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Insulin Pump?

Discussion in 'Insulin Pump Forum' started by Hayley78, Jan 23, 2021.

?

Pump fitting?

  1. yes

    4 vote(s)
    100.0%
  2. no

    0 vote(s)
    0.0%
  1. Hayley78

    Hayley78 Type 1 · Member

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    Hi all, Question.....

    Not sure about having a pump fitted.
    Pros: more flexibility, maybe?
    Cons: not getting dosages right, overdosing, causing more issues with Hypo's

    I have been t1 diabetic for almost 27 years. First 10 years injecting mix insulin twice ad day, 12 hourly. during third pregnancy, 20 years ago went onto fast acting, ActRapid, with carb counting. and 12 hour background insulin. During fourth pregnancy, 16 years ago, went onto Novorapid with Levemir background. Last year I changed onto Degludec, and Fiasp fast acting.

    I have always had poorly controlled levels, never tested. And had the Libre fitted a year ago, which has worked well for me. (Hba1c levels came down from 119 Dec 2019, to 69 by June). Since having Covid last year, possibly twice, and now struggling with maybe Long Covid (not been diagnosed yet) my sugars have sky rocketed (average 83mmol/9.7%). I have increased my insulin doses, doubling the amount.

    I would like to know peoples thoughts on having a pump, advantages/disadvantages etc.
    I shall be sending an email to my diabetic nurse with my thoughts regarding this and asking on her thoughts, (the team have mentioned this to me before). TIA :)
     
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  2. Peter03

    Peter03 Type 1 · Well-Known Member

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    Absolutely yes, at least for me,
     
  3. Hayley78

    Hayley78 Type 1 · Member

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    What's your reason why it's a yes for you? Tell me about your positives with it please :)
     
  4. Peter03

    Peter03 Type 1 · Well-Known Member

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    Many reasons, one is how easy it is to give yourself insulin for a meal, a main meal is normally easy but when you are out and you are offered a snack it is much better to just use your pump, control is another important reason you notice your blood sugers are going up or down is easy to just do an correctintion either with a bolus or reducing your basil rates the same for exercising, I am sure other posters will come up with many more reasons, and with cgm,s now life pumping will become even better
     
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  5. In Response

    In Response Type 1 · Well-Known Member

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    For me
    Pros
    - finer insulin adjustments. I can dose 0.05 units at a time.
    - basal is adjusted for different levels at different times of the day. So more basal to avoid dawn phenomenon, for example.
    - suspending basal when I exercise to avoid hypos.
    - easy to increase basal when I am unwell. I can adjust the increase every hour rather than having to wait a day for my next slow acting insulin
    - easy to spread bolus over longer period for high carb, high fat meals like pizza and curry
    - easier to avoid hypos by suspending basal as I see my blood sugars dropping.

    Cons
    - permanently attached
    - difficult to hide my diabetes. Even if my pump is under my clothes, there is still a bump.
    - it could fail
    - much much more stuff to take with me when I go away
    - pump changes can be tedious.
    - need to take Spares with me even for a short trip of a few hours.
     
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  6. EllieM

    EllieM Type 1 · Moderator
    Staff Member

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    I don't have a pump, as I have allergy issues and can barely tolerate a cgm, but would probably go for it otherwise. The thought of being able to suspend my insulin when hypo really appeals.

    But using a cgm means I can achieve my target hba1c without pumping, so I've wimped out.

    But if I had a pump I could do much better with dawn phenomena, exercise and HYPOS.

    It sounds like you have to be quite disciplined with carb counting though, which may or may not appeal.

    My reasons against are
    1) skin allergies (I prefer a cgm to a pump)
    2) worries about kinks in the line meaning I get DKA
    3) hyperlipotrophy meaning I have reduced areas sites for cgm or pump.

    If it weren't for nos 1 and 3 I'd probably go for it. You can always go back to basal/bolus if it doesn't work out.

    Pumpers, please fell free to tell me that points 1 and 3 are irrelevant and I should go for it, (I could get my clinic to give me one.)
     
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  7. Maco

    Maco Type 1 · Well-Known Member

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    Hi, I’m 26 & been diabetic from the age of 14. I started on injections then moved over to a pump at 15, I was your typical teenage and didn’t take well to it so stopped using it. On the 7th of January I started on the new Medtronic 780G alongside there guardian 3 CGM.

    I honestly can’t think of any downsides to a pump, apart from it been on show so people can ask you what it is but that doesn’t bother me in the slightest. I’ve told a few people my CGM is a nicotine patch before for a laugh.

    The 780G has an automode when used alongside its CGM, which basically means it controls all of your basal insulin for you. Shuts off insulin when it senses a low & also gives correction doses when your running high. I’ve gone from having graphs that look like rollercoasters up & down all day long to steady straight lines and I’m 85-95% in range over 24hrs.

