So I am 14 weeks pregnant and beginning to think a pump would make things so much easier for me. My blood sugar randomly goes to 200 before bed for no apparent reason, my insulin needs are changing daily and with MDI I can only increase by a unit at a time which is often too much or too little, I am tired of being stuck with only being able to eat every 4 hours with no flexibility and having to wait 4 hours since my last bolus to fix a high bg which is bad for the baby. So my point? Is the pump as wonderful as I have heard? Everyone I have spoken to have said “I will never go back to shots, wish I had started pumping sooner, I love it, etc.” How long was the learning process when you started the pump? Do you have less highs and lows with the pump/better A1C? How often do you have an issue with your pump?Also what pump do you use? My endo suggests the minimed for his patients but the thought of a tubeless pump -the omnipod sounds lovely.
-Jenn
Congratulations, Jenn, on your pregnancy! I have been pumping (MiniMed 522) since April 2007 and I highly recommend a pump to serious users. There is a lot to learn about any model pump: new terms, calibration processes (read John Walsh’s Pumping Insulin for these!), effects of different types of food on BG (low-fat vs. high fat, for example), etc. Frequent testing is still required: I test before and two hours after each meal, bed time, any time I change my “routine” (heavy exercise, for example). Logging and analysis of pump events (your endo has a form that I use) will allow you to modify safely pump settings.
In spite of the “work” involved, I still love my pump! Best of luck to you!
Gerry
You don’t need to wait 4 hours to correct (2 hours is probably safe), nor will a pump solve that problem (it uses the same short-acting insulin, after all). I’d suggest correcting (maybe a bit less than you think you need, if you’re worried about hypos?) after 2 hours and see what happens. I doubt you’re going to have horrible crashing hypos especially b/c from what I gather you don’t take a ton of insulin.
Congratulations…I know nothing about pregnancy and diabetes, but if you are finding your basal rates are very different at different times of the day or you want to make small corrections, then you may find the pump helpful.
The one thing that you need to be careful of is a lot of times the pump is sold as a “cure all” for diabetes control. It is not. As Gerry said there is still a lot of work involved. You will find it will help you fine tune your control as well as the convenience of not using syringes.
I’m too scared to correct at 2 hours. When I’m talking about correcting I need a small correction like less than one unit which I cannot do. Can’t you temporarily increase your insulin on a pump when you are high?
Hi Jenn -
If your insulin needs change almost daily with MDI, they will change almost daily with a pump. The two big advantages with a pump are you can use multiple basal rates and you can make tiny little adjustments as needed. I love my pump and even if I wasn’t needle phobic, I wouldn’t go back. Most of my “corrections” are little pops of around 3/10 of a unit.
If you don’t use very much insulin, you might end up throwing away more insulin with an Omnipod. I change my sites every 3 days but a cartridge lasts around 5.
Maurie
Oh, if it’s an issue of changing your basal rates or giving smaller corrections, then yeah; I thought you were trying to say that the insulin gets absorbed faster or something which is why I was confused.
As for small corrections, if you can’t give half a unit, you can’t give half a unit, whether you correct 2 or 4 or 8 hours out. You can always have a glucose tab or a small amount of food alongside a correction dose, which granted is sort of weird and some people will say this is a path to weight gain, but I think the impact is probably negligible (a glucose tab has like 15 calories). If you do that I’d probably take it like half an hour after bolus’ing. Some people have also switched to syringes or “junior pens” for this reason, although TBH I like the convenience of pens more than I like the precision of syringes, YMMV.
You can get half-unit pens for Humalog and NovoRapid, at least here in Canada. Not sure if anything is available for Apidra to delivery half units.
I didn’t have the same problem with eating every four hours. Part of the reason I like the pump is that I don’t have to eat as often as I used to, although I was shooting R/N rather than the 'log insulins. I got going on the pump pretty quickly, spent much of the training class thinking “hmmm, 2 tacos or 3 tacos?”" and headed for the border on the way back to the office and was 85 two hours later and was like “wow”. I was also embroiled in pretty challenging martial arts classes and notice the improvement in how I felt almost immediately. I should really paint a black belt on my pump or maybe get “minimed” embroidered on my belt or something like that but it amazed me how much easier it was to control things. I also found it easier to notice when I needed to make changes as the quality of my data improved tremendously, I could spot workouts b/c of the reduced basal rates, it logged all of my food, etc. Stuff I’d tried to write down to get the pump but the results seemed to make much more sense to fine tune things. I can only imagine what diabetes and pregnancy would be like but I presume you have a lot of changes and a pump seems very useful to make fine adjustments to keep things oriented properly.
You can get syringes with 1/2 unit markings. If you’re concerned about correcting highs before 4 hours, a pump isn’t going to solve that problem.
