Why get a pump if you’re happy with MDIs?

Home Forums Living with type one Why get a pump if you’re happy with MDIs?

This topic contains 29 replies, has 9 voices, and was last updated by  Anonymous 8 years ago.

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  • #9819

    Anonymous

    I was just thinking about pumps and how ace they are, and wondering why everyone wouldn’t want one. I reckon Shoot Up is pretty pumptastic – lots of stories about how brilliant they are etc. Are there any readers out there who definitely know they don’t want a pump? If so, care to share why? I wonder if there’s fear of wearing something all the time? A perception of having to think more about your diabetes? Squeamish? I’m not on a campaign to persuade you, just wondering….

  • #10378

    Tim
    Keymaster

    The whole being attached to something all the time thing put me off for a long time. And it is, still, a minus point; but one that is outweighed by the benefits of being able to more finely control my insulin intake.

    However, of course I don’t actually have a pump and this may all change when I do get one in November!

  • #10379

    Annette A
    Participant

    When I was on the carb counting course, the other members of the group were very definite they were not interested in pumps. The main reasons they gave were needle phobia – the idea of having a needle permanently inserted was enough to make at least one of them feel ill (a valid reason I guess, but he was giving 5 or 6 injections a day anyway – surely one ‘injection’ then a tube for a couple of days is better, but who can fathom phobias!) and the thought of having to carry something of that size permanently attached and (to them) a very visible indicator of ‘non-normality’.

  • #10380

    Anonymous

    @tim Need to bag some swag from you know who? Maybe they may have one lying around somewhere! :)

  • #10381

    Anonymous

    Still massively pump-averse over here… I love being able to leave my bag of bits on the table, rather than having to carry it around will me all day every day. You can’t even take them off at night! The way I thrash around while asleep would make that a recipe for disaster. I do hear many brilliant ‘best thing I ever did’ success stories – and congrats to all those on here who have slashed their HbA1c’s while pumping, but I also hear plenty of stories about people who try it and then go back to MDI having seen little benefit in control and who hate the permanent attachment thing.

    Pumps were suggested to me several years ago by a consultant as a way to get rid of a few low-level hypos, but I remain fairly firmly in the ‘no thanks’ camp (never say never though eh!).

  • #10382

    Tim
    Keymaster

    @mikeinspain – entirely my plan!

  • #10383

    Tim
    Keymaster

    @mike – I will be reporting back on just this at the end of the year when I get mine. It’ll be ironic if I return to MDI after waiting 18 months for a pump…!

  • #10384

    Anonymous

    I’ll be watching with interest :)

    What are you hoping the pump will provide? Better HbA1c’s? Convenience? fewer spikes? Fewer hypos? All of the above?

    Would be very interesting if you had some before and after records kept. I did this myself recently over the period of an insulin switch (from NovoRapid to Humalog). Allowed me to see how much better I was actually doing as opposed to how much better I *thought* I was doing!

  • #10385

    Tim
    Keymaster

    @mike – I’m hoping it will provide all of the above, except for better HbA1c – which is already pretty good. I think the main thing I’m looking for is the ability to adjust my background insulin more effectively than using dumb old Lantus. Like a lot of people I have huge insulin resistance in the mornings, but not in the evenings; I’m also a lot more active during weekends. So by having more control over the background I can hopefully iron out these problems. Possibly.

  • #10386

    Anonymous

    Ah yes Lantus… the ugly child of MDI therapy – been tackling that myself of late but have finally beaten it into submission (I think)

  • #10387

    Anonymous

    Personally I think pumps are superb, loads of control, set your doses overnight to overcome DP etc,, duel wave and square wave bolus are great especially if your enjoying a large meal.
    I undertsand that some may not relish the idea of being constantly attached but its no different to having a very small mobile in your pocket allbeit attached via an easily hidden cannula,,
    Sleeping with the pump is easy and after a week you dont even notice it,. To date (2.5yrs) my eldest (4yrs) hasnt managed to yank it out despite trying with his toes daily !
    I really dont understand the needle phobia argument as surely one (very small) insertion every 3 days is much better than jabbing multiple times daily?
    Its just my little old opinion but I reckon 99.99999% wouldnt go back after a couple of weeks on a pump ..

  • #10390

    Anonymous

    @simon Good points – Clearly works brilliantly for you.

    Personally I hate having anything in my back pockets and front are plenty full enough with aforementioned mobile/keys/change/emergency hypo sugar tin/fluff/assorted rubbish… Not quite sure what I’d do with it. It’s deffo the permanent attachment I’m not keen on. Changing infusion sites must mean you have to move things about a bit ocasionally too. I’ve also heard about blocked tubes/infusion site probs stopping the insulin delivery which the pumper in question only spotted when their bgs went through the roof.

    How about going swimming? Pulling on that wetsuit for a go at surfing on holiday? Trips to the gym? Catching your thumb in the cannula while thrashing around the tennis court? Bedroom shenanigans?

    I’ve been dual- or triple-wave bolusing for carb-heavy meals for years on MDI. And I’d still have to guess/calc the carbs and factor in activity etc. All the human errors I make I’d still make.

