Comparing MDI and pumping in advance of the REPOSE study

[ewelina]

Ive just had my HbA1c done and its down to 49 from 69 pre pump. In my case the pump plus libre (I'm on my third sensor now) proved to work very well. I feel quite confident that with libre I will bring it even lower.
Pump is a great tool and I definitely wouldnt achieve the same results on MDI. The fact I can react quickly to any changes in my basal requirements makes my control much easier. I also use quite a lot of extended boluses which on the pump is much less hassle than on MDI. Exercising and long day hiking trips stopped to be a nightmare since on the pump too

 

[ewelina]

When it comes to Dafne I think it just confused me and didn't really help in anything

 

[donnellysdogs]

Before pump I had reasonable hba1c's but with some hypo's almost losing my driving licence.

Pump for 5 years (and CGM for a while) gave the same hba1c but with "milder" hypo's. Hypo's more of a slide down rather than a crash......

After pump and almost 9 months back on MDI. I got to admit that now I realise just how much time was spent analysing and changing stuff on the pump. My hba1c remains good (too low for me)..... The hypo's for the daytime are just as recognisable but night time they can be harsher....

Never been on a DAFNE course or seen a dietitian either.

Being back on MDI has given me a total break. Of course I still do as many blood tests, fasting etc but I'm not giving up valuable "me" time to the pump fine tuning.... Yep, in the morning or evening I have to think what am I doing for the next 12 hours and adjust my basal or waking bolus etc but I'm not faffing around phoning or emailing Accuchek or doing set changes. The time it took for the Insight pump to wake up and to work out the bolus and press the buttons, I've done the blood test and injection for meal a long time ahead of the Insight even waking up. I do not have to think every time I lie in to change the profile the night before... Or when hubby changes shift.. Or even when my stomach decides to block up or work...

My insulin usage has gone from a 13-18 basal on pump to just 6 on MDI now. I haven't got a clue why it's lowered so dramatically. Even 6 units spilt in to two 3's is still giving me too low levels....on Levemir too, never got the tresiba./degludec.

I've just got my quality of life back in so many ways...I have more "me" time and it isn't at the detriment of my health.

 

[Loliz]

I, too use a pump because of hypos, rather than HbA1c. In fact mine has gone up considerably - because it was the result of loads of highs and loads and loads of lows.... it is a very rough guide to control as it is only an average, and can be misleading.

I need no basal at all from midnight to 4 and from 2-3 in the afternoon.

i spent years on way too much insulin, almost unable to do anything. When I was diagnosed there was 20, 40 and 80 strength insulin as well as 100. I went from about 5 u on 20 strength twice a day to having to use a tiny, tiny dose in a half ml syringe on 100u. It was a disaster.

MDI basal never worked for me, because it couldn't copy what i needed, or to be more accurate, what I didn't need.

I was given one of the experimental pumps in 1981, but my dumbass Consultant didn't understand the principle and kept me on Ultratard, which meant I was fighting hypos all the time, culminating in a 3 day one where I couldn't actually get back up. I was take off of it after that and given one of the new Novopens - one of the first to have one.

MDI cannot stop you dying from 'diabetic dead in bed syndrome' from a hypo in the middle of the night.

 

[tim2000s]

Based on the evidence of a case from 2009, neither can a pump...

 

[ElyDave]

That's a whole load of interesting posts there, I found that both basal haves and my bolus ratio also reduced from about 1:15g to 1:25g, better absorption in my case I think.

Interesting to see those two criteria as written, only one of which can be quantified as a single number HbA1c, the other is HbA1c with a qualification. How do you measure the lack of disabling or the lack of fear of potentially disabling hypos?

 

[Loliz]

Based on the evidence of a case from 2009, neither can a pump...

Ah... I agree, just a pump cannot. But I'd argue that being able to have a lower basal at certain times is bound to help those with problems during the night, so safer at least. And, that was before 'low suspend'. My new 640G pump suspends my basal before i go low - at about 5, and what happens then is my blood sugar pootles along at about 5, sometimes goes a bit lower, but then starts to rise, at which time the basal cuts back in. There are alarms at the 5, which wake me up and allow me to have a look at whether there are are any arrows - an arrow down, or two arrows down, and i'd also have something to eat. There's also an alarm AT low, just as a backup. I would suggest that this is about as safe as you could possibly be.