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!