who is on a insulin pump?

dancer

Well-Known Member
Messages
1,360
Type of diabetes
Type 1
Treatment type
Pump
I started off with a glass syringe and have seen many changes over the years but the pump is the best thing ever. I'm due my first upgrade in a few weeks.
 

noblehead

Guru
Retired Moderator
Messages
23,618
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
Disrespectful people
I'm using a pump, if you want to know more about them and people experiences of using one have a good look around the Insulin Pump section of the forum.
 
  • Like
Reactions: 2 people

Riri

Well-Known Member
Messages
1,174
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
The conservative party, people who are cruel to animals and aggressive people
Same here. Been on a pump for almost 4 years now. Wouldn't change back to MDI.
 

Jeannie87

Well-Known Member
Messages
84
Type of diabetes
Type 1
Treatment type
Insulin
This is copied from my reply on the introduction forum.......Well I am back, took me a while to find my original post on here, was surprised it was January!! Update on my progress or lack of it with pump to follow. Apparently the only pump nurse at my clinic is away on long term sick leave, which means my lovely dietician who works part time, is rather overloaded with pump start up meetings. Took my husband along with me in early March to a meeting with her, and to take a look at two different pumps which are available. The one I liked was a very new one - can't recall now the exact name, but it was Accucheck and it was a Bluetooth affair with remote control dosage on the blood test meter. So, it was agreed as soon as my dietician could manage a start up meeting, with other new to the pump diabetics. I would give it a go. Well that was almost a month ago, and it's given me way too much thinking time. Also to confuse matters, my control just lately with NovoRapid before meals and Levemir (twice daily has actually improved so much near to perfect results, if sometimes even a wee bit too low. So now I am confused, I am still not sure if I want to be attached to a pump, I am liking the flexibility I have with the pens, and seem to have totally reversed how I feel about getting a pump. Would be very grateful for anyone's advice or experience of similar. I live In Scotland, where availability of insulin pumps is very good and also use of pumps encouraged. I am starting to wonder whether after 43 years of being a relatively well controlled diabetic, am I too old to get to grips with a pump. Any advice most welcone
 

RuthW

Well-Known Member
Messages
1,158
Type of diabetes
Type 1
Treatment type
Pump
This is copied from my reply on the introduction forum.......Well I am back, took me a while to find my original post on here, was surprised it was January!! Update on my progress or lack of it with pump to follow. Apparently the only pump nurse at my clinic is away on long term sick leave, which means my lovely dietician who works part time, is rather overloaded with pump start up meetings. Took my husband along with me in early March to a meeting with her, and to take a look at two different pumps which are available. The one I liked was a very new one - can't recall now the exact name, but it was Accucheck and it was a Bluetooth affair with remote control dosage on the blood test meter. So, it was agreed as soon as my dietician could manage a start up meeting, with other new to the pump diabetics. I would give it a go. Well that was almost a month ago, and it's given me way too much thinking time. Also to confuse matters, my control just lately with NovoRapid before meals and Levemir (twice daily has actually improved so much near to perfect results, if sometimes even a wee bit too low. So now I am confused, I am still not sure if I want to be attached to a pump, I am liking the flexibility I have with the pens, and seem to have totally reversed how I feel about getting a pump. Would be very grateful for anyone's advice or experience of similar. I live In Scotland, where availability of insulin pumps is very good and also use of pumps encouraged. I am starting to wonder whether after 43 years of being a relatively well controlled diabetic, am I too old to get to grips with a pump. Any advice most welcone
Jeannie, I can't say I ever had such good control with MDI so I can't say much about how that may affect your motivation. For me that is a big reason. But the second reason you can consider it is the flexibility. For me, once I have my base rate settled, it means that the slightest effort - twenty-minute walk to the shops, vacuuming the house, let alone actual real-life exercise - has me hypoing like crazy. Or I have keep stuffing carbs down myself. If I am trying to get fitter or lose weight, it's really frustrating.

But with a pump, I turn my basal rate down for a couple of hours while I do housework, or longer if I am exercising and it reduced the need for stuffing my face with carbs any time I do anything spontaneous! So that's my second big reason for loving it.
 
