Hi
@Cobia, I thought I would post this separate:
Choice of pump:
Advantages over multiple injections:
- indwelling cannula under the skin means only one actual injection through the skin every 72 hours (sometimes only 48 hours)
- the basal rate is 'sculpted' by the endo to best cover basal needs including DP (Dawn Phenomenon) see on Home Page under Type one Diabetes - DP. The basal rate can vary between day and night, something that long acting insulin cannot always cover.
- with the bolus side set up, the bolus doses for meals and for correction of high BSLs are easily done
- reminders and alerts prompt one to do forgotten meal bolus and remind one of when to change sites etc
- option of some pumps to display and use CGM and loop which greatly simplifies control of BSLs
- the finer tuning of the pump reduces the number/risk of hypos
- insulin doses can be given more discretely in company, at restaurants etc and many types of carrying devices are on the market.
- most pump companies provide pumps with excellent reliability and service and prompt provision of supplies, and through their reps, help train Diabetes Nurses about the latest models and work well with such nurses to help solve patient's problems
Disadvantages:
- bolus doses may sting
- sometimes a cannula goes in bent, or becomes bent, or detaches and BSLs rise more quickly as there is no long-acting reservoir of insulin in the body (alarms often do not detect these 'slow-downs in insulin delivery). Finding the right length and style of cannula can take time. Cannula troubles as above are the most usual pump problem.
- The tubing between indwelling cannula and the pump can become tangled on things and lead to the cannula being pulled out so requiring extra vigilance and taping etc.
- a scar tissue can form at old infusion sites and make insulin delivery near those sites less reliable - the problems usually takes years to develop
- cosmetic - some find the bulk of the pump unsightly and the need to find more suitable places difficult
- some pumps have a degree of waterproofness but not all - the ability of a pump to survive being splashed or immersed briefly may enhance its use for persons who undertake certain sports.
-some pumps seem more prone to failure and need of replacement or repair, some companies are not as prompt with provision of supplies or advice
- some pumpers complain of the difficulties with removing the pump for showers, intimacy etc. and the pump getting in the way.
- whilst pumps have come a long way, there are still occasional failures of the pump, so supplies of short and long acting insulin and syringes need to be carried in case of the need to revert to multiple insulin injections, spare batteries or charging cord and power bank etc.
I hope that helps.