Should I get a pump or should I not?

[blueflower]

Hello, and sorry if this subject isn't in the correct category.

I have been a type one diabetic for more than twelve years. I use pens, and the two insulins that I use are lantus and novorapid.

I have depression as well. And I haven't been handling my diabetes well in months, because I just would not care about it anymore. I often would not get correct doses because I did not bother calculating them well, and I also would accumulate shots or even forget to give myself lantus. Which eventually resulted in many bad blood sugars.

After a few critically low blood sugars and a lot of panic attacks, I finally understood that it was time to change things and to handle things like they were being handled before.

When things are good, my blood sugar does not get higher than 190 mg/dL and it never gets lower than 75 mg/dL. Unless a big accident happens. Moreover, I have had good A1Cs for years (between 6,1% and 6,7%), except for the last 6 months, in which my A1C was at 7,5%.

But my entire family thinks that the problem actually comes from insulin and from my pens, and that it wasn't my fault all along. Therefore they want me to get an insulin pump instead of using my pens. But I do not want a pump. I do not really want to try it, and I fail to see how could my life get any better with a pump, considering that my problem mostly comes from the fact that I would not adjust my shots correctly.

I am seeing my endocrinologist in two days and I am afraid she will persuade me to get a pump as well, considering she had been proposing it to me even when I would get correct glycemias and A1Cs. But I insist on the fact that I do not want to change my way of getting insulin and that if it ever had to happen, it would impact me greatly. I have been using pens for twelve years, I cannot imagine a life without them. I also have some diabetic friends who have a pump and aren't that satisfied, which also makes me doubt its reliability.

Could anyone who has a pump or who has had a pump in the past help me with that decision? Should I really get a pump or should I not?

I have been asking myself this question for weeks and weeks, and the more I think about it, the more I do not want to get a pump, but I could be wrong.

Thank you in advance!

 

[BobCornelius]

Hey blueflower!

I wear the Animas Vibe pump, and it has changed my life with diabetes! There are things that you can do with a pump (extended/combo bolus) that you cannot with injections, which makes things like pizza much easier.
The six to eight sub cut injections a day, predominantly in abdomen if I was out or at work, have been replaced by one cannula change every three days, using both legs as well as abdomen.
Reliability - I have not had a single issue, even though I wear pump outside clothing during the day, and sometimes it gets battered and bumped, but hey.
The vibe is waterproof, I go swimming in it. It comes off in the bath, because I like a hot bath but not hot insulin.
Pumping is not for everyone, I get that. But you never know until you try?
I love mine!

 

[WhiteleyGirl]

I have the Medtronic 640g and can say it has changed my life. So much easier and accurate to control blood sugars been on mone since August 2016 and my hba1c gone from 59 to 53.

This time last year it was 84 and I was in a bad place. But i think if you control blood sugars better makes you feel better within yourself. Thats what I found anyway, wasn't tired all the time was't feeling ill.

Its so discreet and easy to change the sets and you don't need to do injections. Pump works out your corrections for you. Excuse the pun but its a piece of cake.

Good luck xx

 

[blueflower]

Hello, thank you so much for your answers!

After reading what you two have told me, I believe I should try it nevertheless, even if it does not really appeal to me for the moment. I guess it is only because I am so used to my pens and that change is sometimes difficult.

I think my endocrinologist may propose me to try it for something like three months. In case it does not work for me or if I do not like it, I think I will always be able to not wear it anymore and use my pens again.

Trying new things is essential I believe. Especially with a chronic disease like that. Moreover, I may get a CGM at the same time. It could be nice.

Thanks again, your messages were really reassuring!

 

[Juicyj]

Hello @blueflower My control before going onto the Medtronic 640g a year ago was pretty rubbish, every HbA1C swung high/low there was never a happy medium, I really was banging my head against the wall all the time, I felt useless and most of the time out of control, I was scared of going onto the pump and saw it as 'defeat' (please don't ask me where I got this mindset from, I still don't understand it now), I felt like I had to win the battle with MDI before qualifying for a pump. Fortunately I had a very sympathetic DSN who didn't push me but made me start to see things a little differently and that I could fine tune, tweak, and have a different life with a pump, so eventually after alot of pushing I got there and was offered one. At this point I knew there was no going back and that I would have to embrace it and really work on it and the honest answer a year on is why didn't I push for it sooner, I had my best HbA1c in October at 52, this time last year I was 68. I cannot recommend using a pump enough now, I also am not so anxious, on MDI I felt like I was always on edge trying to calculate, get it right, now I fine tune the pump settings when I see a pattern, I have much better control and a better quality of lifestyle. It is discrete and it's never an issue with sleep or exercise. The worst case scenario for you is that you get a pump, decide it's not for you after say 3 months and hand it back, best case scenario is improved HbA1c, better quality of life, bit of a no brainer really..

