I am considering switching to a pump, any advice is much appreciated

General
1

I was diagnosed back in September 2005.  At the time I was told I was type 2, but have switched doctors since then due to a lack of support.  The new doctor didn't change my diagnosis, but did change my treatments.  He explained that according to my records, at the time of my diagnosis my pancreas was barely producing any insulin at all, but since it still was the type 2 diagnosis was given. 

I have felt like a walking roller coaster/pin cushion/chemistry lab for the last five years and would love to have better control.  Right now I use Humalog and Levemir, multiple times daily.  My last A1C was 8.6.  This last week I have had a few bad lows (lower than 50) and rebounded higher than 250.  I have watched what I ate, counted carbs until the cows come home, and exercised, and yet don't have the control I nor my doctor would like to see.  Would a pump be helpful?

Thanks,
Jenn

2

You're still diagnosed as a T2 but treated as a T1?

 

A pump might be worth trying, but it doesn't work for everyone so you might end up back on shots. I average A1C's in the 8's, and have been diagnosed for 16years with T1. I tried the pump for 3months, but found on top of the restriction of having something attached to me 24/7 and the worse control(way more lows and more extreme highs), it wasn't for me. I also poked myself a lot more with the pump, since my sites would come out so often in my sleep or while exercising, etc. I went through a month supply of infusion sites in about 2weeks.

It's also more expensive to be on the pump than shots, so you need to take that into account. If you don't have insurance, or you don't have insurance that will cover a pump, it might be harder for you to try the pump and stay on it if it works. If anything, it might just end up giving you good tips for MDI if you try the pump but don't stick with it.

If you're going to try a pump, I suggest the Animas Ping. Even though I didn't stick with the pump, and I'm limited in options in Canada, I did like the functions and features it had.

3

Yup.. still considered T2 but treated as a T1. 

One of the reasons I'm considering a pump, other than the possibility of better control, is that my insurance will be changing next month and has a MUCH better benefit for pumps.  So if I'm going to get one, now would be the time.  I am a little concerned with the difference in cost from the syringes to the infusion sets, but have not been able to find out what that difference is.

The restriction of something attached would almost be more workable than the restriction of having to carry around a insulated pack with syringes and insulin.  There are also times when we've gone grocery shopping and ended up out longer than planned and I get hungry, but have no insulin with me.  I know the simple solution would be to carry it with me all the time, but isn't that what a pump would do?  I've bantered this thought around for more than a year and there doesn't seem to be a simple solution.

Thanks Batts, for your input.

4

[quote user="JennCh"]

Yup.. still considered T2 but treated as a T1. 

One of the reasons I'm considering a pump, other than the possibility of better control, is that my insurance will be changing next month and has a MUCH better benefit for pumps.  So if I'm going to get one, now would be the time.  I am a little concerned with the difference in cost from the syringes to the infusion sets, but have not been able to find out what that difference is.

The restriction of something attached would almost be more workable than the restriction of having to carry around a insulated pack with syringes and insulin.  There are also times when we've gone grocery shopping and ended up out longer than planned and I get hungry, but have no insulin with me.  I know the simple solution would be to carry it with me all the time, but isn't that what a pump would do?  I've bantered this thought around for more than a year and there doesn't seem to be a simple solution.

Thanks Batts, for your input.

[/quote]

 

For some people it's more convenient for things such as what you described. For me though, I find it easier to carry insulin with me and do a shot, than deal with failed pump sites, sites pulling out, insulin cartridge changes, clothing issues, disconnecting and re-connecting, etc etc. but it's all personal preference. I also don't carry an insulated bag. My insulin & needles are kept in a small cosmetic case and my kit in the case it came in. I throw my insulin out after 30days as it isn't refrigerated after I open it.

The cost is quite a bit more from what I recall. the cartridge the insulin goes into, which holds 200u, is $20 a pop. You change it every 2-4days, depending on how fast you go through 200u. I think a 3month supply of infusion sets was about $900..but I could be wrong.

I was lucky enough to have already hit my 100% coverage at that point so paid zero of the supplies. I had to pay $100 outta pocket for the pump itself, but they covered the other $6500. I'm not sure if I would've stayed on the pump even if I liked it, when my coverage re-set to 80% Jan 1. I barely get by month to month and usually rely on my mom to help me cover the 20% I pay on my supplies until my limit is hit and they cover 100%.

 

It's gonna take a while for the pump to be approved by your insurance anyways(I didn't get approved until my endo sent them a personal letter, after my request was rejected, asking for them to approve me and going into more detail than the original forms he filled out asked for)..so I would suggest doing some research on the different pumps available in the US, narrowing it down to one or two and then doing a saline trial. I did the trial first while I waited for approval and found being able to take it off when I got tired of it helpful and testing all the functions.

5

Jen,

I have been living with Type 1 for 20 years.  I tried a pump in 2002 and decided that it wasn't for me.  In 2008 I decided to give it another try due to my bloodsugar roller coaster.  I switched to the OmniPod, a wireless pump, and could not be happier!  You should definitely check it out.  Go to www.myomnipod.com.  I feel so much better and my diabetes is under much better control.  I would recommend it to anyone.  Let me know if you want more info. 

