1. This site uses cookies. By continuing to use this site, you are agreeing to our use of cookies. Learn More.
  2. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  3. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2019 »
    Dismiss Notice
  4. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Benefits and Drawbacks of an insulin pump

Discussion in 'Insulin Pump Forum' started by MeiChanski, Apr 17, 2019.

  1. MeiChanski

    MeiChanski Type 1 · Well-Known Member

    Messages:
    153
    Likes Received:
    65
    Trophy Points:
    48
    Hello Diabuddies!

    I hope you are well :)

    I had a brief conversation with my consultant on the phone, in regards to my hypoglycemias and being unaware of it during the night.

    A short start: I am on novorapid and levemir.

    I was prescribed Tresiba by my new consultant on 2nd April.as a way to reduce hypos and as we all know, Tresiba is a flat profile insulin. I started this on the 3rd April starting at 9 units. From then onwards I was experiencing hypos during the night and with the libre, my boyfriend was able to help me. I took it every day at 21:10 at night and because of the hypos I switched to take Tresiba during the afternoon around 12:15, then I was experiencing hypos during the day and wake up low during the morning without novorapid on board.

    Fast forward to 15th April, I spoke to my GP asking about what I should do, because I don't see my consultant until June and I'm going back to university for my final year living by myself this september. GP said it is out of their expertise but only referred me for therapy.

    17th April - a DSN contacted me because of my urgency and in need of help and advice, she told me to reduce my Tresiba by 50% so 4 units and ask my consultant about the technologies that are available because I'm hypo unaware during the night (my boyfriend did witness this on my libre).
    So after that conversation, I contacted my consultant to talk about my concerns. He said he would refer for pump therapy but even then I might experience hypos with a pump. I said I understand that as well, but my main concern is I could be dead during my sleep and being away from home, I have no one to call for help if I needed it. He also said a CGM wouldn't help in safeguarding my hypos either. In the end he said if I can reduce my hypos on MDI, it'll be better for everyone and myself. (I know pumps are expensive).

    So other than reducing my insulin doses, I feel I've exhausted my options I am on minuscule dosages of novorapid and small dose of Tresiba.

    My question is: In theory, how would a pump help my situation if I were to be given that opportunity to have one?
     
    • Friendly Friendly x 1
  2. Robinredbreast

    Robinredbreast Type 1 · Oracle

    Messages:
    15,602
    Likes Received:
    24,659
    Trophy Points:
    298
    • Like Like x 1
  3. Juicyj

    Juicyj Type 1 · Moderator
    Staff Member

    Messages:
    6,085
    Likes Received:
    5,460
    Trophy Points:
    198
    Hi @MeiChanski :)

    Can I check when you were going hypo during the night did you check in your BG meter too ? The Libre when compressed during the night can give false low readings, a few of us here have experienced them. I do always check any Libre reading when high/low against my meter anyway to double check.
     
    • Agree Agree x 1
  4. MeiChanski

    MeiChanski Type 1 · Well-Known Member

    Messages:
    153
    Likes Received:
    65
    Trophy Points:
    48
    Yes I've been without the libre for some time now and it's all finger pricks with hypos.
     
  5. Juicyj

    Juicyj Type 1 · Moderator
    Staff Member

    Messages:
    6,085
    Likes Received:
    5,460
    Trophy Points:
    198
    Ok just needed to check as you didn't mention using a meter.

    The difference between using Tresiba/novorapid and a pump is the pump works solely on novorapid, Tresiba takes up to 36 hours to deplete from your system, whereas novorapid in the pump up to 4 hours so making adjustments can happen much quicker on the pump, also your dosing in 0.1 units compared to using 1 unit of insulin on injections meaning you can really fine tune your doses, you add basal settings depending on activity levels or illness and can adjust your basal settings many times during the 24 period so can drop basal setting right down at night if your going low then and increase for the morning if you tend to run higher then.

    The pump does require a bedding in period where a lot of work will be required to changes ratios and adjust so you would need to be prepared to deal with this and do the work to get settings adjusted, but if your consultant has suggested this then I would seize the opportunity with both hands and go for it, it's certainly helped me reduce my HbA1c right down and I much prefer it to injections now.
     
    • Agree Agree x 1
  6. MeiChanski

    MeiChanski Type 1 · Well-Known Member

    Messages:
    153
    Likes Received:
    65
    Trophy Points:
    48
    Thank you, sorry I didn't mention using my BM. In that case then, could people still abuse the pump and still have hypos and hypers? My consultant is the only person who can initiate the process for the pump. But i'm trying to understand his theory/perspective of going low on a pump.
     
