I’m thinking of taking a break from all my diabetes technology and going back to shots for a while. I’ve never taken a pump break, but lately I’ve had a series of bad sites. It’s so frustrating to do well on diet and exercise and then end up in the mid-300’s with a bad site. One of the reasons I’ve had more bad sites recently is because the Dexcom real estate requirements are so large that it’s taken over my favorite pump sites (lower abdomen). I keep trying new spots but often get irritation from them.
Since the Dexcom adhesive doesn’t last as long as the sensor lasts, I’ve been using Transpore tape for the edges when they start pulling up. I used to do fine with that tape, but now I gets horrible itching and pain from it. At work this evening as I was dealing with a plus 300 reading from a new infusion set, I finally ripped of the Transpore tape and am keeping the Dexcom on with all the tape edges loose. I did follow many people’s advice and just ordered the Opsite Flexifix tape.
I know I don’t want to do shots, but they actually are painless compared to pump sites. I just can’t imagine being able to remember Lantus twice a day plus all the many Novolog shots.
I have a better idea! Maybe I’ll just take a break from having diabetes. I really never wanted it anyway.
I agree with Gerri - let’s all send diabetes packing!
But in all seriousness, maybe you should just take a break here and there, especially if your skin is starting to get irritated. Unfortunately, I haven’t had your experience yet, as I am still waiting for my pump to get in.
Oh, and I set reminders on my phone throughout the day to buzz at me when it’s time to take my insulin shots. It can be a pain having to stick to a schedule, but that’s what I’ve been doing… hope that helps =)
I’ve never pumped, but one of my biggest concerns about pumping is scarring. I actually think taking a break on a regular basis (along with aggressive site rotation) is a really good idea. While it may seem like it will be hard to get back into MDI, you will be fine. I think using mulitple sets of reminders like Gerri suggested is a good way of changing your habits. Once they are habits, you won’t even think about it.
And remember, there are some advantages to going untethered.
I don’t think I could take a break. I am so reliant on my pump and CGM that I would no longer feel like myself, I am afraid. Shots, the hassle, the inaccuracy, carrying all the stuff around. Hate to say it, but NO THANKS!
BSC: I have not had scarring from the pump or the CGM and have been using a pump for 9 years. The worst thing is I sometimes bruise around the CGM site, but that goes away.
I had way more problems with scarring with shots than with pumping. Granted, I did shots for 16 years and I’ve only been pumping for 3. But the last few years of shots, I was doing two Lantus shots a day plus 4+ Novolog shots. That’s a lot of needles. Now I have two-three needles per week.
One long-acting injection in the morning when I wake up (thats automatic for me - no reminder needed). The other long-acting injection when my cell-phone alarm goes off at night. Any meal or correction through the day requires a short-acting injection before eating - but it would also require a pump bolus so really no different. The only one that is harder to remember than using a pump is the night time long-acting injection - and the cell phone makes that one impossible to forget.
I agree that injections are painless - pens even more so (I sometimes can’t even feel the pen needle go in let alone feel pain). I did a trial of a medtronic CGM and that was certainly NOT painless.
I hated the cgm the first time and quit but mm contacted me and I went to a class for retraining and the trainer is a diabetic herself and she showed me a different place to wear the sensor. I use stomach for pump sites so I wanted to steer away from there. She had me try the area which would be a saddlebag area if you had them. Side of upper thigh down fr. the hip. My sensor sites have been hurting so bad so I just tried the tops of my thigh for the first time this week. No pain what so ever. So I am going to keep rotating on upper thigh area. I have had to go back to shots once when a pump broke it took a day to get a new one and I absolutely hated it.
I hope you are happy with whatever you decide is best for you.
Nothing could make me take a break from my pump or CGM. I was diagnosed at 11ish (I honestly don’t remember), and according to my mom my personality changed that year. I went on the pump when I was 25ish and my mom was amazed, she said I got my personality back. Not that I was immature, just that I was back to being me. I hadn’t noticed, but think she’s right.
With the pump, I am free, I am mentally and physically good.
I would give sites a rest, try the backs of your arms, or legs or butt (if you have help, LOL) - but not the pump a rest, never!
I’m not questioning that pumping is working well for you. But if you stopped using injections in about 1992, then you haven’t tried the newer basal insulins (Lantus and Levemir) nor injecting the fast bolus insulins (Humalog, Novolog, Apridra). These are much, much better than the old stand-by NPH and Regular that I assume you were using back then. So I think its not really fair to compare pumping today to injecting NPH and Regular 19 years ago.
