Benefits and Drawbacks of an insulin pump

[MeiChanski]

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.

I indeed have, this weekend I'm seeing my parents and got some hustling to do.

 

[MeiChanski]

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

Thank you, I've heard from a few diabetics that it is indeed more work than MDI, with an ounce of feeling assured. I am confident on MDI, it's just the aftermath I don't really know because I can't extract the insulin out. Congrats on your A1c, I'm quite jealous now.

 

[MeiChanski]

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.

Oh yes I was looking at the payment plan for it, but gosh diabetes is a rich man's disease. I'll weigh it up against the miaomiao

 

[MeiChanski]

Hello again,

Gosh I feel like i'm doing a research paper for my thesis. But I find it difficult because I have nothing to compare to MDI so I want to know if there's anyone who disliked the way the pump worked? I've only heard good things about the pump.
Moreover, several consultants couldn't give me an answer on my question:
is the control much better on average on a pump vs MDI?

 

[Chas C]

Hi @MeiChanski

I moved to a pump for very similar reasons to why your considering one and asking questions. I had similar thoughts to you and wasted 7 years deciding, in the end I bit the bullet and never regretted it.

Take up the offer of a pump - if you don't like it then go back to MDI's, just remember the first few weeks/months of pumping is a lot of effort.

 

[Juicyj]

Oh yes I was looking at the payment plan for it, but gosh diabetes is a rich man's disease. I'll weigh it up against the miaomiao

I thought that before I signed up but was fed up with going low/high and wanted to try and stabilise my control more, but the funny thing is once you're a few payments down the line and have seen the benefits of control then it becomes almost necessary, as I said to my mum last week, you find the money, it's like being addicted to fags, you need to fund it

 

[MeiChanski]

I thought that before I signed up but was fed up with going low/high and wanted to try and stabilise my control more, but the funny thing is once you're a few payments down the line and have seen the benefits of control then it becomes almost necessary, as I said to my mum last week, you find the money, it's like being addicted to fags, you need to fund it

My boyfriend was like "that's like paying for a car"
My mum was sending me money for libres every 2 weeks, so it is in a way supporting a drug habit. Apparently my hospital does so dexcom loan outs for a week for a try out. I suppose that could be an option but I'd rather have my own tbh. Has it ever been inaccurate for you?

 

[MeiChanski]

Hi @MeiChanski

I moved to a pump for very similar reasons to why your considering one and asking questions. I had similar thoughts to you and wasted 7 years deciding, in the end I bit the bullet and never regretted it.

Take up the offer of a pump - if you don't like it then go back to MDI's, just remember the first few weeks/months of pumping is a lot of effort.

Hello! Well my consultant is like pulling on some straws before considering me for one. Like "reduce tresiba by 50%" then "consider increasing your carb ratio to 1:1.5" So we got a few hoops to jump still.

 

[Juicyj]

My boyfriend was like "that's like paying for a car"
My mum was sending me money for libres every 2 weeks, so it is in a way supporting a drug habit. Apparently my hospital does so dexcom loan outs for a week for a try out. I suppose that could be an option but I'd rather have my own tbh. Has it ever been inaccurate for you?

Yes there are times where it's been inaccurate, so after doing a 5km run it's registered low when i've been in range, it does take a while to catch up with my meter at times and I do check against my meter for lows anyway, but on the whole it's pretty accurate particularly at night time, i've never had anomalies then.

Ask about getting a try out from your hospital and see what you think ?

 

[MeiChanski]

Yes there are times where it's been inaccurate, so after doing a 5km run it's registered low when i've been in range, it does take a while to catch up with my meter at times and I do check against my meter for lows anyway, but on the whole it's pretty accurate particularly at night time, i've never had anomalies then.

Ask about getting a try out from your hospital and see what you think ?

Thank you, So it is similar to the libre, it needs a bit of time to catch up. I could ask about it, but my potato brain didn't ask if the diabetes centre has one yesterday, but rather the DSN told me to ask my consultant for one to be considered on prescription.