    As for your worries, you can get your doses wrong just the same as you would with an injection. Your diabetic team would work out your carb ratios etc & input these settings into your pump and you would just need to carb count like you would with fast acting insulin. Once you have your correct ratios worked out you shouldn’t have many hypos at all & I think that’s what the new Medtronic pump has done cut out a lot of lows!

    For me I would never go back to injections unless forced, this new pump is absolutely amazing. Especially if you use the CGM so you can use the automode features because it literally does everything for you apart from carb count. A quick example would be I had a pizza last weekend and completely guessed the carbs, my readings started to spike through the night but automode jumped in to give me correction doses and I woke up with a reading of 7.8.

    Probably the only down side is needing to change infusion sets and draw up new insulin every 3 days & also the CGM needs changing every 7 unlike the freestyle Libre which lasts 2 weeks. Any questions just ask
     
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  8. Hopeful34

    Hopeful34 Type 1 · Well-Known Member

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    When you say you're in target 85-89% of the time, would you mind me asking what your target range is please?
     
  9. Jollymon

    Jollymon Type 1 · Well-Known Member

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    Pros:
    I was lousy with a long acting basal insulin. After injected it was not flexible for me.
    I like the data that it collects for me.

    Cons:
    I’m a very small person, and my pump just seems huge on me.
    New technology creates a new learning curve, and new problems.
    To me the infusion set is the weakest link- we need to be aware of this (I kinked 2 cannulas today)
     
    #9 Jollymon, Jan 24, 2021 at 2:46 AM
    Last edited: Jan 24, 2021
  10. himtoo

    himtoo Type 1 · Well-Known Member
    Retired Moderator

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    i am in the mood to use an analogy this morning to describe the benefits of a pump

    think of your long acting insulin as a car with a fixed speed of 30 mph
    and a pump having an accelerator and brakes to shift the speed from 0 to 70 mph depending on conditions

    i also very much liked the reply above given by @In Response which matched my thoughts on the pros and cons
     
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  11. Peter03

    Peter03 Type 1 · Well-Known Member

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    Very off topic, but your post made me think if I was a car, I think I would be a 50,s or 60,s mini, I would think I was sporty and fast but I would be just a small tin can and not very fast
     
  12. Maco

    Maco Type 1 · Well-Known Member

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    4-10mmol is the target range the hospital set for you a pump, averaging 6.9 over a 24hr period
     
  13. Katiel1

    Katiel1 · Newbie

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    Went on the Tandem t:slim pump last October after 16 years on MDI. BEST decision I've ever made, can't believe it took me so long to be convinced to take my clinic up on the opportunity to move on to this.

    I use it in conjunction with the Dexcom G6 CGM so the 2 devices speak with each other. I never knew I could see such in-range levels, typically 80-90% in range most days.
    Hb1Ac is the lowest it has been in years after only 4 months on the pump. Still some tweaks to basals and carb ratios to bring this down further but for context my Hb1AC in Feb 2019 was 9.6% (81 / 12.6mmol), October 2020 the day before starting the pump it was 8.6% (71 / 11.1mmol) and today it's 7% (53 / 8.6mmol) after only 4 months!
    - Nearly impossible to stack insulin since you get a real time update of insulin on board and it will warn you if you're overdosing
    - Integration with Dexcom allows for insulin suspension if it predicts a hypo in 20 minutes so hypos are less sever and easier to treat
    - Ability to tweak basal rates to allow for exercise / stress / hormones (on MDI I was consistently battling hypos on days where I was more active than planned yet still have same whopping dose of background Levemir on board). Can set temporary basal rates on days you're on your cycle for example where your insulin resistance might be higher.
    - Hypos are few and far between once you get your basals settled (which really doesn't take much time at all and your clinic will help with). I had a really bad fear of hypos and was referred to a clinical psychologist but it's only since starting on the pump that my fears have really eased.
    - If any nervousness around the fact that you're reliant on the fast acting insulin being delivered correctly since no more long acting insulin injections (which was my biggest hesitation) opt for the metal needle cannulas - insertion issues are essentially non-existent with these, it's the plastic cannulas you can hear about problems with
    - Night time levels once basal rates are well tweaked and set can be pretty much a beautiful straight line of 5mmol ALL NIGHT. This alone will help with your Hb1AC hugely.

    I am the biggest advocate of pump therapy now! Complete game changer for me. Hit a real low with burnout and anxiety during uni and past few years but this amazing little bit of technology has given me so much hope and freedom.

    Hope it can do the same for you!! Let me know if there's any specific question you have, I'd be happy to help!
     
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