Hi there! I am a type 1 diabetic who is working on a Ph.D. in Health Psychology. I am just starting to formulate a research topic and was wondering…
Why do some type 1 diabetics choose not to use the pump?
Any ideas? All (pump or not) are welcome to comment!!!
Thank you!
If you ask this question to people in the UK, it’s not a question of choice on the part of the diabetic but rationing on the part of the health service because of the high cost of pump therapy.
Some people don’t like to be attached to a piece of equipment all the time, for some it makes diabetes visible.
For me, I’m feeling ok with the progress I’ve made in getting my numbers down with MDIs. But probably the most important reason I’m not considering a pump, at least at this time, is lifestyle. I’m mostly retired (still do some work online) and so my schedule is open. When I was working two jobs I would have found four shots a day and 8 tests a bit daunting with my schedule (though my limited understanding is that pumpers have to test as well?).
I also just returned to the U.S. after two years and am having enough trouble learning how my phone works…lol.
I resisted getting a pump for years because I was afraid it would be visible under my clothes. I was uncomfortable with people knowing that I had diabetes. Now, I really don’t care who sees it. I’m actually pretty proud of it.
Getting a pump was the best thing I ever did for my health. It changed my life, and I could kick myself for resisting for so long.
I thought it would make me “feel” more diabetic as it would remind me of my diabetes more.
I was wrong. What makes me feel diabetic is being high and/or having to eat at specific times.
I’d never go off the pump now.
honestly price alone is enough to make the decision. I guess it’s cheaper to do mdi’s, but it all depends on your insurance. When i have the insurance i will definitely try it.
We are trying out a pump for my son david, the onmipod. This is his second pump change and he’s already wanting to go back to injections. I’m trying to figure out why. He’s 5 and has a mind of his own. I don’t know if it’s just another big change to deal with and he had finally got used to things the way they were? Or maybe the anxiety is too much when comparing the pain of an injection vs. a pump site? I certainly don’t know the psychology behind all of it. Since I’m the one that has control over his numbers then I know he wouldn’t be thinking better control it’s more about what works for him and his body. His complaints are that he doesn’t like having something “sticking out” as he puts it. I can tell without having even said anything that he feels different. I didn’t think it was that big of a deal but he obviously does. We’ll see how the next few weeks goes with the omnipod and if he still wants to continue injections.
I don’t want a pump for several reasons. Primary reason is the initial expense & the additional expense of supplies. Being connected & tethered to something all the time gives me the creeps. This doesn’t have anything to do with making diabetes more visible as several other people mentioned. I’ll test & inject anywhere.
Other reasons have to do with all the problems I’ve read from pumpers here: scar tissue causing absorption problems, forgetting to turn the pump back on after suspending it for a bit, mechanical problems where insulin wasn’t delivered, bent canulas, bleeding at sites, infusion set problems, tubing issues, etc.
I prefer the simpler approach. Fiddling with settings constantly seems like a lot of trouble. I count carbs & know my ratios, how to adjust & correct. Know the pump has many advantages for fine tuning doses & timing, but for now MDIs are working fine for me.
Wow Gerri–your reasons are so similar to mine!
After a year and a half of D, I still have a hard time accepting this is for real…I definitely cannot accept being attached to a machine. Yes, it’s mental. I also feel like if I had a pump, I could never pretend anymore…yes, I have a lot of moments of denial like this even though I carb count, inject 4 x/day and test 8-10x.
My Endo tried to push the issue, but can’t give me a good reason except that you can do less than 1 unit and be more precise. But the MDI thing is working (as well as it can) for now.
I also have a weakened immune system (without a spleen) and a couple other chronic illnesses, so I am concerned about an open entry point into my blood stream (I’ve read about people getting infected) since I am at particular risk of sepsis.
Oh, and the cost is ridiculous.
I just started pumping, so I’ll tell you why it took me 19 years before deciding to do it.
But then I got married and my wife’s response when I brought up the subject was “Will it make you healthier? Then yes, I want you to get a pump” and that changed everything. Then after investigating what it could do for me I realized that “good enough” was not nearly as good as I could achieve with a pump and that my fears of malfunction were overblown and born of ignorance.
Being connected & tethered to something would make feel like an invalid.
Without a pump I can be in denial and feel normal.
When I look at myself in the mirror I look normal.
