Anne, pumps are a useful tool in controlling diabetes. They are not a panacea. It will probably take you several months to really learn how to use it effectively. I think John Walsh’s book Pumping Insulin is worth the investment.
There are several bad things that may happen, the likelihood of some of these is low.
1. Run out of a battery Risk: low because it generally runs for several hours on a low battery. 2. Completely stops working. Risk: low because the pump tests itself constantly. This has only happened to me once in nearly 11 years of pump. 3. Accidental or deliberate disconnection. Risk: low to medium. If you’re disconnecting develop some trick to remind yourself to reconnect. Because you will get used to it and may forget. If you’re disconnected for 2-3 hours your blood sugar will rocket up because there’s no long acting insulin in your system. 4. Insulin stacking. Risk: Medium. While the pumps help you figure out how much insulin you need at any time, it’s possible to ignore the suggestion. Given how easy it is to take a dose, it’s possible to take two or more boluses (doses) of insulin and end up going really low because of the surplus of insulin. I probably do this several times a year.
Despite all this I still think a pump is great for me. You can achieve the same results with injections, but it’s harder work.
Most people can count on a 1 mg/dL rise for every minute of missed basal. Depending on the range a person is comfortable with, a 60 point rise could be dangerous or at least potentially so. I know if I was 130 and went an hour with no insulin and then was up around 200 or higher, I would feel sick and could possibly see some small ketones. DKA, maybe not, but definitely a situation in need of correction from an hour of missed insulin.
The person they were working on probably had other problems. The person that made that outloud comment (nix by HIPPA) had no right to say so and that, it seems, like just a way of identification.
The biggest drawback about the pump is the costof the DME. The next “inconvenience” is where to put it when you’re fat and don’t have a waistline!
I wouldn’t be without it if I can possibly be.
Good luck and don’t let a totally unrelated incident affect you.
I was also afraid from the pump and it was all rumors. They told me it causes infection and it causes hypo and other stuff. Since i installed it " thanks to God" i had less hypos and no infection from the insersion had occured. My prayers with that man but i am sure it was something else or maybe other complications.
I just relised that putting a pump was the best decision i did. With normal isnulin i use to have alot of Hpos if i skipp a meal. But now if i dont want to eat i am ok i just reduce my temp. I am still adpting to it, but its much better than normal shots. In normal shots you take the long acting insulin and no one knows when the peek wll be. Not like the pump, you will have less active insulin that the pump will tell you how much is there it also calculates for you automatically. I think you should try it and dont listen to rumors. If it matches you then you have nothing to lose. Good Luck.
Generally 1mg/dl per minute rise w/o a basal dose onboard? Any idea when that “acclimation” happens? The second you first get attached? After a week? After two weeks?
If they told you was “guaranteed” to cause you site infection something is wrong!
They infusion sets CAN cause infections, the infections I got I had wrongly assumed were just normal skin irritation caused by the tape, the adhesive skin prep, being attached three days, my skin, etc, The skin was red, a little sensitive to the touch, just slightly raised. Once a pump nurse (btw via phone) figured it out whilst discussing a different problem, I was proven wrong, “…nope that sounds like a site infection… have someone check until you know what they look like…”.
Happened a lot for me but never realized what it was until after the fact…it does happen; the body does not like any foreign bodies in it (even sterile ones) below the skin. Unless its a big one you might not notice. The cure btw is a little dab of that neosporin ointment. Its an irritation on all kinds of levels.
Was kinda hoping they were using new polymers in the sets that eliminated the problem entirely by now. Unfortunately not so ehhhh? A possible risk, an irritation but not the end of the known universe.
Without a bolus or food on board, yes, that’s supposedly the statistic. If one has no insulin from a meal bolus on board and it has been several hours since a meal, one can assume roughly that rate of change in the blood sugar. Your body requires a basal insulin (which injectors get via their long-acting insulin and pumpers get through their basal infusion of fast-acting every couple of minutes) for natural metabolic processes - not just to cover a meal. So if you’re going without your basal, it stands to reason that there will be a rise in your blood sugar.
Significant? Depends on your personal high/low thresholds, your control range (tight vs. lax), your starting blood sugar when you begin to miss your basal, your activity level while disconnected (your body needs basal insulin even while exercising), and the amount of time you’re disconnected.