  7. Juicyj

    Juicyj Type 1 · Moderator
    Staff Member

    Messages:
    6,085
    Likes Received:
    5,460
    Trophy Points:
    198
    Hi @MeiChanski You generally find people who are using the pump have tried and exhausted themselves on multiple daily injections, so folk who are committed to looking after their diabetes but who are not succeeding in good management and who are prepared to put the effort in, the NHS don't hand pumps out due to cost hence why they are prepared to review cases where patients are showing willing in making it work for them but meet NICE criteria.

    The pump alone will not avoid hypos/hypers but with careful monitoring and adjustments it can make hypo and hyper events less severe as your taking smaller doses of insulin. I still have the same amount of hypos a week but they are very mild now and easier to treat and recover from.
     
    • Agree Agree x 1
  8. MeiChanski

    MeiChanski Type 1 · Well-Known Member

    Messages:
    153
    Likes Received:
    65
    Trophy Points:
    48
    Thank you again, I thought I cracked the code by taking my Tresiba during the day, but hypos during the day is lesser than the two evils. Awkwardly I don't feel them but I am alive during the day so it is easier to treat. I understand the pump alone isn't a miracle product but as you say you can fine tune dosages and manage yourself better. Along with small doses of insulin, it is more manageable than taking two different types of insulin.

    Could you think why some people would say the pump wouldn't work for them?
     
  9. Geordie lass

    Geordie lass Type 1 · Well-Known Member

    Messages:
    146
    Likes Received:
    154
    Trophy Points:
    103
    I too am hypo unaware. I live alone and I always have hypo's overnight...my Consultant was very worried about this and I was last year funded for CGM. I have been using a Medtronic pump for years now and I currently use the 640G, which links up with the CGM Enlite sensors provided by Medtronic, to read my BGL's 24/7. I still have to test my BGL's a few times during the day to callibrate my pump & CGM, but it has been a life saver for me, especially overnight.

    This is great because I can set my pump so that when the CGM suspects me going low it suspends my insulin pump until my BGL's rise above a certain level. It is definitely worth getting a pump and using it along with CGM, especially as you have nocturnal hypo unawareness. You should push this with your Consultant as you should be funded for the CGM alongside an insulin pump, especially not being hypo aware! Good luck!
     
  10. MeiChanski

    MeiChanski Type 1 · Well-Known Member

    Messages:
    153
    Likes Received:
    65
    Trophy Points:
    48
    Thank you for your input, I don't know what the CCG here offers in terms of pumps and CGMs. I've been worrying about overnight hypos since my accident in 2013 and I did DAFNE last year for a deeper understanding of carb ratios. I will be living alone during my final year of university and I have expressed this to my consultant. He said very briefly he'll consider me for one if Tresiba is making my go hypo from now until I see him in June.

    Have you had any troubles or frustrating moments with your current kit?
     
  11. Geordie lass

    Geordie lass Type 1 · Well-Known Member

    Messages:
    146
    Likes Received:
    154
    Trophy Points:
    103

    Yes, I've had a few issues with my sensors not working properly. They are supposed to work for 6 days, but sometimes they only last 3-4 days. I've reported this to Medtronic on many occasions, and I must say, they have been very good in sending replacement sensors for me as well as a replacement transmitter! But, other than that the CGM's have been a lifesaver for me over the last 18 months of wearing them. I would be totally lost without them now. My pump also alarms and tells me when I am heading towards hypo stage, so that is a double bonus for me. Sometimes when I'm asleep I don't always hear my alarm, but that doesn't bother me as I know my pump will suspend insulin when I reach a BGL reading of 4.5! And, it doesn't resume insulin until my BGL numbers are in the safe zone!
     
  12. Chowie

    Chowie Type 1 · Well-Known Member

    Messages:
    383
    Likes Received:
    191
    Trophy Points:
    83
    Hi,
    I have the Medtronic 640g with CGM. I have disabled the hypo prevention as the sensor connectivity to the pump is very problematic and unreliable. They have just released the new sensors in Australia and they maybe better.

    Pros
    Better control
    More flexibility with eating
    Fewer Hypos
    Fewer Hypers

    Cons
    Poor quality control of the pump (Medtronic)
    Not able to calibrate the sensors when you need to (pump and sensor are having a hissy fit)
    A few obnoxious call centre staff
    Door handles (Medtronic) the tubing jumps out and wraps itself around anything it can
    Skin damage from the adhesive tape sometimes causing ulceration and pain half way through the life of the sensor (Medtronic)
    I kept putting off going onto a pump, I wish I had done it sooner.


    I don’t have an issue being tethered to it or carrying it around or sleeping with it I let it roam free in the bed and I toss and turn all night. With a little thought QA and sone good managers in the company this could be an exceptional device, however I wouldn’t go back to MDI even with all it’s faults.
     
