My Endo brought up using a pump again. I
keep saying no because it’s just another thing to break or watch out for or to learn.
I’m only 2 years with LADA and doing MDIs and being insulin dependent.
I feel like I’m just getting on solid ground with using a CGM and understanding food/insulin/exercise/diet holistically (ie identifying lows in my body and false highs on the cgm). I’ve learned to eat to my meter and dose accordingly following all the great advice here.
I’m not tech-phobic at all. It just seems like another thing that can “fail” and need a back up anyways.
Reading folks experiences here about the effort required for a pump… it seems like so much more work!!!
I’m also concerned that if I let the pump just pump out, I’ll become less aware of what I’m eating.
I know where all different — but, are there any benefits to a pump vs MDIs that I’m not understanding? Has anyone gone from a pump back to MDIs?
I work from home. I’m not out with people thanks to COVID.
It’s like most things, there’s pluses and minuses with both. I transitioned from MDI to pump 7 months ago. Over time the changing of cartridges and infusion sites has become automatic. One thing I appreciate with the pump is being able to do a correction bolus on the fly, especially after my recent bout with Covid that cause high insulin resistance.
It really wouldn’t bother me to go back to MDI. I have syringes, a vial of Lantus and a few pens of both.
I agree with @Luis3. There are advantages and disadvantages to both methods. I’ve primarily used a pump for a long time but I have taken a few deliberate pump vacations to refresh my MDI chops. My last one was 2016, I’m due for another.
The primary factor that tips the scale for me to pump use is the automated insulin delivery system that I use. You can essentially simulate that with MDI but for me it is not as consistent as an AID pump system.
I think that pump and MDI are both viable systems that pivot mostly on personal preference.
I agree with both @Luis3 and @Terry4. I went to a pump when I qualified for Medicare quite a few years ago. An additional bonus since then was having insulin and supplies, plus CGM covered by Medicare and supplemental insurance.
But that does not address the actual use of pump and CGM. I love the use of ONE insulin for both basal and bolus. Also the ability to alter basal according to time of day. My change to the Tandem slim x2 three years ago, brought night times free from lows. And that is a BIG thing for me.
MDI gave me the DM education and training necessary for good control. I believe it is indispensable for later being able to program the pump for best performance. Yes, dealing with a pump and CGM is much more work than using strictly MDI. But the extra control is truly awesome.
Probably if I could use MDI for the daytime and pump at night, I’d be happiest.
But advantages of pump are:
I never get out and realize I left my pen at home. Or it’s empty. Or I bent the needle and have no more. Or it fell out of my pocket.
Pump boosting basal rate and auto bolus if I’m heading high and so occupied I forget to check.
Suspend insulin basal infusion rate if I’m trending lower.
Drop in A1C from 6.5% to 6%.
But the Dexcom helped me to get from 8.3% to 6.5%, so was a much bigger bang for buck.
Actually, my A1c was a bit lower before I got the Tandem slim x2 and the CGM. But considering the fact that I loosened up my eating by including fruit and also the reduction of exercise because of age, I am reasonably content with where I am now… the mid- to low-6%. AND no lows at night!
There are quite a few people who love and choose to stick with MDI. Your understanding, protocols, and intuition about management don’t really change, it’s just a different application method. If you’re managing well and your don’t want to change, there’s no need to. “If it ain’t broke, don’t fix it.” If you’re struggling to meet goals, though, the evolving tech might make a big difference for you and your health.
I wouldn’t want to go back to MDI, but I’m prepared to if I must. I was in terrible control on MDI. More than 30 years of this, and I’m still needle-phobic. I never injected nearly as often as I should have. I would wait to correct until I didn’t feel well. For me, the pump means zero hesitation to deliver any correction, and much better resulting control. Add the new automation in on top of it that gives me control I never thought was possible with my lifestyle, and I’m finally living my best life despite my diabetes. But I 100% appreciate why other people would rather be untethered. It’s good to have choices!
Sure, electronics break. It’s not a deal-breaker, in my opinion. It happens rarely, and we should all have backup plans in place in case they do. That generally means reverting back to MDI until the warranty replacement gets delivered. Since that’s what you’re doing anyway, it’s kind of a moot point. The bigger concerns to ponder are whether you can actually be happy wearing the device and the tubing (if applicable), how well to adapt to change, if you’re up to the maintenance (changing batteries/charging, reordering supplies, loading it with insulin, changing infusion sites regularly, etc…), and how you’d do with another medical device setting off alarms/alerts. If you feel like raging when the Dexcom alarms, then a pump is probably a terrible idea.
I love complaining about my Dexcom, but I would not be where I am today without (6.1-6.3) or my fingers would be a bunch of holes from pricking all the time.
I cannot fathom living without a CGM—serious props to the long time T1s who had to do so.
Plus, the needles now are so small. My finger pricks hurt more than the MDI needles.
I have thought about changing to a pump, but I doubt that I ever will. Robyn gave a great answer to this question and I agree with her.
I get excellent control with insulin pens. My last A1c was 4.6, TIR 99% and Standard Deviation was 17. I admit that was on my best day, but on average I do very well with pens. Yes, I am bragging but after 63 yrs of living with this illness, I feel like I have a right to brag here.
I love insulin pens so much more than insulin vials and syringes. I would never go back to syringes. Using a short needle doesn’t bother me at all, but I am phobic about other shots. I understand that many pump wearers would detest going back to injections.
I think it would drive me crazy to wear a pump. I don’t mind wearing a CGM, but a pump just might be too much for me. I am bothered by tags in clothing so I think that I might be bothered by a pump, but maybe I would love it. I just don’t know.
