Thinking about a pump for the first time in 37 years

I have been taking insulin shots for 37 years since being diagnosed at 14. In that entire time I have always resisted getting a pump for many reasons. First because they weren't available and now because they still seem too big and cumbersome. I have been reading here about snagged lines, bad pods, sore sites, not enough sites and all sorts of other reasons for not having one. But on the other side I have also read both here and on the pump company websites of how easy diabetes control would be if you let a pump do it for you. I have done it for myself for a long time. My last A1C was 6.1 of which I was really happy. Before that the best number I had was 6.9 but that was rare. I have been hovering in the 7-8 range and even higher during my crazy teens and college days, but I finally decided to take control of diabetes and started with a frank discussion with the endo in November. Problem with endos is they see you for a total of maybe 30 minutes during the year. 2 - 15 minute appointments. He was not particularly useful so I turned to the CDE who has been fantastic. She switched me from sliding scale (who even uses that anymore ?) to carb counting. I split my Lantus dose myself and also decided to go 70/30 in the morning instead of taking a single shot at night. This simple step changed my average bs from 160 to 125 and A1C from 7.5 to 6.1. Last week I got fitted with a Medtronic IPro to see what kind of glucose excursions were happening at night etc. I know CGMS is the in thing now, but I totally hated it. It started to move around during a golf game and I ended up removing it. I still have a mark on my stomach where the sensor was inserted. I am anxious to see though what the numbers say. So back to my original question. I have looked at the Omnipod and Animas. I am drawn to the tubeless, but 2.4" by 1.6" is still just too large to be wearing anywhere on my body. Thoughts ?

I love my Animas Ping. Aside from the bulk, I have heard the Omnipod isn't nearly as reliable as the Animas and Medtronic pumps. Everyone is concerned about the tubing and that is the thing you adjust to very quickly. I use the 43 inch tubing so I can move it around and hook the pump anywhere on my clothes.

I had a 6.3 before getting the pump and thought "I didn't need one". But it makes life so much easier not having to take shots and do the math for I:C and corrections. Also you can do minute parts of a unit so you give the exact dose you need by just pushing buttons. The Ping has a meter/remote so you test your blood sugar and do your bolus without even taking out the pump. You can do several different basal rates which suits the needs of our bodies much better than the one or two shot long-acting. Like many people, I'd never go back.

Now the negative so you don't think I work for Animas! There is a steep learning curve and it can take weeks to adjust doses and get used to inserting sets. It costs more of course and yes, there are set problems. But I realized recently that I heard about set problems on here a lot, but then when I asked people said they were rare. People just post, of course when they are having problems!

Hi Clare, we are the same age! :) My story is very similar to yours. I stayed on injections for 25 years and just started pumping about 3 months ago because old lady hormones got the best of me. I got to the point with hormonal fluctuations causing crazy bg fluctuations that I needed the ability to set different basal rates and to change them frequently. As my CDE said "you were out of options and now you have options again".

I chose the OmniPod for several reasons.
(1) Tubeless - I know that people say you get used to the tubing, but I didn't want to have to get used to tubing. I would rather stick a pod on and forget about it - I often have to pat myself down to remember which site I used.

2) OmniPod has automated insertion - you stick the pod on with the adhesive and push a button on the pdm...you hear 3 little clicks and *snap* a little pop like a rubber band and it's done.

(3) No need to disconnect or remove anything for showers/ bathing/ swimming - pods are waterproof.

(4) No need to hook anything to your belt or clothing - If people look at me, they see no signs of my diabetes "equipment".

(5) The pdm also serves as my bg test meter and I can stick it in my purse - and I would have to carry a meter anyway.

Good luck and I hope you find the best fit for you! :)

I love my Minimed pump, but I don't think pumps are for everyone. They are certainly not a panacea and they definitely come with their own issues. Some of these issues include:

  • Infusion set problems. Plenty of folks develop allergies or have kinks in their canulas, which can interfere with insulin delivery. Infusion sets can come out (although I am very active and never have had an issue with this) and sites can go bad (again, I rarely have this problem, but I know some folks routinely get bad sites).
  • Cost. Pumps are not cheap. The pump itself costs a significant amount of money (even with insurance) and then you have the issue of monthly supplies.
  • Bulk. Yes, wearing something on you all the time does create some bulk. I like tubed pumps because the infusion site is virtually flat. I have never found tubing to be an issue. You learn to deal with it.
  • Stuff. With pumps, you need to carry around more stuff. You always need to make sure to have back-up supplies, and you still have to carry around a couple of syringes and extra insulin, just in case of a pump failure.

This all aside, I have found the pump to have many benefits.

