I have been on shots from the time i was diagnosed and i’ve been doing quite well with them, however my doctors keep trying to push me and talk me into the pump and i have always been second guessing it, i never thought i would need it because i have maintained such tight control over the years with just shots. However lately my BS have been creeping up and i have found myself having to experiment and up my dosage of insulin ( I am on a very small amount of insulin, 17 units of Lantis once a day). So here i am 20 years old, I want to maintain tight control, i want to travel and do regular things, so I contemplate on the pump… i love fashion, i love wearing all sorts of different clothing and i have always felt that i would have to hold myself back from wearing certain things if i went on the pump. Like every girl i worry about different social situations, dates, sex, fashion dilemmas, swimming - I have also heard the infamous rumor of the pump causing weight gain… can someone fill me in on these details and tell me the REAL pros and cons of pump using? 
Jill-
I did shots for 26 years. I’ve now been on the pump for 10+. I understand your concerns about the pump. So, my thoughts…
-
Weight gain. You can gain weight MUCH easier on a pump. It gives you the freedom to pump when you eat, so … you eat something extra, pump for it… it can be a very vicious cycle, but if you are in good control now, and maintain a healthy diet, there is no reason to be concerned about gaining weight just by pumping. (Note: after the birth of my second child I lost 40 pounds on the pump).
-
Travel. I mentioned on another post to you that I travelled to all 7 continents and 104 countries - that was done on shots. I have traveled a lot on the pump too. Either way … you have to have a letter from your doctor and prescription info with you. and your Supplies… diabetes supplies are what they are… a part of our life. You pack accordingly.
-
Regular things : ) There is NOTHING stopping me.
-
Fashion- There are SO many options on how to wear a pump that it should not inhibit your fashion sense. It can get creative, but it keeps things fun!
Now, I have 2 kids. I had the first one on shots and the second on a pump. I met my husband on shots and never thought about the sex thing. So, on that account I was lucky. But, when I got the pump, it never stopped us. If someone has a problem with your pump, then you don’t want to be that intimate with them anyway!
My honest opinion. I would never go back to shots. I have so much freedom on a pump. I’m in the best control I’ve ever been in and I’ve always been in “good” control. I love my pump!
Erin
hi Jill, the only way I can control my weight is WITH the pump. I finally don’t have consistent lows and have to correct with glucose tabs (calories). A1c dropped a whole point. (7.5 to 6.5) Lost 8 pounds in the first 6 months, my total insulin requirements dropped 25%, and am very happy with my new found level of control.
Cheers!
thats great to know thanks for the heads up guys
Dear Jill: Hi, I am also a pump user for the second time. This time, since April 2008. My dear, may I be blunt??? The pump doesn’t cause you to gain weight, what you put in your mouth does. Too many people take advantage of being able to play with the dose and, therefore, eat more or things they shouldn’t at all. I find it is a great temptation!! You may need to talk to a nurse, doctor or the manufacturer’s rep to determine that answer for sure. As to clothing, I just clip my pump to the outside of my blouse and people must think it’s a pager because they hardly ever get it a second look. As to swimming, that you will have to discuss with the pump manufacturer. I, myself, have to take it off for the period it will get wet. You may find some made to withstand swimming. Travel? I travel better on the pump. Not having to worry about needles is wonderful. You may even select one of the new monitors that check your BG automatically. You still have to pick yourself several times per day, but that’s small potatoes. I would like to have one, but Medicare won’t pay for it. Social situations? If you’re not affected by it now, why let it get to you then? Sex? Don’t know … haven’t had that problems for years!!! Hope this helps a little. Lois
I started the pump when I was 20 (am 29 now). There are such creative ways to wear a pump (pockets, bra, belts, clips, etc) that I have NEVER found a situation where I couldn’t find some place to put it. I have performed in formal gowns with it on a garter under my dress, I have worn tight fitting dresses with the pump tucked in my bra, I wore it clipped to my underwear under my wedding gown, I even clip it on my bikini at the beach. As for those social situations, I have never had a problem with it. Most people don’t notice I’m wearing it if we’re just in conversation. As for the opposite sex, it depends on how you feel telling others you have diabetes. You really need only take it out to bolus, so you can always do it in the bathroom. As for sex, you can always disconnect it if you don’t have anywhere to clip it and don’t want it in your way.