  • Like
Reactions: 2 people

ann34+

Well-Known Member
Messages
393
Type of diabetes
Type 1
Treatment type
Pump
This is copied from my reply on the introduction forum.......Well I am back, took me a while to find my original post on here, was surprised it was January!! Update on my progress or lack of it with pump to follow. Apparently the only pump nurse at my clinic is away on long term sick leave, which means my lovely dietician who works part time, is rather overloaded with pump start up meetings. Took my husband along with me in early March to a meeting with her, and to take a look at two different pumps which are available. The one I liked was a very new one - can't recall now the exact name, but it was Accucheck and it was a Bluetooth affair with remote control dosage on the blood test meter. So, it was agreed as soon as my dietician could manage a start up meeting, with other new to the pump diabetics. I would give it a go. Well that was almost a month ago, and it's given me way too much thinking time. Also to confuse matters, my control just lately with NovoRapid before meals and Levemir (twice daily has actually improved so much near to perfect results, if sometimes even a wee bit too low. So now I am confused, I am still not sure if I want to be attached to a pump, I am liking the flexibility I have with the pens, and seem to have totally reversed how I feel about getting a pump. Would be very grateful for anyone's advice or experience of similar. I live In Scotland, where availability of insulin pumps is very good and also use of pumps encouraged. I am starting to wonder whether after 43 years of being a relatively well controlled diabetic, am I too old to get to grips with a pump. Any advice most welcone

Hi, Jeannie, i am not sure why you would want a pump, given what you say. i wanted a pump for 30 years, i use quite low amounts of insulin, never the same over a day, and had numerous hypos, but because they did not hospitalise me or lead to my needing care from others, despite my living in fear of them, and with a poor quality of life, i could not qualify until the rules changed sometime around 2008, even then it took ages to get one - this experience must be quite common, as when i last asked only 6-8% of type one adults were on the pump in England.
There are many downsides, but the upside is the limiting of hypos, and the gradual lessening of the fear. (i was told recently by one nurse that this fear is very common). My control has not improved if you take HbA1c as the measure,(this is higher) but that is, i am told, because i am not having the hypos that would have been included in the average blood glucose. I am told that i must not in any circumstances try to lower the hbA1c anyway, as it is being increasingly realised that hypos are themselves dangerous, especially for older women (see the recent Paris conference) so i am very happy to be on the pump, but if you are not having these issues i am puzzled as to why you or Darwin195 would think of one.
The downsides are many - just some are the pump being attached, lack of ease re some clothes, the high maintenance element, making sure you check infusion sites, etc (when ill or with another related autoimmune disease these may need more changing) - more testing, etc in fact overall more time is involved, (even small things like having to remember when to re-order, and to make sure the right order comes, and to be in when it does, and to deal with things if the order is wrong or delayed). There are also the safety issues, one has to keep on ones toes, one time the screen went blank and i had to get a new pump, another time i had a problem with a couple of infusion tubes detaching, I reported it, though i did not get to send the faulty sets back before warning letters were issued about just this problem, which had happened to others.
 
  • Like
Reactions: 2 people

Jeannie87

Well-Known Member
Messages
84
Type of diabetes
Type 1
Treatment type
Insulin
Thank you for your kind reply. Ann 34. Well this is my dilemma all the time lately, I already turned down the offer of a pump last year, main reason being at that time, the dislike of being attached to something nearly 24/7. As I live in central Scotland the availability of insulin pumps is excellent to those who are thought to be suitable. I have an absolutely excellent diabetic team and a very good relationship with everyone, consultant, DSN, and dieticians. The reason I changed my mind towards a pump was over Christmas when I just couldn't get good control. I thought the pump maybe a magic wand and I decided to go for it. Of course as luck would have it, once I decided and now on the list to get one within a short while, my control went back to normal! I use Levemir twice daily, 10 units in the morning, and 4 units in the evening. And I try to keep my NovoRapid total over the day to between 14 and 20 units overall. I have been using Levemir and NovoRapid combo coming up for 3 years this Summer. Once I started on this, I lost nearly a stone and a half in weight, which was a much needed weight loss, as previously I had been on far too much insulin resulting in weight gain. I was at the correct weight for my height until late autumn this year, but because of ups and downs with general control. I've put on 7lbs.which I am trying to lose valiantly! So I also thought the pump may help with weight loss, although I am not so sure on talking to my dietician .
I am actually very well controlled most of the time, I have poor hypo awareness, so I test quite frequently. I think I just got tired of the pens maybe, and thought the pump would be the cure all. As I have been told by my consultant for someone who has been a type 1 diabetic since 1972, with no complications, I am very lucky. I am kind of wondering "if it's not broke, don't fix it". I really don't feel I have the enthusiasm to begin again maybe. Since being on the pens, I have never had a really bad hypo, and those I have had haven't been anywhere near as dramatic as the few in my past. I am really grateful for everyone's input on here, it truly is helping me come to a decision .
 

