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Pump vs Injections: pros and cons

Polska_Gurom

Polska_Gurom

Well-Known Member
Messages
49
Location
Wales
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
Diabetes
Hypos
I don't know whether or not I want a pump, right now I'm on injections and I have no problem with them. I just want a basic list of pros and cons of both, and any personal experiences with people who have/had a pump would be helpful.
 
Good morning,

I’m an injector. Which is all I’ve known?
I’ve had some big needles & syringes in the early days, (the first ones were glass.) modern insulin pens in comparison are convenient.
I’m not sure a pump would suit my lifestyle.

What I will do is tag pump users to give thier perspective..

@Juicyj @EllieM @himtoo @Nicola M
 
It very much depends I think on whether it’s something you can learn to adapt to.

I got my first insulin pump in 2015 I was 18 at the time and it scared me to death and I hated the thought of having to be attached to something 24/7 but with my situation of having dawn phenomenon and not being able to split my basal due to constant lows at night it was a necessary change for me.

For me personally all of the pros outweighs any cons, I love that I can essentially customise my “basal” to be anything I want it to be and with the introduction of hybrid-closed loop things have only gotten better for me. I also love that I can give such small amounts of insulin, I’m not sure how pens are now but I was limited to 0.5 unit increments, with my pump I can give as little as 0.025.

I was diagnosed at 1 and my control now is probably the best it has ever been with an insulin pump/cgm combination. I’m now in range more than 70% of the time and my HbA1c consistently floats around the 48 range. It’s not been above 50 in probably 3 years now.

I suppose some of the biggest cons are being attached 24/7, I’ve learnt to adjust to that and depending on the pump you get you may or may not be able to disconnect but even if you do they say to only disconnect for around an hour. It’s like carrying a permanent phone and sometimes I do forget it’s there.

Things like insulin/set/tubing failures can happen, I don’t get that terribly often but I have to make sure I’ve got supplies everywhere just incase it does.

Learning how an insulin pump works and getting it right for your needs takes time, people underestimate how long it actually takes to get all your settings correct.

You’ll still need insulin pen supplies and may need to inject occasionally, going on holiday is definitely a whole other process at least for me, there’s a lot more I need to think about and take with me.

You’re more at risk for DKA when using an insulin pump mainly because you rely solely on the pump to deliver insulin 24/7 if it stops for any reason or is faulty you could be without insulin for an extended period of time. I don’t worry so much about this though as my insulin pump loves to alarm at me and I think I’d catch it before anything serious happened.

If insulin injections work for you I don’t particularly see a need to change what works but I also could not recommend an insulin pump enough although I’d say I’m a little biased as mine works so well for me. As I said above any pros more than outweigh the cons for me and I would never go back to insulin injections.
 
Hi @Polska_Gurom . I've been T1 for 55 years, since I was 8, and have moved on from injections and fixed meal times and amounts (with urine testing to check blood sugar) to insulin pens with varying amounts and insulin and glucometers, to cgm sensors (about ten years ago) and , a year ago, a pump.

The biggest changes for me were getting a glucometer and then, eventually, the invention of cgms.

I was offered a pump about 5 years ago, to help against hypos and turned it down then, as I didn't fancy being connected to a tube all the time. But when I was offered a pump last year, I said yes, and I just wish I'd done it earlier. It makes it much easier for me to manage my blood sugar and I almost never go hypo now.

I love the fact that I don't have to carry an insulin pen with me, and can just dial up a dose whenever I eat (or need to do a correction.) I'm on a tubed pump, so I can disconnect it for a swim or a shower. The closed loop system isn't perfect, but for me it is much better than MDI (multiple daily injections)

I wouldn't want to be without it now.

Can I get a hybrid closed loop system on the NHS?

The National Institute for Health and Care Excellence (NICE) shared the final guidance in 2023 which recommends hybrid closed-loop systems for certain people living with type 1 diabetes in England and Wales.
www.diabetes.org.uk www.diabetes.org.uk

Bear in mind that pump priority is given to under 18s and pregnant women so if you do think you want a pump it may be worth asking about it while you're still under 18.
 
I was micro managing my t1d on injections which was causing me to feel burnt out, I started using a pump around 8 years ago and despite initial fears in handing over control to a machine it has helped alot, I can program in different basal patterns for exercise, illness, weekends, holidays etc, I can take it off for short periods like bathing/showers/swimming (not waterproof), the Tandem has been pretty reliable, my last pump failed around 5 times - Medtronic. I wouldn't be without it now but do use pen back ups for holidays and in case of pump failure (that's necessary). If you are offered one do your research, instagram/tik tok are good platforms to find information on these. Think about how your life could change with using one and how you would feel being attached to one, bear in mind these are not a magic tool to good control, in fact the first few months I was completely disillusioned and unsure if I could continue as my control got a lot worse before it improved so align your expectations that your control could suffer and work is required with tweaking and basal testing to make it work for you.
 
