To pump or not to pump- that is the question

I am type 2 and I don’t know if I wnat to pump. i just received the pump and have not opened it. i am thinking about returning it. I am on 1 Lantus shot at bedtime. My BG runs about 161- to 261 (when I do bad). i am just not sure that is worth the cost and truble of the pump. Even with my insurance it will cost me $1450 and $30 a month for the kit. Anyone outhere in this same boat?
supergirl

I’m a type 2 (we think…possibly a 1.5) on a pump and for me there is no question of going back to shots. Since I got on the pump, my A1c’s are consistently in the 6.6 to 6.8 range, and I couldn’t achieve that on multiple daily injections.

However, before you make the decision, you need to be honest with yourself and assess how much work you’re willing to do to manage your diabetes. Those numbers (161-261) are not good, yet you’re only on one shot a day…has no one suggested to you that you learn how to count carbs and bolus rapid-acting before each meal? If you’re not willing to do that, then there’s no point in going on the pump because, in order to achieve good results on a pump, you MUST count carbs and bolus before eating, as well as test more frequently (usually at least 4 times a day and possible 6).

So the issue is, IMHO, how dedicated are you to achieving good blood glucose control? It’s a bit easier on a pump than on multiple daily injections, but it still requires some work. On the other hand, if your numbers are consistently running that high, you are going to be facing some serious complications down the road.

Ruth

Thank you so much Ruth. The pump vendor lady gave am a demo how to key in the carbs to figure the bolus. My Dr gave me the quick acting insulin before starting the long acting I am on now, but he has not combined the two. I admit that the taking the shot before meals was a small hassle. I know how to count my carbs and exercise but working in an office all days does not allow me to excercise. I guess the truth is if I were committed to controling my BG I would not eat the bad foods and find some time to exercise. But the past 4 years show that is not likely to happen. I am 59 and wonder what i will do when I am not working any longer. The cost really bugs me. I do have some questions for you if you don’t mind.
I sleep on my stomach and I don’t see how I will ever stay connected- was this a problem for you?
Do you have any more energy now on the pump than you did on shots?

You need to do whatever it takes to get better control. Learning to count carbs & matching to insulin is important with or without a pump. Most people who have pumps love them. Pump companies will usually provide a loaner so you can see if you like it before commiting.

High BG (161-261) makes you feel tired. When your numbers are better, you’ll feel better.

I fought for almost 2 years to be placed on a pump. If I had to do it all over again I would do it in a heart beat. It is worth it.

Are you overweight? If so, then you should wait until you get to your target weight and see what your insulin needs are. Only then should you decide if you need the pump or not.

Supergirl,
If you can count carbs, then you can probably manage a pump. The key here is that you’ve got to bolus every time you eat (which is why you need to know how to count carbs), and you have to be willing to test frequently.

As for sleeping with the pump…not a problem. I, personally, just clip it to the front neckline of my nightgown. I sleep kind of half on my stomach, half on my side, and it nestles nicely between my boobs. Other people use longer tubing and just place it on the bed beside them. There are also special pouches you can get, such as a waist pouch. I have one of those too, and sometimes I use that…I just twist it so the pump is at the small of my back and, since I never sleep on my back, not a problem. You could also do that if you wear PJ’s…just clip it to your PJ bottoms in the back, since you sleep on your tummy.

"I guess the truth is if I were committed to controling my BG I would not eat the bad foods and find some time to exercise. " The truth is…you need to be committed to keeping your bg under control or a pump is a waste of money. I have a hard time with diet and exercise for various reasons I won’t go into here, but I am VERY committed to keeping my numbers in a good range. I count carbs, bolus appropriately, and test my bg at least 6 times a day, and often 8-10 times a day. There’s a whole lot of work involved at the beginning, too, in fine-tuning your basal rates and your insulin to carb ratio, so again, you really need to be committed. On the other hand…if you can make the commitment, I believe you’ll find your numbers will be much better and you’ll feel better, too.

Ruth

I’ve been a T2 for over 25 years and using a pump since October. I wouldn’t go back to MDI for anything. The pump gives you so much more latitude and freedom in life styles. Once you learn to count carbs and get the fine tuning dialed in you’ll be amazed how easy it really is.

There is a definite learning curve involved, but the time and effort put forward are well worth it. You’ll have a host of professionals at your side and countless people who have been there before you for encouragement and help champion you.

In order to become a winner you have to be willing to start the race.

I am not so worried about the learning curve. I am 45 lbs overweight. I really don’ think this will change! I am concerned with causing my pancreas to totally stop prodcuing cells. My c-peptide was 2.6 ( in normals range) . Am I wrong or is this mean I am still producing inlusin but maybe just not sensitive any longer. I have been on most of the kinds of pills for 4 years (and Byetta for 9 months). I just don’t know if I am ready for insulin. Maybe I need to try other pills. Yes, I am questioning the Dr.s - but I always do this also. I am just plain confused and worried.

I have to tell you that i love the pump! my A1C is staying at 6.6%, and it is so convenient.

I disagree. Every minute with high blood sugars is too many. The pump can be adjusted based on your insulin needs. I believe the priority is to get your blood sugars under control ASAP. Significant weight loss, done correctly, can be a lengthy process.

John, for some it is difficult to bring weight to target due to injection of insulin causing weight gain as a side effect. I’ve been pumping since July and have lost 22 lbs. I still eat the same way. I needed to lose the weight the insulin had put on me but was trying for diabetes control as the most important so the loss is just from having a more titrated insulin dose and a different kind of insulin. Before my pump, I just gained weight on the insulin no matter how I ate. The pump has changed my health in many ways and so the weight loss is just one extra I got from it.

Maybe this is an outdated view, and as time goes on being on a pump will be the first step when someone begins insulin. But to me it seems like you are skipping a step and that making the investment for a pump is premature for you right now. You are still considering whether additional or different oral meds will work for you and you should explore this with your doctor. You haven’t yet made the emotional or psychological committment to insulin. You haven’t yet been tried on the proper basal/bolus regimen. You haven’t had any practice counting carbs and figuring insulin:carb ratios. You aren’t willing to do the work to change your lifestyle and lose weight. To me, I think you might need to work through your ambivalence about your diabetes and its treatment first. You need to make the committment to get those numbers down below the level where you are making complications inevitable. You need to change how you eat, reduce carbs and work on weight loss…and yes, I know that is hard! Then you need to try the basal/bolus regimen for awhile on MDI’s before deciding you are ready to go on the pump. Just don’t wait too long.

That’s just my take on things.

I am in the second week of the 30 day trial now with the pump. I admitted taking it off a couple of times but I have been wearing it for a few days now. Seems like I do have more energy the last couple of days. I do count my carbs and set the bolus accoding to the bolus wizard that figures it for me. I have tried lots of the pills and still had high blood sugar. If I can have more energy then I may decide to stay with the pump. I will keep you’all updated. Thanks for the support.