Opinion about Pumps

Hey guyz

My Doc has been behind me for the last 6 months to switch over to the pump instead of using syringes for my insulin needs.
Now after 6 mos I decided to atleast go to a Pump rep and discuss about benefits of the pump.

I actually wanted to get a better opinion from you all about Pump therapy…
Is pump therapy really really beneficial as they say or is the same as using insulin pens.
If so which pump is better… Personally, based on my research online … I like the Omnipod… only coz it is tubeless…
I hate to carry a pump that hangs round me all the time coz I m too shy to wear it to my work or parties…
I dont want to advertise my diabetes to everyone…

Help me make a decisoin here…

Thanks

I’m also being pressured to change to a pump, so will be interested to see replies.

You really can’t say which pump is best. They all are basically the same but then it’s really what brand you like. Just like a car. I am a person that does not like whistles and bells b/c it just gets to be too complicated for me. I love my Animas and I also loved the MiniMed Paradigm pump. I did not like the OmniPod at all. Maybe you can see if the reps for each company have pumps you can trial wear. The Animas btw does have the whistles and bells but you do not have to turn them on. ha ha to clarify that



Good luck and do your homework b/c once you get one you are basically stuck for the next 4 to 5 years.



Sandy

I got the pump (minimed) last November, and after using it for 3 months, I decided that it wasn’t for me… well, at least not now. So I am back on shots now. I figured that if I ever miss it and want to go back, I can. Overall, I didn’t really feel like I had better control, and hated being attached all of the time. Plus, I started having a lot of problems with site changes. That was my experience. I know most people love it and would never go back. My advice is to at least give it a try, and if you don’t like it, you can always go back to shots.

The pump is not for everyone and there are misconceptions about both its benefits and drawbacks.

In my view the primary benefit of the pump is that you have more control over basal insulin, so you can adjust it up or down depending on your activities. Secondly, you have less crap to carry around, which means less crap you’ll forget and have to turn around and go back to get. Third, it helps you keep an accurate record of your insulin intake, and possibly your carb intake and blood sugars.

There are many misconceptions about pump therapy on both the pro and con sides. For instance:

  1. Using a pump will give you better control. False. Only you will give you better control. The pump is a tool and can make it easier for you to take control. But you still have to pay attention.
  2. The pump will advertise my diabetes. False. No more than taking a shot in a public place or excusing yourself to test or shoot up will advertise you. Pumps are unobtrusive. Nobody notices them unless they’re looking for them and nobody is looking for them. When’s the last time you saw a person and thought “Oh, look! They have an insulin pump!”
  3. Tubes get in the way. False. They don’t. Well. Sometimes. Just not as often as you think.

Some conceptions about pumps that new users aren’t always aware of:

  1. They’re noisy. You’ll sound like R2D2 unless you respond to alarms immediately.
  2. You need a backup plan. If the pump stops working it could be 24 hours before you get a replacement. So have a plan just in case.
  3. You need a good supply of AAA batteries.

Don’t give in to pressure. Do what works for you. Most manufacturers will give you one to try with a saline solution before you commit.

Good luck,

Terry

I agree! Don’t give in to pressure! Terry is SO correct in stating that only you give you better control (kind of a Smokey the Bear feeling?). There are pros and cons to each pump - personally, I love my omnipod! However, I completely understand why some people don’t :slight_smile: If I were in your shoes, I would contact the rep or a CDE to try each of them out for a bit before committing to one or the other (or giving up shots altogether!). Good luck!

I also agree that it won’t neccesarily give you better control (although there is something to be said about changing basal rates to control things like dawn phenomenon which could equate to better control). I believe most people usually see an initial change in control because they are paying SO much more attention (not in all cases mind you). It is a whole new way to treat and in my case I wanted to ensure it was doing what is was suppose to do so I was paying way more attention. And yes this did translate into a 1% drop in A1c when I first went on the pump.

Just wondered why specifically 4-5 years? Can’t you go back to injections if not happy with a pump?

Agreed. The most important question is: Does the pump offer benefits that you find appealing? Like Terry, the #1 benefit for me is basal control, you aren’t stuck with the same basal rate for half to whole days. Fewer lows during exercise and good-bye to dawn phenomenon. This is followed very closely by #2, the ease of pulling the pump out of my pocket to administer boluses even compared to whipping out a pen and dialing up the dose.

