Do pumps help you not get so many lows or do they increase the risk of getting more lows since a computer is in charge? I am considering getting going on a pump. I like the tubeless ones:I am very physically active, live in the snowy mountains, eat super strict diet. I am currently on 15 lantus and bolus no more than 4 units 0-2 times a day. Do you think it is for me? Or should I just stick to the pens for now?
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i pump about 20 units a day to replace lantus and fast acting equivalent which totalled 30-35 units
the pump with CGMS is very very useful tool and if you are motivated the information will definitely help you get the level of control you will never achieve on pens
finally - the wireless system get so so reviews (omnipod) the minimed is a very well thought through and integrated system - the efforts of all our fellow pwds working out the bugs and refining the system and all the components really tells through and mikes the whole experience much more accessible and quickly positive
cheers
The pump can help people who are physically very active (and therefore need to change their basal rates to accommodate physical activity), have a somewhat variable schedule, are insulin sensitive (and thus experience differences between 1 and 2 units of insulin), and are really committed to D management.
In terms of lows, in my experience (as someone who is very physically active and insulin sensitive), the pump has decreased my lows and the severity of lows when I do have them. On MDI, I just could not work out without going low. And those lows were sometimes really scary. On a pump, I can turn down my basal rate before exercising and prevent from going low.
Also, when on a pump, you're only using fast-acting insulin, so that insulin clears your system faster when you do go low. On MDI, it would sometimes take 50g carbs to bring me up to an acceptable BG, but on a pump, I find that I can get my BG up faster when I do go low.
Also, the lows while pumping (for me) have been milder. I generally catch them faster and they aren't as bad.
Really do the research before selecting a pump. I know a lot of people like the omnipod, but they have a lot of issues and I know quite a few folks who have quit using the omnipod because of all the pod failures. I use a tubed pump (Revel) and love it. I am very active and the tubing doesn't get in my way. I use a Spibelt when I run or do other exercising and it works quite well.
I recently switched from pens (and Lantus) to OmniPod and it's been helpful for when I'm sporadically active because I can set a temp basal rate. I've personally had fewer lows since starting with a pump because of how much more accurate the bolusing can be for my carb ratios because I had been going low after meals frequently.
I'm going on a pump, just started my pump training yesterday. I only take 8 units levemir and never bolus more then 3 units per meal, as I'm still low carbing about (40 per day). My goal(s) for going on the pump is hopefully to bolus more, eat more, gain weight and because I'm very insulin sensitive, make corrections more easily. I just want to get off the basal roller-coaster! I too am active but I've decided on the Medtronic Revel w/CGM. I wanted the built in CGM and have heard better reviews on the Medtronic pumps. The Omnipod is kinda big. So far, the Medtronic Customer Service people have been FANTASTIC. My local Medtronic Rep even came to my house, in person, to drop off my Sil-Serter. All my supplies now, except insulin, come directly to me, through them.
I think you have to figure out what works best for you. If you have great control and take very few shots, maybe you're still 'good'. I split my basal so I'm up to about (at least) 5 shots a day, that's w/out doing corrections. If you're pretty stable and not having to do a lot of correctios, adjustments, etc..then that's something to think about.
I think there are less lows because if you need .85 units of insulin, you can bolus .85, you don't have to round up to 1.00.
But you say "a computer is in charge" and I think this is not a good way to think of a pump. Remember the old saying, "garbage in/garbage out"? Not only are you responsible for programming the data into your pump (I:C ratios, basal rates, ISF), but you should always look at what the wizard recommends with a practiced eye. I, for example, when I am on the low side find that if I bolus a reduced amount for my meal, I will go high. So I bolus the full carb amount and just do it closer to my meal, after my meal or treat the low first. Pumps are a great tool, but like any tool they are only as good as the person using it.
They also require more frequent (not less) monitoring. Since there is no long lasting insulin in your system, if the site is bad and you are not getting insulin you can quickly go high into the danger zone.
geez, zoe...this (the pump) is, or at least right now feels like a huge learning curve, at least from yesterday and today. we're not starting the pump today, as we thought..have to go back again for training next week. feel like i'm learning some foreign language all over again. it will kick in, I'll get it..but feels like a lot right now. the fear is there, the notion of easy DKA..but for those of us who test a lot, that minimizes that a bit.
What you describe, Type 1, is pretty much how I felt when I started the pump. It is a lot to learn and it is a real change from shots. Only, ultimately, all the skills you have from shots will become even more useful with the pump. Once you iron out your basals (which for me were more of a change than I:C ratios which stayed the same), and learn the technical aspects of the pump and the sets, you will find you have a great flexibility. And yes, testing a lot especially at first, will help you tweak the numbers and stay (feel) safe. I always think of learning curves as a huge hill you have to climb, and then once you get over the top you get to cruise down, laughing all the way!
true..! very true..thanks! :)
Hey Type1Gal -
I wouldn't focus too much on the "easy DKA". I've had exactly 1 bad site over the past 3.5 years and even that one was good enough to keep me under 250.
