Pump vs Injections- Help!

Technology & Management
1

I've been a type1 diabetic for the last thirteen years, ie for all but three years of my life. And since I've joined Typeonenation, I can't help but notice how many people favor the pump over insulin injections, so it sort of got me thinking. 

My control with injections is hardly satisfactory, although if truth is to be told, its not like I try very hard, anyway. A1c's are usually around 7-7.5 and cases of both hyperglycemia and hypoglycemia are fairly common ( hypoglycemia around thrice a week, blood sugar readings going down to as low as 30 mg/dl and hyperglycemia almost every third day, readings going up to 300 or so. )

Also, I'm fed up of the injections. Four injections a day, what with having to monitor readings and accordingly adjust doses, I daresay, gets on my nerves at times.

So I've been considering the pump as an alternative (based solely, however, on the positive reactions I'm seeing from users). I have nearly NO idea about it. Could anyone throw some light on it? How it works, the mechanics, the effect on readings, the effect on lifestyle, and of course, the effect on overall control? Basically, am in need of an introduction to the functioning of pumps and users' responses. 

2

Hello,  There are some very qualified people here to answer your questions, and I went through this process as well, but I am back on injections. It is good to change your schedule and methods of delivery to help you understand other options. Picking the pump, tubed or free attachments are the biggest choice you have to make, and that is just if you want to have tubing or not (I had tubing and had no issue with the tubes) I have never tried the tube free types yet. The mechanics are easy enough, the pump is pre-programmed to steadily feed your body short acting insulin over the day, 24/7 as it goes. At times it needs refilled or replaced tank of insulin, and that is based on your needs, which you would know up front with training and they all require that. I understand that many types are available for test drives, you can get them with saline solution instead of insulin for trying out. If you are in no hurry that might be the best thing to find is which you like the best, or which would work the best for your lifestyle. I understand your lack of knowledge with pumps too, I knew nothing about them until a rep showed up at my doctors office and was doing the hard sell at me, I took it hook, line, and tubing as it were, major failed too. So you don't need to wait until you can design them, but take a good look before you commit. Good Hunting!

3

I've been pumping for 18years and on a CGM for 3.  The pump changed my life but you do need a good rep and support either from your Dr's office , a Certified Diabetes Educator (CDE), or a good pump group in your area.  It does take time to get the hang of it, it is not the magic pill but it can be real close when you figure out how it can work for you.  I'm on the MiniMed but they all have their strong points and I think having a good supportive Rep is a key.  And all of the artificial pancreas stuff that is coming down the line is all based on the pumps and CGM's  

4

Go on youtube and look for insulin pump videos.  Lots of everyday people have posted videos of infusion site changes and demos.  

If you do well with shots it's okay to stay with them.  I was diagnosed at age 4 and after 25 years of injecting I started having hypoglycemia unawareness.  The pump reversed it and I rarely have lows anymore, just a couple mild ones a month, and can sense when my blood sugar is below 80.  

With a pump my A1cs are in the 6s with less effort than I spent on shots.  When pregnant I was able to get a 5.1 with few lows.  I still have highs and a few lows, but it's not a mystery anymore what caused them.

With a pump you have a small plastic catheter or needle that stays in the same spot for 3 days and delivers insulin.  I can't usually feel it in my skin.  Pumps are more like a pancreas and use only short acting insulin like Novolog or Humalog and give a small amount every few minutes, plus you tell it to give more to correct a high or cover carbs eaten.  

I have pumped for 10 years and would never willingly go back to shots.  

 

PROS of the pump:

Base rate is tailored to what your body needs so you have fewer unexplained highs & lows

Site changes only every 3 days

Flexibility to skip meals (I've fasted 24 hrs. with perfect blood sugars)

Can easily correct a slight high

Easier to exercise since you can remove the pump when working out

Bolus wizard will calculate the insulin in your system and determine how much more is needed

Pump tracks total daily insulin used, last dose and other info

Make insulin adjustments for illness or pregnancy much easier

Can dose insulin with little fuss at a restaurant or while talking to someone

 

CONS of the pump:

More expensive than shots

Supplies aren't available in local pharmacies

Learning curve is steep for first week or so

If you're small or lean it can be hard to find good infusion sites all the time

Beach days are kind of a pain, but not impossible

5

Thanks for the responses, everyone!

I somehow managed to build up the courage to speak to my parents about this, and they seem to think it's a  great idea. There are a lot of things that still need sorting out, though. I, for one, am really confused between the choice of tubing or non tubing. Any specific disadvantages of the non tubing pumps? It seems to me that the reviews I've seen on them are not quite as bright as the ones for the tubing ones.

6

Tube vs. non-tube pumps is purely personal.  There are fans of both types.

I am barely 5'2" and use a Medtronic with the short tubing.  It usually stays tucked in my pocket and doesn't get in the way.  People who have known me for years are surprised when they learn I have a pump because it's not obvious.  I tried an Omnipod and it was big and could be seen through my clothes.  Plus I didn't like that you couldn't take it off and had to use a remote to program it.  But in the town where I live there's a teenager who uses the Omnipod and she loves it because she's a cheerleader and doesn't have to worry about the pump flying off her.

If you contact Medtronic Minimed and Animas (One Touch Ping) they can tell you about pump groups and demos in your area.  Omnipod is the tubeless pump and they'll send you a free sample to try.  Check them out and see which fits you and your life best.

7

My son was dx just over 3 yrs ago. We did 70/30 for almost 2 years with nothing but rebounds highs for a couple days then lows.  Had lows all hours of the day and night.  And his A1C got up to 9.4 and we could get anywhere under 9 % until just 2 months ago and it went down to 7.9 (Hooray!!)  But I'm afraid that was just because the whole first month of school he had lows 2x a day just while at school everyday for a month.  We then did MDI for 1 year and he finally got on the pump just about 3 weeks ago.  Even though it hasn't been that long we go days with wonderful #s all day long something we are not quite use to.  I know it will never be perfect but I'm glad my son decided he wanted to try the pump.  If we can just get these darn Sets to stay stuck long enough it would be great!!

8

Isn't it amazing to wake up with about the same blood sugar you went to bed with?  That's my favorite part of having a pump.

Jennifer - Do you use IV prep pads on the skin before putting in a new infusion set?  Insurance doesn't cover them, but you can pay  out of pocket to whichever company provides your supplies.  It's just $20 - 30 for a year supply of them.  If you see a corner of the adhesive coming up use a little medical tape to keep it down.  I also use big waterproof bandages before swimming or soaking in the bathtub if my site is newer.  If I've already had it on 2 1/2 day I take my chances since I'll have to replace it soon anyway.  

9

Jenna

Yeah we use the IV prep pads they send them to us every month.  I contacted Medtronic and they sent me some replacements.  Which stuck much better than the first box.  And the new box we got from our company have been sticking pretty good.  And Medtronic sent me some samples of different kinds of sticky things to try out.