i use mutiple shot of insulin accrding to my b. suger i do my b.suger before break fast before lunch and before dinner i think pump is too costly for me My whole expenditure in month about 90 $ in month whitch i get re-embursed by goverment being my mother is govt doctor employee my A1c in last 3 yrs was between 6to8 does the person using pump have always A1c between 6to 7 do u think pump is essential for me
There is no one right answer here. Every diabetic’s goal should be to maintain the best possible blood sugar control with a reasonable effort. Multiple daily injections (MDI) can work just fine if the the diabetic is willing to test, count carbs, and dose accordingly.
The biggest advantage of a pump over MDI is the ability to adjust basal rates for different times of day. The MDI basal protocol is built on the action curve of whatever background insulin one takes. Using this method you may not adjust the basal insulin for an increase in glucose kicked out by the liver in the early morning hours (dawn phenomena).
Being a pumper, I personally find a marked decrease for basal insulin from 2 p.m. to 5 p.m. If I were to use MDI, I would probably have to include an afternoon snack to compensate. That’s no big deal but you better have that snack food with you every day, even if life does get busy!
The ability to adjust basal rates during the different times of day is probably the biggest difference between a pump and MDI. The other convenience is always having your insulin with you if you need some. You don’t have to depend on remembering your “kit” every time you leave the house.
If you can keep your A1c below 7% using MDI and that seems to suit your lifestyle, I say don’t worry about the pump. If however, you wish to fine tune your control (various basal rates during the day) and don’t mind being attached to a small piece of electronics, then I would consider a pump.
It’s all about a reasonable degree of BG control while fitting it into your lifestyle that counts. I prefer the pump but that’s just me. As I said at the outset, there’s no one right answer.
It’s not necessary though it helps. I’ve used both. A pump doesn’t guarantee a low A1C because I’ve had high A1Cs while on a pump. It provides certain advantages, but in the end it really depends on the user. There are several MDI users on this site that have achieved A1Cs below 7.
Another difference between pump and MDI, is that a pump allows for smaller doses of insulin (say a less than 1 unit bolus or correction) which you can’t really get with injections. the other advantage is being able to do dual/combo/wave bolus (i.e. you give yourself a certain percentage of your bolus and then the rest is slowly given to you over a specified time period like 2-4 hours). Pumps overall are more flexible as well.
So as Terry said there is not right answer here…and a lot of it depends on your preferences and lifestyle, but it is definitely possible to achieve an A1C under 7 with MDI.
It is definitely possible to achieve A1C below 6 without a pump.
I just remembered another thing that I like about the pump. It remembers if and when I took a bolus. When I was on MDI I sometimes had to stop and think if I took my meal dose or not. That was back in the day when it was good practice to lead a meal by 30-45 minutes with Regular (fast acting but not rapid acting). When life gets busy it’s sometimes easy to forget.
The pump will also do all the arithmetic to calculate how much insulin on board (IOB) you have at any given point in time. If you’re handy with numbers you can calculate this without too much trouble. I always idealized the IOB calculation with the assumption that I used the same amount of insulin every hour during its action time. The pumps, however, do a more sophisticated calculation that distributes the insulin in a curve over time. This more closely approximates real world experience.
When life otherwise distracts you or your brain is addled with too little or too much insulin, the number crunching part of your brain can become compromised. I like the machine doing the numbers. It allows me to concentrate on higher level challenges while the electronics do what electronics do best – accurately calculate the required math and do it right the first time and every time.
If I went back on MDI, I would look for a smart BG meter that could calculate IOB, insulin to carb ratios, and corrective insulin doses. Does such a meter exist today?
I am currently not on a pump and my last A1C was 6.5. I want to switch to a pump because of bad dawn- syndrome but like said it is a lot of time a personal preference if you want to take shots or pumping.