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Considering returning to insulin pens

Discussion in 'Insulin Pump Forum' started by Soplewis12, Jul 25, 2021.

  1. Soplewis12

    Soplewis12 Type 1 · Well-Known Member

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    Has anyone else considered returning to insulin pens? I had a decent Hba1c of 51 before commencing omnipod dash in early March this year. Libre is showing current 48 which is great but I am finding the day to day usage of pump such a struggle, especially busy weekends & this hot weather. When on pens I reduced basal by 2 units at weekends, which worked well for me. If doing any exercise I'd have my ususl 40g carb lunch, no bolus & then exercise. My reason for swapping to pump was I had very early signs of retinopathy in one eye (31 years type 1). I feel as if the pump has increased my diabetic anxiety. I am normally quite chilled about it. I am constantly checking & adjusting for patterns but there are so many outside influences having an impact than when on pens. Big example is the heat & sun did not affect me when on pens & today I am now down to 50% insulin & still had to suspend insulin earlier. I find it so frustrating.
    Any thoughts? X
     
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  2. In Response

    In Response Type 1 · Well-Known Member

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    Whilst I have not reverted back to pens, you wouldn’t be the first to do so.
    If you find them easier and you were able to maintain a HbA1C in the low 50s without lots of hypos and with less anxiety, I think you should talk to your diabetes team and explain your thinking.
    Pumps don’t suit everyone. And you shouldn’t judge yourself on others. It is your diabetes that you have to manage every day.
    I love mine but it has made it think about diabetes more. Dosing no longer feels like the conveyor belt of same sized pieces that come out of the factory; it feels more like the conveyor belt of a supermarket shop in preparation for Christmas. (Sorry, I think my analogy ran away with itself.)
     
  3. thelma W

    thelma W Family member · Newbie

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    Insulin pens for diabetes are widely used in most countries, with the exception of the United States where vials, injections and syringes are the preferred tools for insulin injection. They come in different sizes ranging from 1.5 ml to 3.0 ml.

    Types of insulin pens:

    There are several manufacturers of insulin pens that allow users to have a variety of options. There are pre-filled pens that are generally recommended for type 2 diabetics. These pens have a pre-mixed insulin dosage, which makes it easier for users to determine how much insulin to use. These pens are disposable and must be replaced when the insulin cartridge is empty. The disadvantage of this type of pen is that it does not allow for adjustment of exercise and diet.

    The other type of pen is the durable pen. It uses replaceable insulin cartridges that are only discarded when their contents are completely used up. Once a new cartridge is in place, the pen is ready for use again.

    Insulin pens with built-in memory allow users to store the time, date and amount of the dose. This makes it easier for users to track their insulin consumption.

    Benefits of insulin pens for diabetes:

    There are three advantages to using insulin pens: ease of use, accuracy and portability.
     
  4. KK123

    KK123 Type 1 · Well-Known Member

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    Hi there, I think we know all of this but the poster was asking a specific question about pumps and a potential return to pens. Do you use pens yourself?
     
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  5. Soplewis12

    Soplewis12 Type 1 · Well-Known Member

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    I appreciate your comments & way of thinking. I just find it way harder to manage. I think the main difference is my body seemed to prefer the slow & fast acting insulin.
    I am going to call my team tomorrow & suggest I try 2 weeks back on pens before I decide what's best for me.
    Thank you for responding x
     
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  6. Soplewis12

    Soplewis12 Type 1 · Well-Known Member

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    Thank you for responding. I am a previous user of insulin pens & live in Scotland. X
     
  7. searley

    searley Type 1 · Moderator
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    I don't think it's a case of your body prefers.. it a case of getting the basal on the pump exactly right.. and that can take some effort and need multiple different basal through the day.. as rapid insulin isn't quite as forgiving as the long acting

    It took about 2 months tweaking to get my basal right.. and even now I have to tweak from time to time..

    NO one will judge you if you feel its not for you... your care team should be ok.. after all it going to save the a lot of money each year..

    I have an erratic life so mdi was difficult for me... if my life was more stable I would have stayed mdi

    Good luck with whatever you decide
     
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  8. Soplewis12

    Soplewis12 Type 1 · Well-Known Member

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    Thank you for your response. I have multiple basal rates set up throughout a working day & another rate for weekends, I do get a few great days & then some rubbish days. I'm just feeling a bit fed up & burnt out. Will speak to my NHS team tomorrow. Thanks again x
     
  9. sleepster

    sleepster Type 1 · Well-Known Member

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    I'm sorry to hear you're having a frustrating time with your pump :(
    I had to have a good think about going back to pens when my previous consultant kept threatening to withdraw my pump funding. I have a new consultant now and renewed pump funding but it wasn't going to be the end of the world if I did go back to pens.
    I think pumps are a lot of work to get right, I'm onto my third one now and my settings still get tweaked fairly frequently.
    I think some people (not saying this is you) think you get a pump and away you go and get on with your life and it sorts it all out for you :hilarious: If only!
    I think a break from your pump is a good idea to see how you feel about things.
    At the end of the day we're all different and different things suit us and our diabetes.
     