I should have said: “I looked normal.”. I experienced frequent episodes of 200+ bg which I was not able to get under control. Being more frightened by complications than looking disabled I took the plunge and got a CGM. No tubing, just a little patch. After 5 months it still freaks me out when I wear the sensor on my abdomen. I feel less sick when I wear the sensor on my side. It’s all about my ego. Part of me wants to deny my diabetes, the other part wants to avoid the ugliness of complications. I was dx’ed 36 years ago and I have seen the first signs of complications. I want to switch into reverse.
Other than the damaging effect to my ego the CGM is a godsend. I don’t have 200+ bg anymore and knowing my bg at all times gives me piece of mind.
Since I now lost my virginity I decided to go all the way. I saw an endo this week and petitioned for a pump. The paperwork is on it’s way to the insurance. I still have a very bad attitude in regard to the hassles that Gerri mentioned. I have no idea whether a pump is for me. My inclination is to read all posts and decide based on other people’s experiences. I always lean towards the safety and comfort of being book smart. If anything this adventure will contribute to my person growth. I might even like the pump and live a longer and healthier life. Who knows? There are a lot of diabetics out there who say that getting a pump was the best thing they ever did in their life.
Jeff,
Too bad that I did not read your post before I posted. I could have just said ‘Ditto’ and saved a lot of typing. My wife was the catalyst too. She said “What is the downside to trying?”. My answers did not even convince me.
One of the main reasons why I haven’t made the switch to the pump is that I am a creature of habit (which diabetes has complicated to some extremes). But I have figured out what to eat, when to eat, and the amount of insulin to cover it all. My numbers are great and I don’t really want to mess with that. I’m also fairly busy and I don’t want to take on the trial-and-error of experimenting with food and insulin again. Maybe someday, but right now I have things figured out.
D for 26 years.
I was afraid of: 1. Infection
2. Ripping out the infusion set (I’m a klutz)
3. Malfunction computer. I trust a syringe and vial more than I do the computer to dose me.
Now I think: 1. Better blood sugar control. (therefore fewer complications)
2. History of how much insulin was given.
3. Tighter control of how much insulin I can take at once. Right now it is difficult to get exactly 1/2 unit. What if I wanted to take less to bring my bs down lik 20 points. I can have 1 unit drop me around 100 points, during the right time of the month.
My A1c is 6.8 and my doctor thinks I am doing good enough on MDI. He said that right now I don’t always check the required 7 times a day (before & after each meal and before bed), so if I want the pump I have to have a history of all of those blood sugars without missing a day. I check at least 7 times a day, but some days I miss b/c I am in a meeting or I get distracted. 3 hours after a meal doesn’t count for him.
I talked to him about the CGM, though, and he okayed that, He wants to see what that does to my A1c.
Hi Jessie: 
Well, a large number of People drive motorized vehicles while many prefer to ride on the bus. Other Folks like to walk while numerous People enjoy their bikes, for transportation. We all have different likes and needs.
I have had the option of a free pump and accessories for about 6 years. I’ve observed and listened to what new and more experienced pumpers have had to say about their experiences with pumping on Diabetes sites for about 7 years since I was Very interested. I also did a 45 minute session at the Hospital and listened to what the pump trainer explained about pumping and she demonstrated all the pumps. She also allowed me to play with them to get a feel for them and answered my questions.
Except for the expense part, I agree with what Gerri had to say and there are many other reasons as some have mentioned, why I prefer not to pump my Insulin at this point. My particular reasons would be:
-pump/accessory failure
-gaining weight because I just need to push a button to eat more
-Forgetting to re-attach
-having something stuck in me 24/7
-the pain and inconvenience of changing the infusion set
-inevitable GUSHERS
-possible infections(never had one with shots)
-possible Lipoatrophy and definite absorption problems
-constant worry if I am getting the proper amount or any Insulin
I have had Type 1 for 48 years. I have gone through my learning struggles involving Diabetes including my body and how I react to things, my treatments for D and other meds., dealing with the public and Family, etc. Learning never ends and problems will arise.
I have had some complications particularly in my earlier years but most have been reversed or repaired and I will not repeat them. My Hospital Lab test results are in the Good range area that they should be and my A1c has been mostly 6.4 for a long time. I don’t mind the short syringes at all.
I’m Glad that you are having Success with your pump. Every Diabetic deserves to feel Good and Confident about their treatment system. Best Wishes with your career Jessie.
This was sort of how I felt for a long time (the tethering part - not the creepiness; I tend not to get creeped out). I was also reluctant due to possible intimacy issues and also where I’d put the “thing” - the pump…until my CDE lifted her shirt and showed me how she hid it in her bra between her boobs - lol!
