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insulin pump??

Discussion in 'Insulin Pump Forum' started by davidM1996, Jul 12, 2020.

  1. davidM1996

    davidM1996 Type 1 · Active Member

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    Hello everyone, I’ve been a T1 for three years now and have been doing multiple daily injections ever since diagnosis, I’ve recently started contemplating speaking to my diabetes team!about getting a pump I just want to know the pros and cons of them, I’m keen on keeping fit so I’m always out running etc is it something that will effect my current life style ?
     
  2. TypeZero.

    TypeZero. · Well-Known Member

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    Hi, I made a similar post a few days ago and I don’t know why but I can’t find it. Anyways it’s not important I can tell you the things I know and the things other people said.

    You can speak to your diabetes team about getting a pump and find out which pumps they offer. If you know the specific pumps you’re eligible for then it will be easier to decide if you want it or not, aside from doing the basic function of delivering constant basal and bolus during meals some pumps have advantages over other pumps. Some pumps can be connected with a CGM and can be used to automatically adjust basal while others just give a constant basal. I believe the NICE criteria is that you must be having frequent hypos, hypos without warning, hba1c over 8.5% despite MDI but you are considered on an individual basis so some people may be offered a pump even if they do not fit the criteria. You do not need to fit all of these criteria either, you just need to fit one of these and even if you don’t fit the criteria if your medical team makes a good case then you can still get it funded. Unlike CGMs, NICE actually appraises pumps and recommends it

    PROS of a pump:

    -Different bolus options. For example a dual bolus where you can split your dose into two, simple bolus and a square bolus (slow release of desired insulin amount)

    -Temporary basal rates. For example if you know you go low at 6pm every day then you can decrease your basal rate or if you’re exercising you can decrease your basal rate offering you much more lifestyle flexibility

    -Suspend before low function. Not all pumps have this but when connected with a CGM, the pump can suspend insulin delivery if it detects you will go low in certain amount of x minutes. The T slim x2 pump has a control IQ function which suspends insulin delivery when approaching low and increases basal when you are high which is certainly good if you want to live your life to the fullest and not have the worry of BG on your shoulders, but you still need to check BG manually since CGMs are not 100% accurate.

    -Pump allows you to control BG more tightly. If you’re like me and sometimes can’t be bothered to inject because you’re only slightly high e.g. 9 mmol/L then it’s good because you can just deliver insulin with a few buttons

    -Ability to deliver microdoses. Some pumps can deliver as little as 0.1 units of insulin which can allow you tighter control. If you’re 7.5 and want to be 6 then you can give yourself half a unit or so. Tighter glucose control means a lower risk of diabetic complications

    -Pumps store data which you can use to learn about your diabetes and what you could do to improve glucose control

    -Pumps also do calculations for you. When setting it up you enter your insulin sensitivity factor and a number of other things which allows you to just enter the carbs and the pump will calculate an insulin dose and even calculate a correction dose so you can correct your BG and also cover your food— no need to pull out a calculator. Because of the microdoses it can give it will reduce glucose variability as you can bolus exactly for 37g of carbs instead of rounding it up which could make you go lower than what you would’ve wanted

    CONS of a pump:

    -Infusion site failures is the biggest con. Two options of cannulas: Teflon or steel. Teflon is the most flexible and comfortable cannula but it is prone to kinking so insulin won’t be delivered to you and you may end up in DKA within a few hours so you need to check your BG more often however this shouldn’t be a problem if you have a CGM and are committed to improving diabetes control. I personally scan my CGM at least every 2 hours apart from when I’m sleeping where I might scan once a night if I wake up. Steel cannula doesn’t kink but it is said to be a tiny bit uncomfortable. For thinner, athletic, children or active people Teflon is recommended. Steel is recommended more for very very active people because of less chance of kinking.

    -Pump failures. So many different issues might arise. Random pump malfunction so you will need to go back on MDI, tubing may be damaged or you might forget about your pump and do something which causes your pump to fall and pull your tubing out.

    -Higher risk of fatty lumps forming as cannulas are changed every 2-3 days so all of your insulin enters in the same spot for 2-3 days

    -Machine attached to your body 24/7 might make you feel conscious but for some people this is not a problem, I don’t care what anyone thinks to be honest with you

    -From my knowledge I don’t know any insulin pumps that cool your insulin so if you’re abroad and it’s hot then the insulin might spoil. If you were on MDI you could just keep your insulin in the fridge until you need to use it. Don’t worry about this too much because most people take a pump holiday where they remove their pump for the duration of their holiday and use injections. Pumps cause a bit more of a hassle at the airport than standard needles but it’s fine

    -Your personal comfort? When I first got my Libre I felt so uncomfortable but now I don’t even realise it’s on my arm. You may feel uncomfortable sleeping with a machine attached to you and some people people are worried about the potential side effects in a relationship but pumps are quite small so nothing should really happen

    -If you are on the slimmer side then it’s more visible unless you put it in your pocket, tuck in tubing and wear something to cover it. You’ve had diabetes for a few years now so you shouldn’t really feel shy or embarrassed about it.

    Before even starting the process into getting a pump you should:

    -Research the pumps available with your CCG to see if they will be useful for you

    -Imitate the physical presence of those pumps and see if you wouldn’t mind it. I know this sounds a bit weird but you could find anything to imitate the feeling of the pump and see if you will like it e.g. tape earphones to your abdomen and connect your phone. Unfortunately the NHS doesn’t allow you to try pumps so if you request funding for it then you kind of need to use it because it’s a waste of money

    -You should watch in depth YouTube reviews of different pumps of people who have had diabetes for years. They will know everything in detail. I can only provide so much information, I’m 3 months in and in the process of getting a pump in 2021
     
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  3. davidM1996

    davidM1996 Type 1 · Active Member

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    Thanks so much I’ll take all of the points above into consideration a lot of useful info there to think over
     
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  4. NicoleC1971

    NicoleC1971 Type 1 · Well-Known Member

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    You have all the info you need. I will just add that i got my pump because I exercised a lot and it tended to make things harder! I ran a marathon a month afterwards so it worked and continues to work for me. Do note that MDI gets just as good hba1c results as pumps but all my pumping friends in our t1 social group would not give theirs back either as they feel more in control of things.
     
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