 

[blueflower]

@Juicyj , thank you so much! I totally understand the "failure" point of view because this is sort of how I felt like when my endocrinologist first proposed me to get a pump a few months ago. It's unexplainable, but that's definitely how I felt. Not so much right now, however.

It also reassures me because my A1Cs are my biggest anxiety. Every time I go to my endo, I'm always afraid to get bad numbers. This should as well make me feel better.

I do not exercise mainly because I am afraid to get low blood sugars, but now that you told me there were no problems with the pump, I might even start something

It's mostly difficult to make a choice like that when it's non-diabetic people who propose it to you, because there is no "direct proof" but now that I have gotten such positive reviews, I think I am more confident about it now. I don't know if you see what I mean? But anyway, thanks a lot

 

[Juicyj]

Glad to hear it @blueflower - yes exercise is easier as you can put an exercise setting into your pump to reduce your basal over a period of time, the same goes for other events say shopping which can burn the glucose a little quicker, you can also put single units into the pump, so if you want .8 units for your carbs eaten then you can set your pump to bolus for this, rather than .5/1 units on a pen. You are only using novorapid in a pump for both basal and bolus, so one insulin only.

It's re-assuring that i'm not the only one to consider the act of defeat in moving onto this, it's silly really as it's your health and life at stake here. I have a daughter and want to live a long and complication free life, moving onto the pump was my insurance policy that I could do this and have a healthy life, I really haven't looked back since I started on it

 

[azure]

Only you can decide whether a pump is right for you @blueflower

Personally, I love my pump - a lot! I'd never give it back! It's given me freedom and the ability to fine-tune my insulin to an extent injections never could. My pump is an Animas Vibe. I've been pumping for 13 years

One important thing to say is, as you correctly imply, a pump is only as good as its user. If someone doesn't bother to adjust the basal as needed, or to carb count properly, etc, then the pump isn't a good idea.

Have you explained to your family that you hadnt been giving your diabetes the attention it needed and that that was the cause of your less good numbers?

Are you receiving good help with your depression? To my mind, that would be more important than a pump.

A final thing to say - don't have preconceptions about pumps. The reality would probably be very different from what you're imagining, so don't let any concerns put you off.

 

[blueflower]

@Juicyj I didn't know about the exercise setting! That's really great honestly, nobody told me about it. Thank you!

@azure , what a nice profile picture you have Thank you for your input, I have tried to tell my family about it but they did not really understand, they still think that injections are bad for me and that a pump would increase my life quality. I guess they're not entirely wrong, but since I badly counted my carbs for months... that is my fault only if my numbers were / are bad!

About depression, I haven't seen a therapist in months, mostly because of lack of time and money (and also motivation considering I had a bad experience with all the therapists I have seen) but I really should see one at this point.

I'm seeing my endo tomorrow, I guess I should give it a try? I actually have two endos, this one works at a specialized center for young diabetics and the other one is in a hospital. If I had to get a pump, perhaps it would be wiser if I tried it in the specialized center?

Many thanks!

 

[vans]

See if you can get on a carb counting course too.
I'm sure if you can get a handle on your diabetes management through a pump and proper carb counting, your depression and panic attacks will decrease too

Best of luck

 

[blueflower]

Hello everyone!

I just got out of my endo appointment. My endocrinologist analyzed the situation, and she told me that indeed my biggest problem is from carb counting. And from lantus also, because apparently it is too strong for me. So she told me to get toujeo instead, which apparently is a new variant of lantus. She told me that a pump would not get rid of bad carb counting, but if I ever wanted to get one, there would be no problems. For the moment I am going to see how it goes with a good carb counting and toujeo, and if it still is bad, I will try a pump.

I thank you all for your help and support, you all helped me to get rid of my prejudice about pumps

Oh by the way my A1C is at 8%, dear god