I have been using Lantus at night and Apidra when I eat and have maintained a 6.5 A1C and don't mind testing and injecting. My endo. and my nutritionist both say the next step is to start using a pump. Why my numbers are better than ever, I feel great and like I said, I don't mind the checking and injecting. I notice that a lot of you guys here at "tu" use pumps. Whats wrong with the way I'm doing it now? Is there something better about the pump? Honestly, I don't want one! It almost seems like there's money to be made for someone.... Any thoughts? Thnx.
I'm new to the pump, one month and I love it!!
Was diagnosed type 2, put on oral meds and after horrible control was found to be type 1. Endo put me on MDI for 6 months before pump.
A couple of pluses for me...using less insulin - for me (and most) it's more efficient.
And because I'm out and about all the time it's easier and more flexible.
But newest part is fine tuning...little tweeks that I can setup just for me and how my diabetes reacts to life.
Good luck in your choice.
It's your choice. Pumps cost more, generate more waste, require a 24-hour catheter in your skin, and can lead to DKA if tubing or pump fails. You have to test your BG just as much with a pump as without a pump - so there's no difference there. The only real difference is the injections. If you have been able to match your basal needs with your basal insulin injections, then that removes the primary reason for most to use a pump.
Some people love pumps and find it makes control easier. Others don't like them, and don't see any improvement in control (or even a decline). It's an expensive toy to put in a drawer. If you don't want one, then just say no. I think most doctors who push them feel it is in their patient's best interests; but I've read that some doctors receive a financial incentive from the pump company for signing new customer up. I can't prove that is true, but it seems plausible.
I'm still injecting 38 years later; I've tentatively decided to wait until they integrate the CGM into a functional open or closed loop system. Until then, I view a pump as a unnecessarily complicated syringe.
If you are feeling good and injections are working for you, you're not doing anything wrong. A pump is only the next step IF you want it to be. I'm surprised that they said that to you.
I was the one who asked my Endo about getting a pump and the training. He said, Sure. I wanted to see first hand what I was missing. Granted, I didn't try one on but when I handled the different machines and saw all the equipment and work involved, I said, No thanks. My Hubby(whom I dragged with me for his opinion) agreed with me. On the other hand, it might be a good idea for you to have the same experience, if you are interested. Maybe they would change your mind.
I've been doing injections for 51+ years and don't mind 98% of the time and my A1c's have been good for many years. I use Levemir twice a day and Humalog. I have a few but minor complications. Neither pumps or injections are perfect and the world plays havoc with our blood sugars sometimes even though we are doing things right.
Jag brings up many good points, as does IChoose. It is your choice.
I don't want a pump either. First endo insisted & on a particular brand, no less. Yea, agree, people are making money. When I rejected his pump requirement, endo lost interest & I changed doctors.
My primary objections are pump failures & scar tissue. Taking an injection, I know it's been done. Reading here about bent canulas, kinked tubing, air bubbles & site failures has made me even less interested. Oops, 275 BG due to a pump problem is unacceptable to me. Add to that the expense & waste. When traveling, you have to take a ton of supplies along. I don't need 10 basal settings, nor do I want to be playing with buttons. That doesn't feel like freedom & seems more of pain. My goal is to simplify. It's nothing to take a vial & put syringes in a meter case. Pumpers have syringes also in case of pump issues.
I absolutely agree it's an option which many people are happy with, but is not for everyone. That being said, ddubs, you sound just like me before I got mine. I had a similar A1C and I didn't mind shots; no longer work full time and so have time to do it. So I figured I didn't need a pump. Then I started a Type 1 Women's Group and the vast majority of women in the group are on pumps. Maybe it was just wanting to be "in with the in crowd"..lol but I decided I wanted one. I am glad I got my Ping and I couldn't imagine going back.It is so much easier when the pump does all the math and yes, being able to have different basal settings really does help.As does being able to bolus for exactly what I'm eating, not rounding up or down, and do exact corrections. I don't even notice being "attached' (most of us find that's the easiest thing to adapt to) and I can now give myself a bolus anywhere anytime easy as can be with my meter remote. I love it.
But yeah, pushing it on you if you don't want it is ridiculous. If you are thinking about it, find out more. If not, tell your doc, not interested.
I think I may stick with that old time religion...
I feel more in control with my insulin pens as opposed to a pump.
Furthermore, walking around with a machine attached to me would make me feel like a cyborg.
That and the constant worry about the pump conking out or possibly kinking up (and being completely unaware that my BG maybe sky rocketing).
Granted, I am sure they may make a pump with less room for error, but until then I'll stick with pens...at least until there is a cure.