Sister, I am 24 and was in the same boat as you are now. I didn’t get an insulin pump merely because I didn’t want the tubing and the way it looked. However, when the Omnipod came out, I jumped on it and i have loved, loved, loved it. It is small and discreet and no tubes. It has been the best thing for me and I hardly ever notice it’s on. I love fashion too and clothing that fits (!) and it never shows or looks bad or obvious. I highly reccommend it!
I love my pump. I wear it either in my bra or out in the open. Why be ashamed of what keeps you alive? As for intimate moments, you can disconnect if needed. I eat when I want to, but I do stick to my diet. If I want to sleep in on a Saturday, I will. I don’t have a strict schedule it changes daily, and my pancreas in my pocket makes me feel and fit in with the more “normal” people of society. Also, some think my pump is a cell phone due to the mickey mouse skin on the 722
One thing to watch out for on the pump is the health of the skin in which you place the infusion sets and the comfort issues that may arise if you are very lean. To put it bluntly, it hurts to place an infusion set in an area in which you have little or no fat and infusing insulin can cause scarring and bruising at the infusion sites, both on top of and below the skin. The scarring can be mitigated by changing your infusion sites more often and using insulin such as Apidra which tends to irritate the tissues less than say, Humalog.
You may also find that only one area of your body gives you consistent absorption of insulin, which further limits your ability to deal with the cosmetic issues. In my case, only my abdomen is suitable and only a portion of it has enough fat to allow me to comfortably wear the infusion set. That said, after over ten years of pumping and using only my abdomen, I have minimal scarring.
Being dependent on a machine feels different than being on MDI therapy- pumps are very, very reliable but nothing is more reliable than a bottle of insulin and a syringe. And it does come with its own set of related problems and frustrations: infusion sets that don’t work, pump malfunctions, insertions gone awry, forgetting to reconnect, etc… Again, these are things that can be mitigated to a significant degree but it is best to know about them going in (and I see you are already making a lot of headway there, kudos to you!).
Swimming is no big deal at all. You disconnect and the infusion set stays in. It is generally not affected by water, although hot tubs can destroy the adhesive in a matter of minutes so avoid them if possible, unless you’re due for a set change anyway.
I have discovered only one problem with regards to sex and pumping. Some infusion sets (I use the silhouette sets from Minimed), when disconnected from the pump, reveal a somewhat sharp, plastic edge that can rub up against your partner and scratch them during sex. This typically will not pull the infusion set out and you probably won’t even notice, but it can be quite uncomfortable for your partner, so give thought to infusion set placement and, to put it bluntly, sexual positions that help you avoid this issue. Obviously, if you use the front of your abdomen for placement and engage in missionary this is more of a problem than if you used the side of your abdomen for placement or a different position.
Weight gain, as others have said, is due to what you eat and how much exercise you get. I am in much better shape on the pump than I was on MDI.
Good luck and feel free to fire more questions at me.
Jill: Further reply - I have the Medtronic Paradign 722. It has what is called a Bolus Wizard. You plot in your current BG (before eating) and the amount of carbs you are going to have and it calculates the amount of insulin!! No more math … unless you count counting the carbs. Also, I have a really nifty color on mine – PURPLE. I adore it. I’m sure there are many more “pro” points to it! Lois
That is a very nice feature, but it takes a lot of work to get it right. You need to have a good understanding of how your basal rates and insulin-to-carb ratios fluctuate throughout the day and then there is a good deal of trial and error before you can rely on the wizard completely.
It took me about 6 weeks to do this. I use the wizard for every bolus now, corrective, meal, or otherwise, and my A1c is quite good.
Oneless: Thanks for your reply about the Bolus Wizard. I must be missing something because I don’t have different rates for boluses during any part of the day. Just my basal rate changes. Is that what you mean? My insulin-to-carb ratio has never been changed. I do have an endocrinologist who does work with Medtronic nurses, so I am confident that I’m getting the best of care. Lois
We have slightly different methods of controlling our blood glucose. Because I tend to stick to the same meal timing each day, I have different basal profiles throughout the day that match that routine as well as my own body’s varying needs. So my insulin to carb ratio is effectively lower at my normal mealtimes because I use a “heavier” basal profile then. I have found this method to be better in combination with Symlin, because my blood glucose levels rise gradually over hours following meals.
My insulin to carb ratio also changes after strenuous exercise, for at least 24 hours. My nurse practitioner is actually a Medtronic consultant and is responsible for a lot of my regimen.
