Pump vs Shots

Last week I had another appointment with my doctor.She said she likes to start out with injections vs a pump,partly because she finds in a lot of cases patients will get a false sense of security and not monitor bg as well.She did say it was an option at some point.Does that sound accurate to anyone pumping?She also does not have me seeing an endo right now.She says she has no problem treating my diabetes.I am seeing a dietitian with diabetes management team.I have only had three lows since I started insulin,felt symptoms at 69 the first time,went to 52 the second and 50 the third time.What is a dangerously low bg?Thanks everyone!

I tend to treat in the 70 and so far I recognize I am at that level. My target is 100, high or low that is what I aim for.

I just looked at your profile and saw you were diagnosed a few weeks after me, hows it going so far?

Hi Stephen,
I think things are going ok.Frustrating at times. I wonder about my doc not having me see an endo though.She is a preferred provider for my insurance company.

I suspect your doctor is right in that some people have a false sense of security with a pump - or more accurately, that some folks have a false idea of what the pump can and can not do for them. It is my opinion that to use a pump with great effectiveness, the pump user should have a good understanding of carb counting, how their bgl’s are affected by mixed meals, what their carb/insulin ratio is, how to take correction shots, how to estimate the number of units on board etc. I see you are fairly newly diagnosed - I would recommend you read get a copy of “Using Insulin” by John Walsh, and learn about these and other insulin treatment issues.

When your doc says, “She says she has no problem treating my diabetes”, does she not realize it is YOU who are treating your diabetes, and she is supposed to be supporting your efforts as part of your team. A slightly different, however, imo, important difference. I would be asking her to support me in my efforts to treat my diabetes by pump, and to help me prepare for that.

Carb counting is easy, just learn it and follow along with her for a little bit. If she gives you problems, dump her and get an endo. Has she suggested you see a certified diabetic educator (CDE)? Has she mentioned counting carbs?

Figure out what it is you want and tell her, you are the boss, she is there to guide you. She will not be the one to fret over a wrong calculation on a dinner bolus, you will.

I like my endo and my CDE, although they are in seperate practices they work together constantly. My CDE is also a T1, so she can relate. I also like my doctor, he’s a great guy. It’s a tough call, but in the end you got to do what you feel comfortable with. Good Luck

When I was first DX in 2004 with diabetes I saw a ENDO. When I moved to Cali in 2006 I saw a GP for my diabetes…I went back to an ENDO in Jan 2008! The only reason I didn’t that is because my Dr office couldn’t figure me out!!! gotta love type 1.5. I tried to tell them I was a little different. Let’s just say I will never go to a GP for my diabetes ever again. If my GP would have known to run the appropriate test me going further into TYPE 1 would have been caught a lot sooner. I made my GP send my to a ENDO and you have the Right to do the same.

Definitely start looking for an Endo. There are many out there but only a handful of good ones so it may take some time to find one that you like and is willing to treat your diabetes in a fashion that you desire.

I use a pump and love it. I did start out on shots which I think was a good thing. Insulin syringes are small and thin and there is nothing like some baby steps to warm yourself up to larger needles like ones used with a pump or CGMS. It is also a good idea to know what works besides using fast acting insulin in a pump. I was on Lantus for my basal and Novolog for my bolus. I was able to control my numbers fairly well. I know that if I for any reason my pump broke or some random event happened that I could fall back on shots without a problem. My opinion is definitely get a pump at some point but learn how to drive before purchasing the mac daddy sports car (Insulin Pump)!!! This of course is just my opinion!!

Hello Matthew:

Your MD sounds like a wise lady, keep her!

If she is comfortable, and YOU with her then let her treat you. An Endo has nothing radical to offer… Now any low, under the wrong circumstances can be obscenely dangerous, literally. Oooopsey the ole “…sugar took a nose dive while I was driving, I’d had three nights with little/no sleep because of a work project I was trying to get out, it was humid and hotter than hell… didn’t realize it was happening…” said Janey on the way to the hospital.

Lows are like the Tiger in the cage (sic. that we live in). Ignore and or deny them… become too jaded, blaise about them and they can have some serious teeth to do us harm. 99.9% of them are bad memories, but that one tenth of one percent that one whopper can ruin our day for sure… That said, I do not let them faze me if I can prevent it.

Myself, personally I find the “paranoia approach” far, far more dangerous… meaning the folks who believe “…I’m not going to let this happen, I’m never going to get low (sic. again), because I will test (literally) 300 times per month… 10 times a day to prevent it…”

That’s insanity and unhealthy…IMHO-fwiw

Merely my opinion, I could surely be mistaken,


Hello Flo:

A normal MD has the same training re: what insulin does, the only thing an Endo gets is a larger patient base of diabetics from which to form her/his assorted opinions.

I can teach an 8 year old child to do any adjustments… they are not hard to do…


Definitely get an endo. When I was first diagnosed my endo wanted me to get my sugar levels under control before going onto a pump (about 6 months), but she has never fretted over a false sense of security. I am on pump now and wow what a difference. I feel great.

While it can be helpful to see an endo, you might inquire about what kind of CME (continuing medical education) your general practitioner has had with regards to diabetes? She sounds pretty knowledgeable, and she’s right that many people think a pump will solve everything without having good knowledge and education to begin with. Plus, the habit of testing and counting carbs is probably best learned as a prerequisite. I had an excellent GP and found him far more approachable than an endo when I lived in Philly, but its best to make that decision on your own. You may find it helpful to have a GP who is involved in your diabetes care, as many aren’t and may not work with your endo in terms of treatment otherwise. Endos are increasingly in short supply nationwide, and if you have a good GP, that may be sufficient, but for others, that’s not enough. YMMV (your mileage may vary).

Matthew have her refer you to an endo I used to use a md and after seeing an endo and going on the pump I now have a1c in mid 6 not mid 7 or low 8s. It is your body insist. The pump has given me more freedom and I am now taking a active role in controling my D and not an observer.

I with you Flo