So I am new to the forum but also excited to be on it. I have been taking injections for 15 years and recently was “granted” a pump. I used it for a month or so then put it away. I wasn’t used to having something on me all the time. I probably over whelmed myself since I also got the CGM enlite. Enlite sucked for me and the numbers were way off and honestly disrupting my sleep with false lows. I went on to get a Dexcom G5 CGM and went back to my rapid acting insulin & Lantus. I love my Dexcom and it’s extremely accurate… No more than 10 points off usually and sometimes right on with my actually Blood sugar tester. Now I have been working hard on eating well & exercising I am ready to try the pump again. My Endo appt is next Wednesday. I’m curious if you could tell me what you prefer? Did you see a big difference switching from injections to an insulin pump? How do you comfortably sleep with your pump if you use one? Thank you
I’ve been taking insulin for 32 years. I used multiple daily injections (NPH + Regular) for three years. I adopted pump therapy after that and have used a pump exclusively except a few month break to experiment with the basal, Tresiba. Please understand that I set aggressive goals for myself and I can meet them if I pay attention and remain disciplined with food and exercise.
During my recent Tresiba trial I was able to get pretty good control but struggled to achieve overnight consistency. I finally gave up on MDI and returned to the pump. The pump allows you to discover a customized basal profile that allows stable BGs between meals and overnight. It also permits an extended bolus that can deliver a certain amount of insulin over an extended period of time. This is a highly effective technique that I use for every meal.
As far as sleeping with the pump, here’s what I do. I use the 43 inch infusion sets and simply lay the pump onto the bed near me. I’m so used to it that I can grab it in my sleep and move it when I want to roll over. I’m sure you’ll hear of other successful sleeping tactics.
You need to find what works for you. Some people prefer MDI to pumping. There is no right or wrong reason. It’s a lifestyle decision. Be open to trying new things and you will find a system that works well for you.
Thank you @Terry4 for your feedback Happy Friday!
I’ve done 1) R/NPH (20 yrs), 2) Lantus-Novolog MDI (10 years), and 3) Medtronic pump (coming up on 3 years), as well as Dexcom CGM (2 years). For me the transition from 1 to 2 was the biggest change (life altering). I also didn’t take to the pump very easily when I first started. I had a lot of problems getting it dialed in and it turned out part of that was because my first batch of reservoirs were flawed and eventually recalled, though I didn’t find out until I’d pretty much used 'em all.
But all in all it’s definitely an improvement in both control and convenience once I finally got it all stabilized. Essential for finally getting my dawn phenomenon reined in for one thing. Biggest issue with lantus is that you’re stuck with whatever you injected for the whole day, or at best half a day if you split doses. With the pump you can set as many different basal levels as you want, and you can mostly leave it to do its thing and not worry about it. Exercise is also a major adjustment issue, and again, unless you live an exceedingly regimented and regular life, that’s much easier to accommodate with the pump than with Lantus.
A lot of people do rave about Tresiba, which I’ve never tried, so that may be a good alternative if you find being “tethered” and the other aspects of pump management too annoying. One thing I didn’t like in transitioning from 2) to 3) was that, whatever its drawbacks, I had the MDI regimen down to where I didn’t have to think about it much, whereas the pump demands a much bigger “mindshare,” especially toward the beginning. Having your reservoir run out at 3 a.m. or in the middle of your workday–much bigger pain in the butt than anything I dealt with on MDI. CGM also ends up making your BG levels a much more constant part of your awareness, which can be a good or bad thing depending on your temperament.
As for bed time–probably the single most common question. Certainly was for me, starting out. Turns out not to be a problem at all. I prefer to sleep with a pocket-t-shirt so I have somewhere to put it, but sometimes it comes out, or I don’t have one to wear, and it lies on the mattress next to me and it’s fine. Seems like it would be a problem (I’m gonna get all tangled up!) but it never has been. The thing of being tethered too: it’s occasionally still awkward but mostly your body-awareness kind of incorporates it and you unconsciously adapt so you don’t snag it on things or accidentally yank it out removing your clothes etc. I had way more occurrences of that sort of thing early on than I do now, though it still happens.
