Possible Insulin Pump

[holmroad]

Hi, I've recently requested that my diabetic consultant investigates the possibility of me transferring from the Base Bolus daily insulin injection regimen I've been on for many years, to an insulin pump, as I believe my many injection sites built up over 50 nyears of injecting myself have become very unreliable for the good absorbtion of my injections, resulting in overall control being affected and sites now looking very ugly and lumpy!
I used to be a keen sportsman - soccer, tennis, badminton, squash, etc and therefore avouded investigating insulin pump technology due to possible complications when out and about, with the risks of damaging the pump, but now I've given up all the sporting activities I feel a pump could be very advantageous to my control and well being, especially as I now wish to dramatically cut down the use of daily injections for the reasons given above!
My Diabetic Consultant has advised a course in diet control as he's never discussed it with me over the years, yet he's totally therefore unaware that I've always in any case practised a carbohydrate exchange type diet of achieving so many 'portions' per day as a control mechanism.

I've now been referred to a dietician, after many years of automatically applying the carbohydrate exhange philosophy, before they'll consider me for an insulin pump!

All comments re above would be most welcome please!

 

[Deleted member 527103]

I have been pumping for the last 6 years. And continuing with a lot of exercise which the pump has greatly helped.
(I added that last sentence for anyone else reading this. It is not a dig at you @holmroad.)

I am not familiar with the carbohydrate exchange philosophy - I have always carb counted and dosed accordingly.
However, I am not surprised that you are being referred to a dietician. My pump is great but, to get the most out of it, I initially found it more work than injections. Therefore, it is common requirement to have training on carb counting, etc. Part of this is carb counting needs to be more precise with a pump (due to matching basal pattern to your body's needs at different times of the day, you have no "spare" basal to mop up extra carbs). However, I also believe it is important to the CCG (via the DSN or dietitian) to know that you are willing and able to put in the effort to get the benefit of the large expense of a pump.

You mention the reason you want a pump is because of site absorption problems. A pump still needs sites and could suffer from the same issues so I do not know if it will help you in this regard. Maybe someone else will know. However, bear in mind, I have read of pumpers experiencing absorption issues.

The typical reasons for migrating to an insulin pump are the ability to dose smaller bolus (especially true for children) and the ability to adjust basal when your needs differ such as pronounced Dawn Phenomenon or needing less insulin when exercising. You may benefit from considering these criteria as it is common to need to convince the CCG (often via the DSN) that you need a pump.

 

[Member34835]

Hi, I've recently requested that my diabetic consultant investigates the possibility of me transferring from the Base Bolus daily insulin injection regimen I've been on for many years, to an insulin pump, as I believe my many injection sites built up over 50 nyears of injecting myself have become very unreliable for the good absorbtion of my injections, resulting in overall control being affected and sites now looking very ugly and lumpy!
I used to be a keen sportsman - soccer, tennis, badminton, squash, etc and therefore avouded investigating insulin pump technology due to possible complications when out and about, with the risks of damaging the pump, but now I've given up all the sporting activities I feel a pump could be very advantageous to my control and well being, especially as I now wish to dramatically cut down the use of daily injections for the reasons given above!
My Diabetic Consultant has advised a course in diet control as he's never discussed it with me over the years, yet he's totally therefore unaware that I've always in any case practised a carbohydrate exchange type diet of achieving so many 'portions' per day as a control mechanism.

I've now been referred to a dietician, after many years of automatically applying the carbohydrate exhange philosophy, before they'll consider me for an insulin pump!

All comments re above would be most welcome please!

Just a few thoughts having now been on my 3rd pump :
1) lumps and bumps (insulin fat deposits) - my stomach where the canula goes in still has lumps but I think because I've got 24 x little squirts of insulin going in hourly, then there is less volume. I tend not to have high carb meals (aim for 30g) so this further reduces the lumps. As with jabs, it can be easy to have a favourite place when you put the canula in as you will know but I'd hope you would at least avoid big lumps!
2) I am a personal trainer and do Crossfit which is pretty active. I ihave a tandem basal iq pump (smaller than most) and either have it in a band around my stomach or in a crop top (tight fittting). It occasionally slips out but I am also aware that if I want to I can disconnect for up to an hour and that actually helps deal with keeping me on an even keel without having to stop for jelly babies. Easier to deal with a temporary stoppage than the inflexibility of basal dosing anyway.
3) Carb counting
The consultant will have to get you on this course to ensure you are able to use the bolus calculator that coms with pumps. I think we all intuitively count carbs as you describe but when programming your pump you will be able to enter insulin correction dose ratios as well as carbs for insulin ratios. Plus it can be a useful way to meet fellow type 1s and share ideas... I am still going to the pub with my carb counting course buddies after 15 years.

I hope you can get to try this tool and that it helps. If it doesn't though there is no shame in going back to MDI. The diabetes tech is improving all the time and hopefully you will get accessed to a closed looping system at some stage too.