 

[Juicyj]

Hi @MeiChanski I have also used the libre and in regards to accuracy i've found the G6 much more accurate than the libre, you have the added benefit of calibrating the G6 too, which helps accuracy, all systems are fallible and more so if glucose levels are moving quickly, so after events like exercise or if dropping due to too much insulin. Generally the G6 has been much closer to my meter than the libre ever was.

 

[MeiChanski]

Hi @MeiChanski I have also used the libre and in regards to accuracy i've found the G6 much more accurate than the libre, you have the added benefit of calibrating the G6 too, which helps accuracy, all systems are fallible and more so if glucose levels are moving quickly, so after events like exercise or if dropping due to too much insulin. Generally the G6 has been much closer to my meter than the libre ever was.

Thank you again

I guess our taste is getting a bit more expensive,
I know the libre is a bit different to the G6, would you say without a pump, is it still useful to have one?

 

[Juicyj]

Thank you again

I guess our taste is getting a bit more expensive,
I know the libre is a bit different to the G6, would you say without a pump, is it still useful to have one?

Your main benefits are accuracy and it's linked to the app on your phone which is alerting you if high/low, even if you're on injections it's still a really useful piece of kit, the issue with getting access to a pump is that it can take a while from being accepted, pump order to then getting it and still then it needs user input to manage it, at least with the G6 you can be using it within a week and able to make significant changes to your control in using it - also to note the G6 is used with Clarity software, which looks for patterns in your readings and can alert you to where doses need adjusting to improve control, it's a more intelligent approach to blood glucose management that puts the user in control.

 

[MeiChanski]

Your main benefits are accuracy and it's linked to the app on your phone which is alerting you if high/low, even if you're on injections it's still a really useful piece of kit, the issue with getting access to a pump is that it can take a while from being accepted, pump order to then getting it and still then it needs user input to manage it, at least with the G6 you can be using it within a week and able to make significant changes to your control in using it - also to note the G6 is used with Clarity software, which looks for patterns in your readings and can alert you to where doses need adjusting to improve control, it's a more intelligent approach to blood glucose management that puts the user in control.

Thank you, that's an interesting input. No wonder why it's so expensive Have you come across anyone not getting on with it? It's like ordering food, this talk about G6 is making my mouth drool like "oooooooo, better blood glucose management? i'm in".

 

[Deleted Account]

@MeiChanski I apologise for not answer the direct question in your original post.

From my perspective the benefits of a pump are
- ability to vary my basal insulin which reduces highs and lows
- I don't have to remember to take my insulin with me wherever I go because it is always attached
- the pump includes a bolus calculator which saves my maths. Some meters provide this but I found them tedious to use.
- the pump allows "combo bolus". This provides a bolus over a longer time which means it is great for eating meals with high fat without the need for double bolusing

The negatives are
- it takes some time to set up which meant there were frustrations at the beginning
- my basal needs seem to change over time (weather, exercise, illness, ...) so even when it is set up, I still need to tweak it ever so often
- I have to take much more paraphernalia with me when I go away. Pump sets are bulky and I have to take my pens in case the pump fails
- If the pump fails, as I have no long acting basal insulin, my BG can rise much quicker so the risk of prolonger hyper is higher than injecting.
- For me, the pump is bulky and difficult to hide whilst making it available for bolus doses. Therefore, it feels as if my diabetes is on display at all times. I currently use a tubed pump (which I have not caught on door handled because I tuck the tube away) but I am hoping to get a patch pump which will have no tube and easier to hide.

My pump and I have a love-hate relationship. But most of the time we are friends and I would fight hard if it was suggested I went back to injecting.

 

[MeiChanski]

@MeiChanski I apologise for not answer the direct question in your original post.