  • Smaller dosing, better control. With a pump, I can dose in increments that are as small as 0.025 units of insulin at a time. This means I have more freedom with what I eat and what I can correct. For me, this has translated into far better control. I find that my highs and lows are less severe and I'm better able to catch the lows before they get really bad.
  • Adjustable basal rates. By far my biggest issue with MDI was my basal insulin. I was constantly going low, and then shooting up because of over-treating bad lows that were brought on by my basal insulin (especially following exercise). I had a hard time accounting and adjusting for exercise with basal insulins. With the pump, I can adjust my basal rate on the fly, and this means I am better able to respond to changes in my schedule, routine, and activity level.
  • More flexibility. On MDI, my schedule was SO regimented and it drove me crazy. I was always scared of deviating from my scheduled routine because I knew that would bring on a high or low. With my pump, I can easily adjust my basal rates (see above) and generally feel more comfortable doing something spontaneously. Oh, and I can sleep in during the weekends, which is priceless.

I don't think pumps are for everyone, and there is certainly nothing saying that you HAVE to use a pump. If you're able to achieve good control with MDI, and you really don't like the idea of a pump, stick with MDI. But, if you are curious, give a pump a try. It is definitely a big change that requires a good 6 months of adjustment, but it's certainly not something you have to stick with if you don't like it. You can always pull out your infusion set and go back to MDI.

Yeah, I second that. I've been using my Revel for over a year now and I have only had maybe 2 failed infusion sets (and in one case, it was more user error). The posts on here about failed infusion sets are, in my experience, the exception (not the norm!).

One other benefit of the pump is the math/data aspect. Once your settings are in there, the pump does all your math for you. In addition, if you use the wireless meter that comes with your pump, you can easily capture all your data and upload it via your pump's software. This for me has been a HUGE benefit because I was a horrible logger. Now, all my data is captured effortlessly and I have nice pretty logs that I use to adjust basal rates and just show my endo that I am a star patient :-)

I love my pump been pumping for 25 years now. I have no opinion on the 2 u mentioned b/c I use the MM Reveal Of Rebal can't right off remember right now I know it's one of those though. I don't think thir near as big now as they were. It has really helped me with control Now I'll shut up!

HAHA! I was right the 1st time on it's name!!! I don't like the CGM either

This has provided a lot to think about. Thank you for giving me more honest opinions than those available on the pump websites. If one were to believe them, pumps are the equivalent of a pancreas without all the work and learning that goes in to using them properly and getting all the details ironed out. And now I also realize that it is a constant series of adjustments whether basal rates or correction dose or boluses to cover carbs. It is easy to get completely overwhelmed by it. I appreciate all of the information. Thanks

Hi Claire, I was 25 years in before I finally decided to go with a pump. I narrowed my choices to the Animas and the Omnipod as well. My endo recommended the Animas but I went with the Omnipod because of the tubeless design and I couldn't be happier with my choice.

I have absolutely no experience with a tubed pump so I have no point of reference. However, after a bit of a learning curve, the Omnipod has been an absolute joy. I know you will find much talk about the Omnipod here on these boards both from people who have had experience with it and people who have not, with mixed results, but if you are even considering a tubeless design, try it for yourself. I haven't had anywhere near the bad experience that you will often read about here and my guess is that vast majority of users who are perfectly happy with the pod are also perfectly content enough not to have to post issues here.

That being said, MBP has some great advice regarding pumps in general. They do come with a whole bagload of issues that you have to overcome, with no guarantee of having better results than MDI.

There's no way to make being on insulin not suck completely. Going MDI versus a pump is just a matter of deciding which set of issues sucks less for you.

Thank you for your very comprehensive reply. It is great to hear actual users give their honest assessments. I also appreciate that once on a pump always on a pump is not the case. But then again when you invest the time and money in to using a pump I'm don't know if I would feel a failure for going back to MDI ?

Clare,

My Animas Ping has been life changing. Without the pump, my A1-c was in the high 7 range, and even 8 at one point. Being a LADA diabetic, I wasn't always on the pump or injections, but when things went way south for my control, my sharp endo decided that there was something else wrong. When it was all over, insulin was the only option, and the control became much better. however, I was still running high a lot, not taking shots or test when I should and we decided that a pump would be the best option. It took two attempts for my insurance company to approve it, but it is the best money I have ever spent for life-giving medicine.

I have had no issues with clogged or caught tubing. The 9mm canula does not bother me. I live the meter control and its interface with the pump. The tracking software is wonderful, gives all the information the CDE and endo want and more than I want to know; and it shares directly with their offices, so they con monitor my progress. The Animas pump is claimed to be waterproof to thirty feet for 72 hours (I think), but I take it off for showers and I don't swim. I never hide it, but it could be easily worn under clothing. Sometimes, I find myself checking to be sure it is there. The most noticeable feature that I can see is that I have to change sites about every 2.5 days, versus seven shots each day. Things are so much easier. The training tha tI received from Animas was stellar and the customer service has been wonderful and complete. The company does what it says. Even my doctor visits are less frequent because of added control. I would be hard pressed to go back to shots again.

