Good on you
@jade88 for posting and welcome!!
After 45 years on insulin and struggling to prevent nighttime hypos on 8 plus injections per day switching to a pump was a godsend. 7 years later I have not looked back. What I mention below is from my own experience of the insulin pumps and is not meant as professional advice or opinion.
The
pump forum on this site is a good source of information and you can type searches in the question box Right hand top about subjects like pump brands, needle ports, where to wear the pump etc. And there are reviews done by people on the net where you get to hear the stuff that pump reps do not mention such as the level and reliability of service, and annoying features vs good features of each pump brand. Of course rely on your health team who will be training you about the pump etc.
Where you live, what country etc will have a lot to do with what pump(s) are available to you, what costs are involved etc.
You are likely to be pretty familiar with
multiple daily insulin injections per day, called mdi and the idea of a basal-bolus regime? As in bolus is with short-actin insulin and basal is via long-acting insulin.
In an insulin pump only short-acting insulin is used. The basal regime is carried out by the pump putting in small doses of insulin every hour, more or less in a continuous fashion. At meals times a bolus infusion of insulin is used to help cover the rise in blood sugar from the meal, to correct high BSLs etc..
The beauty of the pump is that rather than injecting one or two doses of long acting insulin to deal with ones BSLs overnight and between meals
the basal infusion can be varied hour by hour to best suit your needs. For example some of us have a rise in blood sugar in the early morning (type in 'Dawn Phenomenon' in the question box on the Home page of this site to read about it). My basal regime for example is fashioned to put in extra insulin before this expected rise to prevent the rise happening. Not something that can be easily done with long-acting insulin, or you could wake up at say 3 am each morning and inject some short-acting insulin maybe on your mdi regime. Just the thing you need when sleep is at a premium for you !!
There are ways that the doctor or nurse helps work out
how much insulin you would need to pump in for a meal depending on the current blood sugar level (BSL) and the amount of carbs you are going to eat. Also there is a way to calculate (the pump does it then for you) how much of a
correction dose of insulin you need to correct a high BSL. And as these figures can vary through out the day (do you need more short-acting insulin to control BSL rise after breakfast than after dinner)?
Other features can include, at some cost, a
Continuous Glucose Monitoring system (CGM) where another device is placed on your skin with a fine cannula (tube) inserted under the skin and which reads your BSL and transfers the result to the pump.
One brand, and others to follow, can slow or stop the pump infusing insulin if you experience a hypo, but only if you are wearing the CGM. Not all pumps are capable of using CGM yet. Some pumpers prefer to use one of the other CGM devices like a Libre although these do not link to pumps as readily.
What about the downsides of the pump:
Some people find the pump gets in the way, there being essentially two types of pump: pumps with tubes and those without.
Pumps with tubing,
tubey pumps as we call them, such as the Medtronic, Tandem ones have a tube carrying the insulin from the pump to a needle inserted under the skin. The pump has all the buttons or touch screen on it. So one device only. Whilst this means a lot of variety in where the pump can be put,
the tubing can get tangled or caught on things and the
needle under the skin pulled out. Some pumps are bulkier than others and this can be cosmetically displeasing although there are lots of carrying devices to make life easier. (I like the stuffed Lion toy for children in the Medtronic range)!!!.
Non-tubey pumps such as the the Omnipod have the reservoir of insulin, and pump in a patch stuck to the skin, with the needle going direct from this to under the skin. A separate device, about the size of a mobile phone, is used to deliver instructions to the patch about how much insulin to deliver etc. So the places where to put the patch may limit one a bit and
some people worry about misplacing the separate control device (think about the inconvenience of misplacing the TV remote).
All current pumps have the risk of:
cannula problems - the needle under the skin lasts about 2 to 3 days, so changing that needle and filling up a new reservoir of insulin is a 2nd to 3rd daily routine (compared to 4 plus daily injections that you may be doing now).
When cannulas block or bend the delivery of insulin is affected and this affects BSLs. Because the cannula (either plastic or metal) is under the skin you cannot readily tell if it is bent, or partly blocked. So with otherwise unexplained high BSLs you need to think about changing the cannula set.
The big thing about such situations of less insulin being delivered when on an insulin pump is that there is no great reservoir of insulin in your body compared to when you are taking long-acting insulin. If the pump cannot deliver its supply of shorting insulin or can only do so marginally the last remaining insulin might last ? 6 hours, where as with an injection of long acting insulin that will last ? 20 hours plus from injection.
So you are likely to develop high BSLs and ketones faster with a blocked pump than on mdi.
Rarely pumps can fail. Like every piece of machinery things can go wrong. The way to make provision for this or where the cannulas keep blocking (not a usual situation beyond one or two) is to carry and store not only the short-acting insulin needed for the pump anyway but some long-acting insulin as a back up.
Finally pumps work with a battery which is either replaced periodically or recharged. So charging cords, chargers, or a spare battery is needed.
So there are pluses and minuses of sorts. People will no doubt post in about their individual pumps and the pros and cons. e.g.
@helensaramay,
@Mel dCP ,
@tim2000s ,
@Chowie @aphex2k @Chas C
I shall leave it there for now (to hopefully prevent you getting indigestion )!!
Best Wishes. And about small children:
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