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Injections to pump

D

Dean_F

Newbie
Messages
4
Hi all, so I have recently joined this forum and I have a question to ask. I'm a 38 Yr old male I was diagnosed type 1.5(LADA) 6 years ago, up until a couple of years ago my hba1c has been great but recently I have been struggling. I'm in good condition i exercise nearly every day but my blood sugars just seem to be up and down all the time. I have even recently started college learning to be a barber which makes it even harder. So I inject humalog and lantus and am starting to think if I should go on a pump. Has anyone here made this switch before? Did it help you? How hard is it having something attached to you all the time?.
Thank you in advance sorry for the long post I just don't know anyone else to ask these questions
 
Hello and welcome to the forum!
I've switched from mdi (multiple daily jabs) to pump and wouldn't go back.
In your situation I'd make a list of pros and cons e.g.
Pros -
  1. you will have humalog in small amounts on an houly basis which allows you to tweak those for exercise/illness/busy day at college or a time like dawn when your glucose rises too much.
  2. Bolus can often be calculated by the pump using your carb/insulin ratio (you have to be good at carb counting).
  3. Lack of big doses in one go e.g. the lantus dose for me personally means less lumpy bits...
CONS:
Getting used to the tech then having to order it as well as your usual diabetic kit
You are attached to a pump 24/7 and that sometimes bothers people who don't want to be reminded of their condition.
You will need to persuade your consultant that this will help you i.e. jump through hoops to get it from the NHS since it is more expensive than MDI and not everyone can show an improvement in their HBA1c though most pumpers I know locally find their blood sugars are a lot smoother.
I got mine because I did a lot of exercise and a pump makes that easier. Others have bad hypos or their control has gotten really bad despite their best efforts.
It isn't a magic solution but definitely worth discussing. Gong forward I think lots of diabetics will end up on pumps that talk to their cgms or flash glucose monitors.
 
Hi @Dean_F Welcome to the forum :)

Out of interest when you say up and down all the time, are you experiencing lots of hypers/hypos ? What does this look like on a daily basis ? Getting access to a pump means meeting the criteria set by your diabetes team, so your starting point is having a chat with your DSN to find out how you can access pump funding, I appreciate that from the outset pumps can look like a magic wand, however they do require alot of work to get ratios set up and bed in and many become disillusioned with them as they don't produce the results to start with, however with alot of effort they can make a massive difference to control and insulin management.
 
I changed from injections to pumping about 6 years ago and would push back if someone tried to take my pump away from me. However, it has not been easy and it has not reduced my HBA1C by very much.
What it has allowed is much less rollercoastering - highs followed by lows followed by highs followed by ...
This is due to the possibility of smaller doses and varying my basal especially when I exercise.

I had to learn as much about diabetes management as I already knew and I have to be more precise with my carb counting.

Regarding having something attached to me at all times, I have two different experiences. My first pump was a tuby one. I loved the control it gave me but I hated that my diabetes was always on display, I hated that I was always lying on it in bed, I hated that I had to move it every time I sat down or did I different exercise at the gym. My current pump is tubeless. It is smaller (and getting even smaller later this month) so much more discrete, I have found sites that keep it out of the way and love being able to manage it remotely. That said, there are sometimes problems with it being in the same place for 3 days (I have to think ahead about what I will be wearing or doing when I change it), as a larger area is in contact with my flesh, I have less options for sites and I cannot temporarily remove it. So definitely looking forward to the smaller one which will help with some of these issues.

Different CCGs have different approaches, criteria and pump choices. So, if you are interested, the first thing to do is to talk to your diabetes team to find out if they think you are a candidate, how long it will take to get one and what pumps are available.
 
Juicyj said:
Hi @Dean_F Welcome to the forum :)

Out of interest when you say up and down all the time, are you experiencing lots of hypers/hypos ? What does this look like on a daily basis ? Getting access to a pump means meeting the criteria set by your diabetes team, so your starting point is having a chat with your DSN to find out how you can access pump funding, I appreciate that from the outset pumps can look like a magic wand, however they do require alot of work to get ratios set up and bed in and many become disillusioned with them as they don't produce the results to start with, however with alot of effort they can make a massive difference to control and insulin management.
Click to expand...
Thank you for your response. I just feel like I can't keep my numbers steady, I eat the same meals everyday and most of the time I end up in range and other times it'll send me sky high for no reason then I'll be struggling to get it back down. I have also been having another problem where I'll have horrible hypos before I go to bed that's pretty scary and it messes me up for days it's so frustrating. I have actually done some research on this forum and have been seeing post about lantus lows, this really sounds like what is happening to me. My hypos seem to happen about 30 mins after taking my lantus and it happens for no reason whatsoever. I now just want to get my numbers under control so thinking is a pump the best option for me.
 
