I was one of those people that felt if it wasn’t broken, don’t mess with it. I didn’t want to change things in my treatment plan because I felt it was working fine.
I know this is a human condition. We get comfortable with what we know. We like the comfort of knowing what is happening and knowing we will be able to handle anything because we know the plan.
I just wasn’t going to go with a pump. Injections were fine, I would make it work. 3 shots, no problem, 4 shots ok, 5 shots, I got this. Just no pump! I don’t want something hanging off me all the time.
But baby desires made me finally try something different. And while I didn’t like it at first. The first 6 months were not fun, not my comfort zone. But that change was one of the best changes to date in my treatment plan and so glad my doctor didn’t push but kept saying we could try something else. But she finally had to tell me the reality was no overnight control unless I did a pump. (Darn, she was right)
TCOYD was a big game changer for me get out of my comfort zone. I would go to the conferences and come away with so many new ideas. I didn’t realize how much was happening out there.
My frustration here is that many people, just don’t want to even try something new. Yes, I get sometimes this stuff is expensive. But I got samples for drugs when I was trying something off label. I feel the same about CGM’s. There are doctor pro types that you could wear. Yes, you do get the numbers but at the end of the week, you and your medical team can pull reports and analyze them together and can see what info is out there.
Some pumps will let you try their pumps. I know not all do this, but try it, maybe?!
I just don’t fight anything anymore. If there is something out there that might help, I will try it.
I mean, pump game changer, blood testing meters, yeah, CGM-so much knowledge, type 2 drug off label- so helpful! So I keep on the watch for new things to try and am thankful I have medical professionals that are open to new things, things not always approved and am thankful that I have grown in my mental thought process, change can be good. I don’t want to be that stuffy old lady who thinks her way is the best way!
I don’t use or want a pump because I have excellent control with MDI. I do use a CGM and like it.
I am in tune with my body enough to realize that I would be bothered much more by a pump than having to give multiple injections. I also would rather not have a medical professional interfering with my care.
Type 1 for 63 yrs.
A1c 4.6 (I think my lab reads low)
TIR usually over 95 with no extreme lows, and very few lows.
No extreme highs and very seldom over
150
SD 17 is the best I have done so far.
This works well for me. I will switch to a pump when I find that it would be a real help to me.
I think Marilyn said it best if its not broke don’t try to fix it. Now Marilyn’s A1c is the equivalent to 85 mg/dl which is typical fasting BG for a non-diabetic. At the same time during her 63 years she added the CGM so she was willing to try something new.
I think more people are willing to try something new if its not going to radically change what they have learned. The CGM is a good example of an add on. It also depends on insurance coverage and cost.
In some cases even when running high BG the PWD is fragile and it took a lot of work to get to where they are. The willingness to change is just not there.
In some cases the doctor says things are good enough and the PWD doesn’t push or know the right things to say.
A lot of the technology is not new. Humalog hit the market in 1996.
Al Mann’s pump the MiniMed 502 hit the market in 1983. The CGM was invented by Al Mann more than 20 years ago and hit the market in 1999. Lantus was approved in 2000. Arguably the greatest advance since Banting and Best was Al Mann’s afrezza and that was approved 8 years ago.
The GLP1s have scary labels and so do the SGLT2s but they are doing $30B+ in the T2 market so a lot of people are using them. GLP1s are now finding a home with the T1s to principally help with weight loss. This is another example of an “add on” to the current learned therapy which will probably result in less insulin use and losing a few pounds.
And on Medicare you only need 1 doctor visit every 180 days on MDI rather than the pumpers requiring 1 visit every 90 days. For those of us living in rural remote areas, this is a huge benefit that can’t be overlooked.
I was basically pushed into my first pump 17 years ago. I wasn’t sure I wanted it but I am glad I got it and now wouldn’t want to be without one. I also resisted sensors at first, when Medtronic came out with their sensors that showed the readings on the pump. Again, I’m glad I ended up trying them.
This year I finally decided I want to try something other than Medtronic, which is all I’ve used for the past 17+ years. My warranty on my current pump is up soon. Contacted the other companies and insurance and it turns out that Medtronic is covered one way, the others are covered another way. The cost for me per year to use Medtronic is less than $300. For Tandem/Dexcom it would be thousands. Getting a new pump the first year would definitely make me meet my max out of pocket of $8,700. I just can’t afford it. OmniPod 5 would be more affordable but Dexcom would still be thousands of dollars a year
I am glad that at least i have a pump & CGM, and the Guardian sensors do work well for me. Sometimes just wanting to try something else isn’t feasible.
Mine was a roughly two year delay in testing to support T1 diagnosis in order to get pump and CGM. I was scared that even with a T1 diagnosis, I might be denied pump and CGM. Then as T1 I would lose my GLP-1 agonist (Victoza), and that would definitely have made things bad. Fear was fed in part by repeated unjustifiable insurance denials of short-term CGM for T1 daughter to figure out how to cut down on serious night time episodes of hypoglycemia.
In my case, it was a co-worker that told me of another employee that was using pump, in mid 1980s. Doctors had not mentioned it, and it was first I learned of pumps. Was also when my early eye retinopathy was diagnosed and encouraged to lower A1Cs.
