One year of pumping

By | 3 November, 2011
The cake is a lie!

The cake is a lie!

Bring out cake, candles, streamers and booze! My pump – Englebert Pumperdinck – is a year old today. Technical he’s not, I’m not actually sure how old my pump is. But I have now been pumping for a whole year, so I imagine that amounts to pretty much the same thing.

So what are my observations of pumping one year on, I hear you cry? Well:

  • Pumps are not a panacea

Despite having a pump I still have type one diabetes. I still have crappy days with high blood glucose and I still have hypos – some worse than others. Despite the hype they sometimes get, pumps are not a cure. They’re just different from injections. In my view, some people might actually fair better on injections than pumps as injections are a hell of a lot more simple. Horses – as they say – for courses. This leads me on to the next observation.

  • Pumps are a pain to set up

With injections you shove in your long-acting and you shove in your short acting at approximately the correct time. A pump gives you the ability to adjust nearly every aspect of your insulin delivery. The possibilities are almost limitless. Take, for example, your background insulin – instead of one injection a day of Lantus my pump automatically injects the following amounts throughout the day:

00:00 – 1.95 u/h
01:00 – 2.25 u/h
05:00 – 1.65 u/h
07:00 – 1.70 u/h
10:00 – 0.70 u/h
16:00 – 0.275 u/h
23:00 – 0.70 u/h

As you can see, it’s a hell of range and it took me forever to work out through a lot of trial and error. I also have variable carbohydrate to insulin ratios (00:00 – 7.6; 16:00 – 8.0) and variable insulin sensitivity amounts (00:00 – 1.2 units brings me down 1 mmol/l and 16:00 – 1.5).

So you’ve got to be really knowledgeable about your diabetes – or have a really good team to help you – to get it right. It’s hard work but without being set up correctly a pump is just a big, dumb, expensive lump of plastic.

  • Once they’re set up properly they’re brilliant

However, once you’ve got over the pain and strain of setting the damned thing up, pumps are truly ace.

Take for example, this morning. At 7.30ish I wandered down to have my breakfast of toast with honey and banana. It’s about 52g of carbs and my BG was a nice 5.0. So I went to the pump’s bolus wizard, entered my BG and the amount of carbs and it automatically calculated that I needed 6.9 units of insulin. One press of the ACT button later and 6.9 units were flowing into me and I forgot all about diabetes until I started writing this article later on this morning.

  • Pumps are much more consistent

Not naming names here – oh, okay I’m talking about Lantus – long acting insulin is wildly inconsistent. Will you go high, will you go low? Who knows – all bets are off. When I go high it’s generally traceable to something I’ve done wrong. I didn’t bother carb counting properly, or I’ve been exercising and didn’t allow for it.

My diabetes is therefore much more predictable now. As it’s more predicable I can more easily avoid highs and lows, which can only be a good thing.

  • Pumps are much more flexible

About to exercise? Then turn down the background insulin for the next three hours to 30% of the normal amount. Three button clicks and it’s done.

About to go out on an all-night boozing bender with flagon after flagon of beer? Turn the background insulin up to 110% to cover off the extra beer-carbs and then turn down to 40% before the inevitable BG crash in the early hours. Wey-hey life is suddenly slightly more normal!

  • It’s really not a pain being attached to a pump

Before starting on the pump I worried about being attached to something all the time. I was used to the pump within about a week and it now lives happily on my belt or roams free during the night. It’s really never been a bother.

So there we have it, after the initial anti-honeymoon period (what is the opposite of a honeymoon?) in my view pumps really do score highly on all counts. Good for you Englebert – have a bit of birthday cake!

11 thoughts on “One year of pumping

  1. Dave

    Congratulations EP. Well done for making it through a year attached to @Tim. And well done Tim for mastering the black art so well.

    Pumping must be a November thing. @mike goes live Tuesday and I’m all set for a few days later.

  2. Tim Post author

    All the cool kidz get pumps in November! It means you can get used to the basics before the diabetic-mentalism of Christmas gorging.

    1. Tim Post author

      Depends on what you ask your reservoir to be filled with. You’ve obviously asked for saline. I went for a combo of insulin and vodka – it’s fab!

  3. Annette A

    This is one of the benefits of Shoot Up – it proves just how different people’s needs are. I was astounded by your exercise needs – I only go down to 80% unless I’m out for a day cycling when its 50%, for example. 30%? Wow. (Maybe I’m more active – I understand that if you’re used to doing alot of exercise, you tend to need to come down less? How active are you @Tim ?) 52g carbs for breakfast? That’s almost my entire day’s carbs in one go. Correction ratios (insulin sensitivity) – 1.2 for 1 mmol? Wow. I use 1 : 3.6mmol. But then, your basal is more than double mine for the overnight, similar for the day and then about a third of mine late afternoon.
    Its nice to see that differences abound….
    But a question, to all longterm (I guess, that means a year or more) pumpers – how often do you have to change your settings/basals/ratios? I seem to need to adjust something (usually basals, but just recently its been carb and correction ratios too) every couple of months.