Giving shots just doesn’t bother me. I will pull out a pen almost anywhere to inject insulin, but I keep my CGM covered. Weird, I know.
I am a bit concerned about how much a pump wearer has to worry about DKA. I haven’t experienced that since I was dx in 1959 and I don’t want to.
There just isn’t a right or wrong answer here. Everyone just has to figure out what they can tolerate.
I got my first pump in 2002. Before that I was on NPH and R for 25 years. For me the biggest plus was that I COULD MISS A MEAL!! Before that, no matter what, I had to eat at certain times. Family emergency? Still gotta eat. Sick as a dog? Had to force something down. If I vomited it back up, I had to try again. Now I’ve heard the newer insulins are better for that; I never tried anything else while I was on shots. NPH was horrible.
I have been back and forth a few times with pumps. Each time my pump goes out of warranty I go back to injections but I always end up getting my new pump.
The things I dislike about pumping is the site management and absorption and some scarring. Now I’m getting older the scars bother me less.
The thing I really like is how much easier it is to be on a pump where I can forget about everything for a few hours.
Times where I go really high and I’m afraid of crashing almost never happens, I go high and it brings me right back into range.
I lost my ability to sense lows while on mdi. But that came back with the consistency of my tandem.
My nights were always a problem and now my nights are the my most stable of the entire day. So my a1c is very good and consistent. Usually 6% often in the high 5,s but it’s not possible to get lower on a pump because the targets are too high. But I’m happy with 6%
There is no reason you can’t switch back and forth as you like.
When I was young and unmarried I would never wear a pump on a date. I didn’t have confidence back then. I switched to injections for weekends often.
That was in the crazy days of regular insulin and nph. And my pump was just pumping insulin there was no real difference in control back then.
I became hypo unaware sometime in the late 90s, maybe early 2000s. I was only seeing a primary care doctor at the time who liked to pretend I didn’t have diabetes. I had some severe lows that caused seizures. After this happened for the second time at work (2005) my co-worker stood over me while I looked up an endo on our health insurance site and made an appointment. At my second appointment the endo brought me in to talk to a nurse practitioner who told me I needed a pump. I knew nothing about them and wasn’t sure I wanted something attached to me 24/7. Two months later I was hooked up and haven’t looked back since. I had switched from NPH to Lantus but that wasn’t much better for me. It still had strong peaks that hit me hard, still had to inject it twice a day. Moving the pump and using only Humalog made a huge difference for me. I was finally not afraid to go to sleep at night!
I will take a kinked infusion set or a bad sensor over going back on injected basal insulin any day. I can turn my basal down or up as needed, or shut it off completely for a couple of hours if I have to. I can match my food better and I can extend my bolus delivery to account for high fat/protein meals. MDI is definitely simpler and there have been times I wish I could make it work for me, but so far I have never taken a pump break.
i had a Medtronic 512 with no cgm and often had occlusions or unexpected lows, so i went to mdi around 2008…started dexcom and xdrip in 2016 and have had much better control ever since… tresiba helped a lot, but if I’m exercising more than i predicted, im snacking to raise the glucose or taking extra shots to bring it back down… i started the omnipod with aaps and highly recommend starting there first…seems a lot more customizable, there are approximately 10-20 different reasons it might unnecessarily beep, which can all be turned off or silenced on aaps, plus with an android wear watch, you can snooze xdrip high alarms and bolus without even looking at your phone…ideal for driving…it will also temp suspend basals, so if i reach 80mg/dl, it’ll suspend, and when/if it starts to rise itll start again…you have to build the aaps apk, but as long as you have time, its not difficult and a good way to start to see the advantages…definitely check with your insurance to see if its worth it, and it may not be…i pick up omnipods for the same copay as my pen needles, but in the us, plans vary depending on 1000’s of variables
I love my pump. I was diagnosed with Type 1 after presenting in DKA due to chemotherapy/immunotherapy agent Opdivo. This was in 2016 and I was 60 years old. I was so overwhelmed as I acquired multiple autoimmune problems in addition to diabetes. I was started on injections with a pen which I liked. My endocrinologist and diabetic educator both said I was a good candidate for a pump. My first thought was “how many more things will I have to learn and do.” I started the pump 4 months later. I have never regretted it. I play lots of golf so I am outside and away from home for hours. It is so easy with Dexcom and pump. I know where I stand at all times. I can easily bolus for what I eat and I can easily eat more if I am going low.
Hello. I have had LADA for almost 20 years. Started with pens. Never had a problem. Traveled in hot places etc. switched to pumps a few years in. First Medtronic and then omnipod. For the past couple of years wanted to switch back to MDI. Insurance copay too high for omnipod and I am a little controlling for the new loop pumps. My Endo always talked me out of switching because numbers so good. But switched to MDI about a year ago anyway and numbers still good. Good and bad about both systems. Really happy not to be attached and finding place to put the pump. Traveling is easier. Not so much stuff. Don’t mind giving myself shots. A few times forgot to take my insulin with me but now have system. May go back to a pump at some point but now happy with MDI. Good luck
There are several pumps now, with CGM integration. Most recent is Omnipod5, along with Tandem and Medtronic pumps that have been integrated for longer.
Depending on many settings, features can be active or not. So I could use my Tandem X2 as a dumb pump, and also act as a receiver to see cgm reading. Or I can change settings so that pump will control insulin flow based on cgm data automatically. Food bolus delivery is usually driven by user entry on pump for carbs in meal, with plus/minus of insulin dose based on cgm bg info calculated by “smart” pump.
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