The only way to know ‘for sure’ is to give it a try. I was a pump-skeptic at first and now fully embrace it. It took me at least 6 months to adjust to it fully. I took a few pump vacations during that time. Each time I took it off, I found that I missed it more. Tubing, for me, was never an issue. It just doesn’t get in my way. But, as Terry said, it is not without it’s hassles. It just so happens for me that the benefits far outweigh the hassles.

Control is all about the work. Only if the pump invites you to put in more effort will it lead to better control. The pump is just a tool, one that makes that load lighter for me.

I’ve used the OmniPod since 2 months after my diagnosis (3+ years). I think the pump makes it easier for you to have better control, because it’s so much more convenient than pens/syringes. Being able to vary your basals plus figure out bolusing and corrections to a precision of 0.05 units also made it very appealing to me.

I think most pump companies give you a money-back guarantee period, OmniPod gives you 45 days. I say go for it!

Thanks for the replies guyz…
Its a very good idea to try the pumps before i even think of committing to one …

Personally, I dont like the idea of tubing and carrying the pump 24/7 attached to me… that is the only reason y
i was interested in omnipod more than anything else…

It’s really a matter of cost versus benefit for you personally. If using the insulin pens is giving you the results you want and you’re happy with them, there’s really no justification for the expense and work involved in using an insulin pump. However, if you want to fine-tune your therapy and tighten your control, there’s really no better option than the pump.

I switched from pens to the pump about two months ago, and my BG control has improved immensely. My average since being on the pump (the Medtronic Minimed Paradigm REAL-Time Revel 523) is 113, and 95 since I’ve been using the CGM along with it for the past two weeks. I honestly don’t think I would be able to achieve those kind of numbers using the pens for the simple reason that you’re able to correct and adjust your basal rates and boluses almost in real-time with the pump, whereas you have to wait until the next day (or at least the next meal in the case of boluses) to adjust therapy using the insulin pens.

One more huge advantage to pump therapy (at least in my eyes) is being able to use the dual/square wave options for insulin delivery, something you can’t do with pens. This allows you to set a delivery rate that matches the unique BG patterns that certain foods cause, such as pizza. For these types of higher fat/protein meals, I can set it to give some of the bolus immediately and the rest over 30 minutes or so to account for the delayed/extended rise in BG, and I end up in my normal range (under 120 2 hrs postprandial) a good majority of the time.

My main motivation for wanting this level of tight control is that my husband and I are planning to start a family sometime in the near future, so the pump is the ideal option for this stage in my life. The bottom line is if you’re happy with your progress for the time being or don’t think you’d be up for the commitment and work it takes to adjust to the pump, I would hold off for now and reevaluate in a few months. The pump is an amazing tool for diabetes managment and has really made my life more normal. I have more flexibility in my diet and schedule, and I can adjust my basal/boluses very easily. But you have to remember that it’s only a tool, and you’re the one that has to put up the necessary effort to get optimal results. I think that as long as the motivations for switching to the pump are your own, you’ll do great!

If you have any other questions, I’d be happy to help!

The thing that I noticed with the pump wasn’t so much better control, although I’m doing ok w/ that, but that it was less work than shots. I was totally down w/ shots, had a cool faux-Louis Vuitton syringe schlepper, etc. but the pump made things mellow out a lot. I find it easier and less time consuming to manage lows and don’t run high all that much so it’s been a huge win-win. I don’t see any downside other than perhaps the cost but, to me, the cost is worth it. I have also found that it makes exercising easier and it doesn’t bug me at all. I clip it to a belt loop and I’m good to go.

I agree with Terry that the logging is a bonus that didn’t really pop up in the training/ marketing stuff but it does a good job logging stuff and putting it into reports. I have always loathed writing stuff down as it seems like a brutally unfair “time tax” that I have only done for about 30 days of my diabetic life (to get a pump, of course…). The pump and now the CGM have pretty much changed that. They are not ideal for logging exercise but I think that some applications like glucosurfer.org have the potential to allow you to do an “everything log” cheaper than with shots and a meter. Like syncing an iPod.

I think you had a lot of good answers here. I agree with everyone that said don’t let them push you into it. There is a lot of work in the beginning getting your settings worked out. I had a lot of problems with infusion sets breaking down in the beginning then I started getting hives – I found out I had a Teflon allergy. If someone had pushed me into getting the pump, I know I would have put it in a box and sent it back.