It is taking me months to get my pump. Not just like two or three, but like 5 right now! I have been to pre-pump class and I have to do a workbook this summer. I am seriously considering the Animas. BTW, Congrats on the babe!
Hi Lil Mama. I got my Ping in January, and btw it only took me two weeks to get, basically the Animas sales rep did all the work, contacting my insurance and then sending the Trainer to go to my doctor’s office and put the form in front of his nose when he took too long to fax it back. But people seem to have very varying experience.
Yes, for me, the learning curve on the pump was pretty steep. There is a lot to learn, and a few things you have to think very differently than you did on MDI. But I found the technology of the Ping pretty intuitive. I had two training sessions. The first one was how to insert the sets and do basic settings. The Trainer advised a basal setting that was a percentage of my MDI basal. They started me on saline. Then I read every page of the Manual and did all the settings during the five days I had the luxury of playing around while not having to worry about dosages. Then she came back and started me on insulin. I had a lot of problems with sets the first month. Hand/eye coordination is not my strong suit and it really took me awhile following directions line by line and getting the feel for it. I then asked for samples and tried other types of sets till I found what worked best for me. It also took me about a month tweaking my basals and the different “time zones” until I got it perfect and then it stayed that way. It’s amazing the small little changes can make a big difference. My use of insulin definitely dropped because my basals were lower and because I could take the exact dose needed for carbs.
For the first month, maybe 6 weeks, my numbers were actually worse as I worked on tweaking. Then they settled down and became better. Much more stable. I also really enjoy using the pump as opposed to MDI. My doses are not as small as yours, but yes, I would find it very frustrating if I couldn’t take a fractional dose for correction. I never wait four hours to correct. Even though I’m good at math and never minded it, and don’t always do exactly what the pump advises, there is definitely a confidence you feel with its advice. So for you, yes, I definitely do recommend the pump. But it is a definite learning curve for between 1 and 2 months so you need to decide if now is a good time for you to do that
See I think a pump would help me because I’m LADA and still honeymooning so I do not take that much insulin I just now moved to 3 units of Levemir a day. My basal needs are higher after dinner and lower in the morning. Thanks for the advice about the omnipod I do use little insulin so didn’t think about that.
You’re a perfect pump candidate. Plus a pump would allow you to eat a few more carbs if you’re intererested as you could wouldn’t have to eat an extra 15 or 25 carbs to match the extra unit (or half unit - if you change pens). Eat an extra cracker and just dose for it. A little flexibility doesn’t mean you have to run wild the way some of us do 
Maurie
Yes, if you find yourself needing corrections that are less than one unit, a pump would be ideal for you. Using a pump takes a lot of work, but it does give you more flexibility and a better ability to make small adjustments. While I still have highs and lows while on the pump, they are within a tighter range; on MDI, I was regularly swinging between BGs in the 40s and 300s. On the pump, I still have fluctuations, but they generally stay within the 60 to 200 range (and generally even tighter than that).
I am currently using the Minimed Revel and really like it. My endo does not work with the Omnipod, as she feels there are just too many failures with it. The tubing really doesn’t bother me that much anymore. I’ve learned how to conceal it in my clothes fairly well and I often forget its even there. I’ve been very happy with Medtronic’s customer service too. No issues there. And the pump seems fairly durable thus far. I also like the revel because it’s small and easy to conceal.
You really have to be committed to logging your BGs, tracking everything, and testing basal rates on the pump. The pump will not automate your diabetes care. BUT, once you get past the learning curve, it really does make D management easier.
Have you read “Pumping Insulin”? If not, read that as soon as possible. It will give you some good insight into how the pump works.
If your insurance will cover the pump (they shouldn’t give you any hassle if your T1 and pregnant) and you can afford the necessary copays for supplies, go for it. It’s not permanent so you can always go back to shots if you don’t like it. Even though I use the pump pretty much all the time, there are some instances where I don’t want to use it and I briefly switch back to MDI.
Just make your decision with caution. The pump is a BIG change from MDI. And like others have said your control may acctually be worse for a while until you get it all figured out. And believe me it will be up to YOU to figure it out. The doctor will not have the perfect “recipe” for you. It took 6 months and I am finally gaining the “great” contol you hear about. So maybe for the sake of your baby and your sanity wait to get your pump until after your pregnancy? I am not trying to tell you not to do it. Just realize most EVERYTHING you know about diabetes will change. and it is a big transition which requires LOTS of time, MONEY and effort. Good luck on whatever you decide!!
This is a fair warning but it doesn’t always take that much time to get a pump “down pat”. Within 6 weeks, I was doing at least as well as I did on MDI with a better quality of life. I was only on MDI for about 18 months before the switchover and my basals were (and are) pretty flat which may be why I had a fairly easy time of it.
Maurie