  13. Geordie lass

    Geordie lass Type 1 · Well-Known Member

    Messages:
    146
    Likes Received:
    154
    Trophy Points:
    103

    Hey @Chowie. Sorry to hear you are having so many problems with your Medtronic pump and CGM. Have you reported these issues? I've not experienced these issues and have been pumping for many years, 18mths with CGM. Sometimes my sensors do not calibrate, but I always report any problems with Medtronic and have found their customer service to be excellent. I hope your issues get resolved.
     
  14. helensaramay

    helensaramay Type 1 · Well-Known Member

    Messages:
    4,634
    Likes Received:
    4,455
    Trophy Points:
    178
    @MeiChanski as others have mentioned an insulin pump in itself does not stop hypos.
    However, the amazing benefit is that you can change your basal requirements throughout the day.
    A slow acting insulin like Tresiba assumes your basal requirements are exactly the same 24 hours a day.
    However, with things like Dawn Phenomenon, we know some people need more background insulin at certain times of the day.
    If you are often having hypos in the middle of the night, this could suggest you need less background insulin at night so you can reduce your basal dose whilst you are sleeping.
    I use a pump and find it incredibly useful when I exercise as my insulin needs plummet during, for example, a Spin class so I can turn off basal rather than stuffing myself with biscuits before I get on the bike.

    I assume your consultant's suggestion for a pump is to allow you to match your basal dose to your body's needs rather than assuming it needs the same amount all the time.
     
    • Agree Agree x 1
  15. Antje77

    Antje77 LADA · Well-Known Member

    Messages:
    2,819
    Likes Received:
    2,185
    Trophy Points:
    198
    Have you looked into the MiaoMiao? You put it on your sensor and makes your phone alarm when going low. That might help you with the night time hypo's. You'll have to buy it yourself but you use it again and again.
    I don't no much about pumps, so no advaice about that.
     
  16. porl69

    porl69 Type 1 · Well-Known Member

    Messages:
    2,053
    Likes Received:
    2,737
    Trophy Points:
    198
    Thanks for the tag @Robinredbreast
    Hi @MeiChanski sorry to hear you are having problems with your diabetes management.
    You will hear this a lot, a pump does not stop hypos! Where you are going hypo during the night you would have the ability to change the basal settings many time in a 24 hour period...You will be attached to the pump 24/7 - less a few minutes for showers. that has never been a problem for me A pump takes a lot of work at the start to get your basal rates etc set up and take a bit of management to maintain the settings to keep your bloods as flat as possible. BUT they are so worth it. After 48 years of T1D I have my lowest A1C for 35 odd years a few weeks ago and that was after starting on the pump

    @Chowie I had an obnoxious cow when I was placing my 1st order with them. I asked to speak to a supervisor and reported her. Sorry BUT she should have been more helpful and less obnoxious. Always report them and any probs you have your pump mate. We deal with enough c**p every day, we certainly don't need it off customer support
     
  17. MeiChanski

    MeiChanski Type 1 · Well-Known Member

    Messages:
    153
    Likes Received:
    65
    Trophy Points:
    48
    I'm glad to hear that :) Is the alarm obnoxious or quite a soothing beep?
     
  18. MeiChanski

    MeiChanski Type 1 · Well-Known Member

    Messages:
    153
    Likes Received:
    65
    Trophy Points:
    48
    Thank you :) Why is it unreliable? is the accuracy is incorrect? Would you have picked another pump/CGM? Oh dear, I'm sorry to hear that you've been unable to calibrate. I understand the skin damage, freestyle libre has left me some marks and bruises after taking it off.
     
  19. Juicyj

    Juicyj Type 1 · Moderator
    Staff Member

    Messages:
    6,085
    Likes Received:
    5,460
    Trophy Points:
    198
    Hello @MeiChanski I currently use the Dexcom G6 which lasts 12 days, the sensor sits on your tum and you can set an alarm for highs/lows through the app on your phone, so as long as your near your phone you will be alerted, I pay a monthly DD of £159 for the system, you can also calibrate the dexcom which you're unable to do with the libre. It's cheaper than the Medtronic Enlite CGM and more accurate than the libre and in my opinion well worth the money for the re-assurance.
     
  20. MeiChanski

    MeiChanski Type 1 · Well-Known Member

    Messages:
    153
    Likes Received:
    65
    Trophy Points:
    48
    Hello, you are indeed correct, fortunately Tresiba is good during the day and unfortunately I drop during the night and waking up low. I was told to reduce it by 50%. When I was on levemir I was constantly tweaking it as well.
    I understand an insulin pump doesn't stop hypos or hypers, from what you're saying an insulin pump does give you that space to alter needs throughout the day or within the 24 hour period. From my consultant and his tone, he would refer me for a pump but at the same time he wouldn't. :hilarious:
     
    • Hug Hug x 1
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook