I've had Type I for 30 yrs, and just switched from Lantus/Novolog regime to pump (Medtronic) back in mid April. Before the switch I was doing fine--consistent 6.0-6.5 A1c's--but my specialist has been nudging me toward trying a pump for a couple of years and I finally decided to give it a shot. So to speak.
Thing is, for all the attention I've had from my Joslin team and the Medtronic guys, I didn't really get the impression it was going to be as long or as tricky as it's turning out to get the thing dialed in. My BG target range is 100-130, and a glance at my testing chart shows I'm spending most of the time well above that, with the occasional "where the heck did THAT come from?" spike toward or beyond 300--numbers I rarely if ever saw on the old regime. We've done some refinements to my basal levels and it's gradually getting better, but I still feel like I'm pretty far from having it right.
So my question, 8 weeks in, is how long did it take you guys to feel like you were really getting adjusted to this? I somehow had the impression a couple weeks would do it, but should I have been thinking more in terms of months than weeks?
Just looking for a little perspective from more experienced pumpers out there--thanks!
My 8 year old some has only had T1D for a little over a year now. We switched to the pump in December and are experiencing the same things still. It is supper frustrating but the freedoms that the pump gives us and the independence that it gives my son make me want to keep trying. We have had a lot of trouble with the canulas crapping out somtime during day two. I hope when he puts on a little weigth, we might solve that problem. I have also been doing some research on the OmniPod which had a needle that goes in at an angle and there are no tubes to get tugged on. After being on a pen for the first 8 months and feeling so in control of the insulin going in, this pump make us feel pretty out of control. Good luck, I hope to see some responses with some ideas.
I've been T1 for almost 31 years, on a pump for 15 and a cgm for almost 6. I'm still working on it :) Seriously, though, your doctors usually want to make conservative changes over time since there's so much that can affect blood sugars (food, activity, stress, medications). They need to make slow changes, then wait a few days to see what those changes did. Even when pregnant, we didn't make changes more than twice a week.
For me, it is still a work in progress. Don't be discouraged, for me it was alot of trial and error. I find my CGM invaluable for learning what causes spikes--it's right there on the screen! Because I was most concerned about going too low overnight, I mastered the skill of doing a 7 hour combo bolus that maintains a flat line on the CGM till the morning.
I agree with what most people have been saying. Being on a pump requires constant work to tweak your numbers so they work for you. Things should start to settle down after a while, but a few weeks is certainly a bit short to really settle into a pump after being on Lantus/Novolog regimen for so long. If you don't use a CGM, get one. It is life changing in my opinion. It will help you pinpoint the areas that are giving you problems and fix them. Also, I wear a Medtronic pump and I love my pump, CGM, and Medtronic. In a very short period of time, their new pump and new CGM sensors will be on the market. Their pump has a built-in algorithm that will suspend insulin delivery when you go below a threshold BG and it will alert you before you have a high or low reading (when you are trending). These all require a CGM, and most companies are moving toward integrated pump/CGM systems now. It's the first step towards an artificial pancreas. It would be wise, in my humble opinion, to get on the CGM now and get used to it because future pumps will basically be a pump/CGM integrated system (not able to separate one from the other). In fact, I know that Medtronic is working on a new sensor that is integrated into the pump's infusion set,. so you only have 1 inserted device.
I just had a call from Medtronic urging me to get the integrated CGM--it was one of the reasons I went with Medtronic--so I actually have the prescription, though my pump trainer at Joslin wanted me to hold off until acclimating to the pump itself. One thing at a time. Given how many people are mentioning it here I'm certainly encouraged to move ahead with that.
The CGMS will assist - though the Medtronic version (for me) was only useful for trending - not actual readings. Still, better than nothing. I waited 21 years to go on the pump and then reduced my A1C by 1.0 point in about a month. I've been pumping for 12 years now. You started with much better numbers than I started with, but I would still expect a bit of a trial and error period. It's early days yet. Read Pumping Insulin if you haven't already and learn to make your own adjustments so you don't have to wait for an endo appt. But pumping isn't for everyone. You may decide you were doing well enough before.
Another thing I learned was that Medtronic is developing a sensor that will use 2 different methods to check BG readings, therefore leading to a self-calibrating sensor and eliminating the need for finger sticks in the future. Apparently, this tech is only a year or two away.
Thanks, all. I just signed on to the site this a.m. and it's encouraging to find such a responsive community.
Some of my "mystery" issues have been due to the trickiness of getting the dratted infusion set loaded and seated properly. I've had a couple of incidents where I discovered the canula had not penetrated even though it seemed like everything went properly (and is ANYONE capable of sticking one of these things on that recommended lower back region without getting it tangled in its own tubing? I'm not even gonna try). So that's produced a couple of scary moments. Finding out your set isn't working, your BG has shot up to 350 and your pump is firing off alerts about ketones and swapping out your infusion set while you're out at a restaurant having lunch with friends... Not fun. Seems like getting the CGM would help avoid that.
Thanks Kelsey. That pretty much describes where I'm at. I've actually started tweaking basals on my own--Joslin is a $40 co-pay, so those meetings with the trainer start to add up! Not quite ready to give up and go back to Lantus/Novolog yet, but the thought certainly has occurred. I was actually only on that regime for the last 10 years--I put in 20 years on the horror known to its suffering initiates as the R/NPH regime, so lantus/novolog was like being let out of prison. Not least because of insulin pen technology and the end of tapping fanatically to get that last stubborn little bubble out of the damn syringe. "Oh my god," I thought at my first pump orientation session, "I'm going to be tapping bubbles again???" Almost bailed right then! :-)
I had similar problems when I started pumping, and it sounds like you may not be using the right infusion set or are having difficulty getting them inserted properly. After experimenting with several kinds, I now use the manually inserted angled infusion sets, as opposed to the straight sets with auto-insertion, which had a near 50% failure rate for me. I recommend you try different infusion sets to find one that works for you and your body type. As I do not use a CGM, I cannot speak to the benefits of one, but I can safely say that a CGM wont necessarily solve your problem if it is related to not having the infusion set properly inserted. Good luck.
Not the only issue but it's definitely a big one, yes. I ended up tossing out quite a few sets and wasted a lot of insulin the first couple of weeks. I think I'm getting better at it now but it is just a finicky little device with a lot of failure points, from bubbles in the reservoir to the tube curling around and getting stuck to the sticky tape, or the canula just getting bent instead of inserting, Someone posted elsewhere about the type that uses a stainless steel rather than teflon canula and that seemed to have some advantages. Have to see if there's a way to try out some alternatives without committing to changing my whole prescription.
That’s too funny. I went straight from R/NPH to the pump. Skipped lantus altogether so the first time my pump broke over a weekend and my endo told me I’d have to do lantus until the new pump arrived, I felt COMPLETELY out of my element!
Only about two months in myself, but getting good control. It takes a lot of tweaking. They also want me to wear the CGM. Its hell. The CGM is a lot of work for very little return. Other people seem to do ok, I guess your diabetes may vary, but I find it an expensive useless toy. Of course, like you I had been doing fingersticks for decades. Maybe you just get used to the technology you have.
In the end, I think the pump beats injections. You have more flexibility with your basal rates. If you have an unusual day, (excercise, stress),you can adjust for it. Still, its not a miracle, just an increment. You end up trading a little extra work for a little extra flexibility.
It took me at least 3 months or more to get my sugar in my range. Give it time..once it stars working well with your sugar, you'll never want to go back!
