Hi All
My doctor advised me to switch to an insulin pump.. My A1c numbers arent that great.. the most recent one was 2 months ago and it was 8.3. But i was only on long acting insulin then..
After that I started with a combination of Long and short acting and am due testing my A1c in July.
Any suggestions on whether to switch on to the pump or stay with the regiment..
thanks
You are very new to diabetes. I went 36 years without a pump. When the first complications show up you might panic and get all the gear. Complications are most likely decades away. It’s a gamble. I thought I was invincible. I am not. Live and learn.
Thanks Helmut … and as u said I am very new and I am not mentally ready to go with the pump…
I really like my DexCom 7+ and wouldn’t like be without it. Less finger pricks. Less surprises. Less disappointments. I would go for a CGM before getting a pump.
Hi Sultansfam: I say go for the pump! I have had Type 1 diabetes for 15 years, and have been on the pump for 12 years. What an improvement it is! Much better blood sugar control, easier to incorporate exercise, eliminated nighttime lows for me, it’s just a better way of doing things. Why not use the best technology available?
I did have a mental resistance to having a machine strapped to my body 24 hours a day, but that feeling went away within the first week.
Good luck to you, whatever your choice, Melitta
There are pros and cons to both methods. The biggest pro for a pump is better control of your BG, and better control = lower risk of complications. I don’t agree with Helmut’s statement that “complications are most likely decades away” because whether that’s true or not, PREVENTION of complications starts now. However, a pump is not all sunshine and daisies. It takes a lot of experimentation and tweaking to determine the patterns that work for you, and there are occasional issues of mechanical failures, bubbles in the lines, sites pulling out - problems you just don’t have with syringes. And, a pump is with you 24-7. It can be a pain in the patuckus. I would recommend that you buy the book Pumping Insulin and read it before you make the decision one way or the other, just so you know what’s involved.
On the other hand, injecting yourself every time you eat something kinda sucks, and having to obtain two different forms of insulin in your fridge and keep tabs on when you opened each vial, and above all making sure you don’t inject the one when you think you’re injecting the other is key!!!
For the record… I take a combination approach with my son. We use a pump for his bolus and correction doses during the day, and long-acting insulin to cover his basal rate. Just started this protocol because he’s taken to yanking out or crimping his pump sites overnight, and I was losing an awful lot of sleep to his middle-of-the-night highs. Not to mention wasting a great many pump sites! It’s clear to me that he simply finds the pump uncomfortable when he sleeps, and when I remove the pump at night, he doesn’t mess with it… or even if he does, I’m at least spared having to change it till morning. But having the pump for the bolus doses means we can have the greater accuracy that a pump offers for dosing.
I’m a little curious as to why you were only on long-acting insulin to start with? It’s a little odd for a T1 to have just long-acting and no short-acting, unless you still had some pancreatic function left that has since dissipated. Given that, I would expect your A1c to go down simply by virtue of adding in the short-acting insulin.
In my view the success with pumps is mainly propagated by those who had good experiences with it. Within the group of T1 diabetics you will find people who need the pump to reach good control - it is their only choice. Of course those think very positive about pumping. Others can exchange pump with pen and vice versa and will only see small differences. The biggest problem of pumping is the false concept or idea to be normal again. Eating always comes with a price for diabetics. Things have to be balanced and it is not done with programing the pump and that is it. This fire and forget thinking is the main reason why many pumpers are having an A1c around 7 and not between 5.5 and 6.5 (please remember that we all want to get 100 years old without complications). With a pen I will make sure that my injection will be sufficient. I will invest efford, think about comparable situations and then I will come up with a dosage that nails the situation. I will also try to keep a certain rhytmn in my life because this allows me the apply experiences from the past to the current situation. You might say that living like this is less flexible and I have to admit that this is true. But I see no benefit in having more flexibility that puts me in harms way in the long run. Of course this mindset that leads to good control is also possible as a pumper. It just needs the right attitude. Pen and pump are just tools and we need to use them wisely.
As an important reminder: stay with the current regime only if you can reach good control with it. There are several improvements to your current regiment you can apply in cooperation with your medical team. The most important part is the correct application of the basal insulin. Please make sure that your basal insulin truely covers 24 hours. Use two shots of Lantus if necessary (splitted dosage) or better (in my view) switch to two shots of Levemir. Without good basal coverage you will fight like Don Quixote against windmills.
My 16 year old son switched to the omnipod pump this week.