From my perspective the benefits of a pump are
- ability to vary my basal insulin which reduces highs and lows
- I don't have to remember to take my insulin with me wherever I go because it is always attached
- the pump includes a bolus calculator which saves my maths. Some meters provide this but I found them tedious to use.
- the pump allows "combo bolus". This provides a bolus over a longer time which means it is great for eating meals with high fat without the need for double bolusing

The negatives are
- it takes some time to set up which meant there were frustrations at the beginning
- my basal needs seem to change over time (weather, exercise, illness, ...) so even when it is set up, I still need to tweak it ever so often
- I have to take much more paraphernalia with me when I go away. Pump sets are bulky and I have to take my pens in case the pump fails
- If the pump fails, as I have no long acting basal insulin, my BG can rise much quicker so the risk of prolonger hyper is higher than injecting.
- For me, the pump is bulky and difficult to hide whilst making it available for bolus doses. Therefore, it feels as if my diabetes is on display at all times. I currently use a tubed pump (which I have not caught on door handled because I tuck the tube away) but I am hoping to get a patch pump which will have no tube and easier to hide.

My pump and I have a love-hate relationship. But most of the time we are friends and I would fight hard if it was suggested I went back to injecting.

It's no problem, I'm just speaking in a theoretical sense whether a pump could be beneficial or not in my case. I just want to be able to sleep at night and tell my parents and bf that i'm okay. unfortunately my parents don't know about my accident in 2013. If I tell them about it, they'll go to hospital up in arms asking why nothing has been done. (They too, have seen me on the floor prior to going to university and they are incredibly worried. They sometimes call university security to check up on me, because they do a route around university).

I've seen some people on instagram that have had an oopsie moment when there is a pump failure and BG does go up into scary levels. is it avoidable? or not really? I've seen some patch pumps and it's slightly thicker and wider than the libre so I don't know how I feel about it, but do let me know.

Would you say you are worry free to some extent? compared to me living life worrying all the time.

 

[Deleted Account]

I've seen some people on instagram that have had an oopsie moment when there is a pump failure and BG does go up into scary levels. is it avoidable? or not really?

I have had a pump for 3 years. In that time, I have had it replaced twice ... and neither time has been an "oopsie moment". One was when I noticed a small crack, The pump appeared to be working fine but the manufacturer replaced it within 24 hours. The other was when it started beeping at me in a cafe in front of my in laws (I got a bit stressed because they got stressed). I had enough time to get home, get my pens out and revert to injections until the pump was replaced.
When I first had the pump, I had a couple of times when I incorrectly inserted the cannula so it was not giving me insulin. I make a habit of being extra vigilant when I have just made a change and do the change when I have time to try again if it is wrong. So, I would never do a set change (fill the pump with insulin and change the cannula) at night - I always do it in the morning and carry a spare set with me for the next couple of hours.
So, as far as avoiding scary levels - it is best achieved through extra testing. Although your BG will go up faster with a pump than when injecting, it will not go up as fast as it can fall if you take too much insulin. So you should have time to notice and do something about it.

I've seen some patch pumps and it's slightly thicker and wider than the libre so I don't know how I feel about it, but do let me know.

I will find out in a month's time. At the moment, I hate my pump being on display. This may be exaggerated because I am quite slim or I may just be vain. So I am looking forward to hiding it away. I tried a dummy patch pump recently and found a couple of places where I can put it without it being seen.
Some people put their patch pump on their upper arm or upper leg. I do not think these places are suitable for me because I climb and exercise a lot so they will get in the way. And if you exercise an area you have just injected into the insulin will be absorbed faster.
I think there are more things to consider with a patch pump. But that may just be because I am familiar with a tubey pump.

Would you say you are worry free to some extent? compared to me living life worrying all the time.

I don't think I will ever be "worry free" with diabetes. To me, that would suggest I am not taking diabetes seriously.
I find I think more about my diabetes with the pump as I adjust the basal rates up and down.
But I am more confident that my BG levels will not go sky-high or plummet (if I count my carbs correctly).

I was unsure about having a pump after injecting for 12 years but the thing that convinced me was being told I could give it back if I didn't like it. I am sure this will cause some problems for the diabetes team but they were open to me changing my mind.
If you are able to get a pump soonish you should have time to break it in and regain your confidence before going back to university.