Jeannie87

Well-Known Member
Messages
84
Type of diabetes
Type 1
Treatment type
Insulin
Since the past 3 years, I meant to add my HBA1c has been at totally normal levels, although slightly raised a few months ago from the previous result but nothing to worry about, also my eyes have passed all the relevant tests too.
 

Jeannie87

Well-Known Member
Messages
84
Type of diabetes
Type 1
Treatment type
Insulin
Jeannie, I can't say I ever had such good control with MDI so I can't say much about how that may affect your motivation. For me that is a big reason. But the second reason you can consider it is the flexibility. For me, once I have my base rate settled, it means that the slightest effort - twenty-minute walk to the shops, vacuuming the house, let alone actual real-life exercise - has me hypoing like crazy. Or I have keep stuffing carbs down myself. If I am trying to get fitter or lose weight, it's really frustrating.

But with a pump, I turn my basal rate down for a couple of hours while I do housework, or longer if I am exercising and it reduced the need for stuffing my face with carbs any time I do anything spontaneous! So that's my second big reason for loving it.

Thanks RuthW! Well my control until the autumn on MDI has been good, see my reply below to Ann. Also I inject my NovoRapid after I've eaten, so it's fairly flexible for me. And now my control has gone back to normal, just as the offer of a pump is waved in front of me! I will keep you posted and thank you very much for your input, it's invaluable
 

gillkin

Active Member
Messages
39
Type of diabetes
Type 1
Treatment type
Pump
Thanks RuthW! Well my control until the autumn on MDI has been good, see my reply below to Ann. Also I inject my NovoRapid after I've eaten, so it's fairly flexible for me. And now my control has gone back to normal, just as the offer of a pump is waved in front of me! I will keep you posted and thank you very much for your input, it's invaluable

Hi Jeannie
I went onto a pump after 44 years of being Diabetic and can honestly say it's the best thing ever.

I was worried about having something attached for 24 hours a day, but you soon get used to it and you can disconnect the tubing and pump for up to an hour anyway if you need to (cap goes over the cannula).

I find the best thing is being able to set different levels of basal over a 24 hour period. I need less through the night, more 6am to 10am, more again 10am to 2pm and then a drop up to 6pm and a drop again from 11pm. Very prescriptive but easy with the pump.

Cannula only needs changing once every 3 days so it's basically 1 injection every 3 days rather than 4 per day and you can still bonus after a meal rather than before.

I've had my pump for 3 1/2 years now and would fight tooth and nail to keep it.

Best wishes

Gill
 
  • Like
Reactions: 8 people

ann34+

Well-Known Member
Messages
393
Type of diabetes
Type 1
Treatment type
Pump
Since the past 3 years, I meant to add my HBA1c has been at totally normal levels, although slightly raised a few months ago from the previous result but nothing to worry about, also my eyes have passed all the relevant tests too.
Reading your posts, Jeannie, i am even more surprised you are thinking of a pump, if control is good without hypos (i dont know your age, but in my hospital your numbers would be seen as too low for a woman over 60 - i had numbers like you for years and hav now been warned about going under 7.0%.after recent research findings ). Maybe you could ask for a trial as it is easier to get them in Scotland? I agree with RuthW re the exercise point and base rate alterations, and gillkin re the ability to alter the base rate over the whole day - i do this all the time, and have learnt the reasons why injections never worked for me. Using under 20 units per day during virus free months - a distant memory after the last 2 months of illness! - and as little as 0.150 - 0-2 units per hr at certain times of the night, (and up to 0.4 units per hr at others), it is clear that injections just could not cope with my needs, and explains why night hypos were always a problem. They can still happen, and i am still in fear of them, but they are rare on the pump. Exercise is not as easy as it is for Ruth. I really have to suspend the pump entirely or have 0.1 units p hr, even for a short brisk walk, and have to plan the base rate change 2 hours in advance. The post exercise effect is not so easy to plan for as it is changeable. Re weight loss, ask your dietician for more details!! Weight gain on the pump is common! I gained weight, only a few pounds, but i had to cut CHO even more - there is less wastage of calories on the pump, or was for me. Be interested to know your decision!
 