I was always very resistant to pumps as well however, once I got one, I found it to be less work and also to be a very useful tool to help improve my numbers. I got high 5/6ish A1Cs w/ "MDI" (quotes as I had no idea what I was doing, other than taking insulin...) but my A1C drifted into the 7s when I started working out a lot and trying to lose weight while guestimating doses. It may be that many of the improvements I've seen were simply because I started counting the carbs more precisely but the fine tuning that I can do with a pump seems to be a bit more precise than what you can do with even the smallest syringes. I also hate logging and the pump/CGM do way more than I would ever do on my own, except to get a pump.
Do you have any interest in improving your A1C? Maintaining it at that level is a great accomplishment but also represents an average of I think around 140. I am always trying to improve some aspect of my plan and am not sure I am mentally equipped to maintain my A1C anywhere without trying to improve A1C/SD/CHO or whatever.
If the cost is not realistic or you'd simply rather not spend the money, you should tell the doc that as they will *always* try to sell stuff.
I think the big push is, pumps give you a lot of flexibility and freedom. Plus, even with really good control on MDI, pumps can even for a lot of people make control that much better. I waited close to 30 years before making the leap, and everyday I could kick myself for NOT having done this YEARS ago. But, everyone is different, and there is nothing wrong if you are satisfied with MDI, continuing MDI. It's not a decision that has to be made this day, week, month or year. Just know it is an option that is available, and it does for many make life even that much more flexible. Good luck, and know that you are in control.
Also for me with the occassional gastroparesis flair ups, pumping really comes in handy when having a flair. The dual wave is an nice feature of pumping.
I agree with others that you must choose on MDI or pumping. It has to be what you want to do.
That said. If money is not a concern; then you might as well try pumping. You can easily switch back if it is not for you. I was on MDI for 20 years before I switched over to pumping and now I don't know what took me so long. I am able to maintain better control and more flexibility.
Thanks everyone, your feedback has been awesome! I think I will keep on truckin with my pens and nano, I don't find it to be inconvenient and i've got a cool carrying case that I call my "laboratory". You guys have been VERY helpful and I appreciate it!
MDI is adequate for most control issues. I did MDI for 25+ years and had periods of fantastic control (A1cs in the low 5s, high 4s) and periods of terrible control (A1cs in the 10+). It as like most things with diabetes, the more attention you pay to it, the better.
There are advantages and disadvantages to both systems, as with all things.
The one area where pumps excel, though, no question about it, is with control over basal rates and fine control over bolusing if you need it. I really had to compromise control over nighttime BGs for safety concerns when I was on Lantus. Lantus just gave me a horrible 24 hour basal BG profile and I was resorting to parlor tricks to keep the baseline as smooth as possible, with sporadic results. I could have gone over to Levemir and given that a try, but I decided to make the jump over to a pump.
If you do decide to make the switch, you can always go back if you don't like it.
Just out of curiosity, how long have you had D? Pumps will always be there, whether you want to make that jump now or later. I think based on age, how long you've had D, what your schedule is like are all big factors. I also agree with others, I'm pretty insulin sensitive, so being able to fine tune boluses is really great too. But there is no hurry if you don't feel it is a delivery system you are interested in trying right now. I think it's great your Dr's are supportive and giving you that option, but they need to also respect it's your choice. If you ever have any other additional questions don't hesitate to ask.
I am a 37 year diabetic and loved doing MDI. In my 27th year following diagnosis, I attended an event of new diabetics at a HS where I was a district administrator. All 7 kids had pumps and one had never ever taken an injection using a syringe outside of the hospital. His brother was also type 1.
My wife had been after me for several years to get a pump and I told he she was way off base. I wanted the MDI. Well after this discussion with the kids I made an appointment for the following week and told the doctor I wanted one ASPA.
So here were my reasons. 1. I could not justify being behind those HS kids who looked at me like a man with three heads when I told I was doing MDI. I know this seems like a silly reason, but i just never wanted to be that far out out of sync with the latest trends. 2. They told me of the fine control they have over insulin. Remember the pump can be set precisely to deliver 1 unit. 3. They could eat a larger variety of foods and 4. They no longer need carry five syringes for a day out. I was way over lugging around my 'stuff'. You know the log books, syringes, swabs, vials of insulin etc. Getting a pump cut my stuff load by 755. Man I hate stuff.
No as for results. i have never been happier with my diabetes then I am now, post MDI. The pump is amazing it takes care of so much, everything from crab counting to covering highs are better in my opinion and finally my A1c dropped by 3 points. from 9.7 to 6.3. That is the positive effect of using the pump.
Now why not get one. If you do work where you are doing heavy constriction of on your belley or side do not get a pump. If you will not learn the system do not buy one. Most pumpers fail if they do because they will not personally invest in it.