  4. Tim Post author

    @Annette – in answer to your questions:

    – I’m not very active. But am currently trying to do more exercise (article waiting in the wings). I think I drop it down so low to compensate for reducing it just as I start exercising, rather than an hour or so before.
    – 52g carbs for brekky! Yup, I’ve never believed in reducing my carb intake post-diagnosis.
    – Corrections – I guess I’m just quite resistant to insulin – especially during the night and morning.

    So basically we can sum this up as “all pumpers have their own weird settings and requirements”!

    I tend to fiddle with my settings once in a while – perhaps every few months. But they don’t vary that much.

  5. Fiona

    Really interesting Tim to read how you are getting on with a pump a year in – glad its working out for you. My son has been told by his consultant that he can have one but only if he ‘takes the opportunity’ before he leaves his care as a child and enters the adult clinic when he turns 18 – in 12 months time. Once there he has to join an orderly queue for one – which could be a few years away – unless we pay for it. He is very resistant to the idea because he thinks by being attached to a pump he will be constantly reminded that he is diabetic whereas with injections he can ‘forget’ about it for a lot more of the time – I do understand that for a teenager. However, he does have a lot of hypos and I worry that his awareness will become less as time goes on. Oh what to do!!

  6. Tim Post author

    @fionac – when I was on injections non-diabetics always commented that the injections must be the worst bit of diabetes. But, of course, they’re pretty trivial themselves. It’s the same with pumps – non-pumpers always think that being attached to the pump must be the worst bit of diabetes, but it’s pretty trivial in fact.

    Being attached to a pump 24/7 isn’t perfect, but to be honest you don’t really notice it most of the time – mine lives in a wee thing on my belt. Using it in public is *much* more subtle than injecting. People (if they notice at all) just think you’re texting.

    If you’re exercising, swimming or doing something else involving taking clothes off *cough* a pump can be taken off and left on the side for an hour or so without any problems; if the canula is somewhere subtle – like on your back or leg – no-one will notice it. It’s more subtle than having loads of injection bruises round your tummy! Or having a hypo mid-exercise.

    Since being on a pump, the greater flexibility and ability to adjust the background levels when eating too much / too little / going out on the piss, etc., etc., means that I actually spend considerably less time now thinking about diabetes than I did before. It has much less of an impact day to day living and a pump has definitely improved my quality of life.

    So…I’m quite a fan! I wonder if your son could try one with saline for a week to see how he gets on with it?

  7. katherine cromwell

    @fionac why not tell your son to try it and if he doesn’t like it give it back …. simple. I’m sure he won’t. They are no bigger than an Iphone/pod imnfact mine is called an Ipump and not many people have them. At the end of the day I’m afraid it will be up to him how he wants to care for himself. With great care from mum and dad, guidance from diab team and understanding friends he will make his own choice. The pump does make it easier and is more beneficial but MDI can and will work if understood and used properly.

    I think the pump is more beneficial as we know we are getting insulin 24/7 and less likely to have diab related illnesses. Lantus… ha ha! my basal rate is now 15 units pre pump it was 21units and those not always in the right place.

    How long has your son been diabetic? What changes has he already seen? Perhaps tackle it from a different point of view. The insulin he would have in a pump would be acting generally for 4hrs ok it is a drip feed but you can turn pump off or reduce by temp basal rate so already hypo’s will be easier to tackle. If he is sporty reducing basal or bolas is possible and if found to be high afterwards can easily be adjusted.

    My DSN told me that a guy in London was set upon by some youths. The young man was obviously shocked and fearful of his pump being harmed pulled it from his waist. The attackers cried bomb and legged it leaving the young guy unharmed. Good Luck!

  8. Jonathan Christie

    I’m Type 1, my HbA1c is 5.1% on [redacted]’s low-carb diet. It’s sustainable, I’ve been doing it for 14 years and my blood tests are just peachy. It’s transformed my life: no more hypos! – somehow, it restores hypoglycemic awareness. I eat bacon and eggs for breakfast – if I ate toast and honey, I’d be back on the roller coaster. I recommend his book, [redacted]. My experiences are more fully detailed at [redacted]

  9. Tim Post author

    Hi Jonathan – thanks for joining Shoot Up; we don’t encourage endorsements for third party diets and products on Shoot Up and as you’re a first time poster I’ve redacted the name of the product in question. Do feel free to join in the chat, but try to avoid the third party promotions!

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