I’ve decided to make the leap because I finally realized that the “tethering” Gerri mentioned will give me what I miss most - freedom. Yep - that’s right - freedom. Freedom not to eat if I don’t feel hungry, freedom to have a weird schedule (that’s so me), freedom from carrying all those little pen needles and 3 different pens - Apidra, Lantus, Symlin (will only need a Symlin pen from now on and it’s not critical if I don’t have it with me), freedom from my dawn phenomenon and the guessing game that goes along with trying to handle it…and…and…and…freedom from insulin (sort of)…in other words, I’ve gotten my insulin usage down so low through a low carb diet and Symlin, I’m looking forward to reducing it even further.
So…I’m waiting for it to arrive
My new endo and I talked about me starting a pump. For the most part, I am “pro-pump”, particularly since I am quite insulin sensitive and the pump would allow me to have more precise control. My biggest concern about getting one, besides the cost, is that I have very sensitive skin. A year ago September, I had a MRSA infection under my arm after I returned to the US from Germany. It had to be cut open to drain it, then packed and bandaged while it continued to drain and heal. While I bought adhesive tape specially designed for sensitive skin, I ended up with a reaction all around my arm. It was almost as bad as the MRSA infection! At first, I thought perhaps my skin was even more sensitive because of the extent of the infection (it was quite bad), but I’ve since put bandages on other cuts that were not infected, or at least not as infected as my arm was, and I’ve had the same thing happen. So, I have some reason to be concerned. I’m more than willing to try a pump, but if my skin disagrees with the adhesive, there’s not much I can do.
I’ve also had some family resistance to the idea of going on the pump. Both of my brothers have told me they do not think a pump is a good idea. They are uncomfortable with the pump failure rate and with the idea of their sister being hooked up to a machine 24/7. Both have tried to talk me out of a pump at different points in time. While it would be nice to have the support of my brothers, I have already decided that I have to do what is in my best interest – not what makes them happy.
I hope this helps.
Angela
Formerly on the pump for 5+ years though for the past 5 months, I returned to injections. While I miss certain functions about the pump (it’s ability to remember if I bolused or not, being able to give myself small increments of insulin like 1/2 units and combo boluses) I actually enjoy moving back to injections and currently would prefer to get a CGM over a pump. My basal rates are pretty steady and I don’t have DP, so the ability to have multiple basal rates was not something that really excites me. Luckily my insurance covered most of the initial cost and all of the supplies…so cost too was not a big issue…
The biggest thing for me was the “tethered” feeling, but also in some ways more pressure to have even more perfect numbers…since I had the technology to do it… Tubed pumping especially creates that feeling because you always need to worry about where it will be secured (unless you disconnect)…which as a female in college was especially troublesome…especially given the way clothes are cut…and I didn’t know about groups like this or I might have found out about different ways to secure it (like around the thigh when you want to wear a dress)… Even when you disconnect, the insertion site is still there… not to mention all the marks leftover from them…In general, I’m someone who doesn’t like always have to carry stuff with me…I’m also probably one of the few people my age who doesn’t always carry their cell phone with them… leaving it at home most days when I go to work.
Since going back on the injections, I’ve felt a certain kind of freedom that I haven’t had while on the pump… being able to just change and not worry about dropping the pump (which I’ve done…though luckily it didn’t hit the ground, but just partially pulled out the insertion site)… and sometimes just having it next to me…creates a kind of revulsion… like the pump somehow embodied everything about D that I hated…
I think if I had felt a noticeable change while on the pump, I would feel differently, but it didn’t happen (due more to my own lack of motivation at the time rather than the pump itself)…I think in some ways to the allure of freedom the pump has let me feel I had more freedom than I really had so was more reckless (more insulin stacking, not really watching what I eat or worrying about timing at all) when this still matters…
Despite not enjoying it… I think I do want to go back because there are things that only a pump can do but I’m not in a hurry and this coming year we should hopefully see more integrated pumps and also a new tubeless pumps(which would give less of a 'tethered" feeling) so overall more and I think better options…
I cannot thank you guys and gals enough!! I am overwhelmed with information and I will keep taking comments for a while. It is always so interesting to see what other people think of the pump and many of you have brought up things that I would never of thought of on my own.
THANK YOU ALL SO MUCH.
If anyone is interested, I will post updates about my research on my profile page. Who knows, I might be able to make this an online project, where you could participate by just taking a quick survey 
Gotta love TuDiabetes.org members! Everyone is so helpful!