    I know all the issues that concern me must be dealt with by pumpers the world over every day… but I’m still not convinced.

    On the plus side tho… that’s one less on the list in front of you @tim

  • #10392

    Alison
    Keymaster

    @mike I kept before and after records of my HbAlc pre and post pump/CGM – the results are amazing. Before is a series of peaks and troughs as I manage to get my HbAlc down below 7%, then it bounces back up again when I can’t sustain the effort needed to keep it low. It’s now 3 1/2 years since I got the pump/CGM and my HbAlc has been flatlining around 5.8% for the whole time – details and pretty graph here – https://www.shootuporputup.co.uk/2009/06/every-picture-tells-a-story/

    I know what people mean about the whole being attached to a pump thing, I had exactly the same fear and it’s what made me avoid getting one for years. In reality, it was a complete non issue, and I actually like the fact I don’t have to remember to carry my pen around with me, my pump is just always there. I fidget a lot in my sleep but the pump’s survived with no issues.

  • #10393

    Anonymous

    @alison That’s the most convincing argument yet. Pump with CGM would be almost worth considering. Almost ;)

  • #10395

    Annette A
    Participant

    @mike – to answer a couple of your questions: Swimming – take it off. You can survive for an hour no probs, just add a bit extra insulin when you put it back on. Ditto wetsuit I guess. I just hang mine on a stretchy elastic belt under my tshirt whilst at the gym – no problems. I think you’d probably want to take it off for tennis, and it is vaguely suggested in the literature that the same goes for bedroom shenanigans, so I go for that option.
    I’m a very restless sleeper, but haven’t yet had a problem with that.
    And the bolus wizards on modern pumps takes a lot of the guesswork out of dosing up.

  • #10396

    Anonymous

    The wonderful Lantus: We need Lantus and Sanofi-Aventis needs us: http://abcnews.go.com/Business/wireStory?id=10505931
    Only swine flu is bigger.

  • #10397

    Alison
    Keymaster

    I leave my pump on for sailing, tennis and most other sports and just tuck it inside my waistband so it doesn’t catch on anything.

    I take it off for swimming but did use a waterproof case for it when I went white water rafting and that worked really well – http://www.aquapac.net/ukstore/insulin-pump-case-154-1162-0.html

  • #10398

    Alison
    Keymaster

    @mike I just noticed that I only responded to half your questions, sorry!

    “Changing infusion sites must mean you have to move things about a bit ocasionally too” – yep, I change my infusion set every 3 days and tend to wear it on my thighs, bum, stomach or back so there’s plenty of places to choose from.

    “I’ve also heard about blocked tubes/infusion site probs stopping the insulin delivery which the pumper in question only spotted when their bgs went through the roof.” – yep,it is a risk. It’s happened to me twice in over 3 years. Both times I saw on my CGM that I was rising really quickly, took insulin via a syringe and changed my infusion set. If you don’t have CGM you’re relying on how you feel to spot the rise, but to be honest to get the most out of the pump you should be testing several times a day so you’d spot it then anyway.

  • #10406

    Anonymous

    Taking it on and off… then guestimating top-up doses to cover. Suddenly sounding a bit more of a faff again! …and you were nearly getting me convinced – are you on commission? ;)

    Not sure I could ‘tuck it in my waitsband’ either. Sounds like it’d go bouncing off at some inopportune moment.

    Silly question… how long is the cannula? Just wondering if you have to wear/hang the pump in different places when you shift infusion sites around.

    I’m so intolerant of sitting/leaning on stuff I suspect I’d need some sort of strapping/sling so I could wear it mid-torso and/or pretend to be an undercover cop with a wire.

    Since the vial of insulin is out in all weathers too do you have to watch how hot you’ve been getting? Just thinking of lying, baking on a beach in the glorious British sunshine(!). With my handy MDI stuff I can just keep it somewhere cool, bottom of a bag or wherever… How do they suggest you cope with summer holidays?

  • #10407

    Annette A
    Participant

    @mike – I dont guesstimate, I work it out (you know how much insulin you get per hour, you know how long you have had it off, you do the maths!)
    I can get cannulas in 30cm, 60cm or 80cm lengths for mine – might be different for other meters, but I just pick the most relevant for whatever I’m wearing, the meter is pretty much always in the same place.
    I have a case on a cord that I wear at night – could be worn during the day like some people wear their mobiles round their necks.
    As the vials dont last too long ( a few days to a week), in normal weather its not a problem, I dont think. There was a story recently (but I cant find the link) about a girl who took hers off to go swimming and left it in full sunlight on the side of a pool in Oz for an hour or so in 40+ degree heat – when she put it back on she didnt realise she had ‘boiled’ the insulin and she went ketotic cos the insulin wasnt working (she recovered fine). So the suggestion was to try and keep it in the shade where possible (ie not in direct sunlight). If you put it in a Frio type wallet (ie one that is supposed to keep things cooler) – you can get them/adapt them for pump type items (or mobile phones, for example) – that should do you for your lobster impression days, I’d say. And if you think you’ve let it get a bit hot, you change the cartridge to be on the safe side.