So I started with Medtronic pump, maybe 503ish? Then several other 5xx pumps, with 523 as last Medtronic pump. Not much changed within those models, although did use Medtronic CGM sof-sensors, then Dexcom CGM with the later ones, but no integration.
Switched to Tandem in 2020, with Dexcom G6. So quite a transition over 35 years.
Who knows what will be my options in 2024 !! I’m quite happy with current pump, but would certainly consider Omnipod or others.
A lot of people can not afford it it. It is not always a matter of trying something new. This stuff is waayyyy overpriced and we have no choice. Also ins approvals etc. I just went through a few weeks nightmare trying to figure out what was going on with changed dexcom coverage. Lets face it we are at the mercy of this awful system and greed that feeds off of sick people who have no choice.
If MDI had worked for me I would not be on a pump- there’s no way I want to be attached to devices for the rest of my life but that is the only way for me to have a life- also attached to a CGM having nonstop irritations and worrying about 50 million things. One day I may be forced back onto MDI and I am guessing I’m not gonna survive it for long. In addition to the terrible bg on mdi I hated injecting myself so much and no record of what I did. In the pump it is all there to read any time.
Again, I am not saying everyone should be on a pump. My frustration is people being so comfortable in their life (and this is not just diabetes) but so entrenched in their current life that they don’t see what else is out there.
I have said over and over again, pumping is not for everyone. But I will say that CGM is available (cost, insurance etc) should be a serious “try something new” situation. While I was of with testing 12+ times a day, once that CGM went on, I realized how much I was missing. For me, knowledge was power. I got a much better handle on little things that could mess things up for me.
I have also been so amazed how many people have been using metformin for years and years and are not happy with where they are but just don’t see the upside to try any of the newer and helpful drugs out there. I have talked to a couple of my coworkers with type 2 and they are all on metformin and have been for years. All are overweight and just don’t want to hear about all the new possibilities out there. Yes, I understand, some people have issues with side effects and yes have insurance issues, but there are oh, so many possibilities out there but we get into that comfort zone and can’t see the possibilities. Life could be easier if you take a chance , take a risk, try something new.
Not saying this will work for everyone. And maybe listening to others who have taken the dive and tried something that was not in the norm but for some success. Has everything I tried worked? No, but I have learned nothing is a failure, it’s just another diabetes experiment that didn’t work for me but might work for someone else.
Another coworker is using a Medtronic pump and is ready for a new one. She wanted to talk about what I like and don’t like about my pump, but decided to just get the newest Medtronic available to her. While, I am sad, she is not even going to look at options out there, it is not my call, but was surprised that she didn’t want to try one of my Dexcom sensors as she hates the Medtronic ones. I said, many people use dexcom with Medtronic, they just don’t communicate with each other. But just couldn’t bring herself to try it. Not sign up for one, just try it. Again, I am so sad that we just get stuck in our little zones and don’t see the possibilities.
I will continue to push the envelope and keep trying new things. Even the tech stuff that I hate and it hates me. But this tech has made my life so much easier for me and so much less worry for my family.
And I will continue to wonder why people who are ok with things being the status quo. And please remember, I am not knocking, complaining, telling someone they are wrong. If it works for you great! But all those who are happy with where they are, have made some major changes in how they do things. Taking a chance and trying some different.
Love you guys and this post is just me wondering! Been doing this a lot lately. Just wondering!
I started on a pump when they discontinued ultra lente. I wen5 to my doctor to get a replacement long acting insulin. Lantus had been released at that time, but my doctor told me a pump would be better. Since my a1c was 7 ish.
So I did, the first dex came out 5 years later. Insurance would not pay for it. When I started sofsensors it was finally paid by insurance but they were never any good.
On tandem now. And very happy.
I always welcomed new things when it comes to diabetes.
It’s crazy expensive though.
Sally - I wonder if your T2 friends even test their blood sugar. I have been to many T2 educational sessions and at first was shocked that their doctors never explained BG testing. Most did not even own a BG meter.
There is a new what I call “Tech” diet company Levels which is using CGMs for “diet” control. The one thing they found which surprised them was that it was after their clients lost post prandial control they started putting on all the weight.
With the GLP1s its a real decision. The labels are very scary. The guy who got metformin approved by the FDA Ralph DeFronszo now says using metformin is not the way to go. He is now a big GLP1 supporter. The real benefit is weight reduction since the PWDs have no appetite and the side affect is reduced A1c and for some on insulin reduce insulin use because they don’t eat much. Its also interesting according to the study below that about half only use them for 6 months and more than 70% stop within 2 years. For a quick weight loss reduction its something to consider.
If you follow the ADA’s step program which most doctors do and are trained on in medical school the very last thing T2s are given is prandial insulin. As Levels is now seeing the first thing they need is to get their post prandial glucose under control. The reason prandial insulin is the last step is fear of needles and risk of hypoglycemia but its a bit more complicated. When Al Mann developed afrezza he solved the needle issue and for a T2 not taking other meds its pretty hard to get severe hypos yet very few PWDs are using it. Talk about not wanting to try “new” things and it was approved 8 years ago.
The GLP1 usage study