 

[MeiChanski]

I have had a pump for 3 years. In that time, I have had it replaced twice ... and neither time has been an "oopsie moment". One was when I noticed a small crack, The pump appeared to be working fine but the manufacturer replaced it within 24 hours. The other was when it started beeping at me in a cafe in front of my in laws (I got a bit stressed because they got stressed). I had enough time to get home, get my pens out and revert to injections until the pump was replaced.
When I first had the pump, I had a couple of times when I incorrectly inserted the cannula so it was not giving me insulin. I make a habit of being extra vigilant when I have just made a change and do the change when I have time to try again if it is wrong. So, I would never do a set change (fill the pump with insulin and change the cannula) at night - I always do it in the morning and carry a spare set with me for the next couple of hours.
So, as far as avoiding scary levels - it is best achieved through extra testing. Although your BG will go up faster with a pump than when injecting, it will not go up as fast as it can fall if you take too much insulin. So you should have time to notice and do something about it.

I will find out in a month's time. At the moment, I hate my pump being on display. This may be exaggerated because I am quite slim or I may just be vain. So I am looking forward to hiding it away. I tried a dummy patch pump recently and found a couple of places where I can put it without it being seen.
Some people put their patch pump on their upper arm or upper leg. I do not think these places are suitable for me because I climb and exercise a lot so they will get in the way. And if you exercise an area you have just injected into the insulin will be absorbed faster.
I think there are more things to consider with a patch pump. But that may just be because I am familiar with a tubey pump.

I don't think I will ever be "worry free" with diabetes. To me, that would suggest I am not taking diabetes seriously.
I find I think more about my diabetes with the pump as I adjust the basal rates up and down.
But I am more confident that my BG levels will not go sky-high or plummet (if I count my carbs correctly).

I was unsure about having a pump after injecting for 12 years but the thing that convinced me was being told I could give it back if I didn't like it. I am sure this will cause some problems for the diabetes team but they were open to me changing my mind.
If you are able to get a pump soonish you should have time to break it in and regain your confidence before going back to university.

Thank you again, Helen. I'd like to give you the biggest virtual hug. Going back onto pens while waiting for your new pump to arrive, did that mess up with your routine in any way? out of control blood sugars?
I can relate on the topic of being vain, I remember back in secondary school, other students hated me taking my insulin in class, so from there on wards, I would rather people not see the gadgets. I've seen some people mostly stick it on their belly or upper thighs, the juicy areas. Are you still considering which patch pump to go with?
Not entirely worry free, but less worried that you can sleep a few hours, feel refreshed and be prepared to conquer the next day. Have you had any other problems with your pump, or things that I need to keep my heads up about the pump? I'm a bit unsure whether it would work for me because I don't want to be on the pump and face more issues and wasting NHS money for an expensive kit. How long did it take you to be referred? I know each CCG is different, my consultant said it won't be long, but never told me the estimated time frame to have funding approved.

 

[Deleted Account]

Going back to my pen was a little bit of a pain for 2 days until I got a replacement pump but mostly because of the basal - I had got used to the variable basal and I had to take it as soon as possible after my pump failed which was not a convenient time of day. But as it was for a short period (2 days out of over 3 years), I do not think it is something to worry too much about as long as you keep your pens (and insulin in date) as a backup.

The only other pump "problem" is airport travel as it cannot be x-rayed. I fly a lot (at least one return trip a month) so have got used to politely telling the security guy that I will not go in the body scanner. Most of them (in various countries) understand what this means. Heathrow were once nasty and told me I chose to have diabetes (I reported her to her manager) and, I learnt, in Brussels, not to wrap it around my thigh as it meant I had to lift my dress up in public to prove it to the security person!

Apart from that I think I have covered everything.

I think I expressed an interest in the pump in September. I then had to go on the DAFNE course (this is a prerequisite in most areas to ensure you know how to carb count) which was 6 weeks long (one night a week for 6 weeks). And I got my pump in January.
I think if I had already been on the DAFNE course, I think I would have got it quicker. But as you say, all CCGs seem to be different.

 

[Geordie lass]

I'm glad to hear that Is the alarm obnoxious or quite a soothing beep?

The pump alarms are annoying, especially throughout the night, when hypoing, but I guess that's a good thing as it makes you wake up to stop the alarms. However, I sometimes sleep through my alarms!!