  • #10409

    Tim
    Keymaster

    Live in Scotland – that’ll keep insulin nice and cool whatever the weather…

  • #10410

    Alison
    Keymaster

    I’ve never had any heat issues with insulin and my pump has been trekking in a rainforest, on safari in Africa and sailing in the Med so it’s spent plenty of time outside of the typical British summer. That said, I don’t really want to add skin cancer to my list of woes so I don’t tend to spend much time sitting in the blazing sun for hours on end.

    I use 30cm tubing and that’s long enough for me to wear my infusion set in my thigh, stomach, bum or back and have my pump clipped to my waistband, keep it in my pocket or clip it to my bra at the front if I’m wearing a dress. If you’re looking for pump issues, my biggest one is where to put it when wearing a dress – you can get garter type things that go round your leg or torso but I don’t like them. I’m assuming the dress side of things won’t be a problem for you Mike? ;-)

    Pumping isn’t the perfect answer and it certainly doesn’t stop diabetes being an inconvenience at times but for me it’s just a much better tool for the job than MDI.

  • #10411

    Tim
    Keymaster

    Given that so many people hide their pumps in their bras, does this mean that bloke-pumpers have to wear them too? I hope so.

  • #10412

    Annette A
    Participant

    I do wonder, I have to admit, where in their bras people put them. I’ve been told many times about people who do, but I’m at a loss as to where in my bra one would fit, and I can’t see how to clip mine at the front (maybe depends on type of pump – they are all different shapes)…Maybe I just wear too clingy clothes :-)
    I solve the dress problem by making small slits in the side seams (or creating a ‘buttonhole’ if there’s no side seam) just big enough to fit the end of the tube through, then wear it on a belt/strap outside the dress. How’s your seamstress skills, @mike?

  • #10413

    Anonymous

    Hmmm so no more clingy dresses eh? How *will* you cope @tim?

  • #10414

    Alison
    Keymaster

    @tim I’m sure your diabetes control would benefit from you wearing a bra. I believe red lace is meant to be best for lowering HbAlc.

    @annette I clip mine at the front in the middle, so the clip goes over the bottom bit of the bra and the pump hangs down. In most dresses you really can’t see it. I’ll stop there, I’m not doing a very good job at explaining it and I’ll get myself into trouble soon! I know some people wear them at the side underneath their armpit but I found that really uncomfy.

  • #10415

    Anonymous

    I always insert my set in the.top of my leg alternating each leg every 3 days when changing vials , the pump goes straight into either my left or right pocket , no problem to date , tried it in stomach , arms and back of leg but top is soo easy! Only time its a nusience is when wearing 1 piece motorbike leathers and have to let it dangle down the leg !

  • #10418

    Anonymous

    I know I said I wasn’t out to convert someone, but @mike, you’ve been asking some fairly searching questions about pumps, so I’m going to put a couple of my thoughts into the pot. I’ve been told you can take your pump off for more than an hour, as long as you test and dose in between times. This couldn’t be easier – faffless. Quick blood test (a problem if you’re not keen on blood tests, but I have realised (with help from the wisdom of my DSN) that blood tests are much easier when you don’t expect the result to be ‘bad’. Fact finding blood tests, not punishment inducers.), then you put the result into the pump, it will suggest the accurate dose to correct your levels, based on the active insulin you already have in your system – it knows when you last had what dose), you press a button, it delivers the dose, you remove the pump again and carry on. No longer than it takes to eat a mini mars bar. Apart from the lack of injections, it’s been the fact I don’t need to do any annoying sums any more that has pleased me the most. Eg 42 grammes of food, 4.2 units of insulin. Nae bother big man.

    Bra – in the middle, just like @alison said. But underwires don’t seem that keen on the idea – 2 bras needed stitching in 3 months of pump wearing. The only ‘dress’ problem I’ve encounted is when I have to get my strong pants out in order to wear said dress, and this puts a wee bit of pressure on my infusion set. Nothing too untoward though….

  • #10419

    Anonymous

    Thanks @Caroline. I’ve just been thinking out loud really. Trying to understand my own pump aversion myself. And truth be told though I respect you all for your pumpery I’m still not convinced it’s for me. No blood test aversion here – anything from 6-10 times a day (would love a CGM!). No problem with multi-jabs – split doses can mean 4-6 of those a day too. HbA1c has been between 6 and 7 since diagnosis, last one was 7.0

    This has been a fascinating discussion and I’ve learned loads about the practicalities. The results for many of you are clearly astonishing (though I do read lots of accounts of pumpers whose levels look just like mine too).

    For the moment I’m happy with MDI and happy to keep myself of the pumpy waiting lists so it can go to someone who’s desperate for it. Goodness knows there are enough of them!

  • #10486

    Anonymous

    heya every1 i would advice to try the pump , even if you do not like the sound of it first. better to try the new tecno..

    i think the pump is the best sort of medication for diabetices and i have had ten years of not being stable with it and that why i tried the pump and its great , helpted a lot with the illness and stuff. so i would tell any diabetic to try it. it is really worth it.

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