Hi guys, I was diagnosed with T1 not too long ago and I am now on the search for the right pump!
I have been hearing a lot of praise about pumps and how many prefer them over needles, but I’m worried that this “praise” has become the sole basis in my decision to start pumping. Also, transferring over to the pump seems to be “the norm” once you’ve mastered carb count & control with needles.
If my numbers are within target range 95% of the time(70-120) with needles, then what other benefits will the pump provide me?
I understand that we have more control with the pump, but is all this fine control necessary? My endo said I should be between 70-120. If my numbers are in that range then why sacrifice more to get 100. Does that 10-20 mg difference mean that much?
From a personal stand point, I feel that being attached to a tube 24/7 and the expenses of the pump may get in the way sometime in the future. This whole pumping gig seems like too much work and of course, very time consuming. On the other hand, I can definitely see myself getting used to all of this as well. I can definitely understand the importance of a pump for toddlers/infants but how do these benefits amplify to grown ups? I’m using pen needles now and it’s not bad at all. The pump clearly has greater control but does that justify the extra work involved? Many on the forums keep complaining about pump malfunctions, waterproof or not, pod getting in the way,changing infusion sets, etc. Are all these inconveniences really worth it?
I’m confident many will know exactly how I feel as I’m sure many of you have been where I’ve been, and have much more experience. I would just like to remind everyone that I’m still very interested in the pump and will be on one soon, but would just like to get more educated and have more reasons thrown at me to justify my decision.
With needles you are only suposed to bolus every 3 hours, so you have to eat your desert with dinner or wait 3 hours for desert. with a pump you can eat anything anytime and bolus as you go.
It is all about good control. The tools to reach that are your personal choice. After more than 20 years on MDI I am still convinced that this is the right treatment for me. I have good control and for my sports activities I will eat some carbs - no big deal. More than 4 years ago I used regular and NPH insulin. The switch from these insulin to the pump would have been a blessing. But with todays insulins like NovoLog and Levemir I have no desire for better or faster. I can skip meals, I can do sports, I can count carbs and my factors seem to be sufficient. Despite of all that the pump is important to me: It is always good to have options and to think of them when my control would get worse.
If you like being 70-120, you may be able to push it to more like 70-100 or 110? Not a huge difference but I like to push things a bit? I also like the more precise basal adjustments for events, whether they are highs from illness, medication (e.g. steroids…), stress or lows (exercise, shopping, running up and down the stairs to load the car before car trips or whatever can be fixed pretty easily with a pump. I also find it easier to manage lows when I get carried away with the 70s all the time business. I also like it because it keeps track of carbs for me and I am waay to lazy to log anything.
The pump might give you more control but it doesn’t necessarily give you better control. You provide that part.
It’s unfortunate if you’re feeling pressure to use the pump. I say you should use whatever works. It’s expensive for an initial outlay, but I don’t think the continuing costs are any greater than MDI. It does offer convenience when you’re out and about but if you use pens and don’t mind injecting in public the added convenience is minor. The pump does make it easier to log your insulin intake and BG readings (if it’s electronically tethered to your meter.)
But don’t get the pump just for the sake of getting the pump.
A 10-20 mg difference on average is a difference of .3-.7 of a point on an A1c. That is a real difference especially at the upper end. How many times a day are you testing? If you aren’t missing any highs and you’re under 120 95% of the time then a pump isn’t going to do a great deal to improve your control - it is already outstanding. However, part of the “hassle” of a pump is more frequent testing which shows hidden problems and if you are missing your out of range numbers then a pump whith its greater precision will help you deal with them.
I hated giving myself shots and cutting down from 4+ shots a day to one insertion every three days has been worth all of the hassles and costs even though it hasn’t made much a difference in my A1c. On the other hand, I wouldn’t change if you are happy where you are. A pump is a four year committment so it doesn’t make sense to get one before you really want one since a better model might be around when you really think the time is right.