The thing that we like for him are the different basal rates during the day and night and temporay basal rates when he exercises.He plays ice hockey which is scheduled and we have not had too much trouble with but also does other teenage boy activities at the spare of the moment like street basketball and taking off on a bike which have sent him spiraling down.
He, of course, really likes feeling a little more normal around frineds at eating time. After 7 months he had only given himself a shot one time when around friends otherwise he would either not eat or eat only a small amount and come home right after very high and correcting.He did not won’t to be embarrassed by a shaky low so he was always running high on purpose to avoid it.
The “Extend Bolus” Feature is wonderful for fast food type meals which are more common for a teenager. He is not getting the 3-4 hour rises after a less than perfect meal. The fractional units for corrections have helped a lot too. We were always correcting with two units and being low or one unit and being 30 - 40 points over target range. We could never seem to get into that perfect target area with whole units. The first afternoon he was almost exactly 120 for every reading which was the target set in the pump for adjustments.
He seems to have a little more energy on the fast acting all the time regime. But I hate that if the pump goes down he will have no basal and in a matter of hours be in big trouble with extreme highs. Teenagers so don’t think this can happen to them so it is the scariest part. There is suppossed to be a really loud alarm.
As far as carrying things around which he hates and sometimes refuses to do, you don’t have to carry needles and pens and meters (the controller is the meter) but the suggested Omnipod bag of supplies is just as much to carry. We though that he could just carry the Controller which can be stuck in cargo pants pockets but they also recommend an extra pod package, insulin vial, IV prep, alcohol, extra batteries and a lancet. If the pod errors, it is important to be able to get a new one attached and active ASAP. Some people even carry an insulin pen just in case. Some people leave a set of extra supplies at school or work and we will probably do that.
Hope this helps with your decision.
Before you jump on with a pump I would definatly educate yourself about your diabetes. I see that you are recently diagnosed. I would suggest that you understand the soo called “mechanics” of this disease. There are several books out there that can help you understand the insulin and pump process. If your A1C are relatively high prior to the pump, the pump may not necessary fix it for you. You need to clearly understand how food intake, insulin dosing, physical activity and everything else effects you. Once you have that under your belt GO FOR IT. I LOVE MINE. I WAITED WAY TO LONG TO JUMP ON 38 YEARS.
I would suggest Think like a pancreas, Pumping Insulin and many more.
I personally love my pump and CGM it has provided me with more freedom and peace of mind but at the same time it takes time to get use to. you have to get your basal just right and carb count all your meals and then if you exercise you need a diffrent basal and other factors like sick days and spur of the moment stuff. there is always a chance of pump failure which means you carry a little more supplies with you like an short acting pen and site change and what not. I know that you were just dx’ed I don’t know if you do carb count for your short acting or a sliding scale but if not carb counting I recommend you perfect that first because you need it for all pumps plus your correction factor but the great thing is the pump calculates this for you with the carb counts being programed in it and your correction factor being programed in it as well so all you do is check your bg and put it in as well as carbs you are eating and your pump will calculate the dose. these are the pros to the pump but you have to ask yourself do you want to put in the extra effort and be tied to a pump 24/7 even if it is tube or tubeless it will always be with you. like I said I love it it makes my job easier and I have three carb counts throughout the day plus two correction factors and my pump gives me that precise control. I say do your research and talk to your endo again ask him the questions that you have about pumping let him know your fears and what not he can guide you in the right direction but at the end of the day it is your decision.
Thank you all for your feedbacks… I do try to caculate my doses based on my recent meals and also based on carb counts coz most of my meals are similar to ones I had a day before…
I did get a lot of information from your replies and personal experiences.
You guys are very helpful …
Rest I will keep you all updated on what I finally decide in my next appt with the Doctor.
By the way she is very fixed with her decision… she already warned me saying she will not treat me
if I dont listen to her and go with the pump … he he
Thanks
Your doctor seems to have a definate agenda, the question is which one!!! One in your actual benefit, or one in their financial benefit?
“…Doctor justify your statement… if you dare? I do not take well to blackmail, nor to morons who get paid by companies only if they sign me up…”
Stuart
Elizabeth,
I agree that in an ideal world nobody would be obese, everybody would love vegetables more than meat, and there would be always somebody on standby to help an old lady cross the street.
It takes a lot to maintain a routine that makes complications unlikely. I thought I could slide by with an A1C in the low 6s.It turned out that that was not good enough. Complications are a great motivator. Now I strive for low 5s. Without the help of complications I would not have the resolve.