  • Like
Reactions: 2 people

ann34+

Well-Known Member
Messages
393
Type of diabetes
Type 1
Treatment type
Pump
Hi @ann34+ would you mind posting a link to the research you mentioned? Thanks.
Hi, Tim, the whole area is very controversial at present, esp re the published studies, see below most are related to type 2, there are a lot i may not have included, and the one or two which have looked at type one do not find the same problem, but very recently there have been studies on type one women showing they have a relatively higher risk of CVD than Type one men. (ie, they still have a lower risk in numbers but relative to the general pop they have a higher risk). It seems clear that hypos are not good re CVD for Type 2, but until recently little was done on Type 1.
My consultant may well be wrong but he is in a major teaching hospital and i imagine must know something of the ongoing research. i have no eye or kidney problems at all - so CHD and stroke is seen as a poss potential prob and the recent report from Paris showed that 61 yr plus Type one women were more likely, over a year, to have a major hypo event leading to seizure, heart attack, or death than other groups of type ones. I do not by any means do everything my consultants say, but my own experience has shown that i just do not recover from a fairly minor hypo as i used to - and it is possible that my older brain just cant jump back - after even a relatively simple - or what i would have called a simple one years ago - hypo i can take days to feel normal. If i could have seen these studies, and the explanations of what a hypo does, years ago, i would have tried even harder to avoid hypos, but at the time i was told, rather abruptly, that i was well controlled and unfortunately that was how things were...as the consultant saying this was very senior i recall i was pretty shattered at the time, feeling there was no way out - there wasn't really, as we only got 4 strips a day. But i think i would have bought more myself, if i had realised. Times are a lot better now, though would be better with CGM
2008 http://www.ncbi.nlm.nih.gov/pubmed/18539917/

http://www.bmj.com/content/347/bmj.f4533

2012 not a prob for type 1 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3379603/

2013 type 2 study - esp see conclusions. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609481/

2013 general http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743541/

2014 abstract http://www.ncbi.nlm.nih.gov/pubmed/25623545

2014 http://www.ncbi.nlm.nih.gov/pubmed/24526393
 

ann34+

Well-Known Member
Messages
393
Type of diabetes
Type 1
Treatment type
Pump
sorry, Tim, i missed out the comment on the 2012 Gruden study - reservations re the study are mentioned and the need for further work - i assume my consultant may know about this ongoing work, so for the moment i am doing as he suggests - he seems confident when he writes to my GP no lower than 6.8%, and that 7% very good -- see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3507574. i would be interested to know what you and others make of the research
 

Spiker

Well-Known Member
Messages
4,685
Type of diabetes
Type 1
Treatment type
Pump
This evidence all seems pretty weak doesn't it?

It's also the type of situation where a public policy decision is different from an individual patient decision.

Say hypothetically the mortality linked low HBa1c targets (targets, not HBa1c) is caused by hypos or by erratic BG or both. As a public body you might say "don't set low HBa1c targets". But as an individual you could well decide "I will aim for low HBa1c but make sure I do it without hypos or erratic BG, I'll make avoiding those a higher priority than the lower HBa1c".
 

ann34+

Well-Known Member
Messages
393
Type of diabetes
Type 1
Treatment type
Pump
This evidence all seems pretty weak doesn't it?

It's also the type of situation where a public policy decision is different from an individual patient decision.

Say hypothetically the mortality linked low HBa1c targets (targets, not HBa1c) is caused by hypos or by erratic BG or both. As a public body you might say "don't set low HBa1c targets". But as an individual you could well decide "I will aim for low HBa1c but make sure I do it without hypos or erratic BG, I'll make avoiding those a higher priority than the lower HBa1c".

Agreed, the evidence re Type ones is weak, but either my consultant knows about something that is ongoing, or he has been told to give certain advice to all, and to make sure his patients have no hypos, while more research is waited for. I think it may be the latter, as in one recent letter he says i have no hypos, which is hardly possible, and not true, i just have less, and milder ones.. You are right, of course, the best thing to do would be to aim for lower HbA1c without hypos, which i could only attempt to do with the CGM. I imagine you came to that decision?
 

ann34+

Well-Known Member
Messages
393
Type of diabetes
Type 1
Treatment type
Pump
Tim and Spiker - i should have said that i am very pleased my consultant highlighted this issue, as it made me think, and do more tests than ever for a while - I realised i was sometimes just coasting along on a 3.4 or so, or not correcting a mild hypo as fast as i would now. i now work to keep above 5.5 mmol/l or 6.0 mmol/l at all times in order to try to eliminate lows, even very minor ones. Not completely possible, of course, but my brain does feel better, and my memory has improved. So whatever the current research finds, i do now feel i over-tolerated too many mild hypos in the past and should have invested in more strips to learn more about blood glucose changes.
 
  • Like
Reactions: 2 people

Spiker

Well-Known Member
Messages
4,685
Type of diabetes
Type 1
Treatment type
Pump
I don't think it's just your consultant, it seems like some advice has gone out within the NHS to be wary of low HBa1c, because this advice is coming from multiple NHS sources in the last year or two.
 
  • Like
Reactions: 2 people