 

Good luck,

Christi

6

The pump is not for everyone, but I found the transition to be easy and love it. I was on MDI for 25 years prior to going on the pump and love my MM pump. You can have more lows and highs if your basal rates are not set correctly as you are only using rapid acting insulin. Setting them can take some time to get them just right. 

There are 3 major pump manufactures, Minimed (www.minimed.com), Animas (www.animas.com), and Omnipod (website given above). They all have their own advantages and disadvantages with the MM and Animas pumps being very similar to each other in terms of features and specs.

I would suggest talking with your doctor first, and requesting information from the various companies. Once you've decided this is the right thing to do I would put a spreadsheet together with all the features and benefits and which pumps have those. I would then rank the features by what is important to you. The higher ranking of the feature means it should be included in said pump you choose. Some companies will send you a sample dummy pump to try for size and how it will work with your clothing. 

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Jenn.......I was a pump user, but it didn't really like me too much!  I had a bad reaction to the tubing..actually the cannula...the part that is inserted just beneath the skin....when I first started using the pump, I absolutely loved it.  After many adjustments, my blood sugars were the best they ever were in the 25 years that I've had type 1.  When the problems started, I was constantly high and my endo decided it was time for me to go back to injections.  I am pretty bitter that it didn't work out for me.  It sure beat taking an injection every time I consumed food!  Pumps take some getting used to, but I say give it a try!  You won't know until you give it a chance!  Good Luck!

8

I am a diabetic using the pump and i love it. It makes life so much easier. The pump might be able to control ur blood sugar a lil bit better but because you are have a contant flow of insulin you are at more of a risk of going low. so while you are on it, it is very important to check your blood sugar and eat regulary.

9

The pump didn't work out for me either, but I don't think this is a very "representative" group responding here, b/c I think it works well for most people. Even though it didn't work for me, I was really glad I gave it a try. I guess my advice is to talk to the different pump companies (or just check the websites!) to see what features they have (e.g., if you take a lot of units each day, some hold less insulin than others; one has a continuous glucose monitor that works with it; some work with different insertion sets...). Also, I'd check with your insurance and your endo to make sure you have both on board...

I hope you get your diagnosis worked out! I have 2 friends who got T1 as adults, but both were dx'ed at T2 b/c their primary care doctors incorrectly thought it was only a childhood disease. It took one much longer than the other to get a correct diagnosis. Have they tested you for the auto-immune antibodies?

That being said, I knew a lady w/ T2 through work a few years ago who had a pump (used it through both her pregnancies) and found it very useful.

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P.S. Jonathon, I just realized I repeated some of what you said. Getting tired, should stop posting w/o reading carefully. (; (;

11

Okay, first - and this is off-topic, sorry - JennCh:  my husband used to have the tissue box in your profile picture.  I thought I would never see that thing again!!  That made me laugh.

And, now down to business.  I have been using insulin pumps for five years, and am currently using the Animas Ping.  I love it, for the most part. 

Insulin pumps can offer many benefits, both short- and long-term.  Here are the main ones that come to mind (and are reasons I chose pump therapy): 

  • the ability to vary what, when, and how much you eat by enabling different insulin delivery settings
  • flexibility to adjust your "basal rate" (what your long-acting insulin does now) for exercise and other activities
  • memory:  it can remember how much insulin you've taken and how much is still active in your system (with insulin pumps, the insulin you take for food is called a "bolus", and active insulin from you last bolus is called IOB - Insulin On Board)
  • less injections - you change your insertion site once every 2-3 days, instead of injecting insulin multiple times each day
  • discretion:  many insulin pumps have a "remote" that looks similar to a cell phone, so no one needs to know what you're doing when delivering insulin
  • improved blood sugar control, with fewer low blood sugar episodes and better long-term control (according to clinical studies)

There can also be negatives - the main one seems to be that some people do not like having "this thing" attached to them all the time.  Pumps are worn 24/7, with the exception of when you're showering, etc.  Also, without the stricter eating schedule dictated by injections, many of us insulin pump users find ourselves snacking a bit more - you just have to watch yourself! 

I was definitely one of the people who resisted the idea of "something being attached to me all the time".  I liked the privacy that injections offered me - no one knew I was diabetic unless I wanted them to.  Now that I've used insulin pumps, I really don't think I'd ever go back to injections, if I have the choice.  The flexibility and convenience they provide me is great - and it does all of the math for me!  (I was never that good at logging numbers, or keeping track of when the last time I took insulin was.)  The insulin pump remembers what my insulin to carb ratio is for the specific time of day I'm giving a food bolus, and figures my correction bolus for me, if my blood sugar level is too high, among other things.  And, my fears of "no privacy" ended up being unfounded.  There are many, many clever ways to hide insulin pumps under clothing, if you choose to do so.

