Hi
@type1gabs, You (and your parents) are stars for navigating 20 years on the river of life with diabetes. Congrats!
At the 45 year mark on insulin I was having trouble with night hypos with 8 injections per day. Being prescribed an insulin pump saved me from the terror of those hypos, enabled me to keep my driver's license and employment, improved my HBA1C's no end.
Now 7 years later I could not go back to injections. Sheer stubbornness to remain as independent as possible is now ended!
From what I can gather very few but some diabetics cannot tolerate or adapt to insulin pumps.
Each brand of pump has its
pluses and minuses, mainly to do with
tube vs tubeless,
alarms and Medtronic with its dose reduction feature (the Continuous Glucose Monitoring, CGM feature which alerts the pump to a low BSL and triggers a go-slow on the basal program of insulin),
size, and whether a
remote control is a plus (convenience) or minus (what if it is lost ?).
Where the pump shines for me is as others have said,
programming for exercise AND
for stress (exciting movies can put my BSLs up !),
after a influenza
vaccination my basal and bolus dosing goes up 30% plus for about 4 days. Much, much easier to handle that way than trying to do so with MDI ( long-acting insulin, plus short-acting before meals) Being a guy, I leave how
cycles can be handled to others. For a
'slow carb' meal like some Indian and Italian cuisine (where BSL rise may peak at 3 instead of 2 hours, the split combo feature of the pump (e.g. options to do 20 -50% at meal and obverse say 1 or 2 hours later. And the
Dawn Phenomenon is managed by programmed basal rather than upping long-acting insulin and ending up hypo etc.
Downsides: 1) the
needle insert procedure which leaves a plastic cannula through to under the skin can go in bent, or become bent or detach enough to allow insulin to slowly leak under the sticky patch leading to
diminished insulin delivery and otherwise unexplained high BSLs (unfortunately
this restriction of insulin supply does not trigger an alarm except maybe if you are using CGM)) and this raises the next point: The
reserve of insulin is stored in the pump, compared to your current insulin regime where
long-acting insulin is stored in your body for ? 12 ? 24 hours after each injection. The short-acting insulin used in the pump wears off in ? 4 to 6 hours, so with reduced or no insulin input via pump
ketones show up pretty quickly.
2) if the
battery cap loses connection, the battery no longer powers the pump and as every alarm works off battery power you will be unaware that the pump is not delivering insulin until you check a BSL (and the CGM will not be working either to alarm about high BSL) ( I am unsure if this applies to the pump powered by body heat )
3) with exercise, the
sweatiness may cause the needle insert to detach, and thus it may be only when the CGM, if in use, may alert you to the fact that no insulin is being delivered under the skin.
4) not only is the pump a 'potential threat' to fashion,
one needs to consider for any outing taking along spare needle insert, reservoir, batteries, insulin, and pens with short and long-acting insulin to cover the need to change the reservoir, cover low battery alarm, and failure of the pump with need to revert to short-and long-acting insulin. Some countries have agreements to provide a spare pump in case of pump failure but not all and some have had hassles at airports as the pump is not to go through luggage strength scanning. Of course a pump would need to be removed for medical imaging.
Redeeming points: You still need to be taking spare insulin pens and glucose meter along with your current insulin regime; pump failure is rare; you adapt by learning to automatically check the needle insert; handle the potential tube tangles, either check CGM or do check of BSL with meter to look for trends. What I love are the accessories for pumps, whether you buy a commercial one or re-purpose a travel wallet etc. I turn my pyjama shirt inside out and use the now inner pocket to house my tubey pump at night.
My daughters in law joke about fashion bum bags to carry a pump, fake hip pads to balance out an insulin pump worn on a belt/hip area, same for the bra area (Modesty prevents me from explaining further !!) And the piece de resistance for me happens to be an accessory from Medtronic (i do not use their pump) the soft toy lion !! At age 64 (yeah, the Beatles song and all that) I could almost get away with carrying a soft toy lion or similar around.
Best Wishes on your deliberations, from a biased pumper (in his jumper in Australia)!
