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Help!! Need advice on whether pump is worth it in pregnancy.

tigger

Well-Known Member
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569
Type of diabetes
Type 1
Treatment type
Pump
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registrars asking silly questions
I have just found out I'm pregnant. This will be my 3rd pregnancy and it was a complete surprise as I was using contraception. I have therefore not been exercising tight control and from memory my last hba1c was somewhere around 7.5. I inject 3 times a day and use pork insulin. I'm in a complete state at the moment about whether the baby has been damaged by my lack of tight control and all other precautions for the last month. I'm also really not sure how I'm going to manage 8 months of really tight control again. I have done this twice before and it involved lots of testing, nighttime coma hypos, not much eating and a pretty depressing regime. I was wondering if a pump would make it easier to handle the ever fluctuating insulin requirements of pregnancy.

If anyone has switched to a pump in pregnancy I'd be really interested to hear your experiences. I'm going to discuss it with my consultant this week and would really like to know a bit more before having the discussion.

Also does anyone have any recommendations on types of pumps? The closest I ever got to using one was a week of a CGM in my last pregnancy I hated it. It was really really uncomfortable. Is a pump as painful?

Finally I am a long term user of pork insulin (I've been type 1 for 32 years). I had 3 years on the "new" human insulin in the 1980s and lost all my hypo symptoms resulting in comas. I have never had a desire to try any other insulin since that experience. When I read the boards here I see the same complaints about the newer insulins which makes me averse to changing. Has anyone here ever found a way to use a pump with animal insulin?
 
I'm currently pregnant and I use a pump with porcine insulin in.

Please ignore anyone who tells you that you can't use animal insulin in a pump. You can.

I had my pump before I became pregnant so I'm used to it. It provides me with much better control and far more flexibility. The main good thing is the ability to control basal rates very precisely. This has reduced my nighttime hypos a huge amount.

Your HbA1C is above what is recommended, but not certainly not horribly so. Im sure you coukd soon improve that. You do need a high dose folic acid tablet though. Have you spoken to your team at the hospital to let them know?

I've not found being diabetic and pregnant depressing or the regime bad. I've just eaten normally and healthily. It can be hard work controlling your sugars, but thats par for the course with diabetes.

And no, my pump doesn't hurt me :)
 
"Thanks that's really helpful. Yes I had 5mg folic acid in the cupboard so am taking it again. What model of pump do you use? How long does it take to get the hang of pumping?"

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Sadly, AccuChek are stopping production of my pump :mad: I'd better not get into a rant about this else I'd never stop, but it's an accurate, simple and very, very convenient little pump.

When I got my pump 11 years ago, I had one day of one to one training and had my pump on and active within a couple of hours with insulin in. I then had daily checks from my DSN fir a few days to make sure all was well.

The first few days I was very nervous, but I soon noticed the benefits. I got the hang of operating it very quickly. It was inserting the cannulas that took the longest. So maybe a couple of weeks? I was lucky enough to have my basal rates pretty much perfectly set up to start with. I didn't find the pump hard at all really. It was just different. As the weeks went by, I appreciated the freedom more and more.

You could ask your team what pumps would be available to you. I'd hope they'd prioritise you if you're pregnant. I know its not uncommon for pregnant ladies to swap to a pump. I believe the research shows that they have better control on it.
 
Thanks a lot. Why is it that anything that works the manufacturers discontinue for something more expensive and less good????:mad:
 
I can't speak to the insulin issues, but I've been pumping for about 15 years. I'm sure it would be a bit stressful to start pumping while pregnant, but you may find it's worth it. I know not everyone is a fan of pumps when they try them, but it seems like most people find them easier to manage. I'd say it took me a couple of weeks to get the hang of things and get my rates where I needed them, but I was only 14 when I first got one so it's hard to remember.

I can only speak to the minimed pumps because that's all I've used. I currently have a Veo and I was never able to use the CGM when I first got it because the Sof-Sensors were so painful and uncomfortable. They were truly horrible and I gave up trying. I just started using the Enlite sensor last week and it's amazingly better. It's 67% smaller than the Sof-Sensor and the Enlite wire is like a piece of tinsel, where in the Sof-Sensor it was more like a stiff piece of plastic.

I waited until I was 10 weeks along to get the new sensor and wish I'd gotten it a lot earlier - I assumed it would be as bad as the sof-sensor so I kept putting it off. I can't really feel it at all, and the only annoying part is I sometimes get rashes from the tape. I also don't usually have issues with my pump insertion site - it's pretty pain free unless I hit a bad spot on insertion, but then I take it out and re-insert somewhere else (I use Quick Set infusion sets).

The CGM has been really nice the last week because it predicts when I'm heading towards a low or high and it just keeps me in the loop a lot more. I had a lot of swings in my first few weeks and found it extremely frustrating. I was really anxious and stressed out for quite a while but I'm feeling more comfortable now. It's expensive but I'm planning to use them as much as I can for the rest of the pregnancy.

ETA: This site has a good comparison of the Dexcom CGM and Minimed CGM (using Enlite):
http://typeonenation.org/groups/cgms/forum/topic/review-medtronic-enlite-vs-dexcom-g4/

I think this is a year or two old, but they compare 6 different pumps here:
http://integrateddiabetes.com/insulin-pump-comparisons/
http://diatribe.org/issues/57/thinking-like-a-pancreas
 
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Thanks sleapyheadzzz. That's really helpful to know. I still remember how uncomfy the cgm was so it's good to know the pump and other sensors are not as bad.
 
I was put on the pump at about 10 weeks pregnant due to on going issues with night time highs ( I had been waiting 7yrs for it!) it took a few weeks to get the control but would recommend it - Sadly things didn't end well nothing to do with the pump I will add, what it did allow were the adjustments needed as insulin requirements changed throughout. I am TTC at the moment at the pump has allowed a much better control. It is nowhere near as uncomfortable as the CGM and to be honest you get used to it, as you get bigger you can change the canaual to more flexible ones, all in all I would recommend at least a chat with your consultant and if they agree get it earlier on in the pregnancy as you can before insulin level fluctuate and regular changes are need - I use an accu-check spirit combo.
 
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