Anywho, that's my two cents.  Others have brought up doing a trial of the ones you like first - that sounds like a great idea for you.  You also may consider getting a CGM.  Having the real-time information on what your blood sugars are doing may help you detect some patterns and avoid the extreme highs and lows - since going on the Dexcom in January, my A1C has dropped from 8.2 to a 7.1 in April, and I'm confident it will be even lower when I get it tested again in July.  I know there are members on here who use a CGM while MDI, and it's very helpful for them as well.  Something to consider!

Good luck!

Kim

 

12

^^ what she said.

 

i have had good a1cs on both the pump and MDI (MDI for 10 years, pump for almost 11). i use the pump out of convenience. i'm not one to carry a bunch of stuff around with me, so the minimalist in me loves having what i need for diabetes in my pocket. i still carry my monitor around with me, but that's fairly small and fits in my purse or my lab coat pocket at work.

i have used medtronic, deltec, and now animas. as far as customer service goes (in my opinion) medtronic has beat every other pump company. i also feel they made a superior product (i haven't used them in 3 years, so things may have changed). in the 8 years i used medtronic i only had 3 insulin pump replacements. i used deltec for almost 2 years and had 4 pumps, and now with animas i've used them almost a year and am on my 3rd pump. however, the features offered by animas and deltec are what caused me to switch companies. i'm already dreaming about my next pump, and i would like to try the omnipod.... although i just applied for a job with medtronic, so i might be using their products soon ;o)

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I have been using a pump for around 11 years, and I love it. I have a Medtronic MinMed now and it is great. I rarely ever have trouble with my sites and I feel as though I have much better control with it. They take a little getting used to, and sometimes it may take a bit to get your rates figured out, but I think it is totally worth it. The freedom I have now versus when I was on shots is something I have no interest in giving up. Besides, trying one out to see how it goes can't hurt anything. Give it a couple months, I don't feel as though a week trial with saline is enough to get a good feel for it. If you don't like it, you can always go back to injections. Also, dig around some of the other discussions at this site, there are tons of conversations about different kinds of pumps and all sorts of advice and how much people love them. Good luck making a decision!

14

your voice of experience (voe) is great, thanks.  i am looking to go on a pump after being mdi for a year.  a few of the issues with mdi, you have covered.  thanks

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              Hi Jenn, I'm here in ontario, canada were they now supplement pumps and help with costs i have no medical insurance, i have been t1 since 1999 and have been on the pump since 2005 which allowed me to have a fourth child which other wise without the pump, being allergic to most insulins and poking insulin needles about 10 times a day , preking my fingers 8 times a day ect... would no of been able to carry through with a pregnancy.

              I LOVE my pump it's my partner and i Love having it , take it off for showers and swimming, for up to two hours and it works great ... i have a Medtronic Ice Blue Pump, there are two style in this one one that carries less insulin , i have the bigger one, i change my set every 3 days, and have the option to use a continous blood glucose monitor that communicates to your pump your levels ...it checks your blood glucose every 5 mins and warns u of high sor lows before they even happen i really recommend it   ;) good luck hope this helps

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Hey Jenn!  I'm 31 and was diagnosed last year.  I'm curious, did you start out on oral meds for type 2 and they didn't work well for you?  My initial tests also showed that my pancreas was making "almost no insulin," which earned me an immediate diagnosis of type 1 from my GP, which was seconded by my new endo and agreed with by my first team of CDEs.  I'm sure that's not necessarily 100% true 100% of the time, but still, your diagnosis of type 2 is interesting to me.

Anyway, I've love my pump!  Shots were working OK for me, but I definitely had more highs and lows on them than I do on the pump.  Plus, OMG, I much prefer pushing a few buttons before I eat than going through the injection ritual every single time...

Your blood sugar is likely to be a little wacky when you first switch to a pump (you kind of have to redisover your new basal rates and I:C ratios), but you can really customize your basal rates more than you can with long-acting insulin, which I love about the pump.  (Not to mention, you can use a temporary basal rate if you're having an unusual day that makes you trend high or low.) Also, you're more precise with your boluses.  With insulin pens, you have to give the bolus in full units (unless you have a model designed for kids, I think), and the syringes aren't much more precise (though I can manage to eyeball half a unit), but a pump could deliver something like 2.55 units of insulin if the math says that's what you need (and the pump can do that math for you), whereas you'd have to round up to 3u with an injection.  So I think that's another reason why I'm more stable on the pump.

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@Elizabeth - I think my diagnosis of type 2 originally was due to my doctor not fully looking into my test results.  I had always been healthy and only needed a dr. when something came up (broken bone, infection, etc) so I only used a CFNP (certified family nurse practioner).  She ran the A1C and my bs levels (11.2 and 511 respectively) and that is all.  She then put me on metformin and avandia (avandamet actually) that day.  I didn't know any better at the time, and figured that due to my age (29) that there was no way it was type 1.  After YEARS of things not quite working, and getting no support from the CFNP, I went looking for a better dr.