Thanks for the list Heather! You want to add to pump advantages ?: increase temp basal with sick days . I increase temp basal for long car rides .
The question came up for me while reading the discussion , why I went from MDI to pumping over 9 years ago and I am clear …I want to continue ( till I go to the Home at least)
Quite simple actually : Lantus and Levemir unavailable in Canada then . Had lots of morning wake- ups with terrific headaches due to lows . The Internist I saw kept suggesting more insulin , because my A1C was not that great. I just knew, that was not the answer; …did not have access to a computer to " research" as I can do on TuD. either .
Pumping would get me lined up with a Team outside my community , but it was worth the drive .Now I am at the tender age of 70 and very unwilling to test and learn , how I would handle Lantus or Levemir …I am used to the technology ; am willing to try Apidra instead of NovoRapid , am willing to try the different infusion sets …actually MM’s Sure-T’s do it for me . Orbit Micro ( 90 Steel Infusion Sets) promised to make them available for the MM reservoir , not certain if available in Canada yet.?? …I tried them with the Luer Lock and I felt very frustrated and returned to using Sure-T’s ( no kinking )
Prior to pumping my TDD approx 29 u …since pumping approx 21 u with a better A1C and I am a much happier camper , because the headaches are hardly happening .
I have travelled through time zones prior to pumping and the math I had to go through while using needles ,even after having an appointment with my Endo …I don’t want to go there again .
Heather , what was your reason to change from MDI to pumping ?
A deal breaker for me, referencing MDI, would be the unchangeability of basal rates. I workout a couple times a week. I participate in endurance cycling. As a result, my insulin sensitivity will decrease dramatically for a day or two after an event, where basal must be reduced. I keep 4 basal rates in my pump and use them all. And the temp rates.
Another deal breaker for MDI is using Symlin. When I was on MDI and Symlin I was doing 7 shots a day. I still use Symlin, but I use a pump. 3 shots per day is tolerable.
The basal increase with sick days is normal routine for good educated MDI users. It is part of the standard education given by CDEs (in Germany I have to add). So it might be more convenient with the pump but in general it is not reserved to pump users.
I agree, the training and education help, but aren’t entirely responsible. Being able to turn off the pump, use temp basals and dose in very small amounts are wonderfully helpful things.
The pump has been a very positive change for me, but not as great as when Lantus came out and I got to leave that awful NPH behind. Boy, things have changed a lot in a short period of time!
I can see your point. In the progression of a sickness it can be useful to do that so rapidly because otherwise it would feeld like using water instead of insulin. But often the increase in blood glucose while being sick is due to the fact that I am personally reluctant to adjust my dosage so rapidly. Maybe this is something you are more willing to do when the adjustment is much easier with the pump - and the basal increase can be ended at any time you wish.
By the bye, FHS, how do you find carrying around both the Omnipod device and the Dexcom device? Do you use your pockets or something else? Is it a bother?
Hey Heather, yes, it is a bit of a hassle. Onesaint can be my witness. =P
I usually carry everything around with me in my cargo shorts. I have a small bag I take with me to the gym. At work, I just carry everything around in my computer bag and lay it all out on my desk. Casual nights out with friends is the most hassle because I refuse to carry a man bag. I just drop the Dex into my pocket and carry my pod and extra supplies around in the Omnipod case, that conveniently fits into my girlfriend’s purse. =P
I don’t mind carrying a purse, but I draw the line at cargo shorts! 
It’ll be nice when the Omnipod device integrates with CGM. I really do like the Minimed configuration (as far as pumps with tubes go), but its readings are just so dodgy. Well, for me anyway! If I could get the Dexcom up here, I’d probably start double-devicing like you. (All of this “not available in Canada” business is reminding me of when I was a kid, and I’d see all sorts of cool toys and crap on American TV and not understand why my parents and Santa Claus weren’t able to come up with the goods!)
Thanks for the extra info! Hope your teaching year is off to a good start!
Heh, definitely a guy thing. =P
I felt the exact same way about impossible to get Japanese toys when I was groing up.
Np, thank you, and I’m off to a hectic but great start. =)
Hello Joe:
Lets look at this one. Perhaps we’ll agree perhaps not.
What on earth is the problem re: changing the long acting insulin dosage, the “basal rate” of MDI whenever you choose to do so? If I were sick, or doing a marathon, the long acting gets changed because of that. Its identical to situational specific basal rates…
What am I missing…?
Stuart
Hello Sarah:
How does that work… it being any “less hassel” I mean?
We don’t test any less…
We still must get all the guesstimation(s) right.When, how much… guess wrong, its major trouble period.
Pump equipment is problematic; delivery errors, etc… DKA is rarely a side effect of injections. The same cannot be said for pumps.
An insulin pen covers all my “backup equipment”. How about you?
Please help me understand better would you ?
Stuart
Hello SF Pete:
Re: your CGM.
How many extra tests are mandatory to callibrate the thing? Is it daily? Is it per week? Per month? In order to get any valid data… doing so is mandatory, right?
Before using any CGM data provides, cross verification (extra tests) are mandatory, per manufacturers instructions. Seems a horrible paradox… As a CGM user how do you tackle that one?
Not attacking simply hoping to overcome my own objections, perceptions to one… so I can talk myself into one.
Stuart
Hello Hope:
Apparently your kittens never saw your tubing moving under the covers as their “INVISIBLE STRING”, did they… ???.
Stuart
Hi, Stuart ~
The problem, I find, with MDI (for me, anyway) is that once I’ve taken an injection, I’m committed to that basal rate for its duration. With regard to exercise, I don’t always know, at the time that I take my Levemir injection, when or for how long I’m going to work out … and, even if I did, the basal rate that’s best for the hours affected by exercise won’t necessarily be the one that’s appropriate for the remaining hours of the injection’s lifespan. I also find that my basal needs vary throughout the day even when I’m not working out, which is something that pumping accommodates more easily than MDI does.
As I said in my original post, I think there are annoying disadvantages to both systems (well, the mother of them all is having diabetes in the first place!), but I’m finding myself leaning toward a preference for the pumping package of hassles. Which isn’t to say I’m out to convert others … not at all. If MDI works best, I say stick with it!
Cheers,
Heather
These are great points because I too have been considering going back to MDI (been on pump 11 years) mainly due to health insurance concerns when next upgrade time comes (on an individual plan now, many thousands of dollars a year in premiums alone and they can drop me if I get too expensive.). I would like to find out if you pumpers gained weight with the pump and whether you were able to lose any when you switched back to MDI. I tell myself that maybe that could be an advantage to losing the pump, but overall I think pumping is the more convenient option ( I was on injections for 20 years before pumping). Thanks!
INteresting question about weight gain. I did gain weight, but I was pregnant at the time so there’s that. Why the hypothesis that a pump would make people gain weight? More loose eating habits? Tighter control? Not sure, I hadn’t seen these put together before. I would love to hear feedback about this too.
I think for me the difference is the length of time it is changed for…with the pump I can change a basal rate for a few hours, with the long acting, it was for much longer.
HA! I could see this happening completely! But my hubby has allergies, so cats are and banished from the bedroom:) During the day I wear it under my clothes, with the tubing tucked inside, so none shows.
Mine needs to be calibrated twice per day, although I often do it more. It may vary based on type, I am not sure.
Hello Amy:
Point of information…?!
We did not mis-read… 7 DAYS of continous usage, without needing to be changed out before then. Please reconfirm that if you would…
Resepectfully,
Stuart