I have dropped over 25 pounds since I went on that pump… so don’t let that stop you. I had a really hard time following a regular exercise routine before I went on the pump becuase I had way too many lows. Now, with the pump, instead of eating extra before goin to the gym I just have to dial down my pump. Its so wicked!!
I keep my pump clipped to the middle of my bra and never have a problem. You can get longer tubes and shorter tubes which allows you flexibility in where you want your inset to be and still keep it clipped to your bra (in the middle). Having it there keeps it out of the way when doing activities & even sleeping (I always wear my bra when sleeping as well to keep my pump secure).
You can disconnect for up to an hour to disconnecting to go for a quick swim wouldn’t be a problem. Although, my pump is water-proof so I just kept it clipped to my bikini bottoms or even the top… not a big deal at all.
Sex… I usually always disconnect. :o)
If you have any other questions feel free to ask me. I’ve had my pump now for over 1 year and I’m loving it! I can’t imagine going back to the shots (which I was on for over 10 years).
Jill I think about getting on the pump all the time. I’m 17 years on the shots and I’m doing all right. I like the pump because it seems “easier” but your regimen is working (nice a1c) so stick with it until you’re sure. It’s all about lifestyle, and I don’t see the pump really fitting into my lifestyle quite as easily as shots.
The pump should not affect weight gain if you continue to take in the same amount of calories and take around the same amount of insulin from shots to pump. Often times people gain weight from the going to the pump. I think it has to do with being out of control for so long then finally getting under control with the pump.
Its no secret that if you take more insulin it just means more food which means more jelly for the belly unless you work it off.
Personally I like the old school shots. I take my insulin shot and I’m done. I don’t have a robo-pager on my belt giving me little shots all day, begging me to eat more food just so I can dial him up. That does sound nice and convenient sometimes though, I must admit. And then I think about the physical attachment and I freak out a little…
In all honesty the pump really is a modern miracle. Sorry if I offended any pumpers.
Great thread of pros & cons. I will only share my experience. I was probably one of the 1st MDI’s. I did ok with a1c’s being near normal. I was sick of the shots so went to pump (animus 1250). I lasted a year. Not for me. No better control. I did gain 15 lbs plus it cost me much more out a pocket $. I did not like a thing connected to me. I have now been back on MDI Lantus 9 units am/pm plus novolog sliding scale before meals for over 1 year. Of course frequent bs testing - diet - excercise - stress managment all play a big role in maintaining good control. For me right now I will stay on MDI. I may try the omni pod as not tubes. I also have insurance that may do a beter job of covering the pump and pump supplies. Try it for a while and see what you think. Good Luck :)!
Dave: What’s MDI and DP? I’m a newbie to some of these things. Lois La Rose
Hi
I have been on the pump for almost two years. As opposed to shots, the pump is great. My weight hasn’t changed since starting the pump, I still have the same amount I need to lose. I think it makes life easier, my schedule more flexible. I wear it on my waist band of pants, a dress is a little more tricky. It doesn’t bother me at night (doesn’t bother my husband either).
MDI - multiple daily injections
DP - dawn phenomena, blood sugar rise, in the morning, even if you don’t eat any carbs
=)
I’m 20 years old as well (21 in March) and I just started on the pump. I love to go out dancing and wear cute clothes and it hasn’t stopped me at all yet. I don’t have any of the special clips or bands made to hold it anywhere either, although my friend who uses a pump does and likes them. My a1c was a 5.5 pre-pump so for me it was just about more freedom, not control. I haven’t gained any weight because of it either, even with all the holiday eating, lol. If you haven’t gained weight and on shots and have that good of control then I doubt you’ll have a problem with the pump. You can disconnect the pump to go swimming, although the site is still on. If you plan on spending a whole day at the beach or pool you can always switch back to shots for just that day if you really wanted. I’m not embarassed at all for people to know about my diabetes or my pump so I don’t have a problem wearing a bikini with it on. It hasn’t affected my sex life whatsoever either. I just suspend and disconnect it, like I would for swimming or a shower and set it out of the way. I have yet to find anyone who is really bothered by the fact that I wear it or that I’m diabetic and if I did, I’m pretty sure they’re not the type of person I would get on well with anyways.
I honestly have yet to find any real cons that make it not worth it in any way. I still do everything I did before: go out, party, dance, ride horses, workout, swim, go to theme parks, If you have any more personal questions or want more details, feel free to send me a message. I’m more than happy to talk about any aspect, I’m not shy ; )