Sometimes, it's good to be diabetic! ;)

Be well.

Brian Wittman

Nope, you should not at all feel like a failure. For some, the issues that come with pumping just aren't outweighed by the benefits of pumping. And some folks (such as those who are not really that insulin-sensitive) don't see the benefits. For me, a mere difference in 0.25 units can make the difference of whether I'm in range or out. But some folks are just not this sensitive and don't realize this value of pumping. If you can easily and accurately correct with MDI (which I almost never could), then pumping may not be worth it.

Yes, getting started will definitely eat up some time and money. I think MM and Animas both have a money-back guarantee policy (but please check to be sure). That said, it really does take about 6 months to get all your basal rates fully adjusted and to feel comfortable pumping.

Well said, FHS.

Isn't it the Rebel, Doris?

The most noticeable feature that I can see is that I have to change sites about every 2.5 days, versus seven shots each day Here, Here Briann . I was on shots and old school once a day dosages, being diagnosed back in 1968.. so I despised MDI. could not get into the pens. I felt the needles were larger and they hurt more.Skin was getting lumpy and bumpy and was I always sore from taking shots.. I could not match insulin to activity levels; It was inconvenient to never deviate from my planned eating schedule, even on when I was on Lantus. I felt MDI made me limit many life activities and eating choices because I just did not want to pull out another needle!! I felt like a medical doctor carrying all those syringes and the "I have to keep cool" vial of insulin. As the oher posters have abley described.. The learning curve is long, at least 6-months, and I did not use the dual wave or square wave boluses until I had been on the pump 3 years..but I would not go back!! I am pumping 9 years and loving it.

God Bless,
Brunetta
Type one 43 years

Thanks for the response, I just got the OmniPod test kit today. The company is very helpful both on the phone and by email. The positive is they are located in Bedford, MA which is literally down the street from me. I stuck the test Pod on my stomach problem is I really have no idea how it will feel with a canula because the test kit is just an empty pod with adhesive. I played tennis tonight and felt it the whole time I was playing. Maybe my stomach was not the ideal spot. I will contact them tomorrow and have them send me a few more test pods because I don't want one poor placement to influence my decision. I had the CGMS iPro on my stomach last week and I have to say while it produced some useful information it is not something I would ever consider doing again. I haven't had the old lady hormone issues yet and I am fairly happy with my control using MDI but I am really tired of having to work so hard to achieve it and when the newer, smaller omnipods come out hopefully later this summer it might be the way I choose to go, it's really great to get some first hand information, thanks

thanks for the info. I am currently wearing a "test pod" to see what I think. So far I think I put it in the wrong place but I will call them tomorrow for a few more test pods. My CDE has said they are coming out with a much smaller version and they confirmed that on the phone today. They are currently getting FDA approval, same 200 unit capacity but 1/3 the size of the current pod. I think I can wait til that comes out.

Clare, I went 40 years on MDI before going to a pump. I should have started a LONG time ago! :) The tube was one of my hold backs. So, I went with Omnipod. I find it smaller than a tubed pump overall, and much easier to handle than I thought. I wore a demo unit for a while, call Insulet and ask them to send you a demo unit. It's a non-operating pump you can just wear for a couple days to see what you think. I wore a couple demos before I started real-time with pumping. That taught me a lot about how it wears and how to treat it. The first demo pod I wore, withing a few hours I had knocked it into door frames and corners 'til it fell off. I don't wear the pod in that way now that I'm pumping, and have yet to knock one like I did that demo unit. I can't imagine getting a tube yanked! Ouch!

Anyway, get to pumping ASAP is my advise. Oh, and the Omnipod will have a new pod later this year that's about 30% smaller. I wanted to wait until that one, but decided to get busy right away, as I'd already waited too long.

Thanks Scott, I have already tried out the demo pod and found that it was a bit big and heavy. I put it on my stomach and played tennis with it on and it was obviously not a good placement choice because I pulled it off within a few hours but the adhesive is really quite impressive. It is definitely the one I will eventually go with but I am ok with MDI until the newer, lighter, sleeker, model comes out. I have spoken with the people at Insulet which incidently is literally down the street from my house and they have offered to loan me a working pod for a couple of weeks if I want to try it out but I still think I want to wait for the smaller version. It is already available in Europe of couss, but should be out soon here. The company is very responsive and I already feel like one of the family there. At least I can get the paperwork started and even that shouldn't be a big deal as my insurance company covers pumps 100% so the only expense for me will be a copay on the insulin to put in it. I currently have at least 3 months worth of humalog and lantus pens and I would rather that up as well.

Yeah, the test pod lasted two hours for me. I put it on my thigh and ripped it off sitting into my computer chair when it caught the armrest on the way down. Turns out, I couldn't even wear a real one on my thigh.

The new pods look nice. When it comes, it comes though. I'm managing well enough with the current pod. The new one will be gravy.

Good luck!