Nicola M said:
It very much depends I think on whether it’s something you can learn to adapt to.

I got my first insulin pump in 2015 I was 18 at the time and it scared me to death and I hated the thought of having to be attached to something 24/7 but with my situation of having dawn phenomenon and not being able to split my basal due to constant lows at night it was a necessary change for me.

For me personally all of the pros outweighs any cons, I love that I can essentially customise my “basal” to be anything I want it to be and with the introduction of hybrid-closed loop things have only gotten better for me. I also love that I can give such small amounts of insulin, I’m not sure how pens are now but I was limited to 0.5 unit increments, with my pump I can give as little as 0.025.

I was diagnosed at 1 and my control now is probably the best it has ever been with an insulin pump/cgm combination. I’m now in range more than 70% of the time and my HbA1c consistently floats around the 48 range. It’s not been above 50 in probably 3 years now.

I suppose some of the biggest cons are being attached 24/7, I’ve learnt to adjust to that and depending on the pump you get you may or may not be able to disconnect but even if you do they say to only disconnect for around an hour. It’s like carrying a permanent phone and sometimes I do forget it’s there.

Things like insulin/set/tubing failures can happen, I don’t get that terribly often but I have to make sure I’ve got supplies everywhere just incase it does.

Learning how an insulin pump works and getting it right for your needs takes time, people underestimate how long it actually takes to get all your settings correct.

You’ll still need insulin pen supplies and may need to inject occasionally, going on holiday is definitely a whole other process at least for me, there’s a lot more I need to think about and take with me.

You’re more at risk for DKA when using an insulin pump mainly because you rely solely on the pump to deliver insulin 24/7 if it stops for any reason or is faulty you could be without insulin for an extended period of time. I don’t worry so much about this though as my insulin pump loves to alarm at me and I think I’d catch it before anything serious happened.

If insulin injections work for you I don’t particularly see a need to change what works but I also could not recommend an insulin pump enough although I’d say I’m a little biased as mine works so well for me. As I said above any pros more than outweigh the cons for me and I would never go back to insulin injections.
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Thanks for the helpful reply,
lots to think about. I think i'm seeing both options as equal, but then again i haven't had a pump yet. I'll discuss with my team, and probably try a pump since im only 16 and have so much time to change my mind. The main reason I'm skeptical of a pump is because of the errors you mentioned, with injections i feel more secure and in control.
I also have the growth hormone BG spikes at night so a pump would probably be useful for this. Again, lots to discuss with my team and family. :)
 
Juicyj said:
I was micro managing my t1d on injections which was causing me to feel burnt out, I started using a pump around 8 years ago and despite initial fears in handing over control to a machine it has helped alot, I can program in different basal patterns for exercise, illness, weekends, holidays etc, I can take it off for short periods like bathing/showers/swimming (not waterproof), the Tandem has been pretty reliable, my last pump failed around 5 times - Medtronic. I wouldn't be without it now but do use pen back ups for holidays and in case of pump failure (that's necessary). If you are offered one do your research, instagram/tik tok are good platforms to find information on these. Think about how your life could change with using one and how you would feel being attached to one, bear in mind these are not a magic tool to good control, in fact the first few months I was completely disillusioned and unsure if I could continue as my control got a lot worse before it improved so align your expectations that your control could suffer and work is required with tweaking and basal testing to make it work for you.
Click to expand...
I don't think I'm so susceptible to burning out badly, but then again I do micro manage all my BG stuff.
 
Polska_Gurom said:
I don't think I'm so susceptible to burning out badly, but then again I do micro manage all my BG stuff.
Click to expand...

I would seriously consider one if you are micro managing, you may be ok now but it's not a given that it will always be that way, life can throw stress at you so the less you have to worry about your t1d the easier your life will be, I was mum to a young child, trying to hold down a busy job and trying to cope with that as well as my t1d was wearing me down. Circumstances do change and it's best to bear that in mind.

Good luck with what ever option you choose, see if you can trial one first as that may help and your team can give you guidance on that.
 
Interesting......
I suppose i micro manage my MDI regime but i've never thought about it getting me down.
Quite the reverse as my HBA1C is 39 (5.7) and i take pleasure and pride in those results.
Its thanks to my libre, 4mm needles and my soectacular analytical skills....lol lol lol

I have never been offered or wanted a pump.