Like the others said, it is not a magic fix and you still need to understand stuff to get it to work right. If you decide you want to eat 10 grams of carbs and tell the pump your BS is 105, it will tell you exactly how much insulin to take. But if you don’t have your basals, carb ratios, sensitivity factor and IOB set right, it won’t give you the right number.

You can really fine tune your basal rates with the pump. I have DP and a pump makes it nice because I have my basals changing before my BS starts going up at 5 AM. I can actually sleep longer than 6 hours without hearing an alarm. I joined Danny’s TAGgers group & bolus for protein & fat. I know the protein I eat for lunch uses 2.9 units of insulin spread over 4.5 hours. That is not something you can get that precise with on MDI.

One thing that I was not aware of was that pump companies can replace a broken pump with a refurbished one. My Ping died after 6 months and they gave me a new Ping. That 2nd one died 2 months later (last weekend), and I was sent a refurbished one. I did not check the warranty and never would have thought that they would replace a $6k pump that has a 4 year warranty with a used one. I am now back to MDI.

I think it’s a choice. Some people can get great control with injections. Others get better control with the pump. I also like the convenience of the pump and actually find it to be more discreet than injections. But it’s about your life style and what fits you best. If you have been having trouble obtaining good control with injections, I suppose an endo might urge you to go on the pump. It’s no different than some people preferring syringes over pens. It’s all about what works best for you.

You can go back to shots if you don’t like the pump. If you get a pump and like pumping but realize there are features on a different brand that you would prefer, you are stuck with what you got unless you change jobs and have new insurance.

Thanks all… for the updates and feedbacks…
I think if working with the pump can give me better control, i will positively switch to it…

my numbers with the pens aren’t that great…
kelly, I will remember the Danny’s TAGgers group for the protein and other calculations…
Can you post the link here
Thanks

Here is the link - you can also do it with MDI, just can’t get quite as precise:

http://www.tudiabetes.org/group/tagers

You got a wide range of answers, and a really good overview! Now I’m going to tell you my story:

I am a professional ditz. I like to be spontaneous. I would go out to dinner with friends on the spur of the moment, and guess what – I don’t have any insulin with me. One friend actually took me home to get it, but most of the time, I’d just go without, with predictable results.

I always hated fumbling with vials and syringes, and although the pen was somewhat better, I’m much happier discreetly bolusing with my pump (I have an MM 722) in my lap. One friend asked me if I was saying Grace! LOL!

As far as tubing, I just coil it up and tuck it in my pants. It really doesn’t bother me at all. I don’t want an Omnipod, because you can’t disconnect, whereas with tubing, you can disconnect at the site for showers, or for the endo to download your pump, or for MRIs!

VERY few people have ever noticed my pump, although it’s clipped to my pants, and does make a bulge under my shirt. (I’m a T-shirt and jeans kind of person). It’s very light, and doesn’t drag my pants down (good thing, huh?)

I’ve been on the pump for 12 years (as of March 17 – my pump needs an Irish name!), and have no scar tissue to speak of, and no absorption problems – this is a very YMMV issue. I have had one site infection, but it cleared up on its own – that’s another YMMV thing.

Since I joined the Flatliners Club, and have made the effort to cut way down on my carbs, I’m getting better control than I ever have after 17 years on insulin. It does take time to get all your basals and carb ratios and insulin sensitivity factors worked out, so in the beginning, you might have more problems, but as you work things out, that will improve.

I find the pump to be far less work than shots, and I’m with acidrock – I hate logging, and the pump keeps good records for me!

So I’m going to say the same thing as everyone else – best bet is to see if you can get loaners to try out with saline, and choose the method which fits YOU best – and no one knows better than you do!

I went with the Animas Ping because when I tried out the Omnipod it seemed like it was so big that it would be noticeable under my clothing. I do like the Ping but sometimes I wish I would have taken the Omnipod instead. I have to disagree with Terry about not even noticing that the tubing is there. I definitely notice it. A lot. It’s not like I feel it when I’m walking around but when I go to the bathroom and have to drop my pants and my pump goes with them…that hurts! :slight_smile: Probably not as big of a deal for a guy because you don’t always have to pull your pants down in the bathroom but still something to think about :slight_smile: It also drives me a little crazy when I’m changing clothes because I have to disconnect it until I get situated. And I think it really limits my site locations because my tubing is only so long and I keep my pump on my belt. Anyway, like everyone else is saying, pumps aren’t for everyone and different brands work for different people. I don’t regret the day I switched to the pump, even if the tubes do bug me sometimes…so did needles! :slight_smile: Good luck!