NicoleC1971 said:
Hello and welcome to the forum!
I've switched from mdi (multiple daily jabs) to pump and wouldn't go back.
In your situation I'd make a list of pros and cons e.g.
Pros -
  1. you will have humalog in small amounts on an houly basis which allows you to tweak those for exercise/illness/busy day at college or a time like dawn when your glucose rises too much.
  2. Bolus can often be calculated by the pump using your carb/insulin ratio (you have to be good at carb counting).
  3. Lack of big doses in one go e.g. the lantus dose for me personally means less lumpy bits...
CONS:
Getting used to the tech then having to order it as well as your usual diabetic kit
You are attached to a pump 24/7 and that sometimes bothers people who don't want to be reminded of their condition.
You will need to persuade your consultant that this will help you i.e. jump through hoops to get it from the NHS since it is more expensive than MDI and not everyone can show an improvement in their HBA1c though most pumpers I know locally find their blood sugars are a lot smoother.
I got mine because I did a lot of exercise and a pump makes that easier. Others have bad hypos or their control has gotten really bad despite their best efforts.
It isn't a magic solution but definitely worth discussing. Gong forward I think lots of diabetics will end up on pumps that talk to their cgms or flash glucose monitors.
Click to expand...
Thank you for your response, this really helps
 
In Response said:
I changed from injections to pumping about 6 years ago and would push back if someone tried to take my pump away from me. However, it has not been easy and it has not reduced my HBA1C by very much.
What it has allowed is much less rollercoastering - highs followed by lows followed by highs followed by ...
This is due to the possibility of smaller doses and varying my basal especially when I exercise.

I had to learn as much about diabetes management as I already knew and I have to be more precise with my carb counting.

Regarding having something attached to me at all times, I have two different experiences. My first pump was a tuby one. I loved the control it gave me but I hated that my diabetes was always on display, I hated that I was always lying on it in bed, I hated that I had to move it every time I sat down or did I different exercise at the gym. My current pump is tubeless. It is smaller (and getting even smaller later this month) so much more discrete, I have found sites that keep it out of the way and love being able to manage it remotely. That said, there are sometimes problems with it being in the same place for 3 days (I have to think ahead about what I will be wearing or doing when I change it), as a larger area is in contact with my flesh, I have less options for sites and I cannot temporarily remove it. So definitely looking forward to the smaller one which will help with some of these issues.

Different CCGs have different approaches, criteria and pump choices. So, if you are interested, the first thing to do is to talk to your diabetes team to find out if they think you are a candidate, how long it will take to get one and what pumps are available.
Click to expand...
Thank you this really helps me. I'll talk to my team
 
Dean_F said:
I have actually done some research on this forum and have been seeing post about lantus lows, this really sounds like what is happening to me. My hypos seem to happen about 30 mins after taking my lantus and it happens for no reason whatsoever. I now just want to get my numbers under control so thinking is a pump the best option for me.
Click to expand...
A simpler option maybe to change your basal insulin. Lantus seems to be an older long acting insulin and there are newer flatter insulins such as Tresiba that many have adopted.
If you need a bit more flexibility (e.,g. your day time and night time basal needs vary), Levemir is another common one. This requires two injections each day.
 
In Response said:
I changed from injections to pumping about 6 years ago and would push back if someone tried to take my pump away from me. However, it has not been easy and it has not reduced my HBA1C by very much.
What it has allowed is much less rollercoastering - highs followed by lows followed by highs followed by ...
This is due to the possibility of smaller doses and varying my basal especially when I exercise.

I had to learn as much about diabetes management as I already knew and I have to be more precise with my carb counting.

Regarding having something attached to me at all times, I have two different experiences. My first pump was a tuby one. I loved the control it gave me but I hated that my diabetes was always on display, I hated that I was always lying on it in bed, I hated that I had to move it every time I sat down or did I different exercise at the gym. My current pump is tubeless. It is smaller (and getting even smaller later this month) so much more discrete, I have found sites that keep it out of the way and love being able to manage it remotely. That said, there are sometimes problems with it being in the same place for 3 days (I have to think ahead about what I will be wearing or doing when I change it), as a larger area is in contact with my flesh, I have less options for sites and I cannot temporarily remove it. So definitely looking forward to the smaller one which will help with some of these issues.

Different CCGs have different approaches, criteria and pump choices. So, if you are interested, the first thing to do is to talk to your diabetes team to find out if they think you are a candidate, how long it will take to get one and what pumps are available.
Click to expand...
I was just wondering what you meant by "more precise with my carb counting"? What weren't you doing that you then had to?
 
StewM said:
I was just wondering what you meant by "more precise with my carb counting"? What weren't you doing that you then had to?
Click to expand...
There are two reasons why you need to be more precise...
- when injecting you are injecting whole (or half) unit doses and calculate to the nearest single dose. For example, if your ration is 1 until to 10g carbs, you only need to calculate to the nearest 10g. My pump allows doses of 0.05units. To benefit from these small increments, you need to carb count down to 1g.
- when injecting, your background basal assumes your basal needs are the same 24/7. Sometimes of the day you need more and sometimes you need less. For example, you may be using more basal at night. This means that, during the day you have "spare" basal. With a pump, your basal pattern can be adjusted down to 0.05 units for every 30 minutes. This means you should have no "spare" basal to mop up any under counts with your carb.

Edited to add: I deliberately used the term "precise" because I have always been accurate but it is the additional precision (to the nearest 1g rather than 10g) that is significant with a pump ... and because I am a pedant :)
 
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