I think there’s not really an acclimation period - or at least there wasn’t in my case. When you begin pumping, you’re not adding new insulin, you’re substituting your long-acting for a more frequent short-acting. Either way, your body is used to receiving insulin in the background whether you realize it or not. When I first started pumping, I ran empty once while at work and thought “no biggie, used to go hours between shots - I’ll fill the pump when I get home.” After about 3 hours, I was sick and throwing up. At the time (8 years ago), I didn’t understand that, before, my body had had NPH on board. Once I started pumping, I didn’t have that safety net of longer-acting insulin.
Dave…why has the pump lessened your worries about lows? Are you using a GCM as well? Or do you not eat sometimes and need to suspend? I am a new pumper so curious about the bennies.
Yea, I do get worried at times. If I am not focused on something else, I can feel my lows at about 60. If I am focused on work or something, I may be well into the 40s before I realize I am having one. Hypoglycemic unawareness, it’s not just for zombies any more!
Honestly, there have been a few times when I have literally come-to in the middle of the night, drenched in sweat. Last time it happened, my sugar was at 34 when I was able to test it and that was on the way back up.
Yeah, suspending your pump is never a good solution for avoiding a blood sugar dip. Dave is right. Skipping a meal, your body still needs background insulin and your sugar should stay level with just the basal running. If your BG is falling, you’ll need to tweak your basal rates.
Your body needs insulin in the background at all times - whether you take a long-acting insulin via daily injection or wear a pump.
If you think infection from the infusion sets are “rumors” then I recommend that you keep on praying.
Last year I spent a good amount of time comforting and encouraging a Nice Dutch Lady on another site who had a Bad staph infection due to her infusion set. She wasn’t new to pumping either.
She had already been on antibiotics for a few months when I met her. She said it looked like the “hole” (which was filled with pus, sorry TMI) in her abdoman, was a bit smaller, so she was hoping that the infection would soon be gone. Believe me, I prayed for that Girl.
That is definitely not the only Person I’ve seen on Diabetes sites who had an infection from pumping. They may be few and far inbetween BUT they do happen.
DKA’s happen to pumpers also just as they do to non-pumpers. Just because People are pumpers, it doesn’t mean they know how to operate the pump properly to keep their sugars in check. Just as some non-pumpers find it difficult to understand how to control their Diabetes with Diet and exercise, oral medications or injections. All People are not born equal and none are born Perfect.
My 2 2nd Cousins went through several DKA’s each because the novelty of pumping wore off as young Adults, so they didn’t test as much or keep up the basic rules of pumping.
I have not been suspending…thought maybe you were. So far I do love the pump…on it 10 days. I still feel that lows could be an issue caused by too much insulin (or not enough carbs to match,) or activity. I am just looking forward to becoming more familiar and astute with the extended bolusing and varied ratios…working with my CDE on that. So far, so good.
I left a quick-set infusion set in once for five days (was waiting on a supply shipment and trying to make my remaining infusion sets last until the shipment arrived - bad planning, bad idea). When I removed the set, the area showed signs of irritation and itching. After a couple days, I noticed a hard bump about the size of a raisin under the skin and noticed that the insertion hole seemed kind of open still and a little hard. My blood sugars were running higher and I suspected infection. The lump eventually swelled to the size of a quarter and I was diagnosed with a staph infection and sent home with Levaquin. The infection went away, but the site stayed red and the lump (though softer) was still there.
About four months later, on my wedding night and the day before I was leaving for Paris on my honeymoon, I discovered the site had flared up again and I had another infection - despite having avoided that area of my abdomen for nearly 4 months. I don’t know why then - maybe my pantyhose and undergarments had irritated the area?? The infusion set was elsewhere. But I had to do another stint of levaquin while on my honeymoon. It’s been over a year and I STILL have a raised red bump there to remind me - though now it’s only the size of a pencil eraser (very tiny). And it’s scarred from where I opened it to drain the fluid from the area. (yuck, but morbid curiosity got the better of me)
So, yes, infusion set site infections should be treated seriously. BUT, I’ve had only the one since I started pumping in 2000. So I think with PROPER site maintenance and rotation, they are completely avoidable. Mine was certainly my fault. Irritation from adhesives is another tricky issue, but not nearly so serious as an infection of the tissue beneath.
Really glad I asked this question ‘cause I received enough positives to convince me to give it a try. The negatives about pumping will keep me aware and wary. I start pump tomorrow…no more alarms to take lantus at night…just alarms to adjust my pump. Hmmn! Pretty exciting really and scary at the same time. No looking back now though I’m about to trial it…course if the car doesn’t start tomorrow morning I’ll just have to forget the whole idea for a long time…jus’ joking! I’m actually glad and can’t wait to make the change now. Thanx everyone I value all your contributions.