Maurie
ah..thanks so much, maurie. i was reading on here last night that some folks gave up their pumps, stating they kept having issues with their cannulas, bad sites, tubing because they're thin, insulin sensitive and take some amounts of insulin (as do I) which made the pumps not alarm with 'no delivery', etc..and they had problems with insertions, etc..which concerned me because i'm thin too. i'm in..i'm gonna go for it..for me, i just want to get rid of these rollercoasters and getting hit with these peaks and drops of levemir. i'm actually excited about it but it does seem like a lot to take in right now.
Maurie, are you actually saying that you haven't had any problems with sites in 3.5 except that one?? That every site you insert is fine for 3 days?? Wow!
Type1Gal-I've been using Silhouettes since I started pumping 7 years ago. The first thing my pump instructor said about the Sils is that she and others thought the Sil-Serter was wicked. Most of her patients inserted them manually and that is what I have always done. One advantage of manual insertion is that you can insert them at any angle. I'm quite thin and insert them at a shallow angle, much shallower than the inserter would do. I am able to use many more areas for my sites than I would be able to using the inserter. So just know that's an option if you don't like the Sil-Serter.
Jomama- I don't know if I have fewer lows on the pump, but I definitely have fewer severe lows. I feel much safer than I did on my old insulin regimens because I'm only using one fast-acting insulin and things are much more predictable than with a combination of long-term and short-term insulins.
I personally am not interested in the Omnipod, but that doesn't mean that I won't be some day. I do not mind the tubing at all and feel that I would have a harder time finding appropriate and discrete sites for the pods. A new smaller pod will be released soon, but I don't think that they know the exact date. I think that lots of people are very happy with the pods and some aren't. But that's true of any pump.
So do your homework and make the right decision for you. Most of us consider our lives and health immeasurably improved by the pump. They are ideal for people who use small amounts of insulin because you can be much more exact.
Let us know what you decide.
thanks, lathump...i was told that too, that's one of the reasons they recommend the sils for me or for thin people, as we can insert at an angle so it doesn't hit down into the muscle (think that's what the nurse said yesterday) and we'll probably do the manual insertion as well. have you had many problems with 'no delivery' of insulin, any DKA?
great insight..! :)
I agree with Lathump re the lows not being as severe. I find the "dive" is easier to pull out of and that being able to check "on-board" insulin is also handy. That was always a mystery to me when I was on MDI (only R/NPH...) and the pump was like night and day.
That being said, when I have had severe lows, the pump ones are as wicked as the shot ones, sometimes maybe more?
I think in all my years of pumping, I have only had "No Delivery" once. That's not to say that I haven't had bad sites that weren't identified by a no delivery message. Most of my bad sites have been when I tried Quick-Sets and Mios. I just don't do well with 90 degree sets. They hurt more often, they're higher profile and easier for me to accidentally pull out, and I get a higher percentage of sites that don't deliver insulin properly (kinks? or hitting bone or muscle? Don't Know).
With Silhouettes, I probably only have 1 or maybe 2 times a year where my BG rises precipitously because of not getting insulin. I know very quickly because by 2+ hours without insulin I start feeling nauseous. If I have a high BG number because of eating cr*p, I don't spill ketones and I feel perfectly fine (except for guilt). However, when I have an absolute deficit of insulin (bad site), I feel horrible very quickly. It does remind me of how vulnerable we are. I have never been close to DKA because of my pump.
In 7 years of using Medtronic pumps, I have never once had a pump malfunction. I have had pumps replaced because of superficial cracks and once for water infiltration. Obviously I consider myself lucky, but I think that there are many of us with various brands of pumps who have had great experiences with the quality of our devices. And there are the unfortunate ones who have had many pump problems.
I will say that although I trust my pump with my life, I do always carry a couple of syringes in my meter case as back-up. I don't carry extra insulin on a day-to-day basis because you can always use a syringe to get insulin from your pump reservoir.
I had one problem, a day we ran 14 miles and it was like 87 out so I was drenched! The pump was clipped to the outside of my fuel belt but it was still pretty hot. I forget what the error message was but it was fritzed out and I called and they said "you need a new pump" so I took it home, took the batteries out and left it in the sun to dry it out and bleep outside (it didn't stop bleeping...). Then I brought it in and took the battery out and put it back, still bleeping. I figured I didn't want to listen to it so I put it in the freezer to 1) dry it further and 2) so I didn't have to hear it. I took it out the next morning, put the battery in...and it seemed like it was fixed! I had already arranged a new pump and didn't exactly trust my repair method but it was sort of freaky! I've had very few issues, maybe 2-3 in 3.5 years of pumping too.
THANKS! I asked about that yesterday; the nurse told me to carry a supply of syringes - novolog w/me at all times in case there's a problem with the pump. I asked if I could draw insulin from the pump, she said, "NO, due to contamination or health reasons?"