing. I applied to their program and am now getting my supplies for free through Foundation Care. SSSSiiiiiigggggggghhhhhhhhhhhhh!! Hope this helps.
Lois
Thanks, Lois. I’ll have to check with them to make sure I don’t qualify for that before switching.
I was on a pump for quite some time, and then made the switch back to MDI for cost reasons. Here are my thoughts on the switch & your particular situation:
- The possible switch to MDI doesn’t have to be permanent, right? Why not give it a trial run for a while? Yes, it would be a hassle to make the switch to MDI, try it, and if you hated it switch back, but unless your insurance is super fussy, and your doctor is willing to work with you, why not try it and see if you like it?
- When I switched I had a much better understanding of how insulin worked because of pumping, so it helped out a lot.
- MDI takes a little more planning. Since your insulin isn’t physically attached to you, you have to make sure you have fast acting insulin readily available to use to correct if you are unexpectedly high, or if you are going to eat an unplanned snack or meal. So, less freedom there.
- It’s hard to “fine tune” insulin needs with MDI like you can with a pump, and this is the most frustrating part to me. For example, I’m super insulin resistant in the morning and it’d be great to be able to take more basal insulin from 4am-11am for me, but Lantus doesn’t quite work like that.
All in all, it’s been an OK switch. I do think that I can’t get as tight of control on MDI that I can on a pump, but I can still get pretty darn good control.
Good luck with your decision!
I’ll echo some of the other comments here and say that I was surprised at how well I managed when I went from pumping back to MDI. For me it was only for a few months when I was in the process of switching to a new pump, but I actually really enjoyed being back on MDI. And as I have off-and-on issues with infusion sets, I still consider going back to MDI from time to time since I saw how well I could manage.
I was pumping for almost 2 years and since the beginning of the year I have switched because of the supply cost. I actually love it!! I switched to an insulin pen which I have never used before and absolutely love it. I think it is so much easier to control my blood sugar now because I actually “think like a pump”. Of course I miss being lazy and letting my pump think for me because now I have to do all the numbers in my head.
Thanks Erin!
You’re right, It doesn’t have to be permanent. I don’t think my insurance would protest if I switch back to a pump after stopping. And my Endo is super supportive and understanding. He’s pretty awesome.
I’m not really worried about having to tote supplies around, I take my purse/meter with me everywhere anyway. But more the loss of fine-tuning and I’m worried about not remembering what/when my last bolus was. On the pump I can just look at the menu & there’s a record there. I’m sure I can handle it, it may even turn out to be really good for me. Sometimes I worry that I rely on the pump a little too much. The bolus wizard makes it really easy to kind of bolus mindlessly. (zombie bolus, anyone?)
Iol, I really feel you there. I HATE doing the math!
A small amount of NPH taken at bedtime can help with that extra insulin required from 4-11am
It’s unconventional, but I used NPH with Lantus when I returned to MDI from pumping… I had experimented with it before pumping, but didn’t really have the knowledge of what my basal needs truly were to get it “just right”.
Most insulin dependent diabetics can reach good control with MDI. The key to this success is the basal insulin. One of the biggest mistakes is that the basal insulins are advertised as being active for x hours. In reality the duration depends on individual factors. For example Lantus and Levemir state in their description that they are active for 24 hours. They can claim that because the length of duration is also dependent on the dosage. The more the longer is the rule here.
With high dosages the Lantus shows more constant delivery but in most cases the duration will not reach 24 hours. Thus it is no miracle that Lantus users have problems at least one hour before the next shot. Some circumvent this by adjusting their insulin factors. But this makes it impossible to skip the meal at that time because a portion of the bolus insulin is used to replace the degrading Lantus. More badly is that most user try to increase their dosage to reach 24 hours. As a side effect they have lows in the night for example (probably many undetected lows). Another problem of Lantus is that it will connect to the body tissue and from there it is constanly released at a slow rate into the blood stream. If you hit a blood vessel and inject the Lantus there it will not connect fully to the body tissue. Thus several Lantus users have experienced sudden lows after their Lantus injection.
At the last diabetes fair in Germany I asked several diabetes trainers about the claim of Levemir to last for 24 hours. Most of them said that Levemir is a very stable and good insulin and should be taken twice a day for optimal performance. None of them thought that one shot is sufficient for type 1 diabetics.
I am using Levemir too and I think it is the best basal insulin you can get. It will connect to the haemoglobin of the blood first. From there it is released constantly into the blood stream. This connection to the haemoglobin is very much preferable to the tissue connection of Lantus because there is no risk of having a low by injecting into the blood stream. To need two shots is a little more work but you will be rewarded with a real 24 hour coverage. Furthermore you can adjust your dosage for example for the night to compensate for higher physical activity on that day. Most Lantus users do not adjust their dosage at all but with the two shot regime (every 12 hours) you will have more flexibility for fine-tuning.
If the basal is working properly you have to find a quick acting bolus insulin. The choice between Apidra, Novolog and Humalog is purely individual. You should tests these brands to find the quickest insulin for you. It is really worth to investigate the differences because it will tremendously influence you post meal values.
As a last point: After the switch you will have no pump to save all your glucose values and injections. Thus you need to keep a log with MDI. You can do that manually with a written log or you use our project Glucosurfer.org to do that via mobile or smart phone or web.
Hi Holger,
You are a fountain of information… I did not know that about Levemir. I have LADA and I still have some insulin production, I am also insulin sensitive. I only use 20 units of Levemir a night. This seems to work for me best. if I split my dosages, oddly I experience hypos (probably because of my morning walks)… I love both Novolog & Levemir… They work so well with me. I know exactly how they work in my body, and their timing in my body (which really helps a lot in terms of predicting lows and so forth…)
I really do wish that pumping supplies wasn’t so damn expensive. It is absolutely appalling that some of us have to financially struggle, with a technology that everyone has a right to use and experience!!
One little correction: Levemir binds to albumin not haemoglobin as I have learned here.
Your comment has a very important message: you do what works best for you. This also means to be proactive and to explore better alternates if necessary. If your control is good and stable with one Levemir shot there is no need to change something. But if your control deteriorates you will have the option to go on two shots again. It is just something to keep in mind: the day may come when the blood glucose shows a rise before the next shot of Levemir. This would be a clear indicator that the basal coverage is not sufficient anymore.
Wow Holger,
Thanks for all the great tips! you’ve really got some good info. I was using humalog & lantus when I was doing MDI before the pump. I really didn’t have great results, but I think I really just didn’t know what I was doing either. I use Novolog with the pump & I’ve been curious about both Levemir & Aprida.
I think with enough work I’ll be able to get pretty decent control with MDI. It will just take a bit more effort & planning. Which will be worth it to cut back on my expenses.
Personally I would never, unless I actually had to go back to MDI. I was on MDI for the first FIFTY years or so…it was always “hit-or-miss”…with MDI, never knowing when the insulin would kick in…forgetting to do the shots…being embarrased, constantly checking and going to the bathroom…and just “pure” laziness…my control was horrible with MDI. I love my pump and my A1c’s went from 9 point something to 6.5-7’ish My control on the pump is so much better and I am hoping for a much longer D life using the pump. The long term effects of pumping are so much better on a pump, and hopefully less complications…
Sheila