  10. Soplewis12

    Soplewis12 Type 1 · Well-Known Member

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    Thanks sleepster. The pump team didn't handle the expectations of our wee group too well. It was within a month you'll never look back, you'll have it all worked out within 2 months, you'll feel better in 3 months. Anyway, it is what it is maybe just not for me. Thanks again.
     
  11. Juicyj

    Juicyj Type 1 · Expert
    Retired Moderator

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    How did you feel about the pump before you went onto it ?

    I find the way we are initiated into pump therapy can affect our outlook on it's usage greatly, your care team may not quite understand the amount of work required mentally to adjust to using a new system and it's difficult for us to let go of something we become so well adjusted to before using a machine and relying on it's ability to keep our BG levels in check, I know some expect it to be a magic wand in terms of control and so go into it with the expectation that within a few weeks everything will be easy and control great, when the reality is that a great deal of work is required to control and monitor it to begin with before reaching a state of 'normality' with control.

    Personally I struggled with MDI, I found that I just couldn't nail it despite constant basal tweaking and I was constantly in a state of anxiety, moving to the pump I knew I had to work hard at it but my mission was to take control of my care 100% without input from anyone, I didn't want to feel that if there was a hiccup that I couldn't manage it myself. I am now on my second pump having used the 640g for a number of years and now using the tandem slim, I found on the 640g I had some major wobbles and wanted to go back to what I was comfortable doing despite improving my HbA1c but stuck to it, partly because I knew in my area I was really fortunate to get funding for it, and in time it worked great for me, even now using the Tandem I had some wobbles early on but I am at a stage now having experienced excellent control (something I would never of achieved on MDI) that I would never go back to MDI, personally in your shoes I would think long and hard before changing back, you need to really reason with yourself as to what it is that is causing you anxiety and is it the pump itself or any other factors in your life currently that's making you feel this way. Remember if you do change back to MDI that you'll still need to adjust and that period could also cause you more anxiety as you adjust your doses back. It's best to have a good chat with a DSN and see if you can work things through with them, they may be able to help you work through this, whatever you decide good luck.
     
  12. Soplewis12

    Soplewis12 Type 1 · Well-Known Member

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    Thank you Juicy J for your kind & wise words:
    I was resistant to using a pump due to tubing until I was offered the omnipod dash & then I was super excited. We were warned that the first month would be a lot of work, was 100% prepared for this, next review was it will be easier soon. I am a bit of a perfectionist which probably is my main anxiety cause as I thought by now I should be on an even keel. I do appreciate lots of the pump benefits in one hand & on the other get fed up with the pitfalls, mainly:
    Pump falls off in hot weather (have now bought skin tac to try)
    Sticks well on my upper arm but hate it being on show.
    I now react poorly when in the sun, insulin needs are drastically reduced.
    Initially lots of hypos just after eating at dinner time but now extend all teatime boluses. (Never happened with pens)
    Do you know Juicy J this has been a great reflection for me, I am going to try & accept its a steep learning curve but it will get better. So what if I have some highs, better very slightly high than low!
    My DSN has told me today that I am being too hard on myself. I think I just had an expectation of a smoother level with reduced highs & lows but still experiencing too many lows for my liking.
    I've reduced 2 basal settings just now & timing of them. Will hopefully help. ♥️
     
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  13. Juicyj

    Juicyj Type 1 · Expert
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    @Soplewis12 I think you wouldn't be a typical t1 unless you had these thoughts, but having a sounding board whether it's to reflect or offer reassurance is vital.

    Trust me you're not alone, each pump has it's love and hate factors, I hate the fact my tubing can be on show despite tucking into my belt, mine needs recharging which can take 20-30 mins and I have to remove it when I do one so have to take a small bolus to keep things in check, I dislike set changes so end up changing every 3-4 days, my levels stay pretty sound so I can get away with it, but the pump rep was keen for me to change every 2, think he was keen for me to turn over a higher rate of consumables.. I have the same issue with heat, however if running into double digits then run high for long periods or if I am in range I can run low quite easily so find heat plays a difficult hand. Generally though it's niggles rather than major issues which are annoying but easy to handle, and I rarely adjust basal ratios now, but still have to deal with the highs and lows all the same. I was a perfectionist at some point but i've had to realign my expectations in regards to my t1 as achieving perfection is nigh on impossible, I try to take the view of time in range now and focus on 70% each week. some weeks I am 60 and once I even got 80, but again it's just a number and a chance to review when not on target.

    Glad it's given you a chance to reflect, no one here will tell you what's best for you as we all find out on our own, but when it means making a major step change it's best to have a chat with others before arriving at your decision.
     
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  14. Soplewis12

    Soplewis12 Type 1 · Well-Known Member

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    Yep, you are spot on. We all need a sounding board at times to bounce off of. My target range on my libre is set at 3.9-10 & last 7 days 85% in target, 14 days 82%, 30 days 83%, 90 days 78%. So a massive improvement. I am going to try & keep focussing on this rather than the % highs & lows.
    I know I am not alone in this fight but it can be lonely at times. Friends & family just don't understand the pressures we put ourselves under & I hate whinging about it to them.
    Thanks again, you've really helped me feel more positive @Juicyj
     
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