I just saw when you were diagnosed, I’m guessing you are still in your honeymoon phase, which might be why you are able to have such excellent control. Once your honeymoon phase wanes you might find control more difficult, in which case a pump might be a good help.
When you say 95% of the time do you mean your preprandial readings? How often are you testing? Or do you have a CGMS? It might be the case that there are highs or lows that you are missing. In Think Like a Pancreas Gary Scheiner states that even the best controlled insulin dependent diabetics are out of range 33% of the time…
I was exactly where you are. A1c’s of under 6 on MDI for 30 years. I actually told my Doc, “why fix what ain’t broke!” statement I’ve been on the Omnipod for 3 months and it is definitely more work than shots, at least during this learning curve. I chose not to go on a regular pump for the very reason you state, being tethered 24/7 is not for me. When on shots I only felt different when I had to test or bolus, other than that my pen was out of sight. After training myself to eat a certain way I find it didn’t make a huge difference in my eating habits, it’s easier to bolus as you eat but I used to do that with shots too. The one big advantage is I can now exercise, anytime and not have to consume 200 calories in candy and juice to keep my BS up. I just dial in a temporary reduced basal. It’s also easier to skip a meal or eat later or earlier. That’s the main reason I decided to give it a try.
It’s the learning curve that’s more work. I had the shots down. But all the 1:5 and 1:125 and percent this and that, it’s definitely more work. Ask me again a year from now and hopefully it won’t be.
I am a total slacker and hardly ever calculate anything, except turning it down to go on longer runs/ bike rides. And even that I’m sort of “hmmm, 60%, 55%, 70%, hmmmm…”. Occasionally I’ll notice a shift, like when I stop cycling and do pretty much straight running, my BG will run lower and I’ll turn it down a shade. Except this year, I waited until after the holidays figuring an extra ‘boost’ wouldn’t hurt with Snickerdoodles, etc. around?
For dessert, I include the dessert ‘bolus’ with the dinner bolus. It can get a bit dicey but this can work. I’m not sure about with a kid though. With some kids dessert can become a ritual that may be easier to do without? I’d never heard that particular rule. It may be that they are trying to avoid lows that stacking insulin doses can cause but if I am at a party or something like that, I seem to get much better results doing multiple boluses for what I’m eating than guessing with extended boluses and all that?
get an omni pod. no tubing, so no wires to interfere with your life. Also, the pen is not that discrete. If your having some lunch with friends, and you have to take insulin with the pen, you have to probably leave the table. The omni pod can be brought out in public because it looks sorta like a pda and you blend in. Also, the omni pod PDM is not physically attached to you, so, you won’t need a belt clip. good luck with your decision.
You were only diagnosed at the end of October. I agree with others that suggest that your level of control right now may simply be a honeymoon. I guess the real question is whether you are on a simple basal regime or whether you are on an intensive insulin regime, basal, counting carbs, bolus for every meal and corrections. If you are just taking a basal and doing fine, then you just need to put off this whole pump thing, it is a waste. But if you really feel like you have the whole carb counting down and are very comfortable with an intensive regime there is no reason not to consider a pump. But it is more work and expense and if it won’t get you much better control, then there is no harm putting it off.
I don’t pump for control, my A1cs run 6-6.4% and that’s fine with me. I use pumps (Omnipod right now) for convenience. That is the benefit I get out of them and the expense is the downside.
I’ve been on the Omnipod for 3 months and it is definitely more work than shots, at least during this learning curve. I chose not to go on a regular pump for the very reason you state, being tethered 24/7 is not for me. When on shots I only felt different when I had to test or bolus, other than that my pen was out of sight. After training myself to eat a certain way I find it didn’t make a huge difference in my eating habits, it’s easier to bolus as you eat but I used to do that with shots too. The one big advantage is I can now exercise, anytime and not have to consume 200 calories in candy and juice to keep my BS up. I just dial in a temporary reduced basal. It’s also easier to skip a meal or eat later or earlier. That’s the main reason I decided to give it a try.