I’m not a huge pump zealot though. It’s a more complicated system with a lot more failure points that can drive you nuts (a recent and recurrent one: the little plunger thingy sticks and doesn’t want to unscrew after you’ve filled the reservoir and ends up sucking air in and being just a general pain in the *ss, especially when you’re changing sites while in a hurry to get off for the morning bus in time). But on the whole the advantages far outweigh the few times when you want to throw the thing really hard against a brick wall.
I noticed your other topic about wanting to get pregnant. It is much more feasible to maintain the very tight control you should have before and during pregnancy with a pump.
I started on MDI R & NPH back when I was diagnosed in 1988. I tried Humalin & Pork. I always had erratic absorption curves if I was either not active enough or too active. I switched to Humalog and Ultra Lenta in 1996. That Ultra Lenta was terrible but it was an early 24 hour basal insulin. I would find if I was physically active; I would bottom out and then later in the day would run out of basal maybe in the middle of the night. We tried splitting the doses of the Ultra Lenta and that helped but it was still erratic.
I went to a pump in 1998; I prefer the pump because before if your basal was taking you for a ride either high or low it was at minimum a 12 hour window of time for me. With the pump I can make corrections and be out of the danger zone in no more than 4 hours. Before the pump I had shots schedules for working outside, working inside, going to school ect… Using the dual bolus I can extend the insulin action over the duration of the meal.
The pump just offered so much flexibility. At night I just tuck it in my waist band. I use a medtronic pump coupled with a dexcom G4. My goals are very aggressive; my alerts are set on 80-140; I start taking insulin corrections when I go over 120; when I am not physically active. When I mow the lawn or work in the yard I typically like my numbers in the 130s for safety. I don’t think I would ever go back to MDI. I do still use syringes for corrections if I encounter a bad infusion set; but I do this just to get insulin on board while I fiddle with the tubing.
I used MDI for 28 years and switched to the pump 14 years ago. I love my pump, I will never go back. Sleep with it? I do it both ways, sometimes if i am laying the pump side I let it go and it sort of floats around the bed with me. Other times I attach it to my waist. I am sure other females have a better solution, But in my experience whatever you do you will shortly get used to it. I like the long tube and dislike the short tube.
Diabetic for 10 years, pumping for 3. Ish. I had great control during the day but the dawn phenomenon was brutal. There’s something very discouraging about being between 80 and 100 all day, going to sleep at 82 and waking up at 205. I didn’t try waking up every hour or so to bolus in anticipation of the dawn phenomenon, but I need my sleep or I’m even less functional than usual With the pump, my dawn phenomenon is mostly countered.
I sleep with it tucked in my waistband and don’t notice it. The comment @DrBB made about body awareness seems to work for me too. I find that I tend to put it on my waist, just inside my hip bone. I’m very thin, and there’s a sort of hollow right there where it sits naturally. If such a thing can be said to be natural
No CGM (insurance reasons).
Similar stories as the others, started insulin pump in 1995, and have not used injections since. In fact, have never even used pens, levemir or lantus, since they came out after that time ! (I do have syringes for backup, and on a few occasions used them when there were infusion set problems, maybe 4-5 times in 20 years !)
For me, the best advantages are the options to vary basal settings, use temp basals, give extended boluses for meals, and give very small corrections. My total daily insulin is 20-25, and common for me to do .2 or .4 unit corrections, or do more bolus when I decide to eat a bit more.
After hearing Terry’s experience, if I did stop using the pump, I’d probably try Tresiba, with Novolog/Afrezza for meals/corrections and think it would work almost as well as pumping…
I also use Dexcom CGMS, and feel that makes a bigger difference, in how successful you are with either pump or injections.