Good luck

Tony
 
Well done Tony on achieving this - my circumstances with being mum to a young child, holding down a full time job as well as trying to put food on plates, clothes clean and keeping my t1d manageable so I could juggle all those balls meant my mental health struggled greatly, we don't always share the same experiences as others.
 
Juicyj said:
Well done Tony on achieving this - my circumstances with being mum to a young child, holding down a full time job as well as trying to put food on plates, clothes clean and keeping my t1d manageable so I could juggle all those balls meant my mental health struggled greatly, we don't always share the same experiences as others.
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Absolutely understand @Juicyj and i would be genuinly upset if you thought for a second i was critisizing!
Diabetes is ghastly and i wish anybody and everybody with it all the luck in the world and whatever works can only be a good thing.

There are so many options available now compared to 50 years ago and every single diabetic on the planet is different and i recall doing a DAFNE course about 15 years ago and i learnt so much simply talking to the dozen people on the course.

I wish you well

Tony
 
I suppose my question would be if you re not having any problem with your regime now why ? Personally I have been using injections forever and haven’t ever thought about a pump my results are good , so I guess the question Is is there really a need to change
 
Ushthetaff said:
I suppose my question would be if you re not having any problem with your regime now why ? Personally I have been using injections forever and haven’t ever thought about a pump my results are good , so I guess the question Is is there really a need to change
Click to expand...
I think he's been diabetic for less than a fortnight so it's way too early to make these decisions? However, it isn't too early to be considering options....
 
Ushthetaff said:
I suppose my question would be if you re not having any problem with your regime now why ? Personally I have been using injections forever and haven’t ever thought about a pump my results are good , so I guess the question Is is there really a need to change
Click to expand...
Yeah that's what I was thinking, I'm fine with injections. However I've never tried a pump and maybe I would prefer it so much more, especially with high bg at night. I don't know.
 
Diabetes is definitely a challenge when you’re first diagnosed, so much info flowing hard to know what to do all I will say as a person with 45 years of T1 behind him is small steps . Try and get the basic essentials in the bag before trying more advanced things shall we say . Working out how certain foods work with the insulin you take is so important it’s what diabetes is all about. It doesn’t happen over night unfortunately , don’t try and eat the whole elephant so to speak , you’re here which is a positive step plenty of people t help and give you advice
 
Polska_Gurom said:
I don't know whether or not I want a pump, right now I'm on injections and I have no problem with them. I just want a basic list of pros and cons of both, and any personal experiences with people who have/had a pump would be helpful.
Click to expand...
I'm another one who has been happy on injections for the 8+ years I've been on insulin, I do not want a pump, at least not in the near future.
And I know there are many who feel that finally getting on an insulin pump was a godsent.
So it's all down to personal preference, like you suspect, both approaches have their pros and cons.

However, like everyone you're starting out on injections, and even if I wanted to switch to a pump eventually, I'd want to be comfortable with injections first. Pumps can and do fail, and like all failing equipment, they tend to do so at the least convenient moment.
Injections are the back up plan if you're on a pump, and I've read panicked questions from people who were put on a pump very quickly after diagnosis and had no idea how to manage with pens when their pump failed during a weekend or far away from home.

At only 9 days into diagnosis, I'd focus on getting the hang of the basics first, and look into possibly wanting a pump a couple of months from now.
 
Polska_Gurom said:
I don't know whether or not I want a pump, right now I'm on injections and I have no problem with them. I just want a basic list of pros and cons of both, and any personal experiences with people who have/had a pump would be helpful.
Click to expand...
One advantage of a pump is to use an automatic pancreas system. I use AAPS which controls my pump and keeps me in range. Typically now I am in range 80plus percent.
If you chose to consider an automatic pancreas system, it will take many months of effort to learn and understand. Insulin control is so different.
The big advantage of the AAPS is that I am not having to think about it every minute. For example, in the evening I give myself 75% bolus for my evening meal and the AAPS manages the rest.
 
Polska_Gurom said:
I don't know whether or not I want a pump, right now I'm on injections and I have no problem with them. I just want a basic list of pros and cons of both, and any personal experiences with people who have/had a pump would be helpful.
Click to expand...
This list will vary from person to person, for example I had terrible control on injection I have great control on the pump - for me that's a big pro

But if you have good control on injection it's not a Pro

So the cons of a pump is it's attached practically 24/7
Needs to be changed/refilled every 2-3 days, you get 3 months supplies at a time to need storage.. you have to consider backup plans when going out incase the pump/ cannula fail or get ripped out

You still need to keep injection supplies incase the pump fails

Exercise/swimming can be difficult

Having a partner can be complicated depending on the pump type... So much so I've been single since having the pump


The biggest pros are that I have good control and it's more discrete when out... Oh and it got me out of jury service

Would I be without it... No
 
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