Actually, it is. No matter how ‘good’ insulin choices are, their pharmacokinetics are still stuck. You have an absorption, a peak, and an elimination phase. Our bodies aren’t that regimented. My life isn’t regimented - I ride my bike to work a few days/wk. I never decide when until that morning - I turn the pump down for the first 30 min of the ride and voila, it fits.
I ate Twizzlers for lunch today (can’t believe I just admitted that in a public forum), extra bolus and I’m fine right now. I could do that with a shot, but I also will increase my basal a little as things like that last a long time for me.
Maybe its because of what I do for a living, but I totally don’t understand why all T1 diabetics aren’t on pumps. They take an awful lot of work, including education and calculations, but the end result is the closest thing to a cure we’ll see in my lifetime.
Tomorrow I may get up and go to a city improvement event (ie help clean up a public park) - again the pump will allow me to do that on the fly.
I have dawn phenomenon badly, which is the whole reason I was allowed to adopt the pump earlier than most - the pump takes care of it seamlessly.
I could go on and on…
I also had bad dawn phenonmenon I could never fix with injectons. The doctors made a good point the pump is the closest thing that resembles what a working pancreas can do I really had to be convinced to be on one. I had one in college many many years ago, the thing was huge. But once they got me to try it again 6 yrs ago, I was hooked.
But it is ultimately a personal choice and what works for you personally and makes you the happiest.
I have found that what I thought was a dawn phenomenon when using Lantus, was completely fixed by changing the time of my evening basal insulin and by using Levemir, so I found I didn’t need a pump for that.
My life is pretty unregimented too, with extreme exercise, varying times or missed meals, etc. And I will occasionally eat “meals” that would make low-carbers cry. But to take your example, I don’t see how a pump makes eating Twizzlers any easier than when injecting? In both cases the same fast acting insulin will be used, and in both cases the insulin bolus is being delivered subcutaneously. So why would delivering the same bolus from a pump make any difference?
It wouldn’t - the 60 min infusion I also need does. it’s just an example.
A shot, and shot, can NOT mimic the highly variable insulin needs that the pancreas deals with in any individual.
If shots work for you, then congratulations and I’m happy for you.
A pump is the closest thing to a working pancreas we can get. As I said, it’s also complicated, a PITA to deal with both the wearing and the security (ie airline travel, visiting government offices, etc), it might not be for everyone, but it should be an option for everyone.
OK, but to extend your example, a pump can also NOT mimic the highly variable insulin needs that the pancreas deals with in any individual, UNLESS that individual is varying his insulin basal and bolus rates in real time by keeping his fingers on the infusion rate knob. But since the insulin being infused is the same as when injected, the pharmacokinetics are just as stuck (with the slow ramp, 90 minute peak, four hour tail, whatever), so varying your infusion rate in real time doesn’t sound like something many people who have pumps would ever even try?
That’s why I view the current pump technology somewhat facetiously as simply a complicated syringe.
BUT - if and when the technology that ties the CGM to a pump in a closed or semi-open loop becomes available - THEN I would agree that we have something that is close enough to a working pancreas to be worth putting up with the PITA issues some of which you list.
I’m not entirely sure why remembering to take your shots should be an issue?
After all, we all have indispensable routines in our daily lives. Do we forget to brush our teeth in the morning? Change out of our pajamas? Put on spectacles/contact lenses if short-sighted?
i leave my lantus on my bathroom sink so when i wake i see it when i brush my teeth and when i get out the shower at night i see when i dry off, i tend to be an out of sight out of mind person when it comes to things outside of my normal routine…
i actually do the opposite sometimes i want a shots break and slap on a pod for a few days, its perfect for a change of pace…
I did a pump break for 6 months last year - back to my roots so to speak. It helped that I was MDI 40 years prior to going onto the pump - so it wasn’t a difficult transition for me to go back onto pen needles again. I hear you on how much the CGMS takes up valuable real estate on our bodies. That’s one reason I gave up after 3 months (trial run) - and just relied on the vampire pricking of obtaining blood results. I’m lucky that I am hypo/hyper aware - since some people go onto the CGMS to help them out.
If you are going to use pen needles - remember - they come in 32 gauge (the higher the number the slimmer) - beats using syringes big time. Well - for me it is - if you saw the needles I used in the 80’s - glass syringe / needle that could be sharpened on a stone - I mean - STONE AGE times. What we use now - teflon coated sleek pieces of stainless steel - aka - ouchless - if you don’t hit a muscles or blood vessel).
LOL on never really wanting diabetes - our darn pancreas packed it’s bag without telling us it was going off on a holiday. How rude can that be?!?
